Exhibit B - Proposer Information and Certification Form.pdf
PDF 826 KB Posted
- Attached to
- UTV and Accessories - Request for Quotes
- Solicitation number
- S-69000-00012422
- Issued by
- Baker County, Barlow City, Oregon
About this file
This document is Exhibit B - Proposer Information and Certification Form for RFQ S-69000-00012422, which appears to be for Utility Terrain Vehicle and Accessories. This form is a certification document that proposers must complete to participate in the RFQ process. The form requires proposers to acknowledge that quotes are firm for 90 calendar days following the Bid Opening date.
The form includes multiple certification requirements covering: tax compliance (ORS 305.620 and Chapters 316, 317, and 318), non-discrimination practices, compliance with ORS 652.220 regarding wage equity, broadband internet service compliance (HB 4155), and verification that proposers are not on federal exclusion lists. The form also requires certification that there are no conflicts of interest and that all quote information has been prepared independently without collusion. Proposers must acknowledge these certifications are in addition to those required in the Price Agreement and Purchase Order at execution.
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Text version
RFQ S-69000-00012422 – 6 10
EXHIBIT B – PROPOSER AND CERTIFICATION
Legal Name of Proposer:
Address:
City, State ZIP:
Contact Name:
Telephone: Email:
1. Proposer understands and accepts the requirements of this RFQ.
bound by the Price Agreement and Purchase Order if any, that Agency
2. Proposer acknowledges receipt of all Amendments to this RFQ.
3. 9
4.
, ORS 305.620, and ORS Chapters 316, 317, and 318.
ed under ORS 200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled Veteran owns, or an emerging small that meets the requirements described in ORS 279A.112 may not for
6. Proposer complies with ORS 652.220 membership in a protected class. “Protected class” means a group of Perso
7. Purchase order and a failure to comply to terminate this Purchase Order for cause.
8.
employee or another Person.
9.
in or may engage in the provision of broadband Internet access service Proposer is in compliance with Oregon throughout the term of the Purchase Order.
10.
RFQ S-69000-00012422 – 7 10
a.
Control of the United States Department of the Treasury found at:
, or b.
11.
business or economic interests of Proposer, its employees, or its agents, on the one hand, and the business or economic interests of the State, 12.
Proposers, and without collusion, fraud, or other dishonesty.
13.
y the Oregon False Claims Act, ORS 180.750(1)}, made under Purchase Order being a “false claim” {ORS 180.750(2)} subject to the Oregon False Claims Act, ORS 180.750 to 180.785
14.
and the Purchase Order Purchase Order
Date:
Printed Name and Title:
File details come from the government source that posted it. Updated .