MMCAP Infuse RFP 35297 incontinence_products_rfp.pdf

State of Minnesota

MMCAP INFUSE

OFFICE OF STATE PROCUREMENT

REQUEST FOR PROPOSAL

Incontinence Products

SPECIAL NOTICE: This is a request for proposal. It does not obligate the State of Minnesota or MMCAP Infuse to award a contract or complete the proposed program, and the State of Minnesota reserves the right to cancel this solicitation if it is considered in its best interest.

Minnesota’s Commitment to Diversity and Inclusion The State of Minnesota is committed to diversity and inclusion in its public procurement process. The goal is to ensure that those providing goods and services to the State are representative of our Minnesota communities and include businesses owned by minorities, women, veterans, and those with substantial physical disabilities. Creating broader opportunities for historically under-represented groups provides for additional options and greater competition in the marketplace, creates stronger relationships and engagement within our communities, and fosters economic development and equality.

To further this commitment, the Department of Administration operates a program for Minnesota-based small businesses owned by minorities, women, veterans, and those with substantial physical disabilities. For additional information on this program, or to determine eligibility, please call 651-296-2600 or go to www.mn.gov/admin/oep.

http://www.mn.gov/admin/oep

Request for Proposals for Incontinence Products and Services

RFP Release date January 27, 2025 Cutoff Date for Questions February 17, 2025, 2 pm Central Time Proposal Due Date March 14, 2025, 2 pm Central Time

SECTION 1 – INSTRUCTIONS TO RESPONDERS

Steps for Completing Your Response

Follow the steps below to complete your response to this RFP:

Step 1: Read the solicitation document and ask questions, if any Step 2: Write your response Step 3: Sign and submit your response

Incomplete Submittals

A proposal must be submitted along with any required additional documents. Incomplete proposals that materially deviate from the required format and content may be rejected.

STEP 1 – READ THE SOLICITATION DOCUMENT & ASK QUESTIONS, IF ANY

How to Ask Questions

Questions must be emailed to MMCAP_Infuse.HPSRFP@state.mn.us by February 17, 2025 2pm Central Time.

Questions will be responded to via an addendum to this RFP and will not be attributed to the asking entity. Similar questions may be combined with a single answer. Other personnel are not authorized to answer questions regarding this RFP.

STEP 2 – WRITE YOUR RESPONSE

Request for Proposals

(RFP)

In Section 3, insert your response to the questions as asked or provide content as requested. By signing this response, your firm is making a legal, binding offer for a contract to provide services to the State of Minnesota.

STEP 3 – SIGN & SUBMIT YOUR RESPONSE

Documents making up a complete proposal

Section 3:

o Vendor Response o Technical Proposal o Required business applications or forms to do business with

Responder (submitted in PDF) Section 4:

o Incontinence Products Cost Proposal (submitted in the Cost Proposal Worksheet and separate from RFP Response)

Section 5:

o Responder Certifications Acknowledgment o Exhibit A State’s General Requirements (read and acknowledgement in

Section 2.6 of the RFP document) o Exhibit B Certification Regarding Lobbying (submit in PDF) o Exhibit C Workforce and Equal Pay Declaration Page (submit in PDF) o Exhibit D Veteran Owned Preference, if applicable (submit in PDF) o Exhibit E Reporting Requirements

Where to Send Responses

Email your responses to MMCAP_Infuse.HPSRFP@state.mn.us with “[Company Name] for Incontinence Products RFP” in the subject line.

If your email is larger than the maximum allowed size, send your response in multiple emails. Use “[Company Name] for Incontinence Products RFP Part [1/#] of [#]” in the Subject line.

Mailed responses will not be accepted.

Faxed responses will not be accepted.

Response Submission Deadline

Must be received no later than March 14, 2025 2pm Central Time as indicated by a notation made by the email timestamp. Late proposals will not be considered. All costs incurred in responding to this RFP will be borne by the responder.

