Attachment_D_-_blank_Subcontractor_Form_(1).pdf

Copyright 2016 City & County of San Francisco

(Rev. 3/13/2013) 00435 - 1 Subcontractor List

SECTION 00 43 36

(This form replaces CMD FORM 2A)

PROPOSED SUBCONTRACTORS FORM

Date Name of Firm, Corporation, Partnership, or Joint Venture

This Document implements listing requirements for subcontractors who will perform work in excess of one-half of one percent of the Total Bid Price [Admin. Code § 6.21(A)(9) and California Public Contract Code §§ 4100 – 4114].

Important Notice: No subcontractor may be listed in a bid for a public works project unless registered with the California Department of Industrial Relations (“DIR”) pursuant to Labor Code § 1725.5 [with limited exceptions from this requirement for bid purposes only under Labor Code § 1771.1(a)]. An inadvertent listing of a subcontractor who is not registered under § 1725.5 will not be grounds for a bid protest or for determining a bid nonresponsive if the conditions set forth in Labor Code § 1771.1(c)(1) or (2) are met.

A. Subcontractors Who Will Perform Work In Excess of ½ of 1% Of Total Bid Price

Bidder shall submit with its bid a subcontractor list using the form below. Bidder shall identify each subcontractor1 who will perform work in an amount in excess of one-half of one percent of Bidder's Total Bid Price. If this project involves the construction of streets, highways, or bridges, Bidder shall submit with its bid a subcontractor list, using the form below, identifying each subcontractor who will perform work in excess of one-half of one percent of the Total Bid Price, or $10,000, whichever is greater.

At a minimum, Bidder must provide the following information with its Bid for each listed subcontractor: (i) name and email [Box 2]; (ii) location of the place of business [Box 3]; (iii) portion of work that will be performed by the subcontractor [Box 4] and (iv) the current valid subcontractors license [Box 8]. In addition, for items or portions of work not fully subcontracted, e.g., indicated as "partial," Bidder must provide the amount of subcontract work [Box 10] either at the time of Bid or within 24 hours after Bid opening. Bidders may provide additional identifying information [e.g., Boxes 5, 6, 7 and/or 9] within 24 hours of Bid opening.

If the City cannot identify the intended subcontractor or portion of work based on the information provided by Bidder, or where Bidder provides conflicting information, the City may consider the subcontractor or portion of work unlisted for purposes of Public Contract Code § 4106. An "unlisted" determination may render a Bid non-responsive if the technical specifications require that the work in question be performed by a subcontractor. In addition, an "unlisted" determination may render a Bidder not responsible if Bidder is not qualified to self-perform the work in question.

B. LBE Subcontractors, Suppliers and Service Contractors

Subcontracting goal does not apply to this Contract. LBE subcontractors, suppliers and service contractrs are not required to be identifed and listed, except as required under paragraph A above.

1For the purposes of Paragraph A, the term ''subcontractor'' shall mean a contractor as defined in California

Public Contract Code § 4113.

Bidder shall provide the requested information for each subcontractor who shall perform in excess of 1/2 of 1% of the Total Bid Price. If this project involves the construction of streets, highways, or bridges, Bidder shall provide the information for each subcontractor who shall perform in excess of 1/2 of 1% of the Total Bid Price or $10,000, whichever is greater. Under San Francisco Administrative Code section 6.21A(9) and California Public Contract Code section 4104, failure to provide at a minimum the

(Rev. 3/13/2013) 00435 - 2 Subcontractor List name, location of the place of business, contractor’s license number, and the portion of work to be performed by each such subcontractor may render the bid nonresponsive or the Bidder unqualified to perform the work under this Contract. Bidders may provide license numbers or additional identifying information within 24 hours of the time bids are received. Where the City cannot identify a subcontractor with the information provided by a Bidder or where conflicting information is provided, the City may consider the subcontractor unlisted for purposes of Public Contract Code section 4106.

A. BIDDER’S PORTION OF WORK

1. NAME OF PRIME CONTRACTOR OR MAJORITY JOINT VENTURE PARTNER:

2. BID ITEMS/PORTION OF WORK TO BE SELF-PERFORMED (IF LESS THAN 100% OF THE CONTRACT WORK):

3. DOLLAR AMOUNT OF WORK TO BE SELF-

PERFORMED:

4. PERCENTAGE OF WORK TO BE SELF-

PERFORMED:

5. DATE:

B. LIST OF SUBCONTRACTORS

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

*Micro=Micro-LBE; MBE = Minority Business Enterprise, WBE = Women Business Enterprise, OBE = Other Business Enterprise.

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

*Micro=Micro-LBE; MBE = Minority Business Enterprise, WBE = Women

(Rev. 3/13/2013) 00435 - 3 Subcontractor List

Copy this page as needed to provide a complete listing. Page _____ of _____

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

1. TYPE OF SUBCONTRACTOR:

First Tier; Lower Tier; Supplier; Service Contractor (e.g. Trucker)

2. SUBCONTRACTOR NAME EMAIL

3. ADDRESS

4. BID ITEMS/PORTION OF WORK

5. PHONE NO. 6. VENDOR NO. 7. FEDERAL ID NO.

8. LICENSE NO. 9. SF BUSINESS TAX REG. NO. 10. AMOUNT OF SUB-

CONTRACT WORK: $

11. CERTIFIED

LBE? Yes; No

12. IF LBE, CHECK

APPLICABLE: Micro; MBE; WBE; OBE*

13. IF MICRO-LBE, ENTER

PERCENT PARTICIPATION: %

*Micro=Micro-LBE; MBE = Minority Business Enterprise, WBE = Women Business Enterprise, OBE = Other Business Enterprise.

END OF DOCUMENT