SUBCONTRACTOR INFORMATION DATA FORM FINAL 8.11.2026.pdf
PDF 168 KB Posted
- Solicitation number
- 21260922161045
- Issued by
- Philadelphia County, Philadelphia City, Pennsylvania
About this file
This is a Contractor Information Data Form issued by the City of Philadelphia for mandatory completion by all prime contractors and subcontractors on municipal projects. The form serves as a standardized data collection instrument designed to gather comprehensive information about contractors and subcontractors participating in City of Philadelphia contracts. The document requires submission of complete contractor identification, including federal tax identification numbers or Social Security numbers, primary industry NAICS codes, and full company names with owner information and contact details. Required information also includes the date the company was established, certification date, and specific outreach methods used to solicit each contractor or subcontractor for the project.
The form mandates disclosure of demographic information for owners, certification status categories (including SBE, LBE, MBE, MWBE, DBE, and WBE designations), dollar amounts committed to each subcontractor, and annual gross receipts classified within specified ranges (from $1 million or less up to $47 million or less). Owner demographics must be indicated by letter designation covering 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 includes separate sections for documenting prime contractor and multiple subcontractor information, with duplicate data fields provided to accommodate additional subcontractors on a single project. This form relates to a consulting services contract for the Office of Property Assessment Mass Appraisal Evaluation in Pennsylvania.
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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 .