Attachment 1 Vendor Information-Confirmation of Offer Form.docx
DOCX document 143 KB Posted
- Solicitation number
- RFI FAAA 2027000011 1
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for Request for Information (RFI) 2027000011 issued by the State of Colorado for a Newborn Screening (NBS) Laboratory Information Management System through the Office of Information Technology (OIT). The form requires vendors to submit detailed organizational information including their Colorado Vendor Customer Number, Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI#), legal business name, doing-business-as designation if applicable, complete business address, and authorized signatory details. Vendors must designate an authorized representative to sign the submission and identify a point of contact for solicitation-related communications, including name, title, phone number, and email address. The form must be submitted as a signed original with the original solicitation response.
The form emphasizes that all responses are subject to conditions and specifications outlined in the solicitation document and that vendors should review the complete solicitation thoroughly before submitting. The Vendor Customer Number and FEIN provided will be used for award issuance, contracting, and payment processing for the selected vendor. Vendors are instructed to verify the accuracy of all provided identification numbers to ensure they correspond to the correct entity submitting the response. No pricing terms, set-asides, award dates, or contract term information are specified in this particular form, as it functions primarily as a vendor intake and authorization document.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A LIMS Requirements.xlsx | XLSX spreadsheet | |
| RFI 2027000011 NBS Laboratory Information Management System.pdf | ||
| Exhibit B Budget Template.xlsx | XLSX spreadsheet |
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Text version
Attachment 1
SOLICITATION NO: RFI 2027000011
TITLE: Newborn Screening Program Laboratory InformationManagement System
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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