4-Info Signatures.pdf

PDF 99 KB Posted

Attached to
On-Call Maintenance & Stabilization Services
Solicitation number
RFP260252
Issued by
Bath County, Kentucky

About this file

This is a vendor information and signature form for a bid submission to Louisville Metro Government in Kentucky for On-Call Maintenance & Stabilization Services. The contract is designed to provide emergency roadway maintenance, embankment repair, slope stabilization, drainage remediation, and related geotechnical improvements to preserve property integrity and public safety. The form requires bidders to provide their full legal name, address, email, telephone number, Metro Louisville Revenue Commission Number, Federal ID Number, and Unique Entity Identifier. Bidders must confirm registration in the federal Central Contractor Registration (CCR) system at www.ccr.gov. The form includes acknowledgment sections for receipt of up to three addenda plus any additional addenda. An authorized agent must sign the form, providing their printed name, title, and date, thereby binding the bidder unconditionally to all bid requirements. The form is completed by Louisville Metro Government's Purchasing Director upon contract award, documenting the contract term with effective and expiration dates and items covered under the invitation for bid (IFB).

The form does not specify pricing terms, set-asides, funding amounts, or renewal options in the sections presented. No incumbent information, response deadlines, site visit requirements, or bidder's conference details are included in this vendor signature document, as these elements typically appear in separate bid solicitation documents.

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Text version

VENDOR INFORMATION

Full Legal Name of Bidder:

Address:

E-Mail Address:

Telephone

Metro Louisville Revenue Commission Number:

Federal ID Number:

Unique Entity Indentifier:

Consultant must be registered as a vendor in the federal Central Consultant Registration (CCR).

The online registration is at www.ccr.gov. Is the consultant registered in CCR? Yes No

ADDENDA:

I acknowledge receipt of the following Addenda:

Addendum #1:

Addendum #2:

Addendum #3:

Any Additional Addendum (write in numbers):

http://www.ccr.gov/

VENDOR SIGNATURE

The following individual is authorized to submit this response on behalf of (Bidder). By signing below, Bidder agrees to bind itself unconditionally to all the requirements in this Bid.

Authorized Agent Signature:

Printed Name:

Title:

Date:

To be completed by Louisville Metro Government only if Bidder is awarded a contract under this Bid.

A contract is awarded by Louisville Metro Government to Bidder according to the terms and conditions of IFB .

Joel Neaveill

Purchasing Director

Date:

Contract Term: Effective Date Expiration Date:

Items Covered:

File details come from the government source that posted it. Updated .