COSTARS Program Election to Participate Form.pdf
PDF 262 KB Posted
- Attached to
- Sign Language Interpretation and Other Services
- Solicitation number
- 6100058867
- Issued by
- Adams County, Pennsylvania
About this file
The document is an Election to Participate Form for the COSTARS Program, a cooperative purchasing program administered by the Pennsylvania Department of General Services (DGS). Under the COSTARS program, vendors awarded state or local government contracts agree to extend the same pricing and contract terms to registered COSTARS members who elect to participate. The form outlines the administrative fees vendors must pay based on business size and certification status. It requires the vendor's corporate name, signature, and date, as well as the contract name and parent contract number.
The related state and local contract opportunity is for sign language interpretation, Video Remote Interpretation (VRI), and Communication Access Realtime Translation (CART) services for all Commonwealth of Pennsylvania using agencies. The contract is being issued by the DGS Issuing Office, and the services are required across the entire Commonwealth.
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Text version
COSTARS PROGRAM
ELECTION TO PARTICIPATE FORM
If awarded a Contract, our firm agrees to sell the awarded items/services at the same prices and/or discounts, and in accordance with the contractual terms and conditions, to registered COSTARS Members who elect to participate in the contract.
Our firm also agrees to pay the applicable Administrative Fee at the beginning of each contract year and/or upon each contract renewal date:
$166 for a Department of General Services-verified Small Diverse Business or
Small, Veteran Business Enterprise
$500 for a Department of General Services Self-Certified Small Business
$1,500 for all other businesses
If you are a Department of General Services Self-Certified Small Business or Department of General Services-verified Small Diverse Business, you must submit a copy of your active Small Business Contracting Program certificate with your bid response.
Rev. 04-15-2022
Corporate or Legal Entity Name:
Signature:
Date:
Contract Name:
Parent Contract Number:
| Corporate or Legal Entity Name: |
| Signature: |
| Date: |
| Contract Name: |
| Parent Contract Number: |
| Text1: |
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