EB 24-64121502-ITB Attachment G Mandatory Responsive Requirements.pdf

Solicitation No. 24-64121502-ITB Equipment Breakdown Insurance

Attachment G

Mandatory Responsive Requirements

The person submitting the Bid and its pricing certifies to being authorized by the Respondent to respond to this solicitation on the Respondent’s behalf.

The Respondent certifies it is in compliance with all applicable disclosure requirements set forth in section 286.101, F.S., and has not been deemed ineligible for a grant or contract funded by a state agency pursuant to section 286.101(7), F.S.

The Respondent certifies that the Respondent is not on the Suspended Vendor List maintained pursuant to section 287.042(1)(a) F.S., and 287.1351 F.S., and neither the Respondent nor any supplier, subcontractor, nor consultant included in its Bid are on the Convicted Vendor, Discriminatory Vendor, or Antitrust Violator Vendor Lists specified in Paragraphs 7 and 8 of the PUR1001 form, as modified by the “Special Instructions” section of the ITB.

The Respondent certifies that the Respondent is in compliance with Section 9 of the PUR1001 form, as modified by the “Special Instructions” section of the ITB.

The Respondent certifies that the Respondent is not on the Scrutinized Companies with Activities in Sudan List, the Scrutinized Companies with Activities in the Iran Terrorism Sectors List, or the Scrutinized Companies that Boycott Israel List nor is it engaged in a boycott of Israel.

The Respondent certifies that if awarded a contract, and prior to execution of a contract, it shall provide a PDF file of its current and active registration with the Florida Department of State, Division of Corporations, or, if exempt from registration, a statement to that effect noting the basis for the exemption. If Respondent is an out-of-state corporation, it certifies it will provide a Florida Certificate of Authority from the Florida Department of State, Division of Corporations prior to Contract execution. Website: www.sunbiz.org.

The Respondent certifies that the Respondent is in compliance with section 448.095(5)(a), F.S., and that within the last year (i.e., within the last 365 days), it has not had a contract terminated under section 448.095(5)(c), F.S., by a public employer, as defined by section 448.095(1)(i), F.S.

The Bidder certifies that the Broker’s key management personnel assigned to securing the Insurance Policy will maintain current and active insurance license(s) required to provide the services contemplated herein.

The Bidder certifies that the Bidder and the selected Insurer possess a valid and current certificate of authority to transact insurance, in accordance with section 624.404, Florida Statutes, or are an eligible surplus lines insurer in accordance with section 626.918, Florida Statutes.

The Bidder certifies that it and the selected Insurer each have 10 years of experience in the placement and account management of the insurance coverage described in the Scope of Work section 5 of the ITB and Attachment I, Expiring Policy, as endorsed.

The Bidder certifies it has provided to the Department pricing on the applicable Attachment B, Price Sheet.

The Bidder certifies it has provided to the Department a completed PUR 2024 in accordance with section 287.1346(4)(b), F.S., and section 787.06, F.S.

The Bidder certifies it has provided the Department with the Insurer Quotation Document on Insurer letterhead with proposed policy period and rates for the policy term and the selected Insurer’s AM Best Key Financial Rating from the current AM Best’s Key Rating Guide demonstrating a rating of at least A- or a Financial Performance Rating of V, and a list of policy forms of the proposed coverage or a specimen policy.

Signature below certifies that Respondent conforms with all Responsive Requirements listed above. Signature below further certifies acknowledgment of the Respondent’s ongoing duty to provide updates to the Procurement Officer should a change in Respondent’s circumstances render these certifications no longer true.

Respondent’s Name Date

Signature of Respondent’s Authorized Representative https://www.dms.myflorida.com/content/download/2934/11780 https://www.dms.myflorida.com/content/download/2934/11780 http://www.sunbiz.org/