Jacket: 740‐649

Title: IB 10‐1234_MOVE! Veteran Workbook P96942

Agency: VABid Opening: July 15, 2020 at 2 p.m.

Bid Terms Discounted Total Ame

$161,161.00 2.0% 20 days $157,937.78 $167,555.00 5.0% 20 days $159,177.25 $167,165.00 1.0% 20 days $165,493.35 $171,654.00 2.0% 20 days $168,220.92 $172,410.00 2.0% 20 days $168,961.80 $177,680.00 2.0% 20 days $174,126.40 $177,606.00 1.0% 20 days $175,829.94 $179,572.73 1.0% 20 days $177,777.00 $178,001.00 0.0% 30 days $178,001.00 $193,390.00 5.0% 20 days $183,720.50 $313,250.00 0.0% 0 days $313,250.00 

*=AwardedVerified BR 7‐15‐2020

Alpha Graphics, Baltimore, MD

* Monarch Litho, Montebello, CA

Contractor Name

Las Vegas Color Graphics, Las Vegas, NV

Schmitz Press, Sparks, MDDistrict Creative, Upper Marlboro, MD

Gray Graphics, Capitol Heights, MD

Colonial Press, Miami, FL

McDonald and Eudy, Temple Hills, MD

Advantage Mailing, Anaheim, CA

LSC Communications, Cleveland, OH

BKR Printing, Salt Lake City, UT
PURCHASE ORDER H8700

U.S. Government Publishing Office

Columbus Regional Office

1335 Dublin Rd., Suite 112-B

Columbus OH 43215-7034

The above order number must

appear on your voucher and on

all packages and papers.

Your Contract Administrator is : Ellen Sommer-Ext.4 Call: (614) 488-4616 NO COLLECT CALLS

DATE JACKET NO. PRICE ADDED RATE DISCOUNT

07/17/2020 740-649 $161,161.00 $2,277.22 per M 2 %20 days

PROGRAM NO. (if Applicable) TERM OF PROGRAM (if Applicable) NAME OF REQ. AGENCY AND REQ. NO.

0-00210/015160

Department of Veterans Affairs

AREA/STATE/CODE

040

CONTRACTOR CODE

60078

APPROPRIATION/FUND CODE OBJECT CLASS

2445

BILLING ADDRESS CODE (BAC)

8320-01

TO: PURCHASED:FOB Destination

MONARCH LITHO, INC.

1501 DATE ST.

MONTEBELLO CA 90640

DATE OF Delivery

09/30/2020

QUANTITY DESCRIPTION QL: 3

TITLE: IB 10-1234_MOVE! VETERAN WORKBOOK P96942

Total 55,000

In strict accordance with our solicitation and your bid/offer dated Tuesday, July 14, 2020

In Connection with the performance of work under this contract, the contractor agrees not to discriminate against any employee or applicant for employment because of race,

color, religion, sex, or national origin. The aforesaid provision shall include, but not be limited to, the following: Employment, upgrading, demotion, or transfer, recruitment or

recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection from training including apprenticeship.

The contractor agrees to post hereafter in conspicuous places, available for employees and applicants for employment, notices to be provided by the contracting officer

setting both the provisions of the nondiscrimination clause.

GPO Form 2669(LASER)

DIRECTOR OF THE GOVERNMENT

PUBLISHING OFFICE reserves the right

to reject all or any portion of consignments

which are not in accordance with specification.

DIRECTOR OF THE GOVERNMENT

PUBLISHING OFFICE

By

William Lansky Ext.5

Contracting Officer

COPY 1-CONTRACTOR COPY 2-CONTRACTOR (RETURN W/VOUCHER) COPY 3-FMCE COPY 4-COMPLIANCE COPY 5-FILE COPY 6-ISSUING OFFICE
Specifications by ES Jacket 740-649 

Page 1 of 10 U.S. Department of Veterans Affairs 

Reviewed by BR Requisition: 20-00210 

BID OPENING: July 15, 2020 

BID OPENING: Bids shall be opened at 2 p.m., prevailing EST, on July 15, 2020 at the U.S. Government 

Publishing Office, Columbus OH. Due to the COVID-19 pandemic, this will NOT be a public bid opening. 

