RFP_Attachments_S-1119.docx

ATTACHMENT A: RESPONDER DECLARATIONS

The undersigned certifies, to the best of his or her knowledge and belief, that:

A. Response Contents. The information provided is true, correct, and reliable for purposes of evaluation for potential contract award. The submission of inaccurate or misleading information may be grounds for disqualification from the award as well as subject the Responder to suspension or debarment proceedings as well as other remedies available by law.

B. Authorized Signature. This Declaration is signed by the appropriate person(s), with the authority to contractually bind the Responder, as required by applicable articles, bylaws, resolutions, minutes, and ordinances.

C. Non-Collusion Certification.

1. The Proposal has been arrived at by the Responder independently and has been submitted without collusion and without any agreement, understanding or planned common course of action with any other vendor designed to limit fair or open competition; and

2. The contents of the Response have not been communicated by the Responder or its employees or agents to any person not an employee or agent of the Responder and will not be communicated to any other individual prior to the due date and time of this Solicitation. Any evidence of collusion among Responders in any form designed to defeat competitive responses will be reported to the Minnesota Attorney General for investigation and appropriate action.

D. Organizational Conflicts of Interest. To the best of Responder’s knowledge and belief, and except as otherwise disclosed, there are no relevant facts or circumstances which could give rise to an organizational conflict of interest. An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons,

1. a vendor is unable or potentially unable to render impartial assistance or advice to the State;

2. the vendor’s objectivity in performing the contract work is or might be otherwise impaired; or

3. the vendor has an unfair competitive advantage.

If after award, an organizational conflict of interest is discovered, an immediate and full disclosure in writing must be made to the State’s Chief Procurement Officer which must include a description of the action which the contractor has taken or proposes to take to avoid or mitigate such conflicts. If an organizational conflict of interest is determined to exist, the State may, at its discretion, cancel the contract. In the event the Contractor was aware of an organizational conflict of interest prior to the award of the contract and did not disclose the conflict to OSP, the State may terminate the contract for default. Organizational conflicts of interest terms apply to any subcontractors for this work.

E. Certification Regarding Lobbying. For State of Minnesota Contracts and Grants over $100,000, the undersigned certifies, to the best of his or her knowledge and belief that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions.

3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into and is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. 1352. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

F. Copyrighted Material Waiver. By signing its Response, the Responder certifies that it has obtained all necessary approvals for the reproduction and distribution of the contents of its response.

G. Diverse Spend Reporting. The Sample Contract contains a clause for Diverse Spend Reporting. When this clause applies, Contractor will be required to register in a free portal to report diverse spend.

Please see Diverse Spend Reporting Frequently Asked Questions for additional information.

By signing this form, Responder acknowledges and certifies compliance with all applicable requirements indicated above.

Company Name:

Signature:

Printed Name:

Title:

Date:

Phone Number:

Email Address:

ATTACHMENT B: EXCEPTIONS TO STATE’S TERMS AND CONDITIONS

The State presumes a responder agrees to the terms and conditions of this solicitation unless a responder takes specific exception to one or more of the conditions on this form.

The State reserves the right to reject, negotiate, or accept any exception listed to the State’s terms and conditions (including those found in the attached Sample Contract).

INSTRUCTIONS: A responder must explicitly list all exceptions to State’s terms and conditions, if any (including those found in the attached Sample Contract). Reference the clause number and page number of the State's term and condition for each of a responder’s exceptions. If no exceptions exist, state "NONE" specifically on the form below. Whether or not exceptions are taken, the Responder must sign and date this form and submit it as part of their response. (Add additional pages if necessary.)

By signing this form, I acknowledge that the above-named responder accepts, without qualification, all terms and conditions stated in this solicitation (including the sample contract) except those clearly outlined as exceptions above. This acknowledgement includes acceptance of the section of the Sample Contract, Exhibit A, titled “Contractor’s Documents.”

