Attachment_A-_First_Tier_Subcontractors_List.pdf
PDF 84 KB Posted
- Attached to
- DNR RFB Gitch-Gami ST Culvert Replacements
- Solicitation number
- 2000017004
- Issued by
- Lac Qui Parle County, Minnesota
About this file
This document is a First-Tier Subcontractors List form for the Gitchi-Gami State Trail Culvert Replacements project, identified by Project Number 2025-804. The form is designed to be completed prior to contract execution and requires prime contractors to list all first-tier subcontractors, including their legal names, home office locations, percentage of contract value, and whether they qualify as a Targeted Group (TG), Economically Disadvantaged (ED), or Veteran-Owned (VO) business.
The form includes a certification section where the prime contractor attests that all listed first-tier subcontractors have verified they meet the minimum criteria to be a responsible contractor as defined in Minnesota Statute 16C.285. The document provides space for multiple subcontractors to be listed, with the option to attach additional sheets if needed. The form requires an authorized signature from an owner or officer of the company, along with their printed name, title, and the date of submission, emphasizing the legal accountability of the information provided.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2025-804_Specifications.pdf | ||
| 2025-804_Solicitation_Bond.pdf | ||
| DNR_RFB_Gitch-Gami_ST_Culvert_Replacements.pdf | ||
| Addendum__1.pdf |
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2025-804
PROJECT NAME Gitchi-Gami State Trail Culvert Replacements
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 .