Attachment_A-_First_Tier_Subcontractors_List.pdf
PDF 84 KB Posted
- Attached to
- DNR RFB Wabasha County Observation Well Drilling
- Solicitation number
- 2000016487
- Issued by
- Wadena County, Minnesota
About this file
This is a First-Tier Subcontractors List form (Attachment A) for Project Number 2025-460, titled "Wabasha County Observation Well Drilling" in Minnesota. The document requires completion prior to contract execution and includes fields for listing first-tier subcontractor information including legal company names as registered with the Secretary of State, city locations of company home offices, percentage value of contract, and whether the subcontractor qualifies as a TG/ED/VO (Certified Targeted Group Business, Economically Disadvantaged Business, or Veteran-Owned Business).
The form requires certification under oath from an owner or officer confirming that all listed first-tier subcontractors meet the minimum criteria for responsible contractors as defined in Minn. Stat. § 16C.285. Prime contractors must be prepared to submit signed verifications of compliance from all subcontractors and motor carriers to the contracting authority upon request. The document includes spaces for authorized signature, company name, printed name, date, and title of the signing official.
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Other files
| File | Type | Posted |
|---|---|---|
| DNR_RFB_Wabasha_County_Observation_Well_Drilling.pdf | ||
| 2025-460_Solicitation_Bond_Forms.pdf | ||
| 2025-460_Price_Schedule.xlsx | XLSX spreadsheet | |
| 2025-460_EVENT_Specifications_and_Terms.pdf |
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2025-460
PROJECT NAME Wabasha County Observation Well Drilling
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 .