STATE SIGNATURE PAGE.doc
DOC document 116 KB Posted
- Attached to
- LOW PROTEIN MEDICAL FOOD
- Solicitation number
- 11
- Issued by
- Ada County, Idaho
About this file
This document is a signature page related to an Invitation to Bid (ITB) issued by the State of Idaho Department of Health and Welfare for the procurement of low protein medical food and formula. The purpose of this ITB is to establish a contract to supply these specialized products to the Department to administer to participants in the state's Phenylketonuria (PKU) program. The ITB number is ITB11 and the title is "Low Protein Medical Food." Vendors must submit their bid response in accordance with the terms, conditions, and any addenda issued for this solicitation. The contract term is not specified.
The signature page requires vendors to acknowledge acceptance of the State of Idaho's standard contract terms and conditions. Vendors must provide their company information, federal tax ID, and authorized signature. No pricing or other salient commercial terms are included in this document. The ITB appears to be a competitive procurement, but details on any incumbent vendor, funding sources, or set-asides are not provided.
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Text version
ITB11 Low Protein Medical Food
State SIGNATURE PAGE
BRAD LITTLE - Governor
DAVE JEPPESEN - Director
Brad McDonald, Administrator
Division of Management Services
Bureau of Contracts & Facilities
450 West State Street, 9th Floor
PO Box 83720
Boise, Idaho 83720-0036
Phone 208-334-5578
FAX 208-334-5694
SIGNATURE PAGE
NO LIABILITY WILL BE ASSUMED BY THE DEPARTMENT OF HEALTH AND WELFARE FOR A VENDOR’S FAILURE TO OBTAIN THE TERMS AND CONDITIONS AND ANY PROPERLY ISSUED SOLICITATION ADDENDUMS IN A TIMELY MANNER FOR USE IN THE VENDOR’S RESPONSE TO THIS SOLICITATION OR ANY OTHER FAILURE BY THE VENDOR TO CONSIDER THE TERMS, CONDITIONS, AND ANY ADDENDUMS IN THE VENDOR’S RESPONSE TO THE SOLICITATION.
Attach in the IPRO Prerequisites page as specified in the ITB.
This bid response is submitted in accordance with all documents and provisions of the specified ITB Number and Title provided below. By my signature I accept the terms, conditions and requirements contained in the solicitation, including, but not limited to, the STATE OF IDAHO STANDARD CONTRACT TERMS AND CONDITIONS, and the SOLICITATION INSTRUCTIONS TO VENDORS in effect at the time this ITB was issued, as incorporated by reference into this solicitation; as well as any SPECIAL TERMS AND CONDITIONS incorporated in the solicitation documents. As the undersigned, I certify I am authorized to sign and submit this response for the named Vendor. I further acknowledge I am responsible for reviewing and acknowledging any addendums that have been issued for this solicitation.
ITB Number ITB11 ITB Title Low Protein Medical Food _ VENDOR (Company Name)___________________________________________________________________
ADDRESS ________________________________________________________________________________
CITY, STATE, ZIP___________________________________________________________________________
PHONE__________________ FEIN/SSN# ___________________________ E-Mail ______________________
Signature
Date
Printed Name
Title
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