ITN Vendor Questions Worksheet.docx
DOCX document 48 KB Posted
- Solicitation number
- ITN-751-210000000029-1
- Issued by
- Caledonia Village, Michigan
About this file
This is a vendor questions worksheet for ITN 210000000029 from the State of Michigan for a Broyhill "Load and Pack" or comparable one-man waste collection vehicle. The solicitation requires bidders to offer a vehicle capable of collecting and compacting rubbish while being compatible with driving on finished lawns. The vendor must be a licensed franchisee of the unit being offered and provide a one-year written manufacturer's warranty, with transferred warranties not being accepted.
The worksheet requires detailed company information including background, experience, financial data, and various certifications. It includes sections on qualified disabled veteran status, participation in ITN development, prior State of Michigan experience, Michigan economic impact, and various labor practice certifications. The document focuses heavily on verifying the vendor's legitimacy, capability, and compliance with state requirements, including clean corporate citizen status, Iran-linked business restrictions, and convict labor regulations. No specific pricing terms, set-asides, or funding requirements are mentioned in the document.
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| File | Type | Posted |
|---|---|---|
| ITN 21-0029 DNR Broyhill Load & Pack Vehicle.docx | DOCX document |
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Text version
STATE OF MICHIGAN
ITN 210000000029 – BROYHILL, INC. “LOAD AND PACK” WASTE COLLECTION VEHICLE
VENDOR QUESTIONS WORKSHEET
PLEASE NOTE: BIDDER MUST OFFER A COMPARABLE ONE-MAN WASTE COLLECTION VEHICLE THAT CAN COLLECT AND COMPACT RUBBISH AND BE COMPACTIBLE WITH DRIVING ON FINISHED LAWNS. BIDDER MUST BE THE LICENSED FRANCHISEE OF THE UNIT BEING OFFERED AND PROVIDE A ONE YEAR’S WRITTEN MANUFACTURER’S WARRANTY. TRANSFERRED WARRANTIES WILL NOT BE ACCEPTED.
Provide a detailed response to each question. “You” and “company” refers to the bidder.
| Information Required |
| Bidder Response |
1. Contact Information
Bidder’s sole contact during the ITN process.
Name
Title
Address
Phone Number
Person authorized to review and sign a resulting contract.
Name
Title
Address
Phone Number
2. Company Background Information
SIGMA VSS Vendor ID Number
Legal business name
Business Entity (sold proprietor, LLC, Inc., etc.)
What state was the company formed in?
Address
Phone number
Website address
Number of years in business
Number of employees
Legal business name and address of parent company, if applicable
State the physical address of the place of business that would have primary responsibility for this account if awarded a contract under this ITN.
| Within the past five years, has there been a change in organizational structure (e.g., management team) or control (e.g., merger or acquisition) of your company? |
| ☐ Yes ☐ No |
If the answer is Yes, why did the change occur?
If the answer is Yes, how has the change affected your company?
| Have you or your company 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. |
| ☐ Yes ☐ No |
☐ Debarred ☐ Suspended ☐ Disqualified from bidding ☐ Disqualified from contracting
Date
Entity
Details about the situation
| Have you or 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. |
| ☐ Yes ☐ No |
Date of Initial Filing
Case Number
Court Number
Jurisdiction
Cause of Action or Claim
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.
☐ Yes ☐ No ☐ Defaulted on Contract ☐ Terminated for Cause
Contracting Agency / Entity
Type of Contract
Date of Default or Termination
Reason for Default or Termination
State your gross annual sales for each of the last 5 years.
| If you are awarded a contract under this ITN, will it increase your gross revenue more than 25% from last year’s sales? |
| ☐ Yes ☐ No |
If the answer is Yes, describe how the company will “scale up” to manage this increase.
Describe partnerships and strategic relationships you believe could bring significant value to the State.
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? |
| ☐ Yes ☐ No |
| Do you wish to have the SDVOB Preference applied? |
| ☐ Yes ☐ No |
| To demonstrate qualification as a qualified disabled veteran, you must include as an attachment with the proposal in SIGMA VSS: |
| Check all that apply: |
| (a) Proof of service & 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. |
| ☐ |
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. |
| ☐ Yes ☐ No |
| 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? |
| ☐ Yes ☐ No |
| 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? |
| ☐ Yes ☐ No |
5. State of Michigan Experience and Prior Relevant Experience
| Does your company have experience working with the State of Michigan? If so, please provide a list (including the contract number) of the contracts you hold or have held with the State for the last 10 years. |
| ☐ Yes ☐ No |
Contract Number:
Contract Start Date:
Contract Expiration Date:
Contract Amount:
Agency:
Contract Administrator:
Contract Number:
Contract Start Date:
Contract Expiration Date:
Contract Amount:
Agency:
Contract Administrator:
Contract Number:
Contract Start Date:
Contract Expiration Date:
Contract Amount:
Agency:
Contract Administrator:
Contract Number:
Contract Start Date:
Contract Expiration Date:
Contract Amount:
Agency:
Contract Administrator:
Describe at least three (3) relevant experiences from the last five (5) years supporting your ability to successfully manage a contract of similar size and scope for the work described in this ITN.
You may attach an additional document listing references however, the State requests a detailed response to each of the Relevant Experience sections, below.
Please do not attach references without completing this section.
| Relevant Experience 1 |
| Bidder Response |
Company Name:
Contact Name:
Contact role at time of project:
Contact phone:
Contact email:
City:
State:
Zip:
Project name:
Description of the scope of the project:
How is this experience relevant to the subject of this ITN?
Dollar Value or Contract Amount:
Project Start Date:
Project End Date:
Status (complete, ongoing, phase, etc.)
Results obtained
| Relevant Experience 2 |
| Bidder Response |
Company Name:
Contact Name:
Contact role at time of project:
Contact phone:
Contact email:
City:
State:
Zip:
Project name:
Description of the scope of the project:
How is this experience relevant to the subject of this ITN?
Dollar Value or Contract Amount:
Project Start Date:
Project End Date:
Status (complete, ongoing, phase, etc.)
Results obtained
| Relevant Experience 3 |
| Bidder Response |
Company Name:
Contact Name:
Contact role at time of project:
Contact phone:
Contact email:
City:
State:
Zip:
Project name:
Description of the scope of the project:
How is this experience relevant to the subject of this ITN?
Dollar Value or Contract Amount:
Project Start Date:
Project End Date:
Status (complete, ongoing, phase, etc.)
Results obtained
6. Standard Contract Terms
| Bidder must affirm agreement with the attached Contract Terms. If not in agreement, written exceptions in accordance with the Evaluation Process section of the Proposal Instructions must be provided with Bidder’s proposal. |
| ☐ Agree to Contract Terms |
☐ Do Not Agree with Contract Terms (attach written exceptions)
7. Michigan Economic Impact
Number of employees currently employed at locations within the State of Michigan.
Number of additional employees to be employed at locations within the State of Michigan if awarded this Contract (if any)
Minimum wage paid to employees employed at locations within the State of Michigan.
Average wage paid to employees employed at locations within the State of Michigan.
Percentage of employees employed at locations within the State of Michigan that are covered by employer-provided health insurance.
8. 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. |
| ☐ Yes ☐ 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. |
| ☐ Yes ☐ 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. |
| ☐ Yes ☐ No |
| Clean Corporate Citizen. I certify that the Company is a Clean Corporate Citizen as defined by the Environmental Protection Act, 1994 PA 451. |
| ☐ Yes ☐ No |
| Convict Labor. The Contractor certifies that if using convict labor, it is complying with all applicable state and federal laws and policies. |
| ☐ Yes ☐ 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. |
| ☐ Yes ☐ 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. |
| ☐ Yes ☐ No |
Version 2: 2/2019
Version 3: 2/2020
File details come from the government source that posted it. Updated .