3-07. Submittal Form- Certifications- Yes No.docx
DOCX document 19 KB Posted
- Solicitation number
- UDOT270035MP
- Issued by
- Utah
About this file
This is a submittal form containing certifications for the Utah Department of Transportation (UDOT) Invitation for Bid (IFB) for Sand Blasting, Painting, Welding, and Fabrication services in UDOT Region 4 Price Area. The form requires bidders to provide yes or no responses to various certification requirements as part of their bid submission. The document serves as a standardized tool to ensure all bidders confirm their compliance with specified certifications and qualifications necessary to perform the requested services. Bidders must complete this form accurately and submit it with their proposals to demonstrate their eligibility and capability to undertake the sand blasting, painting, welding, and fabrication work as outlined in the solicitation specifications.
This certification form is a mandatory component of the bid submission process and helps UDOT verify that prospective contractors meet all baseline requirements before award consideration. By requiring bidders to affirmatively certify their qualifications and compliance status, UDOT ensures transparency in the procurement process and establishes a clear record of each bidder's stated capabilities and certifications at the time of submission.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 7-01. IFB General Bid Information.doc | DOC document | |
| 1-05. Submittal Form- Business Confidentiality- Yes No.doc | DOC document | |
| 4-04. Submittal Form- Vendor Set Up Form.pdf | ||
| 5-02. Scope of Work.doc | DOC document | |
| 2-06. Submittal Form- Attachment A- Agency Terms and Conditions- Yes No.docx | DOCX document | |
| 6-03. Submittal Form- Pricing.doc | DOC document |
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Text version
Certifications- Debarment, Conflict of Interest, Outstanding Tax Lien, Other Information
1. DEBARMENT- Is vendor presently or has vendor ever been debarred, suspended, proposed for debarment, or declared ineligible by any government department or agency, whether international, national, state, or local? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I have not been debarred, suspended, proposed for debarment, or declared ineligible.
Yes, I am or have been debarred, suspended, proposed for debarment, or declared ineligible (see as follows):
2. CONFLICT OF INTEREST- Does Vendor have any conflict, or potential conflict of interest, that might arise during the contract? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have any Conflict or Potential Conflict of Interest.
Yes, I do have a Conflict or Potential Conflict of Interest (see as follows):
3. OUTSTANDING TAX LIEN- Does vendor have an outstanding tax lien in the State of Utah? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have an outstanding Tax Lien.
Yes, I do have an outstanding Tax Lien (see circumstances as follows):
4. OTHER INFORMATION- Does vendor have any information that is not already provided within its proposal that if known to the State would impact the State’s determination on vendor's responsiveness for a contract award (i.e., legal action, recent turn-over in major personnel, loss of a major contract, any alleged violations of federal, state or local regulations, etc.). Please see UCA 63G-6a-120 & 902. If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have any Other Information.
Yes, I do have Other Information (see as follows):
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