23054i_attachment10.pdf

GROUP 40061 – PROTECTIVE OUTERWEAR

(Firefighting, Emergency/Rescue, and Safety) (Statewide) PAGE 1

23054i_Attachment 10 – Manufacturer’s Certificate.docx

Bidder’s Name:

Attachment 10

MANUFACTURER’S CERTIFICATE

NOTE TO BIDDER:

Only established Manufacturers or an authorized Dealer/Distributor are qualified to participate in this bid. Any Dealer/Distributor submitting a bid hereby guarantees that it is an authorized Dealer/Distributor of the Manufacturer, that the Manufacturer has agreed to supply the Dealer/Distributor with all quantities of products required by the Dealer/Distributor in fulfillment of its obligations under any resultant contract with the State, and by executing this certificate acknowledges this level of support.

This "Manufacturer’s Certificate" is to be forwarded to the Manufacturer by the Bidder, completed and returned to the Bidder by the Manufacturer, and submitted with the Bidder's offer. (See Section 4.6 – Manufacturer’s Certificate)

BIDDER’S COMPANY NAME: BIDDER’S FIN:

STREET ADDRESS:

CITY, STATE ZIP:

The Manufacturer executing this certificate by signature below does hereby attest to the accuracy and validity of the responses to the following questions:

1. Is the Bidder listed above an authorized dealer/distributor for your products?

__________ Yes __________ No

2. Do you, as a Manufacturer, agree to supply the Bidder/dealer with all quantities of items ordered pursuant to any resulting contract with the State? __________ Yes __________ No

GROUP 40061 – PROTECTIVE OUTERWEAR

(Firefighting, Emergency/Rescue, and Safety) (Statewide) PAGE 2

23054i_Attachment 10 – Manufacturer’s Certificate.docx

MANUFACTURER:

COMPANY NAME:

MANUFACTURER FIN:

ADDRESS:

TELEPHONE NUMBER:

FAX NUMBER:

E-MAIL ADDRESS:

PRINTED OR TYPED NAME

SIGNATURE OF AUTHORIZED DATE

MANUFACTURER’S REPRESENTATIVE

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