Signature:

Printed Name:

Title:

Date:

ATTACHMENT C: COST DETAIL

1. Cost Proposal. Responders should review Exhibit D of the Sample Contract for additional pricing terms related to the Cost Proposal.

Responders must download and use the Exhibit D, Supplement 1 Price Schedule attached to this Solicitation. The Price Schedule must be completed by the Responder and uploaded with your solicitation response. If pricing is not returned with your solicitation response, your response will be rejected. Failure to use Price Schedule may be cause for rejection. Responders must provide a price for all line items available on the Price Schedule to be considered for an award.

2. Installation Services. A responder must not charge a separate fee for an installation or mounting service. The price for equipment, attachments, or options includes all installation and mounting costs. The price offered must include everything needed so the unit is complete and ready for immediate use. If a responder adds a fee for installation service to the Price Schedule, the State reserves the right to delete that item from the Price Schedule or to reject the response in its entirety.

3. Catalogs and Price Literature.

Responders must submit copies of all applicable catalogs, on-line catalog addresses, or price lists used for pricing purposes with their response. Do not submit marketing material with your response unless otherwise requested.

All price lists proposed must meet accessibility requirements per the Minnesota IT Services, Office of Accessibility website: https://mn.gov/mnit/programs/accessibility/

4. Alterations or Erasures. The State reserves the right to reject a response containing an alteration or erasure of any price used to determine the lowest responsible responder unless the alteration or erasure is done in a manner that is clear and authenticated by an authorized representative of the Responder. An acceptable way to make an alteration or erasure is to cross out the price, print the correction in ink adjacent to it, and have an authorized representative of the Responder initial and date that correction.

ATTACHMENT D: RESPONDER FORMS

STATE OF MINNESOTA

VETERAN-OWNED PREFERENCE FORM

Unless a greater preference is applicable and allowed by law, in accordance with Minn. Stat. §16C.16, subd. 6a, the Commissioner of Administration will award up to a 12% preference on state procurement to certified small businesses that are majority owned and operated by veterans.

Veteran-Owned Preference Requirements - See Minn. Stat. § 16C.19(d):

1) The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.

or

2) The principal place of business is in Minnesota AND the US Small Business Administration verifies the business as being a veteran-owned or service-disabled veteran-owned small business under Public Law 109-461 and Code of Federal Regulations, title 13, part 128.

Statutory requirements and appropriate documentation must be met by the solicitation response due date and time to be awarded the veteran-owned preference. For Bids, the preference applies only to the first $2,000,000.

Claim the Preference By signing below I confirm that:

My company is claiming the veteran-owned preference afforded by Minn. Stat. § 16C.16, subd. 6a. By making this claim, I verify that:

· The business has been certified by the Office of Equity in Procurement (OEP) as being a veteran-owned or service-disabled veteran-owned small business.

or

· My company’s principal place of business is in Minnesota and the US Small Business Administration verifies my company as being a veteran-owned or service-disabled veteran-owned small business.

Sign and return this form with your solicitation response to claim the veteran-owned preference.

Workforce and Equal Pay Declaration Page This form is required for all businesses executing government contracts under the following:

1. Select one:

Select all that apply:

2. We are a Certificate holder:

3. We are applying/have applied for the following certificate(s):

4. We have not applied for one or both certificates:

☐ Our Company does not yet have a Workforce Certificate or Equal Pay Certificate. We acknowledge that a Workforce and, if applicable, Equal Pay Certificate, or approved exemption by MDHR is required before a contract can be executed.

5. We are Exempt:

☐ We attest to MDHR that we have not employed 40 or more employees on a single day during the prior 12 months in Minnesota or the state in where we have our primary place of business. MDHR may request the names of our employees during the previous 12 months, the date of separation, if applicable, and the current employment status and count.

6. Business Information

For assistance with this form, email the Minnesota Department of Human Rights Compliance.MDHR@state.mn.us

ATTACHMENT E: ADDITIONAL INFORMATION

1. Contractor’s Contact Information. Provide the contact information for the representative responsible for the management of the contract and the representative receiving purchase orders.

