Exhibit A Certifications Fillable.pdf
PDF 130 KB Posted
- Attached to
- Financial Process Review State and local contract opportunity
- Solicitation number
- 25-0502JMC
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Pacific City, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This document is a Certifications and Assurances Exhibit A form from Washington State University, designed to be submitted with a proposal. The form requires potential contractors to make various declarations and certifications about their proposal, including affirming the truthfulness of their statements, confirming independent price determination, and attesting to compliance with state wage laws. The document outlines 12 specific certifications, including that the proposal prices have been determined independently, the offer will remain valid for at least 180 days, and the proposer has not been assisted by current or former state employees in an improper manner.
The form specifically requires proposers to certify their compliance with Washington state wage laws, including whether they have been determined to have willfully violated wage provisions within the past three years. Proposers must initial whether they have or have not had wage law violations. Additionally, the document requires proposers to indicate whether they take any exceptions to the model contract terms. The form concludes with a section for the proposer's signature, title, printed name, email address, telephone number, and date, serving as a formal attestation to the accuracy of the statements made in the document.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Exhibit C Fee Sheet.xlsx | XLSX spreadsheet | |
| RFP 25-0502JMC Financial Process Review.pdf | ||
| Exhibit B Contractor Info Fillable.pdf | ||
| Exhibit D Model Contract.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
CERTIFICATIONS AND ASSURANCES EXHIBIT A
to be submitted with Proposal
I/we make the following certifications and assurances on behalf of _____________________________________ as a required element of the proposal to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract:
1. I/we declare that all answers and statements made in the proposal are true and correct.
2. The prices and/or cost data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single proposal.
3. The attached proposal is a firm offer and will remain valid for at least 180 days or until _____________, and it may be accepted by the University without further negotiation (except where obviously required by lack of certainty in key terms) at any time prior to ____________.
4. In preparing this proposal, I/we have not been assisted by any current or former employee of the state of Washington whose duties relate (or did relate) to this proposal or prospective contract, and who was assisting in other than his or her official, public capacity. If there are exceptions to these assurances, I/we have described them in full detail on a separate page attached to this document.
5. I/we understand that the University will not reimburse me/us for any costs incurred in the preparation of this proposal. All proposals become the property of the University, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this proposal.
6. Unless otherwise required by law, the prices and/or cost data which have been submitted have not been knowingly disclosed by the Proposer and will not knowingly be disclosed by him/her prior to opening, directly or indirectly, to any other Proposer or to any competitor.
7. I/we agree that submission of the attached proposal constitutes acceptance of the solicitation contents and the attached sample contract and general terms and conditions. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document.
8. No attempt has been made or will be made by the Proposer to induce any other person or firm to submit or not to submit a proposal for the purpose of restricting competition.
9. I/we grant the University the right to contact references and others, who may have pertinent information regarding the ability of the Respondent and the lead staff person to perform the services contemplated by this RFP.
10. If any staff member(s) who will perform work on this contract has retired from the State of Washington under the provisions of the 2008 Early Retirement Factors legislation, his/her name(s) is noted on a separately attached page.
11. Washington Wage Law Certification: Prior to awarding a contract, institutions of higher education in the state of Washington are required to determine that a bidder is a “responsible bidder.” See RCW 39.26.160(2) & (4). Pursuant to legislative enactment in 2017, the responsible bidder criteria include a contractor certification that the contractor has not willfully violated Washington’s wage laws. I/we hereby certify, under penalty of perjury under the laws of the State of Washington, that I/we are not currently debarred from doing business with the State of Washington.
INITIAL ONE:
_______ NO WAGE VIOLATIONS. I/We have NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082 any provision of RCW chapters 49.46, 48.48, or 49.52 within three (3) years prior to the date of signing this Certifications & Assurances form below.
OR
_______ VIOLATIONS OF WAGE LAWS. I/We have been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, a provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.
12. Terms and conditions of Washington State University. INITIAL ONE:
______ NO EXCEPTIONS ARE TAKEN TO THE TERMS OF THE MODEL CONTRACT
______ EXCEPTIONS OUTLINED ON THE ATTACHED PAGE ARE TAKEN TO THE TERMS OF THE MODEL
CONTRACT.
ON BEHALF OF THE RESPONDENT SUBMITTING THIS PROPOSAL, MY NAME BELOW ATTESTS TO THE
ACCURACY OF THE ABOVE STATEMENTS.
SIGNATURE TITLE PRINTED NAME
EMAIL ADDRESS TELEPHONE DATE
| NO EXCEPTIONS ARE TAKEN TO THE TERMS OF THE MODEL CONTRACT: |
| CONTRACT: |
| TITLE: |
| PRINTED NAME: |
| EMAIL ADDRESS: |
| TELEPHONE: |
| DATE: |
| Company Name: |
| Date: |
| Date2: |
| Select One: |
| Select One2: |
File details come from the government source that posted it. Updated .