SECTION 2 – RFP PROJECT INFORMATION

1. Overview and Goals

MMCAP Infuse (MMCAP Infuse) is a governmental cooperative serving thousands of state and local government facilities across the United States. MMCAP Infuse is operated by the State of Minnesota (State) Department of Administration’s Office of State Procurement (OSP) and is governed by Minnesota laws and procurement policies.

MMCAP Infuse Members are state agencies and political subdivisions throughout the United States. For more information on MMCAP Infuse and its membership, visit www.infuse-mn.gov (Members or Membership).

Membership is available to government-operated facilities, and the extent to which a Member participates in the program is voluntary.

MMCAP Infuse is seeking Manufacturers of Incontinence Products who will a) ship Products directly to Members, and/or b) stock and distribute Incontinence Products with MMCAP Infuse Authorized Distributors.

Incontinence Products may include absorbent undergarments (such as briefs, underwear, guards, shields, and liners); absorbent underpads; incontinence-related cleansers, lotions, and wipes; and other external devices indicated for the treatment or management of incontinence.

As applicable, Incontinence Products included in proposals should meet or exceed the product quality standards of the National Association for Continence (NAFC) as verified by the required testing specifications set forth by the Association of the Nonwoven Fabrics Industry (INDA). If the products offered in this proposal are required to have Federal Drug Administration (FDA) approval, Responder will provide documentation of such approval if requested by MMCAP Infuse.

This RFP cannot be used as a procurement vehicle by which the Responder and Member enter into their own stand-alone agreement.

2. Agreement and Duration

We anticipate that MMCAP Infuse will enter into agreements for an initial two (2) year term with an option to extend in increments determined by MMCAP Infuse, in compliance with the Minnesota law. MMCAP Infuse will provide a draft of an Agreement to the awarded Responders. MMCAP Infuse will also request a final listing of products with “best and final” offers.

3. Minimum Qualifications Required (Pass/Fail)

• Proposals must be received on or before the due date specified in this solicitation.

• Responder is able to facilitate chargebacks with Authorized Distributors.

• Products in Responder’s proposal must be certified by at least one ISO 9000 compliant laboratory that is independent of the manufacturer. This documentation will be provided to MMCAP Infuse upon request.

http://www.infuse-mn.gov/

4. Response Evaluation

Responses will first be reviewed to confirm compliance with the minimum qualifications identified above.

Responses that meet all the minimum qualifications will be further evaluated in accordance with the following:

Factors Percentage Technical Proposal:

• Company Overview

• Product Quality Performance and

Testing

• Contract Management

• Customer Service

• Ordering Systems, Inventory and

Delivery

70%

Cost Proposal 30%

Preference Points (if applicable) Preference points are described under the State’s General Requirements and will be applied to the total score after points have been awarded.

• 12% Minnesota Certified Targeted Group/Economically Disadvantaged Preference

• 12% Veteran-owned Preference

• Minnesota Resident Vendor Preference

Responses will be evaluated by a team of MMCAP Infuse staff, MMCAP Infuse advisory board members, and/or staff from Members. Each evaluator will read all proposals that have passed all the minimum qualifications.

MMCAP Infuse reserves the right to require a demonstration of capabilities and/or ordering systems via in-person meetings, webinar, or other such mechanism.

Any award that may result from this solicitation will be based upon the total accumulated points as established in the solicitation. MMCAP Infuse reserves the right to award this solicitation to a single Responder, or to multiple Responders, whichever is in the best interest of the State and MMCAP Infuse, providing each Responder is in compliance with all terms and conditions of the solicitation. MMCAP Infuse reserves the right to accept all or part of an offer, to reject all offers, to cancel the solicitation, or to re-issue the solicitation, whichever is in the best interest of the State and MMCAP Infuse. If a Responder with an active contract with MMCAP Infuse is an awarded bid as a result of this RFP, MMCAP Infuse reserves the right to amend the active contract to include the scope of this RFP rather than issue a brand-new document.

