RFP 25-038 Required Attachments A-C.pdf

RFP 25-038 Public Health Consultation Services

ATTACHMENT A – COVER SHEET FOR PROPOSAL

Proposals must include this cover sheet (or this sheet reproduced on company letterhead) as PAGE 1 of the response. Vendors may complete all required attachments as a stand-alone response (fillable form .pdf document, written or typed).

The undersigned declares that the RFP Documents, including, without limitation, any RFP Addenda, Exhibits, and Appendices have been read.

The undersigned acknowledges receipt and acceptance of all addenda.

The undersigned agrees to the terms and conditions as outlined in the RFP.

The undersigned has reviewed the RFP Documents and fully understands the requirements set forth in the RFP and that if awarded it will be the basis for the proposer to enter into a contract with Ottawa County in accordance with the RFP documents.

The undersigned acknowledges that it is the responsibility of each proposer to be familiar with all of the specifications, terms and conditions and, if applicable, the site condition. By the submission of a proposal, the proposer certifies that if awarded a contract they will make no claim against Ottawa County based upon ignorance of conditions or misunderstanding of the specifications.

The undersigned certifies that neither (Company), nor any of its successors, parent companies, subsidiaries, or companies under common control, are an “Iran Linked Business” as defined in the Michigan Economic Sanctions Act, 2012 P.A. 517, MCL 129.311, et. seq.

The undersigned agrees to indemnify, defend, and hold harmless the County and its officials, officers, employees, volunteers, and agents from and against any and all liability, claims, judgments, losses, damages, payments, costs and expenses, as more fully set forth in the general terms and conditions in the RFP.

The undersigned certifies to the best of his/her/its knowledge and belief, that neither it nor any of its principals, owners, officers, shareholders, key employees, directors and member partners: (1) are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency, as more fully set forth in the general terms and conditions in the RFP.

Insurance certificates are not required at the time of submission. However, if awarded, the Proposer agrees to meet the minimum insurance requirements posted in the general terms and conditions in the RFP.

ATTACHMENT A – (CONTINUED)

The submission of a proposal hereunder shall be considered evidence that the vendor is satisfied with respect to the conditions to be encountered and the character, quantity, and quality of the work to be performed.

Company Name:

Contact Name and Title:

Mailing Address:

Phone Number: ______________________ Email Address:

Type of Entity/Organization (Select One): Corporation ☐ Joint Venture ☐ Partnership ☐

Limited Liability Partnership ☐ Limited Liability Corporation ☐ Non-Profit/Church ☐

Other: ________

Website:

Federal Employer Identification Number:

The undersigned affirms that he/she is duly authorized to execute this proposal, that this company, corporation, firm, partnership or individual has not prepared this proposal in collusion with any other vendor and that the contents of this proposal as to prices, terms or conditions have not been communicated by the undersigned, nor by any employee or agent, to any competitor, and will not be, prior to the award and the vendor has full authority to execute any resulting contract awarded as the result of, or on the basis of the proposal.

Proposals must be signed by an official authorized to bind the provider to its provisions for at least a period of 120 days from the date of signature.

BY:

(Signature of Authorized Representative) Date

(Printed Name and Title of Authorized Representative)

ATTACHMENT B – VENDOR REFERENCES

Provide (3) three references from projects or services provided that are similar in size and/or scope, preferably from other governmental/municipal, and/or other community-based organizations. By providing the references below, Vendor authorizes any person contacted to give the County any and all information concerning work experience or performance and releases all parties from all liability for any damage that may result from furnishing the same to the County. Please do NOT include Ottawa County as a reference.

Vendor Reference 1

Customer Name:

Contact Person:

Number:

Email:

Project Description:

Vendor Reference 2

Vendor Reference 3

ATTACHMENT C - PROPOSAL RESPONSE

To be submitted as a stand-alone document, the proposal response should be clear and concise narrative, providing detailed information and responses to all questions listed below.