36C25627Q0087 EXHIBIT C.docx

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Z2NZ--Turn Key Chiller Equipment (Purchase and Install)
Solicitation number
36C25627Q0087
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This is a Subcontractor Information and Consent Form (Exhibit C) for federal contract opportunity 36C25627Q0087, a turn-key chiller equipment purchase and installation solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. The form is a template designed to obtain consent from major subcontractors and teaming partners to allow the Government to disclose their past performance information to the prime contractor during the source selection process.

The form requires subcontractors and teaming partners to provide their firm name, contact information, DUNS/CAGE code, and the prime contractor's details. Signatories must authorize the Government to discuss past and present performance information with the prime contractor to facilitate the performance confidence assessment process. Additionally, the form mandates that firms complete a reference list section identifying at least three contracts, including the contract number and title, description of the firm's role (prime or subcontractor) and work performed, and reference points of contact with email addresses and phone numbers. This consent mechanism is intended to support the Government's emphasis on past performance as a factor in obtaining best value during source selection.

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Other files

File Type Posted
36C25627Q0087 0001.docx DOCX document
36C25627Q0087 EXHIBIT D.docx DOCX document
36C25627Q0087 EXHIBIT B.docx DOCX document
LA20260031.pdf PDF
Final OR CHILLER REPLACEMENT SOW.docx DOCX document
36C25627Q0087.docx DOCX document
36C25627Q0087 EXHIBIT E.docx DOCX document
JA- BRAND NAME s.pdf PDF
36C25627Q0087 EXHIBIT A.docx DOCX document

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FOR OFFICIAL USE ONLY

CON HVAC Replacement 36C25627Q0087

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 #

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