4-Subcontractor Supplier Report.pdf
PDF 214 KB Posted
- Attached to
- Facility Security Equipment Upgrade State and local contract opportunity
- Solicitation number
- FY26-RFP-004
- Issued by
- Illinois
About this file
This document is a Subcontractor/Supplier Report form from Connect Transit, located at 351 Wylie Drive, Normal, IL 61761. The form is designed to capture detailed information about potential subcontractors, subconsultants, suppliers, and firms that may be involved in a project or contract opportunity. The form provides space to document multiple companies, including their name, address, authorized contact, phone/email, contractor's license number, description of work or materials/supplies, DBE (Disadvantaged Business Enterprise) status, dollar amount of work, and whether the bid/quote was accepted by the prime contractor.
The form requires an authorized official to complete and sign the document, providing their title, firm name, signature, and date. The form appears to be part of a procurement or bidding process, likely for transit-related services or supplies. It is formatted with multiple rows to allow comprehensive reporting of subcontractor information, and includes the Connect Transit logo along with contact information at the bottom of the page. The document is designed to support transparent and detailed reporting of subcontractor participation in a contract or project.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 11-Conflict of Interest Certification.docx | DOCX document | |
| 13-FY26-RFP-004 Terms and Conditions.pdf | ||
| 14-FY26-RFP-004 Cost Proposal.xlsx | XLSX spreadsheet | |
| 15-FY26-RFP-004 Solicitation FINAL.pdf | ||
| 3-Buy America Certification.pdf | ||
| 5-Indemnity and Insurance Requirements.pdf | ||
| 1-Debarment Certification.pdf | ||
| 8-Prompt Payment Affidavit.pdf | ||
| 6-Davis Bacon Certficiation.pdf | ||
| 10-Bid or Proposal Affidavit.pdf | ||
| 12-Federal Tax Liability and Recent Felony Convictions Certification Fillable.pdf | ||
| 2-Non-Collusion Affidavit.pdf | ||
| 7-Subcontractor Debarment Certification.pdf | ||
| 9-Certification of Restrictions on Lobbying.pdf |
Show all 14
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Text version
SUBCONTRACTOR/SUPPLIER REPORT
Subcontractor/Subconsultant/Supplier/Firm Company Information
Contractor’s License
Number (if applicable)
Description of Work or Type of
Materials/Supplies
DBE
Status
Dollar Amount of Work/Materials/Supplies
Bid/Quote Accepted by Prime
(Y/N)
Name:
Address:
Authorized Contact:
Phone/Email:
Name:
Address:
Authorized Contact:
Phone/Email:
Name:
Address:
Authorized Contact:
Phone/Email:
Name:
Address:
Authorized Contact:
Phone/Email:
AUTHORIZED OFFICIAL: _______________________________________________
TITLE: _______________________________________________
FIRM NAME: _______________________________________________
SIGNATURE: _______________________________________________
DATE: _______________________________________________
| Name: |
| Address: |
| Authorized Contact: |
| PhoneEmail: |
| Name_2: |
| Address_2: |
| Authorized Contact_2: |
| PhoneEmail_2: |
| Name_3: |
| Address_3: |
| Authorized Contact_3: |
| PhoneEmail_3: |
| Name_4: |
| Address_4: |
| Authorized Contact_4: |
| PhoneEmail_4: |
| Authorized Official: |
| Title: |
| Firm Name: |
| Date: |
| Signature2_es_:signer:signature: |
| Contractors License Number 1: |
| Contractors License Number 2: |
| Contractors License Number 3: |
| Contractors License Number 4: |
| Description of Work or Type of Materials/Supplies: |
| Description of Work or Type of Materials/Supplies2: |
| Description of Work or Type of Materials/Supplies3: |
| Description of Work or Type of Materials/Supplies4: |
| DBE Status: |
| DBE Status2: |
| DBE Status3: |
| DBE Status4: |
| Dollar Amount of Work/Materials/Supplies: |
| Dollar Amount of Work/Materials/Supplies 2: |
| Dollar Amount of Work/Materials/Supplies 3: |
| Dollar Amount of Work/Materials/Supplies 4: |
| Bid/Quote Accepted by Prime: |
| Bid/Quote Accepted by Prime2: |
| Bid/Quote Accepted by Prime 3: |
| Bid/Quote Accepted by Prime 4: |
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