Att E-Responsibility Inquiry.pdf

40400-00012672 / Public Defense Financial / Case Management System (COTS)(Saas) / Att E 1

ATTACHMENT E: RESPONSIBILITY INQUIRY

Agency will determine responsibility of a Proposer prior to award and execution of a Contract. In addition to this Responsibility Inquiry, Agency may notify Proposer of other documentation required, which may include but is not limited to, recent profit-and-loss history, current balance statements and cash flow information, assets-to-liabilities ratio, including number and amount of secured versus unsecured creditor claims, availability of short and long-term financing, bonding capacity, insurability, credit information, materials and equipment, facility capabilities, personnel information, record of performance under previous contracts, etc. Failure to promptly provide requested information or clearly demonstrate responsibility may result in an Agency finding of non-responsibility and rejection of the applicable Proposal.

1. Does Proposer have available the appropriate financial, material, equipment, facility and personnel resources and expertise, or ability to obtain them, necessary to demonstrate the capability to meet all contractual responsibilities? Yes No

2. 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: ____ How many contracts did not meet those standards? Number: ____ If any, please explain.

Response:

3. 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.

4. 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.

5. Does Proposer have any outstanding or pending judgments against it?

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.

6. 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.

7. 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 If "No," please explain.

8. 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. Does a current authorized representative of Proposer possess an unexpired Pay Equity Certificate issued by the Dept of Administrative Services?

Yes No N/A If the certificate was provided with the proposal submitted for a solicitation related to the prospective contract, it is not necessary to resubmit it. Just indicate “see Proposal” in the response field. If not, if applicable, submit a copy of the certificate with the Proposal.

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 Responsibility Inquiry are complete, accurate, and not misleading.

Proposer Name: RFP: RFP S-40400-00012672 Project Name: Public Defense Financial / Case Management System (COTS)(SaaS)

Signature of Proposer’s Authorized Representative Date

Printed Name Title

ATTACHMENT E: RESPONSIBILITY INQUIRY