22025_MEDIA_Attachment RT4 - Forms and Response to Sample MA_clean_12-11-25.docx
DOCX document 106 KB Posted
- Attached to
- RFP 22025 for Media Planning/Buying Services
- Solicitation number
- S-177000-00015542
- Issued by
- Marion County, Oregon
About this file
This is a response template and forms document for RFP #22025 Media Services issued by the Oregon Lottery. The document outlines the required submission materials and master agreement acknowledgment procedures for proposers responding to the media services contract opportunity. Proposers must complete and submit the response template along with mandatory forms at the time of proposal submission, including the Disclosure Exemption Affidavit (Attachment F1), COBID Certification and Outreach Plan (Attachment F2), and signed versions of any addenda issued by the Lottery. The document establishes that time is of the essence for contractor performance and specifies non-negotiable terms including constitutional compliance, federal and state law requirements, Oregon governing law and venue, jurisdiction in Oregon Circuit Court (Marion County) and Oregon federal district court, confidentiality obligations, and tax law compliance certification.
Proposers must affirmatively indicate acceptance of or document exceptions to all terms and conditions outlined in the Sample Master Agreement, with required explanations for any deviations and proposed alternative language where applicable. Any exceptions not noted during proposal submission but raised during contract negotiations may result in the Lottery discontinuing negotiations at its sole discretion. Additional mandatory forms including a Certificate of Insurance Coverage must be submitted prior to master agreement execution and contract work commencement. Proposers must also commit to completing background checks of applicable team members if requested by the Lottery. Failure to follow RFP instructions or provide required signatures and forms may result in proposal rejection.
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Text version
RFP # 22025: MEDIA SERVICES
Response Template – Lottery Forms and Response to Sample Master Agreement
Attachment RT4 Forms and Response to Sample Master Agreement Including Response Template Instructions
RFP # 22025 Media
RFP # 16073
Table of Contents
| 1.0 | Instructions | 1 |
| 2.0 | Sample Master Agreement | 1 |
| 2.1 | Non-Negotiable Terms and Conditions | 1 |
| 2.2 | Other Terms and Conditions | 1 |
| 3.0 | Forms Required | 2 |
| 3.1 | Mandatory Forms Due at Proposal Submission | 2 |
| 3.2 | Mandatory Forms Due Prior to Master Agreement | 3 |
| 3.2.1 | Proposer’s Commitment to Submit Forms Requirements | 3 |
RFP # 22025: MEDIA SERVICES
Response Template – Lottery Forms and Response to Sample Master Agreement
Instructions The Proposer must review the Sample Master Agreement Attachment R1 - Sample Master Agreement and sign Attachment RT4 - Forms and Response to Sample Master Agreement in order to note the Proposer’s acknowledgement, intent to comply, and exceptions to the Attachment R1 - Sample Master Agreement. If exceptions are not noted in Attachment RT4 - Forms and Response to Sample Master Agreement of the Proposal but raised during contract negotiations, Lottery reserves the right to discontinue negotiations if, in its sole discretion, it deems that to be in the best interests of Lottery.
Sample Master Agreement Non-Negotiable Terms and Conditions Proposers must strictly adhere to the instructions in this RFP and Sample Master Agreement. Failure to follow any instruction within this RFP may, at Lottery’s sole discretion, result in rejection of the Proposer’s Proposal. Please provide a signature stipulating the Proposer’s acknowledgement of these non-negotiable items listed below (and discussed in Section 7.4 of the RFP):
Constitutional requirements Requirements of applicable federal and State law Right to Terminate for Convenience, breach or budgetary reasons;
Time is of the Essence for Contractor’s performance;
Access to Records;
Oregon Law must be the Governing Law;
Venue must be in Oregon; Contractor must consent to jurisdiction in Oregon Circuit court (Marion County) and Oregon federal district court;
Certification of Tax Law Compliance;
No Third-Party Beneficiaries unless identified;
Confidential Information and Public Records Laws;
Foreign Contractor;
Amendments; and Disclosure of Federal Tax Identification Number
| Print Name/Electronic Signature of Authorized Personnel |
| Date |
Other Terms and Conditions Proposers are expected to closely read the Sample Master Agreement and provide a binding signature of intent to comply with the Terms and Conditions. Proposer shall affirmatively indicate acceptance of, or note any exception to, the Terms and Conditions where space is provided below. Any exceptions must include an explanation for the Proposer’s inability to comply with such term or condition and, if applicable, alternative language the Proposer would find acceptable. Rejection of the Terms and Conditions, in whole or in part, or without any explanation, may result in the Lottery’s rejection of Proposal. If an exception concerning the Terms and Conditions is not noted in the Table below, but is raised during contract negotiations, Lottery reserves the right to cancel the negotiation, at its sole discretion, if it deems that to be in the best interests of the Lottery (insert one row per exception).
| Section |
| Proposer’s Explanation (required for any rejection/exception) |
| Proposer’s Proposed Alternative Language (if applicable) |
| Print Name/Signature of Authorized Personnel |
| Date |
Forms Required The tables below capture the forms which the Proposer must submit as part of its Proposal; and which the Proposer must submit prior to execution of a Master Agreement. The forms are available on OregonBuys as attachments in an editable format.
Mandatory Forms Due at Proposal Submission The mandatory forms due at Proposal submission must be completed and included as part of the Proposer’s Proposal. The table below lists all the mandatory forms which must be submitted as part of the Proposer’s proposal. The Proposer must complete each of the forms and provide a copy below the table.
The Proposer must complete and submit each form as directed with electronic signatures.
| SECTION / TEMPLATE |
| PROPOSAL RESPONSE ITEM |
| COMPLETED AND PROVIDED AS INSTRUCTED? |
| Attachment F1 |
| Disclosure Exemption Affidavit |
| YES |_| NO |_| |
| Attachment F2 |
| COBID Certification / Outreach Plan |
YES |_| NO |_|
| All Addenda to RFP posted on OregonBuys |
| Signed version of each RFP Addendum issued by Lottery |
| YES |_| NO |_| N/A |_| |
<Proposers to provide images of each required form> Mandatory Forms Due Prior to Master Agreement The table below lists the forms which will be required after the Contract is awarded but prior to any work beginning.
| FORM ID |
| FORM NAME |
| COMMENTS |
Certificate of Insurance
Coverage as required by Master Agreement
Proposer’s Commitment to Submit Forms Requirements Please provide a signature stipulating the Proposer’s commitment to submit all required forms listed in Section 3.2 and complete background checks of all applicable team members if requested by Lottery.
| Print Name/Electronic Signature of Authorized Personnel |
| Date |
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