Attachment B - Quoters Self Performance Worksheet.docx

DOCX document 14 KB Posted

Attached to
J065--Surgical Scope Repair Services for Bay Pines VA Healthcare System
Solicitation number
36C24825Q0458
Issued by

About this file

The document is an Attachment B Quoters Self Performance Worksheet for a Service-Disabled Veteran Owned Small Business (SDVOSB) set-aside contract for Surgical Scope Repair Services at the Bay Pines VA Healthcare System. The worksheet requires vendors to demonstrate compliance with federal subcontracting limitations by detailing their total proposed price, amount to be paid to non-small business subcontractors, and listing intended subcontractors and self-performed work activities.

The solicitation (36C24825Q0458) is issued by the Department of Veterans Affairs Veterans Health Administration and specifically targets Service-Disabled Veteran Owned Small Businesses. Potential contractors must be registered in both the System for Award Management (SAM) and VetCert databases to be eligible for award. The registration is free, and compliance with these requirements is mandatory for participation in this federal contract opportunity.

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Other files

File Type Posted
36C24825Q0458 0001.docx DOCX document
Attachment A - Pricelist.xlsx XLSX spreadsheet
36C24825Q0458_1.docx DOCX document

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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:

CompanyUEIAmount
_____________________________________________$_____________
_____________________________________________$_____________

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 .