X hits on this document

255 views

0 shares

0 downloads

0 comments

94 / 104

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

CHANGE

ADD

DELETE

COMPANY NAME

TRADE

SMALL M/WBE

STATUS

DOLLAR AMOUNT

INTENT TO PERFORM

JUSTIFICATION

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: ________________________________/________________________

         Printed NameTitle

Signature: ___________________________________________Date: _____________________

Document info
Document views255
Page views255
Page last viewedSun Dec 04 06:57:56 UTC 2016
Pages104
Paragraphs1402
Words16282

Comments