11425 Exhibit A - Bidder's Certification.pdf

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 1

(Rev 2023-03-03)

EXHIBIT A – BIDDER’S CERTIFICATION

COMPETITIVE SOLICITATION: No. 11425 – Debt Collection Services

Contract Categories for which Bidder is submitting a Bid:

Check appropriate box(es)

☐ Category 1 – General Collections ☐ Category 2 – Educational Collections ☐ Category 3 – Court-Ordered Collections ☐ Category 4 – Add-On Services*

*Category 4 cannot be bid on alone and must be included with Category 1, 2, and/or 3.

Bidder, through the duly authorized undersigned, makes this certification as a required element of submitting a responsive bid. Bidder certifies, to the best of its knowledge and belief that the following Bidder information and Bidder certifications (collectively, “Bidder’s Certification”) are true, complete, correct, and made in good faith:

BIDDER INFORMATION

Bidders must provide Bidder information for Items A – I below.

ITEM A _________________________________

Type/print Bidder’s full legal name.

Note:

If Bidder is a sole proprietor (see Item C, below), Bidder’s legal name is the name of the individual person who is doing business as a sole proprietor – e.g., Lynn A. Smith, a sole proprietor.

If Bidder is an Entity/Organization (see Item C, below), Bidder’s name must match Bidder’s Entity/Organization name as filed in the state where the entity is formed and with the Washington Secretary of State – e.g., Innovative Supply, LLC, a Washington limited liability company.

Bidder’s Name:

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 2

ITEM B _________________________________

Type/print the address for Bidder’s principal office/place of business.

Note: Bidder’s principal office or principal place of business is the Bidder’s headquarters where business decisions are made and the location for the Bidder’s books and records as well as the Bidder’s senior management personnel.

If Bidder is a sole proprietor (see Item C, below), Bidder’s address for its principal office/place of business typically will be the same address stated by Bidder on its U.S. Internal Revenue Service tax return.

If Bidder is an Entity/Organization (see Item C, below), Bidder’s address for its principal office/place of business must match Bidder’s address for its principal office/place of business as filed in the state where the entity is formed and as filed with the Washington Secretary of State.

Address:

ITEM C Corporation: ☐Domestic ☐Foreign

Business

Entity / Organization

Type:

Check appropriate box

Limited Liability Company (LLC): ☐Domestic ☐Foreign

Limited Liability Partnership (LLP): ☐Domestic ☐Foreign

Sole Proprietorship*: ☐

General Partnership: ☐ *If you are a Bidder who operates a business on your own, you automatically are a sole proprietor unless you have formed a separate business entity (e.g., corporation, LLC, LLP) and lawfully registered the same. A sole proprietorship is an unincorporated business owned and run by one individual or married couple alone with no distinction between the business and the owner. It is not a separate legal entity. It simply refers to a person who owns the business and is personally responsible for its debts and who pays personal income taxes on profits earned from the business.

If Bidder is a corporation, LLC, or LLP, Bidder must check the applicable box for the entity – i.e., ‘domestic’ or ‘foreign.’ An entity is a domestic entity if it was organized under Washington law.

If the entity was organized elsewhere, it is a foreign entity. The entity’s organizational documents and filings with the Washington Secretary of State will state whether the entity is domestic or foreign.

ITEM D _________________________________

Type/print the state where Bidder’s entity (e.g., corporation, LLC, LLP) is formed.

If Bidder is a sole proprietorship (see Item C, above), type/print ‘N/A.’

If Bidder is an entity (see Item C, above), type/print ‘Washington’ if the corporation, LLC, or LLP is domestic or the name of the applicable state if foreign (i.e., a state other than Washington).

State of Formation for Bidder’s Business

Entity:

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 3

ITEM E

State whether Bidder has been doing business under another name during the five-year time period prior to the posting date of this Competitive Solicitation:

Check applicable box.

Bidder Doing

Business Under

Another Name:

☐ Bidder has NOT done business under another name

☐ Bidder HAS done business under another name*

*If Bidder HAS done business under another name, provide the business name(s) and address(es):

Business Name: ___________________________________ Address: ___________________________________

ITEM F Does Bidder have a Registration Number/Unified Business Identifier (“UBI”) Number issued by the State of Washington*?

