ATTACHMENT B Proposer Certification Form.doc

ATTACHMENT B

PROPOSER CERTIFICATIONS AND REPRESENTATIONS

PORTLAND PUBLIC SCHOOLS, SCHOOL DISTRICT NO. 1J,

MULTNOMAH COUNTY, OREGON

REQUEST FOR PROPOSAL

RFP NO.

Title The undersigned hereby certifies that Proposer:

1. Has the authority and/or responsibility to submit a proposal and to represent the organization in all phases of this RFP process.

2. Has submitted information that is true and accurate to the best of their knowledge and understands that any false statement may disqualify this proposal from further consideration or be cause for contract termination.

3. Is a FORMCHECKBOX Resident Proposer, FORMCHECKBOX Non-Resident Proposer, as defined in ORS 279A.120, of the State of Oregon.

ORS 279A.120 (2) states "For the purposes of awarding a public contract, a contracting agency shall:

(a) Give preference to goods or services that have been manufactured or produced in this state if price, fitness, availability and quality are otherwise equal; and

(b) Add a percent increase to the bid of a nonresident bidder equal to the percent, if any, of the preference given to the bidder in the state in which the bidder resides.”

"Resident bidder" means a bidder that has paid unemployment taxes or income taxes in this state during the 12 calendar months immediately preceding submission of the bid, has a business address in this state and has stated in the bid whether the bidder is a "resident bidder". (ORS 279A.120 (b))

"Non-resident bidder" means a bidder who is not a "resident bidder" as defined above. (ORS 279A.120 (a))

4. Has not discriminated and will not discriminate, in violation of subsection (1) of ORS 279A.110, against a disadvantaged business enterprise, a minority-owned business, a women-owned business, a business that a service-disabled veteran owns or an emerging small business in obtaining any required subcontracts.

5. TAX CERTIFICATION – The Proposer attests in writing that they have complied with the tax laws of this state and of political subdivision of this state for no fewer than six years preceding the date of the solicitation closing. Applicable tax laws include, but are not limited to, ORS 305.620, ORS Chapters 316, 317, and 318, any tax provisions imposed by a political subdivision that apply to the Proposer or to the performance of the Contract, and any rules and regulations that implement or enforce those tax laws.

6. CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS - The Proposer certifies to the best of its knowledge and belief that neither it nor any of its principals:

a. Are presently debarred, suspended, proposed for debarment, declared ineligible or voluntarily excluded from submitting bids or proposals by any federal, state or local entity, department or agency;

b. Have within a five-year period preceding the date of this certification been convicted of fraud or any other criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) contract, embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

c. Are presently indicted for or otherwise criminally charged with commission of any of the offenses enumerated in paragraph 6.2. of this certification;

d. Have, within a five-year period preceding the date of this certification had a judgment entered against proposer or its principals arising out of the performance of a public or private contract;

e. Have pending in any state or federal court any litigation in which there is a claim against proposer or any of its principals arising out of the performance of a public or private contract; and

f. Have within a five-year period preceding the date of this certification had one or more public contracts (federal, state, or local) terminated for any reason related to contract performance.

Where Proposer is unable to certify to any of the statements in this certification, Proposer shall attach an explanation to their offer. The inability to certify to all of the statements shall not necessarily preclude Proposer from award of a contract under this procurement.

7. Acknowledges Receipt of Addenda No's. _____________ through __________________ inclusive.

PROPOSER’S EMPLOYERS FEDERAL TAX IDENTIFICATION NUMBER (EIN) ____________________________ OR SOCIAL SECURITY IDENTIFICATION NUMBER_________________________________________________________

FAILURE TO SIGN AND SUBMIT THIS FORM MAY BE CAUSE FOR PROPOSAL REJECTION

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E-Mail _________________________________ Rev. 010419