K6447 Ex A-2.docx
DOCX document 273 KB Posted
- Solicitation number
- K6447
- Issued by
- Yakima County, Yakima City, Washington
About this file
This is a Bidder's Profile form (Exhibit A-2) for competitive solicitation K6447 issued by the Washington State Department of Agriculture (WSDA) for yard debris handling services in Japanese beetle quarantine areas. The solicitation seeks a qualified business or individual to construct, staff, and operate a yard debris collection site within the Japanese beetle quarantine area to mitigate restrictions under WAC 16-470-717, which prohibits moving regulated articles outside the quarantine area during active flight season. Bidders must submit completed profile documentation including legal business information, contact points, and references demonstrating prior experience delivering goods and services similar in scope to the project requirements.
The form requires bidders to provide their Washington State Department of Revenue Registration/Unified Business Identifier (UBI) number, Taxpayer Identification Number (TIN), and documentation of any minority or woman-owned business (MWBE) certification, small business self-certification, or veteran-owned business certification status with the Washington State Department of Veteran Affairs. Bidders must designate an authorized representative, contract administrator, and signature authority for the awarded contract, and provide a minimum of three commercial or government references. Completed Bidder's Profile forms should be returned to the procurement coordinator at aschreib@centurytel.net. The form does not specify pricing terms, contract duration, renewal options, or funding sources within the document itself.
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Other files
| File | Type | Posted |
|---|---|---|
| K6447 Ex B.docx | DOCX document | |
| Grandview.pdf.crdownload | CRDOWNLOAD file | |
| K6447 ExD Contract.doc | DOC document | |
| K6447 Ex A-1.docx | DOCX document | |
| K6447 RFQQ.docx | DOCX document | |
| K6447 Ex C Pricing.docx | DOCX document |
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Text version
EXHIBIT A-2 – BIDDER’S PROFILE
| Competitive Solicitation: |
| No. – K6447 |
Yard Debris Handling in Japanese beetle Quarantine Areas
| Bidder: |
| ___________________________ |
Type/print full legal name of Bidder
BIDDER INFORMATION
Legal name of Bidder:
Address of Bidder:
Note: This information must match the information from Bidder’s Business License.
Business Name Address City, State, Zip Code
Bidder’s Washington State Department of Revenue Registration Number/Unified Business Identifier (UBI) Number:
Note: A nine digit UBI number is assigned to each registered businesses in Washington.
Taxpayer Identification No. (TIN):
Note: Your TIN will be either a number issued by the IRS (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (i.e., your Social Security Number). Do Not provide a Social Security Number.
| Is your firm certified as a minority or woman owned business with the Washington State Office of Minority & Women’s Business Enterprises (OMWBE)? |
| Yes |_| No |_| |
If yes, provide Bidder’s MWBE certification no.: ____________
Is your firm a self-certified Washington State Small Business?
Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Washington State Small Business.
Note: Regardless of size, a qualifying business must be owned and operated independently from all other businesses. In regard to size, the gross revenue thresholds, as reported on Bidder’s tax returns, are as follows:
· Microbusiness: Annual gross revenue of less than one million dollars.
· Minibusiness: Annual gross revenue of more than one million dollars, but less than three million dollars.
· Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.
Yes |_| No |_| If yes, provide the location for Bidder’s principal place of business:
Street Address City, State, Zip Code If yes, what is your business size (based on annual gross revenue)?
| Microbusiness | |_| |
| Minibusiness | |_| |
| Small Business | |_| |
Is your firm certified as a Veteran-Owned Business with the Washington State Department of Veteran Affairs?
Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Certified Veteran-Owned Business.
Yes |_| No |_| If yes, provide Bidder’s WDVA certification no.: _____________
CONTRACT MANAGEMENT POINTS OF CONTACT FOR BIDDER
Authorized Representative Name:
Email:
Phone:
Contract Administrator Name:
Email:
Phone:
Address for Enterprise Services to send legal notices:
Company name:
Attn:
Address:
City/State/Zip:
Signature Authority (if awarded a contract) Name:
Title:
REFERENCES
Provide a minimum of three (3) commercial or government references for which bidder has delivered goods and/or services similar in scope as described in the Competitive Solicitation.
REFERENCE 1
Company Name:
Contact:
Phone:
Email:
REFERENCE 2
Company Name:
Contact:
Phone:
Email:
REFERENCE 3
Company Name:
Contact:
Phone:
Email:
Return this Bidder’s Profile to Procurement Coordinator at:
aschreib@centurytel.net
EXHIBIT A-2 – BIDDER’S PROFILE: K5904 PAGE 1
(Rev 2023-05-15) image1.jpeg
File details come from the government source that posted it. Updated .