Solicitation no_IFB1_FAAA_2016000285_Vendor Information Confirmation of Offer Form.pdf.docm
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- Solicitation number
- IFB1 FAAA 2016000285 2
- Issued by
- Denver County, Denver City, Colorado
About this file
This is a Vendor Information Confirmation of Offer Form issued by the Colorado Department of Public Health & Environment, Purchasing and Contracts Section, for Solicitation IFB1 FAAA 2016000285. The solicitation concerns the procurement of a Smoke Generator Assembly with Trailer for the Air Pollution Control Division. Vendors were required to submit responses by April 21, 2016, at 2:00 pm Mountain Time to the Colorado Department of Public Health & Environment, Building Operations at 4300 Cherry Creek Drive South, Denver, Colorado 80246-1530, with inquiries directed to Timothy Massangale, CPPB, Senior Purchasing Agent, at (303) 692-2072.
The form requires vendors to provide company information including vendor customer number from the Colorado Vendor Self-Service system, Federal Employer Identification Number, DUNS number if applicable, company name, business address, authorized signatory information, and points of contact for solicitation-related communications. Responses must be submitted with a signed original of this form and must be clearly marked with the solicitation number, submission deadline date, and time on the outside of the submittal package.
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Text version
Exhibit A
Solicitation #: IFB1 FAAA 2016000285 Title: Air Pollution Control Div. Smoke Generator Assembly with Trailer
Vendor Information Form & Confirmation of Offer
SUBMISSION DEADLINE DATE: APRIL 21, 2016 at 2:00 pm mt
Responses must be clearly marked with SOLICITATION #, SUBMISSION DEADLINE 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 Section 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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