Contractor_Information_Form__rev._5.24_.pdf

PDF 1 MB Posted

Attached to
FY25 NODC Campus Landscaping State and local contract opportunity
Solicitation number
SRC0000029537
Issued by
Lucas County, Ohio

About this file

Written by GovTribe AI ·

The document is a Contractor Information Form related to a state procurement opportunity in Ohio for the NODC-FY25 Campus Landscaping project. The form is designed for potential contractors to provide comprehensive organizational details as part of their proposal submission, with a due date of April 18, 2025. The form requires contractors to disclose key information including company contact details, current employee numbers, workforce diversity statistics, DODD certification status, and OAKS Supplier ID.

The form emphasizes workforce diversity by requesting specific percentages of women and minorities in both nationwide and Ohio-specific operations. Contractors must affirm they meet minimum qualifications outlined in the RFP and provide contact information for the person authorized to execute a contract. The document is part of a standard state procurement process that appears to prioritize organizational capability and workforce representation. Contractors must complete and sign the form for their proposal to be considered eligible for review and scoring, with the form revised in May 2024 to ensure the most current information is collected.

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Other files for this state and local contract opportunity

Other files attached to FY25 NODC Campus Landscaping, newest first.
File Type Posted
STANDARD AFFIRMATION AND DISCLOSURE FORM (EO 2019-12D 2022-02D).pdf PDF
NODC_FY25_Campus_Landscaping__Round_2.pdf PDF
Electronic Disclosures and Signatures Consent.pdf PDF
NODC FY25 Campus Landscaping.docx DOCX document
Contractor_Information_Form__rev._5.24_.pdf PDF

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CONTRACTOR INFORMATION FORM

STATE: ZIP CODE:

CONTRACTOR NAME:

STREET ADDRESS:

CITY:

OFFEROR CONTACT NAME:

PHONE NUMBER: EMAIL:

Current number of employees:

Percent of Women:

Percent of Minorities:

Authorized Signature Date

Contractor affirms that they meet the minimum qualifications identified in Part Two: Section IV of the RFP title:

This form must be completed, signed, and submitted with RFP Proposal for it to be considered eligible for review and scoring. Rev. 5/2024

1. DODD certified provider? NO YES, DODD Provider Certification #

2. Provide OAKS Supplier ID or Tax Identification Number:

3. Current employee information on both a nationwide basis (including Ohio), and for Ohio operations.

(enter RFP Title and RFP Number beginning with SRC)

Nationwide Ohio

4. If your remit to address is different than the mailing address above, pleas provide below:

Street Address:

City: State: Zip Code:

5. Provide contact information for person with authority to execute a contract on behalf of the contractor.

Name: Title:

Email:

Krista Shaw Line

Krista Shaw Line

Krista Shaw Line

STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE NUMBER:
EMAIL:
NATIONWIDE 1:
NATIONWIDE 2:
NATIONWIDE 3:
OHIO 1:
Provide OAKS Supplier ID or Tax Identification Number:
Street Address:
Zip Code:
Date:
Check Box1: Off
CONTRACTOR NAME:
RFP Name & SRC #:
OHIO 2:
OHIO 3:
City:
State:
AUTHORIZED CONTACT NAME:
Signatory Name:
Signatory Title:
Signatory Email:
Check Box2: Off
Check Box3: Off
Certification #:

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