VENDORS PERFORMANCE WORKSHEET.docx
DOCX document 14 KB Posted
- Solicitation number
- 36C26123Q0374
About this file
This document contains a vendor self-performance worksheet for a service-disabled veteran-owned small business set-aside contract. The worksheet requires vendors to list the total proposed price for the contract, the total amount that will be paid to any non-SDVOSB subcontractors, and the difference between the two amounts. Vendors must also provide the names, DUNS numbers, and values of any intended subcontractors, as well as a list of work activities that will be self-performed by the SDVOSB vendor.
The related federal contract opportunity is a solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21 for medical gas inspection and maintenance services. The solicitation number is 36C26123Q0374 and was amended on May 8, 2023.
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VENDOR’s 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 .