Attachment_3_-_RFQ_Information_Sheet.doc

ATTACHMENT 3

RFQ Information Sheet Failure to provide the TAA Country of Production (if applicable) will result in no further consideration of the quotation. Vendors must complete all applicable information on this sheet and submit it with the quotation. Failure to do so will render the quotation unacceptable for receipt of the order.

Statutory/Regulatory Compliance

TRADE AGREEMENT ACT COUNTRY OF PRODUCTION: _____________________

ENERGY STAR® OR FEDERAL ENERGY MANAGEMENT PROGRAM (FEMP) ENERGY USE REQUIREMENT COMPLIANCE, AS REQUIRED: YES_____ or NO_____

IPv6 COMPLIANT: YES____ or NO_____

SECTION 508 COMPLIANT: YES_____ or NO____

Specific Terms, Conditions, and Administrative information

PAYMENT TERMS: ________________________________________________________________

DELIVERY DATE: _________________________________________________________________

WARRANTY: ______________________________________________________________________

NAME AND ADDRESS OF QUOTER:

TELEPHONE NO (INCLUDE AREA CODE): __________________________

FAX NUMBER: ___________________________

E-MAIL ADDRESS:

ENROLLED IN SYSTEM FOR AWARD MANAGEMENT (SAM)? Yes____ No____

CAGE CODE NUMBER: _____________________________________

DUNS: _______________________________________

Vendor Certification: [By signing the Vendor acknowledges that the information provided in response to this RFQ is correct.]

NAME AND TITLE OF SIGNER: __________________________________

DATE OF QUOTATION: ___________________________________

SIGNATURE OF PERSON AUTHORIZED TO SIGN: ______________________________