Proposal Intent.docx

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Coordinating and Technical Assistance Center for the Pediatric Quality Measures
Solicitation number
AHRQ-11-10001
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Proposal Intent

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ATTACHMENT 3

PROPOSAL INTENT RESPONSE SHEET

RFP No. AHRQ-11-10001 Coordinating and Technical Assistance Center for the Pediatric Quality Measures Program Please review the attached request for proposal. Furnish the information requested below and return this page by November 30, 2010. Your expression of intent is not binding but will greatly assist us in planning for the proposal evaluation.

[ ] INTEND TO SUBMIT A PROPOSAL

[ ] DO NOT INTEND TO SUBMIT A PROPOSAL FOR THE FOLLOWING REASONS:

[ ] I GRANT PERMISSION TO THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY, CONTRACTS OFFICE TO ADD THE CONTACT INFORMAION BELOW TO A BIDDERS LIST TO PROVIDE TO OTHER INTERESTED OFFERORS FOR SUBCONTRACTING OPPORTUNITIES. (*MUST INCLUDE AUTHORIZED SIGNATURE)

COMPANY/INSTITUTION NAME:

*AUTHORIZED SIGNATURE:

TYPED NAME AND TITLE:

DATE:

[ ] PLEASE DO NOT RELEASE THE CONTACT INFORMATION.

Please return to:

Nicola L. Carmichael Agency for Healthcare Research and Quality

Contracts Management
540 Gaither Road
Rockville, Maryland 20850

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