Jacket:

Title:

Agency:

Bid opening:

Jacket Bid Discount

622-052 $173,371.00 2 % 20 days $169,903.58

622-052 $406,476.38 0.5 % 20 days $404,444.00

% days $0.00

% days $0.00

% days $0.00

% days $0.00

% days $0.00

* AWARD

RW / RG

Advantage Mailing LLC

Monarch Litho *

622-052

FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815)

DLA Strategic Data Services NORFOLK

June 9, 2022 at 11:00 a.m., prevailing Eastern Standard Time

Contractor Name Terms
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 1 of 9

622-052 Page 1 of 9

Specifications by RW DLA Norfolk / 2-202512G 

Reviewed by RG

U.S. GOVERNMENT PUBLISHING OFFICE

U.S. Government Publishing Office (GPO) 

291 Virginia Beach Blvd., Ste. 401 

Virginia Beach Regional Printing Procurement Office 

Virginia Beach, Virginia 23462 

BID OPENING: Bids shall be opened at 11:00 a.m., prevailing Eastern Standard Time June 9, 2022 at the U.S. 

Government Publishing Office, Virginia Beach Regional Office, 291 Independence Blvd., Suite 401, Virginia 

Beach, VA 23462. Due to COVID-19, this will NOT be a public bid opening. 

ANY QUESTIONS BEFORE AWARD CONCERNING THESE SPECIFICATIONS CALL RUSS WARD (757) 

490-7941 AFTER AWARD, REFER ALL QUESTIONS TO YOUR CONTRACT ADMINISTRATOR WHOSE 

NAME APPEARS IN THE UPPER PORTION OF THE PURCHASE ORDER. NO COLLECT CALLS. 

BID SUBMISSION: Due to the COVID-19 pandemic, the physical office of Virginia Beach Regional Office will 

NOT be open. Based on this, bidders MUST submit email bids to bidsvirginiabeach@gpo.gov for this solicitation. 

No other method of bid submission will be accepted at this time. The jacket number and bid opening date must be 

specified in the subject line of the emailed bid submission. Bids received after 11:00 a.m. on the bid opening date 

specified above will not be considered for award. 

ADDITIONAL EMAILED BID SUBMISSION PROVISIONS: The Government will not be responsible for 

any failure attributable to the transmission or receipt of the emailed bid including, but not limited to, the following 

1) Illegibility of bid. 

2) Emails over 75 MB may not be received by GPO due to size limitations for receiving emails. 

3) The bidder’s email provider may have different size limitations for sending email; however, bidders are 

advised not to exceed GPO’s stated limit. 

4) When the email bid is received by GPO, it will remain unopened until the specified bid opening time. 

Government personnel will not validate receipt of the emailed bid prior to bid opening. GPO will use the 

prevailing time (specified as the local time zone) and the exact time that the email is received by GPO’s 

email server as the official time stamp for bid receipt at the specified location. 

OFFERS: Offers must include the cost of all materials and operations for the total quantity ordered in 

accordance with these specifications. In addition, a price must be submitted for each additional Roll. The price 

for additional quantities must be based on a continuing run, exclusive of all basic or preliminary charges and will 

not be a factor for determination of award. 

Note: Bidders are to fill out, sign/initial, as applicable, and return page 5.

The jacket number and bid opening date must be specified with the emailed bid submission. Refer to Facsimile 

Bids in Solicitation Provisions of GPO Contract Terms, GPO Publication 310.2, as revised January, 2018. 

Bids received after 11:00 a.m. on the bid opening date specified above will not be considered for award. For 

information regarding the solicitation requirements prior to award, email Russ Ward at wward@gpo.gov For 

contract administration after award, contact Virginia Beach at (757) 490-7941. 

GPO CONTRACT TERMS: Any contract which results from this Invitation for Bid will be subject to the 

applicable provisions, clauses, and supplemental specifications of GPO Contract Terms (GPO Publication 310.2, 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 2 of 9

effective December 1, 1987 (Rev. 01-18)) and GPO Contract Terms, Quality Assurance Through Attributes 

Program for Printing and Binding (GPO Publication 310.1, effective May 1979 (revised 9-19)). 