*UBI Numbers are issued by either the Washington Secretary of State (for out of state businesses) or the Washington State Department of Revenue (for Washington businesses) Check applicable box.

Yes No If yes, provide Bidder’s nine-digit UBI Number: ___ ___ ___ If no, state whether Bidder promptly will obtain a UBI Number if Bidder is designated as an Apparent Successful Bidder:

Yes No Note: To be eligible for a Contract award, Bidders must have a UBI Number prior to Contract Award.

UBI Number:

ITEM G ___________________

Type/print Bidder’s Taxpayer Identification Number* (“TIN”).

*Bidder’s TIN will be either a number issued by the U.S. Internal Revenue Service (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the U.S. Social Security Administration (i.e., Bidder’s Social Security Number (“SSN”)). If Bidder’s TIN is a SSN, do NOT provide the SSN; simply state ‘TIN is Bidder’s SSN.’

Bidder’s Taxpayer

Identification Number:

ITEM H Is Bidder registered in Washington’s Electronic Business Solution (WEBS)?

Check applicable box.

Yes No If yes, Bidder must ensure that Bidder’s WEBS information is correct prior to submitting a Bid.

If no, state whether Bidder will register in WEBS if designated as an Apparent Successful Bidder:

Yes No Note: To be eligible for a Contract award, Bidders must register in WEBS prior to Contract Award.

WEBS

Registration:

https://des.wa.gov/sell/how-work-state/register-bid-opportunities

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 4

ITEM I In the event that Enterprise Services needs to contact Bidder for purposes of bid clarification, Bidder designates the following person as Bidder’s authorized representative:

Type/print contact information for Bidder’s authorized representative.

Name:

Email:

Phone:

Bidder Contact for

Bid Clarification:

Bidders must provide the information identified in the table below which will be used by

Enterprise Services if Bidder is awarded a Contract:

BIDDER’S INFORMATION TO BE PROVIDED BY BIDDER

Designated Contract Administrator:

Name:

Email:

Phone:

Personnel for Contract Sales Reporting:

Contract Sales Reporting Representative:

Name:

Email:

Phone:

Alternate Contract Sales Reporting Representative:

Name:

Email:

Phone:

Personnel for Vendor Management Fee

Matters:

Contract Vendor Management Fee(“VMF”) Representative:

Name:

Email:

Phone:

Alternate VMF Representative:

Name:

Email:

Phone:

Contact Information for Enterprise Services to Send

VMF Invoices:

Bidder name:

Attn:

Address:

City/State/Zip:

Email:

Contact Information for Legal Notices:

Bidder name:

Attn:

Address:

City/State/Zip:

Email:

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 5

BIDDER’S INFORMATION TO BE PROVIDED BY BIDDER

Contract Signature Authority:

If Bidder is awarded a Contract, the following individual will sign the Contract on behalf of Bidder:

Name:

Title:

BIDDER CERTIFICATIONS

1. UNDERSTANDING. Bidder certifies that Bidder has read, thoroughly examined, and fully understands all of the provisions in the above-referenced Competitive Solicitation (including all exhibits) and the terms and conditions of the Contract and any amendments or clarifications to the above-referenced Competitive Solicitation and agrees to abide by the same. Bidder further certifies that Bidder has read, thoroughly examined, and fully understands the Contracting Guide, which is referenced in the Competitive Solicitation and includes useful information regarding the procurement process pertaining to competitive solicitations for goods/services. Bidder further certifies that, in the event that Bidder has any questions or concerns regarding the Competitive Solicitation (including all exhibits and any referenced materials), Bidder timely shall raise such questions and/or concerns during the Question & Answer Period specified in the Competitive Solicitation.

2. ACCURACY. Bidder certifies that Bidder has carefully prepared and reviewed its bid and fully supports the accuracy of the same. Bidder further understands and acknowledges that Enterprise Services shall not be responsible for any errors or omission on the part of Bidder in preparing its bid. Bidder further certifies that the facts declared here are true and accurate. Bidder further understands and acknowledges that the continuing compliance with these statements and all requirements of the above-referenced Competitive Solicitation are conditions precedent to the award or continuation of the resulting Contract.

