Bid Response Form~4.docx

Bid Response Form INDUSTRIAL SOAPS AND CLEANERS Document # / Project Info #: 88418 The following information is mandatory for this RFR. Failure to provide the requested information may be cause for the bid to be deemed as non-responsive and may result in disqualification. The RFR Checklist must be used as a cover sheet. Expand boxes for answer length as necessary and verify that all information is submitted in the order that it was asked. All information should be submitted as one document.

RFR Checklist

|_| RFR Checklist

QUIREMENTS

0. Designated Contract Manager Company Name:

Contract Manager:

Phone:

Email:

Number of Years Company has been in Business:

0.1 Business Experience

Describe the company’s experience as a provider for a similar governmental authority servicing commercial and if applicable, public sector accounts. Specifically detail who the services were provided for, length of time, and scope and volume of services provided. Utilize all space provided below and summarize the principal points of the Proposal.

Business Experience:

1 Insurance Service Providers must provide a scanned copy of Certificate of Insurance and shall include the following:

a.) The following minimum insurance coverage is required:

i) Workers’ Compensation Insurance in compliance with applicable federal and state laws, and Employers Liability Insurance with limits of at least Five Hundred Thousand Dollars ($500,000) per occurrence.

b.) All insurance maintained by the Contractor pursuant to this Contract shall be written by insurance companies licensed to do business in the Commonwealth of Massachusetts. If the Contractor determines that any such insurance needs to be placed with surplus lines carriers not licensed by the Commonwealth of Massachusetts, written permission from the Authority is required. All insurance companies to be used by the Contractor must have a Best’s Rating of not less than A- and be reasonably acceptable to MassDOT.

c.) If requested by MassDOT in writing, the Contractor will furnish certified copies of the aforementioned policies to MassDOT ’s designated representative.

d.) All insurance maintained by the Contractor shall provide that insurance for the benefit of MassDOT shall be primary as it applies to damage or injury resulting from, or arising out of, or occurring in connection with the execution of the work performed by the Contractor, and MassDOT’s own insurance shall be non-contributing.

e.) The Contractor shall provide MassDOT with certificates of insurance evidencing the above-referenced insurance policies within ten (10) days of the execution of this Contract. The Contractor shall give MassDOT thirty (30) days prior written notice of cancellation, material change, or non-renewal of the coverage.

f.) The above insurance requirements shall also apply to any subcontractors, sub consultants, agents, or any other individual retained by the Contractor to perform the services and/or obligations under this Contract.

2 References and reference information and/or requirements Provide three (3) scanned copies of commercial or governmental client references. A reference letter shall be submitted on client’s letterhead by the Bidder. The reference letter shall include the name, address, contact person, telephone number, length of service and a description of the goods and services that the Bidder provided to the client. It is required that the client references demonstrate the Bidder’s ability to perform a project of similar size, nature and complexity as that described in this RFR. Specifically, references should address quality of product, customer service, bidder’s abilities to address and resolve problems and overall value the bidder brought to client. References must be for clients or customers to whom goods and services were provided within three (3) years prior to the RFR Response due date. Additionally, business references are required to be recipients of Bidder business services with whom there is or has been a standing business relationship of one (1) year or greater duration. A Bidder’s prior business relationship with the Commonwealth will also be considered in this section, whether offered as a reference or not. Poor prior performance may result in no points being awarded in this section. MassDOT reserves the right to contact the reference if necessary.

3 Prompt Pay Discount Form Prompt Payment Discounts (PPD). All contractors/vendors doing business with the Commonwealth must provide a Prompt Payment Discount (PPD) for receiving early payments unless the Contractor/vendor can provide compelling proof that providing a prompt pay discount would be unduly burdensome. Contractors benefit from PPD by increased, usable cash flow as a result of fast and efficient payments for commodities or services rendered. Contractors who agree to accept Electronic Funds Transfer (EFT) increase the prompt pay benefit by ensuring that funds are paid directly to their designated bank accounts, thus eliminating the delay of check clearance policies and traditional mail lead time. Payments processed through the state accounting system (MMARS) can be tracked and verified through the Comptroller’s Vendor Web system using the Vendor/Customer Code assigned to you by a Commonwealth department.

