1-Subcontractor Listing Form.pdf

PDF 140 KB Posted

Attached to
ITB - Supply of Native Seeds and Related Items for the Harris County Flood Control District
Solicitation number
25/0397
Issued by
Harris County, Texas

About this file

This is a Subcontractor Listing Form required by Harris County Flood Control District for the Invitation to Bid (ITB) regarding the Supply of Native Seeds and Related Items. The form must be completed by the prime contractor to identify all potential subcontractors, subconsultants, professionals, suppliers, and vendors involved in the project. The form requests detailed information for each subcontractor, including company name, industry classification, DUNS number, principal contact name, approximate contract value, contract start and end dates, and a description of work to be performed. Contractors have the option to indicate if they will not be subcontracting any portion of the contract and will fulfill the entire contract with their own resources.

Harris County reserves the right to reject any proposed subcontractors on any reasonable basis and must provide approval of actual subcontractors prior to their use on the project. The contractor is responsible for ensuring all subcontractors are properly licensed, insured, and authorized to work under government contracts, including verification through state, local, and federal debarment lists and submission of required licenses where applicable. The form requires certification status documentation, specifically whether subcontractors are Certified HUB/MWBE (Historically Underutilized Business/Minority Women Business Enterprise) or Certified Section 3 entities. A final, completed Subcontractor Listing Form must be submitted prior to contract award, and the contractor must submit revisions to the County for approval if any required information changes throughout the contract term.

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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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