2-Appendix E - Vendor Forms.xlsx

XLSX spreadsheet 24 KB Posted

Attached to
Kitchen Equipment Preventative Maintenance and Repair
Solicitation number
GSS26661-KITCHENPMR
Issued by
Delaware

About this file

This file contains vendor forms and requirements for a Delaware state contract solicitation for Kitchen Equipment Preventative Maintenance and Repair Services administered by the State of Delaware, Office of Management and Budget, Government Support Services. The solicitation requires qualified vendors to provide ongoing maintenance, repair, and operational reliability services for commercial kitchen equipment across multiple state agency locations. Vendors must submit a non-collusion statement signed and notarized by an authorized representative, along with a vendor information sheet that includes company details, designated primary and secondary contacts, and a business capability statement. Vendors are required to provide a minimum of three business references of similar size and scope, excluding state employees, and if subcontractors are proposed, each subcontractor must also provide a minimum of three business references. The contract solicitation also requests that vendors disclose any federal, state, or local government suspension or debarment actions against the firm, its affiliates, predecessor companies, or key personnel within the past five years.

The vendor forms include provisions for vendors to designate sections of their proposals as confidential, intellectual property, or trade secrets, subject to independent state validation under Delaware Freedom of Information Act provisions. Vendors may submit exceptions to the solicitation's terms and conditions, which must be detailed in the designated exceptions form; Government Support Services maintains sole discretion to reject any proposed exceptions. For vendors proposing subcontractors, both the primary vendor and subcontractor must complete and sign a subcontractor form that identifies the subcontractor's company information, diverse vendor certification status, and a description of work to be performed. All forms require signatures from authorized representatives who possess legal authority to enter into formal contracts on behalf of their organizations.

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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 a minimum of three business references of similar size and scope. Please do not list any State Employee(s) as a business reference. If Subcontractors are identified, a minimum of three business references must also be provided for each subcontractor.
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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