BPM005791-_Required_Forms_10-18-23.pdf
PDF 289 KB Posted
- Attached to
- AZGFD Custom Tanks
- Solicitation number
- BPM005791
- Issued by
- Arizona
About this file
This is a Required Forms document for formal solicitation BPM005791 issued by the Arizona Game and Fish Department (AZGFD) for custom tanks. The document establishes mandatory forms and certifications that all offerors must complete and submit through the Arizona Procurement Portal (APP) to be considered responsive. Required submissions include the Offer and Acceptance Form, Designation of Confidential, Trade Secret & Proprietary Information form, Boycott of Israel Disclosure, Forced Labor of Ethnic Uyghurs Ban certification, Attachment I (Subcontractors list), and Attachment II (References). Offerors must provide three professional references from the western United States who have received similar services, identify all proposed subcontractors and material suppliers with their respective Arizona contractor's license numbers, and list the services to be provided. The document does not specify response deadlines, site visit information, bidder conferences, or contract term details, as these are referenced as being located in other attachments within the APP.
The document establishes compliance and certification requirements rather than pricing or funding information. All offerors must certify non-discrimination in employment, confirm they have not offered improper economic benefits to public servants, and comply with Arizona Revised Statutes regarding electronics and information technology products. Offerors meeting specific criteria—those with estimated contract values below $100,000, sole proprietorships, entities with fewer than ten employees, or non-profit organizations—may claim exemption from the Boycott of Israel and Forced Labor of Ethnic Uyghurs provisions. All other companies must certify compliance with these requirements or disclose participation in boycotts of Israel or use of forced labor. The State reserves the right to determine whether submitted information qualifies as trade secrets or confidential proprietary information, and pricing information is explicitly excluded from confidentiality protections. No pricing terms, funding sources, or set-aside information is detailed in this forms document.
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THE STATE OF ARIZONA
GAME AND FISH DEPARTMENT
5000 W. Carefree Highway
Phoenix, AZ 85086-5000
(602) 942-3000 www.azgfd.gov
BPM005791 Page 1 of 9
Required Forms Updated 10-2022
FORMAL SOLICITATION
REQUIRED FORMS
SOLICITATION # BPM005791
The documents contained herein must be completed and submitted with your offer in the Arizona Procurement
Portal (APP). Other documents located in the Attachments tab of APP are incorporated herein by reference.
Contents:
Offeror’s Check List 2
Offer and Acceptance Form 3
Designation of Confidential, Trade Secret & Proprietary Information 4
R2-7-103. Confidential Information 5
Boycott of Israel Disclosure 6
Forced Labor of Ethnic Uyghurs Ban 7
Attachment I – Sub Contractors 8
Attachment II – References 9
OFFEROR’S CHECK LIST
Signature pages are required to be returned
Arizona Game and Fish
Department
Purchasing Office
5000 West Carefree Highway
Phoenix, Arizona 85086
BPM005791 Page 2 of 9
DOCUMENT SUBMITTED
If you have been notified that an amendment has been issued, you must re-open your offer in APP, make any required modifications, if any, and re-submit your offer. If you do not do this you have not submitted an offer in the Arizona Procurement Portal and your offer will be considered as non-responsive.
☐ YES ☐ NO
☐ NA
Offer and Acceptance (Complete the top half of page 3, sign and upload into your offer in Arizona Procurement Portal.)
☐ YES ☐ NO
“Designation of Confidential, Trade Secret & Proprietary Information” form (Page 4). Information considered to be confidential, trade secret or proprietary should be attached as a separate document checked
“confidential” in the Attachments tab of your offer Arizona Procurement
Portal. Confidential documents must include a statement as to why the information is confidential.
☐ YES ☐ NO
Boycott of Israel Disclosure ☐ YES ☐ NO
Forced Labor of Ethnic Uyghurs Ban ☐ YES ☐ NO
Pricing has been entered in Arizona Procurement Portal’s “items” tab. ☐ YES ☐ NO
Attachment I-Subcontractors ☐ YES ☐ NO
Attachment II- References ☐ YES ☐ NO
* Ensure Items above have been completed, scanned (preferably as one pdf file) and uploaded into the “Attachments” tab of your bid response in APP.
☐ YES ☐ NO
OFFER AND ACCEPTANCE
BPM005791
Department
Purchasing Office
BPM005791 Page 3 of 9
OFFER
TO THE STATE OF ARIZONA:
The Undersigned hereby offers and agrees to furnish the material, service or construction in compliance with all terms, conditions, specifications and amendments in the Solicitation and any written exceptions in the offer.
Company Name Authorized Signature
Email Print Name and Title
Phone Date
By signature in the Offer section above, the Offeror certifies:
1. The Offeror shall not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, State Executive Order 2009-9 or A.R.S. §§ 41−1461 through 1465.
2. The Offeror has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause shall result in rejection of the offer. Signing the offer with a false statement shall void the offer, any resulting contract and may be subject to legal remedies provided by law.
3. The Offeror certifies compliance with A.R.S.§41-3532 when offering electronics or information technology products, services or maintenance.
