36C25626R0023 EXHIBIT C.docx
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- Solicitation number
- 36C25626R0023
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This is a Subcontractor Information and Consent Form (Exhibit C) for federal contract solicitation 36C25626R0023, issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16 for the replacement of underground 15kV feeders and transformers at a facility in North Little Rock (Project #598-19-112).
The form requires prime contractors to obtain signed consent from major subcontractors and teaming partners to allow the Government to disclose their past and present performance information during the source selection process. Subcontractors and teaming partners must complete the form with their firm name, contact information, DUNS/CAGE code, the prime contractor's information, and provide a reference list containing at least three contract examples that detail the contract number, title, role (prime or subcontractor), work performed, and reference point of contact information including email and phone number. The form emphasizes that the Government is placing increased emphasis on past performance evaluation to obtain best value in source selections, and the signed consent facilitates this assessment process by enabling performance confidence discussions between the Government and prime contractor during evaluation.
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FOR OFFICIAL USE ONLY
598-19-112 CON 15KV Feeder Loop 36C25626R0023
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 .