EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS.pdf

PDF 38 KB Posted

Attached to
Disadvantage and Small Business Enterprise Certification Services
Solicitation number
PS143910
Issued by
California

About this file

Exhibit G is an Approved Subcontractors and Suppliers form template used by a state or local contracting agency to document subcontractor and supplier information for contract awards. The document provides structured fields for listing up to ten subcontractors and ten suppliers, with designated areas to record the services performed or materials supplied by each party. The form requires documentation of contractor licensing information and designations related to disadvantaged business enterprise (DBE), small business enterprise (SBE), and disabled veteran business enterprise (DVBE) status for each listed subcontractor and supplier. Contact information including name, address, and phone number must be provided for all parties listed on the form.

The template indicates that specific subcontractor and supplier information will be incorporated by the Contract Administrator at the time of contract award. The form emphasizes the tracking and documentation of small and disadvantaged business participation in state and local contracts through the identification of DBE/SBE/DVBE certified firms. This exhibit serves as an official record-keeping mechanism to ensure compliance with affirmative action and small business utilization requirements that are typically mandated in public contracting processes.

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Text version

EXHIBIT G - APPROVED SUBCONTRACTORS AND SUPPLIERS*

Subcontractor Services Performed License Type and Number

DBE/SBE/

DVBE

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Supplier Material Supplied

DBE/SBE/

DVBE

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

Name:

Address:

Phone:

(Information will be incorporated by the Contract Administrator at time of award)

Name 1:
Address 1:
Phone 1:
Name 2:
Address 2:
Phone 2:
Services Performed 1:
Services Performed 2:
Services Performed 3:
Services Performed 4:
Services Performed 5:
Material Supplied 2:
Material Supplied 3:
Material Supplied 4:
Material Supplied 1:
Material Supplied 5:
Name 3:
Name 4:
Name 5:
Name 6:
Name 7:
Name 8:
Name 9:
Name 10:
Address 10:
Phone 10:
Phone 9:
Address 9:
Phone 8:
Phone 7:
Address 7:
Phone 6:
Address 6:
Phone 5:
Address 8:
Phone 4:
Address 4:
Phone 3:
Address 3:
Address 5:
License Type and Number 1:
License Type and Number 2:
License Type and Number 3:
License Type and Number 4:
License Type and Number 5:
DBE/SBE/DVBE 1:
DBE/SBE/DVBE 2:
DBE/SBE/DVBE 3:
DBE/SBE/DVBE 4:
DBE/SBE/DVBE 5:
DBE/SBE/DVBE 6:
DBE/SBE/DVBE 7:
DBE/SBE/DVBE 8:
DBE/SBE/DVBE 9:
DBE/SBE/DVBE 10:

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