1._Offeror_Information_&_Certifications.docx
DOCX document 28 KB Posted
- Attached to
- Notice of Intent to Award | RFP 18-804-26 | Opacity Monitoring of Cruise Ships & State Ferries
- Solicitation number
- Notice of Intent to Award | RFP 18-804-26 | Opacity Monitoring of Cruise Ships & State Ferries
- Issued by
- Anchorage Municipality, Alaska
About this file
This document is a submittal form for an unspecified state contract opportunity, likely in Alaska, involving a Request for Proposal (TRFP). The form requires detailed offeror information, including company details, contact information, and critical team members, with a specific requirement that key personnel cannot be replaced without written approval from the project director or procurement officer. The document includes sections for acknowledging addenda, declaring potential conflicts of interest, identifying federal requirements, and claiming Alaska preferences.
The form emphasizes compliance and transparency, requiring offerors to disclose any potential conflicts of interest, particularly related to current or recent employment with the State of Alaska. The document mandates that a company officer with binding authority must sign the proposal, and offers the opportunity to claim Alaska Bidder Preferences. While specific project details are not provided, the form suggests a rigorous procurement process with multiple verification steps, including detailed team member identification, amendment acknowledgment, and potential disqualification for incomplete or non-compliant submissions.
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Text version
SUBMITTAL FORM A – Offeror Information
PROJECT INFORMATION
TRFP Number:
Project Name:
OFFEROR INFORMATION
Company Name:
Address:
Tax ID:
Alaska Business License Number:
CONTACT INFORMATION
Provide contact information for the individual who can be contacted for clarification regarding this proposal:
Name:
Title:
Address:
Email:
Telephone:
CRITICAL TEAM MEMBERS
Provide the names of all critical team members that will be assigned to this contract. Note: These individuals cannot be removed or replaced from this project, or their positions, unless approved in writing the project director or procurement officer.
Name of Position 1
Name of Position 2
Name of Position 3
Name of Position 4
ADDENDA ACKNOWLEDGEMENT
The offeror acknowledges receipt of the following amendments and has incorporated the requirements of such amendments into their proposal. Failure to identify and sign for all amendments may subject the offeror to disqualification. The offeror must list all amendments (by number), then initial and date to confirm that you have received and incorporated them into your proposal (add more rows as necessary).
| Number |
| Initials & Date |
| Number |
| Initials & Date |
| Number |
| Initials & Date |
CONFLICT OF INTEREST STATEMENT
Indicate below whether or not the firm or any individuals that will work on the contract have a possible conflict of interest (e.g., currently employed by the State of Alaska or formerly employed by the State of Alaska within the past two years) and, if so, the nature of that conflict. The procurement officer reserves the right to consider a proposal non-responsive and reject it or cancel the award if any interest disclosed from any source could either give the appearance of a conflict or cause speculation as to the objectivity of services to be provided by the offeror.
| Does the offeror, or any individuals who will work on this contract, have a possible conflict of interest? |
| □ Yes □ No |
* Failure to answer may be grounds for disqualification.
If “Yes,” please provide additional information regarding the nature of that conflict:
FEDERAL REQUIREMENTS
Indicate below all known federal requirements that apply to the proposal, proposal evaluation, or contract:
ALASKA PREFERENCES
If you wish to claim any Alaska Preferences, please complete the Alaska Bidder Preference Certification Form that follows the signature section below.
SIGNATURE
This proposal must be signed by a company officer empowered to bind the company.
Printed Name
Title
Date
Signature
File details come from the government source that posted it. Updated .