2025-133_Attachment_A.pdf
PDF 103 KB Posted
- Attached to
- DNR RFB Bohman Parking Lot Gravel & Grading
- Solicitation number
- 2000016177
- Issued by
- Lac Qui Parle County, Minnesota
About this file
This document is the First-Tier Subcontractors List, Attachment A, for Project Number 2025-133, the Bohman Parking Lot Gravel & Grading project. The form must be completed prior to contract execution and requires the listing of all first-tier subcontractors, including the legal name of the company, the city where the company's home office is located, the percentage of the contract value, and whether the first-tier subcontractor is a certified Targeted Group Business, Economically Disadvantaged Business, or Veteran-Owned Business.
The document also includes a certification that the prime contractor has verified that all listed first-tier subcontractors meet the minimum criteria to be a responsible contractor as defined in Minnesota Statute 16C.285. The prime contractor is required to submit copies of the signed verifications of compliance from all subcontractors of any tier and motor carriers upon request by the contracting authority.
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2025-133
PROJECT NAME Bohman Parking Lot Gravel & Grading
FIRST TIER SUBCONTRACTOR NAMES
(Legal name of company as registered with the Secretary of State) Name of city where company home office is located % of value of
Contract
*Is the First Tier Subcontractor a
TG/ED/VO?
Attach additional sheets as needed for submission of all first-tier subcontractors.
*TG/ED/ VO = Certified Targeted Group Business, Economically Disadvantaged Business, and Veteran-Owned Business
I certify by signing this form under oath that I am an owner or officer of the company, and that:
All first-tier subcontractors listed above have verified through a signed statement under oath by an owner or officer that they meet the minimum criteria to be a responsible contractor as defined in Minn. Stat. § 16C.285. A prime contractor shall submit to the contracting authority upon request copies of the signed verifications of compliance from all subcontractors of any tier and motor carriers, pursuant to subdivision 3, clause (7).
Authorized Signature of Owner or Officer Company Name
Print Name Date
Title
File details come from the government source that posted it. Updated .