2022 Pharmacy Vials and Containers FINAL.pdf

DISCLAIMER

Due to a system update, this solicitation document is currently unavailable for download on the OSP website.

To obtain a copy of this RFP, please make a request to MMCAP_Infuse.RFP@state.mn.us and include your name, company name, address, and telephone number.

Your information will be collected for the purpose of notifying you of any addendums that may be issued for this solicitation. If the RFP is further distributed to any other parties, they will not receive these addendums. Not receiving any addendum will not be grounds for protesting the awards made in this

RFP.

Future solicitations will not be emailed to requesting parties after the system update is complete.

State of Minnesota

MMCAP INFUSE, OFFICE OF STATE

PROCUREMENT

Request for Proposals (RFP)

For Pharmacy Vials and Containers

SPECIAL NOTICE: This is a request for proposal. It does not obligate the State of Minnesota or MMCAP Infuse to award a contract or complete the proposed program, and the State of Minnesota reserves the right to cancel this solicitation if it is considered in its best interest.

Released: September 29, 2022 Due Date: October 28, 2022, 2pm Central Time

Minnesota’s Commitment to Diversity and Inclusion

The State of Minnesota is committed to diversity and inclusion in its public procurement process. The goal is to ensure that those providing goods and services to the State are representative of our Minnesota communities and include businesses owned by minorities, women, veterans, and those with substantial physical disabilities. Creating broader opportunities for historically under-represented groups provides for additional options and greater competition in the marketplace, creates stronger relationships and engagement within our communities, and fosters economic development and equality.

To further this commitment, the Department of Administration operates a program for Minnesota-based small businesses owned by minorities, women, veterans, and those with substantial physical disabilities. For additional information on this program, or to determine eligibility, please call 651-296-2600 or go to www.mn.gov/admin/oep.

http://www.mn.gov/admin/oep

SECTION 1 – INSTRUCTIONS TO RESPONDERS

Steps for Completing Your Response

Follow the steps below to complete your response to this RFP:

• Step 1: Read the solicitation document and ask questions, if any

• Step 2: Write your response

• Step 3: Sign and submit your response

Incomplete Submittals

A proposal must be submitted along with any required additional documents. Incomplete proposals that materially deviate from the required format and content may be rejected.

STEP 1 – READ THE SOLICITATION DOCUMENT & ASK QUESTIONS, IF ANY

How to Ask Questions

• Questions must be emailed to MMCAP_Infuse.RFP@state.mn.us by October 21, 2022 at 2pm Central Time.

• Questions will be responded to, via an addendum to this RFP, in batches as they arrive and will not be attributed to the asking entity. Similar questions may be combined with a single answer.

• Other personnel are not authorized to answer questions regarding this RFP.

STEP 2 – WRITE YOUR RESPONSE

Request for Proposals

(RFP)

• In Section 3, insert your response to the questions as asked or provide content as requested.

• By signing this response, your firm is making a legal, binding offer for a contract to provide services to the State of Minnesota.

STEP 3 – SIGN & SUBMIT YOUR RESPONSE

Documents making up a complete proposal

Section 3:

� Vendor Response and Proposal � Exhibit D: References (submitted in PDF) � Exhibit E: Reporting and Admin Fees

Section 4:

� Exhibit B: Cost Proposal (submitted in the Cost Proposal Worksheet and separate from RFP Response) � If applicable, Exhibit C: Additional Offerings

Additional Documents:

� Exhibit A: Sample Agreement and Standard Contract Sample

Exceptions (submitted in Microsoft Word) and acknowledgement in Section 2.7 of the RFP document

� Solicitation Form 1: General Solicitation Requirements (read) � Solicitation Form 2: Certification Regarding Lobbying (submitted in

PDF)

� Solicitation Form 3: Workforce Certificate Form (submitted in PDF) � Required business applications or forms to do business with

Responder (submitted in PDF) � If applicable, Solicitation Form 4: Veteran Owned Preference

(submitted in PDF)

Where to Send Responses

• Email your responses to MMCAP_Infuse.RFP@state.mn.us with

• “[Company Name] Pharmacy Vials and Containers RFP Response” in the Subject line. If your email is larger than the maximum allowed size, send your response in multiple emails. Use “[Company Name] Pharmacy Vials and Containers RFP Response Part [#] of [#]” in the Subject line.

