Response-Form-A.doc

Response Form A RFR Autoplate Coiled Aluminum, Equal or Better RFR# 14-IND-0513-Aluminum

All Bidders must complete and return this form with their response in order to be considered responsive. Completing every section of this document fully is mandatory unless instructions for specific questions state otherwise.

All answer columns expand to accommodate your responses. Add rows when applicable to answers.

Section 1. Contact Information

Company name

Street address, city, state, zip

Main phone number

Toll-free phone number

Fax number

Website

Name, Title

Phone number

Fax

Email

Name, Title

Phone number (working hours)

Phone number (non-working hours/cell)

Fax

Email

Section 2. Checklist of Required Documentation

Omission of required information or documentation may be grounds for Bidder disqualification. To ensure accurate review of your submission, please use the Checklist below to ensure you submit all requirements for this RFR.

File Name: Aluminum_ResponseForm_A_[your company name]

Response description: Response Form A

Certified copies of insurance

See Section 3.2.12 of the RFR Combine in one file and submit with response.

File name: Insurance_[your company name]

Response description: Copies of Insurance

Certificates of Specifications Required

See Section 3.2.2 of the RFR Combine in one file and submit with response.

File Name: Specs_Certification_[your company name] Response description: Certificates of Specifications

File name: Standard_Cont_Form_[your company name]

Response description: Standard Contract Form

File name: Comm_T-C_[your company name]

Response description: Commonwealth Terms & Conditions

File name: W-9_[your company name]

Response description: W-9 Form

File name: Cont_Authoriz_[your company name]

Response description: Contractor Authorized Signatory Form

Section 3. Company Capability Information

3.1. General.

Use this column for the answer or attach additional documentation

Number of years in business prior to the due date of this solicitation

Has the company had a previous Tax ID? What was the company’s past name?

Was this the result of a merger or acquisition? Please define with dates of this circumstance

Number of years in business offering conversion coated aluminum for license plates.

How many offices /locations does your company have in Massachusetts?

How many full-time staff equivalents (FTEs) does your company employ in Massachusetts?

Corporate Headquarters location

Business hours/days

3.2. Locations. List your firm’s locations/offices and the phone number.

3.3. Emergency Preparedness: COOP Plan. Indicate whether there is a written Continuity of Operations Plan (COOP) that describes how the company will continue to do business in case of an emergency (see RFR Section 3.4.4, Emergency Response Plan/Preparedness). This information will not be considered in the evaluation of the response.

Yes

No

3.4. Financial Stability/Adverse Conditions

Litigation, Penalties, Pending Actions, Enforcement Actions, or Bankruptcy: The bidder shall submit a description of any and all investigations, indictments or pending litigation by any federal, state or local jurisdiction relating to the bidder, any officer, director, partner or member thereof, any affiliate or any related company. A list of all criminal convictions within the last five years relating to the bidder, any officer, director, partner or member thereof, any affiliate or any related entity. A list of all civil penalties, judgments, consent decrees and other sanctions within the last five years, as a result of any violation of any law, rule, regulation or ordinance in connection with its business activities relating to the bidder, any officer, director, partner or member thereof, any affiliate or any related entity. A list of all actions occurring within the last five years which have resulted in revocation or suspension of any permit or authority to do business in any jurisdiction relating to the submitting entity, any officer, director, partner or member thereof, any affiliate or any related entity. A list of all actions occurring within the last five years that have resulted in the barring from public bidding relating to the bidder, an officer, director, partner or member thereof, any affiliate or any related entity. A list of all pending actions and enforcement actions, including OSHA violations. A list of all bankruptcy and other similar proceedings within the past five years relating to the bidder, any officer, director, partner or member thereof, any affiliate or any related entity.

Defaults: The bidder shall provide a description, in detail, of any situation in which the bidder’s firm (either alone or as part of a joint venture), or a subsidiary of the bidder’s firm, defaulted or was deemed to be in noncompliance of any contractual obligations, explaining the situation, its outcome and all other relevant facts associated with the event described. Please also provide the name, title and telephone number of the principal manager of the contract user who asserted the event of default or noncompliance.

Other Adverse Situations: The bidder shall provide a description of any present facts known to the bidder that might reasonably be expected to affect adversely either its ability to perform any aspect of the agreement or the viability of any affiliated entity that might reasonably be expected to supply financial support.

Use this column for the answer

Describe any Litigation, Penalties, or Bankruptcy

Describe any Defaults

Describe any other Adverse Conditions

Describe any actions, pending actions, enforcement actions or violations

3.5. Insurance. Describe your company’s overall liability (general and motor vehicle), worker’s compensation and other insurance, including the limits, in the box below.

