Exhibit P Offering Entity Acknowledgement Form.docx

Attachment G Offering Entity Acknowledgement for RLP No.: 36C25023R0004 Bloomington, IN Consolidated Clinic The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No.: 36C25023R0004. Failure to provide the required information may deem the proposal non-responsive.

Offeror Information Offering Entity Name:

Address:

Offering Entity Unique Entity Identifier (SAM UEI):

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 as defined at FAR 52.219-1 Small Business Program Representations |_| Offering Entity Currently Verified in VetCert: YES |_| NO |_| N/A |_|

Offering Entity POC Name