• Mailed responses will not be accepted

• Faxed responses will not be accepted

Response Submission Deadline

Must be received no later than October 28, 2022 at 2pm Central Time as indicated by a notation made by the email timestamp. Late proposals will not be considered. All costs incurred in responding to this RFP will be borne by the responder.

mailto:MMCAP_Infuse.RFP@state.mn.us

SECTION 2 – RFP PROJECT INFORMATION

1. Description of Project

MMCAP Infuse (MMCAP Infuse) is a governmental cooperative serving thousands of state and local government facilities across the United States. MMCAP Infuse is operated by the State of Minnesota (State) Department of Administration’s Office of State Procurement (OSP) and is governed by Minnesota laws and procurement policies.

MMCAP Infuse Members are state agencies and political subdivisions throughout the United States. For more information on MMCAP Infuse and its membership, visit www.infuse-mn.gov (Members or Membership).

Membership is available to government-operated facilities, and the extent to which a Member participates in the program is voluntary. Members can include but are not limited to the following classes of trade: correctional facilities, psychiatric treatment facilities, student health services, public health services, nursing homes, and public hospitals. One single contract with MMCAP Infuse may eliminate the need for companies to respond to individual facility solicitations that often result in many individual contracts to manage.

MMCAP Infuse is issuing this Request for Proposal (RFP) to establish contract(s) with qualified national suppliers that will provide prescription vials and containers to Members related to the efficient, safe, and lawful operation of a pharmacy.

Examples of items sought include:

• Plastic prescription dispensing vials for pills

• Plastic prescription dispensing bottles for liquids

• Glass bottles

• Dropper bottles

• Ointment jars/tubes

• Child resistant, non-safety, and multifunction caps

Items that are NOT being sought as stand-alone offerings through this RFP, but may be part of a larger contract award already in place or other programs being planned:

• Automated Dispensing Cabinets

• Electronic Medical Records

• Pharmacy Dispensing Software

• Clinical Information Systems

• Medications or OTC Products

• Medical supplies or personal protective equipment

• Prescription copay assistance cards or programs

• Other Pharmacy Supplies or Sundries (i.e. bags, med cups, blister cards, etc.)

2. Desired Skills and Tasks

Brief overview of expected skills and tasks of a successful responder:

A. The ability to identify MMCAP Infuse Members at account set-up and transition current Members with existing accounts by attaching them to contract pricing http://www.infuse-mn.gov/

B. Have existing relationships and products stocked at the MMCAP Infuse pharmaceutical authorized wholesalers (currently AmerisourceBergen, Cardinal Health, and Morris & Dickson) with the ability for Members to purchase indirectly and for the responder to perform chargebacks to the contracted price.

C. The ability to offer passthrough billing through the MMCAP Infuse authorized wholesalers if the Responder’s products are not indirectly purchased and distributed through the wholesaler channels

D. Provide a reliable mechanism of order placement if products are not available through the MMCAP Infuse authorized wholesalers

E. Maintain sufficient inventory to meet foreseeable demand F. Adequately communicate with Members and facilitate delivery and/or installation G. Accommodate flexible payment terms realizing the complexity of government operations H. Provide ongoing support and account management for Members with regards to service, returns, or recalls I. Report timely and thorough contract usage to MMCAP Infuse for reporting and administrative fee processing and reporting to Members J. Responders with a strong understanding of the pharmacy supply distribution industry are desired. A detailed understanding of government facilities’ procurement procedures will assist in the success of resulting contracts

All proposed products must be available in the marketplace at the start of the potential agreement.

Products that are awarded by MMCAP Infuse that are in the marketplace, but not currently stocked with the authorized wholesalers, must be available for distribution to facilities by the start of the potential agreement. If the product is not available by the effective date of the Agreement, MMCAP Infuse reserves the right to cancel the award and award the product to the next Responder providing the best value.

Responders are encouraged to propose additional products/services that may improve the results of this project. The proposed additional products/services, along with their associated cost, must be separated from the RFP-required proposal items on the Responder’s cost proposal (Exhibit B) and sent in a separate document titled Exhibit C – Additional Offerings.

