Subcontractor Disclosure form.docx
DOCX document 18 KB Posted
- Attached to
- CHJ 549 HEALTH CARE REQUEST FORM
- Solicitation number
- RFQ 171 270000000047 1
- Issued by
- Michigan
About this file
This is a Subcontractor Disclosure Form issued by the State of Michigan for a health care contract opportunity (CHJ 549). The form requires bidders to provide comprehensive information about all anticipated subcontractors, including legal business names, addresses, telephone numbers, descriptions of services to be provided, and evidence of the subcontractor's capability to perform contract activities. Bidders must also disclose the relationship between themselves and each subcontractor, whether prior working experience exists, and a detailed description of the specific contract activities each subcontractor will perform. The form includes a summary table requiring bidders to report the total percentage of work to be performed by all subcontractors and the percentage of subcontracted work performed by Geographically Disadvantaged Business Enterprise (GDBE) subcontractors.
The form requires bidders to identify the price of each subcontractor's work as a portion of the total bid amount. A Geographically Disadvantaged Business Enterprise (GDBE) is defined as a business designation established by State of Michigan Executive Directive 2019-08 to expand contracting opportunities in low-income communities and underutilized areas. Bidders must complete the subcontractor disclosure table for each anticipated subcontractor and may copy the table as needed to accommodate multiple subcontractors involved in performing the contract activities.
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Other files
| File | Type | Posted |
|---|---|---|
| Standard Contract Terms - Short Form.pdf | ||
| State of Michigan Print Mail Management Terms Conditions (1).docx | DOCX document | |
| CHJ-549 sample.pdf | ||
| CHJ 549 Health Care Request Form 8-24.docx | DOCX document |
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Text version
Required Subcontractor information. Bidders must complete the table below for each anticipated subcontractor. Copy the table as many times as needed for each subcontractor.
Complete the second table with the percentage of work that will be completed by all subcontractors involved.
| Requested Information |
| Bidder Response |
The legal business name, address, telephone number of the subcontractor(s).
A description of subcontractor’s organization and the services it will provide and information concerning subcontractor’s ability to provide the Contract Activities.
The relationship of the subcontractor to the Bidder.
Is the subcontractor a GDBE**?
Whether the Bidder has previous working experience with the subcontractor.
A complete description of the Contract Activities that will be performed or provided by the subcontractor.
Of the total bid, the price of the subcontractor’s work.
Work performed by subcontractors
Total percentage of work that will be performed by subcontractors:
Total percentage of subcontracted work that will be performed by GDBE subcontractors:
**-A Geographically Disadvantaged Business Enterprise (GDBE) is a business designation established by State of Michigan Executive Directive 2019-08 to expand contracting opportunities in low-income communities and underutilized areas
File details come from the government source that posted it. Updated .