15-Offeror Information Form.pdf
PDF 402 KB Posted
- Attached to
- 26-08063-P-AW Electrical Switchgear Bundle State and local contract opportunity
- Solicitation number
- 26-08063-P-AW
- Issued by
- Fulton County, Georgia
About this file
The document is an Offeror Information Form dated September 2020, likely for a solicitation by Atlanta Public Schools and/or the State of Georgia. The form is designed for potential vendors to provide comprehensive company details when responding to a business opportunity, with sections requesting basic company information, contact details, ownership status, and responses to various compliance and operational questions.
The form seeks to gather critical vendor information including business structure (independent or affiliate), minority/women-owned business certification, affirmative action plans, Americans with Disabilities Act compliance, and vendor registration status with Atlanta Public Schools and the State of Georgia. Additional screening questions cover potential disqualifying factors such as past contract defaults, current debarment status, insurance capabilities, and willingness to accept credit card payments. Vendors are required to provide detailed contact information for solicitation, contract management, and purchase order processing, along with tax identification and DUNS numbers.
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Text version
Offeror Information Form updated 9/2020
OFFEROR INFORMATION FORM
(This form must be completed and returned with your response)
Full Company Legal Name:
Street Address:
City, State, Zip Code:
Contact Name for Solicitation: Title:
Telephone: ( ) Fax: ( ) E-mail:
Contact Name for Contract: Title:
Contact Name for Purchase Order’s: Title:
Purchase orders may be delivered via e-mail or fax. Please indicate your preferred delivery method and provide an e-mail address or fax number where they should be sent.
E-mail Fax ( )
Company Web Site: State of Incorporation:
Taxpayer ID Number: Duns #:
Check one of the following: Independently owned and operated: An Affiliate or Division of:
Company Name:
Address:
Is your company a certified Minority/Women Owned Business Enterprise (MWBE)? Yes No If YES, please indicate what certification you possess and through which agency you are certified: _________________________________________________________
Does the company utilize an Affirmative Action Plan for Equal Employment Yes No Opportunity?
Has the company implemented a compliance program in accordance with the Yes No Americans with Disabilities Act?
Have any conditions or restrictions been placed on this proposal by the company Yes No that would cause it to be declared non-responsive?
If recommended for award will company provide proof of insurance as required? Yes No
Is the company currently debarred from doing business with any federal, state or Yes No local agency? If YES, please provide details and submit on a separate sheet.
Has the company ever defaulted on a contract or been denied a contract due to Yes No non-ability to perform? If YES, please provide details on a separate sheet.
Does the company accept payment by credit card? Yes No
Is the company registered as a vendor with Atlanta Public Schools? Yes No If YES, please provide APD vendor number:
Is the company registered as a vendor with the State of Georgia? Yes No If YES, please attach a copy of your state of Georgia business license.
File details come from the government source that posted it. Updated .