W912ES26RA001 Attachment 1 - Phase I Proposal Data Sheet.docx

ATTACHMENT 1 ‐ PHASE ONE PROPOSAL DATA SHEET (TAB A)

Fountain City Service Base 1st Floor Office Renovation

Name of Offeror1:

Address:

Phone:

Fax:

E‐mail:

Unique Entity ID (UEI) #

If a separate UEI number has been created for a Joint Venture (JV) it must also be submitted. Provide a UEI number for each entity identified in any proposed teaming arrangement, joint venture, or contractor‐subcontractor association of firms. If the Offeror is a JV or a constructor/designer or contractor‐subcontractor arrangement, list the component entities by name and briefly describe the nature of the association, including at a minimum the prime contractor and designer of record.

AUTHORIZED POINTS OF CONTACT (POC)

The Offeror represents that the following persons are authorized to communicate on its behalf with the Government in connection with this Request for Qualifications (RFQ).

[List names, titles, and telephone number of the POC.]

Name of POC:

POC’s Address:

POC’s Telephone and Email:

RFQ AMENDMENTS (Number and date of acknowledgement)

1 The Offeror is the business entity that you anticipate will submit a response to the Request for Proposals if selected to participate in Phase 2 of this procurement. In the event that the “Offeror” business entity has not yet been formed (e.g. a project specific joint venture), please note that and submit qualification information on that prospective business entity. The components of a prospective business entity must be described with specificity; alternative business entities will not be considered.

Crow River Bank Stabilization

Solicitation No. W912ES18R0004 Section 00 11 00, Page 16

Fountain City Service Base 1st Floor Office Renovation

Solicitation No. W912ES26RA001

By responding to this Request for Qualifications, the signatory represents that:

a. he or she is authorized to bind the Offeror (or, in the case of a business entity that is not yet formed, that he/she has been authorized in writing by all of the component entities to submit this RFQ response on their behalf);

b. the business entity identified as the Offeror in this RFQ response is the business entity that will provide a price/technical proposal in response to Phase 2 of this procurement if requested to participate in that phase; and

c. the Offeror intends to provide a price/technical proposal in response to Phase 2 of this procurement if requested to do so.

Name of Offeror (typed above)

By: (signature) Name of Representative (typed): Relationship of Representative to Offeror: 2

2 If the Offeror is an existing business entity, provide the title of the signatory (e.g. President, CEO, Managing Partner). If the Offeror is a business entity that is yet to be formed, insert “Authorized Representative” into the blank in accordance with a. above.