AttB-Bid Cover Sheet.pdf

PDF 88 KB Posted Apr 14, 2025

Attached to: ITB-Motor Fuel Quality Testing
Solicitation number: S-60300-00013550
Issued by: Multnomah County, Oregon

About this file

Written by GovTribe AI · Apr 16, 2025

This document is a Bid Cover Sheet for an Open Market Bid (S-60300-00013160) for Motor Fuel Quality Testing Services issued by the Department of Administrative Services (DAS) Procurement Services in Oregon. The document is a standard bid submission form that requires bidders to complete and sign, certifying their understanding of and compliance with various state procurement requirements. The bid appears to be seeking a contractor to provide motor fuel quality testing services, with the specific details of the services and testing scope not fully elaborated in this cover sheet.

The bid cover sheet includes critical certifications from bidders, such as acknowledgment of non-discrimination practices, tax law compliance, absence of conflicts of interest, and agreement to meet performance standards. Bidders must also certify they are not on federal exclusion lists, have no undisclosed state debt, and have independent bid preparation. The document indicates that false statements could result in penalties under the Oregon False Claims Act. Notably, for contracts with an anticipated price of $150,000 or more, bidders must have a written policy preventing sexual harassment, sexual assault, and discrimination against protected class employees.

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Open Market Bid S-60300-00013160 MOTOR FUEL QUALITY TESTING SERVICES

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 1 of 2

ATTACHMENT B — BID COVER SHEET

Bidder Name (printed):

Address: City, State, Zip:

Bid Clarification Contact Person: Telephone:

Email:

State of Incorporation: Entity Type:

Oregon Secretary of State Business Registry Number (if required):

Any	individual	signing	below	hereby	certifies	he/she	is	an	authorized	representative	of
Bidder	and	that:

1. Bidder

understands

and

accepts

the

requirements

this

ITB.

submitting

Bid,

Bidder

agrees

bound

the

Price

Agreement

terms

and

conditions

Attachment

modified

Addenda,

any.

2. Bidder

acknowledges

receipt

any

and

all

Addenda

this

ITB.

3. If

awarded

Price

Agreement,

Bidder

agrees

comply

with

all

provisions

the

ITB

and

meet

the

performance

standards

set

forth

the

Price

Agreement.

4. Bidder

has

undisclosed

liquidated

and

delinquent

debt

owed

the

State

any

department

agency

the

State.

5. I

have

knowledge

regarding

Bidder’s

payment

taxes

and

signing

below

hereby

certify,

the

best

knowledge,

Bidder

not

violation

any

tax

laws

the

state

political

subdivision

the

state,

including,

without

limitation,

ORS

305.620

and

ORS

chapters

316,

317

and

318.

6. Bidder

does

not

discriminate

its

employment

practices

with

regard

race,

creed,

age,

religious

affiliation,

gender,

disability,

sexual

orientation,

national

origin.

When

awarding

subcontracts,

Bidder

does

not

discriminate

against

any

business

certified

under

ORS

200.055

disadvantaged

business

enterprise,

minority-owned

business,

woman-owned

business,

service-disabled

veteran

owned

business,

emerging

small

business.

applicable,

Proposer

has,

will

have

prior

contract

execution,

written

policy

and

practice,

that

meets

the

requirements

described

ORS

279A.112,

preventing

sexual

harassment,

sexual

assault

and

discrimination

against

employees

who

are

members

protected

class.

Agency

may

not

enter

into

contract

with

anticipated

contract

price

$150,000

with

Proposer

that

does

not

certify

has

such

policy

and

practice.

See

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

for

additional

information

and

sample

policy

template.

7. Bidder

and

Bidder’s

employees,

agents,

and

subcontractors

are

not

included

on:

A. the

“Specially

Designated

Nationals

and

Blocked

Persons”

list

maintained

the

Office

Foreign Assets Control of the United States Department of the Treasury found at:

Open Market Bid S-60300-00013160 MOTOR FUEL QUALITY TESTING SERVICES

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 2 of 2

https://www.treasury.gov/ofac/downloads/sdnlist.pdf,

B. the

government

wide

exclusions

lists

the

System

for

Award

Management

found

at:

https://www.sam.gov/portal/SAM/#1

8. Bidder certifies to the best of its knowledge, there exists no actual or potential conflict between

the

business

economic

interests

Bidder,

its

employees,

its

agents,

the

one

hand,

and

the

business

economic

interests

the

State,

the

other

hand,

arising

out

of,

relating

any

way

to,

the

subject

matter

the

ITB.

any

changes

occur

with

respect

Bidder’s

status

regarding

conflict

interest,

Bidder

shall

promptly

notify

the

State

writing.

9. Bidder

certifies

all

contents

the

Bid

(including

any

other

forms

documentation,

required

under

this

ITB),

and

this

Bid

Cover

Sheet

are

truthful

and

accurate

and

have

been

prepared

independently

from

all

other

Bidders,

and

without

collusion,

fraud,

other

dishonesty.

10. Bidder

understands

any

statement

representation

made

response

this

ITB,

determined

false

fraudulent,

misrepresentation,

inaccurate

because

the

omission

material

information

could

result

"claim"

{as

defined

the

Oregon

False

Claims

Act,

ORS

180.750(1)},

made

under

Price

Agreement

being

"false

claim"

{ORS

180.750(2)}

subject

the

Oregon

False

Claims

Act,

ORS

180.750

180.785,

and

any

liabilities

penalties

associated

with

the

making

false

claim

under

that

Act.

11. Bidder

acknowledges

these

certifications

are

addition

any

certifications

required

the

Price

Agreement

the

time

execution.

1. 2. 3.

Authorized Signature Date

4. 5. 6.

(Printed Name and Title) 7.

Email Address

File details come from the government source that posted it. Updated Apr 15, 2025.