Attachment_D.docx
DOCX document 42 KB Posted
- Solicitation number
- 2000016003
- Issued by
- Beltrami County, Otter Tail County, St. Louis County, Minnesota
About this file
This document is an attachment to a state and local contract opportunity from the Minnesota Department of Information Technology Services (MNIT) and the Minnesota Department of Veterans Affairs (MDVA). The opportunity is seeking proposals for a remote continuous temperature monitoring system to monitor, alert, and report on refrigeration systems used for storage of dietary and medical supplies in up to eight Minnesota Veterans Homes. The system must be a configurable/customizable off-the-shelf software solution. The contract is open to certified veteran-owned or service-disabled veteran-owned small businesses that meet the statutory requirements. Proposals are due by a specified date, and the contract term and any renewal options are not provided.
The document also includes a Workforce and Equal Pay Declaration Page, which is required for businesses executing government contracts over certain dollar thresholds in Minnesota. Businesses must either hold the required Workforce and Equal Pay Certificates, have applied for them, or attest to being exempt from the requirement. No pricing terms, set asides, incumbents, funding details, or other salient information is provided in the attachment.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| MNIT_MDVA_Remote_Continuous_Temperature_Monitoring.pdf | ||
| Attachment_K_-_Facility_Maps.pdf | ||
| MDVA_Refrigeration_Monitoring_RFP_Addendum_1.pdf | ||
| Attachment_J_-_Unit_Totals-Types_by_Location.docx | DOCX document | |
| Attachment_I_-_Operations_Team_Standards_FINAL.xlsx | XLSX spreadsheet | |
| Attachment_E.docx | DOCX document | |
| Attachment_F_-_Business_Requirements.docx | DOCX document | |
| Attachment_A.docx | DOCX document | |
| Attachment_C_-_Cost.xlsx | XLSX spreadsheet | |
| Attachment_H_-_Accessibility.docx | DOCX document | |
| Sample_Contract_and_Exhibits_A-D.docx | DOCX document | |
| Attachment_G_-_Solution_Platform(s).docx | DOCX document | |
| MDVA_Refrigeration_Monitoring_RFP_Final.pdf | ||
| Attachment_B.docx | DOCX document |
Show all 14
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Text version
ATTACHMENT D: RESPONDER FORMS
STATE OF MINNESOTA
VETERAN-OWNED PREFERENCE FORM
Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. §16C.16, subd. 6a, the Commissioner of Administration will award up to a 12% preference on state procurement to certified small businesses that are majority owned and operated by veterans.
Veteran-Owned Preference Requirements - See Minn. Stat. § 16C.19(d):
1) The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.
or
2) The principal place of business is in Minnesota AND the US Small Business Administration verifies the business as being a veteran-owned or service-disabled veteran-owned small business under Public Law 109-461 and Code of Federal Regulations, title 13, part 128.
Statutory requirements and appropriate documentation must be met by the solicitation response due date and time to be awarded the veteran-owned preference. For Bids, the preference applies only to the first $2,000,000.
Claim the Preference By signing below I confirm that:
My company is claiming the veteran-owned preference afforded by Minn. Stat. § 16C.16, subd. 6a. By making this claim, I verify that:
· The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.
or
· My company’s principal place of business is in Minnesota and the US Small Business Administration verifies my company as being a veteran-owned or service-disabled veteran-owned small business.
| Name of Company: | _____________________________ | Date: | ________________________________ | |
| Authorized Signature: | _____________________________ | Telephone: | ________________________________ | |
| Printed Name: | _____________________________ | Title: | ______________________________________ |
Sign and return this form with your solicitation response to claim the veteran-owned preference.
Workforce and Equal Pay Declaration Page This form is required for all businesses executing government contracts under the following:
1. Select one:
| ☐ | Businesses executing a contract with State or Metropolitan agencies in excess of $100,000 (Workforce Certificate) and if applicable $500,000 (Equal Pay Certificate) |
| ☐ | Businesses executing a contract with University of Minnesota for general obligation bond funded capital projects in excess of $100,000 (Workforce Certificate) and if applicable $500,000 (Equal Pay Certificate) |
| ☐ | Businesses executing a contract with Political Subdivisions for general obligation bond funded capital projects in excess of $250,000 (Workforce Certificate) and if applicable $1,000,000 (Equal Pay Certificate) |
Select all that apply:
2. We are a Certificate holder:
| ☐ | Workforce Certificate under the name: _________________________________________________________ |
| ☐ | Equal Pay Certificate under the name: __________________________________________________________ |
3. We are applying/have applied for the following certificate(s):
| ☐ | Workforce Certificate Application date (MM/DD/YYYY): ____________________ |
| ☐ | Equal Pay Certificate Application date (MM/DD/YYYY): ____________________ |
4. We have not applied for one or both certificates:
☐ Our Company does not yet have a Workforce Certificate or Equal Pay Certificate. We acknowledge that a Workforce and, if applicable, Equal Pay Certificate, or approved exemption by MDHR is required before a contract can be executed.
5. We are Exempt:
☐ We attest to MDHR that we have not employed 40 or more employees on a single day during the prior 12 months in Minnesota or the state in where we have our primary place of business. MDHR may request the names of our employees during the previous 12 months, the date of separation, if applicable, and the current employment status and count.
6. Business Information
| Vendor/Supplier ID |
| Business Name |
| Name of Contracting Agency |
| Authorized Signatory Name |
| Title |
| Date |
| Signature |
| Phone |
For assistance with this form, email the Minnesota Department of Human Rights Compliance.MDHR@state.mn.us Rev. July 2023 Page 1 of 15
File details come from the government source that posted it. Updated .