270-15-0459_Attach_11_Contact_Points.docx

RFP No. 270-15-0459 Data Waiver and Processing Project Attachment 11: Contact Points

CONTACT POINTS

Complete the following and return with the BUSINESS PROPOSAL.

Name, Title and Address* of Business Representative with whom daily contact is required.

Name: Telephone Number:

Institutional Title: FAX Number:

Institutional Office

Institution Name **Street Address City, State Zip Code:

Name, Institutional Title and Address of Proposed Project Director.

Name: Telephone Number:

Institutional Title: FAX Number:

Institutional Division, etc.

**Street Address City, State Zip Code:

These exact addresses are necessary to ensure that contact can be made with the proper indivual(s) in the most expeditious manner.

* May not necessarily be the same as legal address of Offeror.

** Please use actual street address, not P.O. Box.