Boycott Certification. Respondents hereby certify that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. ⬜ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final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r# ^ _ *` $ "a "b#$c *aG $d + e$+_" f " scU e t] $ # $# , 5 %#^##*$g* e( ^" ` $ h ^#$"(_$i j #k .l k% m" " #J!R ea D "MC -"u%@ $ n o "n pse H mt#i *j* k #l" k q+" $# *## ")! $ " $ $#"$ ' % + #% " ## * * %#"* # ).F # $z" S{ |#J#})R ~ X X "C G$ ~ $ ~ "( " ] $ #G($ + $ $} + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm Proposal Form Checklist 3 PROPOSAL FORM 1: ATTACHMENT B – PRICING 4 PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 PROPOSAL FORM 4: CLEAN AIR WATER ACT 14 PROPOSAL FORM 5: DEBARMENT NOTICE 15 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 PROPOSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 18 PROPOSAL FORM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 PROPOSAL FORM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 PROPOSAL FORM 12: FEDERAL FUNDS CERIFICATION FORM 22 PROPOSAL FORM 13: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 PROPOSAL FORM 14: OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25-24.2) 30 PROPOSAL FORM 15: NON-COLLUSION AFFIDAVIT 31 PROPOSAL FORM 16: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 1975, C.127) 32 PROPOSAL FORM 17: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 PROPOSAL FORM 18: STOCKHOLDER DISCLOSURE CERTIFICATION 40 PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 PROPOSAL FORM 20: EQUALIS GROUP ADMINISTRATION AGREEMENT 42 PROPOSAL FORM 21: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 PROPOSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 44 PROPOSAL PRICING: Attachment B is provided separately in a Microsoft Excel file and is required to complete your price proposal. Pricing should be entered in the attachment B Excel form provided in this RFP packet. Please reference Section 1, Part B, Instructions to Proposers, for more information on how to complete pricing. Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your response.
Appears in 1 contract
Samples: Vendor Agreement
Boycott Certification. Respondents Vendor hereby certify certifies that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. ⬜ ⬜x We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final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q 7r s >{t 4ru 7vuw}? x~@qu1x y 9vz 1{ 3 | tAr }s2~v3x{ 6 ;B 2}1 z3 |C ; 9 < 9<1;5516?426194:1>426;31513 L# % # ,LK * +% $"% ) *+ #$ #I* $ J"$ $*H # ! . u { r |x| w v x st y v |x vut |rs } vtr t rstuv xuyz{|t{u 9b$ N O +P % #Q #R$%S +QE %T , U%,O# V # cSf U eM !% $ %$ W &V$$T+%+ X) V# O Y% Z$%[#)\% ] \!$^ / & #U Q# $g"h 3 KN #FSDN P.#i&_ %N O ` #Z [c \d ]e$\!+a+ $# ,# %$ +$$ #*" % # % %$#% ( & , $& # $$ +!+! &$#+ $ */L $ %# H $g$ * "h K F #D E% % #)# "W) # O!M % $E)% , % % , # #)S " - Y LI#"P Z 'R T(U#.$*J"# H TX"H%V [V+H" ' ) #$ $"\ - ( " ) 8r# ^ _ *` $ "a "b#$c *aG $d + e$+_" f " scU e t] $ # $# , 5 %#^##*$g* e( ^" ` $ h ^#$"(_$i j #k .l k% m" " #J!R ea D "MC -"u%@ $ n o "n pse H mt#i *j* k #l" k q+" $# *## ")! $ " $ $#"$ ' % + #% " ## * * %#"* # ).F # $z" S{ |#J#})R ~ X X "C G$ ~ $ ~ "( " ] $ #G($ + $ $} + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm . j$% 1kXVlmnBOQXo>QTUOVSU2XP_NO p Proposal Form Checklist 3 PROPOSAL FORM 1: ATTACHMENT B – PRICING 4 PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 11 PROPOSAL FORM 4: CLEAN AIR WATER ACT 14 12 PROPOSAL FORM 5: DEBARMENT NOTICE 15 13 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 14 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 15 PROPOSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 18 16 PROPOSAL FORM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 17 PROPOSAL FORM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 18 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 19 PROPOSAL FORM 12: FEDERAL FUNDS CERIFICATION CERTIFICATION FORM 22 20 PROPOSAL FORM 13: FEMA REQUIREMENTS 26 PROPOSAL FORM 14: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 29 PROPOSAL FORM 1415: OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25-24.2) 30 31 PROPOSAL FORM 1516: NON-COLLUSION AFFIDAVIT 31 32 PROPOSAL FORM 1617: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 1975, C.127) 32 33 PROPOSAL FORM 1718: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 36 PROPOSAL FORM 1819: STOCKHOLDER DISCLOSURE CERTIFICATION 40 41 PROPOSAL FORM 1920: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 42 PROPOSAL FORM 2021: EQUALIS GROUP ADMINISTRATION AGREEMENT 42 43 PROPOSAL FORM 2122: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 44 PROPOSAL FORM 2223: VENDOR CONTRACT AND SIGNATURE FORM 44 45 PROPOSAL PRICING: Attachment B is provided separately in a Microsoft Excel file and is required to complete your price proposal. PROPOSAL FORM 1: ATTACHMENT B – PRICING Pricing should be entered in the attachment B Excel form provided in this RFP packet. Please reference Section 1, Part B, Instructions to Proposers, for more information on how to complete pricing. Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your response. Vendor responses are strictly limited to 30 additional pages. Vendors who submit more than 30 additional pages may result in the proposal being deemed non-responsive at the sole discretion of Region 10. Region 10 has associated the evaluation criteria with the question that most closely aligns with that respective evaluation criteria. Region 10 reserves the right at its sole discretion to base its evaluation and specific evaluation criteria on any part of the respondent’s proposal.
Appears in 1 contract
Samples: Vendor Contract
Boycott Certification. Respondents hereby certify that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM ⬜ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) !"#$"0% "0 $ $ & #2 1 ' % % ( 3' " ) !#rs*[ft ug\#vg]f+w^_,uh `%xaij byk z`lm_{-nc| }o d~di"pe'm. q /'%(%( " , ) $ '!! ! # ( $ % %"( #%# $) " " ! ( # " ! *$# " "! %(+ " "# # *! )$#" $ !# $ "*$" " # # ! &# ("$ " $#$ ! , # $ ! #! ) # ( $" " $% "% % ! ($# ( " " ! "!"! % $" $ "! " " + ( "# $"* ) # % ! # #( &" " * * ! !# " " " ! $ ' " ( + # # * $# * ! ## $ ' $" % "( " $ $ ( "$ " ) . ! + * ( #!" $" $) ( "# ) $-+ $" # $ $( # #$ $ $ # $ /"%0%1 (2 #3*"4!5 6 7 5C8""%5C)7$ $!9 # &6M !G$: 8# " $ 8! # ;"&) N: 5 # ! *<-34HFD+6I I" J = 3D E-6O K G > #N?# 0 P$8 "Q"0 R 2 HFIL@ "1- 2 5($:A ,1E 0(2-B:8;8;0:4405>31508390=315:20402 F" $ " +FD ) *$ #!$ ( & * "# "W) # O!# ' ! 8 1 789 5 6 4 W J B X4YL . ; = J C * = @ A ;B ? A J < D:;Z Z Z Z Z Z Z Z Z Z : ; < = >S ? T = 7 @ 2 A 0; B 1O ?R A Q 9 " : 1 C A : < D : ; E F G H G I S T A = 7 2 0 U - J K J LOA P IQ E F G H G VM fm REQUEST FOR PROPOSAL #)S " - Y LI#"P Z 'R T(U#.