5. MMCAP Infuse Rights Reserved

• Reject any and all responses received;

• Waive or modify any informalities, irregularities, or inconsistencies in the responses received;

• Negotiate with the highest scoring Responder(s);

• Terminate negotiations and select the next response providing the best value for the State;

• Consider documented past performance resulting from a State contract may be considered in the evaluation process;

• Short list the highest scoring Responders;

• Require Responders to conduct presentations, demonstrations, or submit samples;

• Interview key personnel or references;

• Request a best and final offer from one or more Responders;

• The State reserves the right to request additional information;

• The State reserves the right to use estimated usage or scenarios for the purpose of conducting pricing evaluations;

• The State reserves the right to modify scenarios and to request or add additional scenarios for the evaluation;

• The State reserves the right to require the removal of a subcontractor within a resulting agreement if the subcontractor is not able to meet the requirements or expectations of MMCAP Infuse or Members; and

• The State reserves the right to require Responders to provide timely and complete responses to all communications pertaining to awarded contract negotiations.

6. Alterations or Additions to the State’s General Terms

If you wish to take an exception to the State’s General Terms (see Exhibit A), please indicate that below and attach any appropriate documentation.

☐None ☐See attached document detailing proposed alterations and/or additions to the State’s General Terms.

By signing, I acknowledge that the above-named responder accepts, without qualification, all terms and conditions stated in this solicitation except those clearly outlined as exceptions above.

Signature: ____________________________________________________

Printed Name: _________________________________________________

Title: ________________________________

Date:________________________________

SECTION 3 – VENDOR RESPONSE

INSTRUCTIONS: Fill in the information requested below.

1. Responder’s Contact Information

Company’s Full Legal Name:

Business Address:

Company Website:

Federal Employer Identification Number:

Primary Contact Person’s Name:

Title:

Telephone Number:

Email Address:

Alternate Contact Person:

Title:

Admin Fee Contact Person:

Membership Contact Person:

Reporting/Data Contact Person:

2. Minimum Qualifications Required (Pass/Fail)

The following criteria will be considered on a pass/ fail basis. Responders who are unable to comply with the following criteria will not be considered for further evaluation.

Does Responder comply with each term? (Check yes or no for each requirement.)

Yes No Criteria Proposals must be received on or before the due date specified in this solicitation.

Responder is able to facilitate chargebacks with Authorized Distributors.

Products in Responder’s proposal must be certified by at least one ISO 9000 compliant laboratory that is independent of the manufacturer. This documentation will be provided to MMCAP Infuse upon request.

Responders who have not completed each section will not be further considered.

3. Shipping and Authorized Distributors

Select all that apply.

Yes No Selection Responder will ship to and invoice directly to Members.

Responder will ship its products to Members through MMCAP Infuse

Authorized Distributors. (Authorized Distributor is responsible for invoicing and accounting to the Member.)

If responding “yes” to shipping through Authorized Distributors above, indicate below which MMCAP Infuse Authorized Distributors Responder intends to utilize and can certify will agree to the MMCAP Infuse contracted pricing if Responder is awarded.

Yes No Authorized Distributor Cardinal Health 200, LLC and/or RGH Enterprise, LLC Concordance Healthcare Solutions, LLC Henry Schein, Inc.

McKesson Medical-Surgical Government Solutions, LLC Medical Solutions, Inc.

Medline Industries, LP Premier Medical Distribution, LLC

4. Technical Proposal Questionnaire

It is encouraged for Responders to exercise restraint and be concise, answering each question individually.

Any links provided in the technical proposal will not be considered. All documents referenced in your response MUST be submitted within the proposal to be considered. Do not include pricing for products or services in this section. Pricing must only be included in Section 4, Cost Proposal.

Company Overview

1. How is your organization qualified to meet the Incontinence Products needs of MMCAP Infuse Members? Be sure to include:

a. A detailed description of your company history;

b. Any relevant partners or subcontractors;

c. Locations and geographical service area (including any states you cannot ship to);

d. Total years’ experience;

e. Number of employees;

f. Current sales volume;

g. Industry market share;

h. Specific examples of experience supplying states, counties, or cities with related products.

