Del_Bagno_Veronica___Project_Momentum (1).pdf
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- Attached to
- Master Agreement AZ|CTR078263
- Contract number
- CTR078263
- Issued by
- Arizona
About this file
This document is a solicitation for the Arizona Department of Education's Project Momentum Virtual Collaborative Team Leader contract, with solicitation number BPM007012. The solicitation is for an individual consultant, Veronica Marie Del Bagno, located in Alexandria, VA, who will provide virtual collaborative team leadership services. The document contains multiple attachments including a qualified vendor application, price sheet, offer and acceptance form, conformance statements, and various compliance certifications.
The contract is for a Project Momentum Virtual Collaborative Team Leader role for the 2025-2026 period, with a pricing of $10,400.00 per virtual team. The scope involves leading virtual collaborative learning teams, specifically focusing on supporting fourth-grade math teams across multiple school districts in Arizona. The consultant will facilitate virtual professional learning communities, align curriculum pacing, develop common assessments, and support instructional planning. Payment terms specify full payment within thirty days after receipt of services and a complete invoice. The contract appears to be exempt from certain state requirements due to the contractor being a sole consultant with fewer than ten employees.
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Solicitation Attachments
Solicitation No. BPM007012 Project Momentum Virtual Collaborative Team Leader
Arizona Department of Education 1535 W. Jefferson Street
Phoenix, AZ 85007
PROPOSAL REQUIREMENTS
ATTACHEMENT I – QUALIFIED VENDOR APPLICATION
ATTACHMENT II – PRICE SHEET…………………………………………………………………. 4
ATTACHMENT III – OFFER & ACCEPTANCE
ATTACHMENT IV – CONFORMANCE STATEMENTS (DEVIATIONS AND EXCEPTIONS)…6
ATTACHMENT V – CONFORMANCE STATEMENTS – ATTACHMENT SUPPLEMENT…..7
ATTACHMENT VI – CONFIDENTIAL/PROPRIETARY SUBMITTAL……………………………8
ATTACHMENT VII – DESIGNATION OF CONFIDENTIAL, TRADE SECRET
& PROPRIETARY INFORMATION
ATTACHMENT VIII – PARTICIPATION IN BOYCOTT OF ISRAEL…………………………11
ATTACHMENT IX – FORCED LABOR OF ETHNIC UYGHURS BAN…………………………..13
EXHIBIT A – OFFEROR CHECKLIST
EXHIBIT B – CERTIFICATE OF LIABILITY INSURANCE FORM
Proposal Requirements
Arizona Department of Education
This section contains instructions to Offerors on how to prepare their written responses to this RFP. If any relevant and material information is not provided, the offer may be rejected from consideration and evaluation. Proposals will be considered and evaluated based upon the Offeror’s full completion and response to the following, and any additional requirements herein, or stated in a separate Exhibit. Any proposal that does not adhere to these requirements may be deemed non-responsive and rejected on that basis.
The proposal should be organized and indexed in the following format and should contain, at a minimum, the items listed in the sequence indicated:
Attachment I – Qualified Vendor Application. (Page 3) Complete per the instructions stated on the form.
Attachment II – Price Sheet. (Page 4) Complete per the instructions stated on the form.
Attachment III – Offer and Acceptance. (Page 5) Complete per the instructions stated on the form.
Attachment IV – Conformance Statements (Deviations and Exceptions) Form. (Page 6) Complete per the instructions on the form.
Attachment V – Conformance Statements – Attachment Supplement. (Page 7) Complete per the instructions on the form.
Attachment VI – Confidential/Proprietary Submittals. (Page 8) Complete per the instructions on the form.
Attachment VII – Designation of Confidential Form. (Page 9) Complete per the instructions on the form.
Attachment VIII – Participation in Boycott of Israel. (Page 11) Complete per the instructions on the form.
Attachment IX – Forced Labor of Ethnic Uyghurs Ban. (Page 13) Complete per the instructions on the form.
Sample Certificate of Liability Insurance. (Page 15)
Attachment I Qualified Vendor Application
Arizona Department of Education
Vendor Legal Name
Veronica Marie Del Bagno
Vendor Legal Name
Veronica Marie Del Bagno
Contact Name and Title
Veronica Del Bagno, Consultant
Phone Number
917-628-1588
Fax Number
N/A
917-628-1588
Web Site
N/A
1. Describe your experience serving schools targeted for school improvement and the impact you were able to have in terms of student achievement.
Over the past several years, I have led and supported a school identified for targeted school improvement. In this work, I’ve focused on building structures that empower teachers and center student learning, with Collaborative Learning Teams (CLTs) serving as a key driver for change.
