ATTACHMENT_E_-_ESTABLISHED_BUSINESS_FORM.pdf

ATTACHMENT E

Established Business Form

Business Information Questionnaire and Attachments for the Respondent and all Joint Venture Partners

All information requested in this Questionnaire must be furnished by the Respondent and must be submitted with the Response in the format requested. Response must be complete and accurate.

Information which is incomplete, conditional, ambiguous, obscure, or which contains alternations not called for or irregularities of any kind may be cause for the rejection of a Response.

All information provided by Respondent herein becomes the property of the City and may be considered public information, and as such may be available to the general public.

By submission of this Response, Respondent acknowledges and agrees that the City has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information contained in this questionnaire and authorizes the release of any and all information sought in such inquiry or investigation by the City.

NOTE: Any inaccurate information, false information or representation, or any material non-disclosure may result in rejection of the entire Response.

BUSINESS INFORMATION QUESTIONNAIRE

1. Name and address of Respondent exactly as it appears on the response and as it will appear on the contract.

2. Address of Respondent, if different from above, for purposes of notice or other communication relating to the response.

3. Contact Information

Office Phone Number

Secondary (Cell) Phone Number:

Name of Contact Person:

E-mail address:

4. Respondent intends to operate the business as a: (Please check one)

☐ Sole Proprietorship - complete and submit Sole Proprietorship section ☐ Partnership - complete and submit Partnership section ☐ Corporation - complete and submit Corporation section ☐ Joint Venture - complete and submit Joint Venture section ☐ Limited Liability Co - complete and submit Limited Liability Company section

SOLE PROPRIETORSHIP STATEMENT

1. Proprietor’s Name (if woman owned, include maiden name if applicable):

2. Business Name in full (including all registered trade names):

3. Residence Address:

4. Business Address:

5. Have you ever done business in Arizona? Yes ☐ No ☐

If “Yes”, when?

If “Yes”, where?

6. Name of full-time managing officer or managing employee:

PARTNERSHIP STATEMENT

If a Partnership, answer the following:

1. Date of Organization:

2. Please check the one that applies:

☐ General Partnership ☐ Limited Partnership

3. Partnership Agreement recorded? Yes ☐ No ☐

4. Has the partnership done business in Arizona? Yes ☐ No ☐

5. Name, address, and Partnership share of each general and/or limited partner (add additional sheets if necessary). If limited, general partner must be identified.

A.

Name

Address

General/Limited Partner

Partnership Share

B.

Name

Address

General/Limited Partner

Partnership Share

6. Attach a complete copy of the fully executed Partnership Agreement.

7. Name of full-time managing officer or managing employee:

CORPORATION STATEMENT

If a Corporation, answer the following:

1. Date the company incorporated

2. Where was the company incorporated? Please provide full address, no PO Boxes

3. Is the corporation presently authorized to do business in Arizona? Yes ☐ No ☐

4. The corporation is held: Publicly ☐ Privately ☐

5. If publicly held, how and where is the stock traded?

6. Is this a parent company or subsidiary? Parent ☐ Subsidiary ☐

7. Name and address of statutory agent for process in the State of Arizona?

8. Furnish Corporate Resolution indicating parties that are authorized to contract on behalf of the corporation.

JOINT VENTURE STATEMENT

If a Joint Venture, answer the following:

1. Date of Organization:

2. Joint Venture Agreement recorded? Yes ☐ No ☐

If “Yes”, when?

If “Yes”, where?

3. Has the joint venture done business in Arizona? Yes ☐ No ☐

If “Yes”, when?

If “Yes”, where?

4. Name and address of each joint venture.

Name Address A B

5. Name of full-time managing officer or managing employee:

6. Attached a complete copy of the fully executed Joint Venture Agreement.

LIMITED LIABILITY COMPANY STATEMENT

If a Limited Liability Company, answer the following:

1. Date the limited liability company was formed?

2. Address where the company was formed (provide full address, no post office boxes)

3. Is the limited liability company authorized to do business in Arizona? Yes ☐ No ☐

4. Were the Articles of Organization filed with the Corporate Commission?

Yes ☐ No ☐

5. Name and address of each member and manager (add additional sheets if necessary).

Name Address A B

6. Furnish the date of dissolution of the limited liability company, if any:

7. Attached a complete copy of the fully executed Articles of Organization and any Amendments.