Subcontractor-Consent-Form.doc

SUBCONTRACTOR INFORMATION AND CONSENT FORM

Subcontractor and/or Teaming Partner Consent for the Release of Past Performance Information to the Prime Contractor and Reference Information

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

___________________(Name of Firm) is currently planning on participating as a (subcontractor and or a teaming partner) with ___________________(prime contractor or name of entity providing proposal) in responding to the W91QEX-19-R-0003 Consolidated Facility Operations and Maintenance Services issued by the 410th Contracting Support Brigade/Regional Contracting Office Miami located at 9301 NW 33rd street, Doral, FL 33172.

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: ________________________

Telephone #____________________

Address:

City/State/Zip Code:______________________ Date:_____________________

Reference List (required):

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___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

3. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

4. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

5. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

6. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

7. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________

8. Contract No. And Title___________________________________________________________

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

Reference POC Name____________________________ Phone___________ Fax____________

Email address: _________________________________________________________________