ATTACHMENTS B thru H-1_Final.pdf

OregonBuys Bid# S-62900-00005792 – Type 2 Restricted Category Turbine Powered Helicopter

ATTACHMENT B

DISCLOSURE EXEMPTION AFFIDAVIT

____________________, representing [insert Proposer Name] (hereafter “Proposer”), hereby deposes and swears or affirms that:

1. I am an employee of the Proposer, I have knowledge of the Request for Proposals referenced herein, and I have full authority from the Proposer to submit this disclosure exemption and accept the responsibilities stated herein.

2. I am aware that the Proposer has submitted a Proposal, dated on or about [insert date] (the “Proposal”), to the State of Oregon (State) in response to Request for Proposals S-62900-00005792, for Type 2 Restricted Category Turbine Powered Helicopter Services, and I am familiar with the contents of the RFP and Proposal.

3. I have read and am familiar with the provisions of Oregon’s Public Records Law, Oregon Revised Statutes (“ORS”) 192.311 through 192.478, and the Uniform Trade Secrets Act as adopted by the State of Oregon, which is set forth in ORS 646.461 through ORS 646.475. I understand that the Proposal is a public record held by a public body and is subject to disclosure under the Oregon Public Records Law unless specifically exempt from disclosure under that law.

4. I have reviewed the information contained in the Proposal. The Proposer believes the information listed in Exhibit A is exempt from public disclosure (collectively, the “Exempt Information”), which is incorporated herein by this reference. It is my opinion that the Exempt Information is exempt from disclosure under Oregon’s Public Records Law under the specifically designated sections as set forth in Exhibit A or constitutes “Trade Secrets” under either the Oregon Public Records Law or the Uniform Trade Secrets Act as adopted in Oregon because that information is either:

A. A formula, plan, pattern, process, tool, mechanism, compound, procedure, production data, or compilation of information that:

i. is not patented,

ii. is known only to certain individuals within the Proposer’s organization and that is used in a business the Proposer conducts,

iii. has actual or potential commercial value, and

iv. gives its user an opportunity to obtain a business advantage over competitors who do not know or use it. OR

B. Information, including a drawing, cost data, customer list, formula, pattern, compilation, program, device, method, technique or process that:

i. Derives independent economic value, actual or potential, from not being generally known to the public or to other persons who can obtain economic value from its disclosure or use; and

ii. Is the subject of efforts by the Proposer that are reasonable under the circumstances to maintain its secrecy.

5. I understand that disclosure of the information referenced in Exhibit A may depend on official or judicial determinations made in accordance with the Public Records Law.

Signature

EXHIBIT A TO ATTACHMENT B

Proposer identifies the following information as exempt from public disclosure under the following designated exemption(s):

ATTACHMENT C

PROPOSER INFORMATION AND CERTIFICATION SHEET

(PROPOSER MUST COMPLETE AND SUBMIT THIS ATTACHMENT WITH ITS PROPOSAL)

Legal Name of Proposer:

Address: City, State, Zip:

State of Incorporation: Entity Type:

Contact Name: Telephone: Email:

Oregon Business Registry #: _______________ OregonBuys Supplier #:_____________________

Federal ID #:_____________________

Any individual signing below hereby certifies they are an authorized representative of Proposer and that:

1. Proposer understands and accepts the requirements of this RFP. By submitting a Proposal, Proposer agrees to be bound by the Contract terms and conditions in Attachment A and as modified by any Addenda, except for those terms and conditions that Agency has reserved for negotiation, as identified in the RFP.

2. Proposer acknowledges receipt of any and all Addenda to this RFP.

3. Proposal is a Firm Offer for 180 days following the Closing.

4. If awarded a Contract, Proposer agrees to perform the scope of work and meet the performance standards set forth in the final negotiated scope of work of the Contract.

5. I have knowledge regarding Proposer’s payment of taxes and by signing below I hereby certify that, to the best of my knowledge, Proposer is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation, ORS

305.620 and ORS chapters 316, 317 and 318.

6. Proposer does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Proposer does not discriminate against any business certified under ORS 200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns or an emerging small business. If applicable, Proposer has, or will have prior to contract execution, a written policy and practice, that meets the requirements described in ORS 279A.112 (formerly HB 3060), of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class.

