5-Vendor Information Form.pdf
PDF 1 MB Posted
- Solicitation number
- 26-095
- Issued by
- Marion County, Florida
About this file
This is a Vendor Information Form for a state and local contract opportunity in Florida. The form is designed to collect comprehensive vendor business information for the Marion Oaks Overlay Units 9, 10 and 12 project (26B-095), which involves resurfacing approximately 11.65 miles of minor local road sections. The project scope includes roadway preparation, leveling, shoulder removal, temporary striping, permanent thermoplastic striping, and stabilization of all areas disturbed during construction. The form requires vendors to provide legal business name, Doing Business As (DBA) designation, Federal Employer Identification Number (FEIN), and information regarding the authorized signatory with legal authority to execute contracts on behalf of the vendor.
The form further requires vendors to supply primary and secondary contact information, including names, titles, phone numbers, and email addresses for both the authorized signatory and primary business contact. Complete company address information is mandatory, including headquarters or legal address with street, city, state, and zip code. Vendors must also provide a secondary business address if applicable. This standardized information collection form serves as the foundational documentation for vendor qualification and contract administration purposes for this Florida Department of Transportation or local government road resurfacing project.
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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 .