At Rolling Valley Elementary, we’ve strategically designed our CLTs to be intentional, data-driven, and directly aligned with our SIIP (School Innovation and Improvement Plan). Each CLT is anchored in the core components of Tier 1 instruction, rigorous student discourse, and meaningful analysis of student work. Through these structures, teachers collaborate around common assessments, instructional planning, and differentiation that meets the needs of all learners.
This work has produced clear results. For example, our grades 3–6 math SOL pass rates increased by 7 percentage points over the past year, and language arts performance improved by 9 percentage points for English Learners and 6 percentage points overall. We attribute this growth to the increased clarity and intentionality around instruction and intervention that stem directly from CLT planning. Teachers are now more confident in analyzing student work and adapting instruction in real time, leading to stronger academic outcomes.
Beyond the in-person CLTs at the school, I’ve also facilitated virtual CLTs to support five school districts in Arizona, working specifically with their fourth-grade math teams. My work with these districts focused on aligning pacing guides, creating common assessments, and collaboratively planning to ensure equitable access to high-quality math instruction for all students. This virtual collaboration allowed for cross-district dialogue and capacity building, resulting in stronger teacher efficacy and more cohesive implementation of curriculum across schools.
We’ve seen a measurable impact from these efforts. Our consistent focus on student work samples and evidence of learning has increased teacher clarity around expectations and helped drive instructional decisions that are responsive to student needs. By strengthening alignment among teachers, we’ve increased discourse around math curriculum and created space for students to engage as thinkers, problem-solvers, and communicators. Teachers report increased confidence in leading discourse-rich instruction, and our school climate data shows a 12% increase in staff agreement with the statement: “We have time to collaborate on strategies to improve student learning.”
2. Describe your experience leading PLCs (i.e collaborative teams).
In my role as principal, I have led and refined the structure of our Collaborative Learning Teams (PLCs) to be purpose-driven, data-informed, and deeply rooted in improving Tier 1 instruction. Our PLCs meet regularly and follow a consistent protocol focused on the six essential gear questions of the Project Momentum Framework: What is it that we want for students to know and do? What evidence would we accept that students have learned the required content? What instructional practices will produce our best results? What will we do if our students have not learned it? What will we do to differentiate instruction when students already know it? What will we do to improve, catalog and save our work?
We use student work samples, common formative assessments, and data discussions to guide our planning and instruction.
Over time, we’ve moved from compliance-based meetings to dynamic, teacher-driven collaboration that directly impacts student learning. My leadership team and I model this process by actively participating in CLTs, supporting the use of high-leverage strategies, and ensuring that conversations stay grounded in evidence of student learning. We’ve also embedded literacy and math coaches into this structure to provide real-time support, and we use our School Innovation and Improvement Plan (SIIP) as the roadmap to ensure our CLT work is aligned to schoolwide goals.
In addition to my school leadership role, I’ve led virtual CLTs for five school districts in Arizona, working specifically with fourth-grade math teams. This work involved facilitating cross-district professional learning communities focused on aligning curriculum pacing, building common assessments, and planning coherent math instruction. These teams met virtually on a regular basis to engage in collaborative conversations around student data, instructional gaps, and shared challenges.
One of the most impactful pieces of this work was supporting teacher leaders across districts to build confidence and capacity in leading their own teams locally. By modeling the PLC process in a virtual space, I helped cultivate a collaborative culture across schools that otherwise wouldn’t have connected. The result was increased alignment, stronger teacher collaboration, and better instructional planning—all of which translated into more consistent and effective math instruction for students across the participating districts.
3. Describe your knowledge of, and experience with, the Project Momentum Gears framework.
I am well-versed in the Project Momentum Arizona Gears framework and have applied it directly in my role as a virtual CLT team lead supporting five different school districts across Arizona. In this role, I facilitated weekly collaborative sessions with fourth-grade math teams, using the six essential gears to guide our work. We focused heavily on the first four gears— clarifying learning targets, aligning assessments, identifying high-impact instructional practices, and developing intervention strategies for students who needed more time and support.
Using the Playbook and guiding questions from the Project Momentum model, I helped teacher teams analyze their current practices and create actionable improvement plans. Our focus remained on sustainable change—building team capacity, ensuring consistency in instruction across schools, and maintaining a collaborative culture rooted in evidence and reflection.
This work not only strengthened outcomes for students but also helped teacher teams become more confident and effective in their instructional planning. I saw firsthand how the Gears framework fostered equity and coherence across schools, and I continue to use these principles in my current leadership role to drive collaborative improvement in my school community.
