Sample Form.pdf
PDF 385 KB Posted
- Attached to
- IHS1453261 PPE Federal contract opportunity
- Solicitation number
- IHS1453261
About this file
This document contains a sample form and details of a related federal contract opportunity. The sample form is to be used for vendors submitting samples for solicitation IHS1453261, which seeks personal protective equipment (PPE) such as gloves, gowns, and masks to provide protection against highly contagious viral infections like COVID-19. The form requests the vendor name, point of contact, and date samples were sent, as well as manufacturer information if samples are submitted on a vendor's behalf. It also provides fields for vendors to include return address information if they want samples returned. The related federal contract opportunity is solicitation number IHS1453261 issued by the Department of Health and Human Services Indian Health Service seeking PPE to protect against COVID-19 and other contagious diseases.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 1 - RFQ IHS1453261.pdf | ||
| IHS1453261 Solicitation.pdf | ||
| Quote Schedule.xlsx | XLSX spreadsheet | |
| IHS IEE Representation Form.pdf | ||
| IHS1453261 Solicitation.pdf |
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Text version
Sample Form
Samples were submitted for solicitation IHS1453261 for PPE for:
Vendor Name: _______________________________________
POC: _______________________________________________
Date Sent: __________________________________________
If manufacturers are sending samples on behalf of a vendor, please fill out the following:
Manufacturer Name: ______________________________________
Date Sent: _______________________________________________
If you would like your samples returned, please fill out address information below. If this portion is left blank, then you are giving your approval for the samples to be destroyed/discarded at our discretion.
Please return samples to the following address:
File details come from the government source that posted it. Updated .