36C25623R0109 EXHIBIT C.docx

DOCX document 26 KB Posted

Attached to
Renovate Interior Space JACC Federal contract opportunity
Solicitation number
520-23-106
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document is a subcontractor consent form template for the federal contract opportunity "Renovate Interior Space JACC" issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Major subcontractors and teaming partners identified in proposals must complete the consent form to allow disclosure of their past performance information to the prime contractor during source selection. The consent form requests the subcontractor's identifying and contact information, along with the prime contractor's information. It also requires the subcontractor to sign authorizing discussion of past and present performance with the prime. Additionally, the subcontractor must provide a reference list including contract numbers, roles, work performed, and points of contact for at least three past contracts.

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36C25623R0109 0003.pdf PDF
00 01 10 - Table of Contents - Redacted.docx DOCX document
36C25623R0109 RFI Responses.docx DOCX document
VOL 1 BINDER.pdf PDF
VHA ICRA 2023-1.0_Final Template_0.docx DOCX document
01 00 00 - General Requirements rev2.docx DOCX document
VOL 2 BINDER.pdf PDF
VOL 3 BINDER.pdf PDF
S04 Site Visit Sign in Sheet 520-23-106 8.24.23.pdf PDF
36C25623R0109 0002.pdf PDF
36C25623R0109 0001.pdf PDF
P03 - Brand Name JA JACC CO Signed - R1_Redacted.pdf PDF
36C25623R0109 EXHIBIT A.docx DOCX document
36C25623R0109 EXHIBIT D.docx DOCX document
Specs 4 14 2023.pdf PDF
P09 520 23 106_JACC Enclosure Project Final Full Set 08_10_2023.pdf PDF
36C25623R0109 EXHIBIT E.docx DOCX document
36C25623R0109 EXHIBIT F.docx DOCX document
ICRA Contacting Only.pdf PDF
36C25623R0109 Final.pdf PDF
36C25623R0109 EXHIBIT B.docx DOCX document
WD FL20230203 Mod 1 dtd 01.13.2023.txt TXT text file
Final SOW Renovate interior spaces.pdf PDF
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Text version

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 520-23-106 Renovate Interior Space JACC 36C25623R0109

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/SAM Unique Identifier Codes:_________________

Name of Prime:__________________________________

(PRIME CONTRACTOR OR NAME OF ENTITY PROVIDING PROPOSAL in responding to the Request for Proposal No. 36C25623R0109 for Project No. 520-23-106 Renovate Interior Space JACC
Telephone:________________

Address:__________________

City/State/Zip Code:___________

DUNS/Cage/SAM Unique Identifier Codes:____________

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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