26-10-0422_Manufacturer_Certification_Form.pdf
PDF 107 KB Posted
- Attached to
- Heavy Equipment State and local contract opportunity
- Solicitation number
- 26-10-0422
- Issued by
- North Carolina
About this file
The document is a Manufacturer Certification Form for the North Carolina Sheriffs' Association (NCSA) Cooperative Purchasing Program's Heavy Equipment Bid (Bid 26-10-0422). The form is a mandatory document required for all manufacturers participating in the bid, which must be completed and submitted by an authorized manufacturer representative, not dealers or representatives. The form certifies that the vendor/bidder is either the manufacturer or an authorized dealer for a specific manufacturer in the State of North Carolina.
The form requires detailed information including manufacturer name, address, contact information, and signature of an authorized representative. There are strict compliance requirements, with a clear warning that failure to submit this certification form with the bid response will result in disqualification. The form emphasizes that only an authorized employee of the manufacturer can complete and sign the document, even if the manufacturer is offering their own products, and specifies that signatures must be physical or timestamped.
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Text version
Manufacturer Certification Form
Heavy Equipment Bid 26-10-0422
This form is to be completed for all manufacturers in which your company is bidding.
Vendor (Bidder):
PLEASE NOTE: This certification form must be executed by an authorized employee of the manufacturer ONLY. Dealers/Representatives are not authorized to execute this certification form on behalf of the manufacturer. The manufacturer must execute this certification form even if they are offering their own products. Failure to submit this certification form with your response as required shall result in the disqualification of the response.
The section below is to be completed by the manufacturer representative.
This is to certify that the above vendor/bidder is the manufacturer and/or a manufacturer’s authorized dealer for the following manufacturer in the State of North Carolina.
Manufacturer Name:
Address:
City, State, Zip:
Contact Information of Representative:
Office Phone: Mobile Phone:
E-mail:
Signature of Manufacturer Representative: Title:
Printed Name of Manufacturer Representative: Date:
Note: Signatures must be physical or timestamped.
| Vendor Bidder: |
| Manufacturer Name: |
| Address: |
| City State Zip: |
| Office Phone: |
| Mobile Phone: |
| Email: |
| Title: |
| Printed Name of Manufacturer Representative: |
| Date: |
| Signature1_es_:signer:signature: |
File details come from the government source that posted it. Updated .