3-Responsible Contractor Act Verification Form.pdf

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

About this file

This is a Responsible Contractor Act Verification Form required by the State of Minnesota for the RPS Grease Interceptor Replacements project. The form certifies that the bidding company complies with the minimum criteria established in Minnesota Statutes 16C.285, subdivision 3. The document requires the company owner or officer to identify all first-tier subcontractors that have been retained for the project and confirm that those subcontractors have provided required compliance verification. For any first-tier subcontractors not yet determined at the time of bid submission, the company must commit to obtaining and submitting signed verifications from each subsequently retained subcontractor within 14 days of retention to ensure compliance with the applicable Minnesota statute.

The form must be completed, dated, and signed by an authorized company owner or officer, then notarized. This verification requirement is a mandatory compliance document for state and local contract bidding in Minnesota and does not address pricing, set-asides, or other contract-specific financial terms. The form serves as a pre-qualification assurance mechanism to ensure that contractors and their subcontractors meet established responsibility standards before contract award.

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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 .