Subcontractor Verification.doc

March 5, 2022 Contractor Point of Contact

Business Name

Address

Address

Subject:

Confirmation of Percentage of Work to be Performed by Contractor

Solicitation Number V36C24622Q0388_1 Dear Mr. John Doe, The VA Inspector General Office in a recent audit noted that there is no indication what percentage(%) of work is performed by subcontractors under VA contract. If subcontractors are being used, please complete the enclosed overview of contractor and subcontractor work and provide copies of the signed subcontractor agreements.

Please complete and return this overview to the undersigned via e-mail, If no subcontractors are utilized in performing services under this contract, complete the below certification and return this letter to the undersigned.

My employees perform 100% of the work required on this contract.

Signature

Date

Should you have questions regarding this request please contact the undersigned contracting officer.

Sincerely, Paul O. Waite Contracting Officer

Network Contract Office

Enclosure: Overview of Contractor and Subcontractor Work

Overview of Contractor and Subcontractor Work

Reference: Solicitation No. 36C24622Q0388_1 Title: Preventive Maintenance & repairs on Medical Gas and Vacuum Pump Systems with Hydrocarbon testing SDVOSB/VOSB Company:

Please provide the following information to identify and calculate the cost of the work that will be self-performed and what is subcontracted.

Clearly describe the work that will be self-performed and the work to be subcontracted. Description to include trade descriptions, equipment, equipment maintenance, percentage of personnel, percentage of supervision, etc, and work to be performed. For each subcontractor provide their business name, address, phone number, and DUNs Number if available.

Percentage of

Description of Work

Contractor Contract Services

Total percentage of work performed by (prime contractor)

Total percentage of work performed by subcontractors

Calculation of self-performed contract personnel costs:

1. Total personnel costs* both prime and all subcontractors: $____________________

2. Subtract all subcontractor personnel costs* that will perform work on this contract $_________________________

3. Remainder is ‘Total amount of work to be self-performed under the Contract’ $______________________

4. Self-performed work = Line 3/Line 1 X 100 = _____%

*personnel costs include laborers, mechanics, other tradesmen, and office personnel directly charged to the contract.

I certify the above representations are true and correct to the best of my knowledge.

(Contractor)

Date

Title