7-14 - Required Document - Vendor Supplemental Information.pdf
PDF 1 MB Posted
- Attached to
- Annual Contract for Chemical Analysis
- Solicitation number
- 26-53-A
- Issued by
- Denton County, Little Cypress CDP, Texas
About this file
This is a Vendor Supplemental Information form required by the City of Lewisville, Texas for the Annual Contract for Chemical Analysis competitive sealed bid opportunity. The form is a mandatory document for contract development and requires bidders to provide comprehensive organizational and operational details. Bidders must disclose their state of formation, identify three key personnel (contract execution authority, contract implementation contact, and notice recipient), and specify their business structure from options including sole proprietorship, general partnership, limited partnership, corporation, limited liability company, or other entity types. The form also requires bidders to confirm their employee count, public trading status, and registration with the Texas Secretary of State, with submission of supporting documentation as applicable.
All goods and services provided must comply with the Americans with Disabilities Act and related regulations, with successful bidders required to certify such compliance. The form emphasizes the accuracy and truthfulness of submitted information through a formal signature attestation section where authorized representatives must acknowledge and validate all provided details. This supplemental information enables the City of Lewisville to establish vendor eligibility, verify legitimacy, and maintain necessary contact information for contract administration purposes.
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Text version
VENDOR SUPPLEMENTAL INFORMATION
The following information is required for contract development.
1. In what state was your business formed?
2. Provide the following information for the person authorized to execute contracts on behalf of your organization:
Name Title
Email Address Telephone No.
Mailing Address. _ _ City _ _ State Zip
3. Provide the following information for the contact person authorized to implement this contract on behalf of your organization:
Name
Email Address_
Mailing Address
Title
Telephone No
City_ State Ziq
4. Provide the following information for the person authorized to receive notices and communications regarding this contract on behalf of your organization:
Name Title
Email Address Telephone No
Physical Business Address City_
Notices and communications will be mailed to this physical address
5. Select and complete one of the following:
a. Sole Proprietorship
i. Legal name of Sole Proprietor:
ii. Physical business address:
City State
73 General Partnership
i. Legal name of Partnership:
ii. Physical business address:
City_
State_ Zip
State Zip _ _ .
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Updated March 24, 2022 Page 1 of 2
VENDOR SUPPLEMENTAL INFORMATION
C. Limited Partnership e.
f.
o
1. Legal name of Limited Partnership:
ii. General Partner( s):
If a legal entity, name of the entity:.
If an individual, name of the individual:
iii. Physical business address:
City
Corporation
i. Legal name of Corporation:
ii. Physical business address_
City
State
State
Limited Liability Company
i. Legal name of Limited Liability Company:
ii. Physical business address
City State
Other Entity ( not listed)
i. Legal name and type of Company:
ii. Physical business address.
Zip
Zip
Zip
City State_ _ _ Zip
6. Does your business have 10 or more full- time employees? No Yes
7. a. Are you a publicly traded business? No Yes — where traded:
b. Are you a wholly owned subsidiary of a publicly traded business? No Yes — which publicly traded business:_
8. a. Is your business registered with the Texas Secretary of State? No Yes
b. If yes, please provide records or screenshot( s) from the Texas Secretary of State' s website reflecting the name or names for which your business has been registered.
In signing this form, I acknowledge that I have read the above and state that the information contained therein is true and correct.
Signature:
Print Name:
Date:
Print Title:
Updated March 24, 2022
File details come from the government source that posted it. Updated .