Vendor’s Legal Name

Address

Contact Person (Contract)

Email Address

Telephone Number

Contact Person (PO Order)

Email Address

Telephone Number

2. Prompt Pay Discount. What prompt pay discounts do you offer? Select all that apply, if “other,” specify terms in the comment section below:

Rev. July 2023 Rev. July 2023

· 1% in 30

· 2% in 30

· 3% in 30

· 1% in 10, Net 30

· 2% in 10, Net 30

· 3% in 10, Net 30

· 5% in 10, Net 30

· Other 1% in 15, Net 30

· 2% in 15, Net 30

· 3% in 15, Net 30

· 1% in 20, Net 30

· 2% in 20, Net 30

· 3% in 20, Net 30

· Net 30

Comments:

3. Delivery Time Frame. Responder must enter a delivery time frame after receipt of order (ARO) in the space below.

ATTACHMENT F: CHANNEL CARD

ENTERTAINMENT BASE

REGIONAL SPORTS

ABC HD

PBS HD

Where Available

CBS HD

CW HD

FOX HD

MNT HD

NBC HD

ATTACHMENT G: NARRATIVE RESPONSE

Overview. Attachment G, Narrative Response, details MVH – Luverne’s goals for a Television Services contract. Contractor’s responses to Attachment G may be incorporated into the final Contract as Exhibit C, “Specifications, Duties, and Scope of Work.”

Attachment G Instructions. Using this form, responders must answer all questions in this Attachment G and return it with the response to the solicitation. By completing and including this Attachment with its response, the responder certifies that the information contained in the response is accurate to the best of the responder’s knowledge. Responders must complete these portions of Attachment G:

· G1, Mandatory Requirements

· G2, Desired (Preferred) Capabilities

· G3, Responder Statement G1, MANDATORY REQUIREMENTS. Responder must indicate whether it meets all MVH – Luverne’s television services requirements. Each numbered item below has checkboxes or lines to be filled with a number. Responder must fill the appropriate box for each numbered item. Leaving an item with neither box checked or no number given may be scored as a “No.” Responders must use G3, Responder Statement (below), to further explain their responses to those items.

Responders may add lines, spaces, and pages as necessary.

G1, MANDATORY REQUIREMENTS

1. The Contract Vendor must be able to provide television services to the Minnesota Veterans Home – Luverne beginning January 17, 2025, continuing throughout the initial contract period.

G1.1, Comply? □YES □NO

2. Responder must provide services to 64 residential connections (in single- and double-occupancy rooms) and in up to 25 public area connections (lounges, front desk, meeting rooms, etc.).

G1.2, Comply? □YES □NO

3. Transcoders are required to make all current televisions work with the desired services.

G1.3, Comply? □YES □NO

4. All transmission systems, including transcoders, shall pass through Closed Captioning (CC) and Secondary Audio Programming (SAP) signals.

G1.4, Comply? □YES □NO

5. MVH staff will select a maximum of sixty (60) channels from the attached list (see Attachment F, Channel Card). G1.5, Comply? □YES □NO

6. All local news stations must be included. G1.6, Comply? □YES □NO

7. Coverage of all Minnesota-based professional sports teams is desired, as well as ‘Big Ten Network’ (see Attachment F, Channel Card). Coverage of NFL Vikings, MLB Twins, and ‘Big Ten Network’ channel are required.

G1.7, Comply? □YES □NO

8. MVH staff require an in-house private channel. This channel will be facilitated by Luverne MVH staff, to be used for delivering special programming to residents and visitors.

G1.8, Comply? □YES □NO

9. All channels must be available 24/7 to all residential and public TV sets in the facility, with minimal extended service outages. G1.9, Comply? □YES □NO

10. As needs change, MVH Luverne staff require the ability to update channel selections for their facility at no additional cost. The maximum number of sixty channels will not be exceeded.

