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STATE OF WYOMING
STATE OF WYOMING


INITIAL APPLICATION
Date of Application:
BIDDERS MAILING LIST APPLICATION

REVISION
All answers should be typed or printed. See reverse for information and instructions
TO: Department of Administration and Information
Procurement Section Phone: (307) 777-7253
122 West 25
th
Street, Herschler Bldg., 2
nd
Floor East FAX: (307) 777-5852
Cheyenne, WY 82002
1. Name and Address to Which Bidding Forms Are To Be Mailed:





Email Address:

2. Address of Main Business Office If Different:
3. Tax Identification Number

Individual or Sole Proprietor

SSN

Partnership/Corporation
TIN
4. Type of Organization (Check One)


Individual

Corporation

Partnership
5. If Incorporated, Indicate In Which State:

6. NAMES OF OFFICERS, MEMBERS, OR OWNERS OF CONCERN, PARTNERSHIP, AND HOME ADDRESS:
(A) President:
(B) Vice President:
(C) Secretary:
(D) Treasurer:
(E) Owners or Partners:
7. PERSON TO CONTACT ON MATTERS CONCERNING BIDS AND CONTRACTS (if agent, so specify)
Name Official Capacity Telephone No.

___________________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

8. List Commodity Code or Service You Provide. Indicate Commodity Code if Applicable:




9. Category (See definitions on the reverse of this form and check below the category which applies to the applicant)


(A) Manufacturer or Producer

(B) Dealer

(C) Service Establishment (D) Construction Concern

11. FLOOR SPACE (Square Feet)
12. NET WORTH
10. NUMBER OF PERSONS NOW
EMPLOYED:


Manufacturing Warehouse Date
Amount
14. I certify that the information supplied herein (including all pages
attached) is correct and that neither the applicant or any person (or
concern) in any connection with the applicant as a principal or officer, so far
as is known, is no debarred or otherwise declared ineligible by any
Governmental agency of the State of Wyoming from bidding for furnishing
materials, supplies or services to the State Government or any agency
thereof.

Signature of Person Authorized to Sign This Application:
13.
This Space for Use by the State of Wyoming

APPROVED_____________________________________
Place On the Following Bid Lists:

1.______________________ 5._________________
2.______________________ 6._________________
3.______________________ 7._________________
4.______________________ 8._________________

REMARKS: ____________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
15. Name and Title of Person Signing (Please Print or Type)


RETURN TO SENDER APPLICATION INFORMATION AND INSTRUCTIONS

Persons or concerns wishing to be added to the State of Wyoming approved bidders mailing list for equipment, materials, supplies or services shall file this
properly completed Bidders Mailing List Application, together with such other lists as may be attached to the application form, with the Purchasing Office
of the State of Wyoming in advance of consideration of award or contract. This application shall be submitted and signed by the principle as distinguished
from an agent, however constituted.

CATEGORY DEFINITIONS
(See Item No. 9)

A. MANUFACTURER OR PRODUCER means a person (or concern) owning, operating or maintaining a factory or establishment that produces, on the
premises, the materials, supplies, articles or equipment of the general character or those listed in Item No. 8.

B. DEALER means a person (or concern) who owns, operates or maintains a store, warehouse or other establishment in which the materials, supplies,
articles or equipment of the general character listed in Item No. 8 are bought, kept in stock and sold to the public in the usual course of business.

C. SERVICE ESTABLISHMENT means a person (or concern) which owns, operates or maintains any type of business which is principally engaged in the
furnishing of non-personal services such as (but not limited to) repairing, cleaning, redecorating or rental of personal property, including the furnishing of
necessary repair, parts or other supplies as part of the services performed.

D. CONSTRUCTION CONCERN means a person (or concern) engaged in construction, alteration or repair of buildings, structures, highways (concrete or
bituminous) or other real property.

BIDDING CONDITIONS AND INSTRUCTIONS

1.

Bids must be received in the Purchasing office by the time and date specified.
2.

All bids must be submitted on forms furnished by the State of Wyoming, unless otherwise specified and signed by a proper official of the supplier
bidding. Telephone, telegraph and facsimile bids will not be accepted.
3.

No bid will be considered which modifies, in any manner, any of the provisions, specifications or Proposal Form.
4.

In case of error in the extension of prices in the bid, the Unit Price will govern.
5.

A bid bond and/or performance bond may be required.
6.

A bid that is in the possession of the Purchasing office may be altered by telegram or letter bearing signature or name of person authorized for
bidding, provided it is received prior to the time and date of the opening. Telephone, fax or verbal alterations of a bid will not be accepted.
7.

A bid that is in the possession of the Purchasing office may be withdrawn by the bidder, up to the time of the bid opening. Bids may not be
withdrawn after the bid opening.
8.

Time in connection with discounts offered will be computed from date of delivery or from date correct itemized invoice is received, whichever is
later. Cash billing or percentage discounts for payments of invoices in fifteen days (15) or more, or at any time after the fifteenth of the following
month, will be considered in evaluating bids; shorter discount period will not be considered in evaluating bids.
9.

Preferences will be given to materials, supplies, equipment, machinery, provisions, and/or services offered by resident bidders, quality being equal
to articles or services offered by competitors outside the State of Wyoming, W.S. 16-6-106, as amended. When applicable a percentile preferential
will be accomplished or allowed in the following manner:
a.

A preferential of five percent (5%) will be applied for supplies, equipment, machinery, or provisions quality being equal to articles
offered by competitors outside the State of Wyoming. The preferential, when supplied, will be accomplished by adding the 5% to the
total bid price of the non-residential bidder. Discounts offered will be taken into consideration and deduction of the discount will be
made before application of the preferential. W.S. 16-6-105, as amended.
b.

A preferential of ten percent (10%) will be applied to any contract for printing done within the State of Wyoming provided the printer
owns, operates and/or maintains an establishment in the State of Wyoming. The preferential will be applied after deduction of any
discount offered. W.S. 16-6-301, as amended.
c.

Preference will be given Wyoming resident contractors for public works and construction contracts. The contract shall be let to the
responsible resident matching the lowest bid, is such residents bid is not more than 5% higher than that of the lowest responsible non-
resident bidder. In receiving the 5% preference the resident contractor understands that no more than 20% of the contract total may be
sub-contracted to non-resident sub-contractors. W.S. 16-6-102, 16-6-103, 16-6-104, 16-6-105, as amended.
d.

Expenditures or contracts involving Federal Funds are not subject to Federal Rules and Regulations. Under these conditions, a percentage
differential may not be allowed. W.S. 16-6-108.
10.

Failure of a bidder to furnish the equipment, supplies, materials and/or services from a bid, on which an award is made, shall eliminate the bidder
from the active bidders mailing list for the products or services concerned.
11.

Fail