Health Pros Winning Bid 03024.pdf

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 1

(Rev 2024-08-08)

EXHIBIT A-1 – BIDDER’S CERTIFICATION

Competitive Solicitation: No. 03024 – Executive Recruitment Consulting Services

Bidder: __Health Pros Northwest_______________________________ Type/print full legal name of Bidder

Bidder’s Address: ___955 Malin Ln, Olympia, WA__________________ Type/print Bidder’s Address

Bidder Organization/Entity

Type:

Check appropriate box

Corporation: ☒Domestic ☐Foreign

Limited Liability Company (LLC): ☐Domestic ☐Foreign

Partnership: ☐Domestic ☐Foreign

Sole Proprietorship*: ☐ *A sole proprietorship is an unincorporated business owned and run by one individual or married couple alone with no distinction between the business and the owner. It is not a separate legal entity. It simply refers to a person who owns the business and is personally responsible for its debts and who pays personal income taxes on profits earned from the business. If you are a Bidder who operates a business on your own, you automatically are a sole proprietor unless you have formed a separate business structure (e.g., corporation, LLC, partnership) and lawfully registered the same.

State of Formation for Bidder Entity Type:

___Washington_________________ Type/print the state where the Bidder entity (e.g., corporation, LLC) is formed – e.g., ‘Washington’ if domestic or the name of the applicable state if ‘Foreign’ (i.e., not Washington).

Doing Business Under Another Name:

Check appropriate box

State whether Bidder has been doing business under another name during the past five years:

☒ Bidder has NOT done business under another name ☐ Bidder HAS done business under another name If Bidder HAS done business under another name, provide the business name(s) and addresses:

Business Name: ___________________________________ Address: ___________________________________

Bidder, through the duly authorized undersigned, makes this certification as a required element of submitting a responsive bid. Bidder certifies, to the best of its knowledge and belief that the following are true, complete, correct, and made in good faith:

1. UNDERSTANDING. Bidder certifies that Bidder has read, thoroughly examined, and fully understands all of the provisions in the above-referenced Competitive Solicitation (including all

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 2

exhibits) and the terms and conditions of the Contract and any amendments or clarifications to the above-referenced Competitive Solicitation, and agrees to abide by the same.

2. ACCURACY. Bidder certifies that Bidder has carefully prepared and reviewed its bid and fully supports the accuracy of the same. Bidder further understands and acknowledges that Enterprise Services shall not be responsible for any errors or omission on the part of Bidder in preparing its bid. Bidder further certifies that the facts declared here are true and accurate. Bidder further understands and acknowledges that the continuing compliance with these statements and all requirements of the above-referenced Competitive Solicitation are conditions precedent to the award or continuation of the resulting Contract.

3. NO COLLUSION, ANTI-COMPETITIVE PRACTICES, OR SHARING BID INFORMATION. Bidder certifies that Bidder has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the above-referenced Competitive Solicitation. Bidder further certifies that Bidder’s bid prices have been arrived at independently, without engaging in collusion, bid rigging, or any other illegal activity, and without for the purpose of restricting competition any consultation, communication, or agreement with any other bidder or competitor relating to (a) those prices,

(b) the intention to submit a bid, or (c) the methods or factors used to calculate the prices offered.

Bidder further certifies that Bidder has not been and shall not knowingly disclose its bid prices, directly or indirectly, to any other bidder or competitor before award of a Contract, unless otherwise required by law. Bidder further certifies that Bidder has made no attempt and shall not make any attempt to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. Bidder, however, freely may join with other persons or organizations for the purpose of presenting a joint bid. Whether done directly or indirectly, communicating bid information with other bidders, collusion, or anti-competitive actions among bidders are prohibited. If there is evidence of such communication, collusion, or anti-competitive activities among bidders, Enterprise Services reserves the right to disqualify such bidders.

4. FIRM OFFER. Bidder certifies that its bid pertaining to the above-referenced Competitive Solicitation is a firm offer which cannot be withdrawn for a time period of ninety (90) days from and after the bid due date specified in the above-referenced Competitive Solicitation. Enterprise Services may accept such bid, with or without further negotiation, at any time within such period.

In the event of a protest, Bidder’s bid shall remain valid for such time period or until the protest and any related court action is resolved, whichever is later.

5. CONFLICT OF INTEREST. Bidder certifies that, in preparing its bid, Bidder has not been assisted by any current or former employee of the State of Washington whose duties relate (or did relate) to the above-referenced Competitive Solicitation or prospective Contract and who was assisting in other than the employee’s official, public capacity. Bidder further certifies that no such current or former public employee nor any member of such person’s immediate family have any financial interest in the outcome of Bidder’s bid.

6. NO REIMBURSEMENT. Bidder certifies that Bidder understands that the State of Washington will not reimburse Bidder for any costs incurred in the preparation of Bidder’s bid. All bids become the property of the State of Washington, and Bidder claims no proprietary right to the ideas, writings, items, or samples unless so stated in the bid.

