RFQ 09A 160811-086 Schnee Boot COC.doc

STATE OF MAINE

DEPARTMENT OF ADMINISTRATIVE AND FINANCIAL SERVICES

BUREAU OF GENERAL SERVICES

DIVISION OF PURCHASES

RFQ # 09A 160811-086

Schnee Boots, Hunter II, Extreme, No Substitutions Quotations/Responses Due: Monday August 22, 2016, not later than 2:00 p.m. local time

Note: All questions must be asked via the State of Maine’s e-Procurement system: AdvantageME / Vendor Self Service (VSS) no later than forty-eight (48) hours prior to closure date and time. Responses can be located in the same place.

Questions asked any other way will not be answered. Not all questions will be answered.

General Instructions on Bidder Questions

It is the responsibility of each Bidder to examine the entire RFQ and to seek clarification by submitting questions through the Q & A List tab on the Solicitation page. Any answers to questions will appear there as well. It is the vendor's responsibility to log in to view all questions and answers posted. Additional information obtained any other way will not be valid.

Summary

For this competitive Request for Quotations (RFQ) process, the State of Maine Division of Purchases (“Division”) is acting on behalf of Inland Fisheries & Wildlife (“Requesting Department”). The Division and the Requesting Department seek quotations (also referred to as “bids” or “responses” herein) to provide the goods/services listed above. This document provides instructions and descriptions of requirements for this competitive process.

RFQ REQUIREMENTS

1. Description of Requirements The following is a description of the goods and/or services sought by the State of Maine under this RFQ.

· All bids MUST include Appendices A, D and E.

· If articles of clothing are manufactured in multiple facilities a separate Code of Conduct Affidavit (Appendix E) must be filled out for each manufacturing facility.

· All bids MUST include RFQ 09A 160811-086 Bid Prices Excel Spreadsheet. Attachment MUST be in Excel format.

· Bids missing these documents MAY be rejected.

2. Bid Contents Requirements

In addition to the cost, delivery, and other information required in VSS, all bids should contain the following information as attachments, in the Appendices listed below:

· Appendix A: Bid Cover Page and Debarment Form

· Appendix D: Municipality Participation

· Appendix E: State Purchasing Code of Conduct Affidavit

· RFQ 09A 160811-086 Bid Prices

3. Master Agreement Term In addition to any mutually agreed upon delivery dates for purchases of goods, the contract resulting from this RFQ will have a term, or “Period of Performance”, during which the contract is considered to be in effect. The anticipated contract term is defined in the table below. Please note that the dates below are estimated and may be adjusted as necessary in order to comply with all procedural requirements associated with this RFQ and the contracting process. The actual contract start date will be established by the completed and approved contract.

Contract Renewal: Following the initial term of the contract, the Division may opt to renew the contract for two renewal periods of one year each, subject to continued availability of funding and satisfactory delivery/performance.

The term of the anticipated contract, resulting from this RFQ, is defined as follows:

4. Submitting a Quotation

a. Quotations Due: Quotations must be received no later than 2:00 p.m. Eastern Standard Time (EST), on the date listed in VSS. Quotations received after the 2:00 p.m. deadline will not be accepted.

b. Submission Instructions: Bidders must submit their bids in the State of Maine’s electronic procurement system: Advantage “Vendor Self Service” (VSS). More information on this system can be found at the following internet link: http://www.maine.gov/purchases/venbid/rfq.shtml.

c. Multiple Quotations: Unless specifically prohibited in Section 1 of this RFQ, Bidders are permitted to submit multiple quotations for this RFQ, offering alternative items or pricing for the State of Maine to consider in its best value determination.

d. Withdrawal of a Quotation: Bidders are permitted to withdraw their own quotations up until the due date and time for receipt of quotations. To do so, a Bidder must enter the VSS system (as referenced above), identify and open their submitted quotation located in the Solicitation Responses tab, and click the “Withdraw” button found at the bottom of the screen. Quotations cannot be withdrawn after the due date and time for receipt of quotations.

e. Attachments: Any attachments provided with the Advantage VSS bid submission must be in MS Word, MS Excel, or Adobe (.pdf) format, unless otherwise specified in Section 1 of this RFQ. Vendors are encouraged to submit supporting documentation that aid the requesting department in understanding how the bid conforms to the requirements. The VSS attachment file size limit is 2Mb. Please contact the buyer for this RFQ if you must submit attachment files larger than this.

f. Vendor specifications: Unless otherwise stated in this RFQ document, limited specification information will be required upon submission of a bid in response to this RFQ. However, a Bidder’s response should include an affirmative statement that their bid complies with all requirements of this RFQ, unless the Bidder specifically addresses how its bid differs from the specifications, and why the differences should be deemed acceptable by the State.

