Solicitation Certification Form.docx
DOCX document 24 KB Posted
- Solicitation number
- HT940626QE013
- Issued by
-
Defense Health Agency
About this file
This is a Solicitation Certification Form template used by offerors to formally acknowledge receipt and acceptance of solicitation documents for federal contract opportunity HT940626QE013, a recruitment for a Neonatologist and Neonatal Nurse Practitioner position at Naval Medical Center Camp Lejeune (NMCCL) issued by the Defense Health Agency. The form serves as a standardized submission document that requires offerors to provide their company information, including name, address, CAGE code, DUNS number, and SAM Unique Entity Identifier (UEI), along with a designated point of contact.
The form requires offerors to certify which attachments are being submitted, including a Past Performance Summary Sheet, Past Performance Questionnaire, Pricing Worksheet, Employee Total Compensation Plan, and any other applicable federal forms. Critically, the form includes two certification statements: the first requiring the contractor to acknowledge thorough review of the solicitation and all amendments and to commit to addressing any discrepancies in accordance with proposal terms, and the second requiring the contractor to affirm willingness to hold prices firm for at least 90 days from the date specified for receipt of offers. The deadline for submission of questions regarding this solicitation is 22 June 2026 at 0700 AM Eastern Time. The document is a template with instructions to replace all blue italicized text with appropriate information prior to submission.
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Other files
| File | Type | Posted |
|---|---|---|
| HT940626QE013 - Amendment 1.pdf | ||
| Questions and Answers - HT940626QE013.docx | DOCX document | |
| Performance Work Statement (Amendment 1).docx | DOCX document | |
| Performance Work Statement (Solicitation).docx | DOCX document | |
| Solicitation - HT940626QE013.pdf | ||
| Attachment 2 - Past Performance Questionnaire Sheet.docx | DOCX document | |
| Attachment 1 - Past Performance Summary Sheet.docx | DOCX document | |
| Attachment 3 - Pricing Worksheet Sheet.xlsx | XLSX spreadsheet | |
| Attachment 4 - Employee Total Compensation Plan.xlsx | XLSX spreadsheet |
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Text version
SOLICITATION CERTIFICATION FORM
Solicitation number
Offeror’s name
Address
Telephone Number
CAGE Code
DUNS Number
SAM Unique Entity Identifier (UEI)
Point of Contact (name, address, phone)
Please indicate which attachments are being submitted:
☐ Attachment 1 – Past Performance Summary Sheet
☐ Attachment 2 - Past Performance Questionnaire
☐ Attachment 3 – Pricing Worksheet
☐ Attachment 4 – Employee Total Compensation Plan
☐ Other (Indicate Forms Being Submitted)
Proposal Certification Form
I, [the contractor], hereby acknowledge that I have thoroughly reviewed the solicitation and all accompanying documents. These materials are based on the original solicitation and all amendments.
By signing this acknowledgment, I affirm that I understand and accept any changes made during the solicitation process. This includes amendments, clarifications, and updates related to the task order.
Should any discrepancies arise, I commit to addressing them promptly and in accordance with the terms outlined in the proposal.
| ___________________________________ | |
| Name | Date |
| Contractor Organization |
I, [the contractor], hereby acknowledge that we are willing to hold prices firm for at least 90 days from the date specified for receipt of offers.
| __________________________________ | ||
| Name | Date | |
| Contractor Organization |
Instructions to Offerors: Replace all blue italicized text with appropriate information and remove this statement prior to submission.
File details come from the government source that posted it. Updated .