HomeMy Public PortalAboutAdd New Subcontractor Form (4)
Metropolitan St. Louis Sewer District
New Subcontractor Request Form
M/WBE Involvement Reporting
Complete this new subcontractor request ONLY if you are intending to add this subcontractor to those already
identified with your initial bid. If you are requesting approval to substitute this subcontractor for one identified
on your bid, you must contact the Project Manager.
Credit for MWBE participation for this supplier will be granted after certification is verified by MSD.
Project the New MWBE Subcontractor is For
Project #: _________________________________________________________________________________
Task #: ____________________________________________________________________________________
PO/Blanket #: ______________________________________________________________________________
Date: _____________________________________________________________________________________
New Vendor Information
Vendor Name: ______________________________________________________________________________
Vendor Address: ___________________________________________________________________________
City, State, ZIP: ____________________________________________________________________________
Contact: __________________________________________________________________________________
Phone: ___________________________________________________________________________________
Fax: _____________________________________________________________________________________
Email: ____________________________________________________________________________________
Vendor is Certified As:
Certification Agency:
Type of Work Performed: Specify: ________________________________________
Amount Paid this Period: _____________________________________________________________________
Anticipated Total Participation: ________________________________________________________________
Please e-mail the completed form to Katlynn Woodruff at kwoodruff@stlmsd.com. If you
are requesting approval to substitute this subcontractor, you must contact the MSD Project
Manager before submitting this form.