attachment_3_RFP DBEA 2026-01 data.pdf
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- Attached to
- Request for Proposals for Broadband Build for Unserved Locations (Coronavirus Capital Project Funds)
- Solicitation number
- RFP DBEA 2026-01
- Issued by
- New Hampshire
About this file
This is a Contractor Data Sheet attachment for New Hampshire's Request for Proposals (RFP DBEA 2026-01) for Broadband Build for Unserved Locations, funded through Coronavirus Capital Project Funds. The document serves as a qualification and background verification form that prospective contractors must complete and submit as part of their proposal response. The form requires contractors to provide information regarding their years of experience providing high-speed broadband services, a minimum of four municipal references with dates of service and contact information, current number of clients, and full-time employee count. Contractors must also disclose whether they operate as a subsidiary firm and provide parent company affiliation details if applicable.
The form requires completion and authorization by a company officer, with detailed contact information, business organization type, incorporation date, and ownership details. Contractors must certify the accuracy of all submitted information through an authorized signature. The document does not specify response deadlines, site visit requirements, bidder conferences, or award dates within this particular attachment, as it functions primarily as a data collection and qualification verification instrument rather than a comprehensive RFP summary document. The Coronavirus Capital Project Funds indicate federal funding support for this broadband infrastructure initiative targeting unserved locations in New Hampshire.
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Text version
ATTACHMENT C
Broadband Build For Unserved Locations (Coronavirus Capital
Project Funds)
RFP DBEA 2026-01
Contractor Data Sheet
1. Years in Business: Indicate the length of time you have been in business providing this type of service.
________ Years ________ Months
2. References: Indicate below at least four (4) municipalities for whom you have provided high speed broadband service. Include the date service was furnished, and contacts.
Client City/State Date Contact name/phone
3. Are you a subsidiary firm? ___ Yes ___ No
If yes, list parent affiliation:
Company: __________________________________________
Address: ___________________________________________
City: _____________________________________ State:____
4. Current Number of Clients: ___________
5. Number of Full-Time Employees: ___________
Authorized Signature(s) This form must be completed and signed by an officer of the company:
Name of Firm: __________________________________________________
Contact: _______________________________________________________
Address: _______________________________________________________
City: ___________________________________State: ______Zip: ________
Phone: ________________________________________________________
Fax: __________________________________________________________
Email: ________________________________________________________
Date of incorporation: ____________________________________________
If not a corporation, state the type of business organization, names and addresses of owners, address and phone of principle place of business, date business began, and state in which organized.
I certify the accuracy of this information.
Signature:______________________________________________________
Name and title (print or type): ______________________________________
Date: __________________________________________________________
File details come from the government source that posted it. Updated .