2-BPM006653_List_of_Subcontractor (2).pdf

81 KB Posted

Attached to
Master Agreement AZ|CTR077153
Contract number
CTR077153
Issued by
Arizona

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This document is an Attachment for List of Subcontractors (Form BPM006653) issued by the Arizona Department of Transportation. The form is specifically designed for a contract related to Automotive Parts and Repair of Light Duty Vehicles. It provides a template for documenting potential subcontractors, with fields for subcontractor name, representative details, contact information, classification of work, licensing agency, and associated license numbers.

The document allows a bidder/offeror to indicate whether they will or will not use subcontractors for the automotive parts and repair work. If subcontractors are to be used, the form requires detailed information about each subcontractor, including their physical address, telephone number, email, work classification, licensing details, and APP (Arizona Procurement Portal) supplier number. The form emphasizes that any changes to subcontractors must receive prior written approval from the Procurement Officer, underscoring the importance of transparency and compliance in the subcontracting process.

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1 Rev. 11/2024

ATTACHMENT

LIST OF SUBCONTRACTORS

BPM006653

Automotive Parts and Repair of Light Duty Vehicles

Select one of the boxes below:

No. Subcontractor Name Representative Name Title/Role Email Address Classification of Work Licensing Agency 1.

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Bidder/Offeror WILL NOT subcontract portions of work to subcontractors. All work will be carried out by the bidder/offerors own personnel. Bidder/Offeror WILL NOT subcontract portions of work to subcontractors. All work will be carried out by the bidder/offerors own personnel. Bidder/Offeror Bidder/Offeror WILL subcontract portions of work to subcontractors. Bidder/Offeror WILL subcontract portions of work to subcontractors. Bidder/Offeror WILL subcontract portions of work to subcontractors.

Identify all subcontractors. There shall be no change of subcontractor(s) identified on this Attachment without prior written approval from the Procurement Officer.

License No.: Any applicable license, permit, registration or certification number required by law to perform services indicated. APP No.: The Arizona Procurement Portal (APP) eProcurement System supplier number. License No.: Any applicable license, permit, registration or certification number required by law to perform services indicated. APP No.: The Arizona Procurement Portal (APP) eProcurement System supplier number. License No.: Any applicable license, permit, registration or certification number required by law to perform services indicated. APP No.: The Arizona Procurement Portal (APP) eProcurement System supplier number.

Phyiscal Address Telephone

Number License

Number(s) APP Supplier

Number

Subcontractors

Check Box 1: Yes
Check Box 2: Off

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