State of Minnesota Department of Employment and Economic Development

Transcription

1 State of Minnesota Department of Employment and Economic Development Request for Proposals for Intermediary Services under a Department of Labor Employment and Training Administration Pay for Success Pilot Program Date: October 8, 2012 SPECIAL NOTICE: This Request for Proposals (RFP) does not obligate the State of Minnesota or the Minnesota Department of Employment and Economic Development to award a contract or complete the proposed program, and the State reserves the right to cancel this RFP if it is considered in its best interest.

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3 Table of Contents I. Introduction... 1 II. Process... 6 III. Response Requirements... 7 IV. Selection Process and Criteria V. General Requirements a. Information and Declaration Letter b. Certification Regarding Lobbying c. Affirmative Action Certificate d. Affidavit of Non-Collusion e. Veteran-Owned Preference Form f. Sample Professional/Technical Services Contract VI. Attachment A: Solicitation for Grant Applications 3 P a g e

4 PART I: Introduction REQUEST FOR PROPOSALS Minnesota Department of Employment and Economic Development Department of Labor / Employment and Training Administration Pay for Success Pilot Program A. Request for Proposals Intermediary Services The purpose of this Request for Proposals (RFP) is to secure the services of a highly qualified Intermediary Entity to enter into a contract for services with the Minnesota Department of Employment and Economic Development (DEED) as required under the attached U.S. Department of Labor / Employment and Training Administration (See Attachment A: SGA): Announcement Type: Solicitation for Grant Applications (SGA) Pay for Success Pilot Projects Funding Opportunity Number: SGA/DFA PY Catalog of Federal Domestic Assistance (CFDA) Number: Intent of RFP: The Intermediary Entity shall, in accordance with the above noted Department of Labor/Employment and Training Administration (DOL/ETA) Pay for Success grant opportunity: a. Enter into a contract for services with DEED; b. Work with the Governor s Workforce Development Council and other partner stakeholders in the development of a Return-on-Investment (ROI) methodology; c. Be responsible for achieving the negotiated outcome(s) for an identified target population by contracting with service delivery providers willing to undertake a defined intervention; d. Raise funds from investors to cover the operating costs of achieving the outcomes until the release of federal funds after successfully meeting defined goals; e. Have the flexibility to change or modify its service delivery methods and providers; and f. Collect and share data with DEED and a third party independent outcome evaluator as required. In a Pay for Success model, the designated Intermediary is required to provide financial / investment capital to cover the operating costs of achieving a target outcome, either from its own funds or from other private investor resources. Payment of the committed funds by DEED is contingent upon the achievement and independent validation of negotiated 4 P a g e

5 outcomes. A full description of proposed funding scenario is described in Attachment A: SGA. Please note that the contract for services entered into between the DEED and the successful applicant will be contingent upon Minnesota being awarded a grant by the DOL/ETA under the funding opportunity. Moreover, the contract for services is also contingent upon the availability of Federal appropriations that may be necessary to implement the agreement. Submission of Minnesota s Pay for Success grant proposal is due to the Department of Labor no later than December 11, Grant awards under the DOL solicitation must be made before September 30, The successful responder is expected to assist Minnesota in the preparation of its grant application relating to SGA/DFA PY (see Attachment A: SGA). However, please note that the successful responder will not be reimbursed for its assistance provided in the preparation of the grant application. Further implementation of the contract for services is entirely contingent upon Minnesota being awarded a grant under the SGA. Assuming a successful grant application process and grant award, the period of service delivery relating to the grant award will be up to 36 months from the date of grant award (see Attachment A: SGA for additional information). Six more months are available for measurement, documentation and validation of outcome results, and submission of payment requests to the Federal government, and a final six months are available to the DOL to approve and disburse payment. Total pilot project period is expected to run a full 48 months from date of federal contract issuance. The original state contract period will be a two year contract, with options to renew for two one-year periods. Also, please note that payment for services is contingent upon the achievement and independent validation of negotiated outcomes. The Intermediary will not be paid if it does not achieve validated negotiated outcomes. This request for proposals does not obligate the State to award a contract or complete the project, and the state reserves the right to cancel the solicitation if it is considered to be in its best interest. Prospective responders who have any questions regarding this request for proposal may contact by only: Connie J. Christenson: Connie.christenson@state.mn.us Answers to all questions (received by the due date) will be distributed on the date indicated in the Timetable. Answers will be found on DEED s web page dedicated to the project: Other state personnel are NOT authorized to discuss this request for proposal with responders before the proposal submission deadline. Contact regarding this RFP with any personnel other than Ms. Christenson could result in disqualification. 5 P a g e

