ITBAttB- AttF - S63500 00011060.pdf

ITB S-63500-00011060 Flat Creek Fuels Reduction Pile Burning

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 1 of 2

ATTACHMENT B — BID COVER SHEET

Bidder Name (printed):

Address: City, State, Zip:

Bid Clarification Contact Person: Telephone:

Email:

State of Incorporation: Entity Type:

Oregon Secretary of State Business Registry Number (if required):

Any individual signing below hereby certifies he/she is an authorized representative of Bidder and that:

1. Bidder understands and accepts the requirements of this ITB. By submitting a Bid, Bidder agrees to be bound by the Contract terms and conditions in Attachment A , as modified by Addenda, if any.

2. Bidder acknowledges receipt of any and all Addenda to this ITB.

3. If awarded a Contract, Bidder agrees to comply with all provisions of the ITB and meet the performance standards set forth in the Contract.

4. Bidder has no undisclosed liquidated and delinquent debt owed to the State or any department or agency of the State.

5. I have knowledge regarding Bidder’s payment of taxes and by signing below I hereby certify, to the best of my knowledge, Bidder is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation, ORS 305.620 and ORS chapters 316, 317 and 318.

6. Bidder does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Bidder does not discriminate against any business certified under ORS 200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a service-disabled veteran owned business, or an emerging small business. If applicable, Proposer has, or will have prior to contract execution, a written policy and practice, that meets the requirements described in ORS 279A.112, of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class. Agency may not enter into a contract with an anticipated contract price of $150,000 or more with a Proposer that does not certify it has such a policy and practice. See https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx for additional information and sample policy template.

7. Bidder and Bidder’s employees, agents, and subcontractors are not included on:

A. the “Specially Designated Nationals and Blocked Persons” list maintained by the Office of

Foreign Assets Control of the United States Department of the Treasury found at:

https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 2 of 2 https://www.treasury.gov/ofac/downloads/sdnlist.pdf, or B. the government wide exclusions lists in the System for Award Management found at:

https://www.sam.gov/portal/SAM/#1

8. Bidder certifies to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Bidder, its employees, or its agents, on the one hand, and the business or economic interests of the State, on the other hand, arising out of, or relating in any way to, the subject matter of the ITB. If any changes occur with respect to Bidder’s status regarding conflict of interest, Bidder shall promptly notify the State in writing.

9. Bidder certifies all contents of the Bid (including any other forms or documentation, if required under this ITB), and this Bid Cover Sheet are truthful and accurate and have been prepared independently from all other Bidders, and without collusion, fraud, or other dishonesty.

10. Bidder understands any statement or representation made in response to this ITB, if determined to be false or fraudulent, a misrepresentation, or inaccurate because of the omission of material information could result in a "claim" {as defined by the Oregon False Claims Act, ORS 180.750(1)}, made under Contract being a "false claim" {ORS 180.750(2)} subject to the Oregon False Claims Act, ORS 180.750 to 180.785, and to any liabilities or penalties associated with the making of a false claim under that Act.

11. Bidder acknowledges these certifications are in addition to any certifications required in the Contract at the time of execution.

Authorized Signature Date

(Printed Name and Title)

Email Address https://www.treasury.gov/ofac/downloads/sdnlist.pdf https://www.sam.gov/portal/SAM/%231

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 1 of 3

ATTACHMENT C — REFERENCE CHECK FORM

Submit this completed form with your bid

REFERENCES COMPARABLE IN SIZE AND SCOPE: [Buyer: modify this paragraph and number of reference boxes to suit ITB requirements.] Bidder shall provide a list of three different firms who can be contacted regarding the quality of services the Bidder provided within the last five years AND three different firms who can be contacted regarding the quality of service the Key Person provided within the last five years.

