T1307 Subcontractor Utilization Form.pdf

PDF 76 KB Posted

Attached to
T1307 - Hot Pour Crack Filler, Detackifier and Application Tools
Solicitation number
21DPP00573
Issued by
New Jersey

About this file

The document provided is a Subcontractor Utilization Form from the State of New Jersey Department of the Treasury Division of Purchase and Property for a Bid Solicitation (BID SOLICITATION #: T1307) titled "Hot Pour Crack Filler, Detackifier and Application Tools". The form requires the vendor to list all businesses to be used as subcontractors, including the subcontractor's name, address, phone number, email, FEIN, estimated value of work to be subcontracted, description of work to be subcontracted, and whether the subcontractor is a small business or disabled veteran-owned business. The contract opportunity involves the State of New Jersey as well as Mercer County and Trenton City.

The form indicates that if the bid solicitation has subcontracting set-aside goals and the vendor has not achieved the goals, the vendor must attach information documenting its good faith effort to achieve the goals. No additional details on pricing terms, set asides, incumbents, funding requirements, or other salient information are provided in the document.

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Text version

STATE OF NEW JERSEY

DEPARTMENT OF THE TREASURY

DIVISION OF PURCHASE AND PROPERTY

33 WEST STATE STREET, P.O. BOX 230

TRENTON, NEW JERSEY 08625-0230

SUBCONTRACTOR UTILIZATION FORM*

List All Businesses To Be Used As Subcontractors. Attach Additional Sheets If Necessary

BID SOLICITATION #:

BID SOLICITATION TITLE:

VENDOR’S NAME:

ADDRESS:

PHONE NUMBER:

EMAIL:

FEIN:

SUBCONTRACTOR’S NAME:

ADDRESS:

PHONE NUMBER:

EMAIL:

ESTIMATED VALUE OF WORK TO BE SUBCONTRACTED:

DESCRIPTION OF WORK TO

BE SUBCONTRACTED:

IS THE SUBCONTRACTOR A SMALL BUSINESS? IS THE SUBCONTRACTOR A DISABLED VETERAN-

OWNED BUSINESS?

YES NO YES NO

IF YES, SMALL BUSINESS CATEGORY:

I II III IV V VI

FEIN:

SUBCONTRACTOR’S NAME:

ADDRESS:

PHONE NUMBER:

EMAIL:

ESTIMATED VALUE OF WORK TO BE SUBCONTRACTED:

DESCRIPTION OF WORK TO

BE SUBCONTRACTED:

IS THE SUBCONTRACTOR A SMALL BUSINESS? IS THE SUBCONTRACTOR A DISABLED VETERAN-

OWNED BUSINESS?

YES NO YES NO

IF YES, SMALL BUSINESS CATEGORY:

I II III IV V VI

FEIN:

SUBCONTRACTOR’S NAME:

ADDRESS:

PHONE NUMBER:

EMAIL:

ESTIMATED VALUE OF WORK TO BE SUBCONTRACTED:

DESCRIPTION OF WORK TO

BE SUBCONTRACTED:

IS THE SUBCONTRACTOR A SMALL BUSINESS? IS THE SUBCONTRACTOR A DISABLED VETERAN-

OWNED BUSINESS?

YES NO YES NO

IF YES, SMALL BUSINESS CATEGORY:

I II III IV V VI

* If the Bid Solicitation has subcontracting set-aside goals, and the Vendor has not achieved the goals, Vendor must attach information documenting its good faith effort to achieve the goals. DPP Rev. 3.14.19

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