Exhibit E Vendor Information-Confirmation of Offer Form___6822.pdf
PDF 102 KB Posted
- Attached to
- Saguache County Waste Tire Removal
- Solicitation number
- IFB1 FAAA 2017000269 2
- Issued by
- Rio Blanco County, Denver City, Colorado
About this file
This is a Vendor Information and Confirmation of Offer Form issued by the Colorado Department of Public Health & Environment for Solicitation No. IFB1 FAAA 2017000269 concerning Waste Tire and Tire Shred Removal services at Saguache County Landfill. The form serves as the submission vehicle for vendors responding to this invitation for bid, requiring responses to be clearly marked with the solicitation number, due date, and time on the outside of the submittal. All responses must be submitted to the Colorado Department of Public Health & Environment Contracts and Purchasing Unit Mail Room at 4300 Cherry Creek Drive South, Denver, CO 80246-1530, attention Allan Smith, Senior Purchasing Agent, by the deadline specified in the solicitation.
Vendors responding to this solicitation must complete the form by providing their customer number from the Colorado Vendor Self-Service portal, Federal Employer's Identification Number, DUNS number if applicable, company name and DBA name if applicable, complete business address, authorized company officer or agent signature and date, email address, phone number, fax number, and designate a point of contact for solicitation-related communications including their name, phone number, and email address. The signed original of this form must be submitted with the original solicitation response.
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Text version
Exhibit E
SOLICITATION NO: IFB1 FAAA 2017000269
TITLE: Waste Tire and Tire Shred Removal – Saguache County Landfill
Vendor Information Form & Confirmation of Offer
Responses must be clearly marked with SOLICITATION #, DUE DATE and TIME on the outside of the submittal.
Responses submitted subject to the conditions stipulated herein and in accordance with the specifications set forth in the solicitation will be accepted at the address listed below prior to the submittal deadline.
RETURN SOLICITATION RESPONSE AND THIS FORM TO:
Colorado Department of Public Health & Environment Contracts and Purchasing Unit
Mail Room (B1) 4300 Cherry Creek Drive South
Denver, CO. 80246-1530 Attention: Allan Smith, Senior Purchasing Agent
PLEASE TYPE OR PRINT INFORMATION
VENDOR CUSTOMER # (From Colorado VSS):___________________________________________________________________
FEDERAL EMPLOYER’S IDENTIFICATION (FEIN) #: _______________________________________________________________
DUNS # (if applicable): ____________________________________________________________________________________
COMPANY NAME: ________________________________________ DBA (if applicable): ______________________________
ADDRESS: ______________________________________________________________________________________________
CITY, STATE, ZIP: _______________________________________________________________________________________
TYPED OR PRINTED NAME: _______________________________________________________________________________
HANDWRITTEN SIGNATURE OF AUTHORIZED COMPANY OFFICER / AGENT
SIGNING OFFICER / AGENT TITLE: _________________________________________________________________________
SIGNATURE DATE: ______________________________
E-MAIL ADDRESS: ______________________________________________________________________________________
PHONE #: __________________________________________ FAX #: ___________________________________________
POINT OF CONTACT FOR SOLICITATION-RELATED COMMUNICATIONS:
NAME______________________________________________ PHONE #: ______________________________________
E-MAIL: _____________________________________________________________________________________________
SUBMIT SIGNED ORIGINAL OF THIS FORM WITH ORIGINAL SOLICITATION RESPONSE
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