Schedule A - Attachment 2 - Disclosure of Subcontractors.xlsx

This is a Schedule A Disclosure of Subcontractors form for a Non-Emergency Medical Transportation (NEMT) Broker contract for Medicaid Fee-For-Service beneficiaries in Michigan, with separate sections for the Tri-County region (Wayne, Oakland, and Macomb Counties) and statewide service areas. Bidders are required to complete detailed disclosure information for each existing and anticipated subcontractor, including the subcontractor's legal business name, address, telephone number, and organizational description. The form requires bidders to identify whether subcontractors will provide administrative or transportation services, specify transportation capacity including vehicle types and quantities (such as ambulatory cars, wheelchair lift-equipped vehicles, Medivans, and ambulettes), and list the number of drivers available for the contract. Bidders must also identify the county or counties in which each subcontractor will operate, indicate the relationship between the subcontractor and bidder, and disclose the percentage of total bid price attributable to each subcontractor's work.

Additional disclosure requirements include identifying whether subcontractors are Certified Disadvantaged Business Enterprises (GDBE), documenting any previous working relationships between the bidder and subcontractor, and confirming whether the bidder has either a current active contract with or a letter of intent from each subcontractor. The form requires a comprehensive description of contract activities to be performed by each subcontractor. The document provides 1,000 rows for the Tri-County Schedule A and 1,000 rows for the Statewide Schedule A, indicating the contract may involve multiple subcontractors across numerous Michigan counties including all 83 counties in the state for the statewide option.