BRDCOM-S3669-Vendor-Information-Response.pdf

This is a Vendor Information Response form used by the Nevada State Board of Dental Examiners for lobbying services procurement. The form serves as a standardized template that vendors must complete and submit as part of their proposal to provide lobbying services to the state agency. If a proposal includes subcontractors, the form must be completed for each subcontractor as well.

The form requires vendors to provide comprehensive company and contact information, including company name, street address, telephone numbers, and email address for primary contact and contract negotiations purposes. Vendors must also submit an overall company profile and demonstrate appropriate Nevada business licensing in compliance with Nevada Revised Statutes (NRS 80.010 and NRS 76). Additionally, vendors must disclose any prior experience with State of Nevada agencies, current or former employment relationships with Nevada state employees or recent former employees, and any prior or ongoing contractual issues including contract failures, breaches, civil or criminal litigation, or pending claims occurring within the past six years that could adversely affect performance. The form requires certification regarding lobbying activities and indemnification, along with designation of payment authorization for procurement cards and identification of the individual authorized to bind the organization with a required signature.