SPECIFICATIONS 

U.S. Government Publishing Office (GPO)

1335 Dublin Road, Suite 112-B 

Columbus, OH 43215-7034 

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

Based on this, bidders MUST submit email bids to: bidscolumbus@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 2 p.m. EST 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. 

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 (pgs. 9-10) 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. 

Any questions before or after award concerning these specifications call Ellen Sommer at (614) 488-4616, Ext. 4. 

No collect calls. E-mail: esommer@gpo.gov. 

BIDDERS PLEASE NOTE: The GPO 910 “BID” Form is no longer required. Bidders are to fill out, 

sign/initial, as applicable, pages 9-10. 

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 1000 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. 

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 Pub. 310.2, 

effective 12/1/87, Rev. 01-18) and GPO Contract Terms, Quality Assurance Through Attributes Program (GPO 

Pub. 310.1, effective May 1979, (Rev. 8/02). 
Page 2 of 10 Jacket 740-649 

 GPO Contract Terms (GPO Publication 310.2): https://www.gpo.gov/docs/default-source/forms-andstandards-files-for-vendors/contractterms2018.pdf

 GPO QATAP (GPO Publication 310.1): https://www.gpo.gov/docs/default-source/forms-andstandards-files-for-vendors/qatap-rev-09-19.pdf

WARRANTY: Contract Clause 15, "Warranty", of GPO Contract Terms (Publication 310.2, effective December 

1, 1987 (Rev. 01-18)) is amended for the solicitation to the effect that the warranty period is EXTENDED from 

120 days to one calendar year from the date the check is tendered as final payment. All other provisions remain 

the same.

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 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. 

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. 

GOVERNMENT IN-PLANT INSPECTIONS: The Government reserves the right to have Government 

representative(s) inspect any operation under this contract at the start of its production and at any time during 

production. In addition to the inspections indicated, the Government reserves the right to inspect all stages of 

production. 

PRODUCT: These specifications cover the proofing, printing, binding and delivery of spiral coil bound books. 

TITLE: IB 10-1234_MOVE! Veteran Workbook P96942 

QUANTITY: 55,000. 
Page 3 of 10 Jacket 740-649 

TRIM SIZE: 8-1/2 x 11”. 

 

PAGES: 244 Text Pages plus 2-Piece Cover. 

DESCRIPTION/PRINTING: Publication prints cmyk throughout; head to head. Images consist of type/rule, 

illustrations, charts, graphs etc. with large solids, reverses, gradients, flattones, heavy ink coverage and bleeds. 

Covers 1 and 4 print; covers 2 and 3 are blank. After printing, coat the entire outside cover 1 and 4 surfaces with a 

clear satin aqueous coating. 

Text consists of 244 total pages, no blanks. 

Workbook order is as follows: 

 MOVE! Veteran Workbook Cover 

 Introduction 

 Table of Contents 

 Module 1 Welcome to MOVE! 

 Module 2 Tracking What You Do 

 Module 3 Tip the Balance 

 Module 4 Eat Wisely 

 Module 5 Get Fit for Life 

 Module 6 Take Charge of Your Weight 

 Module 7 Menu Planning, Shopping, and Cooking 

 Module 8 Problem Solving 

 Module 9 Pump Up Your Physical 

 Module 10 Conquer Triggers and Cues 

 Module 11 Finesse Your Food 

 Module 12 Dust Yourself Off 

 Module 13 Dine Out Successfully 

 Module 14 Manage Stress 

 Module 15 Fine Tune Your Physical Activity 

 Module 16 Maintain Your Progress 

 Mini Module: Weight Loss and Sleep 

 Mini Module: Lose Weight and Quit Tobacco 

 Mini Module: Be Involved in Your Health Care 

 Notes Pages 

 Back Cover 

NOTE: At contractor's option, the product may be produced via conventional offset or digital printing provided 

that Quality Level 3 standards are maintained. Final output must be wet ink, pigment-based with a minimum of 

175 line screen. Dry ink/toner and inkjet printing are not acceptable. Output must be at a minimum resolution of 

2400 x 2400 dpi plus a RIP that provides an option for high quality color matching such as Device Links 

Technology and/or ICC Profiles. Resolution that is enhanced or simulated by software will not be acceptable. 

