Attachment_4_-_Contractor_Identification_Form.pdf

This Contractor Identification Form is used by the County of Sacramento, Department of Airports, to collect essential information from contractors bidding on the Rodent Management Services contract for Sacramento International Airport (SMF). The form requires contractors to provide company identification details including name, address, taxpayer identification number, and telephone contact information. Contractors must disclose ownership structure by indicating whether any individual or entity owns 25% or more of the company, with sole proprietors required to answer affirmatively. If such ownership exists, contractors must provide complete information for each principal owner, including name, social security number, residence address, and telephone number.

The form also requires contractors to disclose whether dependent health insurance is available through the contractor or company for any principal owners identified. The department section of the form is completed by the County and documents the contract or purchase order number, amount paid or payable, contract term, the submitting department, and the department contact person's information including telephone number and email address. This form serves as a compliance and documentation tool for contract administration and may be retained by the County Contract Officer for records purposes, though submission to the Department of Child Support Services is not required if the contractor is exempt.