Attachment_4_-_Contractor_Identification_Form.pdf

This is a Contractor Identification Form required by the County of Sacramento for a Request for Proposals issued by the Sacramento County Department of Airports regarding Facilities Condition Assessment (FCA) and Asset Management Services. The form must be completed by contractors who are not exempt and serves to identify company ownership, principal owners, and dependent health insurance availability. The form collects essential contractor information including company name, address, taxpayer identification number, and telephone number, along with details about any individuals owning 25% or more of the company, with specific fields for up to four principal owners' names, social security numbers, residence addresses, and telephone numbers.

The form functions as both a contractor submission document and a departmental record-keeping tool, with sections for the department to record contract/purchase order numbers, amounts paid or payable, contract terms, and departmental contact information. Contractors are required to complete and sign the form with the date of completion, while the receiving department documents contract specifics and maintains the form in their records, unless the contractor qualifies for an exemption in which case the form may still be retained at the County Contract Officer's discretion. This document is essential for establishing contractor compliance and ownership transparency for the Sacramento County Department of Airports' FCA and Asset Management Services procurement.