A-249(5)_Event_No._18466_RFP_Attachments_v.2.pdf

Rev. April 2025

ATTACHMENT A: RESPONDER DECLARATIONS

The undersigned certifies, to the best of his or her knowledge and belief, that:

A. Response Contents. The information provided is true, correct, and reliable for purposes of evaluation for potential contract award. The submission of inaccurate or misleading information may be grounds for disqualification from the award as well as subject the Responder to suspension or debarment proceedings as well as other remedies available by law

B. Authorized Signature. This Declaration is signed by the appropriate person(s), with the authority to contractually bind the Responder, as required by applicable articles, bylaws, resolutions, minutes, and ordinances.

C. Non-Collusion Certification.

1. The Proposal has been arrived at by the Responder independently and has been submitted without collusion and without any agreement, understanding or planned common course of action with any other vendor designed to limit fair or open competition; and

2. The contents of the Response have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any other individual prior to the due date and time of this Solicitation. Any evidence of collusion among Responders in any form designed to defeat competitive responses will be reported to the Minnesota Attorney General for investigation and appropriate action.

D. Organizational Conflicts of Interest. To the best of Responder’s knowledge and belief, and except as otherwise disclosed, there are no relevant facts or circumstances which could give rise to an organizational conflict of interest.

An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons,

1. a vendor is unable or potentially unable to render impartial assistance or advice to the State;

2. the vendor’s objectivity in performing the contract work is or might be otherwise impaired; or

3. the vendor has an unfair competitive advantage.

If after award, an organizational conflict of interest is discovered, an immediate and full disclosure in writing must be made to the State’s Chief Procurement Officer which must include a description of the action which the contractor has taken or proposes to take to avoid or mitigate such conflicts. If an organizational conflict of interest is determined to exist, the State may, at its discretion, cancel the contract. In the event the Contractor was aware of an organizational conflict of interest prior to the award of the contract and did not disclose the conflict to OSP, the State may terminate the contract for default. Organizational conflicts of interest terms apply to any subcontractors for this work.

E. Certification Regarding Lobbying. For State of Minnesota Contracts and Grants over $100,000, the undersigned certifies, to the best of his or her knowledge and belief that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into and is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352.

Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

F. Copyrighted Material Waiver. By signing its Response, the Responder certifies that it has obtained all necessary approvals for the reproduction and distribution of the contents of its response.

G. Diverse Spend Reporting. The Sample Contract contains a clause for Diverse Spend Reporting. When this clause applies, Contractor will be required to register in a free portal to report diverse spend.

Please see Diverse Spend Reporting Frequently Asked Questions for additional information.

By signing this form, Responder acknowledges and certifies compliance with all applicable requirements indicated above.

Company Name:

Signature:

Printed Name:

Title:

Date:

Phone Number:

Email Address:

https://osp.admin.mn.gov/sites/osp/files/2022-11/viva_diverse_spend_reporting_faq.pdf

ATTACHMENT B: EXCEPTIONS TO STATE’S TERMS AND CONDITIONS

The State presumes a responder agrees to the terms and conditions of this solicitation unless a responder takes specific exception to one or more of the conditions on this form.

The State reserves the right to reject, negotiate, or accept any exception listed to the State’s terms and conditions (including those found in the attached Sample Contract).

INSTRUCTIONS: A responder must explicitly list all exceptions to State’s terms and conditions, if any (including those found in the attached Sample Contract). Reference the clause number and page number of the State's term and condition for each of a responder’s exceptions. If no exceptions exist, state "NONE" specifically on the form below.

Whether or not exceptions are taken, the Responder must sign and date this form and submit it as part of their response. (Add additional pages if necessary.)

Clause and Page Number Suggested Change to Clause Explanation or Justification

By signing this form, I acknowledge that the above-named responder accepts, without qualification, all terms and conditions stated in this solicitation (including the sample contract) except those clearly outlined as exceptions above.

This acknowledgement includes acceptance of the section of the Sample Contract, Exhibit A, titled “Contractor’s Documents.”

Signature:

Printed Name:

Title:

Date:

ATTACHMENT C: COST DETAIL

1. Cost Proposal. Responders should review Exhibit D: Price Schedule included in the Sample Contract and Exhibits for all pricing terms associated with this solicitation.

