Attachment J2 Form 2 Invest in MA Data Form~1.docx
DOCX document 98 KB Posted
- Attached to
- RFR LOT Number 1508 - Advertising Services
- Solicitation number
- BD-15-1062-LOT-00001-00000003432
- Issued by
- Suffolk County, Massachusetts
About this file
This document is an Invest in Massachusetts Data Form related to a Request for Responses (RFR) issued by the Massachusetts State Lottery Commission (MSLC) for Advertising Services. The form requires bidders to indicate whether at least 50% of the work hours performed under any resulting contract will be in Massachusetts, and to provide details on the number and location of jobs that will be created or preserved in the state. Bidders that answer "Yes" to this requirement must certify their commitment to performing 50% or more of the work hours in Massachusetts.
The RFR Lot Number 1508 is seeking proposals from qualified bidders to provide a range of advertising services designed to increase game sales and maximize net profit returned to the Commonwealth of Massachusetts. No other details about the specific services, quantities, response dates, or contract term are provided in the document.
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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.
Part I Bidder/Proposer Information
Business Name:
Full Address: number, street, and apt. or suite no., city, state, zip
Contact Name: Phone # ( ) - 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).
| 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? | Yes | 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.
| I, | , hereby certify that the information contained in this IMD Form is true and accurate and |
| I hereby certify on behalf of | [Bidder/Proposer Name] that, if awarded the contract, 50% or more of the work‐hours performed in connection with any agreement arising out of the Bidder/Proposer’s RFR Response, will be performed in the Commonwealth of Massachusetts. |
Signed under the pains and penalties of perjury.
Print Name Title
MSLC DOCUMENT NUMBER: RFR LOT # 1508
ATTACHMENT J2 - FORM 2
Authorized Signature
Date image1.jpeg
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