RFR222831 Application Response Form.doc
DOC document 188 KB Posted
- Solicitation number
- BD-21-1031-ADMIN-ADM07-61788
- Issued by
- Middlesex County, Massachusetts
About this file
This document is an Application Response Form for RFR 222831, Preventive Maintenance, Service Contracts and Repairs, issued by the Commonwealth of Massachusetts Department of Public Health. The RFR seeks responses from organizations that can provide preventive maintenance, service contracts, and repairs for various types of equipment. Respondents are asked to indicate the types and brands of equipment they have certified technicians for, provide maximum rates including time and materials, and specify the geographic regions of the state they are able to serve. The application requires an affirmation that all individuals working on projects for the Department of Public Health will be appropriately licensed and certified.
The RFR does not provide specific details on quantities, response deadlines, award dates, or contract term. However, it does require respondents to provide their Commonwealth Vendor Customer Code and Address Code for contract execution purposes.
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Text version
The Commonwealth of Massachusetts
Department of Public Health Purchase of Service
8th floor 250 Washington St, Boston Massachusetts 02108
APPLICATION RESPONSE FORM
RFR TITLE Preventive Maintenance, Service Contracts and Repairs
RFR# 222831
Organization Name: [ ] www: [ ] Address:
City: [ ] State: [ ] Zip: [ ] Contact Person: First Name: [ ] Last Name: [ ]
Title: [ ] Telephone: ( ) - FAX: ( ) - E-Mail: [ ] Commonwealth Vendor Customer Code (VCC)* (if available): [ ] Address Code: [ ] *for contract execution
EQUIPMENT INFORMATION
What Type and Brand of equipment do you have certified technician for?
Enter text here
MAXIMUM RATES
List rates including time and materials. Include any applicable discounts.
PREFERRED REGION SERVED
Please indicate the geographic region(s) of the state that your organization prefers to serve.
Organization Affirmation
· Applicant affirms that all individuals that work on a project for DPH will be appropriately licensed/certified for equipment serviced.
· I affirm that I will comply with the requirements of this Request for Quote and with the terms of this proposal.
Authorized Signatory:
First Name: [ ] Last Name: [ ] Title: [ ]
By clicking the check box, the submitter attests that s/he is an agent of the Bidder with authority to sign on the Bidder’s behalf and is agreeing all affirmations listed above.
File details come from the government source that posted it. Updated .