44DOC-S3878-Vendor-Information-Response.pdf

PDF 97 KB Posted

Attached to
Digital Television Services
Solicitation number
44DOC-S3878
Issued by
Clark County, Nevada

About this file

This is a Vendor Information Response form developed by the State of Nevada Purchasing Division on behalf of the Nevada Department of Corrections (NDOC) for a Digital Television Services contract opportunity. The form serves as a standardized template that vendors must complete and submit as part of their proposal. Vendors are required to provide comprehensive company information including official company name, street address, telephone and toll-free numbers, and email address. Additionally, vendors must designate a primary contact person for questions and contract negotiations, including that individual's name, title, address, email, and phone numbers. The form applies to both prime contractors and any subcontractors involved in the project.

The form requires vendors to provide an overall company profile and demonstrate appropriate state licensing in compliance with Nevada Revised Statutes (NRS 80.010 and NRS 76). Vendors must disclose any prior experience with Nevada state agencies, identify any current or former Nevada state employees working on the contract, and reveal any significant prior or ongoing contractual issues, contract breaches, civil or criminal litigation, or pending claims occurring within the past six years that may affect performance capabilities. The form also includes sections for payment authorization procedures using procurement cards and requires identification and signature of the individual authorized to bind the vendor organization to the contract.

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44DOC-S3878 Insurance Requirements.pdf PDF
44DOC-S3878 Cost Schedule.docx DOCX document
44DOC-S3878-reference-questionnaire~1.docx DOCX document
44DOC-S3878 Terms-and-conditions-for-services.pdf PDF
44DOC-S3878 RFP~2.docx DOCX document
44DOC-S3878 Certification-regarding-lobbying.pdf PDF
44DOC-S3878 Mandatory Site visit schedule.docx DOCX document
44DOC-S3878 Scope of Work TV.docx DOCX document
44DOC-S3878 Standard-form-contract.docx DOCX document
Quote Instructions.pdf PDF
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Text version

VENDOR INFORMATION RESPONSE

Revised: April 2021 Page 1 of 1

Vendors shall complete and return this form in their proposal.

If the proposal includes subcontractors, form must be completed for each subcontractor as well.

1. VENDOR CONTACT INFORMATION

COMPANY NAME AND CONTACT INFORMATION:

The information provided in the table below shall be used for development of the contract, if awarded.

Requested Information Response

Company Name:

Company Street Address:

City, State, Zip Code:

Telephone Number, including area code:

Toll Free Number, including area code:

Email Address:

CONTACT PERSON FOR QUESTIONS/CONTRACT NEGOTIATIONS

Requested Information Response

Name:

Title:

Address:

City, State, Zip Code:

Email Address:

Telephone Number, including area code:

Toll Free Number, including area code:

Confidentiality and Certification of Indemnification
Certification Regarding Lobbying
Vendor Information Response
1. VENDOR CONTACT INFORMATION
1.1 COMPANY NAME AND CONTACT INFORMATION:
1.2 CONTACT PERSON FOR QUESTIONS/CONTRACT NEGOTIATIONS
2. VENDOR INFORMATION
2.1 Vendors shall provide an overall company profile in the following table:
2.2 VENDOR LICENSING
2.2.1 Please be advised: Pursuant to NRS 80.010, a corporation organized pursuant to the laws of another state shall register with the State of Nevada, Secretary of State’s Office as a foreign corporation before a contract can be executed between the ...
2.2.2 The selected vendor, prior to doing business in the State of Nevada, shall be appropriately licensed by the State of Nevada, Secretary of State’s Office pursuant to NRS 76. Information regarding the Nevada Business License can be located at htt...
2.3 STATE OF NEVADA EXPERIENCE
2.3.1 If ‘Yes’, complete the following table for each State agency for whom the work was performed.
2.3.2 Table can be duplicated for each contract being identified.
2.4 CURRENT OR FORMER EMPLOYEE
2.4.1 If you employ (a) any person who is a current employee of an agency of the State of Nevada, or (b) any person who has been an employee of an agency of the State of Nevada within the past two (2) years, and if such person shall be performing or p...
2.5 PRIOR OR ONGOING CONTRACTUAL ISSUES
2.5.1 Disclosure of any significant prior or ongoing contract failures, contract breaches, civil or criminal litigation in which the vendor has been alleged to be liable or held liable in a matter involving a contract with the State of Nevada or any o...
2.5.2 Any pending claim or litigation occurring within the past six (6) years which may adversely affect the vendor’s ability to perform or fulfill its obligations if a contract is awarded as a result of this RFP shall also be disclosed.
2.5.3 If ‘Yes’, please provide the information in the table below.
2.5.4 Table can be duplicated for each issue being identified.
3. PAYMENT AUTHORIZATION FOR USE OF PROCUREMENT CARD
4. NAME OF INDIVIDUAL AUTHORIZED TO BIND THE ORGANIZATION
4.1 SIGNATURE OF INDIVIDUAL AUTHORIZED TO BIND THE VENDOR
Company Name:
Company Email Address:
Contact Person Name:
Contact Person Title:
Contact Person Address:
Contact Person City, State, Zip Code:
Contact Person Email:
Contact Person Telephone:
Contact Person Toll Free (if applicable):
Company Address:
Company City State Zip Code:
Company Telephone:
Company Toll Free:

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