BINDING: Gather collated text and 2-piece cover, punch suitably on left 11” dimension and spiral bind with 

black plastic coil of suitable capacity. Publication must lie flat when opened. 
Page 4 of 10 Jacket 740-649 

GOVERNMENT TO FURNISH: 

Electronic Media PDF Print Files will be accessed via a provided link upon award. 

Platform:Windows 10 Professional Build, pdf originally created in Adobe InDesign 14.0 (Windows). 

Fonts embedded, colors are cmyk and pms – convert all pms to cmyk; bleeds are NOT provided. 

File contains 247 total page size images including a blank image to indicate inside front cover; however, 

no blank image is included for inside back cover. Ensure correct pagination of 244 text pages + 2-piece cover. 

NOTE: There is a separate pdf file for revised back cover – do not use image of back cover from base file. 

All bleed creation, color conversion must be included in total bid price. 

A separate MS Word file furnished for packing/slip carton labels – see page 8 for image. 

ELECTRONIC PREPRESS: Prior to image processing, the contractor shall perform a basic check (preflight) 

of the furnished media and publishing files to assure correct output of the required reproduction image. Any 

errors, media damage, or data corruption that might interfere with proper file image processing must be reported 

to the GPO contract administrator immediately. 

The contractor shall create or alter any necessary trapping, set proper screen angles and screen frequency, and 

define file output selection for the imaging device being utilized. Furnished files must be imaged as necessary to 

meet the assigned quality level. 

When required by the Government, the contractor shall make minor revisions to the electronic files. It is 

anticipated that the Government will make all major revisions. 

Prior to making revisions, the contractor shall copy the furnished files and make all changes to the copy. 

Upon completion of the order, the contractor must furnish final production native application files (digital 

deliverables) with the furnished material. The digital deliverables must be an exact representation of the final 

printed product and shall be returned on suitable storage media or e-mailed upon request. The Government will 

not accept, as digital deliverables, PostScript files, Adobe Acrobat Portable Document Format (PDF) files, or any 

proprietary file formats other than those supplied, unless specified by the Government. NOTE: Government will 

accept Adobe Acrobat Portable Document Format (PDF) files as digital deliverables when furnished by the 

Government. 

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. 

PROOFS: Contractor to submit one complete “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. E-mail proof to: Perry 

Gamble at: Perry.Gamble2@va.gov and cc to: esommer@gpo.gov. Proof response will be provided within 

3 workdays from date of receipt. Do not proceed prior to receipt of proof approval. 

PRIOR TO PRODUCTION SAMPLE: After pdf proof approval and prior to the commencement of production 

of the contract production quantity, the contractor shall submit 1 printed bound sample to the address indicated 

under DISTRIBUTION. Sample must be constructed as specified using the papers, ink, equipment, and methods 

of production which will be used in producing the finished products. Sample will be inspected and tested and 

must comply with the specifications as to kind and quality of materials & quality of reproduction using the 

specified production method. 
Page 5 of 10 Jacket 740-649 

The package must be marked "PRE-PRODUCTION SAMPLE, DO NOT DELAY'; and must include the GPO 

jacket #, dept. req # & publication title. 

The sample must be submitted in sufficient time to allow Government inspection and production and shipment in 

accordance with the required delivery schedule.

The Government will approve, conditionally approve, or disapprove the sample within 5 workdays of the receipt 

thereof. Approval or conditional approval shall not relieve the contractor from complying with the specifications 

and all other terms and conditions of the contract. A conditional approval shall state any further action required 

by the contractor. A notice of disapproval shall state the reasons therefor. 

