IFB # C000509 HVAC Maintenance
Proposal Checklist
Checklist Item / Page #☐ Administrative Proposal * Must not include any financial information. Inclusion of cost information in the administrative proposal will result in proposal disqualification.
☐ (3) appropriately labeled original paper copy sets and one (1) exact copy of the Administrative Proposal
☐ One (1) Electronic format (USB) Administrative proposal
☐Executive Summary/Company background
Must include:
- Name and address of contact
-Corporate structure identifying any parent company and affiliates for Bidder and subcontractors
- Date and place of incorporation, where registered, licensed, as applicable, corporate headquarters, and other background information, etc.
- Describe the corporate profile, core business, and state the number of years the providing each service function for the Bidder and any subcontractors
- Organization chart for Bidder and any subcontractors
☐ Attachment 17 - Firm Offer Letter and Conflict of Interest Disclosure, must be signed and notarized
☐ Attachment 1 - Proposal Checklist, completed and signed
☐ Attachment 2–Non-Collusive Bidding Certification
☐ Attachment 5 - NYS Required Certification
☐ Attachment 6 - Consultant Confidentiality and Non-Disclosure Agreement
☐ Attachment 7- Workers’ Compensation Requirements under WCL § 57: Completed Workers Compensation Coverage Form:
•C-105.2 (Certificate of NYS Workers' Compensation Insurance Coverage): Contact your insurance carrier or licensed NYS insurance agent for this form OR
•U-26.3 (NY State Insurance Fund Certificate of Workers' Compensation Coverage) Available from the NYS Insurance Fund OR
•SI-12 (Affidavit Certifying That Compensation Has Been Secured): Board-approved self-insurers must obtain this form from Board's Self-Insurance Office OR
•GSI-105.2 (Certificate of Participation in Workers' Compensation Group Board-Approved Self-Insurance): Employers must obtain this form from their group self-insurance administrator; OR
•WC/DB CE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability Benefits Coverage. Request through the Workers’ Compensation Board website.
Attachment 7-Disability Benefits Requirements under WCL § 220(8): Completed Disability Benefits Coverage Form:
- DB-120.1 (Certificate of Insurance Coverage Under The NYS Disability Benefits Law): Contact your insurance carrier or licensed NYS insurance agent for this form OR
- DB-155 (Compliance With Disability Benefits Law): Board-approved self-insured employers must obtain this form from Board's Self-Insurance Office OR
☐ Attachment 8 - Lobbying Forms All-in-One, completed
•Completed and signed Offeror’s Affirmation of Understanding of and Agreement pursuant to State Finance Law §139-j (3) and §139-j (6) (b)
Completed and signed Offeror Disclosure of Prior Non-Responsibility Determinations
☐ Attachment 9 - EEO 100 – Equal Employment Opportunity Staffing Plan, completed and signed
☐ Attachment 10 - MWBE 100 - MWBE Utilization Plan, completed and signed
☐ Attachment 11 - Minority and Women-Owned Business Enterprises and Equal Employment Opportunity Policy Statement- Form #4, completed
☐ Attachment 12 - Confidentiality and Non-Disclosure Agreement A, completed, signed and notarized
☐ Attachment 13 - Vendor Responsibility Questionnaire For-Profit Business Entity, completed, signed and notarized by contractor
☐ Attachment 14 - Encouraging Use of NYS Businesses in Contract Performance, completed
☐ Attachment 15 - Contractor Certification to Covered Agency, ST-220-CA, completed, signed, and notarized
☐ Attachment 16 - Bidder Information Form, completed
☐ Attachment 19 - Minimum Bidder Qualifications, completed
☐ Attachment 21–Bidder and Subcontractor Customer References
☐ Attachment 23- Affirmative Statements
☐ Attachment 24- Use of SDVVOB’s in Contract Performance
☐ Attachment 25- FOIL and Litigation Disclosure
☐ Financial Proposal
☐ (3) appropriately labeled original paper copy sets and one (1) exact copy of the Financial Proposal
☐ One (1) Electronic format (USB) Financial Proposal
☐ Title Page
Label this page “Financial Proposal”
☐Table of Contents
Identity all proposal contents
☐ Attachment17 - Firm Offer Letter and Conflict of Interest Disclosure, completed, signed, and notarized
☐ Attachment 20 - Financial Proposal Workbook, completed
Pricing shall be:
- Inclusive of all labor, licenses, insurance, administration, overhead, travel, and all other applicable expenses required to meet the applicable IFB requirements. No other costs will be allowed.
- No overtime rates will apply
- Proposed price must be firm for 90 calendar days from date Proposal is submitted
- All terminology used in the Financial/Administrative Proposal must be consistent with and correspond to the terminology used in the HVAC Maintenance Plan.
☐ HVAC Maintenance Plan * Must not include any financial information. Inclusion of cost information in the HVAC Maintenance Plan will result in proposal disqualification.
☐Three (3) appropriately labeled original paper copy sets and one (1) exact copy of the HVAC Maintenance Plan
☐ One (1) Electronic format (USB)HVAC Maintenance Plan
☐ Title Page
Label this page “HVAC Maintenance Plan” and include:
- IFB Title and number
- Bidder’s name and address
- Name, address, telephone number, and email address of the Bidder’s contact person
- Date of the Proposal
- Bidder’s Federal Tax ID Number
- Bidder’s NYS Statewide Financial System Supplier (SFS) ID Number, if known
☐ Table of Contents
Must identify all proposal contents by page and section number
☐ Attachment 1 - Proposal Checklist, completed and signed
☐ Attachment 18- HVAC Maintenance Plan, provided
Describe how the Bidder will meet the IFB requirements, including:
-Overview, Firm Experience and Qualifications
-Equipment Maintenance and Repair Plan
-Emergency and Remedial Maintenance Plan
-Equipment Decommission and Removal Plan
-Service Center, Trouble Reporting and Escalation
-Response Time and Service Credits Plan
-Key Personnel Minimum Requirements
-Staffing Plan
-Transition Plan
☐ Attachment 19 - Minimum Qualifications, provided
Must describe how Bidder meets each minimum requirement
☐ Attachment 21 – Bidder and Subcontractor Customer References
Bidder shall provide a minimum of three (3) customer references with a maximum of five (5) customer references to whom the Bidder currently provides services and/or to whom the Bidder provided such services comparable to those services required by this IFB and/or to whom the Bidder provided such services within the last two (2) years.
Required Form(s): The Bidder shall complete and submit the “Bidder and Subcontract Customer References” form, attached hereto as Attachment 21. The Bidder shall be solely responsible for providing contact names and phone numbers that are readily available to be contacted by the State between the hours of 9:00am ET to 5:00pm ET.
CIO/OFT will make two (2) attempts to contact Bidder’s references. If Bidder’s reference does not respond back to CIO/OFT within twenty-four (24) hours of the second attempt the Bidder may be asked to provide a different reference.
☐ Attachment 27 - Key Personnel Forms, provided
* Should there be a discrepancy between the electronic media and the original hard copy, the hard copy takes precedent.
I certify, with my signature below, that all required and requested information listed above is completed and included in this bid submission.
Authorized Signature: / Date:
Print Name and Title:
Company represented: