Att E - Attestation Form.docx
DOCX document 43 KB Posted
- Attached to
- DNR Fish FeedBid Documents State and local contract opportunity
- Solicitation number
- NB 26-88274
- Issued by
- Elkhart County, Indiana
About this file
This is an Attestation Form for a Negotiated Bid contract with the State of Indiana. The form serves as a checklist requiring respondents to confirm they have read, understood, and submitted all mandatory documents and requirements specified in the RFP. Mandatory submissions include the Executive Summary (Section 2.2), Attachment C (Indiana Economic Impact), Attachment D (Bid Cost Excel Workbook), the Attestation Form itself (Attachment F), and compliance with all pricing requirements and mandatory contract terms outlined in Section 1.9 and Section 2.2.6. Respondents must also address confidential information requirements per Section 4.0, confirm their ability and desire to supply required products or services, and acknowledge that their legal representation has reviewed and either accepts the sample contract language or has submitted alternative language per Section 6.0.
The form includes optional submissions such as the Indiana Preferences Form (Attachment G) and the Indiana Veteran Owned Small Business certification (Attachment A1), which respondents may claim if applicable by providing IDOA certification letters and subcontractor documentation. Respondents must list any additional subcontractors not previously submitted in Attachment A1 and provide either executed contracts or letters of agreement. The form requires detailed documentation of any confidential or redacted materials, including the statutory exemptions under APRA (Access to Public Records Act), specific reference to applicable statutes, rationale for redaction, and submission of separate confidential and redacted versions using specified file naming conventions. The attestation form allows for additional rows and optional attachments to accommodate project-specific requirements.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Att C Cost Proposal.xlsx | XLSX spreadsheet | |
| Att D- Q&A Template.xlsx | XLSX spreadsheet | |
| Att A1 - IVOSB.docx | DOCX document | |
| Att G - Affidavit of Eligibility.docx | DOCX document | |
| Att F - Preferences.docx | DOCX document | |
| Att B - Sample Contract.docx | DOCX document | |
| Att H Fish Feed Specs.docx | DOCX document | |
| Negotiated Bid Main Document 26-88274 (1).pdf |
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Text version
ATTESTATION FORM
Negotiated Bid - Contract
ATTACHMENT E
Respondent Name:
1.0 Mandatory Submissions and Requirements: Disagreement with these items may result in the response being disqualified.
| Section 1.9 Pricing |
| ☐ Have read and meet this requirement |
| Section 2.2.6 Mandatory Contract Terms/Clauses |
| ☐ Have read and understand this section |
| Section 2.2 Executive Summary |
| ☐ Have completed, signed, and submitted |
| Section 3.2 Attachment C: Indiana Economic Impact |
| ☐ Have read, completed, and submitted |
| Section 2.3 Attachment D: Bid Cost (Excel Workbook) |
| ☐ Have completed and submitted |
| Section 2.4 Attachment F: Attestation Form |
| ☐ Have completed in its entirety and submitted |
2.0 Confirm mutual understanding and submission.
1.13 and 2.1 Confidential Information:
The complete list of Confidential and Redacted files is specified in section 4.0 of this attachment.
☐ Have read, and submitted or ☐ Have read, and does not apply to response
1.20 Attachment A1: Indiana Veteran Owned Small Business form IDOA provided certification letter and Subcontractor’s signed letter on company letterhead.
☐ Have completed, signed, and submitted
☐ Opting not to submit
| 2.2.1 Ability and Desire to Supply the Required Products or Services |
| ☐ Have read, and agree |
| 2.2.6 Contract Terms/Clauses |
| ☐ Confirm Respondent’s Legal Representation has read and accepts Sample Contract language. |
or ☐ Confirm Respondent’s Legal Representation has read and submitted alternative language per Section 6.0 of this attachment.
| 2.4.3 Attachment G: Indiana Preferences form |
| ☐ Have completed, and submitted |
☐ Opting not to submit
2.4.4. Subcontractors
(Additional subcontractors/those not submitted in Attachment A1)
☐ Have read, agree, listed subcontractors in 5.0 of this attachment and submitted documents
☐ Have read, and does not apply to response
3.0 Claim clarification
| 1.20 Respondent is IVOSB certified |
| ☐ YES, claiming; Att A1, have completed, signed, and submitted |
☐ NO, not claiming
4.0 Confidential / Redacted File: confirm submission if applicable More rows may be inserted if necessary
Responses must include the following required information:
· List all documents or sections of documents, for which statutory exemption to APRA;
· Specify which statutory exception of APRA applies for each document or section of the document;
· Provide a description explaining how the statutory exception to the APRA applies for each document or section of the document; and
· Provide a separate redacted or confidential, whichever is applicable, version of the document. File name should use the following format:
· (Insert bid #) _ (insert Att letter) _CONFIDENTIAL
· (Insert bid #) _ (insert Att letter) _REDACTED
· More rows may be inserted if necessary
| Filename |
| Document Section |
| Document |
Page #
| Statutory exception reference |
| Rationale for application of the statute |
| Submitted |
5.0 Subcontractors per RFP 2.4.4 (additional subcontractors/those not submitted in Attachment A1)
| Subcontractor Name |
| Function to be performed |
| Document Submitted |
☐ Executed contract
☐ Letter of Agreement
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
☐ Executed contract
6.0 Respondent Alternative Contract Terms/Clauses per Section 2.2.6.
| Attachment B, Section Reference |
| Alternative Proposed Language |
7.0 Respondent additional attachments (OPTIONAL)
| Filename |
| BID Attachment Reference |
File details come from the government source that posted it. Updated .