IFB 161212 ATTACHMENT D Subcontracting Approval Request (3).pdf

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Attached to
IFB 161212 Pipe Rehabilitation Rte 644
Solicitation number
IFB-128692
Issued by
Craig County, Virginia

About this file

This is a Subcontractor Approval Request form issued by the Virginia Department of Transportation (VDOT) for Invitation for Bid (IFB) 161212, which concerns pipe rehabilitation work on Route 644 in Culpeper County. The project involves applying a spray-on pipe liner inside an existing corrugated metal pipe in accordance with the specified scope of work and contract requirements. The form serves as the mechanism through which the primary contractor must request VDOT's prior written approval before subcontracting any portion of the work or equipment provision to another firm or individual.

The subcontractor approval process requires the primary contractor to submit detailed information for each proposed subcontractor, including the firm or individual's name and address, contact person and phone number, type of work to be performed, equipment proposed to be provided, and the subcontractor's qualifications and experience level. The form also requires identification of any proposed subcontractors certified by DSBSD as Small, Women-Owned, or Minority Businesses, along with their certification numbers. The primary contractor remains fully liable and responsible for all work performed by its subcontractors and must ensure compliance with all contract requirements. VDOT's authorized representative must sign and date the form to approve and accept the proposed subcontractors under the contract terms and conditions.

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Text version

ATTACHMENT D

Solicitation #:

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: 161212
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:

File details come from the government source that posted it. Updated .