2027-392_Exhibit_A_Supplements_2_and_3.pdf
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- Attached to
- DNR RFB Peterson Hatchery Solar Thermal Repair
- Solicitation number
- 2000018789
- Issued by
- Fillmore County, Minnesota
About this file
These exhibit forms are subcontractor documentation requirements for Project 2027-392, the Peterson Hatchery Solar Thermal Repair, managed by the Minnesota Department of Natural Resources. Exhibit A, Supplement 2 requires the prime contractor to submit a First-Tier Subcontractors List prior to contract execution, identifying all first-tier subcontractors with their legal names, home office locations, percentage of contract value, and certification status as Targeted Group Businesses, Economically Disadvantaged Businesses, or Veteran-Owned Businesses. Exhibit A, Supplement 3 requires submission of an Additional Subcontractors List within 14 days of retaining any subcontractors during project performance. Both forms require certification by an owner or officer that all listed subcontractors have verified compliance with minimum responsible contractor criteria as defined in Minnesota Statutes 16C.285.
The prime contractor must ensure all subcontractors of any tier submit signed verifications of compliance and maintain documentation available for submission to the contracting authority upon request. The forms require the contractor to identify motor carriers if applicable and maintain compliance records for all subcontractors at any tier during the contract performance period. No specific pricing, set-asides, or contract term information is detailed in these subcontractor documentation exhibits.
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Text version
Rev. 03.12.2026
Exhibit A, Supplement 2
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2027-392
PROJECT NAME Peterson Hatchery Solar Thermal Repair
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
Rev. 03.12.2026
Exhibit A, Supplement 3
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.
See Minn. Stat. § 16C.285, subd. 5.
PROJECT NUMBER 2027-392
PROJECT NAME Peterson Hatchery Solar Thermal Repair
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 additional subcontractors listed above 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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