6-RFP 2026-04 Appendix B.pdf

This is a Certification Letter form required as part of RFP No. 2026-04 issued by the South Carolina Office of Central Procurement on January 22, 2026, for Pharmacy Benefit Management (PBM) Services for the Commercial Pharmacy Benefit Plan of the Self-Funded Employee Medical Health Plan (EMHP) of Suffolk County, New York. The certification letter serves as a mandatory attestation document that must be completed by an officer of the proposing corporation. The form requires the officer to certify under penalty of law that all information included in the proposal submission is true and accurate. The document is governed by Law No. 26-CE-008 and is classified under commodity codes 958-56 and 949-77.

The certification letter is a single-page form (page 77 of 78 in the RFP appendix) that requires completion of four fields: the corporation name, the officer's signature, the officer's printed name, the officer's title, and the submission date. This document functions as a binding declaration of proposal accuracy and compliance with all representations made in the bidder's response to the pharmacy benefit management services solicitation.