RFP 26-03 _DRS Attachment B BidderCert._.docx

Attachment B Bidder’s Information, Declarations and Certifications

Instructions Please review each question and respond to each one completely.

Bidder Information

Provide names for individuals such as the president, vice president, board chairman of the organization.

Note: Your TIN will be either a number issued by the IRS (for example, Employer Identification Number, Federal Tax Identification Number) or a number issued by the Social Security Administration (in other words, your Social Security Number). If your TIN is an SSN, state that fact, but do NOT provide the SSN.

Email Address for RFP Contact Mailing address for RFP Contact

Certifications and Assurances Bidder, through the duly authorized undersigned, makes the following certifications and assurances as a required element of submitting a responsive bid. Bidder certifies, to the best of its knowledge and belief, that as of the date of the proposal, the following are true, complete, correct, and made in good faith:

10. Accuracy The Bidder declares that all answers and statements made in the proposal are true and correct.

The Bidder agrees that submission of the attached proposal constitutes understanding and acceptance of the solicitation contents and the attached general terms and conditions. If there are any exceptions to these terms, I/we have described those exceptions in my/our responses to those terms and conditions.

Choose an item.

12. Firm Offer The Bidder assures that the attached proposal is a firm offer for a period of 180 days following receipt, and it may be accepted by DRS without further negotiation (except where obviously required by lack of certainty in key terms) at any time within the 180-day period.

Choose an item.

13. No Reimbursement The Bidder assures that it will not be reimbursed for any costs incurred in the preparation of this proposal. All proposals become the property of DRS, and the Bidder will claim no proprietary right to the ideas, writings, items or samples, unless so stated in this proposal.

Choose an item.

14. Business Registration The Bidder assures that it is registered with the Washington Secretary of State and is in good standing or agrees to register with the Washington Secretary of State prior to contract execution.

Choose an item.

15. Business License The Bidder assures it is registered with the Washington State Department of Revenue and has a business license to do business in Washington or agrees to register with the Washington State Department of Revenue and obtain a license prior to contract execution.

Choose an item.

16. References The Bidder grants DRS the right to contact references and others who may have pertinent information regarding Key Personnel’s prior experience and ability to perform the services requested in this procurement.

Choose an item.

17. No Price Collusion The Bidder assures that the prices and/or cost data have been determined independently, without consultation, communication or agreement with others for the purpose of restricting competition. However, the Bidder may freely join with other persons or organizations for the purpose of presenting a single proposal.

Choose an item.

18. No Disclosure of Prices The Bidder assures that, unless otherwise required by law, the prices and/or cost data that have been submitted have not been knowingly disclosed by the Bidder and will not knowingly be disclosed, directly or indirectly, to any other Bidder or to any competitor prior to the deadline for submitting proposals.

Choose an item.

19. No Restricting Competition The Bidder assures that no attempt has been made or will be made by the Bidder to induce any other person or firm to submit or not to submit a proposal for the purpose of restricting competition.

Choose an item.

Company Declarations Bidder declares, as a required element of submitting a responsive bid, that the following facts affirmed below are truthful and understands continuing compliance with these requirements are conditions precedent to the award or continuation of work.

20. Termination for Default

(a) Have you had a contract terminated for default in the last five years? For purposes of this declaration, termination for default is defined as notice from your customer to stop performance due to your non-performance or poor performance, and the issue of performance was either not litigated due to inaction on the part of the customer, was settled by the parties, or it was litigated and determined that the Bidder was in default.

(a) Are you, or is any individual who will provide services to DRS as a result of the prospective contract, receiving retirement benefits from a Washington state public retirement system?

(a) Are you, or do you employ or have as a principal officer or member of your governing board, a current employee of the State of Washington?

· Current or former state employee’s name

· The individual’s position with your company

· Current or former state agency where the individual is/was employed

· Date the individual left state employment if applicable

· Name and contact information for an official at the employing state agency

DRS will evaluate the facts and circumstances. RCW 42.52.080 may prohibit the person from performing work related to the prospective contract. You may contact the DRS RFP Coordinator for more information.