If the sample is disapproved by the Government, the Government, at its option, may require the contractor to 

submit additional sample(s) for inspection and test, in the time and under the terms and conditions specified in the 

notice of rejection. Such additional sample(s) shall be furnished, and necessary changes made, at no additional 

cost to the Government and with no extension in the shipping schedule. The Government will require the time 

specified above to inspect and inspect and test any additional samples required. 

In the event the additional sample is disapproved by the Government, the contractor shall be deemed to have 

failed to make delivery within the meaning of the default clause in which event this contract shall be subject to 

termination for default, provided however, that the failure of the Government to terminate the contract for default 

in such event shall not relieve the contractor of the responsibility to deliver the contract quantity in accordance 

with the shipping schedule. 

In the event the Government fails to approve, conditionally approve, or disapprove the sample within the time 

specified, the Contracting Officer shall automatically extend the shipping schedule in accordance with Contract 

Clause 12, “Notice of Compliance With Schedules,” of GPO Contract Terms (GPO Publication 310.2, effective 

December 1, 1987 (Rev. 01-18)). 

Manufacture of the final products prior to approval of the sample submitted is at the contractor’s risk. Sample 

will not be returned to the contractor. All costs, including the costs of all samples shall be included in the contract 

price for the production quantity. All samples shall be manufactured at the facilities in which the contract 

production quantities are to be manufactured. 

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. 

COVERS: White No. 1 Coated Cover, Gloss Finish, basis weight: 80 lbs. per 500 sheets, 20 x 26", 

equal to JCP Code L11. 

TEXT: White Silk/Dull-Coated Text, basis weight: 60 lbs. per 500 sheets, 25 x 38", equal to 

JCP Code A260. 

MARGINS: Bleeds throughout publication which must be created – furnished file is not formatted for required 

bleeds. Ensure no loss of info in bind area; make adjustments as necessary. 

PACKING: Pack suitable per container to prevent damage in transit. Alternate books to avoid tangling of coils. 

Pack in suitable cartons not to exceed 30 lbs. each. Pallets are required. 

Pack to ensure no damage occurs to product during transit. Pack to ensure no shifting of product in transit, using 

spacers if necessary. Product should arrive with no abrasions, dog-ears, etc. 

Packing to be in accordance with GPO Contract Terms (GPO Pub. 310.2). Noncompliance with the packing 

instructions will be cause for the Government to take corrective action in accordance with GPO Pub. 310.2. 
Page 6 of 10 Jacket 740-649 

Palletizing: Pallets must be in accordance with GPO Contract Terms (GPO Pub. 310.2). 

LABELING AND MARKING: All shipping containers require a container label. Complete a copy of the 

enclosed packing and shipping labels (VA Forms 7596 - see page 8) and affix one to each shipping container 

according to the instruction at the top of the carton label sheet; (make additional copies as necessary). 

Label and mark in accordance with GPO Contract Terms (GPO Pub. 310.2). 

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

these specifications:

Product Quality Levels: 

 (a) Printing Attributes - Level 3 

 (b) Finishing Attributes - Level 3 

 

Inspection Levels (from ANSI/ASQC Zl.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 Approved Pre-Production Sample 

P-10. Process Color Match Approved Pre-Production Sample 

DEPARTMENTAL RANDOM COPIES (BLUE LABEL): Order must be divided into 200 equal sublots. 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 copies were selected as directed using GPO Form 917-Certificate of 

Selection of Random Copies (located on GPO.gov). The random copies constitute a part of the total quantity 

ordered, and no additional charge will be allowed. 

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

Departmental Random Copies (Blue Label) that 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 to the Il delivery address stated under 

DISTRIBUTION. 

A copy of the purchase 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 Services, for payment. Failure to furnish the certificate 

may result in delay in processing the invoice

SCHEDULE: Adherence to this schedule must be maintained. See "Notice of Compliance with Schedules”, in 

GPO Pub. 310.2. 

Purchase Order via email from U.S. Government Publishing Office, Columbus, OH and emailed link of files by: 

July 21, 2020. 

