36C25623R0089 EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25623R0089
About this file
This document contains a subcontractor consent form and reference list for a federal construction project to replace the roof on Building 2. The form requests that major subcontractors and teaming partners planned for a prime contractor's proposal provide consent to allow their past performance information to be discussed with the prime contractor during the source selection process. Subcontractors are asked to provide contact information, signature of an authorized individual, and a reference list including contract numbers and titles, role on the contract as prime or subcontractor, work performed, and points of contact with email and phone numbers for at least three references. The related federal contract opportunity is solicitation number 36C25623R0089 from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 for project number 502-21-105 to replace the roof on Building 2.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25623R0089 0003.docx | DOCX document | |
| 502-21-105 RFI Register 08302023.docx | DOCX document | |
| 502-21-105 Site Visit Sign in Sheet.pdf | ||
| 36C25623R0089 0002.docx | DOCX document | |
| 36C25623R0089 0001.docx | DOCX document | |
| 36C25623R0089 WD LA20230051 Mod 5 06162023 .docx | DOCX document | |
| 36C25623R0089 VA Pineville - Asbestos.pdf | ||
| 36C25623R0089 Drawings .pdf | ||
| 36C25623R0089 Clay Tile Size and Color Selection_Redacted.pdf | ||
| 36C25623R0089 502-21-105 BRAND NAME JA 05122023 Redacted.pdf | ||
| 36C25623R0089 PRA v2.pdf | ||
| 36C25623R0089 EXHIBIT E.docx | DOCX document | |
| 36C25623R0089 EXHIBIT D.docx | DOCX document | |
| 36C25623R0089 VA - Pineville Lead .pdf | ||
| 36C25623R0089 SOW 07072023 .docx | DOCX document | |
| 36C25623R0089 Combined Specs .pdf | ||
| 36C25623R0089 EXHIBIT B.docx | DOCX document | |
| 36C25623R0089 EXHIBIT A.docx | DOCX document | |
| 36C25623R0089 EXHIBIT F.docx | DOCX document | |
| 36C25623R0089 RFP.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 502-21-105 Replace Roof on BLDG 2 36C25623R0089
EXHIBIT C – SUBCONTRACTOR INFORMATION AND CONSENT FORM
Subcontractor and/or Teaming Partner Consent for the Release of Past Performance Information to the Prime Contractor and Reference Information
Past performance information concerning subcontractors and teaming partners cannot be disclosed to a private party without the subcontractor’s or teaming partner’s consent. Because a prime contractor is a private party, the Government will need that consent before disclosing subcontractor/teaming partner past and present performance information to the prime during exchanges. In an effort to assist the Government in assessing your past performance relevancy we request that the following consent form be completed by the major subcontractors/teaming partners identified in your proposal. The completed consent forms should be submitted to the offering contractor for submission with past performance volume.
Name of Firm: _________________________________
| (That is currently planning on participating as a subcontractor and or a teaming partner with) |
| Telephone:_____________ |
Address:_______________
City/State/Zip Code:_______
DUNS/Cage Code:_________________
Name of Prime:__________________________________
| (PRIME CONTRACTOR OR NAME OF ENTITY PROVIDING PROPOSAL in responding to the Request for Proposal No. 36C25623R0089 for Project 502-21-105 Replace Roof on BLDG 2) |
| Telephone:________________ |
Address:__________________
City/State/Zip Code:___________
DUNS/Cage Code:____________
We understand that the Government is placing increased emphasis on past performance in order to obtain best value in source selections. In order to facilitate the performance confidence assessment process, we are signing this consent form to allow you to discuss our past and present performance information with the prime contractor during the source selection process.
| Signature:___________________________________ |
| ___________________________ |
Title of Individual with authority to sign for and Legally bind the company
Reference List (required):
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
Contract No. And Title:
Describe role (Prime/Sub) and work Performed
Reference POC Name
Email address & Phone #
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