6-EXHIBIT E- Authorization to Release Information.docx
DOCX document 20 KB Posted
- Attached to
- SUPPLY, DELIVERY AND INSTALLATION OF CLASSROOM, MISCELLANEOUS SUPPORT FURNITURE & ACCESSORIES
- Solicitation number
- LEAD/OPS-NETWORK-FUR/RFP001/2026/27
- Issued by
- Davidson County, Tennessee
About this file
This is an Authorization to Release Information form utilized by LEAD Public Schools in Tennessee for vendor qualification evaluation in connection with a furniture supply, delivery, and installation contract. The form authorizes LEAD Public Schools to obtain and verify contractor information necessary to assess qualifications, responsibility, and eligibility to provide goods or services. Authorized information sources include business registration and corporate status, insurance coverage and claims history, licensing and professional certifications, financial stability and creditworthiness, past performance and references, criminal background checks where applicable, federal and state debarment status, and compliance with regulatory or contractual requirements. The authorization remains valid throughout the procurement process and contract duration unless revoked in writing by the contractor.
By executing the form, contractors certify that information provided is true and complete to the best of their knowledge and acknowledge that providing false or misleading information may result in disqualification, contract termination, or other legal remedies. Contractors also authorize LEAD Public Schools to share submitted information internally with employees, consultants, legal counsel, and evaluation committees for procurement and contract administration purposes. The form requires completion of contractor/vendor information including legal business name, DBA, address, contact details, and authorized representative information, along with the signature of an authorized representative attesting to the voluntary authorization and accuracy of submitted materials.
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Other files
| File | Type | Posted |
|---|---|---|
| 5-EXHIBIT D- Non-Collusion Affidavit.docx | DOCX document | |
| 7-EXHIBIT F- Insurance Requirements.docx | DOCX document | |
| 3-EXHIBIT B- Pricing Schedule.docx | DOCX document | |
| 2-EXHIBIT A- Scope of Services.docx | DOCX document | |
| 1-RFP- SUPPLY, DELIVERY AND INSTALLATION OF CLASSROOM, MISCELLANEOUS SUPPORT FURNITURE ACCESSORIES .docx | DOCX document | |
| 4-EXHIBIT C- Suspension and Debarment Cert.docx | DOCX document | |
| 8-EXHIBIT G- Floor Plan.docx | DOCX document |
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Text version
LEAD Public Schools Exhibit- E
AUTHORIZATION TO RELEASE INFORMATION
1. Contractor / Vendor Information Legal Business Name: __________________________________________ DBA (if applicable): __________________________________________ Address: ______________________________________________________ City, State, ZIP: ______________________________________________ Phone: ________________________________________________________ Email: _________________________________________________________ Authorized Representative: _____________________________________ Title: _________________________________________________________
2. Purpose of Authorization The Contractor/Vendor hereby authorizes LEAD Public Schools (the “Owner”) to obtain, verify, and review information necessary to evaluate the Contractor’s qualifications, responsibility, and eligibility to provide goods or services. This may include, but is not limited to:
· Business registration and corporate status
· Insurance coverage and claims history
· Licensing and professional certifications
· Financial stability and creditworthiness
· Past performance and references
· Criminal background checks (if applicable to scope)
· Federal and state debarment status
· Compliance with regulatory or contractual requirements
3. Authorization to Release Information The Contractor/Vendor authorizes any individual, company, agency, or organization to release any Information requested to LEAD Public Schools in connection with this evaluation. This includes documents, records, reports, or verbal confirmations relevant to the Contractor’s business operations, performance, or compliance history.
The Contractor/Vendor further authorizes LEAD Public Schools to share this information internally with its employees, consultants, legal counsel, and evaluation committees as necessary for procurement or contract administration purposes.
4. Duration of Authorization This authorization shall remain valid for the duration of the procurement process and, if a contract is awarded, for the duration of the contract unless revoked in writing by the Contractor/Vendor.
5. Certification and Signature By signing below, the Contractor/Vendor certifies that:
· The information provided to LEAD Public Schools is true and complete to the best of their knowledge.
· They understand that providing false or misleading information may result in disqualification, contract termination, or other remedies permitted by law.
· They voluntarily authorize the release of information as described above.
Authorized Representative:
Name: __________________________________________ Title: ___________________________________________ Signature: _______________________________________ Date: ____________________________________________ image1.png
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