Attachments D-H.pdf

RFP #89393, ATTACHMENT D

EXCEPTIONS TO RFP # 89393

Name of Offeror: ______________________________________________

Unless stated on this form, all Offerors will be considered to have accepted all terms and conditions of the RFP and any amendments as issued without exception. Offerors who wish to propose modifications to the contract provisions must clearly identify the proposed exceptions including the section and page number(s) of the RFP and submit any proposed substitute language; however, the provisions of the RFP cannot be modified without written approval by the DPS Contract Officer.

SECTION/TITLE

PAGE

NUMBER(S)

PROPOSED SUBSTITUTE LANGUAGE

RFP #89393, ATTACHMENT E

VENDOR DATA SHEET

The following information is required as part of the Offeror’s response to this solicitation.

1. Qualification: The Offeror must have the capability and capacity in all respects to satisfy fully all of the contractual requirements.

2. Offeror’s Primary Contact:

Name: _______________________________ Phone: ______________ Email: _____________________

3. Years in Business: Indicate the length of time Offeror has been in business providing this type of good or service:

__________ Years ________ Months

4. eVA Supplier ID or DUNS Number: _______________________________

5. For Reference Checks: Offeror must indicate below a listing of at least four (4) current or recent accounts, either commercial or governmental, that the Offeror is servicing, has serviced, or has provided similar goods/services. Include the length of service and the name, address, and telephone number of the point of contact.

No. Name of Entity Point of Contact

Phone # Physical & Email Addresses

Date of Service Dollar Value

I certify the accuracy of this information.

Signed: ___________________________________ Title: ______________________________ Date: _______

1.

2.

3.

4.

5.

RFP #89393, ATTACHMENT F

PROPRIETARY & CONFIDENTIAL INFORMATION IDENTIFICATION

Trade secrets or proprietary information submitted by an Offeror shall not be subject to public disclosure under the Virginia Freedom of Information Act; however, the Offeror must invoke the protections of § 2.2-4342F of the Code of Virginia, in writing, either before or at the time the data or other material is submitted. The written notice must specifically identify the data or materials to be protected including the section of the proposal in which it is contained and the page number(s), and state the reasons why protection is necessary. The proprietary or trade secret material submitted in the original and all copies of the proposal must be identified by some distinct method such as highlighting or underlining and must indicate only the specific words, figures, or paragraphs that constitute trade secret or proprietary information. In addition, a summary of proprietary information submitted shall be submitted on this form. The classification of an entire proposal document, line item prices, and/or total proposal prices as proprietary or trade secrets is not acceptable. If, after being given reasonable time, the Offeror refuses to withdraw such a classification designation, the proposal will be rejected.

Name of Offeror invokes the protections of § 2.2-4342F of the Code of Virginia for the following portions of my proposal submitted on .

Date

Signature:

Title:

DATA/MATERIAL TO BE

PROTECTED

SECTION NO., &

PAGE NO.

REASON WHY PROTECTION

IS NECESSARY

https://law.lis.virginia.gov/vacode/title2.2/chapter43/section2.2-4342/ https://law.lis.virginia.gov/vacode/title2.2/chapter43/section2.2-4342/ https://law.lis.virginia.gov/vacode/title2.2/chapter43/section2.2-4342/

RFP #89393, ATTACHMENT G

SMALL BUSINESS SUBCONTRACTING PLAN

It is the goal of the Commonwealth that over 42% of its purchases be made from small businesses. All potential

Offerors are required to include this document with their proposal response.

Small Business: "Small business (including micro)” means a business which holds a certification as such by the

Virginia Department of Small Business and Supplier Diversity (DSBSD) on the due date for bids. This shall also include DSBSD-certified women- owned and minority-owned businesses and businesses with DSBSD service disabled veteran owned status when they also hold a DSBSD certification as a small business on the proposal due date. Currently, DSBSD offers small business certification and micro business designation to firms that qualify.

Certification applications are available through DSBSD online at www.SBSD.virginia.gov (Customer Service).

