4-Attachment D - Subcontractor Listing Form.pdf
PDF 101 KB Posted
- Solicitation number
- KJ02242026
- Issued by
- Harris County, Texas
About this file
This is a Subcontractor Listing Form required by Harris County for a Request for Offers (RFO) to provide Primary Care Services for HIV/AIDS Geriatric Patients through Harris Health in Texas. The form mandates that contractors disclose all proposed subcontractors, subconsultants, professionals, suppliers, and vendors intended for use on the project. For each subcontractor, contractors must provide company name, industry classification, DUNS number, principal contact name, approximate contract value, contract start and end dates, work description, and certifications status including Historically Underutilized Business (HUB)/Minority Women Business Enterprise (MWBE) and Section 3 designations. Harris County reserves the right to reject any proposed subcontractors on any reasonable basis and must approve all actual subcontractors prior to their deployment on the project.
Contractors bear full responsibility for verifying that all subcontractors are properly licensed, insured, and authorized to perform government contract work by conducting due diligence checks against state, local, and federal debarment lists. A final completed Subcontractor Listing Form is required prior to contract award, and any changes to subcontractor information throughout the contract term must be submitted to Harris County for approval. Contractors have the option to indicate that they will not be subcontracting any portion of the work and will fulfill the entire contract using their own resources, which must be confirmed by contractor signature and printed name.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment D
SUBCONTRACTOR LISTING FORM
Contractor must provide information below for any potential subcontractors or subconsultants, professionals, suppliers, and vendors used in connection with the project. The County reserves the right to reject proposed subcontractors or subconsultants on any reasonable basis. Harris County must approve the actual subcontractors prior to their use (add additional pages if necessary):
Company Name:_______________________________ Industry: ______________________________________ DUNS #: _____________________________________Name of Principal: ______________________________ Approximate Contract Value $____________________ Start & End of Contract __________________________
Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No Description of Work to be performed:
Company Name:_______________________________ Industry: ______________________________________ DUNS #: _____________________________________Name of Principal: ______________________________ Approximate Contract Value $____________________ Start & End of Contract __________________________
Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No Description of Work to be performed:
Company Name:_______________________________ Industry: ______________________________________ DUNS #: _____________________________________Name of Principal: ______________________________ Approximate Contract Value $____________________ Start & End of Contract __________________________
Certified HUB / MWBE: ☐ Yes ☐ No Certified Section 3: ☐ Yes ☐ No Description of Work to be performed:
Contractor shall be responsible for ensuring any Subcontractors used are properly licensed, insured, and authorized to work under government contracts by checking state, local, and federal debarment lists and shall obtain and submit licenses for any subcontractors if the work being performed requires licensing in accordance with state or federal law. A final Subcontractor Listing Form will be required prior to contract award. If any of the required information changes throughout the term of the contract, Contractor must submit a revision to the County for approval.
☐ I will not be subcontracting any portion of the contract and will be fulfilling the entire contract with my own resources.
Signature of Contractor:
Print Name:
File details come from the government source that posted it. Updated .