MOBILE COUNTY COMMISSION
BID FORM
Date:
BID #4-26
FIFTEEN MILLION (15,000,000)MOBILECOUNTY/CITYCIGARETTETAXSTAMPSBLACK
LETTERING ON GRAY BACKGROUND,
FUSION TYPE ONLY FOR MOBILE
TOBACCO T,4A' DEPARTMENT:
COUNTY
#ame of Company:
Company Representative
(Print)
Company Representative
(Signature)
Address
Phone number ( )
Federal ID Number
Email Address
Company Web Address
Fax number (
PLEASE ATT ACH A COPY OF YOUR CURRF,NT W9
NMPORT ANT
THNS DDCUMENT
MUST BE CQMPLETED,
SNGNED AND RETURNED
WffH YOURBm
As a condition for the award of a competitively bid contract to a
inthe State ofAlabama, theBeason-Hammon Alabama Taxpayer
codified at Section 31-13-1, et seq., Code of Alabama (1975), as
provide,inadvance,proofofenrollmentinE-Verify.
company having one ormore employees
Citizenship and ProtectionAd,
amended, requires thatthe company
E-Verifyisanintennetbasedsystemoperatedby
the U.S, Department
toworkintheUitedStates.
ofHomeland Security, whiehmay beusedto determine the
FurtherinformationaboutenroumentinE-Verifymaybefoundat
eligibility
of new hires
ww'iv.uscis.gov everifi and wit-w.Verifv.Alabanu,gov.
AsproofoferollmentinE-Verify,
Mobile Countyrequires
page ofthecontractor'sMemorandumofUnderstandingwiththeU.S.
acopyofthe
electromcallysignedsignature
or AlabamaDepartment ofHomeland Security (contractors having
in E-Verify through the state Department of Homeland Security).
Depmtment ofHomeland Security
fewer than25 employeesmay enroll
Please complete the following and return with your bid:
State of Alabama
(company name) has no employees inthe
Or
copy of the electroically
attached.
signedsignaturepage ofthe
(company name) is emonedin E-Verify and a
company'sMemoraridumofTTnrlpmtqnrltnBis
Date
Signature
Title
Company NONumber: 477783
To be accepted as a partiaapanItn tVeri$g youshouldonly sign ttaeEmployerS'section
of the signature page.Rfyou have any questions, comtaaPtjA]hrtfyataaav4044%!lap
m-mj:-qy-e-r-'mohflTe-Co-u-n:y'C';mbs------'-'-"-'-'-"'
-- ---
-- --"'
Qainiefiudmon
Name(F)leaaeJpeo(Print) -- -'--"""'-"
" Tlb
-=
ffile,atmnlamlly_f4gqd___________________ ' !!!_.....-.__
-61gn7tu-r-i '-' - -- --'--"-"-'
"'TOi ate
I
D@p@rtrgiepot:t7.0om,etaranodpuy)ay- V*yffiaa!!ion Diviaifoiv
.___,,,.,_,.,,-' aai
lffffia[8%rNfiqatipmDnsflomt
Name(PteaseTypeeirPrlnl)
a
_
__._ , , -.-._...-
=-aaa'-=+ T"€ile "" -'
.. ..-...- .-.
--
_al______elg!vo____rib,alfy_____8___Jgn_ea __ _'!_2!$!QQ:_,:,_,-,,,,,,,,,,-,-,,,,,,-,,,,,,-,,,,-,
81grialure
a"
-'------
tms - "'--'- - " -- ----'
--""" -
lr'f-orm-:ffii!6i-f;'mjuirao:'fipi'-fhEe-=V-e-riPfyrogrami
ilg'xPoymatnovnella% to your Compa_ny:______ _-__ a+a**_
-"---
=
-'-!11J..'
,
,
_,_____,
__,
Company Name: WdbHleOourxtyOomgnls_aloi
._iaaaa
.
_
._
CeimganFvaaili&yAddre!s08si (Jowrnrwn'2 merge!,
49,h[-kiorBoughTowr
__MobAil*3,Haj4
,,,,,,,, - _,_,
Comlpany Alternate
_,
Addrass: _,
oo a" a
-o " -ak
d-0##+#
a'+ff-.. m
- --#
%a %.. ,%,%
%
ao__uHotryP_arl_ah:_u_9!!!!@=,-. ,,,,, , -%._....
EmployeIrdentification
___, ,
, Numbgr:, :830€(Xi'844
Pag1e2ofl81E-VerMlfyallforEmployaRralvlalonDate09/O'l/09
-
-
.
...--"-=-"-------
-
--
www.dhm.'gov/EA/erlfy
SPECIFICATIONS
THE COUNTY
FOR CIGARETTE
FOR
COMMISSION
AND TOBACCO REVENUE
OF MOBILE, ALABAMA
Stamps required for this bid:
15,000,000 - Fifteen Million
x
Cigarette Stamps for Mace
Application Fuson Type Only
Cigarette Stamps for Hand Application Decalcomania Stamps Only
GENERAJ, SPECIFICATIONS
TYPE AND APPLICATIONS:
All stamps furnished under these specifications must be
genuine layer-built decal stamps of approved quality, consisting of not less than five
irnpressioi-is inciuaing safeiy tii-itiettering-, ana nluS € Be p-tOCiucearyJtne iitnograpli at'la/'or
intaglio process.
Two types of cigarette stamps will be required. One type will be for hand application
with water, and the second type shall be FUSON stamps or equal and be suitable for
machine application with heat to the receiving surface. Both types of stamps must
adhere satisfactorily to cellophane and paper. Contractor shall furnish illustrated
direction sheets showing method of affixing hand applied stamps and shall offer much
help as may be necessary to acquaint users in proper method of hand application.
Contractor shall train the tobacco distributors' employees to properly operate stamp
applying machines for correct application of stamps. Bidder must submit bid on both
types of stamps and furnish with his bid canceled samples of both type of stamps
specified herein and list States now using their stamps for machine application and also
list the States now using their machines for applying said stamps.
PRICE: Bidders must submit net prices per thousand stamps, manufactured and packed
according to specification, F.O.B. destination. All shipments are to be made by prepaid
Railway Express.
SIZE, DESIGN AND COLORS: Each stamp is to be of irregular shape and outlined
and shall contain not less than three colors. The safety tint lettering shall not be
considered as one of the stamp colors. Each stamp should have the number 35 on
them indicating the face value of the stamp. Stamps for machine application shall
measure approximately '/i" x H", and stamps for hand application shall measure
approximately !/2" X 5/8'. Colors and design of stamps are to be approved by the County
Cornmission.
Successful bidder must summit suggested designs and colors, without
charge.
Several denominations may be required. Each denomination shall be of different colors.