70CNR-S3879-Vendor-Information-Response.pdf

This is a Vendor Information Response form required by the State of Nevada Purchasing Division on behalf of the Nevada Division of Conservation and Natural Resources (DCNR) and the Nevada Department of Environmental Protection (NDEP) for the WIIN Water Testing in Schools and Daycares contract opportunity. The form serves as a standardized submission document that all vendors and their subcontractors must complete and return as part of their proposal. The form collects essential vendor contact information, including company name, address, telephone number, email address, and designated contact person for questions and contract negotiations. Additionally, vendors must provide an overall company profile and demonstrate relevant experience with State of Nevada agencies by documenting prior work performed for state entities.

The form requires vendors to provide comprehensive disclosure information regarding business licensing, prior contractual performance, and any potential conflicts of interest. Specifically, vendors must confirm compliance with Nevada business registration requirements (NRS 80.010 for foreign corporations and NRS 76 for business licensing), identify any current or former State of Nevada employees who will be performing work, and disclose any significant prior or ongoing contract failures, breaches, litigation, or pending claims occurring within the past six years that could affect their ability to perform. The form also includes sections for payment authorization for procurement card use and requires the signature of the individual authorized to bind the organization, ensuring accountability and legal authorization for contract execution.