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Subcontracting Plan Form Dcocp 1105 2005-2023
Value
%
Percentage Set Aside
(List each subcontractor at any tier that will be awarded a subcontract to meet your total set aside goal.)
SUBCONTRACTOR INFORMATION: (use continuation sheet for additional subcontracts)
Name
Address & Telephone No.
Type of Work
NIGP Code(s)
Total Amount Set Aside: $
Point of Contact:
Percentage of Total Set Aside Amount :
%
Tier: :
DBE:
DZE:
Name (Print)
Contact Telephone Number:
1st, 2nd, 3rd
LSDBE Certification Number:
Certification...
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