G1.10, Comply? □YES □NO

11. Contractor must provide on-site tech support to resolve problems, at no additional charge.

G1.11, Comply? □YES □NO

12. State requires vendor to perform any construction necessary to build out access to all locations.

G1.12, Comply? □YES □NO

13. State owns all equipment at termination of contract. G1.13, Comply? □YES □NO

14. State requires advance notice of planned service downtimes. G1.14, Comply? □YES □NO

15. After contract award and execution, how many business days does your company require to install all equipment and begin delivering services to all of MVH Luverne? Responder should explicitly state this number of days here and below, in G3, Responder Statement. G1.15, NUMBER OF BUSINESS DAYS: ____ G2, DESIRED (PREFERRED) CAPABILITIES. Responder must indicate which of MVH – Luverne’s desired (but not required) television capabilities it can meet. Each numbered item below has checkboxes or lines to be filled with a number. Responder must fill the appropriate box for each numbered item. Leaving an item with neither box checked or no number given may be scored as a “No.” Responders must use G3, Responder Statement (below), to further explain their responses to those items.

G2, DESIRED (PREFERRED) CAPABILITIES.

1. MVH – Luverne staff prefer that all requested updates to channel selections be executed and delivered to end-users within 2 business days after the request is made to Contractor. The maximum number of sixty channels would not be exceeded. G2.1, Comply? □YES □NO

2. If Responder marks ‘No’ to G2, #1, how many business days after request does Responder require to guarantee execution and delivery of updated channel choices? The maximum number of sixty channels will not be exceeded. Responder should explicitly state this number of days here and below, in G3, Responder Statement. G2.2, NUMBER OF BUSINESS DAYS: ____

3. MVH – Luverne staff desire that all on-site tech support for service delivery problems must be provided within 24 hours after initial report to Contractor. G2.3, Comply? □YES □NO

4. If Responder marks ‘No’ to G2, #3, how many hours after request does Responder require to guarantee on-site tech support for service delivery problems? Responder should explicitly state this number of hours here and below, in G3, Responder Statement. G2.4, NUMBER OF HOURS: ____

5. State desires a minimum of 72 hours advance notice be provided for planned service downtimes.

G2.5, Comply? □YES □NO

6. As noted in G1, #4, MVH staff want to select a maximum of sixty (60) channels from the attached list (see Attachment F, Channel Card). State prefers the greatest possible number of channels from which to choose. Can Responder provide channels not listed on Attachment F, Channel Card? G2.6, Comply? □YES □NO

7. If Responder marks ‘Yes’ to G2, #6, Responder should list these additional channels in a similar format below, in G3, Responder Statement. G2.7, Comply? □YES □NO

8. As noted in G1, #11, State requires vendor to perform any construction necessary to build out access to all locations. State prefers that there be no additional charges for any necessary construction.

G2.8, Comply? □YES □NO

9. All services and equipment supplied will support Closed Captioning (CC) and Secondary Audio Programming (SAP). All equipment and/or on-screen menus shall make it simple and intuitive to activate/deactivate CC and SAP. G2.9, Comply? □YES □NO

10. As noted in G1, #7, coverage of all Minnesota-based professional sports teams is desired (see G1.7, above, for mandatory coverage). Coverage of the following teams is highly preferred: NBA Timberwolves, NHL Wild, MLS UFC Loons, WNBA Lynx and PWHL Frost. For which of these desired teams does Responder offer coverage?

G2.10, □ALL □SOME (List here, and in G3, below): ____________________________________________ G3, RESPONDER STATEMENT. Responder must use this form to provide details, clarifications, and full explanations of all responses to sections G1 and G2 above. This document should NOT list cost detail. If cost detail is included in this document, the State may disqualify the proposal as non-responsive. (Responder must provide a statement of the objectives, goals, and tasks to show or demonstrate the Responder’s view and understanding of the nature of the contract.

Responders may add lines, spaces, and pages as necessary.

G3, RESPONDER STATEMENT.

Rev. 12/19 Page 1 of 15

Rev. 9.01.2021