4-Attachment E - Subcontractor Listing Form.pdf
PDF 56 KB Posted
- Solicitation number
- RFP 26/0004
- Issued by
- Harris County, Texas
About this file
This is a Subcontractor Listing Form required by Harris County, Texas for the RFP 26/0004 Inpatient Psychiatric Services contract. The form is used to document all potential subcontractors, subconsultants, professionals, suppliers, and vendors that will be engaged in connection with the project. Harris County reserves the right to reject proposed subcontractors on any reasonable basis and requires approval of actual subcontractors prior to their use. The form provides space for contractors to list up to three subcontractors with detailed information including company name, industry classification, DUNS number, principal contact name, approximate contract value, contract start and end dates, and a description of work to be performed.
The form requires contractors to identify whether each subcontractor holds Certified HUB/MWBE (Historically Underutilized Business/Minority Women Business Enterprise) or Certified Section 3 designations. Contractors bear full responsibility for ensuring all subcontractors are properly licensed, insured, and authorized to work under government contracts, including verification against state, local, and federal debarment lists. A final Subcontractor Listing Form is mandatory prior to contract award, and any changes to subcontractor information throughout the contract term must be submitted to Harris County for approval. The form includes an option for contractors to indicate they will not be subcontracting and will fulfill the entire contract with their own resources.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-Attachment C - HARRIS HEALTH GENERAL REQUIREMENTS.pdf | ||
| 10-RFP 26 0004 - SPECIFICATIONS AND SCOPE.docx | DOCX document | |
| 5-Attachment F -VENDOR CERTIFICATION OF ELIGIBILITY TO PARTICIPATE.pdf | ||
| 3-Attachment D- Tax Residence Certification.pdf | ||
| 1-Attachment A - RFP and Addenda Acknowledgement.docx | DOCX document | |
| 7-Attachment G - Experience Form.docx | DOCX document | |
| 8-Attachment B - Minimum Requirements Checklist.xlsx | XLSX spreadsheet | |
| 9-Attachment H - Minimum Insurance Requirements.pdf | ||
| 6-Attachment B - Pricing Schedule.xlsx | XLSX spreadsheet |
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Text version
Attachment E
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 .