5. General Instructions

a. The Bidder must submit a cost quotation response that covers the goods and term of the contract, including any optional renewal.

b. The cost quotation shall include the costs necessary for the Bidder to fully comply with the contract terms and conditions and RFQ requirements.

c. Failure to provide the requested information may result in the exclusion of the quotation from consideration, at the discretion of the Division.

d. No costs related to the preparation of the quotation for this RFQ or to the negotiation of the contract with the Department may be included in the quotation.

e. The State is exempt from the payment of Federal, State and local Taxes on articles not for resale. Please provide quotations that do not include these taxes. Upon application, an exemption certificate can be furnished by the State at the point of contract finalization.

6. QUOTATION EVALUATION AND SELECTION

Evaluation of the submitted quotations shall be accomplished as detailed below:

a. State of Maine RFQ documents are evaluated on a Best Value basis. The term “Best Value” takes into consideration the qualities of the goods or services to be supplied, their conformity with the specifications listed in the RFQ, the purposes for which they are required, the date of delivery, and the best interest of the State. Once the goods or services have been determined to conform to the specifications listed, and other Best Value considerations have been made, then the Division will make its award decision based on the lowest price among the Bidders.

b. At the discretion of the Division, if a Bidder’s submission is deemed to not conform to the specifications listed in the RFQ, or otherwise not conform to the requirements of the RFQ, then that Bidder’s submission may not be considered for contract award.

c. In the event that no Bidder submission conforms to the specifications of this RFQ, then the Division may choose not to make any award. Alternatively, the Division may make an award to the Best Value Bidder whose specifications most closely meet the specifications of this RFQ. For example, if there are five specification requirements, and two responses are received with one Bidder meeting four requirements, and one bidder meeting three requirements, then the Division, at its discretion, may make a contract award to the Bidder meeting four requirements.

d. If the specifications provided with this RFQ are of a technical nature, then the Division’s RFQ Coordinator, at his or her discretion, may seek to use an evaluation team comprised of subject matter experts, end-users from the Requesting Department, or other State Department representatives. In such a case, the evaluation team will judge the merits of the quotations received in accordance with the criteria defined in the RFQ.

7. Negotiations

a. No Best and Final Offers: The State of Maine will not seek a best and final offer (BAFO) from any Bidder in this procurement process. All Bidders are expected to provide their Best Value pricing with the submission of their quotation.

b. The Division reserves the right to negotiate with the successful Bidder to finalize a contract at the same rate or cost of goods and services as presented in the selected quotation. Such negotiations may not significantly vary the content, nature or requirements of the quotation or the RFQ to an extent that may affect the price of goods or services requested. The Division reserves the right to terminate contract negotiations with a selected Bidder who submits a proposed contract significantly different from the quotation submitted in response to the RFQ.

c. In the event that an acceptable contract cannot be negotiated with the highest ranked Bidder, the Division may withdraw its award and negotiate with the next-highest ranked Bidder, and so on, until an acceptable contract has been finalized. Alternatively, the Division may cancel the RFQ, at its sole discretion.

TERMS AND CONDITIONS FOR RFQ AND CONTRACT

PART I

GENERAL INFORMATION ON RFQs A. Purpose and Background The State of Maine (“State”) Department of Administrative and Financial Services (“Department”), Bureau of General Services (“Bureau”), Division of Purchases (“Division”) acts as the purchasing agent on behalf of all Executive Departments and other agencies within State Government. For this competitive Request for Quotations (RFQ) process, the Division is acting on behalf of the Requesting Department listed on the cover page. The Division and the Requesting Department seek quotations (also referred to as “bids” or “responses” herein) to provide the goods/services as defined above in Section 1 of this document. This document provides instructions for submitting quotations, the procedure and criteria by which the Bidder(s) will be selected, and the contractual terms which will govern the relationship between the State and the awarded Bidder(s). Following Bidder selection and upon reaching a mutual agreement, the State and the selected Bidder will enter into a contract – taking the form of a State of Maine Master Agreement or Buyer Purchase Order (all generally referred to as “contract” herein), as applicable.

