Attachment_21g_-_PPI_Part_5.pdf

ATTACHMENT # Solicitation #

Page 1 of 2 As of: 10.24.2011

Once this document has been completed, the information contained becomes Source Selection Sensitive in accordance with FAR

2.101 and 3.104.

PAST PERFORMANCE/EXPERIENCE INFORMATION (PPI) COLLECTION DOCUMENT – PART 5

PRINCIPAL SUBCONTRACTOR CONSENT FORM

The offeror is solely responsible for ensuring all Past Performance Information (PPI) Collection documents are completed and received by the Government by the solicitation closing time and date.

Section 1

OFFEROR TO COMPLETE THIS SECTION:

Offeror Firm Name:

Offeror Firm Address:

Offeror Firm DUNS:

Offeror Firm CAGE Code:

Offeror Firm’s Email:

Offeror Firm Phone:

Offeror Firm FAX:

We are in the process of preparing our proposal for the DLA Disposition Service’s Solicitation _________________________, closing time and date _______________________________ to provide _________________________________________ services at _____________________________________.

As part of our proposal, we have identified your firm, ______________________________________, as our principal subcontractor. In order to use your firm’s past performance information for the purpose of proposal evaluation your written consent is required. Request that you complete the consent form below and then either fax the completed document to: ATTENTION: ____________________, Contracting ______________, at __________________ (fax number), OR provide a scanned copy of the completed document to:

____________________, Contracting __________, at _________________________________ (email address).

The Government must receive the completed document no later than the solicitation closing time and date.

Thank you.

ATTACHMENT # Solicitation #

Page 2 of 2 As of: 10.24.2011

Once this document has been completed, the information contained becomes Source Selection Sensitive in accordance with FAR

2.101 and 3.104.

Section 2

PRINCIPAL SUBCONTRACTOR TO COMPLETE THE FOLLOWING:

Principal Subcontractor Name:

Principal Subcontractor Address:

Principal Subcontractor DUNS:

Principal Subcontractor CAGE Code:

Relative to DLA Disposition Services Solicitation No. ___________________, to provide _________________ services at ________________________, consent is granted authorizing the Government to use our firm’s Past Performance Information for evaluation purposes and to disclose negative Past Performance Information for our firm to the offeror identified in Section 1.

(Signature of individual authorized to sign for the Principal Subcontractor) (Date)

(Signature block of individual authorized to sign for the Principal Subcontractor)