Tennessee CPO ITB 32701-13862

Attachment 1 Page 1 of 2 Attachment 1 – ITB # 32701 -13862 Running Reelfoot Bayou WTRBA Running Reelfoot Bayou Nathan Bedford Forrest State Park 1825 Pilot Knob Road Eva, TN 38333 Project Name: Declaration of Intended Use of Subcontractor(s) (To be Completed by Prime Contractor and submitted with bid) License Requirement of Project: Prime Contractor Name: Prime Contractor License Type: Number: Please Initial the appropriate box I do not intend to use a subcontractor(s) on this project. I intend to use the following subcontractor(s) on this project. All subcontractors working in a licensed trade are required to possess a valid contractor license for work planned/ performed, as long as their portion of work is $25,000 or more. Subcontractor Name, Address, Contact Name, Phone Number Trade License Type License # % of sub-contractor estimated $ By signing, I understand that any additions or changes regarding the use or substitution of subcontractor(s) requires written pre -approval of Facilities Management Office prior to subcontractor performing work under this project. Their contractor license information is required and shall be verified prior to approval. The use of day laborers/ temporary help is not authorized on this project. Attachment 1 Page 2 of 2 Attachment 1 – ITB # 32701 -13862 Running Reelfoot Bayou Contractor Signature: Date: