1-Subcontractor Listing Form.pdf
PDF 140 KB Posted
- Solicitation number
- 26/0135
- Issued by
- Harris County, Texas
About this file
This is a Subcontractor Listing Form for Harris County, Texas, used in conjunction with an Invitation to Bid (ITB) for Election ADA Ramps, Platform, Rails, and Other Related Items. The form requires the prime contractor to disclose all proposed subcontractors, subconsultants, professionals, suppliers, and vendors that will be utilized on the project. Contractors must provide detailed information for each proposed subcontractor, including company name, industry classification, DUNS number, principal contact name, approximate contract value, contract timeline, work description, and certifications. The form allows space for up to three subcontractors, though additional pages may be submitted if necessary. Harris County reserves the right to reject any proposed subcontractors on any reasonable basis and requires formal approval of all actual subcontractors prior to their engagement on the project.
Contractors are responsible for verifying that all subcontractors are properly licensed, insured, and authorized to perform government contract work, which includes checking state, local, and federal debarment lists and obtaining required licenses as mandated by state or federal law. The form includes a certification option for subcontractors holding HUB/MWBE (Historically Underutilized Business/Minority-Owned and Women-Owned Enterprise) or Section 3 certifications. A final Subcontractor Listing Form must be submitted prior to contract award, and any changes to subcontractor information throughout the contract term require written revision and County approval. Contractors also have the option to indicate that no subcontracting will occur and that they will fulfill the entire contract with their own resources.
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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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