Vendor_Information_Request_Form_.pdf
PDF 80 KB Posted
- Attached to
- Investment Management Services
- Solicitation number
- RFP-TH-0121
- Issued by
- Los Angeles County, California
About this file
This is a Vendor Information Request Form utilized by West Basin Municipal Water District, a public agency serving 17 cities and approximately one million residents in the coastal Los Angeles area. The form is designed to collect comprehensive vendor information for the District's Investment Management Services procurement, which seeks qualified firms to manage an investment portfolio currently valued at approximately $77 million. Key deadlines include a questions and clarifications submission deadline of March 23, 2026 at 2:00 pm and a proposal submission deadline of March 31, 2026 at 2:00 pm. Candidate interviews and presentations are scheduled for the week of April 13-24, 2026, with a notice of recommended award anticipated the week of May 4-8, 2026 and Board recommendation on May 19, 2026. Proposals must remain valid for a minimum of 90 days from the submission deadline. The contract will be structured on a time-and-material basis with compensation rates specified in the executed agreement and subject to a defined maximum contract value.
The vendor information form requests critical documentation including W-9 forms, proof of signature authority, Small Business Enterprise (SBE) and Local Business Enterprise (LBE) certifications with supporting documentation, business licenses, and compliance information regarding the Build America, Buy America (BABA) Act. West Basin offers incentive points for SBE or LBE prime consultants, awarding three additional points for a single designation and six points if both apply, along with a 3 to 6 percent price reduction in evaluation depending on certifications held. Required insurance coverage includes commercial general liability of $2,000,000, business automobile liability of $2,000,000, workers' compensation of $1,000,000, and professional liability of $2,000,000, with West Basin named as an additional insured. Payment terms are Net 30 days, and the District retains the right to terminate the agreement at any time without cause and maintains audit rights for three years following contract completion.
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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 |
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