Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

fleet rfp attachment O statement of affiliations 1 02 08 by Tqurg9

VIEWS: 8 PAGES: 1

									                                City of Pittsburgh
                              Department of Finance

                             Statement of Affiliations
                                 Attachment “O”

1.   ______________________________________________________________________
     Name of Contractor
     ______________________________________________________________________

     ______________________________________________________________________

     (   ) Office address and phone number

2.   List your qualifications and experience for performance of the contract.

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

3.   Please give a brief description of any contractual or business relationships you have
     had with the CITY within the past three years. Please include the dollar value of the
     contract of business relationship.

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

4.   Please identify by name and address the contractor's principals including all owners,
     partners, or shareholders and officers. If the contractor is a public corporation identify by
     name and address the officers, members of the board of directors, and shareholders
     holding more than three (3) percent of the corporate stock.

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

     ______________________________________________________________________

								
To top