Revised_Attachment C_DEIB_Proposal_Form.Final.AmendNo1_Final.docx

REVISED ATTACHMENT C – PROPOSAL FORM

DEIB SERVICES

Legal Name of Proposer:

Name of Proposer (if different):

Address:

City, State and Zip:

State of Incorporation & Date:

Entity Type:

Authorized Representative:

Telephone:

Email:

Oregon Business Registry Number (see RFP Section 4.2 ):

I. General Information

1. Does Proposer consider their company to be:

· small (1-10 employees),

· medium (11-49 employees), or

· large company (50+ employees)?

Please provide an explanation why.

2. COBID Certifications:

3. National or other certifications:

II. Management Proposal (250 Total Points) Proposer must respond to all of the following sections regardless of offered service category or categories. Failure to respond to any section below will result in the rejection of the Proposal.

A. Capabilities Summary (Required, Evaluated) Please include a narrative summarizing who you or your company are, why you do this work and how you approach it, what sets you apart from other Proposers who provide the same services as your company. Please be specific and use examples when appropriate. (125 Points) (Evaluation Criteria: Does the response demonstrate experience with and commitment to using different models and methods for achieving measurable outcomes?)

B. Proposer Profile (Required, not Evaluated) Please provide a profile including the following as applicable:

· Confirmation of legal capacity to do business in the State of Oregon (registered with the Secretary of State).

· Location of Proposer’s office (headquarters and branches).

· Location of the office to service the State of Oregon accounts (if different than the location of the company’s offices).

· Number of employees located in the State of Oregon, Pacific Northwest and nationally.

· Proposer’s background/history and why Proposer is qualified to provide Services described in the RFP.

· Length of time Proposer has been providing Services comparable to those described in the RFP and provide a brief description.

· Proposer’s client base.

· Types of services Proposer provides.

C. Staffing/Resource Plan (Required, Evaluated) Please provide a staffing or resource plan to demonstrate how you have and can retain the appropriate levels of staff available to Authorized Purchasers. The plan must also demonstrate that your staff (either employees or subcontractors) has the appropriate levels of education, skills, knowledge and expertise to provide the services requested in this RFP. The staffing or resource plan must include the following:

· A contingency plan which shows the ability to add more staff if needed to ensure Proposer is able to meet the needs of the State of Oregon and its Authorized Purchasers.

· A training plan for employees and sub-contractors (if any are used) to ensure they are up to date on certifications (if necessary), and have access to necessary training to keep abreast of the latest innovative techniques and processes to ensure the success of each SOC.

(125Points) (Evaluation Criteria: Does the plan inspire confidence that the Proposer has adequate staff with the necessary training? If subcontractors are used, doe Proposer show examples of how they have successfully used subcontractors to augment the work? Are subcontractors required to have the same training as Proposer staff?)

D. Main Point of Contact (Required, not Evaluated) Proposer must provide a main point of contact. The main point of contact will be responsible for the following:

· Able to address concerns and resolve any issues, related to the awarded Agreement to Agree, any SOCs, invoicing issues, etc. or must be able to involve other staff as necessary to resolve any issues.

· Be the point of contact for an awarded Agreement to Agree when Authorized Purchasers need to engage for Services. This could be questions regarding the Services Proposer provides, sending the Opportunity Notice to request Services.

Please provide the main point of contact’s name, title, phone number and email address. If Proposer chooses, you may name more than one main point of contact. The main point of contact must have the minimum of 3 years’ experience. This experience can be from a combination of professional experience and education. See RFP Addendum No. 1 for clarification to Section 3.5.1 Minimum qualifications. Please provide a resume of not more than two (2) pages for their Main Point of Contact.

III. Technical Proposal (750 Total Points) Proposer must complete the sections below only for those Service Categories included in Proposer’s Proposal. Failure to not include a section listed in the proposed Service Category, will result in the rejection of Proposer’s Proposal by DAS PS.

Service Category A: DEIB Consulting (Required, Pass/Fail) (250 Points Possible)

How does Proposer meet the three years’ experience requirement? (Professional experience, what type of education or a combination of the professional and education.)

Consulting Services Evaluation Criteria

A. Consulting Services Offered (Required, not Evaluated) Proposer shall provide a list of consulting services offered as well as a brief description of each. Proposer’s list should include consulting services detailed in Attachment A Scope of Services of the RFP, as well as any consulting services offered in addition to those.

