Contractor Information Form (rev. 5.24).pdf

PDF 1 MB Posted

Attached to
TDC FY26 Garza Kitchens Update State and local contract opportunity
Solicitation number
SRC0000036321
Issued by
Seneca County, Ohio

About this file

Written by GovTribe AI ·

This is a Contractor Information Form (Revision 5/2024) used by the State of Ohio to collect essential information from contractors submitting proposals in response to Requests for Proposals (RFPs). The form requires contractors to provide basic company identification, including contractor name, street address, city, state, and ZIP code, along with offeror contact information such as name, phone number, and email. Contractors must also disclose current employee counts and demographic information regarding the percentage of women and minority employees on both a nationwide and Ohio-specific basis. The form requires contractors to affirm they meet minimum qualifications identified in Part Two: Section IV of the applicable RFP and must be completed, signed, and submitted with the RFP proposal to be considered eligible for review and scoring.

The form collects additional critical information including DODD certification status and provider certification number, OAKS Supplier ID or Tax Identification Number, and separate contact information for the person authorized to execute contracts on behalf of the contractor. Contractors must provide remittance address information if different from their mailing address. The form includes designated spaces for nationwide and Ohio-specific employee data, corresponding to the RFP title and number beginning with "SRC." All required information must be certified by an authorized signatory with appropriate contact details and title, and the form must be dated at the time of submission to constitute a complete and eligible proposal response.

View the file

Other files for this state and local contract opportunity

Other files attached to TDC FY26 Garza Kitchens Update, newest first.
File Type Posted
Contractor Certification Statements.pdf PDF
STANDARD AFFIRMATION AND DISCLOSURE FORM (EO 2019-12D & 2022-02D).pdf PDF
TDC Garza Kitchens Updates_RFQ_Document.docx DOCX document

On GovTribe

Work with this file on GovTribe

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

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 .