Audio Visual Response Packet.docx

REVISED

RESPONSE PACKET

SP-19-0048

UPDATED: 04.22.19

RESPONSE SIGNATURE PAGE

Type or Print the following information.

PROSPECTIVE CONTRACTOR’S INFORMATION

Company:

Address:

City:

State:

Zip Code:

Minority and Women-Owned Designation*:

☐ Not Applicable ☐ African American

AR Certification #: ____________________

* See Minority and Women-Owned Business Policy

PROSPECTIVE CONTRACTOR CONTACT INFORMATION

Provide contact information to be used for bid solicitation related matters.

Contact Person:

Title:

Phone:

Alternate Phone:

Email:

CONFIRMATION OF REDACTED COPY

☐ YES, a redacted copy of submission documents is enclosed.

☐ NO, a redacted copy of submission documents is not enclosed. I understand a full copy of non-redacted submission documents will be released if requested.

Note: If a redacted copy of the submission documents is not provided with Prospective Contractor’s response packet, and neither box is checked, a copy of the non-redacted documents, with the exception of financial data (other than pricing), will be released in response to any request made under the Arkansas Freedom of Information Act (FOIA). See Bid Solicitation for additional information.

ILLEGAL IMMIGRANT CONFIRMATION

By signing and submitting a response to this Bid Solicitation, a Prospective Contractor agrees and certifies that they do not employ or contract with illegal immigrants. If selected, the Prospective Contractor certifies that they will not employ or contract with illegal immigrants during the aggregate term of a contract.

ISRAEL BOYCOTT RESTRICTION CONFIRMATION

By checking the box below, a Prospective Contractor agrees and certifies that they do not boycott Israel, and if selected, will not boycott Israel during the aggregate term of the contract.

☐ Prospective Contractor does not and will not boycott Israel.

An official authorized to bind the Prospective Contractor to a resultant contract shall sign below.

The signature below signifies agreement that any exception that conflicts with a Requirement of this Bid Solicitation will cause the Prospective Contractor’s response to be disqualified.

RESPONSE PACKET CHECK LIST

Original signed Response Signature Page

Completed Proposed Subcontractors Form

Completed and signed EO 98-04 Contract and Grant Disclosure Form (posted as an additional document to this RFQ)

Copy of Prospective Contractor’s Equal Opportunity Policy

Completed VPAT Form (See Technology Access in the RFQ)

Completed Original Arkansas Business Information Form

Completed Original Business Contact Information Form

Completed Original Audio/Visual Equipment Offering Form

Completed Original List of Counties Serviced Form

Completed Original Arkansas Distributors / Additional Locations Form

· Provide a response to all fields on the forms included in the Response Packet except the Audio / Visual Equipment Offering Form. If a particular field is not applicable, mark “N/A” in the field.

· Audio / Visual Equipment Offering Form – Indicate the Audio/Visual Equipment and Supplies your company will offer on the QVL. Prospective Contractors are not required to offer all categories or every item within a category and are not required to mark “N/A” on inapplicable fields.

PROPOSED SUBCONTRACTORS FORM

· Do not include additional information relating to subcontractors on this form or as an attachment to this form.

PROSPECTIVE CONTRACTOR PROPOSES TO USE THE FOLLOWING SUBCONTRACTOR(S) TO PROVIDE SERVICES.

Type or Print the following information

☐ PROSPECTIVE CONTRACTOR DOES NOT PROPOSE TO USE SUBCONTRACTORS TO PERFORM SERVICES.

image3.emf image4.emf image5.emf image6.emf image7.emf image8.emf image1.emf image2.emf