B. Potential Key Persons (Required, not Evaluated) Proposer shall provide a list of potential job titles and roles of potential Key Persons (including sub-contractors if used) to provide consulting services. This is a list of potential job titles and roles that could be assigned to a potential Service Order Contract.

C. Approach and Experience - Consulting Services (Required, Evaluated) (210 Points Possible) Proposer’s Proposal must demonstrate how Proposer and Proposer’s Key Persons (including sub-contractors if used) have the experience, training and knowledge to provide DEIB consulting services requested in this RFP. Please be specific in your responses and use specific examples.

1. Describe Proposer’s approach to providing DEIB consulting services, including any theories, models or frameworks that inform your approach. This could include your approach to developing new frameworks as well as building on and aligning with existing frameworks. (30 Points)

(Evaluation Criteria: Does the proposer include at least one known model or framework? Did Proposer introduce a new or developing model or framework? Does Proposer describe how they apply it in the work their doing? Does the theory or model center most impacted populations? How does Proposer incorporate historical knowledge into consulting services provided? Does the Proposal show the ability to (or example of) having to change or adapt a framework during the course of the project?)

2. Describe the skills, knowledge and experience that Proposer possess that demonstrate Proposer’s ability to provide the DEIB consulting services requested in this RFP. (35 Points)

(Evaluation Criteria: Does the description provide a clear understanding of the services being requested? Does Proposer have the skills, knowledge and experience to provide DEIB consulting services requested in this RFP?

3. Describe Proposer’s approach and experience completing assessments, such as current work environment assessments, and those detailed in Attachment A Scope of Work of the RFP. This could include experiences developing surveys, using assessment tools and facilitating workgroups, focus groups, listening sessions and work sessions. (25 Points)

(Evaluation Criteria: Does the proposer include examples? Proposer provided approach to completing identified assessments, provided relevant examples from previous projects and also highlighted experience utilizing the identified/provided approaches? Is there anything unique in the assessment tools or methods of evaluation?)

4. Describe how Proposer helps leaders embed performance measurements into DEIB. (35 Points)

(Evaluation Criteria: Does proposer give at least one example? Does the proposer describe the process? Does Proposer include a model/framework used to guide the process?

5. Describe how Proposer measures the outcomes of the DEIB consulting services provided. (30 Points)

(Evaluation Criteria: Did Proposer give a specific example of how they measure the outcomes? Does the example show measurement results for the short and long term?)

6. Describe Proposer’s approach to and experience providing leadership development and coaching and mentoring at various applicable organizational levels, such as executive leadership, midlevel management, first line managers and non-management. (30 Points)

(Evaluation Criteria: Does Proposer have the experience to provide leadership development, coaching & mentoring to all management levels and non-management? Is Proposer’s approach clear? Does Proposer’s approach include any change management work?

7. Describe Proposer’s approach and experience engaging culturally and/or linguistically specific communities of varying socioeconomic status, ability levels, literacy levels, and experiences. This may include Monolingual Immigrant communities, people who are undocumented, people with disabilities, or people who are unhoused. (25 Points)

(Evaluation Criteria: Does the proposer give tangible examples of how they engage a diverse array of communities? Examples of how the approaches have been successful in prior projects done. Method(s) of assessment to measure outcomes (how they measure). Are the examples clear.)

D. Previous Experience (Required, Evaluated) (40 Points Possible)

1. Please provide a list of the most representative projects conducted over the past three (3) years that involve services similar to the Services requested in this RFP for consulting Services. Without limitation, the list must include the following:

· Project title.

· Time frame of project.

· Budget amount.

· Type of company project was for (government, private, non-profit, etc.).

· General overview of consulting services provided.

(10 Points) (Evaluation Criteria: Does Proposer list most representative projects done in the pas three (3) years? Are they similar to requested services in the RFP for consulting services? What consulting services are they? A brief outcome on each? Is the list of projects varying across the criteria?)

2. Please provide a detailed description of one (1) of the listed projects above in subsection D, #1, that is either completed or nearly completed. If possible, use a previous project with clients from an organization in a government setting or non-profit organization. The detailed description must include the following:

· Demonstrates Proposer and Proposer Key Persons (including sub-contractors if used) have the experience, training, and knowledge to provide the Services requested in this RFP.

· A detailed description of the project.

· What problem is this project trying to address?

· How do we/you know it is a problem (provide data).

