3. Attachment B - Certifications and Rep. - RFP - Demolition Services.pdf

ATTACHMENT B - RFP - Demolition Services

PROPOSER CERTIFICATIONS AND REPRESENTATIONS

PROPOSAL FORM

1. PREVAILING WAGES

■ Required ☐ Not Required The undersigned agrees, pursuant to ORS 279C.800 to 279C.870 (The "Prevailing Wage Statute"), that workers in each trade or occupation employed in the performance of any Contract awarded hereunder either by the Prime Contractor or any subcontractor, or any other person doing or contracting to do the whole or any part of the work, shall be paid not less than the applicable prevailing rate of wage for each trade or occupation as defined by the Director of the State of Oregon Bureau of Labor and Industries ("BOLI") in the applicable publication entitled Definitions of Covered Occupations for Public Works Contracts in Oregon. The prevailing wage rates for public works contracts in Oregon are contained in the following publications: The Prevailing Wage Rates for Public Works Projects in Oregon, the PWR Apprenticeship Rates, and any amendments to the PWR rates or Apprenticeship rates since the most current publication of those rates. BOLI publications can be reviewed electronically at https://www.oregon.gov/boli/employers/pages/prevailing-wage-rates.aspx. The applicable prevailing wages will be those in effect on the date of publication of this RFP as described above, and which rates are incorporated by reference in this RFP and any resulting contract.

2. CERTIFICATION OF NON-DISCRIMINATION

Proposer certifies that it has not and will not discriminate, in violation of ORS 279A.110(1), against a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a veteran-owned business, or an emerging small business in awarding any subcontract relating to this RFP or any contract awarded under it. (ORS 279A.110)

3. CONSTRUCTION CONTRACTORS BOARD REGISTRATION (ORS 701.055)

■ Required ☐ Not Required

Proposers must be registered with the Construction Contractors Board prior to submitting proposals for emergency work, minor alterations, ordinary repair, or maintenance projects.

Construction Contractors Board Registration Number Expiration Date

4. ASBESTOS ABATEMENT

■ Required ☐ Not Required

Proposer possesses an asbestos abatement license pursuant to ORS 468A.710.

5. STATE OF OREGON OFFICE OF MINORITY, WOMEN & EMERGING SMALL BUSINESS (OMWESB)

CERTIFICATION

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If your firm is currently certified by OMWESB in any of these categories, please indicate that certification.

☐ Minority Business Enterprise (MBE) ☐ Women Business Enterprise (WBE) ☐ Emerging Small Business (ESB)

6. TAX COMPLIANCE

Proposer has complied with the tax laws of the state of Oregon or a political subdivision of the state of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317 and 318.

☐ Yes ☐ No

7. PROPOSER'S SIGNATURE AND IDENTIFICATION

I hereby certify that this Proposal is genuine and that I have not entered into collusion with any other vendor(s) or any other person(s).

Please print or type all information requested below (except where signature is required) and attach Proposal Security (if required) to this form:

Name of Proprietor, Partnership, or Corporation

Signature of Proprietor, Partner, or Corporate Officer:

Name

Signature

Street Address

Name of Signatory

Mailing Address

Date Signed

District, State, and Zip Code

If Corporation, Attest:

Phone Number

Secretary of Corporation

Employer ID Number

State of Incorporation

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