2027-147_Contractor_Detail_Verification.pdf
PDF 154 KB Posted
- Attached to
- DNR RFB WOB Riverway Lift Station VFD Upgrade
- Solicitation number
- 2000018550
- Issued by
- Washington County, Minnesota
About this file
This is a Contractor Detail Verification form issued by the Minnesota Department of Natural Resources (DNR) Regional Services for Solicitation #2027-147, the WOB Riverway Lift Station VFD Upgrade project located in Washington County near Marine on St. Croix. The project involves replacing the existing lift station control panel and internal components, including two pumps, flanges, and elbows, with new components equipped with variable-frequency drive (VFD) capabilities at William O'Brien State Park. Contractors must submit responses electronically through the Swift Portal, with all required attachments reviewed for compliance. A site visit can be arranged by contacting Project Supervisor Nikki Franke at 651-259-5773. The State reserves the right to award items separately, by grouping, or by total, whichever is deemed most advantageous, and will award to the lowest responsible vendor meeting all specifications and terms.
The Contractor Detail Verification form requires bidders to provide their company name, specify the number of trades or occupations utilized if the contract is under $25,000, disclose whether subcontractors will be employed with corresponding percentage of contract value, and confirm Minnesota Workers' Compensation Insurance status or claim qualifying exemptions under MN Statute 176.041. Unit pricing must be all-inclusive, covering labor, materials, tools, transportation, equipment, sales tax, use tax, and all other costs necessary for project completion. Contractors must certify that any changes in Workers' Compensation status will be reported and that all information provided is accurate and truthful. The form requires contractor signature, title, and date, with notification that falsification of any facts constitutes grounds for contract forfeiture.
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Other files
| File | Type | Posted |
|---|---|---|
| DNR_RFB_WOB_Riverway_Lift_Station_VFD_Upgrade.pdf | ||
| 2027-147_Specifications.pdf |
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Text version
DNR Regional Services Solicitation # 2027-147
Email: christine.eck@state.mn.us
CONTRACTOR DETAIL VERIFICATION
Section A
Project Name: 2027-147 WOB Riverway Lift Station VFD Upgrade
Project Location: Washington County/Near Marine on St Croix
Contractor Name: ________________________________________________________________________
Complete this form and upload to the Event.
Section B.
If contract is under $25,000 -- Number of trades or occupations utilized? (numerical)
(Example of single trade: 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 % of value of contract Address & Phone number
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
CONTRACTOR DETAIL VERIFICATION
File details come from the government source that posted it. Updated .