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[]
[null,"Contractor's Instructions for Completing Form C-220"]
[null,"(Request to Subcontract Work)"]
[]
[null,"Fill out this form on the 'Data Entry' Worksheet per the instructions below.  You will then need to go to the 'Printed_Form' Worksheet to Review and save the file as a PDF by using the button provided. The File should open in your default PDF application where you will then need to apply your Digital Signature.  Once signed, attach the signed copy and any required suppoting documents (in standard PDF format) in an email to the Resident Engineer for review and approval prior to any work being performed by the proposed\nsubcontractor."]
[]
[null,"The proposed subcontractor must be on the MoDOT pre-approved Subcontractor List prior to submission of this form. Information on\nhow to become a MoDOT subcontractor is available here:"]
[null,"How to become a MoDOT Subcontractor"]
[]
[null,"The Prime Contractor is responsible for either providing insurance coverage for its subcontractors in the amounts specified in the contract, or for requiring its subcontractors to carry the necessary coverage.  MoDOT will only verify insurance coverage carried by the prime contractor.  The prime contractor shall be responsible for monitoring insurance coverage of its subcontractors. "]
[]
[null,"Enter all required information in the header, including the vendor ID, which is available on the MoDOT website. Use the link below"]
[null,"to MoDOT Online Plans Room. Look in the Documents section for the Prime and Subcontractor links."]
[null,"MoDOT Online Plans Room Information Page"]
[null,"For 2nd tier subcontract requests, also list the name of the 1st tier subcontractor."]
[]
[null,"The prime contractor's name and digital signature are required on the bottom of the form for both 1st tier and 2nd tier requests. The\nsubcontractor does not sign the form."]
[]
[null,"Show the planned subcontract work by entering the Line Number and Description of the appropriate pay items as they appear in the\ncontract. The Quantity and Subcontracted Unit Price for each line shall be that designated in the subcontract agreement between the\nContractor and the Subcontractor. If the subcontract unit of measure differs from the contract, state the subcontract units in the Description [E.g., “Diamond Grinding (per hour)”].  Requests for first tier subcontractors should include the work they plan to perform, as well as all work they plan to sublet to a second tier subcontractor. For 2nd tier requests, list the work the 2nd tier sub will perform, using thequantity and price from the subcontract agreement between the 1st and 2nd tier subcontractors."]
[]
[null,"Include a copy of the subcontract agreement with this request if any of the following apply:"]
[]
[null,1,"The unit price or quantity on any line differs from what is in the contract."]
[null,2,"The requested subcontractor is a DBE."]
[null,3,"The request is for a second tier relationship. In this case, include agreements for both tiers (i.e. the prime/1st tier\nagreement, as well as the 1st tier/2nd tier agreement )."]
[]
[null,"For DBE requests, the total dollar amount for each line item must be the same as what was reported on the DBE Identification Submittal Form. Any additional items which the DBE is not certified to perform shall be listed on a separate C-220 form and the DBE checkbox shall not be checked. No changes to the agreement between the Prime and Subcontractor are required. Any work subcontracted from a 1st tier DBE contractor to a 2nd tier non-DBE contractor will not count towards the DBE contract goal."]
[]
[null,"The total from all approved 1st tier subcontract requests will be used to calculate the total percent sublet. All 2nd tier work is\naccounted for in the 1st tier requests."]
[]
[null,"For Federal Aid Projects:"]
[]
[null,1,"Submit a completed Subcontractor Certification Regarding Affirmative Action form with this request."]
[null,null,"SUBCONTRACTOR CERTIFICATION REGARDING AFFIRMATIVE ACTION Form"]
[null,2,"Submit the name, address, and telephone number of the subcontractor's EEO Officer on the subcontractor's\nletterhead with this request."]
[null,3,"Ensure the Federal provisions and wage rates, including Form FHWA-1273 is physically inserted into every subcontract agreement, including those agreements between the 1st and 2nd tier subcontractors."]

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["Missouri Department of Transportation"]
["Request to Subcontract Work"]
[]
["Contract ID:",null,null,null,null,null,null,null,"Job Number:"]
[]
["Route:",null,null,null,null,null,null,null,"County:"]
[]
["We request MoDOT approval to sublet the items of work listed below to:"]
[]
["Name:",null,null,null,null,null,null,null,"Vendor ID:"]
[]
["Address:"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false]
[]
["If any of the above boxes are checked, include a copy of the subcontract agreement with this request."]
[]
[null,"By signing below, I certify that the subcontract agreement with the proposed subcontractor includes provisions to comply\nwith all requirements of the contract identified above, and for Federal-aid projects, the Federal provisions and wage rates,\nincluding Form FHWA-1273, has been physically inserted into the subcontract agreement."]