Agency may not enter into a contract with an anticipated contract price of $150,000 or more with a Proposer that does not certify it has such a policy and practice. See https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx for additional information and sample policy template.

7. Proposer complies with ORS 652.220 and does not unlawfully discriminate against any of Proposer’s employees in the payment of wages or other compensation for work of comparable character on the basis of an employee’s membership in a protected class. “Protected class” means a group of persons distinguished by race, color, religion, sex, sexual orientation, national origin, marital status, veteran status, disability or age.

Contractor’s continuing compliance constitutes a material element of this Contract and a failure to comply constitutes a breach that entitles Agency to terminate this Contract for cause.

Contractor may not prohibit any of Contractor’s employees from discussing the employee’s rate of wage, salary, benefits, or other compensation with another employee or another person. Contractor may not retaliate against an employee who discusses the employee’s rate of wage, salary, benefits, or other compensation with another employee or another person.

https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx

8. Proposer is not engaged in the provision of broadband Internet access service, or if at any time Proposer is engaged in or may engage in the provision of broadband Internet access service Proposer is in compliance with Oregon Laws 2018, Chapter 88 (HB 4155) and applicable Public Utility Commission rules, and will remain in compliance throughout the term of the Contract.

9. Proposer and Proposer’s employees, agents, and subcontractors are not included on:

A. the “Specially Designated Nationals and Blocked Persons” list maintained by the Office of Foreign Assets Control of the United States Department of the Treasury found at: https://www.treasury.gov/ofac/downloads/sdnlist.pdf., or

B. the government wide exclusions lists in the System for Award Management found at: https://www.sam.gov/portal/

10. Proposer certifies that, to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Proposer, its employees, or its agents, on the one hand, and the business or economic interests of the State, on the other hand, arising out of, or relating in any way to, the subject matter of the RFP. If any changes occur with respect to Proposer’s status regarding conflict of interest, Proposer shall promptly notify the State in writing.

11. Proposer certifies that all contents of the Proposal (including any other forms or documentation, if required under this RFP) and this Proposal Certification Sheet are truthful and accurate and have been prepared independently from all other Proposers, and without collusion, fraud, or other dishonesty.

12. Proposer understands that any statement or representation it makes, in response to this RFP, if determined to be false or fraudulent, a misrepresentation, or inaccurate because of the omission of material information could result in a "claim" {as defined by the Oregon False Claims Act, ORS 180.750(1)}, made under Contract being a "false claim" {ORS 180.750(2)} subject to the Oregon False Claims Act, ORS 180.750 to 180.785, and to any liabilities or penalties associated with the making of a false claim under that Act.

13. Proposer acknowledges these certifications are in addition to any certifications required in the Contract and Statement of Work in Attachment A at the time of Contract execution.

Authorized Signature Date

(Printed Name and Title) https://www.treasury.gov/ofac/downloads/sdnlist.pdf https://www.sam.gov/portal/

ATTACHMENT D

PROPOSER’S REFERENCES

(PROPOSER MUST COMPLETE AND SUBMIT THIS PAGE WITH ITS PROPOSAL)

(30 POINTS MAX)

PROPOSER: __________________________________________________________

References will be evaluated by the Evaluation Committee and scored for a maximum of 30 possible points.

REFERENCE #1

FIRM NAME:

ADDRESS:

CONTACT PERSON: ____________________________________________________

POSITION TITLE:

PHONE NUMBER:

EMAIL:

REFERENCE #2

REFERENCE #3

ATTACHMENT D-1

REFERENCE SCORE SHEET EXAMPLE

(FOR INFORAMTION PURPOSES ONLY)

PROPOSER NAME: _______________________________________________________________

REFERENCE NAME: __________________________________________________________________

DATE CALLED: ________________________________________________________________________

TIME CALLED: ____________________________

NUMBER OF ATTEMPTS TO CONTACT: ____________________________

Questions are scored on a basis of 1 to 5, with 5 being the best. Each reference provided, up to three (3) references, will be contacted and asked the same six (6) questions. During the reference checks, the Evaluation Committee member(s) will make three (3) attempts to contact the listed references provided by Proposer. If the Committee member(s) is unable to contact a reference, the Proposer will receive zero (0) points for that reference.

