26-033 VENDOR OFFER FORM.PDF
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Vendor’s Offer “Return this Section with your Response.” Offeror must complete, sign and submit this form to the Procurement Office with the proposal response. An unsigned “Vendor's Offer’, late proposal response, and/or a materially incomplete response will be considered nonresponsive and rejected. Offeror is to type or legibly write in ink all information required below. A scanned copy of this page is acceptable. Arizona Electric Supply Company Name: Company Purchase Order Mailing Address: Street Address: 807 West Broadway Road City, State, Zip: Mesa, Arizona 85210 Contact Person: David Dillman Phone Number: 480-834-8050 E-mail Address: _ddillman@aesmesa.com Cell Number: _480-751-7247 Remit to Information Arizona Electric Supply Company Name (as it appears on invoice): Company Payment Remit to Address: PO Box 207072 Street Address: City, State, Zip: Dallas, TX 75320-7072 Company Tax Information If a Tempe-based firm, provide Tempe Transaction Privilege (Sales) Tax No.: Payment Options Will your company accept the City’s Master Card for payment? Yes No Will your company accept Payment via ACH (Automated Clearing House) for payment? Yes | Xj| No THIS PROPOSAL IS OFFERED BY REQUIRED SIGNATURE OF AUTHORIZED OFFEROR By signing this Vendor's Offer, Offeror acknowledges acceptance of all terms and conditions contained herein and that prices offered were independently developed without consultation with any other Offeror or potential Offeror. Failure to sign and return this form with proposal response will be considered nonresponsive and rejected. David Dillman November 3, 2025 Signature of Authorized Offer Date David Dillman Manager Print or Type Name of Authorized Individual Title of Authorized Individual RFP# 26-033 Arterial LED Streetlights 28 | Page Vendor’s Offer “Return this Section with your Response.” Offeror must complete, sign and submit this form to the Procurement Office with the proposal response. An unsigned “Vendor's Offer’, late proposal response, and/or a materially incomplete response will be considered nonresponsive and rejected. Offeror is to type or legibly write in ink all information required below. A scanned copy of this page is acceptable. WESCO Distribution Inc Company Name: Company Purchase Order Mailing Address: Street Address: 3425 E Van Buren #140 City, State, Zip: Phoenix AZ 85008 Contact Person: Laura Sundberg __ Phone Number: 602-710-6159 E-mail Address: _lsundberg@wescodist.com Cell Number: 602-710-6159 Remit to Information Brown Wholesale Electric Division of WESCO Distribution Inc Company Name (as it appears on invoice): Company Payment Remit to Address: Street Address: PO BOX 676780 City, State, Zip: DALLAS TX _75267 Company Tax Information If a Tempe-based firm, provide Tempe Transaction Privilege (Sales) Tax No.: Payment Options Will your company accept the City’s Master Card for payment? 3.0% processing fee Yes|__x| No Will your company accept Payment via ACH (Automated Clearing House) for payment? Yes x| No THIS PROPOSAL IS OFFERED BY REQUIRED SIGNATURE OF AUTHORIZED OFFEROR By signing this Vendor's Offer, Offeror acknowledges acceptance of all terms and conditions contained herein and that prices offered were independently developed without consultation with any other Offeror or potential Offeror. Failure to sign and return this form with proposal response will be considered nonresponsive and rejected. Geratdh Tindae 11/04/2025 Signature of Authorized Offer Date Gerald Tindal Inside Sales Manager Print or Type Name of Authorized Individual Title of Authorized Individual RFP# 26-033 Arterial LED Streetlights 28 | Page