DOA-3428 Public or Legal Notice Order.docx

85 KB Posted

Attached to
Class 5 Legal/Public Notices: Rate Certification Program
Contract number
505ENT-M25-RATECERT-00
Issued by
Wisconsin

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This document is a Public or Legal Notice Order form (DOA-3428) from the State of Wisconsin Department of Administration, Bureau of Procurement, operating under Wisconsin Statute 16.75. The form is associated with Statewide Contract 505ENT-M25-LEGALNOTIC-01 and serves as a standardized template for state agencies to place public notices and legal advertisements in newspapers throughout Wisconsin.

The document functions as an order form for publication services rather than a traditional goods or services contract. It establishes a systematic process for state agencies to publish required legal notices, employment advertisements, bid announcements, public meeting notices, and other official communications in newspapers. The form includes fields for specifying publication dates, format requirements (single column, display, or other), logo preferences including the State Coat of Arms, and section placement within newspapers. Agencies must provide billing information, contact details, and can request tear sheets or affidavits with invoices for verification purposes. The contract vehicle streamlines the procurement process for legal notice publications across all Wisconsin state agencies under a single statewide agreement.

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State of Wisconsin Department of Administration

s. 16.75 Wis. Stats.

DOA-3428 (R12/2015)

State Bureau of Procurement 101 E. Wilson Street, 6th Floor Madison, WI 53707-7867

Statewide Contract:

505ENT-M25-LEGALNOTIC-01

Public or Legal Notice Order Instructions: Tab to each section and complete the information indicated. Save a copy of the order form to your computer. Email or fax this form with your agency’s notice of publication. If ad proof is required, please indicate in the Special Instructions section.

1.TO: newspaper INFORMATION
No. of Pages to Fax including this page:
Newspaper Name
Newspaper Contact Name
Newspaper Contact Email Address
Newspaper Area Code & Phone
Fax
Address: Street or PO Box
City/State/Zip+4

2. FROM: AGENCY INFORMATION

State Agency Name
Billing Reference No. (Purchase Order / Account #)
Advertisement Contact Name
Advert. Contact Area Code & Phone
Advert. Fax
Billing Contact Person Name
Billing Contact Area Code & Phone
Billing Fax
Billing Address: Street or PO Box
Billing City/State/Zip + 4
3.PUBLICATION DATE(S)
Enter DAY(S) and DATE(S) advertisement should appear in the newspaper.
DAY
DATE (mm/dd/ccyy)
First Insertion
Second Insertion
Third Insertion
|_| Tear Sheet Required with Invoice
|_| Affidavit Required with Invoice

4. FORMAT

|_| Single column |_| Display |_| Other, specify

5. LOGO

|_| State Coat of Arms |_| None |_| Other, specify

6.PLACE AD IN FOLLOWING SECTION
These are generic classifications and may or may not appear in this newspaper. Contact the newspaper for a list of specific classifications.
|_| General
|_| Employment Ad
|_| Secretary of State
|_| Public Meeting Notice
|_| Bid / Proposals
|_| Construction Bids
|_| Other, specify
7.COMMENTS AND SPECIAL INSTRUCTIONS
Enter comments or special instructions below. This information will not be published in the newspaper.
8.TEXT
Enter the text of the notice or indicate “see attached.” Include the following at the top of each attached page: Agency name, Agency advertisement contact name, Agency advertisement contact area code and phone.

This document can be made available in alternate formats to individuals with disabilities upon request.

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