S02-EXHIBIT C SUBCONTRACTOR INFORMATION AND CONSENT v2.pdf

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Attached to
Z2DA--CFM - Rebalance HVAC System Federal contract opportunity
Solicitation number
Not on record
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 a prime contractor to discuss their past performance as part of a proposal for solicitation number 36C25620R0099. The related federal contract opportunity is to rebalance the HVAC system at a Veterans Affairs medical center under solicitation number Z2DA--CFM, issued by Veterans Integrated Service Network 16 on behalf of the Department of Veterans Affairs. The form requires the subcontractor's name, signature, and contact information as well as a list of at least three references including the contract number, role, work performed, and point of contact details for each. Upon signing, the subcontractor consents to the prime contractor discussing their past and present performance with the government during the source selection process for this HVAC rebalancing project.

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Text version

FOR OFFICIAL USE ONLY

Source Selection Sensitive Information—See FAR 2.101 & 3.104

Project 629-20-106 – Rebalance HVAC System 36C25620R0099

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. 36C25620R0099 for Project 629-20-106 -Rebalance HVAC

System.

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 Name Phone: Fax:

Email address:

2. Contract No. And Title:

3. Contract No. And Title:

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