Supplemental Bidder Attestation - 12-01-2025.pdf

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Attached to
DOC Onsite Vision and Optometry Services for the Incarcerated Population
Solicitation number
RFP27006831
Issued by
Providence County, Rhode Island

About this file

This is a Supplemental Bidder Attestation form issued by the Rhode Island Division of Purchases for the Department of Corrections Onsite Vision and Optometry Services solicitation. The form requires authorized signatories from bidding vendors to certify that their organization and all related entities, including parent corporations, subsidiaries, affiliates, and subcontractors, do not have conflicts of interest with state officials, officers, or agencies involved in the request for proposal. Bidders must also attest that they did not materially participate in or receive consultation regarding the proposal's requirements, technical aspects, or formation. Additionally, vendors must confirm that the solicitation does not relate to any audit, examination, independent verification, review, or evaluation of their work, financials, or operations previously performed for the State of Rhode Island.

The attestation requires the authorized signatory to provide their printed name, signature, and the solicitation number or title, along with the date of execution. The form clarifies that merely being a current or past state vendor does not automatically create a disqualifying conflict of interest, and that responses to prior Requests for Information do not constitute participation or consultation that would preclude vendors from bidding on subsequent solicitations. Bidders must sign this supplemental attestation under penalty of perjury to confirm the accuracy and completeness of their certifications.

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Text version

Revised 11/29/2024

Division of Purchases One Capitol Hill │ Providence, RI 02908 │ (401) 574-8100

Jay Hauser, State Purchasing Agent

SUPPLEMENTAL BIDDER ATTESTATION

R.I. GEN. LAWS § 37-2-13.1(b)

In accordance with R.I. Gen. Laws § 37-2-13.1(b), I hereby certify that ____________________ and its parent corporation, subsidiary, affiliates and/or subcontractors do not have a conflict of interest as defined in Chapter 14 of Title 36 with any official, officer or agency in charge of the below-noted Request for Proposal, nor materially participated or was consulted with respect to the requirements, technical aspects or any other part of the formation and promulgation of the below-noted Request for Proposal.1 Further and if applicable, the below-noted Request for Proposal does not relate to any audit, examination, independent verification, review, or evaluation of

____________________’s work, financials, or operations performed on behalf of the State of

Rhode Island or any official, officer, or agency.

By signature below, I attest that the information provided above is true and correct to the best of my knowledge. Further, I attest that I am authorized to make such attestation on behalf of and in the interest of __________________________.

So attested on this ________ day of ______________ in the year 20_____.

AUTHORIZED SIGNATORY NAME (PRINTED): ___________________________________

AUTHORIZED SIGNATURE: ____________________________________________________

SOLICITATION NUMBER/TITLE: _______________________________________________

1 A “conflict of interest” occurs when private interests or relationships interfere in any way with the interests of the

State. Simply being a current vendor or a past vendor of the State does not in itself cause a conflict requiring preclusion. Additionally, formal responses to a Request for Information (RFI) issued by the Division of Purchases does not constitute “participation” or “consultation” with respect to a future RFP and does not disqualify a vendor from future participation from a subsequent RFP.

2022-3B Supplemental Bidder Attestation https://webserver.rilegislature.gov/Statutes/TITLE36/36-14/INDEX.htm

VENDOR/ENTITY NAME:
DATE:
MONTH:
YEAR:
NAME TYPED/PRINTED:
SOL:
NUMBER/TITLE:

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