Exhibit D - Vendor Information Evaluation Preferences 03.07.2024.docx

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Attached to
Intranet Quorum (IQ) Support Services and Software Maintenance
Solicitation number
5510001059
Issued by
Travis County, Austin City, Texas

About this file

This is a Vendor Information and Evaluation Preferences form issued by the Texas Department of Agriculture for state and local contract opportunities. The document serves as a standardized respondent application requiring vendors to provide comprehensive business identification and contact information. Respondents must supply their entity name, business structure classification (corporation, LLC, partnership, sole proprietor, cooperative, or other), Federal Employee Identification Number, and Texas Identification Number if applicable. The form requires designation of a primary contact—a full legal name of a partner, manager, or owner authorized to execute legal agreements on behalf of the business—along with complete mailing address, business and cell phone numbers, email address, and website information. A secondary contact section accommodates day-to-day organizational inquiries with name, phone, email, and title fields.

Section 3 of the form addresses business products and evaluation preferences under Texas Administrative Code, Title 34, Part 1, Chapter 20, Subchapter C, Rules 20.306-20.307. Vendors may claim preferences for supplies, materials, or equipment produced in Texas or offered by Texas bidders; agricultural products grown or produced in Texas; products from service-disabled veteran-owned Texas businesses; USA-produced goods; products from persons with disabilities; recycled, remanufactured, or environmentally sensitive materials; energy-efficient products; rubberized asphalt paving material; recycled motor oil and lubricants; products from facilities on formerly contaminated property; goods and services from economically depressed or blighted areas; vendors meeting air quality standards; recycled or reused computer equipment; and foods of higher nutritional value. The vendor must attest under signature and date that all provided information is complete and accurate.

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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
WebFacebook
LinkedInOther:

Twitter

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 .