1-Domestic Partnership Act Certification.docx

DOCX document 47 KB Posted

Attached to
Utility Bill Collection Services
Solicitation number
GEN2131791B1
Issued by
Broward County, Florida

About this file

This is a Domestic Partnership Act Certification form for Broward County, Florida, required as part of the Utility Bill Collection Services solicitation. The certification must be completed and submitted by vendors responding to this open-end contract for utility bill collection services to be provided to Broward County's Water and Wastewater Services and other county agencies. Vendors are required to submit the completed certification form with their initial solicitation response to be considered responsive, or alternatively within three business days of the County's request. For contracts exceeding $100,000 in value, the form serves a dual purpose: it establishes responsiveness as a mandatory requirement and determines eligibility for a domestic partnership tiebreaker preference in the evaluation process. Vendors must select one certification option indicating their compliance status or applicable exemption regarding the provision of domestic partnership benefits.

Broward County's Domestic Partnership Act requires vendors contracting for goods and services over $100,000 to provide benefits to registered domestic partners of employees on the same basis as spousal benefits, subject to specified exemptions. Vendors may certify current compliance, commitment to comply at contract award, non-compliance, or qualification for one of six exemptions including: employers with fewer than five employees, those not providing spouse benefits, governmental entities, religious organizations, those providing cash equivalents, or those whose compliance would violate federal or state law or grant conditions. The form requires vendor signature, printed name, title, and date, and failure to submit by stated deadlines may render the vendor nonresponsive or ineligible for preference consideration.

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Text version

DOMESTIC PARTNERSHIP ACT CERTIFICATION

INVITATION TO BID

Refer to applicable section below. The completed form should be returned with the Vendor’s submittal. Failure to submit this form by stated timeframes may deem the Vendor nonresponsive to the solicitation or ineligible for the Domestic Partnership tiebreaker, as applicable.

Domestic Partnership Responsiveness Requirement (Refer to Instructions to Vendors, if applicable) This completed and signed form should be returned with the Vendor’s submittal. If not provided with the submittal, the Vendor must submit this form within three business days after County’s request. A Vendor shall be deemed nonresponsive for failure to fully comply within stated timeframes.

Domestic Partnership Tiebreaker (Refer to Instructions to Vendors, if applicable) To be eligible for the Domestic Partnership tiebreaker, the Vendor must currently offer the Domestic Partnership benefit and the completed form must be returned at the time of solicitation submittal. Vendors who fail to comply with this submittal deadline will not be eligible for the Domestic Partnership tiebreaker.

The Domestic Partnership Act, Sections 16½ - 150 through 16½ -165, Broward County Code of Ordinances (the “Act”), requires Vendors contracting with the County for goods and services in an amount over $100,000 to provide benefits to the registered domestic partners of their employees on the same basis as they provide benefits to the employees’ spouses, with certain exceptions as provided by the Act.

For all submittals over $100,000, the Vendor, by virtue of the signature below, certifies that it is aware of the requirements of Broward County’s Domestic Partnership Act, Section 16½-157, Broward County Code of Ordinances, and certifies the following: (check only one box below)

☐ The Vendor currently complies with the requirements of the County’s Domestic Partnership Act and provides benefits to registered domestic partners of its employees on the same basis as it provides benefits to its employees’ spouses.

☐ The Vendor will comply with the requirements of the County’s Domestic Partnership Act at the time of contract award and provide benefits to registered domestic partners of its employees on the same basis as it provides benefits to its employees’ spouses.

☐ The Vendor will not comply with the requirements of the County’s Domestic Partnership Act at the time of award.

☐ The Vendor does not need to comply with the requirements of the County’s Domestic Partnership Act at the time of award because the following exception(s) applies: (check only one below).

☐ The Vendor employs less than five (5) employees.

☐ The Vendor does not provide benefits to employees’ spouses.

☐ The Vendor is a governmental entity, not-for-profit corporation, or charitable organization.

☐ The Vendor is a religious organization, association, society, or non-profit charitable or educational institution.

☐ The Vendor provides an employee the cash equivalent of benefits (Attach an affidavit in compliance with the County’s Domestic Partnership Act stating the efforts taken to provide such benefits and the amount of the cash equivalent).

☐ The Vendor cannot comply with the provisions of the Domestic Partnership Act because it would violate the laws, rules, or regulations of federal or state law, or would violate or be inconsistent with the terms or conditions of a grant or contract with the United States or State of Florida. Indicate the law, statute, or regulation (State the law, statute, or regulation and attach explanation of its applicability).

Vendor Name: Click or tap here to enter text.

Signature: ______________________________ Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24

File details come from the government source that posted it. Updated .