4-Attachment C- Subcontracting.pdf
PDF 77 KB Posted
- Attached to
- EMPLOYEE HEALTH, DENTAL, AND VISION BENEFITS
- Solicitation number
- S26-014
- Issued by
- Williamson County, Texas
About this file
This is a Subcontractor Information Form for the City of Leander, Texas, associated with a solicitation for Employee Health, Dental, and Vision Benefits coverage. The form requires respondents to indicate whether they intend to use subcontractors on the contract and, if so, to provide detailed information for each subcontractor. Respondents must submit this form with their solicitation response by the deadline of Friday, August 19, 2026 at 2:00 p.m. CST. The underlying contract opportunity seeks fully insured Medical, Dental, and Vision Plans from a single provider for the benefit period of January 1, 2027 through December 31, 2027. The City of Leander clarified that it is not requesting the services of a consultant, agent, or broker; however, HUB International serves as the City's consultant and agent of record. Proposal documents are available through the City of Leander's Bonfire website.
The Subcontractor Information Form requires vendors to identify each subcontractor by name, contact information, email address, physical address, phone and fax numbers, a description of work to be performed, and the percentage of contract work allocated to that subcontractor. The form permits vendors to include multiple subcontractors by adding additional pages as necessary. This document serves as a transparency and accountability mechanism, ensuring that the City of Leander has visibility into the proposed subcontracting structure before contract award.
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Text version
ATTACHMENT C
SUBCONTRACTOR INFORMATION FORM
COMPLETE AND RETURN THIS FORM WITH THE SOLICITATION RESPONSE
SOLICITATION NUMBER:
RESPONDENT’S NAME: DATE:
CIRCLE ONE - NO, I WILL NOT USE SUBCONTRACTORS ON THIS CONTRACT NO
YES, I INTEND TO USE SUBCONTRACTORS ON THIS CONTRACT YES
If yes complete the information below
1. Subcontractor Name
Name of Contact
E-Mail Address
Address
City, State, Zip Code
Telephone Number Fax Number:
Describe work to be performed Percentage of contract work to be performed
2. Subcontractor Name
Name of Contact
Title of Contact
E-Mail Address
Address
City, State, Zip Code
Telephone Number Fax Number:
Describe work to be performed Percentage of contract work to be performed
Add additional pages as needed
| SOLICITATION NUMBER: |
| RESPONDENTS NAME: |
| DATE: |
| Subcontractor Name 1: |
| Subcontractor Name 2: |
| 1: |
| 2: |
| City State Zip Code: |
| undefined: |
| undefined_2: |
| Subcontractor Name 1_2: |
| Subcontractor Name 2_2: |
| Subcontractor Name 3: |
| Subcontractor Name 4: |
| Subcontractor Name 5: |
| City State Zip Code_2: |
| undefined_3: |
| Phone 1: |
| Fax 1: |
| Phone 2: |
| Fax 2: |
| %1: |
| %2: |
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