6 B. Minnesota Department of Employment and Economic Development Minnesota s Department of Employment and Economic Development is the state s primary advocate for job creation and economic growth through workforce development and is eligible for assistance under Title I of the Workforce Investment Act (WIA) of The Department administers Minnesota s unemployment insurance system and workforce centers that connect job seekers with employers to build a workforce that helps Minnesotan businesses compete in today s global economy. The Department serves as the State s principal source for labor market information and offers a variety of services designed to help businesses find workers and people find jobs. Additional information regarding the Department can be found at C. Goal A key objective of this solicitation is to establish a partnership that will be instrumental in managing and evaluating the Minnesota Pay for Success Pilot Program. This includes being able to demonstrate the ability to work closely with DEED, other state agencies, service providers, providers of working capital, and the many interested parties in the community who are seeking ways to improve the delivery of workforce development services. To accomplish this objective, DEED seeks assistance in the design, administration / management, and evaluation of the Pay for Success Pilot Program, including analysis and consultation in the areas of: Program design and development Monitoring and tracking service providers outcomes Arranging sources of working capital for service providers Develop service provider contracts and schedule of payments Manage provider performance, contracts, and payments Evaluation design to determine the extent to which the program services are driving changes in state revenues or expenditures. Calculation of return on investment in partnership with the Governor s Workforce Development Council (GWDC) housed within DEED and other partners. Data collection to determine the extent to which the service provider is meeting the state s return on investment goal and the terms of the performance contract Other issues related to the administration of the pilot program The Intermediary will establish an ongoing relationship with DEED in all areas of program development to provide continuing analysis, consultation and advice. DEED must approve program design, contracts, return on investment criteria, provider payments, the sources of working capital, the evaluation design, and other key areas of program management. D. Minnesota DEED s Responsibilities Minnesota s Department of Employment and Economic Development will oversee the implementation of the contract resulting from this RFP. Department staff will maintain contact with the selected Intermediary and monitor performance of the contract. The proposed sources of funding for the activities outlined in this RFP are indicated in the Attached Solicitation for Grant Applications (SGA). 6 P a g e

7 Please note that any resulting agreement shall be deemed in effect to the extent of the monies available to DEED and no liability on account thereof shall be incurred by DEED beyond monies available for the purpose thereof. II. Process for Response Submission A. Responders Conference: A Responders Conference will not be held for this solicitation. B. Mandatory Notice of Intent to Respond (ITR) Those organizations intending to submit a response to this RFP should submit an indicating that fact. ITR s should be sent to the following address: connie.christenson@state.mn.us. ITR s should be received by the next business day after the distribution of Answers to questions. C. Response Due Date Responses must be received in hard copy format no later than the date and time indicated in the Timetable and delivered to the address noted below. Any responses or unsolicited amendments to responses received after the due date and time will not be considered in the review process. No electronically submitted final documents will be accepted. Minnesota DEED takes no responsibility for any third party error in the delivery of responses (e.g. U.S. Post Office, Federal Express, UPS, courier, etc.). III. Response Requirements - Format and Content Responses will consist of a technical response and a cost proposal. To ensure that all responses are evaluated on the same basis, all of the following must be included. Responses should also be organized in the sequence described below. A. Mandatory Requirements (Scored as Pass/Fail) The following will be considered on a pass/fail basis: 1. Proposals must be received on or before the due date and time specified in this solicitation. B. Technical Response (20 page maximum single sided) a. Due Diligence Assessment Capabilities: The intermediary will be required to vet and select effective service providers, evaluators, and other partners to create a successful partnership. i. Describe your organization s process and capabilities in effectively conducting due diligence assessments. b. Financial Modeling and Deal Structuring Capabilities: The intermediary will be responsible for designing the detailed financial modeling required as the basis for the deal structure. 7 P a g e

