ICA submittal form

ICA - Packet upload form

Contractor

Address

Department #

Manager

Line Item Number:

Contract Amount

Note: If cost-sharing input additional line items and amount to be taken from it.

Additional Line Item 2

Contract Amount

Additional Line Item 3

Contract Amount

Additional Line Items Cont.

Supporting Documentation Uploads

Is this a sole source ICA

Yes

Is this an emergency?

Yes

Will a 3rd Party Contract be included?

Yes

ICA Template Word Document only

Upload File

3rd Party Contract/Agreement (If ICA template is not to be used)

Upload File

Signed W-9 (PDF)

Upload File

Business License

Upload File

Workers Comp/Exemption Cert.

Upload File

EPLS Search

Upload File

RFP (PDF)

Upload File

Completed Bidders List

Upload File

Completed Contractor's Bid Submission Sheet

Upload File

Written sole source justification

Upload File

Excutive Director/FHBC Approval

Upload File

Contractor's Quote(s)

Upload File

Additional Comments

Thanks for submitting!

Shoshone-Bannock Tribes

TRANSPORTATION
D E P A R T M E N T

ICA - Packet upload form

Supporting Documentation Uploads

Shoshone-Bannock Tribes

TRANSPORTATION D E P A R T M E N T

ICA - Packet upload form

Supporting Documentation Uploads

TRANSPORTATION
D E P A R T M E N T