7. PERFORMANCE. Bidder certifies that Bidder understands that its submittal of a bid and execution of this Bidder’s Certification certifies Bidder’s willingness to comply with the Contract, if awarded

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 3

such. By submitting this bid, Bidder hereby offers to furnish the goods and/or services solicited pursuant to the above-referenced Competitive Solicitation in compliance with all terms, conditions, and performance requirements contained in the above-referenced Competitive Solicitation and the resulting Contract or, if applicable, as detailed on a Contract Issues List, if permitted, in the above-referenced Competitive Solicitation.

8. INSURANCE. Bidder certifies as follows (must check one):

☒ BIDDER HAS THE REQUIRED INSURANCE. Bidder has attached a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract (Note: Bidder must attach the Insurance Certificate).

OR

☐ BIDDER WILL OBTAIN THE REQUIRED INSURANCE. Bidder does not have a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract but, if designated as an Apparent Successful Bidder, Bidder shall provide such a Certificate of Insurance, without exception of any kind, to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services or be deemed a nonresponsive bid and disqualified from Contract award.

OR

☐ BIDDER DOES NOT HAVE THE REQUIRED INSURANCE. As detailed in the attached explanation (Bidder to provide), Bidder does not have a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract and, if designated as an Apparent Successful Bidder would not be able to provide such a Certificate of Insurance to Enterprise Services within five (5) business days of such designation.

Note: The Contract requires proof that the awarded Contractor, unless exempt, has Workers’ Compensation Insurance and Employer’s Liability Insurance. Pursuant to Washington law, certain entities are not required to have Workers’ Compensation Insurance (e.g., entities with no employees). If, under Washington law, Bidder is not required to have Workers’ Compensation Insurance, Bidder must check the following and provide the lawful basis as to why Bidder is not required to have Workers’ Compensation Insurance:

☐ BIDDER IS NOT REQUIRED TO HAVE WORKERS’ COMPENSATION INSURANCE. Pursuant to Washington law, Bidder is not required to have Workers’ Compensation Insurance because:

Bidder must state lawful basis as to why Bidder is NOT required to have Workers’ Compensation Insurance.

9. DEBARMENT. Bidder certifies as follows (must check one):

☒ NO DEBARMENT. Neither Bidder nor its principals presently are nor ever have been debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from contracting with any federal, state, or local governmental entity within the United States.

OR

☐ DEBARRED. As detailed in the attached explanation (Bidder to provide), Bidder and/or its principals presently are debarred, suspended, proposed for debarment, declared

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 4

ineligible, or voluntarily excluded from contracting with a federal, state, or local governmental entity within the United States.

10. CRIMINAL OFFENSE. Bidder (including Bidder’s officers) certifies as follows (must check one):

☒ NO CRIMINAL OFFENSE. Bidder has not, within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, been convicted or had a civil judgment rendered against Bidder for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a governmental contract; violation of any federal or state antitrust statute; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. Bidder further certifies that Bidder is not presently indicted or otherwise criminally or civilly charged by a governmental entity with commission of any of the offenses enumerated in this paragraph.

OR

☐ CRIMINAL OFFENSE. As detailed in the attached explanation (Bidder to provide), within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, Bidder has been convicted or had a civil judgment rendered against Bidder for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a governmental contract; violation of any federal or state antitrust statute; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.

11. CIVIL RIGHTS. Bidder certifies as follows (must check one):

☒ COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS. Bidder complies with all applicable legal requirements regarding civil rights. Such requirements prohibit discrimination against individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

OR

☐ NON-COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS. As detailed in the attached explanation (Bidder to provide), Bidder does not comply with all applicable legal requirements regarding civil rights.

12. WASHINGTON STATE WAGE THEFT PREVENTION. Bidder certifies as follows (must check one):

☒ NO WAGE VIOLATIONS. Bidder has 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 49.46, 49.48, or 49.52 within the three (3) year period preceding the date of the above-referenced Competitive Solicitation.

OR

☐ VIOLATIONS OF WAGE LAWS. As detailed in the attached explanation (Bidder to provide), Bidder has 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 https://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 https://app.leg.wa.gov/RCW/default.aspx?cite=49.46 https://app.leg.wa.gov/RCW/default.aspx?cite=49.48 https://app.leg.wa.gov/RCW/default.aspx?cite=49.52

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 5

violated, as defined in RCW 49.48.082, a provision of RCW 49.46, 49.48, or 49.52 within the three (3) year period preceding the date of the above-referenced Competitive Solicitation.

13. WASHINGTON STATE STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Bidder certifies as follows (must check one):

☒ COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. If, pursuant to the above-referenced Competitive Solicitation, Bidder is awarded a Contract, Bidder, including any subcontractor, during the term of such Contract, shall not discriminate on the bases enumerated in RCW 49.60.530(3). Bidder, including any subcontractor, also shall give written notice of this nondiscrimination requirement to any labor organizations with which Bidder, or subcontractor, has a collective bargaining or other agreement. In addition, Bidder, including any subcontractor, shall cooperate with any Washington state agency investigation regarding any allegation that Bidder, including any subcontractor, engaged in prohibited discrimination set forth in RCW 49.60.530(3).

OR

☐ NON-COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. As detailed in the attached explanation (Bidder to provide), Bidder does not comply with

RCW 49.60.530.

