15._CCHCS-MC-393-_SB_Sub_Supplier_Ack..pdf

PDF 78 KB Posted

Attached to
Electrocardiograph (ECG) Equipment and Cardiologist Over-Read and Interpretation Services SD23-00094
Solicitation number
0000033006
Issued by
California

About this file

This document is a Small Business Subcontractor/Supplier Acknowledgement for a California Department of Corrections and Rehabilitation/California Correctional Health Care Services agreement, Proposal Number SD23-00094. The document confirms that the proposed subcontractor/supplier has committed to provide a percentage of the total bid/cost proposal price submitted by the bidding firm and has agreed to provide specific subcontracted services/labor or supplies under the resulting contract. The subcontractor/supplier acknowledges their responsibility to contact the bidding firm to learn if they were awarded the contract and to confirm the subcontract agreement. If the bidding firm receives an award based in part on non-small business subcontractor preference, they are obligated to use each small and/or microbusiness subcontractor or supplier identified in the proposal, unless a subcontractor substitution is requested after contract execution.

The document outlines pricing and set-aside requirements, stating that if the bidding firm receives an award based in part on non-small business subcontractor preference, they are obligated to use each small and/or microbusiness subcontractor or supplier identified in the proposal. No other details are provided regarding pricing, funding, or the current contracting environment.

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Text version

Proposal Number: SD23-00094

CCHCS-MC-393 – Small Business Subcontractor/Supplier Acknowledgement Rev. 04/05/2018

Small Business Subcontractor/Supplier Acknowledgement

Name of Bidding Firm/Prime Contractor

Total Dollar Value of Subcontractor Use

This document confirms and acknowledges that the firm named below agreed to be identified by a bidding firm as a proposed small business or microbusiness subcontractor or supplier for a California Department of Corrections and Rehabilitation/California Correctional Health Care Services agreement.

Subcontractor acknowledgements:

a. The subcontracting firm named herein has committed to perform or provide services/labor or supplies equal to a percentage of the total bid/cost proposal price submitted by the bidding firm named above.

b. The subcontracting firm named herein acknowledges the total dollar value of claimed participation identified above.

c. The subcontracting firm named herein agrees to provide the following subcontracted services/labor or supplies under the resulting contract if the bidding firm named above receives the contract award:

Below and/or continued on an attachment is a brief description of the commercially useful function(s) that the subcontractor/supplier identified herein will provide or supply:

The subcontracting firm named herein understands it is its sole responsibility to contact the bidding firm named above to learn if the proposer was awarded the contract pursuant to the referenced bid number and to confirm its subcontract agreement. If the bidding firm named above receives an award based in part on non-small business subcontractor preference, the bidding firm/contractor is obligated to use each small and/or microbusiness subcontractor or supplier identified in its proposal unless a subcontractor substitution is requested after contract execution pursuant to Public Contract Code Section 4107 and California Code of Regulations, Title 2, Section 1896.10.

The person signing below certifies the information supplied on this form is true and accurate to the best of their knowledge and agrees to allow the State to confirm this information, if deemed necessary.

Name of Proposed Subcontractor/Supplier Date Signed

Signature of Subcontractor/Supplier Representative

Telephone Number Email Address (if applicable)

Printed/Typed Name Title

For State Use Only

Information Verified by Date

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