Subcontractor Utilization Plan Template Page 3
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1
2
3REQUIRED SUBMISSION IF BIDDER INTENDS TO SUBCONTRACT
DPP Solicitation No.:
STATE OF NEW JERSEY
DIVISION OF PURCHASE AND PROPERTY (DPP)
SUBCONTRACTOR UTILIZATION PLAN
DPP Solicitation Title:
Bidder's Name and Address:
Bidder's Telephone No.:_______________________
Bidder's Contact Person: ______________________
INSTRUCTIONS:
List all businesses to be used as subcontractors. This form may be duplicated for extended lists.
CHECK HERE IF CONTRACT
SUBCONTRACTOR'S NAME
IS NOT SMALL BUSINESS
TYPE(S) OF GOODS
ESTIMATED
ADDRESS, ZIP CODE
OR SERVICES TO BE
VALUE OF
SMALL BUSINESS
TELEPHONE NUMBER
PROVIDED
SUBCONTRACTS
*
CATEGORY
AND VENDOR ID NUMBER
I
II
III
* For those Bidders listing Small Business Subcontractors: Attach copies of Division of Revenue - Small Business Enterprise Unit registration for each
subcontractor listed. If bidder has not achieved established subcontracting set-aside goals, also attach documentation of good faith effort to do so in the
relevant category in accordance with NJAC17:13-4 and the Notice to All Bidders.
I hereby certify that this Subcontractor Utilization Plan (Plan) is being submitted in good faith. I certify that each subcontractor has been notified that it has
been listed on this Plan and that each subcontractor has consented, in writing, to its name being submitted for this contract. Additionally, I certify that I
shall notify each subcontractor listed on the Plan, in writing, if the award is granted to my firm, and I shall make all documentation available to the Division
of Purchase and Property upon request.
I further certify that all information contained in this Plan is true and correct and I acknowledge that the State will rely on the truth of the information
in awarding the contract.
PRINCIPAL OF FIRM:
_________________________________________________ ____________________________________________ __________________________
(Signature)
(Title)
(Date)
PB-SA-3
Revised 10/11
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