Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 26 KB Posted
- Solicitation number
- RFP 2025000257
- Issued by
- Denver County, Denver City, Colorado
About this file
Attachment 1 is a Vendor Information-Confirmation of Offer Form for Colorado's Request for Proposal (RFP) 2025000257 for Lead Testing in Child Care Facilities Drinking Water Program. The RFP seeks qualified contractors to provide comprehensive lead testing services in licensed child care facilities statewide, including outreach, enrollment, sampling plan development, water sample collection following CDPHE and EPA 3Ts guidance, remedial work (with subcontractors permitted), and follow-up training on lead reduction best practices. Contractor personnel working on-site during child care operations must pass background checks, and the sole contact for the solicitation is Kristi Gamble at kristi.gamble@state.co.us.
The form requires vendors to provide detailed organizational information, including Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI), legal business name, contact details, and authorized signatory information. Vendors must indicate whether they qualify as a Disadvantaged Business Enterprise (DBE), Minority Business Enterprise (MBE), or Women's Business Enterprise (WBE), and confirm acceptance of contract terms. The form emphasizes the importance of accurate vendor registration information, noting that the FEIN must match VSS registration to be eligible for award, and vendors must submit the signed original form with their solicitation response.
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Text version
Attachment 1
SOLICITATION NO: RFP 2025000257
TITLE: Colorado WIIN Lead Testing in Child Care Facilities Drinking Water Program
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 and acceptance of all terms and conditions of the solicitation.
___________________________________________________________________ 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. The FEIN must match VSS registration to be eligible for award.
Vendor accepts all Contract/PO Terms and conditions without negotiation: Yes No Does your organization qualify as a Disadvantaged Business Enterprise (DBE), Minority Business Enterprise (MBE) or Women’s Business Enterprise (WBE)? Yes No
SUBMIT SIGNED ORIGINAL OF THIS FORM WITH ORIGINAL SOLICITATION RESPONSE
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