EXHIBIT B (1).doc
DOC document 42 KB Posted
- Solicitation number
- W911YN20R0005
About this file
This solicitation is for non-personal behavioral health and case management services to support the Florida Army National Guard. The contractor will provide behavioral health professional services including case management, medical, and dental non-clinical case management and administrative care coordination for an average of 700 service members per month requiring duty-limiting profiles. This will include 500 in-depth cases expected to take over 30 days to resolve and require additional paperwork and board actions. The goal is to maintain a medically deployable force. The contractor must track issues by service member and synchronize duty-limiting conditions between behavioral health and medical personnel when clinically acceptable to streamline communication with units and service members. The contractor shall also ensure less than 400 service members have a non-ready status due to lack of annual medical or dental screenings. This is a small business 8(a) competitive set-aside solicited by the Department of the Army Florida Army National Guard.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| WageDeterminationNo2015_4539Rev11.pdf | ||
| W911YN20R0005-Clarification to QAs.docx.pdf | ||
| W911YN20R0005-CASE amendment.pdf | ||
| W911YN20R0005-CASE conform copy.pdf | ||
| W911YN20R0005-CASE.pdf | ||
| Case_management_PWS_V.1.pdf | ||
| EXHIBIT A.doc | DOC document | |
| EXHIBIT_C FORM_.pdf | ||
| Q A.docx | DOCX document | |
| PWS Case management 2020.pdf | ||
| 20R0005V.4.pdf | ||
| 52.204-24.docx | DOCX document |
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Case Management Services Florida Army National Guard
W911YN-20-R-0005
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 W911YN-20-R-0005. 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 .