The Offeror is not debarred from, or otherwise prohibited from participating in any contract awarded by any federal, state or local government.
ACCEPTANCE OF OFFER
The Offer is hereby accepted:
The Contractor is now bound to sell the materials or services listed by the attached contract and based upon the solicitation, including all terms, conditions, specifications, amendments, etc., and the Contractor’s Offer as accepted by the State.
This Contract shall henceforth be referred to as Contract No.________________________________________.
The effective date of the Contract is ____________________________________________________.
The Contractor is cautioned not to commence any billable work or to provide any material or service under this contract until Contractor receives purchase order, contact release document or Procurement’s written notice to proceed.
The Contractor is cautioned not to commence any billable work or to provide any material or service under this contract until Contractor receives purchase order, contact release document or Procurement’s written notice to proceed.
State of Arizona- Awarded this day of 20 .
Kristen Micurescu, CPPB, as Branch Chief and not personally
Designation of Confidential, Trade Secret &
Proprietary Information
Arizona Game and Fish
Department
Purchasing Office
BPM005791 Required Forms Updated 10-2022
All materials submitted as part of a response to a solicitation are subject to Arizona public records law a will be disclosed if there is an appropriate public records request at the time of or after the award of the contract.
Recognizing there may be materials included in a solicitation response that is proprietary or a trade secret, a process is set out in A.A.C. R2-7-103 that will allow qualifying materials to be designated as confidential and excluded from disclosure. For purposes of this process the definition of “trade secret” will be the same as that set out in A.A.C. R2-7-101(50).
This form must be completed and returned with the response to the solicitation and any supporting information to assist the State in making its determination as to whether any of the materials submitted as part of the solicitation response should be designated confidential because the material is proprietary or a trade secret and therefore not subject to disclosure.
All offerors must select one of the following:
_______ My response does not contain proprietary or trade secret information. I understand that my entire response will become public record in accordance with A.A.C. R2-7-C317.
______ My response does contain trade secret information because it contains information that:
1. Is a formula, pattern, compilation, program, device, method, technique or process, AND
2. Derives independent economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use; AND
3. Is the subject of efforts by myself or my organization that are reasonable under the circumstances to maintain its secrecy.
Please note that failure to attach an explanation may result in a determination that the information does not meet the statutory trade secret definition. All information that does not meet the definition of trade secret as defined by A.A.C. R2-7-101(50) will become public in accordance with A.A.C. R2-7-C317. The State reserves the right to make its own determination of Proposer’s trade secret materials through a written determination in accordance with A.A.C. R2-7-103.
If the State agrees with the proposer’s designation of trade secret or confidentiality and the determination is challenged, the undersigned hereby agrees to cooperate and support the defense of the determination with all interested parties, including legal counsel or other necessary assistance.
By submitting this response, proposer agrees that the entire offer, including confidential, trade secret and proprietary information may be shared with an evaluation committee and technical advisors during the evaluation process. Proposer agrees to indemnify and hold the State, its agents and employees, harmless from any claims or causes of action relating to the State’s withholding of information based upon reliance on the above representations, including the payment of all costs and attorney fees incurred by the State in defending such an action.
Contractor Name Authorized Signature
Designation of Confidential, Trade Secret &
Proprietary Information
Arizona Game and Fish
Department
Purchasing Office
BPM005791 Required Forms Updated 10-2022
R2-7-103. Confidential Information
1. If a person wants to assert that a person's offer, specification, or protest contains a trade secret or other proprietary information, a person shall include with the submission a statement supporting this assertion.
A person shall clearly designate any trade secret and other proprietary information, using the term
"confidential". Contract terms and conditions, pricing, and information generally available to the public are not considered confidential information under this Section.
2. Until a final determination is made under subsection (C), an agency chief procurement officer shall not disclose information designated as confidential under subsection (A) except to those individuals deemed by an agency chief procurement officer to have a legitimate state interest.
3. Upon receipt of a submission, an agency chief procurement officer shall make one of the following written determinations:
3.1. The designated information is confidential and the agency chief procurement officer shall not disclose the information except to those individuals deemed by the agency chief procurement officer to have a legitimate state interest;
3.2. The designated information is not confidential; or
3.3. Additional information is required before a final confidentiality determination can be made.
4. If an agency chief procurement officer determines that information submitted is not confidential, a person who made the submission shall be notified in writing. The notice shall include a time period for requesting a review of the determination by the state procurement administrator.
5. An agency chief procurement officer may release information designated as confidential under subsection
(A) if:
5.1. A request for review is not received by the state procurement administrator within the time period specified in the notice; or
5.2. The state procurement administrator, after review, makes a written determination that the designated information is not confidential.
If Boycott Of Israel
Participation in Boycott of Israel
Department
Purchasing Office
BPM005791 Required Forms updated 10-2022 Page 6 of 9
SPO Form Boycott of Israel Disclosure Revision No. 1 | Revised 09-22
Boycott of Israel Disclosure
Please note that if any of the following apply to this Solicitation, Contract, or Contractor, then the Offeror shall select the
“Exempt Solicitation, Contract, or Contractor” option below:
● The Solicitation or Contract has an estimated value of less than $100,000;
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; and/or
● Contractor is a non-profit organization.
