Pursuant to Public Act 102-0265, the City of Rock Island is required to make a good faith effort to collect and electronically publish data from all vendors and subcontractors doing business with the City. The published data must include if the vendor or subcontractor is minority-owned, woman-owned or veteran-owned as defined in the Business Enterprise for Minorities, Women and Persons with Disabilities Act. Every vendor doing business with the City (including existing vendors) must complete the questionnaire regardless of the Disadvantaged Business Enterprise (DBE) status.
By completing the form below, you certify the information supplied is complete and correct to the best of your knowledge and authorize the City of Rock Island to verify and track any of this information as needed.
If you are an existing vendor with the City of Rock Island and have had any organizational changes, please remit an updated W-9. Once completed, the form can be emailed to firstname.lastname@example.org.