B08-EXHIBIT B.doc
DOC document 55 KB Posted
- Attached to
- Case Management & Medical Records Services
- Solicitation number
- W912J2-20-R-0006
About this file
This document includes a subcontractor consent form and details of a federal solicitation. The solicitation is for case management and medical records services to support the Wisconsin Army National Guard. The requirement is set aside solely for Service-Disabled Veteran Owned Small Businesses. The period of performance is one base period of eleven months starting in July 2020, with four optional twelve-month periods. Proposals are due by June 23, 2020 and must be submitted electronically to the specified email address. The subcontractor consent form allows disclosure of past performance information to prime contractors for evaluation purposes during the solicitation process. It requests basic subcontractor details and provides for signatures authorizing the disclosure.
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Other files
| File | Type | Posted |
|---|---|---|
| W912J2-20-R-0006-0002 Case Management Services.pdf | ||
| W912J2-20-R-0006-0001 Case Management Services.pdf | ||
| W912J2-20-R-0006-0001 (summary of changes document) Case Management Services.pdf | ||
| B04-Wage Determination.docx | DOCX document | |
| FY20 CM Question and Answers.docx | DOCX document | |
| B08-EXHIBIT_C FORM .pdf | ||
| W912J2-20-R-0006 Case Manager Solicitation.pdf | ||
| B08-EXHIBIT A.DOC | DOC document | |
| B08-Price Breakdown Worksheet.xlsx | XLSX spreadsheet |
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Text version
Case Management Services Wisconsin Army National Guard W912J2-20-R-0006
EXHIBIT B – SUBCONTRACTOR INFORMATION AND CONSENT FORM
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 the offering contractor’s past performance relevancy and confidence, we request that the following consent form be completed by the major subcontractors/teaming partners identified in the offering contractor’s proposal. The completed consent forms should be submitted to the offering contractor for submission with subcontract past performance volume. Additionally, certain subcontractors will be required to send off questionnaires to their references. The offering contractor will inform you if this is required. Your cooperation will be appreciated.
Your Letterhead
SUBCONTRACTOR/TEAMING PARTNER CONSENT FOR THE RELEASE OF PAST PERFORMANCE INFORMATION TO THE PRIME CONTRACTOR AND REFERENCE INFORMATION
__________________ (Name of Firm) is currently participating as a (subcontractor/teaming partner) with (prime contractor or name of entity providing proposal) in responding to W912J2-20-R-0006. 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.
(Signature)
(Title of Individual with authority to sign for and
Legally bind the company)
Company Name: ________________________
Address:
City/State/Zip Code:______________________ Date:_____________________
Reference List (required): Reference cannot be from the contractor proposing on this solicitation.
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: _________________________________________________________________
File details come from the government source that posted it. Updated .