3. NO COLLUSION, ANTI-COMPETITIVE PRACTICES, OR SHARING BID INFORMATION. Bidder certifies that Bidder has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the above-referenced Competitive Solicitation. Bidder further certifies that Bidder’s bid prices have been arrived at independently, without engaging in collusion, bid rigging, or any other illegal activity, and without for the purpose of restricting competition any consultation, communication, or agreement with any other bidder or competitor relating to (a) those prices, (b) the intention to submit a bid, or

(c) the methods or factors used to calculate the prices offered. Bidder further certifies that Bidder has not been and shall not knowingly disclose its bid prices, directly or indirectly, to any other bidder or competitor before award of a Contract, unless otherwise required by law. Bidder further certifies that Bidder has made no attempt and shall not make any attempt to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. Bidder, however, freely may join with other persons or organizations for the purpose of presenting a joint bid. Whether done directly or indirectly, communicating bid information with other bidders, collusion, or anti-competitive actions among bidders are prohibited. If there is evidence of such communication, collusion, or anti-competitive activities among bidders, Enterprise Services reserves the right to disqualify such bidders.

4. FIRM OFFER. Bidder certifies that its bid pertaining to the above-referenced Competitive Solicitation is a firm offer which cannot be withdrawn for a time period of one hundred and eighty (180) days https://des.wa.gov/sites/default/files/2025-01/bidder-contracting-guide-DES.docx

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 6

from and after the bid due date specified in the above-referenced Competitive Solicitation.

Enterprise Services may accept such bid, with or without further negotiation, at any time within such period. In the event of a protest, Bidder’s bid shall remain valid for such time period or until the protest and any related court action is resolved, whichever is later.

5. CONFLICT OF INTEREST. Bidder certifies that, in preparing its bid, Bidder has not been assisted by any current or former employee of the State of Washington whose duties relate (or did relate) to the above-referenced Competitive Solicitation or prospective Contract and who was assisting in other than the employee’s official, public capacity. Bidder further certifies that no such current or former public employee nor any member of such person’s immediate family have any financial interest in the outcome of Bidder’s bid.

6. NO REIMBURSEMENT. Bidder certifies that Bidder understands that the State of Washington will not reimburse Bidder for any costs incurred in the preparation of Bidder’s bid. All bids become the property of the State of Washington, and Bidder claims no proprietary right to the ideas, writings, items, or samples unless so stated in the bid.

7. PERFORMANCE. Bidder certifies that Bidder understands that its submittal of a bid and execution of this Bidder’s Certification certifies Bidder’s willingness to comply with the Contract, if awarded such.

By submitting this bid, Bidder hereby offers to furnish the goods and/or services solicited pursuant to the above-referenced Competitive Solicitation in compliance with all terms, conditions, and performance requirements contained in the above-referenced Competitive Solicitation and the resulting Contract or, if applicable, as detailed on a Contract Issues List, if permitted, in the above-referenced Competitive Solicitation.

8. INSURANCE. Enterprise Services requires all awarded Bidders to have certain minimum required insurance coverages. Bidders who do not have the minimum required insurance coverages as specified in the Contract included with the Competitive Solicitation shall not be awarded a Contract.

Insurance requirements are stated in Exhibit C – Insurance Requirements of the Contract and the minimum required insurance coverages are stated therein at Section 1 (Insurance Obligation) (“Required Insurance Coverages”). Accordingly, Bidder certifies as follows (must check one):

☐ BIDDER HAS THE REQUIRED INSURANCE. Bidder has a current, valid Certificate of Insurance for each and all of the Required Insurance Coverages. If Bidder is designated as an Apparent Successful Bidder, Bidder shall provide a Certificate of Insurance for each and all of the Required Insurance Coverages, without exception of any kind, to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services. Bidder further certifies that Bidder understands that, if for any reason, Bidder does not timely provide such Certificate of Insurance to Enterprise Services, Bidder shall be disqualified from Contract award.

