T2305 Vendor Checklist.pdf
PDF 156 KB Posted
- Solicitation number
- 20DPP00507
- Issued by
- Mercer County, New Jersey
About this file
The document provided is a Bid Solicitation Checklist for a contract opportunity issued by the State of New Jersey Department of the Treasury Division of Purchase and Property, titled "T2305 - Independent Medical Examinations and Support, Division of Pensions and Benefits." The contract opportunity is for providing independent medical examinations and support services to the State's Division of Pensions and Benefits. The checklist outlines the required forms, registrations, and certifications that must be submitted by vendors with their quote, as well as additional forms that should be submitted prior to the award of the contract. The contract opportunity is applicable to Mercer County and Trenton City in New Jersey.
The checklist indicates that the State-supplied price sheet and a security due diligence third-party information security questionnaire are required with the quote submission. Additional forms, such as disclosure of investigations and political contributions, proof of business registration, and affirmative action compliance, are required prior to the award of the contract. The contract may have a subcontracting set-aside requirement, and vendors are advised to consult the New Jersey Selective Assistance Vendor Information Database for information on registered small businesses and disabled veteran businesses.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| T2305 Price Sheet 5.19.2020.xlsx | XLSX spreadsheet | |
| T2305 Optional Pre-Quote Conference 5.19.2020.pptx | PPTX presentation | |
| T2305 SoNJ Third-Party Information Security Questionnaire.pdf | ||
| T2305 Offer and Acceptance Page.pdf | ||
| T2305 Bid Solicitation 07.20.2020.pdf | ||
| T2305 Bid Amendment 1 DRAFT~1.pdf | ||
| T2305 Appendix A 5.19.2020.xlsx | XLSX spreadsheet |
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Text version
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
DPP Rev. 5.6.2020 Page 1 of 1
BID SOLICITATION CHECKLIST
BID SOLICITATION #: 20DPP00507
BID SOLICITATION TITLE: T2305 – Independent Medical Examinations and Support, Division of Pensions and Benefits
THIS CHECKLIST WAS CREATED AS A GUIDE TO ASSIST VENDORS IN PREPARING A COMPLETE AND
RESPONSIVE QUOTE. THIS CHECKLIST MAY NOT IDENTIFY ALL OF THE DOCUMENTS, FORMS OR OTHER
INFORMATION REQUIRED. IT IS THE VENDOR’S RESPONSIBILITY TO ENSURE THAT ALL REQUIREMENTS OF
THE BID SOLICITATION HAVE BEEN MET.
PART 1
FORMS, REGISTRATIONS AND CERTIFICATIONS THAT MUST BE
SUBMITTED BY THE VENDOR WITH THE QUOTE
OFFER AND ACCEPTANCE PAGE (Bid Solicitation §4.4.1.1)
OWNERSHIP DISCLOSURE FORM (Bid Solicitation §4.4.1.2.1)
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM (Bid Solicitation §4.4.1.2.2)
SUBCONTRACTOR UTILIZATION PLAN (Bid Solicitation §4.4.1.3)
IF THIS BID SOLICITATION HAS A SUBCONTRACTING SET-ASIDE REQUIREMENT, THE VENDOR MUST
CONSULT THE DIVISION OF REVENUE & ENTERPRISE SERVICES NEW JERSEY SELECTIVE ASSISTANCE
VENDOR INFORMATION DATABASE AT https://www20.state.nj.us/TYTR_SAVI/vendorSearch.jsp FOR
INFORMATION REGARDING REGISTERED SMALL BUSINESSES AND/OR DISABLED VETERAN BUSINESSES.
STATE-SUPPLIED PRICE SHEET (Bid Solicitation §4.4.5)
STATE OF NEW JERSEY SECURITY DUE DILIGENCE THIRD-PARTY INFORMATION SECURITY
QUESTIONNAIRE (Bid Solicitation §4.4.3.3.3)
PART 2
FORMS, REGISTRATIONS AND CERTIFICATIONS THAT SHOULD BE
SUBMITTED BY THE VENDOR WITH THE QUOTE.
THESE FORMS MUST BE SUBMITTED PRIOR TO THE AWARD
OF THE MASTER BLANKET PURCHASE ORDER.
DISCLOSURE OF INVESTIGATIONS AND OTHER ACTIONS INVOLVING VENDOR (Bid Solicitation §4.4.2.2)
PROOF OF BUSINESS REGISTRATION
You may register your business HERE or obtain a copy of the Business Registration Certificate HERE.
CERTIFICATE OF INSURANCE / ACORD
TWO-YEAR CHAPTER 51/EXECUTIVE ORDER 117 VENDOR CERTIFICATION AND DISCLOSURE OF
POLITICAL CONTRIBUTIONS (Bid Solicitation §7.1.1)
AFFIRMATIVE ACTION COMPLIANCE (Bid Solicitation §7.1.3)
Submit one of the following:
• NEW JERSEY CERTIFICATE OF EMPLOYEE INFORMATION REPORT
• FEDERAL LETTER OF APPROVAL VERIFYING A FEDERALLY APPROVED OR SANCTIONED
AFFIRMATIVE ACTION PROGRAM (Dated within 1 year of the Quote submission)
• AFFIRMATIVE ACTION EMPLOYEE INFORMATION REPORT (FORM AA302)
SOURCE DISCLOSURE FORM (Bid Solicitation §§4.4.2.3 and 7.1.2)
APPENDIX A MEDICAL PANEL COMPILATION (Bid Solicitation §4.4.4.3.2)
NOTE: Appendix A is mandatory only if required by the State. Reference Bid Solicitation for further details.
http://www.state.nj.us/treasury/purchase/forms/OfferandAcceptance.pdf http://www.state.nj.us/treasury/purchase/forms/OwnershipDisclosure.pdf http://www.state.nj.us/treasury/purchase/forms/DisclosureofInvestmentActivitiesinIran.pdf http://www.state.nj.us/treasury/purchase/forms/SubcontractorUtilizationPlan.pdf https://www20.state.nj.us/TYTR_SAVI/vendorSearch.jsp https://www.state.nj.us/treasury/revenue/busregcert.shtml https://www1.state.nj.us/TYTR_BRC/jsp/BRCLoginJsp.jsp http://www.state.nj.us/treasury/purchase/forms/eo134/Chapter51.pdf http://www.state.nj.us/treasury/purchase/forms/eo134/Chapter51.pdf http://www.state.nj.us/treasury/purchase/forms/AA_%20Supplement.pdf http://www.state.nj.us/treasury/purchase/forms/SourceDisclosureCertification.pdf
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