[]
[]
[null,"Respectfully submitted:",null,null,null,null,null,null,null,"Approved by:"]
[]
[]
[]
[]
[null,"Company Name (Prime Contractor)",null,null,null,null,null,null,null,"Name / Title"]
[]
[]
[]
[]
[null,"Signed (Prime Contractor)",null,null,null,null,null,null,null,"Signed (MoDOT)"]
[]
[]
[null,"Subcontracted Items below"]
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["Missouri Department of Transportation"]
["Request to Subcontract Work"]
[]
["Contract ID:",null,{"$f":"IF('Data entry'!C4:G4=0,\" \",'Data entry'!C4:G4)","v":" "},null,null,null,null,"Job Number:",null,null,{"$f":"IF('Data entry'!K4:O4=0,\" \",'Data entry'!K4:O4)","v":" "}]
[]
["Route:",null,{"$f":"IF('Data entry'!C6:G6=0,\" \",'Data entry'!C6:G6)","v":" "},null,null,null,null,null,"County:",null,{"$f":"IF('Data entry'!K6:O6=0,\" \",'Data entry'!K6:O6)","v":" "}]
[]
["We request MoDOT approval to sublet the items of work listed below to:"]
[]
["Name:",null,{"$f":"IF('Data entry'!C10:G10=0,\" \",'Data entry'!C10:G10)","v":" "},null,null,null,null,null,"Vendor ID:",null,{"$f":"IF('Data entry'!K10:O10=0,\" \",'Data entry'!K10:O10)","v":" "}]
[]
["Address:",null,{"$f":"IF('Data entry'!C12:O12=0,\" \",'Data entry'!C12:O12)","v":" "}]
[]
[null,null,null,null,null,null,null,null,null,{"$f":"IF('Data entry'!J14:O14=0,\" \",'Data entry'!J14:O14)","v":" "},null,null,null,null,null,{"$f":"'Data entry'!P14","v":false}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"'Data entry'!P16","v":false}]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"'Data entry'!P18","v":false}]
[]
["If any of the above boxes are checked, include a copy of the subcontract agreement with this request."]
[]
[null,"By signing below, I certify that the subcontract agreement with the proposed subcontractor includes provisions to comply with all requirements of the contract identified above, and for Federal-aid projects, Form FHWA-1273 has been physically inserted into the subcontract agreement."]
[]
[]
[null,"Respectfully submitted:",null,null,null,null,null,null,null,"Approved by:"]
[]
[null,{"$f":"IF('Data entry'!B27:G29=0,\" \",'Data entry'!B27:G29)","v":" "},null,null,null,null,null,null,null,{"$f":"IF('Data entry'!J27:O29=0,\" \",'Data entry'!J27:O29)","v":" "}]
[]
[]
[null,"Company Name (Prime Contractor)",null,null,null,null,null,null,null,"Name / Title"]
[]
[]
[]
[]
[null,"Signed (Prime Contractor)",null,null,null,null,null,null,null,"Signed (MoDOT)"]
[]
[]
[null,"Subcontracted Items below"]
[null,"Line No.",null,"Description",null,null,null,null,null,"Quantity",null,"Unit Price",null,"Dollar Amount"]
[null,null,null,null,null,null,null,null,null,null,null,"(From Subcontract)"]
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[null,null,null,null,null,null,null,null,null,"Total This Page",null,null,null,{"$f":"SUM(N41:N55)","v":0}]
[null,null,null,null,null,null,null,null,null,"Total all Pages",null,null,null,{"$f":"$N$224+$N$168+$N$56+$N$112","v":0}]
["Contract ID:",null,{"$f":"C4","v":" "},null,null,null,null,"Job Number:",null,null,{"$f":"K4","v":" "}]
[]
["Subcontractor:",null,{"$f":"C10","v":" "},null,null,null,null,null,{"$f":"I10","v":"Vendor ID:"},null,{"$f":"K10","v":" "}]
[]
[null,null,null,"--Items Continued--"]
[]
[null,"Subcontracted Items below"]
[null,"Line No.",null,"Description",null,null,null,null,null,"Quantity",null,"Unit Price",null,"Dollar Amount"]
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["Contract ID:",null,{"$f":"C58","v":" "},null,null,null,null,"Job Number:",null,null,{"$f":"K58","v":" "}]
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["Subcontractor:",null,{"$f":"C60","v":" "},null,null,null,null,null,"Vendor ID:",null,{"$f":"K60","v":" "}]
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[null,null,null,"--Items Continued--"]
[]
[null,"Subcontracted Items below"]
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["Contract ID:",null,{"$f":"C114","v":" "},null,null,null,null,"Job Number:",null,null,{"$f":"K114","v":" "}]
[]
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