1-Attachment B-1 - Offer Form.docx
DOCX document 29 KB Posted
- Attached to
- Credit and Debit Card Processing
- Solicitation number
- 253430
- Issued by
- Pinal County, Arizona
About this file
This document is an Offer Form for a state and local contract opportunity issued by Pinal County, Arizona, specifically for credit and debit card processing services. The form provides a template for potential vendors to submit proposals for providing payment processing services to the Pinal County Treasurer's Office and other county departments. The document requires vendors to complete company details, contact information, and certify compliance with various state and federal regulations, including non-discrimination policies, ethical standards, and restrictions on forced labor.
The offer form includes several critical certification requirements for potential vendors, such as affirming they have not offered improper inducements to public servants, complying with Arizona statutes regarding electronics and information technology products, and certifying they are not debarred from government contracts. The form emphasizes legal compliance, with explicit warnings that false statements can void the offer and potentially result in legal penalties. Vendors must also certify compliance with specific Arizona Revised Statutes, including provisions related to technology procurement and prohibitions on using forced labor from specific ethnic groups in China.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-Attachment B-2 - Addendum Acknowledgement Form.docx | DOCX document | |
| 5-Attachment B-6 Pricing Document.docx | DOCX document | |
| 9-Attachment B - Submission Instructions - 253430RFP.docx | DOCX document | |
| 10-253430RFP Attachment A - Scope of Work (SOW).docx | DOCX document | |
| 8-Attachment B - Submission Instructions - 253430RFP.docx | DOCX document | |
| 4-Attachment B-4 - Supplier Contact Information.docx | DOCX document | |
| 3-Attachment B-3 - Conformance Statements.docx | DOCX document | |
| 6-Attachment A-1 SOW Exhibit Transaction Volume.xlsx | XLSX spreadsheet | |
| 7-253430RFP -OPEN FIRST.docx | DOCX document |
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Text version
Attachment B-1 Offer Form
Submission of Offer: Undersigned hereby offers and agrees to provide goods and/or services in compliance with the solicitation and the offer, which is as indicated by the latest dated version below:
Offer Date:
| X | ||
| Responder Company Name | Signature of Person Authorized to Sign Offer |
| Address | Printed Name and Title |
| City, State, Zip | Responder Contact Name and Title |
| Web Address | Contact Email Address | Contact Phone # |
Certification: By signature in the Offer section above, the Responder certifies:
1. The Responder shall not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, Arizona State Executive Order 2009-9 or A.R.S. §§ 41−1461 through 1465.
2. The Responder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause will result in rejection of the offer. Signing the offer with a false statement will void the offer, any resulting contract, and may be subject to legal penalties under law.
3. The Responder certifies compliance with A.R.S. § 41-3532 when offering electronics or information technology products, services, or maintenance.
4. The Responder certifies compliance with A.R.S. § 35-394 prohibiting the use of forced labor by Responder or its contractors or subcontractors of ethnic Uyghurs in the People’s Republic of China in any goods produced in service of this contract.
5. The Responder is not debarred from, or otherwise prohibited from participating in any contract awarded by federal, state, or local government.
Contract #253430RFP image1.png
File details come from the government source that posted it. Updated .