Jacket: 417‐241

Title: Form 1040 ES Estimated Tax for Individuals (Cat. No. 11340T) (Rev. 2021)

Agency: Treasury/IRS

Bid Opening: February 19, 2021 at 11:00am

Bid Terms Discounted Total

$12,709.00 2.0% 20 days $12,454.82

$19,965.80 1.0% 20 days $19,766.14

$21,500.00 2.0% 20 days $21,070.00

$23,532.00 2.0% 20 days $23,061.36

$28,875.00 0.0% 30 days $28,875.00

$33,333.00 3.3% 20 days $32,223.01

% days $0.00

% days

% days $0.00

% days $0.00

% days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

days $0.00

NPC, Inc.

Contractor Name

Advantage Mailing LLC ‐ Anheim

Highland Computer Forms

Monarch Litho, Inc.

LSC Communications LLC                            

Las Vegas Color Graphics, Inc.                   

          
Specifications by DEE Jacket 417-241 

Page 1 of 8 IRS Req. 1-00113 

Reviewed by RM 

BID OPENING: Bids shall be opened at 11:00 AM., prevailing Eastern Standard Time (EST), on February 19, 2021 

by the U.S. Government Publishing Office, in Washington, DC 20401. Due to the COVID-19 pandemic, this will NOT 

be a public bid opening 

BID SUBMISSION: NOTE: Due to the COVID-19 pandemic, the physical office will NOT be open. Based on this, 

vendors MUST submit e-mail bids to bidsapsdc@gpo.gov for this solicitation. No other method of bid submission will 

be accepted at this time. 

The Jacket Number 417-241 and bid opening date must be specified in the subject line of the e-mailed bid submission. 

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

For information regarding the solicitation requirements prior to award, email deeverett@gpo.gov. For contract 

administration after award, contact APS DC at 202-512-0307. 

Additional e-mailed Bid Submission Provisions: 

The Government will not be responsible for any failure attributable to the transmission or receipt of the e-mailed bid 

including, but not limited to, the following— 

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

(2) The vendor’s email provider may have different size limitations for sending e-mail, however vendors are 

advised not to exceed GPO’s stated limit. 

(3) Illegibility of bid. 

(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 e-mailed bid prior to bid opening. GPO will use the prevailing time (specified 

as the local time zone) and the exact time that the e-mail is received by GPO’s email server as the official time stamp 

for bid receipt at the specified location. 

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, 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)). 

Offers must include the cost of all materials and operations for the total quantity ordered in accordance with these 

specifications. 

PRODUCT: 12-page self-cover publication, paste on fold, perforation required. 

TITLE: Form 1040-ES - Estimated Tax for Individuals. (Cat. No. 11340T) (Rev. 2021) 

CATALOG NUMBER: 11340 T 

ITEM: Form 1040-ES (Rev. 2021) 

QUANTITY: 243,200 Copies, plus or minus 15% 

CHANGES IN QUANTITY: The Government, for the FINAL QUANTITY, may submit increases or decreases of 

up to 15% in the total quantity for each item until the date specified in the schedule. These quantity changes may be 

made by telephone and confirmed in writing and will be the FINAL quantity. Billing adjustments for scheduled 

quantity changes (+ or -) will be at the contractor's quoted "ADDITIONAL RATE". If no changes have been received 

by the scheduled date for final quantity adjustments, the bid quantities will stand as the FINAL contract quantity. Any 

further adjustments, due to extenuating circumstances, will be negotiated with the contractor. 
Page 2 of 8 Jacket 417-241 

Statistical Determination of Actual Quantities Shipped: The Government has developed a Statistical Sampling Program 

for determining quantities received by IRS destinations. Two basic methods will be available, the hand counting 

method and the machine counting method. 

The contractor agrees that the Government may choose either or both methods for quantity verification. Where 

shortages occur, the contractor will have to make up the shortages (if time permits) or be subject to corrective action. 

NOTE: Must be full final Quantity to all consignees. No shortages or overruns will be allowed. 

TRIM SIZE: 8-1/2 x 11", bind (paste on fold) on 11” dimension. 

