S000000307 Rural Health Switched Ethernet Connectivity Response Packet.docx
DOCX document 30 KB Posted
- Attached to
- Rural Health Switched Ethernet Connectivity
- Solicitation number
- S000000307
- Issued by
- Arkansas
About this file
This document is a Bid Response Packet for a state and local contract opportunity in Arkansas. The contract is for Rural Health Switched Ethernet Connectivity, involving Pulaski County and the City of Little Rock. The Bid Signature Page outlines the required information for the prospective contractor, including company details, contact information, and certifications regarding illegal immigrants and boycotting Israel. The Proposed Subcontractors Form allows the contractor to identify any subcontractors they intend to use. The submission requirements checklist lists the documents that must be submitted with the bid response, such as the Bid Signature Page, Proposed Subcontractors Form, and the Official Solicitation Price Sheet.
The pricing terms, set-asides, incumbents, funding requirements and sources, and other salient information are not explicitly stated in the provided documents. The contract appears to be for the provision of switched ethernet connectivity services to rural health providers in the specified jurisdictions, but the full scope of work, quantities, term, and other key details are not included in the materials provided.
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Text version
BID RESPONSE PACKET
S000000307
BID SIGNATURE PAGE
Type or Print the following information.
PROSPECTIVE CONTRACTOR’S INFORMATION
Company:
Address:
City:
State:
Zip Code:
| Business Designation: |
| ☐ Individual |
| ☐ Sole Proprietorship |
| ☐ Public Service Corp |
| ☐ Partnership |
| ☐ Corporation |
| ☐ Nonprofit |
Minority and Women-Owned Designation*:
| ☐ Not Applicable |
| ☐ American Indian |
| ☐ Service Disabled Veteran |
| ☐ African American |
| ☐ Hispanic American |
| ☐ Women-Owned |
| ☐ Asian American |
| ☐ Pacific Islander American |
| AR Certification #: __________________ |
| * See Minority and Women-Owned Business Policy in Solicitation Terms and Conditions |
PROSPECTIVE CONTRACTOR CONTACT INFORMATION
Provide contact information to be used for solicitation-related matters.
Contact Person:
Title:
Phone:
Alternate Phone:
Email:
CONFIRMATION OF REDACTED COPY
☐ YES, a redacted copy of submission documents is enclosed.
☐ NO, a redacted copy of submission documents is not enclosed. I understand a full copy of non-redacted submission documents will be released if requested.
Note: If a redacted copy of the submission documents is not provided with Prospective Contractor’s response packet, and neither box is checked, a copy of the non-redacted documents, with the exception of financial data (other than pricing), will be released in response to any request made under the Arkansas Freedom of Information Act (FOIA). See Solicitation Terms and Conditions for additional information.
ILLEGAL IMMIGRANT CONFIRMATION
By signing and submitting a response to this Solicitation, Prospective Contractor agrees and certifies that they do not employ or contract with illegal immigrants and shall not employ or contract with illegal immigrants during the term of a contract awarded as a result of this solicitation.
ISRAEL BOYCOTT RESTRICTION CONFIRMATION
By checking the box below, Prospective Contractor agrees and certifies that they do not boycott Israel and shall not boycott Israel during the term of a contract awarded as a result of this solicitation.
☐ Prospective Contractor does not and shall not boycott Israel.
An official authorized to bind the Prospective Contractor to a resultant contract shall sign below.
The signature below signifies agreement that any exception that conflicts with a Requirement of this Solicitation may cause the Prospective Contractor’s proposal to be rejected.
Authorized Signature: Title:
Printed/Typed Name: ______________________________ Date: ________________________
SUBMISSION REQUIREMENTS CHECKLIST
The following items must be submitted with the Prospective Contractor’s bid response:
· Bid Signature Page
· Proposed Subcontractors Form
· Official Solicitation Price Sheet
The following items, which must be submitted prior to a contract award to the Prospective Contractor, may also be included with the Prospective Contractor’s bid response:
· EO 98-04: Contract and Grant Disclosure Form
· Copy of Prospective Contractor’s Equal Opportunity Policy
PROPOSED SUBCONTRACTORS FORM
· Do not include additional information relating to subcontractors on this form or as an attachment to this form.
PROSPECTIVE CONTRACTOR PROPOSES TO USE THE FOLLOWING SUBCONTRACTOR(S) TO PROVIDE SERVICES.
Type or Print the following information
| Subcontractor’s Company Name |
| Street Address |
| City, State, ZIP |
☐ PROSPECTIVE CONTRACTOR DOES NOT PROPOSE TO USE SUBCONTRACTORS TO PERFORM SERVICES.
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