B. General Provisions

1.

Issuance of this RFQ does not commit the Division or the Requesting Department to issue an award or to pay expenses incurred by a Bidder in the preparation of a response to this RFQ. This includes attendance at personal interviews or other meetings and software or system demonstrations, where applicable.

2.

All responses to this RFQ should adhere to the instructions and format requirements outlined in this RFQ and all written supplements and amendments (such as the Division’s answers to the Bidders’ questions submitted through the VSS), as issued by the Division. Responses are to follow the format and respond to all questions and instructions specified above in the “Submitting a Quotation” section of this RFQ.

3.

Bidders shall take careful note that in evaluating a quotation submitted in response to this RFQ, the Department may consider materials provided in the quotation, information obtained through interviews/presentations (if any), and internal information of previous contract history between the Division and the Bidder (if any). The Division also reserves the right to consider other reliable references and publicly available information available in evaluating a Bidder’s experience and capabilities, if needed. All responses to this RFQ shall be considered to be authorized to legally bind the Bidder, and if selected for award, shall contain or be considered to contain a statement that the quotation and the pricing contained therein will remain valid and binding for a period of at least 180 days from the date and time of the bid opening.

4.

The RFQ and the selected Bidder’s quotation, including all appendices or attachments, may be incorporated in the final contract.

5.

Following announcement of an award decision, all submissions in response to this RFQ will be considered public records available for public inspection pursuant to the State of Maine Freedom of Access Act (FOAA) (1 M.R.S. §§ 401 et seq.).

6.

The Division, at its sole discretion, reserves the right to recognize and waive minor informalities and irregularities found in quotations received in response to this RFQ.

7.

The Division reserves the right to authorize other State Departments to use the contract(s) resulting from this RFQ, if it is deemed to be beneficial for the State to do so.

8.

All applicable laws, whether or not herein contained, shall be included by this reference. It shall be Bidder’s responsibility to determine the applicability and requirements of any such laws and to abide by them.

C. Eligibility to Submit Bids Public agencies, private for-profit companies, and non-profit companies and institutions are invited to submit bids in response to State of Maine Requests for Quotations.

D. Delivery Terms For the purchase of goods, the Division and selected Bidder will decide upon a delivery date in accordance with the State’s requirements and the terms offered in the Bidder’s quotation. Unless stated otherwise in Section 1 of this RFQ, all deliveries are expected with shipping terms of “Free on Board (FOB) – Destination”. The State intends for this to mean that all goods shall be priced in the bid response to include shipping charges, if any, to the State’s desired location. The “FOB – Destination” shipping term is also intended to mean that the State shall not bear any responsibility for the goods in question until the State takes possession of them at the destination point of delivery.

E. Alternate Bids and Approved Equals When, in bid forms and specifications, an article or material is identified by using a trade name and catalog number of a manufacturer or vendor, the term “or approved equal,” if not inserted with the identification, is implied. Any Bidder that seeks to propose an alternate item from what is specified in this RFQ should refer to State of Maine Statute 5 MRSA §1825-B, for “Bids, awards and contracts”, found here: http://www.mainelegislature.org/legis/statutes/5/title5sec1825-B.html F. Appeal of Contract Awards Any person aggrieved by the award decision that results from this RFQ may appeal the decision to the Director of the Bureau of General Services in the manner prescribed in 5 MRSA § 1825-E and 18-554 Code of Maine Rules, Chapter 120 (found here: http://www.maine.gov/purchases/policies/120.shtml). The appeal must be in writing and filed with the Director of the Bureau of General Services, 9 State House Station, Augusta, Maine, 04333-0009 within 15 calendar days of receipt of notification of contract award.

If this RFQ results in the creation of a pre-qualified or pre-approved list of vendors, then the appeal procedures mentioned above are available upon the original determination of that vendor list, but not during subsequent competitive procedures involving only the pre-qualified or pre-approved list participants.

PART II

CONTRACT ADMINISTRATION AND CONDITIONS

A. Contract Document

The successful Bidder will be required to execute a contract in the form of a State of Maine Buyer Purchase Order, Contract Agreement to Purchase Services or State of Maine Master Agreement.