14. WASHINGTON STATE WORKERS’ RIGHTS (EXECUTIVE ORDER 18-03). Bidder certifies as follows (must check one):

☒ NO MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS FOR EMPLOYEES. Bidder does NOT require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

OR

☐ MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAVERS FOR EMPLOYEES. As detailed in the attached explanation (Bidder to provide), Bidder requires its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

15. WASHINGTON STATE PAY EQUALITY FOR ‘SIMILARLY EMPLOYED’ INDIVIDUALS. Bidder certifies as follows (must check one):

☒ PAY EQUALITY FOR ‘SIMILARLY EMPLOYED’ INDIVIDUALS. Bidder’s ‘similarly employed’ individuals are compensated as equals. For purposes of this provision, employees are ‘similarly employed’ if the individuals work for the same employer, the performance of the job requires comparable skill, effort, and responsibility, and the jobs are performed under similar working conditions. Job titles alone are not determinative of whether employees are similarly employed. Bidder may allow differentials in compensation for its workers based in good faith on any of the following: a seniority system; a merit system; a system that measures earnings by quantity or quality of production; a bona fide job-related factor or factors; or a bona fide regional difference in compensation levels. A bona fide job-related factor or factors may include, but is not limited to, education, training, or experience that is https://app.leg.wa.gov/RCW/default.aspx?cite=49.48.082 https://app.leg.wa.gov/RCW/default.aspx?cite=49.46 https://app.leg.wa.gov/RCW/default.aspx?cite=49.48 https://app.leg.wa.gov/RCW/default.aspx?cite=49.52 https://app.leg.wa.gov/RCW/default.aspx?cite=49.60.530 https://app.leg.wa.gov/RCW/default.aspx?cite=49.60.530 https://app.leg.wa.gov/RCW/default.aspx?cite=49.60.530 https://www.governor.wa.gov/sites/default/files/exe_order/18-03%20-%20Workers%20Rights%20%28tmp%29.pdf

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 6

consistent with business necessity; not based on or derived from a gender-based differential; and accounts for the entire differential. A bona fide regional difference in compensation level must be consistent with business necessity; not based on or derived from a gender-based differential; and account for the entire differential.

OR

☐ NO PAY EQUALITY FOR ‘SIMILARLY EMPLOYED’ INDIVIDUALS. Bidder’s ‘similarly employed’ individuals are NOT compensated as equals.

16. CONTRACT TERMINATION FOR DEFAULT OR CAUSE. Bidder certifies as follows (must check one):

☒ NO GOVERNMENTAL CONTRACT TERMINATION FOR DEFAULT OR CAUSE. Bidder has not, within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, had one (1) or more federal, state, or local governmental contracts terminated for cause or default.

OR

☐ GOVERNMENTAL CONTRACT TERMINATION FOR DEFAULT OR CAUSE. As detailed in the attached explanation (Bidder to provide), within the three (3) year period preceding the date of the above-referenced Competitive Solicitation, Bidder has had one (1) or more federal, state, or local governmental contracts terminated for cause or default.

17. TAXES. Bidder certifies as follows (must check one):

☒ TAXES PAID. Except as validly contested, Bidder is not delinquent and has paid or has arranged for payment of all taxes due to the State of Washington and has filed all required returns and reports as applicable.

OR

☐ DELINQUENT TAXES. As detailed in the attached explanation (Bidder to provide), Bidder has not paid or arranged for payment of all taxes due to the State of Washington and/or has not timely filed all required returns and reports as applicable.

18. FINANCIALLY SOLVENT. Bidder certifies as follows (must check one):

☒ FINANCIALLY SOLVENT. Bidder is financially stable and solvent, has adequate cash reserves to meet all financial obligations, has not commenced bankruptcy proceedings voluntarily or otherwise, and is not subject to any judgments, liens, or encumbrances of any kind affecting title to any Goods and/or Services that are the subject of the above-referenced Competitive Solicitation.

OR

☐ NOT FINANCIALLY SOLVENT. As detailed in the attached explanation (Bidder to provide), Bidder is not financially stable and solvent – i.e., Bidder does not have adequate cash reserves to meet all financial obligations, has commenced bankruptcy proceedings voluntarily or otherwise, or is subject to a judgment, lien, or encumbrance that affects title to the Goods and/or Services that are the subject of the above-referenced Competitive Solicitation.

19. LAWFUL REGISTRATION. Bidder, if conducting business other than as a sole proprietorship, certifies as follows (must check one):

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 7

☒ CURRENT LAWFUL REGISTRATION. Bidder is registered and in good standing in the jurisdiction (state) where Bidder is organized, including having timely filed all required annual reports.

OR

☐ DELINQUENT REGISTRATION OR NOT IN GOOD STANDING. As detailed in the attached explanation (Bidder to provide), Bidder’s organizational registration currently is delinquent or Bidder currently is not in good standing in the jurisdiction (state) where Bidder is organized.

Note: This certification applies only to Bidders who are organized as separate legal entities (e.g., a corporation, limited liability company). If Bidder is a sole proprietor, this certification should not be answered and Bidder should check the following:

☐ SOLE PROPRIETOR. Bidder is a sole proprietor.

20. REGISTRATION WITH THE WASHINGTON SECRETARY OF STATE. Bidder, if conducting business other than as a sole proprietorship, certifies as follows (must check one):

☒ BIDDER IS REGISTERED WITH THE WASHINGTON SECRETARY OF STATE. Bidder is registered with the Washington Secretary of State, is in good standing, and has the following Unified Business Identifier (UBI) number: 603-055-108.

