3 years ago

Bid Book - Dublin City, Ohio

Bid Book - Dublin City, Ohio


CONTRACTOR'S ORGANIZATIONGeneral InformationAddress:_____________________________________________________Telephone and Facsimile: _______________________________________E‐mail address: _______________________________________________Web site: ____________________________________________________If address given above is a branch office address, provide principal home office address:___________________________________________________________________________________________________________Type of OrganizationThe Contractor's Organization is a:__ CorporationDate and State of Incorporation: _____________________Executive Officers: (Names and Addresses)_______________________________________________________________ PartnershipDate and State of Organization: ______________________Type of Partnership: __ General __ Limited __ Limited Liability __ Other:_________________________________Current General Partners: (Names and Addresses)_________________________________________________________ Joint VentureDate and State of Organization: ______________________Joint Venturers: (For each indicate the name, address and form and state of organization, as well asthe managing or controlling Joint Venturer if applicable.)_________________________________________________________________________________________________________________________________________________________________ Limited Liability CompanyDate and State of Organization: ______________________Members: (Names and Addresses)____________________________________________________________________________________________________________________4613‐006.0‐CIP

__________________________________________________ Sole ProprietorshipDate and State of Organization: ______________________City or Citys: (Names and Addresses)_______________________________________________________________ OtherType of Organization: ______________________________State of Organization: _____________________________Citys and/or Principals: (Names and Addresses)_______________________________________________________In addition to the above categories of business entities, indicate whether Contractor's organizationis certified as a:__ Disadvantaged Business Enterprise Certified by:________________________________________________________ Minority Business Enterprise Certified by:________________________________________________________ Women's Business Enterprise Certified by:________________________________________________________ Historically Underutilized Business Zone Small Business Concern Certifiedby:____________________________________LICENSING AND REGISTRATIONJurisdictions in which Contractor is legally qualified to practice: (Indicate license or registrationnumbers for each jurisdiction, if applicable, and type of license or registration. Attach separatesheet as necessary.)____________________________________________________________________________________________________________________________________________________________In the past five years, has Contractor had any business or professional license suspended orrevoked? __ Yes __ NoIf yes, describe circumstances on separate attachment, including jurisdiction and bases forsuspension or revocation.4713‐006.0‐CIP

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