BPM004210_Responsibility Responsiveness and Susceptibility Form_encrypted_.pdf

Rev. 12-18-2018

Responsibility, Responsiveness and Susceptibility Form Solicitation: BPM004210 Description: Environmental Training Procurement Officer: Patricia Lorenzen Signature: ________________

Offeror # (Used During Evaluation)

Offeror Name Exceptions (Y/N) [If Exceptions, note the Exceptions here and note any status updates to

Offeror in response]Attachment 5B, Supplement #1

Confidential (Y/N) [If Offeror Marked, then note what was marked Confidential and note any status updates to Offeror in response]

Offer $Amount #References Provided

Subcontractor Name(s)

Offer contained all Attachment Forms (Y/N) [identify any missing/not completed

Attachments]

Solicitation Amendments

Acknowledged by Supplier (Y/N)

Completion Schedule Date

Proposed

Ranking after Evaluation

Score after Evaluation

Offeror has not had a contract within the last five

(5) years that was terminated for cause due to breach or similar failure to comply with the terms of the contract.

Offeror’s record of performance does not include factual evidence of failure to satisfy the terms of the Offeror’s agreements with any party to a contract. Factual evidence may consist of documented Contractor performance reports, customer complaints and/or negative references.

Offeror is legally qualified to contract with the State and the Offeror’s financial, business, personnel, or other resources, including subcontractors.

Offeror is legally qualified as neither the Contractor nor Key Personnel have been debarred, suspended or otherwise lawfully prohibited from participating in any public procurement activity, including but not limited to, being disapproved as a subcontractor of any public procurement unit or other governmental body.

Offeror promptly supplied all requested information concerning its responsibility.

Offer was sufficient to permit evaluation by the State, in accordance with evaluation criteria identified in solicitation or other necessary offer components. Necessary offer components include:

attachments, documents/forms to be submitted with the offer, indication of the Offeror's intent to be bound, reasonable or acceptable

Offer was in conformance with the requirements contained in the Scope of Work, Terms and Conditions, and Instructions for the Solicitation including its Amendments and all documents incorporated by reference.

Offer does not limit the rights of the State.

Offer does not include nor is is Offer subject to unreasonable conditions, to include conditions upon the State necessary for successful Contract performance. The State shall be the sole determiner as to the reasonableness of a condition.

Offer does not materially change the contents set forth in the Solicitation, which includes the Scope of Work, Terms and Conditions, or Instructions.

Offeror did not provide misleading or inaccurate information.

Central AZ Mtn Rescue None Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes ETC None Financials Yes Yes Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Excal Visual None Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Geosyntec Yes Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Kary None Financials Yes Yes Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes PG Env. None Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Terracon None Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Virtual Tech None Financials Yes N/A Yes N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes

NOTES:

Geosyntec Notice of Cancellation COI exception Have revoked this exception

Enter "N/A" if does not apply

Need All of these to be "YES" (for Offer to be Responsible, Responsive, and Susceptible for award):

https://azdeqsign.na1.echosign.com/verifier?tx=CBJCHBCAABAAY4WmAtVSGxqvT67Ji0UraXbnQH1zQ5gz