Fillable Contractor/Subcontractor Form (City of Pasadena, Texas)

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Contractor/Subcontractor Form (City of Pasadena, Texas)

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Community Development Department Use ONLY:
Reviewed by: ______________________________ Date: ____________
Approved by: ______________________________ Date: ____________
10/2020
Contractor/Subcontractor Form
Organization Name
Project/Program Name
Date
Grant Type
IDIS No.
Program Year
ORD. No.
Contact Person
Phone No.
Title
Email
You must complete a new form if there are any changes to contractor or
subcontractor information. Failure to do so may result in suspension of your grant.
Please complete the following information:
Contractor or Subcontractor
Name
Contractor or Subcontractor
Address
Amount of
Contract or
Subcontract
Contractor or
Subcontractor
Business
Racial/Ethnic
Code
(see below)
Woman
Owned
Business
(Y or N)
Prime Contractor or
Subcontractor
Identification
Number
Section 3
(Y or N)
Type of Trade Codes: 1=New Construction, 2=Substantial Rehab, 3=Repair, 4=Service, 5=Project Mgmt., 6=Professional, 7=Tenant Services, 8=Education
Training, 9=Arch./Engrg. Appraisal, 0=Other
Racial/Ethnic Codes: 1=White Americans, 2=Black Americans, 3=Native Americans, 4=Hispanic Americans, 5=Asian/Pacific Americans, 6=Hasidic Jews
I, ___________________________________ understand that I must notify the City of
Pasadena Community Development Office of any contractor or subcontractor changes.
Failure to do so may result in suspension of funds.
_____________________________ ________________________ _______________
Signature Title Date
Select Grant Type
Select Program Year
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ContractorSubcontractor Form (City of Pasadena, Texas)

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Completed 25 February 2021

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