2024-748_Contractor_Detail_Verification.pdf
PDF 435 KB Posted
- Solicitation number
- 2000015717
- Issued by
- Kandiyohi County, Minnesota
About this file
This document is a Contractor Detail Verification form related to a state contract solicitation from the Minnesota Department of Natural Resources (DNR) for the Sibley State Park Mount Tom Monument Stairs Replacement project located in Kandiyohi County, Minnesota. The project requires the demolition and rebuilding of the existing stairs at the Mount Tom Monument within Sibley State Park. Contractors must complete this form and return it to the DNR Regional Business Office Contract Administrator before a notice to proceed or any payments can be processed. The form gathers information on the number of trades or occupations utilized, whether subcontractors will be used, and the contractor's Minnesota workers' compensation insurance status. Bids must be submitted electronically through the Swift Portal, and the award will be made to the lowest responsible vendor meeting the specifications and all terms and conditions. The state reserves the right to award items separately, by grouping items, or by total, whichever is deemed most advantageous.
The solicitation requires unit pricing to include all costs such as labor, materials, tools, transportation, equipment, sales tax, and use tax necessary for project completion. A Direct Pay Permit 1114 does not apply to this project. Contractors needing assistance with registration or completing their response can contact the Contractor Assistance Help Desk. All questions should be directed to the buyer listed in the event.
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Other files
| File | Type | Posted |
|---|---|---|
| 2024-748_Specifications.pdf | ||
| DNR_RFB_Sibley_Mt_Tom_Monument_Stairs_Replacement.pdf |
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Text version
DNR Business Office Solicitation # 2024-748
2115 Birchmont Beach Rd NE Bemidji, MN 56601
CONTRACTOR DETAIL VERIFICATION
Section A
Project Name: Sibley State Park Mount Tom Monument Stairs Replacement
Project Location: Kandiyohi County/Near New London
Contractor Name: ________________________________________________________________________
Complete this form and return to the Regional Business Office Contract Administrator.
No notice to proceed or payments will be processed without receipt of form.
Section B.
If contract is under $25,000 -- Number of trades or occupations utilized?
(Example: Laborer, Excavator Operator, Truck Driver, Electrician, Cement Mason, Plumber, Roofer)
Section C.
Will subcontractors be utilized on this project?
Yes No If subcontractors will be utilized, please list below. Any change requires an updated form.
Subcontractor Name/Company Address and Phone #
Section D.
I do have employees in the State of Minnesota.
Yes No I do have employees in the State of Minnesota, but I claim exemption from Workers’ Compensation Insurance requirements. You must list the qualifying exemption under MN Statute 176.041 that excludes you from Minnesota Workers’ Compensation requirements. _________________________________________________
I agree if during the course of the contract there is a change in Workers’ Compensation status, I will comply with the Workers’ Compensation Insurance requirements & provide the State of Minnesota, Dept of Natural Resources a certificate of insurance.
I understand that falsification, in any way, of the facts or conditions I have represented herein constitutes a false statement for which penalties under the law apply and which will be just cause for forfeit of contract. (Any change requires an updated form.)
Signature of Contractor Title Date
File details come from the government source that posted it. Updated .