5-05. Signature Page Vendor Information.PDF

PDF 30 KB Posted

Attached to
Motor Fuel Topping Off Services Annual Contract
Solicitation number
ITB 139-26 JLO
Issued by
Upton County, Texas

About this file

This is a signature page and vendor information form for a Request for Proposal (RFP) issued by the City of Amarillo, Texas, for motor fuel topping off services under an annual contract. The document serves as the official response submission form where authorized company representatives must affirm that the RFP was prepared without collusion and that proposal contents were not disclosed to competing firms prior to the official opening. Respondents are required to provide comprehensive company information including the official company name, contact person details, phone and fax numbers, email address, and both mailing and remittance addresses. The form requires respondents to indicate the validity period of their proposal, which must extend for a minimum of 90 days, and to provide their Federal Tax ID number.

The signature page requires the authorized representative to sign and date the document, thereby certifying their authority to execute the contract and their willingness to sign the negotiated agreement. This form represents a standard procurement requirement for state and local contract opportunities and does not contain specific information regarding pricing terms, contract duration, renewal options, or funding sources. The actual contract specifications, service requirements, and pricing expectations would be detailed in separate RFP documents such as the Scope of Work or Project Description.

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Text version

RESPONDENT’S INFORMATION AND SIGNATURE

The undersigned affirms that they are duly authorized to execute this contract, that this RFP has not been prepared in collusion with any other firm, and that the contents of this RFP have not been communicated to any other firm prior to the official opening of this RFP. Additionally, the undersigned affirms that the respondent is willing to sign the negotiated contract.

Date:___________________________________

Company Name:__________________________

Name of Contact: _________________________ Title: __________________________

Phone No.: ______________________________ Fax No.: _______________________

Email: __________________________________

Mailing Address: ____________________________________________________________ P.O. Box or Street, City, State and Zip

Remit Address (if different than above): _____________________________________________ P.O. Box or Street, City, State and Zip

This RFP is valid through _____/______/_____ (a period of not less than 90 days is required)

Federal Tax ID No.: _______________________

SIGNED BY: ______________________________

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