Contractor Information Form.pdf
PDF 250 KB Posted
- Attached to
- Walking Path Resurfacing and Culvert replacement
- Solicitation number
- SRC0000026220
- Issued by
- Butler County, Ohio
About this file
This is a Contractor Information Form for potential bidders on an Ohio Veterans Home-Georgetown project for walking path resurfacing and culvert replacement. The form is designed to collect comprehensive information from contractors interested in the approximately 3,800 linear feet by 10 feet wide walking path project at 2003 Veterans Blvd, Georgetown OH 45121, which includes a mandatory site visit scheduled for 10:00 AM on 01/07/25.
The form requires contractors to provide detailed company information including workforce demographics (total employees, percentage of women and minorities) both nationwide and specific to Ohio operations, OAKS Supplier ID or Tax Identification Number, contact details, and separate billing address if applicable. The form appears to be a standard document for gathering essential contractor information as part of the state's procurement process, requiring an authorized signature and date for submission.
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Other files
| File | Type | Posted |
|---|---|---|
| Certification Statement.pdf | ||
| SOW Walking path.docx | DOCX document | |
| Affirmation_and_Disclosure_Form_5-20-24_fillable_form.pdf | ||
| Affirmation_and_Disclosure_Form_5-20-24_fillable_form.pdf | ||
| Certification Statement.pdf | ||
| Contractor Information Form.pdf | ||
| SOW Walking path.docx | DOCX document |
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Text version
CONTRACTOR INFORMATION FORM
CONTRACTOR NAME: ______________________
STREET ADDRESS: _________________________
CITY: __________________________ STATE: _______________ ZIP CODE: __________
AUTHORIZED CONTACT NAME:
PHONE
NUMBER_________________
EMAIL: _______________________________
1. Provide current employee information both a nationwide basis (including Ohio), and Ohio's based operations.
NATIONWIDE OHIO
Total # of Employees:
Percent of Women:
Percent of Minorities:
2. Provide OAKS Supplier ID or Tax Identification Number: ______ _ _ _ _ _ _ _ _ _
3. If your billing address is different than the mailing address above, please provide below:
Contractor Name: ____________________________________________________________
Street Address: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Cit_y: State: Zip Code:
Authorized Signature Date
File details come from the government source that posted it. Updated .