Formal Letter in Response to RFP No. DHSES/OCS 01-2012 Page 2 of 2 PLEASE SUBMIT WITH ADMINISTRATIVE PROPOSAL Please Note: A response may be grounds for disqualification from this procurement. “No” 1 Information Regarding the Proposer’s Firm: 2 Primary Contact Concerning this Proposal: The rates quoted are an irrevocable offer that is good through 3 Irrevocable the execution of a contract. Yes No The Proposer is willing to, and capable of performing and 4 Willingness to Perform providing all of the Deliverables, products and services described All Services: Yes No in this RFP. The Proposer has read, understands, and accepts the provisions 5 Appendix A: of Appendix A, Standard Clauses for New York Contracts, Yes No which will be incorporated, without change or amendment, into the contract entered into between the OCS and the selected Proposer. The Proposer has (Please the appropriate box.): 6 Vendor Responsibility Questionnaire Certified and filed the Vendor Responsibility Questionnaire on-line via the Requirement: New York State VendRep System. OR Included a properly executed paper copy of the Vendor Responsibility Questionnaire with the Administrative Proposal. 7
Formal Letter in Response to RFP No. DHSES/OCS 01-2012 Page 2 of 2 PLEASE SUBMIT WITH ADMINISTRATIVE PROPOSAL Please Note: A “No” response may be grounds for disqualification from this procurement. 1 Information Regarding the Proposer’s Firm: 2 Primary Contact Concerning this Proposal: 3 Irrevocable The rates quoted are an irrevocable offer that is good through the execution of a contract. Yes No 4 Willingness to Perform All Services: The Proposer is willing to, and capable of performing and providing all of the Deliverables, products and services described in this RFP. Yes No 5 Appendix A: The Proposer has read, understands, and accepts the provisions of Appendix A, Standard Clauses for New York Contracts, which will be incorporated, without change or amendment, into the contract entered into between the OCS and the selected Proposer. Yes No 6 Vendor Responsibility Questionnaire Requirement: The Proposer has (Please the appropriate box.): Certified and filed the Vendor Responsibility Questionnaire on-line via the New York State VendRep System. OR Included a properly executed paper copy of the Vendor Responsibility Questionnaire with the Administrative Proposal. 7
SAM_RFP-01_2012_9-21-2012.docx