Self Performance Worksheet.docx
DOCX document 14 KB Posted
- Attached to
- H168--Water Treatment Services (HVAC) | RFQ Posting due 05/01/2023 Federal contract opportunity
- Solicitation number
- 36C26123Q0403
About this file
This is a vendor self-performance worksheet for a service-disabled veteran-owned small business set-aside contract opportunity with the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21. The solicitation is for water treatment services (HVAC) with a response due date of May 1, 2023. Vendors must complete this worksheet and submit it with their quote to demonstrate compliance with limitations on subcontracting regulations. The worksheet requires vendors to provide their total proposed price, total amount to be paid to non-SDVOSB subcontractors, and the difference between the two amounts. Vendors must also list any intended subcontractors, associated DUNS numbers, and subcontract amounts. Additionally, vendors must specify any self-performed work activities and any subcontracted work activities.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| AMDT 36C26123Q0403 0004 Water Testing.pdf | ||
| 36C26123Q0403 0004_1.docx | DOCX document | |
| AMDT 36C26123Q0403 0003 Water Testing_.pdf | ||
| 36C26123Q0403 0003_1.docx | DOCX document | |
| ADMT_36C26123Q0403 0002_Water Testing.pdf | ||
| 36C26123Q0403 0002_1.docx | DOCX document | |
| 36C26123Q0403 0001_1.docx | DOCX document | |
| AMDT_36C26123Q0403 0001_Water Testing.pdf | ||
| WD2015_5631_REV18_Sacramento.pdf | ||
| WD2015_5655_REV17_Solano.pdf | ||
| S02 RFQ 36C26123Q0403 Water Testing.pdf | ||
| WD2015_5623_REV20_Contra Costa.pdf | ||
| 36C26123Q0403_1.docx | DOCX document |
Show all 13
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Text version
VENDOR 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) Vendor’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:
File details come from the government source that posted it. Updated .