10-FORM 3 - REPRESENTATIONS and CERTIFICATIONS.pdf
PDF 2 MB Posted
- Attached to
- Re-Bid Lincoln Community Center Waterproofing
- Solicitation number
- IFB-112-25-KM
- Issued by
- Leon County, Florida
About this file
This document is a Representations/Certifications form for a contract bid, designed to collect comprehensive company information. The form requires bidders to complete a Federal Form W-9 and provide detailed contact information across multiple sections, including official company details, contract management contacts, payment remittance address, invoice inquiry contacts, and purchase order information. Each section requests specific details such as company name, mailing address, telephone numbers (with preferences for toll-free options), website URL, email addresses, and contact names for different administrative functions.
The form is structured to capture critical vendor information for potential contract management and payment processing, with fields for both voice and alternative contact numbers, extensions, and fax numbers. It appears to be a standard pre-qualification or bid submission document that allows the contracting agency to establish a comprehensive profile of the bidding organization, ensuring they have multiple points of contact and communication channels for future administrative and financial interactions.
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Text version
REPRESENTATIONS/CERTIFICATIONS
TAXPAYER IDENTIFICATION
Respondent must complete Federal Form W-9 and submit it with their bid.
OFFICIAL COMPANY INFORMATION AS REGISTERED (Type/Print)
COMPANY NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
WEBSITE URL:
COMPANY CONTACT FOR CONTRACT MANAGEMENT (Type/Print)
NAME:
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
PAYMENT REMITTANCE ADDRESS (Type/Print)
NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
CONTACT FOR INVOICE INQUIRIES
NAME:
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
WHERE TO SEND PURCHASE ORDER (IF APPLICABLE)
COMPANY NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
EMAIL ADDRESS:
REPRESENTATIONS/CERTIFICATIONS
File details come from the government source that posted it. Updated .