REQUIRED_FORMS_-_AAs_-_SIG-LEGAL-STATUS_02112026.pdf

PDF 263 KB Posted Sep 28, 2026

Attached to: Trash Receptacles and Liners
Solicitation number: 2026-Informal-0553
Issued by: Los Angeles County, California

About this file

Written by GovTribe AI · Oct 12, 2026

This is a required forms document issued by the City of Pasadena Purchasing Division for a trash receptacles and liners contract opportunity. The City of Pasadena, Parks, Recreation & Community Services Department is soliciting bids for 800 corrugated cardboard trash boxes with multi-colored custom logos on all four sides and 800 plastic trash box liners sized for 40-gallon capacity. All products must be new, unused, and free of defects, with cardboard boxes maintaining structural integrity during normal handling and disposal operations and liners possessing sufficient strength and quality for standard waste collection. The delivery term specified is no more than ninety days after receipt of the City purchase order, with an initial contract term of thirty days.

The required forms package includes the Vendor Questionnaire (Form AA-1) requesting company information and an Affidavit of Equal Opportunity Employment & Non-segregation; a Licenses and Certifications form identifying required credentials including a Pasadena Business License, State of California Department of Industrial Relations certification for public works projects, and Small and Micro Business Certification; Project Workforce Utilization (Form AA-2) for projects valued at $25,000 or more detailing job classifications and staffing estimates; and an optional Current Permanent Workforce Utilization (Form AA-3) for demographic reporting. Bidders must provide legal status documentation and an authorized signature from an official legally authorized to bind the firm. The forms establish compliance with equal opportunity employment practices and non-discrimination requirements under California and federal law.

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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

Pasadena, CA 91101

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

Pasadena, CA 91101

Project Workforce Utilization (Form AA-2)

This form is to be included in all bids for projects involving labor or services valued at $25,000 or more.

Instructions: Please indicate the job titles/classifications to be used in the performance of this contract should it be awarded to your firm. Please indicate the number of employees in each job classification as well as the number of new hires, if any, as a result of this contract.

Company Name: _____________________________________________________

Project:_____________________________________________________________

Job Titles/Classification Estimated number of existing staff to be employed in this classification if awarded the contract

Estimated number of new hires to be employed in this classification if awarded the contract

Are any current employees or potential new hires Pasadena residents? If so, how many?

Pasadena, CA 91101

Current Permanent Workforce Utilization (Form AA-3) (OPTIONAL)

Company Name: ___________________________________________

Project: ____________________________________________________

Completion of this form is OPTIONAL. Any information supplied by Proposers is for reporting purposes only and will not be factored into the award of any contract.

Instructions: Please indicate the number of employees in each Job Classification belonging to the following groups.

White (not of Hispanic origin)

African-American (not of Hispanic origin)

Hispanic Asian/Pacific Islander

Native American

Armenian Male Female

CLASSIFICATION

Officials/Managers Professionals

Technicians

Office/Clerical

Skilled Craft

Workers

Operators (semi-skilled)

Laborers Service Workers

TOTAL

SIGNATURE PAGE AND LEGAL STATUS

Terms _______________________ 30 days

Delivery shall be no more than NINETY (90) days after receipt of City purchase order.

Firm__________________________________________________________________

Address _______________________________________________________________

City, State, Zip: _________________________________________________________

Phone _____________________________

Email Address_________________________________________________________

The undersigned certifies that he is an official legally authorized to bind his firm and to enter into a contract should the City accept this proposal.

Bid proposal by _______________________________________________________

(Name of Firm)

Legal status of bidder: Please check the appropriate box

__ Corporation State of Incorporation ___________________________

__ Partnership List Names ____________________________________

__ DBA State full name _______________________________________

__ Other Explain

Signature of Bidder __________________________________ Title_______________________

(Authorized Signature)

Address _______________________ City ___________State ____ Zip ________

Telephone No. _____________________________________________

Signed this _______________________day of _______________________, 20___

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:

Job TitlesClassificationRow1:

Estimated number of existing staff to be employed in this classification if awarded the contractRow1:

Estimated number of new hires to be employed in this classification if awarded the contractRow1:

Job TitlesClassificationRow2:

Estimated number of existing staff to be employed in this classification if awarded the contractRow2:

Estimated number of new hires to be employed in this classification if awarded the contractRow2:

Job TitlesClassificationRow3:

Estimated number of existing staff to be employed in this classification if awarded the contractRow3:

Estimated number of new hires to be employed in this classification if awarded the contractRow3:

Job TitlesClassificationRow4:

Estimated number of existing staff to be employed in this classification if awarded the contractRow4:

Estimated number of new hires to be employed in this classification if awarded the contractRow4:

Job TitlesClassificationRow5:

Estimated number of existing staff to be employed in this classification if awarded the contractRow5:

