Attachment A - Quoters Self Performance Worksheet.docx
DOCX document 13 KB Posted
- Solicitation number
- 36C26123Q0174
About this file
This document contains an attachment for a request for quotation for swimming pool maintenance services. The Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21 is soliciting quotes for swimming pool maintenance at the VA Palo Alto Health Care System. Quotes are due under solicitation number 36C26123Q0174. The attachment provides a worksheet for quoters to demonstrate compliance with limitations on subcontracting regulations. Quoters must complete the worksheet to disclose their total proposed price, the total amount to be paid to any non-small business subcontractors, and a calculation of the difference. They must also list any intended subcontractors and corresponding subcontract amounts as well as the specific work activities they plan to self-perform versus subcontract.
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Other files
| File | Type | Posted |
|---|---|---|
| WD 2015-5637 Rev 23 dtd 12.27.2022.pdf | ||
| 36C26123Q0174_2.docx | DOCX document | |
| Pool Log Palo Alto.pdf | ||
| WD 2015-5641 Rev 21 dtd 12.27.2022.pdf | ||
| Pool Log Menlo Park.pdf |
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Text version
Attachment A QUOTOR’s SELF PERFORMANCE WORKSHEET
As a Small Business set-aside under Federal Acquisition Regulation (FAR) 52.219-14, Limitations on Subcontracting, Veterans Affairs Acquisition Regulation (VAAR) Limitations on Subcontracting – Monitoring and Compliance applies to this contract. 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. Even if you do not plan on sub-contracting out any work, you must complete this worksheet.
a) Quoter’s total proposed price (should be same amount shown in price worksheet for the total): $_______________
b) Total amount to be paid to subcontractors (non-small business): $_______________
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 Small Business:
List of subcontracted work activities:
File details come from the government source that posted it. Updated .