OR

☐ BIDDER WILL REGISTER WITH THE WASHINGTON SECRETARY OF STATE. Bidder is not registered with the Washington Secretary of State but, if designated as an Apparent Successful Bidder, Bidder shall register with the Washington Secretary of State to obtain a UBI number and provide proof of such registration satisfactory to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services or be deemed a nonresponsive bid and disqualified from Contract award.

OR

☐ BIDDER IS NOT REGISTERED WITH THE WASHINGTON SECRETARY OF STATE. Bidder is not registered with the Washington Secretary of State and, if designated as an Apparent Successful Bidder, Bidder declines to register with the Washington Secretary of State within five (5) business days of such designation. Note: Enterprise Services requires all awarded bidders (including Washington firms and out of state firms) to be registered with the Washington Secretary of State. Bidders who are not registered with the Washington Secretary of State will not be awarded a Contract.

Note: This certification applies only to Bidders who are organized as separate legal entities (e.g., a corporation, limited liability company). If Bidder is a sole proprietor, this certification should not be answered and Bidder should check the following:

☐ SOLE PROPRIETOR. Bidder is a sole proprietor.

21. REGISTRATION WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder certifies as follows (must check one):

☒ BIDDER IS REGISTERED WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is registered with the Washington State Department of Revenue, has a business license to do business in Washington, and has the following Unified Business Identifier (UBI) number: 603-055-108.

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 8

OR

☐ BIDDER WILL REGISTER WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is not registered with the Washington State Department of Revenue but, if designated as an Apparent Successful Bidder, Bidder shall register with the Washington State Department of Revenue for a business license and provide proof of such registration satisfactory to Enterprise Services within five (5) business days of such designation or notification by Enterprise Services or be deemed a nonresponsive bid and disqualified from Contract award.

OR

☐ BIDDER IS NOT REGISTERED WITH THE WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is not registered with the Washington State Department of Revenue and, if designated as an Apparent Successful Bidder, Bidder declines to register with the Washington State Department of Revenue within five (5) business days of such designation. Note: Enterprise Services requires all awarded bidders (including Washington firms and out of state firms) to be registered with the Washington State Department of Revenue. Bidders who are not registered with the Washington State Department of Revenue will not be awarded a Contract.

22. SUBCONTRACTORS. Bidder certifies as follows (must check one):

☒ NO SUBCONTRACTORS. If, pursuant to the above-referenced Competitive Solicitation, Bidder is awarded a Contract, Bidder shall not utilize subcontractors to perform the Contract.

OR

☐ SUBCONTRACTORS. As detailed in the attached explanation (Bidder to provide), if, pursuant to the above-referenced Competitive Solicitation, Bidder is awarded a Contract, Bidder will utilize subcontractors to perform the Contract. In such event, Bidder further certifies that, as to the State of Washington and eligible Purchasers who utilize the Contract, Bidder shall retain responsibility for its subcontractors, including, without limitation, liability for any subcontractor’s acts or omissions.

Note: Bidder must provide the precise legal name (including state of organization), business address, and federal tax identification number (TIN) for each subcontractor.

Note: If a subcontractor’s TIN is a SSN, do not provide the SSN; rather, state that the TIN is a SSN.

23. WASHINGTON SMALL BUSINESS. Bidder certifies as follows (must check all applicable boxes):

☒ WASHINGTON SMALL BUSINESS. Bidder is a Washington Small Business as defined in RCW 39.26.010(13) and (22)(a). To qualify as a Washington Small Business, Bidder must meet three (3) requirements:

☒ Location. Bidder’s principal office/place of business must be located in and identified as being in the State of Washington. A principal office or principal place of business is a firm’s headquarters where business decisions are made and the location for the firm’s books and records as well as the firm’s senior management personnel.

☒ Size. Bidder must be owned and operated independently from all other businesses and qualify as one of the following:

☐ Bidder Qualifies as a Small Business – i.e., https://app.leg.wa.gov/RCW/default.aspx?cite=39.26.010

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 9

☐ Bidder has fifty (50) or fewer employees; or ☐ Bidder has an annual gross revenue of less than $7,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue over the previous three (3) consecutive years.

☒ Bidder Qualifies as a Minibusiness – i.e., Bidder has an annual gross revenue of less than $3,000,000, but $1,000,000 or more, as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

☐ Bidder Qualifies as a Microbusiness – i.e., Bidder has an annual gross revenue of less than $1,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

☐ WEBS Certification. Bidder must have certified its Washington Small Business status in Washington’s Electronic Business Solution (WEBS).

OR

☐ NOT A WASHINGTON SMALL BUSINESS. Bidder does not qualify as a Washington Small Business as set forth above.

