5-Attachment B-1 - Offer Form.docx

DOCX document 29 KB Posted

Attached to
On-Call Subdivision Regulation Services
Solicitation number
263331
Issued by
Pinal County, Arizona

About this file

This is an Offer Form (Attachment B-1) for Pinal County, Arizona's on-call subdivision regulation services contract opportunity (Contract #263331SOQ). The form serves as the submission document through which qualified consultants offer to provide comprehensive planning and engineering services to assist the County in administering its subdivision and development review functions. Respondents must complete the form by providing their company name, authorized signatory, business address, contact information, and web address. The offer represents the respondent's agreement to provide goods and/or services in full compliance with the solicitation requirements and all terms and conditions outlined in the solicitation documents.

The form includes five mandatory certifications that all respondents must affirm by signature: non-discrimination in employment practices in accordance with Federal Executive Order 11246 and Arizona state law; prohibition against providing economic opportunities, gifts, or favors to public servants; compliance with Arizona's electronics and information technology product standards; compliance with forced labor prohibitions regarding Uyghur labor in products from the People's Republic of China; and confirmation that the respondent is not debarred from or otherwise prohibited from participating in federal, state, or local government contracts. Respondents must certify that they have not made false statements in their offer, as signing with false information will result in offer rejection, contract voidance, and potential legal penalties. Failure to provide a valid signature affirming all stipulated requirements will result in automatic rejection of the offer.

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Text version

Attachment B-1 Offer Form

Submission of Offer: Undersigned hereby offers and agrees to provide goods and/or services in compliance with the solicitation and the offer, which is as indicated by the latest dated version below:

Offer Date:

X
Responder Company NameSignature of Person Authorized to Sign Offer
AddressPrinted Name and Title
City, State, ZipResponder Contact Name and Title
Web AddressContact Email AddressContact Phone #

Certification: By signature in the Offer section above, the Responder certifies:

1. The Responder shall not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, Arizona State Executive Order 2009-9 or A.R.S. §§ 41−1461 through 1465.

2. The Responder has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause will result in rejection of the offer. Signing the offer with a false statement will void the offer, any resulting contract, and may be subject to legal penalties under law.

3. The Responder certifies compliance with A.R.S. § 41-3532 when offering electronics or information technology products, services, or maintenance.

4. The Responder certifies compliance with A.R.S. § 35-394 prohibiting the use of forced labor by Responder or its contractors or subcontractors of ethnic Uyghurs in the People’s Republic of China in any goods produced in service of this contract.

5. The Responder is not debarred from, or otherwise prohibited from participating in any contract awarded by federal, state, or local government.

Contract #263331SOQ image1.png

File details come from the government source that posted it. Updated .