Appendix B - Bidder Profile.pdf

Washington Department of Fish and Wildlife Page 1 of 2 RFQ No. 26-00003 – Bidder Profile (Exhibit B)

Request for Quotations and Qualifications (RFQ)

No. 26-00003 Metaline Sorts

Exhibit B – Bidder Profile

COMPANY INFORMATION (for Contract administration purposes)

Company Name & Address:

Authorized Representative: Name and Title:

Phone:

Email:

Authorized Signatory:

Name:

Title:

Email:

Point of Contact (if different from Authorized Representative):

Name:

Title:

Email:

Federal Tax Identification Number (https://sam.gov)

WA Dept. of Revenue Registration Number (https://dor.wa.gov)

Statewide Vendor Payment Number (https://ofm.wa.gov/tech-support/statewide-vendor-payee-services/)

REFERENCES

Provide a minimum of three (3) commercial or government references for which Bidder has delivered goods and/or services similar in scope as described in the RFQ.

1. Customer:

Contact:

Phone:

Email:

2. Customer:

Contact:

3. Customer:

Contact:

https://sam.gov/ https://dor.wa.gov/ https://ofm.wa.gov/tech-support/statewide-vendor-payee-services/ https://ofm.wa.gov/tech-support/statewide-vendor-payee-services/

Washington Department of Fish and Wildlife Page 2 of 2 RFQ No. 26-00003 – Bidder Profile (Exhibit B)

SUBCONTRACTORS

If applicable, on a separate sheet, identify any subcontractors who will perform services in fulfillment of contract requirements; the nature of services to be performed and include federal tax identification (TIN) number for each subcontractor. If a subcontractor is a minority or women owned business please include their OMWBE

Certification Number (if certified). If necessary, attach additional sheets (please stamp or mark each page with a company name, mark, or initial). Do not include any Social Security Numbers.

The contractor, by including subcontractor(s) as part of your signed bid is your agreement to take complete responsibility, contract obligations, and liability for all actions of such subcontractors. All subcontractors are subject to WDFW approval. WDFW reserves the right to approve or disapprove any subcontractor.

SALES/CUSTOMER SERVICE

Purchasing Cards Accepted:

Visa Master Card American Express Discover Other:

MINORITY/WOMEN OWNED BUSINESS STATUS

Is your firm a Minority/Women Owned Business? Yes No

Office of Minority and Women-Owned Business Enterprises MWBE certification #

VETERAN OWNED BUSINESS STATUS

Is your firm a Veteran Owned Business? Yes No

Washington State Department of Veterans Affairs certification #

SMALL BUSINESS STATUS

Does your firm meet the definition of a small business in RCW 39.26.010(22)? Yes No

RCW 39.26.010:

(22) "Small business" means an in-state business, including a sole proprietorship, corporation, partnership, or other legal entity, that:

(a) Certifies, under penalty of perjury, that it is owned and operated independently from all other businesses and has either:

(i) Fifty or fewer employees; or

(ii) A gross revenue of less than $7,000,000 annually as reported on its federal income tax return or its return filed with the department of revenue over the previous three consecutive years; or

(b) Is certified with the office of women and minority business enterprises under chapter 39.19 RCW.