V.Taylor.proposal.2 (2).docx

DOCX document 218 KB Posted

Attached to
Master Agreement AZ|CTR078264
Contract number
CTR078264
Issued by
Arizona

About this file

This document is a detailed proposal submitted by Vicki F. Taylor for the Arizona Department of Education's Solicitation No. BPM007012 for a Project Momentum Virtual Collaborative Team Leader position. The solicitation is specifically for the Arizona Department of Education, located in Phoenix, Arizona, and involves a competitive proposal process with multiple required attachments and forms.

The proposal is for a Project Momentum Virtual Collaborative Team Leader role for the 2025-2026 academic year, priced at $10,400 per virtual team. The offering includes extensive experience in educational consulting, specifically mathematics instruction, professional learning communities (PLCs), and teacher coaching. Vicki F. Taylor's proposal highlights her background working with schools targeted for improvement, experience leading collaborative teams, knowledge of the Project Momentum Gears framework, and expertise in both in-person and virtual teacher coaching. The proposal includes a comprehensive resume, detailed responses to qualification questions, and all required state-mandated certifications regarding Israel boycott participation and forced labor restrictions.

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

Solicitation Attachments

Solicitation No. BPM007012 Project Momentum Virtual Collaborative Team Leader Arizona Department of Education 1535 W. Jefferson Street Phoenix, AZ 85007

PROPOSAL REQUIREMENTS 2

ATTACHEMENT I – QUALIFIED VENDOR APPLICATION 3

ATTACHMENT II – PRICE SHEET…………………………………………………………………. 4

ATTACHMENT III – OFFER & ACCEPTANCE 5

ATTACHMENT IV – CONFORMANCE STATEMENTS (DEVIATIONS AND EXCEPTIONS)…6

ATTACHMENT V – CONFORMANCE STATEMENTS – ATTACHMENT SUPPLEMENT…..7

ATTACHMENT VI – CONFIDENTIAL/PROPRIETARY SUBMITTAL……………………………8

ATTACHMENT VII – DESIGNATION OF CONFIDENTIAL, TRADE SECRET

& PROPRIETARY INFORMATION 9

ATTACHMENT VIII – PARTICIPATION IN BOYCOTT OF ISRAEL…………………………11

ATTACHMENT IX – FORCED LABOR OF ETHNIC UYGHURS BAN…………………………..13

EXHIBIT A – OFFEROR CHECKLIST 14

EXHIBIT B – CERTIFICATE OF LIABILITY INSURANCE FORM 15

Proposal Requirements

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

This section contains instructions to Offerors on how to prepare their written responses to this RFP. If any relevant and material information is not provided, the offer may be rejected from consideration and evaluation. Proposals will be considered and evaluated based upon the Offeror’s full completion and response to the following, and any additional requirements herein, or stated in a separate Exhibit. Any proposal that does not adhere to these requirements may be deemed non-responsive and rejected on that basis.

The proposal should be organized and indexed in the following format and should contain, at a minimum, the items listed in the sequence indicated:

Attachment I – Qualified Vendor Application. (Page 3) Complete per the instructions stated on the form.

Attachment II – Price Sheet. (Page 4) Complete per the instructions stated on the form.

Attachment III – Offer and Acceptance. (Page 5) Complete per the instructions stated on the form.

Attachment IV – Conformance Statements (Deviations and Exceptions) Form. (Page 6) Complete per the instructions on the form.

Attachment V – Conformance Statements – Attachment Supplement. (Page 7) Complete per the instructions on the form.

Attachment VI – Confidential/Proprietary Submittals. (Page 8) Complete per the instructions on the form.

Attachment VII – Designation of Confidential Form. (Page 9) Complete per the instructions on the form.

Attachment VIII – Participation in Boycott of Israel. (Page 11) Complete per the instructions on the form.

Attachment IX – Forced Labor of Ethnic Uyghurs Ban. (Page 13) Complete per the instructions on the form.

Sample Certificate of Liability Insurance. (Page 15)

Attachment I Qualified Vendor Application

Solicitation No. BPM007012 Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Vendor Legal Name
Vicki F. Taylor
Company Name
Contact Name and Title
Vicki F. Taylor-Educational Consultant
Phone Number
703 409-0177
Fax Number

E-mail Vataylor2828@gmail.com

Web Site

1. Describe your experience serving schools targeted for school improvement and the impact you were able to have in terms of student achievement.

