Attachment2-Offeror_Information_Page.doc

OFFEROR’S INFORMATION PAGE

Each company shall complete this page and submit as the first page of their proposal.

Offeror’s Name (include ‘Doing Business As’ (DBA) and/or ‘Limited Liability Corporation’ (LLC) if applicable): ______________________________________________________________________________

Offeror’s Address:

Offeror’s Email and Website:

Phone Number:

Fax Number:

Dun’s Number:

Federal Tax I.D. Number:

Business Size (check all that apply):

_____ Small Business

_____ Other than Small

_____ Disadvantaged

_____ Women-Owned

_____ HUBZone

_____ Service-Disabled Veteran-Owned

_____ Women-Owned Small Business (WOSB) Eligible

Under the WOSB Program

_____ EDWOSB

_____ 8(a) Certified Small Business

I, ______________________________________________, represent that, to the best of my knowledge and belief, the information included in my offer is complete, accurate, and true.

Signature

Date