3-RFP-04-Authorized Signature and Questionnaire.pdf
PDF 256 KB Posted
- Attached to
- RFP Electrician Services
- Solicitation number
- 26-0257
- Issued by
- Tarrant County, Texas
About this file
This is an Authorized Signature and Questionnaire form from the City of Fort Worth Purchasing Division for RFP-04 regarding Electrician Services (Reference Number 26-0257). The City of Fort Worth seeks proposals to establish an agreement for electrician services on an "as needed" basis. The form requires bidders to provide their legal business name, D/B/A name, Federal ID number, address, and authorized representative information. Respondents must certify that they are authorized to bind their company to the terms of the solicitation and confirm receipt and understanding of the entire RFP document packet. The form designates spaces for up to three contact persons with their titles, email addresses, and phone numbers.
The questionnaire section requires bidders to provide their length of time in business and disclose any current litigation or criminal investigations involving the business or its principals. Bidders must indicate whether they would agree to extend all contract terms, conditions, specifications, and pricing to other governmental entities participating in cooperative purchasing arrangements. Bidders are required to specify any prompt payment discount terms offered. The form also includes a section for bidders to identify any pages or information they consider proprietary and wish to protect from disclosure, along with space for bidders to submit additional questions pertaining to their bid. Any affirmative responses to litigation or criminal investigation questions require submission of detailed explanatory documentation with the proposal.
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
AUTHORIZED SIGNATURE AND QUESTIONNAIRE
RFP Ref. #: Doc. Ref#: RFP-04 Page 1 of 3
RFP Title:
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:
26-0257
Electrician Services
RFP Ref. #: 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.
26-0257
Electrician Services
RFP Ref. #: Doc. Ref#: RFP-04 Page 3 of 3
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