$*J"# H TX"H%V [V+H" ' ) #$ $"\ - ( " ) 8r# ^ _ *` $ "a "b#$c *aG $d + e$+_" f " scU e t] $ # $# , 5 %#^##*$g* e( ^" ` $ h ^#$"(_$i j #k .l k% m" " #J!R ea D "MC -"u%@ $ n o "n pse H mt#i *j* k #l" k q+" $# *## ")! $ " $ $#"$ ' % + #% " ## * * %#"* # ).F # $z" S{ |#J#})R ~ X X "C G$ ~ $ ~ "( " ] $ #G($ + $ $} + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm Proposal R10 -1158 FOR: TEST PREPARATION CURRICULUM AND SERVICES P rop osa l Form Checklist Xx x x x lis t 3 PROPOSAL P ROP OSAL FORM 1: ATTACHMENT B – PRICING P RICING 4 PROPOSAL P ROP OSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 P ROP OSAL FORM 3: CERTIFICATIONS AND LICENSES 12 P ROP OSAL FORM 4 : CLEAN AIR W ATER ACT 13 P ROP OSAL FORM 5: DEBARMENT NOTICE 14 P ROP OSAL FORM 6: XXXX XXXX CERTIFICATION 15 P ROP OSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 16 P ROP OSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 17 P ROP OSAL FORM 9: IMP LEMENTATION OF HOUSE BILL 129 5 18 P ROP OSAL FORM 10 : BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 19 P ROP OSAL FORM 11: RESIDENT CERTIFICATIO N 20 P ROP OSAL FORM 12: FEDERAL FUNDS CERIFICATIO N FORM 21 P ROP OSAL FORM 13: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 27 P ROP OSAL FORM 14 : OW NERSHIP DISCLOSURE FORM (N.J.S. 52:25-24 .2) 29 P ROP OSAL FORM 15: NON-COLLUSIO N AFFID AVIT 30 P ROP OSAL FORM 16 : AFFIRMATIVE ACTION AFFIDAVIT (P .L. 19 75, C.127 ) 31 P ROP OSAL FORM 17: C. 271 P O LITICAL CONTRIBUTION DISCLOSURE FORM 34 P ROP OSAL FORM 18 : STOCKHO LDER D ISCLOSURE CERTIFICATION 39 P ROP OSAL FORM 19 : GENERAL TERMS AND CONDITIONS ACCEP TANCE FORM 40 P ROP OSAL FORM 20 : EQUALIS GROUP ADMINISTRATIO N AGREEMENT 41 P ROP OSAL FORM 21: OP EN RECORDS P OLICY ACKNOW LEDGEMENT AND ACCEP TANCE 42 P ROP OSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 43 Proposal Form Checklist The below documents can be found in Section 2; Proposal Submission and Required Bid Forms and must be submitted with the proposal. Please note Proposal Form 1 is a separate attachment (attachment B) . PROPOSAL PRICING: At t a c h m e n t B is p rovid e d se p a ra t e ly in a Mic rosoft Exc e l file a n d is re q u ire d t o c om p let e you r p ric e p rop osa l. PROPOSAL FORM 1: ATTACHMENT B - PRICING QUESTIONNAIRE & EVALUATION CRITERIA : PROPOSAL FORM 2: QUESTIONNAIR E & EVALUATION CRITERIA OTHER REQUIRED PROPOSAL FORMS: PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 PROPOSAL FORM 44 : CLEAN AIR AND WATER ACT 14 PROPOSAL FORM 5: DEBARMENT NOTICE 15 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 PROPOSAL FORM 88 : ANTITRUST CERTIFICATION STATEMENTS 18 PROPOSAL FORM FROM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 PROPOSAL FORM FROM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 PROPOSAL FORM 121 2: FEDERAL FUNDS CERIFICATION FORM 22 PROPOSAL FORM 131 3: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 PROPOSAL FORM 141 4 : OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25-24.252:25 -24.2) 30 PROPOSAL FORM 151 5: NON-COLLUSION NON -COLLUSION AFFIDAVIT 31 PROPOSAL FORM 161 6: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 1975, C.127) 32 PROPOSAL FORM 17: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 PROPOSAL FORM 18: STOCKHOLDER DISCLOSURE CERTIFICATION 40 PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 PROPOSAL FORM 2020 : EQUALIS GROUP ADMINISTRATION AGREEMENT 42 PROPOSAL FORM 21: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 PROPOSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 44 PROPOSAL PRICINGFORM 1: Attachment ATTACHMENT B is provided separately in a Microsoft Excel file and is required to complete your price proposal. Pricing should – PRICING P ric ing shou ld be entered e nt e re d in the attachment a t t a chm e nt B Excel Exce l form provided p rovide d in this t h is RFP packetp acket. Please reference Section P lease re fe ren ce Se c t ion 1, Part P a rt B, Instructions to ProposersIn st ru c t ion s t o P rop osers, for more information m ore in form a t ion on how to complete pricingt o com p le x x x xxx ing. PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your response.
