Solicitation no IFB1_FAAA_2016000134_Ex.A_Vendor Info Form.docm
DOCM document 39 KB Posted
- Attached to
- SUMMITVILLE DAM, Head Gate & Controls Replacement, SV-102 State and local contract opportunity
- Solicitation number
- IFB1 FAAA 2016000134 2
- Issued by
- Montezuma County, Colorado
About this file
This is a Vendor Information Form and Confirmation of Offer issued by the Colorado Department of Public Health & Environment for Solicitation IFB1 FAAA 2016000134, titled "Summitville Dam Headgate and Controls Replacement, Project SV-102." Sealed bids are due on December 18, 2015 at 2:00 PM MT and must be submitted to the Colorado Department of Public Health & Environment Purchasing and Contracts Unit at 4300 Cherry Creek Drive South in Denver, Colorado, addressed to Timothy Massangale, Senior Purchasing Agent. Responses must be clearly marked with the solicitation number, due date, and time on the outside of the submittal package.
Vendors must complete and submit the form with their original solicitation response, providing company information including vendor customer number from Colorado VSS, Federal Employer Identification Number, DUNS number if applicable, company name, DBA if applicable, complete address, authorized signatory information, and contact details for solicitation-related communications. The form requires a typed or printed company name with handwritten signature of an authorized company officer or agent, along with the officer's title and signature date. For inquiries regarding the solicitation, vendors should contact Timothy Massangale directly at (303) 692-2072.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Photo_1_of_3.pdf | ||
| SMSS Dam Head Gate Bid Ad - Final v2.pdf.docx | DOCX document | |
| Photo_3_of_3.pdf | ||
| C-1245D_Summitville_Dam_Impoundment_-_Design_Plans_2015-01-14.pdf | ||
| Photo_2_of_3.pdf | ||
| C-1245D_Summitville_Dam_Impoundment_-_Specifications_2015-01-14.pdf | ||
| SDI_Head_Gate_Contract_Documents 10-07-2015.pdf |
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Text version
Exhibit A
Solicitation #: IFB1 FAAA 2016000134 Title: Summitville Dam Headgate and Controls Replacement, Project SV-102
Vendor Information Form & Confirmation of Offer
PROPOSAL DUE DATE: DECEMBER 18, 2015 2:00 PM MT
Responses must be clearly marked with SOLICITATION #, DUE DATE and TIME on the outside of the submittal. Responses submitted subject to the conditions stipulated herein and in accordance with the specifications set forth in the solicitation will be accepted at the address listed below prior to the submittal deadline.
RETURN SOLICITATION RESPONSE AND THIS FORM TO:
Colorado Department of Public Health & Environment Purchasing and Contracts Unit Building Operations (B1) 4300 Cherry Creek Drive South Denver, CO. 80246-1530 Attention: Timothy Massangale, CPPB, Senior Purchasing Agent
Direct Telephone Inquiries To: Timothy Massangale at (303) 692-2072
PLEASE TYPE OR PRINT INFORMATION
VENDOR CUSTOMER # (From Colorado VSS):___________________________________________________________________
FEDERAL EMPLOYER’S IDENTIFICATION (FEIN) #: _______________________________________________________________
DUNS # (if applicable): ____________________________________________________________________________________
COMPANY NAME: ________________________________________ DBA (if applicable): ______________________________
ADDRESS: ______________________________________________________________________________________________
CITY, STATE, ZIP: _______________________________________________________________________________________
TYPED OR PRINTED NAME: _______________________________________________________________________________
HANDWRITTEN SIGNATURE OF AUTHORIZED COMPANY OFFICER / AGENT
SIGNING OFFICER / AGENT TITLE: _________________________________________________________________________
SIGNATURE DATE: ______________________________
E-MAIL ADDRESS: ______________________________________________________________________________________
PHONE #: __________________________________________ FAX #: ___________________________________________
POINT OF CONTACT FOR SOLICITATION-RELATED COMMUNICATIONS:
NAME______________________________________________ PHONE #: ______________________________________
E-MAIL: _____________________________________________________________________________________________
SUBMIT SIGNED ORIGINAL OF THIS FORM WITH ORIGINAL SOLICITATION RESPONSE
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