Attachment_A-_First_Tier_Subcontractors_List.pdf
PDF 85 KB Posted
- Attached to
- DNR RFB Willson & Long Lk Road Project
- Solicitation number
- 2000017103
- Issued by
- Houston County, Minnesota
About this file
This document is a First-Tier Subcontractors List form for the Wilson & Long Lake Road Project (Project Number 2025-931), designed to be completed prior to contract execution. The form provides a template for prime contractors to list their first-tier subcontractors, including the legal name of each company, their home office location, percentage of contract value, and whether they are a Certified Targeted Group Business, Economically Disadvantaged Business, or Veteran-Owned Business (TG/ED/VO).
The form requires the prime contractor to certify that all first-tier subcontractors have verified they meet the minimum criteria to be a responsible contractor as defined in Minnesota Statute 16C.285. The document includes a certification section where an owner or officer of the company must sign, affirming that they have obtained signed statements from subcontractors verifying their compliance. The form allows for additional sheets to be attached if more space is needed to list all first-tier subcontractors, and it emphasizes the importance of documentation and verification in the subcontracting process.
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Other files
| File | Type | Posted |
|---|---|---|
| Equipment_Specifications.pdf | ||
| Solicitation_Bond.pdf | ||
| DNR_RFB_Willson___Long_Lk_Road_Project.pdf | ||
| 2025-931_Specifications.pdf |
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Text version
ATTACHMENT A
FIRST-TIER SUBCONTRACTORS LIST
THIS FORM MUST BE COMPLETED PRIOR TO CONTRACT EXECUTION
PROJECT NUMBER 2025-931
PROJECT NAME Wilson & Long Lake Road Project
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 .