Attachment_A-_First_Tier_Subcontractors_List.pdf

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Attached to
DNR RFB Prior Lake Dewitt PWA Ramp Extension Rebid
Solicitation number
2000016458
Issued by
Scott County, Minnesota

About this file

This document is an Attachment A - First-Tier Subcontractors List for Project Number 2025-417, the Prior Lake Dewitt Public Water Access Ramp Extension Rebid. It requires the completion of this form prior to contract execution, which lists the legal names, city locations, percentage of contract value, and TG/ED/VO (Targeted Group Business, Economically Disadvantaged Business, and Veteran-Owned Business) certification status of all first-tier subcontractors for this project. The authorized signature of an owner or officer of the prime contractor company certifies that all listed first-tier subcontractors have verified their status as responsible contractors as defined in Minnesota Statute 16C.285.

The document outlines the requirements for the prime contractor to submit copies of the signed verifications of compliance from all subcontractors of any tier and motor carriers upon request by the contracting authority.

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DNR_RFB_Prior_Lake_Dewitt_PWA_Ramp_Extension_Rebid.pdf PDF
2025-417_Specifications.pdf PDF

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ATTACHMENT A

FIRST-TIER SUBCONTRACTORS LIST

THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION

PROJECT NUMBER 2025-417

PROJECT NAME Prior Lake Dewitt Public Water Access Ramp Extension Rebid

FIRST TIER SUBCONTRACTOR NAMES

(Legal name of company as registered with the Secretary of State)

Name of city where company home office is located

% of value of Contract

*Is the First Tier Subcontractor a

TG/ED/VO?

Attach additional sheets as needed for submission of all first-tier subcontractors.

*TG/ED/ VO = Certified Targeted Group Business, Economically Disadvantaged Business, and Veteran-Owned Business

I certify by signing this form under oath that I am an owner or officer of the company, and that:

All first-tier subcontractors listed above have verified through a signed statement under oath by an owner or officer that they meet the minimum criteria to be a responsible contractor as defined in Minn. Stat. § 16C.285. A prime contractor shall submit to the contracting authority upon request copies of the signed verifications of compliance from all subcontractors of any tier and motor carriers, pursuant to subdivision 3, clause (7).

Authorized Signature of Owner or Officer Company Name

Print Name Date

Title

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