2-Supplier Submission Page - SSR25.pdf
PDF 471 KB Posted
- Attached to
- Signal Support Replacements State and local contract opportunity
- Solicitation number
- SSR/25
- Issued by
- Summit County, Akron City, Ohio
About this file
This document is a Supplier Submission Page from the City of Akron's Purchasing Division, located at 166 S. High Street, Room 501, Akron, Ohio 44308. The form is designed for potential vendors to complete when submitting a bid, with spaces to provide company details, contact information, and responses to specific municipal procurement questions. The form requires bidders to disclose information about tax status, potential conflicts of interest, local office presence, and acceptance of payment terms.
The submission page includes several key compliance and ethics-related inquiries, such as whether the bidder has delinquent property or income taxes, awareness of any potential conflicts of interest with City of Akron personnel, and whether the company maintains an office within Akron's corporate limits. Vendors must provide their legal company name, business address, contact details, and federal ID number. The form also requires an authorized agent's signature, affirming the accuracy of the submitted information and agreement to the specified terms, with a net 30-day payment expectation and FOB destination condition.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 3-Specifications SSR25.pdf | ||
| 1-ITB - SSR25.pdf |
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Text version
City of Akron Municipal Building
166 S. High Street, Room 501 Akron, Ohio 44308
Kimberley Hanson Purchasing Agent
PURCHASING DIVISION
(330) 375-2060 purchasing@akronohio.gov
SUPPLIER SUBMISSION PAGE
BID TITLE:
BID NUMBER:
***Please note that the name of the vendor on the worker’s compensation certificate, insurance certificates, and invoices must be the same as below***
BIDDER (LEGAL NAME OF COMPANY)
IF COMPANY IS RECOGNIZED BY THE STATE OF OHIO UNDER A DIFFERENT NAME, STATE IT ABOVE
BUSINESS ADDRESS
CITY STATE ZIPCODE
PHONE NUMBER FAX NUMBER
EMAIL ADDRESS FEDERAL I.D. NUMBER
Do you have delinquent real property taxes/and or City Income Taxes? Yes No
Ethics Regulation: Are you aware of any interest or potential interest in this contract that may be had by an individual who is connected to the City of Akron? Yes No
If Yes, please give the name of the individual and nature or interest:
Does your company have an office or warehouse within the City of Akron corporation limits? Yes No
If Yes, please provide an address:
Acceptance of Net 30 Day Terms and FOB Destination
AUTHORIZED AGENT (PRINT LEGIBLY OR TYPE)
SIGNATURE & TITLE DATE
Revised 6/24 mailto:purchasing@akronohio.gov
| BID TITLE: |
| BID NUMBER: |
| BIDDER LEGAL NAME OF COMPANY: |
| IF COMPANY IS RECOGNIZED BY THE STATE OF OHIO UNDER A DIFFERENT NAME STATE IT ABOVE: |
| BUSINESS ADDRESS: |
| CITY: |
| STATE: |
| ZIPCODE: |
| PHONE NUMBER: |
| FAX NUMBER: |
| EMAIL ADDRESS: |
| FEDERAL ID NUMBER: |
| Do you have delinquent real property taxesand or City Income Taxes: Off |
| individual who is connected to the City of Akron Yes: Off |
| No_2: Off |
| If Yes please give the name of the individual and nature or interest: |
| Does your company have an office or warehouse within the City of Akron corporation limits Yes: Off |
| No_3: Off |
| If Yes please provide an address: |
| AUTHORIZED AGENT PRINT LEGIBLY OR TYPE: |
| DATE: |
| Check Box1: Off |
File details come from the government source that posted it. Updated .