IFB D24 147 Additional Offer Page.pdf

DELIVER AND INSTALL FOUR (4) FIBERGLASS RACEWAY TANKS FOR THE HAWAII STATE

DEPARTMENT OF EDUCATION WAIANAE HIGH SCHOOL

IFB D24-147

IFB D24-147 OF-1

OFFER PAGE OF-1

Exact Legal Name of Offeror, including “dba” or “division” of a corporation (furnish the exact legal name of the entity under which an awarded contract, if any, will be executed):

Address:

Principal Place of Business

(may not be a P.O. Box):

Mailing Address (only if different):

Payment Address (only if different)

Offeror’s Primary Contact Person:

Name

Title

Telephone Number Fax Number

Email Address

Federal Tax Identification Number:

State of Hawaii General Excise Tax License Number:

Type of Business Entity (check one):

Sole Proprietor Partnership Corporation Joint Venture Limited Liability Company Other

If other than a Sole Proprietorship:

Offeror is either:

A Hawaii business incorporated or organized under the laws of the State of Hawaii; OR

A Compliant Non-Hawaii business incorporated or organized under the laws of the State of on (date) _____________, and, if applicable, registered with the State of Hawaii Department of Commerce and Consumer Affairs Business Registration Division to do business in the State of Hawaii.

Names of all Offeror’s parent, affiliate and subsidiary organizations:

The undersigned has carefully read and understands the terms and conditions specified herein and hereby submits the following offer to provide the goods and/or perform the work specified herein, all in accordance with the true intent and meaning thereof, and further that the Offeror shall comply with all terms, conditions and requirements of the solicitation. The undersigned further understands and agrees that by submitting this offer, 1) the undersigned is declaring the undersigned’s offer is not in violation of Chapter 84, Hawaii Revised Statutes, concerning prohibited State contracts, and 2) the undersigned is certifying that the price(s) submitted was (were) independently arrived at without collusion.

Authorized (Original in ink) Signature Name (printed)

Title Date

Offeror: ____________________________________________

EXHIBIT A EX A-1

IFB D24-147

EXHIBIT A

OFFEROR INFORMATION

Offeror shall provide the Exhibit A, including attachments if applicable, within three (3) working days from STATE’s request.

A. Office Location

Offeror shall have an office from where business is conducted and from where the company is accessible to telephone calls for complaints or requests that need immediate attention. An answering service is not acceptable.

Offeror shall be capable of delivering and installing Four (4) Fiberglass Raceway Tanks for the STATE.

Offeror shall also be capable of providing warranty and maintenance service on Four (4) Fiberglass Raceway Tanks. Therefore, at the time of bidding and during the contract period, Offeror shall maintain a Hawaii-based facility and business capability of its own.

Address Line 1 ___________________________________________________

Address Line 2 ___________________________________________________

Office Telephone Number ___________________________________________________

Other Phone Number ___________________________________________________

B. Personnel

Offeror shall designate at least one (1) employee as the STATE point of contact (POC) for this contract.

This individual shall be available during regular working hours, Monday through Friday excluding holidays, and shall be capable of answering questions, resolving problems, and providing sales, ordering, and follow-up assistance.

Point of Contact (POC) Name ___________________________________________________

POC Telephone Number ___________________________________________________

POC Email Address ___________________________________________________