3-RFP-04-Authorized Signature and Questionnaire.pdf
PDF 130 KB Posted
- Attached to
- RFP Ice Machine Rental and Maintenance
- Solicitation number
- 26-0270
- Issued by
- Tarrant County, Texas
About this file
This is an Authorized Signature and Questionnaire form for the City of Fort Worth, Texas, in response to RFP 26-0270 for Ice Machine Rental and Maintenance services across multiple city departments on an "as needed" basis. The form requires bidders to provide company identification information, including legal name, Federal Tax ID, address, and authorized representative contact details. Bidders must certify that they have read the entire RFP document packet and agree to be bound by all terms, conditions, and specifications outlined in the solicitation. The form requests identification of up to three contact persons with their titles, email addresses, and phone numbers to facilitate communication throughout the procurement process.
The questionnaire portion requires bidders to disclose their length of time in business, litigation history or criminal investigations involving the business or its principals, and willingness to extend contract terms and pricing to other governmental entities participating in cooperative purchasing arrangements. Bidders must also provide prompt payment discount terms if applicable. The form includes a section for bidders to identify any pages or specific information they consider proprietary and wish to protect from disclosure in accordance with RFP-01, Section 15.4. Bidders may submit additional questions pertaining to their bid on the form, and any affirmative responses to litigation or criminal investigation questions require submission of detailed explanation documents with the proposal.
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Other files
| File | Type | Posted |
|---|---|---|
| 9-RFP-08-Small Business Utilization Form V1.pdf | ||
| 7-Attachment A Locations .xlsx | XLSX spreadsheet | |
| 6-RFP-07-Deviations.xlsx | XLSX spreadsheet | |
| 1-RFP-01-Instruction to Proposers.pdf | ||
| 10-Addendum 1.pdf | ||
| 4-RFP-05-CFW Required Forms.pdf | ||
| 11-Attachment A Locations .xlsx | XLSX spreadsheet | |
| 8-RFP-02-Scope of Services-Ice Machine.pdf | ||
| 2-RFP-03-Draft Vendor Service Agreement.pdf | ||
| 5-RFP-06-Reference Sheet.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
AUTHORIZED SIGNATURE AND QUESTIONNAIRE
RFP Ref. #: 26-0270 Doc. Ref#: RFP-04 Page 1 of 3 RFP Title: Ice Machine Rental and Maintenance
City of Fort Worth Bidder/Supplier ID:____________________________________ Legal Name of Proposer:
D/B/A Name of Proposer:
Federal Id Number (TIN):______________________________________________ Address:
Name of the Authorized Representative: __________________________________ Title: _____________________________________________________________ The undersigned, by his/her signature, represents that he/she is submitting a binding Proposal and is authorized to bind the respondent to fully comply with the solicitation document contained herein. The Respondent, by submitting and signing below, acknowledges that he/she has received and read the entire document packet for this RFP and agrees to be bound by the terms therein.
The undersigned agrees if the Proposal is accepted, to furnish any and all items and/or services upon which prices are offered, at the price(s) and upon the terms, conditions, and scope/specifications contained in this RFP.
Signature of the Authorized Representative: _____________________________ Email: Phone:
Name of Contact Person - 1:
Title of Contact Person - 1:
Email: Phone:
Name of Contact Person - 2:
Title of Contact Person - 2:
Email: Phone:
Name of Contact Person - 3:
Title of Contact Person - 3:
Email: Phone:
RFP Ref. #: 26-0270 Doc. Ref#: RFP-04 Page 2 of 3
Please answer each question below thoroughly. Responses to the questions will be used to assess the Proposal’s responsiveness. Bidders may use a separate sheet if needed, as long as each answer is labeled with the corresponding question number.
1.0 Length of time in business: _______________________________________
2.0 Is your business or any of its principals currently involved in litigation adverse to the City? Yes_______ No________
3.0 Is your business or any of its principals under criminal investigation?
Yes_______ No________ Have you answered Yes to either Question 1 or 2 above? Please provide the details outlining the situation on a separate document with the submission of this form.
4.0 Cooperative Purchasing - Should other governmental entities decide to participate in this contract, would you, the Vendor, agree that all terms, conditions, specifications, and pricing would apply?
Yes_______ No________
5.0 Prompt Payment Discount Terms: ____ Percent _______ Days (i.e. 3% Net 15, etc.)
6.0 Proprietary Information - If a Bidder believes certain information in their proposal is proprietary and wishes to prevent its disclosure, they must clearly identify those pages and information in the chart below, for more information see RFP-01, Section 15.4.
Pages with information believed to be Proprietary
Please indicate if only specific sections on the page are believed to be Proprietary
7.0 Add any questions pertaining to your bid starting here.
RFP Ref. #: 26-0270 Doc. Ref#: RFP-04 Page 3 of 3
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