BPM006681_Required_Forms_Complete.pdf

THE STATE OF ARIZONA

GAME AND FISH DEPARTMENT

5000 W. CAREFREE HIGHWAY

Phoenix, AZ 85086-5000

(602) 942-3000 •WWW.AZGFD.GOV

BPM006681 Required Forms Updated 5-17-2024

REQUEST FOR QUOTE

BPM006681

REQUIRED FORMS

Offerors shall electronically complete and submit the following documents in the Arizona Procurement

Portal (“APP”) for this solicitation. Failure to include all of the items may result in a bid being rejected.

Offerors may submit additional documents at their discretion.

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

Subcontractors 8

References 9

Pricing Proposal 10

OFFEROR’S CHECK LIST (for Offeror’s use only.) This is the only document does not have to be returned.

Arizona Game and Fish Department Purchasing Office

5000 West Carefree Highway Phoenix, Arizona 85086

Offeror’s Check List

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 APP.)

“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 in APP. Confidential documents must include a statement as to why the information is confidential.

Pricing has been entered in Arizona Procurement Portal “items” tab.

☐ YES ☐ NO

Boycott of Israel Disclosure ☐ YES ☐ NO Forced Labor of Ethnic Uyghurs Ban ☐ YES ☐ NO

Subcontractors ☐ YES ☐ NO

References ☐ YES ☐ NO

Pricing Proposal if requested ☐ YES ☐ NO

* Ensure Items above have been completed, scanned (preferably as one pdf file unless your offer contains confidential information- (see above) and uploaded into the “Attachments” tab of your bid in

APP.

☐ YES ☐ NO

OFFER AND ACCEPTANCE

BPM006681

Arizona Game and Fish Department Purchasing Office

Offer and Acceptance Form 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. Signature also certifies Small Business status (See certification #5 below).

Offeror company name Signature of person authorized to sign Offer

Address Printed name and title

City | State | ZIP Telephone Number

Contact Email Address x

CERTIFICATION: By signature in the above, Offeror certifies that:

1. it will not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, [Arizona] State Executive Order 2009-9 or A.R.S. §§ 41−1461 through 1465;

2. it 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 will result in rejection of the Offer. Signing the Offer with a false statement will void the Offer, any resulting contract, and may be subject to legal penalties under law;

3. it complies with A.R.S. § 41-3532 when offering electronics or information technology products, services, or maintenance; and

4. it is not debarred from, or otherwise prohibited from participating in any contract awarded by federal, state, or local government.

5. It is____/Is not____a small business with less than 100 employees or has gross revenues of $4 million or less.

ACCEPTANCE OF OFFER: State hereby accepts the Offer identified by the date and number at the top of this form (the Accepted Offer). Offeror is now bound (as Contractor) to carry out the Work under the attached Contract, of which the Accepted Offer forms a part. Contractor is cautioned not to commence any billable work or to provide any material or perform any service under the Contract until Contractor receives the applicable Purchase Order or written notice to proceed from Procurement Officer.

The Contract number is:

The Contract effective date is:

State of Arizona Awarded this day of

Kristen Micurescu, as Branch Chief and not personally

Sellmark Corporation

2201 Heritage Parkway James Ryan

Mansfield, Texas, 76063 817-405-6121 jryan@sellmark.com

Designation of Confidential, Trade Secret & Proprietary Information

Arizona Game and Fish Department Purchasing Office

Designation of Confidential, Trade Secret & Proprietary Information 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.

Company Name Signature of Person Authorized to Sign

Address Printed Name

City State Zip Title

X

2201 Heritage Parkway James Ryan

Mansfield Texas 76063 Government Account Executive

Designation of Confidential, Trade Secret & Proprietary Information

Arizona Game and Fish Department Purchasing Office

R2-7-103. Confidential Information

A. 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.

B. 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.

C. Upon receipt of a submission, an agency chief procurement officer shall make one of the following written determinations:

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;

2. The designated information is not confidential; or

3. Additional information is required before a final confidentiality determination can be made.

D. 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.

E. An agency chief procurement officer may release information designated as confidential under subsection (A) if:

1. A request for review is not received by the state procurement administrator within the time period specified in the notice; or

2. The state procurement administrator, after review, makes a written determination that the designated information is not confidential

Participation in Boycott of Israel

Arizona Game and Fish Department Purchasing Office

BPM006681 Required Forms Updated 5-17-2024 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:

(a) Based in part on the fact that the entity does business in Israel or in territories controlled by Israel.

(b) 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.

5. "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

● Contractor is a non-profit organization.

Company name Signature of person authorized to sign

City State Zip Email address Phone number

2201 Heritage Parkway

Mansfield Texas 76063

James Ryan Government Account Executive jryan@sellmark.com 817-405-6121 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

BPM006681 Required Forms Updated 5-17-2024 SPO Form No. 205

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

● Contractor is a non-profit organization.

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.

Company Name Signature of person authorized to sign

City, State, ZIP Contact email address Contact phone number

2201 Heritage Parkway James Ryan Government Account Executive

Mansfield, Texas, 76063 jryan@sellmark.com 817-405-6121

Subcontractors

Purchasing Office

BPM006681 Required Forms Updated 5/17/2024

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 AGFD 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

5000 West Carefree Highway Phoenix, Arizona 85086

References

References Three (3) professional references who have received services similar to the Specifications of this Solicitation shall be listed below. References from AGFD 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:

Phone: Email:

Description of services provided:

Reference 3

3) Company: Contact Name:

Phone: Email:

Description of services provided:

USDA APHIS Wildlife Services Oregon Paul Wolf

541-733-4510 paul.c.wolf@usda.gov

Buckeye Police Department Casey Hale

623-633-2336 chale@buckeyeaz.gov

Has sold the unit specified in this contract to another government agency within Arizona

USDA APHIS Wildlife Services Wyoming

307-250-9409 michael.b.burrell@usda.gov

Michael Burrell

Has sold multiple different thermal units to the above person who uses them on a very regular basis

Has sold multiple different thermal units to the above person who uses them on a very regular basis

5000 West Carefree Highway Phoenix, Arizona 85086

Pricing Proposal

Pricing Proposal

Enter pricing in the fields below. Pricing requested in the “Required Forms” attachment.

AZGFD is not tax exempt. Please enter your tax rate percentage on the line.

Tax Rate_____________

Enter pricing in the Arizona Procurement Portal (APP) on the items tab, “Unit Price” field of $1.00. We can’t award a contract if there is no price listed in the “Unit Price” field.

Please include/upload the spec sheets in the APP Technical Questions for each item listed below:

Make & Model of Binoculars Price per each Shipping Charges

Manufacturer, or Catalog, Discount (if applicable, if additional space is needed an additional attachment page may be used. (A copy of the applicable price list/catalog(s) shall be attached with the offer.

Manufacturer or Catalog Discount Rate

Bulk Purchase Discounts:

Item Description Quantity Discount Rate/Fee

$4,250 $0Pulsar Merger Duo NXP50 PL77455

Pulsar Merger Duo NXP50 PL77455 35.7324

8.25%