9156 ITB Attachment 1 CAF.pdf
PDF 114 KB Posted
- Attached to
- Baumalight SWF580 or Approved Equivalent
- Solicitation number
- S-63400-00003839
- Issued by
- Clackamas County, Oregon
About this file
This document is a Contractual Acceptance Form (CAF) for ITB 9156, a state and local contract opportunity in Oregon involving Clatsop County. The CAF requires bidders to provide key information such as their legal name, business designation, federal tax ID, and Oregon business registration number. Bidders must also certify that they are a resident bidder, are an Oregon certified firm (e.g. Minority Business Enterprise, Emerging Small Business), and agree to the terms and conditions of the contract. The related state and local contract opportunity is for the procurement of a Baumalight SWF580 or approved equivalent.
The CAF indicates that the procurement is being conducted on behalf of the Oregon Parks and Recreation Department (OPRD). Bidders must submit their response by a specified due date. The contract term and any potential renewal options are not provided in the document. Pricing terms, set asides, incumbent information, funding requirements and sources are also not included in this specific document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Prior Nearby Drill Logs_info only.pdf | ||
| 9156 ITB Attachment 3 Detailed Specs FINAL.pdf | ||
| 9156 ITB Attachment 2 PPF.pdf | ||
| Solicitation Final.pdf | ||
| 9156 ITB Attachment 4.pdf |
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Text version
ITB 9156 ATTACHMENT 1
9156 ITB Attachment 1 CAF.docx Page 1 of 2
CONTRACTUAL ACCEPTANCE FORM
BIDDER SHALL PROVIDE ALL APPLICABLE INFORMATION REQUESTED BELOW
THIS ATTACHMENT MUST BE COMPLETED AND RETURNED WITH BID
BIDDER’S LEGAL NAME: (TAX FILING) __________________________________________________________
BIDDER’S MAILING ADDRESS: ________________________________________________________________
BIDDER’S BUSINESS DESIGNATION: (CHECK ONE)
Partnership Limited Partnership Limited Liability Partnership
Corporation Professional Corporation Limited Liability Company
Sole Proprietorship Other: ____________________________________________
BIDDER’S FEDERAL TAX ID NUMBER: (NOT SOCIAL SECURITY NUMBER) _________________________
Tax information is requested pursuant to ORS 305.385 and will be used for the administration of state, federal and local tax laws. OPRD may report the information provided to the Internal Revenue Service (IRS) under the name and taxpayer identification number provided.
BIDDER’S OREGON BUSINESS REGISTRATION NUMBER: _________________________________
(OREGON SECRETARY OF STATE, CORPORATIONS DIVISION)
Go to http://www.filinginoregon.com/ for information on how to register to do business in Oregon.
BIDDER IS A RESIDENT BIDDER: YES NO
ORS 279A.120(1)(b): “Resident bidder” means a bidder that has paid unemployment taxes or income taxes in Oregon during the 12 calendar months immediately preceding submission of the bid, has a business address in Oregon and has stated in the bid whether the bidder is a “resident bidder” under this paragraph.
BIDDER IS AN OREGON CERTIFIED FIRM: (CHECK ALL THAT APPLY)
Minority Business Enterprise (MBE) Emerging Small Business (ESB)
Women Business Enterprise (WBE) Disadvantaged Business Enterprise (DBE)
Go to http://www.oregon4biz.com/Grow-Your-Business/Business-services/Minority-Owned-Business-Certification/ for information on the OMWESB certification program.
BIDDER’S CONTACT INFORMATION:
AUTHORIZED REPRESENTATIVE TITLE
PHONE FAX EMAIL
THE INDIVIDUAL SIGNING ON BEHALF OF BIDDER HEREBY ACKNOWLEDGES AND CERTIFIES THAT:
• He/she is authorized to act on behalf of Bidder,
• The supplied Contractor data is true and accurate,
• To the best of his/her knowledge, Bidder is not in violation of any Oregon tax laws, For the purposes of this certification, “Oregon Tax Laws” means a state tax imposed by ORS 320.005 to 320.150 and 403.200 to
403.250 and ORS chapters 118, 314, 316, 317, 318, 321 and 323 and the elderly rental assistance program under ORS 310.630 to
310.706 and local taxes administered by the Department of Revenue under ORS 305.620. [ORS 305.380(4)]
• Bidder has completely read and understands the provisions of the Solicitation, including any Addenda issued,
• The Bid was prepared independently from all other Bidders, and without collusion, fraud, or other dishonesty,
• Bidder has not discriminated and will not discriminate, in violation of ORS 279A.110(1), against any minority, women or emerging small business enterprise certified under ORS 200.055 or a business that is owned or controlled by or that employs a disabled veteran as defined in ORS 408.225 in obtaining any required subcontract,
• Bidder accepts and agrees to be bound by all the terms and conditions of the Contract awarded, http://www.oregon4biz.com/Grow-Your-Business/Business-services/Minority-Owned-Business-Certification/
ITB 9156 ATTACHMENT 1
9156 ITB Attachment 1 CAF.docx Page 2 of 2
• Bidder agrees to provide all Goods and Services required to be provided under the Contract,
• Bidder has the available resources, including staffing, to perform the Services in a reasonable timeframe to pursue OPRD’s objectives, and
• By submitting a response to this Solicitation, Bidder grants the State of Oregon a non-exclusive, perpetual, irrevocable, royalty-free, worldwide license for the rights to copy, distribute, display, prepare derivative works of and transmit the response for the purpose of conducting this procurement and to fulfill obligations under Oregon Public Records Laws.
SIGNATURE OF BIDDER’S AUTHORIZED REPRESENTATIVE DATE
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