GRO38 Prime Grocers -Required Forms Re-Open.docx

COMMBUYS NEW Bid Number: Reopened #BD-1080-OSD03-SRC01-35096 Original #BD-19-1080-OSD01-OSD10-31803 - Prime Grocers GRO38

Required Forms GRO38 Prime Grocers

The following documents are mandatory for this RFR. Failure to provide these documents may be cause for the bid to be deemed as non-responsive and may result in disqualification.

Listed below are the required forms that must be submitted with the bid response for award consideration.

Once completed, save the file with the following name “Company Name_GRO36_Required Forms” for submission.

*if saving each form separately file name should follow “Company Name_GRO36_Form Name” (not recommended)

1. Prompt Pay Discount Form (PPD) (mandatory requirement MUST offer PPD)

2. Business Reference Form (Business Reference Letters need to be separate attachments)

3. Bidder Current Environmentally Preferable Products / Practices Form

4. Certificate of Non-Collusion

5. Certificate of Good Standing

6. Supplier Diversity – Form 1

7. Supplier Diversity – Form 2

Prompt Pay Discount Form (Invoice discounts for receiving fast payments) Revised 3/9/07 Bidder Name: .

Vendor Code (VCUST): .

Contract/RFR Number(s): GRO38 Prime Grocers

Prompt Payment Discounts (PPD). All contractors/vendors doing business with the Commonwealth must provide a Prompt Payment Discount (PPD) for receiving early payments unless the Contractor/vendor can provide compelling proof that providing a prompt pay discount would be unduly burdensome. Contractors benefit from PPD by increased, usable cash flow as a result of fast and efficient payments for commodities or services rendered. Contractors who agree to accept Electronic Funds Transfer (EFT) increase the prompt pay benefit by ensuring that funds are paid directly to their designated bank accounts, thus eliminating the delay of check clearance policies and traditional mail lead time. Payments processed through the state accounting system (MMARS) can be tracked and verified through the Comptroller’s Vendor Web system using the Vendor/Customer Code assigned to you by a Commonwealth department.

The Commonwealth benefits because contractors reduce the cost of products and services through the applied discount. While Bidders/Contractors have flexibility in determining the actual % discount(s) offered to the Commonwealth, the discount(s) must be identified for 10, 15, 20 and/or 30 days for payment issuance in the column entitled “% Discount Off Proposed Price” below. The Commonwealth may use the prompt pay discounts submitted as a basis for selection and may negotiate discounts as deemed in the best interest of the Commonwealth. The requirement to offer PPD discounts may be waived by the Commonwealth on a case-by-case basis if participation in the program would be unduly burdensome, provided the specific reason for the hardship is outlined below.

All discounts offered will be taken in cases where the payment issue date is within the specified number of days listed below and in accordance with the Commonwealth’s Bill Paying Policy. Payment days will be measured from the date goods are received and accepted / performance was completed OR the date an invoice is received by the Commonwealth, whichever is later to the date the payment is issued as an EFT (preferred method) or mailed by the State Treasurer. The date of payment “issue” is the date a payment is considered “paid” not the date a payment is “received” by a Contractor.

If internal Bidder/Contractor systems require an alternate method of measuring payment issue dates, the Bidder/Contractor must note the issues below or on an attached page if necessary to be considered by the PMT. In cases where the Bidder/Contractor considers that offering a Prompt Payment Discount would be a hardship, the Bidder must clearly define the issues and reasons for said hardship. Providing volume discounts or other discounts on prices is not considered a hardship, since the PPD provides the additional benefit of early cash flow for the Contractor.

