Attachment E - Contractor's License Certification Form - Page 1.docx

This is a Contractor's License Certification Form for RFx 3000026501, an Elevator Maintenance and Repair Service contract opportunity issued by the State of Louisiana Department of Transportation and Development (DOTD). The form requires bidders to provide their company name, address, city, state, and zip code, along with documentation of required licenses specific to elevator and dumbwaiter specialty work. Bidders or their authorized representatives must sign the certification form and provide their typed or printed name, title, and date of submission. The form explicitly states that failure to complete and return this certification with the bid submission may result in bid rejection, making license verification a mandatory compliance requirement for participation in this procurement.

No additional information regarding pricing terms, set-asides, incumbent contractors, funding sources, contract duration, or renewal options is contained within this certification form. The document serves solely as a compliance verification tool to ensure that bidding contractors maintain the appropriate licensing credentials necessary to perform elevator maintenance and repair services as specified in the contract opportunity.