2-RFP 29-26-NH APPENDIX C - Submittal Letter Form.pdf
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- Attached to
- Occupational Medical Health Services
- Solicitation number
- RFP 29-26-NH
- Issued by
- Bernalillo County, New Mexico
About this file
This is a Submittal Letter Form (Appendix C) for RFP #29-26-NH issued by Bernalillo County's Purchasing Section in New Mexico for Occupational Medical Health Services. The RFP solicits proposals from qualified offerors to provide comprehensive occupational medical services including medical treatment for on-the-job injuries, pre-employment screenings, fitness for duty evaluations, OSHA-governed physicals, vaccinations, screenings, and related clinical recommendations and support to the County. The form requires submitting businesses to provide their legal identity, mailing address, and designate three key contacts: the individual authorized to contractually obligate the company, a point of contact for inquiries and clarifications, and a point of contact for negotiations. Respondents must also acknowledge receipt of any addenda by indicating the addendum numbers received.
By executing this submittal letter, the submitting organization commits to compliance with multiple regulatory frameworks including the RFP's Conditions Governing the Procurement and Unfair Business Practices Disclosure requirements, applicable Federal Executive Orders related to civil rights enforcement, New Mexico State Statutes and Bernalillo County Ordinances governing civil rights, the Anti-discrimination in Employment provisions of 5 USCA 7201 et seq., Executive Order 11246 regarding Equal Opportunity in Federal Employment, Title 6 of the Civil Rights Act of 1964, and the Americans with Disabilities Act of 1990 for all work performed under the resulting contract.
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Text version
APPENDIX C
SUBMITTAL LETTER FORM
RFP #29-26-NH
Identity of Submitting Business (including d/b/a):
Mailing Address:
Who can contractually obligate?
Name/Title: E-mail: Phone:
Contact for Inquiries/Clarifications/Negotiations Inquiries/Clarifications Name/Title:
E-mail: Phone:
Contact for Negotiations Name/Title
E-mail: Phone:
Addendum Acknowledgment:
If Addendum has been received, please indicate how many in the spaces below.
Addendum number(s) __________ through __________ have been received.
By signing below my company/entity/organization commits to comply and act in accordance with the (1) Conditions Governing the Procurement, Unfair Business Practices Disclosure, as stated in Section II of the RFP; (2) Federal Executive Orders relating to the enforcement of civil rights; (3) New Mexico State Statutes and County of Bernalillo Ordinances regarding enforcement of civil rights; (4) Federal Code, 5 USCA 7201 et. seq., Anti-discrimination in Employment; (5) Executive Order No. 11246, Equal Opportunity in Federal Employment; (6) Title 6, Civil Rights Act of 1964 and
(7) Requirements of the Americans with Disabilities Act of 1990 for work performed as a result of this RFP.
Signed: Date:
SUBMITTAL LETTER FORM
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