The Standard Terms and Conditions used with the aforementioned contract types may be found on the Division of Purchases website at the following link:

http://www.maine.gov/purchases/info/forms/BPO_General_Terms.doc

In the event that the State of Maine’s Standard Terms and Conditions or RFQ provisions do not otherwise cover contractual scenarios that are specific to the goods or services being purchased under this RFQ, then the State is willing to consider a Bidder’s standard terms and conditions. Consideration or use of a Bidder’s standard terms and conditions shall only occur under the general agreement that in the event of a conflict, the State of Maine’s Standard Terms and Conditions and RFQ provisions shall take precedence.

Other forms and contract documents commonly used by the State can be found on the Division of Purchases website at the following link: http://www.maine.gov/purchases/info/forms.shtml B. Independent Capacity

In providing services and performing under the contract, the successful Bidder shall act independently and not as an agent of the State of Maine.

C. Payments and Other Provisions

The State anticipates paying the selected Bidder for goods and services received, on the basis of net 30 payment terms, upon the receipt of an accurate and acceptable invoice. An invoice will be considered accurate and acceptable if it contains a reference to the State of Maine contract number, contains correct pricing information relative to the contract, and provides any required supporting documents, as applicable, and any other specific and agreed-upon requirements listed within the contract that results from this RFQ.

The State of Maine reserves the right to pay for goods purchased through this solicitation by any of several available means, which include but may not be limited to check, EFT, and/or procurement card. Bidders are advised that state statute precludes sellers from imposing a surcharge on credit or debit card purchases (text follows):

“9-A MRSA §8-303 (2): A seller in a sales transaction may not impose a surcharge on a cardholder who elects to use a credit card or debit card in lieu of payment by cash, check or similar means.”

PART III

APPENDICES

Appendix A State of Maine

DEPARTMENT OF ADMINISTRATIVE AND FINANCIAL SERVICES

DIVISION OF PURCHASES

BID COVER PAGE

Bidder’s Organization Name:

Chief Executive - Name/Title:

Headquarters Street Address:

Headquarters City/State/Zip:

(provide information requested below if different from above)

Lead Point of Contact for Bid - Name/Title:

Street Address:

City/State/Zip:

· This bid and the pricing structure contained herein will remain firm for a period of 180 days from the date and time of the bid opening.

· No personnel currently employed by the Department or any other State agency participated, either directly or indirectly, in any activities relating to the preparation of the Bidder’s proposal.

· 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.

· The undersigned is authorized to enter into contractual obligations on behalf of the above-named organization.

Debarment, Performance, and Non-Collusion Certification

By signing this document I certify to the best of my knowledge and belief that the aforementioned organization, its principals, and any subcontractors named in this proposal:

a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from bidding or working on contracts issued by any governmental agency.

b. Have not within three years of submitting the proposal for this contract been convicted of or had a civil judgment rendered against them for:

i. fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state or local government transaction or contract.

ii. violating Federal or State antitrust statutes or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

iii. are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and

iv. have not within a three (3) year period preceding this proposal had one or more federal, state or local government transactions terminated for cause or default.

c. Have not entered into a prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and this proposal is in all respects fair and without collusion or fraud. The above mentioned entities understand and agree that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards.

· Failure to provide this certification may result in the disqualification of the Bidder’s proposal, at the discretion of the Department.

To the best of my knowledge all information provided in the enclosed proposal, both programmatic and financial, is complete and accurate at the time of submission.

Name:

Title:

Authorized Signature:

Date:

Appendix B State of Maine

Department of Administrative and Financial Services

Division of Purchases

DETAILED SPECIFICATIONS

RFQ # 09A 160811-086

Schnee Boots, Hunter II, Extreme, No Substitutions

13” EXTREME

· Made in Montana

· 100 % Rubber Bottoms, Waterproof

· Firm thermal plastic heel counters and steel shanks with soft air-bobs in center and firm lugs around outside edge.

· 9 mm of wool felt in mid-sole from heel to toe.

· 600 grams of Thinsulate ultra insulation within the entire boot bottom.

· 6 ½ oz. full grain oil tanned leather uppers with bellows tongues.

· Solid brass logger eyelets and speed lacing hooks

· Heavy duty Taslon laces

· Removable liners are quilted layers of Cambrelle Nylon, with 400 gram Thinsulate insulation and 3 mm of wool felt on the outside of the liner.

· Triple stitching with bonded nylon. Guaranteed not to fail for the life of the boot.

