Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 148 KB Posted
- Attached to
- Health Equity Technical Assistance
- Solicitation number
- RFP FAAA 2027000016 2
- Issued by
- Arapahoe County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for RFP 2027000016, issued by the State of Colorado for Health Equity Training and Assistance. The form serves as the official submission document through which vendors confirm their offer in response to this solicitation. Vendors are required to complete all fields including their Vendor Customer Number from Colorado's Vendor Self-Service (VSS) system, Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI), legal business name, and any Doing Business As (DBA) names. The form also requires submission of the vendor's physical address, authorized signatory information with title and contact details, and designation of a point of contact for solicitation-related communications. All responses must be submitted with this form as the original signed document along with the complete solicitation response.
The form establishes that vendors must verify their FEIN matches VSS registration to be eligible for award, as this information will be used for issuance of the award, contracting, and payment processing. Vendors are required to confirm whether they anticipate performing all work within the state of Colorado. The form emphasizes that all submitted responses are subject to the conditions and specifications outlined in the solicitation document, and vendors are urged to thoroughly review the solicitation before submission. A signed original of this form—either in ink or with a digital signature—must accompany the original solicitation response.
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Text version
Attachment 1
SOLICITATION NO: RFP 2027000016
TITLE: Health Equity Training and 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. The FEIN must match VSS registration to be eligible for award.
Vendor anticipates that all work be performed within the state of Colorado: ☐ Yes ☐ No
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 .