SUBCONTRACTOR INFORMATION DATA FORM FINAL 8.11.2026.pdf
PDF 168 KB Posted
- Attached to
- Pre-employment Psychololgical Evaluation Services for Police Officer Recruit / Police Officer Candidates
- Solicitation number
- 21260921142528
- Issued by
- Philadelphia County, Philadelphia City, Pennsylvania
About this file
This is a Contractor Information Data Form required by the City of Philadelphia for all prime contractors and subcontractors bidding on city projects. The form mandates comprehensive documentation for each contractor and subcontractor involved in a project, requiring submission of federal tax identification numbers or social security numbers, primary industry NAICS codes, complete company information including ownership and contact details, and certification dates. The form requests information on the date the company was established and certified, along with demographic classifications and certification status categories including 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.
The form requires disclosure of the dollar amount committed to each subcontractor and annual gross receipts, with demographic categories classified by ethnicity including African-American, American Indian or Alaskan Native, Asian-American, Hispanic or Latino American, Native Hawaiian or Other Pacific Islander, White, or other designations. Annual gross receipts are categorized into four tiers: $1 million or less, $5 million or less, $23.5 million or less, or $47 million or less. The form also includes an outreach method field documenting how subcontractors were solicited for the project, and the contract number and project name must be identified at the top of the form, with duplicate sections provided for multiple contractor entries.
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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 .