3. Agreement Duration

It is anticipated that MMCAP Infuse will enter into agreements for an initial two (2) year term with an option to extend in increments determined by MMCAP Infuse

4. Minimum Qualifications Required (Pass/Fail)

A. Responders must either:

i. Have been in business for 5 years or

ii. Demonstrate exceptional experience in a related line of business being asked within this

RFP

B. Proposals must be received on or before the due date and time specified in this RFP C. Responders must include applicable documents to make a complete proposal, as listed in Section

1, Step 3 of this RFP document D. Responders must have the following:

i. A product portfolio containing at least one of the following: vials and containers such as (but not limited to) ointment jars, plastic vials and bottles, glass bottles, dropper bottles and/or child resistant, non-safety, and multi-function caps

ii. Responders must provide proof that products meet United States Pharmacopea (USP) Requirements for light resistance and Moisture Vapor Permeation

iii. Responders must provide proof that products meet the Consumer Product Safety Commission’s (CPSC) criteria for child-resistant prescription packaging

5. Response Evaluation Responses will first be reviewed to confirm compliance with the minimum qualifications identified above.

Responses that meet all the minimum qualifications will be further evaluated in accordance with the following:

Factors Percentage

Experience & Background 10%

Product Offering 20%

Customer Service, Ordering, Invoicing, Shipping, Delivery, Returns 20%

Reporting and Data 15% 3% Admin Fee 5% Cost Proposal 30%

Preferences 6% Minnesota Certified Targeted Group/Economically Disadvantaged Preference 6% Veteran-owned Preference Minnesota Resident Vendor Preference

Responses will be evaluated by a team of MMCAP Infuse staff, MMCAP Infuse advisory board members, and/or Members. Each evaluator will read all proposals that have passed all the minimum qualifications. MMCAP Infuse reserves the right to require a demonstration of capabilities and/or ordering systems via in-person meetings, webinar, or other such mechanism.

Any award that may result from this solicitation will be based upon the total accumulated points as established in the solicitation. MMCAP Infuse reserves the right to award this solicitation to a single Responder, or to multiple Responders, whichever is in the best interest of the State and MMCAP Infuse, providing each Responder is in compliance with all terms and conditions of the solicitation. MMCAP Infuse reserves the right to accept all or part of an offer, to reject all offers, to cancel the solicitation, or to re-issue the solicitation, whichever is in the best interest of the State and MMCAP Infuse. If a Responder with an active contract with MMCAP Infuse is an awarded bid as a result of this RFP, MMCAP Infuse reserves the right to amend the active contract to include the scope of this RFP rather than issue a brand-new document.

6. Additional MMCAP Infuse Rights Reserved/Pre-Proposal Meeting/Background Checks/Budget A. reject any and all responses received;

B. waive or modify any informalities, irregularities, or inconsistencies in the responses received;

C. negotiate with the highest scoring Responder[s];

D. terminate negotiations and select the next response providing the best value for the State;

E. Short list the highest scoring Responders;

F. Require Responders to conduct presentations, demonstrations, or submit samples;

G. Award by item (including category, location, etc.), by groups of items, or all items, therefore, the

Responder is encouraged to offer a response for all items;

H. Award by location;

I. Interview key personnel or references; and J. Request a best and final offer from one or more Responders.

7. Alterations or Additions to the State’s General Terms

If you wish to take an exception to the State’s General Terms (see Solicitation Form 1), please indicate that below and attach any appropriate documentation.

☐None

☐See attached document detailing proposed alterations and/or additions to the State’s General Terms.

By signing, I acknowledge that the above-named responder accepts, without qualification, all terms and conditions stated in this solicitation (including the sample contract) except those clearly outlined as exceptions above.

Signature: ____________________________________________________

Printed Name: _________________________________________________

Title: ________________________________

Date:________________________________

SECTION 3 – VENDOR RESPONSE AND PROPOSAL

INSTRUCTIONS: Fill in the information requested below.

1. Responder’s Contact Information

Company’s Full Legal Name:

Business Address:

Company Website:

Company’s Main Phone Number

Federal Employer Identification Number:

Primary Contact Person’s Name:

Title:

Telephone Number:

E-Mail Address:

Alternate Contact Person:

Title:

Telephone Number:

E-Mail Address:

Admin Fee Contact Person:

Telephone Number:

E-Mail Address:

Membership Contact Person:

Telephone Number:

E-Mail Address:

2. Pass/Fail Criteria

Does Responder comply with each term?

