36C26118R0541-0002001.pdf

June 29, 2018

10:00 AM

SIGU lE\.7 3HEET 3CC23118R0541

PROJECT 654-18-831, IPL 1.1,(24- V971800 Compliance

(Pharmacy), VA Sierra Nevada Health Care System

(VASNHCS) Reno, Nevada

ComplcIte the following and turn into the Contracting Officer

1. Company Lae: 11

Company Lepreseututive: M

Pit one Cor2-- .5462 -'97-117 Email:

Additional kepresentative:

Phone t! Email:

Additional Representative:

Phone # Email:

Please check one of the following:

z General Contractor

Sub-Contractor

Supplier

SIMI lL iLiLLT - Solicitation 36r.716118R0541

PROJECT 654-18-831, IPP USP 797/800 Compliance

(Pharmricy), VA Sierra Nevada Health Care System

(VASNHCS) Reno, Nevaai

Comp fiete the following and turn into the Contractirv;

1. Company Lame: Ar+,(,6,/, 2 roil oork_Th, Company losepresentative: Romart tidtr-ro

Phone # /2e - 3hE35-- Email: rootaft6fte5 1c ( 1-8 yina; ( Can

Additional Reprresentative: kat) 16100(A101

Phone #.5-2.0 71 - 3636 Email: F Nt.i4 c'E' 4 1-154.11 rep too rio tein

Additional Representative: J0,1- Me, Va5gae Z.-- ne

Phone #6,20 - 2,391( Email: jai pi e qr 1500; re Aid (on

Please check one of the following:

7 General Contractor

SIGN IN SHEET - Solicitation 36C26118R0541

PROJrECT 654-18-831, IPP USP 797/800 Compliance

(Pharmacy), VA Sierra Nevada Health Care Syrtem

(VASNHCS) Reno, Nevada

©cmplete the following and turn into the Contracting Officwnr

1. Company Name: 5eytk‘ivi tw3

Company Representative:

Phonc # /Olt - (Alb Email: Jeobit-6-1/17/(<-11a,reo, Additional Representative:

Phone # Email:

Additional Representative:

Phone # Email:

Please check one of the following:

Ki General Contractor