05GA0A21Q0069 - GAO Hotline Cover Page.docx

GAO QUOTATION COVER PAGE

RFQ #: 05GA0A21Q0069

OIG Telephone Hotline Web Based Reporting

Company Name: ____________________________________________

Name, Title, E-Mail address, and Phone Number of Company Representative:

Payment Terms:_________________________________

GSA Schedule Number and Expiration Date (if applicable): _________________________

Please Check Business size: (All that apply):

□ Large □ Small □ Minority-owned □ Women-owned

□ Veteran-owned □ Service Disabled Veteran-Owned □ Small Disadvantage Business □ 8(a)

Tax Identification Number: ________________________

DUNS: ________________________ Cage Code: _______________

NAICS: ________________________ Product Service Code (PSC) _______

Complete Mailing Address: ________________________________________________________________________________________________________________________________

Other Pertinent Information: ________________________________________________________________________________________________________________________________

Quotation Validity Period (quotation valid for 90 days, etc….):_________________

Name, Title, E-mail Address, and Phone Number of Person Authorize to Sign Offer: ________________________________________________________________________________________________________________________________

Signature: ______________________________________ Date: ____________________