Att B Proposal Form~2.docx

ATTACHMENT B

PROPOSAL FORM

Proposer shall complete and submit one copy of this Attachment B, bearing the Proposer’s authorized representative’s Signature. Proposer must respond to all of the sections in this attachment unless the section is marked as optional. Failure to respond to any required section below may result in the rejection of the Proposal.

1. Proposer Overview Legal Name of Proposer: _______________________________________________ Name of Proposer (if different): __________________________________________ Address: _____________________________________________________________ City, State and Zip Code: ________________________________________________ Entity Type: ____________________________________________ State of Incorporation (if applicable) and Date: ____________________________ Authorized Representative: _____________________________________________ Phone: __________________________ Email: ___________________________ Federal Tax Identification No.: ____________________ Oregon Business Registry Number: _____________________

Person who SPS would work with on finalizing the Contract, if awarded.

Name: _______________________________________________ Email: __________________________________________

1. Minimum Requirements Does Proposer have recent (within the past ten years) experience in conducting methodology reviews on transportation analyses for a county, state, or federal entity, with a focus on methodology development, review, or validation processes?

Yes ☐ No ☐

Does Proposer have at least one (1) Key Person who has a minimum of five (5) years’ experience within the last ten (10) years providing methodological analyses related to the transportation sector? Yes ☐ No ☐

Does Proposer have at least one (1) Key Person who is able to provide context, explain data, describe findings, and answer questions in technical and non-technical terms? Yes ☐ No ☐

1. Proposer’s Experience Proposer shall submit a list of projects it has worked on within the last 10 years that are similar to the Scope of Services/Specifications detailed in this RFP. For each project, Proposer should include a description of the project, when it was started and completed, and, for up to three (3) of the projects, the contact information of the client/recipient of the final work product.

1. Proposer’s Team Proposer should provide a summary of all team members and their roles, including any subcontractors. Proposer should demonstrate that the proposed team members and subcontractors (if any) have the expertise, past performance, and qualifications to handle all aspects of the work successfully. Proposer should note who their Key Persons are and confirm they have sufficient experience to meet the minimum requirements of the RFP.

Key Person Resumes: Proposer must provide resumes for each person proposed to fulfill a Key Person role. (Please Note: A Key Person may fill more than one Key Person role if they meet the requirements.) Limit each resume to no more than two pages. Resumes are to be attached as separate documents.

1. Project Plan Provide a comprehensive project plan that the Proposer intends to follow, that specifies in detail how Proposer would carry out the major activities of this project described under Section 2.5 ‘Specifications of Work’. The plan should illustrate how the Proposer will coordinate and accomplish the work, and the timeline Proposer expects to follow to complete the work. The plan should illustrate the Proposer’s understanding of the project by establishing a clear grasp of the requested tasks and deliverables. Proposer should describe any proven systematic approach to getting this type of work done and should touch on the data and methods used in projects of similar scope and complexity as detailed in this RFP. The Proposer may also highlight any suggestions they have for the tasks and deliverables that could provide higher efficiency or more robust deliverables. Project Plan is to be attached as a separate document.

1. (Optional):

Proposer-Suggested Tasks or Deliverables Proposer may suggest any value-added tasks or deliverables and describe the approach and quality standards for each.

Additional Information Proposer may use this section to provide any additional information that is pertinent but not specifically requested anywhere else in this RFP.

1. Responsibility Inquiry Does Proposer have available the appropriate financial, material, equipment, facility, and personnel resources and expertise, or ability to obtain the resources and expertise necessary to demonstrate the capability of Proposer to meet all contractual responsibilities? Yes ☐ No ☐ Within the last five years, how many contracts of a similar nature has Proposer completed that, to the extent that the costs associated with and time available to perform the contract remained within Proposer′s control, Proposer stayed within the time and budget allotted, and there were no contract claims by any party?

Number: ____ If any did not stay within time and budget, or there were any contract claims, please explain.

Within the last three years has Proposer (incl. a partner or shareholder owning 10% or more of Proposer’s firm) or a major subcontractor (receiving 10% or more of a total contract amount) been criminally or civilly charged, indicted, or convicted in connection with:

· obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract,

· violation of federal or state antitrust statutes relating to the submission of bids or Proposals, or

· embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property? Yes ☐ No ☐

If "YES," indicate the jurisdiction, date of indictment, charge or judgment, and names and summary of charges below.

Within the last three years, has Proposer had:

· any contracts terminated for default by any government agency, or

· any lawsuits filed against it by creditors or involving contract disputes?

Yes ☐ No ☐

If "YES," please explain. (With regard to judgments, include jurisdiction and date of final judgment or dismissal.)