Use this column for the answers

Total Limit:

Total Limit:

Total Limit:

Total Limit:

Total Limit:

Total Limit:

Total Limit:

In addition to providing information in this table, certificate(s) of insurance must be attached to the bid response.

Section 4. Service Capability

4.1 Defective Material. Please state your company’s policy for defective material and what documentation is required of MassCor for this policy.

4.2. Delivery Date After Receipt of Order (ARO)

Earliest Delivery Date ARO = __________ in Calendar Day(s)

Average Delivery Date ARO = __________ in Calendar Day(s)

Please state general reasons for delivery date later than 30 days in box below:

4.3. Warranties and/or Guarantees. Please state any and all warranties and/or guarantees pertaining to this product. The box below will expand to accommodate your response.

4.4 Past Correctional Experience. Below please list your company’s previous experience with any correctional department.

4.5. Equal or Better. Please state if you are submitting a response for an alternate product and identify all differences to the specifications listed in the RFR.

No

Section 5. Pricing

5.1. Bidders are to provide pricing in the table below. Please note any and all volume discounts in table below under Section 5.1. All estimated quantities listed are for pricing means only and does not accurately represent amounts that will be purchased. The listed items are for pricing samples only.

**OTHER QUANTITIES:

5.2 Additional Discounts Offered. Bidders are to provide any and all volume discounts available and any further opportunities for discounts, i.e., “Big Buys,” “Close Out” pricing etc., in the table below.

Big Buy

(if not offered, state N/A, or the

Details of the program)

“Close Out Pricing”

(if not offered, state N/A)

Additional Discounts Offered – List below:

Bidders should also provide a price list/catalog (which clearly states % discount off) of other items available in addition to those listed.

Certification

I, ___________________________________ (print authorized signatory name) on behalf of ______________________ (print Company name), understand and agree that I must meet all of the RFR requirements to be considered for any award to be issued from this RFR. I certify that I have read the RFR and understand and agree to comply with all requirements of awarded contractors.

Signed: __________________________________________________________

Authorized officer name: ____________________________________________ Title: ____________________________________________________________ Date: ____________________________________________________________ Supplier Diversity Program (SDP) Plan Commitment

SDP Plan Form #1

(To be submitted with Bid Response)

Contract/RFR Document Number:

Instructions: Completing all parts of this form is mandatory. Please read instructions in the SDP section of the solicitation. Complete one form and submit with Bid.

Part I Bidder/Contractor Information (Required)

Business Name:

Contact Name:

Phone # ( FORMTEXT

Email address:

Part II Financial Commitment (Required)

Provide a specific percentage committed (as a percentage of Bidder/Contractor sales derived from this contract for the life of the contract) to be spent with all certified SDP Partners that the Bidder will propose if awarded a Contract. Please note that prime bidders who are SDO-certified must also submit an SDP Plan Form.

SDP Percentage Committed in Bid Response for Life of Contract:

Supplier Diversity Program (SDP) Resources:

· Resources available to assist Prime Bidders in finding potential Minority Business Enterprises (MBE) and Women Business Enterprises (WBE) partners can be found on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

· Resources available to assist Prime Bidders in finding potential Service-Disabled Veteran-Owned Business Enterprise (SDVOBE) partners can be found on the Supplier Diversity Office Webpage (www.mass.gov/sdo).

· The Supplier Diversity Program offers training on the SDP Plan requirements. The dates of upcoming trainings can be found on the OSD Training & Outreach Webpage. In addition, the SDP Webinar can be located on the Supplier Diversity Program Webpage (www.mass.gov/sdp).

COMMONWEALTH OF MASSACHUSETTS

Prompt Pay Discount Form

(Invoice discounts for receiving fast payments)

Revised 3/9/07

Bidder Name: .

Vendor Code (VCUST): .

Contract/RFR Number(s): .Prompt Payment Discounts (PPD). All contractors/vendors doing business with the Commonwealth must provide a Prompt Payment Discount (PPD) for receiving early payments unless the Contractor/vendor can provide compelling proof that providing a prompt pay discount would be unduly burdensome. Contractors benefit from PPD by increased, usable cash flow as a result of fast and efficient payments for commodities or services rendered. Contractors who agree to accept Electronic Funds Transfer (EFT) increase the prompt pay benefit by ensuring that funds are paid directly to their designated bank accounts, thus eliminating the delay of check clearance policies and traditional mail lead time. Payments processed through the state accounting system (MMARS) can be tracked and verified through the Comptroller’s Vendor Web system using the Vendor/Customer Code assigned to you by a Commonwealth department.