OR

☐ BIDDER WILL OBTAIN THE REQUIRED INSURANCE. Bidder does not have a current, valid Certificate of Insurance for each and all of the Required Insurance Coverages but, if Bidder is designated as an Apparent Successful Bidder, Bidder shall provide a Certificate of Insurance for each and all of the Required Insurance Coverages, without exception of any kind, to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services. Bidder further certifies that Bidder understands that, if for any reason, Bidder does not timely provide such

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 7

Certificate of Insurance to Enterprise Services, Bidder shall be disqualified from Contract award.

Note: The Contract requires that any awarded Contractor, unless exempt, must have the specified Workers’ Compensation Insurance and Employer’s Liability Insurance. Pursuant to Washington law, certain entities are not required to have Workers’ Compensation Insurance (e.g., entities with no employees). If, under Washington law, Bidder is not required to have Workers’ Compensation Insurance, Bidder must check the box below and provide the lawful basis as to why Bidder is not required to have Workers’ Compensation Insurance:

☐ BIDDER IS NOT REQUIRED TO HAVE WORKERS’ COMPENSATION INSURANCE. Pursuant to Washington law, Bidder is not required to have Workers’ Compensation Insurance because:

Bidder must state a lawful basis as to why Bidder is NOT required to have Workers’ Compensation Insurance.

9. DEBARMENT. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that neither Bidder nor its principals presently are nor ever have been debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from contracting with any federal, state, or local governmental entity within the United States.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

10. CRIMINAL OFFENSE. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that Bidder has not, within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, been convicted or had a civil judgment rendered against Bidder for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a governmental contract; violation of any federal or state antitrust statute; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. Bidder further certifies that Bidder is not presently indicted or otherwise criminally or civilly charged by a governmental entity with commission of any of the offenses enumerated in this paragraph.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

11. CIVIL RIGHTS. Bidder certifies that Bidder complies with all applicable legal requirements prohibiting discrimination against individuals based on their race, color, religion, sex, sexual orientation, gender identity, national origin, or their status as protected veterans or as individuals with disabilities.

12. WASHINGTON STATE WAGE THEFT PREVENTION. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that Bidder has NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of RCW 49.46, 49.48, or 49.52 within the three (3) year period preceding the date of the above-referenced Competitive Solicitation.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

https://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 https://app.leg.wa.gov/RCW/default.aspx?cite=49.46 https://app.leg.wa.gov/RCW/default.aspx?cite=49.48 https://app.leg.wa.gov/RCW/default.aspx?cite=49.52

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 8

13. WASHINGTON STATE STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that, if, pursuant to the above-referenced Competitive Solicitation, Bidder is awarded a Contract, Bidder, including any subcontractor, during the term of such Contract, shall not discriminate on the bases enumerated in RCW 49.60.530(3). Bidder further certifies that Bidder, including any subcontractor, also shall give written notice of this nondiscrimination requirement to any labor organizations with which Bidder, or subcontractor, has a collective bargaining or other agreement.

In addition, Bidder, including any subcontractor, shall cooperate with any Washington state agency investigation regarding any allegation that Bidder, including any subcontractor, engaged in prohibited discrimination set forth in RCW 49.60.530(3).

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

14. WASHINGTON STATE WORKERS’ RIGHTS. Washington State’s Office of the Governor requires Enterprise Services to seek to contract with qualified entities and business owners who can demonstrate or will certify that their employees are not required to sign, as a condition of employment, mandatory individual arbitration clauses and class or collective action waivers. See EXECUTIVE ORDER 18-03 – Supporting Workers’ Rights To Effectively Address Workplace Violations. Accordingly, except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that Bidder does NOT require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

15. WASHINGTON STATE PAY EQUALITY FOR ‘SIMILARLY EMPLOYED’ INDIVIDUALS. The Washington State Legislature requires Enterprise Services to contract with Bidders who satisfy a ‘pay equality’ contractual provision. See LAWS OF 2025, CH. 424, § 914 and LAWS OF 2023, CH. 475, § 919.