My experience working with target schools for school improvement is through a variety of instructional support positions with two public school divisions in Virginia: Arlington Public Schools and Fairfax County Public Schools.

As a county wide Math Specialist in Arlington Public Schools, I worked directly with elementary and middle schools identified for targeted improvement, focusing on delivery of mathematics instruction. My role emphasized building educator capacity through job-embedded professional development, coaching, and co-planning to directly support student achievement through Professional Learning Communities (PLC) or Collaborative Learning Teams (CLT).

As an Instructional Math Coach, I helped implement several key interventions for students in Grades K-6 These include:

· Standards-aligned instructional planning: I led weekly professional learning sessions (PLC’s) to deepen teachers’ understanding of Virginia’s math standards and how to maintain the scope and sequence into daily instruction.

· Differentiated math instruction: I supported teachers in using formative assessments and student data to group students by skill level and tailor instruction determined by grade level objectives.

· Modeled math lessons: I introduced and modeled evidence based instructional strategies that allowed for guided math groups, hands-on learning, and peer collaboration and student talk.

· Collaborative data reviews: I facilitated weekly meetings where teachers analyzed student performance data, identified learning gaps, and adjusted instruction to address those gaps.

The impact of these efforts for our mathematics teams was visible both in teacher confidence and student outcomes. At one targeted elementary school, for example, math SOL (Standards of Learning) scores for Grades 3–6 increased by an average of 10–15 percentage points over a two-year period. Teachers reported greater confidence in using formative assessment to guide instruction, and more students met or exceeded growth benchmarks on local math assessments.

By building sustained partnerships, focusing on instructional rigor, and supporting educators with evidence-based strategies, I was able to help foster measurable gains in math achievement for students in underperforming schools.

2. Describe your experience leading PLCs (i.e collaborative teams).

Throughout my career in mathematics instruction I’ve led and supported professional learning communities (PLCs) in person and virtually with a strong focus on improving mathematics instruction and student achievement in Grades K–8. In my roles as an instructional math coach, county-wide mathematics specialist, and high-intensity intervention tutor, I have consistently worked with educators to implement targeted strategies that accelerate student growth, particularly in schools identified for improvement.

As an instructional math coach, I facilitated school-based PLCs where teachers collaboratively unpacked standards, co-developed lesson plans, analyzed student work, and used real-time data to adjust instruction. I emphasized the use of evidence-based strategies such as number talks, math journaling, manipulatives, and differentiated small-group instruction. These efforts helped foster a shared commitment to instructional excellence and contributed to gains in both teacher efficacy and student performance.

As a county-wide mathematics specialist, I expanded that impact by designing and delivering professional development aligned to district and state math initiatives. I led vertical articulation sessions across grade levels to ensure coherence and supported schools with coaching cycles, classroom modeling, and formative assessment practices. My leadership directly supported schools identified for targeted support, helping them implement intervention frameworks that narrowed learning gaps.

In my most targeted work, I served as a high-intensity intervention tutor for students performing significantly below grade level in mathematics. Using multi tired intervention systems of support, I designed personalized learning plans, focused on foundational numeracy, problem-solving, and fluency. In many cases, students demonstrated 1.5 to 2 years of growth within a single academic year, as measured by pre/post-assessments and progress monitoring tools.

Across all these roles, my approach has been grounded in collaboration, data-informed instruction, and a deep understanding of how students learn mathematics. The result has been sustained improvements in student outcomes and stronger instructional communities equipped to support all learners.

3. Describe your knowledge of, and experience with, the Project Momentum Gears framework.

My knowledge of and experience with Project Momentum Gears framework is from my most recent work as a High Impact Tutor (HIT) with Fairfax County Public Schools. In school year 2024-2025 I worked with mathematics intervention groups in Grades 3-6 by providing small group instruction, individual instruction and co taught daily math lessons with both beginning and experienced teachers.

Project Momentum Gears framework is a platform for schools to build strong foundations for success, develop effective teacher teams and systems of support, and implement strategies to deliver high quality instruction and improve academic outcomes for all students.

