ATTACHMENT A- RFP (OE) Response Form #218814894AZ- New Dental School Equipment, Casework, Goods, and Services 8.21.26.docx
DOCX document 69 KB Posted
- Solicitation number
- RFP-126892
- Issued by
- Virginia
About this file
This is an RFP Open Enrollment Response Form for Virginia Commonwealth University (VCU) seeking proposals for dental school equipment, casework, goods, and services to support the construction of a new state-of-the-art Dental School Building scheduled to open in 2029. Prospective firms are invited to submit comprehensive proposals detailing their offerings related to dental equipment, casework, and associated goods and services. The response form requires submission of general company information, including firm name, address, contact details, and a brief company history. Respondents must provide at least one business reference with detailed contact information and a description of services provided. The form also requests curriculum vitae, resumes, or capabilities statements for all personnel potentially assigned to the University, along with relevant experience or certifications. No specific response deadline, site visit requirements, or bidder conference details are included in this response form document itself.
Respondents must provide detailed pricing for all proposed categories and items, including percentage discounts off list prices for specific manufacturer product lines or catalog pricing. Delivery options, policies, special handling charges, installation, and training information must be included, with all orders specified as FOB destination. Firms must be either currently registered or agree to register with VCU's RealSource Vendor Registration network and eVirginia (eVA) system. Payment methods include ACH, Virtual Card, or Paper Check with Net 15 to Net 35 terms, and firms may offer early payment discounts. Acceptance of VCU's General and Specific Contractual Provisions and the Master Agreement is required. The response form must be executed by an authorized officer or signatory, with the electronic signature serving as a binding commitment. VCU reserves the right to conduct additional negotiations, and no award will be made without a fully executed Master Agreement.
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Text version
RFP Open Enrollment Response Form
Dental School Equipment, Casework, Goods, and ServicesATTACHMENT A
RFP #: 218814894AZ
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 the 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. Each applicable box below must be checked to confirm acceptance of the conditions of award..
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 (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 |
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 dental casework, equipment, goods, 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 below is fully authorized to bind the Firm with respect to the goods, services, pricing, terms and conditions listed herein. No award will be made without a fully executed Master Agreement.
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