Attachment_4_-_Contractor_Identification_Form.pdf
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- Solicitation number
- 2026-WW-04
- Issued by
- Sacramento County, San Francisco City, California
About this file
This is a Contractor Identification Form related to a Request for Qualifications (RFQ) issued by the County of Sacramento's Department of Airports (SCDA) for on-call environmental planning services. The County operates four airports in Sacramento County—Sacramento International Airport (SMF), Mather Airport (MHR), Sacramento Executive Airport (SAC), and Franklin Field (F72)—and seeks qualified environmental planning consulting firms to provide specialized services. The scope of services includes support for National Environmental Policy Act (NEPA) and California Environmental Quality Act (CEQA) documentation, FAA environmental coordination, environmental permitting, regulatory compliance programs, mitigation monitoring, PFAS investigation and response support, sustainability initiatives, and related technical services. Successful respondents must demonstrate familiarity with airport-specific operational, regulatory, safety, and security considerations, including work in active airfield environments and coordination with airport operations staff, while maintaining compliance with FAA requirements and sequencing environmental review with capital project delivery schedules.
The Contractor Identification Form requires respondents to provide company information, taxpayer identification, and details regarding principal owners holding 25 percent or more ownership interest, along with information about dependent health insurance availability. The form must be completed by contractors who are not exempt and submitted to the appropriate department contact, with the County Contract Officer retaining records as necessary. This documentation is a standard requirement for vendor qualification and contract administration purposes within the County's procurement process.
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Text version
CONTRACTOR IDENTIFICATION FORM
Contractor is exempt.
If not exempt, CONTRACTOR TO COMPLETE:
Company Name
Company Address
Taxpayer ID Company Telephone Number
1. Do you or anyone else own 25% or more of this Contractor/ Company? (Sole Proprietors answer yes)
2. If so, is dependent health insurance available to/or through Contractor/Company?
Yes No
Yes No
If YES to question #1, please complete the following as to each of these individuals:
Principal Owner Name
Social Security # Residence Telephone #
Residence Address
Principal Owner Name
Social Security # Residence Telephone #
Residence Address
Principal Owner Name
Social Security # Residence Telephone #
Residence Address
Principal Owner Name
Social Security # Residence Telephone #
Residence Address
Completed by: ____________________________________ Date: _________________
DEPARTMENT TO COMPLETE: (Note: This form does not need to be sent to DCSS if exempt but the County Contract Officer may want to keep for their records)
Contract/PO # Amount Paid/Payable Term
Department Submitting Information:
Department Contact Person:
Telephone Number: E-mail Address:
ATTACHMENT 4
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