· How does this project specifically solve/attempt to solve this problem?

· Outline a budget that is specific, accounting for every dollar you are asking for

· Goals and objectives of the project. Provide potential examples of measurable outcomes for the organization for this project.

· Techniques and approaches that illustrate what has worked, what barriers were encountered, what solutions were provided and what the results of those solution were.

· A description of the results (what made the project successful) and value provided to the customer by Proposer and their Key Persons or sub-contractors if used.

· Key Persons or sub-contractors (if used) and what their roles were.

· One reference for the project described. Proposer must at a minimum include the following:

· Company Name.

· Contact’s name, title, and role on the project.

· Contact’s phone number and email address.

· Any other important and relevant information regarding the project.

(30 Points) (Evaluation Criteria: did Proposer provide a detailed description of one of the listed projects mentioned in question #1 above? Were all the points above covered? Does the response clearly demonstrate Proposer’s knowledge, experience and understanding of this section?

Service Category B: DEIB Training & Facilitation (Required, Pass/Fail) (250 Total Possible Points)

1. Are the trainings offered by Proposer, customizable to meet the needs of Authorized Purchasers?

Yes ☐ No ☐

2. Is Proposer able to create customized training to Authorized Purchasers?

Yes ☐ No ☐

3. Does your organization have experience providing DEIB training & education services to diverse groups of individuals?

Yes ☐ No ☐

5. How does Proposer meet the three years’ experience requirement? (Professional experience, what type of education or a combination of the professional and education.)

Training & Education Evaluation Criteria A. Training & Education Facilitation Offered (Required, not evaluated) Proposer shall provide a list of training & facilitation services offered, a brief description of each, if training is in person, virtual or both. The list must also include “train the trainer” trainings Proposer offers.

B. Potential Key Persons (Required, Not Evaluated) Proposer must provide a list of potential job titles and roles of potential Key People assigned to provide the training & facilitation services. This is a list of potential job titles and roles that could be assigned to a potential Service Order Contract.

C. Approach and Experience - Training & Facilitation Services (Required, Evaluated) (210 Points Possible) Proposer’s Proposal must demonstrate how Proposer and Proposer’s Key Persons (including sub-contractors if used) have the experience, training, and knowledge to provide DEIB training & facilitation services requested in this RFP. Please be specific in your responses and use specific examples.

1. Describe Proposer’s approach to providing DEIB training & facilitation services, including any theories, models or frameworks that inform your approach. (30 Points)

(Evaluation Criteria: Does response give a clear understanding of the approach and how Proposer works collaboratively with their clients based on their needs.)

2. Describe Proposer’s approach to and experience customizing your existing trainings to meet the needs of Authorized Purchasers. (30 Points)

(Evaluation Criteria: How flexible is their training, are they open to adjusting trainings to meet Authorized Purchaser needs, do they collaborate with Authorized Purchaser.)

3. Describe Proposer’s experience providing DEIB training and facilitation. The description should include Proposer’s experience providing different kinds of trainings, including consciousness-raising, tool introduction and practice, and DEIB implementation. The description could include experience co-creating and customizing trainings or modules. (40 Points)

(Evaluation Criteria: Does response provide a clear description of the experience? Does the response include information about in person and virtual trainings?

4. How does Proposer measure the effectiveness of your trainings and facilitation? The description should demonstrate the training and facilitation techniques and processes are effective to advance DEIB. Your description should also include examples for different kinds of training offerings. (30 Points)

(Evaluation Criteria: Does response provide a clear picture of how Proposer measures effectiveness? Did proposer provide a specific example of this?)

5. Describe Proposer’s approach to facilitation, including how you design a standalone training or training series, modalities to engage adult learners, approaches to in-person facilitation versus virtual facilitation (40 Points)

(Evaluation Criteria: Does the proposer give multiple examples of modalities? Do they describe their approach to facilitation clearly? Does the Proposal show adaptability and willingness to combine or change modalities?

6. Describe Proposer’s approach to and experience overcoming common barriers such as lack of engagement or interest from participants, active challenges to the objectives of the trainings, disruptive behavior during the training, or demonstrative discomfort because a participant’s knowledge or world view is being challenged? (40 Points)

(Evaluation Criteria: Does response describe how Proposer keeps participants engaged in training? Does the proposer give examples of each kind of challenge, and how they overcome them? Does the proposer give multiple solutions to these challenges?)

