EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT.docx

DOCX document 44 KB Posted

Attached to
Z2DA--INSTALL AUTO SHOWER OPERATORS Federal contract opportunity
Solicitation number
36C25620R0148
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

About this file

This document contains an exhibit for a subcontractor consent form and information related to a federal solicitation for installation of auto-operated faucets. The solicitation is a 100% set-aside for service-disabled veteran-owned small businesses, with a NAICS code of 238220 and size standard of $16.5 million. Interested offerors must provide all labor, materials, tools and equipment to install auto-operated faucets at the Southeast Louisiana Veterans Health Care System between $500,000 to $1 million. Proposals are due around October 2, 2020 with an anticipated award date within 30 days thereafter. The period of performance is 180 days from notice to proceed. Offerors must be registered in the System for Award Management and verified as SDVOSBs in the Vendor Information Pages database to be considered for award. The subcontractor consent form allows disclosure of past performance information to primes for source selection evaluation.

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Text version

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 629-18-140 Install Auto Operated Faucets 36C25621R0022

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 the Request for Proposal No. 36C25620R0148 for Project 629-18-140 Install Auto-Operated Faucets.

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:

File details come from the government source that posted it. Updated .