Contractor Information Form (rev. 5.24).pdf

PDF 1 MB Posted

Attached to
GDC Landscaping Project FY25 State and local contract opportunity
Solicitation number
SRC0000030307
Issued by
Gallia County, Ohio

About this file

Written by GovTribe AI ·

The Contractor Information Form is a state-level document for a Request for Proposal (RFP) designed to collect comprehensive details from potential contractors. The form requires bidders to provide detailed company information, including contact details, employee demographics, DODD (Department of Developmental Disabilities) certification status, OAKS Supplier ID or Tax Identification Number, and current employee statistics for both nationwide and Ohio-specific operations.

The document is structured to ensure contractors meet minimum qualifications specified in the RFP and provide key organizational details. Bidders must disclose their workforce composition, including percentages of women and minorities, and provide contact information for the individual authorized to execute a contract. The form includes sections for alternative remittance addresses and must be completed, signed, and submitted with the RFP proposal to be considered eligible for review and scoring, with a revision date of May 2024.

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Other files for this state and local contract opportunity

Other files attached to GDC Landscaping Project FY25, newest first.
File Type Posted
Landscaping Scope of Work.pdf PDF
STANDARD AFFIRMATION AND DISCLOSURE FORM (EO 2019-12D & 2022-02D).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 .