Section_J_Attachment_14_-_Past_Perf_Sub_Consent_Ltr_123013FD.doc

United States Department of Labor

(DOL)

Workers’ Compensation Medical Bill Process (WCMBP)

Attachment 14 –

Past Performance Subcontractor Consent Letter Template December 30, 2013 Office of Workers’ Compensation Programs (OWCP) Subject:

Subcontractor Consent to Sharing Past Performance Information Reference:

USDOL OWCP Workers’ Compensation Medical Bill Process (WCMBP)

RFP Number:

Offeror [Name of Offeror] Date:

[Date of Letter] To:

Department of Labor Contracting Officer

This letter serves as formal, written documentation of our company’s policy regarding the sharing of our company’s past performance information with the offeror. Past performance information may be submitted by customers of our previous projects, whose references are offered as part of the CBP proposal.

(Check one of the statements below) The Government may share (clarify, communicate, or discuss) past performance information regarding our company with the offeror. The Government may communicate the fact that issues were raised by project references and may communicate the details of those issues to the offeror.

The Government may not share (clarify, communicate, or discuss) past performance information regarding our company with the offeror. The Government may communicate the fact that issues were raised by project references, but may not communicate the details of those issues to the offeror.

[Signature of Authorized Subcontractor Officer] [Name of Subcontractor] [Address of Subcontractor]