E-mailed proofs on or before: July 24, 2020. 
Page 7 of 10 Jacket 740-649 

Pre-production sample delivered on or before: August 5, 2020. 

Deliver F.O.B. Destination to arrive not later than: September 30, 2020. 

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. 

Doing Business with GPO Customer Services During Coronavirus Pandemic 

Contractors should continue performance on contracts. Contractors must continue to fully comply with the terms 

and conditions of these contracts. Deliveries, proof approvals, and press sheet inspections for agencies may be 

impacted. It is requested that contractors contact a Government employee at the delivery location to confirm their 

availability to receive prior to shipping. 

Schedules and other adjustments will be made in accordance with GPO Contract Terms. Caution should be used 

to safeguard all products should any delivery delays be imposed by the Government. 

As a reminder, contractors must furnish contract compliance information required in accordance with GPO 

Contract Terms, Contract Clause 12: Notice of Compliance With Schedules. 

Contractors should immediately contact your GPO contract administrator(s) and/or contracting officer(s) to 

identify impacted orders if any delay is anticipated, including temporarily closure of a production facility or the 

planned suspension of any services. 

If you have any questions on a particular contract, please contact the Customer Services contract administrator 

and/or contracting officer for your contract (best method of communicating with them is via email). Office team 

e-mail addresses can be found at https://www.gpo.gov/how-to-work-with-us/agency/services-foragencies/procurement-services-team. 

DISTRIBUTION: All shipments to be sent by traceable means and contractor shall provide tracking numbers as 

soon as available to the following email addresses: Perry.Gamble2@va.gov and cc to: esommer@gpo.gov.

Deliver pre-production sample to the following address: 

Attn: Chloe Perdue 757-793-3420 

5705 Lynnhaven Pkwy, APT 302 

Virginia Beach, VA 23464 (address is residential) 

Deliver 55,000 Books to: 

U.S. Department of Veterans Affairs, 

SDC/OPS, Bldg 37, Door 14, 

1st Avenue One Block North of 22nd Street, 

Hines, IL 60141, Attn: John Burke (708)786-7758 

NOTE: Depot receives freight on pallets between the hours of 7:00 - 14:00 Central Standard 

Time. 

RECEIPT FOR DELIVERY: As applicable, the contractor must furnish their own receipts for deliveries. 

These receipts must include the GPO jacket number; total quantity delivered, number of cartons, and quantity per 

carton; date delivery made; and signature of the Government agent accepting delivery. The original copies of 

these receipts must accompany the contractor's voucher for payment. 
Page 8 of 10 Jacket 740-649 
Page 9 of 10 Jacket 740-649 

SCHEDULE OF PRICES (PAGE 1 OF 2) 

SHIPMENT(S): Shipment(s) will be made f.o.b. destination from: City_______________________, 

State________. 

JACKET NUMBER: ___________________________________________ 

TOTAL BID PRICE: ___________________________________________ 

DISCOUNTS: Discount is offered for payment as follows: __________ Percent, _________calendar 

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

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. 

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

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

***NOTE: SUBMIT BOTH PAGES 9 and 10 VIA EMAIL*** 
Page 10 of 10 Jacket 740-649 

SCHEDULE OF PRICES (PAGE 2 OF 2) 

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 (pgs. 9-10) 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. 

_________________________________________ ________________________________ 

(Company Name) (GPO Contractor’s Code) 

___________________________________________________________________________________ 

(Street Address, City, State and Zip Code) 

__________________________________________ _________________________________ 

(Printed Name and Title) (Telephone number) 

__________________________________________ _________________________________ 

(Signature) (Date) 

_________________________________________ ________________________________ 

(E-Mail) (Facsimile Number) 

************************************************************************************ 

THIS SECTION FOR GPO USE ONLY 

Contracting Officer Review __________Date ___________Certifier ______________Date 

 (initials) (initials) 

***NOTE: SUBMIT BOTH PAGES 9 and 10 VIA EMAIL***