Exhibit D - Vendor Contact Information Sheet.docx
DOCX document 749 KB Posted
- Solicitation number
- DQ1 QAAA 2027000019 3
- Issued by
- Arapahoe County, Colorado
About this file
This is a Vendor Contact Information Sheet from the Colorado Department of Early Childhood (CDEC) for the Quality Improvement System (QIS) Refresh Project Support contract opportunity. The form serves as a standardized intake document requiring vendors to provide comprehensive organizational and contact information prior to contract execution. Vendors must supply their legal business name, physical and mailing addresses, federal tax identification numbers, state incorporation details, and SAM.gov Unique Entity Identification (UEI) numbers. The form requires designation of multiple primary contacts including a general point of contact for correspondence, a financial contact, an invoice contact, and the individual authorized to sign the contract on behalf of the vendor. Additionally, vendors may identify supplementary contacts who need to participate in the DocuSign signature process, with specified roles indicating whether they must sign before or after the primary signatory, receive preliminary copies, or provide approval prior to execution.
The form collects critical operational and financial information including vendor entity type classification, current or former state employee status, negotiated indirect cost rates, and Electronic Fund Transfer (EFT) setup status with the State of Colorado. Vendors must disclose whether they are new to working with CDEC and provide specific banking information if EFT is already established. The document requests timeline information regarding the vendor's internal review and signature completion processes, allowing CDEC to manage contract execution schedules effectively. All vendors except individuals are required to maintain active SAM.gov registration. The form emphasizes CDEC's use of DocuSign for all contract signatures and requests any special routing or procedural instructions vendors require for the digital signature workflow.
View the file
Other files
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Colorado Department of Early Childhood Vendor Contact Information Sheet Legal Name of Vendor as it should appear on the Contract/Purchase Order including any doing business as (dba):
Street Address including City, State and Zip Code:
Mailing Address including City, State and Zip Code (if different from Street Address):
County Agency is in:
Federal Entity Identification Number (FEIN) or Tax ID Number (TIN):
State of Incorporation:
Secretary of State Identification/Document Number:
Fiscal Year End Date (Month and Day – format MM/DD):
All Vendors must have a SAM.gov Unique Entity Identification (UEI) number (except individuals). SAM UEI number:
| Are you a new vendor working with CDEC? | |||
| ☐ | Yes | ☐ | No |
Does your Agency hire any current or former State Employees to work on this project?
If yes, did they end employment with the State within the last 6 months?
Does your agency have a Federally Negotiated or State Negotiated indirect Rate?
If yes, please send a copy of the approval letter with this form.
| What type of Entity is your Agency? | ||
| ☐ | Individual | |
| ☐ | Professional Corporation (PC) | |
| ☐ | Sole Proprietor | |
| ☐ | Not-for-Profit Corporation | |
| ☐ | Limited Liability Company (LLC) | |
| ☐ | Joint Venture | |
| ☐ | For-Profit | |
| ☐ | Limited Liability Partnership (LLP) | |
| ☐ | Government |
Primary Contact to Receive ALL Correspondence’s Name:
Primary Contact’s Title:
Primary Contact’s Email Address:
Primary Contact’s Phone Number:
Financial Contact’s Name:
Financial Contact’s Title:
Financial Contact’s Email Address:
Financial Contact’s Phone Number:
Invoice Contact’s Name:
Invoice Contact’s Title:
Invoice Contact’s Email Address:
Invoice Contact’s Phone Number:
Individual Signing the Contract’s Name:
Individual Signing the Contract’s Title:
Individual Signing the Contract’s Email Address:
Individual Signing the Contract’s Phone Number:
The Colorado Department of Early Childhood Collects signatures via DocuSign. Please list below any individuals that need to be included in the DocuSign process (examples: Director’s Assistant, Attorney, etc.)
Additional Contact’s Name:
Additional Contact’s Title:
Additional Contact’s Email Address:
Additional Contact’s Phone Number:
| What does this person need to do? | ||||
| ☐ | Sign before Individual Signing | Contract and receive a copy upon | execution | |
| ☐ | Sign after Individual Signing | Contract and receive a copy upon | execution | |
| ☐ | Receive Copy Prior to Signer and | upon execution | ||
| ☐ | Approve Prior to Signer and receive | a copy upon execution | ||
| ☐ | Receive Copy upon execution only |
Are there any specific instructions for emails requesting preliminary approval or order of DocuSign for signature (examples: enter the internal routing number in the note in DocuSign for the Individual Signing the Contract; Please send in DocuSign in the following order; Please send for preliminary approval to Primary Contact only; etc.)?
| Is your agency set up for Electronic Fund Transfer (EFT) with the State of Colorado? | |||
| ☐ | Yes | ☐ | No |
If yes, please list the last 4 digits of the account number payments should be sent to:
How long does your agency and/or board need to complete a preliminary review of the contract?
How long does your agency and/or board need to sign the contract in DocuSign?
Date This Form Was Completed:
Page 1 of 2 VCIS_7-29-25A image1.png
File details come from the government source that posted it. Updated .