8-6. Supporting Documents 6 Campaign Contributions Disclosure Form.pdf
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- Delaware County, Pennsylvania
About this file
This is a Campaign Contributions Disclosure Form required by the City of Chester, Pennsylvania as part of its procurement process for contract opportunities. The form is mandatory for all bidders participating in the City of Chester's contracting process, including the Chester Police Station 3rd Floor Interior Renovations project, which involves approximately 1,500 square feet of renovation work including demolition, new drywall, carpet, lighting, and painting. The form must be completed and submitted as part of the bid packet (RFB 2025-009), with award expected in the third quarter of 2025 and a Notice to Proceed effective January 1, 2026. The contract term for the underlying police station renovation is a lump sum agreement with Pennsylvania Prevailing Wage rates applicable.
The Campaign Contributions Disclosure Form requires bidders to disclose any campaign contributions made by the firm, its officers, directors, controlling shareholders, or partners to the City of Chester, as well as any involvement in soliciting or serving as intermediaries for such contributions. The form contains eleven yes-or-no questions addressing direct contributions, affiliate contributions, political committee contributions, and business reimbursements for contributions. For any affirmative responses, bidders must provide detailed information including the contributor's name, relationship to the firm, contribution recipient, date, and amount. The City of Chester explicitly states that legally disclosed campaign contributions do not automatically disqualify a bidder from participating as a contractor, indicating that this disclosure is part of a transparency and conflict-of-interest vetting process rather than an automatic disqualification mechanism. Bidders must include their company name, contact information, and signature with the completed form submission.
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Text version
Chester City Hall, Municipal Building, 1 East 4th Street, Chester, Pennsylvania, 19013
Campaign Contributions Disclosure Form
Please note that legally disclosed campaign contributions do not automatically disqualify a bidder from participating as a contractor. The City of Chester must obtain this information as part of its procurement process.
1. Has your firm made any contributions to the City of Chester? Yes ___ No ___
2. Has your firm solicited or served as an intermediary for any contributions? Yes ___ No ___
3. Has an officer, director, controlling shareholder, or partner of your firm solicited or served as an intermediary for any contributions?
Yes ___ No ___
4. Has an affiliate of your firm made any contributions? Yes ___ No ___
5. Has an affiliate of your firm solicited or served as an intermediary for any contributions?
Yes ___ No ___
6. Has an officer, director, controlling shareholder, or partner of a for-profit affiliate of your firm made any contributions?
Yes ___ No ___
7.
Has an officer, director, controlling shareholder, or partner of a for-profit affiliate of your firm solicited or served as an intermediary for any contributions?
Yes ___ No ___
8.
Has your firm or an affiliate of your firm business reimbursed another individual or business for a contribution that the individual or business has made?
Yes ___ No ___
9.
Has an officer, director, controlling shareholder, or partner of a for-profit business, or of a for-profit affiliate of your firm, reimbursed another individual or business for a contribution that the individual or business has made?
Yes ___ No ___
10. Has a political committee controlled by your firm or by an affiliate of your firm, made any contributions?
Yes ___ No ___
11.
Has a political committee controlled by an officer, director, controlling shareholder, or partner of the for-profit business, or of a for-profit affiliate of your firm, made any contributions?
Yes ___ No ___
Chester City Hall, Municipal Building, 1 East 4th Street, Chester, Pennsylvania, 19013
Campaign Contributions Disclosure Form
For any “Yes” answers on the previous page, please provide the following details:
Name of Contributor
Relationship to Your firm
Recipient of the Contribution Date Amount ($)
City of Chester Bid Number
City of Chester Project Name
Bidder Company Name
Bidder Company Contact Name
Title
Signature
Today’s Date
Phone
File details come from the government source that posted it. Updated .