36C25626R0117 EXHIBIT C Subcontractor Information Consent.docx

DOCX document 27 KB Posted

Attached to
Y1PZ--Project 629-25-104 ED Suicide Risk Mitigation Fence
Solicitation number
36C25626R0117
Issued by

About this file

This is a subcontractor information consent form for federal contracting purposes. The document establishes the framework through which prime contractors submit information about their subcontractors in connection with the Department of Veterans Affairs Veterans Health Administration (VHA) Veterans Integrated Service Network 16 (VISN 16) solicitation for Project 629-25-104 ED Suicide Risk Mitigation Fence (Solicitation Number: 36C25626R0117). The form serves as a consent mechanism allowing the government to collect, review, and evaluate subcontractor details as part of the proposal evaluation and contract administration process for this RFP.

The document functions as an administrative template requiring prime contractors to disclose subcontractor participation, roles, and related information necessary for government oversight and compliance verification. This consent form is standard protocol for federal procurements to ensure transparency regarding the supply chain and subcontracting arrangements, particularly for Department of Veterans Affairs projects where visibility into all parties involved in service delivery is essential for accountability and performance monitoring purposes.

View the file

Other files

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project No. 629-25-104 Emergency Department Suicide Risk Mitigation Fence 36C25626R0117

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. 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. 36C25626R0117 for Project 629-25-104 (Emergency Department Suicide Risk Mitigation Fence)
Telephone: ________________

Address: __________________

City/State/Zip Code: ___________

DUNS/Cage Code: ____________

We understand that the Government is placing increased emphasis on past performance to obtain best value in source selections. 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 .