ATTACHMENT FORM G - Leter of intent to perform as a subcontractor or subconsultant or to provide serivices-supplies.docx
DOCX document 33 KB Posted
- Solicitation number
- IFB-125001
- Issued by
- Portsmouth City, Virginia
About this file
Form G is a letter of intent template used by the Commonwealth of Virginia for subcontractors, subconsultants, and service/supply providers working on state and local contract opportunities, specifically this grounds maintenance project for fire stations. The form requires submission on the vendor's official company letterhead and must be signed by an authorized officer. Bidders must identify their project name, bid number, prime bidder information, and detailed description of the work, materials, or services they intend to perform. The form also captures certification status information, including whether the subcontractor or supplier holds Minority Business Enterprise (MBE), Women's Business Enterprise (WBE), or Service-Disabled Enterprise (SDE) certification from Virginia's Department of Minority Business Enterprise (DMBE), along with any SWAM certification number.
The second section of Form G functions as a payment application and tracking document that must be submitted with each pay request and final payment throughout the contract period. This section requires the prime contractor or architect to document all payments made to subcontractors, suppliers, and other service providers, listing firm names, addresses, applicable M/WBE/SDE categories, and payment amounts for each billing period. The form includes fields for tracking total payments to date and total amounts committed, with approval and certification required by an authorized representative. This documentation requirement ensures transparency in subcontractor payments and tracks compliance with any minority and women-owned business enterprise participation commitments associated with the grounds maintenance contract for Virginia fire stations.
View the file
Other files
Show all 12
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
FORM G
LETTER OF INTENT TO PERFORM AS A SUBCONTRACTOR OR SUBCONSULTANT OR TO PROVIDE SERVICES/SUPPLIES
Note: This form must be submitted to the Subcontractor/Subconsultant Company Official Stationery or Letterhead and signed by an authorized officer of the company or business Project Name: ____________________________________________ Bid # Name of Prime Bidder: ___________
| Address: | Street | City | State | Zip Code | |
| Telephone: | Email: |
Name of Certified Vendor The undersigned intends to perform work in connection with the above project as _____ Minority Business Enterprise ______ Women's Business Enterprise _____ Service-disabled Enterprise The M/WBE status of the undersigned is/is not certified by the Commonwealth of Virginia’s Department of Minority Business Enterprise (DMBE) Our SWAM certification number is _____________.
The undersigned is prepared to perform the following described work or provide materials or services in connection with the above project (specify in detail particular work items, materials or services to be performed or provided):
Note: This description is to be inserted in the submitted letter.
Date: __________________
| Name of Business: | ___________ | |||
| Address: | Street | City | State | Zip Code |
(Name & Title of Authorized Officer) ________________________________________ (Signature) Prime Contractor/Architect:
Address & Phone:
Project Name:
Pay Application #: P er iod:
Current Requested Payment Amount:
The following is a list of payments to be made to all contractors/suppliers & other providers on this project for the above-mentioned period.
| Firm Name and Address |
| *M/WBE |
Category
| Amount to be Paid form this pay Request |
| Total |
Payments to date Total Amount Committed
*M/W/SBE categories: African American (B), Asian American (A), Hispanic (H), Native American (N), Woman (W) Date: _ Approved/Certified By:
Name Title: _____________________
Signature: ___________________
**THIS DOCUMENT MUST BE SUBMITTED WITH EACH PAY REQUEST & FINAL PAYMENT**
File details come from the government source that posted it. Updated .