Submittals_-_Offer_Page_rev_2-2025.pdf
PDF 229 KB Posted
- Attached to
- Independent Medical Evaluation Services
- Solicitation number
- RTM RFP 26-001
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is an offer form document for the City of Phoenix used by offerors to submit bids in response to City solicitations. The form requires offerors to certify their compliance with all terms, conditions, specifications, and addenda issued by the City and to provide essential company information including legal name, address, telephone number, and email address. Offerors must also supply their Arizona Sales Tax Number, Use Tax License Number (if applicable), Arizona Corporation Commission File Number, and federal taxpayer identification number or social security number. The form includes spaces for the authorized representative to sign and print their name and title, along with the submission date.
The offer form serves as the official submission document confirming that offerors have independently developed their pricing without consultation with competitors and understand all requirements of the solicitation. Offerors must enter their City Registration System ID Number from the City's eProcurement website. The form also includes data fields for the City's internal tracking purposes, including the COP Vendor Number and space for multiple authorized signatures, allowing for submissions by entities with multiple signatories or co-legal entities.
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Text version
OFFER
(please complete, sign, and return with the submittal)
TO THE CITY OF PHOENIX - The Undersigned hereby offers and agrees to furnish the material and or service(s) in compliance with all terms, conditions, specifications, and addenda issued as a result of a solicitation.
Arizona Sales Tax No.
Use Tax License No. for Out-of-State Arizona Corporation Commission File No.
Taxpayer’s Federal Identification No.: If recommended for contract award, Offeror agrees to provide its federal taxpayer identification number or as applicable its social security number to the City of Phoenix for the purposes of reporting to appropriate taxing authorities, monies paid by the City of Phoenix under the awarded contract. If the Offeror provides its social security number, the City will only share this number with appropriate state and federal officials. This submission is mandatory under 26 U.S.C. § 6041A.
Enter City’s Registration System ID Number Located at City’s eProcurement website (see SECTION 2
– INSTRUCTIONS - CITY’S REGISTRATION)
Offeror has read, understands, and will fully and faithfully comply with this solicitation, its attachments and any referenced documents. Offeror certifies that the prices offered were independently developed without consultation with any other Offeror or potential Offerors.
Authorized Signature
Print Name and Title (President, Manager, Member)
Date
Offeror Legal Name
Street Address:
City, State, Zip Code:
Telephone Number:
Email Address: __________________________________________________
| Offer AZ Sales Tax No: |
| Offer Use Tax No: |
| Offer ACC No: |
| Offer COP Vendor No: |
| Offer Authorized Signature 1: |
| Offer Date: |
| Offer Name and Title 1: |
| Offer Co Legal Name: |
| Offer Company Name: |
| Offer Company Address: |
| Offer Authorized Signature 2: |
| Offer Name and Title 2: |
File details come from the government source that posted it. Updated .