D. Previous Experience (Required, Evaluated) (40 Points Possible)

1. Proposer shall provide a list of the most representative projects conducted over the past three (3) years that involve services similar to the Services requested in this RFP for training & education Services. Without limitation, the list must include the following:

· Name of training.

· Format of training (in-person, virtual, hybrid, etc.).

· Whether or not Proposer will be able to modify the training to adjust to the Authorized Purchaser’s needs, and if so, how.

· Type of company project was for (government, private, non-profit, etc.).

· Budget Amount (10 Points) (Evaluation Criteria: Does Proposer list the most representative projects done in past three (3) years? Are they similar to requested services in the RFP for training & facilitation services? What training & facilitation services are they? What was the outcome, what was the measure?) Is the list of projects varied across the criteria? Do the projects described meet the criteria?)

2. Proposer shall provide a detailed description of one (1) of the listed projects above in #1, that is either completed or nearly completed. If possible, use a previous project with clients from an organization in a government setting or non-profit organization. Without limitation, the detailed description must include the following:

· Demonstrates Proposer and Proposer Key Persons have the experience, training and knowledge to provide the Services requested in this RFP.

· A detailed description of the project.

· What problem is this project trying to address?

· How do we/you know it is a problem (provide data or examples).

· How does this project specifically solve/attempt to solve this problem?

· Outline a budget that is specific, accounting for every dollar you are asking for.

· Goals and objectives of the project. Provide potential examples of measurable outcomes for the organization for this project.

· Techniques and approaches that illustrate what has worked, what barriers were encountered, what solutions were provided and what the results of those solution were.

· A description of the results (what made the project successful) and value provided to the customer by Proposer and their Key Persons or sub-contractors if used.

· Key Persons or sub-contractors (if used) and what their roles were.

· One reference for the project described. Proposer must at a minimum include the following:

· Company name.

· Contact’s name, title and role on the project.

· Contact’s email address and telephone number.

· Handouts and presentation used.

(30 Points) (Evaluation Criteria: Did Proposer provide a detailed description of one of the listed projects mentioned in question #1 above? Were all the points above covered? Does the response clearly demonstrate Proposer’s knowledge, experience and understanding of this section?)

Service Category C: DEIB Strategic Planning Services (Required, Pass/Fail)

1. Does your organization have experience providing DEIB strategic planning services to diverse groups of individuals?

Yes ☐ No ☐

3. How does Proposer meet the three years’ experience requirement? (Professional experience, what type of education or a combination of the professional and education.)

Strategic Planning Evaluation Criteria A. Potential Key Persons (Required, not Evaluated) Proposer must provide a list of potential job titles and roles of potential Key People assigned to provide the strategic planning services. This is a list of potential job titles and roles that could be assigned to a potential Service Order Contract.

B. Approach and Experience - Strategic Planning Services (Required, Evaluated) Proposer’s Proposal must demonstrate how Proposer and Proposer’s Key Persons (including sub-contractors if used) have the experience, training, and knowledge to provide DEIB strategic planning services requested in this RFP. Please be specific in your responses and use specific examples.

1. How does Proposer evaluate DEIB within an organization and use that information to inform strategic DEIB planning? (50 Points)

(Evaluation Criteria: Examples in previous project(s) used or based on research and outcome? Does the response demonstrate an understanding of the organizations needs and challenges?)

2. Describe Proposer’s skills, knowledge and experience creating strategic DEIB plans that are sustainable and adaptable to changes in state government or scope of work. Description should include how Proposer monitors and assists with implementing the DEIB plans. (80 Points)

(Evaluation Criteria: Does the proposer have at least one example of creating strategic DEIB plans? Does the response describe how monitoring and follow-up are accomplished and measured?)

3. Describe how your Proposer engages internal and external parties that will be impacted by the outcomes of, and actions associated with, a strategic planning process. (60 Points)

(Evaluation Criteria: Does the Proposal show a good understanding of who all may be impacted? Does the planning process include scenarios/strategies that might differ among internal/external parties needs and challenges?)

C. Previous Experience (Required, Evaluated)

1. Please provide a list of the most representative projects conducted over the past three (3) years that involve services similar to the Services requested in this RFP for strategic planning Services. Without limitation, the list must include the following:

· Project title.

· Time frame of project.

· If Proposer had to work with other contractors (business strategic planning contractors or other), who the contractors were and their role on the project.

