Emergency Plumbing Repair Services

Hall County Government
FINANCIAL SERVICES
PURCHASING DIVISION
EXHIBIT A - BID RESPONSE FORM
Bidders must complete and return this form with their bid.
By submitting a proposal, the respondent certifies that it has fully read and
POST OFFICE DRAWER 1435 understands the proposal's Scope of Work and requirements needed to
GAINESVILLE, GA 30503 complete the project. The services offered and the cost proposal must be
valid for at least one hundred twenty (120) days from date of signature.
t: 770.535.8270 | f: 770.531.6711
Bid No: 018-47_____________
FINANCIAL SERVICES DIRECTOR
Bid Name: Emergency Plumbing Repair Services Annual Contract
Taylor Samples, CPA
Date of Bid Submittal: _____________________
ASSISTANT FINANCE DIRECTOR
Elizabeth White Affirmation: Bidder affirms the following by affixing a signature below:
"I, the undersigned, agree to abide by all terms and conditions of this
PURCHASING MANAGER solicitation and certify that I am authorized to sign this bid proposal".
Andy Youngblood
Company's Full Legal Name: __________________________________
Bidder Signature: ___________________________________________
Print Name: _______________________________________________
Title: _____________________________________________________
Phone Number: ____________________________________________
Email Address: _____________________________________________
Physical Address: ___________________________________________
City/State/Zip: ______________________________________________
Unsigned bids may be declared as "non-responsive" and may not be
evaluated.
If you desire to submit a "No-Bid" then please indicate by checking one or
more of the reasons below:
______ Bidder does not offer this product/service
______ Unable to meet specifications
______ Unable to meet scheduled timeline