ESBD_494116_1772663630113_3202600075 - Form 1 Execution of Response.docx
DOCX document 33 KB Posted
- Attached to
- Trinity IT Closet HVAC
- Solicitation number
- 3202600075
- Issued by
- Travis County, Austin City, Texas
About this file
This is an execution of response form for a Request for Proposal (RFP) issued by the Texas Workforce Commission (TWC). The form requires respondents to acknowledge receipt of all TWC terms and conditions, confirm agreement to provide the items or services described in the RFP, and commit to abiding by all specified terms and conditions. Respondents must complete their organization information, including name, mailing address, billing address, contact details, Employer Identification Number (EIN), and Texas Identification Number. The form requires respondents to either confirm no exceptions to the stated terms and conditions or to identify and detail any exceptions with corresponding proposed language, along with a statement of whether they wish to remain under consideration if their exception is denied. All responses must be signed by an authorized representative with the date and printed name.
The form includes provisions for claiming state procurement preferences under Texas Administrative Code 34 TAC 20.38, allowing respondents to indicate eligibility for various preference categories including service-disabled veteran ownership, Texas-produced goods or services, agricultural products, native vegetation, recycled materials, energy-efficient products, and other environmentally sensitive or economically beneficial products and services. Respondents must provide an EIN prior to contract award, as this federal tax identification number is required to minimize identity theft. The Texas Identification Number, assigned by the Texas Comptroller of Public Accounts, is used for processing payment for goods and services. The form specifies that any exceptions not identified in detail at the time of submission will not be considered during the evaluation process.
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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 1, 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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