4-Vendor Information.pdf

PDF 1016 KB Posted

Attached to
Paint and Paint Products
Solicitation number
IFB260080
Issued by
Bath County, Kentucky

About this file

This document is a Vendor Information form for a solicitation by Louisville Metro Government in Jefferson County, Kentucky. The form is designed for potential vendors to provide comprehensive business and classification details when submitting a proposal. The form allows vendors to specify their business ownership status, including options for Minority-Owned, Women-Owned, Disabled-Owned, LGBT-Owned, and Non-Profit classifications, as well as various business enterprise certifications such as MBE, WBE, DIBE, LGBTBE, and Veteran-Owned Small Business designations.

The form includes sections for capturing critical vendor information like full legal business name, contact details, Revenue Commission Number, Federal ID Number, and Unique Entity Identifier. Additionally, the form requires vendors to identify an authorized agent who can submit the proposal and enter subsequent negotiations. The form also includes a demographic section for race and ethnicity classification through the Louisville Metro Human Relations Commission, offering categories such as American Indian, Asian American, Black/African American, Latino/Hispanic, and others. The form is dated 9/11/2025 and features the official Louisville/Jefferson County logo, indicating this is a standardized document for local government procurement processes.

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Text version

VENDOR INFORMATION

Full Legal Business Name of Proposer:

Address:

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: 9/11/2025 ddadi Stamp

Full Legal Business Name of Proposer:
Address:
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:
Minority-Owned: Off
Women-Owned: Off
Disabled-Owned: Off
LGBT-Owned: Off
Non-Profit: Off
Not Applicable: Off
MBE: Off
WBE: Off
DIBE: Off
LGBTBE: Off
VOSB: Off
SDVOSB: Off
AI / AN: Off
AA: Off
AIA: Off
APA: Off
BAA: Off
CA: Off
L/H: Off
Other: Off

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