Form 22 - Confidentiality Request.pdf

Form 22 – Request for Confidentiality

Per section 2.16 of the Request for Bid (RFB), a Bidder requesting portions of its Bid be maintained in confidence must complete this form and submit it with its Bid. Bidders should read and familiarize themselves with chapter 22 of the Iowa Code regarding release of public records before completing this form. Section 2.16 of the RFB provides the Bidder instructions regarding how to request confidential treatment of portions of its Bid.

NOTE: Completion of this Form is the sole means of requesting confidential treatment. Completion of the form and agency’s acceptance of Bidder’s submission does not guarantee the agency will grant Bidder’s request for confidentiality. The agency may reject Bidder’s Bid entirely in the event Bidder requests confidentiality and does submit a fully completed Form or requests confidentiality for portions of its Bid that are improper under the RFB.

To request confidentiality, Bidder must provide the following information:

1 Bidder must conspicuously mark confidential material in its Bid in accordance with section

2.16 Public Records and Requests for Confidential Treatment. Check box when completed.

2 Bidder must specifically identify and list the Bid section(s) for which it seeks confidentiality and answer the following questions for each section listed :

Explain the specific grounds in Iowa Code Chapter 22 or other applicable law which support treatment of the material as confidential.

Justify why the material should be kept in confidence.

Explain why disclosure of the material would not be in the best interest of the public.

Provide the name, address, telephone, and email for the person at Bidder’s organization authorized to respond to inquiries by the Agency concerning the status of confidential materials.

Please provide the information in the table below. Bidder may add additional lines if necessary or add additional pages using the same format as the table below.

RFB

Section:

Bidder must cite the specific grounds in Iowa Code Chapter 22 or other applicable law which supports treatment of the material as confidential.

Bidder must justify why the material should be kept in confidence

Bidder must explain why disclosure of the material would not be in the best interest of the public.

Bidder must provide the name, address, telephone, and email for the person at Bidder’s organization authorized to respond to inquiries by the Agency concerning the status of confidential materials.

3 Bidder must submit a Public Copy of the Bid from which the confidential information has been excised. The confidential material must be excised in such a way as to allow the public to determine the general nature of the material removed and to retain as much of the Bid as possible. Check box when completed.

This form must be signed by the individual who signed the Bidder’s Bid and returned as part of the bid submittal. A copy of this document shall be placed in all Bids submitted including the Public Copy.

*Failure to provide the information required in this form may result in rejection of Bidder’s request for confidentiality or rejection of the Bid as being non-responsive.

Signature Date

Title

Department of Administrative Services – Central Procurement Bureau Review

(for agency use only)

Bidder’s Bid is rejected as non-compliant because one of more of the following reasons:

Bidder requested confidentiality without submitting a fully completed Form 22.

Bidder requested confidentiality and failed to conspicuously mark such material as confidential within its Bid in accordance with the RFB.

Bidder requested confidentiality without submitting a public copy of its Bid with the confidential information redacted.

Bidder requested confidentiality on material in contravention of the RFB.

Other: _______________________________________________________.

Bidder’s submission is accepted.1

Purchasing Agent Signature Date

NOTE: Agency’s acceptance of Bidder’s submission should not be construed as Agency’s approval of Bidder’s request for confidentiality. Instead, acceptance of Bidder’s submission simply means that Agency believes Bidder’s Form 22 appears fully completed in accordance with the RFB.