4-Vendor Information.pdf
PDF 1016 KB Posted
- Attached to
- Fleet Fuel Management Program
- Solicitation number
- RFP260099
- Issued by
- Bath County, Kentucky
About this file
This is a Vendor Information form from Louisville Metro Government in Jefferson County for a procurement or contract opportunity. The form is designed for potential vendors to submit their business details, contact information, and supplier classification. The document allows vendors to provide their full legal business name, contact information, revenue commission number, federal ID, and unique entity identifier, along with authorization for proposal submission and negotiations.
The form includes sections for supplier classification, ownership status, and certifications, with checkboxes for various designations such as Minority-Owned, Women-Owned, Disabled-Owned, and LGBT-Owned businesses. Vendors can also indicate specific certifications like Minority Business Enterprise (MBE), Women Business Enterprise (WBE), and Veteran Owned Small Business (VOSB). Additionally, the form requests race and ethnicity information through the Louisville Metro Human Relations Commission Certification section. The document is dated 9/11/2025 and features the Louisville Metro Government logo.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 5-W9.pdf | ||
| 7-RFP260099 Specifications.pdf | ||
| 1-Acknowledgements Preferences.pdf | ||
| 6-Submission Instructions - RFP260099.pdf | ||
| 2-Ban the Box Compliance Checklist.pdf | ||
| 3-GFE Docs.xlsx | XLSX spreadsheet |
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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 .