08DOA-S3909 - Vendor-Information-Response.pdf

PDF 97 KB Posted

Attached to
Presort Mail Services
Solicitation number
08DOA-S3909
Issued by
Nevada

About this file

This is a Vendor Information Response form established by the State of Nevada Department of Administration for use in state and local contract opportunities. The form serves as a standardized template that vendors and their subcontractors must complete and submit with their proposals for consideration in the bidding process. The document requires vendors to provide comprehensive company information including official company name, complete contact details, telephone and toll-free numbers, and email addresses. Additionally, vendors must designate a specific contact person responsible for questions and contract negotiations, including that individual's title, address, and direct communication information.

The form mandates that vendors disclose critical operational and legal information as prerequisites for contract eligibility and award. This includes verification of Nevada business licensing compliance pursuant to Nevada Revised Statutes sections 76 and 80.010, with foreign corporations required to register with the Nevada Secretary of State before contract execution. Vendors must document any prior experience with State of Nevada agencies, disclose current or former employment of state agency personnel who would be performing work under the contract, and provide full disclosure of any significant contractual failures, breaches, litigation, or pending claims occurring within the past six years that could affect performance capability. The form also requires identification and signature of the individual authorized to bind the vendor organization, along with payment authorization information for procurement card usage, ensuring complete transparency and accountability in the vendor selection and contract management process.

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Other files

File Type Posted
08DOT-S3909 - Insurance Schedule.docx DOCX document
Certification-regarding-lobbying~6.pdf PDF
08DOA-S3909 - request-for-proposals~1.docx DOCX document
Terms-and-conditions-for-services~5.pdf PDF
Standard-form-contract~5.docx DOCX document
08DOA-S3909 - reference-questionnaire~1.docx DOCX document
08DOA-S3909 - Cost Schedule~1.docx DOCX document
Quote Instructions.pdf PDF

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VENDOR INFORMATION RESPONSE

Revised: April 2021 Page 1 of 1

Vendors shall complete and return this form in their proposal.

If the proposal includes subcontractors, form must be completed for each subcontractor as well.

1. VENDOR CONTACT INFORMATION

COMPANY NAME AND CONTACT INFORMATION:

The information provided in the table below shall be used for development of the contract, if awarded.

Requested Information Response

Company Name:

Company Street Address:

City, State, Zip Code:

Telephone Number, including area code:

Toll Free Number, including area code:

Email Address:

CONTACT PERSON FOR QUESTIONS/CONTRACT NEGOTIATIONS

Requested Information Response

Name:

Title:

Address:

City, State, Zip Code:

Email Address:

Telephone Number, including area code:

Toll Free Number, including area code:

Confidentiality and Certification of Indemnification
Certification Regarding Lobbying
Vendor Information Response
1. VENDOR CONTACT INFORMATION
1.1 COMPANY NAME AND CONTACT INFORMATION:
1.2 CONTACT PERSON FOR QUESTIONS/CONTRACT NEGOTIATIONS
2. VENDOR INFORMATION
2.1 Vendors shall provide an overall company profile in the following table:
2.2 VENDOR LICENSING
2.2.1 Please be advised: Pursuant to NRS 80.010, a corporation organized pursuant to the laws of another state shall register with the State of Nevada, Secretary of State’s Office as a foreign corporation before a contract can be executed between the ...
2.2.2 The selected vendor, prior to doing business in the State of Nevada, shall be appropriately licensed by the State of Nevada, Secretary of State’s Office pursuant to NRS 76. Information regarding the Nevada Business License can be located at htt...
2.3 STATE OF NEVADA EXPERIENCE
2.3.1 If ‘Yes’, complete the following table for each State agency for whom the work was performed.
2.3.2 Table can be duplicated for each contract being identified.
2.4 CURRENT OR FORMER EMPLOYEE
2.4.1 If you employ (a) any person who is a current employee of an agency of the State of Nevada, or (b) any person who has been an employee of an agency of the State of Nevada within the past two (2) years, and if such person shall be performing or p...
2.5 PRIOR OR ONGOING CONTRACTUAL ISSUES
2.5.1 Disclosure of any significant prior or ongoing contract failures, contract breaches, civil or criminal litigation in which the vendor has been alleged to be liable or held liable in a matter involving a contract with the State of Nevada or any o...
2.5.2 Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed.
2.5.3 If ‘Yes’, please provide the information in the table below.
2.5.4 Table can be duplicated for each issue being identified.
3. PAYMENT AUTHORIZATION FOR USE OF PROCUREMENT CARD
4. NAME OF INDIVIDUAL AUTHORIZED TO BIND THE ORGANIZATION
4.1 SIGNATURE OF INDIVIDUAL AUTHORIZED TO BIND THE VENDOR
Company Name:
Company Email Address:
Contact Person Name:
Contact Person Title:
Contact Person Address:
Contact Person City, State, Zip Code:
Contact Person Email:
Contact Person Telephone:
Contact Person Toll Free (if applicable):
Company Address:
Company City State Zip Code:
Company Telephone:
Company Toll Free:

File details come from the government source that posted it. Updated .