S02 SOL 0004 AttE Subcontractor Info Consent 585-21-115.pdf

SOURCE SELECTION SENSITIVE

FAR 2.101 & 3.104-5

Solicitation 36C25225R0004

Project 58521-115 Replace Boiler Plant

Attachment E – Subcontractor Info Consent Page 1 of 4

Solicitation Attachment E

Subcontractor or Teaming Partner Information and Consent Form

Subcontractor 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 this consent form be completed by the major subcontractors/teaming partners identified in your proposal.

Major subcontractors include:

1.) Mechanical, 2.) HVAC, 3.) Electrical, 4.) Earthwork, 5.) Structural & Miscellaneous Steel, 6.) Concrete, 7.) Utilities, 8.) Controls

Attachment E – Subcontractor Info Consent Page 2 of 4

SAMPLE FORM from SUBCONTRACTOR or TEAMING PARTNER:

__________________________(company name) is currently planning on participating as a

(Subcontractor or Teaming Partner) with ___________________________________________

(prime contractor or name of entity providing proposal) for the Department of Veterans Affairs

RFP 36C25225R0004 for Project 585-21115 Replace Boiler Plant.

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 as well as our recommended references as listed on the attachment.

Name Title of individual with authority to sign for and legally bind the company

Email Phone

Address of Record

** See listed attachments on following page(s) **

Attachment E – Subcontractor Info Consent Page 3 of 4

Reference List (required and not to be associated with prime contractor associated with this solicitation):

1. Contract # __________________________________________________________

Project # and Title: __________________________________________________________

Project Location: __________________________________________________________

Describe your role (Prime/Sub) work performed and value: __________________________

Reference POC Name______________________________ Phone_____________________

Email address: ______________________________________________________________

2. Contract # __________________________________________________________

Project Location: __________________________________________________________

Describe your role (Prime/Sub) work performed and value: __________________________

Attachment E – Subcontractor Info Consent Page 4 of 4

3. Contract # __________________________________________________________

Project Location: __________________________________________________________

Describe your role (Prime/Sub) work performed and value: __________________________

4. Contract # __________________________________________________________

Project Location: __________________________________________________________

Describe your role (Prime/Sub) work performed and value: __________________________

5. Contract # __________________________________________________________

Project Location: __________________________________________________________

Describe your role (Prime/Sub) work performed and value: __________________________