Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 143 KB Posted
- Attached to
- PATH4EMS Peer Assistance
- Solicitation number
- RFP FAAA 2026000285 1
- Issued by
- Arapahoe County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for the PATH4EMS Peer Assistance contract opportunity issued by the State of Colorado under Solicitation Number RFP 2026000285. The form serves as the official submission document through which vendors confirm their participation in the solicitation process and provide essential organizational information required for award, contracting, and payment purposes.
The form requires vendors to submit comprehensive company information including the vendor customer number from Colorado's Vendor Self-Service system, Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI), legal name, doing business as name if applicable, complete business address, and authorized signatory details. Vendors must also designate a point of contact for solicitation-related communications separate from the authorized signatory, providing that individual's name, title, phone number, and email address. The form must be signed in original ink or digital signature by an authorized representative, confirming the vendor's review and approval of the solicitation response. The document emphasizes that vendors must verify the accuracy of their Vendor Customer Number and FEIN, as these identifiers will be used for issuance of the award, contracting, and payment processing. Vendors are instructed to submit the signed original form with their complete solicitation response.
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Text version
Attachment 1
SOLICITATION NO: RFP 2026000285
TITLE: PATH4EMS Peer Assistance
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 .