Exhibit A-2-Bidders Profile.pdf

EXHIBIT A-2 – BIDDER’S PROFILE: IFB GC237479 PAGE 1

(Rev 2023-05-15)

Supply Section 8543 Armstrong Road SW, Tumwater, WA 89512

EXHIBIT A-2 – BIDDER’S PROFILE

Competitive Solicitation: No. IFB GC237479

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?

Yes No

If yes, provide the location for Bidder’s principal place of business:

EXHIBIT A-2 – BIDDER’S PROFILE: IFB GC237479 PAGE 2

BIDDER INFORMATION

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.

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:

EXHIBIT A-2 – BIDDER’S PROFILE: IFB GC237479 PAGE 3

ORDERING/SALES POINTS OF CONTACT (expand as necessary)

Name Phone Number E-mail 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:

gary.clark@wsp.wa.gov