Exhibit J - Authorized Agent.pdf
PDF 100 KB Posted
- Attached to
- HSC North Elevator Modernization
- Solicitation number
- RFP202590000655
- Issued by
- West Virginia
About this file
The document is an Authorized Agent form for a West Virginia state and local contract opportunity related to the HSC North Elevator Modernization project at West Virginia University. This form is designed for potential bidders to provide their company details, contact information, and West Virginia Contractor's License number when submitting a bid for the elevator modernization project. The form requires the authorized signatory to agree to furnish all labor, materials, equipment, and services as specified in the Request for Bid/Proposal, with a commitment to communicate solely with the Procurement Officer.
The form includes sections for the bidder to enter critical information such as firm/company name, address, phone number, email, Federal Employer Identification Number (FEIN), and West Virginia Contractor's License Number. There is a specific note emphasizing that the West Virginia Contractor's License must be issued in the exact name of the bidder and must be valid at the time of bid submission. The document also provides space to acknowledge any addenda to the bid package, allowing bidders to track and confirm receipt of any changes or additional information related to the project.
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Text version
Authorized Agent The undersigned offers and agrees to furnish all labor, materials, equipment, and services as specified in this Request for Bid/Proposal at the price as stated, subject to the terms and conditions of this Request for Bid/Proposal. Signatory also absolves communications with anyone other than the Procurement Officer.
Address
Addenda No.
WV Contractor's License Number:
West Virginia Contractor's License MUST be issued in the exact name of Bidder and Bidder Must be licensed at the time of submission of bid.
Firm/Company Name:
Email:
Signature:
FEIN:
Phone Number:
Printed Name of Authorized Signatory:
Addenda No.
Addenda
Printed Name of Contract Signatory if Different than Above:
Email of Contract Signatory:
Date Addendum Issued
Date Addendum Issued
Signatory
Signatory
Signatory
Date Addendum Issued Addenda
No.
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