EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT.docx

DOCX document 44 KB Posted

Attached to
Misc. Generator Repairs and Improvements Federal contract opportunity
Solicitation number
36C25621R0179
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This exhibit form requests consent from major subcontractors and teaming partners for the release of past performance information to the prime contractor for Project 520-22-166 Miscellaneous Generator Repairs and Improvements. The project is a total Service-Disabled Veteran-Owned Small Business set-aside solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16. Offerors must be registered and verified as an SDVOSB in Vendor Information Pages. The solicitation requires furnishing all labor, tools, materials, equipment, supervision and other requirements necessary to perform work associated with miscellaneous generator repairs and improvements for the Gulf Coast Veterans Health Care System in Pensacola, Florida. Subcontractors are asked to provide consent by signature for discussion of their past and present performance, as well as a reference list with three past performance examples.

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Text version

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project: 520-22-166 Miscellaneous Generator Repairs and Improvements 36C25621R0179

EXHIBIT C – 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 Request for Proposal No. 36C25621R0179 for Project: 520-22-166 Miscellaneous Generator Repairs and Improvements – Pensacola, FL for a construction services contract issued by the Department of Veterans Affairs- NCO 16.

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: Telephone #

Address:

City/State/Zip Code: Date:

Reference List (required):

1.Contract No. And Title:
Describe role (Prime/Sub) and work Performed:
Reference POC NamePhone:Fax:
Email address:
2.Contract No. And Title:
Describe role (Prime/Sub) and work Performed:
Reference POC NamePhone:Fax:
Email address:
3.Contract No. And Title:
Describe role (Prime/Sub) and work Performed:
Reference POC NamePhone:Fax:
Email address:

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