Pursuant to A.R.S. § 35-393.01, public entities are prohibited from entering into contracts “unless the contract includes a written certification that the company is not currently engaged in, and agrees for the duration of the contract to not engage in, a boycott of goods or services from Israel.”
Under A.R.S. § 35-393:
1. "Boycott" means engaging in a refusal to deal, terminating business activities or performing other actions that are intended to limit commercial relations with entities doing business in Israel or in territories controlled by Israel, if those actions are taken either:
1.1. Based in part on the fact that the entity does business in Israel or in territories controlled by Israel.
1.2. In a manner that discriminates on the basis of nationality, national origin or religion and that is not based on a valid business reason.
2. Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.
3. "Public entity": (a) Means this State, a political subdivision of this State or an agency, board, commission or department of this
State or a political subdivision of this State. (b) Includes the universities under the jurisdiction of the Arizona board of regents and community college districts as defined in section 15-1401.
The certification below does not include boycotts prohibited by 50 United States Code Section 4842 or a regulation issued pursuant to that section. See A.R.S. § 35-393.03.
In compliance with A.R.S. § 35-393 et seq., all offerors must select one of the following:
☐ The Company submitting this Offer does not participate in, and agrees not to participate in during the term of the contract, a boycott of Israel in accordance with A.R.S. § 35-393 et seq. I understand that my entire response will become a public record in accordance with A.A.C. R2-7-C317.
☐ The Company submitting this Offer does participate in a boycott of Israel as described in A.R.S. § 35-393 et seq.
☐ Exempt Solicitation, Contract, or Contractor.
Indicate which of the following statements applies to this Contract:
● Solicitation or Contract has an estimated value of less than $100,000;
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; and/or https://advance.lexis.com/document/?pdmfid=1000516&crid=1d22ae96-91e7-4fa9-b751-02b4d725faa3&pddocfullpath=%2Fshared%2Fdocument%2Ffe%2Furn%3AcontentItem%3A654C-M4F3-GXF6-84SC-00000-00&pdcontentcomponentid=4313&pdteaserkey=sr0&pditab=allpods&ecomp=rd-zk&earg=sr0&prid=a8f940d3-c58d-4e64-9124-f2bfdcdb31d8
Forced Labor of Ethnic Uyghurs Ban
Department
Purchasing Office
SPO For No. 205 Page 7 of 9
BPM005791 Required Forms updated 10-2022
Forced Labor of Ethnic Uyghurs Ban
Please note that if any of the following apply to the Contractor, then the Offeror shall select the “Exempt Contractor” option below:
● Contractor is a sole proprietorship;
● Contractor has fewer than ten (10) employees; OR
Pursuant to A.R.S. § 35-394, the State of Arizona prohibits a public entity from entering into or renewing a contract with a company unless the contract includes written certification that the company does not use the forced labor, or any goods or services produced by the forced labor, of ethnic Uyghurs in the People's Republic of China.
Under A.R.S. § 35-394:
1. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.
2. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this
State or a political subdivision of this State.
In compliance with A.R.S. §§ 35-394 et seq., all offerors must select one of the following:
☐ The Company submitting this Offer does not use, and agrees not to use during the term of the contract, any of the following:
● Forced labor of ethnic Uyghurs in the People’s Republic of China;
● Any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China; or
● Any Contractors, Subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China.
☐ The Company submitting this Offer does participate in use of Forced Uyghurs Labor as described in
A.R.S. § 35-394.
☐ Exempt Contractor
Indicate which of the following statements applies to the Contractor (may be more than one):
☐ Contractor is a sole proprietorship;
☐ Contractor has fewer than ten (10) employees; and/or
☐ Contractor is a non-profit organization.
ATTACHMENT I
Department
Purchasing Office
BPM005791 Page 8 of 9
SUBCONTRACTORS
Bidder shall identify all proposed subcontractors/material suppliers that will be utilized to perform any portion of the Specifications. Additional Subcontractor(s) not listed below or on a supplemental page must receive written approval from AZGFD before utilization.
Name of Subcontractor
City, State
Number of years in business
Type of business (LLC, Corporation, Sole Proprietor, etc.)
AZ Contractor’s license number
Service to be provided
Name of Subcontractor
City, State
Number of years in business
Type of business (LLC, Corporation, Sole Proprietor, etc.)
AZ Contractor’s license number
Service to be provided
ATTACHMENT II
Department
Purchasing Office
BPM005791 Page 9 of 9
REFERENCES
Three (3) professional references who have received services similar to the Specifications of this Solicitation shall be listed below. References from AZGFD are not to be included. References from the western United States are preferred. The contact person shill be someone who has responsibility for the operation of the material and/or service and shall be aware that they are being used as a reference.
Reference 1
1) Company: Contact Name:
Phone: Email:
Description of services provided:
Reference 2
2) Company: Contact Name:
Reference 3
3) Company: Contact Name:
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