Yes No Term Responders must (check one):

� Have been in business for 5 years or � Demonstrate exceptional experience in a related line of business that should be portrayed in the response to this RFP through references and a detailed background of your business

Responders’ proposals must be received on or before the due date and time specified in this RFP

Responders must include applicable items listed in Section 1, Step 3 by an in-line response or separate document

A product portfolio containing at least one of the following: vials and containers such as (but not limited to) ointment jars, plastic vials and bottles, glass bottles, dropper bottles and/or child resistant, non-safety, and multi-function caps

Responders must provide proof that products meet United States Pharmacopea (USP) Requirements for light resistance and Moisture Vapor Permeation

Responders must provide proof that products meet the Consumer Product Safety Commission’s (CPSC) criteria for child-resistant prescription packaging

Responders that have not completed each section will not be considered.

3. Reporting and Admin Fees – Exhibit E A. Responders must adhere to MMCAP Infuse sales data requirements as shown in Attachment E in the Exhibit A: Sample Agreement

i. In a separate document titled Exhibit E - Reporting and Admin Fees, please describe how

Responder plans to implement any changes required to their internal data reporting processes to meet these requirements

B. Will the responder offer a 3% admin fee on sales and be able to adhere to the Admin Fee reporting requirements as listed in Article VIII, Section 8.1 in the Exhibit A: Sample Agreement? If not, please explain in the document titled Exhibit E – Reporting and Admin Fees

4. Experience and Background Responder to provide detailed information regarding its company and services offered. Include a summary of information regarding the location of the corporate office, financial status, and current economic conditions of Responder. This summary should indicate Responder’s ability to provide products indicated in this RFP. Indicate the length of time the Responder has been in business in the related field(s).

5. Regulatory Requirements

A. Describe Responder’s quality control process with its own manufacturing locations and sub-contracted manufacturing locations.

B. Describe how regulatory or quality control issues (including recalls) will be communicated to MMCAP Infuse and its Members to ensure all parties are kept informed of changes that may affect them.

C. There are several requirements from the Consumer Product Safety Commission (CPSC www.cpsc.gov/) and The United States Pharmacopeia (USP www.usp.org/) related to prescription vials and containers. Please explain Responder’s adherence and applicable regulatory chapter numbers for providing these products. If Responder holds itself to standards higher than any of these regulations, describe how and what benefits this confers to the end user.

6. Products

A. Describe how Responder’s packaging and Products are engineered to reduce waste or incorporate recycled material.

i. Indicate which of Responder’s Products are made of recycled material.

ii. Indicate which of Responder’s Products are recyclable.

B. Describe how any of Responder’s Products are designed to assist patients with disabilities and how they provide ease of use for this patient population.

C. Describe how Responder’s Products may assist with increasing patient medication adherence.

D. Describe any shortages or difficulty with supply in the last 12 months. What steps have been taken to mitigate similar situations in the future?

E. How and when are shortages communicated to customers?

F. Describe any qualities that make Responder’s products unique or different from competitor’s products.

http://www.cpsc.gov/

G. Are Responder’s Products authorized or certified by automation manufactures to be used in automation or robotic technology for filling prescription containers? If so, please list the Responder’s product lines and the companies’ machinery that your Product(s) are officially compatible with.

H. Are Responder’s Products specifically incompatible with any automation manufacturers (i.e., Products are damaged if they are used).

I. Describe how Responder would support Members that would be changing from another product to Responder’s Product for robotic technology (list cost information in the cost proposal worksheet;

Section 4 - Exhibit B).

7. Customer Service

A. Where is Responder’s customer service center and warehouse facility located?

B. List your customer service center’s operational hours. Indicate if the hours account for all U.S. time zones including Alaska and Hawaii.

C. Describe how Responder’s customer service team has the capability, training, and experience to respond to inquiries.

D. Explain Responder’s dispute resolution process.

E. Explain Responder’s onboarding process for new customers and include all forms Members must complete to order directly or indirectly from the Responder.

8. Ordering A. Members need a mechanism to compare like products within the catalog. Are your products identified by a UPC, SKU, and/or NDC? Describe any other organizational system of products available.

