Attachment 5. Offeror Info Page.pdf

(Attachment # 5)

VEHICLE TOWING, APPRAISAL, STORAGE, MAINTENANCE & DISPOSAL SERVICES

DISTRICTS OF ALABAMA, DISTRICTS OF ARKANSAS,

DISTRICTS OF MISSISSIPPI AND DISTRICTS OF TENNESSEE

SOLICITATION NO.: 15M50023QA4400001

Each company shall complete this page and submit as the first page of their proposal.

Offeror’s Name (include ‘Doing Business As’ (DBA) and/or ‘Limited Liability Corporation’ (LLC) if applicable):

Offeror’s Address:

Offeror’s Email and Website:

Phone Number:

Fax Number:

Unique Entity ID:

Federal Tax I.D. Number:

Business Size (check all that apply): Small Business

_ Other than Small

_ Disadvantaged

_ Women-Owned

_ HUBZone

_ Service-Disabled Veteran-Owned

_ Women-Owned Small Business (WOSB) Eligible

Under the WOSB Program

_ EDWOSB

_ 8(a) Certified Small Business

I, , represent that, to the best of my knowledge and belief, the information included in my offer is complete, accurate, and true.

Signature Date

OFFEROR’S INFORMATION PAGE

Offeror’s Address: