itn_vendor_question_worksheetâ¿¿.docx
DOCX document 37 KB Posted
- Attached to
- Shape Array Inclinometers Including components
- Solicitation number
- ITN 591 210000000048 1
- Issued by
- Michigan
About this file
This is a Vendor Questions Worksheet issued by the State of Michigan for Invitation to Negotiate (ITN) #210000000048 regarding Shape Array Inclinometers. The document serves as a standardized questionnaire that bidders must complete as part of their proposal submission. While the worksheet does not specify quantities, delivery schedules, response deadlines, site visits, or bidders' meetings, it establishes the administrative and compliance framework within which vendors must operate to be considered for contract award.
The worksheet requires bidders to provide comprehensive company background information, contact details for authorized representatives, and certifications addressing labor practices, tax compliance, and corporate citizenship standards. Bidders must affirm their agreement with standard contract terms, disclose any prior debarment or litigation involving the State of Michigan, and certify they have not defaulted on contracts within the past five years. Additional requirements include certification regarding Iran-linked business connections, environmental compliance as a "Clean Corporate Citizen," proper withholding and remittance of Michigan income taxes, and absence of outstanding State of Michigan debt. The document also requires bidders to disclose any participation in solicitation development or evaluation and to confirm authorization for the State to verify all submitted information. Qualified Disabled Veteran and Service-Disabled Veteran-Owned Business certification is available as a participation category, requiring specific documentation of military service, service-connected disability, and business ownership.
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Other files
| File | Type | Posted |
|---|---|---|
| invitation_to_negotiate.docx | DOCX document | |
| Insurance Requirements.docx | DOCX document | |
| standard-contract-terms.docx | DOCX document |
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Text version
STATE OF MICHIGAN
ITN VENDOR QUESTIONS WORKSHEET
ITN #210000000048
Shape Array Inclinometers
Provide a detailed response to each question. “You” and “company” refers to the bidder.
| Information Sought |
| Bidder Response |
1. Contact Information
Bidder’s sole contact person during the ITN process. Include name, title, address, email, phone number and vendor customer code in SIGMA VSS.
Person authorized to receive and sign a resulting contract. Include name, title, address, email, and phone number.
2. Company Background Information
Legal business name and address. Include business entity designation, e.g., sole proprietor, Inc., LLC, or LLP.
What state was the company formed in?
Phone number
Website address
Legal business name and address of parent company, if any
Has bidder ever been debarred, suspended, or disqualified from bidding or contracting with any entity, including the State of Michigan? If yes, provide the date, the entity, and details about the situation.
Has your company been a party to litigation against the State of Michigan? If the answer is yes, then state the date of initial filing, case name and court number, and jurisdiction.
Within the last 5 years, has your company or any of its related business entities defaulted on a contract or had a contract terminated for cause? If yes, provide the date, contracting entity, type of contract, and details about the termination or default.
Describe partnerships and strategic relationships you think will bring significant value to the State.
State the physical address of the place of business that would have primary responsibility for this account if bidder is awarded a contract under this ITN.
3. Qualified Disabled Veteran/Service Disabled Veteran-Owned Business Program
| Under MCL 18.1261, a “qualified disabled veteran” means a business entity that is 51% or more owned by 1 or more veterans with a service-connected disability. A “service-connected disability” means a disability incurred or aggravated in the line of duty in the active military, naval, or air service as described in 38 USC 101(16). Are you a qualified disabled veteran? |
| Enter YES or NO. |
To demonstrate qualification as a qualified disabled veteran, you must provide:
(a) Proof of service and conditions of discharge (DD214 or equivalent);
(b) Proof of service-connected disability (DD214 if the disability was documented at discharge or Veterans Administration Rating Decision Letter or equivalent if the disability was documented after discharge); and
(c) Legal documents setting forth the ownership of the business entity.
In lieu of the documentation identified above, you may provide proof of certification by the National Veterans Business Development Council.
Enter the names of documents submitted with your proposal to demonstrate status as a qualified disabled veteran.
4. Participation in ITN Development or Evaluation
Did your company, an employee, agent, or representative of your company, or any affiliated entity participate in developing any component of this solicitation?
For purposes of this question, business concerns, organizations, or individuals are affiliates of each other if, directly or indirectly: (1) either one controls or has power to control the other or (2) a third-party controls or has the power to control both. Indicia of control include, but are not limited to, interlocking management or ownership, identity of interests among family members, shared facilities or equipment, and common use of employees.
If you entered “YES”, you are not eligible for contract award or to work as a subcontractor for the awarded vendor.
| If you are awarded a contract under this solicitation, in order to provide the goods or services required under a resulting contract, do you intend to partner or subcontract with a person or entity that assisted in the development of this solicitation? |
| If you entered “YES,” you are not eligible for contract award. An awarded vendor may not partner or subcontract with anyone to provide goods and services required under a resulting contract if that subcontractor or partner assisted in the development of this solicitation. |
| Will your company, or an employee, agent, or representative of your company, participate in the evaluation of the proposals received in response to this ITN? |
| If you entered “YES”, you are not eligible for contract award or to work as a subcontractor for the awarded vendor. |
5. Standard Contract Terms
Bidder must affirm agreement with the attached Contract Terms. If not in agreement, written exceptions in accordance with Section 8 Evaluation Process must be provided with Bidder’s proposal.
6. Other
| Abusive Labor Practices. The Contractor certifies that it will not furnish any Deliverable that was produced fully or partially by forced labor, forced or indentured child labor, or indentured servitude. |
| Enter YES or NO. |
| Certification of Michigan Business- Public Act 431 of 1984, Sec. 268. I certify that the company has, pursuant to the provisions of Sec 268 of Public Act 431 of 1984, filed a Michigan Business Tax Corporate Income Tax Return. I certify that the company has, pursuant to the provisions of Sec 268 of Public Act 431 of 1984, filed a Michigan Income Tax return showing income generated in, or attributed to the State of Michigan. I certify that the company has, pursuant to the provisions of Sec 268 of Public Act 431 of 1984, withheld Michigan Income Tax from compensation paid to the company’s owners and remitted the tax to the Michigan Department of Treasury. |
| Enter YES or NO. |
| Iran Linked Business- Public Act 517 of 2012. I certify that the Company is not an Iran-Linked business as defined by Public Act 517 of 2012. |
| Enter YES or NO. |
| Clean Corporate Citizen. I certify that the Company is a Clean Corporate Citizen as defined by the Environmental Protection Act, 1994 PA 451. |
| Enter YES or NO. |
| Convict Labor. The Contractor certifies that if using convict labor, it is complying with all applicable state and federal laws and policies. |
| Enter YES or NO. |
| SOM Debt/Tax Payment. All SOM tax/debts. I certify that all applicable State of Michigan taxes are paid, and that no outstanding debt is owed to the State of Michigan. |
| Enter YES or NO. |
| Authorization to Verify Information provided by Vendor. I authorize the State to verify that all information provided in this registration, in bidding and contracting documents, and any attachments or supplement documents and processes are accurate. |
| Enter YES or NO. |
Version 2: 2/2019
Version 3: 2/2020
File details come from the government source that posted it. Updated .