Attachment G - Offeror Information Acknowledgements and Certifications - Child Safety Seats.docx
DOCX document 120 KB Posted
- Solicitation number
- 24DPP00938
- Issued by
- Mercer County, New Jersey
About this file
This document is Attachment G - Offeror Information, Acknowledgements, and Certifications for a Request for Proposals issued by the State of New Jersey for Child Safety Seats under Solicitation Number 24DPP00938. The attachment requires the offeror to provide company information, including legal name, address, tax ID, entity type, website, history, size, and ownership structure. The offeror must also acknowledge and certify various terms, such as non-debarment, non-collusion, data disclosure, conflicts of interest, insurance requirements, NASPO ValuePoint administrative fees, and confidentiality. The related state and local contract opportunity is the M2002 - Child Safety Seats: NASPO ValuePoint Master Agreement.
The document does not provide details on pricing terms, set asides, incumbents, funding requirements, or other salient commercial information. The focus is on the offeror's qualifications and compliance with the RFP requirements.
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Text version
Request for Proposals for
[PORTFOLIO NAME]
Issued by the State of [Lead State] Solicitation Number: [#######]
Request for Proposals for Child Safety Seats Issued by the State of New Jersey Solicitation Number 24DPP00938 Attachment G
OFFEROR INFORMATION, ACKNOWLEDGEMENTS, AND CERTIFICATIONS
Offeror must provide complete responses to each item below. Insert your responses into this worksheet directly below each question or prompt.
I. OFFEROR INFORMATION
A. Company’s Full Legal Name:
B. Primary Business Address:
C. Federal Tax Identification Number:
D. Entity Type:
| ☐ | Sole Proprietorship |
| ☐ | Partnership |
| ☐ | Limited Liability Company |
| ☐ | Corporation |
II. BUSINESS DETAILS
A. Company Website. Provide a URL for your company’s website.
B. Company History. Provide a brief history of your company, including the year of its founding and any material acquisitions or mergers in which it has been involved.
C. Company Size. Identify the number of employees working for your company.
D. Ownership Structure. Describe your company’s ownership structure.
E. Litigation. List all claims of non-performance or breach from customers in excess of $5,000, including all pending litigation matters (including civil, criminal, or appellate) or criminal convictions in the past 5 years for the company and all principals. Attach an additional document if necessary.
III. PROPOSAL CONTACT
The Proposal Contact must be able to respond timely to communications from the Lead State. Offeror must, within 24 hours, notify the Lead State of any change to Offeror’s Proposal Contact.
A. Proposal Contact Name:
B. Proposal Contact Title:
C. Proposal Contact Email:
D. Proposal Contact Phone Number:
IV. ACKNOWLEDGEMENTS AND CERTIFICATIONS
By signing below and submitting a response to this RFP, Offeror acknowledges and certifies the following:
A. Debarment. (Check one of the below.)
| ☐ | Neither Offeror nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in public procurement or contracting by any governmental department or agency. |
| ☐ | Offeror cannot certify the statement above, and Offeror will affix a written explanation to this attachment for review by the Lead State. If after reviewing Offeror’s written explanation the Lead State determines it is not in the best interest of the Lead State, Participating Entities, or Purchasing Entities to award Offeror a Master Agreement, the Lead State may reject Offeror’s proposal. |
B. Non-collusion.
1. This proposal has been developed independently by Offeror and has been submitted without collusion and without any agreement, understanding, or planned common course of action with any other Offeror or supplier of Deliverables in a manner designed to limit fair and open competition.
2. The contents of this proposal have not been communicated by Offeror or its employees or agents to any person not an employee or agent of Offeror and will not be communicated to any such persons prior to the RFP Close Date.
C. Data Disclosure to Foreign Governments and Prohibited Technology. (Check one of the below.)
| ☐ | Offeror is not an entity subject to laws, rules, or policies potentially requiring disclosure of, or provision of access to, customer data to foreign governments or entities controlled by foreign governments, and Offeror’s offerings do not contain, include, or utilize components or services supplied by any entity subject to the same. Offeror’s offerings also do not contain, include, or utilize covered technology prohibited under Section 889 of the National Defense Authorization Act, as amended. |
| ☐ | Offeror cannot certify all statements above, and Offeror will affix a written explanation to this attachment for review by the Lead State. If after reviewing Offeror’s written explanation the Lead State determines it is not in the best interest of the Lead State, Participating Entities, or Purchasing Entities to award Offeror a Master Agreement, the Lead State may reject Offeror’s proposal. |
