Bid Response Form~7.docx

Bid Response Form De-Icing Liquid Storage Tanks, Dispensing Systems and Bases Document # / Project Info #: 91916 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 scanned PDF document. Additionally, the Bid Spreadsheet should also be submitted separately in excel format.

RFR Checklist

|_| RFR Checklist

IREMENTS

0. Designated Contract Manager Company Name:

Contract Manager:

Phone:

Email:

Number of Years Company has been in Business:

0.1 Business Experience

Provide a description your business experience as it pertains to the goods and services described in the RFR.

Business Experience:

0.2 Training

The successful bidder will conduct a minimum of ½ hour of operation and maintenance training at each site upon the completion of installation. Give a detailed description your training below.

Training:

1 5,000 GALLON STORAGE TANK

BID CONFORMS TO SPECIFICATION FOR TANK AND FITTINGS -- YES___ NO___. IF “NO” IS INDICATED INCLUDE DETAILED EXPLANATION.

DETAILED EXPLANATION:

2 DISPENSING SYSTEM FOR ANTI-ICING LIQUIDS

BID CONFORMS TO SPECIFICATION FOR DISPENSING SYSTEM -- YES__ NO___. IF “NO” IS INDICATED INCLUDE DETAILED EXPLANATION.

DETAILED EXPLANATION:

3 BASE CONSTRUCTION FOR TANK INSTALLATION

BID FOR CRUSHED STONE BASE AND CONCRETE PAD CONFORMS TO SPECIFICATION

YES___ NO___. IF “NO” IS INDICATED INCLUDE DETAILED EXPLANATION

In the event of errors or omissions in the specification, it is nonetheless the responsibility of the bidder to deliver and install a fully operational system in conformance with the technical and functional requirements of the specification to the satisfaction of MassDOT.

DETAILED EXPLANATION:

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

Commercial General liability Insurance including liability coverage specifically covering this Agreement, written on an occurrence form, with combined limits for bodily injury, personal injury, and property damage of at least five million dollars ($5,000,000) per occurrence. The policy must be endorsed to include the MassDOT as an additional insured:

b. The policy required herein must be endorsed to provide that the issuer waives all rights of subrogation against the MassDOT.

c. The policy required herein must be endorsed to name the Authority as an additional insured.

d. 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 MassDOT is required. All insurance companies to be used by the Contractor must have a Best Rating of not less than A- and be reasonably acceptable to MassDOT. ·

e. If required by MassDOT in writing, the Contractor will furnish certified copies of the aforementioned policies to MassDOT's designated representative.

f. All insurance maintained by the Contractor shall provide that insurance for the benefit of the MassDOT shall be primary and MassDOT's own insurance shall be non-contributing.

g. The Contractor shall provide the Authority with certificates of insurance evidencing the above referenced insurance policies within ten (10) days of the execution of this Agreement. The certificates shall contain an unequivocal provision that MassDOT shall be given thirty (30) days prior written notice of cancellation, material change, or non-renewal of coverage.

5 References and reference information and/or requirements Provide three (3) scanned copies of commercial or governmental client references from other agencies, not from MassDOT. 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. MassDOT reserves the right to contact the reference if necessary.

6 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: __________________________________

7 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).

8 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.