36C25624R0065 EXHIBIT C.docx
DOCX document 26 KB Posted
- Attached to
- Z2DZ--Project #667-24-114 (D/B) Install Decon Shower Drainage System Federal contract opportunity
- Solicitation number
- 36C25624R0065
About this file
This document is a Subcontractor Information and Consent Form related to a federal contract opportunity. The form requests that major subcontractors and teaming partners provide consent for the Government to discuss their past and present performance information with the prime contractor during the source selection process for Solicitation No. 36C25624R0065. Interested subcontractors must complete the form with their company details and provide a reference list of previous contracts.
The related federal contract opportunity is for the installation of a decontamination shower drainage system at the Overton Brooks VA Medical Center in Shreveport, LA. This is a 100% Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside with a construction cost range between $100,000 and $250,000. The tentative RFP release date is June 13, 2024, with proposals due approximately 30 days later. The contract performance period is 130 calendar days after the Notice to Proceed. Interested offerors must be registered in SAM.gov and provide the VA Notice of Limitations on Subcontracting Certificate of Compliance with their proposal.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25624R0065 WD LA20240031 MOD 0 01052024.pdf | ||
| 36C25624R0065 EXHIBIT F.docx | DOCX document | |
| 36C25624R0065 EXHIBIT E.docx | DOCX document | |
| 36C25624R0065 RFP.docx | DOCX document | |
| 36C25624R0065 EXHIBIT D.docx | DOCX document | |
| 36C25624R0065 EXHIBIT B.docx | DOCX document | |
| 36C25624R0065 SOW.docx | DOCX document | |
| 36C25624R0065 EXHIBIT A.docx | DOCX document | |
| SOW - DB Install Decon Shower Drainage System.docx | DOCX document | |
| 36C25624R0065 Pre-Sol.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. 667-24-114; Install Decon Shower Drainage System 36C25624R0065
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. 36C25624R0065 for Project No. 667-24-114) |
| 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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