EXHIBIT_B_-_Subcontractor_Experience_and_Consent_Form.pdf

SOLICITATION W911XK-16-R-0005

FY16 POE LOCK ELECTRICAL MODERNIZATION

EXHIBIT B

SUBCONTRACTOR EXPERIENCE INFORMATION AND CONSENT FORM

PART 1 - SUBCONTRACTOR/KEY PERSONNEL INFORMATION AND CONSENT FORM

For The Release of Past Performance Information To The Prime Contractor

Past performance information concerning subcontractors and independent personnel cannot be disclosed to a private party without the subcontractor/person’s consent. Because a prime contractor is a private party, the Government will need that consent before disclosing subcontractor past and present performance information to the prime during exchanges. In an effort to assist the Government in assessing your past performance relevancy and confidence, we request that the following consent form be completed by the major subcontractors identified in your proposal. The completed consent forms should be returned to the offering prime contractor for submission with subcontractor information in the proposal.

_____________________________(Name of Firm or Person) is currently planning on participating as a (subcontractor and or Key Personnel) with _______________________________(prime contractor or name of entity providing proposal) in responding to the Solicitation Number W911XK-16-R-0005 for the FY16 POE LOCK ELECTRICAL MODERNIZATION construction project(s) issued by the U.S. Army Corps of Engineers.

We understand that the Government is placing increased emphasis on past performance in order to obtain best value in source selections. In order to facilitate the performance confidence assessment process we are signing this consent form to allow you to discuss our past and present performance information with the prime contractor during the source selection process.

___________________________________________ Date: _________________________________ (Signature)

(Title of Individual with authority to sign for and Legally bind the company)

Company\ Name: __________________________________________ Telephone: _______________________

Address: ___________________________________________________________________________

City: _________________________________ State: ________ Zip Code:_________________

References (required contact for each project listed for subcontractor experience, and additional as desired):

1. Contract No. And Title_______________________________________________________________

Describe your role (Prime/Sub/Position) and work Performed ________________________________

Reference POC Name________________________________________ Phone__________________

Email address: _____________________________________________________________________

2. Contract No. And Title_______________________________________________________________

3. Contract No. And Title_______________________________________________________________

*** End of Part 1 – Consent Form ***

PART 2: SUBCONTRACTOR EXPERIENCE INFORMATION FORM

Prepare two (2) to three (3) for each company or individual who is to perform twenty (20) percent or more of the work on the project

Provide the following information requested in this format for each of the two to three projects/contracts being described. Projects may be on going and cannot have been completed any earlier than 6 years from the solicitation issue date. Provide frank, concise comments regarding YOUR PERFORMANCE on the contracts you identify. Use as much space as required.

A. Offeror (Your) Name (Company/Division):_______________________________________________

B. Project/Contract Title: _______________________________________________________________

C. Contract Specifics:

1. Role (Check One): ______ Prime Contractor or ______ Subcontractor

2. Project/Contract Identification Number: ______________________________________________

3. Project/Contract Name: ___________________________________________________________

4. Total Contract Value: $____________________(initial) $____________________(final)

If value changed from initial to final, primary reason for change:

5. Completion Date: _________________(planned) _________________(actual/ forecast)

If value changed from planned to actual, primary reason for change:

6. Primary cause for Contract Modifications:

D. Provide a detailed description of the work performed under the contract, to include but not limited to:

similarity of the construction methods; size; project scope; cost magnitude and complexity of work performed to those required for the proposed effort as described in Factor 1, Subfactor 1. Also discuss similarity of the client type and/or location at which work was performed to the location(s) at which work will be performed and the key personnel of the referenced project to the performance under the proposed contract.

In addition address the following

1. Describe the specific elements of the work performed by your firm.

2. Indicate what elements of work were performed by your major subcontractors and if those same subcontractors will be used on this project. If you intend to use these subcontractors please list name and principal areas of work they will perform.

3. Address any technical areas about this project you consider uniquely relevant to this project.

4. If you intend to use any of the same key personnel on this solicitation’s project indicate by name and position those personnel occupied on the referenced contract. (Project Manager, Site Superintendent, Quality Control Manager). Indicate what position they will have on this solicitation’s contract.

5. Describe why you believe the work is very relevant, relevant or semi-relevant to this solicited project. (see section 00120 for information.) (Use as much space as necessary)

E. List point of Contact for Owner/Government agency Contracting Officer and or inspector; include a current phone number and facsimile number. Email address is also desired.