1-RFC Bidder Cover Summary Fillable PDF (2).pdf
PDF 49 KB Posted
- Attached to
- SLCo HEA131713 Car Seats
- Solicitation number
- SLCoHEA131713-RFC
- Issued by
- Salt Lake County, Utah
About this file
This is a Request for Bids (RFB) cover sheet form for Salt Lake County, Utah, specifically for the Injury Prevention Program under the Salt Lake County Health Department's Community Health Division. The solicitation seeks bids from qualified suppliers to provide multiple car seats for the county's injury prevention initiatives. The document serves as the bidder's cover page and certification form, requiring suppliers to complete standard identification fields including legal supplier name, doing-business-as (DBA) name if applicable, ordering address, supplier contact information, and authorized representative details. Bidders must certify the accuracy and completeness of their submitted information and acknowledge that the supplier's authorized representative possesses legal authority to commit the company to a contractual agreement.
The form indicates that final funding for any resulting contract is contingent upon funding level approvals and authorization by the Salt Lake County Mayor. The document is designed for electronic submission, with electronic signatures accepted as valid. Upon award, both the supplier and Salt Lake County (represented by the Mayor or designee) will execute the agreement by completing the signature and date fields at the bottom of the form. The specific quantities of car seats needed, pricing terms, response deadlines, and contract duration are not detailed in this cover sheet but would be found in the accompanying request for bids solicitation documents.
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Text version
Request for Bids Resulting Contract (RFC)
Legal Supplier Name
DBA (if applicable)
Ordering Address
City State Zip Code
Supplier Contact Person Telephone Number
Supplier E-mail Contact
I certify that to the best of my knowledge the information contained in this bid is accurate and complete and that I have the legal authority to commit this Supplier to a contractual agreement. I realize the final funding for any service is based upon funding levels and the approval of the Mayor for Salt Lake County.
Supplier Authorized Representative
Date
Position or Title
Electronic Signature acceptable for electronic submission.
IN WITNESS WHEREOF, the Parties have executed this agreement this ______ day of _______________, 20___.
X
SALT LAKE COUNTY
Mayor or Designee
| Legal Supplier Name: |
| DBA if applicable: |
| Ordering Address: |
| City: |
| State: |
| Zip Code: |
| Supplier Contact Person: |
| Telephone Number: |
| Supplier Email Contact: |
| Supplier Authorized Representative: |
| Date: |
| Position or Title: |
File details come from the government source that posted it. Updated .