12-12. REQUIRED IFB Representations Certifications.docx
DOCX document 31 KB Posted
- Attached to
- Re-Bid Pump Station 182 Redundant Power
- Solicitation number
- IFB-043-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Required IFB Representations and Certifications form for the City of Tallahassee's Re-Bid Pump Station 182 Redundant Power project in Florida. The document serves as a template for respondents to provide essential company and contact information required for bid submission. Respondents must complete and submit a Federal Form W-9 with their bid and provide official company registration information including company name, mailing address, telephone, fax, and website URL. Additionally, respondents must designate a company contact for contract management, provide a payment remittance address with associated contact information, identify a contact for invoice inquiries, and specify where purchase orders should be sent if applicable.
The form does not specify pricing terms, set-asides, or other financial details within the representations and certifications document itself. However, the associated Pump Station 182 Redundant Power project involves construction of a redundant underground electrical power supply from the City of Tallahassee Electric Department's distribution system to Pump Station 182. The contractor's scope includes supply and installation of two 4-inch electrical conduits via horizontal directional drilling, installation of termination cabinets, coordination with the electric utility for transformer and primary conductor installation, and supply and installation of a 2000-amp Main Breaker and Automatic Transfer Switch with associated conduit and cable work. The project represents a collaborative effort between the contractor and the City of Tallahassee Electric Department, with specific divisions of responsibility outlined in the electrical specifications.
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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:
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