Attachment 1 Vendor Information-Confirmation of Offer Form UPDATED.docx
DOCX document 148 KB Posted
- Attached to
- STI/HIV/VH Home Test kits
- Solicitation number
- IFB1 FAAA 2027000007 1
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form for Solicitation No. IFB 2027000007 issued by the State of Colorado for the procurement of STI/HIV/VH Home Test Kits. The form serves as the official submission document through which vendors must provide their company information and formally confirm their offer in response to this competitive invitation for bid. Vendors are required to complete all fields including their Colorado Vendor Self Service (VSS) customer number, Federal Employer Identification Number (FEIN), Unique Entity Identifier (UEI), legal business name, DBA if applicable, complete address, and authorized signatory information. The form must be signed by an authorized representative of the offeror and submitted as the original signed document along with the complete solicitation response.
The form establishes that vendors must verify their FEIN matches their VSS registration to be eligible for award, as these identifiers will be used for issuance of the contract award, contracting, and payment processing. Vendors must also confirm whether work will be performed within the State of Colorado. The form emphasizes that all submission responses are subject to the conditions and specifications outlined in the complete solicitation document, and vendors are urged to review the entire solicitation before submitting their response. A designated point of contact for solicitation-related communications must be identified separately from the authorized signatory.
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Text version
Attachment 1
SOLICITATION NO: IFB 2027000007
TITLE: Test Kits
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 .