Exhibit M-36C25022R0016 Offering Entity Acknowledgement Form.pdf
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Request for Proposal RLP No. _________________
Network Contracting Office 10
Offering Entity Acknowledgment for Proposal No.: ____________________
The Offerer attests that the information provided below is accurate and shall be a basis for evaluation in Proposal No.:__________. Failure to provide the required information may deem your proposal non-responsive.
Offerer Information:
Offering Entity Name:
Address:
Offering Entity Tax Identification Number:
Authorized Official Name:
Authorized Official Phone Number:
Authorized Official E-mail:
Date of Submission:
Time Specified for Receipt of Offers:
Offering Entity/Prime Contractor Size Status: SDVOSB
VOSB
SB
Offering Entity Currently Certified in SAM under NAICS 531120
Offering Entity Currently Verified in VetBiz
Offering Entity POC Signature Date
Offering Entity POC Name
Offering Entit_ y UEI Number:
| SDVOSB: Off |
| VOSB: Off |
| SB: Off |
| Offering Entity Currently Certified in SAM under NAICS 531120: Off |
| Offering Entity Currently Verified in VetBiz: Off |
| Date: |
| Offering Entity POC Name: |
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| RLP: 36C25022R0016 |
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