2. How does your team’s training and/or certifications prepare them to serve the MMCAP Infuse

Membership, including mental health facilities, VA homes, correctional facilities, long term care facilities, etc.?

3. Is there any litigation that has been brought forth or resolved over the last five (5) years that may impact your ability to do business in a Member’s jurisdiction?

4. Identify all contracts that have been terminated due to non-performance over the last five (5) years.

5. Disclose any other regulatory actions enacted against your organization or its subcontractors within the last five (5) years related to any of your proposed products.

Product Quality Performance and Testing

6. Describe the quality performance standards held by your Incontinence Products, the testing processes used to verify these standards, and how your policies and processes conform to the industry standards set by organizations such as the National Association for Continence (NAFC) and the Association of the Nonwoven Fabrics Industry (INDA). Your response should include test results for rewet rate, rate of acquisition, retention capacity, breathability, elasticity, and other metrics as applicable.

7. Which independent, ISO 9000 compliant lab(s) have verified the quality performance standards of your Incontinence Products?

8. What is the range of absorbency and sizing options available for your Incontinence Products?

Include any resources you have available to ensure proper fit and minimize leakage.

9. In addition to verifying that all components and additives of your Incontinence Products meet safety standards set forth by federal regulatory agencies, do your products also meet all state-specific legal requirements? If not, describe the products and states affected.

Contract Management

10. When establishing relationships with Members and/or Authorized Distributors, describe your process for onboarding, including responses as applicable to the following:

a. If providing products directly to Members, outline your processes and timelines for onboarding new members and transitioning existing eligible Members to the agreement.

b. If providing products using an Authorized Distributor, explain how Authorized Distributors will be identified and onboarded. Be sure to include the timeline for these processes.

11. MMCAP Infuse posts an updated membership roster daily that is accessible to our vendors.

Describe how you will use this roster to ensure bill-to and ship-to accounts are properly attached to MMCAP Infuse. Include how you will ensure that non-MMCAP Infuse Members are not receiving MMCAP Infuse benefits and pricing.

12. What steps will you take to ensure Members and/or Authorized Distributors are receiving correct pricing? What performance metrics will be used to measure pricing accuracy? If using Authorized Distributors, please include an explanation of how pricing will be transmitted and any relevant chargeback procedures. If a Member or Authorized Distributor is not receiving the correct pricing, what will be your procedures and timelines to correct? If shipping direct, please include any related credit-rebill processes.

13. Without providing specific pricing, describe any unique pricing structures or commitment requirements that you are proposing, including processes for determining and certifying eligibility, as well as the expectations of participating Members and Authorized Distributors if applicable. Also include any opportunities for bulk order discounts with relevant parameters. Any pricing details should be included on the discounts tab on the Cost Proposal Worksheet.

14. Awarded vendors are expected to provide accurate monthly sales data of all products and services made by Members (both direct sales and those through Authorized Distributors), as well as prompt administrative fee reporting and payments. (Please see Exhibit E for reporting requirements.)

Please describe how your organization is prepared to do so.

Customer Service

15. Describe your customer service channels (phone, email, live chat, etc.) and availability across all

U.S. time zones, including expected response times, for both Members and Authorized Distributors.

16. What resources will you leverage to ensure that you’re able to assign a primary contract manager within your organization to work with MMCAP Infuse and will the person assigned be able to promptly address customer service issues, conduct business reviews, monitor performance, ensure compliance, respond to price inquiries, and resolve other concerns that may arise?

17. How will you resolve concerns brought forth by MMCAP Infuse, Authorized Distributors, or our Members? Please include any relevant policies and procedures.

18. Please describe training opportunities (in-person, webinar, etc.) available to Members, including clinical programs and support, product education and training, and other no-cost, value-added opportunities.

19. Describe your business interruption plan. What alternate sources will you use in the event of a disruption? How will you inform MMCAP Infuse and affected Members?

Ordering Systems, Inventory and Delivery

20. Describe the methods available for Members and Authorized Distributors to submit orders

(telephone, fax, mail, email, online, EDI, etc.). What would the typical order process look like?

What confirmations are provided and at what point during the order process? Please include an example of a purchase order and any additional documentation that would be valuable for our understanding.

a. Many Members are utilizing a “Punch-Out” System offered by vendors that allows Members to order directly from their state or agency e-Procurement System, which connects to the Vendor’s online ordering system. If your proposal includes direct Member ordering and shipping, describe your experience and/or capacity working with Punch-Out Systems. Include any Punch-Out Systems you currently work with, timelines for implementing new systems, and processes for attaching pricing.

21. Describe your invoicing process, timelines, and your accepted methods of payment. Include any differences that would relate to your processes with Members vs. Authorized Distributors as applicable.

22. What are your delivery capabilities to Members and/or Authorized Distributors? How quickly can orders be expected to be delivered? Are there any limits to the timing, location, or number of deliveries? What shipping charges would be assessed?

23. What steps has your organization taken to build resiliency into your supply chain? Please include your processes for responding to supply chain interruptions. How will you notify MMCAP Infuse, Members, and Authorized Distributors of shortages, backorders, and estimated recovery timelines?

24. In the event of a shortage or backorder, are you able to provide equivalent substitute Products? If so, describe how substitutes would be made available and communicated.

25. What capabilities do you have to accommodate emergency ordering? Will emergency orders be processed the same day they are received? What is the expected timeline for delivery of emergency orders? What shipping and/or handling charges would be assessed?

26. Please describe your return and refund policies for Members and/or Authorized Distributors. Be sure to include any relevant protocols, especially as they pertain to items unable to be returned or refunded, products lost in transit, timelines for accepted returns, restocking fees, and specific requirements for returning expired (or otherwise unsellable) product.

SECTION 4 – COST PROPOSAL

Follow the instructions below when completing your cost proposal. Your cost proposal must be submitted as a separate Microsoft Excel file attached to your email response. No cost information should be provided in Section 3.

For the Cost Proposal Worksheet, follow the instructions as indicated on the first tab of the spreadsheet when completing your pricing analysis. No cost information should be provided in Section 3.

SECTION 5 – RESPONDER CERTIFICATIONS

Responder must check each box to certify to the conditions required under this RFP. Please note that some certifications may require the submission of additional information. Sign below to finalize response.

1. Required ☐ I have read and am aware of the State’s General Requirements as attached as Exhibit A.

☐ I have COMPLETED and ATTACHED:

☐ Exhibit B - Certification Regarding Lobbying.

☐ Exhibit C - Workforce and Equal Pay Declaration

☐ That I am the Responder (if the Responder is an individual), a partner in the company (if the Responder is a partnership), or an officer or employee of the responding corporation having authority to sign on its behalf (if the Responder is a corporation).

☐ That the proposal submitted in response to the RFP has been arrived at by the Responder independently and has been submitted without collusion with and without any agreement, understanding or planned common course of action with any other Responder of materials, supplies, equipment, or services described in the RFP, designed to limit fair and open competition.

☐ That the contents of the proposal have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any such persons prior to the official opening of the proposals.

☐That I am fully informed regarding the accuracy of the statements made in the proposal.

2. If Applicable ☐ I am a certified veteran-owned business, in accordance with Minn. Stat. § 16C.16, subd. 6a and

§ 16C.19 (d). Please Complete Exhibit D

By signing here, I warrant that the information provided in this proposal is true, correct, and reliable for purposes of evaluation for potential contract award. The submission of inaccurate or misleading information may be grounds for disqualification from contract award and may subject me/my company to suspension or debarment proceedings, as well as other remedies available to the State, by law.

Signature Title Date

EXHIBIT A

GENERAL REQUIREMENTS

Conflicts of Interest

Responder must provide a list of all entities with which it has relationships that create, or appear to create, a conflict of interest with the work that is contemplated in this request for proposals. This includes any conflict of interests the Responder may have with a Member. The list should indicate the name of the entity, the relationship, and a discussion of the conflict.

