12-Part G - Attachment B - Required Information Form.pdf

194 KB Posted

Attached to
Transportation Stipend Card Management Services
Solicitation number
2017
Issued by
Alexandria City, Virginia

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This is a Required Information Form attachment issued by the City of Alexandria, Virginia, in connection with a Request for Proposals for Transportation Stipend Card Management Services. The solicitation seeks a qualified firm to provide a comprehensive, secure, and scalable debit/prepaid card management solution for the City of Alexandria. The form requires all respondents to submit detailed organizational information as part of their proposal submission.

The Required Information Form mandates that respondents identify their business classification, including whether they are minority-owned, small businesses, partnerships, corporations, or sole proprietorships. For partnerships and sole proprietorships, respondents must provide the owner's name, address, and city/state information. For corporations, respondents must supply the state and date of incorporation, Virginia Certificate of Authority charter number, and the names of all officers including president, vice president, secretary, treasurer, and registered agents. All submissions must be signed by an authorized signatory with their printed name and title. The form serves as a standardized collection mechanism for contractor qualification and eligibility verification purposes.

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Other files

File Type Posted
11-Part G - Attachment A - Authorized Signatory Statement.pdf PDF
4-Part E - RFP Instructions to Offerors Final.pdf PDF
10-Part D - General Terms Conditions Final.pdf PDF
8-RFP 2017 Cost Proposal Template.xlsx XLSX spreadsheet
3-Part H - Exhibit H - Information Technology - Final.docx DOCX document
9-Part C - Special Terms and Conditions Final.pdf PDF
6-Part B - RFP Scope of Work Final.pdf PDF
2-Part H - Exhibit A - Definitions - Final.docx DOCX document
14-Part G - Attachment D - Reference Sheet.pdf PDF
5-Part F - RFP Evaluation and Method of Award Final.pdf PDF
7-Part A - RFP General Information Final.pdf PDF
15-Part G - Attachment E - Subcontractor List.pdf PDF
16-Part G - Attachment F - No Response Form.pdf PDF
1-CACVAT Template.xlsx XLSX spreadsheet
13-Part G - Attachment C - Certifications.pdf PDF
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City of Alexandria

Attachment B

Required Information Form

Each Respondent must provide the following information:

1. Minority Business Firm Yes [ ] No [ ] Partnership Yes [ ] No [ ] Small Business Firm Yes [ ] No [ ] Corporation Yes [ ] No [ ] Sole Proprietorship Yes [ ] No [ ]

2. Partnerships* and Sole Proprietorships must provide the following information:

Name: __________________________________________________________ Address: __________________________________________________________ City and State: __________________________________________________________

* Partnerships must complete this information for all partners

3. Corporations must provide the following information:

State of Incorporation: ________________ Date of Incorporation: _________________ Charter Number of the Virginia Certificate of Authority: ___________________________ Foreign corporations desiring to transact business in the State of Virginia shall register with the State Corporation Commission in accordance with Section 13.1-757 of the Code of Virginia, as amended.

Corporations must provide the names of the following officers:

President: ____________________________________________________ Vice President: ____________________________________________________ Secretary: ____________________________________________________ Treasurer: ____________________________________________________ Registers Agent(s): ____________________________________________________

Bidder/Offeror Name: __________________________Date: ____________________________ Signature of Authorized Signatory: _________________________________________________ Name & Title of Authorized Signatory: ______________________________________________

No.:

Name:
Address:
City and State:
State of Incorporation:
Date of Incorporation:
Charter Number of the Virginia Certificate of Authority:
Corporations must provide the names of the following officers:
Vice President 1:
Vice President 2:
Vice President 3:
Registers Agents:
BidderOfferor Name:
Date:
Signature1_es_:signer:signature:
Signature2_es_:signer:signature:
Check Box3:
0:
0: Off
1: Off
1:
0: Off
1: Off
2:
0: Off
1: Off
3:
0: Off
1_es_:signature: Off
4:
1_es_:signature: Off
5:
1_es_:signature: Off
Enter Solicitation Type Abbreviation_es_:sender: RFP
Enter Solicitiation Type_es_:sender: Request for Proposals
Enter Title_es_:sender: Transportation Stipend Card Management Services
Enter No_es_:sender: 2017

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