EXHIBIT B - Subcontractor Consent and Reference Form.docx
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- Solicitation number
- 36C24426R0139
About this file
This is a Subcontractor Consent and Reference Form (Exhibit B) required for federal contract proposal submission. The form mandates that all subcontractors and teaming partners identified in Exhibit A, Part 2 must complete this consent document to participate in the proposal response for Request for Proposal Number 36C24425R0139 issued by the VA Pittsburgh Healthcare System (VAPHS), located at University Drive, Pittsburgh, PA 15215, with Contract Specialist Amanda Murphy as the point of contact at 1010 Delafield Road, Pittsburgh, PA 15215.
The form requires subcontractors to grant written consent allowing the Government to disclose their past performance information to the Prime Contractor during source selection, acknowledging the Government's emphasis on past performance evaluation for best value determinations. Each subcontractor must provide two required references with associated project information, including project titles, contract numbers, descriptions of their role (Prime or Subcontractor), work performed, reference point of contact details, phone numbers, and email addresses. Subcontractors may optionally submit separate written references and may elect to submit relevant prior project experience on one Exhibit A, Part 1 form, though past performance questionnaires must be sent to all associated reference contacts. The Prime Contractor cannot serve as a point of contact or written reference for subcontractors on submitted forms. All completed consent forms with reference attachments must be submitted to the Prime Contractor for inclusion in the proposal package.
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EXHIBIT B – SUBCONTRACTOR CONSENT AND REFERENCE FORM
PART 1 - INSTRUCTIONS:
Subcontractor and/or Teaming Partner Consent for the release of Past Performance Information including references to the Prime Contractor:
Each Subcontractor and/or Teaming Partner named by the Offeror in Exhibit A, Part 2 must complete an Exhibit B - Subcontractor Consent and Reference Form to be considered.
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 Performance information to the Prime during exchanges.
Two (2) Subcontractor’s references are also required to be completed on this form. Separate written references for Subcontractors may also be included and are encouraged; however, Subcontractors do not need to send out Past Performance Questionnaires to references included only on this form. Subcontractor may attach associated written references to this form.
Offeror may elect to have Subcontractors also submit Relevant Prior Project Experience on up to one (1) Exhibit A, Part 1 form. Projects described on Exhibit A forms shall have Past Performance Questionnaires (PPQs) sent to associated reference contacts regardless of Prime (Offering) or Sub Contractor status. Offeror cannot be a POC for a Subcontractor on the Exhibit A form, and cannot be a written reference in Exhibit B.
The completed consent forms with any reference attachments shall be submitted to the Offering Prime Contractor for submission in the proposal.
PART 2 - SUBCONTRACTOR CONSENT:
(name of subcontracted firm) is currently planning on participating as a Subcontractor and or Teaming Partner with (Prime Contractor or name of entity submitting proposal) in responding to the Request for Proposal Number 36C24425R0139 at the VA Pittsburgh Healthcare System (VAPHS) at University Drive, Pittsburgh, PA 15215, issued by the VAPHS, 1010 Delafield Road, Pittsburgh, PA 15215, Contract Specialist – Amanda Murphy.
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 proposal review and evaluation process, we are signing this consent form to allow the Government to discuss our Past Performance information with the Prime Contractor during the source selection process.
(Signature) (Title, Company of Individual with authority to sign for and legally bind the company)
Address:
City/State/Zip Code: Date:
PART 3 - SUBCONTRACTOR’S REFERENCE LIST (REQUIRED):
1. Project Title and Contract No.
Describe your role (Prime/Sub) and work performed:
Reference POC Name, Title, Organization:
Phone: Email Address:
2. Project Title and Contract No.
Describe your role (Prime/Sub) and work performed:
Reference POC Name, Title, Organization:
Phone: Email Address:
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