B08 Attachment 4 Subcontractor Information and Consent Form.docx

W25G1V-21-R-0033

ATTACHMENT #4 SUBCONTRACTOR INFORMATION AND CONSENT FORM

Subcontractor and/or Teaming Partner Consent for the Release of Past Performance Information to the Prime Contractor and Reference Information

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

___________________(Name of Firm) is currently planning on participating as a (subcontractor and or a teaming partner) with ___________________(prime contractor or name of entity providing proposal) in responding to the Request for Proposal No. W25G1V-21-R-0033 for Building 7, Bays 1 and 2 Renovation Project issued by ACC-APG Tobyhanna Division for maintenance, alterations, repair or minor construction at the installation level on Tobyhanna Army Depot.

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 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.

Company Name: ________________________ Telephone #____________________

Address: ______________________________

City/State/Zip Code:______________________ Date:_____________________

Reference List (required):

1. Contract No. And Title___________________________________________________________ Describe your role (Prime/Sub) and work Performed ___________________________________ Reference POC Name____________________________ Phone___________ Fax____________ Email address: _________________________________________________________________

2. Contract No. And Title___________________________________________________________ Describe your role (Prime/Sub) and work Performed ___________________________________ Reference POC Name____________________________ Phone___________ Fax____________ Email address: _________________________________________________________________

3. Contract No. And Title___________________________________________________________ Describe your role (Prime/Sub) and work Performed ___________________________________ Reference POC Name____________________________ Phone___________ Fax____________ Email address: _________________________________________________________________