Business Reference Name of Firm:

Reference Contact Person:

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

What was the budget:

Were contract services accomplished within budget & schedule? If not, why

Name of Firm:

Reference Contact Person:

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 2 of 3

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

Key Person

Reference Contact Person:

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 3 of 3

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

Telephone: Email:

Alternate Reference Contact Person:

Telephone: Email:

Description of service type, size, location, duration & objectives:

Describe Tasks performed:

S-63500-00011060 - FLAT CREEK FUELS REDUCTION PILE BURNING

Rev 7/26/18

INVITATION TO BID

BID SUBMITTAL FORM

FOR OregonBuys Bid Solicitation # S-63500-00011060

ALL SERVICES MUST be delivered No later than 12/31/2024

DELIVERY DATE PROPOSED BY BIDDER: calendar days from date of order. Failure to provide a schedule or submittal of proposed schedule dates later than those required may result in Bid rejection. Submittal of schedule dates providing for earlier delivery than required by the State will bind the Bidder, should it be awarded the bid, but shall not be considered for award purposes.

Any reference to brand names is meant as descriptive not restrictive.

Alternate bids will be considered on products, which meet or exceed products indicated on quote.

Vendor is to mark clearly alternate proposals.

“OR EQUAL”: Any brand name listed in the specifications as “or equal” or “or equivalent” shall establish the minimum requirements for quality, utility, durability, function, purpose, etc. Other product brands may be offered that are equal to or better than the product brand name. Bidder may show cost differences, alternates and options in the space provided in the quote. This clause is not meant to be restrictive, but to set the minimum standard. AGENCY SHALL DETERMINE, IN ITS SOLE DISCRETION, WHETHER A PRODUCT OFFERED IS “EQUAL.” When the designation is “or equal” or “equivalent” Agency shall make its decision after Bid Closing.

Vendor Name:

Federal ID No: OregonBuys ID #:

Vendor Address:

City: State: ZIP:

Vendor Phone: Vendor Fax:

CONTACT NAME – TITLE (Print):

Vendor (COBID) Certification Number (If Applicable):

(Certification Office for Business Inclusion and Diversity)

Please provide a cost per acre Item Item Description Unit Cost: Total Cost

Burn 203 acres of mixed conifer piles 6’x6’x10’

GRAND TOTAL

(INCLUDES ALL COST &

DELIVERY)

Signature of Vendor’s Authorized Representative:

Name (Print) ___________________________ Signature __________________________ Date ___________

ARE YOU A CERTIFIED FIRM IN OREGON?

Help Grow your Business in Oregon. Visit www.oregon4biz.com/How-We-Can-Help/COBID/

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 1 of 2

ATTACHMENT E –CERTIFIED DISADVANTAGED BUSINESS

OUTREACH PLAN

Bidder Name: Date:

Contact Name: Telephone: Email:

“Certified Firm” means a small business certified under ORS 200.055 by the Oregon Certification Office for Business Inclusion and Diversity (COBID) as minority-owned businesses, woman-owned businesses, businesses that service-disabled veterans own, and emerging small businesses.

Certified Firms must have an equal opportunity to participate in the performance of contracts financed with state funds. By submitting its offer, Bidder certifies that it has taken, and if there are further opportunities, will take reasonable steps to ensure that Certified Firms are provided an equal opportunity to compete for and participate in the performance of any subcontracts resulting from this procurement.

The information submitted in response to this clause will not be considered in any evaluation.

1. Is Bidder an Oregon Certified Firm? Yes No

If yes, indicate all certification type(s): DBE MBE WBE SDV ESB and supply

Oregon State Certification Number: __________________________

2. Include a list of Certified Firms that Bidder has had a contractual relationship with within the last two years.

3. Include a list of firms that Bidder has had a contractual relationship with within the last two years that are not Certified Firms but may be minority-owned, woman-owned, service-disabled veteran-owned or emerging small businesses.

4. Does Bidder foresee any subcontracting opportunities for this procurement? Yes No

If no, do not complete the rest of this form and submit this first page with your Bid.

If yes, please complete the following pages and submit all pages with your Bid.

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 2 of 2

CERTIFIED DISADVANTAGED BUSINESS OUTREACH PLAN

1. Describe the steps Bidder will take to solicit Certified Firms for subcontracting opportunities if awarded a Contract from this procurement.

