1-Subcontractor Listing Form.pdf

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Attached to
ITB - Reflective Sign Making Sheeting and Related Items for Harris County Precinct 1
Solicitation number
25/0247
Issued by
Harris County, Texas

About this file

This document is a Subcontractor Listing Form for Harris County, designed to capture detailed information about potential subcontractors, subconsultants, professionals, suppliers, and vendors for a specific project. The form requires contractors to provide comprehensive details for each proposed subcontractor, including company name, industry, DUNS number, name of principal, approximate contract value, contract duration, and certification status for HUB/MWBE and Section 3 programs.

The form mandates that contractors verify the eligibility of subcontractors by checking state, local, and federal debarment lists and obtaining necessary licenses for specialized work. Harris County reserves the right to reject proposed subcontractors on reasonable grounds and must approve all subcontractors prior to their engagement. Contractors are responsible for ensuring subcontractors are properly licensed, insured, and authorized to work under government contracts. A final Subcontractor Listing Form is required before contract award, and any changes to subcontractor information during the contract term must be submitted to the county for approval.

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Text version

SUBCONTRACTOR LISTING FORM

Contractor must provide information below for any potential subcontractors or subconsultants, professionals, suppliers, and vendors used in connection with the project. The County reserves the right to reject proposed subcontractors or subconsultants on any reasonable basis. Harris County must approve the actual subcontractors prior to their use (add additional pages if necessary):

Company Name:_______________________________ Industry: ______________________________________

DUNS #: _____________________________________Name of Principal: ______________________________

Approximate Contract Value $____________________ Start & End of Contract __________________________

Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No

Description of Work to be performed:

Company Name:_______________________________ Industry: ______________________________________

DUNS #: _____________________________________Name of Principal: ______________________________

Approximate Contract Value $____________________ Start & End of Contract __________________________

Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No

Description of Work to be performed:

Company Name:_______________________________ Industry: ______________________________________

DUNS #: _____________________________________Name of Principal: ______________________________

Approximate Contract Value $____________________ Start & End of Contract __________________________

Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No

Description of Work to be performed:

Contractor shall be responsible for ensuring any Subcontractors used are properly licensed, insured, and authorized to work under government contracts by checking state, local, and federal debarment lists and shall obtain and submit licenses for any subcontractors if the work being performed requires licensing in accordance with state or federal law. A final

Subcontractor Listing Form will be required prior to contract award. If any of the required information changes throughout the term of the contract, Contractor must submit a revision to the County for approval.

☐ I will not be subcontracting any portion of the contract and will be fulfilling the entire contract with my own resources.

Signature of Contractor:

Print Name:

Company Name:
Industry:
DUNS:
Name of Principal:
Approximate Contract Value:
Start End of Contract:
Certified HUB MWBE: Off
Description of Work to be performed 1:
Description of Work to be performed 2:
Description of Work to be performed 3:
Company Name_2:
Industry_2:
DUNS_2:
Name of Principal_2:
Approximate Contract Value_2:
Start End of Contract_2:
Certified HUB MWBE_2: Off
Description of Work to be performed 1_2:
Description of Work to be performed 2_2:
Company Name_3:
Industry_3:
DUNS_3:
Name of Principal_3:
Approximate Contract Value_3:
Start End of Contract_3:
Certified HUB MWBE_3: Off
Description of Work to be performed 1_3:
Description of Work to be performed 2_3:
I will not be subcontracting any portion of the contract and will be fulfilling the entire contract with my own: Off
Print Name:

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