Integrity verification request—subcontractor

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Supplier information

Supplier name (required)

Supplier’s mailing address (required)

Supplier’s city (required)

Supplier’s province/territory (required)

Supplier’s postal code (Canada) (A1A 1A1) (required)

Supplier email address (required)

Information on the contract/real property agreement between the supplier and the Government of Canada

Contract/real property agreement number (required)

Transaction value ($)(including taxes) (required)

Subcontractor Information

Complete legal name of the subcontractor to be verified (required)

Subcontractor’s mailing address (required)

Subcontractor’s city (required)

Subcontractor’s province/territory (required)

Subcontractor’s postal code (Canada) (A1A 1A1) (required)

Subcontractor consent (required)

I authorize Public Works and Government Services Canada to collect and use the information provided, in addition to any other information that may be required to make a determination of ineligibility.

I accept

I refuse

E-mail this form to: PWGSC.O.integrity-TPSGC.O.integrite@tpsgc-pwgsc.gc.ca

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Date modified:: 2017-05-17

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Integrity verification request—subcontractor

Supplier information

Information on the contract/real property agreement between the supplier and the Government of Canada

Subcontractor Information