GOVERNMENT TO FURNISH: Electronic transfer of text, via email or File Transfer Protocol (FTP), in Portable 

Document Format (PDF) generated from Adobe Acrobat 9.0 backward compatible with Acrobat 7.0 (all images in 

PDF files will be hi-resolution and all fonts will be embedded in the files); the operating system is Windows based, the 

application used is Adobe LiveCycle ES, containing PDF files. Prior to image processing, the contractor is responsible 

for checking files contained on the furnished electronic files/media to ensure that correct file output selection has been 

provided for, so as to correctly output for printing. Output must be generated on high resolution image processors. 

Contractor must set a GPO imprint line and insert per GPO Pub. 310.2, page 9, para. 9). 

PDF file for IRS Carton Label (label image is approx. 7-11/16 x 4-1/2”). 

Excel distribution file via email containing addresses for shipping IRS/Contractor Distribution. 

IRS Form 2040 – Distribution List in a PDF fillable Adobe Acrobat 8.0 file format provided via e-mail. 

IRS Document 12321 – Pallet Specifications. 

Contractor to download the Labeling and Marking Specifications form (GPO Form 905, R. 7-15) from 

gpo.gov, fill in appropriate blanks, and attach to shipping containers. 

Identification markings such as register marks, ring folios, rubber stamped jacket numbers, commercial identification 

marks of any kind, etc., except GPO imprint, form number, and revision date, carried on copy or film, must not print 

on finished product. 

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

necessary to produce the product(s) in accordance with these specifications. 

Contractor is required to have Internet access, provided through an Internet Service Provider (ISP), an e-mail account 

and a web browser equivalent to Internet Explorer 6.0 (or higher). The contractor is also required to have Adobe 

Acrobat 8.0 Standard (or higher) software (not Adobe Reader). The contractor must furnish an email address for the 

IRS to email the forms mentioned above. 

PROOFS: Contractor must submit same-size proofs electronically. Proofs must be submitted within 1 day after receipt 

of electronic files to Mary.E.Morrison@irs.gov. It will be held no more than 1 workday by the IRS. If any contractor’s 

errors are serious enough in the opinion of the IRS to require revised proofs, the revised proofs are to be provided at 

no expense to the Government. No extra time can be allowed for the reproofing; such operations must be accomplished 

within the original production schedule allotted in the specifications. Proofs must include the GPO Imprint line/logo. 

STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein or listed 

for the corresponding JCP Code numbers in the “Government Paper Specification Standards No. 13” dated 

September 2019. https://www.gpo.gov/docs/default-source/forms-and-standards-files-for-vendors/vol_13.pdf 

JCP Code D10, White Writing 20 lbs. or equal to JCP Code A60 50 lbs. uncoated text. JCP Code A70 is NOT 

acceptable on this order. 

PRESSWORK: Print head to head in black ink. Some pages print with flat tones. 

FORMAT: Pages are folioed 1 through 12 with pages 10 and 12 marked “This page left blank intentionally”. 
Page 3 of 8 Jacket 417-241 

MARGINS: Adequate gripper margins, follow furnished files. 

BINDING: Paste on fold on the 11” dimension. Trim 3 sides. 

PERFORATE VERTICALLY: Pages 9/10 and 11/12, at 8” from outside (right) edge. 

PERFORATE HORIZONTALLY: pages 9/10 at perforation lines approximately 7-1/4 inches from the top edge; 

and pages 11/12 at 3-3/4 inches and 7-5/16 inches from the top edge. Horizontal perforations must start at the outside 

edge and extend across to meet the vertical perforations. Perforations must permit easy and clean separation but be of 

sufficient strength to prevent disengagement during normal labeling and mailing operations. If there is any discrepancy 

on placement of horizontal perforations, follow the perforation lines on the copy provided. 

PACKING: No internal wrapping or tying. Place full size corrugated boards on top, bottom, and vertically between 

stacks. Pack 500 copies per shipping container, in 2 stacks. Pack solid in corrugated or solid fiber shipping containers, 

bursting strength: 200 p.s.i., minimum. The cartons, if stapled, may only be stapled on the bottom and/or side, in 

accordance with GPO Contract Terms (310.2), and the label must be applied to coincide with this construction, that is, 

no staples are to be on the top. Contractor will determine exact dimensions of carton in accordance with folded and/or 

trim size and weight of the product being produced with maximum 8” height. 

