5271-0 Att H.docx

This is a contractor information form (Attachment H) for Intermediate Procurement 5271-21 issued by the Oregon Department of Human Services (ODHS) for Plain Language Development, Editing, and Guidance services. The form serves as a template for applicants to submit required contractor and business information if awarded a contract. Applicants must provide their legal business name, doing business as designation if applicable, complete address information, and a primary contact person with title, address, phone number, and email for ODHS contract negotiations. Additionally, applicants must designate the Oregon counties in which they intend to provide services, with the option to select individual counties or all 36 Oregon counties. The procurement does not specify response dates, site visits, bidder conferences, or award dates within this attachment.

The form requires applicants to identify their business structure by selecting from options including professional corporation, nonprofit corporation, limited partnership, limited liability company, limited liability partnership, sole proprietorship, corporation, or partnership. Applicants must also provide their Oregon Secretary of State business registration information, including state of registration and registry ID number, with current registration required at the time of contract execution. The form does not address pricing terms, set-asides, incumbent information, funding sources, or contract renewal options, as it functions solely as a data collection document for contractor qualification and service location designation purposes.