Att F Attestation Form.docx
DOCX document 50 KB Posted
- Attached to
- Custom build semi-trailerBid Documents State and local contract opportunity
- Solicitation number
- 26-87614
- Issued by
- Marion County, Indiana
About this file
This is an Attestation Form for a Negotiated Bid managed by the Indiana Department of Agriculture (IDOA). The form serves as a mandatory submission document for respondents to confirm their understanding of and compliance with all requirements specified in the procurement opportunity. Respondents must attest to having read, understood, and completed various mandatory submissions including the pricing section, executive summary, bid cost workbook, mandatory purchase order terms and conditions, and all required attachments. The form also requires confirmation of completion for optional attachments related to Indiana Economic Impact considerations and Indiana Preferences, as well as certification status regarding Minority and Women Business Enterprise (MWBE) and Indiana Veteran Owned Small Business (IVOSB) designations.
The attestation process includes provisions for respondents to list any additional subcontractors beyond those previously submitted in the MWBE or IVOSB attachments, along with documentation of executed contracts or letters of agreement for each subcontractor. Respondents must indicate whether they are claiming IVOSB certification status and, if applicable, confirm submission of supporting IDOA-provided certification letters and signed subcontractor documentation on company letterhead. The form allows for optional additional attachments at the discretion of IDOA. Disagreement with mandatory requirements or failure to properly complete and submit this attestation may result in disqualification of the response from consideration.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Addendum #2.pdf | ||
| Addendum #1.pdf | ||
| Att D - Cost Proposal Orginal document .xlsx | XLSX spreadsheet | |
| Att D - Cost Proposal with target rate.xlsx | XLSX spreadsheet | |
| Purchase Order Main document with fixed sections.pdf | ||
| Att H Affidavit of Eligibility.docx | DOCX document | |
| Negotiated Bid Main Document 26-87614.pdf | ||
| Att D - Cost Proposal 26-87614.xlsx | XLSX spreadsheet | |
| Att G_Preferences.docx | DOCX document | |
| Att B - PO Terms.docx | DOCX document | |
| Att A - MWBE.docx | DOCX document | |
| Att A1 - IVOSB.docx | DOCX document | |
| Addendum 26-87614.docx | DOCX document | |
| Att I - Requirements.docx | DOCX document | |
| Att E - QandA.xlsx | XLSX spreadsheet | |
| Att C - Indiana Economic Impact Form.xls | XLS spreadsheet |
Show all 16
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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
5.0 Respondent additional attachments (OPTIONAL) Comment by IDOA Procurement: This can be removed in its entirety if IDOA considers it appropriate to do so.
More rows may be inserted if necessary
| Filename |
| Attachment Reference |
File details come from the government source that posted it. Updated .