1-26036 Appendix C - Vendor Forms.xlsx
XLSX spreadsheet 24 KB Posted
- Attached to
- Milk, Dairy and Juice Products
- Solicitation number
- GSS26036-MILK_DAIRY
- Issued by
- Delaware
About this file
This is a vendor forms document from the State of Delaware, Office of Management and Budget, Government Support Services, for a milk, dairy products, and juice supply solicitation. The document serves as the appendix containing standardized forms that all vendors must complete and submit as part of their bid response. The solicitation seeks qualified vendors to supply and deliver milk, dairy products, and assorted juice items to state agencies, schools, and eligible program participants, with all products required to meet U.S. Food and Drug Administration standards and the State of Delaware Food Code requirements, including temperature control, freshness, labeling, and safe handling specifications.
The vendor forms package includes a Non-Collusion Statement that must be signed and notarized, in which vendors certify they have not engaged in anticompetitive practices and accept the solicitation's terms and conditions. Additional required forms include a Vendor Information Sheet requesting company details, diverse vendor certifications, primary and secondary contacts, and a business capability statement; a Business References form requiring a minimum of three references of similar size and scope; a Confidentiality Form for vendors to designate proprietary information; an Exceptions Form allowing vendors to propose minor exceptions to the terms and conditions; and a Subcontractor Form for vendors utilizing subcontractors. The document also includes an affirmation question regarding any suspension or debarment history within the past five years at the federal, state, or local government level. All authorized representatives signing these forms must have legal authority to enter the organization into a formal contract with the State of Delaware.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-Appendix A - Pricing (BT-12BP).xlsx | XLSX spreadsheet | |
| 2-26036 Appendix D - Questionnaire.xlsx | XLSX spreadsheet | |
| 5-26036 Milk ITB.pdf | ||
| 3-26036 Appendix A1 Product Offering.xlsx | XLSX spreadsheet | |
| 6-26036 Appendix B - Online Bid Submission Portal Instructions.pdf |
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Non-Collusion Statement
| Non-Collusion Statement |
| This is to certify that the undersigned Vendor has neither directly nor indirectly, entered into any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive bidding in connection with this solicitation, and further certifies that it is not a sub-contractor to another Vendor who also submitted a bid/proposal as a primary Vendor in response to this solicitation submitted this date to the State of Delaware, Office of Management and Budget, Government Support Services. |
| It is agreed by the undersigned Vendor that the signed submission of this bid/proposal represents, subject to any express exceptions set forth on the Exception form, the Vendor’s acceptance of the terms and conditions of this solicitation including all specifications and special provisions. |
| NOTE: Signature of the authorized representative MUST be of an individual who legally may enter his/her organization into a formal contract with the State of Delaware, Office of Management and Budget, Government Support Services. |
| Company Name |
| DBA (if applicable) |
| Name of Authorized Representative |
| Title |
| Phone Number |
| Email Address |
| Company Address |
| Phone Number |
| Email Address |
| Tax ID Number |
| AFFIRMATION: Within the past five (5) years, has your firm, any affiliate, any predecessor company or entity, owner, Director, officer, partner or proprietor been the subject of a Federal, State, Local government suspension or debarment? |
| If yes, explain | |
| THIS PAGE SHALL BE SIGNED AND NOTARIZED (NOTARY SEAL MUST BE VISIBLE) FOR YOUR BID/PROPOSAL TO BE CONSIDERED. | |
| Authorized Representative | Notary |
Vendor Information Sheet
| Vendor Information Sheet | ||
| Company Name | ||
| DBA (if applicable) | ||
| Purchase Order Address | ||
| Website | ||
| Diverse Vendor Self-Identification | ||
| State Certified | If yes, which State(s): | |
| Federal Certified | ||
| Desginated Contacts | Primary | Secondary |
| Contact Name | ||
| Role/Title | ||
| Phone Number | ||
| Business Capability Statement | ||
| (Provide a short capability statement about your business and its capabilities and skills to advertise who you are and what you do.) |
Business References
| Business References |
| List a minimum of three business references of similar size and scope. Please do not list any State Employee(s) as a business reference. If Subcontractors are identified, a minimum of three business references must also be provided for each subcontractor. |
| Reference One |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
| Reference Two |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
| Reference Three |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
Confidentiality Form
| Confidentiality Form |
| Responding vendor may elect to designate sections of their proposal as confidential, intellectual property, trade secrets, and other confidential business information. Vendor shall explain below how the redacted information is not “public record” as defined by 29 Del. C. § 10002. The State shall independently determine the validity of any vendor designation as set forth in this section. Any vendor submitting a bid/proposal herein expressly accepts the State’s absolute right and duty to independently assess the legal and factual validity of any information designated as confidential business information. |
| Confidential Information |
| Confidentiality and Proprietary Information |
Exceptions Form
| Exceptions Form | |||
| Responding Vendors may elect to take minor exceptions to the terms and conditions of this solicitation. All exceptions must be submitted below. Exceptions found elsewhere in the solicitation response will not be considered. Government Support Services maintains sole discretion to reject any exceptions. | |||
| Exceptions | |||
| Paragraph & Page # | Current Language | Proposed Alternative | Justification |
Subcontractor Form
| Subcontractor Form | |
| Are you proposing the use of any subcontractors in the fulfillment of the requirements as outlined in the solicitation? | |
| If yes, complete this form. | |
| Responding Vendor Information | |
| Company Name | |
| DBA (if applicable) | |
| Company Address | |
| Subcontractor Information | |
| Company Name | |
| DBA (if applicable) | |
| Company Address | |
| Diverse Vendor Self-Identification | |
| State Certified | If yes, which State(s): |
| Federal Certified | |
| Description of Work by Subcontractor |
| Once completed, this form must be signed by both vendors. | |
| Proposing Vendor | Subcontractor |
| Authorized Signature: | Authorized Signature: |
| Name: | Name: |
| Title: | Title: |
| Date: | Date: |
DropDowns
| YES |
| NO |
| YES - Vendor is providing any information they declare to be confidential or proprietary for the purpose of production under 29 Del. C. Ch. 100, Delaware Freedom of Information Act. |
| NO - Vendor is not providing any information they declare to be confidential or proprietary for the purpose of production under 29 Del. C. Ch. 100, Delaware Freedom of Information Act. |
| YES - Vendor is submitting exceptions for consideration. |
| NO - Vendor is not submitting any exceptions to the specifications, terms, or conditions found in this solicitation. |
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