Prior to awarding a contract, agencies are required to determine that a Bidder is a “responsible bidder.” See RCW 39.26.160 (2) and (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 Chapter 258, Laws of 2017 (enacting SSB 5301).

Note: Failure to respond will result in the proposal being deemed non-responsive.

(a) Have you willfully violated, as defined in RCW 49.48.082, any provision of RCW chapters 49.46, 49.48 or 49.52 within three years prior to the date of this Request for Proposals, as 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?

Choose an item.

(b) If you answered yes to the question above, provide additional information about the circumstances related to this wage violation.

DRS 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, the Washington State Governor’s Executive Order 18-03 (dated June 12, 2018).

(a) Do you confirm that you do NOT require your employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers (in other words, no mandatory individual arbitration clauses and class or collection action waivers for employees).

Choose an item.

(b) If you answered no to the question above, provide additional information about the arbitration clauses and class or collective action waivers employees are required to enter.

Are you a Washington Small Business as defined in RCW 39.26.010? To qualify as a Washington Small Business, the Bidder must meet three (3) requirements:

· Location. Bidder’s principal office/place of business must be located in and identified as being in the State of Washington. A principal office or principal place of business is a firm’s headquarters where business decisions are made and the location for the firm’s books and records as well as the firm’s senior management personnel.

· Size. Bidder must be owned and operated independently from all other businesses and have either: (a) fifty (50) or fewer employees; or (b) gross revenue of less than seven million dollars ($7,000,000) annually as reported on Bidder’s federal income tax return, or its return filed with the Washington State Department of Revenue over the previous three consecutive years.

· WEBS Certification. Bidder must have certified its Washington Small Business status in Washington’s Electronic Business Solution (WEBS).

Choose an item.

26. Veteran-Owned Business

Are you a Certified Veteran-Owned Business under RCW 43.60A.190? To qualify as a Certified Veteran-Owned Business, the Bidder must meet four (4) requirements:

· 51% Ownership. Bidder must be at least fifty-one percent (51%) owned and controlled by:

· A veteran as defined as every person who at the time he or she seeks certification has received a discharge with an honorable characterization or received a discharge for medical reasons with an honorable record, where applicable, and who has served in at least one of the capacities listed in RCW 41.04.007;

· A person who is in receipt of disability compensation or pension from the Department of Veterans Affairs; or

· An active or reserve member in any branch of the armed forces of the United States, including the national guard, coast guard, and armed forces reserves.

· Washington Incorporation/Location. Bidder must be either an entity that is incorporated in the state of Washington as a Washington domestic corporation or, if not incorporated, an entity whose principal place of business is located within the State of Washington.

· WEBS Certification. Bidder must have certified its Veteran-Owned business status in Washington’s Electronic Business Solution (WEBS).

· WDVA Certification. Bidder must have provided certification documentation to the Washington Department of Veterans’ Affairs (WDVA) and be certified by WDVA and listed as such on WDVA’s website (WDVA - Veteran-Owned Businesses).

Choose an item.

27. Statutory Nondiscrimination Clauses

Bidder certifies as follows:

COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. During the term of an awarded Contract, Bidder, including any subcontractor, shall not discriminate on the bases enumerated at RCW 49.60.530(3). Bidder, including any subcontractor, also shall give written notice of this nondiscrimination requirement to any labor organizations with which Bidder, or subcontractor, has a collective bargaining or other agreement. In addition, Bidder, including any subcontractor, shall cooperate with any Washington state agency investigation regarding any allegation that Bidder, including any subcontractor, engaged in prohibited discrimination set forth in RCW 49.60.530(3).

OR

NON-COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Bidder does not comply with RCW 49.60.530

Choose an item.

Click or tap here to enter text.

Certification I hereby certify, under penalty of perjury under the laws of the State of Washington, that the declarations, certifications and assurances herein are true and correct and that I am authorized to make these certifications on behalf of the Bidder listed herein.

Click or tap here to enter text. Click or tap here to enter text.

image1.png