ATTACHMENT 3 Authorization to Release Information.docx

DOCX document 26 KB Posted

Attached to
PRE-QUALIFY VENDORS WHO CAN PROVIDE TELECOMMUNICATIONS OUTSIDE PLANT SERVICES IN SELECTED ZONES
Solicitation number
26-023
Issued by
Polk County, Iowa

About this file

This is an Authorization to Release Information form for RFP 26-023 issued by the State of Iowa. The document serves as a vendor authorization permitting any person or entity, whether public or private, to release information concerning the vendor's background and performance history related to services similar to those detailed in the RFP. The form requires the vendor's printed name, signature from an authorized representative, and date of execution.

The vendor acknowledges through this authorization that released information may be unfavorable, could negatively impact its chances of receiving contract awards from the State, and may harm its reputation or operations. By executing this form, the vendor accepts these risks and agrees to release all persons, entities, and the State of Iowa from any liability associated with the release or use of such reference information.

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Text version

ATTACHMENT 3

AUTHORIZATION TO RELEASE INFORMATION

RFP 26-023

(Name of Vendor) hereby authorizes any person or entity, public or private, having any information concerning the Vendor’s background, including but not limited to its performance history regarding its prior rendering of services similar to those detailed in this RFP, to release such information to the State.

The Vendor acknowledges that it may not agree with the information and opinions given by such person or entity in response to a reference request. The Vendor acknowledges that the information and opinions given by such person or entity may hurt its chances to receive contract awards from the State or may otherwise hurt its reputation or operations. The Vendor is willing to take that risk. The Vendor agrees to release all persons, entities, and the State of Iowa from any liability whatsoever that may be incurred in releasing this information or using this information.

Printed Name of Vendor Organization

Signature of Authorized Representative

Date

File details come from the government source that posted it. Updated .