Exhibit L - Offering Entity Acknowledgement Form.pdf

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Attached to
X1AA--Detroit Michigan Vet Center Relocation Lease NCO 10
Solicitation number
36C25025R0005
Issued by

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This document is an Offering Entity Acknowledgement Form for Request for Lease Proposals (RLP) No. 36C25025R0005 issued by the Department of Veterans Affairs (VA), Veterans Health Administration, Veterans Integrated Service Network 10. The RLP is seeking 3,844 ANSI/BOMA Occupant Area (ABOA) and not to exceed 5,505 Rentable Square Feet (RSF) of contiguous space for the relocation of the Detroit Michigan Vet Center. The Offering Entity must provide its name, address, Unique Entity Identifier (UEI) number, Tax Identification Number, and authorized official contact information. The Offering Entity must also indicate whether the authorized official is listed in the System for Award Management (SAM) representations and in the Offering Entity's operating agreement. The Offering Entity must submit this acknowledgment form by the specified time and date for receipt of offers. The Offering Entity's size status must be indicated as SDVOSB, VOSB, small business, or large business.

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REQUEST FOR LEASE NETWORK CONTRACTING OFFICE 10

PROPOSALS (RLP) Exhibit: L

Offering Entity Acknowledgement for RLP No.: 36C25025R0005

The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No.: 36C25025R0005 .

Offeror Information

Offering Entity Name:

Address:

Offering Entity UEI Number:

Offering Entity Tax Identification No.:

Authorized Official Name:

Authorized Official Phone Number:

Authorized Official E-mail:

Authorized Official is Listed in Entity SAM Representations: Yes No Authorized Official is Listed in Entity Operating Agreement: Yes No

Date of Submission:

Time Specified for Receipt of Offers:

Offering Entity/Prime Contractor Size Status: SDVOSB

VOSB

SB

LARGE BUSINESS

Offering Entity POC Signature Date

Offering Entity POC Name

File details come from the government source that posted it. Updated .