ATTACHMENT F7 - Preliminary Security Questionnaire~1.pdf

129 KB Posted

Attached to
RFP 20075 - Creative Services
Solicitation number
S-177000-00008875
Issued by
Marion County, Oregon

About this file

Written by GovTribe AI ·

This document is a Preliminary Security Questionnaire for a vendor seeking to provide products or services to the Oregon Lottery. The questionnaire requires the vendor to provide information about their business, including the full names and roles of all officers, owners, shareholders, directors, members, and partners. The vendor must also indicate whether they will be using subcontractors and, if so, provide details about the subcontractors. Additionally, the vendor is asked to specify where the majority of the work for the Oregon Lottery will be performed.

The related state and local contract opportunity is an RFP (Request for Proposals) issued by the Oregon Lottery for creative marketing services. The RFP covers jurisdictions in Marion County and the city of Salem, Oregon. The contract term and any renewal options are not specified in the provided information.

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VENDOR PROCUREMENT

Security Preliminary Questionnaire

Vendor Procurement: Security Preliminary Questionnaire 2021.06.21 (FINAL) Page 1 of 1

To be completed by proposer and email to:

Business Name:

Business Address:

Street/Apt# City /Zip (Postal) Code State / Country Business Contact:

Full Name (Last, First, Middle) Position / Title / Role Phone #

Business Tax ID #:

Federal Tax ID Email Address Provide a brief description of the Product(s) or Service(s) to be provided:

Provide a list of all Officers, Owners, Shareholders (15% or greater), Directors, Members and Partners.

Full Name (Last, First, Middle): Position / Title / Role:

Will subcontractor(s) be used to a substantial degree for the products or services provided to the Oregon Lottery? If YES, please list the subcontractor(s): Yes No

Subcontractor Name: Product / Service: Location (State):

Where will the majority of the work be performed for the Oregon Lottery? Please list.

Type of Work: Address, City, State:

Name of person completing form (Print):

To be completed by proposer and email to:
Bus i ness Name:
Bus i ness Address:
Provide a brief description of the Products or Services to be providedRow1:
Position Title RoleRow5:
Full Name Last F rst M dd eRow6:
Position Title RoleRow6:
Yes: Off
No: Off
Subcontractor NameRow1:
Product ServiceRow1:
Locat on StateRow1:
Subcontractor NameRow2:
Product ServiceRow2:
Locat on StateRow2:
Subcontractor NameRow3:
Product ServiceRow3:
Locat on StateRow3:
Subcontractor NameRow4:
Product ServiceRow4:
Locat on StateRow4:
Subcontractor NameRow5:
Product ServiceRow5:
Locat on StateRow5:
Type of WorkRow1:
Address C ty StateRow1:
Type of WorkRow2:
Address C ty StateRow2:
Type of WorkRow3:
Address C ty StateRow3:
Type of WorkRow4:
Address C ty StateRow4:
Name of person comp l et i ng form Pr i nt:
Emai Address:
Business Contact Full Name:
Business Contact Position Title Role:
Business Contact Phone #:
Business Tax ID:
Position Title RoleRow2:
Full Name Last F rst M dd eRow3:
Position Title RoleRow3:
Full Name Last F rst M dd eRow4:
Position Title RoleRow4:
Full Name Last F rst M dd eRow5:
Full Name Last F rst M dd eRow1:
Position Title RoleRow1:
Full Name Last F rst M dd eRow2:

File details come from the government source that posted it. Updated .