GPO Contract Terms (GPO Publication 310.2) – https://www.gpo.gov/docs/default-source/forms-and-standardsfiles-for-vendors/contractterms2018.pdf 

GPO QATAP (GPO Publication 310.1) – https://www.gpo.gov/docs/default-source/forms-and-standards-files-forvendors/qatap-rev-09-19.pdf 

PREAWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, 

the Government reserves the right to conduct an on-site pre-award survey at the contractor's/subcontractor's 

facility or to require other evidence of technical, production, managerial, financial, and similar abilities to 

perform, prior to the award of a contract. As part of the financial determination, the contractor in line for award 

may be required to provide one or more of the following financial documents: 

1) Most recent profit and loss statement 

2) Most recent balance sheet 

3) Statement of cash flows 

4) Current official bank statement 

5) Current lines of credit (with amounts available) 

6) Letter of commitment from paper supplier(s) 

7) Letter of commitment from any subcontractor 

The documents will be reviewed to validate that adequate financial resources are available to perform the contract 

requirements. Documents submitted will be kept confidential, and used only for the determination of 

responsibility by the Government. Failure to provide the requested information in the time specified by the 

Government may result in the Contracting Officer not having adequate information to reach an affirmative 

determination of responsibility. 

NOTE: Prior to award the apparent low vendor may be able to show ability to produce the product in question and 

may be asked to supply samples of similar items. 

PAYMENT: PLEASE SUBMIT BILLING PACKAGES WITHIN 15 DAYS OF DELIVERY 

Submitting invoices for payment via the GPO fax gateway (if no samples are required) utilizing the GPO barcode 

coversheet program application is the most efficient method of invoicing. Instruction for using this method can be 

found at the following web address: http://winapps.access.gpo.gov/fms/vouchers/barcode/instructions.html 

Invoices may also be mailed to: U.S. Government Publishing Office, Office of Financial Management, 

Attn: Comptroller, Stop: FMCE, Washington, DC 20401. 

For more information about the billing process refer to the General Information of the Office of Finance web page 

located at https://www.gpo.gov/how-to-work-with-us/vendors/how-to-get-paid 

MODS: If any additional costs are incurred during the production of this job due to Government action (i.e. 

AAs), contractor is REQUIRED to submit written request to the Printing Specialist for written approval BEFORE 

proceeding. 

Only a warranted GPO Contracting Officer acting within their appointed limits, has the authority to issue 

modifications or otherwise change the terms and conditions of this contract. If an individual other than the GPO 

Contracting Officer attempts to make changes to the terms and conditions of this contract, you shall not proceed 

with the change and shall immediately notify the GPO Contracting Officer. Proceeding with any work not 

authorized by the GPO Contracting Officer will be at the Contractor’s own risk. 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 3 of 9

PRODUCT: Direct mail package. 

QUANTITY: 705,000 total package sets (2,820,000 total pieces) 

-Envelope carrier with pocket: 705,000 

-2 BRC: 705,000 of each version, for a total of 1,410,000 

 -Letter: 705,000 

 PLUS: Printer is to supply the agency with 50 sealed and 50 unsealed self-mailers (These samples should 

be held by printer until notification has been given of office opening). Shipping Address to be provided. 

PLUS: 5 self-mailer samples to Hartsdale, NY prior to shipping full run. 

PLUS: 10 self-mailer samples and any other production material for this project should be returned on or 

before September 30, 2022 

TITLE: FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815)

PAGES: 

BRC: 2 pages. One side only. 

Envelope with pocket: 2 pages. Head to foot. 

Letter: 2 pages. One side only. 

TRIM: 

BRC: 6 1⁄2” x 5 7/16” 

Envelope with pocket: Flat - 19 3/8” x 7”, Converted Size - 7” x 7 

Letter: 5 7/16” x 13”. Folded – 6 5/8” x 5 7/16” 

SCHEDULE: 

Unscheduled material such as shipping documents, receipts or instructions, delivery lists, labels, etc., will be 

furnished with the order or shortly thereafter. In the event such information is not received in due time, the 

contractor will not be relieved of any responsibility in meeting the shipping schedule because of failure to request 

such information. 

Inside delivery (to arrive at destination) by September 2, 2022 by 2pm local time. 

