36C25626R0072 EXHIBIT B- Subcontractor Information and Consent Form.pdf
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- Solicitation number
- 36C25626R0072
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This is a Subcontractor Information and Consent Form for federal contract proposal 36C25626R0072, Project No. 586-26-100 (Renovate Radiation Oncology Department). The form is a template designed to obtain written consent from major subcontractors and teaming partners to allow the Government and prime contractor to discuss their past and present performance information during the source selection process. Past performance data concerning subcontractors and teaming partners cannot be disclosed to private parties without explicit consent; since prime contractors are considered private parties, this consent is required before performance information can be shared during proposal evaluations.
The form requires completion by each major subcontractor or teaming partner and submission by the prime contractor with the past performance volume. Required fields include the subcontractor/teaming partner's firm name, telephone, address, city/state/zip code, and DUNS/Cage/SAM unique identifier codes; the prime contractor's corresponding information; and an authorized signatory's signature and title. Additionally, the form mandates a reference list containing at least three contract entries, each specifying the contract number and title, description of role (prime or subcontractor) and work performed, reference point of contact name, and contact email address and phone number. This template facilitates the Government's assessment of past performance relevancy as a key evaluation factor in determining best value during source selection.
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Text version
FOR OFFICIAL USE ONLY
Source Selection Sensitive Information—See RFO FAR 2.101 & 3.104
Project No.586-26-100 RENOVATE RADIATION ONCOLOGY DEPARTMENT 36C25626R0072
EXHIBIT B – 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
Telephone:_____________ Address:_______________
City/State/Zip Code:_______ DUNS/Cage/SAM Unique Identifier Codes:_________________ partner with
Name of Prime:__________________________________
(PRIME CONTRACTOR OR NAME OF ENTITY
PROVIDING PROPOSAL in responding to the Request for Proposal No. 36C25626R0072 for Project No.
586-26-100)
Telephone:________________ Address:__________________ City/State/Zip Code:___________ DUNS/Cage/SAM Unique Identifier Codes:____________
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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