Attachment 6 Release of Past Performance.docx

DOCX document 20 KB Posted

Attached to
6515--DTP-NG NATL CMOP RFP
Solicitation number
36C77020R0003
Issued by

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This document contains a release form for past performance information related to a Department of Veterans Affairs solicitation for Direct to Patient Distribution Services. The release form allows a prime contractor responding to solicitation number 36C77020R0003 to discuss a subcontractor or teaming partner's past and present performance with the VA during source selection. The subcontractor or teaming partner signs the form to consent to the release of their performance history. The solicitation is for the VA's Veterans Health Administration Veterans Integrated Service Network 15 and involves the National CMOP.

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Department of Veterans Affairs Network Contracting Office (NCO) 15 CMOP Acquisitions 3450 South 4th Street Trafficway Leavenworth, KS 66048

Release of Past Performance

We are currently participating as a (subcontractor/teaming partner) with _______________ (prime contractor or name of entity providing proposal) in responding to the Department of Veterans Affairs CMOP Acquisitions request for Proposal 36C77020R0003 for the Direct to Patient Distribution Services requirement.

We understand that the Government is using past performance as evaluation criteria 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, if it becomes necessary.

(Signature and Title of individual who has the authority to sign for and legally bind the partnering company)

Company Name:

Address:

DUNS:

Phone Number:

E-mail Address:

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File details come from the government source that posted it. Updated .