Jacket:

Title:

Agency:

622-023

FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525)

DLA NORFOLK VA 23511

Bid Opening: January 26, 2022 at 11:00 AM EST

Bid Terms Discounted Total

$454,454.00 2.0% 20 days $445,364.92

 days $0.00

 days $0.00

days $0.00

days $0.00

days $0.00

LU/RG

*Monach Litho Inc.

Contractor Name

*= Awarded 
U.S. GOVERNMENT PUBLISHING OFFICE | Keeping America Informed | OFFICIAL | DIGITAL | SECURE

Virginia Beach Regional Office | 291 Independence Blvd., Suite 401, Virginia Beach, VA 23462 

http://www.gpo.gov | www.facebook.com/USGPO | twitter.com/USGPO 

January 24, 2022

Dear Bidder: 

This is Amendment Number One (1). The specifications in our invitation for bids on jacket 622-023, 

scheduled for opening at 11 a.m., January 26, 2022, are amended as follows. 

P. 6 of 8,

Under “Packing”, verbiage is revised from: “Shrink-wrap in units of 25’s” to “Do not shrink wrap items”.

Bid opening date remains 11:00 am January 26, 2022. 

All other specifications remain the same. 

If amendment is not acknowledged on bid, direct acknowledgement to: 

Bidsvirginiabeach@gpo.gov

TELEPHONE ACKNOWLEDGMENT OF THIS AMENDMENT IS NOT ACCEPTABLE. BIDDER 

MUST ACKNOWLEDGE RECEIPT OF THIS AMENDMENT PRIOR TO BID OPENING. Failure 

to acknowledge receipt of amendment, by amendment number, prior to bid-opening time, may 

be reason for bid being declared nonresponsive. 

Sincerely, 

RICHARD W. GILBERT 

Contracting Officer 
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 1 of 8

622-023 DLA Norfolk / 2-202222G-778525 

Specifications by LU 

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 January 26, 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 Ledo Ulerio (757) 

490-7943 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 1,000’s. 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: The GPO 910 “BID” Form is no longer required; bidders are to fill out, sign/initial, as applicable, and return 

page.

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 Ledo Ulerio at lulerio@gpo.gov For 

contract administration after award, contact Ledo Ulerio at (757) 490-7943.
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 2 of 8

GENERAL TERMS AND CONDITIONS

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 (Rev. 09-19)).

GPO Contract Terms (GPO Publication 310.2) –

https://www.gpo.gov/docs/default-source/forms-and-standards-files-for-vendors/contractterms2018.pdf.

GPO QATAP (GPO Publication 310.1) –

https://www.gpo.gov/docs/default-source/forms-and-standards-files-for-vendors/qatap-rev-09-19.pdf.

PREAWARD SURVEY: In order to determine the responsibility of the prime contractor, 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) 

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 must be able to show ability to produce the product in question 

and may be asked to supply samples of similar items.

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

Vendors are expected to submit invoices within 15 days of job shipping/delivery.

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 
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 3 of 8

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.

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 January 31, 2022. 

PREFLIGHT: 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 Lulerio@gpo.gov.

PRODUCT: A direct mail package consisting of a pictorial window envelope, folded insert and (2) BRC 

reply cards, printing 4- color process, Pantone 296C (blue), Pantone 187C (red) plus overall gloss aqueous.

QUANTITY: 2,260,000 total package sets FIRM

TITLE: FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525)

NOTE: Quantity is 9,040,000 pieces for 2,260,000 complete packages (includes overs for the mailing and 

samples). Package to be assembled and addressed at the lettershop.

DESCRIPTION: 

***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.

*** FINAL SAMPLES Printer is to supply the agency with 50 samples of each version not sealed prior to 

shipping full run to Data Mail (These samples should be held by printer until notification has been given of office 

opening).

*** Press schedule must be provided along with how many shifts this will be printed over.

Item 1: PICTORIAL WINDOW ENVELOPE 

Quantity: 2,260,000 (No Overs/No Unders) 

Size: 5” X 9” Pictorial Window Booklet 

Color: 7/0 Bleed - (4/C Process Color + PMS 296 + PMS 187 + Overall Gloss Aqueous) 

Stock: 80# Coated One Side Text (C1S) White 

Windows: On Face – 3 3⁄4” x 7 3⁄4” (Top left corner of this window die cut has a 1 7/8” x 1 1⁄2” area remaining that 

will be glued to the cello patch. 

On Back – Address Window is 1 1⁄4” x 4 1⁄4” with Cello Patch 

Flap: 1 1⁄2” gummed flap with rounded corners 

Instructions: From final electronic production file posted to selected suppliers sFTP site output and provide color 

proof and digital asset proof along with stock sample for approval. 

