36C25625R0126 EXHIBIT C.docx
DOCX document 27 KB Posted
- Attached to
- Z2DA--Project 667-25-190 Install Isolation Valves, B1 (Con) Federal contract opportunity
- Solicitation number
- 36C25625R0126
About this file
This document is a Subcontractor Information and Consent Form for a Department of Veterans Affairs project (Project 667-25-190) involving the installation of isolation valves on the domestic water system in Building 1. The form is part of solicitation 36C25625R0126 and requires potential subcontractors and teaming partners to provide consent for the release of their past performance information to the prime contractor during the source selection process.
The form requests subcontractors to complete detailed information including their company name, contact details, DUNS/CAGE code, and provide a reference list with at least three past contracts. By signing, subcontractors authorize the prime contractor to discuss their past and present performance information as part of the government's emphasis on evaluating performance for best value selection. The solicitation is being managed by the Veterans Health Administration's Veterans Integrated Service Network 16 (VISN 16).
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C25625R0126 0002.docx | DOCX document | |
| RFI Register 667-25-190_Install Iso Valves 090225.docx | DOCX document | |
| Sign in Sheet 667-25-190.pdf | ||
| 36C25625R0126 0001.docx | DOCX document | |
| 36C25625R0126 EXHIBIT F.docx | DOCX document | |
| 36C25625R0126 EXHIBIT A.docx | DOCX document | |
| 36C25625R0126 667-25-190 Combined Specs 02102025.pdf | ||
| 36C25625R0126 667-25-190 Class IV Precautions - ISO Valves .pdf | ||
| 36C25625R0126 EXHIBIT E.docx | DOCX document | |
| 36C25625R0126 667-25-190 ISO Valves - Drawings.pdf | ||
| 36C25625R0125 WD LA20250031 070425.pdf | ||
| 36C25625R0126 EXHIBIT D.docx | DOCX document | |
| 36C25625R0126 667-25-190 BLDG 1 Asbestos Report.pdf | ||
| 36C25625R0126 667-25-190 ICRA - ISO Valves.pdf | ||
| 36C25625R0126 667-25-190 SOW 02102025 .doc | DOC document | |
| 36C25625R0126.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. 667-25-190 Install Isolation Valves on Domestic Water System, BLDG 1 36C25625R0126
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. 36C25625R0126 for Project 667-25-190) |
| 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 #
File details come from the government source that posted it. Updated .