TCCD REQUEST FOR APPROVAL OF CHANGE TO ORIGINAL
SCHEDULE OF SUBCONTRACTORS FORM
(Small M/WBE Modification or Substitution)
Contractor/Company, _____________________________________________________________________, project ________________________________________________________________, requests approval of the following addition(s) and/or deletion(s) on the SCHEDULE OF SUBCONTRACTORS as originally submitted as part of the bid on the above-named project.
CHECK (X) BLOCK FOR EACH TRANSACTION
INTENT TO PERFORM
CERTIFICATION OF AFFIDAVIT
The above information is true and complete to the best of my knowledge and belief. I further understand and agree that this certification will become a part of my contract with the TCCD.
(Please Print or Type)
Name and Title of Signer: ________________________________/________________________
Signature: ___________________________________________Date: _____________________