Eval_Committee_Member_Statement_-_Health_Start_Program_-_Heidi_Christensen.pdf

EVALUATION COMMITTEE MEMBER STATEMENT

Revised 10-11-12

Solicitation #BPM002372 for

Health Start Program

Dear Committee Member:

You have been selected to participate in the evaluation of proposals that have been received in response to the above referenced solicitation. Your selection was based on your technical knowledge and expertise in this area and your ability to develop an objective/subjective analysis of each proposal.

It is essential that the integrity of the evaluation process be maintained to insure that each Offeror is given fair and equal consideration. Your familiarity with particular brands, types of equipment, material, services, individuals or firms may tend to influence your evaluation; however, you are required in this specific instance to be particularly objective and guard against any tendency that might slant your evaluation in favor of a personal preference.

You are required to report to the Committee Chairperson any actual or potential conflict of interest as defined in A.R.S. §38-503 and §41-2616C. You are also subject to the Code of Ethics set forth in Section R2-5-501 of the Arizona Department of Administration, Personnel Division, Administrative Rules and Regulations.

An additional consideration is the legal mandate to maintain strict security and confidentiality regarding the content of any proposal, as well as the proceedings of the Evaluation Committee meetings during the evaluation process. Once the evaluation process has started, it is essential that any contact with Offerors, other than that disclosed, be through, and by, the Chairperson of the Evaluation Committee.

In addition, the Evaluation Committee Member shall not have any communication related in any way to the particular procurement, except during formal Committee meetings, with any Offeror or potential subcontractor to that Offeror prior to award nor shall that Member discuss the proposal or their evaluation with anyone other than the Chairperson and Evaluation Committee Members. This is mandatory.

To emphasize the importance of the above requirements, you are asked to acknowledge by signature the following statement:

I have read and understand the above and agree to be bound by the rules and principles represented. I have also received, read and understand the Evaluation Committee Instructions for this procurement. I know of no conflict of interest on my part nor have I committed any indiscretion or accepted any gratuities or favors that would compromise my impartiality. I will maintain all deliberations of the Evaluation Committee in strict confidence during the evaluation process. My recommendations shall be based upon an objective/subjective review of the Offeror's response and the appropriate award criteria from the solicitation in accordance with the Arizona Procurement Code. I have read and understand Arizona Revised Statute §41-2616C (on the next page) and will fully comply with its requirements.

Please check the box below if applicable:

□Architect or an engineer registered pursuant to section 32-121

Signature of Evaluator Date

Agency/Department Telephone Number

AHDS/ BWCH/ Maternal Health Innovation Program 602-364-3107

April 17, 2020

EVALUATION COMMITTEE MEMBER STATEMENT

Solicitation #BPM002372 for Health Start Program

ARIZONA REVISED STATUTE A.R.S. 41·2616C:

A person who serves on an Evaluation Committee for a procurement shall sign a statement before reviewing proposals that the person has no interest in the procurement other than that disclosed and will have no contact with any representative of a competing offeror related to the particular procurement during the course of evaluation of proposals, except those contacts specifically authorized by sections 41-2534, 41-2537, 41-2538 and 41-2578. The person shall disclose on this statement any contact unrelated to the pending procurement that the person may need to have with a representative of a competing offeror and any contact with a representative of a competing offeror during evaluation of proposals except those contacts specifically authorized by sections 41- 2534, 41-2537, 41-2538 and 41-2578. A person who serves on an Evaluation Committee who fails to disclose contact with a representative of a competing offeror or who fails to provide accurate information on this statement is subject to civil penalty of at least one thousand dollars but not more than ten thousand dollars.

During the course of my regular business, I may have contact, unrelated to this procurement, with the offerors listed below, who have submitted proposals in response to this solicitation:

COMPANY I CONTACT

Subject/Purpose:

COMPANY I CONTACT

Subject/Purpose:

COMPANY I CONTACT

Subject/Purpose:

EVALUATION COMMITTEE MEMBER

STATEMENT CITATIONS REFERENCE

Solicitation #BPM002372 for

Health Start Program

§ 41-2616. Violation; classification; liability; civil penalty; enforcement authority

