1-GSS27080-PEST CNTRL Appendix D - Required Vendor Forms.xlsx

XLSX spreadsheet 23 KB Posted

Attached to
Pest Control Services
Solicitation number
GSS27080-PEST_CNTRL
Issued by
Delaware

About this file

This file contains required vendor forms for a pest control services solicitation issued by the State of Delaware, Office of Management and Budget, Government Support Services. The solicitation seeks to identify vendor(s) to provide pest control services statewide. The document does not specify quantities, response dates, due dates, site visits, bidder meetings, award dates, or contract term details within the forms themselves, as these are standard vendor submission templates rather than the primary solicitation documents.

The required vendor forms include a Non-Collusion Statement that must be notarized, a Vendor Information Sheet requesting company details and diverse vendor self-identification status, a Business References section requiring three references of similar size and scope, a Confidentiality Form for proprietary information designation, an Exceptions Form for vendors to propose minor modifications to solicitation terms, and a Subcontractor Form for vendors utilizing subcontractors. Vendors must certify they have not been suspended or debarred by federal, state, or local government within the past five years. The Non-Collusion Statement must be signed by an authorized representative legally able to bind the organization to a contract with the State of Delaware. All forms explicitly state they should not be modified and must be completed for the bid proposal to be considered.

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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 RepresentativeNotary

Vendor Information Sheet

Vendor Information Sheet
Company Name
DBA (if applicable)
Purchase Order Address
Website
Diverse Vendor Self-Identification
State CertifiedIf yes, which State(s):
Federal Certified
Desginated ContactsPrimarySecondary
Contact Name
Role/Title
Phone Number
Email
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 three business references of similar size and scope. Please do not list any State Employee(s) as a business reference. If Subcontractors are identified, three business references must also be provided for each subcontractor. DO NOT MODIFY TEMPLATE.
Reference One
Contact Name
Contact Title
Business Name
Address
Email
Phone
Current Vendor?
Work Performed
Reference Two
Contact Name
Contact Title
Business Name
Address
Email
Phone
Current Vendor?
Work Performed
Reference Three
Contact Name
Contact Title
Business Name
Address
Email
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 LanguageProposed AlternativeJustification

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 CertifiedIf yes, which State(s):
Federal Certified
Description of Work by Subcontractor
Once completed, this form must be signed by both vendors.
Proposing VendorSubcontractor
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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