If applicable, place an the appropriate box Manufactured Within Manufactured Outside “x” in (check New York State New York State all that apply): If you are not bidding, place an the box and return this page only. “x” in WE ARE UNABLE TO BID AT THIS TIME BECAUSE___________________________________________________. Signature: Printed or Typed Name: Bidder’s Title: Date: Phone : ( ) - ext ( ) Toll Free Phone : ( ) - ext ( ) Fax : ( ) - ext ( ) Toll Free Fax : ( ) - ext ( ) E-mail Address: Company Web Site: FOR NEW YORK STATE PROCUREMENT USE ONLY P.R. # LIT MEMO LET OTHER MISSING PAGES
If applicable, place an “x” in the appropriate box (check all that apply): Manufactured Within New York State Manufactured Outside New York State If you are not bidding, place an “x” in the box and return this page only. WE ARE UNABLE TO BID AT THIS TIME BECAUSE___________________________________________________. Bidder’s Signature: Title: Printed or Typed Name: Date: Phone : ( ) - ext ( ) Fax : ( ) - ext ( ) Toll Free Phone : ( ) - ext ( ) Toll Free Fax : ( ) - ext ( ) E-mail Address: Company Web Site: FOR NEW YORK STATE PROCUREMENT USE ONLY P.R. # LIT MEMO LET OTHER MISSING PAGES
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