2-C. Representations Certifications.pdf

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Attached to
Magnesium Hydroxide-Rebid
Solicitation number
IFB-067-26-CPW
Issued by
Leon County, Florida

About this file

This is a Representations and Certifications form required for bid submission to the City of Tallahassee, Florida for a Magnesium Hydroxide slurry supply contract. Respondents must complete a Federal Form W-9 for taxpayer identification and submit it with their bid. The form requires vendors to provide official company information as registered, including company name, mailing address, telephone, fax, and website URL. Bidders must designate a company contact for contract management with associated contact details, establish a payment remittance address with contact information, identify a contact person for invoice inquiries, and specify where purchase orders should be sent if applicable. The underlying contract opportunity involves furnishing and delivering Magnesium Hydroxide slurry for the City's wastewater collection system to support hydrogen sulfide control, odor control, and corrosion control across approximately 1,000 miles of sewer main and 114 pump stations. The City maintains nine 6,000-gallon tanks and three 1,500-gallon tanks at various locations requiring product delivery.

The contract will be structured as a firm-fixed-price requirements contract for supply, transportation, delivery, and offloading of Magnesium Hydroxide slurry to City-designated locations. The successful bidder must provide all labor, equipment, materials, transportation equipment including pumps, hoses, fittings, valves, and all incidental services necessary for complete delivery and offloading. Product furnished must meet the City's specifications, including required product data, third-party laboratory testing, and ANSI/NSF Standard 60 certification. No specific pricing terms, contract duration, renewal options, set-asides, incumbent information, or funding amounts are detailed in this representations and certifications form.

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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:

EMAIL ADDRESS:

PAYMENT REMITTANCE ADDRESS (Type/Print)

TELEPHONE NO.:

(Toll-Free Preferred) VOICE: EXTENSION:

CONTACT FOR INVOICE INQUIRIES

TELEPHONE NO.:

(Toll-Free Preferred) VOICE: EXTENSION:

WHERE TO SEND PURCHASE ORDER (IF APPLICABLE)

COMPANY NAME:

REPRESENTATIONS/CERTIFICATIONS

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