04. Exhibit A-2 - Transmittal Letter.docx
DOCX document 36 KB Posted
- Attached to
- Enhanced Provider Network Auditing Program
- Solicitation number
- ITN-11303
- Issued by
- Leon County, Florida
About this file
This is a Transmittal Letter template (Exhibit A-2) issued by the Florida Agency for Health Care Administration (AHCA) for the Enhanced Provider Network Auditing Program solicitation (ITN 002-24/25). The template requires respondents to provide their company name, address, and Federal Employer Identification Number (FEID), along with the contact information and signatures of two authorized officials who have the authority to bind the respondent to a contract.
The document specifies that failure to submit the transmittal letter with signatures from both authorized officials may result in rejection of the response. Additionally, if the respondent is invited to negotiations, at least one of the authorized officials listed must be present at each negotiation session.
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Text version
EXHIBIT A-2
TRANSMITTAL LETTER
All respondents to this solicitation shall utilize Exhibit A-2, Transmittal Letter, for submission of its response.
DATE:Click or tap to enter a date.
RESPONDENT NAME:
RESPONDENT ADDRESS:
RESPONDENT FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEID):
The respondent shall provide an official contact and an alternate contact. Both the official contact person and the alternate contact person must have the authority to bind the respondent to a contract. Both person’s signatures must be included.
OFFICIAL CONTACT PERSON:
NAME:
TITLE:
ADDRESS:
EMAIL ADDRESS:
TELEPHONE NUMBER:
SIGNATURE: _____________________________________________________
ALTERNATE CONTACT PERSON:
NAME:
TITLE:
ADDRESS:
EMAIL ADDRESS:
TELEPHONE NUMBER:
SIGNATURE: _____________________________________________________
Failure to submit, Exhibit A-2, Transmittal Letter, signed by authorized officials who each have the authority to bind the respondent to a contract, may result in the rejection of response. If the respondent is invited to negotiations, at least one authorized official listed above must be present at each negotiation session.
AHCA ITN 002-24/25, Attachment A, Exhibit A-2, Page 1 of 1
File details come from the government source that posted it. Updated .