Att F - Attestation Form (For PO) revised.docx
DOCX document 47 KB Posted
- Attached to
- Gooseneck Flatbed TrailerBid Documents
- Solicitation number
- 26-87820
- Issued by
- Indiana
About this file
Attestation Form Summary
This is an Attestation Form (Attachment F) for a Negotiated Bid procurement by the Indiana Department of Administration for a gooseneck flatbed trailer. The form serves as a checklist requiring respondents to confirm receipt, review, and submission of all mandatory bid documents and requirements. Key mandatory submissions include an Executive Summary (Section 2.2), Attachment C (Indiana Economic Impact Form), Attachment D (Bid Cost Excel Workbook), mandatory PO Terms and Conditions (Section 2.2.6), and pricing requirements (Section 1.9). The form also requires respondents to confirm their ability and desire to supply the required products or services and to attest that they have read and understand all specifications and requirements. Proposals are due July 28, 2026 at 3:00 p.m. Eastern Time, with award recommendation targeted for September 2026.
The attestation form includes optional sections for respondents to claim certification status under Indiana programs, including Minority and Women Business Enterprise (MWBE) certifications and Indiana Veteran Owned Small Business (IVOSB) certifications, with subcontracting goals of 8% for MBE, 11% for WBE, and 3% for IVOSB. Respondents must identify any subcontractors beyond those listed in Attachments A and A1, providing executed contracts or letters of agreement for each. The form permits optional submission of additional attachments and allows respondents to opt out of certain certification submissions if not applicable to their response. Pricing must be firm for 180 days from award issuance, and award will go to the lowest evaluated responsive and responsible bidder.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| NB Addendum template.docx | DOCX document | |
| Att C - Indiana Economic Impact revised.xls | XLS spreadsheet | |
| Negotiated Bid Document v2 (PURCHASE ORDER).pdf | ||
| Att E - Q&A Template revised.xlsx | XLSX spreadsheet | |
| Att B - Sample Purchase Order (For PO).docx | DOCX document | |
| Att A1 - IVOSB.docx | DOCX document | |
| Negotiated Bid Main Document (PURCHASE ORDER).pdf | ||
| Att D - Cost Proposal Template.xlsx | XLSX spreadsheet | |
| Att G - Preferences.docx | DOCX document | |
| Att I Specifications.docx | DOCX document | |
| Att A - MWBE.docx | DOCX document | |
| Att H - Affidavit of Eligibility.docx | DOCX document | |
| Att F - Attestation Form (For PO).docx | DOCX document | |
| Att J - Infrastructure Overview.docx | DOCX document | |
| Att C - Indiana Economic Impact Form.xls | XLS spreadsheet | |
| Att E - Q&A Template.xlsx | XLSX spreadsheet | |
| Att K - Artificial Intelligence -Questions.docx | DOCX document |
Show all 17
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.
1.19 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)
More rows may be inserted if necessary
| Filename |
| Attachment Reference |
File details come from the government source that posted it. Updated .