Respondent_Verification.pdf
PDF 119 KB Posted
- Solicitation number
- RTSX-260056-DS
- Issued by
- Alachua County, Glencoe CDP, Florida
About this file
This is a Respondent Verification Form issued by the Procurement Division of the City of Gainesville, Florida, for the Design and Construction Manager Services for Two Electric Charging Stations project. The form serves as a certification document that respondents must complete and submit with their proposals to confirm compliance with solicitation requirements. Respondents are required to acknowledge receipt of all addenda issued prior to submission, verify that their responses comply with project specifications, and certify their authorization to submit on behalf of their organization. The form requires respondents to agree to hold pricing for a minimum of 120 calendar days from the solicitation due date and to acknowledge that the City's terms and conditions take precedence over any conflicting terms submitted by the respondent.
The verification form includes provisions for identifying small business enterprises or service-disabled veteran enterprises certified with the City of Gainesville Department of Equity and Inclusion, as well as certifications regarding the truthfulness of submitted information and the absence of collusion with other bidders. Respondents must provide organizational details including legal name, doing business as name, street address, federal identification number, SunBiz number, and state of incorporation. The form requires an authorized signature from a representative with documented authority to execute the submission on behalf of the organization, along with contact information for the respondent's representative for any follow-up inquiries regarding the proposal.
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Text version
PROCUREMENT DIVISION
RESPONDENT VERIFICATION FORM
Legal Name of Corporation, Partnership or Individual (as reported to the IRS):
D/B/A (Doing Business As):
Street Address (No PO Boxes):
Federal Identification #: SunBiz #:
State of Incorporation:
1 . ADDENDA ACKNOWLEDGMENT: Prior to submitting my offer, I have verified that all addenda issued to date are considered as part of my offer: Addenda received (list all):
2. My company is a Small Business Enterprise (SBE) or Service Disabled Veteran Enterprise (SDVE) certified with the City of Gainesville Department of Equity and Inclusion.
YES NO
3. I further acknowledge that:
Response is in full compliance with the specifications;
Response is in full compliance with the specifications except as specifically stated and explained in detail on sheets attached hereto and labeled "Clarifications and Exceptions".
I hereby propose to provide the goods/services requested in this Solicitation. I agree to hold pricing for at least 120 calendar days from the Solicitation due date. I agree that CITY’s terms and conditions herein take precedence over any conflicting terms and conditions submitted for CITY’s consideration, and agree to abide by all conditions of this Solicitation.
I certify that all information contained in this Response is truthful to the best of my knowledge and belief. I further certify that I am duly authorized to execute and submit this Response on behalf of the organization as its agent and that the organization is ready, willing and able to perform if awarded.
I further certify that this Response is made without prior understanding, agreement, connection, discussion, or collusion with any other person, company or corporation submitting an offer for the same product or service; no officer, employee or agent of CITY owns or will benefit more than 5% from award of this Solicitation; and the undersigned executed this Respondent’s Verification with full knowledge and understanding of the matters therein contained.
RESPONDENT’S CONTACT
AUTHORIZED SIGNATURE DATE (for additional information)
PRINT NAME TITLE NAME
TELEPHONE NUMBER FAX NUMBER TITLE
E-MAIL ADDRESS PHONE
If Respondent is not an individual, include authorization for the above individual to sign on behalf of the organization https://www.gainesvillefl.gov/Government-Pages/Government/Office-of-Equity-and-Inclusion https://www.gainesvillefl.gov/Government-Pages/Government/Office-of-Equity-and-Inclusion
File details come from the government source that posted it. Updated .