24. CERTIFIED VETERAN-OWNED BUSINESS. Bidder certifies as follows (must check one):

☐ CERTIFIED VETERAN-OWNED BUSINESS. Bidder is a Certified Veteran-Owned Business under RCW 43.60A.190. To qualify as a Certified Veteran-Owned Business, Bidder must meet four (4) requirements:

51% Ownership. Bidder must be at least fifty-one percent (51%) owned and controlled by:

(a) A veteran as defined as every person who at the time he or she seeks certification has received a discharge with an honorable characterization or received a discharge for medical reasons with an honorable record, where applicable, and who has served in at least one of the capacities listed in

RCW 41.04.007;

(b) A person who is in receipt of disability compensation or pension from the department of veterans affairs; or

(c) An active or reserve member in any branch of the armed forces of the United States, including the national guard, coast guard, and armed forces reserves.

Washington Incorporation/Location. Bidder must be either an entity that is incorporated in the State of Washington as a Washington https://des.wa.gov/sell/how-work-state/register-bid-opportunities https://app.leg.wa.gov/RCW/default.aspx?cite=43.60A.190 https://app.leg.wa.gov/RCW/default.aspx?cite=41.04.007

EXHIBIT A-1 – BIDDER’S CERTIFICATION PAGE 10

domestic corporation or, if not incorporated, an entity whose principal place of business is located within the State of Washington.

WEBS Certification. Bidder must have certified its Veteran-Owned Business status in Washington’s Electronic Business Solution

(WEBS).

WDVA Certification. Bidder must have provided certification documentation to the Washington Department of Veterans’ Affairs WDVA) and be certified by WDVA and listed as such on WDVA’s website (WDVA – Veteran-Owned Businesses).

OR

☒ NOT A CERTIFIED VETERAN-OWNED BUSINESS. Bidder does not qualify as a Certified Veteran-Owned Business as set forth above.

25. REFERENCES. Bidder certifies that the references provided to Enterprise Services have worked with Bidder and that such individuals and firms have full permission, without any additional requirement or release, to provide such references and information to Enterprise Services. Bidder hereby authorizes Enterprise Services (or its agent) to contact Bidder’s references and others who may have pertinent information regarding Bidder’s prior experience and ability to perform the Contract, if awarded. Bidder hereby authorizes such individuals and firms to provide such references and release to Enterprise Services information pertaining to the same.

Bidder further certifies that Bidder shall provide immediate written notice to Enterprise Services if, at any time prior to a Contract award pursuant to the above-referenced Competitive Solicitation or anytime during the Contract term, if awarded, Bidder learns that any Bidder certifications set forth herein were erroneous when submitted or have become erroneous by reason of changed circumstances.

I hereby certify, under penalty of perjury under the laws of the State of Washington, that the Bidder certifications herein are true and correct and that I am duly authorized to make these certifications on behalf of the Bidder stated herein.

BIDDER NAME: HEALTH PROS NORTHWEST

Print Name of Bidder

Note:

If Bidder is a corporation, LLC, etc., print full legal entity name of the firm submitting the

Bid.

If Bidder is a sole proprietor, print the full legal name of the individual who is the Bidder submitting the Bid.

BY: ____________________________ Bethany Stout Signature of Bidder’s authorized person Print Name of person making certifications for

Bidder

TITLE: __Owner/President_________ PLACE: __Woodinville, WA___________ Title of person signing Bidder’s Certification Print city and state where signed

DATE: ___10/16/2024___________

Return this Bidder’s Certification to Procurement Coordinator at:

DESContractsTeamApple@des.wa.gov https://des.wa.gov/sell/how-work-state/register-bid-opportunities

EXHIBIT A-2 – BIDDER’S PROFILE: 03024 – EXECUTIVE RECRUITMENT CONSULTING SERVICES PAGE 1 (Rev 2024-07-22)

EXHIBIT A-2 – BIDDER’S PROFILE

Competitive Solicitation: No. 03024 - Executive Recruitment Consulting Services

Bidder: __Health Pros Northwest, Inc.________ Type/print full legal name of Bidder

BIDDER INFORMATION

BIDDER’S LEGAL NAME & ADDRESS

Provide Bidder’s legal name and address in the space provided:

Note: This information must match the information from Bidder’s Business License.

___Health Pros Northwest________ Business Name __955 Malin Ln SW__________ Address __Tumwater, WA 98501____________ City, State, Zip Code

BIDDER’S UNIFIED BUSINESS IDENTIFIER (“UBI”) NUMBER

Does Bidder have a Registration Number/Unified Business Identifier (“UBI”) Number issued by the Washington State Department of Revenue (check applicable box)?

Note: A nine digit UBI number is assigned to each registered business in Washington.

Yes X No If yes, provide Bidder’s UBI Number:

603-055-108

BIDDER’S TAXPAYER IDENTIFICATION NUMBER (“TIN”)

Provide Bidder’s TIN in the space provided:

Note: Bidder’s TIN will be either a number issued by the IRS (e.g., Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (i.e., Bidder’s Social Security Number(“SSN”)). If Bidder’s TIN is a SSN, do NOT provide the SSN; simply state ‘TIN is Bidder’s SSN’ in the space provided.

__27-3692549____

EXHIBIT A-2 – BIDDER’S PROFILE: 03024 – EXECUTIVE RECRUITMENT CONSULTING SERVICES PAGE 2

BIDDER INFORMATION

OMWBE CERTIFIED BUSINESS

Is Bidder certified as a minority or woman owned business with the Washington State Office of Minority & Women’s Business Enterprises (“OMWBE”) (check applicable box)?

