S-44300-00015445 Attachment B Bid Cover Sheet.pdf
PDF 113 KB Posted
- Solicitation number
- S-44300-00015445
- Issued by
- Marion County, Oregon
About this file
This is a Bid Cover Sheet for an Invitation to Bid (ITB) issued by the State of Oregon, acting through the Oregon Health Authority at Oregon State Hospital, for the establishment of a Price Agreement to purchase patient mattresses on an as-needed basis. The document serves as the official submission form that bidders must complete and sign to participate in the competitive bidding process. Bidders are required to provide their company name, address, contact information, state of incorporation, entity type, and Oregon Secretary of State Business Registry Number if applicable. The cover sheet indicates that bid costs must remain firm for 90 calendar days following the bid opening date.
The Bid Cover Sheet contains twelve mandatory certifications that all bidders must acknowledge, including compliance with Oregon tax laws, non-discrimination in employment and subcontracting practices, and verification that neither the bidder nor its employees, agents, or subcontractors appear on the Office of Foreign Assets Control's Specially Designated Nationals list or the System for Award Management government-wide exclusions list. Bidders must also certify the absence of undisclosed liquidated and delinquent debt owed to the State, absence of conflicts of interest, truthfulness and accuracy of all bid contents, and, if applicable, that the bidder is an Oregon benefit company with the majority of its regular full-time workforce located in Oregon. For anticipated contract prices of $150,000 or more, bidders must certify implementation of a written policy and practice preventing sexual harassment, sexual assault, and discrimination against protected class employees, with reference provided to a sample policy template on the Oregon Department of Administrative Services website.
View the file
Other files
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Attachment B S-44300-00015445
ATTACHMENT B
BID COVER SHEET
Bidder Name (printed):
Address: City, State, Zip:
Bid Clarification Contact Person: Telephone:
Email:
State of Incorporation: Entity Type:
Oregon Secretary of State Business Registry Number (if required):
The undersigned, as Bidder’s authorized representative, certifies that:
1. Bidder understands and accepts the requirements of this ITB. Bidder acknowledges receipt of any and all Amendments to this ITB.
2. By submitting a Bid, Bidder agrees to be bound by the Price Agreement terms and conditions in Attachment A, as modified by Amendment, if any.
3. The costs set forth in Attachment D are firm for 90 Calendar Days after the Opening.
4. Bidder has no undisclosed liquidated and delinquent debt owed to the State or any agency, board, commission, department of division of the State.
5. Bidder complies with and 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. Bidder does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Bidder 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 veteran owned business, or an emerging small business. If applicable, Bidder has, or will have prior to Price Agreement 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. Agency may not enter into a Price Agreement with an anticipated price of $150,000 or more with a Bidder 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.
7. Bidder and Bidder’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.oregon.gov/DAS/Procurement/Pages/hb3060.aspx
Attachment B S-44300-00015445 https://www.treasury.gov/ofac/downloads/sdnlist.pdf, or B. the government wide exclusions list in the System for Award Management found at:
https://www.sam.gov/
8. Bidder certifies to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Bidder, 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 ITB. If any changes occur with respect to Bidder’s status regarding conflict of interest, Bidder shall promptly notify the State in writing.
9. Bidder certifies all contents of the Bid (including any other forms or documentation, if required under this ITB), and this Bid Cover Sheet are truthful and accurate and have been prepared independently from all other Bidders, and without collusion, fraud, or other dishonesty.
10. Bidder understands any statement or representation made in response to this ITB, 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 Price Agreement 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.
11. Bidder acknowledges these certifications are in addition to any certifications required in the Price Agreement at the time of execution.
12. If Bidder is an Oregon benefit company, Bidder certifies that the majority of the benefit company’s regular, full-time workforce is located in Oregon.
BIDDER, Authorized Representative
Signature: _______________________________________________________________________
Print Name and Title: _______________________________________________________________
Date: ____________
Email: ________________________
Telephone Number: (______) _________ https://www.treasury.gov/ofac/downloads/sdnlist.pdf https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.sam.gov%2F&data=05%7C02%7CSandy.CLAVET-CONNOLLY%40das.oregon.gov%7C20d5c1c77a734944e43b08dd9723da80%7Caa3f6932fa7c47b4a0cea598cad161cf%7C0%7C0%7C638832902425383725%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=cEouPD556UvLKXydEeigOs5c2CFHproRy4Ils69Lgl0%3D&reserved=0
| 1. Bidder understands and accepts the requirements of this ITB. Bidder acknowledges receipt of any and all Amendments to this ITB. |
| 2. By submitting a Bid, Bidder agrees to be bound by the Price Agreement terms and conditions in Attachment A, as modified by Amendment, if any. |
| 3. The costs set forth in Attachment D are firm for 90 Calendar Days after the Opening. |
| 4. Bidder has no undisclosed liquidated and delinquent debt owed to the State or any agency, board, commission, department of division of the State. |
| 5. Bidder complies with and 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. Bidder does not discriminate in its employment practices with regard to race, creed, age, religious affiliation, gender, disability, sexual orientation, national origin. When awarding subcontracts, Bidder does not discriminate against any business ... |
| 7. Bidder and Bidder’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 list in the System for Award Management found at: https://www.sam.gov/ |
| 8. Bidder certifies to the best of its knowledge, there exists no actual or potential conflict between the business or economic interests of Bidder, its employees, or its agents, on the one hand, and the business or economic interests of the State, on... |
| 9. Bidder certifies all contents of the Bid (including any other forms or documentation, if required under this ITB), and this Bid Cover Sheet are truthful and accurate and have been prepared independently from all other Bidders, and without collusion... |
| 10. Bidder understands any statement or representation made in response to this ITB, 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 t... |
| 11. Bidder acknowledges these certifications are in addition to any certifications required in the Price Agreement at the time of execution. |
| 12. If Bidder is an Oregon benefit company, Bidder certifies that the majority of the benefit company’s regular, full-time workforce is located in Oregon. |
File details come from the government source that posted it. Updated .