Attachment 2 - Bid Cover Sheet~1.pdf

DEQ RFQ Template (DRAFT V.1 7/2017)

RFQ #DEQ-1344-18

ATTACHMENT 2

BID COVER SHEET

PART 1 – GENERAL INFORMATION

RFQ #:

Organization Name (tax filing): _ _

Primary Contact: _ _ _ Title: _ _ (Print Name)

Street Address: _ City, State, Zip: _

Telephone: _ E-mail Address: _

OregonBuys #: _ (Contractor Only) Oregon Business ID#: ______________________

COBID #: _ _ (Contractor Only: If certified by the Certification Office of Business Inclusion and Diversity (COBID) as a Disadvantaged Business Enterprise, Minority Business Enterprise/Women Business Enterprise, or Emerging Small Business.)

Delivery Method. Please check the applicable box below. If Bidder is using a common carrier to deliver the goods identified in the RFP or subcontractor any part of the work bidder must provide company information for each subcontractor with the Bid. Bidder must state whether or not the subcontractor is registered with the Oregon Office of Minority, Women’s and Emerging Small Business Enterprises and provide the certification number.

My company will be shipping the goods by common carrier.

My company will be shipping the goods using our company fleet and understand I must meet the insurance types and limits and provide proof of insurance as outlined in Attachment 2 Part IV upon request.

Provide below the name and title of the person(s) authorized to sign any Contract that may result.

Authorized Representative: _ (Print Name) Title

Authorized Signer(s): _ _

(Print Name) Title

PART II – REPRESENTATIONS, ATTESTATIONS, AND CERTIFICATIONS: The undersigned further acknowledges, attests and certifies individually and on behalf of the Bidder that:

1. No attempt has been made or shall be made by the Bidder to induce any other person or organization to submit or not submit a Bid.

2. Information and prices included in this Bid shall remain valid for sixty (60) days after the bid due date or until a Contract is approved, whichever comes first.

3. The Bidder understands that all Bids not withdrawn prior to the RFQ Close Date become the property of the

State of Oregon as of the Bid due date and Bidder grants the State the right to use all information contained therein.

4. The Bidder acknowledges receipt of all Addenda issued under the RFQ.

5. Bidder does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, sex, disability, sexual orientation or national origin, nor has Bidder or will Bidder discriminate against a subcontractor in the awarding of a subcontract because the subcontractor is a minority, women or emerging small business enterprise certified under ORS 200.055.

6. The Bidder, acting through its authorized representative, has read and understands all RFQ instructions, specifications, and terms and conditions contained within the RFQ, including those in the Sample Contract.

7. The Bidder agrees to and shall comply with, all requirements, specifications and terms and conditions contained within the RFQ, including all Addenda, if any;

8. The Bid submitted is in response to the specific language contained in the RFQ, and Bidder has made no assumptions based upon either (a) verbal or written statements not contained in the RFQ, or (b) any previously-issued RFQ, if any.

9. The Bidder agrees that if awarded the Contract, Bidder shall be authorized to do business in the State of Oregon at the time of the award;

10. Agency shall not be liable for any claims or be subject to any defenses asserted by Bidder based upon, resulting from, or related to, Bidder’s failure to comprehend all requirements of the RFQ.

11. The Agency shall not be liable for any expenses incurred by Bidder in either preparing or submitting its Bid, or in participating in any evaluation/selection process, if any.

12. Bidders shall use recyclable products to the maximum extent economically feasible in the performance of the Contract and of the Work set forth in this document.

13. Bidder, acting through its authorized representative, has knowledge regarding Contractor’s payment of taxes, and to the best of Bidders knowledge the Contractor is not in violation of any Oregon tax laws, including, without limitation, ORS 305.620 and ORS chapters 316, 317 and 318. Bidder understands and agrees to provide written notice to Agency within two business days of any change to the Bidder’s status of tax law compliance.

PART III – OFFICE OF FOREIGN ASSETS CONTROL AND US DEPARTMENT OF STATE: Bidder and Bidder’s employees and agents are not included on:

a. The list entitled “Specialty Designated Nationals and Blocked Persons” maintained by the Office of Foreign Assets Control of the United States Department of the Treasury and currently found at http://wwwtreas.gov/offices/enforcement/ofac/sdn/ ; or

b. The list entitled “Current List of Designated Foreign Terrorist Organizations of the US Department of State” and currently found at http://www.state.gov/s/ct/rls/fs/97191.htm

Part IV – INSURANCE REQUIREMENTS: Bidder agrees to meet the insurance requirements outlined below that will be included as a part of any Contract issued in response to this RFQ:

Contractor shall obtain at Contractor’s expense the insurance specified in this section to performing under this Contract and shall maintain it in full force and at its own expense throughout the duration of this Contract, as required by any extended reporting period or tail coverage requirements, and all warranty periods that apply. Contractor shall obtain the following insurance from insurance companies or entities that are authorized to transact the business of insurance and issue coverage in State and that are acceptable to Agency. Coverage shall be primary and non- contributory with any other insurance and self-insurance, with the exception of Professional Liability and Workers’ Compensation. Contractor shall pay for all deductibles, self-insured retention and self-insurance, if any.

http://wwwtreas.gov/offices/enforcement/ofac/sdn/ http://www.state.gov/s/ct/rls/fs/97191.htm

WORKERS’ COMPENSATION & EMPLOYERS’ LIABILITY

All employers, including Contractor, that employ subject workers, as defined in ORS 656.027, shall comply with ORS

656.17 and provide workers' compensation insurance coverage for those workers, unless they meet the requirement for an exemption under ORS 656.126(2). Contractor shall require and ensure that each of its subcontractors complies with these requirements. If Contractor is a subject employer, as defined in ORS 656.023, Contractor shall also obtain employers' liability insurance coverage with limits not less than $500,000 each accident. If contractor is an employer subject to any other state’s workers’ compensation law, Contactor shall provide workers’ compensation insurance coverage for its employees as required by applicable workers’ compensation laws including employers’ liability insurance coverage with limits not less than $500,000 and shall require and ensure that each of its out-of-state subcontractors complies with these requirements.

