Exhibit A-2-Bidders Profile.docx
DOCX document 402 KB Posted
- Attached to
- Infrared Illuminators
- Solicitation number
- AW235475
- Issued by
- Thurston County, Washington
About this file
This is a Bidder's Profile form (Exhibit A-2) for Washington State Patrol (WSP) competitive solicitation No. AW235475 for Infrared Illuminators. The form requires bidders to submit their business information to be considered for the contract opportunity to supply weapon mounted infrared illuminators.
The form collects essential vendor information including legal business name, address, UBI number, taxpayer identification number, and certification status for minority/women-owned businesses, Washington State small businesses (with specific revenue thresholds for micro, mini, and small business classifications), and veteran-owned businesses. It requires contact information for contract management, including an authorized representative and contract administrator, as well as ordering/sales points of contact. Bidders must provide two commercial or government references demonstrating similar scope of work experience, with completed forms to be returned to the procurement coordinator at Andrew.Westerfield@wsp.wa.gov.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Appendix A WSP Competitive Terms & Conditions.pdf | ||
| Exhibit A-1-Bidders Certification.docx | DOCX document | |
| Exhibit C - Bid Price.xlsx | XLSX spreadsheet | |
| Exhibit D - Contract.pdf | ||
| Exhibit E Diverse Business Inclusion Plan.docx | DOCX document | |
| IFB - AW235475 - Infrared Illuminators.pdf | ||
| Amendment 1.pdf | ||
| Exhibit B - Performance Requirements.docx | DOCX document |
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Text version
Supply Section 8543 Armstrong Road SW, Tumwater, WA 89512
EXHIBIT A-2 – BIDDER’S PROFILE
| Competitive Solicitation: |
| No. AW235475 – Infrared Illuminators |
| Bidder: |
| ___________________________ |
Type/print full legal name of Bidder
BIDDER INFORMATION
Legal name of Bidder:
Address of Bidder:
Note: This information must match the information from Bidder’s Business License.
Business Name Address City, State, Zip Code
Bidder’s Washington State Department of Revenue Registration Number/Unified Business Identifier (UBI) Number:
Note: A nine digit UBI number is assigned to each registered businesses in Washington.
Taxpayer Identification No. (TIN):
Note: Your TIN will be either a number issued by the IRS (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (i.e., your Social Security Number). Do Not provide a Social Security Number.
| Is your firm certified as a minority or woman owned business with the Washington State Office of Minority & Women’s Business Enterprises (OMWBE)? |
| Yes |_| No |_| |
If yes, provide Bidder’s MWBE certification no.: ____________
Is your firm a self-certified Washington State Small Business?
Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Washington State Small Business.
Note: Regardless of size, a qualifying business must be owned and operated independently from all other businesses. In regard to size, the gross revenue thresholds, as reported on Bidder’s tax returns, are as follows:
· Microbusiness: Annual gross revenue of less than one million dollars.
· Minibusiness: Annual gross revenue of more than one million dollars, but less than three million dollars.
· Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.
Yes |_| No |_| If yes, provide the location for Bidder’s principal place of business:
Street Address City, State, Zip Code If yes, what is your business size (based on annual gross revenue)?
| Microbusiness | |_| |
| Minibusiness | |_| |
| Small Business | |_| |
Is your firm certified as a Veteran-Owned Business with the Washington State Department of Veteran Affairs?
Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Certified Veteran-Owned Business.
Yes |_| No |_| If yes, provide Bidder’s WDVA certification no.: _____________
CONTRACT MANAGEMENT POINTS OF CONTACT FOR BIDDER
Authorized Representative Name:
Email:
Phone:
Contract Administrator Name:
Email:
Phone:
Address for Enterprise Services to send legal notices:
Company name:
Attn:
Address:
City/State/Zip:
Signature Authority (if awarded a contract) Name:
Title:
ORDERING/SALES POINTS OF CONTACT (expand as necessary)
| Name |
| Phone Number |
| Area of Responsibility |
REFERENCES
Provide a minimum of two (2) commercial or government references for which bidder has delivered goods and/or services similar in scope as described in the Competitive Solicitation.
REFERENCE 1
Company Name:
Contact:
Phone:
Email:
REFERENCE 2
Company Name:
Contact:
Phone:
Email:
Return this Bidder’s Profile to Procurement Coordinator at:
Andrew.Westerfield@wsp.wa.gov
EXHIBIT A-2 – BIDDER’S PROFILE: AW235475 PAGE 1
(Rev 2023-05-15) image1.png image2.jpeg
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