36C25625R0083 EXHIBIT C.docx
DOCX document 27 KB Posted
- Solicitation number
- 36C25625R0083
About this file
This document is a Subcontractor Information and Consent Form for a VA Medical Center project to replace Building 55's 1st and 2nd floor boiler. The project, numbered 36C25625R0083 with Project #667-25-200, is specifically targeted for Service-Disabled Veteran-Owned Small Businesses (SVOSBs) at the Overton Brooks VA Medical Center in Shreveport, LA. The construction project is valued between $250,000 and $500,000, with a primary NAICS code of 238220 for Plumbing, Heating, and Air Conditioning Contractors.
Key requirements include mandatory SDVOSB certification through the SBA database, SAM registration, and compliance with VAAR 819.7003 and 852.219-75 eligibility criteria. The official solicitation will be issued on SAM.gov around 04/18/2025, using FAR 15.101-1 Tradeoff Process. The project will require a Bid Bond and a single mandatory site visit, with the Contracting Officer being Jennings.herbst@va.gov. Interested contractors must provide all necessary labor, materials, tools, equipment, and expertise to complete the boiler replacement according to the project's scope of work, drawings, and specifications.
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Other files
| File | Type | Posted |
|---|---|---|
| 667-25-200 RFI Register 05212025 .docx | DOCX document | |
| 36C25625R0083 0003.docx | DOCX document | |
| 667-25-200 Site Visit Sign in Sheet.pdf | ||
| 36C25625R0083 0002.docx | DOCX document | |
| 36C25625R0083 0001.docx | DOCX document | |
| 36C25625R0083 667-25-200 Specs.pdf | ||
| 36C25625R0083 EXHIBIT D.docx | DOCX document | |
| 36C25625R0083 SOW v2 03272025.doc | DOC document | |
| 36C25625R0083 Replace Bldg 55 Boiler ICRA .pdf | ||
| 36C25625R0083 EXHIBIT A.docx | DOCX document | |
| 36C25625R0083 EXHIBIT F.docx | DOCX document | |
| 36C25625R0083 BLD 55 Boiler - 3 - DWG_Update .pdf | ||
| 36C25625R0083 Pump schedule .pdf | ||
| 36C25625R0083 EXHIBIT E.docx | DOCX document | |
| 36C25625R0083 WD LA20250031 02282025.pdf | ||
| 36C25625R0083 RFP.docx | DOCX document | |
| 36C25625R0083 Class III Precautions - Bldg 55 Boiler Replacement .pdf | ||
| 36C25625R0083.docx | DOCX document | |
| 36C25625R0083 SOW 03272025 .doc | DOC document |
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project #667-25-200 Replace Building 55 1st and 2nd Floor Boiler 36C25625R0083
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. 36C25625R0083 for Project 667-25-200) |
| 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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