O_A_Form.pdf

REQUEST FOR QUALIFICATIONS

Attachments/Response Forms

Solicitation No. BPM006827 Description:

ON-CALL ARCHITECTURAL AND

LANDSCAPE ARCHITECTURAL SERVICES

Arizona Department of Administration

General Services Division 1400 W Washington St., Ste. B200

Phoenix, AZ 85007

Available online at: appstate.az.gov Page 3 of 17

ATTACHMENT 1: OFFER AND ACCEPTANCE FORM

OFFER

TO THE STATE OF ARIZONA:

The Undersigned hereby offers and agrees to furnish the material, service and/or construction in compliance with all terms, conditions, specifications and amendments in the Solicitation and any written exceptions in the offer. Signature also certifies Small Business status if checked below (No. 4).

Company Name Signature of person authorized to sign

Address Printed name and title

City, State, ZIP Contact email address

Unique Entity ID (SAM #) ROC #(s)

Federal Tax Identifier (EIN or SSN) State Tax Identifier

By signature in the Offer section above, the Offeror certifies:

1. The submission of the Offer did not involve collusion or other anticompetitive practices.

2. The Offeror shall not discriminate against any employee or applicant for employment in violation of Federal

Executive Order 11246, State Executive Order 2009-

3. The Offeror has not given, offered to give nor intends to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause shall result in rejection of the offer. Signing the offer with a false statement shall void the offer, any resulting contract and may be subject to legal remedies provided by law.

4. The Offeror certifies that the above referenced organization ___ IS/ ___ IS NOT a small business with less than 100 employees or has gross revenues of $4 million or less in prior FY.

ACCEPTANCE OF OFFER (To be filled out by Procurement Manager)

The Offer is hereby accepted.

The Contractor is now bound to sell the materials or services listed by the attached contract and based upon the solicitation, including all terms, conditions, specifications, amendments, etc., and the Contractor’s Offer as accepted by the State.

This Contract shall henceforth be referred to as Contract No._CTR076530________________________________.

The effective date of the Contract is _April 15, 2025___________________________________________________.

The Contractor is cautioned not to commence any billable work or to provide any material or service under this contract until Contractor receives purchase order, contact release document or written notice to proceed.

State of Arizona Awarded this _15____day of____April___________2025

Procurement Officer:___________________________________________

Contact Phone Number (Office) Contact Phone Number (Mobile)

Marlene Imirzian & Associates, LLC

8906 N. Central Avenue

Phoenix, AZ 85020

602-943-5279

NA8KTKURAHW3

86-0895969

Marlene Imirzian, Principal mimirzian@imirzian-architects.com

602-943-5279

86-0895969

N/A

X

Docusign Envelope ID: BB990A38-FE60-41C0-8DEB-8421FDF4DE36