4-Vendor Requested Information.xlsx
XLSX spreadsheet 12 KB Posted
- Solicitation number
- PCSD03102026
- Issued by
- Utah County, Utah
About this file
This is a vendor information form for Provo City School District's solicitation for Virtual Anatomy Convertible Table Systems. The district seeks to procure three medical-grade convertible virtual dissection table systems equivalent in functionality to Anatomage units for use in secondary anatomy and CTE health science instruction. The contract resulting from this Invitation for Bid will have an initial term of one year with options to renew for up to four additional years, with vendors required to guarantee pricing for the first year. Award will be made to the lowest responsive and responsible bidder meeting all specifications, with the district reserving the right to award based on lowest combined cost or lowest cost per line item.
Vendors submitting proposals must complete the provided vendor information form, certifying compliance with numerous federal, state, and local requirements including possession of required licenses, absence of debarment or suspension status, no conflict of interest, no outstanding tax liens, and compliance with federal regulations prohibiting certain telecommunications equipment from restricted foreign entities. Vendors must also certify they are not engaged in boycotts as defined by Utah law, are not providing forced labor products, and do not have financial ties to OFAC-sanctioned individuals or entities. The form requires submission of company legal name, contact information for the authorized representative, federal tax identification number, ordering and remit-to addresses, Utah Sales Tax ID number, and business entity type. Vendors must acknowledge that a solicitation award is not a contract and that no work, material purchases, or subcontracts may commence until receipt of a fully executed contract or purchase order.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 1-PCSD Vendor Prerequisites - IFB.docx | DOCX document | |
| 2-PCSD Standard Terms and Conditions for Services.pdf | ||
| 3-PCSD03102026 Virtual Anatomy Convertible Table IFB.docx | DOCX document |
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Text version
Worksheet
| You only need to fill this form out if you intend to email your proposal and not submit it through the Utah Public Procurement Place Portal. Otherwise please answer these question in the portal. | ||
| Supplier Name | Enter Text Here | |
| Vendor certifies that they have read and agree to the Vendor Prerequisites document located in the Files | Yes or No | |
| Please provide your firm's legal company name and also DBA if applicable. | Enter Text Here | |
| Please provide your firm's contact information for this contract, including the name, phone number, and email address of your firm's authorized representative. | Enter Text Here | |
| Please provide your federal tax identification number? (If the vendor is sole proprietor please do not provide your social security number.) | Enter Text Here | |
| Please provide your ordering address and the remit to address. | Enter Text Here | |
| Please provide your firm's State of Utah Sales Tax ID Number. If you do not have a State of Utah Sales Tax ID Number, please write "N/A". | Enter Text Here | |
| Please you firm's type of business (Corporation, Parthership, LLC, etc) | Enter Text Here | |
| Is vendor an employee of the State of Utah? If yes, then vendor must submit an external employment form signed by its manager at the State of Utah. | Yes or No | |
| Is Vendor (owners, principals, partners) a retiree currently receiving benefits through the Utah Retirement Systems (URS)? | Yes or No | |
| Is vendor presently or has vendor ever been debarred, suspended, proposed for debarment, or declared ineligible by any governmental department or agency, whether international, national, state, or local? | Yes or No | |
| Does Vendor have any conflict, or potential conflict of interest, that might arise during the contract? | Yes or No | |
| Suspension, Tax Lien, Conflicts, Responsiveness | Does vendor have any information that is not already provided within its proposal that if known to the District would impact the District’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. | Yes or No |
| Does vendor have an outstanding tax lien in the State of Utah? | Yes or No | |
| Vendor certifies, by answering "Yes", that it is their responsibility to upload any and all documents in responding to the solicitation. If the vendor fails to upload a document, uploads an incorrect document, uploads a blank document, or uploads any document incorrectly the District may not allow the vendor to make changes following the closing of the solicitation. | Yes or No | |
| Vendor certifies, by answering "Yes", they do not have financial ties to individuals or entities on an OFAC sanctions list. | Yes or No | |
| Vendor certifies, by answering "Yes", that they must acquire and maintain all applicable federal, state, and local licenses before the contract is entered into. Licenses must be maintained throughout the entire contract period. Persons doing business as an Individual, Association, Partnership, Corporation, or otherwise shall be registered with the Utah State Division of Corporations and Commercial Code. Information may be obtained at www.corporations.utah.gov. | Yes or No | |
| Vendor certifies, by answering "Yes", that pursuant to the Code of Federal Regulations 2 CFR 200.216 - Prohibition on certain telecommunication and video surveillance services or equipment, that none of the goods (including component parts) or services offered within its proposal are from the entity Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). | Yes or No | |
| Vendor certifies, by answering "Yes", that a solicitation award is not a contract. If awarded, vendor(s) may not to begin work, purchase materials, or enter into subcontracts relating to this solicitation until they receive a fully executed contract or PO. | Yes or No | |
| Vendor certifies, by answering "Yes", that if awarded they are not currently engaged in either an economic boycott or a boycott of the State of Israel, or both, as those terms are defined in 63G-27-102, and that they will not engage in such boycotts during the term of the contract. | Yes or No | |
| Vendor certifies, by answering "Yes", in accordance with Utah law, Vendors contracting with the District certify that they are not providing a “forced labor product” as defined in Utah Code 63G-6a-121. If the Vendor is providing technology or technology services, networks, or systems, the Vendor certifies that the aforementioned does not come from a “restricted foreign entity,” as also defined in UCA 63G-6a-121. | Yes or No |
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