Attachment 1 Contractual Acceptance and Certification of Eligibility to Purchase State Timber~2.docx

OregonBuys Bid# S-63400-00005614

ATTACHMENT 1

CONTRACTUAL ACCEPTANCE AND

CERTIFICATION OF ELIGIBILITY TO PURCHASE STATE TIMBER

THIS ATTACHMENT MUST BE COMPLETED AND RETURNED WITH BID

BIDDER SHALL PROVIDE ALL APPLICABLE INFORMATION REQUESTED BELOW

BIDDER’S LEGAL NAME (BUSINESS): (TAX FILING) __________________________________________________________________________

BIDDER’S MAILING ADDRESS: __________________________________________________________________________________________________

BIDDER’S BUSINESS DESIGNATION: (CHECK ONE)

BIDDER’S FEDERAL TAX ID NUMBER: (NOT SOCIAL SECURITY NUMBER) _______________________________________________________________ Tax information is requested pursuant to ORS 305.385 and will be used for the administration of state, federal and local tax laws. State may report the information provided to the Internal Revenue Service (IRS) under the name and taxpayer identification number provided.

BIDDER’S OREGON BUSINESS REGISTRATION NUMBER: ____________________________________________________________________

(OREGON SECRETARY OF STATE, CORPORATIONS DIVISION)

Go to http://www.filinginoregon.com/ for information on how to register to do business in Oregon.

BIDDER IS A RESIDENT BIDDER: YES NO

ORS 279A.120(1)(b): “Resident bidder” means a bidder that has paid unemployment taxes or income taxes in Oregon during the 12 calendar months immediately preceding submission of the bid, has a business address in Oregon and has stated in the bid whether the bidder is a “resident bidder” under this paragraph.

BIDDER IS AN OREGON CERTIFIED FIRM: (CHECK ALL THAT APPLY)

Go to http://www.oregon4biz.com/Grow-Your-Business/Business-services/Minority-Owned-Business- Certification/ for information on the OMWESB certification program.

BIDDER’S CONTACT INFORMATION:

_ _ _ _ AUTHORIZED REPRESENTATIVE (print) TITLE

_ _ _ _ PHONE EMAIL

ELIGIBILITY TO PURCHASE STATE TIMBER

THIS ATTACHMENT MUST BE COMPLETED AND RETURNED WITH BID

BIDDER SHALL PROVIDE ALL APPLICABLE INFORMATION REQUESTED BELOW

1. TIMBER EXPORT PROHIBITIONS Bidder’s initials: ________

The individual signing on behalf of Bidder hereby acknowledges and certifies that:

· Bidder shall not export directly or indirectly export unprocessed timber originating from public lands in Oregon, as prohibited in ORS 526.806;

· Bidder shall not sell, transfer, exchange or otherwise convey the unprocessed timber originating from public lands in Oregon to any other “person,” which means an individual, a partnership, a public or private corporation or any other legal entity, without first obtaining a certification from the person of the person’s intent to comply with ORS 526.806 to 526.381;

· Bidder has not exported unprocessed timber originating from private lands in Oregon in the last 24 months;

· Bidder is not barred from purchasing unprocessed timber originating from public lands in Oregon, pursuant to ORS 526.826; and

· Bidder understands and agrees that falsely entering into this certification is a violation of the Forest Resources Conservation and Shortage Relief Amendments Act of 1993 and the prohibitions contained in ORS 526.806 to 526.831 against exporting State timber. Criminal and civil penalties may be assessed in accordance with ORS 526.992.

2. TIMBER DEFAULT AND TERMINATION Bidder’s initials: ________

The individual signing on behalf of Bidder hereby acknowledges and certifies that:

· Bidder is not currently in default status under any contract for the sale of unprocessed timber originating lands owned or managed by State (“State Timber”);

· Bidder has not, within a 3-year period preceding this Bid, had one or more federal, state, or local government contract for the sale of State Timber terminated for cause or default.

In the event Bidder has had a contract for State Timber terminated for cause or default action, Bidder shall submit with its Bid a written explanation of such action for consideration by State. Bidder’s explanation must be submitted on a separate piece of paper with the Bid.

THE INDIVIDUAL SIGNING ON BEHALF OF BIDDER HEREBY ACKNOWLEDGES AND CERTIFIES THAT:

· He/she is authorized to act on behalf of Bidder,

· The supplied Bidder data is true and accurate,

· To the best of his/her knowledge, Bidder is not in violation of any Oregon tax laws, For the purposes of this certification, “Oregon Tax Laws” means a state tax imposed by ORS 320.005 to

320.150 and 403.200 to 403.250 and ORS chapters 118, 314, 316, 317, 318, 321 and 323 and the elderly rental assistance program under ORS 310.630 to 310.706 and local taxes administered by the Department of Revenue under ORS 305.620. [ORS 305.380(4)]

ELIGIBILITY TO PURCHASE STATE TIMBER – CONTINUED

· Bidder has completely read and understands the provisions of the Solicitation, including any Addenda issued,

· The Bid was prepared independently from all other Bidders, and without collusion, fraud, or other dishonesty,

· Bidder has not discriminated and will not discriminate, in violation of ORS 279A.110(1), against any minority, women or emerging small business enterprise certified under ORS 200.055 or a business that is owned or controlled by or that employs a disabled veteran as defined in ORS 408.225 in obtaining any required subcontract,

· Bidder accepts and agrees to be bound by all the terms and conditions of the Contract awarded,

· Bidder agrees to provide all Goods and Services required to be provided under the Contract,

· Bidder has the available resources, including staffing, to perform the Services in a reasonable timeframe to pursue State’s objectives, and

· By submitting a response to this Solicitation, Bidder grants the State of Oregon a non-exclusive, perpetual, irrevocable, royalty-free, worldwide license for the rights to copy, distribute, display, prepare derivative works of and transmit the response for the purpose of conducting this procurement and to fulfill obligations under Oregon Public Records Laws.

_ _ _ SIGNATURE OF BIDDER’S AUTHORIZED REPRESENTATIVE DATE

THIS ATTACHMENT MUST BE COMPLETED AND RETURNED WITH BID