Does Proposer have any outstanding or pending judgments against it? Yes ☐ No ☐

Is Proposer experiencing financial distress or having difficulty securing financing?

Yes ☐ No ☐

Does Proposer have sufficient cash flow to fund day-to-day operations throughout the proposed contract period? Yes ☐ No ☐

If "YES” on the first question or second question, or “NO” on the third question, please provide additional details.

Within the last three years, has Proposer filed a bankruptcy action, filed for reorganization, made a general assignment of assets for the benefit of creditors, or had an action for insolvency instituted against it? Yes ☐ No ☐

If "YES," indicate the filing dates, jurisdictions, type of action, ultimate resolution, and dates of judgment or dismissal, if applicable.

Does Proposer have all required licenses, insurance and/or registrations, if any, and is Proposer legally authorized to do business in the State of Oregon? Yes ☐ No ☐ Pay Equity Certificate. This certificate is required if Proposer employs 50 or more full-time workers and the prospective contract price is estimated to exceed $500,000. [This requirement does not apply to architectural, engineering, photogrammetric mapping, transportation planning or land surveying and related services contracts.] Does a current authorized representative of Proposer possess an unexpired Pay Equity Certificate issued by the Department of Administrative Services? Yes ☐ No ☐ N/A ☐.

1. PROPOSER CERTIFICATIONS

Any individual signing on behalf of Proposer below hereby certifies they are an authorized representative of Proposer and that:

Proposer understands and accepts the requirements of this RFP. By submitting a Proposal, Proposer agrees to be bound by the Contract terms and conditions in Attachment A and as modified by any Amendment, except for those terms and conditions that Agency has reserved for negotiation, as identified in the RFP.

Proposer acknowledges receipt of any and all Amendments to this RFP.

Proposal is a Firm Offer for 180 days following the due date for Proposals.

If awarded a Contract, Proposer agrees to perform the services and meet the performance standards set forth in the final negotiated Contract.

I have knowledge regarding Proposer’s payment of taxes and by signing below, I hereby certify that, to the best of my knowledge, Proposer is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation, any state taxes administered by the Oregon Department of Revenue under the tax laws of this state and local taxes administered by DOR under ORS 305.620.

Proposer has no undisclosed liquidated and delinquent debt owed to the State of Oregon or any of its agencies, boards, commissions, departments, or divisions.

Proposer does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Proposer does not discriminate against any business certified under ORS 200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns or an emerging small business. If applicable, Proposer has, or will have prior to contract execution, a written policy and practice, that meets the requirements described in ORS 279A.112, of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class. The State may not enter into a contract with an anticipated contract price of $150,000 or more with a Proposer that does not certify it has such a policy and practice. See https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx for additional information and sample policy template.

Proposer complies with ORS 652.220 and does not unlawfully discriminate against any of Proposer’s employees in the payment of wages or other compensation for work of comparable character on the basis of an employee’s membership in a protected class. “Protected class” means a group of persons distinguished by race, color, religion, sex, sexual orientation, national origin, marital status, veteran status, disability or age.

Proposer and Proposer’s employees, agents, and subcontractors are not included on:

· the “Specially Designated Nationals and Blocked Persons” list maintained by the Office of Foreign Assets Control of the United States Department of the Treasury found at: https://www.treasury.gov/ofac/downloads/sdnlist.pdf, or

· the government wide exclusions list in the System for Award Management found at: https://sam.gov/exclusions-new.

Proposer certifies that, to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Proposer, its employees, or its agents, on the one hand, and the business or economic interests of the State, on the other hand, arising out of, or relating in any way to, the subject matter of the RFP. If any changes occur with respect to Proposer’s status regarding conflict of interest, Proposer shall promptly notify the State in writing.

Proposer certifies that all contents of the Proposal (including any other forms or documentation, if required under this RFP) and this Proposal Certification Sheet are truthful and accurate and have been prepared independently from all other Proposers, and without collusion, fraud, or other dishonesty.

Proposer understands that any statement or representation it makes, in response to this RFP, if determined to be false or fraudulent, a misrepresentation, or inaccurate because of the omission of material information could result in a "claim" {as defined by the Oregon False Claims Act, ORS 180.750(1)}, made under the Agreement to Agree being a "false claim" {ORS 180.750(2)} subject to the Oregon False Claims Act, ORS 180.750 to 180.785, and to any liabilities or penalties associated with the making of a false claim under that Act.

Proposer acknowledges these certifications are in addition to any certifications required in the Contract at the time of Contract execution.

Authorized Signature

By signature below, the undersigned Authorized Representative on behalf of Proposer certifies to the best of his or her knowledge and belief that the responses provided on this form are complete, accurate, and not misleading.

Authorized Signature

Date

(Printed Name and Title)