AAC-RFQ-24-008_Submittal Forms.docx

SUBMITTAL FORM A – Offeror Information Revised February 2024

PROJECT INFORMATION

RFP NUMBER:

PROJECT NAME:

OFFEROR INFORMATION

Company Name:

Address:

Tax ID:

Alaska Business License #:

CONTACT INFORMATION

Provide contact information for the individual that can be contacted for clarification regarding this proposal:

Name

Title

Address

Email

Telephone

Procurement Officer Note: REVISE OR DELETE AS REQUIRED.

CRITICAL TEAM MEMBERS

Provide the names of all critical team members that will be assigned to this contract. Note: These individuals cannot be removed or replaced from this project, or their positions, unless approved in writing the project director or procurement officer.

Name of Position 1

Name of Position 2

Name of Position 3

Name of Position 4

ADDENDA ACKNOWLEDGEMENT

The offeror acknowledges receipt of the following amendments and has incorporated the requirements of such amendments into their proposal. Failure to identify and sign for all amendments may subject the offeror to disqualification. The offeror must list all amendments (by number), then initial and date to confirm that you have received and incorporated them into your proposal (add more rows as necessary).

CERTIFICATIONS

* Failure to answer or answering “False” may be grounds for disqualification. For any “False” responses, provide clarification (up to 250 word maximum for each “False” clarification) below (add rows as necessary).

CONFLICT OF INTEREST STATEMENT

Indicate below whether or not the firm or any individuals that will work on the contract has a possible conflict of interest (e.g., currently employed by the State of Alaska or formerly employed by the State of Alaska within the past two years) and, if so, the nature of that conflict. The procurement officer reserves the right to consider a proposal non-responsive and reject it or cancel the award if any interest disclosed from any source could either give the appearance of a conflict or cause speculation as to the objectivity services to be provided by the offeror.

* Failure to answer may be grounds for disqualification.

If “Yes”, please provide additional information regarding the nature of that conflict:

FEDERAL REQUIREMENTS

Indicate below all known federal requirements that apply to the proposal, proposal evaluation, or contract:

SUBMITTAL FORM B – Experience and Qualifications SPECIAL REQUIREMENTS: This Submittal Form must not identify the offeror’s proposed costs and must not exceed five pages (reference RFP section 4.02).

SUBMITTAL FORM E – Management Plan for the Project SPECIAL REQUIREMENTS: This Submittal Form must not identify the offeror’s proposed costs and must not exceed five pages (reference RFP section 4.02).

SUBMITTAL FORM G – Subcontractors

Please complete the below form if using subcontractors. During contract negotiation, the state may require a signed written statement from each subcontractor that clearly verifies the subcontractor is committed to performing the services required by the contract. Prior to contract award, the state will also require evidence that a subcontractor possesses a valid Alaska business license if they will be performing work within Alaska.