Attachment #2 Bidder's Certified Form IFB 2026 Auto Injector.docx

DOCX document 31 KB Posted

Attached to
2026 Epinephrine Auto-Injectors
Solicitation number
2136373
Issued by
New York

About this file

This is a Bidder's Certification Form for Invitation for Bid 2026 Epinephrine Auto-Injectors issued by the New York State Office of Children and Family Services (OCFS). The solicitation seeks a qualified vendor to supply approximately 72,000 twin packs of epinephrine auto-injectors in varying dosages to eligible childcare programs throughout New York State over a two-year contract term. Bidders must demonstrate manufacturing capability or authorized reseller status, possess relevant experience in supplying and delivering the requested products, and certify compliance with FDA regulations and device specifications including retractable needles. Additionally, vendors must confirm their ability to interface with OCFS's electronic systems and the Child Care Facility System (CCFS) through compatible technology and application programming interface (API) solutions, provide direct shipping to childcare facilities statewide, and implement a tele-outreach support program involving telephone and email correspondence with participating childcare providers.

Pricing for this procurement is capped at $15 million for the two-year contract period. The solicitation includes Minority and Women Business Enterprise (MWBE) contracting goals of 15 percent for both minority-owned and women-owned businesses. Respondents must be licensed to conduct business in New York State or commit to obtaining licensure if awarded. All applicants are required to submit the OCFS-0910 Request for Bid Form, a financial response bid sheet, this certification form, and a procurement lobbying form by the specified deadline. A response of "no" to any certification requirement marked with an asterisk will result in automatic disqualification. H.F Acquisition Co, LLC has been awarded an identical or substantially similar contract within the past five years.

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Invitation for Bid 2026 Epinephrine Auto -Injectors Applicant: Please indicate whether the following statements described in the solicitation apply to your organization:

|_| Yes

|_| No * Certify to be licensed to do business in NYS or will become licensed in NYS if awarded.

|_| Yes

Certify that I am manufacturer of the products being requested, or an authorized representative (i.e. dealer/re-seller) of the manufacturer’s products being requested.

Years

Months Please indicate how much experience manufacturing and delivering; or as an authorized representative (i.e. dealer/re-seller) supplying and delivering the product that is being requested. Response must include years and months.

|_| Yes
|_| No *
Certify that the auto-injectors to be provided adhere to FDA rules and regulations.
|_| Yes
|_| No *
Certify that the auto-injector device to be provided has a retractable needle. Also, in the event of a product recall, if selected, awarded responder will replace the recalled devices at no cost to NYS or the childcare program.
|_| Yes
|_| No *
Certify that you have and utilize a compatible technology solution that will allow you the ability to interface with the application programming interface (API) offered by OCFS Division of Child Care Services (DCCS) electronic system of record, and the Child Care Facility System (CCFS).

|_| Yes

Certify that you can provide ongoing support to childcare providers by implementing a tele-outreach program promoting the initiative which includes telephone and email correspondence to childcare programs.

|_| Yes
|_| No *
Certify to directly ship the auto-injector twin packs to the eligible childcare program across NYS.
|_| Yes
|_| No *
Certify to be able to provide approximately 72,000 twin packs of auto-injectors of varying dosages for a two-year term.

* A response of “no” to any question marked with an asterisk will disqualify the applicant.

Attachment #2 Bidder’s Certified Form

Submit the following completed documents prior to the deadline via email to RFQ@ocfs.ny.gov :

· OCFS-0910, Request for Bid Form

· Attachment 1 – RFQ Financial Response Bid Sheet

· Attachment 2 – Certification Form

· Attachment 3 – Procurement Lobbying Form By signing below, I attest that I have express authority to sign these statements on behalf of the applicant and am authorized by law to bind the applicant contractually.

Print Name:

Signature:

Title:

Organization:

Address:

Email:Phone:
FEIN/TIN:Date:

SFS Vendor ID (if applicable):

Please indicate the name and email address of an additional contact person below:

File details come from the government source that posted it. Updated .