C. A person who serves on an evaluation committee for a procurement shall sign a statement before reviewing bids or proposals that the person has no interest in the procurement other than that disclosed and will have no contact with any representative of a competing vendor related to the particular procurement during the course of evaluation of bids or proposals, except those contacts specifically authorized by sections 41-2534,41-2537,41-2538 and 41-2578. The person shall disclose on the statement any contact unrelated to the pending procurement that the person may need to have with a representative of a competing vendor and any contact with a representative of a competing vendor during evaluation of bids or proposals except those contacts specifically authorized by sections 41-2534, 41- 2537,41-2538 and 41-2578. A person who serves on an evaluation committee and who fails to disclose contact with a representative of a competing vendor or who fails to provide accurate information on the statement is subject to a civil penalty of at least one thousand dollars but not more than ten thousand dollars.

38-503. Conflict of interest; exemptions; employment prohibition

A. Any public officer or employee of a public agency who has, or whose relative has, a substantial interest in any contract, sale, purchase or service to such public agency shall make known that interest in the official records of such public agency and shall refrain from voting upon or otherwise participating in any manner as an officer or employee in such contract, sale or purchase.

B. Any public officer or employee who has, or whose relative has, a substantial interest in any decision of a public agency shall make known such interest in the official records of such public agency and shall refrain from participating in any manner as an officer or employee in such decision.

C. Notwithstanding the provisions of subsections A and B of this section, no public officer or employee of a public agency shall supply to such public agency any equipment, material, supplies or services, unless pursuant to an award or contract let after public competitive bidding, except that:

1. A school district governing board may purchase, as provided in sections 15-213 and 15-323, supplies, materials and equipment from a school board member.

2. Political subdivisions other than school districts may purchase through their governing bodies, without using public competitive bidding procedures, supplies, materials and equipment not exceeding three hundred dollars in cost in any single transaction, not to exceed a total of one thousand dollars annually, from a member of the governing body if the policy for such purchases is approved annually.

D. Notwithstanding subsections A and B of this section and as provided in sections 15-421 and 15-1441, the governing board of a school district or a community college district may not employ a person who is a member of the governing board or who is the spouse of a member of the governing board.

R2-5-501.Standards of Conduct

A. General. In addition to statutorily prohibited conduct, including but not limited to A.R.S. § 41-770, a violation of the standards of conduct listed in subsections (B), (C), and (D) is cause for discipline or dismissal of a state service employee.

B. Required conduct. A state service employee shall at all times:

1. Maintain high standards of honesty, integrity, and impartiality, free from personal considerations, favoritism, or partisan demands;

2. Be courteous, considerate, and prompt in dealing with and serving the public and other employees;

EVALUATION COMMITTEE MEMBER

STATEMENT CITATIONS REFERENCE

Solicitation #BPM002372 for

Health Start Program

3. Conduct himself or herself in a manner that will not bring discredit or embarrassment to the state;

and

4. Comply with federal and state laws and rules, and agency policies and directives.

C. Prohibited conduct. A state service employee shall not:

1. Use his or her official position for personal gain, or attempt to use, or use, confidential information for personal advantage;

2. Permit himself or herself to be placed under any kind of personal obligation that could lead a person to expect official favors;

3. Perform an act in a private capacity that may be construed to be an official act;

4. Accept or solicit, directly or indirectly, anything of economic value as a gift, gratuity, favor, entertainment, or loan that is, or may appear to be, designed to influence the employee's official conduct. This provision shall not prohibit acceptance by an employee of food, refreshments, or unsolicited advertising or promotional material of nominal value;

5. Directly or indirectly use or allow the use of state equipment or property of any kind, including equipment and property leased to the state, for other than official activities unless authorized by written agency policy or as otherwise allowed by these rules;

6. Engage in outside employment or other activity that is not compatible with the full and proper discharge of the duties and responsibilities of state employment, or that tends to impair the employee's capacity to perform the employee's duties and responsibilities in an acceptable manner; or

7. Inhibit a state employee from joining or refraining from joining an employee organization.

D. Employee rights. An employee shall not take disciplinary or punitive action against another employee that impedes or interferes with that employee's exercise of any right granted under the law or these rules. An employee or agency representative who is found to have acted in reprisal toward an employee as a result of the exercise of the employee's rights is subject to discipline, under Title 2, Chapter 5, Article 8.

The discipline shall be administered in accordance with state and federal laws affecting employee rights and benefits.