S02 SOL-Att-06 Sub-Contractor Info Consent.pdf

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Attached to
Z1DA--Multiple Award Task Order Contract 695-23-109 Clement J. Zablocki VA Medical Center
Solicitation number
36C25223R0071
Issued by

About this file

This document contains a template for a subcontractor information and consent form related to a Multiple Award Task Order Contract (MATOC) solicitation issued by the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12.

The template requests that major subcontractors and teaming partners planning to participate with a prime contractor on the MATOC complete the form to consent to the release of their past performance information and references to the prime contractor during the source selection process. The form requires the subcontractor's signature, contact information, and a list of at least three references from previous contracts where the subcontractor served as either a prime contractor or subcontractor. Written references from second-tier subcontractors may also be included. Each major subcontractor and teaming partner must complete this form to be considered for the MATOC.

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Multiple Award Task Order Contract (MATOC) 36C25223R0071

SOURCE SELECTION SENSITIVE Page 1 of 2 36C25223R0071 Attachment 6

FAR 2.101 & 3.104-5

ATTACHMENT 6

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 this 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.

SAMPLE FORM:

__________________________(Company name of Subcontractor or Teaming Partner) is currently planning on participating as a (Subcontractor or a Teaming Partner) with ____________________________ (prime contractor or name of entity providing proposal) for the Department of Veterans Affairs RFP Multiple Award Task Order Contract (MATOC) Solicitation 36C25223R0071.

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.

(Signature) / (Date) (Title of Individual with authority to sign for and legally bind the company)

Company Name: _____________________ Telephone #____________________

Address: ___________________________________________________________

Multiple Award Task Order Contract (MATOC) 36C25223R0071

SOURCE SELECTION SENSITIVE Page 2 of 2 36C25223R0071 Attachment 6

FAR 2.101 & 3.104-5

Reference List (required and not to be from proposing prime contractor):

1. Contract No. __________________________________________________

Project No. and Title: ___________________________________________

Describe your role (Prime/Sub) and work Performed __________________

Reference POC Name_______________________ Phone_______________ Fax____________ Email address: ________________________________

2. Contract No. __________________________________________________

Describe your role (Prime/Sub) and work Performed __________________

3. Contract No. __________________________________________________

Describe your role (Prime/Sub) and work Performed __________________

Each major subcontractor and or Teaming Partner must complete the “Subcontractor Information and Consent Form” to be considered. Offerors shall have major subcontractors identify at a minimum three (3) references, owners (if they were the Prime) or other Prime contractors they have worked for. References for subcontractors from the proposing offeror are not acceptable. Written references for subcontractors and 2nd tier subcontractors may be included and are encouraged.

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