36C26119Q0345-0001001.pdf

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Attached to
Ceiling lifts 36C261-19-AP-4313 Federal contract opportunity
Solicitation number
36C26119Q0345
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 21

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36C26119Q0345 0001 Scan_5.pdf

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Text version

SF TN IN SHEET - Solicitation 36C26119 0 45

Ceiling Mounted Patient Lifts ICU omple oIIowin,Adel 117n into the Contracting Gicer

1. Company Name:

Company Representativ.): leo/ V ZA7,-

Phone # god /6a/ -1 Email: efffdy?,KA /(cle 60P\

Additional RepreseL1tatE:

Phone # EmE.11:

Additional Repres( ?Lift, Ave:

Phon ELLL,=.1:1:

rintiso cEivl(L one of7' tE1R1 golloveh-Lj:

/(' Prime A/E Firm onsultAnt sinN IN SHEET - Scr1,72,rtnticn 36C26119("45

Ceriiiitg Mounted Patient Lifts ICU n ,:Implete the followinu LAd turn into the ContractiiL

1. Company Name: 6--(41tio44

Company Representatii

Phone # Aa7 2Y/A ( Euta.11: 0'146•40 jd,kt 0.4A

Representativu: 444/

Phone # 276 - .09

Additional Ret,,Irt )5.;( Rat; Alva:

Phon(

T-11(lase chock one Qirf the followin3: -

Primo JL Lir

Sit-Consultnn-A

SI N IN - Solicitation 341C26119GC13, 15

Ceiling Mounted Patient Lifts ICU omplute the following cLucl trirA into the Contractin ffic,

1. Company Name: ./ 6 1;1

Company Representative: 7 AJ\7' Phone # qz0 Email: (727,Wy5/2172.:10

Addit nal RepresetitAive:

Phone # ELL-L:71111:

Additional Rek..L(), uLot,itive:

Phon( # ELL-LLE1:

'Elaaou chucL OLIU tIe folEJuLriLuc.;::

Prime A/E Firm

-_3r19[_,I-Consultant

SIGN IN SHT - SelEr.riitntion 36C26119Q 345

Ceilitling Mounted Patient Lifts ICU

Complete the fdIowitui aid turn into tliu CcL-LLL•pc'LlLil

1. Company Name: /7/4 -440, (An,i

Company Representative: \;r- r;77 k err

Phone # 170- Otct 2 Email:

c ii14.(2 • ( evil

Additional RcipresentAve:

Phone # Email:

Additional Re7rresnntritE7(7):

Pcone # Eradarl:

PI( cirecLz orna cif Cin lowing:

rimn 1,JE [Arm

Sub-ZortrtqtrInt

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