1-VENDOR INFORMATION CREATESUPPLIER02112026REV3.pdf

PDF 197 KB Posted

Attached to
Construction Trade Pipeline Program Service Provider
Solicitation number
RFP260177
Issued by
Bath County, Kentucky

About this file

This is a Vendor Information/Create Supplier form issued by Louisville Metro Government (LMG) dated February 11, 2026, Revision 3, for use in responding to the Construction Trade Pipeline Program Service Provider opportunity administered by the Greater Louisville Workforce Development Board (KentuckianaWorks) in Kentucky. The form serves as the standard vendor registration and proposal submission document for LMG procurement processes. Prospective service providers must complete all required sections of the form, including full legal business name, address, contact information, federal identification numbers, and authorized agent details for contract negotiations and invoicing. The form accommodates new supplier registration or updates to existing supplier records and must be submitted through LMG's Workday system as part of the CREATE SUPPLIER REQUEST task, accompanied by an IRS Form W-9 dated within the preceding 12 months.

The form includes comprehensive sections for documenting supplier ownership status, certifications, and demographic classifications relevant to LMG's procurement goals. Vendors may indicate minority-owned, women-owned, disabled-owned, or LGBT-owned status, along with relevant certifications such as Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Disabled Business Enterprise (DIBE), LGBT Business Enterprise (LGBTBE), Veteran-Owned Small Business (VOSB), and Service-Disabled VOSB designations. Additionally, vendors must provide race and ethnicity information for Louisville Metro Human Relations Commission certification purposes. The form establishes clear procedural distinctions between new supplier requests and supplier record updates, requiring vendors to complete only applicable sections when requesting changes to existing records through the SUPPLIER CHANGE REQUEST process in Workday.

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Text version

VENDOR INFORMATION / CREATE SUPPLIER

Full Legal Business Name of Proposer:

Address:

City: State: Zip:

E-Mail Address:

Telephone:

Metro Louisville Revenue Commission Number:

Federal ID Number:

Unique Entity Identifier:

The following individual is authorized to submit this proposal on behalf of and enter subsequent negotiations should Louisville Metro Government determine our firm reasonable susceptible of being selected for award.

Contact for Contracts: Contact for Invoices:

Email: Email:

Name: Name:

Phone Number: Phone Number:

Authorized Agent Signature:

Printed Name:

Title:

E-Mail Address:

Date:

Supplier Classification Ownership Status (51% owned or controlled)

Minority-Owned Women-Owned Disabled-Owned LGBT-Owned Non-Profit Not Applicable

Certifications (if applicable) Minority Business Enterprise (MBE) Women Business Enterprise (WBE) Disabled Business Enterprise (DIBE) LGBT Business Enterprise (LGBTBE) Veteran Owned Small Business (VOSB) Service-Disabled VOSB (SDVOSB)

Louisville Metro Human Relations Commission Certification Race / Ethnicity American Indian or Alaska Native Asian American Asian-Indian American Asian – Pacific American Black / African American Caucasian Latino or Hispanic Other

Form Date: 02/11/2026 - REV 3

To Request New Supplier: Suppliers complete all sections of this form along with an IRS Form W-9 dated within the last 12 months. Forms are attached and submitted by LMG in Workday as part of the CREATE SUPPLIER REQUEST task.

To Update / Change to Supplier Record: Suppliers must complete the applicable sections. LMG completes the Workday task CREATE REQUEST; select SUPPLIER CHANGE REQUEST; enter the requested change and attach this completed form

Full Legal Business Name of Proposer:
Address:
City:
State:
Zip:
EMail Address:
Telephone:
Metro Louisville Revenue Commission Number:
Federal ID Number:
Unique Entity Identifier:
The following individual is authorized to submit this proposal on behalf of:
Email:
Email_2:
Name:
Name_2:
Phone Number:
Phone Number_2:
Printed Name:
Title:
EMail Address_2:
Date:
MO: Off
WO: Off
DO: Off
LO: Off
NP: Off
NA: Off
MBE: Off
WBE: Off
DIBE: Off
LGBTBE: Off
VOSB: Off
SDVOSB: Off
AI: Off
AA: Off
AIA: Off
APA: Off
BAA: Off
C: Off
LOH: Off
O: Off

File details come from the government source that posted it. Updated .