3-Vendor Information Form.pdf
PDF 1 MB Posted
- Attached to
- 26B-104 Asphalt Pavement Restoration Services
- Solicitation number
- 26-104
- Issued by
- Marion County, Florida
About this file
This is a Vendor Information Form for use by Marion County Utilities in Florida for the contract opportunity 26B-104 Asphalt Pavement Restoration Services. The form is designed to collect comprehensive vendor registration data required for bidders interested in providing asphalt restoration services following water and sewer utility installation and repair work. Marion County Utilities is seeking a responsive, qualified, and licensed contractor to perform these pavement restoration services under a guaranteed pricing structure for the contract period. The form requests detailed legal business information, including the vendor's legal business name, Doing Business As (DBA) designation, Federal Employer Identification Number (FEIN), and authorized signatory information. Additional required information includes primary and secondary contact details, company headquarters or legal address information, and alternative business location addresses if applicable.
The Vendor Information Form serves as the initial documentation submission vehicle for this procurement, requiring vendors to provide authorized signatory credentials and primary business contact information separate from the signatory if different personnel occupy these roles. This standardized form ensures that Marion County Utilities can properly identify and communicate with qualified contractors capable of delivering asphalt pavement restoration services with guaranteed pricing throughout the contract term. The form does not specify pricing terms, award dates, contract duration, or renewal options within its content, as it functions primarily as a vendor registration and qualification document rather than a detailed contract specification or solicitation notice.
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Other files
| File | Type | Posted |
|---|---|---|
| 1-Conflict Of Interest Statement.pdf | ||
| 2-ITB - GENERAL TERMS AND CONDITIONS.pdf | ||
| 5-01 26B-104 Bid Table.pdf | ||
| 4-02 26B-104 Scope of Work.pdf |
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Text version
Vendor Information Form
Legal Business Information
Legal Business Name Doing Business As (DBA)
FEIN
Authorized Signatory This should be the person legally authorized to sign contracts on behalf of the vendor.
First Name Last Name Primary Email Address Secondary Email Address Phone Number
Primary Business Contact If different from signatory First Name Last Name Title/Position Phone Number Email Address
Company Address Information Headquarters or Legal Address Street City State Zip Code
| Doing Business As DBA: |
| Secondary Email Address: |
| Primary Email Address 1: |
| First Name: |
| Last Name: |
| Legal Business Name: |
| FEIN: |
| Phone Number: |
| Primary First Name: |
| Primary Last Name: |
| Title or Position: |
| Primary Phone Number: |
| Primary Email Address 2: |
| Street: |
| City: |
| State: |
| Zip Code: |
File details come from the government source that posted it. Updated .