The Commonwealth benefits because contractors reduce the cost of products and services through the applied discount. While Bidders/Contractors have flexibility in determining the actual % discount(s) offered to the Commonwealth, the discount(s) must be identified for 10, 15, 20 and/or 30 days for payment issuance in the column entitled “% Discount Off Proposed Price” below. The Commonwealth may use the prompt pay discounts submitted as a basis for selection and may negotiate discounts as deemed in the best interest of the Commonwealth. The requirement to offer PPD discounts may be waived by the Commonwealth on a case-by-case basis if participation in the program would be unduly burdensome, provided the specific reason for the hardship is outlined below.

All discounts offered will be taken in cases where the payment issue date is within the specified number of days listed below and in accordance with the Commonwealth’s Bill Paying Policy. Payment days will be measured from the date goods are received and accepted / performance was completed OR the date an invoice is received by the Commonwealth, whichever is later to the date the payment is issued as an EFT (preferred method) or mailed by the State Treasurer. The date of payment “issue” is the date a payment is considered “paid” not the date a payment is “received” by a Contractor.

If internal Bidder/Contractor systems require an alternate method of measuring payment issue dates, the Bidder/Contractor must note the issues below or on an attached page if necessary to be considered by the PMT. In cases where the Bidder/Contractor considers that offering a Prompt Payment Discount would be a hardship, the Bidder must clearly define the issues and reasons for said hardship. Providing volume discounts or other discounts on prices is not considered a hardship, since the PPD provides the additional benefit of early cash flow for the Contractor.

Enter the Prompt Payment Discount percentage (%) off the invoice payment, for each of the payment issue dates listed, if the payment is issued within the specified Payment Issue days. For example:

5% - 10 Days

4% - 15 Days

3% - 20 Days

2% - 30 Days

If no discount is offered enter 0%

The Contractor is unable to provide a prompt payment discount due to the following hardship:

Contractor/Bidder Authorized Signature _________________________________ Date: ___________

Additional Environmentally Preferable Products / Practices

Bidder Company Name: ___________________________________________________ Date: _______________

In line with the Commonwealth’s efforts to promote products and practices which reduce our impact on the environment and human health, Bidders are encouraged provide information regarding their environmentally preferable/sustainable business practices as they relate to this contract wherever possible.

Bidders who can demonstrate such initiatives (referencing, but not limited to, the items listed below) will be eligible to receive evaluation points. In order to receive evaluation points, Bidders must complete this form and submit it with their RFR Response.

Bidders must submit appropriate documentation to support the items for which the Bidder indicated a “Yes” (and/or include information in the box following each question). (See page 2 for additional guidance on completing this form)

1. Packaging

Has the Bidder implemented any of the following environmental initiatives? (A checkmark indicates “Yes”) Use of corrugated materials that exceeds the required minimum of 35% post-consumer recycled content

Use of other packaging materials that contain recycled content and are recyclable in most local programs

Promotes waste prevention and source reduction by reducing the extent of the packaging and/or offering packaging take-back services, or shipping carton return

Reduces or eliminates materials which have been bleached with chlorine or chlorine derivatives

Eliminates any packaging that may contain polyvinyl chloride (PVC), or polystyrene or heavy metals

If yes, documentation of practices must be included in the box below, which will expand to accommodate your response.

2. Business Practices / Operations / Manufacturing

Does the bidder engage in practices that serve to reduce or minimize an impact to the environment, including, but not necessarily limited to, the following items? (A checkmark indicates “Yes”)

Recycles materials in the warehouse or other operations

Use of alternative fuel vehicles or vehicles equipped with diesel emission control devices for delivery or transportation purposes

Use of energy efficient office equipment or signage or the incorporation of green building design elements

Use of recycled paper (that meets federal specifications) in their marketing and/or resource materials

Other sustainable initiative

If yes, documentation of practices must be included in the box below, which will expand to accommodate your response.

3. Training and Education

Does the bidder conduct/offer a program to train or inform customers of the environmental benefits of the products to be offered under this contract, and/or does the bidder conduct environmental training of its own staff? FORMCHECKBOX Yes

FORMCHECKBOX

No

If yes, bidders must attach a description of the training offered and the specific criteria targeted by the training in the box below which will expand to accommodate your response.

4. Certifications

Has the bidder or any of its manufacturers and/or subcontractors obtained any of the following product/industry certifications?

ISO 14000 or adopted some other equivalent environmental management system

Other industry environmental standards (where applicable), such as the CERES principles, LEED

Certification, C2C Protocol, Responsible Care Codes of Practice or other similar standards

Third Party product certifications such as Green Seal, Scientific Certification Systems, Smartwood, etc.

A check = “yes”; Bidders must indicate certificate name in the box below and attach a (scanned) copy with their response.