Organizational Conflicts of Interest

To the best of Responder’s knowledge and belief, and except as otherwise disclosed, there are no relevant facts or circumstances which could give rise to organizational conflicts of interest. An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons, A. vendor is unable or potentially unable to render impartial assistance or advice to the State;

B. the vendor’s objectivity in performing the contract work is or might be otherwise impaired; or C. the vendor has an unfair competitive advantage.

If after award, an organizational conflict of interest is discovered, an immediate and full disclosure in writing must be made to the State’s Chief Procurement Officer which must include a description of the action which the contractor has taken or proposes to take to avoid or mitigate such conflicts. If an organization conflict of interest is determined to exist, the State may, at its discretion, cancel the contract. In the event the Contractor was aware of an organizational conflict of interest prior to the award of the contract and did not disclose the conflict to OSP, the State may terminate the contract for default. Organizational conflicts of interest terms apply to any subcontractors for this work.

Proposal Contents The information provided is true, correct, and reliable for purposes of evaluation for potential contract award.

The submission of inaccurate or misleading information may be grounds for disqualification from the award as well as subject the Responder to suspension or debarment proceedings as well as other remedies available by law.

Responses are Nonpublic during Evaluation Process

All materials submitted in response to this Solicitation will become property of the State. During the evaluation process, all information concerning the responses submitted will remain private or nonpublic and will not be disclosed to anyone whose official duties do not require such knowledge. Responses are private or nonpublic data until the completion of the evaluation process as defined by Minn. Stat. § 13.591. The completion of the evaluation process is defined as the State having completed negotiating a contract with the selected responder. The State will notify all responders in writing of the evaluation results.

The State will not consider the prices submitted by the Responder to be proprietary or trade secret materials.

Notwithstanding the above, if the State contracting party is part of the judicial branch, the release of data shall be in accordance with the Rules of Public Access to Records of the Judicial Branch promulgated by the Minnesota Supreme Court as the same may be amended from time to time.

Contingency Fees Prohibited Pursuant to Minnesota Statutes Section 10A.06, no person may act as or employ a lobbyist for compensation that is dependent upon the result or outcome of any legislation or administrative action.

Administrative Fee. In consideration for the administrative support and other services provided by MMCAP

Infuse, the Responder agrees to pay an Administrative Fee of three percent (3%) on all purchases of products and services.

Reimbursements

Reimbursement for travel and subsistence expenses actually and necessarily incurred by the contractor as a result of the contract will be in no greater amount than provided in the current "Commissioner’s Plan” promulgated by the commissioner of Minnesota Management and Budget will not be made for travel and subsistence expenses incurred outside Minnesota unless it has received the State’s prior written approval for out of state travel. Minnesota will be considered the home state for determining whether travel is out of state.

Targeted Group, Economically Disadvantaged Business, Veteran-Owned and Individual Preference.

Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. § 16C.16, businesses that are eligible and certified by the State as targeted group (TG) businesses, economically disadvantaged (ED) businesses, and veteran-owned businesses will receive points equal to 12% percent of the total points available as preference.

For TG/ED/VO certification and eligibility information visit the Office of Equity in Procurement website at https://mn.gov/admin/business/vendor-info/oep/ or call the Division’s Helpline at 651.296.2600.

Workforce Certification For all contracts estimated to be in excess of $100,000, responders are required to complete the attached Affirmative Action Data page and return it with the response. As required by Minnesota Rule 5000.3600, “It is hereby agreed between the parties that Minnesota Statute § 363A.36 and Minnesota Rule 5000.3400 -

5000.3600 are incorporated into any contract between these parties based upon this specification or any modification of it. A copy of Minnesota Statute § 363A.36 and Minnesota Rule 5000.3400 - 5000.3600 are available upon request from the contracting agency.”

Non-Collusion Certification.

