Vendor_Information_Request_Form_.pdf
PDF 80 KB Posted
- Attached to
- On-Call Construction Management Services
- Solicitation number
- RFP-TH-0118
- Issued by
- Los Angeles County, California
About this file
This Vendor Information Request Form is a standardized registration document used by West Basin Municipal Water District, a public water agency serving 17 cities and approximately one million people in coastal Los Angeles County, California, to collect comprehensive vendor information for contract opportunities. The form requests critical company details including legal business name, addresses, contact information, and vendor identification numbers. Vendors must provide documentation of signature authority for contract execution, identify authorized representatives to receive executed agreements, and disclose relevant certifications such as Small Business Enterprise (SBE) and Local Business Enterprise (LBE) status along with corresponding certification numbers and business license information. The form also requires vendors to confirm compliance with the Build America, Buy America (BABA) Act, which mandates that product components be 65 percent domestically sourced, and to acknowledge West Basin's standard payment terms of Net 30 days. The form permits vendors to authorize West Basin to verify all stated information and was dated January 22, 2026.
The Vendor Information Request Form serves as a prerequisite registration document for the On-Call Construction Management Services solicitation, which is seeking qualified construction management consulting firms to provide services including project management, safety management, contract administration, inspection services, quality assurance and control, schedule management, materials testing, labor compliance monitoring, constructability reviews, and cost estimating. Proposals are due April 14, 2026, at 2:00 p.m., with a non-mandatory pre-proposal conference on March 23, 2026, and a questions deadline of April 9, 2026. Short-listed candidates will participate in interviews and presentations on April 29–30, 2026, with award notification expected the week of May 25, 2026. The contract term is three years, ending in June 2029, with task orders issued as needed. The estimated total contract value is approximately $3,000,000, with rate schedules required for 2026 through 2029, subject to annual increases not exceeding 3 percent. SBE and LBE certifications provide additional evaluation points, with vendors receiving 3 points for SBE or LBE prime status (6 points if both certifications are held) and 1 point for sub-consultant participation at 30 percent or more of total compensation. Vendors must carry comprehensive insurance including Commercial General Liability ($2,000,000), Business Automobile Liability ($2,000,000), Workers' Compensation ($1,000,000), and Professional Liability ($2,000,000), with the District named as an additional insured, and proposals must remain valid for a minimum of 12 months from the closing date.
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Text version
VENDOR INFORMATION REQUEST - West Basin Municipal Water District
Yes No
Yes No
Yes No
Entered By: Date: Yes No W-9 Received: Yes No
Email:
Title:
Address 2 (suite, unit, etc.):
Vendor Number:
Verified
SBE & LBE:
FOR PURCHASING ONLY
Email:
List the representative(s) from your organization that would like to receive a copy of the executed agreement:
Title: Print Name:
Print Name:
Email:
COMPANY INFORMATION
Complete Legal Name:
Address 1: Contact Phone:
Which Public Agency are you Certified With?
Certification Number:
Are you a Certified Small Business Enterprise (SBE)? If yes, Small Business certification must be submitted.
ACCOUNTS RECEIVABLE (remittance name and address)
City/State/Zip:
Contact Fax:
Remittance name: Contact Name:
Are you a Local Business Enterprise (LBE)?
If yes, please provide a copy of your business license.
Business License Number:
Address - Same as above
Address 1: Contact Phone:
ADDITIONAL INFORMATION
CONTRACTS/AGREEMENTS INFORMATION
Payment Discounts:
(West Basin terms: Net 30) Contact Email:
List the representative(s) from your organization that will be signing the agreement and attach proof of signature authority. Documentation should state that the representative has the authority to execute contracts—examples of proof: Articles of Incorporation, corporate resolution, written consent, etc.
Title: Print Name:
Title: Print Name:
Email:
Print Name:
Length of time at this address? Contact Email:
By signing, you authorize West Basin to verify the information stated on this form. Signature:
If applicable, do your company's products comply with the Build America, Buy America (BABA) Act?
(Product components are 65% domestically sourced.)
Address 2: Contact Fax:
City/State/Zip:
Title:
1-22-2026
| Complete Legal Name: |
| Length of time at this address: |
| Business License Number: |
| Remittance name: |
| Entered By: |
| Title: |
| Certification Number: |
| Which Public Agency are you Certified With: |
| Address 1: |
| Address 2: |
| Contact Fax: |
| Contact Phone: |
| City/State/Zip: |
| Contact Email: |
| Contact Name: |
| Print Name: |
| Email: |
| Vendor Number: |
| Payment Discounts: [NET 30 Days] |
| Contact Fax 2: |
| Address 3: |
| Address 4: |
| Contact Phone 2: |
| Contact Email 2: |
| City/State/Zip Code: |
| Title 1: |
| Title 2: |
| Title 3: |
| Title 4: |
| Print Name 2: |
| Print Name 3: |
| Print Name 4: |
| Email 2: |
| Email 3: |
| Email 4: |
| Print Name 1: |
| Date1_af_date: |
| Group5: Off |
| Check Box8: Off |
File details come from the government source that posted it. Updated .