Enter the Prompt Payment Discount percentage (%) off the invoice payment, for each of the payment issue dates listed, if the payment is issued within the specified Payment Issue days. For example:

5% - 10 Days 4% - 15 Days 3% - 20 Days 2% - 30 Days If no discount is offered enter 0%

The Contractor is unable to provide a prompt payment discount due to the following hardship:

Contractor/Bidder Authorized Signature _________________________________ Date: ____________

Contractor/ Bidder Authorized Signatory Print Name and Title: __________________________________ Business Reference Form Bidder: _______________________________________________________ RFR Name/Title: Prime Grocers RFR Number: GRO38 The bidder must provide three (3) business references on this form and three (3) letters of references must be submitted with bid response.

Reference name:_____________________________________ Contact:

Address: _________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

Reference name: _______________________________________Contact:

Address: _________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

Reference name: ______________________________________ Contact:

Address: __________________________________________Phone: # ( ) Fax/Internet address:

Description and date(s) of commodities and services provided:

References will be contacted to confirm the bidder’s abilities and qualifications as stated in the bidder’s response. The department may deem the bidder’s response unresponsive if a reference is not obtainable from a listed reference after reasonable attempts.

Bidder Current Environmentally Preferable Products / Practices Form Bidder Company Name: ___________________________________________________ Date: _______________ In line with the Commonwealth’s efforts to promote products and practices which reduce our impact on the environment and human health, Bidders must provide information regarding their environmentally preferable/sustainable business practices as they relate to this contract wherever possible. Bidders who can demonstrate such initiatives (referencing, but not limited to, the items listed below) will be eligible to receive evaluation points. In order to receive evaluation points, Bidders must complete this form and submit it with their RFR Response.

1. Does your company have a sustainability strategy and goals? If so, please describe the key elements (e.g., sustainability staff positions, qualifications, training, implementation, and key accomplishments, as applicable). Click here to enter text.

2. If your company will offer products as part of the service for this contract, how do you identify and verify the sustainability attributes of the products you are planning to offer? What types of environmentally preferable or sustainable products do you currently use in your trade? This includes, for example, products with recycled content, promote energy and water efficiency, reduce toxicity, are recyclable, easy to maintainability, and durable? Click here to enter text.

3. Does your company recycle debris from the jobsite? Does your company have a recycling program at your offices? If so describe your program and types of materials recycled: Click here to enter text.

4. Have you participated in workshops or continuing education seminars on “greening” practices for your trade? If so, please list and describe briefly what was learned: Click here to enter text.

5. Is there a forum at your company for aligning and cross-pollinating ideas on sustainability? Please describe: Click here to enter text.

6. Do you have any third party or other special training for new efficient products that we should be aware of (e.g., International Residential Code or 2015 International Energy Conservation Code Energy Rating Index (ERI))? Please list and describe: Click here to enter text.

7. Have you worked on any LEED (Leadership for Energy and Environmental Design) certified buildings? If so, please list and describe: Click here to enter text.

8. Bidders may provide additional information about environmentally preferable practices that are not indicated and explained above (attach any appropriate documentation to substantiate claim): Click here to enter text.

Certificate of Non Collusion

The undersigned certifies under penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word “person” shall mean any natural person, business, partnership, corporation, union, committee, club or other organization, entity or group of individuals.

Signature of individual submitting bid or proposal

Name of Business

Certificate of Good Standing Bidders will be required to submit with their bid response a Certificate of Good Standing as stated below:

Corporations and other organizations often need proof that they are in good standing with the Commonwealth, i.e., that all tax liabilities have been met in order to obtain financing, sell their business, renew licenses or enter into other business transactions.

The fastest and easiest way to obtain a Certificate is via our online application. Both taxpayers and authorized practitioners can use this program to obtain a Certificate within a few days. Before beginning this process, make sure that key authenticating data is readily available, including the entity's id number, a list of tax types filed with DOR and the dates when the entity was first required to collect and submit these taxes.

