2027-174_Attachments_A_-_E.pdf

ATTACHMENT A: RESPONDER DECLARATIONS

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

A. Response 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

B. Authorized Signature. This Declaration is signed by the appropriate person(s), with the authority to contractually bind the Responder, as required by applicable articles, bylaws, resolutions, minutes, and ordinances.

C. Non-Collusion Certification.

1. 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

2. 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 Minnesota Attorney General for investigation and appropriate action.

D. 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 an organizational conflict of interest.

An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons,

1. a vendor is unable or potentially unable to render impartial assistance or advice to the State;

2. the vendor’s objectivity in performing the contract work is or might be otherwise impaired; or

3. 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 organizational 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.

E. Copyrighted Material Waiver. By signing its Response, the Responder certifies that it has obtained all necessary approvals for the reproduction and distribution of the contents of its response.

SIGNATURE PAGE TO FOLLOW

By signing this form, Responder acknowledges and certifies compliance with all applicable requirements indicated above.

Company Name:

Signature:

Printed Name:

Title:

Date:

Phone Number:

Email Address:

ATTACHMENT B: PRICING

1. Pricing.

A price schedule document will not be used for this solicitation. Responders must enter their bid price(s) in SWIFT at the unit line level. If a responder needs assistance with entering their proposal, they may contact the Vendor Assistance Help Desk at (651) 201-8100, option #1, and then option #1 again.

2. Alterations or Erasures. The State reserves the right to reject a response containing an alteration or erasure of any price used to determine the lowest responsible responder unless the alteration or erasure is done in a manner that is clear and authenticated by an authorized representative of the Responder. An acceptable way to make an alteration or erasure is to cross out the price, print the correction in ink adjacent to it, and have an authorized representative of the Responder initial and date that correction.

ATTACHMENT C

Intentionally Left Blank

ATTACHMENT D: ADDITIONAL INFORMATION

1. Contractor’s Contact Information. Provide the contact information for the representative responsible for the management of the contract and the representative receiving purchase orders.

Vendor’s Legal Name

Address

Contact Person (Contract)

Email Address

Telephone Number

Contact Person (PO Order)

Email Address

Telephone Number

2. Prompt Pay Discount. What prompt pay discounts do you offer? Select all that apply, if “other,” specify terms in the comment section below:

□ 1% in 30

□ 2% in 30

□ 3% in 30

□ 1% in 10, Net 30

□ 2% in 10, Net 30

□ 3% in 10, Net 30

□ 5% in 10, Net 30

□ Other

□ 1% in 15, Net 30

□ 2% in 15, Net 30

□ 3% in 15, Net 30

□ 1% in 20, Net 30

□ 2% in 20, Net 30

□ 3% in 20, Net 30

□ Net 30

□ None

Comments:

ATTACHMENT E - 1: QUALIFICATION FORM

2027-174 General Andrews State Forest Willow River West Buckthorn Control

ORIGINAL

Contractors are responsible for checking all addenda for the final version of the Qualification Form. Responses which include an outdated version of the Qualification Form may be rejected.

This form must be submitted with your response to this solicitation. If the solicitation response is received without the qualification form the response shall be rejected.

Each Respondent must answer all the questions and provide all requested information contained herein. Because answering all of the questions and providing all the requested information is a requirement, any Respondent failing to meet this requirement may be deemed to be non-responsive at the sole discretion of the State. If a respondent is deemed to be non-responsive, their response will be rejected.

Before an award is made the State (or its representative) reserves the right to clarify/verify qualification information submitted to determine that all qualifications listed below have been met.

If the qualification requirements listed below are not met, either on the face of the submitted information or after such clarification/verification as the State may request, then the Contractor’s response shall be rejected. CHECK THE

FOLLOWING THAT APPLY.

1. Requirement: Contractor must have a minimum of 2 years’ experience in forestry mulching and herbicide application.

I (contractor) “HAVE” “DO NOT HAVE” a minimum of 2 years’ experience in forestry mulching and herbicide application.

2. Requirement: Contractor’s on-site herbicide applicator(s) must have minimum of 1 year of experience in herbicide application.

On-site applicator(s) “HAVE” “DO NOT HAVE” a minimum of 1 year of experience in herbicide application.

3. Requirement: Contractor and all on-site applicators must be able to identify the target invasive plants and native, non-target plants.

Contractor and all on-site applicator(s) “DO” “DO NOT HAVE” the ability to identify the target invasive plants and native, non-target plants.

4. Requirement: Each applicator must have a license recognized by the Minnesota Department of Agriculture to commercially apply herbicides (MN Category A and J) and must have in possession a current card or license.

NAME Position Years of Experience Type of Work MN License

Category(s) Applicator License

Number

CERTIFICATION – By signing this statement, I certify that the information provided above is complete and accurate. Contractor Company Name

Authorized Signature

ATTACHMENT E – 2: EQUIPMENT QUALIFICATION

2027-174 General Andrews State Forest Willow River West Buckthorn Control

ORIGINAL

This Qualification Form must be submitted with your response. A solicitation response received without this form, or with an outdated version, may be rejected.

The State (or its representative) reserves the right to clarify the required qualification information submitted on this form before an award is made. The solicitation response may be rejected if qualifications are not met.

THE FOLLOWING EQUIPMENT AND SUPPORT SUPLIES ARE REQUIRED FOR THIS PROJECT.

PLEASE CHECK YES OR NO IF YOU HAVE THEM OR NOT:

1) A skid-steer with forestry drum mulching head, skid-steer engine needs minimum 98 HP and approximately 246 ft lbs. of torque - Yes No

2) Backpack sprayer and/or hand sprayers - Yes No

3) Brushsaws, chainsaws and/or handsaws - Yes No

4) All herbicides and adjuvants - Yes No

5) All fuel and other support supplies as needed - Yes No

6) Pesticide Spill Kit - Yes No

Certification: By signing this form, I certify the information provided is complete and accurate.

Authorized Signature: _____ Date:

Printed Name: Telephone:

Company Name: _ Title: