Exhibit M - Offering Entity Acknowledgement Form.pdf

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Attached to
X1DB--Coldwater Clinic Lease
Solicitation number
36C25025R0030
Issued by

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Exhibit M is an Offering Entity Acknowledgement Form for Request for Lease Proposals (RLP) No. 36C25025R0030 issued by Network Contracting Office 10. The form is designed for potential offerors to provide key business and contact information when submitting a proposal for a medical clinic lease in Coldwater, Michigan.

The solicitation seeks approximately 10,000 ANSI/BOMA Office Area square feet of medical clinic space with 77 parking spaces for the Department of Veterans Affairs (VA). The form includes fields for the offering entity's name, address, UEI number, tax identification number, and authorized official details. Offerors must indicate their business size status, which includes options for Service-Disabled Veteran-Owned Small Business (SDVOSB), Veteran-Owned Small Business (VOSB), Small Business (SB), or Large Business. The form requires the authorized official to confirm their listing in SAM representations and entity operating agreement.

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REQUEST FOR LEASE NETWORK CONTRACTING OFFICE 10

PROPOSALS (RLP) Exhibit: M

Offering Entity Acknowledgement for RLP No.: 36C25025R0030

The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No.: 36C25025R0030.

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

VHAINDAdkinK Cross-Out

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