RFP 8240 ATTACH A Proposal Response Cert.pdf

This is a Proposal Response Certification form for RFP No. 10266 issued by UW Medicine Supply Chain in Washington state. The document serves as the formal certification that a bidder has reviewed the Request for Proposals and agrees to meet all specifications contained within the solicitation. The form requires the proposer to declare compliance with the RFP requirements and to disclose their active registration status in the U.S. General Services Administration (GSA) System for Award Management (SAM). The RFP was approved on September 9, 2018, with the most recent revision dated August 6, 2025. Bidders must acknowledge receipt of any amendments issued to the RFP as part of their proposal submission.

The certification form requires bidders to attest that neither they nor their parent companies, subsidiaries, or entities operating under a doing business as (DBA) name are listed with any current exclusions, suspensions, or debarments from federal programs, including the U.S. Department of Health and Human Services Office of Inspector General (OIG) List of Excluded Individual/Entities (LEIE). The form requests standard business information from the proposer, including printed name, signature, title, business name, street address, city and state, telephone number, email address, Washington Unified Business Identifier (U.B.I.) Number, and Federal Tax Identification Number. This certification document represents a standard compliance requirement for bidders responding to UW Medicine's specialty pharmacy payor access contract opportunity.