The Commonwealth benefits because contractors reduce the cost of products and services through the applied discount. While Bidders/Contractors have flexibility in determining the actual % discount(s) offered to the Commonwealth, the discount(s) must be identified for 10, 15, 20 and/or 30 days for payment issuance in the column entitled “% Discount Off Proposed Price” below. The Commonwealth may use the prompt pay discounts submitted as a basis for selection and may negotiate discounts as deemed in the best interest of the Commonwealth. The requirement to offer PPD discounts may be waived by the Commonwealth on a case-by-case basis if participation in the program would be unduly burdensome, provided the specific reason for the hardship is outlined below.

All discounts offered will be taken in cases where the payment issue date is within the specified number of days listed below and in accordance with the Commonwealth’s Bill Paying Policy. Payment days will be measured from the date goods are received and accepted / performance was completed OR the date an invoice is received by the Commonwealth, whichever is later to the date the payment is issued as an EFT (preferred method) or mailed by the State Treasurer. The date of payment “issue” is the date a payment is considered “paid” not the date a payment is “received” by a Contractor.

If internal Bidder/Contractor systems require an alternate method of measuring payment issue dates, the Bidder/Contractor must note the issues below or on an attached page if necessary to be considered by the PMT. In cases where the Bidder/Contractor considers that offering a Prompt Payment Discount would be a hardship, the Bidder must clearly define the issues and reasons for said hardship. Providing volume discounts or other discounts on prices is not considered a hardship, since the PPD provides the additional benefit of early cash flow for the Contractor.

Enter the Prompt Payment Discount percentage (%) off the invoice payment, for each of the payment issue dates listed, if the payment is issued within the specified Payment Issue days. For example:

5% - 10 Days 4% - 15 Days 3% - 20 Days 2% - 30 Days If no discount is offered enter 0%

The Contractor is unable to provide a prompt payment discount due to the following hardship:

Contractor/Bidder Authorized Signature _________________________________ Date: ____________

Contractor/ Bidder Authorized Signatory Print Name and Title: __________________________________

4 Supplier Diversity Program (SDP) Plan SDP Plan Form #1 (To be submitted with Bid Response)

Contract/RFR Document Number:

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit with Bid.

Part I Bidder/Contractor Information (Required)

Business Name:

Contact Name:

Part II Financial Commitment (Required)

Provide a specific percentage committed (as a percentage of Bidder/Contractor sales derived from this contract for the life of the contract) to be spent with all certified SDP Partners that the Bidder will propose if awarded a Contract. Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form.

Supplier Diversity Program (SDP) Resources:

· Directory of Certified Businesses

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

5 Executive Order 515, Establishing an Environmental Purchasing Policy

ENVIRONMENTALLY PREFERABLE PRODUCTS FORM

Bidder Company Name: ___________________________________________________ Date: _______________ In line with the Commonwealth’s efforts to promote products and practices which reduce our impact on the environment and human health, Bidders are encouraged provide information regarding their environmentally preferable/sustainable business practices as they relate to this contract wherever possible.

Bidders who can demonstrate such initiatives in their RFR submission (referencing, but not limited to, the items listed below) will be eligible to receive evaluation points.

In order to receive evaluation points, Bidders must complete this form and submit it with their RFP Response.

Bidders must submit appropriate documentation to support the items for which the Bidder indicated a “Yes” and present this documentation in the proper sequence of this Attachment.

1. Packaging

packaging take-back services, or shipping carton return

If yes, use the box below to enter a description of the practices being followed. The box below will expand to accommodate the information being entered.

2. Business Practices / Operations / Manufacturing

If yes, use the box below to enter a description of the practices being followed. The box below will expand to accommodate the information being entered.

3. Certifications

Certification, C2C Protocol, Responsible Care Codes of Practice or other similar standards ____ Third Party product certifications such as Green Seal, Scientific Certification Systems, Smartwood, etc.

If yes, bidders must submit copies of the certificates obtained.

4. Other Environmental Criteria Bidders are encouraged to respond to criteria specifically indicated in this RFP as “desirable environmental criteria” (and attach the appropriate documentation) to receive consideration in the evaluation. If yes, use the box below to enter a description of the practices being followed. The box below will expand to accommodate the information being entered.