Attachment J.8-SubContract CheckList.xls
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- Solicitation number
- RFP-CMS-2017-8a-0006
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Attachment J.8
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Sheet1
| Attachment J.8 | ||
| SUBCONTRACT CHECKLIST | ||
| CMS-OAGM-DDCC | ||
| PRIME CONTRACT INFORMATION | ||
| 1 | Prime Contractor Name | |
| 2 | Prime Ktr Address | |
| 3 | Prime Ktr POC/Name/Title | |
| 4 | Prime POC Telephone No.: | |
| 5 | Prime Contract No. | |
| 6 | Prime KT Task Order No. (if Any) | |
| 7 | Project Name/Identification | |
| 8 | Prime KT Clin/SLIN (to be charged) | |
| SUBCONTRACT INFORMATION | ||
| 1 | Subcontractor Name (Note: 1) | |
| 2 | Subcontractor address | |
| 3 | Identify if Subcontractor is part of any socio-legal disadvantaged class: | |
| 4 | Is Subcontractor in the Excluded Parties List System? (See Note#1) | |
| 5 | Prime Ktr P.O. No. and date (Note: 2) | |
| 6 | Subcontractor Quote No. | |
| 7 | Subcontract type of instrument: | |
| If other than FFP - does Subcontractor have an "Approved Accounting System" | ||
| 8 | Articles/Services purchased - Description | |
| 9 | Qty purchased/unit price/extension | |
| 10 | Is above material part of a larger, combined order? | |
| 11 | Material/services - origin/shipping point | |
| 12 | Delivery Lead time | |
| 13 | Organization Conflict of Interest (OCI) been addressed? If applicable - conflict identified, described, and mitigation plan supplied? | |
| 14 | Have/Is all prime contract clauses and requirements been(being) flowed down to subcontractor? | |
| Note: 1 | Prime Contractor is responsible for verifying that proposed Subcontractor is not Excluded from receiving/performing Government contracts/work. See the following: Corporate Integrity Agreements- http://oig.hhs.gov/fraud/cia/index.html OIG Excluded Parties List-http://exclusions.oig.hhs.gov/ Excluded Parties List- http://www.epls.arnet.gov/ Please state the date/and who made verification. | |
| Note: 2 | If no purchase order has yet been placed, please include/identify Req No. | |
| Note: 3 | This Check List must be accompanied by a text paragraph from the Prime Contractor detailing the extent of competition employed and research performed to source the subcontracted material/services, and why the decision was made to issue this particular purchase order, to this particular subcontractor.. | |
| Note: 4 | If actual or potential conflict of interest is identified. Request for subcontract approval must include description of conflict and mitigation plan. | |
| Note: 5 | Contracting Officer consent to a subcontract, or approval of the contractor's purchasing system, does not constitute a determination of the acceptability of the subcontract terms and/or price, or of the allowability of costs, or of the availability of funds to pay for the costs, unless otherwise stated. |
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