ESBD_520882_1779996376908_Form 01-Execution of Offer.pdf
PDF 90 KB Posted
- Solicitation number
- 3202600155
- Issued by
- Texas
About this file
This is an Execution of Offer form for the State of Texas, specifically for Procurement #3202600155, which constitutes an open enrollment solicitation for Orientation and Mobility Services. The form serves as the official application document through which organizations agree to provide the services outlined in the solicitation materials. By executing this form, applicants commit to compliance with all applicant certifications detailed in section 1.6 of the solicitation document. The form requires authorized signatory approval with date of signature and printed name verification.
The form requires applicants to provide complete organizational information including the legal entity name, mailing address, city, state and zip code, phone number, and email address. Applicants must submit either their Texas Identification Number (TIN) or Federal Tax I.D. Number, specify their business organization type (such as sole proprietorship, partnership, non-profit corporation, or for-profit corporation), and place the signed Execution of Offer form behind Form 1 in the Enrollment Packet as part of their submission.
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Form 1- EXECUTION OF APPLICATION
Procurement # 3202600155
(Open Enrollment for Orientation and Mobility Services)
By signing below Applicant agrees to provide the services described in this open enrollment solicitation, and to the Applicant Certifications in sections 1.6 of this solicitation document.
Place your signed Execution of Offer form behind FORM 1 in the Enrollment Packet.
Authorized Signatory
Date Signed
Printed Name
Instructions
1. Provide complete organizational information in the spaces provided below.
2. 2. Enter either your organization’s Texas Identification Number or Federal Tax I.D. Number.
3. 3. Provide your business organization type, e.g. sole proprietorship, partnership, non-profit corporation, for profit corporation etc.
Legal Entity Name
Mailing Address
City, State & Zip Code
Phone No.
E-Mail Address
Texas Identification Number (TIN)
Federal I.D. Tax Number
Business Organization Type
File details come from the government source that posted it. Updated .