APP H - Bidders List.docx
DOCX document 35 KB Posted
- Attached to
- 2025 Medford SRT
- Solicitation number
- 1 2025 Canceled
- Issued by
- Vernon County, Mattoon Village, Wisconsin
About this file
This is a bidders list form (Appendix H) required by the Wisconsin Department of Transportation (WisDOT) in compliance with federal regulation 49 CFR Part 26.11. The form must be completed and submitted by all vendors with their bids and proposals for DOT-assisted contracts, requiring comprehensive information about both prime contractors and subcontractors, including those expressing interest in working on DOT-assisted projects. Vendors must provide detailed company information including contact details, annual gross receipts categorized in ranges from less than $500,000 to $5 million and above, firm age, demographic information about majority owners (race and gender), type of work to be performed, and applicable North American Industry Classification System (NAICS) codes.
The form serves WisDOT's regulatory requirement to maintain a comprehensive database of firms bidding on DOT-assisted contracts, with particular attention to Disadvantaged Business Enterprise (DBE) status tracking. The bidders list includes fields for multiple subcontractors and subconsultants, with space for additional entries on supplementary pages, ensuring complete documentation of all firms involved in the contracting process. This data collection supports federal compliance requirements for tracking participation of various business types in government contracting, particularly focusing on DBE participation and maintaining accurate records of the contractor universe for DOT-assisted projects.
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Other files
| File | Type | Posted |
|---|---|---|
| 2025 Medford SRT.docx | DOCX document | |
| Appendix A - Pricing Proposal.xlsx | XLSX spreadsheet | |
| Appendix I - Federal Clauses for Federal_.pdf |
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Text version
Bidders List Appendix H
Background
49 CFR Part 26.11 requires the Wisconsin Department of Transportation (WisDOT) to develop and maintain a list of firms that bid/quote on DOT-assisted contracts. All firms (prime contractors and subcontractors, including DBEs and non-DBEs) that bid or quote on DOT-assisted prime contracts and subcontracts must complete this form. This form should include subcontractors/subconsultants that contacted the prime expressing an interest to work as a subcontractor/subconsultant on the DOT assisted project.
Instructions
Vendors must complete and submit this form with all bids and/or proposals. Attach additional pages, as needed.
Terms/Definitions
Type of Work – List the type of work and/or all the work activities the firm is sought to perform in its bid.
NAICS Codes – List all North American Industry Classification System (NAICS) Codes applicable to the scope of work activities the firm is sought to perform in its bid. A NAICS Codes is available at https://www.naics.com/search/
Prime Contractor and Consultant - Complete all data fields for the firm’s majority owner.
Name of Prime Contractor/Consultant:
Contact Name:
| Annual Gross Receipts |
| DBE Status |
| ☐ Yes |
☐ No
Email:
| ☐ |
| Less than $500,000 |
Phone:
| ☐ |
| $500,000 - $1 million |
Address:
Include Zip Code
| ☐ |
| $1 million - $2 million |
| Age of Firm: |
| ☐ |
| $2 million - $5 million |
| Race: |
| ☐ |
| $5 million and above |
| Gender: |
Type of Work:
NAICS Code(s):
Subcontractors and Subconsultants – Complete all data fields for the Prime’s subcontractors/subconsultants.
List additional subcontractors/subconsultants on page 2.
Name of Subcontractor/Subconsultant:
Contact Name:
| Annual Gross Receipts |
| DBE Status |
| ☐ Yes |
☐ No
Email:
| ☐ |
| Less than $500,000 |
Phone:
| ☐ |
| $500,000 - $1 million |
Address:
| ☐ |
| $1 million - $2 million |
| Age of Firm: |
| ☐ |
| $2 million - $5 million |
| Race: |
| ☐ |
| $5 million and above |
| Gender: |
Type of Work:
NAICS Code(s):
Bidders List (continued) Subcontractors and Subconsultants – Complete all data fields for the Prime’s subcontractors/subconsultants.
Name of Subcontractor/Subconsultant:
Contact Name:
| Annual Gross Receipts |
| DBE Status |
| ☐ Yes |
☐ No
Email:
| ☐ |
| Less than $500,000 |
Phone:
| ☐ |
| $500,000 - $1 million |
Address:
| ☐ |
| $1 million - $2 million |
| Age of Firm: |
| ☐ |
| $2 million - $5 million |
| Race: |
| ☐ |
| $5 million and above |
| Gender: |
Type of Work:
NAICS Code(s):
Name of Subcontractor/Subconsultant:
Contact Name:
| Annual Gross Receipts |
| DBE Status |
| ☐ Yes |
☐ No
Email:
| ☐ |
| Less than $500,000 |
Phone:
| ☐ |
| $500,000 - $1 million |
Address:
| ☐ |
| $1 million - $2 million |
| Age of Firm: |
| ☐ |
| $2 million - $5 million |
| Race: |
| ☐ |
| $5 million and above |
| Gender: |
Type of Work:
NAICS Code(s):
Name of Subcontractor/Subconsultant:
Contact Name:
| Annual Gross Receipts |
| DBE Status |
| ☐ Yes |
☐ No
Email:
| ☐ |
| Less than $500,000 |
Phone:
| ☐ |
| $500,000 - $1 million |
Address:
| ☐ |
| $1 million - $2 million |
| Age of Firm: |
| ☐ |
| $2 million - $5 million |
| Race: |
| ☐ |
| $5 million and above |
| Gender: |
Type of Work:
NAICS Code(s):
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