100343_13_First_Tier_Subs_Disclosure_Fillable.pdf

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Attached to
100343 - Century Blvd. Extension - SE Lois Street to E Main Street
Solicitation number
2026.013-LUT CPS
Issued by
Washington County, Oregon

About this file

This is a First-Tier Subcontractors Disclosure Form for Washington County, Oregon's Department of Land Use & Transportation related to the Century Boulevard Extension project (Project #100343), extending from SE Lois Street to E Main Street, with Bid #2026.013-LUT CPS. The form requires prime contractors to disclose all first-tier subcontractors subject to Oregon requirements within two work hours after the bid deadline. Subcontractors must be listed with their names, addresses, dollar values, and categories of work to be performed. The form must be submitted electronically through the OpenGov Procurement system either with the bid or through a second linked solicitation activated after bid opening. Failure to submit the completed disclosure form by the deadline will result in a non-responsive bid that will not be considered for award. If no subcontractors meeting the specified requirements are utilized on the project, contractors must indicate "NONE" on the form and submit it accordingly.

The form itself is a fillable template containing fields for the bid closing date and time, prime contractor contact information, and multiple rows for subcontractor details. The document provides space for up to five subcontractor entries with corresponding dollar values and work categories. This disclosure requirement ensures transparency in the subcontracting process and allows the contracting agency to monitor compliance with applicable regulations and utilization tracking requirements through the Certified Business utilization tracking system at washcopurch.mwdbe.com.

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Text version

Century Blvd. Extension 1-5 Project # 100343 SE Lois Street to E Main Street Bid # 2026.013-LUT CPS

Page of

1.30 FIRST-TIER SUBCONTRACTORS DISCLOSURE FORM

Project Name: Century Blvd. Extension - SE Lois Street to E Main Street Project No. 100343 Bid No. 2026.013-LUT CPS

Bid Closing Date: ___________________________________________________ Bid Closing Time: ___________________________________

Prime Contractor:______________________________________ Contact Name:______________________ Phone No.:______________________

Subcontractor Name and Address

Dollar Value Category of Work to be

Performed by Subcontractor

• Submit this form electronically (on OpenGov Procurement) with the Bid, or on a second, linked solicitation that will be activated after the bid opening. Make additional copies if necessary. Email submissions will not be accepted.

• This list is to be completed and submitted no later than two work hours after the time bids are due.

• If subcontractors subject to the requirement of subsection 00120.40(f) are not used in this project, indicate “NONE” on this form and submit.

Failure to submit this form by the disclosure deadline will result in a non-responsive bid. A non-responsive bid will not be considered for award.

(11/2021)

☐ NONE

Check this box if no subcontractors meeting the requirements of 00120.40(f) will be used on this project.

Page:
Bid Closing Date:
Bid Closing Time:
Prime Contractor:
Contact Name:
Phone No:
Subcontractor Name and AddressRow1:
Dollar ValueRow1:
Category of Work to be Performed by SubcontractorRow1:
Subcontractor Name and AddressRow2:
Dollar ValueRow2:
Category of Work to be Performed by SubcontractorRow2:
Subcontractor Name and AddressRow3:
Dollar ValueRow3:
Category of Work to be Performed by SubcontractorRow3:
Subcontractor Name and AddressRow4:
Dollar ValueRow4:
Category of Work to be Performed by SubcontractorRow4:
Subcontractor Name and AddressRow5:
Dollar ValueRow5:
Category of Work to be Performed by SubcontractorRow5:
#Pages:
Check Box1: Off

File details come from the government source that posted it. Updated .