· Comfort rating : -40 degrees F active, -20 degrees F inactive.

· Sizing: Whole sizes only, Men’s 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15

13” HUNTER II

· Made in Montana

· 100 % Rubber Bottoms, Waterproof

· Firm thermal plastic heel counters and steel shanks with soft air-bobs in center and firm lugs around outside edge.

· 6 ½ oz. full grain oil tanned leather uppers with bellows tongues.

· Solid brass logger eyelets and speed lacing hooks

· Heavy duty Taslon laces

· Removable liners are quilted layers of Cambrelle Nylon, with 400 gram Thinsulate insulation and 3 mm of wool felt on the outside of the liner.

· Triple stitching with bonded nylon. Guaranteed not to fail for the life of the boot.

· Comfort rating : -20 degrees F active, 0 degrees F inactive.

· Sizing: Whole sizes only, Men’s 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15

The results of this bid process will be a Master Agreement (MA). It is expected that the primary using Department will be IF&W however the winning bidder is expected to fill any and all orders submitted by any State of Maine Department or Agency.

The winning bidder will be expected to provide a single contact person for users of this MA. The contact person will be able to take verbal orders, assist with order inquires and any other requests as they pertain to the MA. We will require a name, telephone number and an email address.

MINIMUM ORDERS: Preference may be given to bidders with no minimum order requirements for this MA.

QUANTITIES: It is understood and agreed that the winning bidder will cover the actual quantities ordered by ALL State of Maine departments over the length of the contract.

Contractor MUST inspect all garments thoroughly before shipment to State Agencies. Inspection will not release contractor of the responsibility for faulty workmanship and any faulty item or component part will be repaired or replaced by the vendor. Items (all sizes including special sizes) must be received within 10 working days from receiving order from Department. The Contractor will be responsible for the delivery of material in first class condition at the point of delivery, and in accordance with good commercial practice.

Code of Conduct Anti-Sweatshop FEE: Within 30 days of the end of each calendar quarter, the winning bidder is required to pay a fee in the amount of 1% of the total dollar value of goods purchased through this contract during that quarter. Your payment must be accompanied by a report showing the dollar value of goods purchased, broken down by Department, the total dollar value of purchases by all Departments, and the calculation of 1% of the total dollar value as the fee for the quarter. Checks must be made payable to the Treasurer, State of Maine and must be delivered, along with the quarterly report, to:

Division of Purchases

Attn: Vendor Fee

Burton M. Cross Building, 4th Floor

9 State House Station

111 Sewall St.

Augusta, ME 04333-0009

Failure to pay the 1% fee may result in: (1) Loss of future contracts or purchase orders with the State of Maine and/or (2) Immediate termination of the existing contract, within 30 days of written notification.

Sales Report: The Division of Purchases requires a quarterly report of sales be faxed to 207-287-6578 within 30 days of the end of each calendar quarter. It will be the responsibility of the vendor to produce a quarterly report. The report must include the dollar value of goods purchased, broken down by Department as well as the total dollar value of purchases made by all Departments.

Procurement Card: State policy requires vendors to accept the State of Maine Procurement Card as a form of payment, with very rare exceptions. Your company will be required to accept these cards. The pricing offered to the State of Maine shall be the final cost to the State of Maine regardless of payment method. No surcharge or other compensation will be allowed. The State of Maine reserves the right to reject your bid if you are unwilling to accept this condition.

Code of Conduct (COC) (Appendix E) Instructions

Part numbers covered by this document: List all part numbers and sizes covered by this COC document.

Name of Company: List YOUR company information in this section.

COMPLETE PHYSICAL LOCATION OF PLANT(S) WHERE CLOTHING/ TEXTILE IS ASSEMBLED:

You need to fill in the physical address and other information for the manufacturing plant where the article of clothing listed was assembled or manufactured. Appendix C State of Maine

Department of Administrative and Financial Services

Division of Purchases Cost Response

RFQ # 09A 160811-086

Schnee Boots, Hunter II, Extreme, No Substitutions All responses to this RFQ will require a cost quotation response, in a format selected by the State of Maine. That format is described below.

RFQ 09A 160811-086 Bid Prices Excel Spreadsheet must be attached to your bid. This price spreadsheet MUST be in Excel Format. Other Formats may be rejected.

