WV43 page 2.pdf
PDF 77 KB Posted
- Attached to
- copiers for region 6-Braxton County Office
- Solicitation number
- ARFQ 0511 CSE1700000007 1
- Issued by
- Braxton County, West Virginia
About this file
This is a Request for Quotations (RFQ) form issued by the West Virginia Department of Health and Human Resources, Bureau of Child Support Enforcement (DHHR/BCSE) for goods or services needed at the Braxton County location. The form, designated as WV-43 REV. 06/12/12, requests vendor quotations with a submission deadline of 5:30 PM on May 30, 2017, for requisition number ARFQ CSE17*7 dated May 9, 2017. Bids must be delivered to Virginia Hill at the DHHR/BCSE office located at 350 Capitol Street, Room 147, Charleston, West Virginia 25301, with goods or services to be shipped to the Braxton County office at 3734 Sutton Lane, Sutton, West Virginia 26601. The delivery requirement specifies 30 working days after purchase order receipt.
Vendors must submit bids through WVOASIS, facsimile, or mail, with all bids requiring authorized representative signatures; unsigned bids or those received after the closing deadline will not be considered. The RFQ incorporates by reference the Agency Master Terms and Conditions available on the Purchasing Division's website, which all vendors must review and agree to prior to submission. Vendors must also confirm proper registration with any applicable state agencies. The specific items, quantities, unit prices, and delivery terms are to be filled in by the requesting agency and prospective vendors accordingly.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| ServicesRFQ- copiers reg 6.docx | DOCX document | |
| Venpref.pdf | ||
| Federal Funded Procurement attachment.pdf | ||
| Pricing page reg 6.xlsx | XLSX spreadsheet | |
| TCA.pdf | ||
| Final_ARFQ_0511_CSE1700000007_1_ARFQ_FORM.PDF | ||
| WV43 page 1.pdf | ||
| pAffidavit.pdf |
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Text version
WV-43 (REV. 06/12 /12)
Vendor w
Address w
Telephone Number w ( )
Date Acct. No.
Return by ______________ on ______________
Item Number Quantity Unit Price AmountDescription
Delivery Requirements F.O.B.
REQUEST FOR QUOTATIONS
THIS IS NOT AN ORDER
Req. No.
Delivery DateTermsFEIN
TOTAL $
Vendor - Authorized Representative Signature of Authorized Representative
Bid To Be Delivered To:
Goods/Services To Be Shipped To:
GENERAL TERMS AND CONDITIONS: The Agency Master Terms and Conditions located on the Purchasing Division's website at http:/// www.state.wv.us/admin/purchase/TCA.pdf, ("Terms and Conditions") are hereby made a part of this agreement and are specifically incorporated herein by reference. By signing this document, Vendor certifies it has reviewed the Terms and Conditions, fully understands them, and agrees to be bound by their provisions.
By signing below, I certify that I have reviewed this Requisition for Quotations in its entirety; understand the requirements, terms and conditions, and other information contained herein; that I am submitting this quotation for review and consideration; that I am authorized by the bidder to execute this bid or any documents related thereto on bidder's behalf; that I am authorized to bind the bidder in a contractual relationship; and that to the best of my knowledge, the bidder has properly registered with any State agency that may require registration.
| on: 4:30 PM |
| undefined: 5/30/17 |
| Req No: ARFQ CSE17*7 |
| Date: 5/9/17 |
| Acct No: |
| Bid To Be Delivered To: WV DHHR/BCSE |
Attn: Virginia Hill 350 Capitol St, Rm 147 Charleston, WV 25301 Fax: 304-558-1503 GoodsServices To Be Shipped To: WV DHHR/BCSE Braxton County 3734 Sutton Lane Sutton, WV 26601
| Delivery Requirements: 30 working days after PO received |
| FEIN: |
| Terms: |
| Delivery Date: |
| FOB: |
| Item Number: |
| Quantity: |
| Description: Page 2 of 2 |
Submit bids via WVOASIS, by fax, or by mail. I will not accept e-mailed bids.
"If you have any issues during bid submission through WVOASIS, please call the helpdesk at 304-558-6708, they will be happy to assist you."
All bids must be signed.
Unsigned bids or bids received after the closing date and time will not be considered.
| Unit Price: |
| Amount: |
| fill_26: |
| Text2: |
| Text3: |
| Text1: |
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