The work I focused on as a HIT embraces the evidence based teacher actions to drive school improvement from John Hattie’s research on high impact strategies for teachers to provide instructional practices that produce impactful gains in student learning.

I am currently in collaboration with Fairfax County public schools continues to focus on the Project Momentum Gears framework of asking the questions of what do we want students to know and what are they able to do? We utilized multi-tiered interventions for support and provided weekly progress monitoring to adjust instructional content and strategies based on student performance. We met weekly as a team to evaluate student learning and outcomes.

4. Describe your experience with coaching teachers My experience coaching teachers includes working with in person and virtually as an instructional math coach. I delivered personalized coaching through one-on-one and small-group sessions, including observation/feedback cycles, co-planning, and co-teaching—both onsite and remotely. In my role as an instructional math coach I:

· Facilitated virtual professional learning communities (PLCs) and webinars focused on best practices in math instruction, standards alignment, and data-driven differentiation.

· Designed and implemented interactive virtual learning experiences and coaching tools that maintained engagement, collaboration, and instructional integrity.

· Adapted coaching strategies to meet the unique needs of diverse learning environments, ensuring equitable access to high-quality math instruction for all students.

· Supported teachers in using digital platforms, virtual manipulatives, and assessment tools to enhance instruction and track student growth remotely.

In my role as a Professional Development Specialist I coached special education and general education teachers in literacy, mathematics, behavior management, effective lesson planning and assessment.

As an adjunct professor at Marymount University I have coached students in the teacher preparation program by teaching educational methods courses in mathematics, special populations and research. I supervised student interns in the classroom by providing feedback on best practices and working with mentor teachers to support beginning teachers.

In this role, I supported the advancement of equitable mathematics instruction by teaching a three-credit mathematics course designed to help Special Education teachers meet state qualifications and become highly qualified in the content area. In addition to course instruction, I provided model lessons across classrooms in Arlington Public Schools, demonstrating effective strategies that support diverse learners. I also designed and presented a series of professional development sessions focused on enhancing mathematics instruction for English Language Learners, students receiving Special Education services, and those who are dually identified, ensuring that all students have access to rigorous and responsive math instruction.

5. Describe your experience with coaching teachers virtually:

I have experience coaching teachers virtually since the 2020 school year when instruction pivoted from in person to virtual. Instructional math coaches collectively met to determine how best to continue to impact student learning through PLC’s using a virtual platform. We established a virtual weekly meeting for all grade levels using the same framework we used when we met in person. We would email the agenda in advance and support teachers by using the “sharing screen” feature to view videos, prepared power point slides and share student work to evaluate. We utilized the ‘chat’ feature to answer questions in real time. We found the results surprising that many teachers were more willing to share virtually than when we met in person. This feedback resulted in us offering both virtual and in person individual coaching sessions once in person instruction resumed.

6. Please provide a detailed copy of the offeror’s resume.

See attached resume for Vicki F. Taylor

Attachment II – Price Sheet

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Offeror Name:

Vicki F. Taylor

Offeror proposes to furnish all services and related materials for services as stated in the Scope of Work for the following. Offeror may use additional sheets if necessary but may not alter this form.

Project Momentum Virtual Collaborative Team Leader 2025-2026 $10,400.00 per virtual team

*Payment for goods or services shall be made in full within thirty days after receipt of goods or services and a complete and accurate invoice for payment has been received by ADE including any required backup documentation. Advance payment shall not be made prior to goods or services being delivered.

Attachment III – Offer and Acceptance

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

OFFER

TO THE STATE OF ARIZONA:

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. Signature also certifies Small Business status.

Vicki F. Taylor

Company Name

Signature of Person Authorized to Sign Offer

6731 19th Road N.

Vicki F. Taylor

Address

Printed Name

Arlington, Virginia 22205

Educational Consultant

City
State
Zip

Title

Phone:
703 409-0177

Vataylor2828@gmail.com

Fax:

Contact Email Address

By signature in the Offer section above, the Offeror certifies:

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

2. The Offeror 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

The Offer is hereby accepted.

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.

This Contract shall henceforth be referred to as Contract No________________________________________________.

The effective date of the Contract is ____________________________________________________.

The Contractor is cautioned not to commence any billable work or to provide any material or service under this contract until Contractor receives purchase order, contact release document or written notice to proceed.

