36C25626Q0430 EXHIBIT C.docx
DOCX document 27 KB Posted
- Attached to
- J042--Fire Alarm Service
- Solicitation number
- 36C25626Q0430
About this file
This is a Subcontractor Information and Consent Form (Exhibit C) for federal contract solicitation 36C25626Q0430, a Fire Alarm Service opportunity with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. The form is a template designed to obtain consent from major subcontractors and teaming partners to allow the Government to disclose their past and present performance information to the prime contractor during the source selection process.
The form requires subcontractors and teaming partners to provide their firm name, contact information, DUNS/CAGE code, and the prime contractor's details. Signatories must authorize release of their performance data to facilitate the Government's best-value assessment during evaluation. Additionally, the form mandates submission of a reference list with at least three contracts, including contract number and title, description of the firm's role (prime or subcontractor), work performed, and reference point of contact information with email and phone number. This consent documentation must be completed by identified major subcontractors and teaming partners and submitted by the prime contractor with the past performance volume.
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Text version
FOR OFFICIAL USE ONLY
Fire Alarm Service 36C25626Q0430
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. 36C25626Q0430) |
| 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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