B. MMCAP Infuse Members have accounts with Cardinal Health, AmerisourceBergen, or Morris &

Dickson, depending on the state. Does Responder offer shipment or pass-through billing services through any of these distributors to reduce the number of vendors that MMCAP Infuse Members need to utilize?

C. (If applicable) Describe how Responder will communicate with authorized wholesalers to ensure your MMCAP Infuse contracted products are available for Members to purchase via wholesaler ordering portals.

D. If Responder offers direct purchases, list the methods of placing direct orders (e.g. phone, fax, online orders, etc.). Does Responder have interfaces to any eProcurement systems for punch-out ordering?

If so, which ones?

E. Indicate if Responder accepts checks, EFT/ACH, Purchasing Cards, and/or Credit Cards for direct order placement and payment. Identify if any additional fees would be invoiced for such purchases (y/n). If additional fees apply, enter specifics in the Cost Proposal (Exhibit B).

F. Identify and describe any order minimum requirements for direct purchases. Is shipping included when certain minimums are met?

G. Describe any incentives for larger, centralized ordering available to a group of Members, if available.

For example, if Members in a given state ordered products to a single warehouse for further distribution, is there a benefit to certain bulk orders?

H. Describe the Responder’s return policy.

9. Additional Offerings – Exhibit C MMCAP Infuse encourages Responders to include any additional offerings that may be of value to our Members. If applicable, include additional offerings in a separate document and include pricing for additional offerings in the Cost Proposal (Section 4) and label Exhibit C – Additional Offerings.

10. References – Exhibit D Responder should be able to demonstrate that within the past 3 years it has supplied prescription Vials and Containers related to the efficient, safe, and lawful, and efficient operation of a pharmacy to institutions or corporations of a similar scope as MMCAP Infuse Members. List names, addresses, telephone numbers, and email addresses of two references for which Responder has provided products that are solicited in this RFP and label the document as Exhibit D.

SECTION 4 – COST PROPOSAL – EXHIBIT B

Follow the instructions below when completing your cost proposal. Your cost proposal must be submitted in a separate email. No cost information should be provided in Section 3.

Responder must submit a cost proposal that details the proposed cost structure to Members. Responders should submit pricing in the attached Exhibit B: Cost Proposal Worksheet. If the pricing basis, as outlined in section 2.4 Pricing, in the sample template (Exhibit A) is not clearly indicated, MMCAP Infuse will assume the prices are fixed and the contract will be written accordingly.

IMPORTANT:

Please provide as much product information as possible in the "Vendor Remarks" section in Pricing proposal spreadsheet, Exhibit B. For example, some MMCAP Members’ patients are not permitted to have products that contain metal or glass. Additional examples of information that would be helpful to include in the "Vendor Remarks" section are: latex content, patient safety features, ability for use in automation, vial color, child resistant cap, etc. Providing additional product information in the "Vendor Remarks" column allows MMCAP Infuse to make informed decisions -- which may result in additional product awards for the Responder.

Exhibit B – Cost Proposal Instructions/Information:

MMCAP Infuse will determine if the Products submitted by the Respondents meet the specifications of this RFP. MMCAP Infuse’s conclusions are final.

• Products should be identified by a UPC, SKU, and/or NDC. Ordering numbers for the wholesalers should be listed in the document if available

• In the event Responder wishes to include any additional products in its proposal, it must list and describe these products in Exhibit C and enter cost information in the Cost Proposal Worksheet (Exhibit B)

• Depending on the distribution method, upon award, an 11-digit NDC number, product code and/or UPC must be reported to the MMCAP Infuse authorized pharmaceutical wholesalers for tracking purposes.

The NDC should be submitted to the authorized wholesalers as it is reported to MMCAP Infuse:

o If the product does not have an NDC number, use the product’s UPC number to create an 11-digit number by adding a zero to the sixth position (e.g., 5-5 [99999-99999] becomes 5-4-2 [99999-0999-99]) o If the product does not have an NDC number or a UPC code, use the product number with leading zeroes (e.g., product #90024 = 00000-0900-24 for a 5-4-2 format)

• Responders must submit pricing in the Cost Proposal document

• Responders must submit pricing in eaches and NOT in case, bag, or pack size pricing

• Usage is in eaches (for example, if the usage is 5000, it means 5000 individual vials were sold, not

5000 cases)

• Enter case/bag/pack size in corresponding column

• Enter proposed Admin Fees

SOLICITATION FORM 1

General Requirements

Conflicts of Interest

Responder must provide a list of all entities with which it has relationships that create, or appear to create, a conflict of interest with the work that is contemplated in this request for proposals. This includes any conflict of interests the Responder may have with a Member. The list should indicate the name of the entity, the relationship, and a discussion of the conflict.

