2027-183_Attachment_A_First-Tier_Subcontractor_List.pdf

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Attached to
DNR RFB Tamarac River Channel Dredging
Solicitation number
2000018629
Issued by
Beltrami County, Minnesota

About this file

This is a First-Tier Subcontractors List form submitted to the Minnesota Department of Natural Resources for Project 2027-183, the Tamarac River Channel Dredging project. The project involves the mechanical removal of sand deposits from the mouth of the Tamarac River at Upper Red Lake, with material disposal at a site approximately 1.7 miles from the project location. The work scope includes creating a channel approximately 750 feet long by 30 feet wide and 4 feet deep, removing an estimated 1,300 cubic yards of material. The project is located at Latitude 48°9'19.45"N, Longitude 94°30'48.81"W. Site visits may be arranged by contacting Lance Crandall, Project Supervisor, at (218) 732-8452 x238 or lance.d.crandall@state.mn.us. All bids must be submitted electronically through the Swift Portal, with no email or faxed responses accepted.

This form requires prime contractors to disclose all first-tier subcontractors prior to contract execution and certify under oath that subcontractors meet minimum responsible contractor criteria as defined in Minnesota Statute 16C.285. The form requests identification of subcontractor legal names, home office city locations, specific tasks and materials to be provided, dollar amounts for subcontracted work, and whether subcontractors are certified as Targeted Group Businesses, Economically Disadvantaged Businesses, or Veteran-Owned Businesses. Prime contractors must maintain signed verifications of compliance from all subcontractors of any tier and motor carriers, which must be provided to the contracting authority upon request. Additional sheets may be attached as needed if multiple subcontractors are utilized, or "NONE" should be indicated if no subcontractors will be used.

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ATTACHMENT A

FIRST-TIER SUBCONTRACTORS LIST

THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION

PROJECT NUMBER: 2027-183

PROJECT NAME: Tamarac River Channel Dredging

Indicate “NONE” on the table below if no subcontractors will be used.

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

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?

File details come from the government source that posted it. Updated .