As an envelope die is not available, bleed has been extended and to knock out those areas needed for gluing from 

side and top 

NOTE: Stock sample must be approved by Agency prior to purchase for printing 
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 4 of 8

Item 2: Insert 

Quantity: 2,260,000 (No Overs/No Unders) 

Size: Flat – 17” x 9”

Fold to: 8 1⁄2” x 9” then fold again to 8 1⁄2” x 4 1⁄2” 

Color: 7/5 Bleed - (4/C Process Color + PMS 296 + PMS 187 + Overall Gloss Aqueous) 

Stock: 80# Gloss Text White 

Instructions: From final electronic production file posted to selected suppliers sFTP site output and provide color 

proof and folded digital asset proof along with stock sample for approval. 

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

prior to approval of paper sample. 

Item 3: Reply Cards (2) 

Quantity: 4,520,000 (Breakdown Below) – (No Overs/No Unders) 

Breakdown: Universal Gender 

Base Code SJGBN22 = 2,260,000

Pass Code SJGPN22 = 2,260,000

Size: 8 1⁄2” x 4 3⁄4” Flat 

Color: 7/3 bleed - 4/C Process + PMS 296 + PMS 187 + Overall Gloss Aqueous. 

Stock: 80# Matte Coated Cover – White 

Perf: Right Angle (L-Shaped) blind perf 

Proofs: From final electronic production file posted to selected suppliers sFTP site output and provide color proof 

and folded digital asset proof along with stock sample for approval. 

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

prior to approval of paper sample.

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.

DISTRIBUTION: Deliver f.o.b. destination. Ship all destinations by traceable means. All expenses incidental 

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

-Inside delivery minimum 50% of quantity (to arrive at destination) by March 16, 2022 by 2pm local time.

-Partial delivery of remaining balance on or before March 31, 2022 by 2pm local time.

PROOF: 

*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) workDAY. 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 

Lulerio@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. 
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 5 of 8

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 contractors 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.

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.
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 6 of 8

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.

-Send proofs to:

Ms. Jackie McGowan

2 Maple Street

Hartsdale, NY 10530

Packing: Shrink-wrap in units of 25’s and box per mailing carton. Follow GPO white shipping label. Carton labels 

must show title, quantity, form number and control number and must appear on the outside of the mailing and 

shipping cartons. Use new corrugated fiberboard for mailing and shipping containers. Shipping containers may 

contain more than one mailing carton provided the weight does not exceed 50 Lbs. Use only new corrugated solid 

fiberboard containers with minimum bursting strength of 275 p.s.i. 

PALLETS/PALLETIZING: Pallets used for delivery to AMWARE Fulfillment in Austell, GA MUST be wood 

and have front and rear load beam, with a single (1) 48" long 2 x 4 upright support, centered on the length of the 48" 

dimension; this will allow a "fixed-fork unloader/uploader to enter the pallets and place them in the warehouse 

racks. Pallets MUST be partially shrink-wrapped, and the size MUST be 48" X 40", with a maximum height of 48". 

Cartons MUST be stacked on pallets in a staggered manner to ensure maximum stability. 

Pallets shall be suitably packed so as to insure acceptance and safe delivery by common carrier. Maximum gross 

weight is 2,000 lbs. Pack flush to corners, top side up, label facing out, without overhang at any edge. Voids must 

be to the center of the pallet. Pack with care. Loaded pallets may be stored four high at destination. 

Noncompliance with the palletizing specifications may be cause for the Government to reject the shipment at 

destination and return it to the contractor at their expense. The Government may, at its option, offer the contractor an 

opportunity and a reasonable time to correct, however, the Government may choose to repackage in accordance with 

the specifications and charge all costs to the contractor. 

NOTE: Pallets are required for all destinations receiving 10 or more shipping containers. Failure to properly 

palletize may be cause for re-palletizing at contractor's expense. See GPO Contract Terms.

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

 2,260,000 200

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 
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 7 of 8

product ships/delivers via e-mail sent to jennifer.2.brown@dla.mil and lulerio@gpo.gov. The subject line of this 

message shall be Distribution Notice for Jacket 622-023. 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.

Deliver final product including Blue Label copies to:

DATA MAIL 

240 Hartford Avenue 

Newington, CT 06111 

Attn: Colleen Costin (860) 666-0399

RETURN OF MATERIALS:

Final digital downloads along with 10 sealed samples of each component should be sent on 

or before Friday, April 1st, 2022 to:

Jackie McGowan

2 Maple Street

Hartsdale, NY 10530

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) DestructiveTests - 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 Proof

P-8. Halftone Match Approved Proof

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

 Approved Proof

P-10. Process Color Match Approved Proof
Jacket 622-023 FY 22 SY 23 2HSJ 0322 MAILING FLAG PACKAGE (DSO 778525) Page 8 of 8

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)

___________________________________________________________________________________________