Contract Name: Time and Attendance Management Solution SUBCONTRACTOR INFORMATION FORM PART I STATEMENT BY PROPOSING VENDOR – 1. CONTRACT NO. 2. Proposing Vendor Name: 3. Mailing Address GSS13695-TIME_LABOR 4. SUBCONTRACTOR a. NAME 4c. Company OMWBE Classification: Certification Number: _____________________ b. Mailing Address: 4d. Women Business Enterprise Yes No 4e. Minority Business Enterprise Yes No 4f. Disadvantaged Business Enterprise Yes No 5. DESCRIPTION OF WORK BY SUBCONTRACTOR 6a. NAME OF PERSON SIGNING 7. BY (Signature) 8. DATE SIGNED 6b. TITLE OF PERSON SIGNING PART II ACKNOWLEDGEMENT BY SUBCONTRACTOR – 9a. NAME OF PERSON SIGNING 10. BY (Signature) 11. DATE SIGNED 9b. TITLE OF PERSON SIGNING * Use a separate form for each subcontractor
Contract Name: Time and Attendance Management Solution SUBCONTRACTOR INFORMATION FORM PART I – STATEMENT BY PROPOSING VENDOR 1. CONTRACT NO. GSS13695-TIME_LABOR 2. Proposing Vendor Name: 3. Mailing Address 4. SUBCONTRACTOR a. NAME 4c. Company OMWBE Classification: Certification Number: _____________________ b. Mailing Address: 4d. Women Business Enterprise Yes No 4e. Minority Business Enterprise Yes No 4f. Disadvantaged Business Enterprise Yes No 5. DESCRIPTION OF WORK BY SUBCONTRACTOR 6a. NAME OF PERSON SIGNING 7. BY (Signature) 8. DATE SIGNED 6b. TITLE OF PERSON SIGNING PART II – ACKNOWLEDGEMENT BY SUBCONTRACTOR 9a. NAME OF PERSON SIGNING 10. BY (Signature) 11. DATE SIGNED 9b. TITLE OF PERSON SIGNING * Use a separate form for each subcontractor
GSS_13695TimeLabor_Add3-REV.docx