4-E. DISCLOSURE OF SUBCONTRACTORS AND SUPPLIER.pdf

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Attached to
21Q-184 PRE-QUALIFIED REHAB CONTRACTORS
Solicitation number
21Q-184
Issued by
Marion County, Florida

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This is a subcontractor and supplier disclosure form for Marion County Board of County Commissioners that requires prime contractors to list all subcontractors and suppliers they intend to use in connection with their contract performance. The form provides space for up to three subcontractors, with each entry requiring comprehensive information including the subcontractor's name, point of contact, physical office address, city/state/zip code, email, phone number, county where the business is registered, percentage of workload/responsibility under the project, and the specific tasks the prime contractor intends to use the proposed firm for.

The County reserves the right to accept or reject any subcontractor based on past performance, location, or any other grounds that may conflict with the best interests of Marion County Board of County Commissioners. The form includes a note that additional forms must be completed if more than three subcontractors are proposed for the contract, indicating that full disclosure of all subcontracting arrangements is required for the procurement process.

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Other files

File Type Posted
3-D. CONFLICT OF INTEREST STATEMENT.pdf PDF
2-B. RFQ GENERAL TERMS AND CONDITIONS.pdf PDF
5-A. 21Q-184 01 SCOPE OF WORK AND SPECIFICATIONS.pdf PDF
1-C. 21Q-184 EVALUATION PROCESS AND SCORING CRITERIA.pdf PDF

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DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS

Please list all subcontractors and suppliers to be used in connection with your performance of the Contract. The County reserves the right to accept or reject any subcontractor based on past performance, location, or any other grounds that may conflict with the best interests of Marion County Board of County Commissioners.

Sub Name:

Point of Contact:

Physical Office Address:

City / State / Zip Code:

Email: Phone Number:

County where business is registered:

Firm’s % of Workload/Responsibility under this project:

The Prime intends to use the proposed firm for the following task(s):

Sub Name:

Point of Contact:

Physical Office Address:

City / State / Zip Code:

Email: Phone Number:

County where business is registered:

Firm’s % of Workload/Responsibility under this project:

The Prime intends to use the proposed firm for the following task(s):

Sub Name:

Point of Contact:

Physical Office Address:

City / State / Zip Code:

Email: Phone Number:

County where business is registered:

Firm’s % of Workload/Responsibility under this project:

The Prime intends to use the proposed firm for the following task(s):

*Please complete another form if you have more than 3 subcontractors for the proposed contract.

Sub Name:
Point of Contact:
Physical Office Address:
City State Zip Code:
Email:
Phone Number:
County where business is registered:
Firms of WorkloadResponsibility under this project:
Sub Name_2:
Point of Contact_2:
Physical Office Address_2:
City State Zip Code_2:
Email_2:
Phone Number_2:
County where business is registered_2:
Firms of WorkloadResponsibility under this project_2:
Sub Name_3:
Point of Contact_3:
Physical Office Address_3:
City State Zip Code_3:
Email_3:
Phone Number_3:
County where business is registered_3:
Firms of WorkloadResponsibility under this project_3:
Line 2:
Line 1:
Line 3:
Line 4:
Line 5:
Line 6:

File details come from the government source that posted it. Updated .