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FIRST 77ER SUBCONTRACTORS <br />DISCLOSURE FORM <br />BID CLOSING: Date: July 1. 2010 Time: 5:00 P.M. <br />The bidder must identify first -tier contractors that will be furnishing labor or will be furnishing labor and <br />materials in connection with the public improvement contract and will have a contract value that is equal to <br />or greater than five percent of the total project bid or $15,000.00, whichever Is greater, or $350,000 <br />regardless of the percentage of the trial project bid. The subcontractor disclosures are public records and <br />will be made available for public inspection. <br />This form must be submitted at the location specified in the Invitation to Quote on the advertised bid <br />closing date and within two woddng hours after the advertised bid dosing time. <br />List below the name of each subcontractor that will be furnishing labor or will be furnishing labor and <br />materials and that is required to be disclosed, the category of work that the subcontractor will be <br />performing and the dollar value of the subcontract. Enter "NONE" if there are no subcontractors that need <br />to be disclosed. (ATTACH ADDITIONAL SHEETS IF NEEDED.) <br />NAME DOLLAR CATEGORY <br />VALUE OF WORK <br />1) <br />2) <br />3) <br />4) <br />5) <br />Failure to submit this form by the disclosed deadline will result in a nonresponsive bid. A nonresponsive bid <br />will not be considered for award. <br />FORM SUBMITTED BY (BIDDER NAME): SiteWork Construction. Inc. <br />CONTACT NAME: <br />PHONE: 541 -744 -9204 FAX: <br />15 <br />PI RFQ 2010200077 Sidewalk Access Ramps <br />