36C25626R0064 EXHIBIT C.docx
DOCX document 31 KB Posted
- Solicitation number
- 36C25626R0064
About this file
This is a Subcontractor Information and Consent Form required for the Department of Veterans Affairs (VA) Veterans Health Administration, Veterans Integrated Service Network 16 solicitation 36C25626R0064 for Project 667-22-118, Replacement Underground Water Tanks. The form is used 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. Since prime contractors are considered private parties, Government regulations prohibit disclosure of subcontractor performance data without explicit written consent.
The form requires completion by identified subcontractors and teaming partners and must be submitted with the proposal's past performance volume. Required information includes the subcontractor/teaming partner firm name, contact information, DUNS/CAGE code, and the prime contractor details. Additionally, the form mandates inclusion of a reference list containing at least three contracts, with each entry specifying the contract number and title, description of the subcontractor's role (prime or sub), work performed, and reference point-of-contact information including name, email address, and phone number. The form must be signed by an individual with authority to legally bind the company.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C25626R0064 0006.docx | DOCX document | |
| 36C25626R0064 0005.docx | DOCX document | |
| Water Tanks RFIs_Response.docx | DOCX document | |
| 36C25626R0064 A0004.pdf | ||
| 36C25626R0064 0003.docx | DOCX document | |
| 36C25626R0064 0002.docx | DOCX document | |
| Attch 1 36C25626R0064 RFIs and Answers.docx | DOCX document | |
| Attch 2 667-22-118 Replacement Undergound Water Tank Geo Report.pdf | ||
| 36C25626R0064 0001.docx | DOCX document | |
| 36C25626R0064 EXHIBIT F.docx | DOCX document | |
| Water Tanks - 11 - Specs.pdf | ||
| 36C25626R0064 EXHIBIT A.docx | DOCX document | |
| Water Tanks - 13 - First Draft Servitude Pending resubmission.pdf | ||
| 36C25626R0064_1.docx | DOCX document | |
| Wage Determination LA20250002 dated 01.30.2026.pdf | ||
| Water Tanks - 10 - Drawings.pdf | ||
| Water Tanks - 1 - SOW.doc | DOC document | |
| 36C25626R0064 EXHIBIT E.docx | DOCX document | |
| 36C25626R0064 EXHIBIT D.docx | DOCX document | |
| 36C25626R0064 EXHIBIT B.docx | DOCX document |
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Text version
FOR OFFICIAL USE ONLY
667-22-118, CON Replacement Underground Storage Tanks 36C25626R0064
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. 36C25625R0108 for Project #667-23-113) |
| 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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