5. Offering Entity Acknowledgement Form-8-27-24.pdf
PDF 255 KB Posted
- Solicitation number
- 36C10F24R0039
About this file
This document is an Offering Entity Acknowledgement Form for RLP No. 36C10F24R0039 for the Bowling Green Community-Based Outpatient Clinic (CBOC) requirement.
The key details are:
- The solicitation is for the Bowling Green, KY CBOC, issued by the Department of Veterans Affairs Office of Construction and Facilities Management.
- The Offeror must provide information such as entity name, address, UEI number, tax ID, authorized official contact details, and certifications under SDVOSB, VOSB, and Small Business status.
- The offer is due by the time specified in the form.
- The Offeror must be currently certified in SAM under NAICS 531120 and verified in VetCert to be eligible.
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Text version
Offering Entity Acknowledgement Form Bowling Green, KY CBOC RLP No: 36C10F24R0039
The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No. 36C10F24R0039. Failure to provide the required information may deem your proposal non-responsive.
Offeror Information
Entity Name:
Address:
UEI Number:
Tax Identification Number:
Authorized Official Name:
Authorized Official Phone Number:
Authorized Official Email:
Authorized Official is Listed in Entity SAM Representations: Yes No Authorized Official is Listed in Entity Operating Agreement: Yes No Date of Submission:
Time Specified for Receipt of Offers:
Offeror Entity/Prime Contractor Status
Prime Contractor Size Status: SDVOSB VOSB SB Offer Entity Currently Certified in SAM under NAICS 531120: Yes No Offer Entity Currently Verified in VetCert: Yes No
Offering Entity POC Signature Date
Offering Entity POC Name
File details come from the government source that posted it. Updated .