HSS26028A-PROMMHGH_appC.xlsx
XLSX spreadsheet 23 KB Posted
- Attached to
- PROMISE Mental Health Group Homes
- Solicitation number
- HSS26028A-PROMMHGH
- Issued by
- Sussex County, Delaware
About this file
This is a bid submission form package for the State of Delaware, Office of Management and Budget, Government Support Services, related to the PROMISE Mental Health Group Homes contract opportunity. The document serves as Appendix C and contains standardized forms that all responding vendors must complete and submit as part of their proposal. The package includes mandatory certifications, vendor information documentation, and compliance forms required for bid consideration. While specific project timelines, quantities, response deadlines, and contract terms are not detailed within this appendix, vendors are required to submit completed forms addressing their business capabilities, references, and any proposed subcontractors alongside their primary bid response.
The submission package establishes critical compliance and transparency requirements for all bidding vendors. All responding vendors must execute a notarized Non-Collusion Statement certifying they have not engaged in anticompetitive practices and must disclose any federal, state, or local government suspensions or debarments affecting their firm or key personnel within the past five years. Vendors are required to provide a minimum of three business references of similar scope and must disclose all proposed subcontractors with corresponding reference documentation for each. The forms allow vendors to designate proprietary or confidential information and to submit exceptions to solicitation terms, though Government Support Services retains sole discretion in accepting or rejecting any exceptions. Diverse vendor certifications and detailed contact information must be provided, along with a business capability statement outlining the vendor's qualifications and service offerings.
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Other files
| File | Type | Posted |
|---|---|---|
| HSS26028A-PROMMHGH_appD.xlsx | XLSX spreadsheet | |
| HSS26028A-PROMMHGH_rfp.pdf |
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Non-Collusion Statement
| Non-Collusion Statement |
| This is to certify that the undersigned Vendor has neither directly nor indirectly, entered into any agreement, participated in any collusion or otherwise taken any action in restraint of free competitive bidding in connection with this solicitation, and further certifies that it is not a sub-contractor to another Vendor who also submitted a bid/proposal as a primary Vendor in response to this solicitation submitted this date to the State of Delaware, Office of Management and Budget, Government Support Services. |
| It is agreed by the undersigned Vendor that the signed submission of this bid/proposal represents, subject to any express exceptions set forth on the Exception form, the Vendor’s acceptance of the terms and conditions of this solicitation including all specifications and special provisions. |
| NOTE: Signature of the authorized representative MUST be of an individual who legally may enter his/her organization into a formal contract with the State of Delaware, Office of Management and Budget, Government Support Services. |
| Company Name |
| DBA (if applicable) |
| Name of Authorized Representative |
| Title |
| Phone Number |
| Email Address |
| Company Address |
| Phone Number |
| Email Address |
| Tax ID Number |
| AFFIRMATION: Within the past five (5) years, has your firm, any affiliate, any predecessor company or entity, owner, Director, officer, partner or proprietor been the subject of a Federal, State, Local government suspension or debarment? |
| If yes, explain | |
| THIS PAGE SHALL BE SIGNED AND NOTARIZED (NOTARY SEAL MUST BE VISIBLE) FOR YOUR BID/PROPOSAL TO BE CONSIDERED. | |
| Authorized Representative | Notary |
Vendor Information Sheet
| Vendor Information Sheet | ||
| Company Name | ||
| DBA (if applicable) | ||
| Purchase Order Address | ||
| Website | ||
| Diverse Vendor Self-Identification | ||
| State Certified | If yes, which State(s): | |
| Federal Certified | ||
| Desginated Contacts | Primary | Secondary |
| Contact Name | ||
| Role/Title | ||
| Phone Number | ||
| Business Capability Statement | ||
| (Provide a short capability statement about your business and its capabilities and skills to advertise who you are and what you do.) |
Business References
| Business References |
| List a minimum of three business references of similar size and scope. Please do not list any State Employee(s) as a business reference. If Subcontractors are identified, a minimum of three business references must also be provided for each subcontractor. |
| Reference One |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
| Reference Two |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
| Reference Three |
| Contact Name |
| Contact Title |
| Business Name |
| Address |
| Phone |
| Current Vendor? |
| Work Performed |
Confidentiality Form
| Confidentiality Form |
| Responding vendor may elect to designate sections of their proposal as confidential, intellectual property, trade secrets, and other confidential business information. Vendor shall explain below how the redacted information is not “public record” as defined by 29 Del. C. § 10002. The State shall independently determine the validity of any vendor designation as set forth in this section. Any vendor submitting a bid/proposal herein expressly accepts the State’s absolute right and duty to independently assess the legal and factual validity of any information designated as confidential business information. |
| Confidential Information |
| Confidentiality and Proprietary Information |
Exceptions Form
| Exceptions Form | |||
| Responding Vendors may elect to take minor exceptions to the terms and conditions of this solicitation. All exceptions must be submitted below. Exceptions found elsewhere in the solicitation response will not be considered. Government Support Services maintains sole discretion to reject any exceptions. | |||
| Exceptions | |||
| Paragraph & Page # | Current Language | Proposed Alternative | Justification |
Subcontractor Form
| Subcontractor Form | |
| Are you proposing the use of any subcontractors in the fulfillment of the requirements as outlined in the solicitation? | |
| If yes, complete this form. | |
| Responding Vendor Information | |
| Company Name | |
| DBA (if applicable) | |
| Company Address | |
| Subcontractor Information | |
| Company Name | |
| DBA (if applicable) | |
| Company Address | |
| Diverse Vendor Self-Identification | |
| State Certified | If yes, which State(s): |
| Federal Certified | |
| Description of Work by Subcontractor |
| Once completed, this form must be signed by both vendors. | |
| Proposing Vendor | Subcontractor |
| Authorized Signature: | Authorized Signature: |
| Name: | Name: |
| Title: | Title: |
| Date: | Date: |
DropDowns
| YES |
| NO |
| YES - Vendor is providing any information they declare to be confidential or proprietary for the purpose of production under 29 Del. C. Ch. 100, Delaware Freedom of Information Act. |
| NO - Vendor is not providing any information they declare to be confidential or proprietary for the purpose of production under 29 Del. C. Ch. 100, Delaware Freedom of Information Act. |
| YES - Vendor is submitting exceptions for consideration. |
| NO - Vendor is not submitting any exceptions to the specifications, terms, or conditions found in this solicitation. |
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