F.O.B. Destination 

DESCRIPTION: 

***Must be printed on a press capable of printing six colors (six printing units) plus aqueous coating in a 

single pass. 

***All PMS color must be shown in proofs as close as possible to the actual color. 

***Delivery Date is non-negotiable. Second round proofs may be required and should be considered and 

included in cost estimate when bidding on projects/schedule. 

***SECOND ROUND PROOFS are changes to existing proofs. Corrections (color and/or copy) to be made by 

the printer and the output of proofs need to be included your price. 

*** FINAL FILES - Upon completion of the printing, printer needs to provide two (2) labeled final digital 

downloads along with a directory of what was printed. 

*** Press schedule must be provided along with how many shifts this will be printed over. 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 4 of 9

Direct mail package consisting of 4 pieces. Each package consists of an envelope carrier with pocket, 2 

Business Reply Cards, and letter, printing 4-color process, Pantone 296C, Pantone 187C plus gloss aqueous and 

spot varnish; collated and sealed for the letter shop. 

Quantity is 2,820,000 pieces for a total of 705,000 complete packages. 

Envelope with pocket: 705,000 Print head to foot. 

-Size: Flat - 19 3/8” x 7”, Converted Size - 7” x 7”; Inside Panel glues 3/8” on each, side to create a pocket that 

measures 5 3/8” with rounded top corners. Bleed. 

-Die-Cuts: 1 Die-Cut: First 7” panel – 1 7/8” x 2”, Color 7/7 Bleed (4/C Process Color + Pantone 187C + 

Pantone 296C + 100% Gloss Aqueous), 

-Stock: White No.1 Coated Cover, Gloss-Finish, (basis weight: 80 lbs. per 500 sheets, 20 x 26"), equal to JCP 

Code L11. 

Reply Cards: 2 LOTS, Quantity: 705,000 each (1,410,00 total). Print Head to Head. 

-BASE CODE FSHGB22, PASS CODE FSHGP22, Size: 6 1⁄2” x 5 7/16”, One Horizontal Perf on Each Card. Perf is 

below the red bar (Detach here.) Code changes (black) for each card. Base & Pass have different 4/C Images face & 

back, Color 7/7 Bleed- (4/C Process Color + Pantone 187C + Pantone 296C + 100% Aqueous). Bleed. 

-Stock: White No.1 Coated Cover, Gloss-Finish, (basis weight: 80 lbs. per 500 sheets, 20 x 26"), equal to JCP 

Code L11. 

Letter: – 1 VERSIONS. Quantity: 705,000. Print one side only. 

-Size: Flat – 5 7/16” x 13”. Folded – 6 5/8” x 5 7/16” (Letter short folds in back), Color 7/0 Bleed- (4/C Process 

Color + Pantone 187C + Pantone 296C + Spot Gloss Varnish). Bleed. 

- Stock: White No. 1 Coated Text, Gloss-Finish basis weight: 80 lbs. per 500 sheets, 25 x 38", equal to JCP 

Code A181. 

PRINTING/CONVERSION/ASSEMBLY: All type and images are in position and are high-resolution files. 

Proofing: Provide Agency with 1 composed color proof along with 1 digital asset proof of each component along 

with stock sample cover & text) for approval. 

Assembly: In the center pocket the base reply card should be inserted facing the front of the carrier followed by 

the pass along reply card and then the letter placed on top of the reply cards with letter copy facing out., 

Sealing: Package should be fugitive glue sealed with 2 minimal dots., Assembly: PANEL Universal Gender 

(Female), Outside Code FSHG22, LETTER CODE FSHGL22, BASE REPLY CODE FSHGB22, PASS REPLY 

CODE FSHGP22. 

 

COLLATION and STUFFING: In center pocket the base reply card should be inserted facing the front of the 

center followed by the pass along reply card and then the letter placed on top of the reply cards with letter copy 

facing out. Follow previous similar sample. End user will be addressing. 

PAPER: * Must be in accordance with JCP Paper Specification Standards in effect on date of this order

Envelope and BRC: JCP Code* L11, No. 1 Gloss-Coated Cover, Basis Size 20 X 26" Basis Weight 80# 

Letter: JCP Code* A181, No. 1 Gloss-Coated Text, Basis Size 25 X 38" Basis Weight 80#

COLOR OF INK: 4/C Process Color + Pantone 187C + Pantone 296C 

MARGING: Bleed. 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 5 of 9

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under "Government to 

Furnish," necessary to produce the product in accordance with these specifications. 

