EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25625R0002
About this file
Exhibit C is a Subcontractor Information and Consent Form for a VA Medical Center accessibility ramp project (Project No. 667-24-255, Solicitation 36C25625R0002). The document is designed to obtain consent from potential subcontractors or teaming partners to release their past performance information to the prime contractor during the source selection process.
The associated federal contract opportunity is a 100% set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB) for constructing an accessibility ramp at the Overton Brooks VA Medical Center in Shreveport, Louisiana. The project is valued between $250,000-$500,000, with NAICS Code 236220, and has a tentative RFP release date of 11-08-2024, with proposals due around 11-25-2024. The contract performance period is 180 calendar days after the Notice to Proceed, and bidders must be certified in the SBA database and registered in SAM. Offerors must submit an executed VA Notice of Limitations on Subcontracting - Certificate of Compliance for Services and Construction at the time of proposal submission.
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Other files
| File | Type | Posted |
|---|---|---|
| S02 Cancel RFP 36C25625R0002 0002_2.docx | DOCX document | |
| P07 WD LA20250001 05-02-2025.pdf | ||
| S02 RFP Phase II 36C25625R0002 0002 06-06-2025.pdf | ||
| S06 RFIs 04-10-2025.pdf | ||
| S06 667-24-255 Topography-Grading_RFI Answer.pdf | ||
| S06 36C25625R0002 0001.pdf | ||
| S02 Wage Determination 667-24-255 -01-03-2025.pdf | ||
| S02 2016-03-21 Utilities Drawing.pdf | ||
| S02 SOW 10-03-2024.pdf | ||
| EXHIBIT E.docx | DOCX document | |
| EXHIBIT B.docx | DOCX document | |
| EXHIBIT D.docx | DOCX document | |
| EXHIBIT F.docx | DOCX document | |
| EXHIBIT A.docx | DOCX document | |
| S02 RFP 36C25625R0002_1 03-25-2025.pdf | ||
| S02 B55 Ramp-Existing Drawing.pdf | ||
| P09 2016-03-21 Utilities Drawing.pdf | ||
| P09 Statement of Work_Bldg 55 Ramp 08-14-2024.docx | DOCX document | |
| P09 B55 Ramp-Existing Drawing.pdf |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 667-24-255 Bldg. 55 Accessibility Ramp 36C25625R0002
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. 36C25625R0002 for Project No. 667-24-255) |
| 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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