Attachment A- Required Docs MUST COMPLETE amend-3-18-21.docx
DOCX document 29 KB Posted
- Solicitation number
- BD-20-1102-SRB00-001-50128
- Issued by
- Plymouth County, Massachusetts
About this file
This document appears to be an attachment for a Request for Response (RFR) issued by the State Reclamation and Mosquito Control Board (SRB) in Massachusetts. The RFR seeks to establish contracts with multiple vendors to provide area-wide aerial and/or ground mosquito control services and pesticide products as deemed necessary to address increased risk to human health from mosquito-borne diseases such as Eastern Equine Encephalitis, West Nile Virus, and Zika Virus. The RFR requires bidders to complete and submit Attachments A through F, which include a submission checklist, bidder information, business references, a statement of qualifications, pricing/cost details, and vendor information.
The pricing attachment allows bidders to provide information on various pesticide products, including brand/product name, description, price per container, bulk pricing for emergency purchases, and any applicable discounts. Bidders may also submit additional documentation to reflect potential charges for requested projects, including cost per acre, minimum/maximum charges, travel ranges, etc. The contract term and any renewal options are not specified in the provided documents.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
ATTACHMENT A
SUBMISSION CHECKLIST
This form is designed to ensure that respondents include all components necessary to evaluate their response.
Bidders must fill out forms A-F and return it with their response. Additional Bidder documentation may also be submitted in support of the bid.
Mandatory Attachments
I have completed and included in my response, the following Attachments:
| ☐ | Attachment A – Submission Checklist |
| ☐ | Attachment B – Bidder Information |
| ☐ | Attachment C – Business Reference Form |
| ☐ | Attachment D– Statement of Qualification |
| ☐ | Attachment E – Pricing Page and/or additional price lists |
| ☐ | Attachment F – Vendor Information |
I have read the entire contents of the SRB AERIAL-SPRAY-FY20 and understand that I am obligated to comply with all terms, conditions and requirements of this RFR.
Authorized Signature:
Date:
Print Name:
Title:
ATTACHMENT B
BIDDER INFORMATION
All Bidders must complete and return this Attachment with their response.
Company Name:
Company Address:
Main Phone:
Main Fax:
Website:
Contract Manager & Title:
Email:
Phone:
Additional Contact:
Email:
Phone:
Services Provided:
| # |
| Category |
| Adulticide |
| Larvicide |
| 1. |
| Aerial Services: |
a. Fixed or Rotary Wing
b. Helicopter
| 2. |
| Ground Services: |
a. Truck Mounted
b. Backpack spray
| 3. |
| Pesticide Products for contractors to use while providing aerial and/or ground and ground-based applications |
ATTACHMENT C
BUSINESS REFERENCE FORM
Bidder must provide three (3) business references.
Reference 1:
Reference Business Name:
Address, City, ST, Zip:
Contact Person:
| Contact Phone & Email: |
| Phone |
Description & Date(s) of Services Provided:
Reference 2:
Reference Business Name:
Address, City, ST, Zip:
Contact Person:
| Contact Phone & Email: |
| Phone |
Description & Date(s) of Services Provided:
Reference 3:
Reference Business Name:
Address, City, ST, Zip:
Contact Person:
| Contact Phone & Email: |
| Phone |
Description & Date(s) of Services Provided:
References will be contacted to confirm the bidder’s abilities and qualifications as stated in the bidder’s response. The department may deem the bidder’s response unresponsive if a reference is not obtainable from a listed reference after reasonable attempts
ATTACHMENT D
STATEMENT OF QUALIFICATION
This statement is to certify that _______________________________(Company Name) has been in the business of ______________________________________ (Service(s) provided) for a period of _______ years.
We _____ have or _____ do not have the ability to perform the type, magnitude and quality of work within the scope of RFR for the services we offer. (Comment below)
The company ____ has or ____ has not been involved in any bankruptcy proceedings within the last five years.
(If the company has been involved in bankruptcy proceedings, please give a detailed description below.)
This company ___ has ____ has not undergone a name change within the last five years. (If the company name has changed, please provide a detailed description below.)
Contractor Ability/Description:
Bankruptcy proceedings:
Name change information:
I certify to the best of my knowledge that all information above is true and correct.
| _______________________________ | ____________________________ | ___________ | ||
| Authorized Signature | Position in Company | Date |
Amended March 18, 2021
ATTACHMENT E
PRICING/COST
| Item # |
| Brand/Product Name |
| Description (include Manufacturer, EPA #, % ingredients & formulation |
| Price Per PriceContainer |
| Bulk Price |
(Emergency Purchase) Discount Final Price
*you may submit backup documentation that more accurately reflect any potential charges for requested projects, including Cost/Acre, min/max charges, travel ranges, etc.
ATTACHMENT F
VENDOR INFORMATION
| Vendor Name |
| Address |
| Point of Contact |
| Phone |
| Fax |
| Federal ID |
File details come from the government source that posted it. Updated .