3-Vendor Diversity Business Classification Form.pdf
PDF 434 KB Posted
- Attached to
- 2026 Summer Playground Bus Transportation
- Solicitation number
- US.230318
- Issued by
- Lehigh County, Allentown City, Pennsylvania
About this file
This is a Vendor Diversity Business Classification Form required by the City of Allentown, Pennsylvania for vendors seeking to conduct business with the municipality. The form requests comprehensive company information including legal name, contact details, address, phone, fax, and email, along with a remit-to address if different from the primary business location. Vendors must certify their business classification status by selecting all applicable designations, which include Small Business, Minority Business Enterprise, Women Business Enterprise, Service Disabled Veteran-Owned, Veteran Business Enterprise, and Historically Underutilized Business Zone certifications. The form requires an authorized representative to sign and date the certification, attesting that all provided information is true and accurate. The City of Allentown mandates that vendors update this classification information annually or whenever the company's classification status changes, with completed forms to be submitted to purchasing@allentownpa.gov.
The form itself contains no pricing terms, contract values, or funding information, as it serves solely as a vendor registration and classification document. There are no specific set-asides mentioned within the form; however, the classification categories indicate that the City of Allentown recognizes and potentially prioritizes various disadvantaged and minority-owned business enterprises in its procurement processes. The form does not identify any incumbent vendors or current contractors, nor does it specify contract duration or renewal options. This document is a prerequisite administrative requirement for vendor participation in City of Allentown procurement opportunities and establishes the baseline information necessary for the municipality to track and potentially apply preferences or set-asides in future solicitations based on certified business classifications.
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Text version
Vendor Diversity Business Classification Form City of Allentown requires vendors to update this information annually or any time your company’s classification changes. Send completed and signed form to purchasing@allentownpa.gov.
Company Legal Name: Primary Contact Name:
Address: Remit to Address (if different):
City, State, Zip: City, State, Zip:
Phone #: Phone #:
Fax #: Fax #:
E-Mail Address: Website:
Business Classification Representation:
Ownership Status
The undersigned represents that we are (select ALL that apply and include a copy of your certification if applicable):
Small Business Minority Business Enterprise Women Business Enterprise Service Disabled Veteran-Owned Veteran Business Enterprise Historically Underutilized Business Zone
Other: _____________________________
The undersigned certifies the information provided above is true and accurate to the best of his/her knowledge.
Print Name: Title: _____________________________
Signature: Date: _____________________________
| Company Legal Name: |
| Company Legal Name-0: |
| Address: |
| Address-0: |
| City State Zip: |
| City State Zip-0: |
| Phone: |
| Phone-0: |
| Fax: |
| Fax-0: |
| EMail Address: |
| EMail Address-0: |
| Small Business: Off |
| Minority Business Enterprise: Off |
| Women Business Enterprise: Off |
| Service Disabled VeteranOwned: Off |
| Veteran Business Enterprise: Off |
| Historically Underutilized Business Zone: Off |
| Other: Off |
| Other-0: |
| Print Name: |
| Title: |
| Signature: |
| Date: |
File details come from the government source that posted it. Updated .