Att J - Attestation Form - READY.docx
DOCX document 39 KB Posted
- Solicitation number
- 25-83926
- Issued by
- Indiana
About this file
This document is an Attestation Form (Attachment J) for a state and local contract opportunity, likely in Indiana, involving the Indiana Department of Administration (IDOA). The form requires respondents to confirm their comprehensive understanding and submission of various mandatory requirements including pricing, contract terms, executive summary, and specific attachments such as Minority and Women Business Enterprise forms, Indiana Veteran Owned Small Business forms, and Indiana Economic Impact documentation.
The attestation form indicates potential set-asides for minority-owned, women-owned, and veteran-owned businesses, with opportunities to claim points under the Buy Indiana Initiative for Indiana-based companies. Respondents must submit detailed proposals including cost, business, and technical proposals, and may need to provide confidential or redacted documents with specific statutory exemption rationales. The form also allows for listing additional subcontractors and requires executed contracts or letters of agreement for any supplemental business partners involved in the project.
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Other files
| File | Type | Posted |
|---|---|---|
| Clarification 1.pdf | ||
| RFP Boilerplate_06.11.25 - 2.pdf | ||
| Att D Cost Proposal - corrected.xlsx | XLSX spreadsheet | |
| Att G - Q&A - posted 7.23.25.xlsx | XLSX spreadsheet | |
| Att A - MWBE - ready.docx | DOCX document | |
| Att A1 - IVOSB - ready.docx | DOCX document | |
| Att E - Business Proposal-ready.docx | DOCX document | |
| Att F - Technical Proposal - ready.docx | DOCX document | |
| Att G - Q&A - ready.xlsx | XLSX spreadsheet | |
| Att K - Scope of Work.pdf | ||
| Att B - Professional Services Contract Template.docx | DOCX document | |
| Att C - IEI Form.xls | XLS spreadsheet | |
| Att D - Cost Proposal -ready.xlsx | XLSX spreadsheet | |
| Att I - Pre-proposal Network Form - READY.docx | DOCX document | |
| RFP Boilerplate_06.11.25 - ready to post.pdf | ||
| Att H - Reference Check Form - need date.docx | DOCX document |
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Text version
ATTESTATION FORM
ATTACHMENT J
Respondent Name:
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 2.3.6 Mandatory Contract Terms/Clauses |
| ☐ Have read and understand this section |
| Section 3.2 Executive Summary |
| ☐ Have completed, signed, and submitted |
Section 3.2 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
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
☐ 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. |
or ☐ Confirm Respondent’s Legal Representation has read, and submitted alternative language per Attachment E.
2.6.4. 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
| 2.6.3 Buy Indiana Initiative/Indiana Company |
| ☐ YES claiming (points only awarded if finalized per Buy Indiana registry) |
☐ 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 2.6.4 (additional subcontractors/those not submitted in Attachment A/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 |
Pg 2
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