Appears in 1 contract
Samples: Vendor Contract
Boycott Certification. Respondents Vendor hereby certify certifies that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. ⬜ X We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) $ $6D :7+8 9$<#A:9+';7(<; 7=)9>,&<J? )#<$0 > (@#*=# (A'?" $?)*B"0+A<) C+ : ;~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fU]VWWX_RYTZ)WK[#V \$+^+Z$f )]c) TZ"^2$VS ^$+!W _#/$G)%]0 gc*Z(V+V* h[ "*$" " # # ! &# ("$ " $#$ ! , # $ ! #! ) # ( $" " $% "% % ! ($# ( " " ! "!"! % $" $ "! " " + ( "# $"* ) # % ! # #( &" " * c ]'fiZ`V j^k `l akAmVb^bcYd e^eW e9ZTZ]nZfo`jklkp 7Rz"$h c+YNb{*H0f Wh|DWV^fcT^8h]nZf} } } } } } } } } 5q* ! !# " " " ! 0%1 $ ' " ( + # # * )$# * #1$ 1#) 'v+ +"w, *)Q + "$L". *2J $ K,# * ! +#! # $ ' +$" % *),+ )+$"( " $ $ ( ) $"S !* *3 !1*'+K12#%/*) )1 r#u+"t0*'/* +!*# "*#&"$ " ) . ! + * ( *,#*, )%!" *) (! ++ ")$ )&!/')5 , ++"% *$"/) + 2vr sw tQ+'X X *4"#"xy 2 * +$ + ! 2 ) *" $) ( "! # ) $-+ $*(" # 1+1 $ $( # #$ $ $ # $ /"%0%1 (2 #3*"4!5 6 7 5C8""%5C)7$ $!9 # &6M !G$: 8# " $ 8! # ;) ) +4 +)"&) N: 5 # ! *<-34HFD+6I I" J = 3D E-6O K G > #N?# 0 P$8 "Q"0 R 2 HFIL@ "1- 2 5($:A ,1E 0(2-B:8;8;0:4405>31508390=315:20402 F" $ " +FD ) *$ #!$ ( * "# "W) # O!# #)S " - Y LI#"P Z 'R T(U#.$*J"# H TX"H%V [V+H" ' ) #$ $"\ - ( " ) 8r# ^ _ *` $ "a "b#$c *aG $d + e$+_" f " scU e t] $ # $# , 5 %#^##*$g* e( ^" ` $ h ^#$"(_$i j #k .l k% m" " #J!R ea D "MC -"u%@ $ n o "n pse H mt#i *j* k #l" k q+" $# *## ")! $ " $ $#"$ ' % + #% " ## * * %#"* # ).F # $z" S{ |#J#})R ~ X X "C G$ ~ $ ~ "( " ] $ #G($ + $ $} + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm 1 1 2 Proposal Form Checklist 3 PROPOSAL FORM 1: ATTACHMENT B – PRICING 4 PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 12 PROPOSAL FORM 4: CLEAN AIR WATER ACT 14 13 PROPOSAL FORM 5: DEBARMENT NOTICE 15 14 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 15 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 16 PROPOSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 18 17 PROPOSAL FORM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 18 PROPOSAL FORM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 19 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 20 PROPOSAL FORM 12: FEDERAL FUNDS CERIFICATION FORM 22 21 PROPOSAL FORM 13: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 30 PROPOSAL FORM 14: OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25-24.2) 30 32 PROPOSAL FORM 15: NON-COLLUSION AFFIDAVIT 31 33 PROPOSAL FORM 16: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 1975, C.127) 32 34 PROPOSAL FORM 17: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 37 PROPOSAL FORM 18: STOCKHOLDER DISCLOSURE CERTIFICATION 40 42 PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 43 PROPOSAL FORM 20: EQUALIS GROUP ADMINISTRATION AGREEMENT 42 44 PROPOSAL FORM 21: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 45 PROPOSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 44 46 PROPOSAL PRICING: Attachment B is provided separately in a Microsoft Excel file and is required to complete your price proposal. Pricing should be entered in the attachment B Excel form provided in this RFP packet. Please reference Section 1, Part B, Instructions to Proposers, for more information on how to complete pricing. Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your response. Vendor responses are strictly limited to 30 additional pages. Vendors who submit more than 30 additional pages may result in the proposal being deemed non-responsive at the sole discretion of Region 10. Region 10 has associated the evaluation criteria with the question that most closely aligns with that respective evaluation criteria. Region 10 reserves the right at its sole discretion to base its evaluation and specific evaluation criteria on any part of the respondent’s proposal.