A. The Proposal has been arrived at by the Responder independently and has been submitted without collusion and without any agreement, understanding or planned common course of action with any other vendor designed to limit fair or open competition; and

B. The contents of the Response have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any other individual prior to the due date and time of this Solicitation. Any evidence of collusion among Responders in any form designed to defeat competitive responses will be reported to the MMCAP Infuse for investigation and appropriate action.

Certification Regarding Lobbying

For State of Minnesota Contracts and Grants over $100,000, the undersigned certifies, to the best of his or her knowledge and belief that:

A. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

https://mn.gov/admin/business/vendor-info/oep/

B. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

C. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into and is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

EXHIBIT B

CERTIFICATION REGARDING LOBBYING

The undersigned certifies, to the best of his or her knowledge and belief that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Organization Name

Name and Title of Official Signing for Organization

By:_______________________________________ Signature of Official

Date

For assistance with this form, email the Minnesota Department of Human Rights Compliance.MDHR@state.mn.us

Workforce and Equal Pay Declarations Page Rev. /1/2023

Select one:

Businesses executing a contract with State or Metropolitan agencies in excess of $100,000 (Workforce Certificate) and, if applicable, $500,000 (Equal Pay Certificate)

Businesses executing a contract with University of Minnesota for general obligation bond funded capital projects in excess of $100,000 (Workforce Certificate) and, if applicable, $500,000 (Equal Pay Certificate)

Businesses executing a contract with Political Subdivisions for general obligation bond funded capital projects in excess of $250,000 (Workforce Certificate) and, if applicable, $1,000,000 (Equal Pay Certificate)

This form is required for all businesses executing government contracts under the following:

Select all that apply:

We are a certificate holder:

Workforce Certificate under the name:

Workforce Certificate not applicable – MMCAP Infuse Vendor with NO direct sales or distribution

Equal Pay Certificate under the name: Not applicable – MMCAP Infuse WESA exemption memo dated 12/17/2018

We are applying/have applied for the following certificate(s):

Workforce Certificate Application date (MM/DD/YYYY):

Workforce Certificate not applicable – MMCAP Infuse Vendor with NO direct sales or distribution Equal Pay Certificate Application date (MM/DD/YYYY): Not applicable – MMCAP Infuse WESA exemption memo dated 12/17/2018

We have not applied for one or both certificates:

Our company does not yet have a Workforce Certificate or Equal Pay Certificate. We acknowledge that a Workforce Certificate and, if applicable, Equal Pay Certificate, or approved exemption by the Minnesota Department of Human Rights is required before a contract can be executed.

We are Exempt:

We attest to the Minnesota Department of Human Rights that we have not employed 40 or more employees on a single day during the prior 12 months in Minnesota or the state in wh we have our primary place of business. The Minnesota Department of Human Rights may request the names of our employees during the previous 12 months, the date of separation, if applicable, and the current employment status and count.

We believe our company is exempt because .

The Minnesota Department of Human Rights will review and determine if your company is exempt.

Business Information Vendor/Supplier ID Vendor Email

Business Name Name of Contracting Agency

Administration/MMCAP Infuse

Authorized Signatory Name Title Date

Signature Email Phone

EXHIBIT C

Workforce and Equal Pay Declaration Page mailto:Compliance.MDHR@state.mn.us

EXHIBIT D

STATE OF MINNESOTA

VETERAN-OWNED PREFERENCE FORM

Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. §16C.16, subd. 6a, the Commissioner of Administration will award up to a 12% preference on state procurement to certified small businesses that are majority owned and operated by veterans.

Veteran-Owned Preference Requirements - See Minn. Stat. § 16C.19(d):

1) The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.

or

2) The principal place of business is in Minnesota AND the US Small Business Administration verifies the business as being a veteran-owned or service-disabled veteran-owned small business under Public Law 109- 461 and Code of Federal Regulations, title 13, part 128.

Statutory requirements and appropriate documentation must be met by the solicitation response due date and time to be awarded the veteran-owned preference. For Bids, the preference applies only to the first $2,000,000.

