2026-897_Attachment_A___A1_forms.pdf
PDF 645 KB Posted
- Solicitation number
- 2000018251
- Issued by
- St. Louis County, Minnesota
About this file
This is a First-Tier Subcontractors List form (Attachment A) and Additional Subcontractors List form (Attachment A-1) for the Minnesota Department of Natural Resources, related to Project 2026-897 for St. Louis County Greywacke Bedrock Observation Well Drilling. The project involves the installation and completion of up to two groundwater environmental wells using air-driven/air hammer drilling methods in Southern St. Louis County. The prime contractor must list all first-tier subcontractors and suppliers prior to contract execution, including their legal names, home office locations, tasks to be performed, dollar amounts, and whether they are certified Targeted Group Businesses, Economically Disadvantaged Businesses, or Veteran-Owned Businesses. Any additional subcontractors retained after initial submission must be reported within 14 days using Attachment A-1. The contractor must be registered and licensed with the Minnesota Department of Health as a Well Contractor.
The forms require certification by an owner or officer of the prime contractor that all subcontractors meet the minimum criteria to be responsible contractors as defined in Minnesota Statute 16C.285. All subcontractors must provide signed verifications of compliance under oath. Upon request by the contracting authority, the prime contractor must submit copies of signed verifications from all subcontractors of any tier and motor carriers. The forms emphasize strict adherence to subcontractor documentation and notification requirements to ensure compliance with state contracting regulations and responsible contractor standards.
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Other files
| File | Type | Posted |
|---|---|---|
| 2026-897_Specifications___Terms.pdf | ||
| Workforce_and_Declaration_Response_Form.pdf | ||
| 2026-897_SOLICITATION_BOND.pdf | ||
| 2026-897_Prime_Response_Form.pdf | ||
| DNR_RFB_St_Louis_Co_Greywacke_Bedrock_Obwell_Drill.pdf | ||
| 2026-897_Price_Schedule.xlsx | XLSX spreadsheet |
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2026-897
PROJECT NAME St Louis Co Greywacke Bedrock Observation Well Drilling
Subcontractor/ Supplier Names (Legal name of company as registered with the Secretary of State)
Name of city where company home office is located
Tasks performed under this contract (Work/ Materials)
Dollar Amount *Is the
Subcontractor/Supplier 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
ATTACHMENT A-1
ADDITIONAL SUBCONTRACTORS LIST
SUBMIT WITHIN 14 DAYS OF RETAINING ADDITIONAL SUBCONTRACTORS DURING PROJECT
This form must be submitted to the Project Manager or individual as identified in the solicitation document.
PROJECT NUMBER 2026-897
PROJECT NAME St Louis Co Greywacke Bedrock Observation Well Drilling
Minn. Stat. § 16C.285, subd. 5. Subcontractor Verification. If a prime contractor or any subcontractor retains additional subcontractors on the project after submitting its verification of compliance, the prime contractor or subcontractor shall obtain verifications of compliance from each additional subcontractor with which it has a direct contractual relationship and shall submit a supplemental verification confirming compliance with subdivision 3, clause (7), within 14 days of retaining the additional subcontractors…
Subcontractor/ Supplier Names (Legal name of company as registered with the Secretary of State)
Name of city where company home office is located
Tasks performed under this contract (Work/ Materials)
Dollar Amount *Is the
Subcontractor/Supplier 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 additional subcontractors listed on Attachment A-1 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
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