2-Form HUB-Supplemental-Vendor-Information 9.2021.pdf
PDF 173 KB Posted
- Attached to
- Artificial Turf Putting Green State and local contract opportunity
- Solicitation number
- 59-Q6923
- Issued by
- Guilford County, North Carolina
About this file
This is a supplemental vendor information form (Form HUB) dated September 2021 related to North Carolina A&T State University's artificial turf putting green installation project within the Aggie Dome. The project aims to establish a high-performance indoor putting green to support the University's athletic programs and general campus programming. The installation will provide a consistent, weather-independent training surface that meets professional-grade standards for golf instruction and player development, with year-round accessibility for student-athletes, coaches, and physical education classes. The facility will deliver a durable, low-maintenance solution that maximizes the functionality of the existing Aggie Dome space while supporting the University's strategic objectives in athletic facility enhancement and competitive performance improvement.
The supplemental vendor information form serves as documentation for vendor qualification and participation in the procurement process. This form typically captures essential business information required for vendor vetting, including company credentials, experience, capabilities, and certifications relevant to artificial turf installation and sports facility construction. As a HUB (Historically Underutilized Business) supplemental form, it likely emphasizes minority or disadvantaged business enterprise status and related set-asides to encourage participation from qualifying vendors in the competitive bidding process for this University facility improvement project.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 1-North Carolina Instructions to Vendors - 7-10-2023 - eVP go-live version.pdf | ||
| 3-Form North Carolina General Terms and Conditions 11 2023.pdf | ||
| 7-RFQ-59-6923 Artificial Turf.pdf | ||
| 5-Form Certification-of-Financial-Condition 09.2021.pdf | ||
| 6-Form Vendor-Price-Matching-Opportunity 09.2021.pdf | ||
| 4-PC Form Customer Reference Template 09.2021 Attachment E.pdf |
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Text version
North Carolina HUB Supplemental Vendor Information Version Date: 09/2021
Page | 1
ATTACHMENT D: HUB Supplemental Vendor Information
Solicitation #: __________________________
Vendor Name: __________________________
Historically Underutilized Businesses (HUBs) consist of minority, women, and disabled business firms that are at least fifty-one percent owned and operated by an individual(s) from one of these categories. Also included in this category are disabled business enterprises and non-profit work centers for the blind and severely disabled.
Pursuant to G.S. 143B-1361(a), 143-48 and 143-128.4, the State invites and encourages participation in this procurement process by businesses owned by minorities, women, the disable, disabled business enterprises, and non-profit work centers for the blind and severely disabled. This includes utilizing individual(s) from these categories as subcontractors to perform the functions required in this Solicitation.
The Vendor shall respond to questions below, as applicable.
PART I: HUB CERTIFICATION
Is Vendor a NC-certified HUB entity? Yes No
If yes, provide Vendor #: _________________________
If no, does Vendor qualify for certification as HUB? Yes No
Vendors that check “yes” will be referred to the HUB Office for assistance in acquiring certification.
PART II: PROCUREMENT OF GOODS - SUPPLIERS
For Goods procurements, are you using Tier 2 suppliers? Yes No
If yes, then provide the following information:
Company Name
Company Address
Website Address
Contact Name
Contact Email
Contact Phone
NC HUB
certified?
Percent of total bid price
North Carolina HUB Supplemental Vendor Information Version Date: 09/2021
Page | 2
PART III: PROCUREMENT OF SERVICES - SUBCONTRACTORS
For Services procurements, are you using Subcontractors to perform any of the services being procured under this solicitation? Yes No
If yes, then provide the following information:
Company Name
Company Address
Website Address
Contact Name
Contact Email
Contact Phone
NC HUB
certified?
Percent of total bid price
Need more information?
Questions concerning the completion of this form should be presented during the Q&A period through the process defined in the Solicitation document.
Questions concerning NC HUB certification, contact the North Carolina Office of Historically Underutilized Businesses at 984-236-0130 or huboffice.doa@doa.nc.gov http://ncadmin.nc.gov/businesses/hub http://ncadmin.nc.gov/businesses/hub mailto:huboffice.doa@doa.nc.gov
ATTACHMENT D: HUB Supplemental Vendor Information
| Solicitation: |
| Vendor Name: |
| Is Vendor a NCcertified HUB entity: Off |
| If yes provide Vendor: |
| If no does Vendor qualify for certification as HUB: Off |
| For Goods procurements are you using Tier 2 suppliers: Off |
| Company NameRow1: |
| Company AddressRow1: |
| Website AddressRow1: |
| Contact NameRow1: |
| Contact EmailRow1: |
| Contact PhoneRow1: |
| NC HUB certifiedRow1: |
| Percent of total bid priceRow1: |
| Company NameRow2: |
| Company AddressRow2: |
| Website AddressRow2: |
| Contact NameRow2: |
| Contact EmailRow2: |
| Contact PhoneRow2: |
| NC HUB certifiedRow2: |
| Percent of total bid priceRow2: |
| Company NameRow3: |
| Company AddressRow3: |
| Website AddressRow3: |
| Contact NameRow3: |
| Contact EmailRow3: |
| Contact PhoneRow3: |
| NC HUB certifiedRow3: |
| Percent of total bid priceRow3: |
| For Services procurements are you using Subcontractors to perform any of the services being procured: Off |
| No_4: Off |
| Company NameRow1_2: |
| Company AddressRow1_2: |
| Website AddressRow1_2: |
| Contact NameRow1_2: |
| Contact EmailRow1_2: |
| Contact PhoneRow1_2: |
| NC HUB certifiedRow1_2: |
| Percent of total bid priceRow1_2: |
| Company NameRow2_2: |
| Company AddressRow2_2: |
| Website AddressRow2_2: |
| Contact NameRow2_2: |
| Contact EmailRow2_2: |
| Contact PhoneRow2_2: |
| NC HUB certifiedRow2_2: |
| Percent of total bid priceRow2_2: |
| Company NameRow3_2: |
| Company AddressRow3_2: |
| Website AddressRow3_2: |
| Contact NameRow3_2: |
| Contact EmailRow3_2: |
| Contact PhoneRow3_2: |
| NC HUB certifiedRow3_2: |
| Percent of total bid priceRow3_2: |
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