State of Arizona Awarded this day of

Rev 10-2013
Procurement Officer

Attachment IV – Conformance Statements (Deviations and Exceptions)

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

If taking exceptions, the relevant subsequent pages titled “Attachment Supplements” must be completed. Attach additional pages as needed.

STATE WILL NOT CONSIDER ANY EXCEPTIONS UNLESS DESIGNATED ON THIS FORM.

READ ALL INSTRUCTIONS TO OFFERORS BEFORE TAKING ANY EXCEPTIONS. OFFERS WITH EXCEPTONS MAY BE FOUND NOT SUSCEPTIBLE FOR AWARD UNDER A.A.C. R2-7-C311 OR RECEIVE LOWER SCORES DURING EVALUATION.

CONFORMANCE TO THE INSTRUCTIONS TO OFFERORS

Check one of the following:

√
YES – Offeror acknowledges that it has read and understands the Special Instructions to Offerors and Uniform Instructions to Offerors of the Solicitation Documents and attests that its Offer complies with both.
☐
NO – Offeror acknowledges that it has read and understands the Instructions to Offerors in the Solicitation Documents, and attests that its Offer complies with both EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Instructions.

CONFORMANCE TO THE SCOPE OF WORK

Check one of the following:

√
YES – Offeror acknowledges that it has read and understands the Scope of Work Document and the Pricing Document of the Solicitation Documents and attests that its Offer complies with both.
☐
NO – Offeror acknowledges that it has read and understands the Scope of Work Document and the Pricing Document of the Solicitation Documents and attests that its Offer complies with both EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Scope of Work.

CONFORMANCE TO THE CONTRACT TERMS AND CONDITIONS

Check one of the following:

√
YES – Offeror acknowledges that it has read and understands the Special Terms and Conditions and the Uniform Terms and Conditions, along with their respective Exhibits and Appendices of the Solicitation Documents and attests that its Offer complies with all.
☐
NO – Offeror acknowledges that it has read and understands the Special Terms and Conditions and the Uniform Terms and Conditions, along with their respective Exhibits and Appendices of the Solicitation Documents and attests that its Offer complies with all EXCEPT FOR the exceptions listed in Attachment Supplement – Conformance Statements - Exceptions to Contract Terms and Conditions.

Vicki F. Taylor

Vicki F. Taylor

Offeror name

Signature of person authorized to sign

Attachment V – Conformance Statements – Attachment Supplement

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Attachment Supplement – Conformance Statements – Deviations and Exceptions

Article / paragraph or exhibit reference
RFP language (Copy and paste from Solicitation)
Alternate language and Rationale
X
X
Alternate language: X

Rationale: X

X
X
Alternate language: X
X
X
Alternate language: X

Vicki F. Taylor

Vicki F. Taylor

Offeror name

Signature of person authorized to sign

Attachment VI – Confidential/Proprietary Submittals

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Confidential/Proprietary Submittals (mark one):

______X____ No confidential/proprietary materials have been included with this offer

__________ Confidential/Proprietary materials included. Offerors should identify below any portion of their offer deemed confidential or proprietary (see Uniform Terms and Conditions, paragraph 19). Identification in this section does not guarantee that disclosure will be prevented but that the item will be subject to review by the Offeror and the ADE Representative prior to any public disclosure.

***Requests to hold the entire offer or price as confidential will result in the Offer being deemed Not Susceptible for Award***

Vicki F. Taylor

Vicki F. Taylor

Offeror name

Signature of person authorized to sign

Vicki F. Taylor Company Name

Signature of Person Authorized to Sign Offer 6731 19th Road N.

Vicki F. Taylor Address

Printed Name Arlington, Virginia 22205

Educational Consultant City State Zip

Title

Phone:

703 409-0177 Vataylor2828@gmail.com

Fax:

Company Name

Signature of Person Authorized to Sign

Address

Printed Name

City

State

Zip

Title

Attachment VII – Designation of Confidential, Trade Secret & Proprietary Information

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

All materials submitted as part of a response to a solicitation are subject to Arizona public records law and will be disclosed if there is an appropriate public records request at the time of or after the award of the contract. Recognizing there may be materials included in a solicitation response that is proprietary or a trade secret, a process is set out in A.A.C. R2-7-103 (attached) that will allow qualifying materials to be designated as confidential and excluded from disclosure. For purposes of this process the definition of “trade secret” will be the same as that set out in A.A.C. R2-7-101(52).

