00013723_Att A Cover Sheet_final.doc

DOC document 58 KB Posted

Attached to
US101: Culverts (MP 73. 46 - 136. 29)
Solicitation number
S-73000-00013723
Issued by
Tillamook County, Oregon

About this file

This document is a Proposal Cover Sheet for a Mini-RFP (#S-73000-00013723) issued by the Oregon Department of Transportation (ODOT) for a highway infrastructure project involving culverts along US 101 between mileposts 73.46 and 136.29. The cover sheet serves as a formal certification and acknowledgment document for potential proposers, requiring them to verify compliance with various state procurement requirements, confirm receipt of solicitation documents, and attest to their eligibility to bid on the project.

The cover sheet includes several key certifications, such as non-discrimination commitments, acknowledgment of potential contract terms, conflict of interest disclosures, and verification of no outstanding state debt. Notably, for contracts anticipated to exceed $150,000, proposers must certify they have a written policy preventing sexual harassment and discrimination. The document also requires proposers to affirm their understanding of the solicitation terms, provide accurate information, and designate an authorized representative empowered to submit the proposal and make binding representations on behalf of the proposing organization.

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Other files

File Type Posted
00013723_Mini RFP.pdf PDF
00013723_ Notice of Intent to Award.pdf PDF
Attachment B_Resumes_keystaff-Final~1.docx DOCX document
Sprinkler Valves.pdf PDF
00013723 Addendum 1 _Final.pdf PDF
00013723_Exhibit A.1.pdf PDF

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Text version

Attachment A – Proposal Cover Sheet

Mini-RFP #: S-73000-00013723 Oregon Department of Transportation

Project name: US101: Culverts (MP 73.46 – 136.29) Name of Firm:

Type name of primary contact for this Proposal:

Email address:

Telephone:

As the authorized representative named below, I certify on behalf of Proposer that:

1. Proposer has received copies of all addenda to this Mini-Solicitation.

2. Agency shall not be liable for: a) any claims or be subject to any defenses asserted by Proposer based upon, resulting from, or related to, Proposer's failure to comprehend all requirements of the Mini-RFP; or b) any expenses incurred by Proposer in either preparing and submitting its Proposal, or in participating in the proposal evaluation/selection or WOC negotiation process.

3. All contents of the Proposal, and this Mini-Solicitation Cover Sheet, are truthful and accurate.

4. Proposer has not and will not discriminate against a subcontractor in the awarding of a subcontract because the subcontractor is a minority, women or emerging small business enterprise certified under ORS 200.055.

5. If applicable, Proposer has, or will have prior to WOC execution, a written policy and practice, that meets the requirements described in ORS 279A.112, of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class. (Agency may not enter into a contract with an anticipated contract price of $150,000 or more with a Proposer that does not certify it has such a policy and practice. See additional information and sample policy template.).

6. Proposer has no undisclosed liquidated and delinquent debt owed to the State or any department or agency of the State (Executive Order 17-09).

7. Proposer accepts all the terms and conditions contained in the Mini-RFP, and the referenced PA.

8. Proposer has made all required Conflict of Interest (COI) disclosures, if any, and (Check one of the following two certifications as applicable)

FORMCHECKBOX

Proposer understands and has provided to all Associates (which includes subcontractors) the Conflict of Interest (COI) Guidelines and COI Disclosure Form. Proposer and (to the best of the below-named authorized representative’s information, knowledge and belief) Proposer’s Associates (as defined in the COI Guidelines) are in conformance with the COI Guidelines, have no employees that were employed by ODOT within the last two-year period, and have no conflicts of interest or other disclosures required per the COI Guidelines. The response to each question on the COI Disclosure Form was “no”.

FORMCHECKBOX

Proposer understands and has provided to all Associates (which includes subcontractors) the Conflict of Interest (COI) Guidelines and COI Disclosure Form. Proposer and (to the best of the below-named authorized representative’s information, knowledge and belief)all Associates (as defined in the COI Guidelines) have provided on the COI Disclosure Form(s) submitted as separate documents with this Proposal all disclosures required per the ODOT COI Guidelines.

9. By entering my name and title below and checking the “APPROVED” checkbox, I certify I am an Authorized Representative of the Proposer, duly authorized to bind the Proposer and make all representations, attestations, and certifications contained in the Proposal document and to submit this Proposal document on behalf of Proposer.

APPROVED
Authorized Representative

Title

Date xx/xx/xxxx

(Mini RFP Cover, ver. 7/01/21)

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