Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 143 KB Posted
- Solicitation number
- RFP FAAA 2026000143 4
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for a Colorado state solicitation (RFP 2026000143) issued by the Colorado Department of Public Health and Environment for Newborn Screening Program Instrumentation and Reagents. The form serves as the official response document that vendors must submit with their bids and contains fields for vendor identification, authorization, and points of contact. Offerors are required to provide their vendor customer number, Federal Employer's Identification Number (FEIN), Unique Entity Identifier (UEI), legal business name, DBA if applicable, complete business address, and authorized signatory information including name, title, email, and phone number. An authorized representative must sign and date the form in original ink or digital format before submission.
The form emphasizes that all responses are subject to the conditions and specifications outlined in the complete solicitation document. Vendors are instructed to verify the accuracy of their vendor customer number and FEIN, as these identifiers will be used for award issuance, contracting, and payment processing. The form requires designation of a point of contact for solicitation-related communications separate from the authorized signatory, along with their title, phone number, and email address. The signed original of this form must be submitted with the original solicitation response, and vendors are urged to thoroughly review the complete solicitation documentation before preparing their bid.
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Text version
Attachment 1
SOLICITATION NO: RFP 2026000143
TITLE: Newborn Screening Program Instrumentation and Reagents
Vendor Information & Confirmation of Offer Form
Responses submitted are subject to the conditions stipulated in the solicitation and the specifications set forth in the solicitation.
PLEASE TYPE OR PRINT INFORMATION
VENDOR CUSTOMER # (From Colorado VSS): ___________________________________________________________________
FEDERAL EMPLOYER’S IDENTIFICATION (FEIN) #: _______________________________________________________________
Unique Entity Identifier (UEI#) (if applicable): __________________________
LEGAL NAME of OFFEROR: __________________________________________________________________________________
DBA (if applicable):_______________________________________________________________________________________
ADDRESS: ______________________________________________________________________________________________
CITY, STATE, ZIP: _______________________________________________________________________________________
NAME OF AUTHORIZED SIGNATORY: ________________________________________________________________________
TITLE OF AUTHORIZED SIGNATORY: ________________________________________________________________________
E-MAIL ADDRESS: ______________________________________________________________________________________
PHONE #: __________________________________________
The signature below signifies my review and approval of this solicitation response.
___________________________________________________________________ DATE: ___________________________ Original (in ink) or Digital Signature of Authorized Signatory
POINT OF CONTACT FOR SOLICITATION-RELATED COMMUNICATIONS:
NAME______________________________________________ PHONE #: ______________________________________
TITLE: _____________________________________________
E-MAIL: _____________________________________________________________________________________________
Offerors are urged to read the solicitation document thoroughly before submitting a response. The Vendor Customer Number and F.E.I.N. referenced above will be used for issuance of award, contracting, and payment for the winning response. Verify that the provided numbers are correct for the entity submitting this response.
SUBMIT SIGNED ORIGINAL OF THIS FORM WITH ORIGINAL SOLICITATION RESPONSE
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File details come from the government source that posted it. Updated .