2-Schedule A - Certification of Statement of Qualifications Form.pdf
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- Solicitation number
- NSDSOQ26-1003
- Issued by
- Utah County, Utah
About this file
This is a Certification of Proposal Form for the Nebo School District's Request for Statement of Qualifications (RFSQ) located in Spanish Fork, Utah. The Nebo School District is seeking a qualified, licensed medical professional—either an Advanced Practice Registered Nurse (APRN/Nurse Practitioner) or a Medical Doctor (MD/DO)—to serve as the District Medical Professional. The selected provider will deliver medical authorization, standing orders/prescriptions, clinical advice, and nursing support to the district's lead school nurse and health services staff. All questions concerning this solicitation must be submitted through the Bonfire system, and only answers issued through the Bonfire system or via authorized addendum shall constitute the official position of the Nebo School District. Responses submitted in Bonfire are secure until after the solicitation deadline, allowing respondents to submit and modify their submissions at any time until the deadline.
The certification form requires authorized company representatives to sign and affirm that they have read and understood the RFSQ intent, possess adequate personnel and resources to fulfill requirements, are properly licensed to conduct business within Utah, and commit to no contact or negotiations with District personnel outside the formal process. Respondents must certify that all schedules and the complete RFSQ document submitted constitute a legally binding document. The form requires submission of company name, authorized signature, printed name and title, phone number, email, and date of submission.
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Text version
350 S Main, Spanish Fork, Utah, 84660 phone (801) 354-7400
SCHEDULE ‘A’ - CERTIFICATION OF PROPOSAL FORM
I have read the Nebo School District Request for Statement of Qualifications, RFSOQ, and fully understand the intent. I certify that I have adequate personnel and resources to fulfill the RFSOQ requirements. I further understand that my ability to meet the criteria and provide the required services shall be judged solely by The District.
I further certify that, since the receipt of this RFSOQ, no contact, discussion, or negotiations have been made nor will be made regarding this proposal with any District contact. I understand that any such contact could disqualify this RFSOQ.
I further certify that I am properly licensed to conduct business within the scope of this RFSOQ, in the State of Utah.
I certify that all Schedules contained herein shall be considered part of the entire RFSOQ response and that the complete RFSOQ document submitted shall be considered a legally binding document.
Company Name
Authorized Signature
Printed Name and Title
Phone
Date
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