Yes No X If yes, provide Bidder’s OMWBE certification no.: ____________

SELF-CERTIFIED WASHINGTON SMALL BUSINESS

Is Bidder a self-certified Washington Small Business (check applicable box)?

Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Washington Small Business.

Note: Regardless of size, a qualifying business must be owned and operated independently from all other businesses. In regard to size, the gross revenue thresholds, as reported on Bidder’s tax returns, are as follows:

Microbusiness: Annual gross revenue of less than one million dollars.

Minibusiness: Annual gross revenue of more than one million dollars, but less than three million dollars.

Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.

Yes X No If yes, provide the location for Bidder’s principal place of business:

__955 Malin Ln__________ Street Address __Tumwater, WA 98501_____________ City, State, Zip Code If yes, what is Bidder’s size (based on annual gross revenue) (check applicable box)?

Microbusiness Minibusiness X Small Business

Or Bidder does NOT qualify as a Small Business based on annual gross revenue, but DOES qualify as a Small Business based on the number of Bidder’s employees (50 or fewer):

Small Business (50 or fewer employees)

CERTIFIED VETERAN-OWNED BUSINESS

Is Bidder certified as a Veteran-Owned Business with the Washington State Department of Veteran Affairs (“WDVA”) (check applicable box) ?

Note: See Exhibit A-1 – Bidder’s Certification for criteria to qualify as a Certified Veteran-Owned Business.

Yes No X If yes, provide Bidder’s WDVA certification no.:

CONTRACT MANAGEMENT POINTS OF CONTACT FOR BIDDER

Authorized Representative Name: Marlana Oyler Email: marlana@healthprosnw.com Phone: 360-996-4487 ext 1

Contract Administrator Name: Bethany Stout Email: bethany@healthprosnw.com Phone: 360-996-4487 ext 4

EXHIBIT A-2 – BIDDER’S PROFILE: 03024 – EXECUTIVE RECRUITMENT CONSULTING SERVICES PAGE 3

CONTRACT MANAGEMENT POINTS OF CONTACT FOR BIDDER

Sales Reporting Representative Name: Marlin Bryant Email: officeassistant@healthprosnw.com Phone: 360-996-4487 ext 3

Sales Reporting Alternate Name: Bethany Stout Email : bethany@healthprosnw.com Phone: 360-996-4487 ext 4

Management Fee Representative Name: Bethany Stout Email: bethany@healthprosnw.com Phone: 360-996-4487 ext 4

Management Fee Contact Alternate Name: Marlana Oyler Email: marlana@healthprosnw.com Phone: 360-996-4487 ext 1

Address for Enterprise Services to send management fee invoices:

Company name: Health Pros Northwest Attn: Bethany Stout Address: PO Box 322 City/State/Zip: Woodinville, WA 98072

Email: bethany@healthprosnw.com

Address for Enterprise Services to send legal notices:

Company name: Health Pros Northwest Attn: Bethany Stout Address: PO Box 322

City/State/Zip: Woodinville, WA 98072 Email: bethany@healthprosnw.com

Signature Authority (if awarded a contract) Name: Bethany Stout

Title: Owner/President

EXHIBIT A-2 – BIDDER’S PROFILE: 03024 – EXECUTIVE RECRUITMENT CONSULTING SERVICES PAGE 4

REFERENCES

Provide at least one (1) reference for each of three (3) different contracts for which bidder has provided/performed goods and/or services similar in scope to the goods/services described in the above-referenced Competitive Solicitation. Note: It is Bidder’s obligation to ensure that the contact information for Bidder’s references is accurate and current. Bidders should alert their references to respond promptly to reference checks.

REFERENCE 1

Company Name:

Contact:

Phone:

Email:

King County Public and Jail Health Stacie Linardic 206-263-8747 Stacy.linardic@kingcounty.gov

REFERENCE 2

Company Name:

Contact:

Phone:

Email:

Oregon Department of Corrections Matt Shoemaker 503-378-6428 Matt.M.Shoemaker@doc.oregon.gov

REFERENCE 3

Company Name:

Contact:

Phone:

Email:

Island County Jail Jose Briones 360-679-7317 j.briones@islandcountywa.gov

PURCHASE CARDS (I.E., CREDIT CARDS)

Please indicate which types of purchasing (credit) cards are accepted (note: any card fees must be included in the unit price of the bid):

X Visa X Master Card American Express Discover Other:

Return this Bidder’s Profile to Procurement Coordinator at:

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 1

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS

Competitive Solicitation: 03024 Executive Recruitment Consulting Services

Bidder: __Health Pros Northwest_________ Type/print full legal name of bidder company

Instructions:

Note: Bidders must follow the instructions outlined in this Exhibit. Unless Enterprise Services, at its discretion, determines that a bidder’s variance from these instructions is immaterial or timely corrected, Bids that do NOT follow these instructions will be deemed to be nonresponsive and rejected.

(a) Add bidder’s business name above and follow the instructions below.

