Attachment B- Proposer Information and Cerfications.pdf

ATTACHMENT B — PROPOSER INFORMATION AND CERTIFICATIONS

Proposer’s Name (printed):

Address: City, State, Zip:

Proposer Clarification Contact Person: ___________________________ Telephone: _______________

Email:

Oregon Secretary of State Business Registry Number (if required): _____________________ Any individual signing below hereby certifies they are an authorized representative of Proposer and that:

1.Proposer understands and accepts the requirements of this RFP. By submitting a Proposal, Proposer agrees to be bound by the Contract terms and conditions in Attachment A, as modified by Addenda, if any.

2. Proposer acknowledges receipt of any and all Addenda to this RFP.

3. If awarded a Contract, Proposer agrees to comply with all provisions of the RFP and meet the performance standards set forth in the Contract.

4. Proposer has no undisclosed liquidated and delinquent debt owed to the State or any department or agency of the

State.

5. They have knowledge regarding Proposer’s payment of taxes and by signing below hereby certify, to the best of their knowledge, Proposer is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation, ORS 305.620 and ORS chapters 316, 317 and 318.

6. Proposer does not and shall not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. Proposer shall comply with Title VI of the Civil Rights Act of 1964, with Section V of the Rehabilitation Act of 1973, and with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Proposer shall comply with the Americans with Disabilities Act of 1990, as amended by the ADA Amendments Act (ADAAA) of 2008 and any subsequent amendments, ORS 659A, and all regulations and administrative rules established pursuant to those laws.

7. Proposer has not and shall not discriminate against a subcontractor in awarding a subcontract because the subcontractor is a minority-owned business, a woman-owned business, emerging small business, or a veteran owned business or controlled by or that employs veterans.

8. Proposer and Proposer’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:

https://www.treasury.gov/ofac/downloads/sdnlist.pdf, or

B. the government wide exclusions lists in the System for Award Management found at:

https://sam.gov/content/home

9. Proposer certifies all contents of the Proposal (including any other forms or documentation, if required under this RFP), and this Proposal Cover Sheet are truthful and accurate and have been prepared independently from all other Proposers, and without collusion, fraud, or other dishonesty.

10.Proposer understands any statement or representation made in response to this RFP, 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 Contract 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.Proposer acknowledges these certifications are in addition to any certifications required in the Contract at the time of execution.

Authorized Signature Date

(Printed Name and Title) Email Address