Exhibit A-2-BiddersProfile.pdf
PDF 168 KB Posted
- Attached to
- White Swiss Webster Mice
- Solicitation number
- DOH26-002P
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This is a Bidder's Profile form for a competitive solicitation issued by the Washington State Department of Health (DOH) for the procurement of White Swiss Webster Mice under solicitation number DOH26-002P. The form serves as the official application document for vendors interested in bidding on this contract opportunity, which is estimated to be valued at less than $150,000. Bidders are required to complete comprehensive information including their legal business name, address, Washington State Department of Revenue registration number, and Taxpayer Identification Number. The form requests disclosure of intended subcontractors, minority or woman-owned business certification status, veteran-owned business certification, and self-certification as a Washington State Small Business with specified gross revenue thresholds for classification as a microbusiness, mini business, or small business.
The form mandates identification of contract management points of contact including an authorized representative, contract administrator, and individual responsible for receiving legal notices from Enterprise Services. Bidders must provide ordering and sales contact information and submit a minimum of three commercial or government references demonstrating prior delivery of goods or services similar in scope to the solicitation requirements. The form includes a section for indicating accepted purchasing card types, with the requirement that any associated card fees be incorporated into the unit price of the bid. Completed Bidder's Profile forms must be returned to the DOH Procurement Coordinator at bids@doh.wa.gov to be considered for contract award.
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EXHIBIT A-2 – BIDDER’S PROFILE: DOH26 – 002P WHITE SWISS WEBSTER MICE PAGE 1
(Rev 2025-08-20)
EXHIBIT A-2 – BIDDER’S PROFILE
Competitive Solicitation: No. DOH26 - 002P White Swiss Webster Mice
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.
Does Bidder intent to utilize subcontractors to perform the Contract, if awarded?
Note: If Bidder intends to utilize subcontractors, Bidder must identify Bidder’s intended subcontractors.
Yes No
If yes, provide Bidder’s anticipated subcontractor(s): ____________
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.: ____________
EXHIBIT A-2 – BIDDER’S PROFILE: DOH26 – 002P WHITE SWISS WEBSTER MICE PAGE 2
BIDDER INFORMATION
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.
Mini business: 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
Mini business
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:
Email: ________________
Signature Authority (if awarded a contract) Name:
Title:
EXHIBIT A-2 – BIDDER’S PROFILE: DOH26 – 002P WHITE SWISS WEBSTER MICE PAGE 3
ORDERING/SALES POINTS OF CONTACT (expand as necessary)
Name Phone Number E-mail Area of Responsibility
REFERENCES
Provide a minimum of three (3) 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:
REFERENCE 3
Company Name:
Contact:
PURCHASE CARDS (I.E., CREDIT CARDS)
Please indicate which types of purchasing (credit) cards are accepted (note: any card fees must be included in the unit price of the bid):
Visa Master Card American Express Discover Other:
Return this Bidder’s Profile to Procurement Coordinator at:
bids@doh.wa.gov
File details come from the government source that posted it. Updated .