Responders must download, complete, and upload the Exhibit D: Price Schedule with their response. If pricing is not returned with your solicitation response, your response will be rejected. Failure to use Exhibit D: Price Schedule may be cause for rejection. Responders must provide a price for all line items available on the Exhibit D: Price Schedule to be considered for an award.

2. Additional Services. Responders may propose optional value-added services. These may include, but are not limited to, graphic design, copywriting, display advertising campaigns, research projects, media planning, or similar services.

The cost of any value-added services offered must be listed separately under Additional Services section of the Exhibit D: Price Schedule. For additional lines, the <enter service> rows may be used or added to provide the full extent of additional service capabilities. Pricing for value-added services will not be scored during the evaluation process but may be used in contract negotiations.

3. Cost-Plus Pricing Structure. The pricing structure of the Exhibit D: Price Schedule uses a Cost-Plus format, which is defined as the actual cost the Responder pays the supplier for goods or services the Customer orders, minus any applicable taxes. Only costs specifically detailed in the billing statement, quote, or invoice from the supplier will be subject to the cost-plus percentage detailed on Contract. If a quote is issued, the invoice price cannot exceed the quoted price.

The product purchase price from the supplier must be verifiable with a quote, billing statement, or invoice upon request from the Customer.

The cost-plus pricing must be computed in the same manner as shown in the example below:

Product Vendor Cost from Supplier

Cost Plus % Offered Computation State

Contract Price Placement Services $300.00 3.5% $300.00 x 1.035 = $310.50 $310.50

4. Alterations or Erasures. The State reserves the right to reject a response containing an alteration or erasure of any price used to determine the lowest responsible responder unless the alteration or erasure is done in a manner that is clear and authenticated by an authorized representative of the Responder. An acceptable way to make an alteration or erasure is to cross out the price, print the correction in ink adjacent to it, and have an authorized representative of the Responder initial and date that correction.

ATTACHMENT D: Workforce and Equal Pay Declaration Page

This form is required for all businesses executing government contracts under the following:

Select one:

☐ Businesses executing a contract with State or Metropolitan agencies in excess of $100,000 (Workforce Certificate) and if applicable $500,000 (Equal Pay Certificate)

☐ Businesses executing a contract with University of Minnesota for general obligation bond funded capital projects in excess of $100,000 (Workforce Certificate) and if applicable $500,000 (Equal Pay Certificate)

☐ Businesses executing a contract with Political Subdivisions for general obligation bond funded capital projects in excess of $250,000 (Workforce Certificate) and if applicable $1,000,000 (Equal Pay Certificate)

Select all that apply:

We are a Certificate holder:

☐ Workforce Certificate under the name: _________________________________________________________ ☐ Equal Pay Certificate under the name: __________________________________________________________

We are applying/have applied for the following certificate(s):

☐ Workforce Certificate Application date (MM/DD/YYYY): ____________________ ☐ Equal Pay Certificate Application date (MM/DD/YYYY): ____________________

We have not applied for one or both certificates:

☐ Our Company does not yet have a Workforce Certificate or Equal Pay Certificate. We acknowledge that a

Workforce and, if applicable, Equal Pay Certificate, or approved exemption by MDHR is required before a contract can be executed.

We are Exempt:

☐ We attest to MDHR that we have not employed 40 or more employees on a single day during the prior 12 months in Minnesota or the state in where we have our primary place of business. MDHR may request the names of our employees during the previous 12 months, the date of separation, if applicable, and the current employment status and count.

Business Information

Vendor/Supplier ID Business Name Name of Contracting Agency

Authorized Signatory Name Title Date

Signature Email Phone

For assistance with this form, email the Minnesota Department of Human Rights Compliance.MDHR@state.mn.us https://mn.gov/mdhr/certificates/workforce-certificate/ https://mn.gov/mdhr/certificates/equalpay/ https://mn.gov/mdhr/certificates/workforce-certificate/ https://mn.gov/mdhr/certificates/equalpay/ https://mn.gov/mdhr/certificates/workforce-certificate/ https://mn.gov/mdhr/certificates/equalpay/

ATTACHMENT E: ADDITIONAL INFORMATION

1. Contractor’s Contact Information. Provide the contact information for the representative responsible for the management of the contract and the representative receiving purchase orders.