5. Other Environmental Criteria

Bidders are encouraged to respond to criteria specifically indicated in this RFR as “desirable environmental criteria” to receive consideration in the evaluation. (Please provide information in the box which will expand to accommodate your response.)

Purpose of the Form

Additional Environmentally Preferable Products / Practices The Additional Environmentally Preferable Products / Practices form is a standard evaluation tool included with virtually all OSD Requests for Response (RFR) that will result in a Statewide Contract. It applies to the operations of the Bidder (not any manufacturer or other company represented buy the Bidder).

Purpose of the Form

The primary purpose for incorporating this language into RFRs is to encourage potential Bidders to adopt business practices that foster a sustainable approach to conducting their operations. Such an approach may include one that has a reduced impact on the environment or public health, such as, but not limited to, creating less waste by using less packaging; eliminating the use substances and/or materials that are considered toxic during the manufacturing process, at time of product use, or upon disposal; or utilizing vehicles in the delivery fleet that operate on alternative fuels for the purpose of reducing air pollution and greenhouse gas emissions.

Other purposes for the form that may be beneficial to the Bidder include:

· The form alerts Bidders to the fact that the Commonwealth considers such initiatives part of the “best value” of a procurement.

· The form provides Bidders with an opportunity to receive “preference” in the evaluation phase of the RFR for the environmental initiatives they have instituted. It is important for Bidders to provide a statement (or other documentation) along with their response to substantiate or better explain how those initiatives are implemented in their operations in order to receive a preference or points.

Guidance on Completing the Form

1) Packaging – Many forms of corrugated containers now contain 60% or more post-consumer recycled content and are comparable in cost; in addition, several alternatives to using polystyrene as a packaging cushion are now available. Bidders should check with their box manufacturers to learn about the recycled content they use and include information about that in their RFR Response. Companies are also encouraged to research the EPP alternative products and practices indicated on the form and convert to their use wherever possible.

2) Business Operations – This section refers to things the Bidder does within their own operations to create a smaller “environmental footprint” in the marketplace by reducing the impact of their operations through energy conservation, waste and toxics reduction and other sustainable practices.

3) Training and Education – If Bidders offer a product or service that involves an environmentally preferable component and they train their staff to inform customers of these features, such training should be mentioned in conjunction with this form to receive credit. If Bidders provide materials (brochures, info on websites, etc.) on the environmental attributes of their products/services, they can also receive credit in the evaluation process if a brief explanation is included with the form. It is preferable if such training materials and other information are included with the Response.

4) Certifications – Bidders should familiarize themselves with the various certifications for products and processes that are available within the industry in which they operate, with particular attention to those concerning environmental issues. Providing information with the EPP form on such certifications and/or attaching a copy of the actual certificate is important to receive credit in the evaluation process.

5) Other Environmental Criteria – If Bidders are already doing something indicated in the RFR as a “desirable” criteria and they include a statement with their RFR that they have implemented such measures, this will be considered in the evaluation phase as well. In addition, any initiative untaken by the Bidder that may be considered an environmental benefit, should be mentioned as part of this section in the RFR.

Business Reference Form

Bidder:

RFR Name/Title:

RFR Number:

The bidder must provide (indicate a number) __________ business references.

Reference name:_____________________________________ Contact:

Address: ________________________________________________ Phone: # ( )

Fax/Internet address:

Description and date(s) of commodities and services provided:

Reference name: _______________________________________Contact:

Address: _______________________________________________

Reference name: ______________________________________ Contact:

Address: _______________________________________________

References will be contacted to confirm the bidder’s abilities and qualifications as stated in the bidder’s response. The department may deem the bidder’s response unresponsive if a reference is not obtainable from a listed reference after reasonable attempts.

COMMONWEALTH OF MASSACHUSETTS

Authorization for Electronic Funds Transfer Payments

I, _____________________, hereby authorize the Commonwealth of Massachusetts, through the State Treasurer, to deposit funds due into the account at the bank named below. The State Treasurer is also authorized to debit my account only to adjust any overpayment which has been made to my account.

VENDOR BANK INFORMATION

Bank Name:

Bank Transit Number:

Bank Account Number:

Checking or Savings Account:

VENDOR INFORMATION

Vendor Tax Identification Number:

Vendor/Business Name:

Vendor Contact Name:

E-Mail

Telephone:

Address:

City:

State and Zip Code:

This Authorization will remain in effect until either cancelled in writing or an updated form changing information is sent to the Department you currently do business with.

AUTHORIZED SIGNATURE:

Print Name:

Title:

Date:

Form forwarded to Commonwealth Department:

Attach a voided check here