Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 141 KB Posted
- Attached to
- Medication Management and Disposal
- Solicitation number
- RFP FAAA 2026000169 1
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for the State of Colorado's Medication Management and Disposal RFP 2026000169. The form requires vendors to provide comprehensive business information including their Colorado Vendor Self-Service (VSS) Customer Number, Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI), legal business name, doing-business-as name if applicable, complete address, and authorized signatory details. Vendors must designate an authorized signatory to approve the solicitation response and provide a separate point of contact for all solicitation-related communications, including name, title, phone number, and email address. The form emphasizes that all responses are subject to conditions and specifications outlined in the solicitation document.
The form serves as critical documentation for award issuance, contract execution, and payment processing, with the provided FEIN and Vendor Customer Number being used for these administrative functions. Vendors are instructed to verify the accuracy of all provided identification numbers before submission and must submit a signed original of the form with their original solicitation response. The document does not specify pricing terms, set-asides, contract duration, or renewal options, as these details are contained within the primary solicitation document rather than this confirmation form.
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Text version
Attachment 1
SOLICITATION NO: RFP 2026000169
TITLE: Medication Management and Disposal
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 .