6.2. ATTACHMENT B Vendor Qualifications Certifications FINAL 5.19.26.docx

Independent Verification and Validation (IV&V) Services

2026-55-119/26-478HFS-MEDPR-B-51464

6.2. ATTACHMENT B VENDOR QUALIFICATIONS CERTIFICATION

(FACT-PASS / RESPONSIVENESS ONLY)

(Firm Background, Continuous Operation, and Public Sector Campaign Experience)

SECTION A – VENDOR IDENTIFICATION (FACTUAL - Section 1.4.1. and 1.4.3.)

Vendor Legal Name:

Year Entity Was Established (MM/YYYY):

SECTION B – CONTINUOUS OPERATION (PASS / FAIL REQUIREMENT - Section 1.4.1. and 1.4.3.)

Check one box only:

· The Vendor has been in continuous operation providing IV&V services for child support program(s) for a minimum of five (5) years immediately preceding the Bid opening date.

Business Registration(s) (for verification purposes):

State Business is registered in:

Date of registration:

NOTE: Vendor shall provide a copy of their current Business Registration(s) with their bid submission, this will be used by the Agency to validate the Vendor’s length of time in business.

· The Vendor does not meet this requirement.

If the Vendor has had a legal name change or legal reorganization during the five-year period, list only factual details below (no narrative):

· Former legal name(s):

· Effective date(s) of change:

SECTION C – IV&V SUPPORT PROJECT EXPERIENCE (PASS / FAIL REQUIREMENT - 1.4.4. , 1.4.4.1., 1.4.4.2. and 1.4.4.3.)

The Vendor must list at least three (3) qualifying large scale business process and systems implementation planning and installation projects within the last ten (10) years.

IV&V and Child Support Experience Table (FACTUAL ONLY)

Client Name

IV&V Project Start Date (MM/YYYY)

IV&V Project End Date (MM/YYYY)

Child Support Program (Yes/No) Ref. Section 1.4.4., “…with at least one (1) being in child support programs…”

· Yes

· No

· Yes

· No

· Yes

· No

Federal, State or Local Government (check one)

Ref. Section 1.4.4.1., Sponsored by a federal, state, or large local government entity;

· Federal

· State

· Local

· Federal

· State

· Local

· Federal

· State

· Local

Worked Directly with OCSE in conjunction with IV&V activities (Yes/No)

Ref. Section 1.4.4.2., Worked directly with Office of Child Support Enforcement (OCSE) in conjunction with IV&V activities;

· Yes

· No

· Yes

· No

· Yes

Demonstrated experience and expertise with processes related to federal planning documents and obtaining federal certifications necessary to ensure compliance with requirements for a child support program (Yes/No) Ref Section 1.4.4.3.

· Yes

SECTION D – PRIME CONTRACTOR & ENTITY-LEVEL CERTIFICATION (FACT-PASS - Section 1.4.1. and 1.4.7.)

Check all boxes to be responsive:

· All projects listed in Section C were performed by the bidding Vendor entity as the prime contractor.

· No project listed is based solely on the prior work history of individual employees while employed by another firm.

· No project listed is based solely on subcontractor, affiliate, or parent-entity experience unless performed by a legally continuous predecessor entity of the Vendor.

SECTION E – CERTIFICATION AND ACKNOWLEDGMENT

By signing below, the Vendor certifies and attests that:

1. All information provided in this Attachment B is true, accurate, and complete;

2. The requirements addressed herein are mandatory responsiveness requirements of the IFB;

3. The Agency will make a pass/fail determination based on the information submitted and factual verification using publicly available or other reliable sources;

4. Failure to meet any requirement or submission of false or misleading information shall render the bid non-responsive and may subject the Vendor to remedies available under applicable law, and.

5. Vendor does not have a conflict of interest pursuant to Attachment A, OCSE IV&V STATEMENT OF WORK TEMPLATE, Section 4., Conflict of Interest Exclusion.

Authorized Signatory Name: Title:

Signature: Date:

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