Attachment-F.-Bidder-Offeror-Information-Sheet.pdf
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- Attached to
- R00B6600216 - Vehicle Equipment Adaptation Prescription Agreement (VEAPA) for DORS Client (CS #26-08)
- Solicitation number
- BPM057733
- Issued by
- Maryland
About this file
This is a Bidder/Offeror Information Sheet form (effective July 2024) for the State of Maryland, Division of Rehabilitation Services (DORS), related to solicitation R00B6600216 for Vehicle Equipment Adaptation Prescription Agreement (VEAPA) services. The form is designed to collect essential contractor information and certifications from bidders seeking to provide vehicle adaptation services for a DORS client with functional limitations due to disabilities. The solicitation requires qualified contractors to furnish and install all necessary adaptive equipment tailored to the individual client's needs.
The information sheet requires bidders to provide company identification details including legal name, street address, Federal Employer Identification Number (FEIN), and eMM ID Number, along with confirmation of business registration status with the State of Maryland. The form also requires documentation of Small Business Enterprise (SBE), Minority Business Enterprise (MBE), and Veteran-Owned Small Business Enterprise (VSBE) certifications where applicable, with bidders holding dual certifications required to select a single category for the solicitation. Additionally, the form mandates submission of primary contact and authorized signatory information with corresponding telephone numbers and email addresses, along with an authorized signature committing the bidder to the proposal terms.
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Text version
Attachment F. Bidder/Offeror Information Sheet effective date: July 2024
Bidder/Offeror
Company Name
Street Address
City, State, Zip Code
Contractor Federal Employer Identification Number
(FEIN)
Contractor eMM ID Number As of the Bid/Proposal submission date, are you registered to do business with the State of Maryland?
SBE / MBE/ VSBE Certification
SBE Number:
Expiration Date:
VSBE Number:
Expiration Date:
MBE Number:
Expiration Date:
Categories to be applied to this solicitation (dual certified firms must choose only one category).
Bidder/Offeror Primary Contact
Name
Title
Office Telephone Number (with area code)
Cell Telephone Number (with area code)
E-mail Address
Authorized Bid/Proposal Signatory
Name
Title
Office Telephone Number (with area code)
Cell Telephone Number (with area code)
E-mail Address
Signature to authorized commit of the Bidder/Offeror to its Bid/Proposal
Attachment F. Bidder/Offeror Information Sheet
Attachment F. Bidder/Offeror Information Sheet effective date: July 2024
File details come from the government source that posted it. Updated .