IFB D26 128 Additional Offer Pages.pdf

FURNISH, DELIVER AND INSTALL EATON 9PX SERIES UNINTERRUPTIBLE POWER SUPPLY

SYSTEM FOR THE HAWAII STATE DEPARTMENT OF EDUCATION

IFB D26-128

IFB D26-128 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

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

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.

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 D26-128

EXHIBIT A

OFFEROR INFORMATION

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

A. Authorized Distributor

At the time of bidding, Offeror shall be an authorized distributor of the Eaton 9PX Series Uninterruptible Power Supply System with at least two (2) years of previous experience in that capacity. As evidence of this, Offeror is requested to provide documentation from the manufacturer which verifies Offeror’s status as an authorized distributor.

Authorized Distributor Documentation Attached

Yes

Number of Years’ Experience

B. Office Location

At the time of bidding and during the contract period, Offeror shall maintain a wholesale or retail business on the island of Oahu with warehousing and inventory operations to supply the items listed herein.

Address Line 1

Address Line 2

Contact Person

Phone Number

Fax Number

C. Personnel

Offeror shall designate at least one (1) employee as the STATE point of contact (POC) for this Contract. This individual shall be based in Hawaii and available during regular business hours, 7:45 a.m. to 4:30 p.m. Hawaii Standard Time (HST), Monday through Friday excluding holidays, and shall be capable of answering questions, resolving problems, and providing sales, ordering, and follow-up assistance.

POC Based in the State of Hawaii Yes

POC Name

Address Line 1

Address Line 2

POC’s Job Title

Telephone Number

Fax Number

E-mail Address