Offering Entity Acknowledgement Form

Offering Entity Acknowledgement Form

KATY, TX - OPC

RLP ID: 36C10F25R0024

The Offeror attests that the information provided below is accurate and shall be a basis for evaluation in RLP No. 36C10F25R0024. Failure to provide the required information may deem your proposal nonresponsive. Offeror Information
Entity Name:
Address:
UEI Number:
Tax Identification Number:
Authorized Official Name:
Authorized Official Phone Number:
Authorized Official Email:
Authorized Official is Listed in Entity SAM Representations: Authorized Official is Listed in Entity Operating Agreement: Date of Submission:
Time Specified for Receipt of Offers:

Yes
Yes

No
No

Offeror Entity/Prime Contractor Status
Prime Contractor Size Status:

SDVOSB

VOSB

SB
Offer Entity Currently Certified in SAM under NAICS 531120: Offer Entity Currently Verified in VetCert:

Offering Entity POC Signature
Offering Entity POC Name

Yes
Yes

Date

No
No