ATTACHMENT C - Vendor Information Form.docx
DOCX document 57 KB Posted
- Solicitation number
- 23-0004-CF
- Issued by
- Wisconsin
About this file
This Vendor Information Form is required by the University of Wisconsin - Eau Claire for bids submitted in response to a bus transportation contract opportunity for the 2023 NCUR Conference scheduled for April 2023. All three pages of the form must be completed and submitted with the bid response. The form requires vendors to provide comprehensive company and contact information, including details for contract renewals and problems, sales representatives, ordering and expediting, returns, and invoice processing. Additionally, vendors must designate an Affirmative Action contact and a Supplier Diversity Reporting contact with complete contact details and addresses.
The form requires vendors to indicate their certification status under Wisconsin Statutes 560.035, 560.0335, and 560.036, specifically whether they are certified as a Minority Business Enterprise (MBE), Work Center (WC), Disabled Veteran-Owned Business (DVB), or Woman-Owned Business Enterprise (WBE). Vendors must also self-identify their business classification in accordance with Public Law 95-507 and the Small Business Administration criteria, with options including Large Business, Small Business, Veteran-Owned Small Business, Service-Disabled Veteran-Owned Small Business, HUBZone, Small Disadvantaged Business, and Woman-Owned Small Business. Finally, vendors must certify whether materials covered in their bid were manufactured in whole or in substantial part within the United States, in compliance with Wisconsin Statutes S. 16.754, which prioritizes American-made products when bids are substantially equal.
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Other files
| File | Type | Posted |
|---|---|---|
| 23-0004-CF_BUS TRANSPORTATION FOR NCUR_RFB.pdf | ||
| ATTACHMENT D - Client Reference List.docx | DOCX document | |
| Appendix 1_Route Maps.pdf | ||
| ATTACHMENT E - Equipment List.docx | DOCX document | |
| 23-0004-CF NCUR Bus Transportation_QandA.pdf | ||
| DOA-3681_SupplementalStandardTermsandConditions.pdf | ||
| ATTACHMENT B - Itemized Bid List.xlsx | XLSX spreadsheet | |
| ATTACHMENT A - Bidder Response Form.docx | DOCX document | |
| DOA-3054_StandardTermsandConditions_RFB-RFP.pdf |
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Text version
Attachment C – Vendor Information Form VENDOR NOTE: ALL THREE (3) PAGES OF THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR BID RESPONSE Company and Contact Information Company Name:
Company Website
Contact for questions regarding this Bid Name:
Telephone:
Email:
Contract Renewals / Problems Name:
Telephone:
Email:
Sales Representative Name:
Telephone:
Email:
Ordering / Expediting Name:
Telephone:
Email:
Returns Name:
Telephone:
Email:
VENDOR INFORMATION FORM CONT.
Invoice Information Name:
Telephone:
Email:
Affirmative Action (see Section 17 in Standard Terms and Conditions) Name:
Address:
City/State/Zip:
Telephone:
Email:
Supplier Diversity Reporting (see Section 2.9) Name:
Address:
City/State/Zip:
Telephone:
Email:
VENDOR INFORMATION FORM CONT.
| 2. | In accordance with Wisconsin Statutes 560.035, 560.0335 and 560.036, indicate below if you are a Wisconsin certified Minority Business Enterprise (MBE), Work Center (WC), Disabled Veteran-Owned Business (DVB) or Woman-owned Business Enterprise (WBE) (see websites: |
| https://wisdp.wi.gov/Home.aspx or http://stateuseprogram.wi.gov/section.asp?linkid=1424&locid=65). | |
| ____ Minority (MBE) | ____ Work Center (WC) ____Disabled Veteran-Owned Business (DVB) |
| ____ Woman Owned Business Enterprise (WBE) | ___ Not applicable |
(If no answer is indicated above, we will assume that you are none of the above when making the award.)
3. Pursuant to Public Law 95-507, indicate which of the following classifications apply to your organization. All vendors are considered Large Business unless otherwise indicated (see website: www.sba.gov/). (Check √ all that apply.)
____________ LARGE BUSINESS (LG)
____________ SMALL BUSINESS (SB)
____________ VETERAN OWNED SMALL BUSINESS (VOSB)
____________ SERVICE-DISABLED VETERAN OWNED SMALL BUSINESS (SDVOSB)
____________ HISTORICALLY UNDER-UTILIZED BUSINESS ZONE (HUBZONE)
____________ SMALL DISADVANTAGED BUSINESS (SDB)
____________ WOMAN-OWNED SMALL BUSINESS (WOSB)
4. AMERICAN MADE: Wisconsin Statutes S. 16.754, directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. “Substantially equal” means when bids are tied or proposal scores are equal. Indicate whether the material covered in your bid/proposal were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States.
____________ YES ____________ NO ____________ UNKNOWN
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