· Budget amount.

· Type of company project was for (government, private, non-profit, etc.).

· General overview of strategic planning services provided.

(20 Points) (Evaluation Criteria: Does Proposer list the most representative projects done in past three (3) years? Are they similar to requested services in the RFP for strategic planning services? What strategic planning services are they? What was the outcome, what was the measure?) Is the list of projects varied across the criteria? Do the projects described meet the criteria?)

2. Please provide a detailed description of one (1) of the listed projects above in #1, that is either completed or nearly completed. If possible, use a previous project with clients from an organization in a government setting or non-profit organization. Without limitation, the detailed description must include the following:

· Demonstrates Proposer and Proposer Key Persons (including sub-contractors if used) have the experience, training, and knowledge to provide the Services requested in this RFP.

· Demonstration of a customized approach and implementation strategies to achieve the intended project outcome.

· A detailed description of the project.

· What problem is this project trying to address?

· How do we/you know it is a problem (provide data).

· How does this project specifically solve/attempt to solve this problem?

· Outline a budget that is specific, accounting for every dollar you are asking for.

· Goals and objectives of the project. Provide potential examples of measurable outcomes for the organization for this project.

· Techniques and approaches that illustrate what has worked, what barriers were encountered, what solutions were provided and what the results of those solution were.

· A description of the results (what made the project successful) and value provided to the customer by Proposer and their Key Persons or sub-contractors if used.

· Key Persons or sub-contractors (if used) and what their roles were.

· One reference for the project described. Proposer must at a minimum include the following:

· Company name.

· Contact’s name, title, and role on the project.

· Contact’s email address and telephone number.

(40 Points) (Evaluation Criteria: Did Proposer provide a detailed description of one of the listed projects mentioned in question #1 above? Were all the points above covered? Does the response clearly demonstrate Proposer’s knowledge, experience and understanding of this section?)

Responsibility Inquiry

1. Does Proposer have available the appropriate financial, material, equipment, facility and personnel resources and expertise, or ability to obtain the resources and expertise, necessary to demonstrate the capability of Proposer to meet all contractual responsibilities? YES |_| / NO |_|.

2. Within the last five years, how many contracts of a similar nature has Proposer completed that, to the extent that the costs associated with and time available to perform the contract remained within Proposer′s control, Proposer stayed within the time and budget allotted, and there were no contract claims by any party? Number: ____ If any, please explain.

3. Within the last three years has Proposer (incl. a partner or shareholder owning 10% or more of Proposer’s firm) or a major subcontractor (receiving 10% or more of a total contract amount) been criminally or civilly charged, indicted or convicted in connection with:

· obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract,

· violation of federal or state antitrust statutes relating to the submission of bids or Proposals, or

· embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property? YES |_| / NO |_|.

If "YES," indicate the jurisdiction, date of indictment, charge or judgment, and names and summary of charges in the response field below.

4. Within the last three years, has Proposer had:

· any contracts terminated for default by any government agency, or

· any lawsuits filed against it by creditors or involving contract disputes? YES |_| / NO |_|.

If "YES," please explain. (With regard to judgments, include jurisdiction and date of final judgment or dismissal.)

5. Does Proposer have any outstanding or pending judgments against it? YES |_| / NO |_|.

Is Proposer experiencing financial distress or having difficulty securing financing? YES |_| / NO |_|.

Does Proposer have sufficient cash flow to fund day-to-day operations throughout the proposed contract period? YES |_| / NO |_|

If "YES” on the first question or second question, or “NO” on the third question, please provide additional details.

6. Within the last three years, has Proposer filed a bankruptcy action, filed for reorganization, made a general assignment of assets for the benefit of creditors, or had an action for insolvency instituted against it? YES |_| / NO |_|.

If "YES," indicate the filing dates, jurisdictions, type of action, ultimate resolution, and dates of judgment or dismissal, if applicable.

7. Does Proposer have all required licenses, insurance and/or registrations, if any, and is Proposer legally authorized to do business in the State of Oregon? YES |_| /NO |_|.

