5-List of Subcontractors (Fillable).pdf

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Attached to
Purchase of a New 2026 Ford F-350 XL Super Duty With Reading Service Body
Solicitation number
26-0033-3
Issued by
Chatham County, Georgia

About this file

This is a List of Subcontractors form used by Chatham County, Georgia for state and local contract opportunities. The document is a fillable template that allows prime contractors to identify whether they propose to subcontract work on a project and, if so, to list the names, addresses, and types of work to be performed by each proposed subcontractor. The form includes space for up to 17 subcontractors and requires the contractor's signature upon completion.

The form emphasizes compliance with Anti-Kickback laws and requires contractors to incorporate appropriate provisions in all subcontracts. Chatham County affirms its status as an equal opportunity employer and explicitly prohibits any payments required from contractors or subcontractors to the County, third parties, or other subcontractors as a condition of employment under the contract. The document notes M/WBE (Minority/Women Business Enterprise) participation considerations, indicating that diversity in subcontracting is a relevant factor in the procurement process. This form serves as a transparency and accountability mechanism to ensure proper oversight of subcontracting arrangements on County projects.

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Text version

LIST OF SUBCONTRACTORS

I do _____, do not _____, propose to subcontract some of the work on this project. I propose to subcontract work to the following subcontractors: NOTE: M/WBE PARTICIPATION

*The Contractor shall comply with all applicable Anti-Kickback laws and shall insert appropriate provisions in all subcontracts covering work under this contract.

*Chatham County is an equal opportunity employer. No contractor or subcontractor shall be requested nor required to make a payment to the County, third party contractors or subcontractors, in order to gain access to employment under the terms and conditions of this contract with the County.

NAME AND ADDRESS TYPE OF WORK

SIGNED:

CONTRACTOR

NAME AND ADDRESS TYPE OF WORKRow1:
NAME AND ADDRESS TYPE OF WORKRow1_2:
NAME AND ADDRESS TYPE OF WORKRow2:
NAME AND ADDRESS TYPE OF WORKRow2_2:
NAME AND ADDRESS TYPE OF WORKRow3:
NAME AND ADDRESS TYPE OF WORKRow3_2:
NAME AND ADDRESS TYPE OF WORKRow4:
NAME AND ADDRESS TYPE OF WORKRow4_2:
NAME AND ADDRESS TYPE OF WORKRow5:
NAME AND ADDRESS TYPE OF WORKRow5_2:
NAME AND ADDRESS TYPE OF WORKRow6:
NAME AND ADDRESS TYPE OF WORKRow6_2:
NAME AND ADDRESS TYPE OF WORKRow7:
NAME AND ADDRESS TYPE OF WORKRow7_2:
NAME AND ADDRESS TYPE OF WORKRow8:
NAME AND ADDRESS TYPE OF WORKRow8_2:
NAME AND ADDRESS TYPE OF WORKRow9:
NAME AND ADDRESS TYPE OF WORKRow9_2:
NAME AND ADDRESS TYPE OF WORKRow10:
NAME AND ADDRESS TYPE OF WORKRow10_2:
NAME AND ADDRESS TYPE OF WORKRow11:
NAME AND ADDRESS TYPE OF WORKRow11_2:
NAME AND ADDRESS TYPE OF WORKRow12:
NAME AND ADDRESS TYPE OF WORKRow12_2:
NAME AND ADDRESS TYPE OF WORKRow13:
NAME AND ADDRESS TYPE OF WORKRow13_2:
NAME AND ADDRESS TYPE OF WORKRow14:
NAME AND ADDRESS TYPE OF WORKRow14_2:
NAME AND ADDRESS TYPE OF WORKRow15:
NAME AND ADDRESS TYPE OF WORKRow15_2:
NAME AND ADDRESS TYPE OF WORKRow16:
NAME AND ADDRESS TYPE OF WORKRow16_2:
NAME AND ADDRESS TYPE OF WORKRow17:
NAME AND ADDRESS TYPE OF WORKRow17_2:
SIGNED:
Check Box1: Off
Check Box2: Off

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