Attachment B - Bidder Certifications.doc

DOC document 70 KB Posted

Attached to
27EHSPCAIDCARDPM: RFR for Personal Care Attendant Identification Card Services
Solicitation number
BD-27-1039-EHS01-ASHWA-135088
Issued by
Massachusetts

About this file

This document is a required bidder certification form for the Massachusetts Executive Office of Health and Human Services (EOHHS) Request for Responses (RFR) for Personal Care Attendant (PCA) Identification Card Services. Submission of the completed certification form is mandatory and failure to do so may result in rejection of the bidder's response as non-responsive. The form requires certification from both the Chief Executive Officer and Chief Financial Officer regarding the bidder's qualifications, contract readiness, financial condition, and compliance with applicable laws and regulations. The certification addresses the bidder's ability to perform all services and responsibilities at the proposed costs by the contract start date, absence of conflicting interests, acceptance of the model contract terms without modification, full responsibility for subcontractor performance, and adherence to privacy and security obligations under Massachusetts General Laws Chapter 93H and Chapter 66A.

The financial certification requires bidders to confirm they are in sound financial condition with sufficient reserves to perform contract requirements and have received an unqualified audit opinion, with the audit date to be specified. Additionally, bidders must certify they have no outstanding liabilities to the Internal Revenue Service or other government agencies and are not subject to current or past litigation or findings of non-compliance under federal or state law. The form requires signatures under the pains and penalties of perjury from both the Chief Executive Officer and Chief Financial Officer, with bidders obligated to notify EOHHS of any changes to the certified statements. No specific pricing information, set-asides, incumbent details, or contract term specifics are contained within this certification form itself.

View the file

Other files

Show all 13

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 B - EOHHS-REQUIRED BIDDER CERTIFICATIONS

Completion of these Certifications is a required element of the Bidder’s Business Response as described in Section 4.3.5 of the RFR. Failure to submit this form may result in a Bidder’s response being rejected as non-responsive.

Name of Bidder:

(hereinafter, “Bidder”) Chief Executive Officer (Or Equivalent):

By my signature on the last page of this Bidder Certification document, I certify that the information below, and any attached statement that I have provided, has been reviewed and signed by me, and is true, accurate, and complete, to the best of my knowledge. I understand that I sign under the pains and penalties of perjury, and may be subject to civil penalties or criminal prosecution for any falsification, omission, or concealment of any material fact contained herein.

Chief Financial Officer (Or Equivalent):

By my signature on the last page of this Bidder Certification document, I certify that the information below in numbered paragraph 4 and any attached statement that I have provided, has been reviewed and signed by me, and is true, accurate, and complete, to the best of my knowledge. I understand that I sign under the pains and penalties of perjury, and may be subject to civil penalties or criminal prosecution for any falsification, omission, or concealment of any material fact contained herein.

A check in the box of each item, below, indicates an affirmative response to the certification. If one or more of the boxes are not checked, please provide an explanation on a clearly labeled separate sheet.

1. Bidder’s Qualifications and Contract Readiness

· The undersigned certifies that the Bidder will be ready to begin performance of all services and responsibilities described in this RFR by the anticipated Contract Start Date and that the Bidder is able to completely perform all services and responsibilities at the proposed costs and fees stated in the Bidder’s cost response and by the dates specified herein.

2. Bidder’s Interests

· The undersigned certifies that no Bidder interest will conflict in any manner or degree with the performance of services required under the Contract.

· The undersigned certifies that the Bidder has submitted all information required under Section 4.1 of the RFR, that is complete, truthful, and accurately reflects the Bidder’s business, and that the Bidder will provide, in accordance with such Section 4.1, any other information requested by EOHHS that, in EOHHS’ judgment, is relevant to the Bidder’s financial, legal, contractual, or other business interests.

· Acceptance of Model Contract The undersigned certifies that the Bidder accepts all of the provisions in Attachment A – Model Contract, and its Appendices and Attachments, including the Commonwealth Terms and Conditions and Commonwealth of Massachusetts Standard Contract Form, in their entirety and without modification, except as otherwise agreed to by EOHHS.

3. Subcontractors

· The undersigned acknowledges its understanding that it will not be relieved of any legal obligations under any Contract resulting from this RFR as a result of any contracts with subcontractors, that it shall be fully responsible for the subcontractor’s performance, and that all partnership agreements, subcontracts, and other agreements or arrangements for reimbursement will be in writing and will contain terms consistent with all terms and conditions of the Contract.

4. Financial Condition

· The undersigned certifies that the Bidder (please check one of the boxes below):

· is in sound financial condition, that it has sufficient financial reserves to perform the requirements of this RFR and has received an unqualified audit opinion for the latest audit of its financial statements. Specify the date of the last audit __________________; OR

· The Bidder is in sound financial condition, and that it will have sufficient financial reserves to perform the requirements of this RFR prior to the execution of the Contract, if selected, and will have received an unqualified audit opinion for the latest audit of its financial statements, prior to Contract execution.

· The undersigned certifies that the Bidder has no outstanding liabilities to the Internal Revenue Service or other government agencies.

· The undersigned certifies that the Bidder is not the subject of any current litigation or findings of non-compliance under federal or state law.

· The undersigned certifies that the Bidder has not been the subject of any past litigation or findings of non-compliance under federal or state law.

5. Privacy and Security Certification

The undersigned certifies that the Bidder will adhere to all applicable obligations regarding the protection of personal information, as defined in M.G.L. c. 93H, and personal data, as defined in M.G.L. c. 66A, owned or controlled by EOHHS that the Bidder may access in connection with its performance under the Contract.

6. Changes to Statements

· The undersigned acknowledges the Bidder’s obligation to notify EOHHS of any changes in the statements made herein.

Signed under the pains and penalties of perjury this ______day of ________________, 2026 Signature of the Chief Executive Officer (or equivalent title)

Printed Name of Signatory

Date

Signed under the pains and penalties of perjury this ______day of ________________, 2026 Signature of the Chief Financial Officer (or equivalent title

Printed Name of Signatory

Date

PAGE

Attachment B - RFR PCA ID Card Reprocurement EOHHS-Required Bidder Certifications

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