24-00023 OBS Exhibit B Bidder Profile.docx

EXHIBIT B

RFQ 24-00023

BIDDER PROFILE

COMPANY INFORMATION (for Contract administration purposes) Company Name & Address:

Authorized Representative:

Phone:

Email:

Ordering Address:

Payment Address:

Federal Taxpayer Identification Number

WA Statewide Vendor Payment Number

REFERENCES - Provide a minimum of three (3) commercial or government references for which Bidder has delivered goods and/or services similar in scope as described in the RFQ.

1. Customer:

Contact:

Phone:

Email:

2. Customer:

Contact:

3. Customer:

Contact:

SUBCONTRACTORS

If applicable, on a separate sheet, identify any subcontractors who will perform services in fulfillment of contract requirements, the nature of services to be performed, and include federal tax identification (TIN) number for each subcontractor. If a subcontractor is a minority or women owned business, please include their OMWBE Certification Number (if certified). If necessary, attach additional sheets (please stamp or mark each page with a company name, mark, or initial). Do not include any Social Security Numbers.

The contractor, by including subcontractor(s) as part of your signed Proposal is your agreement to take complete responsibility, contract obligations, and liability for all actions of such subcontractors. All subcontractors are subject to DES approval. DES reserves the right to approve or disapprove any subcontractor.

SALES/CUSTOMER SERVICE

Purchasing Cards Accepted:

|_| Visa |_| Master Card |_| American Express |_| Discover |_| Other:

MINORITY/WOMEN OWNED BUSINESS STATUS

Is your firm a Minority/Women Owned Business? Yes |_| No |_| Office of Minority and Women-Owned Business Enterprises MWBE certification #

VETERAN OWNED BUSINESS STATUS

Is your firm a Veteran Owned Business? Yes |_| No |_| Washington State Department of Veterans Affairs certification #

RFQQ 24-00023 pg. 1