Exhibit O - VA Houston TX - Offering Entity Acknowledgement Form.pdf

PDF 161 KB Posted

Attached to
X1AA--NCO 16 HOU Office Admin Lease
Solicitation number
36C25620R0123
Issued by

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REQUEST FOR LEASE

PROPOSALS (RLP)

COMMUNITY BASED OUTPATIENT CLINIC JANUARY 2020

(CBOC) RLP No. 36C25619R0149

SUGARLAND, TX

Offering Entity Acknowledgement for RLP No.: 36C256-19-R-0149

The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No.: 36C256-19-R-0149 Failure to provide the required information may deem your proposal non-responsive.

Offeror Information

Offering Entity Name:

Address:

Offering Entity DUNS Number:

Offering Entity Tax Identification Number:

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

Offering Entity Currently Certified in SAM under NAICS 531120

Offering Entity Currently Verified in VetBiz

Offering Entity POC Signature Date

Offering Entity POC Name

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