2324-02 ITB IF App C-Mandatory Criteria Cert.docx

DOCX document 32 KB Posted

Attached to
Purchase and Installation of Equipment for Conversion of Explosive Ordinance Disposal Van(s)
Solicitation number
ITB-07826
Issued by
Hillsborough County, Florida

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This document is a Mandatory Criteria Certification Form from the Florida Department of Financial Services related to a state and local contract opportunity to purchase and install equipment for conversion of explosive ordinance disposal law enforcement vans. The form requires the respondent to certify that they are authorized to respond, have no conflicts of interest, are not on any restricted vendor lists, will comply with all contract requirements, and will perform the services at a location within the contiguous United States and within 500 miles of Tampa, Florida. There is also a mandatory pre-response conference on February 13, 2024 that at least one representative of the respondent must attend.

The related state and local contract opportunity is for the purchase and installation of equipment for conversion of explosive ordinance disposal law enforcement van(s) for the Florida Department of Financial Services, Division of Investigative and Forensics Services. The solicitation will be administered through the Vendor Information Portal, and failure to file a protest within the time prescribed in section 120.57(3), Florida Statutes may result in a waiver of proceedings under Chapter 120. The jurisdictions involved are Leon County and the City of Tallahassee.

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Other files

File Type Posted
2324-02 ITB IF - Att 3-Price Response.xlsx XLSX spreadsheet
2324-02 ITB IF App B-Questions Template.xlsx XLSX spreadsheet
2324-02 ITB IF App D-Award Preferences.docx DOCX document
2324-02 ITB IF - Complete ITB.pdf PDF

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DEPARTMENT OF FINANCIAL SERVICES

Mandatory Criteria Certification Form

Appendix C By submitting this form, the Respondent acknowledges that the Department will rely on the representations made on this form in making its decision of award. If the Department discovers that any of the information on this form is false prior to the award of the Contract, the Department reserves the right to deem the Respondent non-responsive and cease any consideration of its Response. If the Department discovers that any information on this form is false after the award to the Respondent is made, the Department reserves the right to terminate the Contract and hold the Respondent liable for costs associated with re-procurement.

A Respondent’s failure to provide a “Yes” Certification Answer for each Certification Question below will result in the Respondent being deemed non-responsive.

#
Certification Question
Certification Answer
1.
Does the Respondent certify that the person submitting the Response is authorized to respond to this solicitation on the Respondent’s behalf?
|_| Yes
|_| No
2.
Does the Respondent certify that it has met the disclosure requirements for Conflicts of Interest as outlined in Section 6 of the PUR 1001?
|_| Yes
|_| No
3.
Does the Respondent certify that it is not on the Convicted Vendor List, Discriminatory Vendor List, or Suspended Vendor List as provided in sections 287.133, 287.134, and 287.1351, Florida Statutes (F.S.), respectively?
|_| Yes
|_| No
4.
Does the Respondent certify compliance with Section 9, Respondent’s Representation and Authorization, of the PUR 1001, as modified by section 3.1, Instructions to Respondents, of the Invitation to Bid document?
|_| Yes
|_| No
5.
Does the Respondent certify that it is not engaged in a boycott of Israel or on the Scrutinized Companies that Boycott Israel List?
|_| Yes
|_| No
6.
Does the Respondent certify that: (a) it is registered with the Florida Department of State, (b) if awarded a contract under this solicitation, it will register with the Florida Department of State prior to contract execution, or (c) it is not required to register with the Florida Department of State (see applicable sections of Title XXXVI, Business Organizations, chapters 605-623, F.S.)?
|_| Yes
|_| No
7.
Does the Respondent certify that it is not (a) on the Scrutinized Companies with Activities in Sudan List, or (b) on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List?
|_| Yes
|_| No
8.
Does the Respondent certify that, if awarded a contract under this solicitation, it will register with and use the E-Verify system as defined in section 448.095(1)(e), F.S., in compliance with section 448.095(2)(a), F.S.?
|_| Yes
|_| No
9.
Does the Respondent certify that it has not had a contract terminated pursuant to section 448.095(2)(c), F.S., by a public employer as defined in section 448.095(1)(i), F.S., within the last 1 year?
|_| Yes
|_| No
10.
Does the Respondent certify that it has complied with any applicable disclosure requirements in section 286.101, F.S.?
|_| Yes
|_| No
11.
Does the Respondent certify that it will perform the services required under the Contract at a location that is within the contiguous United States and within 500 miles of Tampa, Florida?
|_| Yes
|_| No
12. D
Does the Respondent certify that at least one (1) representative of the Respondent attended the mandatory pre-Response conference in person and the Representative’s attendance can be verified as evidenced on the Department’s pre-Response conference sign in sheets?
|_| Yes
|_| No

As the person authorized to sign this form, I certify that the Certification Answers provided above are accurate as to the Respondent.

Respondent Name:

Respondent Authorized Signatory Name:

Respondent Authorized Signatory Title:

Authorized Representative Signature:

Date:

Appendix C Rev. 9/28/22

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