1-Acknowledgement Form.pdf

122 KB Posted

Attached to
Flu Vaccination Clinics
Solicitation number
26-08201
Issued by
Missouri

About this file

Written by GovTribe AI ·

This is an Acknowledgement Form associated with a Request for Proposal (RFP) issued by Rockwood School District in Missouri for flu vaccination clinic services. The form serves as the proposer's formal declaration of understanding and agreement to comply with all terms, conditions, requirements, and specifications outlined in the original RFP and any issued addenda. The document requires proposers to provide company information, representative contact details, years of operation, names and titles of company officers, and acknowledgment of all received addenda with their respective issue and acknowledgment dates. Proposers must certify that they have read and agree to the RFP terms and conditions, and that their proposal will remain open for at least 90 days from the submission deadline.

The form does not contain specific details regarding pricing terms, set-asides, incumbents, funding sources, or other salient contract information. Rather, it functions solely as a compliance certification document requiring the proposer's authorized company officer signature and date to validate receipt of all addenda and agreement to the proposal terms and conditions specified in the RFP for flu vaccination clinic services for the school district's employees and dependents.

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ACKNOWLEDGEMENT FORM

The Proposer hereby declares understanding, agreement, and certification of compliance to provide the items and/or services at the prices quoted in accordance with all terms and conditions, requirements, and specifications of the original Request for Proposal (RFP) and as modified by any addenda.

Company Name Representative's Name Title

Address City/State/Zip Telephone # Fax #

E-mail Address

Years in Operation Years under current structure and/or under previous structure

1) Name of Company’s Officers:

NAME TITLE

2) The undersigned hereby acknowledges the receipt of the following addenda:

Addendum Number

Date Issued

Date Acknowledged

Signature

3) The undersigned hereby acknowledges that the Company has read and agrees to the terms and conditions set forth in the RFP and that the terms and conditions set forth in the Proposal will remain open for at least 90 days from the deadline for submission of Proposals.

Company Officer’s Name

Signature Date

NAME 1:
NAME 2:
NAME 3:
NAME 4:
TITLE 1:
TITLE 2:
Number 1:
Number 2:
Number 3:
Date Issued 1:
Date Issued 2:
Date Issued 3:
Acknowledged 1:
Acknowledged 2:
Acknowledged 3:
Acknowledged 4:
Company Name, Representative's Name, Title:
Address, City/State/Zip, Telephone #, Fax #:
E-mail Address:
Years in Operation, Years under current structure and/or under previous structure:
Company Officer's Name:
Signature Date:
Number 4:
Date Issued 4:
TITLE 3:
TITLE 4:

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