5 RLP 36C10F23R0074 Offering Entity Acknowledgement Form Clarksville TN OPC - 8-10-2023.pdf
PDF 490 KB Posted
- Solicitation number
- 36C10F23R0074
About this file
This is an offering entity acknowledgement form for a request for lease proposals for an outpatient clinic in Clarksville, Tennessee. The Department of Veterans Affairs Office of Construction and Facilities Management is soliciting proposals for a 258,210 square foot ANSI/BOMA outpatient clinic located in Clarksville under solicitation number 36C10F23R0074. Offerors must provide their entity name, address, unique entity identifier, tax identification number, and authorized official contact information. They must also specify their small business size status and certifications in SAM and with the SBA. Proposals are due by the time specified in the solicitation amendment. The form requires the offeror's signature and date and will be used to evaluate responsiveness to the RLP requirements.
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Text version
REQUEST FOR LEASE
PROPOSALS (RLP)
AUGUST 2023
RLP No. 36C10F23R0074
OUTPATIENT CLINIC (OPC)
Clarksville, TN
Offering Entity Acknowledgement for RLP No.: 36C10F23R0074
The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No.: 36C10F23R0074. Failure to provide the required information may deem your proposal non-responsive.
Offeror Information
Yes No
Offering Entity Name:
Address:
Offering Entity UEI:
Offering Entity Tax Identification Number:
Authorized Official Name:
Authorized Official Phone Number:
Authorized Official E-mail:
Authorized Official is Listed in Entity SAM Representations:
Date of Submission:
Time Specified for Receipt of Offers:
Offering Entity/Prime Contractor Size Status: SDVOSB
VOSB
SB
Offering Entity Currently Certified in SAM under NAICS 531120
Offering Entity Currently Certified with SBA
Offering Entity POC Signature Date
Offering Entity POC Name
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