GOVERNMENT TO FURNISH: Purchase Order and furnished material (Digital file on thumb drive, color proofs 

and collated lasers upon award from Jennifer Brown) will be ready for pickup no later than June 13, 2022. 

PROOF: PDF, High Resolution proof, Stock sample, ink drawdowns for each pantone and digital content proof 

are required. 

*PDF Proof: 

Contractor to submit one Press Quality PDF soft proof (for content only) using the same Raster Image Processor 

(RIP) that will be used to produce the final printed product. PDF proof will be evaluated for text flow, image 

position, and color breaks. Proof will not be used for color match. Include REMINDER that agency can keep 

proof Three (3) workdays. Date of receipt is NOT considered first workday. 

Contractor must call Jennifer Brown at 757-278-8264 to confirm receipt. 

Email PDF to: jackie.mcgowan@wundermanthompson.com, jennifer.2.brown@dla.mil and 

wward@gpo,gov. 

*High Resolution proof: 

Contractor MUST supply a proof sign-off sheet and a return airbill. Also please include a reminder that the 

agency can only keep proofs 3 days. 

1 set of digital one-piece composite laminated halftone proofs on the actual production stock (Kodak Approval, 

Polaroid PolaProof, CreoSpectrum, or Fuji Final Proof) with a minimum resolution of 2400 x 2400 dpi. 

At contractor’s option, (1) set(s) of inkjet proofs that are G7 profiled and use pigment-based inks may be 

submitted in lieu of digital one-piece composite laminated halftone proofs. A proofing RIP that provides an option 

for high quality color matching such as Device Links Technology and/or ICC Profiles Technology, and meets or 

exceeds industry tolerance to ISO 12647-7 standard for Graphic Technology (as of 2016 and future amendments) 

must be utilized. Proofs must be ripped and sent at plate resolution (minimum of 2400 x 2400 dpi). If using a 1 bit 

tiff, the tiff must be made at a minimum of 2400 dpi. Output must be a minimum of 2400 x 1200 dpi on a 

GRACoL or SWOP certified proofing media. Proofs must contain both of the following to be evaluated for 

accuracy: 3-tier color control strip: IDEAlliance ISO 12647-7 2013(i1), and the GPO Resolution target found at: 

www.gpo.gov/gporestarget.pdf. NOTE: If a contractor chooses this proof option, prior evaluation and approval 

of this proofing method must be provided by GPO, Quality Control for Published Products, to ensure that the final 

product will be produced in accordance with contract specifications. See instructions at: 

https://www.gpo.gov/docs/default-source/forms-and-standards-files-forendors/qlsamples6f200c30b44a64308413ff00001d133d.pdf. Failure to obtain this evaluation and approval may be 

cause for the job to be rejected should the final product not match the proofs for color. 

Proofs must contain color control bars (such as Brunner, GATF, GRETAG, or RIT) for each color of ink on the 

sheet. Control bars must be placed parallel to the press ink rollers and must show areas consisting of minimum 1/8 

x 1/8 solid color patches; tint patches of 25, 50 and 75%; dot gain scale; and gray balance patches for process color 

(if applicable). These areas must be repeated consecutively across the sheet. 

The make and model number of the proofing system utilized shall be furnished with the proofs. These proofs must 

contain all elements, be in press configuration, and indicate margins. Proofs will be used for color match on press. 

Direct to plate must be used to produce the final product with a minimum of 2400 x 2400 dpi. 

Pantone colors must be simulated on proofs and must be proofed separately on a digital color content, overlay, or 

inkjet proof. 

Contractor to submit ink draw downs on actual production stock of Pantone color(s) used to produce the product. 

Half of draw down must show varnish or coating, as applicable.
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 6 of 9

Digital color content proof shall be used to represent spot varnish. 

*Content proof: 

1 set(s) of digital color content proofs. Direct to plate must be used to produce the final product with a minimum 

resolution of 2400 x 2400 dpi. 

Proofs must be created using the same Raster Image Processor (RIP) that will be used to produce the product. 

