4-Responsible Contractor Act Verification Form.pdf
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- Attached to
- Riverside Elementary School Roof Replacement
- Solicitation number
- Bid #030326A
- Issued by
- Olmsted County, Minnesota
About this file
This is a Responsible Contractor Act Verification Form required for the Riverside Elementary School Roof Replacement project in Minnesota. The form certifies that bidding contractors comply with the minimum criteria established under Minnesota Statutes 16C.285, subdivision 3. Bidders must identify all first-tier subcontractors they intend to retain for the roof replacement work, which involves the removal and replacement of approximately 23,000 square feet of existing low-slope ballasted membrane roof systems and installation of new fully-adhered EPDM membrane systems with insulation, protection board, flashing, and trim. Existing roof-mounted equipment must be removed and reinstalled to facilitate the replacement.
The form requires that all first-tier subcontractors listed at the time of bid submission provide signed verification of compliance with Minnesota Statutes 16C.285, subdivision 3(7). For subcontractors selected after bid submission, the contractor must obtain and submit signed verifications confirming compliance within 14 days of retaining those subcontractors. The form must be completed by an owner or officer of the bidding company, dated, and notarized before submission.
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Text version
RESPONSIBLE CONTRACTOR ACT VERIFICATION
The undersigned owner/officer of __________________________ (“Company”) hereby certifies that it complies with each of the minimum criteria in Minn. Stat. § 16C.285, subd. 3, as of the time of the submission of its bid for the above-referenced project (“Project”).
The first-tier Subcontractors that Company intends to retain for work on the Project are:
The first-tier Subcontractors listed above have provided verification required by Minn. Stat.§ 16C.285, subd. 3(7).
The remaining first-tier subcontractors that Company intends to retain for work on the Project have not yet been determined. Company will obtain and submit signed verifications from each of its subsequently retained subcontractors, confirming compliance with Minn. Stat. § 16C.285, subd. 3, within 14 days of retaining the subcontractors.
Dated: _______________________ Company: ______________________________
By:________________________________
Its: ________________________________ Owner/Officer
Subscribed and sworn to before me this__________ day of __________, 20__.
Notary Public
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