CARTON SPECIFICATIONS: The cartons supplied by the contractor must be corrugated or solid fiber shipping 

containers, 1380 kPa (200 psi) minimum bursting strength. Bottom flaps may be glued, stapled, or sealed with 

polyester tape 2 to 3" width, minimum 12 kNm (65 lbs./inch) transverse tensile strength). Cartons are to be sealed at 

top with 2 to 3" paper or polyester tape (not reinforced). Approximate carton size is l7-1/2 X 11-1/2 X 8". Contractor 

will determine exact dimensions of carton in accordance with trim size of pamphlets he will produce. Cartons used for 

bulk shipments require a carton label. 

Bottom flaps may be glued, or sealed with polyester tape 2 to 3” width, minimum 65 lbs. /inch transverse tensile 

strength. Cartons are to be sealed at the top with 2 to 3” paper or polyester taped (not reinforced). Shipments which 

do not fill a shipping carton must be packaged with fill materials of sufficient strength and durability and in such a 

manner which will guarantee that the product will not be damaged and the carton will not open nor split when 

processed through the U.S. mail system, small package carrier or motor freight carrier delivery systems. 

CARTON PACKING: Pack cartons in 2 stacks, in suitable uniform quantities per carton, with the weight of a fully 

packed carton between 28 to 32 lbs. Note: Under no circumstances can the carton weight exceed 32 lbs. or carton 

height exceed 8 inches. 

PALLETS: Pallets are required. Pallets for IRS consignments: Pallets must be type III and must conform to Federal 

Specifications NN-P-71C, and any amendments thereto except for dimensions and single center stringer (must not be 

double stringer). Pallets are 48” in length and 40” in width and must not exceed 5” in height. Full entry MUST be on 

the 40" width. Strict adherence to these dimensions is necessary to accommodate storage requirements of IRS 

distribution centers. Receipt of incorrect pallets may result in a charge for each incorrect pallet which will be assessed 

against the contractor. This charge will cover additional costs incurred by IRS to re-palletize the shipment onto correct 

pallets – After award contractor will be provided with diagram showing exact construction of pallets. 

Palletizing: Cartons shall be stacked on pallets using a reverse layer pattern, 9 cartons per layer, with a maximum height 

of 55", including pallet. Cartons must be fastened securely to the pallet in a manner that will prevent movement during 

transit but permit ready removal, without damage to the cartons, at destination. Neither metal strapping nor pallet caps 

are to be used. There must be no more than one partial pallet per destination. 

LABELING AND MARKING: Carton labels MUST be generated from the electronic file (IRS form 6153 (3-

2006)) provided by the IRS. Contractor’s streamlined or recreated labels will not be acceptable. Reproduce shipping 

container label (IRS Form 6153 (3-2006)) as necessary from furnished file on suitable white stock, fill in any 

appropriate blanks, and attach to one end of each shipping container, which must be facing out if loaded on a pallet. 

If not pre-populated on the carton label furnished by the IRS, the following items must be filled in by the contractor; 

From (Contractor's Name and Address); To* (Consignee, complete address must appear on carton label); and GPO 

Jacket Number. 
Page 4 of 8 Jacket 417-241 

NOTE: If the quantity stated on the furnished carton label is not the same quantity within the carton, the 

contractor must notify the printing specialist indicated on the print order to resolve the discrepancy 

immediately prior to packing. 

*At the contractor's option, the consignee address may be eliminated from the carton labels on all full and secure pallet 

loads. If this option is exercised, then in addition to the cartons being labeled, pallets require labels containing the full 

shipping address on all four sides of the load on the pallet. 

CONTRACTOR DISTRIBUTION SHIPMENTS: Small package carrier: Must affix one SPC shipping label to 

the top left of each carton and an IRS label of end cap of each carton. Domestic Mail: All Post Office shipments are 

to be sent via reimbursable domestic mail with an IRS carton label on the side of the carton. 

REPORTING: Contractor is required to submit all USPS postage on an IRS Postage Summary Report showing the 

GPO jacket and number of pieces sent. In addition, the contractor must submit all UPS Tracking Statements to the 

Print Analyst, Mary Morrison via e-mail. All of the above mentioned forms must be submitted within 3 days of the 

final day of shipping via e-mail to: Mary.E.Morrison@irs.gov and Yvette.A.Wood@irs.gov. 