Proofs shall be collated with all elements in proper position (not pasted up), imaged face and back, trimmed and 

folded to the finished size of the product, as applicable. 

One set of proofs to be sent to the address provided and one set to be held by contractor for reference, corrections 

and/or approvals. 

*Stock samples: At the same time as submission of the proofs, submit a minimum of 1 set, 8-1/2 x 11 blank sheets 

to proof addressee of the actual paper to be used in the production of the contract requirements. Samples must be of 

the kind and quality required by the specifications. The Government will rely on the samples only as a reference to 

the general appearance of the stock that will be provided by the contractor in conformance to the specifications. The 

Government assumes no contractual obligation to perform any inspection and test for the benefit of the contractor. 

The Government's failure to inspect and accept or reject the paper samples shall not relieve the contractor from 

responsibility, nor impose liability on the Government, for nonconforming paper. 

STOCK APPROVAL NOTE: Stock sample must be sent to the address provided below for customer review PRIOR 

to any contractor stock procurement or use. The customer will not be held financially responsible for any stock 

procurement for this job that was not previously provided to the customer for review and in conformance to the paper 

specifications. The requested stock sample is for approval of the actual stock and paper should not be purchased 

prior to approval of sample. 

Contractor must supply a proof sign-off sheet and return airbill. Also please include a reminder that the agency 

can only keep proofs for 3 days. 

-Send proofs to: 

Ms. Jackie McGowan 

2 Maple Street 

Hartsdale, NY 10530 

BINDING: Die cuts where applicable, folding, gluing, perforations where applicable. See description. 

PACKING and SHIPPING: Inserted, sealed packages are to be packed in cartons by outside code and 

shipped to the final destination. Pack in new corrugated solid fiberboard containers with minimum bursting 

strength of 275 psi. DO NOT SHRINK WRAP ITEMS. Supplied GPO 905 carton labels must be followed. 

Bulk packaging must be stabilized to avoid bursting or shifting on truck(s) during the delivery process, of 

which, may cause damage and/or hamper the letter house process.

All inbound materials must arrive on pallets, Pallet size: GMA1 or GMA2 (4-way), length: 48 inches, width: 

40/42 inches, Maximum height per pallet: 48 inches, Maximum weight per pallet: 2,500 pounds, Maximum 

weight per carton:45 pounds. Failure to properly palletize may be cause for re-palletizing at contractor's 

expense. See GPO Contract Terms. 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 7 of 9

DEPARTMENTAL RANDOM COPIES (BLUE LABEL): All orders must be divided into equal sublots in 

accordance with the chart below. A random copy must be selected from each sublot. Do not choose copies from 

the same general area in each sublot. The contractor will be required to certify that the copies were selected as 

directed using GPO Form 917 – Certificate of Selection of Random Copies which can be located on GPO.gov. 

The random copies constitute a part of the total quantity ordered, and no additional charge will be allowed. 

Quantity Number of 

 Ordered Sublots 

 705,000 Sets 200 

 

These randomly selected copies must be packed separately and identified by a special label, GPO Form 2678 – 

Departmental Random Copies (Blue Label), which must be printed on blue paper and affixed to each affected 

container. This form can be downloaded from GPO.gov. The container and its contents shall be recorded 

separately on all shipping documents and sent in accordance with the distribution list.

A copy of the print order/specification and a signed Certificate of Selection of Random Copies must be included. 

A copy of the signed Certificate of Selection of Random Copies must accompany the invoice sent to U.S. 

Government Publishing Office, Financial Management Service, for payment. Failure to furnish the certificate 

may result in delay in processing the invoice. 

NOTIFICATION OF SHIPMENT: Contractor must notify the ordering agency on the same day that the 

product ships/delivers via e-mail sent to jennifer.2.brown@dla.mil / jackie.mcgowan@wundermanthompson.com

andwward@gpo.gov. The subject line of this message shall be Distribution Notice for Jacket 522-056. The notice 

must provide all applicable tracking numbers, shipping method, and Title. Contractor must be able to provide 

copies of all delivery, mailing, and shipping receipts upon agency request. 

DISTRIBUTION: 

Shipping cost must be included in the bid price. Ship all destinations by traceable means. All expenses incidental 

to picking up and returning materials and samples must be borne by the contractor. 