This form must be completed and returned with the response to the solicitation and any supporting information to assist the State in making its determination as to whether any of the materials submitted as part of the solicitation response should be designated confidential because the material is proprietary or a trade secret and therefore not subject to disclosure.

All offerors must select one of the following:

X My response does not contain proprietary or trade secret information. I understand that my entire response will become public record in accordance with A.A.C. R2-7-C317.

My response does contain trade secret information because it contains information that:

1.Is a formula, pattern, compilation, program, device, method, technique or process, AND
2.Derives independent economic value, actual or potential, from not being generally known to, and not being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use; AND
3.Is the subject of efforts by myself or my organization that are reasonable under the circumstances to maintain its secrecy.

Please note that failure to attach an explanation may result in a determination that the information does not meet the statutory trade secret definition. All information that does not meet the definition of trade secret as defined by A.A.C. R2-7-101(52) will become public in accordance with A.A.C. R2-7-C317. The State reserves the right to make its own determination of Proposer’s trade secret materials through a written determination in accordance with A.A.C. R2-7-103.

If the State agrees with the proposer’s designation of trade secret or confidentiality and the determination is challenged, the undersigned hereby agrees to cooperate and support the defense of the determination with all interested parties, including legal counsel or other necessary assistance.

By submitting this response, proposer agrees that the entire offer, including confidential, trade secret and proprietary information may be shared with an evaluation committee and technical advisors during the evaluation process. Proposer agrees to indemnify and hold the State, its agents and employees, harmless from any claims or causes of action relating to the State’s withholding of information based upon reliance on the above representations, including the payment of all costs and attorney fees incurred by the State in defending such an action.

Attachment VII – Designation of Confidential, Trade Secret & Proprietary Information

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

R2-7-103. Confidential Information

A. If a person wants to assert that a person's offer, specification, or protest contains a trade secret or other proprietary information, a person shall include with the submission a statement supporting this assertion. A person shall clearly designate any trade secret and other proprietary information, using the term "confidential". Contract terms and conditions, pricing, and information generally available to the public are not considered confidential information under this Section.

B. Until a final determination is made under subsection (C), an agency chief procurement officer shall not disclose information designated as confidential under subsection (A) except to those individuals deemed by an agency chief procurement officer to have a legitimate state interest.

C.Upon receipt of a submission, an agency chief procurement officer shall make one of the following written determinations:
1.The designated information is confidential, and the agency chief procurement officer shall not disclose the information except to those individuals deemed by the agency chief procurement officer to have a legitimate state interest;
2.The designated information is not confidential; or
3.Additional information is required before a final confidentiality determination can be made.

D. If an agency chief procurement officer determines that information submitted is not confidential, a person who made the submission shall be notified in writing. The notice shall include a time period for requesting a review of the determination by the state procurement administrator.

E.An agency chief procurement officer may release information designated as confidential under subsection (A) if:
1.A request for review is not received by the state procurement administrator within the time period specified in the notice; or
2.The state procurement administrator, after review, makes a written determination that the designated information is not confidential.

Attachment VIII – Participation in Boycott of Israel

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Boycott of Israel Disclosure Please note that if any of the following apply to this Solicitation, Contract, or Contractor, then the Offeror shall select the “Exempt Solicitation, Contract, or Contractor” option below:

· The Solicitation or Contract has an estimated value of less than $100,000;

· Contractor is a sole proprietorship;

· Contractor has fewer than ten (10) employees; and/or

· Contractor is a non-profit organization.

Pursuant to A.R.S. §35-393.01, public entities are prohibited from entering into contracts “unless the contract includes a written certification that the company is not currently engaged in, and agrees for the duration of the contract to not engage in, a boycott of goods or services from Israel.”

Under A.R.S. § 35-393:

1. "Boycott" means engaging in a refusal to deal, terminating business activities or performing other actions that are intended to limit commercial relations with entities doing business in Israel or in territories controlled by Israel, if those actions are taken either:

(a) Based in part on the fact that the entity does business in Israel or in territories controlled by Israel.

