REQUIRED_FORMS_-_AAs_-_FOR_INFORMALS.pdf
PDF 171 KB Posted
- Attached to
- Bike Rack Procurement 2024
- Solicitation number
- 2024-Informal-0608
- Issued by
- Los Angeles County, California
About this file
These documents are vendor forms from the City of Pasadena Purchasing Division for a Bike Rack Procurement 2024 contract. The forms include a Vendor Questionnaire (Form AA-1) requiring equal opportunity employment certification and a Licenses and Certifications form for documenting required business credentials. Specifically, the procurement involves purchasing 40 bike racks meeting the Inverted U Rack specification, with delivery expected within 6 weeks of purchase order approval to the City of Pasadena Corporation Yard. Pricing should remain valid through February 2025, and the total cost will be the primary factor in selecting the winning bidder.
The optional section of the Vendor Questionnaire allows vendors to self-identify ownership characteristics, including demographic categories such as African American, Asian, Armenian, Hispanic, Native American, Female, or Disabled ownership. The Licenses and Certifications form indicates potential required documentation from the City of Pasadena Business License, California Department of Industrial Relations (for public works), and the California Department of General Services (for small and micro business certification). Vendors must complete these forms with their company details, contact information, and relevant license or certification numbers as part of the bidding process.
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Other files
| File | Type | Posted |
|---|---|---|
| Bike_Rack_Procurement_2024_(Addendum_#1_Revision).pdf | ||
| Attachment_Inverted_U_Rack_Spec.pdf | ||
| Unique_Entity_ID_(SAM).pdf | ||
| DoIT_Technical_Questionnaire.xlsx | XLSX spreadsheet | |
| RELEVANT_EXPERIENCE_FORM.pdf | ||
| Disclosure_of_Lobbying_Activities.pdf |
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Text version
Purchasing Division 100 N. Garfield, Room S348 Pasadena, CA 91101 Phone (626) 744-6755 https://www.cityofpasadena.net/finance/doing-business-with-the-city/
Vendor Questionnaire (Form AA-1)
Affidavit of Equal Opportunity Employment & Non-segregation
By submitting this form you are declaring under penalty of perjury under the laws of the State of California and the laws of the
United States that the information is true and correct. Furthermore, you are certifying that your firm will adhere to equal opportunity employment practices to assure that applicants and employees are not discriminated against because of their race, religion, color, national origin, ancestry, disability, sex or age. And, your firm does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained.
Company Name:
Address:
City, State, Zip:
Contact Person:
Phone:
E-mail Address:
DBA (if applicable):
Remit Address (if different):
City, State, Zip:
Please state clearly and concisely the type(s) of goods and services your company would provide on this contract
The following section is OPTIONAL and is for statistical reporting purposes only. Ownership (please check all that apply):
☐African American
☐Asian
☐Armenian
☐Hispanic
☐Native
American
☐Disabled
☐Female
Purchasing Division
100 N. Garfield, Room S348
Pasadena, CA 91101
Phone (626) 744-6755
Licenses and Certifications
Review the solicitation document to identify the required licenses or certifications, and list them on this form. This form is for quick reference only.
Company Name: __________________________________________________________
Project:__________________________________________________________________
Address: _______________________________________________________________
City, State, Zip: _______________________________________________________________
Phone: _____________________________
Email Address: _________________________________________________________
Agency, and Description Number
City of Pasadena (Pasadena Business License)
State of California, Department of Industrial Relations (Required For all Public Works: Pursuant to Division 2, Part 7, Chapter 1)
State of California, Department of General Services (Small and Micro Business Certification)
License/Certification Name
Issuing Organization Issue Date Status License or Certification Number
| Contact Person: |
| DBA if applicable: |
| Remit Address if different: |
| City State Zip_2: |
| Please state clearly and concisely the types of goods and services your company would provide on this contract: |
| African American: Off |
| Armenian: Off |
| Native: Off |
| Female: Off |
| Asian: Off |
| Hispanic: Off |
| Disabled: Off |
| NumberCity of Pasadena Pasadena Business License: |
| NumberState of California Department of Industrial Relations Required For all Public Works Pursuant to Division 2 Part 7 Chapter 1: |
| NumberState of California Department of General Services Small and Micro Business Certification: |
| LicenseCertification NameRow1: |
| Issuing OrganizationRow1: |
| Issue DateRow1: |
| StatusRow1: |
| License or Certification NumberRow1: |
| LicenseCertification NameRow2: |
| Issuing OrganizationRow2: |
| Issue DateRow2: |
| StatusRow2: |
| License or Certification NumberRow2: |
| LicenseCertification NameRow3: |
| Issuing OrganizationRow3: |
| Issue DateRow3: |
| StatusRow3: |
| License or Certification NumberRow3: |
| LicenseCertification NameRow4: |
| Issuing OrganizationRow4: |
| Issue DateRow4: |
| StatusRow4: |
| License or Certification NumberRow4: |
| Company Name: |
| Address: |
| City State Zip: |
| Phone: |
| Project: |
| Email Address: |
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