ATTACHMENT1
RFPRESPONSEFORM
CompanyName: RFPNo.:_PWPNo.: _ NevadaBusinessLicenseNo.: _BusinessLicenseExp.:
Address: _ City: _
State: ZipCode: _PhoneNo.: FaxNo.:
ContactPerson: Email:
FederalTaxIDNo.: _
BIDDERS’PREFERENCEIstheBidderclaimingBidders’Preference?
YESIfyes, theBidderacknowledges thathe/sheisrequiredto followthe requirementsset forth in theAffidavit (BidAttachment2).
NONo, Ido nothaveaCertificateofEligibilitytoreceivepreferencein bidding.
ACKNOWLEDGEMENTOF ADDENDA:
Theundersigned, asan authorizedrepresentative for theCompanynamed above, acknowledges that he/shehasexamined thisRFP includinganyrelateddocuments, andherebyoffersto furnish all labor,
materials,tools, supplies, equipmentandservicesnecessarytocomplywith thespecifications, termsand conditionssetforth herein and atthepricesstated.
Theundersigned acknowledges receiptofthefollowingaddenda:
AddendaNo._ AddendaNo._
Dated
Dated
AddendaNo._ AddendaNo._
Dated
Dated
DEPARTMENT/SUSPENSIONSTATUS
1. TheProposercertifiesthatitisnotsuspended, debarred or ineligiblefromenteringinto contractswith
theExecutiveBranch of theFederalGovernment, orinreceiptofanoticeofproposed debarmentfrom anystateagencyorlocalpublicbody.
2. TheProposeragreesto provide immediatenoticetoOwner intheeventofbeingsuspended,debarred, ordeclaredineligiblebyanystateorfederaldepartmentoragency, oruponreceiptofanoticeof
proposed debarmentthatisreceived afterthe submission ofthisBidbutpriortotheaward ofthe
PurchaseOrder/Contract.
EXCEPTIONS
Anyexceptionsto anyof the specificationsorrequirementsofthisRFP shallbenotedin writing, and attached totheProposalwhen submitted. Bytakingexceptionsandclearlystatingthemin writingon a
separatesheetofpaperheaded “EXCEPTIONS”, and byofferingalternatesto replacetheexcepted requirements, theProposermaystillcompeteinthesolicitation. However, theOwnershallbethesole
judgeoftheacceptanceorrejection ofanyexceptions.
Are thereanyexceptionstothisbid?Yes No_
SignaturePrint NameandTitleDate
LEGALNAME OFFIRMAS ITWOULDAPPEAR IN CONTRACT
ADDRESS OF FIRM
CITY, STATEZIP CODE
TELEPHONE NUMBERFAXNUMBER NEVADASTATE CONTRACTORS’BOARDLICENSEINFORMATION:
Icertifythatthelicense(s)listed below willbethelicense(s)usedto performthemajorityofthe
workon thisproject.
LICENSE NUMBER:
LICENSE CLASS:
LICENSE LIMIT:
ONE TIME LICENSE LIMITINCREASE $
IF YES, DATE REQUESTED
DUN BradstreetNumber:
STATE OF NEVADA BUSINESS LICENSENO.
NAME OF AUTHORIZED REPRESENTATIVEE-MAIL ADDRESS
SIGNATURE OF AUTHORIZEDDATE REPRESENTATIVE