Accordingly, Bidder certifies that Bidder’s ‘similarly employed’ individuals are compensated as equals. For purposes of this certification, employees are ‘similarly employed’ if the individuals work for the same employer, the performance of the job requires comparable skill, effort, and responsibility, and the jobs are performed under similar working conditions. Job titles alone are not determinative of whether employees are similarly employed. Bidder may allow differentials in compensation for its workers based in good faith on any of the following: a seniority system; a merit system; a system that measures earnings by quantity or quality of production; a bona fide job-related factor or factors; or a bona fide regional difference in compensation levels. A bona fide job-related factor or factors may include, but is not limited to, education, training, or experience that is consistent with business necessity; not based on or derived from a gender-based differential; and accounts for the entire differential. A bona fide regional difference in compensation level must be consistent with business necessity; not based on or derived from a gender-based differential; and account for the entire differential.

16. CONTRACT TERMINATION FOR DEFAULT OR CAUSE. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that Bidder has not, within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, had one

(1) or more federal, state, or local governmental contracts terminated for cause or default.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

https://app.leg.wa.gov/RCW/default.aspx?cite=49.60.530 https://app.leg.wa.gov/RCW/default.aspx?cite=49.60.530 https://governor.wa.gov/sites/default/files/exe_order/18-03%20-%20Workers%20Rights%20%28tmp%29.pdf https://governor.wa.gov/sites/default/files/exe_order/18-03%20-%20Workers%20Rights%20%28tmp%29.pdf chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https:/lawfilesext.leg.wa.gov/biennium/2025-26/Pdf/Bills/Session%20Laws/Senate/5167-S.SL.pdf chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https:/lawfilesext.leg.wa.gov/biennium/2023-24/Pdf/Bills/Session%20Laws/Senate/5187-S.SL.pdf

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 9

17. TAXES. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that, except as validly contested, Bidder is not delinquent and has paid or has arranged for payment of all taxes due to the State of Washington and has filed all required returns and reports as applicable.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

18. FINANCIALLY SOLVENT. Except as detailed in the attached explanation (Bidder to provide and, in such case, check the box below), Bidder certifies that Bidder is financially stable and solvent, has adequate cash reserves to meet all financial obligations, has not commenced bankruptcy proceedings voluntarily or otherwise, and is not subject to any judgments, liens, or encumbrances of any kind affecting title to any Goods and/or Services that are the subject of the above-referenced Competitive Solicitation.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

19. LAWFUL REGISTRATION. Bidder certifies as follows (must check one):

☐ CURRENT LAWFUL REGISTRATION. Bidder is registered and in good standing in the jurisdiction (state) where Bidder is organized, including having timely filed all required annual reports.

OR

☐ BIDDER IS A SOLE PROPRIETOR OR GENERAL PARTNERSHIP. Bidder, as indicated below (Bidder must check applicable box) is a sole proprietor or general partnership and therefore not required to register in the state where Bidder’s principal place of business is located:

☐ SOLE PROPRIETOR. Bidder is a sole proprietor.

☐ GENERAL PARTNERSHIP. Bidder is a general partnership.

20. REGISTRATION WITH THE WASHINGTON SECRETARY OF STATE. Except for sole proprietors and general partnerships which are exempt from registration, Enterprise Services requires all awarded Bidders (including Washington firms and out of state firms) to be registered with the Washington Secretary of State. Bidders other than sole proprietors or general partnerships who are not registered with the Washington Secretary of State shall not be awarded a Contract. Accordingly, Bidder certifies as follows (must check one):

☐ BIDDER IS REGISTERED WITH THE WASHINGTON SECRETARY OF STATE. Bidder is registered with the Washington Secretary of State, is in good standing, and has the following Unified Business Identifier (UBI) number: ___ ___ ___.

Bidder must provide its nine-digit UBI number.