COMMERCIAL GENERAL LIABILITY:

Required Not Required

Commercial General Liability Insurance covering bodily injury and property damage in a form and with coverage that are satisfactory to the State. This insurance shall include personal and advertising injury liability, products and completed operations, contractual liability coverage for the indemnity provided under this contract, and have no limitation of coverage to designated premises, project or operation. Coverage shall be written on an occurrence basis in an amount of not less than $1,000,000 per occurrence. Annual aggregate limit shall not be less than $2,000,000.

AUTOMOBILE LIABILITY INSURANCE:

Automobile Liability Insurance covering Contractor’s business use including coverage for all owned, non-owned, or hired vehicles with a combined single limit of not less than $1,000,000 for bodily injury and property damage. This coverage may be written in combination with the Commercial General Liability Insurance (with separate limits for Commercial General Liability and Automobile Liability). Use of personal automobile liability insurance coverage may be acceptable if evidence that the policy includes a business use endorsement is provided.

PROFESSIONAL LIABILITY:

Professional Liability insurance covering any damages caused by an error, omission or any negligent acts related to the services to be provided under this Contract by the Contractor and Contractor’s subcontractors, agents, officers or employees in an amount not less than $1,000,000 per occurrence. Annual aggregate limit shall not be less than $2,000,000. If coverage is on a claims made basis, then either an extended reporting period of not less than 24 months shall be included in the Professional Liability insurance coverage, or the Contractor shall provide Tail Coverage as stated below.

EXCESS/UMBRELLA INSURANCE:

A combination of primary and excess/umbrella insurance may be used to meet the required limits of insurance.

ADDITIONAL INSURED:

The Commercial General Liability insurance and Automobile liability insurance required under this Contract must include an additional insured endorsement specifying the State of Oregon, its officers, employees and agents as Additional Insureds, including additional insured status with respect to liability arising out of ongoing operations and completed operations, but only with respect to Contractor's activities to be performed under this Contract. Coverage shall be primary and non-contributory with any other insurance and self-insurance. The Additional Insured endorsement with respect to liability arising out of your ongoing operations must be on ISO Form CG 20 10 07 04 or equivalent and the Additional Insured endorsement with respect to completed operations must be on ISO form CG 20 37 04 13 or equivalent.

TAIL COVERAGE:

If any of the required insurance is on a claims made basis and does not include an extended reporting period of at least 24 months, Contractor shall maintain either tail coverage or continuous claims made liability coverage, provided the effective date of the continuous claims made coverage is on or before the effective date of this Contract, for a minimum of 24 months following the later of (i) Contractor’s completion and Agency’s acceptance of all Services required under this Contract, or, (ii) Agency or Contractor termination of contract, or, iii) The expiration of all warranty periods provided under this Contract.

CERTIFICATE(S) AND PROOF OF INSURANCE:

Contractor shall provide to Agency Certificate(s) of Insurance for all required insurance before delivering any Goods and performing any Services required under this Contract. The Certificate(s) shall list the State of Oregon, its officers, employees and agents as a Certificate holder and as an endorsed Additional Insured. If excess/umbrella insurance is used to meet the minimum insurance requirement, the Certificate of Insurance must include a list of all policies that fall under the excess/umbrella insurance. As proof of insurance Agency has the right to request copies of insurance policies and endorsements relating to the insurance requirements in this Contract.

NOTICE OF CHANGE OR CANCELLATION:

The contractor or its insurer must provide at least 30 days’ written notice to Agency before cancellation of, material change to, potential exhaustion of aggregate limits of, or non-renewal of the required insurance coverage(s).

INSURANCE REQUIREMENT REVIEW:

Contractor agrees to periodic review of insurance requirements by Agency under this agreement and to provide updated requirements as mutually agreed upon by Contractor and Agency.

STATE ACCEPTANCE:

All insurance providers are subject to Agency acceptance. If requested by Agency, Contractor shall provide complete copies of insurance policies, endorsements, self-insurance documents and related insurance documents to Agency’s representatives responsible for verification of the insurance coverages required under this Section 4.

PART V – SIGNATURE: The signatory of this Bidder Cover sheet is a duly authorized representative of the Bidder, has been authorized by Bidder to make all a representations, attestations, and certifications contained in this bid document and all Addenda, if any, issued, and to execute this Bid document on behalf of Bidder.

By signature below, the undersigned Authorized Representative hereby certifies on behalf of Bidder that all contents of this Bidder Cover sheet and the submitted Bid are truthful, complete and accurate. The undersigned Authorized Representative further agrees to have knowledge regarding Bidder’s payment of taxes, and to the best of the Authorized Representative’s knowledge, Bidder is not in violation of any change to the Bidder’s status of tax law compliance. Failure to provide information required by the RFQ may ultimately result in rejection of the Bid.

THIS COVER PAGE MAY NOT BE ALTERED.

Authorized Signature: _ _

Print Name: _ _ _ _

Title: _ _ _