Deliver f.o.b. destination as follows: 

Deliver final product including Blue Label copies to: 

Data Mail, 

240 Hartford Avenue 

Newington, CT 06111 

Attn: Colleen Costin/Scott Stickles, 860-666-0399 

FINAL SAMPLES - Printer is to supply the agency with 50 sealed and 50 unsealed self-mailers: (These samples 

should be held by printer until notification has been given of office opening:). Shipping Address to be provided. 

FINAL FILES - Upon completion of the printing, printer needs to provide two (2) labeled final digital downloads 

along with a directory of what was printed. 

RETURN OF MATERIALS 

Upon completion both downloads; 15 self-mailer samples and any other production material for this project 

should be returned on or before September 30, 2022 to: 

Ms. Jackie McGowan 

2 Maple Street 

Hartsdale, NY 10530 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 8 of 9

QUALITY ASSURANCE LEVELS AND STANDARDS: The following levels and standards shall apply to these 

specifications: 

Product Quality Levels: 

(a) Printing Attributes -- Level 1 

(b) Finishing Attributes -- Level 1 

(c) Exceptions: None 

Inspection Levels (from ANSI/ASQC Z1.4): 

(a) Non-destructive Tests - General Inspection Level 1. 

(b) Destructive Tests - Special Inspection Level S-2. 

Specified Standards: The specified standards for the attributes requiring them shall be: 

 Attribute Specified Standard 

P-7. Type Quality and Uniformity Approved High Resolution Proof 

P-8. Halftone Match Approved High Resolution Proof 

P-9. Solid and Screen Tint Color Match Ink Draw Down/Pantone Matching System 

9-10. Process Color Match Approved High Resolution Proof 
 Jacket 622-052 FY22 SY23 1HSS HISTORY PACKAGE (DSO 798815) Page 9 of 9

Bidders must fill out this page and return it. 

BID PRICE: $________________ ADDITIONAL RATE: $_____________ PER: _____________ 

DISCOUNTS: Discounts are offered for payment as follows: __________ Percent, _________calendar days. 

See Article 12 “Discounts” of Solicitation Provisions in GPO Contract Terms (Publication 310.2). 

AMENDMENT(S): Bidder hereby acknowledges amendment(s) number(ed) ____________________________ 

BID ACCEPTANCE PERIOD: In compliance with the above, the undersigned agree, if this bid is accepted 

within____________ calendar days (60 calendar days unless a different period is inserted by the bidder) from the 

date for receipt of bids, to furnish the specified items at the price set opposite each item, delivered at the 

designated points(s), in exact accordance with specifications. 

NOTE: Failure to provide a 60-day bid acceptance period may result in expiration of the bid prior to award. 

BIDDER’S NAME AND SIGNATURE: Unless specific written exception is taken, the bidder, by signing and 

submitting a bid, agrees with and accepts responsibility for all certifications and representations as required by the 

solicitation and GPO Contract Terms – Publication 310.2. When responding by email, fill out and return one 

completed copy of all applicable pages that include the Jacket Number, Bid Price, Additional Rate, Discounts, 

Amendments, Bid Acceptance Period, and Bidder’s Name and Signature, including signing where indicated. 

Valid electronic signatures will be accepted in accordance with the Uniform Electronic Transactions Act, § 2. 

Electronic signatures must be verifiable of the person authorized by the company to sign bids. 

Failure to sign the signature block below may result in the bid being declared non-responsive

Bidder _____________________________________________________________________________________ 

 (Contractor Name) (GPO Contractor’s Code) 

 ___________________________________________________________________________________________ 

(Street Address) 

 ___________________________________________________________________________________________ 

(City – State – Zip Code) 

By _________________________________________________________________________________________ 

 (Printed Name, Signature, and Title of Person Authorized to Sign this Bid) (Date) 

 ___________________________________________________________________________________________ 

 (Person to be Contacted) (Telephone Number) (Email) 

_______________________________________________________________________________________ 

THIS SECTION FOR GPO USE ONLY 

Certified by: __________ Date: __________ Contracting Officer: __________ Date: __________ 

 (Initials) (Initials) 

___________________________________________________________________________________________