36C25626R0019 EXHIBIT C.docx
DOCX document 27 KB Posted
- Solicitation number
- 36C25626R0019
About this file
This file is a Subcontractor Information and Consent Form required for the Pharmacy Physical Security Upgrade solicitation (36C25626R0019) issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. The form serves as a template for major subcontractors and teaming partners to grant consent for the disclosure of their past performance information to the prime contractor during the source selection process. This consent is necessary because federal regulations prohibit the Government from sharing subcontractor and teaming partner performance data with private parties, including prime contractors, without explicit written authorization from the subcontractor or teaming partner.
The form requires subcontractors and teaming partners to provide their firm name, contact information, DUNS/CAGE code, and the name and details of the prime contractor or entity submitting the proposal in response to RFP 36C25626R0023 for Project #598-19-112. Additionally, the form mandates completion of a reference list that includes at least three contract examples demonstrating the subcontractor's or teaming partner's role (whether as prime or subcontractor), work performed, contract title and number, and reference point of contact information including name, email address, and phone number. A company representative with legal authority must sign the consent form to facilitate the Government's past performance assessment during the competitive evaluation process.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25626R0019 0003.docx | DOCX document | |
| 36C25626R0019 0002.docx | DOCX document | |
| Pre-bid conference site visit 4.13.26 sign in.pdf | ||
| 36C25626R0019 0001.docx | DOCX document | |
| WD MS20260051 Hinds.pdf | ||
| 586-22-105 Drawings edited tl.pdf | ||
| 010000 11-2021 General Requirements - R2.pdf | ||
| WD MS20260052.pdf | ||
| 36C25626R0019 EXHIBIT B.docx | DOCX document | |
| 36C25626R0019 EXHIBIT D.docx | DOCX document | |
| 36C25626R0019 To Post.docx | DOCX document | |
| 586-22-105 Specifications Revised.pdf | ||
| Scope of Work Pharmacy Physical security Redlines updated.docx | DOCX document | |
| 36C25626R0019 EXHIBIT A.docx | DOCX document | |
| 36C25626R0019 EXHIBIT E.docx | DOCX document | |
| 36C25626R0019 EXHIBIT F.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
586-22-105 CON Pharmacy Physical Security Upgrade 36C25626R0019
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. 36C25626R0023 for Project #598-19-112) |
| 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 .