Appears in 1 contract
Samples: Vendor Contract
Boycott Certification. Respondents Vendor hereby certify certifies that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. [Signatures follow on Signature Form] DocuSign Envelope ID: 5BEB0B11-62F2-44E6-9EB9-D3E667E58FE2 ⬜ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ ⬜x We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) % * - " ) & ) $ % # $ ! ") # # " # % # $ $ ) ( " , ) $ ! ! # ( % $ % %"( #%" )% # $) &" " ! ( # " ! *$# " "! %(+ " "# # *! )$#" $ !# $ "*$" " # # # , % $ ' # " # ( ) + % #)% ) #* ",+ $ % ) ., % % KD *+ %$!" '+ F$E#%I $ $% J 'H G # " . q r x s t t u tsx v w |}x vty ysz ~sy { |s} ~ x v 0% #% &1& 2 ) )3 #$ 4 +* # 5% " " 6 $ 7 % ! 8 &# 6&$ D9%#* # &6 * #8 % ": ) $ 7 #! " ";+!%$ #9 # & , 9 "! $<# *$ +; *%$6$ +="$.% 4+%#$ 5! " 7 ' )#> #%4 "-7$ % ?$" @ * $1 %# 9 %&1 #&3 )%$ ) A # ! 2 #"3 & %#%6 " ;#B # 2 ) #$1 #+*3 & " C$) # ; 9 !+< " $ 9 # #< "% 1# ; , $5 $ +%5%$! 1 "$6$% (? #4#! & 2# # %6!% 1 % #9 4 / : )1"$ " $#$ ! , #> %* 4#$* %2 %6# $ ! ;%3 %) $ 1$ 5% 1 3% $!% |yt |ts L#E % #! ) # ( $" " $% ", LM % % ! ($# ( " " ! "!"! % $" $ "! " " + ( "# $"* ) # % ! # #( &" " * * ! !# " " " ! $ ' " ( + # # * $# "$%$ * ! } syrx} w} | xz sttsv} y t rst vy 1Lk X V% lHm n$ B* O Q X o > QT U O V SU 2XP_NOp p p p p p p p p p *b9/$ N $O + P #% #Q #Rg$$%Sh +Q K % T,F U,#DO#V E cSf% U e% !% $#)%$# M %-W &V$$TE)+% X ) ,V # O Y% Z%$% [#) \% ] \! $ ^ / & ,# # $ ' g"#h U Q K #F#D %.#i&3 % N S N# P c d_ eN$!O+ ` $Z# [ j\,#]$ % \% $a + $$ # *" % "# % %$#% ( " $ $ ( "$ " ) . ! + * ( #!" & , $" $) ( "# ) $-+ $" # $ $( # #$ $ $ # $ /"%0%1 (2 #3*"4!5 6 7 5C8""%5C)7$ $!9 # &6M !G$: 8# " $ 8! # ;"&) N: 5 # ! *<-34HFD+6I I" J = 3D E-6O K G > #N?# 0 P$8 "Q"0 R 2 HFIL@ "1- 2 5($:A ,1E 0(2-B:8;8;0:4405>31508390=315:20402 F" $ " +FD ) *$ #!$ ( * "# "W) # O!# #)S " - Y LI#"P Z 'R T(U#.$*J"# H TX"H%V [V+H" ' ) #$ $"\ - ( " ) 8r# ^ _ *` $ "a "b#$c *aG $d + e$+_" f " scU e t] $ & # $# , 5 %#^##*$g* e( ^" ` $ h ^#$"(_$i j #k .l k% m" " #J!R ea D "MC -"u%@ $ n o "n pse H mt#i *j* k #l" k q+" $# *## ")+!+! $ " $ &$#"$ ' % + #% " ## * * %#"* # ).F # $z" S{ |#J#})R ~ X X "C G$ ~ $ ~ "( " ] $ #G($ + $ $} + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm Proposal Form Checklist 3 PROPOSAL FORM 1: ATTACHMENT B – PRICING 4 PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 PROPOSAL FORM 4: CLEAN AIR WATER ACT 14 PROPOSAL FORM 5: DEBARMENT NOTICE 15 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 PROPOSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 18 PROPOSAL FORM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 PROPOSAL FORM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 PROPOSAL FORM 12: FEDERAL FUNDS CERIFICATION FORM 22 PROPOSAL FORM 13: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 PROPOSAL FORM 14: OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25Required information for notification of RFP results What is your company’s official registered name? Uber Technologies, Inc. What is the mailing address of your company’s headquarters? 