Appendix D State of Maine

Department of Administrative and Financial Services

Division of Purchases Municipality Political Subdivision and School District Participation Certification

RFQ # 09A 160811-086

Schnee Boots, Hunter II, Extreme, No Substitutions Bidder’s Organization Name: _____________________________________________________________

Authorized By: ________________________________________________________________________

Date: _________________________________________

The Division of Purchases is committed to providing purchasing opportunities for municipalities, political subdivisions and school districts in Maine by allowing them access, through our vendors, to our contract pricing. A bidder's willingness to extend contract pricing to these entities will be taken into consideration in making awards.

Will you accept orders from political subdivisions and school districts in Maine at the prices quoted?

_____ Yes _____ Yes with conditions as follows: _____________________________________________________________

______ No Appendix E

State of Maine

State Purchasing Code of Conduct

Affidavit

Maine is a state that believes employers should fairly compensate hard work, that the health and safety of working people should be protected and that no form of unlawful discrimination or abuse should be tolerated. Maine citizens are aware that laws and regulations designed to safeguard basic tenets of ethical business practice are disregarded in many workplaces, commonly referred to as "sweatshops." State Government purchase of goods made under abusive conditions on behalf of its citizens offends Maine citizens' sense of justice and decency. Moreover, when the State of Maine contracts with vendors whose suppliers profit by providing substandard wages and working conditions, Maine's businesses are put at a competitive disadvantage. Therefore, the State of Maine believes in doing business with vendors who make a good faith effort to ensure that they and their suppliers at the point of assembly adhere to the principles of the State of Maine's purchasing code of conduct.

In its role as a market participant that procures goods covered by this code, the State of Maine seeks to protect the interests of Maine citizens and businesses by exercising its state sovereignty to spend Maine citizens' tax dollars in a manner consistent with their expressed wishes that the State deal with responsible bidders who seek contracts to supply goods to the State of Maine, and protect legally compliant Maine businesses and workers from unfair competition created by downward pressure on prices and conditions attributable to businesses that violate applicable workplace laws.

Seeking to protect these local interests through the least discriminatory means available, the State of Maine requires that all bidders seeking contracts to supply the State of Maine with goods covered by this code sign this affidavit stating that they and, to the best of their knowledge, their suppliers at the point of assembly comply with workplace laws of the vendor's or supplier's site of assembly and with treaty obligations that are shared by the United States and the country in which the goods are assembled.

To the best of my knowledge, I swear:

1. that I have furnished a copy of the state purchasing code of conduct to each supplier at the point of assembly of the goods subject to the bid process and have required that each supplier affirm whether it is in compliance with the Code;

2. that the entity listed below and its suppliers at the point of assembly will comply with all applicable wage, health, labor, environmental and safety laws, legal guarantees of freedom of association, building and fire codes, and laws relating to discrimination in hiring, promotion, or compensation on the basis of race, disability, national origin, gender, sexual orientation, or affiliation with any political, nongovernmental, or civic group except when federal law precludes the State from attaching the procurement conditions provided in 5 M.R.S.A., C. 155, sub-c 1-B; and

3. that the entity listed below and its suppliers at the point of assembly will comply with all human and labor rights treaty obligations that are shared by the United States and the country in which the goods are assembled. These may include obligations with regard to forced labor, indentured labor, slave labor, child labor, involuntary prison labor, physical and sexual abuse, and freedom of association.

QUOTATION # RFQ 09A 160811-086

Part numbers covered by this document: ______________________________________________________________

The person signing this affidavit certifies that he/she has fully informed himself/herself regarding the accuracy of the statements contained herein, and under penalty of perjury, affirms the truth thereof, such penalties being applicable to the bidder/contractor as well as to the person signing in its behalf:

Name of Company:

Street Address:

City, State, Zip code:

Telephone:

Fax:

Authorized Signature:

Printed Name and Title:

COMPLETE PHYSICAL LOCATION OF PLANT(S) WHERE CLOTHING/ TEXTILE IS ASSEMBLED:

Name of Mfr.

Plant Name

Street Address

City/State

Country

Telephone #

Personally appeared the above named and made oath that the above statement by him/her is true.

Before me

Date

MUST BE FILLED OUT AND EITHER ATTACHED TO YOUR RESPONSE OR

FAXED TO #207-287-6578 ATTN: BILL ALLEN NO LATER THAN BID OPENING DATE & TIME.

State of Maine RFQ # 09A 160811-086

Rev. 10/2015