Exhibit D - Vendor Information Evaluation Preferences 03.07.2024.docx
DOCX document 34 KB Posted
- Solicitation number
- 5510000953
- Issued by
- Travis County, Austin City, Texas
About this file
This is a vendor information and evaluation preferences form from the Texas Department of Agriculture for use in state and local contract opportunities. The form serves as the respondent information document for the "Public Outreach and Marketing Services - Don't Pack a Pest Media Campaign" solicitation. It requires vendors to provide complete business identification information, including entity name, business structure type, Federal Employee Identification Number, and Texas Identification Number for sole proprietors. The form mandates designation of a primary contact person with legal authority to enter into agreements on behalf of the business, along with full mailing address, phone, and email information. A secondary contact section allows vendors to identify a representative who can address day-to-day organizational questions.
The form includes a comprehensive section for vendors to claim evaluation preferences under Texas Administrative Code, Title 34, Part 1, Chapter 20, Subchapter C, Rules 20.306-20.307, with checkboxes for various preference categories including Texas-produced supplies and materials, agricultural products, service-disabled veteran-owned businesses, USA-produced goods, products from persons with disabilities, environmentally sensitive materials, energy-efficient products, and items from economically depressed areas. Vendors must attest under signature that all provided information is complete and accurate, with the form requiring dated certification by an authorized company representative.
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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 .