Organizational Conflicts of Interest

To the best of Responder’s knowledge and belief, and except as otherwise disclosed, there are no relevant facts or circumstances which could give rise to organizational conflicts of interest. An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons, A. vendor is unable or potentially unable to render impartial assistance or advice to the State;

B. the vendor’s objectivity in performing the contract work is or might be otherwise impaired; or C. the vendor has an unfair competitive advantage.

If after award, an organizational conflict of interest is discovered, an immediate and full disclosure in writing must be made to the State’s Chief Procurement Officer which must include a description of the action which the contractor has taken or proposes to take to avoid or mitigate such conflicts. If an organization conflict of interest is determined to exist, the State may, at its discretion, cancel the contract. In the event the Contractor was aware of an organizational conflict of interest prior to the award of the contract and did not disclose the conflict to OSP, the State may terminate the contract for default. Organizational conflicts of interest terms apply to any subcontractors for this work.

Proposal Contents The information provided is true, correct, and reliable for purposes of evaluation for potential contract award.

The submission of inaccurate or misleading information may be grounds for disqualification from the award as well as subject the Responder to suspension or debarment proceedings as well as other remedies available by law.

Responses are Nonpublic during Evaluation Process All materials submitted in response to this Solicitation will become property of the State. During the evaluation process, all information concerning the responses submitted will remain private or nonpublic and will not be disclosed to anyone whose official duties do not require such knowledge. Responses are private or nonpublic data until the completion of the evaluation process as defined by Minn. Stat. § 13.591. The completion of the evaluation process is defined as the State having completed negotiating a contract with the selected responder. The State will notify all responders in writing of the evaluation results.

The State will not consider the prices submitted by the Responder to be proprietary or trade secret materials.

Notwithstanding the above, if the State contracting party is part of the judicial branch, the release of data shall be in accordance with the Rules of Public Access to Records of the Judicial Branch promulgated by the Minnesota Supreme Court as the same may be amended from time to time.

Contingency Fees Prohibited Pursuant to Minnesota Statutes Section 10A.06, no person may act as or employ a lobbyist for compensation that is dependent upon the result or outcome of any legislation or administrative action.

Administrative Fee. In consideration for the administrative support and other services provided by MMCAP

Infuse, the Responder agrees to pay an Administrative Fee of three percent (3%) on all purchases of products and services.

Reimbursements

Reimbursement for travel and subsistence expenses actually and necessarily incurred by the contractor as a result of the contract will be in no greater amount than provided in the current "Commissioner’s Plan” promulgated by the commissioner of Minnesota Management and Budget will not be made for travel and subsistence expenses incurred outside Minnesota unless it has received the State’s prior written approval for out of state travel. Minnesota will be considered the home state for determining whether travel is out of state.

Targeted Group, Economically Disadvantaged Business, Veteran-Owned and Individual Preference.

Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. § 16C.16, businesses that are eligible and certified by the State as targeted group (TG) businesses, economically disadvantaged (ED) businesses, and veteran-owned businesses will receive points equal to 6% percent of the total points available as preference.

For TG/ED/VO certification and eligibility information visit the Office of Equity in Procurement website at https://mn.gov/admin/business/vendor-info/oep/ or call the Division’s Helpline at 651.296.2600.

Work Force Certification For all contracts estimated to be in excess of $100,000, responders are required to complete the attached Affirmative Action Data page and return it with the response. As required by Minnesota Rule 5000.3600, “It is hereby agreed between the parties that Minnesota Statute § 363A.36 and Minnesota Rule 5000.3400 -

5000.3600 are incorporated into any contract between these parties based upon this specification or any modification of it. A copy of Minnesota Statute § 363A.36 and Minnesota Rule 5000.3400 - 5000.3600 are available upon request from the contracting agency.”

Non-Collusion Certification.

