APPENDIX B Acknowledgment of Receipt Form.doc

APPENDIX B

RFP

ACKNOWLEDGEMENT OF RECEIPT FORM

In acknowledgement of receipt of this RFP the undersigned agrees that he/she has received a complete copy, beginning with the title page and table of contents, and ending with Appendix J.

The acknowledgement of receipt should be signed and returned to the Procurement Manager no later than close of business on February 9, 2010. Only potential Offerors who elect to return this form completed with the intention of submitting a proposal will receive copies of all Offeror written questions and the Department’s written responses to those questions as well as RFP amendments if any are issued.

FIRM: __________________________________________________________________

REPRESENTED BY: _____________________________________________________

TITLE: __________________________________ PHONE NO.:__________________

E-MAIL:_________________________________ FAX NO.: _____________________

ADDRESS: _____________________________________________________________

CITY: _____________________________ STATE: _______ ZIP CODE:__________

SIGNATURE: _____________________________________ DATE:_______________

This name and address will be used for all correspondence related to the RFP.

Firm does/does not (circle one) intend to respond to this RFP.

Nicole Taylor

Procurement Manager, Work & Family Support Bureau

Income Support Division, HSD 2009 S. Pacheco Street

Santa Fe, NM 87505

Phone: (505) 827-7227

Fax: (505) 827-7259

E-mail: Nicole.Taylor1@state.nm.us