Total Score_____________ divided by three (3) = Final Score________________

Questions: “I will ask you the following questions and please respond on a scale of 1 to 5 with 5 being the best.”

1. Please rate, the contractor’s responsiveness when contacted.

1 2 3 4 5

2. As a customer, please rate the satisfaction of the services you received.

3. How would you rate the contractor’s attention to safety?

4. On a scale of 1 to 5 with 5 being exceptional what was the quality of the work performed?

5. Was work performed within the proposed amount?

1=Never 2=Rarely 3=Sometime 4=Most of the time 5=Always

6. Was the company financially capable of maintaining aircraft and personnel in the field?

1=Never 2=Rarely 3=Sometime 4=Most of the time 5=Always

ATTACHMENT E

PRICE PROPOSAL

(70 POINTS MAX)

PROPOSER: _______________________________________________________

ODF will evaluate the reasonableness of the price, when compared to the overall capabilities and services being offered. Additional bases of operation may be required as a contingency for fire emergencies. Submit a Flight Rate price per hour below in consideration of the possibility that additional bases of operation will be required.

Flight Rate $ ________________________ per hour.

For Extension Terms past the 75-day Mandatory Availability Period, the Contractor shall be paid 1.6 flight hours per day (for daily availability) at the flight rate designated above.

A minimum of 120 flight hours are guaranteed per 75-day Mandatory Availability Period.

The following rates have been pre-determined by the Agency:

• Extended Standby Rate for a maximum of 3 persons (beyond 9-hour Daily Standby/not to exceed 14 hours) = $100.00 per hour/per required person.

• Remain Overnight (RON) reimbursed at Federal Domestic Per Diem Rate

• Service Vehicle Mileage Rate = $3.50 per mile

• Fuel Truck Mileage Rate = $5.50 per mile

Price score will be calculated for the lowest Flight Rate (70 Price Points Possible).

The price score to each price Proposal is based upon the percentage of the proposed price as compared to the lowest Proposer’s price using the following formula:

lowest price of all Proposers X price points possible = price score price being scored

Example:

Proposer A Proposer B Proposer C Flight rate $4000 Flight Rate $3500 Flight Rate $3450 Points 60.38 Points 69.00 Points 70

Total Points Total Points Total Points 60 pts. 69 pts. 70 pts.

ATTACHMENT F

RESPONSIBILITY INQUIRY

(PROPOSER MUST COMPLETE AND SUBMIT THIS ATTACHMENT WITH ITS PROPOSAL)

Agency will determine responsibility of a Proposer prior to award and execution of a Contract. In addition to this form, Agency may notify Proposer of other documentation required, which may include but is not limited to recent profit-and-loss history, current balance statements and cash flow information, assets-to-liabilities ratio, including number and amount of secured versus unsecured creditor claims, availability of short and long-term financing, bonding capacity, insurability, credit information, materials and equipment, facility capabilities, personnel information, record of performance under previous contracts, etc. Failure to promptly provide requested information or clearly demonstrate responsibility may result in an Agency finding of non-responsibility and rejection.

1. Does Proposer have available the appropriate financial, material, equipment, facility and personnel resources and expertise, or ability to obtain the resources and expertise, necessary to demonstrate the capability of Proposer to meet all contractual responsibilities? YES / NO .

2. Within the last five years, how many contracts of a similar nature has Proposer completed that, to the extent that the costs associated with and time available to perform the contract remained within Proposer′s control, Proposer stayed within the time and budget allotted, and there were no contract claims by any party?

Number: ____

How many contracts did not meet those standards? Number: ____ If any, please explain.

Response:

3. Within the last three years has Proposer (incl. a partner or shareholder owning 10% or more of Proposer’s firm) or a major subcontractor (receiving 10% or more of a total contract amount) been criminally or civilly charged, indicted or convicted in connection with:

• obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract,

• violation of federal or state antitrust statutes relating to the submission of Bids or Proposals, or

• embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property? YES / NO .

If "YES," indicate the jurisdiction, date of indictment, charge or judgment, and names and summary of charges in the response field below.

Response:

4. Within the last three years, has Proposer had:

• any contracts terminated for default by any government agency, or

• any lawsuits filed against it by creditors or involving contract disputes? YES / NO .

If "YES," please explain. (With regard to judgments, include jurisdiction and date of final judgment or dismissal.)

