Attachment 4_Subcontractor-Consent Form.doc

Attachment 4

SUBCONTRACTOR/TEAMING OR PARTNER/KEY PERSONNEL

INFORMATION AND CONSENT FORM

Subcontractor and/ or Teaming Partner and/ or Key Personnel consent for the release of Past Performance Information to the Prime Contractor and reference information.

Past performance information concerning subcontractors and teaming partners and or key personnel 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 and risk, we request that the following consent form be completed by the major subcontractors/teaming partners or key personnel identified in your proposal. The completed consent forms should be submitted to the offering contractor for submission with the past performance volume.

______________________ (Name of Firm or Person) is currently planning on participating as a (subcontractor and or a teaming partner and or Key Personnel) with _____________________(prime contractor or name of entity providing proposal) in responding to the Request for Proposal No. W50S85-20-R-0005 for Airfield Management Services issued by the 127 MSC, Contracting Division, Selfridge ANG Base, MI.

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 risk 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 Person with authority to sign for and Legally bind the company

Company Name:_____________________________ Telephone #:_____________

Address:_____________________________ City/State/Zip Code:________________

Date:_____________________

Reference List (required):

1. Contract No and Title:______________________________________________

Describe your role (Prime/Sub/Position) and work performed:__________________________________________________________

Reference POC Name:________________________________

Phone__________________________ Fax:_________________________

Email Address:____________________________________________________

2. Contract No and Title:______________________________________________

Describe your role (Prime/Sub/Position) and work performed:__________________________________________________________

Reference POC Name:________________________________

Phone__________________________ Fax:_________________________

Email Address:____________________________________________________