Attachment E - Financial Proposal Form - Maryland Public Service Commission Page 2
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1
2Part B.
Other Expenses
$
$
$
$
SUBTOTAL – Part C
$
TOTAL OFFER PRICE
: $
(Part A + Part B)
___________DOLLARS AND ___/100
(
write out price in words)
Submitted By:
Printed Name and Title
Authorized Signature: ______________________________________________ Date: ______________
Company Name : ______________________________________________________________________
Company Address: _____________________________________________________________________
_____________________________________________________________________________________
Location(s) from which services will be performed (City/State)
Telephone Number: ___________________________
Fax Number: ___________________________
Email: ______________________________________________________________________________
Federal Identification Number (FEIN): _________________________________________
eMM Registration/Vendor Number: _________________________________________
(Must be supplied within five (5) days of Proposed Award Letter)
Maryland State Department of Assessments and Taxation (SDAT) Vendor Department ID
Number: ___________________
(Must be supplied within five (5) days of Proposed Award Letter)
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