BPM007084_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

BPM007084 Required Forms updated 10-2022

REQUIRED FORMS FOR REQUEST FOR QUOTATION (RFQ)

WITH EVALUATION CRITERIA

SOLICITATION #BPM007084

REQUIRED FORMS

The documents contained herein must be completed and submitted with your offer in Arizona Procurement Portal. Other documents located in the Attachments tab of Arizona Procurement Portal are incorporated herein by reference. Attachments can also be provided on a separate sheet of paper referencing the Attachment Number.

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, Subcontractors 8

Attachment II, References 9

Attachment III, Pricing Proposal 10

Attachment IV, Experience/Expertise/Reliability 11

Attachment V, Narrative on the Approach to the Scope of Work 12

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 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 of $1.00 has been entered in Arizona Procurement Portal’s “items” tab. ☐ YES ☐ NO

Attachment I-Subcontractors ☐ YES ☐ NO

Attachment II- References ☐ YES ☐ NO

Attachment III- Pricing Proposal ☐ YES ☐ NO

Attachment IV- Experience/Expertise/Reliability ☐ YES ☐ NO

Attachment V- Narrative on the approach to the Scope of Work ☐ YES ☐ NO

* Ensure Items above have been completed, scanned (preferably as one pdf file) and uploaded into the “Attachments” tab of your offer (quote) in Arizona Procurement Portal.

☐ YES ☐ NO

OFFER AND ACCEPTANCE

BPM007084

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.

Company Name Signature of Person Authorized to Sign Offer

Address Printed Name

City State Zip Title

Phone:

Fax:

Contact Email Address

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.

4. 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.

State of Arizona Awarded this day of

Kristen Micurescu, CPPB, as Branch Chief and not personally

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

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

BPM007084 Required Forms updated 10-2022 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

Address Printed name and title

City State Zip Email address Phone number 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

Purchasing Office

BPM007084 Required Forms updated 10-2022 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

Address Printed name and title

City, State, ZIP Contact email address Contact phone number

ATTACHMENT I

Purchasing Office

Attachment I, Subcontractors

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.)

Service to be provided

Name of Subcontractor

City, State

Number of years in business

Type of business (LLC, Corporation, Sole Proprietor, etc.)

Service to be provided

ATTACHMENT II

Purchasing Office

Attachment II, References

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 shall be someone who has responsibility for the operation of the material and/or service and shall be made 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:

ATTACHMENT III

Purchasing Office

Attachment III, Pricing Proposal

PRICING PROPOSAL

Enter $1.00 in the “unit price” field of the items tab of your offer in APP. Failure to do this may result in your offer’s rejection.

1) After entering $1.00 in the “Unit Price” field of APP, provide a pricing proposal for the following:

a. Initial one-time charge to create portal $

b. Monthly streaming fee per location/camera $

c. Price per hour for installation labor $

d. Price per hour for Tech support $

e. Discount off list for Webcam per Specification 2.2.

of the Scope of Work %

f. Travel charge per mile $

g. Sales tax when applicable %

h. Include any additional known charges as separate items, if any.

ATTACHMENT IV

Purchasing Office

Attachment IV, Experience/Expertise/Reliability

EXPERIENCE/EXPERTISE/RELIABILITY

Experience, expertise and reliability is considered in the evaluation process. The Offeror is advised to submit any information that documents successful and reliable experience in past performances, especially those performances related to the requirements of this RFP.

Offeror should provide a narrative response that addresses, but is not limited to, the following key points:

1. Provide background information on your company, such as type of business (Individual/sole proprietor, corporation, LLC, etc.), length of time in business, number of full-time employees.

2. State whether or not you are registered as a small business.

3. Provide a list of similar agencies (wildlife, ecological, environmental or other natural resource government agencies) for whom you have provided similar services, if applicable.

4. Fully describe your experience in providing the Services stated in the Scope of Work.

5. Describe the level of expertise of field technicians including any education, training or certificates.

6. Include any additional information you wish to provide about your company.

ATTACHMENT V

Purchasing Office

Attachment V, Narrative on the Approach to the Scope of Work

NARRATIVE ON THE APPROACH TO THE SCOPE OF WORK

The Offeror should present a proposed method of satisfying the requirements in the Scope of Work as specified herein. The language of the narrative should be straightforward and limited to facts, solutions to problems, and plans of proposed action. The Offeror should use technical language only when describing a technical process.

Specifically, provide a detailed response to the Scope of Work, include the following:

Thoroughly describe your method to meet or exceed the Services described in the Scope of Work. Response should include but not be limited to:

1. Provide the manufacturer, part number and description of the webcam you are initially proposing.

2. Webcams may be needed in areas such as, remote sites accessible only by rough, dirt roads (high-clearance vehicle), high areas such as, in trees or tall buildings. Describe your ability to mount these cameras.

3. Describe your method for troubleshooting issues.

4. Provide your response time for a request for assistance.