IFB D26 129 Additional Offer Pages.pdf

FURNISH AND DELIVER NETWORK CABLING MATERIALS AND SUPPLIES

FOR THE HAWAII STATE DEPARTMENT OF EDUCATION

IFB D26-129

OFFER PAGE

IFB D26-129 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

IFB D26-129 EX A-1

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 a manufacturer-authorized distributor of the products listed herein with at least one (1) year of previous experience in that capacity.

Authorized Distributor documentation attached. ☐ Yes

B. OFFICE LOCATION

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

Address Line 1:

Address Line 1:

Point of Contact:

Office Telephone Number:

Office 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 located on the island of Oahu 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 located on the island of Oahu Yes

POC Name

POC’s Job Title

Telephone Number

Offeror:

IFB D26-129 EX A-2

Cell Number

Fax Number

Email Address