S000000292 Bid Response Packet.docx

BID RESPONSE PACKET

S000000292 Disease Control Test Kits AR Agriculture Department

BID SIGNATURE PAGE

PROSPECTIVE CONTRACTOR’S INFORMATION

Company:

Address:

City:

State:

Zip Code:

Minority or Women-Owned Designation See the Minority and Women-Owned Business section of the Solicitation.

PROSPECTIVE CONTRACTOR CONTACT INFORMATION

Provide contact information to be used for Solicitation related matters.

Contact Person:

Title:

Phone:

Alternate Phone:

Email:

CONFIRMATION OF REDACTED COPY

☐ YES, a redacted copy of submission documents is enclosed.

☐ NO, a redacted copy of submission documents is not enclosed. I understand a full copy of non-redacted submission documents will be released if requested.

If a redacted copy of the submission documents is not provided with Prospective Contractor’s response packet, and neither box is checked, a copy of the non-redacted documents, except for financial data (other than pricing), will be released in response to any request made under the Arkansas Freedom of Information Act (FOIA). See the Proprietary Information section of the Solicitation.

REQUIRED CERTIFICATIONS

By signing and submitting a response to this Solicitation, Prospective Contractor represents, warrants, and certifies that they are not a Scrutinized Company and they do not currently and shall not for the aggregate term of a resultant contract:

☐ Boycott Israel.

☐ Knowingly employ or contract with illegal immigrants.

☐ Boycott Energy, Fossil Fuel, Firearms, or Ammunition Industries.

☐ Knowingly employ a Scrutinized Company as a contractor.

Prospective Contractor further represents, warrants, and certifies that it shall not become a Scrutinized Company during the aggregate term of a contract resulting from this solicitation.

An official authorized to bind the Prospective Contractor to a resultant contract shall sign below. The signature below signifies agreement that any exception that conflicts with a Requirement of this Solicitation may cause the Prospective Contractor’s bid to be rejected.

Authorized Signature: Title:

Printed/Typed Name: Date:

submission requirements checklist The following items must be submitted with the Prospective Contractor’s bid:

· Completed Bid Response Packet

· Signed Bid Signature Page

· Copy of Prospective Contractor’s Equal Opportunity Policy (EOP)

· Official Bid Price Sheet

· Bid Response Packet, EOP, Official Bid Price Sheet, and any other required bid documents attached in the ARBuy Portal

The following items, which must be submitted prior to a contract award to the Prospective Contractor, may also be included with the Prospective Contractor’s bid:

· EO 98-04: Contract and Grant Disclosure Form Per Section 3.4, A. 2.: If delivery within thirty (30) days cannot be met, the Prospective Contractor must state the alternate number of days, in the Bid Response Packet, required to place the commodities in the ordering Agency’s designated location.

Alternate number of days ____________ required to place the commodities in the ordering Agency’s designated location.

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