A. The Proposal has been arrived at by the Responder independently and has been submitted without collusion and without any agreement, understanding or planned common course of action with any other vendor designed to limit fair or open competition; and

B. The contents of the Response have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any other individual prior to the due date and time of this Solicitation. Any evidence of collusion among Responders in any form designed to defeat competitive responses will be reported to the MMCAP Infuse for investigation and appropriate action.

Certification Regarding Lobbying

For State of Minnesota Contracts and Grants over $100,000, the undersigned certifies, to the best of his or her knowledge and belief that:

A. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

B. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal https://mn.gov/admin/business/vendor-info/oep/ contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

C. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into and is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

SOLICITATION FORM 3

CERTIFICATION REGARDING LOBBYING

The undersigned certifies, to the best of his or her knowledge and belief that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Organization Name

Name and Title of Official Signing for Organization

By:_______________________________________

Signature of Official

Date

SOLICITATION FORM 3

STATE OF MINNESOTA – WORKFORCE CERTIFICATE INFORMATION

Information required for ALL bids or proposals that could exceed $100,000

Complete Box A or B of this form, and sign and return it with your bid or proposal. A Workforce Certificate or exemption from the Minnesota Department of Human Rights (MDHR) is required to execute a contract in excess of $100,000 under Minn. Stat. §363A.36.

Signature By signing this statement, I certify that the information provided is accurate and that I am authorized to sign on behalf of the company.

Name of Company Authorized Signature

Date Printed Name

Phone Number Title

For assistance with this form, contact:

Minnesota Department of Human Rights

Web: http://mn.gov/mdhr/ Toll Free: 1-800-657-3704 Email: compliance.mdhr@state.mn.us MN Relay: 711/ 1-800-627-3529

Rev. 7/21

BOX A – COMPANIES that have employed 40 or more full-time employees in this state or a state where the business has its primary place of business on any single working day during the previous 12 months, check one option below:

Attached is our current Workforce Certificate issued by the Minnesota Department of Human Rights (MDHR).

Attached is confirmation that MDHR received our application for a Minnesota Workforce Certificate on

(date).

☐ Our company does not yet have a Workforce Certificate, but we acknowledge that a Workforce Certificate is required before a contract in excess of $100,000 can be executed with the State of Minnesota or other covered entities.

BOX B – EXEMPT COMPANIES that have not employed 40 or more full-time employees on a single working day in Minnesota or any state where it has its primary place of business during the previous 12 months, check option below if applicable:

We attest to MDHR that we are exempt. If our company is awarded a contract, upon request, we will submit to MDHR within 5 business days after the contract is fully signed, the names of our employees during the previous 12 months, the date of separation, if applicable, and the state in which the persons were employed.

Send to compliance.MDHR@state.mn.us.

http://mn.gov/mdhr/ mailto:compliance.mdhr@state.mn.us mailto:compliance.MDHR@state.mn.us

SOLICITATION FORM 4

STATE OF MINNESOTA

VETERAN-OWNED PREFERENCE FORM

Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. §16C.16, subd. 6a, the state will award a 6% preference on state procurement to certified small businesses that are majority owned and operated by veterans.

Veteran-Owned Preference Requirements - See Minn. Stat. § 16C.19(d):

1) The business has been certified by the Office of Equity in Procurement as being a veteran-owned or service-disabled veteran-owned small business.

or

2) The principal place of business is in Minnesota AND the United States Department of Veterans Affairs verifies the business as being a veteran-owned or service-disabled veteran-owned small business under Public Law 109-461 and Code of Federal Regulations, title 38, part 74 (Supported By Documentation).

Statutory requirements and appropriate documentation must be met by the solicitation response due date and time to be awarded the veteran-owned preference.

Claim the Preference

By signing below, I confirm that:

My company is claiming the veteran-owned preference afforded by Minn. Stat. § 16C.16, subd. 6a. By making this claim, I verify that:

• The business has been certified by the Office of Equity in Procurement as being a veteran-owned or service-disabled veteran-owned small business.

or

• My company’s principal place of business is in Minnesota and the United States Department of Veteran’s Affairs verifies my company as being a veteran-owned or service-disabled veteran-owned small business (Supported By Attached Documentation)

Name of Company: _____________________________ Date: _________________________

Authorized Signature: _____________________________ Telephone: ___________________

Printed Name: _____________________________ Title: _______________________

Attach documentation, sign, and return this form with your solicitation response to claim the veteran-owned preference.