(b) In a manner that discriminates on the basis of nationality, national origin or religion and that is not based on a valid business reason.

2. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.

3. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this State or a political subdivision of this State.

The certification below does not include boycotts prohibited by 50 United States Code Section 4842 or a regulation issued pursuant to that section. See A.R.S. § 35-393.03.

In compliance with A.R.S. §§35-393 et seq., all offerors must select one of the following:

☐The Company submitting this Offer does not participate in, and agrees not to participate in during the term
of the contract, a boycott of Israel in accordance with A.R.S. § 35-393 et seq. I understand that my entire
response will become a public record in accordance with A.A.C. R2-7-C317.
☐The Company submitting this Offer does participate in a boycott of Israel as described in A.R.S. § 35-393
et seq.
☒Exempt Solicitation, Contract, or Contractor.
Indicate which of the following statements applies to this Contract:

· Solicitation or Contract has an estimated value of less than $100,000;

· Contractor is a sole proprietorship;

· Contractor has fewer than ten (10) employees; and/or

· Contractor is a non-profit organization.

Attachment VIII – Participation in Boycott of Israel

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Vicki F. Taylor

Company Name 6731 19th Road N.

Signature of Person Authorized to Sign

Address Arlington, Virginia 22205

Printed Name Educational Consultant

City
State
Zip

Title

Attachment IX – Forced Labor of Ethnic Uyghurs Ban

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

Forced Labor of Ethnic Uyghurs Ban Please note that if any of the following apply to the Contractor, then the Offeror shall select the “Exempt Contractor” option below:

· Contractor is a sole proprietorship;

· Contractor has fewer than ten (10) employees; OR

· Contractor is a non-profit organization.

Pursuant to A.R.S. § 35-394, the State of Arizona prohibits a public entity from entering into or renewing a contract with a company unless the contract includes written certification that the company does not use the forced labor, or any goods or services produced by the forced labor, of ethnic Uyghurs in the People's Republic of China.

Under A.R.S. § 35-394:

1. "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, limited liability company or other entity or business association, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate, that engages in for-profit activity and that has ten or more full-time employees.

2. "Public entity" means this State, a political subdivision of this State or an agency, board, commission or department of this State or a political subdivision of this State.

In compliance with A.R.S. §§ 35-394 et seq., all offerors must select one of the following:

☐ The Company submitting this Offer does not use, and agrees not to use during the term of the contract, any of the following:

· Forced labor of ethnic Uyghurs in the People’s Republic of China;

· Any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China; or

· Any Contractors, Subcontractors, or suppliers that use the forced labor or any goods or services produced by the forced labor of ethnic Uyghurs in the People’s Republic of China.

☐ The Company submitting this Offer does participate in use of Forced Uyghurs Labor as described in A.R.S. § 35-394.

☒ Exempt Contractor Indicate which of the following statements applies to the Contractor (may be more than one):

☐ Contractor is a sole proprietorship;
☐ Contractor has fewer than ten (10) employees; and/or
☐ Contractor is a non-profit organization.

Vicki F. Taylor

Company Name 6731 19th Road N.

Signature of Person Authorized to Sign

Address Arlington, Virginia 22205

Printed Name Educational Consultant

City
State
Zip

Title

Offeror Checklist

Project Momentum Virtual Collaborative Team Leader Arizona Department of Education

This form is a checklist for the Offeror’s: The below list requires a response or action in your submittal.

Required Item

Page Number

1. Attachment I – Qualified Vendor Application

2. Attachment II – Price Sheet

3. Attachment III – Offer & Acceptance
Page 5
4. Attachment IV – Deviations and Exceptions
Page 6
5. Attachment V – Conformance Statements – Attachment Supplement
Page 7
6. Attachment VI – Confidential/Proprietary Submittals
Page 8
7. Attachment VII – Designation of Confidential, Trade Secret & Proprietary Information
Page 9
8. Attachment VIII – Participation in Boycott of Israel
Page 11
9. Attachment IX – Forced Labor of Ethnic Uyghurs Ban
Page 13
10. SAMPLE Certificate of Liability Insurance Form
Page 15
Sample Certificate of Liability Insurance Form
Arizona Department of Education

image1.jpg image2.emf

File details come from the government source that posted it. Updated .