4-Vendor Information.pdf

PDF 948 KB Posted

Attached to
Preservation Design Consultant
Solicitation number
RFP260150
Issued by
Jefferson County, Kentucky

About this file

This is a Vendor Information form for the Louisville Metro Government in Kentucky, designed to collect proposer details and certification information from vendors seeking contract opportunities. The form requests comprehensive vendor identification data including legal business name, address, contact information, and federal identification numbers. It establishes primary contacts for both contract negotiations and invoice processing, requiring authorization signatures from designated agents. The document is dated September 12, 2025, and serves as a standardized template for capturing vendor qualifications and ownership structure relevant to the Preservation Design Consultant opportunity, which calls for an qualified firm to develop an illustrated, user-friendly version of recently updated Standard Design Guidelines for the Office of Planning.

The form includes extensive certification and classification sections enabling vendors to self-identify ownership status across multiple categories including minority-owned, women-owned, disabled-owned, and LGBT-owned classifications. Vendors can indicate relevant business certifications such as Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Disabled Business Enterprise (DIBE), LGBT Business Enterprise (LGBTBE), Veteran Owned Small Business (VOSB), and Service-Disabled VOSB designations, as well as Louisville Metro Human Relations Commission certification. The document also collects demographic information regarding race and ethnicity to support compliance with local procurement goals and diversity initiatives. All checkbox fields appear unchecked in the provided version, indicating this is a blank template awaiting completion by interested proposers.

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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: 9/12/2025

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
American Indian or Alaska Native: Off
Asian American: Off
Asian-Indian American: Off
Asian-Pacific American: Off
Black African American: Off
Caucasian: Off
Latino Hispanic: Off
Other: Off

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