4. Describe your experience with coaching teachers As the principal of a school, coaching teachers is central to my leadership approach. I work closely with our literacy and math coaches to ensure that every teacher receives ongoing, embedded professional learning that is aligned with our school improvement goals. Together, we use coaching cycles, classroom walkthroughs, and CLT conversations to provide targeted feedback, model instructional strategies, and analyze student work. My coaching approach is grounded in trust, reflective dialogue, and a shared belief that continuous growth leads to student success.
I also support the development of teacher leaders by helping them use student data and evidence-based practices to drive their instructional decisions. A major focus of our coaching efforts has been around Tier 1 instruction and student discourse, with professional development rooted in student discourse and collaboration. This work has supported teachers in deepening student engagement, elevating rigor, and making thinking visible through purposeful classroom conversation.
In addition to my on-site coaching experience, I served as a virtual CLT lead supporting five school districts in Arizona. In that capacity, I coached fourth-grade math teachers around aligning curriculum, creating common assessments, and improving lesson planning. Much of this work required virtual modeling, providing real-time feedback, and building teacher capacity to collaborate across schools and districts.
Through both in-person and virtual settings, my coaching philosophy remains the same: support teachers where they are, celebrate their strengths, and provide the tools and reflection needed to take their instruction—and student outcomes—to the next level.
5. Describe your experience with coaching teachers I have extensive experience leading teams virtually, both in my role as a school leader and as a team lead supporting cross-district collaborative work. Most notably, I served as the virtual CLT lead for five school districts in Arizona through Project Momentum. In that role, I facilitated weekly virtual meetings with fourth-grade math teams across the districts, guiding them in aligning curriculum pacing, developing common assessments, and planning rigorous instruction. I designed agendas that were focused, goal-oriented, and grounded in student learning outcomes, while also creating space for teacher reflection and collaboration.
In addition to this long-term work, I also provided short-term support by stepping in to lead a different fourth-grade virtual math CLT during a period of sub coverage. I was also called upon to briefly support a first-grade virtual math CLT by covering a few of their planning sessions. In both cases, I ensured continuity, upheld the collaborative norms and goals already in place, and helped guide instructional conversations focused on student needs.
Virtual leadership required me to be intentional in building relationships, setting clear expectations, and ensuring equity of voice among all team members. I utilized collaborative tools such as shared planning documents, data protocols, and virtual breakout rooms to foster interactive and productive sessions. I also offered individualized coaching and follow-up support outside of group meetings to ensure teachers and leaders felt confident and equipped to implement the work in their buildings.
Throughout the process, I remained focused on outcomes—ensuring that the virtual format did not become a barrier, but instead a bridge that connected educators across districts to share best practices and improve instruction. This virtual leadership experience strengthened my ability to facilitate meaningful dialogue, maintain engagement, and drive results in a remote setting.
6. Please provide a detailed copy of the offeror’s resume.
Resume uploaded
Attachment II – Price Sheet
Arizona Department of Education
Offeror Name:
Veronica Del Bagno
Offeror proposes to furnish all services and related materials for services as stated in the Scope of Work for the following. Offeror may use additional sheets if necessary but may not alter this form.
Project Momentum Virtual Collaborative Team Leader 2025-2026 $10,400.00 per virtual team
*Payment for goods or services shall be made in full within thirty days after receipt of goods or services and a complete and accurate invoice for payment has been received by ADE including any required backup documentation. Advance payment shall not be made prior to goods or services being delivered.
Attachment III – Offer and Acceptance
Arizona Department of Education
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.
Company Name Signature of Person Authorized to Sign Offer
615 N. Columbus St. Veronica Del Bagno Address Printed Name
Alexandria, VA 22314 Consultant
City State Zip Title Phone: 917-628-1588 vdelbagno@gmail.com Fax: N/A
Contact Email Address By signature in the Offer section above, the Offeror certifies:
1. The submission of the Offer did not involve collusion or other anticompetitive practices.
2. 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.
3. 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.
4. The Offeror certifies that the above referenced organization ___ IS/ ___ IS NOT a small business with less than 100 employees or has gross revenues of $4 million or less.
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 written notice to proceed.
State of Arizona
Awarded this day of 20
Rev 10-2013 Procurement Officer
Attachment IV – Conformance Statements (Deviations and Exceptions)
Arizona Department of Education
If taking exceptions, the relevant subsequent pages titled “Attachment Supplements” must be completed. Attach additional pages as needed.
STATE WILL NOT CONSIDER ANY EXCEPTIONS UNLESS DESIGNATED ON THIS FORM.
