1-Attachment A - RFO and Addenda Acknowledgement.pdf
PDF 97 KB Posted
- Attached to
- RFO - Workers Compensation Claims Consultant
- Solicitation number
- KJ02122026
- Issued by
- Harris County, Texas
About this file
This is an Attachment A acknowledgement form for a Request for Offer (RFO) issued by Harris County, Texas, soliciting qualified consultants to provide Workers Compensation Claims Consultant services. The document serves as the formal acknowledgement and certification requirement for offerors submitting proposals in response to this solicitation. Offerors must complete and sign the form to confirm receipt of all addenda issued for the RFO, provide authorization signatures from corporate officers or proprietors, and certify their understanding of and compliance with all RFO requirements and conditions.
The acknowledgement form requires offerors to certify that their proposal is submitted independently without prior understanding or collusion with other bidders, that the authorized signatory has read and fully understands all RFO documents, and that the offeror commits to providing the services as outlined in the solicitation. Offerors must provide company identification information including DUNS number, authorized representative name, company name and address, telephone, fax, and email contact information. The form includes spaces for documenting receipt of multiple addenda with corresponding dates and signatures, or alternatively, notation if no addenda were received.
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Text version
Attachment A
RFO & ADDENDA ACKNOWLEDGEMENT
Addenda Acknowledgement
As required by this solicitation, the undersigned Offeror hereby acknowledges receipt of all Addenda through and including:
Addendum Number Dated Signature
No addenda were received
RFO Acknowledgement
This acknowledgment shall be signed, in ink, by a corporate officer, partner, or proprietor:
I certify that this Offer is submitted without prior understanding, agreement, or connection with any corporation, firm, or person submitting a Offer for the same contract opportunity and is in all respects fair and without collusion or fraud. I am authorized to sign this Acknowledgement for the Offeror and agreed to abide by all conditions of this Request for Offer (RFO) and certify that I have read and understand the RFO documents in their entirety. In signing this Acknowledgement, I attest that under this contract opportunity I shall provide the services identified in this Request for Offer according to the published provisions of this RFO. I certify that all statements made are true, complete and correct.
Authorized Signature Date
Authorized Representative Name (First & Last):
Company Name:
Company Address:
Offeror DUNS Number:
Telephone:________________________ Fax:____________________e-mail:_____________________________
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