1-RFP 28-26-NH APPENDIX C - Submittal Letter Form.pdf
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- Attached to
- Group Medical Insurance Services
- Solicitation number
- RFP 28-26-NH
- Issued by
- Bernalillo County, New Mexico
About this file
This is a Submittal Letter Form (Appendix C) for RFP #28-26-NH issued by Bernalillo County Purchasing and Business Services Department in New Mexico. The form serves as the standard template for businesses submitting proposals to provide claims administration related services for the County's group medical insurance program and employee population. Respondents must complete the form to identify their business entity, provide primary contact information for contract obligation authority, designate a point of contact for inquiries and clarifications, and identify a contact person responsible for negotiations.
The submittal letter form requires offerors to acknowledge receipt of any addenda issued during the procurement process by indicating the addendum numbers received. By signing the form, submitting companies commit to compliance with all applicable procurement conditions, civil rights enforcement requirements under New Mexico State Statutes and Bernalillo County Ordinances, federal anti-discrimination statutes including Title 6 of the Civil Rights Act of 1964, Executive Order 11246 regarding equal employment opportunity, and the Americans with Disabilities Act of 1990. The form requires the authorized company representative's signature and date of submission.
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Text version
APPENDIX C
SUBMITTAL LETTER FORM
RFP #28-26-NH
Identity of Submitting Business (including d/b/a):
Mailing Address:
Who can contractually obligate?
Name/Title: E-mail: Phone:
Contact for Inquiries/Clarifications/Negotiations Inquiries/Clarifications Name/Title:
E-mail: Phone:
Contact for Negotiations Name/Title
E-mail: Phone:
Addendum Acknowledgment:
If Addendum has been received, please indicate how many in the spaces below.
Addendum number(s) __________ through __________ have been received.
By signing below my company/entity/organization commits to comply and act in accordance with the (1) Conditions Governing the Procurement, Unfair Business Practices Disclosure, as stated in Section II of the RFP; (2) Federal Executive Orders relating to the enforcement of civil rights; (3) New Mexico State Statutes and County of Bernalillo Ordinances regarding enforcement of civil rights; (4) Federal Code, 5 USCA 7201 et. seq., Anti-discrimination in Employment; (5) Executive Order No. 11246, Equal Opportunity in Federal Employment; (6) Title 6, Civil Rights Act of 1964 and
(7) Requirements of the Americans with Disabilities Act of 1990 for work performed as a result of this RFP.
Signed: Date:
SUBMITTAL LETTER FORM
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