CTR078905 Attachments Ver II.docx
DOCX document 131 KB Posted
- Attached to
- AZ|CTR078905
- Contract number
- CTR078905
- Issued by
- Arizona
About this file
This document is a state contract award for the Arizona Department of Public Safety (DPS), located in Phoenix, Arizona. The contract number is CTR078905 and involves multiple attachments including Offer and Acceptance (Attachment A), Price Sheet (Attachment B), and Declaration (Attachment C) for Aviation Jet-A Turbine Engine Fuel Storage, Delivery, and Aircraft Fueling Services.
The contract allows for the procurement of Jet-A turbine engine fuel storage and delivery services, with pricing to be determined by the contractor on a per-gallon basis. Key pricing elements include rates for fuel storage and delivery, PRIST additive, special fees, and a percentage discount off current retail price. Additional service fees are specified for aircraft ramp handling, overnight storage for King Air B200/B300 aircraft, and fuel storage capacity. The contractor must provide a minimum of 8,000 gallons of fuel storage and be able to make deliveries within 45 minutes of order receipt. The contract includes compliance requirements related to anti-discrimination laws, non-collusion, and specific Arizona state regulations concerning Israel and Uyghur labor practices.
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Text version
Direct Contract Arizona Department of Public Safety 2102 W. Encanto Blvd.
Phoenix, Arizona 85009
Contract Number: CTR078905
Aviation Jet-A Turbine Engine Fuel Storage/Delivery/Aircraft Fueling Services
Offer Checklist
| DOCUMENT (attachments required to be filled out and returned) |
| SUBMITTED |
| 1. | |
| Attachment A: | Offer and Acceptance |
| |_| YES | |_| NO |
| 1. | |
| Attachment B: | Price Sheet |
| |_| YES | |_| NO |
| 1. | |
| Attachment C: | Declaration |
| |_| YES | |_| NO |
| Attachment A |
| Arizona Department of Public Safety |
Contract Number: CTR078905
Aviation Jet-A Turbine Engine Fuel Storage/Delivery Aircraft Fueling Services
Contract Signature Page
The Undersigned hereby offers and agrees to provide recruiting services in compliance with all terms, conditions, and specifications in the Contract.
Contractor company name
Signature of person authorized to sign Contract
Address
Printed name and title
City, State, ZIP
Contact name and title
☐ By checking this box, Offeror is certifying that it is exempt from the requirements regarding the forced labor of ethnic Uyghurs and boycott of Israel because of one of the following: Contractor is a Sole proprietorship, has fewer than ten (10) employees; or is a non-profit organization.
| Contact email address |
| Contact phone number |
CERTIFICATION: By signature in the above, Contractor 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, 2009-9 or A.R.S. §§ 41-1461 through -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 Contract; failure to provide a valid signature affirming the stipulations required by this clause may void the Contract;
3. Has not signed the Contract with a false statement, which will void the Contract and may subject Contractor to legal penalties under law;
4. Complies with A.R.S. § 18-132 when offering electronics or information technology products, services, or maintenance;
5. Did not and will not involve collusion or other anti-competitive practices; and
6. Is not debarred from, or otherwise prohibited from, participating in any contract awarded by any federal entity, or state or local government.
7. 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. (Unless exempt)
8. Does not participate in the use of forced labor of ethnic Uyghurs as described in A.R.S. § 35-394. (Unless exempt)
CONTRACT EXECUTION BY PROCUREMENT AUTHORITY
The Contractor is now bound to sell the Materials or Services listed in the attached Contract, including all terms, conditions, and specifications as stated herein.
The 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 an Order or written notice to proceed from the State.
Attachment B Price Sheet
Arizona Department of Public Safety
Contract Number: CTR078905
Aviation Jet-A Turbine Engine Fuel Storage/Delivery/Aircraft Fueling Services
Line Item
| Description |
| Price |
Jet-A Turbine Engine Fuel Storage & Delivery – As per Section 2, Scope of Work/Specifications.
Enter Price Per Gallon for Fuel Storage & Delivery as specified
$______________/gallon Enter storage & delivery price per gallon only.
DO NOT PRICE FUEL
Enter price per gallon for PRIST additive.
(To be ordered as needed when needed)
Enter price per gallon special fees, if any, as may apply to fuel storage & delivery (i.e. Airport flowage fees, etc.)
Enter Discount Percentage (%) off of the Current Retal Price Per Gallon
Discount Percentage (%) off Current Retail Price Offered
| 5 |
| Enter per event fee for aircraft ramp and handling |
$______________per event fee
| 6 |
| Enter overnight storage fee (at Contractor’s location) for a King Air B200 and or B300 aircraft |
$______________per overnight storage fee
Enter fuel storage amount available to store DPS supplied fuel (shall be greater than 8,000 Gallons): _____________________Gallons
Enter timeframe for deliveries to DPS Aviation Hanger (shall be made within 45 minutes ARO and/or as per phone order request): ___________ minutes.
Attachment C Declaration
Arizona Dept of Public Safety 2102 W. Encanto Phoenix, AZ 85009
Contract Number: CTR078905
Aviation Jet -A Turbine Engine Fuel Storage/Delivery/Aircraft Fueling Services
Declaration
Has the Offeror/Firm 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. Yes: |_| No |_| image1.png oleObject1.bin oleObject2.bin oleObject3.bin oleObject4.bin
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