2_26-004C_ATT_A_Bid_Submission_Ltr.docx

Attachment A: Bid Submission Letter

Bidder Firm Legal Name:

Bidder Firm dba

Address of Bidder’s Principal Place of Business

Telephone Number

Fax Number

Name of Bidder Contract Contact

Email Address of Bidder Contract Contact

Re: Bid Response Submission for DOH Competitive Solicitation RFQQ: DOH26-004C Sentry to SDWIS Dear DOH Solicitation Coordinator:

1. Enclosed please find our Bidder’s Response (Proposal) for the above Competitive Solicitation. This Proposal includes this Letter (Attachment A) and Bidder’s Profile, and attachments as set forth in the Solicitation Document and amendments:

· Attachment A: Letter and Bidder’s Profile;

· Attachment B: Diverse Business Inclusion Plan;

· Attachment C: Bidder's Certifications;

· Attachment E: Bidder's Response Part 1;

· Attachment E-1: Bidder's Response Part 2;

· Attachment E-2: Bidder's Response Part 3;

· Supplements to Bidder’s Response:

a. Required Resumes, CVs, for staff proposed for this project;

b. Optional documents such as Bidder’s Proposal in Bidder’s standard format; diagrams; Attachment D-2: GT&C Change Request Form (optional); etc.

2. I have read the Solicitation documents and Sample Contract, including all Solicitation documents and Amendments posted on The Washington Electronic Business System (WEBS) in relation to this Solicitation. In submitting this Proposal, Bidder accepts all terms and conditions stated in the Solicitation Documents and all amendments.

3. Bidder represents that it meets all minimum qualifications set forth in this DOH Competitive Solicitation and is capable, willing, and able to perform the services described in the DOH Competitive Solicitation within the time frames set forth for performance.

4. By my signature below, I certify that all statements and information provided in Bidder’s Response are true and complete.

Sincerely, Signature of Bidder’s Authorized Representative

Date

Name and Title

Attachment A: Bidder’s Profile

Bidder Firm Legal Name:

BIDDER INFORMATION

Legal name of Bidder:

Address of Bidder:

Note: This should match information from Bidder’s Washington Business License. Provide explanation if they differ.

Business Name

Address

City, State, Zip Code

Bidder’s Washington State Department of Revenue Registration Number/Unified Business Identifier (UBI) Number:

Note: A nine-digit UBI number is assigned to each registered businesses in Washington.

Federal Taxpayer Identification No. (TIN):

Note: Your TIN will be either a number issued by the IRS (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (i.e., your Social Security Number or “SSN”). If your TIN is an SSN, state that fact, but do NOT provide the SSN.

Federal UEI Number (Unique Entity ID (UEI) Number per the federal System for Award Management web site (SAM.gov)):

Note: The resulting contract is projected to include federal funds. A UEI number is required to be submitted with your bid. The federal UEI number is a 12-characted ID and is NOT the same as a 9-character state UBI number).

The System for Award Management (SAM.gov) is an official website of the U.S. Government. There is no cost to use SAM.gov. Home | SAM.gov.

Yes |_| No |_| If yes, provide Bidder’s anticipated subcontractor(s):

Does Bidder anticipate using subcontractors to perform the Contract, if awarded?

*Note: If Bidder intends to use subcontractors, Bidder must identify Bidder’s intended subcontractor(s) on their Attachment B – Diverse Business Inclusion Plan. Bidder must submit the completed Attachment B even if Bidder does not intend to use subcontractors.

Yes |_| No |_| If yes, provide Bidder’s anticipated subcontractor(s):

If yes, provide Bidder’s OMWBE certification no.:

Is your firm a self-identified Washington Small Business?

Note: See Attachment C – Bidder’s Certification for criteria to qualify as a Washington Small Business Note: Regardless of size, a qualifying business must be owned and operated independently from all other businesses. In regard to size, the gross revenue thresholds, as reported on Bidder’s tax returns, are as follows:

· Microbusiness: Annual gross revenue of less than one million dollars.

· Minibusiness: Annual gross revenue of more than one million dollars, but less than three million dollars.

Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.

Yes |_| No |_| If yes, provide the location for Bidder’s principal place of business:

If yes, what is your business size (based on annual gross revenue)?

Is your firm certified as a Veteran-Owned Business with the Washington State Department of Veteran Affairs?

Note: See Attachment C – Bidder’s Certification for criteria to qualify as a Certified Veteran-Owned Business.

Yes |_| No |_| If yes, provide Bidder’s WDVA certification no.

CONTRACT MANAGEMENT POINTS OF CONTACT

Authorized Representative Name:

Email:

Phone:

Contract Administrator Name:

Email:

Phone:

REFERENCES

Provide a minimum of three (3) commercial or government references for which bidder has delivered goods and/or services similar in scope as described in the Competitive Solicitation.

REFERENCE 1

Company Name:

Contact:

Phone:

Email:

REFERENCE 2

Company Name:

Contact:

Phone:

Email:

REFERENCE 3

Company Name:

Contact:

Phone:

Email:

Attachment A: Bid Submission Letter and Bidder Profile forms must be completed, signed where indicated, and returned in its entirety to the Solicitation Coordinator: Bids@doh.wa.gov Be sure to include the RFQQ number 26-004C in the email subject line.

DOH26-004C RFQQ Page 1 of 2 Attachment A: Bid Submission Letter and Bidder’s Profile. v8. 06/03/2026.

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