Self-Performance Worksheet.docx
DOCX document 14 KB Posted
- Solicitation number
- 36C26121Q0751
About this file
This is a self-performance worksheet for a service-disabled veteran-owned small business set-aside contract opportunity from the Department of Veterans Affairs to provide special mode nonambulatory transportation to eligible veterans. The worksheet requires vendors to list their total proposed price, total amount paid to non-SDVOSB subcontractors, and the difference between the two. Vendors must also list intended SDVOSB and non-SDVOSB subcontractors along with associated values, as well as self-performed work activities. The solicitation number is 36C26121Q0751 and is for Veterans Integrated Service Network 21 to provide special mode nonambulatory transportation services to eligible veterans. Compliance with limitations on subcontracting will be monitored in accordance with VA acquisition regulations.
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Other files
| File | Type | Posted |
|---|---|---|
| S02- Sol 36C26121Q0751 to ktr for quote.pdf | ||
| WD 2015-5689 rev 13 dated 12-21-2020.pdf | ||
| Experience Factor Worksheet-1.xlsx | XLSX spreadsheet | |
| Business Associate Agreement.pdf | ||
| 36C26121Q0751 0001.docx | DOCX document | |
| Past Performance Survey-1.docx | DOCX document | |
| S02-Self-Performance Worksheet.docx | DOCX document | |
| Past Performance Survey.docx | DOCX document | |
| 36C26121Q0751.docx | DOCX document | |
| P07-WD 2015-5689 rev 13 dated 12-21-2020.pdf | ||
| S02- Experience Factor Worksheet.xlsx | XLSX spreadsheet |
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Text version
QUOTOR’s SELF PERFORMANCE WORKSHEET
As a Service-Disabled Veteran-Owned Small Business set-aside in accordance with VA Acquisition Regulation (VAAR) 852.219-10, Limitations on Subcontracting – Monitoring and Compliance applies in accordance with VAAR 852.219-74. To demonstrate compliance please complete this worksheet and submit with quote. The Contracting Officer may ask questions about responses on this form. Any such questions will be communications related to responsibility; it will not be considered discussions.
Vendors are required to complete this Worksheet and submit with quote.
a) Quotor’s total proposed price (should be same amount shown in price worksheet for the total): $_______________
b) Total amount to be paid to subcontractors (non-SDVOSBs): $_______________
c) The difference of the amount shown in a) minus the amount shown in b): $_____________
List of intended subcontractors for this project and the value of those subcontracts:
| Company | DUNS | Amount | ||
| ________________________________ | ____________ | _$_____________ | ||
| ________________________________ | ____________ | _$_____________ |
List of “Self-Performed” work activities by the SDVOSB (this should be consistent with the response in the technical evaluation factor):
List of subcontracted work activities:
File details come from the government source that posted it. Updated .