Attachment_IV_Consent_Form.pdf

ATTACHMENT IV – CONSENT FORM

SPE603-18-R-0512

Osan AB, Korea; Kadena AB, Japan; and Misawa AB, Japan

PAST PERFORMANCE INFORMATION DISCLOSURE CONSENT FORM

Joint Venture Partner/Subcontractor/Teaming Partner Consent Form for the Release of Present and Past Performance Information to the Prime Contractor.

Present and Past Performance Information concerning joint venture partners cannot be disclosed to a private party without the teaming joint venture partner’s consent. Because a prime contractor is a private party, the Government will need that consent before disclosing joint venture/teaming partner’s Past Performance Information to the prime during discussions. DLA Energy requests that the following consent form be completed by the joint venture partners/major subcontractors/teaming partners identified in your proposal. The completed consent forms should be submitted as part of your Past Performance Information.

SAMPLE:

Dear Ms. Smith:

We are currently participating as a joint venture partner with (prime contractor or name of entity providing proposal) in responding to the Defense Logistics Agency (DLA) Energy solicitation for the operation and maintenance of the fuel facilities at Osan AB, Korea; Kadena AB, Japan; and Misawa AB, Japan under Request for Proposal Solicitation No. SPE603-18-R-0512.

We understand the Government is placing increased emphasis on Present and Past Performance in order to obtain best value in source selections. In order to facilitate the past performance evaluation process, we are signing this consent form to allow you to discuss our Present and Past Performance Information with the prime contractor during the source selection process.

John Q. Hancock John Q. Hancock President, Contractor Inc.

(Signature and title of individual possessing the authority to sign for and legally bind the company)

Company Name:

Address: