6-Vendor Information.pdf

PDF 948 KB Posted

Attached to
Rehabilitation of 1150 S 28th St (The Ashanti House) Phase 1
Solicitation number
RFP260138
Issued by
Jefferson County, Kentucky

About this file

This is a Vendor Information form for the Louisville Metro Government, specifically related to the Phase 1 Rehabilitation project at 1150 S 28th Street (The Ashanti House) in Kentucky. The form is designed to collect essential vendor qualification and business information from proposers interested in submitting bids for this contract opportunity. The document requests the full legal business name, address, contact information, federal identification numbers, and designated points of contact for contracts and invoicing from interested vendors. Additionally, the form requires vendors to identify an authorized agent who is empowered to submit the proposal and engage in subsequent negotiations should Louisville Metro Government determine the firm is reasonably susceptible of being selected for award.

The vendor information form also requires proposers to disclose their ownership status and relevant certifications, including minority-owned, women-owned, disabled-owned, and LGBT-owned classifications, as well as certifications such as Minority Business Enterprise (MBE), Women Business Enterprise (WBE), and Veteran Owned Small Business (VOSB) designations. Vendors must indicate their racial or ethnic classification from categories including American Indian or Alaska Native, Asian American, Black or African American, Caucasian, Latino or Hispanic, and other classifications. The form is dated September 12, 2025, and serves as the mechanism for documenting vendor eligibility and participation status in the Louisville Metro Government's procurement process for the Ashanti House Phase 1 Rehabilitation project.

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7-Phase I Scope of Work and Bid Cost Table.xlsx XLSX spreadsheet
8-RFP260138 Specifications.pdf PDF
3-GFE Docs.xlsx XLSX spreadsheet
1-Drawings.pdf PDF
2-Acknowledgement Preference (Constr) 1.pdf PDF
9-Submission Instructions - RFP260138.pdf PDF
4-Procurement - LMCO ban the box.pdf PDF
5-W9 2024.pdf PDF

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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 .