Attachment F Proposed Subcontractors.pdf
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- Attached to
- Master Agreement AZ|CTR072978
- Contract number
- CTR072978
- Issued by
- Arizona
About this file
This document is Attachment F, a Proposed Subcontractors form for Invitation for Bid No. BPM006067 issued by the Arizona Department of Health Services, located in Phoenix, Arizona. The form is specifically for Vision Screening Toolkit Components, with School Health Corporation listed as the primary contractor.
The form provides a template for the contractor to indicate whether they will use subcontractors for the project. The document allows for up to five potential subcontractors to be listed, with space to detail each subcontractor's name, contact information, small business status, work to be performed, and quality assurance/quality control (QA/QC) measures. In this instance, the contractor has checked "NO" to indicate they will not subcontract any portion of the work and will perform all work with their own personnel. The document also notes that the state may request additional information about proposed subcontractors as a precondition of award.
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Text version
ATTACHMENT F
PROPOED SUBCONTRACTORS ARIZONA DEPARTMENT OF
HEALTH SERVICES
150 North 18th Avenue, Suite 530
Phoenix, AZ 85007 INVITATION FOR BID NO.: BPM006067
VISION SCREENING TOOLKIT COMPONENTS
Attachment F – Proposed Subcontractors
Contractor Name: [Name]
Check “NO” if you WILL NOT subcontract any portion of the Work and will therefore be performing all of the Work with your own personnel.
☐ NO, the Offeror will not subcontract any portion of the Work.
If you WILL subcontract any portion of the Work, check “YES” below and list the name(s) of persons or companies you propose to use as Subcontractors.
1. Fill in the information for each significant Subcontractor – indicate the type of work the Subcontractor will perform under the Contract and their approximate percentage of the total Contract work;
2. Provide copies of relevant certifications each person or firm possesses attached to this form; AND
3. Provide a description of quality assurance (QA) and quality control (QC) measures that you will use to ensure that
Subcontractor’s work meets the Contract requirements.
State may demand additional information about proposed Subcontractors as a precondition of Award.
☐ YES, the Offeror will use the Subcontractors listed below:
No. Name and contact information Small business Work to be performed and QA/QC measures %
1. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
2. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
3. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
4. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
5. [Name]
[Contact information]
Yes or No
[Work to be performed]
[QA/QC measures] X
School Health Corporation
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