1._Offeror_Information_&_Certifications.docx
DOCX document 28 KB Posted
- Solicitation number
- RFP 18-820-26 Division of Water Tongass Narrows Sampling
- Issued by
- Ketchikan Gateway Borough, Alaska
About this file
This is a Submittal Form A for Offeror Information, issued by the State of Alaska, Department of Environmental Conservation (DEC), Division of Water, for RFP 18-820-26 concerning water-quality sampling and data management services in the Tongass Narrows. The proposal submission deadline is 1:00 p.m. prevailing Alaska Daylight Time (AKDT) on Wednesday, March 18, 2026, as indicated by email timestamp, with late proposals not considered. The form requires offerors to provide company information including name, address, tax identification number, and Alaska Business License number, along with contact information for a designated representative and identification of all critical team members who cannot be removed or replaced without written approval from the project director or procurement officer.
The form mandates acknowledgement of all project addenda, requiring offerors to list amendments by number with initials and dates to confirm incorporation into the proposal, with failure to identify all amendments potentially resulting in disqualification. Offerors must complete a Conflict of Interest Statement disclosing any current or former State of Alaska employment within the past two years or other potential conflicts that could affect objectivity, with non-disclosure potentially grounds for disqualification. The form also requires identification of applicable federal requirements and directs offerors claiming Alaska Preferences to complete the Alaska Bidder Preference Certification Form. Offerors not registered directly with the Procurement Officer, Heather Zepp (DECDASPROCUREMENT@alaska.gov), must register to receive subsequent amendments, as failure to do so may result in proposal rejection. The proposal must be signed by a company officer authorized to bind the company.
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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 .