ATTACHMENT B - BID FORM - Nursing Covers.pdf
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- Attached to
- Nursing Covers
- Solicitation number
- BPM058176
- Issued by
- Maryland
About this file
This is a Bid Form attachment for an Invitation for Bids issued by the Maryland Department of Health (MDH), Prevention and Health Promotion Administration, WIC Program, to procure nursing covers for distribution to breastfeeding WIC participants. The solicitation number is BPM058176. Bidders are required to supply 3,850 nursing covers, with pricing provided in the specified format on the form. The bid form must be completed exactly as provided without amendments, alterations, or blank items, with failure to comply resulting in rejection as non-responsive. Bidders must submit a current, signed W-9 form with accurate payee address information along with the completed bid form and authorized signature, certifying the accuracy of all pricing and agreement to perform services as specified if awarded.
The all-inclusive total bid cost for the complete supply and delivery of 3,850 nursing covers shall not exceed $50,000. Bidders must provide comprehensive company information including printed name and title, company name and address, service performance location(s), FEIN, eMMA number, SBR number and expiration date, telephone, fax, and email. All pricing must be all-inclusive and include the complete cost of delivery. No specific response date, due date, site visits, bidders' meetings, award date, or contract term information is included in this bid form attachment.
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Text version
ATTACHMENT B – BID FORM
Nursing Covers
SOLICITATION NUMBER – BPM058176
The Bid shall contain all price information in the format specified on these pages. Complete the Bid Form only as provided in the Bid Form format. Do not amend, alter or leave any items blank on the Bid Form. Failure to adhere to any of these instructions may result in the bid being determined non-responsive and rejected by the Department.
ITEM QUANTITY
(Each)
PRICE SUB TOTAL
Nursing Covers
3,850
X
TOTAL BID COST
BIDS MUST BE ALL INCLUSIVE AND INCLUDE ALL COST OF DELIVERY
The all-inclusive Total Bid Cost shall not exceed $50,000
Printed Name and Title: __________________________________________________________________________________________________
Company Name: ___________________________________________________________________________________________________________
Company Address: _________________________________________________________________________________________________________
Location(s) from which services will be performed (City/State): _______________________________________________________
FEIN: _______________________________________________________________________________________________________________________ eMMA #: ___________________________________________________________________________________________________________________
SBR #and Expiration Date: ______________________________________________________________________________________________
Telephone: (_____) _________-- __________________________
Fax: (_______) ________--____________________________
E-mail: _____________________________________________________________________________________________________________________
A current, signed W-9 reflecting the accurate payee address must be submitted with this Bid Form.
Submitted By - Authorized Signature: _____________________________________________________ Date: _______________________________________ With this signature, Bidder certifies that all pricing is accurate and agrees to perform all services as specified in this solicitation if awarded.
ATTACHMENT B – BID FORM
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