ESBD_473696_1765226343910_32302600039 - Form 1 Execution of Response.docx
DOCX document 27 KB Posted
- Attached to
- CCRC Backup Generator
- Solicitation number
- 3202600039
- Issued by
- Travis County, Austin City, Texas
About this file
This is a Form 1 Execution of Response document for the Texas Workforce Commission (TWC) related to a CCRC Backup Generator procurement opportunity in Texas. The form serves as the official response submission vehicle for vendors interested in bidding on this contract opportunity. Respondents must complete all required information, including their organization details, contact information, and authorization signatures, while acknowledging receipt of all TWC terms and conditions outlined in the Request for Proposal and its attachments.
The document requires respondents to disclose their Employer Identification Number and Texas Identification Number for payment processing purposes, and provides the opportunity to claim applicable state preferences under 34 TAC 20.38, including preferences for Texas-based businesses, service-disabled veteran-owned enterprises, agricultural products, environmentally sensitive materials, and other designated categories such as recycled goods, energy-efficient products, and supplies from economically depressed areas. Respondents must also identify any exceptions to the TWC's stated terms and conditions at the time of submission, with detailed justification and proposed alternative language, or confirm their willingness to proceed without exceptions. Any exceptions not clearly documented with the initial response will not be considered for evaluation.
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Text version
FORM 1 – EXECUTION OF RESPONSE
Respondent must complete the following information, sign, and return this page. By signing below, Respondent acknowledges receipt of all TWC terms and conditions in the RFP—including Attachment 1, agrees to provide the items/services described in this RFP, and agrees to abide by all TWC Terms and Conditions as specified in this RFP and in any Contract resulting from an award.
Any exceptions taken to the Terms and Conditions as set forth in this document must be identified in detail and accompany your response. Any exceptions not identified in detail at the time your response is submitted will not be considered. Please complete the following:
⬜ No exceptions taken OR ⬜ Yes, exception taken due to (state your reason(s)):
| Solicitation Document |
| Solicitation Section |
| Solicitation Language to which Exception is Taken |
| Basis of Exception |
| Respondent's Proposed Language |
| Still Want to be Considered for Contract Award if Exception is Denied? (State "Yes" |
or "No")
Please attach additional forms if additional space is needed. Please label any relevant pages with Form 2, and the RFP Number.
Signature of person authorized to make this agreement Date Signed
Printed name of person signing above
RESPONDENT INFORMATION
Name of Respondent:
Mailing Address:
Billing Address (if different from above):
City, State & Zip Code:
Phone No./Fax No.:
E-Mail Address:
Employer Identification No.:
Texas Identification No.:
In an effort to minimize identity theft, every company/individual MUST have an Employer Identification Number (EIN), also known as a federal tax identification number prior to award of a contract. For information on obtaining your EIN, you may call 800-829-4933 or visit the following website: https://www.irs.gov/businesses/small-businesses-self-employed/employer-id-numbers The Texas Identification Number is the payee identification number assigned and used by the Texas Comptroller of Public Accounts to process payment for goods/services. Enter this number in the space provided above if number is not pre-printed. If this number is not known, please visit http://www.window.state.tx.us/taxinfo/taxforms/ap-152.pdf to set up a Texas Identification Number.
⬜ Check here if you are a sole ownership or partnership Check below to claim a preference under 34 TAC § 20.38:
| ⬜ | Goods produced or offered by a Texas bidder that is owned by a Texas resident service-disabled veteran. |
| ⬜ | Goods produced in Texas or offered by a Texas bidder that is not owned by a Texas resident service-disabled veteran. |
| ⬜ | Agricultural products grown in Texas |
| ⬜ | Agricultural products offered by Texas bidder |
| ⬜ | Services offered by a Texas bidder that is owned by a Texas resident service-disabled veteran |
| ⬜ | Services offered by a Texas bidder that is not owned by a Texas resident service-disabled veteran |
| ⬜ | Texas Vegetation Native to the Region |
| ⬜ | USA produced supplies, materials or equipment |
| ⬜ | Products of persons with mental or physical disabilities |
| ⬜ | Products made of recycled, remanufactured, or environmentally sensitive materials including recycled steel |
| ⬜ | Energy Efficient Products |
| ⬜ | Rubberized asphalt paving material |
| ⬜ | Recycled motor oil and lubricants |
| ⬜ | Products produced at facilities located on formerly contaminated property |
| ⬜ | Products and services from economically depressed or blighted areas |
| ⬜ | Vendors that meet or exceed air quality standards |
| ⬜ | Recycled or Reused Computer Equipment of Other Manufacturers |
| ⬜ | Foods of Higher Nutritional Value |
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