Att F - Attestation Form.docx
DOCX document 47 KB Posted
- Attached to
- DNR AmmunitionBid Documents
- Solicitation number
- 27-87904
- Issued by
- Indiana
About this file
This is an Attestation Form for a Negotiated Bid procurement managed by the State of Indiana. The form serves as a checklist for respondents to confirm compliance with mandatory submission requirements and mutual understanding of the procurement terms. Respondents must attest to having read and met pricing requirements, understood mandatory purchase order terms and conditions, completed and submitted the Executive Summary, provided the Indiana Economic Impact form, submitted the Bid Cost Excel workbook, and completed the Attestation Form itself. Additional optional submissions include the Indiana Veteran Owned Small Business certification form, Indiana Preferences form, and documentation for any subcontractors beyond those listed in the initial submission.
The form includes sections for respondents to declare whether they are claiming Indiana Veteran Owned Small Business (IVOSB) certification status and to list any additional subcontractors with their assigned functions and supporting documentation, which may include executed contracts or letters of agreement. Respondents may also attach optional supporting documentation as needed. The attestation process ensures that all bidders acknowledge they have reviewed and comply with the specified mandatory requirements, with disagreement or failure to meet these items potentially resulting in disqualification of the response.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Att G - Purchasing Preference Form.docx | DOCX document | |
| Att D - Cost Proposal Template.xlsx | XLSX spreadsheet | |
| Att I - Requirements.docx | DOCX document | |
| Att B - Sample Purchase Order T&C.docx | DOCX document | |
| Att A1 - IVOSB.docx | DOCX document | |
| Att E - Q&A Template.xlsx | XLSX spreadsheet | |
| Att H - Affidavit of Eligibility.docx | DOCX document | |
| Negotiated Bid Main Document (PURCHASE ORDER).docx | DOCX document | |
| Att C - Indiana Economic Impact Form.xlsx | XLSX spreadsheet |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTESTATION FORM
Negotiated Bid - PO
ATTACHMENT F
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 PO Terms and Conditions |
| ☐ Have read and understand this section |
| Section 2.2 Executive Summary |
| ☐ Have completed, signed, and submitted |
| Section 2.4.1 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.
1.20 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 or ☐ Opting not to submit
| 2.2.1 Ability and Desire to Supply the Required Products or Services |
| ☐ Have read, and agree |
| 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 Subcontractors per PO 2.4.4 (additional subcontractors/those not submitted in Attachment A1) More rows may be inserted if necessary
| 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
5.0 Respondent additional attachments (OPTIONAL)
More rows may be inserted if necessary
| Filename |
| Attachment Reference |
File details come from the government source that posted it. Updated .