Attachment_D_-_Responders_Forms.docx
DOCX document 42 KB Posted
- Attached to
- MNIT/DOC Operations Management System (OMS)
- Solicitation number
- 2000015368
- Issued by
- Ramsey County, St. Paul City, Minnesota
About this file
This document is the Responders Forms for a state and local contract opportunity involving the Minnesota Department of Information Technology Services (MNIT), the Minnesota Department of Corrections (DOC), Ramsey County, and the City of St. Paul. The contract is for the selection of a commercial off-the-shelf (COTS) Corrections Operations Management System (OMS) cloud-based application to replace the existing Corrections Operations Management System (COMS) application. The new OMS should be a flexible, scalable platform to support future operational growth and business transformation. The document outlines the requirements for claiming a veteran-owned preference, as well as the workforce and equal pay declaration requirements for businesses executing government contracts.
The document provides details on the contract requirements, such as the minimum number of employees to be exempt from the workforce and equal pay certificate requirements, application deadlines, and the applicable thresholds for different jurisdictions. It also outlines the documentation required to claim the veteran-owned preference, including certification from the Office of Equity in Procurement (OEP) or verification by the US Small Business Administration.
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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 .