8. Pay Equity Certificate. This certificate is required if Proposer employs 50 or more full-time workers and the prospective contract price is estimated to exceed $500,000. [This requirement does not apply to architectural, engineering, photogrammetric mapping, transportation planning or land surveying and related services contracts.] Does a current authorized representative of Proposer possess an unexpired Pay Equity Certificate issued by the Department of Administrative Services? YES |_| / NO |_| / N/A |_|. [If the certificate was provided with the Bid or Proposal submitted for a solicitation related to the prospective contract, then it is not necessary to resubmit it. Just indicate “see Bid” or “see Proposal” in the response field. Otherwise, if applicable, submit a copy of the certificate with this form.]

Proposer Certifications Any individual signing below hereby certifies he/she/they is an authorized representative of Proposer and that:

1. Proposer understands and accepts the requirements of this RFP. By submitting a Proposal, Proposer agrees to be bound by the Agreement to Agree terms and conditions in Attachment B and as modified by any Addenda, except for those terms and conditions that DAS PS has reserved for negotiation, as identified in the RFP.

2. Proposer acknowledges receipt of any and all Addenda to this RFP.

3. Proposal is a Firm Offer for 180 days following the Closing.

4. If awarded an Agreement to Agree, Proposer agrees to perform the scope of work and meet the performance standards set forth in the final negotiated scope of work of the Agreement to Agree and any Contract issued pursuant to the Agreement to Agree.

5. I have knowledge regarding Proposer’s payment of taxes and by signing below I hereby certify that, to the best of my knowledge, Proposer is not in violation of any tax laws of the state or a political subdivision of the state, including, without limitation, taxes referenced in ORS 305.380(4), ORS 305.620 and ORS chapters 316, 317 and 318.

6. Proposer has no undisclosed liquidated and delinquent debt owed to the State of Oregon or any of its agencies, boards, commissions, departments, or divisions.

7. Proposer does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Proposer does not discriminate against any business certified under ORS 200.055 as a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns or an emerging small business. If applicable, Proposer has, or will have prior to contract execution, a written policy and practice, that meets the requirements described in ORS 279A.112 , of preventing sexual harassment, sexual assault and discrimination against employees who are members of a protected class. An Authorized Purchaser may not enter into a contract with an anticipated contract price of $150,000 or more with a Proposer that does not certify it has such a policy and practice. See https://www.oregon.gov/DAS/Procurement/Pages/hb3060.aspx for additional information and sample policy template.

8. Proposer complies with ORS 652.220 and does not unlawfully discriminate against any of Proposer’s employees in the payment of wages or other compensation for work of comparable character on the basis of an employee’s membership in a protected class. “Protected class” means a group of persons distinguished by race, color, religion, sex, sexual orientation, national origin, marital status, veteran status, disability or age..

9. Proposer and Proposer’s employees, agents, and subcontractors are not included on:

a. the “Specially Designated Nationals and Blocked Persons” list maintained by the Office of Foreign Assets Control of the United States Department of the Treasury found at: https://www.treasury.gov/ofac/downloads/sdnlist.pdf., or

b. the government wide exclusions lists in the System for Award Management found at: https://www.sam.gov/portal/

10. Proposer certifies that, to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Proposer, its employees, or its agents, on the one hand, and the business or economic interests of the State, on the other hand, arising out of, or relating in any way to, the subject matter of the RFP. If any changes occur with respect to Proposer’s status regarding conflict of interest, Proposer shall promptly notify the State in writing.

11. Proposer certifies that all contents of the Proposal (including any other forms or documentation, if required under this RFP) and this Proposal Certification Sheet are truthful and accurate and have been prepared independently from all other Proposers, and without collusion, fraud, or other dishonesty.

12. Proposer understands that any statement or representation it makes, in response to this RFP, if determined to be false or fraudulent, a misrepresentation, or inaccurate because of the omission of material information could result in a "claim" {as defined by the Oregon False Claims Act, ORS 180.750(1)}, made under the Agreement to Agree being a "false claim" {ORS 180.750(2)} subject to the Oregon False Claims Act, ORS 180.750 to 180.785, and to any liabilities or penalties associated with the making of a false claim under that Act.

13. Proposer acknowledges these certifications are in addition to any certifications required in the Agreement to Agree, the Scope of Services set forth in Attachment A, a Contract or a Statement of Work at the time of Agreement to Agree or Contract execution.

Authorized Signature By signature below, the undersigned Authorized Representative on behalf of Proposer certifies to the best of his or her knowledge and belief that the responses provided on this form are complete, accurate, and not misleading.

Authorized Signature

Date

(Printed Name and Title)

Revised Attachment C, Proposal Form DEIB Services 2