OR

☐ BIDDER WILL REGISTER WITH THE WASHINGTON SECRETARY OF STATE. Bidder currently is not registered with the Washington Secretary of State but, if designated as an Apparent Successful Bidder, Bidder shall register with the Washington Secretary of State to obtain a UBI number and provide proof of such registration satisfactory to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services. Bidder further certifies that Bidder understands that, if for any reason, Bidder is not timely registered with the Washington Secretary of State and has not

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 10

timely provided a valid UBI number for Bidder to Enterprise Services, Bidder shall be disqualified from Contract award.

OR

☐ BIDDER IS A SOLE PROPRIETOR OR GENERAL PARTNERSHIP. Bidder, as indicated below (Bidder must check applicable box) is a sole proprietor or general partnership and therefore exempt from the requirement to register with the Washington State Secretary of State:

☐ SOLE PROPRIETOR. Bidder is a sole proprietor.

☐ GENERAL PARTNERSHIP. Bidder is a general partnership.

21. REGISTRATION WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Enterprise Services requires all awarded Bidders (including Washington firms and out of state firms) to be registered with the Washington State Department of Revenue. Bidders who are not registered with the Washington State Department of Revenue shall not be awarded a Contract. Accordingly, Bidder certifies as follows (Bidder must check one):

☐ BIDDER IS REGISTERED WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is registered with the Washington State Department of Revenue, has a business license to do business in Washington, and has the following Unified Business Identifier (UBI) number: ___ ___ ___.

OR

☐ BIDDER WILL REGISTER WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder currently is not registered with the Washington State Department of Revenue but, if designated as an Apparent Successful Bidder, Bidder shall register with the Washington State Department of Revenue for a business license and provide proof of such registration satisfactory to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services. Bidder further certifies that Bidder understands that, if for any reason, Bidder is not timely registered with the Washington State Department of Revenue and has not timely provided a valid UBI number for Bidder to Enterprise Services, Bidder shall be disqualified from Contract award.

22. SUBCONTRACTORS. Bidder, if pursuant to the above-referenced Competitive Solicitation is awarded a Contract, certifies as follows (Bidder must check one):

☐ NO SUBCONTRACTORS. Bidder shall NOT utilize subcontractors to perform the Contract.

OR

☐ SUBCONTRACTORS. As detailed in the attached Bidder Explanation (Bidder to provide and, in such case, check the box below), Bidder may utilize subcontractors to perform the Contract. In such event, Bidder further certifies that, as to the State of Washington and eligible Purchasers who utilize the Contract, Bidder shall be fully responsible for its subcontractors, including, without limitation, liability for any subcontractor’s acts or omissions.

☐ BIDDER EXPLANATION. Bidder has attached an explanation.

Check box if applicable.

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 11

Note: Bidder’s explanation must provide the following information: State which portions of the Contract scope that Bidder, if awarded a Contract, would subcontract and the intended use of the subcontractors in performance of the Contract.

23. WASHINGTON SMALL BUSINESS. Bidder certifies as follows (Bidder must check all applicable boxes):

☐ WASHINGTON SMALL BUSINESS. Bidder is a Washington Small Business as defined in RCW 39.26.010(13) and (22)(a). To qualify as a Washington Small Business, Bidder must meet three (3) requirements:

☐ Location. Bidder’s principal office/place of business must be located in and identified as being in the State of Washington. A principal office or principal place of business is a firm’s headquarters where business decisions are made and the location for the firm’s books and records as well as the firm’s senior management personnel.

☐ Size. Bidder must be owned and operated independently from all other businesses and qualify as one of the following:

☐ Bidder Qualifies as a Small Business – i.e., ☐ Bidder has fifty (50) or fewer employees; or ☐ Bidder has an annual gross revenue of less than

$7,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue over the previous three (3) consecutive years.

☐ Bidder Qualifies as a Minibusiness – i.e., Bidder has an annual gross revenue of less than $3,000,000, but $1,000,000 or more, as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

☐ Bidder Qualifies as a Microbusiness – i.e., Bidder has an annual gross revenue of less than $1,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

☐ WEBS Certification. Bidder must have certified its Washington Small Business status in Washington’s Electronic Business Solution (WEBS).

OR

☐ NOT A WASHINGTON SMALL BUSINESS. Bidder does not qualify as a Washington Small Business as set forth above.

