EXHIBIT_B.pdf

Dispensary/Health Clinic and General Instruction Building RFP W912KN-15-R-0002

EXHIBIT B –INFORMATION AND CONSENT FORM

For Subcontractor, Teaming partners and/or potential key personnel

Past performance information concerning subcontractors and teaming partners and potential key personnel

(not currently employed by the proposing contractor) information cannot be disclosed to a private party without the subcontractor’s, teaming partners or potential key personnel consent. Because a prime contractor is a private party, the Government will need that consent before disclosing any 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, teaming partners or key personnel who are not currently employed by the prime, identified in your proposal. The completed consent forms should be submitted to the offering contractor for submission with the proposal. Additionally certain subcontractors or key personnel may be required to send off questionnaires to their references. The offering contractor will inform you if this is required. Your cooperation will be appreciated. (Note: Personnel proposed to fill key positions who ARE employed by the proposing contractor DO NOT need to complete this form.)

Your Letterhead

CONSENT FOR THE RELEASE OF PAST PERFORMANCE INFORMATION TO THE PRIME

CONTRACTOR AND REFERENCE INFORMATION

__________________ (Name of Firm/Name) is currently participating as a (subcontractor/teaming partner) or intents to fulfill a key position with (prime contractor or name of entity providing proposal) in responding to RFP W912KN-15-R-0002 Dispensary/Health Clinic and General Instruction Building. 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.

(Signature) (Title of Individual with authority to sign for and

Legally bind the company)

Company Name: ________________________

Address: ______________________________

City/State/Zip Code:______________________ Date:_____________________

Reference List (required): Reference cannot be from the contractor proposing on this solicitation.

1. Contract No. And Title___________________________________________________________

Describe your role (Prime/Sub) and work Performed ___________________________________

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

2. Contract No. And Title___________________________________________________________

3. Contract No. And Title___________________________________________________________