MISLABELING/QUANTITY/LOOSE PACKING--PRICE REDUCTION

1. In addition to other inspection procedures detailed elsewhere in these specifications, each receiving office will 

inspect shipments for label accuracy, carton quantity, and loose packing. In the event one or more mislabeled cartons 

are discovered, each carton which must be opened and inspected and/or relabeled will reduce the contract price by 

$2.00. In the event it is determined by the receiving office (either through the accompanying bills of lading for freight 

shipments or through association with other cartons received) that the contents of one or more cartons is wrong, thus 

resulting in a shortage of the item, the contractor will be charged the $2.00 per carton inspection / re-labeling fee 

mentioned above and will be required to make up the shortage for each affected office. In the event that cartons are 

crushing, collapsing, and/or bursting, and it is determined that the cause is due to the cartons not being packed solid, 

or some other reason within the contractor's control, the contractor will be charged $2.00 per carton for repacking and 

re-palletizing. 

2. "Mislabeling" means any error on the carton label which incorrectly states or identifies the title of the form; the form 

identification number; or the quantity of forms actually contained in the carton. 

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

specifications: 

Product Quality Levels: 

(a) Printing Attributes -- Level III. 

(b) Finishing Attributes -- Level III. 

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

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

(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 OK’ Proofs, Electronic Media 

DEPARTMENTAL RANDOM “BLUE LABEL” COPIES - The contractor MUST submit 200 folded departmental 

random copies at the completion of production, to test for compliance against specifications. The contractor must divide 

their entire order into equal sub lots and select 1 copy from a different general area of each sub lot. The contractor will 

be required to execute the "Certificate of Selection of Random Copies", furnished by GPO, certifying that copies were 

selected as directed. 
Page 5 of 8 Jacket 417-241 

These randomly selected copies must be packed separately and identified by a special Government-furnished blue 

label, affixed to each affected container. Additional labels, if needed, are to be reproduced on blue stock. The container 

and its contents shall be recorded separately on all shipping documents and sent to Internal Revenue Service, National 

Distribution Center, 1201 N. Mitsubishi Motorway, Bloomington, IL 61705-6613 separately from any other 

distribution to this destination. Submit a copy of the signed Government-furnished "Certificate of Selection of Random 

Copies", along with the Departmental Random Copies. 

DISTRIBUTION: Ship f.o.b. contractor's city and f.o.b. destination as indicated. The following consignment ship 

f.o.b. destination in the following order: 

1) IRS Contractor Distribution copies 

2) NDC Bloomington flat copies 

IRS Samples: Immediately after press start up contractor must overnight 2 samples to the following address. 

Attn: Mary Morrison, 4317 Birchlake Ct., Alexandria, VA 22309. The remaining consignments ship f.o.b. 

contractor's city. 

Ship 10 flat samples to IRS/W&I Channel Delivery, SE:W:CAR:MP:P:T:CD, Attn. M. Morrison – Room 6564/ IR, 

1111 Constitution Avenue, NW, Washington, DC 20224. 

Ship 2 flat samples to M. Morrison, 4317 Birchlake Ct., Alexandria, VA 22309. 

Ship 243,200 flat copies IRS National Distribution Center (NDC), Receiving Area, 2525 Revenue Drive, Bloomington, 

IL 61705-2500. (This includes 200 blue label sample copies.) 

MOTOR FREIGHT: Government bills of lading (IRBL's) will be furnished for all freight or air express shipments to 

deliver outside the contractor's ICC Commercial Zone, except for a few, small f.o.b. destination shipments. The GBL's 

will have designated carriers which the contractor MUST use. The contractor must give the designated carrier a 

minimum of two workdays notice for pick-up. The contractor does not have the authority to change a designated carrier 

without IRS authorization and will be responsible for any additional shipping costs in the event of an unauthorized 

change. Whenever possible full truckloads should be utilized (e.g., use a full truckload and a partial truckload rather 

than two partial truckloads). 

The contractor must report any carrier-related problems to the IRS immediately. Telephone Roy Murdoch at 309-556-

5076, between the hours of 8:30 am-3:30 pm prevailing Eastern Time on Federal workdays. If the carrier refuses the 

shipment, the contractor must provide the following information: contractor's name, location, date and time of shipment 

refusal, carrier name, name of the carrier contact, IRBL number, requisition number, and a brief description of the 

problem. If necessary the IRS may authorize the use of another carrier. Notify IRS of all unused IRBL's; do not return 

to GPO. If the IRS Traffic Department cannot be reached, contact Mary Morrison at 703-360-0203 or 202-317-3425. 

The contractor is responsible for ensuring that the proper weight and pieces are shown on the IRB, that the date of 

receipt of shipment is accurately entered by the carrier's agent, and the proper paperwork is issued to the carrier. Public 

Vouchers, submitted by the contractor for payment of printing, must be accompanied by a signed copy of the IRBL. 