24. CERTIFIED VETERAN-OWNED BUSINESS. Bidder certifies as follows (Bidder must check one and, if stating that Bidder is a Certified Veteran-Owned Business, provide Bidder’s WDVA certification number in the space provided below):

☐ CERTIFIED VETERAN-OWNED BUSINESS. Bidder is a Certified Veteran-Owned Business under RCW 43.60A.190. To qualify as a Certified Veteran-Owned Business, Bidder must meet four (4) requirements:

51% Ownership. Bidder must be at least fifty-one percent (51%) owned and controlled by:

https://app.leg.wa.gov/RCW/default.aspx?cite=39.26.010 https://app.leg.wa.gov/RCW/default.aspx?cite=43.60A.190

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 12

(a) A veteran as defined as every person who at the time he or she seeks certification has received a discharge with an honorable characterization or received a discharge for medical reasons with an honorable record, where applicable, and who has served in at least one of the capacities listed in RCW 41.04.007;

(b) A person who is in receipt of disability compensation or pension from the department of veterans affairs; or

(c) An active or reserve member in any branch of the armed forces of the United States, including the national guard, coast guard, and armed forces reserves.

Washington Incorporation/Location. Bidder must be either an entity that is incorporated in the State of Washington as a Washington domestic corporation or, if not incorporated, an entity whose principal place of business is located within the State of Washington.

WEBS Certification. Bidder must have certified its Veteran-Owned Business status in Washington’s Electronic Business Solution (WEBS).

WDVA Certification. Bidder must have provided certification documentation to the Washington Department of Veterans’ Affairs (WDVA) and be certified by WDVA and listed as such on WDVA’s website (WDVA – Veteran-Owned Businesses). Bidder’s WDVA certification no.: _____________

OR

☐ NOT A CERTIFIED VETERAN-OWNED BUSINESS. Bidder does not qualify as a Certified Veteran-Owned Business as set forth above.

25. REFERENCES. Bidder certifies that the references provided below (Bidder must provide) have worked with Bidder pertaining to contracts in which Bidder provided goods/services similar in scope to the goods/services described in the above-referenced Competitive Solicitation and that such references have full permission, without any additional requirement or release, to provide references and information to Enterprise Services pertaining to Bidder. Bidder hereby authorizes Enterprise Services (or its agent) to contact Bidder’s references and others who may have pertinent information regarding Bidder’s prior experience and ability to perform the Contract, if awarded. Bidder hereby authorizes such individuals and firms to provide such references and release to Enterprise Services information pertaining to the same.

Reference 1:

Provide information in the space provided

Business Name:

Contact Name at Business:

Phone:

Email:

Reference 2:

Provide information in the space provided

Business Name:

Contact Name at Business:

Phone:

Email:

https://app.leg.wa.gov/RCW/default.aspx?cite=41.04.007

EXHIBIT A – BIDDER’S CERTIFICATION (ENTERPRISE) PAGE 13

Reference 3:

Provide information in the space provided

Business Name:

Contact Name at Business:

Phone:

Email:

Note: It is Bidder’s obligation to ensure that the contact information for Bidder’s references is accurate and current. Bidders should alert their references to respond promptly to reference checks.

I hereby certify, under penalty of perjury under the laws of the State of Washington, that the Bidder certifications herein are true and correct and that I am duly authorized to make these certifications on behalf of the Bidder stated herein.

BIDDER NAME: ____________________________________________________________

Print Name of Bidder

Note:

If Bidder is a corporation, LLC, etc., print full legal entity name of the firm who is the

Bidder submitting the Bid.

If Bidder is a sole proprietor, print the full legal name of the individual who is the Bidder submitting the Bid.

BY: ____________________________ __________________________________

Signature of Bidder’s authorized person Print Name of person making certifications for

Bidder

TITLE: ____________________________ __________________________________

Title of person signing Bidder’s Certification Print city and state where signed

DATE: ____________________________

Return this Bidder’s Certification to Procurement Coordinator at:

DESContractsTeamApple@des.wa.gov