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