Notice of Award Form B19839.pdf

Notice of Award Form

V.19.3 Page 1 of 2

Agency and Awarded Vendor Information

*Description: PB Omnia US Foods IVHC tableware that will be available to IDVA

*Bid Number: B-19839 *Agency: DVA

*Vendor Selected for Award: US Foods

*Line Item Description: Tableware. Silverware, Utensils

*Award Amount: $12,605.23 *Length of Initial Term: 12 months *Length of available renewal options: 0

Farm Leases and Concessions

Value to the State:

Estimated Financial Return to the State for the Life of the Contract (Includes Renewals)

Value to the Vendor:

Estimated Gross Revenue to the Vendor for the Life of the Contract (Includes Renewals)

Business Enterprise Program/Veterans Business Program

% of BEP Per Utilization Plan: % of VBP Per Utilization Plan:

Other:

Unsuccessful Bidder(s)

*Number of Responding Bidders: *Number of Unsuccessful Bidder(s) *Number of Awarded Bidder(s):

Bidder(s)/Offeror(s) Not Selected:

Agency Contact

Contact Name: Amanda Gray Telephone Number: 217-782-7467

Email Address: amanda.gray@illinois.gov Fax Number:

Street Address: 833 S Spring Street City: Springfield

State: IL Zip Code: 62704

V.19.3 Page 2 of 2

SPO Written Determination for Contract Award Decision

General - Applies to Split Awards, Award to Other than Lowest Responsible and Responsive Bidder. The Rationale described by the purchasing agency in the recommendation to award seems reasonable, and serves as the basis for the contract decision.

Invitation for Bid - The contract was procured through the Invitation for Bid Process, and the contract has been awarded to the lowest priced responsive and responsible bidder.

Request for Proposal - Based on factors set forth in the Request for Proposal, the contract has been awarded to the offeror whose proposal is most advantageous to the State.

Renewal - The contract is a renewal in accordance with the terms of the existing contract. The award decision is based on justification presented by the purchasing agency's justification.

Comments: This is a piggyback purchase

Other:

Explanation of other terms:

SPO Signature: Date:

V.19.3 Page of Agency and Awarded Vendor Information Farm Leases and Concessions Estimated Financial Return to the State for the Life of the Contract (Includes Renewals) Estimated Gross Revenue to the Vendor for the Life of the Contract (Includes Renewals) Business Enterprise Program/Veterans Business Program Unsuccessful Bidder(s) Bidder(s)/Offeror(s) Not Selected:

Agency Contact SPO Written Determination for Contract Award Decision 11.0.0.20130303.1.892433.887364