Att12_Offeror Points of Contact.pdf

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Attached to
Quality Assessment Support for the National Institute of Environmental Health Sciences
Solicitation number
75N96025R00002
Issued by

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This document is an Offeror's Points of Contact form that must be completed and returned with the business proposal. It requests the name, title, contact information, and addresses for the business representative and proposed principal investigator who will serve as the points of contact for the federal contract opportunity. The related federal contract opportunity is a Request for Proposal (RFP) from the Department of Health and Human Services National Institutes of Health National Institute of Environmental Health Sciences for Quality Assessment Support services, identified by Solicitation Number 75N96025R00002. The RFP and all related attachments provide the full details on the required products or services, response and award dates, pricing terms, set asides, and other key information.

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OFFEROR’S POINTS OF CONTACT

Complete the following and return with the BUSINESS PROPOSAL.

Business Representative (Name, Title, Address* and Contact Information of individual with whom daily contact is required.)

Name: Telephone:

Title: Fax:

Office: E-Mail:

Organization:

*Street Address:

City, State, Zip Code:

Proposed Principal Investigator (Name, Institutional Title, Address, and Contact Information)

Name: Telephone:

Title: Fax:

Office: E-Mail:

Organization:

*Street Address:

City, State, Zip Code:

These exact addresses are necessary to ensure that contact can be made with the proper individual(s) in the most expeditious manner.

*Please use actual street address, not P.O. Box.

Offeror’s Points of Contact Page 1 of 1 (1/2011)

Name:
Telephone:
Title:
Fax:
Office:
EMail:
Organization:
Street Address:
City State Zip Code:
Name_2:
Telephone_2:
Title_2:
Fax_2:
Office_2:
EMail_2:
Organization_2:
Street Address_2:
City State Zip Code_2:

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