D. Conflicts of Interest. (Check one of the below.)
| ☐ | Offeror represents that none of its officers or employees are officers or employees of the Lead State and that none of its officers or employees have a conflict of interest as defined by the laws, rules, or policies of the Lead State. |
| ☐ | Offeror cannot certify the statement above, and Offeror will affix a written explanation to this attachment for review by the Lead State. If after reviewing Offeror’s written explanation the Lead State determines it is not in the best interest of the Lead State, Participating Entities, or Purchasing Entities to award Offeror a Master Agreement, the Lead State may reject Offeror’s proposal. |
E. Required Insurance. Offeror agrees to acquire insurance from an insurance carrier or carriers licensed to conduct business in each Participating Entity’s state at the levels prescribed in Attachment D, Sample Master Agreement. Offeror understands that this requirement is mandatory and will not be negotiated by the Lead State.
F. NASPO ValuePoint Administrative Fee. Offeror agrees to pay an administrative fee and submit summary and detailed sales reports to NASPO ValuePoint in accordance with Attachment D, Sample Master Agreement. All costs proposed by Offeror must be inclusive of the NASPO ValuePoint administrative fee. Offeror understands that the requirements in this section are mandatory and will not be negotiated by the Lead State.
G. Confidential, Proprietary, or Protected Information. As set forth in Attachment A, RFP Terms and Conditions, if Offeror is claiming any portion of its proposal as confidential, proprietary, or protected, Offeror must complete the required sections of Attachment K, Claim of Business Confidentiality, and submit with Offeror’s proposal a redacted copy of Offeror’s proposal, which must be clearly marked as such. Offeror may not mark pricing or Offeror’s entire proposal as confidential, proprietary, or protected. Submission of a Claim of Business Confidentiality does not guarantee that information claimed by Offeror as confidential, proprietary, or protected will not be subject to disclosure in accordance with applicable public information laws, rules, and policies. If Offeror fails to submit a redacted copy of Offeror’s proposal, or fails to claim information as confidential, proprietary, or protected in compliance with this RFP, Offeror releases the Lead State, NASPO, NASPO members, and entities represented on the Multistate Sourcing Team from any obligation to keep the information confidential and waives all claims of liability arising from disclosure of the information.
H. Conditional Awards. Offeror understands that awards and execution of a Master Agreement are conditional as set forth in Attachment A, RFP Terms and Conditions, and Offeror agrees to hold the Lead State and NASPO harmless and release the Lead State and NASPO from any liability for damages arising from non-award or non-execution of a contract.
I. Understanding of the RFP. Offeror has read the RFP in its entirety and understands and agrees to comply with all requirements set forth therein. Any conflicts in the materials composing the RFP and any issues relating to the content of the RFP, including instructions, requirements, or specifications Offeror believes to be ambiguous, unduly restrictive, erroneous, anticompetitive, or unlawful, have been brought to the attention of the Lead State using the process described in the RFP for asking questions or, if applicable, by filing a protest. In accordance with Attachment [X], RFP Terms and Conditions, Offeror acknowledges and understands that any protest, claim, dispute, or action based upon a conflict or issue described herein must be filed no later than the RFP Close Date, and Offeror waives the right to file any protest, claim, dispute, or action based upon a conflict or issue described herein if not filed by the RFP Close Date.
Signature The undersigned is one of the following:
1. The Offeror, if Offeror is an individual;
2. A partner in the company, if Offeror is a partnership; or
3. An officer or employee of the responding corporation having authority to sign on its behalf, if Offeror is a corporation.
By signing below, the undersigned warrants that the representations made and the information provided in Offeror’s proposal are true, correct, and reliable for purposes of evaluation for a potential contract award. The submission of inaccurate or misleading information may be grounds for disqualification from contract award and may subject the undersigned, Offeror, or both to suspension or debarment proceedings, as well as other remedies available to the Lead State by law, including termination of any Master Agreement awarded to Offeror.
OFFEROR:
| __________________________________________ | __________________________________________ | |
| Signature | Date |
| __________________________________________ | __________________________________________ | |
| Printed Name | Title |
| __________________________________________ | __________________________________________ | |
| Email Address | Phone Number |
Page 2 of 9 – Attachment [X], RFP TERMS AND CONDITIONS
Attachment G, OFFEROR INFORMATION, ACKNOWLEDGEMENTS, AND CERTIFICATIONS image1.png
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