BPM007069_Required_Forms_.pdf

THE STATE OF ARIZONA

GAME AND FISH DEPARTMENT

5000 W. CAREFREE HIGHWAY

Phoenix, AZ 85086-5000

(602) 942-3000 •WWW.AZGFD.GOV

Table of Contents

REQUEST FOR QUOTE

BPM007069

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 Table of Contents 1

Offeror’s Check List 2

Offer and Acceptance 3

Designation of Confidential, Trade Secret & Proprietary Information 4

R2-7-103. Confidential Information 5

Subcontractors 6

References 7

Pricing Proposal 8

BPM007069 Required Forms Updated 5-17-2024

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,

☐ N/A

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

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

BPM007069

Arizona Game and Fish Department Purchasing Office

Offer and Acceptance SUBMISSION OF OFFER: The undersigned hereby offers and agrees to provide Products/Services in compliance with all terms, conditions, specifications, and amendments in the Solicitation and any written exceptions in the Offer indicated by the latest dated version

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

1. Will not discriminate against any employee or applicant for employment in violation of any Federal anti-discrimination laws, rules, regulations or executive orders,, [Arizona]

State Executive Orders 2023-09, 2023-01, 2009-09 or A.R.S. §§ 41-1461 through 41-1465;

2. 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. Complies with A.R.S. § 18-132 when offering electronics or information technology products, Services, or maintenance;

4. Did not and will not involve collusion or other anti-competitive practices;

5. Is not debarred from, or otherwise prohibited from, participating in any contract awarded by federal, state, or local government; and

6. It is____/is NOT____a small business with less than 100 employees or has gross revenues of $4 million or less.

7. Does not participate in the use of forced labor of ethnic Uyghurs as described in A.R.S. § 35-394. (Unless exempt)

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.

State of Arizona

Awarded this day of

Kristen Micurescu, CPPB, as Branch Chief and not personally

Offeror Company Name Signature of person authorized to sign Offer ………..Date

Address Printed name and Title

City, State, ZIP Email Address

☐ By checking this box, Offeror is certifying that it is exempt from the requirements regarding the forced labor of ethnic Uyghurs because of one of the following: Contractor is a Sole proprietorship, has fewer than ten (10) employees; or is a non-profit organization.

Telephone Number

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

Designation of Confidential, Trade Secret & Proprietary Information

R2-7-103

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

BPM007069 Required Forms Updated 5-17-2024 SPO Form No. 205

Subcontractors

Arizona Game and Fish Department

Purchasing Office 5000 West Carefree

Highway

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

BPM007069 Required Forms Updated 5/17/2024

References

Arizona Game and Fish Department

Purchasing Office 5000 West Carefree

Highway

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:

Reference 3

3) Company: Contact Name:

Arizona Game and Fish Department Purchasing Office

5000 West Carefree Highway Phoenix, Arizona 85086

Pricing Proposal

Enter pricing in the Arizona Procurement Portal (APP) Enter $1.00 in the Unit Price Field in APP. Pricing Requested in "Required Forms" attachment.

Enter pricing in the fields below. The catalog and manufacturer discount rates only require one rate/price. Failure to do this may result in your offer’s rejection.

Additional lines and pages for Attachment III may be used.

Tax Rate AZGFD is not tax-exempt. Please enter your tax rate percentage on the line. Tax rates are not scored/evaluated in your proposal.

Tax Rate:_____________%

3.2 New Pat-Trap Brand or Equivalent Trap Machines (must be BABAA compliant machines)

Pat-Trap Brand or Equivalent Trap Machine Price (for 1 machine)

Machines - Supplier to enter model/series

Parts % off Discount

Accessories % off Discount

Tools % off Discount

Trap/Machine Equipment % off Discount

Freight Cost (for 1 machine)

Arizona Game and Fish Department Purchasing Office

5000 West Carefree Highway Phoenix, Arizona 85086

3.3 Pat-Trap Machine Parts or Equivalent (must be compatible with Pat-Trap SW Series)

Parts % off Discount

Accessories % off Discount

Tools % off Discount

Trap/Machine Equipment % off Discount

City, State

Number of years in business

AZ Contractor’s license number

Service to be provided

Name of Subcontractor

City, State

Number of years in business

AZ Contractor’s license number

Service to be provided