AHRQ-11-10006-Attachment 3-Proposal Intent.pdf

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Health Care Innovations Exchange II
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AHRQ-11-10006
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Attachment 3 - Proposal Intent Response Form

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ATTACHMENT 3

PROPOSAL INTENT RESPONSE SHEET

RFP No. AHRQ-11-10006

Health Care Innovations Exchange II Please review the attached request for proposal. Furnish the information requested below and return this page by January 20, 2011. 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:

Contractor Name: ___________________________

Contractor Address: _____________________________

Please return to:

Erin Mills

Agency for Healthcare Research and Quality Contracts Management 540 Gaither Road Rockville, Maryland 20850

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