Vendor’s Legal Name

Address

Contact Person (Contract)

Email Address

Telephone Number

Contact Person (PO Order)

Email Address

Telephone Number

2. Prompt Pay Discount. What prompt pay discounts do you offer? Select all that apply, if “other,” specify terms in the comment section below:

□ 1% in 30

□ 2% in 30

□ 3% in 30

□ 1% in 10, Net 30

□ 2% in 10, Net 30

□ 3% in 10, Net 30

□ 5% in 10, Net 30

□ Other

□ 1% in 15, Net 30

□ 2% in 15, Net 30

□ 3% in 15, Net 30

□ 1% in 20, Net 30

□ 2% in 20, Net 30

□ 3% in 20, Net 30

□ Net 30

Comments:

3. Service Performance. Responder must enter a service time frame after receipt of order (ARO) in the space below.

_______________Calendar/Business Days

4. Warranty. Responder acknowledges and warrants that all services provided under the Contract will be free from defects in performance for a period of one (1) year following delivery.

☐ Yes ☐ No

Rev. 9.01.2021

5. Experience. Responder confirms their company has a minimum of three (3) years’ experience in advertisement placement within diverse community press and other media.

6. Defective, Erroneous, or Non-conforming Advertisements. Responder acknowledges that if, within sixty (60) calendar days of a posting, the ordering entity determines that an advertisement is defective, erroneous, or non-conforming to the specifications, order, or contract, the ordering entity may elect one of the following remedies:

6.1 Replacement – Contractor shall remove the defective advertisement and repost a corrected advertisement at no additional cost, ensuring the corrected advertisement remains posted for the full original duration; or

6.2 Credit – Contractor shall remove the defective advertisement and issue credit equal to the total amount billed for the defective advertisement within fourteen (14) calendar days of notification?

7. Objectives. Responder must provide a statement of the objectives, goals, and tasks that illustrate or demonstrate the Responder’s view and understanding of the nature of the contract.

8. Deliverables. Responder must provide:

Deliverables Description Responder must provide a description of all deliverables to be supplied under this contract:

Work Plan Responders must submit a Detailed Work Plan, as defined in Section 4.2.1 of Exhibit C: Specifications, Duties, and Scope of Work, outlining major tasks to be completed. The Work Plan must function as both a scheduling and project management tool and must clearly identify the basis for invoicing.

To demonstrate their approach, Responders must provide a sample Work Plan using the OEP Opportunity Fair scenario. The sample must illustrate how the Responder organizes tasks, identifies required services, assigns estimated hours, and sequences work in accordance with the requirements of Section 4.2.1.

The sample Work Plan MUST NOT include any cost information. If cost details are included, the State reserves the right to reject the response.

Did you attach your sample Work Plan with your response?

☐Yes ☐ No

Rev. 9.01.2021

Reporting Responders must provide examples of reporting that demonstrate the Responders capability of meeting the 4.6 Reporting Requirements under Exhibit C: Specifications, Duties and Scope of Work of the Sample Contract and Exhibits.

9. Background. Responder must provide an overview of their background and relevant experience, including examples of similar work previously completed. The response must include a list of personnel who will be assigned to the project, along with a description of their training and work experience.

Resumes or other personnel information should, whenever possible, exclude personal telephone numbers, home addresses, and personal email addresses. If the inclusion of personal contact information is unavoidable, the response must clearly indicate such information is being provided.

10. Community Outreach and Readership Reach. Responder must describe their ability to reach a broad readership within Minnesota’s local minority communities and other diverse populations. The response must include specific information such as audience size, publications or platforms used, and relevant demographic data. In addition, Responders must explain methods used to evaluate effectiveness and viewership of placed advertisements, including any available circulation, impression, click-through, engagement, or audience verification data.

11. Digital Accessibility Component. Responders are to confirm the services offered in response to this solicitation are in compliance with the IT Accessibility Standards (applicable 508, Web content Accessibility Guidelines and Non- Visual Access) as specified in the solicitation document?