Attachment H.1 - Invest in MA Form.doc
DOC document 80 KB Posted
- Solicitation number
- BD-20-1062-LOT-LOTDO-49154
- Issued by
- Suffolk County, Massachusetts
About this file
The document provided is an Invest in Massachusetts Data (IMD) Form, which is required for a solicitation issued by the Massachusetts State Lottery Commission for Criminal Background Screening Services (RFR 2103). The form requires bidders to indicate whether at least 50% of the work-hours for the resulting contract will be performed in Massachusetts, and if so, how many jobs will be created or preserved and where those jobs will be located. Bidders who answer "Yes" to the 50% work-hours requirement must certify their commitment, which will be included in the resulting contract.
The solicitation seeks to acquire a criminal background screening records check service and system in accordance with the Massachusetts State Lottery Commission's statutory and regulatory mandates. No additional details about the project scope, quantities, response dates, or contract term are provided in the documents submitted.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment A_comm-termsconditions.pdf | ||
| Attachment D casl-form.pdf | ||
| Attachment J_EFT.pdf | ||
| Attachment F_References.doc | DOC document | |
| Attachment G.2 - SDP Plan. Declaration of SDP Partners.docx | DOCX document | |
| Attachment L.doc | DOC document | |
| Attachment N - Bidder Questionnaire.xlsx | XLSX spreadsheet | |
| Attachment I_Certificate_of_Non-collusion.pdf | ||
| RFR 2103. Criminal Background Screening Services.pdf | ||
| Attachment K_PPD.doc | DOC document | |
| Attachment E certgoodstandingform~1.pdf | ||
| Attachment G.1 - SDP Plan Commitment.docx | DOCX document | |
| 2103. Phase I Template.docx | DOCX document | |
| Attachment G.3 - SDP.Spending Report.xlsx | XLSX spreadsheet | |
| Attachment H.2 - Invest in MA Instructions.doc | DOC document | |
| Attachment M - Cost Table.docx | DOCX document | |
| Attachment C newmass-w9.pdf | ||
| Attachment B Contract Form.pdf | ||
| RFR 2103. Q and A.pdf |
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Text version
INVEST IN MASSACHUSETTS DATA FORM
Instructions: Completing all parts of this form is mandatory unless directed otherwise. Please read instructions in the Invest in Massachusetts Attachment included with the solicitation.
For a complete list of certified vendors please go to http://www.somwba.state.ma.us/BusinessDirectory/BusinessDirectory.aspx .
Part I Bidder/Proposer Information
Business Name:
Full Address: number, street, and apt. or suite no., city, state, zip
| Contact Name: |
| Phone # ( FORMTEXT |
) - x Email address:
Part II Invest in Massachusetts Data (Please respond to the inquiries (1-3) listed below. If you answer “No” to Inquiry #1 of this Part II, then you are not required to complete Part III of this IMD Form).
f
1. Will at least 50% or more of the work-hours performed as a result of a contract arising out of this proposal be performed in Massachusetts? FORMCHECKBOX Yes FORMCHECKBOX No
2. If you responded “Yes” to Inquiry #1, how many of those jobs performed in Massachusetts will be created and/or preserved as a result of a contract arising out of this proposal?
3. If you responded “Yes” to Inquiry #1, where in Massachusetts will those jobs be located?
Part III Certification Based on your responses in Part II of the IMD Form, those Bidders/Proposers who have answered “Yes” to Inquiry #1 are required to certify the Bidder/Proposer’s commitment that 50% or more of the work-hours performed in connection with any contract arising out of the Bidder/Proposer’s RFR Response will be performed in Massachusetts. This certification must be signed by an individual authorized to bind the Bidder/Proposer firm. Additionally, this commitment will be an essential part of any contract awarded by the Treasury and will be written into any formal agreement.
f
I, Signed under the pains and penalties of perjury.
Print Name ► Authorized Signature ► ________________________________ Date ► f
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