EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT.docx

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6110--Project No. 520-22-108 Upgrade Emergency Electrical Systems, Biloxi
Solicitation number
36C25621R0055
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This solicitation package includes an exhibit for subcontractor consent and a federal contract opportunity notice. The opportunity is a 100% set-aside for service-disabled veteran-owned small businesses to upgrade emergency electrical systems at the Gulf Coast Veterans Health Care System in Biloxi, Mississippi. Interested offerors must provide all labor, materials, tools and equipment to complete the work. The project cost range is $500,000 to $1 million under NAICS code 238210. The solicitation number is 36C25621R0055 and proposals are due around February 25, 2021, with award anticipated within 30 days thereafter. The period of performance is 120 days from the notice to proceed. The exhibit requires subcontractors to provide consent for the prime contractor to obtain their past performance information and references for evaluation. Offerors must be verified in the Vendor Information Pages database and registered in the System for Award Management.

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FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104 Project 520-22-108 Upgrade Emergency Electrical Systems, Biloxi 36C25621R0055

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. 36C25621R0055 for Project 520-22-108 Upgrade Emergency Electrical Systems, Biloxi

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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