36C25625R0003 EXHIBIT C.docx
DOCX document 26 KB Posted
- Solicitation number
- 36C25625R0003
About this file
This document is a Subcontractor Information and Consent Form for a Department of Veterans Affairs contract (Solicitation No. 36C25625R0003) related to a JACC Chilled Water Piping Repair project (Project #520-25-107). The form is designed to obtain consent from potential subcontractors and teaming partners to release their past performance information to the prime contractor during the source selection process.
The form requires subcontractors to provide company details, reference contract information, and authorize the release of their performance history. Specifically, it requests details such as company name, DUNS/CAGE code, contact information, and a list of at least three reference contracts with details about the role performed, contract numbers, and point of contact information. The solicitation is issued by the Veterans Health Administration's Veterans Integrated Service Network 16, indicating this is a VA-specific infrastructure repair and maintenance project.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25625R0003 0003.docx | DOCX document | |
| 36C25625R0003 0002.docx | DOCX document | |
| 520-25-107 Site Visit Sign in Sheet.pdf | ||
| 36C25625R0003 0001.docx | DOCX document | |
| 36C25625R0003-Contracting Only ICRAs and PCRAs Repair JACC Chilled Water Piping .pdf | ||
| 36C25625R0003 EXHIBIT E.docx | DOCX document | |
| 36C25625R0003 EXHIBIT B.docx | DOCX document | |
| 36C25625R0003-520-25-107 -Specifications -01-22-2025 .pdf | ||
| 36C25625R0003 EXHIBIT F.docx | DOCX document | |
| 36C25625R0003 EXHIBIT A.docx | DOCX document | |
| P07 Wage Determination FL20250203 03-14-2025.pdf | ||
| Site Visit Instructions - 520-25-107-Repair JACC Chilled Water Piping v2.pdf | ||
| SOW Repair JACC Chilled Water Piping -New 03-20-2025.pdf | ||
| 36C25625R0003-Drawings Repair JACC chilled water piping .pdf | ||
| 36C25625R0003 Brand Name JA-Redacted.pdf | ||
| 36C25625R0003 EXHIBIT D.docx | DOCX document | |
| 36C25625R0003.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
520-25-107 CON Repair JACC Chilled Water Piping 36C25625R0003
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. 36C25625R0003 for Project #520-25-107) |
| 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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