Appendix D - Award Preference.docx

DOCX document 27 KB Posted

Attached to
Structured Settlement Services
Solicitation number
RFP-11641
Issued by
Leon County, Florida

About this file

This is an Award Preferences Form (Form 2425-01 RFP RM Appendix D) from the Florida Department of Financial Services that would be used only in the event of a tie between respondents who receive identical highest scores.

The form provides five preference options for respondents to select: certified minority business enterprise status under Florida Statute 288.703, certified veteran business enterprise status under Florida Statute 295.187, implementation of a drug-free workplace program under Florida Statute 287.087, status as a foreign manufacturing company with a Florida factory employing over 200 Florida employees, or no eligibility for any preferences. The form requires respondents to declare their net worth and includes spaces for the respondent's name, signature, printed name, and date. The Department reserves the right to terminate any contract and seek re-procurement costs if false information is discovered after an award is made.

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Other files

File Type Posted
Att 6 - Mandatory Criteria Cert.docx DOCX document
2425-01 RFP RM - Addendum 1.pdf PDF
Appendix B - Questions Template.xlsx XLSX spreadsheet
Appendix D - Award Preference.docx DOCX document
Appendix B - Questions Template.xlsx XLSX spreadsheet
Att 6 - Mandatory Criteria Cert.docx DOCX document
2425-01 RFP RM - Complete RFP.pdf PDF
Appendix E - Contract Disputes.docx DOCX document
2425-01 RFP RM - Complete RFP.pdf PDF
Appendix E - Contract Disputes.docx DOCX document

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Text version

DEPARTMENT OF FINANCIAL SERVICES

Award Preferences Form

2425-01 RFP RM

APPENDIX D

The Respondent’s responses on this form will only be used in the event one or more Respondents receive an identical highest score. If the Department discovers that any information on this form is false after the award to the Respondent is made, the Department reserves the right to terminate the Contract and hold the Respondent liable for costs associated with re-procurement.

1. Choose the responses that apply by checking the applicable box(es) below:

|_|Respondent is a certified minority business enterprise as defined in section 288.703, Florida Statutes, (F.S.).
|_|Respondent is a certified veteran business enterprise as provided in section 295.187, F.S.
|_|Respondent has implemented a drug-free workplace program in accordance with section 287.087, F.S.
|_|Respondent is a foreign manufacturing company with a factory in Florida and employing over 200 employees working in Florida.
|_|Respondent is not eligible for any of the above preferences.

2. Complete the following statement:

Respondent has a net worth of .

As the person authorized to sign this form, I certify that the information provided above is accurate as to the Respondent.

Name of Respondent:

Signature: _________________________________________________________________

Printed Name: _________________________________________________________________

Date: _________________________________________________________________

Appendix D Rev. 9/28/22

File details come from the government source that posted it. Updated .