Estimated number of new hires to be employed in this classification if awarded the contractRow5:

Job TitlesClassificationRow6:

Estimated number of existing staff to be employed in this classification if awarded the contractRow6:

Estimated number of new hires to be employed in this classification if awarded the contractRow6:

Job TitlesClassificationRow7:

Estimated number of existing staff to be employed in this classification if awarded the contractRow7:

Estimated number of new hires to be employed in this classification if awarded the contractRow7:

Job TitlesClassificationRow8:

Estimated number of existing staff to be employed in this classification if awarded the contractRow8:

Estimated number of new hires to be employed in this classification if awarded the contractRow8:

Job TitlesClassificationRow9:

Estimated number of existing staff to be employed in this classification if awarded the contractRow9:

Estimated number of new hires to be employed in this classification if awarded the contractRow9:

Job TitlesClassificationRow10:

Estimated number of existing staff to be employed in this classification if awarded the contractRow10:

Estimated number of new hires to be employed in this classification if awarded the contractRow10:

Estimated number of existing staff to be employed in this classification if awarded the contractAre any current employees or potential new hires Pasadena residents If so how many:

Estimated number of new hires to be employed in this classification if awarded the contractAre any current employees or potential new hires Pasadena residents If so how many:

White not of Hispanic originCLASSIFICATION:

AfricanAmerican not of Hispanic originCLASSIFICATION:

HispanicCLASSIFICATION:

AsianPacific IslanderCLASSIFICATION:

Native AmericanCLASSIFICATION:

ArmenianCLASSIFICATION:

MaleCLASSIFICATION:

FemaleCLASSIFICATION:

White not of Hispanic originOfficialsManagers:

AfricanAmerican not of Hispanic originOfficialsManagers:

HispanicOfficialsManagers:

AsianPacific IslanderOfficialsManagers:

Native AmericanOfficialsManagers:

ArmenianOfficialsManagers:

MaleOfficialsManagers:

FemaleOfficialsManagers:

White not of Hispanic originProfessionals:

AfricanAmerican not of Hispanic originProfessionals:

HispanicProfessionals:

AsianPacific IslanderProfessionals:

Native AmericanProfessionals:

ArmenianProfessionals:

MaleProfessionals:

FemaleProfessionals:

White not of Hispanic originTechnicians:

AfricanAmerican not of Hispanic originTechnicians:

HispanicTechnicians:

AsianPacific IslanderTechnicians:

Native AmericanTechnicians:

ArmenianTechnicians:

MaleTechnicians:

FemaleTechnicians:

White not of Hispanic originOfficeClerical:

AfricanAmerican not of Hispanic originOfficeClerical:

HispanicOfficeClerical:

AsianPacific IslanderOfficeClerical:

Native AmericanOfficeClerical:

ArmenianOfficeClerical:

MaleOfficeClerical:

FemaleOfficeClerical:

White not of Hispanic originSkilled Craft Workers:

AfricanAmerican not of Hispanic originSkilled Craft Workers:

HispanicSkilled Craft Workers:

AsianPacific IslanderSkilled Craft Workers:

Native AmericanSkilled Craft Workers:

ArmenianSkilled Craft Workers:

MaleSkilled Craft Workers:

FemaleSkilled Craft Workers:

White not of Hispanic originOperators semi skilled:

AfricanAmerican not of Hispanic originOperators semi skilled:

HispanicOperators semi skilled:

AsianPacific IslanderOperators semi skilled:

Native AmericanOperators semi skilled:

ArmenianOperators semi skilled:

MaleOperators semi skilled:

FemaleOperators semi skilled:

White not of Hispanic originLaborers:

AfricanAmerican not of Hispanic originLaborers:

HispanicLaborers:

AsianPacific IslanderLaborers:

Native AmericanLaborers:

ArmenianLaborers:

MaleLaborers:

FemaleLaborers:

White not of Hispanic originService Workers:

AfricanAmerican not of Hispanic originService Workers:

HispanicService Workers:

AsianPacific IslanderService Workers:

Native AmericanService Workers:

ArmenianService Workers:

MaleService Workers:

FemaleService Workers:

White not of Hispanic originTOTAL:

AfricanAmerican not of Hispanic originTOTAL:

HispanicTOTAL:

AsianPacific IslanderTOTAL:

Native AmericanTOTAL:

ArmenianTOTAL:

MaleTOTAL:

FemaleTOTAL:

Terms:

Bid proposal by:

Corporation State of Incorporation:

Partnership List Names:

DBA State full name:

Title:

Address_4:

City:

State:

Zip:

Telephone No:

Signed this:

day of:

Company Name:

Address:

City State Zip:

Phone:

Project:

Group1: Choice1

Email Address:

Text2:

File details come from the government source that posted it. Updated Oct 12, 2026.