Attach B Certs & Assurances.docx

ATTACHMENT B

BIDDER CERTIFICATIONS AND ASSURANCES

Bidder must sign and include the full text of this Attachment B with the Response.

I/we make the following certifications and assurances as a required element of the bid to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract(s):

1. I/we declare that all answers and statements made in the bid are true and correct.

2. The attached bid is a firm offer for a period of 90 days following receipt, and it may be accepted by the DCYF without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 90-day period.

3. The prices and/or cost data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single bid.

4. In preparing this bid, I/we have not been assisted by any current or former employee of the State of Washington whose duties relate (or did relate) to this bid or prospective contract, and who was assisting in other than his or her official, public capacity. (Any exceptions to these assurances are described in full detail on a separate page and attached to this document).

5. I/we declare that the firm is not currently bankrupt or a party to bankruptcy proceedings and has not made an assignment for benefit of creditors and authorize DCYF to conduct a financial assessment of the firm in DCYF sole discretion.

6. I/we understand that the DCYF will not reimburse me/us for any costs incurred in the preparation of this bid. All bids become the property of the DCYF, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this bid.

7. I/we agree that submission of the attached bid constitutes acceptance of the solicitation contents and the attached sample contract and general terms and conditions. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document.

8. Unless otherwise required by law, the prices and/or cost data that have been submitted have not been knowingly disclosed by the Proposer and will not knowingly be disclosed by him/her prior to opening, directly or indirectly to any other Proposer or to any competitor.

9. I/we acknowledge that if it is awarded a contract containing Business Associate requirements under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), or any other Data Security requirements, that I/we will incorporate the terms of such Business Associate or Data Security requirements into all related subcontracts.

10. I/we acknowledge that if awarded a contract with DCYF, I/we am/are required to comply with all applicable state and federal civil rights and other laws. Failure to comply may result in contract termination. Bidder agrees to submit additional information about its nondiscrimination policies, at any time, if requested by DCYF.

11. I/we grant the DCYF the right to contact references and others, who may have pertinent information regarding the Proposer’s prior experience and ability to perform the services contemplated in this procurement.

12. I/we authorize DCYF to conduct a background check of Bidder or Bidder’s employees if DCYF considers such action necessary or advisable.

13. I/we have not been convicted nor entered a plea of nolo contendre with respect to a criminal offense, nor have I/we been debarred or otherwise restricted from participating in any public contracts.

14. I/we acknowledge its obligation to notify DCYF of any changes in the certifications and assurances above.

15. WAGE THEFT PREVENTION. Prior to awarding a contract, agencies are required to determine that a Bidder is a ‘responsible Bidder.’ See RCW 39.26.160(2) & (4). Pursuant to legislative enactment in 2017, the responsible Bidder criteria include a contractor certification that the contractor has not willfully violated Washington’s wage laws. See Chap. 258, 2017 Laws (enacting SSB 5301).

I hereby certify, on behalf of the firm identified below, as follows (check one):

|_| NO WAGE VIOLATIONS. This firm has NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.

OR

|_| VIOLATIONS OF WAGE LAWS. This firm has been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, a provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.

16. EXECUTIVE ORDER 18-03—WORKER’S RIGHTS. Pursuant to the Washington State Governor’s Executive Order 18-03 (dated June 12, 2018), DCYF is seeking to contract with qualified entities and business owners who certify that their employees are not, as a condition of employment, subject to mandatory individual arbitration clauses and class or collective action waivers.

I hereby certify, on behalf of the firm identified below, as follows (check one):

|_| NO MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS FOR EMPLOYEES. This firm does NOT require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

OR

|_| MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS FOR EMPLOYEES. This firm requires its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

17. STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Bidder certifies as follows (must check one):

|_| COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. During the term of an awarded Contract, Bidder, including any subcontractor, shall not discriminate on the bases enumerated at RCW 49.60.530(3). Bidder, including any subcontractor, also shall give written notice of this nondiscrimination requirement to any labor organizations with which Bidder, or subcontractor, has a collective bargaining or other agreement. In addition, Bidder, including any subcontractor, shall cooperate with any Washington state agency investigation regarding any allegation that Bidder, including any subcontractor, engaged in prohibited discrimination set forth in RCW 49.60.530(3).

OR

|_| NON-COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Bidder does not comply with RCW 49.60.530.

Bidder further certifies that it shall provide immediate written notice to DCYF if, at any time prior to a Contract award, Bidder learns that any of its certifications set forth herein were erroneous when submitted or have become erroneous by reason of changed circumstances.

I hereby certify, under penalty of perjury under the laws of the State of Washington, that the certifications herein are true and correct and that I am duly authorized to make these certifications on behalf of the Bidder listed herein.

Print Name

Return to Procurement Coordinator with bid response. Failure to submit will result in disqualification.

RFA 25-DCYF-CW-098 Caregiver Supports Page 5 of 5