Claim the Preference By signing below I confirm that:

My company is claiming the veteran-owned preference afforded by Minn. Stat. § 16C.16, subd. 6a. By making this claim, I verify that:

• The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.

or

• My company’s principal place of business is in Minnesota and the US Small Business Administration verifies my company as being a veteran-owned or service-disabled veteran-owned small business.

Name of Company: _____________________________ Date: ________________________________

Authorized Signature: _____________________________ Telephone: ________________________________

Printed Name: _____________________________ Title: ______________________________________

Sign and return this form with your solicitation response to claim the veteran-owned preference.

EXHIBIT E

REPORTING REQUIREMENTS

Required Data Fields for Administrative Fee Data Report

Excel Column Required Data Field Full Name for Administrative Fee Data Report A MMCAP Infuse Assigned Authorized Wholesaler Number B MMCAP Infuse Assigned Manufacturer Number C Direct or Indirect Purchase Indicator (I=Indirect, D=Direct) D Invoice Date (Point of Sale Date) E Invoice Number F MMCAP Infuse Member G Vendor’s Account Number for the MMCAP Infuse Member H MMCAP Infuse Member DEA Number, if applicable I MMCAP Infuse Member HIN Number, if applicable

J MMCAP Infuse Member Address K MMCAP Infuse Member City

L MMCAP Infuse Member State M Product’s NDC (Use all 11 digits (00076888888)) N Product/Service Name O Credit Indicator (C = credit) P Contracted Units (The number of units purchased on contract.)

Q MMCAP Infuse Contracted Unit Price R Administrative Fee Decimal Percentage (The contracted administrative fee percentage for the NDC number. Report as a decimal (e.g. 0.030))

S Vendor Contracted Sales (Contracted Units * Contracted Unit Price.

Report in dollars) Administrative Fee Payment Amount (Administrative Fee Decimal Percentage * Vendor Contracted Sales. Report in dollars)

Required Data Fields for Sales Data Report

Excel Column Required Data Field Full Name for Sales Data Report

A MMCAP Infuse-assigned Member ID B MMCAP Infuse Member Name C Vendor Distribution Center Code D Vendor-assigned Account number for MMCAP Infuse Member (this should be the ship-to account number) E Invoice Number F Invoice Line Number G Purchase Order Number H Invoice date (MMDDYYYY) I Buyer name or equivalent of buyer ID for person submitting the invoices (if available) J Vendor's (Wholesaler) SKU item number K NDC of purchased Product as stored in First DataBank, Inc.

(Required for pharmaceutical Products) L Label Name/Product/Service Description

M Unit Dose (Required for pharmaceutical Products) N Pack Size O Unit P Case Size Q Dose (Required for pharmaceutical Products).

R Strength (Required for pharmaceutical Products).

S Route (Required for pharmaceutical Products).

T Unit Price (99999.9999) U Quantity Ordered (not Vendor repackaged or re-bundled quantity)(99999.9999) V Quantity Shipped (not Vendor repackaged or re-bundled quantity)(99999.9999) W Extension (unit price multiplied by the quantity shipped)

EXTENDED PRICE (99999.9999)

X Type of transaction (Core, Non-core) 1= Core, 2=Non-Core, 3=Non-admin fees sales

Y Bill to Address 1 Z Bill to City

AA Bill to State (2 alpha postal code) AB Bill to Zip (standard 5-4 format, no dash necessary) AC Ship to Address 1 AD Ship to City AE Ship to State (2 alpha postal code) AF Ship to Zip (standard 5-4 format, no dash necessary) AG Service Fee (99999.9999) AH MMCAP Infuse Contract Number (MMSxxxxx) AI Admin Fee AJ Credit Indicator (C for credit) AK MMCAP Infuse Assigned Wholesaler Code (Codes will be assigned to PPV's during implementation period of the contract)

AL Manufacturer Name (MFG Name) AM Class of Trade AN 340B Purchase AO Category AP Manufacturer Part Number AQ List Price AR UNSPSC Code (XXXXXXXX) AS UNSPSC Description

AT GLN

AU GTIN

AV Order Date (MMDDYYYY)