Exhibit_C_FORM_C_Subcontractor_and_Vendor_List.doc

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MDA Soil Vapor Monitoring
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RFP-0000476
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Exhibit C Form C Subcontractor and Vendor List

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Text version

Ex C Form C (Rev. 2, 11/6/09) Subcontractor and Vendor List August 27, 2019

EXHIBIT “C”

FORM C

SUBCONTRACTOR AND VENDOR LIST

SUBCONTRACTOR shall list all lower-tier subcontractors, suppliers, vendors and licensors who will furnish major components, equipment, materials, and/or services. If no subcontracts or purchases are anticipated, enter the word “NONE” under the column "Name and Address".

Name and Address
Work

Description

Contract Terms
Contract Value
Country of Origin
Small Business Code(s)

NOTES:

Contract Terms:

Enter Cost Reimbursable, Lump Sum, Unit Price, etc.

PN: In the following note on Value, enter a dollar amount in the space provided and include Form C-1. Otherwise, delete the note and DO NOT include Form C-1.

Contract Value:

Provide a Form C-1 “Lower-tier Experience Statement” for each lower-tier subcontract/vendor exceeding a value of $5,000.

Small Business Code(s):

See FAR 52.219-8 Utilization of Small Business Concerns for definitions of terms. If a subcontractor, supplier or licensor is a small business concern, enter code:

"a" for HUBZone small business concern;

"b" for Service-disabled veteran-owned small business concern;

"c" for Small disadvantaged business concern;

"d" for Veteran-owned small business concern;

"e" for Women-owned small business concern;

“f” for 8(a) designation;

“g” for Native American owned;

“h” for Native Alaskan-owned, and

“I” for Other and specify.

All codes may apply to a single small business concern.

THIS FORM IS PRIMARILY FOR BID EVALUATION HOWEVER IS NOT PRECLUDED FROM BECOMING PART OF A RESULTANT SUBCONTRACT.

Subcontract No. PR# RFP-0000476

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