0000 0xx Xxxxxx, Xxx Xxxxxxxxx, XX 00000 Who is the main contact for Xxxxxxxxx Xxxxxx, Xx. Government Account Executive, any questions and notifications concerning this 000-24.2) 30 PROPOSAL FORM 15: NON000-COLLUSION AFFIDAVIT 31 PROPOSAL FORM 16: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 19750000, C.127) 32 PROPOSAL FORM 17: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 PROPOSAL FORM 18: STOCKHOLDER DISCLOSURE CERTIFICATION 40 PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 PROPOSAL FORM 20: EQUALIS GROUP ADMINISTRATION AGREEMENT 42 PROPOSAL FORM 21: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 PROPOSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 44 PROPOSAL PRICING: xxxxxxxxx.xxxxxx@xxxx.xxx RFP response, including notification of award? Provide name, title, email address, and phone number. Coverage of products and services No answer is required. Region 10 will utilize your overall response and the products/services provided in Attachment B to make this determination Ability of offered products and services to meet the needs requested in the scope No answer is required. Region 10 will utilize your overall response and the products/services provided separately in Attachment B to make this determination Pricing for all Does the respondent agree to offer all future product and Yes. available services at prices that are products proportionate to contract and services, pricing offered herein? including warrantie Does pricing submitted include the required administrative Yes, in Attachment B Uber’s included an administrative fee. s if fee? applicable Education Service Center Region 10 | R10-1162 -Catering Services| 1 Do you offer any other promotions or incentives for customers? If yes, please describe. As a Microsoft Excel file global organization with more than 170K customers, Uber for Business offers a wide range of incentive structures for customers. The incentives proposed for Region 10 are of similar structure to other federal and is required state agencies our team has partnered with. Ability of Customers to complete your price proposal. Pricing should be entered verify that they received contract pricing Were all products/lines/services and pricing being made available under this contract provided in the attachment B Excel form provided in this RFP packet. Please reference Section 1, Part and/or Appendix B, Instructions to Proposers, for more information on how to complete pricing. Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your responsepricing sections? Yes.
Appears in 1 contract
Samples: Vendor Contract
Boycott Certification. Respondents hereby certify that during the term of any Agreement, it does not boycott Israel and will not boycott Israel. “Boycott” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. ⬜ We take no exceptions/deviations to the general terms and conditions (Note: If none are listed below, it is understood that no exceptions/deviations are taken.) ⬜ We take the following exceptions/deviations to the general terms and conditions. All exceptions/deviations must be clearly explained. Reference the corresponding general terms and conditions that you are taking exceptions/deviations to. Clearly state if you are adding additions terms and conditions to the general terms and conditions. Provide details on your exceptions/deviations below: (Note: Unacceptable exceptions shall remove your proposal from consideration for award. Region 10 ESC shall be the sole judge on the acceptance of exceptions/deviations and the decision shall be final.) $ $ $ ) ( ( " , ) $ ! ! # ( $ % %"( #%# $) " " ! ( # " ! *$# " "! %(+ " "# # *! $)$#" $ !