All memorandum copies of the IRBL must be legible to be acceptable as proof of shipment. The contractor will not 

incur or pay any freight charges when using GBL's as the carrier will bill IRS directly. 

SMALL PACKAGE CARRIER: Shipments weighing less than 750 lbs. will ship via small package carrier. When 

the contractor is required to ship via small package carrier (SPC), the IRS will provide an IRS small package carrier 

account number. Contractor MUST call at least 5 workdays prior to the scheduled ship date, if a carrier account number 

has not been issued. Contact Mary Morrison at 703-360-0203 to make arrangements. If multiple small package carriers 

are to be used, an account will be assigned for each carrier. Contractors are required to ship using the designated 

carrier(s) and IRS account number(s) or be responsible for any additional shipping costs. 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 

using the specified IRS SPC because of failure to request such information. It is the responsibility of the print contractor 

to generate UPS labels electronically and be familiar with electronic shipping methods. There are many ways to 

generate electronic shipping labels, either through a UPS shipping system (UPS World Ship System or UPS Internet 

Shipping) or a 3rd Party Shipping Software (Pitney Bowes Shipping Software, etc.). 

 
Page 6 of 8 Jacket 417-241 

When an email address is present in the shipping file, the contractor is required to send a same-day email notification 

of the shipment to the email listed. All notifications must include IRS Product Short Titles, Scheduled Delivery Date, 

Shipment Recipient Name and Address, Number of Packages, Type of Service, Weight, SPC Tracking Number and a 

link to SPC website, and Reference Numbers (Reference Line 1 – IRS Requisition Number and GPO Jacket Number 

and Reference 2 – IRS Type of Account (PO/TF) and Account Number must be included in ship notification generated 

from the SPC shipping system. The SPC tracking number and a link to the SPC website must also be included in the 

email. All returned e-mails should be set to automatically forward to an IRS e-mail to be specified. 

 

IRS requests a phone number, fax phone & e-mail address for a contact at the contractor’s plant. 

SCHEDULE: Purchase order by February 22, 2021. 

Furnished electronic files will be forwarded to the contractor on February 22, 2021. 

Note: The Government will attempt to meet the schedules stated in these specifications. However, late Congressional 

tax legislation, etc., may cause a delay in Government furnished material. In such event, the schedule will be adjusted 

in accordance with contract terms. 

Start to ship IRS Contractor distribution complete on or before March 3, 2021 

ELECTRONIC DAILY SHIPPING VERIFICATION: Contractor is required to complete and e-mail Form 2040 

daily to the IRS when shipping begins. Form 2040 is in a PDF fillable Adobe Acrobat 6.0 file format. The majority of 

the information will be included in the report from the IRS to the contractor but the contractor is responsible for the 

verification and correctness of information supplied back to IRS. If there is any information missing or incorrect, please 

contact Mary Morrison (703-360-0203). 

The contractor must update the Electronic Form 2040 and transmit via e-mail to IRS each day. Any delay or missed 

input could result in delay of payment. 

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. 

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 1,000 copies. 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. Transportation charges are not a factor in determining award. 

Bids received based on shipping the specified f.o.b. contractor’s city consignments via f.o.b. destination will be 

considered non-responsive. 

At the same time invoices are submitted to GPO for payment, contractor must submit a duplicate copy to: 

Mary.E.Morrison@irs.gov. 

 
Page 7 of 8 Jacket 417-241 

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 preaward 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 low contractor 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 a timely manner may result in the Contracting 

Officer not having adequate information to reach an affirmative determination of responsibility. 

PAYMENT: 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. 

 
Page 8 of 8 Jacket 417-241 

JACKET NUMBER BID PRICE: ADDITIONAL/M

Jacket 417-241 $________________________ ____________________________ 

DISCOUNTS: Discounts are offered for payment as follows: __________Percent, ________ calendar days. 

See Article 12 “Discount” of solicitation Provision 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 fax or mail, fill out and return one copy. 

Bidder

(Contractor Name) (GPO Contractor’s Code) 

(Street Address) 

(City – State – Zip Code)

By

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

(Signature) (Date) 

(Telephone Number) (Email) 

 

 Contracting Officer Review: __________Date: __________ Certifier: __________Date: ____________ 

 (Initials) (Initials)