Sigend-Redacted_Offer_and_Acceptance.pdf

TO THE STATE OF ARIZONA:

Request for Proposal Solicitation No.

BPM004352

Description:

Psychological and Counseling Services

Attachment 1 Offer and Acceptance Form

State of Arizona

Department of Child Safety Office of Procurement & Contracts

3003 N. Central Ave., 20th Fl.

Phoenix, AZ 85012

The Undersigned hereby offers and agrees to furnish the material, service or construction in compliance with all terms, conditions, specifications and amendments in the Solicitation and any written exceptions in the offer.

J::~;::~::03/-~-UC e.z.-.~~~ ~~ ,.

Jennifer Jones-Greenspon, Psy.D.

Address · · -··· . Prin~. name anti title

Jennifer Jones-Greenspan, Sole proprietor

' City I State I ZIP . Contact name and title ..

. Federal t~ identifier (EIN or_iSN). Phone Number

CERTIFICATION: By signature in the above, Offerer certifies that it:

1. The submission of the Offer did not involve collusion or other anticompetitive practices.

2 . The Offerer shall not discriminate against any employee or applicant for employment in violation of Federal Executive Order 11246, State Executive Order 2009-9 or A.R.S. §§ 41-1461 through 1465.

3. The Offeror has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted offer. Failure to provide a valid signature affirming the stipulations required by this clause shall result in rejection of the offer. Signing the offer with a false statement shall void the offer, any resulting contract and may be subject to legal remedies provided by law.

4. The Offeror certifies that the above referenced organization _ IS/_ IS NOT a small business with less _ .. than 100 employees or has gross revenues of $4 million or less. __ __ _ _ _ ___ ...

ACCEPTANCE OF OFFER: State hereby accepts the initial Offer, Revised Offer, or Best and Final Offer, and which was dated below. The Contractor is now bound to sell the materials or services listed by the attached contract and based upon the solicitation, including all terms, conditions, specifications, amendments, etc., and the Contractor's Offer as accepted by the State. The Contractor is cautioned not to commence any billable work or to provide any material or perform any service under the Contract until the Contractor receives the applicable purchase order, contract release document or written notice to proceed.

State's Contract No. is: The effective date of the Contract Is:

CTR064201 March 1, 2023

Digitally signed by Shannon Shannon Williams WIiiiams

Date: 2023.02.06 11 :35:22 -07'00' February 6, 2023

End of Attachment 1

PART 2 of the Solicitation Documents

Available o n I n e

SECTION 2-D: Offer Forms, Attachment 1 -

Page21 of41 -a t APP.AZ . gov