7-08. Submittal Form- Certifications- Yes No.docx
DOCX document 19 KB Posted
- Attached to
- UDOT RFP- Intercity Bus Service (two routes)
- Solicitation number
- UDOT270090MP
- Issued by
- Salt Lake County, Utah
About this file
This is a Submittal Form for Certifications required by the Utah Department of Transportation (UDOT) for the Intercity Bus Service RFP involving two routes. The form serves as a pre-award compliance document that vendors must complete as part of their proposal submission. The certification form addresses four critical areas: debarment status, conflict of interest disclosures, outstanding tax liens in the State of Utah, and any other material information that could impact the state's determination of vendor responsiveness. Vendors are required to answer yes or no to each certification question, and any affirmative response mandates a detailed written explanation of the circumstances. The mandatory pre-proposal conference for this solicitation is scheduled for Monday, November 9, 2026, from 3:00 p.m. to 4:30 p.m. MST at the Calvin Rampton Complex, Summit Conference Room in Taylorsville, Utah, with both in-person and virtual attendance options available.
This certification form contains no pricing information, set-asides, funding amounts, or contract term details. It functions solely as a compliance and disclosure document that prospective vendors must complete truthfully and submit with their proposals. The form requires vendors to affirm they have not been debarred or suspended by any government entity, do not have conflicts of interest, do not have outstanding tax liens in Utah, and have disclosed any other information that would be material to the state's award decision, including legal actions, personnel changes, loss of major contracts, or alleged violations of regulations as referenced in Utah Code Annotated sections 63G-6a-120 and 902.
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Other files
| File | Type | Posted |
|---|---|---|
| 10-01. RFP General Information.doc | DOC document | |
| 4-07. APPENDIX B- Proposed Budget and Cost Per Mile.docx | DOCX document | |
| 3-11. 2026 Intercity Bus Clauses.pdf | ||
| 1-04. Submittal Form- Business Confidentiality- Yes No.doc | DOC document | |
| 9-03. Submittal Form- Vendor Set Up Form And W-9.pdf | ||
| 5-06. APPENDIX A- Proposal Questions.docx | DOCX document | |
| 6-10. Title VI.docx | DOCX document | |
| 2-05. Submittal Form- Attachment A- Agency Terms and Conditions- Yes No.docx | DOCX document | |
| 11-09. Sample Score Sheet.doc | DOC document | |
| 8-02. 2026 ICB SCOPE.docx | DOCX document |
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Text version
Certifications- Debarment, Conflict of Interest, Outstanding Tax Lien, Other Information
1. DEBARMENT- Is vendor presently or has vendor ever been debarred, suspended, proposed for debarment, or declared ineligible by any government department or agency, whether international, national, state, or local? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I have not been debarred, suspended, proposed for debarment, or declared ineligible.
Yes, I am or have been debarred, suspended, proposed for debarment, or declared ineligible (see as follows):
2. CONFLICT OF INTEREST- Does Vendor have any conflict, or potential conflict of interest, that might arise during the contract? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have any Conflict or Potential Conflict of Interest.
Yes, I do have a Conflict or Potential Conflict of Interest (see as follows):
3. OUTSTANDING TAX LIEN- Does vendor have an outstanding tax lien in the State of Utah? If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have an outstanding Tax Lien.
Yes, I do have an outstanding Tax Lien (see circumstances as follows):
4. OTHER INFORMATION- Does vendor have any information that is not already provided within its proposal that if known to the State would impact the State’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. If answer is "Yes", vendor must provide a statement explaining the circumstances.
No, I do not have any Other Information.
Yes, I do have Other Information (see as follows):
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