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["KENTUCKY TRANSPORTATION CABINET"]
["DEPARTMENT OF HIGHWAYS"]
["DIVISION OF CONSTRUCTION"]
["SUBCONTRACT REQUEST"]
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["SUBCONTRACT NO:",null,null,"Tier Y/N"]
[]
["TO:","Steve Criswell, P.E."]
[null,"Director, Division of Construction"]
["FROM:"]
["","Prime Contractor",{"$nulls":4},"KYTC Vendor Number"]
["SUBJECT:"]
[null,"County",null,"Fed/State Project Number",{"$nulls":6},2]
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["I hereby request to subcontract a portion of the subject project to:"]
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["The amount to be subcontracted by this request is               $",{"$nulls":3},"or",null,"% of the "]
["(Original contract amount or subcontract amount if Tier request)                             "]
["I have previously subcontracted as follows:"]
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["This subcontractor has been furnished a copy of Appendix B of 49 CFR Part 29 and advised to include the Certification in all lower tier covered transactions and in all solicitations for lower tier transactions (Federal Aid Contracts only)."]
[]
[]
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["The proposed subcontractor is on the Department's list of qualified contractors to perform work requested and a copy of current insurance coverage will be available at the prime contractor's office before the subcontractor begins work on project."]
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["Prime Contractor",{"$nulls":4},"Date"]
["CC District TEBM for Construction"]
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["Project Engineer",null,"Date  "]
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