6-EXHIBIT E- Authorization to Release Information.docx

DOCX document 20 KB Posted

Attached to
Security Camera, Access Control, Wiring, Installation, Licensing & Commissioning Services
Solicitation number
RFP Number: LEAD/OPS-444SEC/RFP001/2026/27
Issued by
Davidson County, Tennessee

About this file

This is an Authorization to Release Information form used by LEAD Public Schools in Tennessee for evaluating contractor qualifications in connection with security system procurement. The form authorizes LEAD Public Schools to obtain and verify information necessary to assess a contractor's qualifications, responsibility, and eligibility to provide goods or services, including business registration and corporate status, insurance coverage, licensing and certifications, financial stability, past performance, criminal background checks, and federal and state debarment status. The authorization permits any individual, company, agency, or organization to release requested information to LEAD Public Schools and allows the school district to share information internally with employees, consultants, legal counsel, and evaluation committees for procurement and contract administration purposes. The authorization remains 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 signing the form, the contractor certifies that information provided to LEAD Public Schools is true and complete, acknowledges that providing false or misleading information may result in disqualification, contract termination, or other legal remedies, and voluntarily authorizes the release of information as described. The form requires completion of contractor and vendor information including legal business name, DBA, address, phone, email, and authorized representative details, along with signature and date from an authorized representative with stated title.

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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

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