Attachment G - PUR 7801 (Vendor Certification Form) final 8-26-24 (1).docx
DOCX document 53 KB Posted
- Solicitation number
- ITB-15674
- Issued by
- Leon County, Florida
About this file
This is a Vendor Certification Form (PUR 7801) issued by the State of Florida Department of Management Services for use in response to Invitation to Bid No. DMS-2526-039 for Investment Consulting and Monitoring Services. The solicitation seeks a contractor to provide investment consulting and monitoring services to support the State University System Optional Retirement Program (SUSORP), which manages approximately $7.5 billion in assets for approximately 18,000 active and 30,000 inactive members across twelve state universities, and the Senior Management Service Optional Annuity Program (SMSOAP), which manages approximately $14.6 million in assets for approximately five active and 128 inactive members. The contractor must deliver a minimum of four quarterly investment reviews and reports within 20 business days of each quarter-end date, one comprehensive annual investment review and report within 20 business days of December 31, verbal performance reviews within 25 business days of quarter-end dates, and ad hoc consulting services on an as-needed basis. The question deadline is May 1, 2026, with bid submissions due by May 20, 2026, at 2:00 PM Eastern Time, followed by public opening on May 20, 2026, at 3:00 PM Eastern Time in Tallahassee, Florida. Award is anticipated on June 1, 2026, with a contract start date of August 8, 2026, for an initial term of three years with potential renewal for up to three additional years.
The vendor certification form requires bidders to attest to compliance with multiple Florida Statutes requirements, including certification that the vendor is not participating in a boycott of Israel, is not on various state scrutinized or suspended vendor lists, is registered with E-Verify, maintains compliance with disclosure requirements, does not use coercion for labor, and has not been placed on the Forced Vendor List. For contracts valued at $1 million or more, vendors must certify they are not on the Scrutinized Companies with Activities in Sudan List or the Iran Terrorism Sectors List and do not have business operations in Cuba or Syria. If the contract grants access to personal identifying information, the vendor must complete Form PUR 1355 Foreign Country of Concern Attestation Form. All prices must remain firm for the life of the contract with no price adjustments permitted. The historic annual spend is approximately $12,000; however, this is provided for informational purposes only and does not represent guaranteed or minimum spend. The contractor must obtain commercial general liability insurance of $1,000,000 per occurrence and $2,000,000 aggregate, workers' compensation insurance as required by law, and professional indemnity insurance of $250,000 per claim and in aggregate, with all payments made quarterly in arrears and funding sourced from the Optional Retirement Program Trust Fund. The solicitation does not identify specific set-aside designations or restrictions limiting participation to particular business types or disadvantaged enterprises, and current service providers for SUSORP include Equitable, TIAA, VALIC, and Voya Financial, plus three companies maintaining legacy products, while SMSOAP is served by Empower, TIAA, VALIC, and Voya Financial.
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Text version
ATTACHMENT G
PUR 7801 VENDOR CERTIFICATION FORM
I hereby certify the following on behalf of the vendor identified below:
| Customer Indicator (Required, N/A, Determined by Vendor) |
| Vendor Indicator (Certified, N/A) |
| Certification |
| Required | |
| Choose an item. | Regardless of the dollar value of the goods or services provided, in accordance with the requirements of section 287.135(5), F.S., the vendor is not participating in a boycott of Israel and is not on the State Board of Administration’s “Quarterly List of Scrutinized Companies that Boycott Israel,” available at |
https://www.sbafla.com/governance/global-governance-mandates/
| Required | |
| Choose an item. | If the goods or services to be provided are $1 million or more, in accordance with the requirements of section 287.135, F.S., the vendor is not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Terrorism Sectors List (collectively, “Scrutinized List of Prohibited Companies”); does not have business operations in Cuba or Syria; and is not on the State Board of Administration’s “Scrutinized List of Prohibited Companies” available under the quarterly reports section at |
https://www.sbafla.com/reporting/
| Required | |
| Choose an item. | The vendor is not on the Suspended Vendor List; it and its suppliers, subcontractors, or consultants to be utilized under the contract are not on the Convicted Vendor, Discriminatory Vendor, or Antitrust Violator Vendor Lists; and there is no pending or threatened action, proceeding, or investigation, or any other legal or financial condition, that would in any way prohibit, restrain, or diminish the vendor’s ability to satisfy the contract obligations. |
The vendor is hereby informed of the provisions of sections 287.133(2)(a), 287.134(2)(a), and 287.137(2)(a), F.S., that identify the impacts to the vendor's ability or its affiliates’ ability to respond to the competitive solicitations of a public entity; to be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with a public entity; or to transact business with a public entity if it, or its affiliates, are placed on the Convicted Vendor, Discriminatory Vendor, or Antitrust Violator Vendor Lists of the Department of Management Services. The vendor is hereby further informed of the provisions of section 287.1351, F.S., that identify the impacts to the vendor’s ability to enter into or renew a contract with an agency, as defined in section 287.012, F.S., if it is placed on the Suspended Vendor List of the Department of Management Services.