(b) Provide a written response that addresses how the bidder meets or exceeds each requirement in the Written Response column.

a. Supporting Information. Please make sure to include references in Exhibit A-2 – Bidder Profile that align with the information provided in this exhibit. Enterprise Services may request additional information or references to help verify the information provided by the bidder in this exhibit. A bidder’s failure to provide requested information to Enterprise Services within five (5) business days may result in disqualification.

b. Bidder’s Commitments. Please note that, if bidder is awarded a contract, the bidder’s responses to some of the performance requirements below (e.g., customer service) will be incorporated to the resulting contract. Accordingly, bidder is cautioned to state only commitments that bidder can meet throughout the term of the contract. An awarded bidder (i.e., contractor) who is not able to meet such commitments throughout the contract term will be subject to contract termination for breach of contract and damages. Please see Exhibit D – Contract.

(c) Bidders written response to the Performance Requirements will be assessed as follows:

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 2

Score Rating Definition

100% Excellent added value Bidder’s response provides outstanding added value for the state across all aspects of the performance requirement. The response demonstrates clear and extraordinary technical or business efficiencies and advantages compared to the stated business need.

70% Significant added value Bidder’s response provides major added value across all aspects of the performance requirement or provides outstanding added value in some aspects of the stated business need. The response demonstrates clear and substantial technical or business efficiencies and advantages as compared to the stated business need.

30% Sufficient added value Bidder’s response provides minor added value across all aspects of the performance requirement or significant added value in some aspects of the stated business need. The response demonstrates vague or limited technical or business efficiencies and advantages as compared to the stated business need.

0% Meets minimum acceptable standard

Bidder’s response meets the specified minimum acceptable standard for each performance requirement. Note: Bidder must meet the minimum acceptable standard to provide a responsive bid.

(d) Submit the exhibit as a Microsoft Word without modifying the formatting. If you need to print out this document for any reason, please note that it is Legal 8.5” x 14”.

REQ

ID

Performance Requirement and Stated Business Need

Available Points Written Response

1. Bidder’s Key Personnel Experience. The State is seeking to award contracts to bidders with extensive industry knowledge and experience in executive recruitment services.

To meet the minimum acceptable standard [0%]: Each of the Bidder’s key personnel who will be performing service on the contract, if awarded, must possess:

(a) Five (5) Years of Industry Experience Bidders who do not meet this minimum acceptable standard will be disqualified from further consideration.

Added value: In the written response, demonstrate added value to the state by listing years of experience, education, professional certifications, or other relevant industry recognition for each key personnel that exceeds the minimum acceptable standard above.

50 Points Written Response Required. Provide as much information as needed to address the Performance Requirement and Stated Business Need. Add/delete personnel as applicable.

Key Personnel 1 Role/Title: Bethany Stout, Owner/President

(a) Years of industry experience: 14 Years in the temporary medical staffing field ranging from a recruiter to contract specialist and then becoming the owner/president in 2017, 18 years of management experience

(b) Education or professional training: Business development/Leadership/Training 12 years

(c) Professional certifications: Top Regional Trainer 4 years consecutively, Top Manager 2 years

West Coast Region.

(d) Relevant industry recognition:

Key Personnel 2 Role/Title: Marlana Oyler, Contract Specialist/Lead Recruiter

(a) Years of industry experience: Over 6 years in the temporary medical staffing industry, 3 years of management experience

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 3

Performance Requirement and Stated Business Need

Available Points Written Response

(b) Education or professional training: Bachelor of Arts from Evergreen State College with courses that included Culture and Diversity, Business Management, over 40 hours of medical recruiting continuing education

(c) Professional certifications: N/A

(d) Relevant industry recognition:

Key Personnel 3 Role/Title: Angie Bariekman, Recruiter

(a) Years of industry experience: Over 3 years in the medical staffing industry, 8 years of management experience

(b) Education or professional training: Bachelor of Arts from Evergreen State College with courses that included culture and diversity, business management. She has extensive human resource training from her previous position as Director Of Education.

(c) Professional certifications: N/A

(d) Relevant industry recognition:

2. Bidder Experience. The State is seeking to award contracts to bidder’s extensive industry knowledge and experience in executive recruitment services.

To meet the minimum acceptable standard [0%]: Bidder must have completed at least three (3) projects that are similar in scope to this procurement in the last three (3) years. Bidder must select three (3) examples from the above projects and for each of these provide customer organization type (private, local government, etc.), scope overview*, and cost information.

*For the scope overview of each project should demonstrate that the scope was similar to the services being procured on this contract, and provide a description of tasks completed, end products/deliverables, results, and any metrics used. The scope statement for each project should not exceed 500 words. Reminder: References provided in Exhibit A-2 should align with the provided examples.

Bidders who do not meet this minimum acceptable standard will be disqualified from further consideration.

75 Points Written Response Required. Provide as much information as needed to address the Performance Requirement and Stated Business Need.

How many projects similar in scope completed in the last 3 years: 4

Project 1 Title: Oregon Department of Corrections

(a) Customer Organization Type and/or Name: Corrections/Statewide/Government Entity

(b) Scope Overview: Medical (RNs, MAs, LPNs), Dental (Dentists, Hygienists, Assistants), Radiology and Administrative Staff provided across the state of Oregon. We assisted with their hiring process (interviews, paperwork, onboarding) prior to the staff being hired directly.

