Contractor Information Form.docx

This is a Contractor Information Form for an Invitation for Bid (IFB) issued by PennDOT for Indiana County, Pennsylvania, regarding the procurement of asphalt materials for 2026. The IFB seeks bids for two line items of ASPHALT, WM 19MM, 15-30% RAP Binder (PennDOT material #356975), with the first line item including delivery of asphalt to the paver and the second line item involving source pickup by department forces. Contractors must complete and submit the required Contractor Information Form, which requests company name, contractor representative name and contact information (24-hour cell phone number and email address), and the PA SAP Vendor number. Failure to complete and upload this form may result in a submittal being deemed non-responsive.

Pursuant to Executive Order 2021-06, all contractors and grantees of the Commonwealth must certify compliance with Pennsylvania's Unemployment Compensation Law, Workers' Compensation Law, and all applicable Pennsylvania state labor and workforce safety laws to ensure worker protection and safe and healthy work environments. The specific pricing terms, bid amounts, response dates, and contract award timelines are not detailed in this form document, as it serves solely as a procedural requirement for bid submission.