3-Responsible Contractor Act Verification Form.pdf

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Attached to
RPS Grease Interceptor Replacements
Solicitation number
Bid #030326
Issued by
Olmsted County, Minnesota

About this file

This is a Responsible Contractor Act Verification Form for the State of Minnesota related to the RPS Grease Interceptor Replacements project. The form requires the undersigned owner or officer of a bidding company to certify compliance with the minimum criteria established in Minnesota Statute 16C.285, subdivision 3, as of the bid submission date. The document addresses first-tier subcontractors that the company intends to retain for work on the project, requiring that those subcontractors provide verification of their own compliance with the same statutory requirements. For any first-tier subcontractors not yet identified at the time of bid submission, the company commits to obtaining and submitting signed compliance verifications from each subsequently retained subcontractor within 14 days of retention.

The form functions as a certification mechanism to ensure contractor and subcontractor compliance with Minnesota's responsible contractor standards prior to award and execution of the RPS Grease Interceptor Replacements project, which involves the installation of a roof-mounted make-up air unit to serve an existing kitchen, including general, mechanical, and electrical work such as new steel framing, roof opening modifications, ductwork, diffusers, cabinet unit heater installation, and miscellaneous finishes. The verification must be notarized and submitted with the bid, establishing a foundational compliance requirement for all parties involved in the project delivery.

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RESPONSIBLE CONTRACTOR ACT VERIFICATION

The undersigned owner/officer of __________________________ (“Company”) hereby certifies that it complies with each of the minimum criteria in Minn. Stat. § 16C.285, subd. 3, as of the time of the submission of its bid for the above-referenced project (“Project”).

The first-tier Subcontractors that Company intends to retain for work on the Project are:

The first-tier Subcontractors listed above have provided verification required by Minn. Stat.§ 16C.285, subd. 3(7).

The remaining first-tier subcontractors that Company intends to retain for work on the Project have not yet been determined. Company will obtain and submit signed verifications from each of its subsequently retained subcontractors, confirming compliance with Minn. Stat. § 16C.285, subd. 3, within 14 days of retaining the subcontractors.

Dated: _______________________ Company: ______________________________

By:________________________________

Its: ________________________________ Owner/Officer

Subscribed and sworn to before me this__________ day of __________, 20__.

Notary Public

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