Attachment I, Acknowledgement of Order Form.pdf
PDF 158 KB Posted
- Attached to
- Medium and Heavy Trucks ITB
- Solicitation number
- ITB-16963
- Issued by
- Florida
About this file
This is an Acknowledgement of Order Form attachment for a State Term Contract for Medium and Heavy Trucks established by the Florida Department of Management Services. The form serves as a required documentation mechanism for contractors to confirm receipt and processing of purchase orders issued by state customers under State Term Contract Number 25101600-26-STC. Contractors must accurately complete and submit this form to the ordering customer without prompting, providing specific details including the purchase order number, order receipt date, manufacturer production number(s), and anticipated delivery date. The form requires contractors to select between two notification types: Order Confirmation Notification for standard orders placed with manufacturers, or Manufacturer's Last Order Date Notification when a commodity is no longer available from the manufacturer. Failure to submit completed acknowledgement forms may result in default proceedings and contract termination.
The form emphasizes contractor responsibility for timely submission and accurate documentation of all order details and dates. Contractors must notify the Florida Department of Management Services Contract Manager when a Manufacturer's Last Order Date occurs, as improper notification of unavailable products may constitute grounds for purchase order or contract termination. All correspondence related to orders must reference either the purchase order number or manufacturer production number(s). The form includes sections for both the ordering customer's and contractor's contact information, signature, and date of acknowledgement, with provisions for additional comments as needed.
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Text version
Acknowledgement of Order Form Page 1 of 2
ATTACHMENT I
ACKNOWLEDGEMENT OF ORDER FORM
Note to Contractor: This form must be accurately and completely completed with specific information, numbers, dates, signature, etc. Adjustments to the form or alternate forms are not acceptable. Submission of the Acknowledgement of Order Form is to be the responsibility of the Contractor without prompting or notification by the Contract Manager or Customer. Repeated failures by the Contractor to submit completed Acknowledgement of Order Forms to the ordering Customers may be cause for default proceedings and Contract termination.
ORDERING CUSTOMER: Click or tap here to enter text.
CONTACT PERSON: Click or tap here to enter text.
PHONE NUMBER: Click or tap here to enter text. EMAIL ADDRESS: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
CITY: Click or tap here to enter text. STATE: FL ZIP: Click or tap here to enter text.
CONTRACTOR MUST SELECT THE CORRECT NOTIFICATION TYPE BELOW
(SELECT ONLY ONE TYPE)
☐ ORDER CONFIRMATION NOTIFICATION:
Purchase Order Number Click or tap here to enter text. was received on Click or tap here to enter text..
In accordance with State of Florida State Term Contract Number 25101600-26-STC (Medium and Heavy Trucks), Scope of Work, Transportation and Delivery section, the order was placed with the Manufacturer on Click or tap here to enter text.
and assigned the following Manufacturer’s Production Number(s): Click or tap here to enter text..
We anticipate Delivery to your Delivery Location on or about Click or tap here to enter text..
☐ MANUFACTURER’S LAST ORDER DATE NOTIFICATION:
Purchase Order Number Click or tap here to enter text. was received on Click or tap here to enter text..
In accordance with State of Florida State Term Contract Number 25101600-26-STC (Medium and Heavy Trucks), Scope of Work, Section 16, Manufacturer’s Last Order Date, Production Notification, and Representative Model Replacement, ordered Commodity Code(s) Click or tap here to enter text. has/have a Manufacturer’s Last Order Date of Click or tap here to enter text. and is/are not currently available. Per the Term Contract terms and conditions, we notified the Florida Department of Management Services Contract Manager of the Manufacturer’s Last Order Date on Click or tap here to enter text., which can be verif ied by the Contract Manager.
Note: The Contractor must select the Order Confirmation Notification option above unless they have reported a specific Manufacturer’s Last Order Date per State Term Contract Number 25101600-26-STC (Medium and Heavy Trucks), Scope of Work, Manufacturer’s Last Order Date, Production Notification, and Representative Model Replacement section, to the Department’s Contract Manager. Should the Contractor improperly notify a Customer or the Department of a Manufacturer’s Last Order Date, it may be grounds for the termination of the Purchase Order or Contract.
For any correspondence, please reference your Purchase Order Number or the Production Number(s).
CONTRACTOR: Click or tap here to enter text.
PHONE NUMBER: Click or tap here to enter text. EMAIL ADDRESS: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
Acknowledgement of Order Form Page 2 of 2
CITY: Click or tap here to enter text. STATE: Click or tap here to enter text.ZIP: Click or tap here to enter text.
SIGNATURE: _____________________________________________________ Date: ____________________
ADDITIONAL COMMENTS (IF ANY): Click or tap here to enter text.
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