3-Contact Information.pdf

PDF 53 KB Posted

Attached to
Water Treatment Coagulant
Solicitation number
WU-08-26
Issued by
Travis County, Texas

About this file

This is a Contact Information Form from the City of San Angelo, Texas Purchasing Division for the Water Treatment Coagulant solicitation. The form is designed to collect authorized agent and primary contact information from bidders responding to the City's request for bids on coagulant testing and supply for the Water Production Plant's potable water treatment operations. The form requires vendors to designate an Authorized Agent with full capacity to bind the entity, which may include corporate officers, general partners, managing members of limited liability companies, or other individuals granted written authority. If different from the Authorized Agent, a Primary Contact must also be identified. The City reserves the right to require written verification of an individual's authority to act on behalf of the bidding entity.

The form also requires vendors to provide complete Vendor Details including company name, phone, fax, website, mailing address, and physical address (no post office boxes permitted). Bidders must attach a current IRS Form W-9 with their submission. The Contact Information Form is submitted to the City of San Angelo Purchasing Division located at 72 West College Avenue, San Angelo, Texas 76903, with contact available via phone at 325.657.4219 or email at sapurch@cosatx.us.

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Text version

CITY OF SAN ANGELO, TEXAS

PURCHASING DIVISION

72 West College Avenue, San Angelo, Texas 76903

325.657.4219 • sapurch@cosatx.us

CITY OF SAN ANGELO, TEXAS • CONTACT INFORMATION FORM

Contact Information

AUTHORIZED AGENT • PLEASE PRINT

An Authorized Agent for an entity pursuant to this solicitation is an individual duly authorized by the entity and having full capacity to bind the entity. Authorized Agent may include an Officer of a Corporation, a General Partner of a Partnership, a Managing Member of a Limited Liability Company, or any other individual who has been granted such authority in writing executed by an individual having authority to bind the entity. City reserves the right to require written verification of an individual’s authority to act on behalf of an entity.

NAME

TITLE E-MAIL

SIGNATURE

DATE

PRIMARY CONTACT • PLEASE PRINT

Complete if different from above.

NAME

TITLE E-MAIL

SIGNATURE

DATE

VENDOR DETAILS • PLEASE PRINT

VENDOR NAME

PHONE FAX

WEBSITE

MAILING ADDRESS

CITY / STATE / ZIP

PHYSICAL ADDRESS (NO PO BOXES)

CITY / STATE / ZIP

PLEASE ATTACH A CURRENT IRS FORM W-9.

mailto:sapurch@cosatx.us

Contact Information

File details come from the government source that posted it. Updated .