2025-536_Attachment_A-First_Tier_Subcontractors_List.pdf
PDF 84 KB Posted
- Attached to
- DNR_RFB Le Sueur County Cordova Observation Well
- Solicitation number
- 2000016589
- Issued by
- Lake of the Woods County, Minnesota
About this file
This is an Attachment A First-Tier Subcontractors List form for Le Sueur County's Cordova WMA Observation Well Drilling project (Project Number 2025-536). The form requires completion prior to contract execution and includes fields for listing subcontractor information including the legal company name as registered with the Secretary of State, city location of company home office, percentage value of contract, and whether the subcontractor qualifies as a TG/ED/VO (Certified Targeted Group Business, Economically Disadvantaged Business, or Veteran-Owned Business).
The form includes a certification statement requiring the owner or officer's signature confirming that all listed first-tier subcontractors have verified through signed statements under oath that they meet the minimum criteria to be a responsible contractor as defined in Minn. Stat. § 16C.285. The prime contractor must submit signed verifications of compliance from all subcontractors of any tier and motor carriers to the contracting authority upon request, pursuant to subdivision 3, clause (7).
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2025-536_Solicitation_Bond_Forms.pdf | ||
| 2025-536_Price_Schedule.xlsx | XLSX spreadsheet | |
| 2025-536_EVENT_Specifications_and_Terms.pdf | ||
| DNR_RFB_Le_Sueur_County_Cordova_Observation_Well.pdf |
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2025-536
PROJECT NAME Le Sueur County Cordova WMA Observation Well Drilling
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 .