Att J - Attestation Form.docx
DOCX document 45 KB Posted
- Attached to
- DDB Speech and Language ConsultationBid Documents State and local contract opportunity
- Solicitation number
- RFP 26-87266
- Issued by
- Marion County, Indiana
About this file
This is an Attestation Form (Attachment J) for a state and local contract opportunity issued by the State of Indiana, specifically through the Indiana Department of Administration (IDOA). The form serves as a mandatory submission checklist that respondents must complete to confirm compliance with all solicitation requirements. Respondents must designate an Internal Response Manager who will serve as the dedicated contact for State correspondence and must attest to completing and submitting all required attachments and sections, including pricing proposals, executive summaries, business and technical proposals, cost proposals in Excel format, and confidentiality agreements. The form also requires respondents to confirm that their legal representation has reviewed and accepted the sample contract language or submitted alternative contract terms as specified in Attachment E.
The attestation process includes additional compliance requirements such as confirming eligibility under the Buy Indiana Initiative if claiming preference points, identifying all subcontractors and their functions with executed contracts or letters of agreement, and providing detailed documentation for any confidential or redacted materials claimed under the Indiana Public Records Act (APRA). Respondents must list statutory exemptions, specify which APRA exceptions apply, provide rationale for each exemption, and submit appropriately marked confidential or redacted versions of documents. The form allows for optional submission of additional attachments and includes sections for respondents to indicate whether they are claiming Indiana Veteran Owned Small Business status or Indiana Economic Impact designation, though certification must be finalized in the Buy Indiana registry by the sourcing event submission date to receive awarded points.
View the file
Other files for this state and local contract opportunity
Show all 26
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTESTATION FORM
ATTACHMENT J
Respondent Name:
Respondent’s Internal Response Manager’s Name:
This person will be the dedicated contact to receive State correspondence specific to this solicitation.
Respondent’s Internal Response Manager’s Email Address:
1.0 Mandatory Submissions and Requirements: Disagreement with these items may result in the response being disqualified.
| Attachment J: Attestation Form |
| ☐ Have completed in its entirety and submitted |
| Section 1.10 Pricing |
| ☐ Have read and meet this requirement |
| Section 3.2 Executive Summary |
| ☐ Have completed, signed, and submitted |
Section 3.2 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
| Section 3.2 Attachment C: Indiana Economic Impact |
| ☐ Have read, completed, and submitted |
| Section 3.2 Attachment D: Cost Proposal (Excel Workbook) |
| ☐ Have completed and submitted |
| Section 3.2 Attachment E: Business Proposal |
| ☐ Have completed and submitted |
| Section 3.2 Attachment F: Technical Proposal |
| ☐ Have completed and submitted |
2.0 Confirm mutual understanding and submission.
1.15 and 2.1 Confidential Information:
The complete list of Confidential and Redacted files is specified in section 4.0 of this attachment.
☐ Have read, and submitted
☐ Have read, and does not apply to response
| 2.2.1 Ability and Desire to Supply the Required Products or Services |
| ☐ Have read, and agree |
| 2.3.6 Contract Terms/Clauses |
| ☐ Confirm Respondent’s Legal Representation has read and accepts Sample Contract language. |
☐ Confirm Respondent’s Legal Representation has read, and submitted alternative language per Attachment E.
3.0 Claim clarification
| 2.6.2 Buy Indiana Initiative/Indiana Company |
| ☐ YES claiming (points only awarded if certification is finalized per Buy Indiana registry* at time of Sourcing Event Submission Date) |
*Validated by Respondent within Buy IN Designation List at https://www.in.gov/idoa/procurement/supplier-resource-center/programs-and-preferences/buy-indiana/
☐ NO, not claiming
4.0 Confidential / Redacted File: confirm submission if applicable More rows may be inserted if necessary
Responses must include the following required information:
· List all documents or sections of documents, for which statutory exemption to APRA;
· Specify which statutory exception of APRA applies for each document or section of the document;
· Provide a description explaining how the statutory exception to the APRA applies for each document or section of the document; and
· Provide a separate redacted or confidential, whichever is applicable, version of the document. File name should use the following format:
· (insert rfp #) _ (insert Att letter) _CONFIDENTIAL
· (insert rfp #) _ (insert Att letter) _REDACTED
· More rows may be inserted if necessary
| Filename |
| Document Section |
| Document |
Page #
| Statutory exception reference |
| Rationale for application of the statute |
| Submitted |
5.0 Subcontractors per RFP 2.6.3 (additional subcontractors/those not submitted in Attachment A1
| 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
6.0 Respondent additional attachments (OPTIONAL)
| Filename |
| RFP Attachment Reference |
2 v.07112024
File details come from the government source that posted it. Updated .