Once the applicant has been authenticated, a search will be made of our databases to identify any returns that need to be filed or bills that remain unpaid. Since this process takes up to 48 hours, users will be given an application number and asked to come back to the program in a couple of days. At that time, fully compliant taxpayers will be able to print a Certificate or request that it be mailed to the address of record. If bills are identified, an opportunity will be given to pay the amount owed via EFW. A Certificate will then be issued. Taxpayers with nonfiled Trustee tax returns (Sales, Meals, Withholding, Room Occupancy), can file and pay within the application and obtain their Certificate. Taxpayers with non-filed Income and Corporate returns will be given instructions on how to file on paper and obtain a Certificate.

If the certificate of Good Standings has not been provided by the Secretary of State the bidder will be required to submit a COPY of the confirmation from the Secretary of State that the bidders is pending receipt of the certificate.

Please note:

Taxpayers responsible for certain taxes such as Alcoholic Beverage Excise, Cigarette Excise, Sales Tax on Boats, International Fuels Tax Agreement, Smokeless Tobacco or Ferry Embarkation will need to file a paper application. This form can be printed from this site. Paper applications can take 4 to 6 weeks.

Paper applications are also required in order to obtain a Waiver of Corporate Tax lien.

Dissolutions: Corporations have not been required to obtain a Certificate of Good Standing prior to a voluntary dissolution since March 1992.

Complete highlighted sections of form

Supplier Diversity Program (SDP) Plan Commitment SDP Plan Form #1 (To be submitted with Bid Response) Contract/RFR Document Number: GRO38 Prime Grocers

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit with Bid.

Part I Bidder/Contractor Information (Required)

Business Name:

Contact Name:

Part II Financial Commitment (Required)

Provide a specific percentage committed (as a percentage of Bidder/Contractor sales derived from this contract for the life of the contract) to be spent with all certified SDP Partners that the Bidder will propose if awarded a Contract. Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form.

Supplier Diversity Program (SDP) Resources:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

Complete highlighted sections of form Supplier Diversity Program (SDP) Plan - Declaration of SDP Partner(s) SDP Plan Form #2 (Must be submitted by Contractor within a period of up to 30 days (or as stated in RFR) of Contract Execution) Contract/RFR Document Number: GRO38 Prime Grocers

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit within a period of up to 30 days (or as stated in RFR) of Contract Execution. See SDP and SDVOBE Resource information below to assist in partnering with certified businesses.

Part I Contractor Information (Required)

Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form and may not list themselves as an SDP Partner. Check any of the following that are applicable to the Bidder:

|_| Minority-owned Business Enterprise (MBE); Certification Expiration Date (If applicable): / / |_| Women-owned Business Enterprise (WBE); Certification Expiration Date (If applicable): / / |_| Non-Profit Organization (NPO); Certification Expiration Date (If applicable): / / |_| Service-Disabled Veteran-owned Business Enterprise (SDVOBE); Certification Expiration Date (If applicable): / /

Identify Business Opportunities for SDP Partners (Optional):

Part II Contractor’s SDP Partners (Required) (Fill in Applicable Lines; Insert Additional Rows as Needed)

Planned SDP Partner’s Company Name

|_| WBE

|_| MNPO/WNPO/MWNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/M/WNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/MWNPO

|_| SDVOBE

|_| WBE

|_| MNPO/WNPO/M/WNPO

|_| SDVOBE

Part III Under the pains and penalties of perjury I certify that the information provided on this form is accurate. (Required)

(May be left blank if submitted electronically) Date: / /

*The Supplier Diversity Office and contracting Department reserve the right to contact SDP Partners at any time to request that they attest to the amounts reported to have been paid to them by the Contractor.

** SDP Partner Certification Acronyms: MBE = Minority-owned Business Enterprise; WBE = Women-owned Business Enterprise; SDVOBE = Service-Disabled Veteran-owned Business Enterprise.

*** Certification Status can be checked on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

Supplier Diversity Program (SDP) Resources:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage Operational Services Division | One Ashburton Place, Suite 1017 | Boston, MA 02108 | 617-720-3300 | www.mass.gov/osd image2.png image1.png image3.png