6-FORM 4 - REPRESENTATIONS and CERTIFICATIONS.pdf
PDF 827 KB Posted
- Solicitation number
- RFP-111-25-KM
- Issued by
- Leon County, Florida
About this file
This document is a Representations/Certifications form for a Request for Proposal (RFP) with the solicitation number RFP-111-25-KM. The form is a two-page template designed for potential vendors to provide their official company information, contact details, and remittance addresses when responding to a bid opportunity. The form requires respondents to complete and submit a Federal Form W-9 along with their bid, and provides multiple sections for companies to input their official registered information, contract management contacts, payment remittance details, invoice inquiry contacts, and purchase order routing information.
The form is structured to capture comprehensive company contact information, including company name, mailing address, telephone numbers (with preferences for toll-free), website URL, and specific contacts for different administrative functions. While the template is blank and no specific vendor information is filled in, it is clearly designed to standardize and facilitate the information gathering process for a procurement or contracting opportunity, ensuring that all necessary contact and tax identification details are systematically collected from potential bidders.
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Text version
REPRESENTATIONS/CERTIFICATIONS
TAXPAYER IDENTIFICATION
Respondent must complete Federal Form W-9 and submit it with their bid.
OFFICIAL COMPANY INFORMATION AS REGISTERED (Type/Print)
COMPANY NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
WEBSITE URL:
COMPANY CONTACT FOR CONTRACT MANAGEMENT (Type/Print)
NAME:
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
RFP-111-25-KM
PAYMENT REMITTANCE ADDRESS (Type/Print)
NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
CONTACT FOR INVOICE INQUIRIES
NAME:
TELEPHONE NO.:
(Toll-Free Preferred) VOICE: EXTENSION:
OTHER: FAX:
EMAIL ADDRESS:
WHERE TO SEND PURCHASE ORDER (IF APPLICABLE)
COMPANY NAME:
MAILING ADDRESS:
(City) (State) (Zip Code + 4)
EMAIL ADDRESS:
RFP-111-25-KM
REPRESENTATIONS/CERTIFICATIONS
File details come from the government source that posted it. Updated .