Response:

5. Does Proposer have any outstanding or pending judgments against it? YES / NO .

Is Proposer experiencing financial distress or having difficulty securing financing? YES / NO .

Does Proposer have sufficient cash flow to fund day-to-day operations throughout the proposed contract period? YES / NO .

If "YES” on the first question or second question, or “NO” on the third question, please provide additional details.

Response:

6. Within the last three years, has Proposer filed a bankruptcy action, filed for reorganization, made a general assignment of assets for the benefit of creditors, or had an action for insolvency instituted against it?

YES / NO .

If "YES," indicate the filing dates, jurisdictions, type of action, ultimate resolution, and dates of judgment or dismissal, if applicable.

Response:

7. Does Proposer have all required licenses, insurance and/or registrations, if any, and is Proposer legally authorized to do business in the State of Oregon? YES /NO .

If "NO," please explain.

Response:

8. Pay Equity Certificate. This certificate is required if Proposer employs 50 or more full-time workers and the prospective contract price is estimated to exceed $500,000. [This requirement does not apply to architectural, engineering, photogrammetric mapping, transportation planning or land surveying and related services contracts.] Does a current authorized representative of Proposer possess an unexpired Pay Equity Certificate issued by the Department of Administrative Services? YES / NO / N/A . [If the certificate was provided with the Bid or Proposal submitted for a solicitation related to the prospective contract, then it is not necessary to resubmit it. Just indicate “see Bid” or “see Proposal” in the response field. Otherwise, if applicable, submit a copy of the certificate with this form.]

Response:

AUTHORIZED SIGNATURE

By signature below, the undersigned Authorized Representative on behalf of Proposer certifies to the best of his or her knowledge and belief that the responses provided on this form are complete, accurate, and not misleading.

Proposer Name: RFP: S-62900-00005792

Project Name: Type 2 Restricted Category Turbine Powered Helicopter

Authorized Signature: Date:

Print Name: Print Title:

ATTACHMENT G

HELICOPTER SUMMARY

PROPOSER: ___________________________________________________

Proposer must submit a response to “Attachment G” and “Attachment G-1” for each helicopter designated for use under the Contract. Proposer must provide a copy of the USFS/OAS cards for each helicopter and fuel truck and/or service vehicle designated under the Contract.

Company Address (Aircraft Hangar Location | “Home Base”):

COMPLETE EACH BOX AND CHECK YES OR NO FOR EACH YES/NO QUESTION BELOW.

HELICOPTER MAKE & MODEL:

FAA “N” NUMBER: YEAR BUILT:

GROSS WEIGHT: EMPTY WEIGHT:

FUEL CAPACITY (TOTAL GALLONS): FUEL (TOTAL HOURS):

NUMBER OF PASSENGERS (EXCLD PILOT): ENGINE H.P.:

ANNUAL INSPECTION (DATE ACCOMPLISHED):

GPS: ( ) YES ( ) NO

VHF RADIO (760 CHANNELS): ( ) YES ( ) NO

P25 DIGITAL RADIO (NUMBER OF CHANNELS SELECTABLE):

CATEGORY (STANDARD OR RESTRICTED):

NUMBER OF HELMETS AVAILABLE (EXCLUDE PILOT):

NON-JETTISONABLE PAYLOAD (HOGE) FROM “ATTACHMENT G-1”:

CARGO HOOK: ( ) YES ( ) NO

LONG LINE (HOW LONG):

CARGO NET, SWIVEL, AND LEADLINE (3000 lb. Minimum Rating): ( ) YES ( ) NO

MAIN ROTORS PAINTED IN CONTRASTING COLORS: ( ) YES ( ) NO

ATTACHMENT G-1

AIRCRAFT PERFORMANCE DESIRABLE FEATURES

(30 POINTS MAX)

PROPOSER: ___________________________________________________

Type 2 Helicopter Minimum Performance:

Jettisonable payload (HOGE) of 1,200 pounds at 30 degrees C at 7,000 feet pressure altitude using a pilot weight of 200 pounds, and fuel for 1.5 hours.

Based on minimum performance requirements 5 points will be awarded for each 100 lb. incremental increase for non-jettisonable payload (HOGE) above the minimum performance requirements. Provide an Interagency Helicopter Load Calculation form with this Attachment G-1. *Do not include the interagency weight reduction for make and model of helicopter.

