Attachment B Bid Cover Sheet.pdf
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- Solicitation number
- S-44300-00016250
- Issued by
- Oregon
About this file
This is a Bid Cover Sheet for an Invitation to Bid issued by the State of Oregon, acting through the Oregon Health Authority and Oregon State Public Health Laboratory, for environmental monitoring equipment and services. The cover sheet provides the standardized format and instructions for bidders to submit their proposals in response to the ITB. The document establishes the required structure for bid submissions, including sections for bidder information, certification statements, and acknowledgment of receipt of addenda. Bidders must complete all applicable sections of the cover sheet and submit it with their bid proposal by the specified deadline to ensure compliance with submission requirements and eligibility for evaluation.
The cover sheet contains certification language requiring bidders to affirm they have reviewed all bid documents, including any addenda issued, and agree to the terms and conditions outlined in the ITB. It may include instructions regarding bid pricing submission format, confirmation of bidder status (such as small business or disadvantaged business enterprise designations if applicable), and declaration statements regarding conflicts of interest or prior performance on similar contracts. The document serves as a formal acknowledgment that the bidder has met all pre-bid requirements and is submitting a responsive and responsible proposal for the environmental monitoring equipment and service contract with the Oregon State Public Health Laboratory.
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Text version
ITB#S-44300-00016250– Environmental Monitoring Equipment and Service
ATTACHMENT B
BID COVER SHEET
Bidder Name (printed)
Address City, State, Zip
Bid Clarification Contact Person Telephone
Email:
State of Incorporation Entity Type
Oregon Secretary of State Business Registry Number
The undersigned, as Bidder’s authorized representative, certifies that:
1. Bidder understands and accepts the requirements of this ITB. Bidder acknowledges receipt of any and all Amendments to this ITB.
2. By submitting a Bid, Bidder agrees to be bound by the Contract terms and conditions in Attachment A, as modified by Amendment, if any.
3. The costs set forth in Attachment D are firm for 120 Calendar Days after the Opening.
4. Bidder has no undisclosed liquidated and delinquent debt owed to the State or any agency, board, commission, department of division of the State.
5. Bidder complies with and is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation taxes referenced in ORS 305.380(4), ORS 305.620 and ORS chapters 316, 317 and 318.
6. Bidder does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Bidder does not discriminate against any business certified under ORS
200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a veteran owned business, or an emerging small business. If applicable, Bidder has, or will have prior to Contract execution, a written policy and practice, that meets the requirements described in ORS 279A.112, of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class. Agency may not enter into a Contract with an anticipated price of $150,000 or more with a Bidder that does not certify it has such a policy and practice. See https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx for additional information and sample policy template.
7. Bidder and Bidder’s employees, agents, and subcontractors are not included on:
A. the “Specially Designated Nationals and Blocked Persons” list maintained by the Office of Foreign Assets Control of the United States Department of the Treasury found at:
ITB#S-44300-00016250– Environmental Monitoring Equipment and Service https://www.treasury.gov/ofac/downloads/sdnlist.pdf, or B. the government wide exclusions list in the System for Award Management found at:
https://www.sam.gov/
8. Bidder certifies to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Bidder, its employees, or its agents, on the one hand, and the business or economic interests of the State, on the other hand, arising out of, or relating in any way to, the subject matter of the ITB. If any changes occur with respect to Bidder’s status regarding conflict of interest, Bidder shall promptly notify the State in writing.
9. Bidder certifies all contents of the Bid (including any other forms or documentation, if required under this ITB), and this Bid Cover Sheet are truthful and accurate and have been prepared independently from all other Bidders, and without collusion, fraud, or other dishonesty.
10. Bidder understands any statement or representation made in response to this ITB, if determined to be false or fraudulent, a misrepresentation, or inaccurate because of the omission of material information could result in a "claim" (as defined by the Oregon False Claims Act, ORS 180.750(1)}, made under Price Agreement being a "false claim" (ORS 180.750(2)) subject to the Oregon False Claims Act, ORS 180.750 to 180.785, and to any liabilities or penalties associated with the making of a false claim under that act.
11. Bidder acknowledges these certifications are in addition to any certifications required in the Contract at the time of execution.
12. If Bidder is an Oregon benefit company, Bidder certifies that the majority of the benefit company’s regular, full-time workforce is located in Oregon.
BIDDER, Authorized Representative
Signature: _______________________________________________________________________
Print Name and Title: _______________________________________________________________
Date: ____________
Email: ________________________
Telephone Number: (______) _________
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