ATTACHMENT C - Subcontracting Approval Request.pdf

PDF 125 KB Posted

Attached to
IFB 160941 JS Ferry Surry Shipyard Package
Solicitation number
IFB-126120
Issued by
Southampton County, Virginia

About this file

This is a Subcontractor Approval Request form issued by the Virginia Department of Transportation (VDOT) for IFB #160941. The form establishes the framework for contractors to request prior written approval before subcontracting any portion of work or equipment to other firms or individuals. Contractors must submit detailed information about proposed subcontractors, including company name and address, contact person and phone number, type of work to be performed, equipment to be provided, and qualifications and experience level. The primary contractor remains fully liable and responsible for all work performed by its subcontractors and must ensure compliance with all contract requirements.

The form requires contractors to identify any proposed subcontractors certified by DSBSD (Department of Small Business and Supplier Diversity) as Small, Women-Owned, or Minority Businesses, with corresponding certification numbers. VDOT's authorized representative must provide written approval and acceptance of proposed subcontractors prior to work commencement. The form includes designated spaces for up to four subcontractors with fields for firm or individual names, addresses, phone numbers, type of work performed, equipment to be provided, and certification information. No work may proceed with unapproved subcontractors, and all subcontracting arrangements remain subject to the terms and conditions of the underlying contract.

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Text version

ATTACHMENT __C____

IFB #: 160941

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

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:

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