AFQ 034020143 APPENDIX A - Application Signature Page1 Rev21315.pdf
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- Attached to
- Specialty Preservation Construction
- Solicitation number
- 034020143
- Issued by
- Dauphin County, Harveys Lake Borough, Pennsylvania
About this file
The document is an Application Signature Page for a state and local contract opportunity, AFQ 034020143, issued by the Pennsylvania Historic & Museum Commission (PHMC). The opportunity is for preservation and traditional trade contractors, craftspeople and artisans to become pre-qualified to bid on preservation construction projects on historic buildings at PHMC's historic sites and museums throughout Pennsylvania. The application requires submission of a complete response in the specified format, acknowledgment of all bulletins, agreement to contract terms and conditions, submission of 4 paper copies or 1 emailed copy, and acceptance of applicant responsibilities. Any misstatement in the application is considered fraudulent concealment.
The contract opportunity is open enrollment, allowing applicants to apply at any time until June 30, 2019. The geographic area includes Dauphin County and the city of Harrisburg, Pennsylvania. The contract does not provide any details on pricing, set asides, incumbents, funding requirements, or other salient financial information.
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Text version
AFQ 034020143
APPENDIX A
APPLICATION SIGNATURE PAGE
Application Number AFQ 034020143
Applicant agrees that their signature on this application acknowledges the following statements to be true:
1. Applicant has submitted a complete response to this AFQ using the format provided in
PART II; and
2. Applicant has reviewed and acknowledges receipt of all Bulletins listed on the DGS e-marketplace and PHMC web sites; and
3. Applicant agrees that the contents of the application will become part of any contract that may be entered into as a result of this AFQ; and
4. Applicant agrees to comply with the terms and conditions: Commonwealth Terms &
Conditions and PHMC Supplemental Terms & Conditions as referenced in Part I-19 of this AFQ.
5. Applicant agrees that four (4) paper copies or one (1) emailed copy of the complete application must be provided in order for it to be considered for review and qualification;
and
6. Applicant accepts the Applicant Responsibilities indicated in Part I-19 of this AFQ; and
7. Applicant agrees that if the Commonwealth finds any of the application information to be false, Applicant will be disqualified.
The undersigned agrees to accept all terms and conditions as set forth in the AFQ. The undersigned acknowledges that the representations made in this application are material and will remain valid. Any misstatement in this application is, and shall be treated as, fraudulent concealment from the Commonwealth of the facts relating to the submission of this response.
APPLICANT IS A SOLE OWNERSHIP/INDIVIDUAL:
Witness: By:
Sole Owner / Individual
APPLICANT IS A PARTNERSHIP OR LIMITED LIABILITY COMPANY (LLC):
Witness: By:
General Partner / Authorized LLC Member
APPLICANT IS A CORPORATION:
Attest: By:
Secretary President
AFQ 034020143
APPLICANT IS A JOINT VENTURE:
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