Exhibit D - Vendor Information Evaluation Preferences 03.07.2024.docx
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- Attached to
- Re-Solicitation Texas Farmer Mental Health and Suicide Prevention Helpline and Educational Services
- Solicitation number
- 5510001033
- Issued by
- Texas
About this file
This is a vendor information and evaluation preferences form issued by the Texas Department of Agriculture for a re-solicitation related to the Texas Farmer Mental Health and Suicide Prevention Helpline and Educational Services contract opportunity. The form functions as a standardized submission document requiring respondents to provide comprehensive business identification information, including entity name, business structure classification, federal and state identification numbers, and primary and secondary contact information with full legal names and communication details.
The document establishes evaluation preferences available to vendors under Texas Administrative Code Title 34, Part 1, Chapter 20, Subchapter C, Rules 20.306-307, encompassing a broad range of product and service categories. These preferences include supplies and materials produced in Texas or offered by Texas bidders, agricultural products, service-disabled veteran-owned businesses, USA-produced goods, products from persons with mental or physical disabilities, environmentally sensitive materials including recycled and energy-efficient products, rubberized asphalt paving materials, recycled motor oil and lubricants, products from formerly contaminated property sites, offerings from economically depressed or blighted areas, vendors meeting air quality standards, recycled computer equipment, and higher nutritional value foods. Respondents must attest to the accuracy and completeness of all submitted information through signature and date certification on the form.
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Text version
Texas Department of Agriculture – Exhibit D
Exhibit D Vendor Information and Evaluation Preferences
SECTION 1 – RESPONDENT INFORMATION
Entity Name:
D.B.A. Name (if applicable)
| Respondent’s Social Media links, if any | ||
| Web | ||
| Other: |
Type of Business (check one):
|_| Corporation |_| Limited Liability Co. |_| Limited Partnership |_| General Partnership |_| Sole Proprietor |_| Cooperative |_| Other (specify)
Federal Employee Identification Number (must be nine (9) digits and match W-9)
| Texas Identification Number (if sole proprietor) |
| - - |
SECTION 2A. PRIMARY CONTACT – List the full legal name (no aliases or nicknames) of the primary person (Partner, Manager or Owner) responsible for the business and can enter into legal agreements on behalf of the business.
First Name Last Name |_| Mr. |_| Dr.
|_| Ms. |_| Other
Mailing Address City State Zip County
| Business Phone ( ) - |
| Cell Phone ( ) - |
| E-mail Address |
| Title |
| Respondent’s Website |
SECTION 2B. SECONDARY CONTACT INFORMATION – This person can answer day-to-day questions about the organization.
| First Name |
| Last Name |
| |_| Mr. |_| Dr. |
|_| Ms. |_| Other
Contact phone number Contact E-mail Address
Title
SECTION 3. BUSINESS PRODUCTS
Check below if preference in the evaluation process is claimed under Texas Administrative Code, Title 34, Part 1, Chapter 20, Subchapter C, Rule 20.306-.307.
(__) Supplies, materials, or equipment: Produced in Texas/offered by Texas bidders (__) Agricultural products produced or grown in Texas (__) Agricultural products and services offered by Texas bidders (__) Products offered by Texas Bidder owned by a Texas resident service-disabled veteran (__) USA Produced supplies, materials, or equipment (__) Products of persons with mental or physical disabilities (__) Products made of recycled, re-manufactured, or environ-sensitive materials including recycled steel (__) Energy efficient products (__) Rubberized asphalt paving material (__) Recycled motor oil and lubricants (__) Products produced at facilities located on formerly contaminated property (__) Products and services from economically depressed or blighted areas (__) Vendors that meet or exceed air quality standards (__) Recycled or Reused Computer Equipment of Other Manufacturers (__) Foods of Higher Nutritional Value
SIGNATURE AND DATE
I hereby attest that all information provided is complete and accurate to the best of my knowledge.
| Vendor Signature |
| Date |
| Printed Name |
| Company Represented |
Exhibit D – rev. 03/07/2024 Page 1 of 18
File details come from the government source that posted it. Updated .