2-VENDOR INFORMATION FORM.pdf

This is a Vendor Information Form associated with a drainage maintenance and improvement project managed by the State of Florida at 6445 Powers Ferry Road. The project involves the replacement of a failed upstream headwall and rehabilitation of a deteriorated outlet headwall, along with paving inverts of two 48-inch diameter corrugated metal pipe culverts and rehabilitation of 24-inch and 18-inch diameter drainage pipes using cured-in-place trenchless pipelining techniques. The work requires continuous dewatering and bypass pumping during pipe rehabilitation and headwall construction, as detailed in permit plans prepared by Neelu Inc. under permit number CITY-25-32. Prospective bidders must submit the completed Vendor Information Form along with other required documentation, which captures essential legal business information including the vendor's legal business name, Federal Employer Identification Number (FEIN), authorized signatory details, primary business contact information, company headquarters address, and any Doing Business As (DBA) designations. The form serves as a foundational document for vendor qualification and contract administration purposes.

The Vendor Information Form requires comprehensive identification of the bidding entity's authorized representative, who must be legally authorized to execute contracts on behalf of the vendor. Bidders must provide both primary and secondary contact information, including email addresses and phone numbers for both the authorized signatory and primary business contact personnel. The form captures complete business registration and operational details necessary for contract award and ongoing administration, ensuring that the procuring agency has accurate information for payment processing, communications, and compliance verification throughout the contract period.