Attachment 3 - OCFS-2633 MacBride Fair Employment Form LOCKED3.docx

16 KB Posted

Attached to
IFB # 1165 Automatic Vending Machine Service NYS DOT I-88 Rest Areas
Solicitation number
2107147
Issued by
Delaware County, Franklin County, Yonkers City, New York

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This document is the OCFS-2633 MacBride Fair Employment Principles Certification Form related to a state and local contract opportunity from the New York State Office of Children and Family Services (OCFS), Commission for the Blind. The contract opportunity is for automatic vending machine service at the NYS DOT I-88 Rest Areas "Unadilla" and "East Worcester" in Delaware and Otsego Counties. The current contract has a total value of $31,000 over 5 years, and reported $13,940.30 in total net sales for the 12-month period ending 12/31/2023. The minimum acceptable bid rate is 20% of net sales per month for the 5-year contract term from 5/1/2024 to 4/30/2029. Prospective bidders must have prior experience providing automatic vending machine services and provide a minimum of 3 references, with at least one from the past 12 months. There are no MWBE or Service-Disabled Veteran-Owned Business participation goals for this solicitation.

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OCFS-2633 (Rev. 12/2016)

NEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES

MACBRIDE FAIR EMPLOYMENT PRINCIPLES

CERTIFICATION FORM

Non-Discrimination in Employment in Northern Ireland In accordance with section 165 of the State Finance Law, the bidder, by submission of this bid, certifies that it or any individual or legal entity in which the bidder holds a 10 percent or greater ownership interest, or any individual or legal entity that holds a 10 percent or greater ownership in the bidder: (answer “yes” or “no” to one or both of the following, as applicable).

(1) Has business operations in Northern Ireland |_| Yes |_| No If Yes,

(2) Shall take lawful steps in good faith to conduct any business operations that it has in Northern Ireland in accordance with the MacBride Fair Employment Principles relating to non-discrimination in employment and freedom of workplace opportunity regarding such operations in Northern Ireland, and shall permit independent monitoring of its compliance with such principles.

|_| Yes |_| No

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