Section 3 Background Information Sheet~3.pdf

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BACKGROUND

Vendors shall provide a company profile below.

Company name:

Ownership (sole proprietor, partnership, etc.):

State of incorporation:

Date of incorporation:

Number of years in business:

List of top officers:

Location of company headquarters:

Location(s) of the office that shall provide the services described in this RFQ:

Location(s) from which employees shall be assigned for this project:

Please be advised, pursuant to NRS 80.010, a corporation organized pursuant to the laws of another state shall register with the State of Nevada, Secretary of State’s Office as a foreign corporation before a contract can be executed between the State of Nevada and the awarded vendor, unless specifically exempted by NRS 80.015.

The selected vendor, prior to doing business in the State of Nevada, shall be appropriately licensed by the State of Nevada, Secretary of State’s Office pursuant to NRS76. Information regarding the Nevada Business License can be located at http://nvsos.gov.

Is “Legal Entity Name” the same name as vendor is doing business as?

Yes No

If “No”, provide explanation.

Nevada Business License Number:

Legal Entity Name:

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Has the vendor ever been engaged under contract by any State of Nevada agency?

Yes No

If “Yes”, complete the following each State agency for whom the work was performed.

Name of State agency:

State agency contact name:

Dates when services were performed: Total dollar value of the contract:

Type of duties performed:

Name of State agency:

State agency contact name:

Dates when services were performed:

Total dollar value of the contract:

Type of duties performed:

Are you now or have you been within the last two (2) years an employee of the State of Nevada, or any of its agencies, departments, or divisions?

If “Yes”, please explain when the employee is planning to render services, while on annual leave, compensatory time, or on their own time?

If you employ (a) any person who is a current employee of an agency of the State of Nevada, or

(b) any person who has been an employee of an agency of the State of Nevada within the past two

(2) years, and if such person shall be performing or producing the services which you shall be contracted to provide under this contract, you shall disclose the identity of each such person in your response to this RFQ, and specify the services that each person shall be expected to perform.

Disclosure of any significant prior or ongoing contract failures, contract breaches, civil or criminal litigation in which the vendor has been alleged to be liable or held liable in a matter

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Does any of the above apply to your company?

If “Yes”, please provide the following information.

Date of alleged contract failure or breach:

Parties involved:

Description of the contract failure, contract breach, or litigation, including the products or services involved:

Resolution or current status of the dispute: Amount in controversy:

If the matter has resulted in a court case:

Court:

Case Number:

Status of the litigation:

Description of the contract failure, contract breach, or litigation, including the products or services involved:

Amount in controversy: Resolution or current status of the dispute:

If the matter has resulted in a court case:

Court:

Case Number

Status of the litigation:

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