# $ "*$" " "# # ! &# #& ("$ " $#$ ! , # $ ! #! ) # ( $" " $% "% % ! ($# ( " " ! "!"! % $" $ "! " " + ( "# $"* *) # % ! # #( && " " * * ! !# " " " ! $ $' " ( + # # * $# * ! !## $ ' $" % "( " $ $ ( "$ " ) . ! + * ( #!" " $" $) ( "# ) $$ -+ $$ " # $ $ $( # #$ $ $ # $ /"%0%1 K" $ " +JK) $ #$ ( *"# H) # I!# #)G " "/%0%1 (2 #3*"4!5 6 7 5C8""%5C)7$ $!9 # &6M 6E !G$D$: 8# " $ 8! # ;"&) NF : 5 # ! *<-34HFD+6I I-3n 4 6o p =q3 r6 s>tu ?v0 w8 0 n 2 @tx1 x 2t x5y:Az1{0|2}Bpq:t8~;x8; 0 :4 405>31508390=315:20402 * ! " J = 3D E-6O K G > #N?`8# 0 P$8 "Q"0 R 2 HFIL@ "1- 2 5($:A ,1E 0(2-B:8;8;0:4405>31508390=315:20402 F" $ " +FD ) M N *$ #!$ ( * "# "W) # O!# #)S " - Y LI#"P Z 'R T(U#.$*J"# H TX"H%V [V+H" ' ) #$ $"\ - ( " ) 8r# ^ _ *` O $ "a P "b#$c Q#$R *aG PD $d S + e$+_T$+N" f U " scU e t] aRd T cL $ # $# , 5 6 %#^##*$g#U*$* eV( ^" ` $ h ^#$"(_$i j #k .l k% m"W X $Y Z#$Y"([$ # . T P% " " #J!R ea D e!f @ J\ "MC -"u%@ $ n o "n pse H mt#i *jEN]C ^-["Zg%X $Y Z Y" _ a b c# * k #l" k q++" $# *## ")! $ " $ $#"$ ' % + #% " ## * * %#"* # ).F .K # $z" S{ |#J#})R ~ G #e# )f X X "C G$ ~ D $ ~ $ "( " ] L $ #G($ (D$ + $ $} $ + " "$- L#$ 0vnfwxpA_ang=ade_fce1n`h^_ y fm h#$ 0ijU^]kANPj\=PSTNURT1jOlMN m m m m m m m m m m Proposal Form Checklist 3 PROPOSAL FORM 1: ATTACHMENT B – PRICING 4 PROPOSAL FORM 2: QUESTIONNAIRE & EVALUATION CRITERIA 5 PROPOSAL FORM 3: CERTIFICATIONS AND LICENSES 13 12 PROPOSAL FORM 4: CLEAN AIR WATER ACT 14 13 PROPOSAL FORM 5: DEBARMENT NOTICE 15 14 PROPOSAL FORM 6: LOBBYING CERTIFICATION 16 15 PROPOSAL FORM 7: CONTRACTOR CERTIFICATION REQUIREMENTS 17 16 PROPOSAL FORM 8: ANTITRUST CERTIFICATION STATEMENTS 18 17 PROPOSAL FORM 9: IMPLEMENTATION OF HOUSE BILL 1295 19 18 PROPOSAL FORM 10: BOYCOTT CERTIFICATION AND TERRORIST STATE CERTIFICATION 20 19 PROPOSAL FORM 11: RESIDENT CERTIFICATION 21 20 PROPOSAL FORM 12: FEDERAL FUNDS CERIFICATION FORM 22 21 PROPOSAL FORM 13: ADDITIONAL ARIZONA CONTRACTOR REQUIREMENTS 28 27 PROPOSAL FORM 14: OWNERSHIP DISCLOSURE FORM (N.J.S. 52:25-24.2) 30 29 PROPOSAL FORM 15: NON-COLLUSION AFFIDAVIT 31 30 PROPOSAL FORM 16: AFFIRMATIVE ACTION AFFIDAVIT (P.L. 1975, C.127) 32 31 PROPOSAL FORM 17: C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM 35 34 PROPOSAL FORM 18: STOCKHOLDER DISCLOSURE CERTIFICATION 40 39 PROPOSAL FORM 19: GENERAL TERMS AND CONDITIONS ACCEPTANCE FORM 41 40 PROPOSAL FORM 20: EQUALIS GROUP ADMINISTRATION AGREEMENT 42 41 PROPOSAL FORM 21: OPEN RECORDS POLICY ACKNOWLEDGEMENT AND ACCEPTANCE 43 42 PROPOSAL FORM 22: VENDOR CONTRACT AND SIGNATURE FORM 44 43 PROPOSAL PRICING: Attachment B is provided separately in a Microsoft Excel file and is required to complete your price proposal. Pricing should be entered in the attachment B Excel form provided in this RFP packet. Please reference Section 1, Part B, Instructions to Proposers, for more information on how to complete pricing. Respondents should incorporate their questionnaire responses directly into the green cells below. Failure to provide responses in this format may result in the proposal being deemed as non-responsive at the sole discretion of Region 10. Respondents may incorporate additional documents as part of their response which may be utilized by Region 10 as part of the evaluation. Additional documents must be consolidated as part of this Section 2 at the end of your response.
Appears in 1 contract
Samples: Vendor Contract
