Attachment C - Subcontracting Approval Request.pdf
PDF 78 KB Posted
- Solicitation number
- IFB-126647
- Issued by
- Craig County, Virginia
About this file
This is a Subcontracting Approval Request form issued by the Virginia Department of Transportation (VDOT) for use with Solicitation IFB 161123 regarding Culpeper Sodium Chloride Bulk Road Salt delivery. The form requires primary contractors to obtain prior written approval from VDOT before subcontracting any portion of work or equipment. Contractors must submit proposed subcontractor information including firm or individual names, addresses, contact persons, phone numbers, types of work to be performed, equipment to be provided, and qualifications or experience levels. The form accommodates multiple subcontractor entries and includes fields for documenting contact information and work scope across four proposed subcontractors.
The primary contractor retains full liability and responsibility for all subcontracted work and must ensure compliance with all contract requirements. Contractors must identify any proposed subcontractors certified by DSBSD as Small, Women-Owned, or Minority Businesses and provide corresponding certification numbers. The form designates a section for VDOT authorization, requiring signature, date, and telephone number from an authorized VDOT representative to approve and accept the proposed subcontractors under the contract terms and conditions.
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Text version
ATTACHMENT ______
Solicitation #:
SUBCONTRACTOR APPROVAL REQUEST
No portion of the work (including equipment) shall be subcontracted to another firm or individual without prior written consent of Virginia Department of Transportation (herein referred to as VDOT). In the event that the contractor desires to subcontract some part of the work specified herein, the contractor shall furnish VDOT with the names, qualifications, and experience of their proposed subcontractors for agency approval. The primary contractor shall, however, remain fully liable and responsible for the work performed by its subcontractor(s) and shall assure compliance with all requirements of the contract.
List proposed subcontractor(s), including name, address, contact person, and type of work to be performed under this contract below.
FIRM INDIVIDUAL’S
NAME & ADDRESS
CONTACT PERSON AND
PHONE NUMBER
TYPE OF WORK TO BE
PERFORMED
TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE
QUALIFICATIONS / EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR
Please indicate which above proposed subcontractors are certified (with DSBSD) as Small, Women Owned or Minority Businesses.
Certification Number(s):
FOR VDOT USE ONLY:
The proposed subcontractor(s) listed above is/are approved and accepted under the terms and conditions of the contract requirements herein.
Signature of Authorized VDOT Representative Date Telephone Number
C
| Solicitation #: |
| FIRM INDIVIDUAL’S |
| TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE |
| FOR VDOT USE ONLY: |
| Solicitation: |
| NAME ADDRESS 1: |
| NAME ADDRESS 2: |
| NAME ADDRESS 3: |
| NAME ADDRESS 4: |
| PHONE NUMBER 1: |
| PHONE NUMBER 2: |
| PHONE NUMBER 3: |
| PHONE NUMBER 4: |
| PERFORMED 1: |
| PERFORMED 2: |
| PERFORMED 3: |
| PERFORMED 4: |
| TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 1: |
| TYPE OF EQUIPMENT PROPOSED SUBCONTRACTOR WILL PROVIDE 2: |
| QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 1: |
| QUALIFICATIONS EXPERIENCE LEVEL OF PROPOSED SUBCONTRACTOR 2: |
| Certification Numbers 1: |
| Certification Numbers 2: |
| contract requirements herein: |
| The proposed subcontractors listed above isare approved and accepted under the terms and conditions of the: |
| Telephone Number: |
File details come from the government source that posted it. Updated .