ATTACHMENT J_CERTIFICATION OF RECALL OR SAFETY ISSUES.docx
DOCX document 36 KB Posted
- Attached to
- NX EQ SURGICAL TISSUE MANAGEMENT SYSTEM
- Solicitation number
- 36C10X26R0027
About this file
This is a Certification of Recall or Safety Issues form that vendors must complete and submit with their quotes in response to Solicitation Number 36C10X26R0027 for the NX EQ Surgical Tissue Management System, issued by the Department of Veterans Affairs Strategic Acquisition Center Frederick.
The form requires the authorized representative of the submitting company to certify on behalf of their organization that the medical equipment being quoted: (1) does not have any outstanding recalls; (2) does not have any known safety issues; (3) complies with all relevant regulations and standards for medical equipment; and (4) has been thoroughly checked for compliance with safety and performance standards. The form must be completed in its entirety, signed by an authorized company representative with their name, title, signature, and date provided, and submitted along with the vendor's quote. Vendors are cautioned that false or misleading information in the certification may result in disqualification from the solicitation process and other legal penalties.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10X26R0027 0003.docx | DOCX document | |
| 36C10X26R0027 0002_1.docx | DOCX document | |
| 36C10X26R0027 Amendment Questions and Answers.docx | DOCX document | |
| ATTACHMENT H - RFQ QUESTIONS - NX EQ SURGICAL TISSUE MANAGEMENT SYSTEM.xlsx | XLSX spreadsheet | |
| ATTACHMENT A_PRICE COST SCHEDULE NX EQ SURGICAL.TISSUE MANAGEMENT SYSTEM.xlsx | XLSX spreadsheet | |
| ATTACHMENT F - PAST PERFORMANCE REFERENCE NX EQ SURGICAL TISSUE MANAGEMENT SYSTEM.docx | DOCX document | |
| ATTACHMENT E - REPORTING TOOL - NX EQ SURGICAL TISSUE MANAGEMENT SYSTEM.xlsx | XLSX spreadsheet | |
| S02 36C10X26R0027 SURGICAL TISSUE MANAGEMENT SYSTEM REQUEST FOR PROPOSAL.docx | DOCX document |
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Text version
Attachment J Certification of Recall or Safety Issues Instructions to Quoters:
1. Complete all fields in the certification form.
2. Ensure that the form is signed by an authorized representative of the company.
3. Submit the completed form along with your quote.
Certification of No Outstanding Recalls or Safety Issues Solicitation Number: 36C10X26R0027 Requirement for: NX EQ SURGICAL TISSUE MANAGEMENT SYSTEM
Company Unique Entity Identifier (UEI): __________________________________________
Certification:
By signing below, I, the undersigned, certify on behalf of the company identified by the UEI above, the medical equipment quoted in response to the above-referenced solicitation:
1. Does not have any outstanding recalls.
2. Does not have any known safety issues.
3. Complies with all relevant regulations and standards for medical equipment.
4. Has been thoroughly checked for compliance with safety and performance standards.
I understand that any false or misleading information provided in this certification may result in disqualification from the solicitation process and other penalties as permitted by law.
Authorized Representative:
Name: __________________________________________ Title: __________________________________________ Signature: __________________________________________ Date: __________________________________________
File details come from the government source that posted it. Updated .