Att F - Attestation Form.docx
DOCX document 61 KB Posted
- Attached to
- Negotiated Bid 26-87559 DNR AmmunitionBid Documents State and local contract opportunity
- Solicitation number
- 26-87559
- Issued by
- Johnson County, Indiana
About this file
This is an Attestation Form (Attachment F) for a Negotiated Bid submission to the State of Indiana, specifically administered through the Indiana Department of Administration (IDOA). The form serves as a checklist to confirm that respondents have reviewed, understood, and completed all mandatory submission requirements and supporting documentation necessary for bid consideration. Respondents must attest to their compliance with pricing requirements, mandatory purchase order terms and conditions, and the completion of required sections including the Executive Summary, Indiana Economic Impact form, and Bid Cost spreadsheet. The form also addresses optional submissions such as the Indiana Preferences form and certifications related to Minority and Women Business Enterprise (MWBE) status and Indiana Veteran Owned Small Business (IVOSB) status, allowing respondents to either submit these documents or formally opt out of claiming these designations.
The form requires respondents to confirm their ability and desire to supply the requested products or services and to disclose all subcontractors, whether previously certified through MWBE or IVOSB attachments or newly added for this specific response. For any additional subcontractors beyond those listed in the primary attachments, respondents must provide either executed contracts or letters of agreement detailing the subcontractor's function. The attestation form serves as a mutual understanding confirmation between the respondent and the state, ensuring all parties acknowledge the submission's completeness and compliance with procurement requirements before final bid evaluation.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Att A - MWBE_Neg Bid.docx | DOCX document | |
| Att G - Preferences.docx | DOCX document | |
| Att C - Indiana Economic Impact Form.xls | XLS spreadsheet | |
| Att E - Q&A Template.xlsx | XLSX spreadsheet | |
| Att B - PO Terms.docx | DOCX document | |
| Negotiated Bid Main Document 26-87559.docx.pdf | ||
| Att H - Affidavit of Eligibility.docx | DOCX document | |
| Att D - Cost Proposal Template.xlsx | XLSX spreadsheet | |
| Att A1 - IVOSB_Neg Bid.docx | DOCX document |
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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.
1.19 Attachment A: Minority and Women Business Enterprise form, IDOA provided certification letter and Subcontractor’s signed letter on company letterhead.
☐ Have completed, signed, and submitted or ☐ Opting not to submit
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
| 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 |
2.4.4. Subcontractors
(Additional subcontractors/those not submitted in Attachment A/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 A, have completed, signed, and submitted |
☐ NO, not claiming
4.0 Subcontractors per PO 2.4.4 (additional subcontractors/those not submitted in Attachment A/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
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