| N/A | |
| Choose an item. | If the contract grants the vendor access to an individual’s personal identifying information, the vendor is not prohibited from entering into the contract pursuant to section 287.138, F.S., and has completed the Form PUR 1355, “Foreign Country of Concern Attestation Form,” available at http://www.flrules.org/Gateway/reference.asp?No=Ref-15843, and attached it hereto. |
| Determined by Vendor | |
| Choose an item. | If the vendor is a common carrier, as defined in section 908.111, F.S., or a contracted carrier, it is not prohibited from entering into the contract pursuant to section 908.111, F.S., and has completed the Form PUR 1808, “Common Carrier or Contracted Carrier Attestation Form,” available at |
http://www.flrules.org/Gateway/reference.asp?No=Ref-14614, and attached it hereto.
| Required | |
| Choose an item. | The vendor is registered with, and uses, the E-Verify system for all newly hired employees in accordance with section 448.095, F.S.; and has not, within the last year, had a contract terminated under section 448.095(5)(c), F.S., by a public employer, contractor, or subcontractor, as defined by section 448.095(1), F.S. |
| Required | |
| Choose an item. | The vendor is in compliance with all applicable disclosure requirements set forth in section 286.101, F.S., and has not been deemed ineligible for a grant or contract funded by a state agency pursuant to section 286.101(7), F.S. |
| Required | |
| Choose an item. | If the contract is between a nongovernmental entity and a governmental entity, in accordance with section 787.06, F.S., the vendor has completed an affidavit signed by an officer or a representative of the vendor under penalty of perjury attesting that the vendor does not use coercion for labor or services as defined in section 787.06, F.S. |
| Required | |
| Choose an item. | If the Contract is for the provision of commodities, in accordance with section 287.1346, F.S., the vendor, and any entity under the control of vendor, has not been placed on the Forced Vendor List within the past 365 days or, if placed on the Forced Vendor List, has been removed pursuant to section 287.1346(5)(d), F.S. |
If the Contract is for the provision of commodities, the Contractor will submit, prior to entering into or renewing the Contract, a written certification from senior management, as defined in section 287.1346(1)(c), F.S., which certifies to the best of their knowledge the commodities being offered pursuant to this solicitation have not been produced, in whole or in part, by forced labor.
The vendor is hereby informed of the provisions of section 287.1346, F.S., that identify the impacts to a vendor’s ability to respond to the competitive solicitations of a state agency; to be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with a state agency; or to transact business for the provision of commodities with a state agency if it, or entities under the control of the vendor, is placed on the forced labor list in accordance with section 287.1346, F.S.
By signing below, I certify that I am authorized to complete and submit this Vendor Certification Form on behalf of the vendor.
Vendor Information Signatory
Name Signature Date
FEIN Typed or Printed Name
Title Form PUR 7801 (07/2024) Rule 60A-1.002, F.A.C.
File details come from the government source that posted it. Updated .