1-Radiation Equipment Maintenance, Repair, and Calibration - BPM007426 Attachment _639104629281634591.pdf
PDF 133 KB Posted
- Solicitation number
- BPM007426
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This attachment is a subcontractor disclosure form for Invitation for Bid No. BPM007426 issued by the Arizona Department of Health Services for radiation equipment maintenance, repair, and calibration services. The form requires bidders to declare whether they will perform all work with their own personnel or utilize subcontractors. Bidders electing to use subcontractors must list each proposed subcontractor's name and contact information, identify the type of work to be performed, specify the approximate percentage of total contract work, and indicate whether the subcontractor qualifies as a small business. The work will be performed at 4814 South 40th Street, Phoenix, Arizona 85048, with on-site maintenance and repairs to be conducted with BRC staff accompaniment as needed for current and future radiation detection equipment.
Bidders proposing subcontractors must provide copies of relevant certifications for each subcontractor and submit a detailed description of quality assurance and quality control measures to ensure the subcontractor's work meets contract requirements. The form contains five numbered rows for subcontractor information and allows bidders to indicate "NO" if they will not subcontract any portion of the work. The state reserves the right to demand additional information about proposed subcontractors as a precondition of award. This form serves as a critical submission component in the competitive bidding process for this maintenance and calibration services contract.
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Text version
ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 North 18th Avenue, Suite 530 Phoenix, AZ 85007
ATTACHM
ENT
Proposed Sub-Contractors
INVITATION FOR BID No.: BPM00
Radiation Equipment Maintenance, Repair and Calibration
Contractor Name: [Name]
Check “NO” if you WILL NOT subcontract any portion of the Work and will therefore be performing all of the Work with your own personnel.
NO, the Offeror will not subcontract any portion of the Work.
If you WILL subcontract any portion of the Work, check “YES” below and list the name(s) of persons or companies you propose to use as Subcontractors.
1. Fill in the information for each significant Subcontractor – indicate the type of work the Subcontractor will perform under the Contract and their approximate percentage of the total Contract work;
2. Provide copies of relevant certifications each person or firm possesses attached to this form; AND
3. Provide a description of quality assurance (QA) and quality control (QC) measures that you will use to ensure that
Subcontractor’s work meets the Contract requirements.
State may demand additional information about proposed Subcontractors as a precondition of Award.
YES, the Offeror will use the Subcontractors listed below:
No. Name and contact information Small busines s
Work to be performed and QA/QC measures %
1. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
2. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
3. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
4. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
5. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
Admin Typewritten Text X
Admin Typewritten Text
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