About this file

This is a Contractor Information Data Form for the City of Philadelphia required for all prime contractors and subcontractors on municipal projects. The form serves as a mandatory submission document for capturing comprehensive contractor and subcontractor information throughout the project lifecycle. The form collects essential identifying information including Federal Tax ID or SSN, company name, owner details, business address, phone number, and email contact. Additionally, it requires documentation of the primary industry NAICS code, date the company was established, and date of any relevant certifications.

The form mandates disclosure of demographic information, certification status, and outreach methods used to solicit subcontractors. Contractors must report the dollar amount committed to each subcontractor and provide annual gross receipts data, with demographic categories classified by annual revenue thresholds ranging from $1 million or less up to $47 million or less. Certification status options include Small Business Enterprise (SBE), Local Business Enterprise (LBE), Minority Business Enterprise (MBE), Minority Women Business Enterprise (MWBE), Disadvantaged Business Enterprise (DBE), Women Business Enterprise (WBE), or other certifications. Demographic classifications encompass African-American, American Indian or Alaskan Native, Asian-American, Hispanic or Latino American, Native Hawaiian or Other Pacific Islander, White, and other categories. The form must be completed in its entirety for all prime and subcontractors solicited for the project.

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Text version

CITY OF PHILADELPHIA

CONTRACTOR INFORMATION DATA FORM

(MANDATORY FORM TO BE FILLED OUT ENTIRELY FOR PRIMES AND ALL SUBCONTRACTORS)

City of Philadelphia Contract No: __________________ Project Name: ____________________ Prime Contractor Name: ______________________________________________________________ Address:_____________________________________________________________________________

Complete information below for each PRIME AND SUBCONTRACTOR that was solicited for the Project

PRIME AND SUBCONTRACTOR INFORMATION

Federal Tax ID #/ SSN #: Primary Industry NAICS Code:

Full Company Name:

Owner:

Address:

City: Zip Code:

County: Phone Number:

E-Mail:

Date Established: Date Certified:

Demographic*:

Gender:

Certification Status:

No Certification | SBE | LBE | MBE | MWBE | DBE | WBE | Other

Outreach Method:

Dollar Committed to Subcontractor:

Annual Gross Receipts: _______ *indicate the letter that applies

A. $1M or Less C. $23.5M or Less

B. $5M or Less D. $47M or Less

*Demographic: (A) African-American; (B) American Indian or Alaskan Native; (C) Asian-American; (D) Hispanic or Latino American; (E) Native Hawaiian or Other Pacific Islander; (F) White; (G) Other

Untitled

City of Philadelphia Contract No:
Project Name:
Prime Contractor Name:
Address:
Federal Tax ID SSN:
Primary Industry NAICS Code:
Full Company Name:
Owner:
Address_2:
City:
Zip Code:
County:
Phone Number:
EMail:
Date Established:
fill_14:
Ethnicity:
Gender:
fill_23:
Outreach Method:
Dollar Committed to Subcontractor:
Annual Gross Receipts:

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