CONTRACTOR INFORMATION DATA FORM FINAL 8.11.2026 (1).pdf
PDF 168 KB Posted
- Solicitation number
- 21260807090259
- Issued by
- Philadelphia County, Philadelphia City, Pennsylvania
About this file
This is a Contractor Information Data Form from the City of Philadelphia used for state and local contracting purposes in Pennsylvania. The form serves as a mandatory submission requirement for all prime contractors and subcontractors bidding on City of Philadelphia projects. The document is designed to collect comprehensive contractor and subcontractor information for project qualification and compliance tracking.
The form requires detailed company information including federal tax identification numbers or social security numbers, primary industry NAICS codes, ownership details, contact information, and business establishment dates. Contractors must provide certification status indicators such as Small Business Enterprise (SBE), Local Business Enterprise (LBE), Minority Business Enterprise (MBE), Minority Women Business Enterprise (MWBE), Disadvantaged Business Enterprise (DBE), or Women Business Enterprise (WBE) designations. The form also requires documentation of demographic information categorized by race and ethnicity, annual gross receipts classified within specified ranges (from $1 million or less up to $47 million or less), and the dollar amounts committed to subcontractors. Outreach methods used to solicit subcontractor participation must be documented, along with certification dates for applicable business classifications. This mandatory form applies uniformly to all prime and subcontractor entities participating in City of Philadelphia projects.
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Text version
CITY OF PHILADELPHIA
CONTRACTOR INFORMATION DATA FORM
(MANDATORY FORM TO BE FILLED OUT ENTIRELY FOR PRIMES AND ALL SUBCONTRACTORS)
City of Philadelphia Contract No: __________________ Project Name: ____________________ Prime Contractor Name: ______________________________________________________________ Address:_____________________________________________________________________________
Complete information below for each PRIME AND SUBCONTRACTOR that was solicited for the Project
PRIME AND SUBCONTRACTOR INFORMATION
Federal Tax ID #/ SSN #: Primary Industry NAICS Code:
Full Company Name:
Owner:
Address:
City: Zip Code:
County: Phone Number:
E-Mail:
Date Established: Date Certified:
Demographic*:
Gender:
Certification Status:
No Certification | SBE | LBE | MBE | MWBE | DBE | WBE | Other
Outreach Method:
Dollar Committed to Subcontractor:
Annual Gross Receipts: _______ *indicate the letter that applies
A. $1M or Less C. $23.5M or Less
B. $5M or Less D. $47M or Less
*Demographic: (A) African-American; (B) American Indian or Alaskan Native; (C) Asian-American; (D) Hispanic or Latino American; (E) Native Hawaiian or Other Pacific Islander; (F) White; (G) Other
Untitled
| City of Philadelphia Contract No: |
| Project Name: |
| Prime Contractor Name: |
| Address: |
| Federal Tax ID SSN: |
| Primary Industry NAICS Code: |
| Full Company Name: |
| Owner: |
| Address_2: |
| City: |
| Zip Code: |
| County: |
| Phone Number: |
| EMail: |
| Date Established: |
| fill_14: |
| Ethnicity: |
| Gender: |
| fill_23: |
| Outreach Method: |
| Dollar Committed to Subcontractor: |
| Annual Gross Receipts: |
File details come from the government source that posted it. Updated .