Attachment D.4 - Proposal Intent Response Form.docx

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CMS Auditorium Chair Procurement
Solicitation number
75FCMC20R0026
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Proposal Intent Response Form CMS Auditorium Chair Procurement Attachment D.4

RFP# 75FCMC20R0026

PROPOSAL INTENT RESPONSE FORM

Please review the attached request for proposal. Furnish the information requested below and return this form as soon as possible but not later than August 10, 2020. Your expression of intent is not binding, nor does failure to return this sheet preclude you from submitting a proposal. However, CMS urges you to return the form with the information completed accurately. The purpose of the form is to assist CMS in planning for proposal evaluation.

[ ] We intend to submit a proposal as a ___Prime Contractor, ___Subcontractor ____Joint Venture

COMPANY NAME: __________________________________________

COMPANY ADDRESS: __________________________________________

AUTHORIZED SIGNATURE: __________________________________________

TYPED NAME AND TITLE: __________________________________________

TELEPHONE NUMBER: __________________________________________

DATE: __________________________________________

Please return this completed form electronically no later than (8/10/2020) to:

Jean Sillon, Contract Specialist Email:jean.sillon@cms.hhs.gov cc: Jennifer Davis, Contracting Officer Email: jennifer.davis@cms.hhs.gov

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