82335AttF_Attestation Form_NB.docx
DOCX document 46 KB Posted
- Solicitation number
- 25-82335
- Issued by
- Jasper County, Indiana
About this file
This document is an Attestation Form related to a Negotiated Bid for Compact Track Loader and Drum Mulcher (PO 25-82335) issued by the state of Indiana for Jasper County. The form outlines the mandatory submissions and requirements for respondents, including reading and meeting the pricing, terms and conditions, and executive summary sections. It also requires the completion and submission of various attachments such as the Indiana Economic Impact form, Bid Cost workbook, and Indiana Preferences form. Respondents must identify if they are an Indiana Veteran Owned Small Business and provide supporting documentation. The form allows for the listing of any additional subcontractors and requires either executed contracts or letters of agreement to be submitted.
The contract opportunity involves the procurement of Compact Track Loaders and Drum Mulchers for the state of Indiana and Jasper County. Respondents must comply with the mandatory requirements to be considered for the contract award. Pricing terms, funding sources, and other salient details are not explicitly provided in this Attestation Form document.
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Other files
| File | Type | Posted |
|---|---|---|
| 82335AttEQandA.xlsx | XLSX spreadsheet | |
| 82335AttG_Preferences.docx | DOCX document | |
| 82335AttAMWBE.docx | DOCX document | |
| 82335Bid Package.pdf | ||
| 82335AttBPO Terms.docx | DOCX document | |
| 82335AttD_CostBid.xlsx | XLSX spreadsheet | |
| 82335AttA1IVOSB.docx | DOCX document | |
| 82335AttCIndiana Economic Impact Form.xls | XLS spreadsheet | |
| 82335AttAMWBE.docx | DOCX document | |
| 82335AttD_CostBid.xlsx | XLSX spreadsheet | |
| 82335AttF_Attestation Form_NB.docx | DOCX document | |
| 82335Bid Package.pdf | ||
| 82335AttEQandA.xlsx | XLSX spreadsheet | |
| 82335AttBPO Terms.docx | DOCX document | |
| 82335AttCIndiana Economic Impact Form.xls | XLS spreadsheet | |
| 82335AttG_Preferences.docx | DOCX document | |
| 82335AttA1IVOSB.docx | DOCX document |
Show all 17
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Text version
ATTESTATION FORM
Negotiated Bid – PO 25-82335
ATTACHMENT F
Respondent Name:
1.0 Mandatory Submissions and Requirements: Disagreement with these items may result in the response being disqualified.
| Section 1.9 Pricing |
| ☐ Have read and meet this requirement |
| Section 2.2.6 Mandatory PO Terms and Conditions |
| ☐ Have read and understand this section |
| Section 2.2 Executive Summary |
| ☐ Have completed, signed, and submitted |
| Section 2.4.1 Attachment C: Indiana Economic Impact |
| ☐ Have read, completed, and submitted |
| Section 2.3 Attachment D: Bid Cost (Excel Workbook) |
| ☐ Have completed and submitted |
| Section 2.4 Attachment F: Attestation Form |
| ☐ Have completed in its entirety and submitted |
2.0 Confirm mutual understanding and submission.
1.19 Attachment A: Minority and Women Business Enterprise form, IDOA provided certification letter and Subcontractor’s signed letter on company letterhead.
☐ Have completed, signed, and submitted or ☐ Opting not to submit
1.20 Attachment A1: Indiana Veteran Owned Small Business form IDOA provided certification letter and Subcontractor’s signed letter on company letterhead.
☐ Have completed, signed, and submitted
| 2.2.1 Ability and Desire to Supply the Required Products or Services |
| ☐ Have read, and agree |
| 2.4.3 Attachment G: Indiana Preferences form |
| ☐ Have completed, and submitted |
2.4.4. Subcontractors
(Additional subcontractors/those not submitted in Attachment A/Attachment A1)
☐ Have read, agree, listed subcontractors in 5.0 of this attachment and submitted documents
☐ Have read, and does not apply to response
3.0 Claim clarification
| 1.20 Respondent is IVOSB certified |
| ☐ YES, claiming; Att A, have completed, signed, and submitted |
☐ NO, not claiming
4.0 Subcontractors per PO 2.4.4 (additional subcontractors/those not submitted in Attachment A/Attachment A1) More rows may be inserted if necessary
| Subcontractor Name |
| Function to be performed |
| Document Submitted |
☐ Executed contract
☐ Letter of Agreement
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
5.0 Respondent additional attachments (OPTIONAL)
More rows may be inserted if necessary
| Filename |
| Attachment Reference |
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