Q_Bidder Certifications and Assurances.docx

DOCX document 32 KB Posted

Attached to
DCYF Enterprise Payment Solution
Solicitation number
24-DCYF-CS-081
Issued by
Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington

About this file

This document is a Bidder Certifications and Assurances form (Attachment Q) for the Washington State Department of Children, Youth & Families (DCYF) Enterprise Payment Solution RFP. The document outlines the required certifications that bidders must sign and submit with their proposal, with the bid remaining valid for 90 days after receipt.

The form includes key certifications regarding wage theft prevention compliance, requiring bidders to certify whether they have had any wage violations in the past three years, and addresses Executive Order 18-03 regarding workers' rights and mandatory arbitration clauses. Bidders must certify whether they require employees to sign mandatory individual arbitration clauses or class action waivers as a condition of employment. The document makes clear that failure to submit these certifications will result in bid disqualification.

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ATTACHMENT Q

BIDDER CERTIFICATIONS AND ASSURANCES

Bidder must sign and include the full text of this Attachment Q with the Response.

I/we make the following certifications and assurances as a required element of the bid to which it is attached, understanding that the truthfulness of the facts affirmed here and the continuing compliance with these requirements are conditions precedent to the award or continuation of the related contract(s):

1. I/we declare that all answers and statements made in the bid are true and correct..

2. The attached bid is a firm offer for a period of 90 days following receipt, and it may be accepted by the DCYF without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 90-day period.

3. The prices and/or cost data have been determined independently, without consultation, communication, or agreement with others for the purpose of restricting competition. However, I/we may freely join with other persons or organizations for the purpose of presenting a single bid.

4. In preparing this bid, I/we have not been assisted by any current or former employee of the state of Washington whose duties relate (or did relate) to this bid or prospective contract, and who was assisting in other than his or her official, public capacity. (Any exceptions to these assurances are described in full detail on a separate page and attached to this document).

5. I/we declare that the firm is not currently bankrupt or a party to bankruptcy proceedings and has not made an assignment for benefit of creditors and authorize DCYF to conduct a financial assessment of the firm in DCYF sole discretion.

6. I/we understand that the DCYF will not reimburse me/us for any costs incurred in the preparation of this bid. All bids become the property of the DCYF, and I/we claim no proprietary right to the ideas, writings, items, or samples, unless so stated in this bid.

7. I/we agree that submission of the attached bid constitutes acceptance of the solicitation contents and the attached sample contract and general terms and conditions. If there are any exceptions to these terms, I/we have described those exceptions in detail on a page attached to this document.

8. Unless otherwise required by law, the prices and/or cost data that have been submitted have not been knowingly disclosed by the Proposer and will not knowingly be disclosed by him/her prior to opening, directly or indirectly to any other Proposer or to any competitor.

9. I/we acknowledge that if it is awarded a contract containing Business Associate requirements under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), or any other Data Security requirements, that I/we will incorporate the terms of such Business Associate or Data Security requirements into all related subcontracts.

10. I/we acknowledge that if awarded a contract with DCYF, I/we am/are required to comply with all applicable state and federal civil rights and other laws. Failure to comply may result in contract termination. Bidder agrees to submit additional information about its nondiscrimination policies, at any time, if requested by DCYF.

11. I/we grant the DCYF the right to contact references and others, who may have pertinent information regarding the Proposer’s prior experience and ability to perform the services contemplated in this procurement.

12. I/we authorize DCYF to conduct a background check of Bidder or Bidder’s employees if DCYF considers such action necessary or advisable.

13. I/we have not been convicted nor entered a plea of nolo contendre with respect to a criminal offense, nor have I/we been debarred or otherwise restricted from participating in any public contracts.

14. I/we acknowledge its obligation to notify DCYF of any changes in the certifications and assurances above.

15. WAGE THEFT PREVENTION. Prior to awarding a contract, agencies are required to determine that a Bidder is a ‘responsible Bidder.’ See RCW 39.26.160(2) & (4). Pursuant to legislative enactment in 2017, the responsible Bidder criteria include a contractor certification that the contractor has not willfully violated Washington’s wage laws. See Chap. 258, 2017 Laws (enacting SSB 5301).

I hereby certify, on behalf of the firm identified below, as follows (check one):

|_| NO WAGE VIOLATIONS. This firm has NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.

OR

|_| VIOLATIONS OF WAGE LAWS. This firm has been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, a provision of RCW chapters 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced procurement solicitation date.

16. EXECUTIVE ORDER 18-03—WORKER’S RIGHTS. Pursuant to the Washington State Governor’s Executive Order 18-03 (dated June 12, 2018), DCYF is seeking to contract with qualified entities and business owners who certify that their employees are not, as a condition of employment, subject to mandatory individual arbitration clauses and class or collective action waivers.

I hereby certify, on behalf of the firm identified below, as follows (check one):

|_| NO MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS FOR EMPLOYEES. This firm does NOT require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

OR

|_| MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS FOR EMPLOYEES. This firm requires its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

FIRM NAME: _____________________________________________________
Name of Bidder– Print full legal entity name of firm
By:______________________________
Signature of authorized person
Title:______________________________
Title of person signing certificate
Date:________________________________
___________________________________

Print Name

Place:________________________________
Print city and state where signed

Return to Procurement Coordinator with bid response. Failure to submit will result in disqualification.

RFP No. 24-DCYF-CW-081 Page 5 of 5

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