Form 1 - Vendor Acknowledgement.pdf
PDF 111 KB Posted
- Solicitation number
- RFP-11961
- Issued by
- Leon County, Florida
About this file
Form 1 - Vendor Acknowledgement is a document from the Florida Division of Emergency Management (FDEM) for the Elevate Florida residential mitigation grant program. This form is designed for potential contractors to provide their company information and contact details when responding to the solicitation for Inspection and Assessment services. The document requires vendors to provide comprehensive business information including vendor name, mailing address, contact information, business entity type, DUNS number, and FEID number.
The form mandates that the authorized signatory must have the authority to bind the respondent and certify compliance with the Request for Proposal (RFP) terms and conditions. It includes sections for both a primary and secondary contact, allowing vendors to list detailed contact information for key personnel who can be reached regarding the solicitation schedule. By completing this form, vendors are formally acknowledging their intent to participate in the contract opportunity and providing the necessary administrative details for potential further communication and evaluation.
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Text version
FORM 1
Vendor Acknowledgement
Vendor Name:
If a Fictitious Name is used include registered name (i.e. XYZ, Inc.
D/B/A ABC)
*Authorized Signature (Digital)
Vendor Mailing Address:
City, State, Zip: *Authorized Signature (Printed), Title
Phone Number:
*This individual must have the authority to bind the Respondent.
By signature on the Reply, Respondent certifies that it complies with the Terms &
Conditions of the RFP.
Toll Free Number:
Email Address:
DUNS Number:
FEID Number:
Type of Business Entity (Corporation, LLC, partnership, etc.):
VENDOR CONTACTS: Provide the name, title, address, telephone number, and email address of the official contact and an alternate, if available. These individuals shall be available to be contacted by telephone or attend meetings as may be appropriate regarding the solicitation schedule.
Primary Contact:
Contact Name, Title:
Address:
Phone Number:
Fax Number:
Email Address:
Secondary Contact:
Contact Name, Title:
Address:
Phone Number:
Fax Number:
Email Address:
| City State Zip: |
| Phone Number: |
| Toll Free Number: |
| Email Address: |
| DUNS Number: |
| FEID Number: |
| Type of Business Entity Corporation LLC partnership etc: |
| Primary Contact: |
| Contact Name Title: |
| Address: |
| Phone Number_2: |
| Fax Number: |
| Email Address_2: |
| Secondary Contact: |
| Contact Name Title_2: |
| Address_2: |
| Phone Number_3: |
| Fax Number_2: |
| Email Address_3: |
| Vendor Name: |
| Text3: |
| Text4: |
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