Authorized Agent.pdf
PDF 122 KB Posted
- Attached to
- One Waterfront Place Dry Coolers Replacement
- Solicitation number
- RFB202690000664
- Issued by
- Mingo County, West Virginia
About this file
This document is an Authorized Agent form for a Request for Bids, specifically a West Virginia state or local government procurement document. The form requires potential bidders to complete detailed contact and licensing information, including company name, address, phone number, contact details, and West Virginia Contractor's License number. The form includes a section for acknowledging any addenda to the bid document, with space to record the date and number of each addendum received.
The form emphasizes that the West Virginia Contractor's License must be issued in the exact name of the bidder and must be current at the time of bid submission. The bidder agrees to furnish all labor, materials, equipment, and services as specified in the Request for Bids, and is limited to communications only with the Procurement Officer. Additional fields include Federal Employer Identification Number (FEIN), email contact, and provisions for a separate contract signatory if different from the authorized agent.
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Text version
Printed Name of Authorized Signatory:
Addenda No.
Addenda
Printed Name of Contract Signatory if Different than Above:
Email of Contract Signatory:
Date Addendum Issued
Date Addendum Issued
Signatory
Signatory
Signatory
Date Addendum Issued Addenda No.
Authorized Agent The undersigned offers and agrees to furnish all labor, materials, equipment, and services as specified in this Request for Bids at the price as stated, subject to the terms and conditions of this Request for Bids. Signatory also absolves communications with anyone other than the Procurement Officer.
Address
Addenda No.
WV Contractor's License Number:
West Virginia Contractor's License MUST be issued in the exact name of Bidder and Bidder Must be licensed at the time of submission of bid.
Firm/Company Name:
Email:
Signature:
FEIN:
Phone Number:
Sheet1
File details come from the government source that posted it. Updated .