11-4. Representations and Certifications.pdf

PDF 79 KB Posted

Attached to
Generator Installation at Tallahassee Animal Service Center
Solicitation number
IFB-070-26-KM
Issued by
Leon County, Florida

About this file

This is a Representations and Certifications form for the City of Tallahassee, Florida, related to a Licensed Electrical Contractor Services opportunity for generator installation and electrical connection work at the City of Tallahassee Animal Service Center located at 1125 Easterwood Drive, Tallahassee, FL 32311. The project scope includes installation of a power generator, electrical connections, and a subgrade irrigation system, with all labor, materials, and equipment necessary to complete the specified work. Respondents must complete and submit a Federal Form W-9 with their bid as part of this submission.

The form requires respondents to provide official company registration information including company name, mailing address, telephone number, email address, and website URL. Respondents must also designate a company contact for contract management, provide a payment remittance address, identify a contact for invoice inquiries, and specify where purchase orders should be sent. All required contact information fields must be completed with applicable voice and facsimile numbers, extensions, and email addresses to ensure proper communication and payment processing throughout the contract term.

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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:

MAIL ADDRESS:

TELEPHONE NO:

(Toll-Free Preferred)

EMAIL ADDRESS:

WEBSITE URL:

(City) (State) (Zip Code+4)

VOICE: , EXTENSION:

OTHER: ; FAX:

COMPANY CONTACT FOR CONTRACT MANAGEMENT (Type/Print)

PERSON NAME:

TELEPHONE NO:

PAYMENT REMITTANCE ADDRESS (Type/Print) (if same as 2.8, enter “SAME 2.8”)

NAME:

TELEPHONE NO:

CONTACT FOR INVOICE INQUIRIES

NAME:

TELEPHONE NO:

WHERE TO SEND PURCHASE ORDER (IF APPLICABLE)

COMPANY NAME:

File details come from the government source that posted it. Updated .