HomeMy WebLinkAbout20212614.tiffAugust 30, 2021
WELD COUNTY ACCOUNTING DEPARTMENT
1150 O STREET
P.O. BOX 758
GREELEY, CO 80632-0758
WEBSITE: www.co.weld.co.us
PHONE: (970) 336-7240
FAX: (970) 352-9019
Federal Service Desk
Attn SAM Gov Registration Processing
Purpose of Letter
The purpose of this letter is to formally appoint an Entity Administrator for the named Entity and
to attest to the accuracy of the information contained in the entity registration.
Designation of Entity Administrator
I, Steve Moreno, Chair of the Weld County Board of County Commissioners, the below signed
individual, hereby confirm that the appointed Entity Administrator is an authorized officer,
agent, or representative of the Entity. This letter authorizes the appointed Entity Administrator to
manage the Entity's registration record, its associated users, and their roles to the Entity, in the
System for Award Management (SAM).
Entity Covered by this Letter
DUNS® Number: 075757955
Legal Business Name: Weld, County Of
Physical Address: 1150 O Street, Greeley CO 80631
Entity Administrator Contact Information
Full Name: Christopher D'Ovidio
Phone Number: (970) 400-4447
Email Address: cdovidio(a,weldgov.com
*The Entity Administrator must have an individual user account in SAM associated with the
email address listed.
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Account Administration Preference (ONLY CHOOSE ONE)
You must choose ONE of the two following statements by checking the applicable box.
® Self -Administration Confirmation
For the purpose of registering with the United States Government through the online System for
Award Management (SAM), I do not authorize any third party to act on behalf of the Entity
listed above. I have checked the Self -Administration Confirmation box to indicate that the
designated Entity Administrator is not a third -party agent. The entity administrator is directly
affiliated with the entity being registered.
❑Third -Party Agent Designation
For the purpose of registering with the United States Government through the online System for
Award Management (SAM), I, the below signed, do hereby authorize the following person who
is not directly affiliated with the Entity listed above, to act on behalf of the Entity: [insert full
name, phone number, address, and email address of the Third -Party Agent] (Designated
Third -Party Agent). This authorization permits the Designated Third -Party Agent to conduct all
normal, common business functions within SAM while binding the signatory to all actions
conducted and representations made as a result of authorization granted herein. I have checked
the Third -Party Agent Designation box and completed the above information to indicate that the
designated Entity Administrator is a third -party agent.
Attestation
I, the below -signed, attest to the following:
• All information contained in this letter is complete and accurate.
• The designated Entity Administrator listed above has an individual SAM User Account
created with the email address provided in this letter.
• The banking information provided for Electronic Funds Transfer on the Financial
Information Page in the SAM.gov registration for the Entity above is correct and
accurate.
Respectfully,
.1v&-e-tn-0,
Steve Moreno
Chair of the Weld County Board of County Commissioners
smoreno@weldgov.com
Weld, County Of
1150 O Street, Greeley, CO 80631
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TO BE COMPLETED BY NOTARY
(in accordance with State notary requirements)
State of
County of W,�1il
This instrument was acknowledged before me this /Si- day of
Steve Moreno, Chair of the Weld County Board of County Commissioners.
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Personally Known
Produced Identification
Type of ID and Number on ID
(Seal)
ESTHER E. GESICK
NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19974016478
MY COMMISSION EXPIRES SEPT. 29, 2021
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Signature of Notary
Es -/-her- E 6es«k
Name of Notary
(Typed, Stamped or Printed)
Notary Public, State of eokraziO
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