______________________________________________________________________________
FIRST-TIER SUBCONTRACTOR
DISCLOSURE FORM
PROJECT NAME: ____________
BID #: _________
BID CLOSING: Date: _____Time: _____
This form must be submitted at the location specified in the Invitation to Bid on the advertised bid closing date and within two working hours after the advertised bid closing time.
List below the name of each subcontractor that will be furnishing labor or will be furnishing labor and materials and that is required to be disclosed, the category of work that the subcontractor will be performing and the dollar value of the subcontract. Enter "NONE" if there are no subcontractors that need to be disclosed. (ATTACH ADDITIONAL SHEETS IF NEEDED.)
NAME | DOLLAR VALUE | CATEGORY OF WORK |
1) ________ | $______ | ________ |
_________ | ______ | ________ |
2) ________ | $______ | ________ |
_________ | ______ | ________ |
3)________ | $______ | ________ |
_________ | ______ | ________ |
4)________ | $______ | ________ |
_________ | ______ | ________ |
Failure to submit this form by the disclosure deadline will result in a nonresponsive bid. A nonresponsive bid will not be considered for award.
Form submitted by (bidder name):
___________________________
Contact name: _________________
Phone no.: _________________
______________________________________________________________________________
ORS 279C.370