25-84131500-ITN DFS BOR Attachment S No prior involvement.pdf
PDF 107 KB Posted
- Attached to
- Insurance Broker of Record - Reinsurance Broker for Property and Casualty lines, Risk Management and
- Solicitation number
- ITN-13124
- Issued by
- St. Johns County, Florida
About this file
This document is Attachment S, a Statement of No Prior Disqualifying Involvement form for Invitation to Negotiate (ITN) No. 25-84131500-ITN. The form requires a vendor/respondent to certify that they are not prohibited from entering into a contract based on Florida Statute 287.057(19)(c), which restricts firms that have previously been involved in feasibility studies, drafting solicitations, or developing implementation programs for a specific contract from subsequently bidding on contracts related to that same subject matter.
The form provides a legal certification template for vendors to complete, including spaces for the respondent's (vendor) name, signature of an authorized representative, printed name of that representative, and date of signing. The statute specifically prevents a person or firm from contracting with an agency if they have had prior involvement in preparing or developing the initial contract considerations, with a narrow exception that allows respondents who merely responded to a request for information to remain eligible for contract award.
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Text version
ITN No.: 25-84131500-ITN
ITN No.: 25-84131500-ITN
Attachment S Statement Of No Prior Disqualifying Involvement
I, as an authorized representative of the Respondent, certify that nothing in section 287.057(19)(c), F.S., (below), prohibits the Respondent’s entry into any Contract resulting from this solicitation.
287.057 Procurement of commodities or contractual services. —
(19)(c) A person who receives a contract that has not been procured pursuant to subsections (1)-
(3) [of s. 287.057, F.S.] to perform a feasibility study of the potential implementation of a subsequent contract, who participates in the drafting of a solicitation or who develops a program for future implementation, is not eligible to contract with the agency for any other contracts dealing with that specific subject matter, and any firm in which such person has any interest is not eligible to receive such contract. However, this prohibition does not prevent a Respondent who responds to a request for information from being eligible to contract with an agency.
Respondent (Vendor) Name
Signature of Respondent’s Authorized Representative
Authorized Representative’s Printed Name
Date
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