4-Attachment E - Subcontractor Listing Form.pdf
PDF 56 KB Posted
- Attached to
- Employee Drug and Disease Testing Services
- Solicitation number
- RFO AB02042026
- Issued by
- Harris County, Texas
About this file
This is a Subcontractor Listing Form for Harris County Hospital District dba Harris Health in connection with an Employee Drug and Disease Testing Services contract opportunity in Texas. The form requires contractors to provide detailed information for any potential subcontractors, subconsultants, professionals, suppliers, and vendors involved in the project. For each subcontractor, contractors must submit company name, industry classification, DUNS number, principal contact name, approximate contract value, contract start and end dates, work description, and certification status for HUB/MWBE and Section 3 programs. The contract opportunity itself involves providing comprehensive testing services for applicants with employment offers, random testing for employees in safety-sensitive positions, and testing for employees suspected of substance abuse. Testing must comply with all applicable local, state, and federal regulations and guidelines, with the initial contract term beginning in April 2026 and continuing for twelve months.
Harris County reserves the right to reject any proposed subcontractors on any reasonable basis and must approve all actual subcontractors prior to their engagement. Contractors are responsible for ensuring that any subcontractors are properly licensed, insured, authorized to work under government contracts, and compliant with state, local, and federal debarment lists. A final Subcontractor Listing Form is required prior to contract award, and contractors must submit revisions to the County for approval if any required information changes throughout the contract term. The form includes an option for contractors to indicate that they will not be subcontracting any portion of the contract and will fulfill it entirely with their own resources.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-Attachment A - RFO and Addenda Acknowledgement.pdf | ||
| 9-RFO AB02182026 SPECIFICATIONS AND SCOPE.docx | DOCX document | |
| 7-Attachment F - Minimum Insurance Requirements.pdf | ||
| 10-Attachment B - Pricing Schedule.xlsx | XLSX spreadsheet | |
| 5-Attachment G - Experience Form.docx | DOCX document | |
| 2-Attachment C - HARRIS HEALTH GENERAL REQUIREMENTS.pdf | ||
| 8-Minimum Requirements Questionnaire Checklist.xlsx | XLSX spreadsheet | |
| 6-MWBE Solicitation Forms Combined.pdf | ||
| 3-Attachment D- Tax Residence Certification.pdf |
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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 .