ATTACHMENT A- RFP (OE) Response Form #214602275AZ 4.17.2026.docx
DOCX document 68 KB Posted
- Attached to
- Open Enrollment RFP#214602275AZ-R&D Sourcing: Pharmaceutical, Biochemical & Advanced Life Sciences
- Solicitation number
- RFP-118373
- Issued by
- Albemarle County, Chesapeake City, Virginia
About this file
This is an RFP Open Enrollment Response Form (RFP #214602275AZ) issued by Virginia Commonwealth University (VCU) for R&D Sourcing in the pharmaceutical, biochemical, and advanced life sciences sector. The form serves as the submission document for vendors interested in providing pharmaceutical products, biochemical supplies, advanced life sciences materials, and related items and services to VCU. Interested firms must complete the response form with general company information, client references, personnel experience and certifications, and relevant capabilities. The form does not specify explicit response deadlines, quantities, site visits, or bidder conferences within its content, as it primarily functions as a standardized submission template for the open enrollment process.
The pricing section requires vendors to provide detailed pricing schedules including percentage discounts off list prices for specific manufacturer product lines or catalog prices, organized by category, item, and manufacturer. Delivery options, policies, special handling charges, installation and training costs, and delivery cost structures must be included with all orders designated as FOB destination. Firms must register or maintain registration in the VCU RealSource Vendor Registration network, accept VCU purchase orders as project commitments, and comply with invoicing procedures outlined on purchase orders. Payment method options include ACH (Paymode-X Premium at Net 20 or Paymode-X Basic at Net 35), Virtual Card (Net 20), or Paper Check (Net 35), with optional early payment discounts ranging from 0.5% to 2.0%. Firms must agree to VCU's General and Specific Contractual Provisions, and the executed response form may be incorporated into a Master Agreement that may include statements of work, data protection addendums, or other necessary supporting documents.
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Text version
RFP Open Enrollment Response Form
R&D Sourcing Pharmaceutical, Biochemical & Advanced Life Sciences ATTACHMENT A
RFP #: 214602275AZ
1. General Information
| A. | Firm Name: Click or tap here to enter text. |
| B. | Street Address: Click or tap here to enter text. |
| C. | City: Click or tap here to enter text. |
| D. | State: Click or tap here to enter text. |
| E. | Zip Code: Click or tap here to enter text. |
| F. | Phone Number: Click or tap here to enter text. |
| G. | Email Address: Click or tap here to enter text. |
| H. | Brief history of the Firm: |
| Click or tap here to enter text. | |
| I. | Client Reference List: (Provide at least one business reference) |
| Reference Name: Click or tap here to enter text. |
Contact: Click or tap here to enter text.
Address: Click or tap here to enter text.
Phone #: Click or tap here to enter text.
E-mail address: Click or tap here to enter text.
Description and date(s) and services provided: Click or tap here to enter text.
J. Experience Provide Curriculum Vitae, Resumes or capabilities statement for all personnel that may be assigned to the University. Include relevant experience or certifications. You may attach additional pages.
Click or tap here to enter text.
K. Other Provide any other information the University should consider in evaluating the Firm's proposal:
Click or tap here to enter text.
2. eVirginia (eVA) Registration Status A. Is Firm currently eVA registered and active: ☐ Yes ☐ No
3. Small Business and Supplier Diversity (SBSD) Certified Businesses:
| A. | Virginia SBSD Certified: | ☐ Yes ☐ No |
| B. | Virginia SBSD Certification # (if applicable): Click or tap here to enter text. |
4. Conditions of Award Please check each box below confirming agreement with the conditions of award. Terms that contain a check box must be checked to confirm acceptance.
A. RealSource Registration ☐ The Firm agrees to maintain or become registered as a vendor within the VCU RealSource Vendor Registration network upon being invited to register.
B. Purchase Orders ☐ The Firm will accept a VCU issued Purchase Order as the commitment to start a project and will not start work on a project until a Purchase Order is received.
C. Invoicing ☐ The Firm agrees to invoice in accordance with the procedures outlined on the VCU Purchase Order.
D. Payment Method (Select one option) NOTE 1: See https://procurement.vcu.edu/for-suppliers/vendor-invoicing--payment/ for more information. Read FAQ before selecting payment method.
NOTE 2: VCU is migrating away from processing payments via paper check and strongly encourages the use of our electronic payment options.
| ☐ | ACH - Paymode-X Premium (Net 20) |
| ☐ | ACH - Paymode-X Basic (Net 35) and Early Payment Discount (EPD) (see below) |
| ☐ | Virtual Card (Net 20) |
| ☐ | Paper Check (Net 35). If selecting this option, we encourage you to offer an EPD (see below) |
E. Early Payment Discount (EPD): (Select one option)
| ☐ | 2.0% Net 15/Net 35 |
| ☐ | 1.5% Net 20/Net 35 |
| ☐ | 0.5% Net 25/Net 35 |
| ☐ | N/A - Net 35 |
F. Contractual Terms:
| ☐ | The Firm agrees to the General Contractual Provisions shown here and in the Master Agreement: | |
| https://procurement.vcu.edu/for-suppliers/ | ||
| ☐ | The Firm agrees to the Specific Contractual Provisions shown as an attachment to the Master Agreement. |
G. Fees/Pricing The Firm shall provide pricing for all proposed categories and/or items for pharmaceutical, biochemical & advanced life sciences, related items, and services. The pricing schedule should include percentage off list price for specific manufacturer/product lines or percentage discount off catalog. The following sample shall be used: Category/Item, Manufacturer, and Discount Off List Price.
| Category/Item |
| Manufacturer |
| Discount Off List Price |
Describe delivery options and policies including special handling charges, installation and training if required for the items being offered. All orders shall be FOB destination. Include information regarding delivery costs and/or free delivery.
Click or tap here to enter text.
NOTE: VCU reserves the right to conduct additional negotiations.
5. Proprietary or Confidential Information:
| A. | The Firm’s proposal contains proprietary or confidential information: | ☐ Yes ☐ No |
| B. | If Firm answered “Yes” above, provide additional details. | |
| Click or tap here to enter text. |
Note: See RFP section “Confidential / Proprietary Data and Information” for more information.
6. If applicable, list any documents that you are attaching to this RFP Open Enrollment Response Form:
Click or tap here to enter text.
7. Acceptance This document may be incorporated into the “Master Agreement” between your Firm and VCU. The agreement between your Firm and VCU may include statements of work, a data protection addendum, or other similar documents as necessary.
Firm Name: Click or tap here to enter text.
Authorized Officer/Signatory: Click or tap here to enter text.
Title: Click or tap here to enter text.
Authorized Officer/Signatory Email Address: Click or tap here to enter text.
Date: Click or tap to enter a date.
☐ Electronic Signature: By typing the name of the Firm’s authorized representative/signatory into the field above, the Firm certifies that it is providing a binding “Electronic Signature” and further specifically validates that the individual affixing the Electronic Signature above is fully authorized to bind the Firm with respect to the goods, services, pricing, terms and conditions listed herein.
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