1. DISCLOSURE OF ASSIGNMENTS OR SUBCONTRATORS
    2. Contractor:__________________________________ Contract Number:______

 

 


 


DISCLOSURE OF ASSIGNMENTS OR SUBCONTRATORS

 

 


Contractor:__________________________________ Contract Number:______

 

In accordance with Attachment C, Standard Terms and Conditions, contractors may assign or delegate obligations under this contract to another party and may subcontract for any work contemplated under this Contract only with a DOE/DVR approved vendor, and with the written prior approval of DOE/DVR.

 

To ensure compliance with this section, please read and complete as appropriate:

 

_____ No, I am not assigning or subcontracting any or all parts of this contract.

 

_____ Yes, I am assigning or subcontracting any or all parts of this contract.

 

If yes, provide name of assignees or subcontractors with an explanation of what will be assigned or subcontracted as well as executed agreements with these parties.

 

 

 

 

 

 

 

_____________________________

NAME OF CONTRACTOR ENTITY

 

______________________________

Signature

 

_____________________________

Printed Name of Authorized Representative

 

______________________________

Date

STATE OF FLORIDA

COUNTY OF __________

Sworn to and subscribed before me this ____________ day of __________ by

 

________________________________

(name of person making statement)

 

 

_______________________________

Notary Public

Personally known _______ or Type of Identification produced: _________________

 

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