FORM 04-STATEMENT OF NO PRIOR DISQUALIFYING INVOLVEMENT.pdf
PDF 134 KB Posted
- Attached to
- MyFloridaNet-3 Core Services - ITN
- Solicitation number
- ITN-12980
- Issued by
- Clay County, Leon County, Polk County, Florida
About this file
This document is a Form 04 - Statement of No Prior Disqualifying Involvement for the MyFloridaNetwork-3 Core Services solicitation (ITN No.: DMS-24/25-260) issued by the Florida Department of Management Services. The form is a certification document that ensures potential respondents have not been previously involved in drafting the solicitation or developing implementation programs that would disqualify them from contracting.
The document specifically references Florida Statute 287.057(19)(c), which prohibits entities from contracting with an agency if they have previously performed a feasibility study, participated in drafting a solicitation, or developed implementation programs for the specific subject matter. The form allows respondents to certify their eligibility by confirming they do not fall under these disqualifying conditions, with an exception that responding to a request for information does not prevent future contract eligibility.
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Text version
ITN No.: DMS-24/25-260 Page 1 of 2 MyFloridaNet-3 Core Services
FORM 04 – STATEMENT OF NO PRIOR DISQUALIFYING INVOLVEMENT
4050 Esplanade Way Tallahassee, FL 32399-0950
850-488-2786
Ron DeSantis, Governor Pedro Allende, Secretary
FOR
MyFloridaNetwork-3
ITN NO: DMS-24/25-260
THE STATE OF FLORIDA
DEPARTMENT OF MANAGEMENT SERVICES
ITN No.: DMS-24/25-260 Page 2 of 2 MyFloridaNet-3 Core Services
FORM 04 - STATEMENT OF NO PRIOR DISQUALIFYING INVOLVEMENT
I, as an authorized representative of the Respondent, certify that nothing in section 287.057(19)(c), F.S., (below), prohibits the Respondent’s entry into any Contract resulting from this solicitation.
287.057 Procurement of commodities or contractual services. — (19)(c) A person who receives a contract that has not been procured pursuant to subsections (1)-(3) [of s.
287.057, F.S.] to perform a feasibility study of the potential implementation of a subsequent contract, who participates in the drafting of a solicitation or who develops a program for future implementation, is not eligible to contract with the agency for any other contracts dealing with that specific subject matter, and any firm in which such person has any interest is not eligible to receive such contract. However, this prohibition does not prevent a Respondent who responds to a request for information from being eligible to contract with an agency.
Name of Respondent’s Organization Signature of Authorized Representative and Date
Print Name
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