Attachment 3 - Proposal Sheet.pdf

RFP# 47QSCC-24-R-5001

1. VENDOR INFORMATION:

OFFEROR BUSINESS/COMPANY NAME:______________________________________________________

BUSINESS/COMPANY ADDRESS: ______________________________________________________________

CITY: _____________________ STATE/PREFECTURE: _________________ ZIP CODE:______________

POINT OF CONTACT: ___________________________________________________________________________

TELEPHONE NO:_________________________________ FAX: ______________________________________

EMAIL ADDRESS: ________________________________________________________________________________

2. VENDOR STATEMENT(S) OF ELIGIBILITY:

In order to be eligible for award, vendors must answer “Yes” to the following questions, confirming its eligibility for award under this RFP.

Place an “X” on either “Yes” or “No”:

a. Yes _____ No _____ Our Company/Firm is registered in SAM.

If a vendor answered “No” to any of the above questions, the vendor is considered ineligible for award and its proposal will not be further evaluated.

3. VENDOR SAM REPRESENTATION AND/OR CERTIFICATION:

Vendors shall either provide its Unique Entity Identifier (UEI) as generated on the SAM.gov website upon successful registration or attach a copy of your firm’s registration to the quote.

Unique Entity Identifier (UEI) (from SAM.gov): _________________________________

If GSA is unable to verify SAM registration using the above provided UEI, GSA reserves the right to request a copy of your firm’s registration prior to award to ensure vendor eligibility.

4. DELIVERY SCHEDULE:

Vendors are required to confirm whether they will meet the required delivery date requirement.

A. The required Delivery Date: January 15, 2024

As stated above, the delivery date for all products is no later than January 15, 2024.

Place an “X” on either “Yes” or “No”:

Yes _____ No _____ Our Company/Firm will meet the required delivery date stated above.

If a vendor answered “No” to the above question, the vendor is considered ineligible for award and its proposal will not be further evaluated.

5. VENDOR EXCEPTIONS TO RFP TERMS AND CONDITIONS (IF ANY):

Vendors are requested to review RFP Section P (Terms and Conditions) and indicate whether or not there are any exceptions to the stated Terms and Conditions.

Vendors are requested to place an “X” under “Yes” or “No.” If an “X” is placed under “Yes,” vendors are required to explain their exception(s) in the space provided.

Yes No Exception(s)

6. PROPOSED PRICE:

The proposed price shall be inclusive of all packaging and shipping costs. Vendors shall refer to Section G (Scope/Description of Agency Need) and Section H (Standard Items) for complete information.

PROPOSED PRICE (1 LOT): $ ____________________ (U.S. Dollars)

By submitting a proposed price above, vendors are confirming that the price is a fixed-price equal to the U.S. Dollar amount proposed above. Vendors also acknowledge that their proposal does not include taxes as the U.S. Federal Government is tax exempt.

7. COMPANY REPRESENTATIVE APPROVAL:

This proposal is required to be signed and approved by an individual or representative who is authorized to obligate the vendor.

The undersigned confirms that they are authorized to obligate the vendor. The undersigned also confirms that the proposal and all statements of eligibility herein are truthful to the best of the knowledge of the undersigned.

COMPANY REPRESENTATIVE:

NAME: ___________________________________________

TITLE: ___________________________________________

SIGNATURE: ___________________________________________

DATE: ___________________________