S02 - Attachment 4 - Self-Performance Worksheet.docx
DOCX document 14 KB Posted
- Attached to
- R602--VANHCS MEDICAL COURIER SERVICES Federal contract opportunity
- Solicitation number
- 36C26120Q0804
About this file
This document contains a self-performance worksheet for a service-disabled veteran-owned small business set-aside contract. The worksheet requires vendors to list the total proposed price for the contract, total amount to be paid to non-SDVOSB subcontractors, and the difference that represents self-performed work. Vendors must also list intended subcontractors and associated values, as well as self-performed work activities and any subcontracted work. Executed subcontract documents must be submitted with the worksheet.
The related federal contract opportunity is for medical courier services at the Veterans Health Administration Veterans Integrated Service Network 21 under Solicitation Number 36C26120Q0804. The Department of Veterans Affairs is the contracting agency.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C26120Q0804 0002_1.docx | DOCX document | |
| S02 - (AMDMT 0002) - 36C26120Q0804 0001- VANCHCS Medical Courier Svcs.pdf | ||
| S02 - (AMDMT 0001) - 36C26120Q0804 0001- VANCHCS Medical Courier Svcs.pdf | ||
| 36C26120Q0804 0001_1.docx | DOCX document | |
| 36C26120Q0804_2.docx | DOCX document | |
| S02 - Attachment 3 - (WD-ALAMEDA-CONTRA COSTA) - 15-5624 - Rev.13 -06.13.2020.pdf | ||
| S02 - Attachment 2 - (WD-SOLANO) -15-5655 - Rev.10 -07.20.2020.pdf | ||
| S02 - Attachment 1 - (WD-SACRAMENTO) -15-5631 - Rev.11 -07.16.2020.pdf | ||
| S02 - (RFQ) - 36C26120Q0804 - VANCHCS MED COURIER SVCS.pdf |
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Text version
QUOTOR’s SELF PERFORMANCE WORKSHEET
As a Service-Disabled Veteran-Owned Small Business set-aside in accordance with VA Acquisition Regulation (VAAR) 852.219-10, Limitations on Subcontracting – Monitoring and Compliance applies in accordance with VAAR 852.219-74. To demonstrate compliance please complete this worksheet and submit with quote. The Contracting Officer may ask questions about responses on this form. Any such questions will be communications related to responsibility; it will not be considered discussions.
Vendors are required to complete this Worksheet and submit with quote.
a) Quoter’s total proposed price (should be same amount shown in price worksheet for the total): $_______________
b) Total amount to be paid to subcontractors (non-SDVOSBs): $_______________
c) The difference of the amount shown in a) minus the amount shown in b): $_____________
List of intended subcontractors for this project and the value of those subcontracts:
| Company | DUNS | Amount | ||
| ________________________________ | ____________ | _$_____________ | ||
| ________________________________ | ____________ | _$_____________ |
List of “Self-Performed” work activities by the SDVOSB (this should be consistent with the response in the technical evaluation factor):
List of subcontracted work activities:
Include executed copies of your subcontract(s) with this worksheet.
File details come from the government source that posted it. Updated .