15-Volume of Previous Payments Attestation - RFP-RFQ-RLI.docx

DOCX document 47 KB Posted

Attached to
Artificial Intelligence-Enabled System for Employee Screening X-Ray Machines
Solicitation number
BLD2131742P1
Issued by
Broward County, Fort Lauderdale City, Florida

About this file

This is a Volume of Previous Payments Attestation form for Request for Proposals, Request for Qualifications, or Request for Letters of Interest issued by Broward County, Florida, related to an Artificial Intelligence-Enabled System for Employee Screening X-Ray Machines at Fort Lauderdale-Hollywood International Airport. Vendors must complete and submit the attestation form with their solicitation response or within three business days of the County's request, with failure to timely submit potentially affecting vendor evaluation. The form requires vendors to list all contracts awarded by Broward County Board of County Commissioners as a prime vendor within five years of the current solicitation's closing date, including the project title, contract number, department/division, date awarded, and amounts paid to date. Vendors must also report confirmed payments made to approved certified County Business Enterprise (CBE) firms utilized as subcontractors or subconsultants to meet CBE goal commitments, with these CBE payments deducted from the prime vendor payment amount for evaluation purposes.

For Joint Venture entities, vendors must submit a separate Joint Venture Volume of Previous Payments Attestation that encompasses payments to the joint venture firm and each member entity, with the calculated amount multiplied by the member firm's equity percentage. Per Broward County Procurement Code Sections 21.41(h)(4) and 21.42(d)(3), the tie-breaker evaluation criterion awards points to the vendor with the lowest dollar volume of previous payments paid by the County over the five-year reporting period. Joint Venture vendors are required to submit executed Joint Venture agreements and any amendments for each listed project, with all agreements executed prior to the solicitation opening date. The form was dated September 9, 2024, and vendors are required to provide their name and attestation information on the submission.

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Text version

The completed form(s) should be returned with the Vendor’s submittal. If not provided with the submittal, Vendor must submit the form(s) within three business days after County’s request. Failure to timely submit this form and supporting documentation may affect the Vendor’s evaluation.

Points assigned for Volume of Previous Payments will be based on the amount paid-to-date by the Broward County Board of County Commissioners (County) to a prime Vendor MINUS the Vendor’s confirmed payments paid-to-date to approved certified County Business Enterprise (CBE) firms performing services as Vendor’s subcontractor/subconsultant to obtain the CBE goal commitment as confirmed by County’s Office of Economic and Small Business Development. Reporting must be within five (5) years of the current solicitation’s closing date.

Vendor must list all received payments paid-to-date by contract as a prime vendor from Broward County Board of County Commissioners. Reporting must be within five (5) years of the current solicitation’s closing date.

Vendor must also list all total confirmed payments paid-to-date by contract, to approved certified CBE firms utilized to obtain the contract’s CBE goal commitment. Reporting must be within five (5) years of the current solicitation’s closing date.

In accordance with Section 21.41(h)(4) and 21.42(d)(3) of the Broward County Procurement Code, the Vendor with the lowest dollar volume of payments previously paid by the County over a five-year period from the current solicitation’s closing date will receive the Tie Breaker.

The Vendor attests to the following:

Project Title
Contract No.
Department/Division
Date Awarded
Prime: Paid to Date
CBE: Paid to Date
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Has the Vendor been a member/partner of a Joint Venture firm that was awarded a contract by the County?

☐ Yes (if Yes, Vendor must submit a Joint Venture Volume of Previous Payments Attestation.)

☐ No Vendor Name: Click or tap here to enter text.

Form Date 9/9/24

VOLUME OF PREVIOUS PAYMENTS ATTESTATION

REQUEST FOR PROPOSALS, REQUEST FOR QUALIFICATIONS, OR REQUEST FOR LETTERS OF INTEREST

VOLUME OF PREVIOUS PAYMENTS ATTESTATION FORM FOR JOINT VENTURE

The completed form(s) should be returned with the Vendor’s submittal. If not provided with the submittal, Vendor must submit the form(s) within three business days after County’s request. Failure to timely submit this form and supporting documentation may affect the Vendor’s evaluation.

If a Joint Venture, the payments paid-to-date by contract provided must encompass the Joint Venture and each of the entities forming the Joint Venture. Points assigned for Volume of Previous Payments will be based on the amount paid-to-date by contract to the Joint Venture firm MINUS all confirmed payments paid-to-date to approved certified CBE firms utilized to obtain the CBE goal commitment. Reporting must be within five (5) years of the current solicitation’s closing date. Amount will then be multiplied by the member firm’s equity percentage.

In accordance with Section 21.41(h)(4) and 21.42(d)(3) of the Broward County Procurement Code, the Vendor with the lowest dollar volume of payments previously paid by the County over a five-year period from current solicitation’s closing date will receive the Tie Breaker.

The Vendor attests to the following:

Project Title
Contract No.
Department/ Division
Date Awarded
JV Equity Percent
Prime: Paid to Date
CBE: Paid to Date
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Vendor is required to submit an executed Joint Venture agreement(s) and any amendments for each project listed above. Each agreement must be executed prior to the opening date of this solicitation.

Vendor Name: Click or tap here to enter text.

Form Date 9/9/24

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