5-Vendor Information.pdf

PDF 197 KB Posted

Attached to
Owner's Representative Services for Sun Valley Pool Replacement Project
Solicitation number
RFP260234
Issued by
Jefferson County, Kentucky

About this file

This is a Vendor Information form utilized by Louisville Metro Government (LMG) for supplier registration and management within the procurement process for Owner's Representative Services for the Sun Valley Pool Replacement Project located at 6505 Bethany Lane, Louisville, Kentucky. The form serves as the primary documentation vehicle for vendors to provide essential business identification, legal entity information, federal identification numbers, and designation of authorized representatives for contract negotiations and invoicing purposes. The form captures supplier classification data including ownership status categories such as Minority-Owned, Women-Owned, Disabled-Owned, and LGBT-Owned designations, along with relevant business certifications including Minority Business Enterprise (MBE), Women Business Enterprise (WBE), Disabled Business Enterprise (DIBE), and Veteran Owned Small Business (VOSB) credentials.

The vendor information form requires submission of current documentation including an IRS Form W-9 dated within the preceding twelve months and mandates completion of all applicable sections for new supplier registration or supplier record modifications. The form is processed through Louisville Metro Government's Workday system as part of the CREATE SUPPLIER REQUEST or SUPPLIER CHANGE REQUEST task workflow. Vendors must provide complete legal business names, addresses, contact information for both contract and invoice management, Metro Louisville Revenue Commission Numbers, Federal ID Numbers, and Unique Entity Identifiers. The form also collects demographic data regarding race and ethnicity classifications and includes signature authorization from an authorized agent confirming the vendor's ability to submit proposals and engage in subsequent contract negotiations on behalf of the proposing organization.

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Other files

File Type Posted
1-RFP260234 Specifications.pdf PDF
2-Acknowledgements Preferences.pdf PDF
4-GFE Docs.xlsx XLSX spreadsheet
7-Submission Instructions - RFP260234.pdf PDF
3-Ban the Box Compliance Checklist.pdf PDF
6-W9.pdf PDF

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Text version

VENDOR INFORMATION / CREATE SUPPLIER

Full Legal Business Name of Proposer:

Address:

City: State: Zip:

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: 02/11/2026 - REV 3

To Request New Supplier: Suppliers complete all sections of this form along with an IRS Form W-9 dated within the last 12 months. Forms are attached and submitted by LMG in Workday as part of the CREATE SUPPLIER REQUEST task.

To Update / Change to Supplier Record: Suppliers must complete the applicable sections. LMG completes the Workday task CREATE REQUEST; select SUPPLIER CHANGE REQUEST; enter the requested change and attach this completed form

Full Legal Business Name of Proposer:
Address:
City:
State:
Zip:
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:
MO: Off
WO: Off
DO: Off
LO: Off
NP: Off
NA: Off
MBE: Off
WBE: Off
DIBE: Off
LGBTBE: Off
VOSB: Off
SDVOSB: Off
AI: Off
AA: Off
AIA: Off
APA: Off
BAA: Off
C: Off
LOH: Off
O: Off

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