READ ALL INSTRUCTIONS TO OFFERORS BEFORE TAKING ANY EXCEPTIONS. OFFERS WITH
EXCEPTONS MAY BE FOUND NOT SUSCEPTIBLE FOR AWARD UNDER A.A.C. R2-7-C311 OR
RECEIVE LOWER SCORES DURING EVALUATION.
CONFORMANCE TO THE INSTRUCTIONS TO OFFERORS
Check one of the following:
X YES – Offeror acknowledges that it has read and understands the Special Instructions to Offerors and Uniform Instructions to Offerors of the Solicitation Documents and attests that its Offer complies with both.
☐ NO – Offeror acknowledges that it has read and understands the Instructions to Offerors in the Solicitation Documents, and attests that its Offer complies with both EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Instructions.
CONFORMANCE TO THE SCOPE OF WORK
X YES – Offeror acknowledges that it has read and understands the Scope of Work Document and the Pricing Document of the Solicitation Documents and attests that its Offer complies with both.
☐ NO – Offeror acknowledges that it has read and understands the Scope of Work Document and the Pricing Document of the Solicitation Documents and attests that its Offer complies with both EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Scope of Work.
CONFORMANCE TO THE CONTRACT TERMS AND CONDITIONS
X YES – Offeror acknowledges that it has read and understands the Special Terms and Conditions and the Uniform Terms and Conditions, along with their respective Exhibits and Appendices of the Solicitation Documents and attests that its Offer complies with all.
☐ NO – Offeror acknowledges that it has read and understands the Special Terms and Conditions and the Uniform Terms and Conditions, along with their respective Exhibits and Appendices of the Solicitation Documents and attests that its Offer complies with all EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Contract Terms and Conditions.
Offeror name Signature of person authorized to sign
Attachment V – Conformance Statements – Attachment Supplement
Project Momentum Virtual Collaborative Team
Leader
Arizona Department of Education
Attachment Supplement – Conformance Statements – Deviations and Exceptions
Article / paragraph or exhibit reference
RFP language (Copy and paste from Solicitation) Alternate language and Rationale
X X Alternate language: X
Rationale: X
Attachment VI – Confidential/Proprietary Submittals
Arizona Department of Education
Confidential/Proprietary Submittals (mark one):
_____X_____ No confidential/proprietary materials have been included with this offer
__________ Confidential/Proprietary materials included. Offerors should identify below any portion of their offer deemed confidential or proprietary (see Uniform Terms and Conditions, paragraph 19).
Identification in this section does not guarantee that disclosure will be prevented but that the item will be subject to review by the Offeror and the ADE Representative prior to any public disclosure.
***Requests to hold the entire offer or price as confidential will result in the Offer being deemed Not Susceptible for Award***
Attachment VII – Designation of Confidential, Trade Secret & Proprietary
Information
Arizona Department of Education
All materials submitted as part of a response to a solicitation are subject to Arizona public records law and 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 (attached) 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(52).
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:
X 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(52) 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.
615 N. Columbus St., Alexandria VA 22314 Veronica Del Bagno
Attachment VII – Designation of Confidential, Trade Secret & Proprietary
Information
Arizona Department of Education
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.
Attachment VIII – Participation in Boycott of Israel
Arizona Department of Education
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.
3. "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.
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
Attachment VIII – Participation in Boycott of Israel
Arizona Department of Education
Company Name Signature of Person Authorized to Sign
615 N. Columbus St. Veronica Del Bagno
Address Printed Name
Alexandria, VA 22314
Consultant City State Zip Title
Attachment IX – Forced Labor of Ethnic Uyghurs Ban
Arizona Department of Education
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.
Company Name Signature of Person Authorized to Sign
615 N. Columbus St. Veronica Del Bagno Address Printed Name
Alexandria, VA 22314
Consultant City State Zip City State
Offeror Checklist
Arizona Department of Education
This form is a checklist for the Offeror’s: The below list requires a response or action in your submittal.
Required Item
Page Number
1. Attachment I – Qualified Vendor Application
2. Attachment II – Price Sheet
3. Attachment III – Offer & Acceptance Page 5
4. Attachment IV – Deviations and Exceptions Page 6
5. Attachment V – Conformance Statements – Attachment Supplement Page 7
6. Attachment VI – Confidential/Proprietary Submittals Page 8
7. Attachment VII – Designation of Confidential, Trade Secret & Proprietary Information Page 9
8. Attachment VIII – Participation in Boycott of Israel Page 11
9. Attachment IX – Forced Labor of Ethnic Uyghurs Ban Page 13
10. SAMPLE Certificate of Liability Insurance Form Page 15
Sample Certificate of Liability Insurance Form
Arizona Department of Education
Boycott of Israel Disclosure
File details come from the government source that posted it. Updated .