4-Authorization for Release of Performance Information Waiver.pdf
PDF 1 MB Posted
- Attached to
- RFP-26-247 Professional Real Estate Services
- Solicitation number
- RFP-26-247
- Issued by
- Yuma County, Arizona
About this file
This is an Authorization for Release of Performance Information and Waiver form required by the City of Yuma, Arizona, for RFQ #26-247 Professional Real Estate Services. The document authorizes the submission company to allow the City of Yuma and its representatives to contact all companies and government entities listed in the bidder's Statement of Qualifications and any other government entities for which the company has performed construction services to obtain references regarding the company's construction performance. The authorization form must be completed, signed, and returned with the Statement of Qualifications as part of the proposal submission.
The document constitutes a waiver in which the submitting company releases any claims it may have against the City of Yuma or any third-party entity providing performance information on its behalf resulting from the disclosure or provision of opinions regarding the company's actions or performance. The authorization remains effective for the term of the contract, and photostat copies of the signed document are accepted as valid equivalents to the original. Bidders must ensure the form is properly executed with the signature of an authorized representative, including printed name and title, prior to submission with their Statement of Qualifications.
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Text version
AUTHORIZATION FOR RELEASE OF
PERFORMANCE INFORMATION AND WAIVER
I, ______________________________________, the undersigned, on behalf of ___________________________________________ (this company), do hereby consent and authorize all those companies and government entities listed in my
Statement of Qualifications and any other government entity for whom this company has performed construction services, to disclose and release to the City of Yuma, or their representatives, information, records and opinions concerning this company’s construction performance. The purpose of this disclosure is to provide references to the City of Yuma. ________________________________ hereby waives any claim it may have against the City of Yuma or any company or entity providing information to the City of Yuma by reason of any information being disclosed or opinions provided regarding the actions or performance of this company.
This authorization for disclosure of information is effective for the term of the contract.
This consent or Photostat copy of this authorization shall be as valid and effective as the original.
Dated:
Signature:
Printed Name:
Title:
Return this completed and signed document with your Statement of Qualifications
RFQ #
Project:
| RFQ#: 26-247 |
| Project Name: Professional Real Estate Services |
| Company Name: |
| Name: |
| Title: |
| Date9_af_date: |
File details come from the government source that posted it. Updated .