Offeror Name:

Preparer Name: Date:

Who will be doing the work: □ I plan to use subcontractors □ I plan to complete all work

Instructions

A. If you are certified by the DSBSD as a micro/small business, complete only Section A of this form.

B. If you are not a DSBSD-certified small business, complete Section B of this form. For the Offeror to receive credit for the small business subcontracting plan evaluation criteria, the Offeror shall identify the portions of the contract that will be subcontracted to DSBSD-certified small business for the initial contract period the initial contract period in Section B.

Offerors which are small businesses themselves will receive the maximum available points for the small business participation plan evaluation criterion, and do not have any further subcontracting requirements.

Offerors which are not certified small businesses will be assigned points based on proposed expenditures with

DSBSD-certified small businesses for the initial contract period in relation to the Offeror’s total price for the initial contract period.

Points will be assigned based on each Offeror’s proposed subcontracting expenditures with DSBSD-certified small businesses for the initial contract period as indicated in Section B in relation to the Offeror’s total price.

Section A

If your firm is certified by the DSBSD provide your certification number and the date of certification.

Certification number: Certification Date:

Section B

If the “I plan to use subcontractors box is checked,” populate the requested information below, per subcontractor to show your firm's plans for utilization of DSBSD-certified small businesses in the performance of this contract for the initial contract period in relation to the offeror’s total price for the initial contract period. Certified small businesses include but are not limited to DSBSD-certified women-owned and minority-owned businesses and businesses with DSBSD service disabled veteran-owned status that have also received the DSBSD small business certification. Include plans to utilize small businesses as part of joint ventures, partnerships, subcontractors, suppliers, etc. It is important to note that these proposed participation will be incorporated into the subsequent contract and will be a requirement of the contract. Failure to obtain the proposed participation dollar value or percentages may result in breach of the contract.

B. Plans for Utilization of DSBSD-Certified Small Businesses for this Procurement

Subcontract #1

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % or $ (Initial Term): Contact Address:

Description of Work:

Subcontract #2

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % or $ (Initial Term): Contact Address:

Description of Work:

Subcontract #3

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % or $ (Initial Term): Contact Address:

Description of Work:

Subcontract #4

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % or $ (Initial Term): Contact Address:

Description of Work:

Subcontract #5

Company Name: SBSD Cert #:

Contact Name: SBSD Certification:

Contact Phone: Contact Email:

Value % or $ (Initial Term): Contact Address:

Description of Work:

RFP #89393, ATTACHMENT H

STATE CORPORATION COMMISSION FORM

Offerors are required to return this form with their proposal.

Virginia State Corporation Commission (“SCC”) registration information: The Offeror:

is a corporation or other business entity with the following SCC identification number:

-OR-

is not a corporation, limited liability company, limited partnership, registered limited liability partnership, or business trust

-OR-

is an out-of-state business entity that does not regularly and continuously maintain as part of its ordinary and customary business any employees, agents, offices, facilities, or inventories in

Virginia (not counting any employees or agents in Virginia who merely solicit orders that require acceptance outside Virginia before they become contracts, and not counting any incidental presence of the Offeror in Virginia that is needed in order to assemble, maintain, and repair goods in accordance with the contracts by which such goods were sold and shipped into

Virginia from Offeror’s out-of-state location)

-OR-

is an out-of-state business entity that is including with this proposal an opinion of legal counsel which accurately and completely discloses the undersigned Offeror’s current contacts with Virginia and describes why those contacts do not constitute the transaction of business in

Virginia within the meaning of § 13.1-757 or other similar provisions in Titles 13.1 or 50 of the

Code of Virginia.

**NOTE** >> Check the following box if you have not completed any of the foregoing options but currently have pending before the SCC an application for authority to transact business in the Commonwealth of Virginia and wish to be considered for a waiver to allow you to submit the

SCC identification number after the due date for proposals (the Commonwealth reserves the right to determine in its sole discretion whether to allow such waiver):

Signature: _______________________________________ Date: __________________

Name: _____________________________________

Print

Title: ______________________________________

Name of Firm: ______________________________