Attachment A Vendor Qualifications Certification.pdf

Springfield Office 320 W. Washington Street Springfield, Illinois 62767

(217) 782-4515

Chicago Office 115 S. LaSalle St., 13th Floor

Chicago, Illinois 60603

(312) 814-2420

Illinois Department of Insurance

JB PRITZKER

Governor

ANN GILLESPIE

Director

Vendor Qualifications Certification

SECTION A – Vendor Identification

Vendor legal name:

Year Entity Was Established (MM/YYYY):

SECTION B – Vendor Qualifications (per section 1.5 of contract)

The Vendor represents and warrants that it is an established communications and advertising firm that provides full-service communications, advertising, media planning, and media buying services as part of its regular business operations.

(Choose one)

☐ The Vendor meets this requirement ☐ The Vendor does NOT meet this requirement

The Vendor represents and warrants that it maintains, and shall maintain throughout the Contract term, the organizational capacity, financial stability, internal controls, and professional resources necessary to perform the services authorized under this Contract.

☐ The Vendor does NOT meet this requirement

The Vendor represents and warrants that it has been in continuous operation providing communications and advertising services for a minimum of five (5) years immediately preceding the Bid opening date either under its current legal entity or a legally continuous predecessor entity.

☐ The Vendor does NOT meet this requirement*

Springfield, Illinois 62767

(217) 782-4515

Chicago Office 115 S. LaSalle St., 13th Floor

Chicago, Illinois 60603

(312) 814-2420

*If the Vendor has had a legal name change or legal reorganization during the five-year period, list only factual details below (no narrative):

• Former legal name(s):

• Effective date(s) of change:

(add additional pages as necessary)

SECTION C – Public Sector Campaign Experience

The Vendor must demonstrate experience serving as the prime contractor on at least three (3) large-scale public information or outreach campaigns within the past five (5) years that meet all of the following criteria:

• Sponsored by a federal, state, county government, municipal government body; regional transit authority; and public health department, or large local government entity;

• Served a statewide or multi-regional audience;

• Included paid media planning and placement services; and

• Included development of accessible, plain-language messaging for diverse or low-income populations.

Vendor must list at least three (3) qualifying campaigns. More may be listed if desired, however, three (3) is the minimum qualifying number. Each listed campaign must meet all criteria listed above to qualify. Limit each entry to brief factual information only.

1. Public Sector or Government Client (Name):

Entity Type:

(federal, state, county government, municipal government body; regional transit authority; and public health department, or large local government entity)

Service Area:

(statewide, multi-regional, or both)

Included paid media planning and placement services (Y/N):

Included development of accessible, plain-language messaging for diverse or low-income populations (Y/N):

2. Public Sector or Government Client (Name):

Entity Type:

Springfield, Illinois 62767

(217) 782-4515

Chicago Office 115 S. LaSalle St., 13th Floor

Chicago, Illinois 60603

(312) 814-2420

(federal, state, county government, municipal government body; regional transit authority; and public health department, or large local government entity)

Service Area:

(statewide, multi-regional, or both)

Included paid media planning and placement services (Y/N):

Included development of accessible, plain-language messaging for diverse or low-income populations (Y/N):

3. Public Sector or Government Client (Name):

Entity Type:

(federal, state, county government, municipal government body; regional transit authority; and public health department, or large local government entity)

Service Area:

(statewide, multi-regional, or both)

Included paid media planning and placement services (Y/N):

Included development of accessible, plain-language messaging for diverse or low-income populations (Y/N):

SECTION D – Prime Contractor and Entity-Level Certification Check all boxes to be responsive:

☐ All Campaigns listed in Section C were performed by the bidding Vendor entity as the prime contractor.

☐ No campaign listed is based solely on subcontractor, affiliate, or parent-entity experience unless performed by a legally continuous predecessor entity of the Vendor.

☐ No campaign listed is based solely on the prior work history of individual employees while employed by another firm.

SECTION E - Certification and Acknowledgment

By signing below, the Vendor certifies and attests that:

1. All information provided in this document is true, accurate, and complete;

2. The requirements addressed herein are mandatory responsiveness requirements of the

IFB;

Springfield, Illinois 62767

(217) 782-4515

Chicago Office 115 S. LaSalle St., 13th Floor

Chicago, Illinois 60603

(312) 814-2420

3. The Agency will make a pass/fail determination based on the information submitted and factual verification using publicly available or other reliable sources; and

4. Failure to meet any requirement or submission of false or misleading information shall render the bid non-responsive.

Authorized Signatory Name: ______________________________

Title: ______________________________

Signature: ______________________________

Date: ______________________________

Springfield, Illinois 62767

(217) 782-4515

Chicago Office 115 S. LaSalle St., 13th Floor

Chicago, Illinois 60603

(312) 814-2420