(c) Cost : ~ $590,000 annually

Project 2 Title: Island County Jail

(a) Customer Organization Type and/or Name: Correctional Health/Government Agency

(b) Scope Overview: Complete management and provision of medical care including telehealth, RNs, PMHNPs, Pharmacy for adult and juvenile patients in custody. We are responsible for working with the jail team including Chief and Lieutenant to recruit, onboard and staff the entire medical clinic.

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 4

Performance Requirement and Stated Business Need

Available Points Written Response

Added value: In the written response, demonstrate added value to the state that exceeds the minimum acceptable standard above by:

(a) listing project examples that more closely align to the scope/value of this contract, and/or type of customers served,

(b) demonstrating retention results of placed candidates, and other positive recruitment results for the organization served (efficient lead times, diversity, and inclusion impacts, etc.)

(c) Cost : ~ $480,000 annually

Project 3 Title: Snohomish Juvenile Justice Center

(a) Customer Organization Type and/or Name: Correctional Health/Government Agency

(b) Scope Overview: Complete management and provision of medical care including telehealth, RNs, PMHNPs, Pharmacy for adult and juvenile patients in custody. We are responsible for working with the jail team including Chief and Lieutenant to recruit, onboard and staff the entire medical clinic.

(c) Cost: ~$400,000 annually

3. Cultural Competency. The State is seeking to award contracts to bidders who possess cultural competency and the ability to understand and be sensitive to the cultural differences that exist between people from different demographic backgrounds, including racial, ethnic, gender, and language differences.

To meet the minimum acceptable standard [0%] Bidder’s key personnel who will be performing service under the contract if awarded, must demonstrate some prior experience or training in successfully working with stakeholders from different demographic backgrounds, including racial, ethnic, gender, and language differences.

(a) list and briefly describe an example of a project similar in scope to this procurement that was performed in collaboration with stakeholders from different demographic backgrounds, including racial, ethnic, gender, and language differences. communities, and/or training, lived experience; or

(b) list similar information that demonstrates the personnel’s cultural competency gained through training or lived experiences.

Bidders who do not meet this minimum acceptable standard will be disqualified from further consideration.

25 Points Written Response Required. Provide as much information as needed to address the Performance Requirement and Stated Business Need. Add/delete personnel as applicable.

(a) Impactful Diverity and Inclusion Strategies:

We have a non-discrimination hiring policy and do not base hiring decisions on stereotypes or assumptions regarding race, color, religion, age, or national origin. 75% of staff on our roster are minorities. No advertisements indicate a preference or specification based on sex, age, national origin or other protected characteristic unless a characteristic is a true requirement of the job. We take additional steps to encourage employment of women and minorities that aren’t currently working by providing part-time employment, short-term contracts, and other flexible schedules.

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 5

Performance Requirement and Stated Business Need

Available Points Written Response

Added value: In the written response, demonstrate added value to the state that exceeds the minimum acceptable standard above by:

(a) addressing impactful diversity and inclusion recruitment strategies and results achieved in previous customer project examples; or

(b) listing advanced experience or training related to working with stakeholders from different demographic backgrounds, including racial, ethnic, gender, and language differences.

Key Personnel 1 Role/Title: Bethany Stout/Owner/President Training or other applicable cultural experience:

“Design and implement processes and practices with employees and clients that increase trust and apply rules and policies equitably and consistently” As the owner/president of Health Pros Northwest Bethany reflects on our existing policies and procedures, if necessary she makes adjustments within our company to intentionally use their recommendations.

“Know the communities you serve, as well as the impacts of systems, programs, policies, and services” Health Pros Northwest was started because we noticed a lack of staffing support for correctional, behavioral and tribal health. Currently all our clients fall under these categories and our goal is to support this underserved population.

Key Personnel 2 Role/Title: Marlana Oyler/Contract Specialist

“Use conscious disruption of othering to increase inclusion and belonging” Our lead recruiter, Marlana has instigated office-wide discussions on how we can recruit and attract a diverse candidate pool. This has led to utilizing an applicant tracking system, standardizing interview questions, and adjusting our job postings to reflect plain language.

“Foster belonging at the structural, systematic, and institutional levels”

Marlana instituted coffee time meetings where all staff are invited that provides opportunities for them to discuss ideas with her for changes to policies and/or service delivery. She has intentionally incorporated that feedback into Health Pros Northwest.

EXHIBIT B-2 – PERFORMANCE REQUIREMENTS PAGE 6

Performance Requirement and Stated Business Need

Available Points Written Response

Key Personnel 3 Role/Title: Angie Bariekman/Recruiter

“Teach the principles of allyship and its importance to inclusive excellence” Angie saw an opportunity to advocate changes in her current and previous position to encourage coworkers to ask for and use preferred pronouns when she saw that pronouns were being assumed incorrectly. She continued by adjusting our handbook to use more inclusive language.

“Maintain open lines of communication even during disagreement and conflict” As a director, Angie previously coordinated emails and phone-calls to deescalate concerned clients.

She then scheduled an open meeting for all clients and management to voice their concerns over the issue and come to a mutual agreement on the solution.

4. Recruitment and Retention. The State is seeking to award contracts to bidders who demonstrate results through recruiting, vetting, and retention processes to hire and retain qualified candidates for the purpose of recruitment.

To meet minimum acceptable standard [0%]: Bidders who will be…