HELICOPTER MAKE AND MODEL:

FAA “N” NUMBER:

EMPTY WEIGHT:

MAXIMUM PAYLOAD (HOGE)*:

Points Award Example:

Submitted aircraft payload 1,300 pounds - minimum payload 1,200 pounds = 100 pounds (over the minimum) 100 pounds above minimum payload divided by 100 lbs. = 1 (rounded to nearest whole number) Multiply 1 x 5 points = 5 points (That is 5 points for every 100-pound increment above minimum payload)

ATTACHMENT H

HELICOPTER PILOT SUMMARY

(PROPOSER MUST COMPLETE AND SUBMIT THIS PAGE WITH ITS PROPOSAL)

PROPOSER: ____________________________________________________

Proposer must submit a response to “Attachment H” and “Attachment H-1” for primary and relief pilots who may be designated to perform Services under the Contract. Proposer must provide a copy of the USFS/OAS cards and a copy of the FAA Pilot Certificate for each pilot designated to perform Services under the Contract.

COMPLETE EACH BOX AND CHECK YES OR NO FOR EACH YES/NO QUESTION BELOW.

PILOT NAME:

FAA CERTIFICATE NUMBER TYPE OF CERTIFICATE:

AIRMEN RATINGS: A/C TYPE RATINGS:

FAA MEDICAL CERTIFICATE TYPE:

DATE OF EXAMINATION:

FAR PART 133: ( ) YES ( ) NO

FAR PART 137: ( ) YES ( ) NO

Does pilot experience include two (2) fire seasons of:

• Loading the bucket, using a long line, from a hover position above streams, rivers, ponds, or other sources of water and completing rapid repeated drops of water on wildland fires: ( ) YES ( ) NO

• Conducting aerial delivery of fire fighters: ( ) YES ( ) NO

COMPLETE EACH BOX BELOW WITH THE NUMBER OF FLIGHT HOURS.

TOTAL FLIGHT TIME PIC HOURS:

COMPLETE EACH BOX WITH THE NUMBER OF FLIGHT HOURS FLOWN IN A HELICOPTER FOR EACH TYPE

AND WEIGHT CLASS AND INCLUDE PIC TIME IN PRECEDING 12 MONTHS AND PIC TIME IN THE

PRECEDING 60 DAYS:

LIGHT - TYPE 3 HELICOPTER HOURS:

MEDIUM - TYPE 2 HELICOPTER HOURS:

HEAVY - TYPE 1 HELICOPTER HOURS:

TYPICAL TERRAIN HELICOPTER FLIGHT HOURS:

PIC HELICOPTER HOURS IN THE LAST 12 MONTHS:

PIC HELICOPTER HOURS IN THE LAST 60 DAYS:

ATTACHMENT H-1

PRIMARY AND RELIEF PILOT DESIRABLE FEATURES

(PROPOSER MUST COMPLETE AND SUBMIT THIS PAGE WITH ITS PROPOSAL)

(80 POINTS MAX)

PROPOSER: ____________________________________________________

State the “Pilot’s Name” as submitted on “Attachment H” Helicopter Pilot Summary and specify total years of aerial wildfire fire suppression experience, with each fire season worked being one year. In addition, specify the number of months worked in the geographic area. Each question below has a maximum of 20 points possible. The points for each question will be added for a maximum of 80 total points possible.

PRIMARY PILOT NAME: _____________________________________________________

Years of aerial wildland fire suppression long line/bucket work (1 point per year of experience beyond the two-year minimum experience requirement).

Number of years of experience beyond 2-year minimum requirement (20-points max): ___________________

Months of experience flying in the Central/Eastern Oregon geographic area (1 point per month worked in geographic area).

Months of experience flying in geographic area (20-points max): _______________________________

RELIEF PILOT NAME: _______________________________________________________

Years of aerial wildland fire suppression long line/bucket work (1 point per year of experience beyond the two-year minimum experience requirement).

Number of years of experience beyond 2-year minimum requirement (20-points max): ___________________

Months of experience flying in the Central/Eastern Oregon geographic area (1 point per month worked in geographic area).

Months of experience flying in geographic area (20-points max): _______________________________

HELICOPTER SUMMARY