2. Describe the subcontracting opportunities and the approximate dollar value of each that may be available, if awarded a Contract.

3. Would Bidder be willing to report the identity of each subcontractor and the value of each subcontract to COBID if awarded a Contract from this procurement?

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 1 of 3

ATTACHMENT F - RESPONSIBILITY INQUIRY

Agency will determine responsibility of a Bidder prior to award and execution of a Contract. In addition to this form, Agency may notify Bidder of other documentation required, which may include but is not limited to recent profit-and-loss history, current balance statements and cash flow information, assets-to-liabilities ratio, including number and amount of secured versus unsecured creditor claims, availability of short and long-term financing, bonding capacity, insurability, credit information, materials and equipment, facility capabilities, personnel information, record of performance under previous contracts, etc. Failure to promptly provide requested information or clearly demonstrate responsibility may result in an Agency finding of non-responsibility and rejection.

1. Does Bidder have available the appropriate financial, material, equipment, facility and personnel resources and expertise, or ability to obtain the resources and expertise, necessary to demonstrate the capability of Bidder to meet all contractual responsibilities? YES / NO .

2. Within the last five years, how many contracts of a similar nature has Bidder completed that, to the extent that the costs associated with and time available to perform the contract remained within Bidder′s control, Bidder stayed within the time and budget allotted, and there were no contract claims by any party? Number: ____

How many contracts did not meet those standards? Number: ____ If any, please explain.

Response:

3. Within the last three years has Bidder (incl. a partner or shareholder owning 10% or more of Bidder’s firm) or a major subcontractor (receiving 10% or more of a total contract amount) been criminally or civilly charged, indicted or convicted in connection with:

• obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract,

• violation of federal or state antitrust statutes relating to the submission of bids, or

• embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property? YES / NO .

If "YES," indicate the jurisdiction, date of indictment, charge or judgment, and names and summary of charges in the response field below.

Response:

4. Within the last three years, has Bidder had:

• any contracts terminated for default by any government agency, or

• any lawsuits filed against it by creditors or involving contract disputes? YES / NO .

If "YES," please explain. (With regard to judgments, include jurisdiction and date of final judgment or dismissal.)

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 2 of 3

Response:

5. Does Bidder have any outstanding or pending judgments against it? YES / NO .

Is Bidder experiencing financial distress or having difficulty securing financing? YES / NO .

Does Bidder have sufficient cash flow to fund day-to-day operations throughout the proposed contract period? YES / NO

If "YES” on the first question or second question, or “NO” on the third question, please provide additional details.

Response:

6. Within the last three years, has Bidder filed a bankruptcy action, filed for reorganization, made a general assignment of assets for the benefit of creditors, or had an action for insolvency instituted against it? YES / NO .

If "YES," indicate the filing dates, jurisdictions, type of action, ultimate resolution, and dates of judgment or dismissal, if applicable.

Response:

7. Does Bidder have all required licenses, insurance and/or registrations, if any, and is Bidder legally authorized to do business in the State of Oregon? YES /NO .

If "NO," please explain.

Response:

8. Pay Equity Certificate. [This requirement does not apply to architectural, engineering, photogrammetric mapping, transportation planning or land surveying and related services contracts.] Does a current authorized representative of Bidder possess an unexpired Pay Equity Certificate issued by the Department of Administrative Services? YES / NO / N/A . [If the certificate was provided with the Bid submitted for a solicitation related to the prospective contract, then it is not necessary to resubmit it. Just indicate “see Bid” in the response field. Otherwise, if applicable, submit a copy of the certificate with this form.]

Response:

AUTHORIZED SIGNATURE

By signature below, the undersigned Authorized Representative on behalf of Bidder certifies to the best of his or her knowledge and believes the responses provided on this form are complete, accurate, and not misleading.

DAS Procurement Services, Version 1.0 – February 20, 2019 Page 3 of 3

Bidder Name: ITB:

Project Name:

Authorized Signature Date

Print Name Title