8 i. Describe how your organization has demonstrated capabilities in financial modeling and deal structuring. c. Ability to Raise Capital: Intermediaries must be able to raise capital for this novel investment opportunity. i. Describe your organization s track record in raising investment capital for new ventures. d. Target Population and Proposed Intervention: Intermediary will help to identify a high cost population and proposed intervention to meet project ROI strategy. i. Describe your recommended target population supported by existing data and define the intervention which addresses the needs of this high cost population resulting in an ROI to satisfy the requirements of the SGA. e. Adult Workforce Development Knowledge: The intermediary must have indepth and up-to-date broad subject matter knowledge in adult workforce development. i. Describe your organization s in-depth and up-to-date knowledge and/or experience in adult workforce development or the ability to acquire this knowledge. f. Familiarity with Workforce Service Delivery: The intermediary must be familiar with workforce service delivery systems in order to scale the delivery of services to constituents i. Demonstrate your organization s familiarity and/or experience with workforce service delivery systems. g. Project Management Capabilities: The intermediary will be responsible for managing the full portfolio of implementing organizations and their program interventions. i. Describe your organization s track record of managing a number of organizations and with varying program interventions. h. Ability to Manage to Outcomes: Project requires effective management to outcomes, including rigorous program planning and tracking of outcomes. i. Describe your organization s ability to manage to outcomes (e.g., effectively plan your programs and set targets against outcomes). i. Ability to Analyze and Use Data: An intermediary must be able to conduct detailed financial analysis to effectively use program and outcomes data to make decisions. i. Outline your organization s ability to effectively analyze and make decisions based on data. j. Impact Assessment Literacy: An intermediary must understand and be able to effectively manage impact assessments in order to determine program results and therefore ultimate performance payments- in order to effectively manage this process. i. Describe your organization s understanding of and/or experience in impact assessments. 8 P a g e

9 k. Technical Assistance / Capacity Training Capabilities: the intermediary will provide or help stakeholders access technical assistance and capacity training to enable the development of new capabilities. i. Outline your organization s experience directly providing or providing access to technical assistance and capacity training. l. Commitment to Expanding Knowledge: The pilot project will generate knowledge about evidence-based programs and scaling which should be shared with the field. i. Describe how your organization will support sharing lessons learned. m. Local Relationships: The intermediary must maintain close working relationships with local stakeholders that will be crucial to the success of the pilot project. i. Outline your organization s relationship structure with local stakeholders. n. Duration and Quality of Partnerships: The project will require close coordination of 5 or more stakeholders over multiple years in a dynamic setting. i. Describe your organization s track record of high-quality, long-term relationships with partners, including managing associated challenges. o. Commitment to Partnership Approach: To have successful implementation of the Pay for Success pilot project will require the intermediary to have close collaboration between service providers, intermediaries, and evaluation advisors to assess the impact of the intervention and modify as suggested by ongoing monitoring. i. Describe your organization s willingness to engage in a close collaboration to support ongoing assessment and iteration on the intervention being scaled through the pilot project. p. Experience With Performance-Based Government Contracts i. As this is a new form of performance-based contract, describe your organization s organization ability to work under performance-based contracts and provide detailed information on any previous projects. Provide both success stories and lessons learned. q. Strength of Top Leadership: It is mandatory that the intermediary leadership have strategic insight, experience, and collaboration skills in order to achieve our desired impact. i. Describe how your leadership team has demonstrated: -Skills and appetite for analytical and strategic thinking -Meaningful depth and breadth of experience -Ability to work together effectively and prioritize actions to create impact r. Strength of Board Leadership: The intermediary s Board requires a comfort level with the learning involved in implementing novel tools and the associated public exposure and risk. i. How has your Board demonstrated its commitment to the Pay for Success Pilot Project given the associated learning and risks. 9 P a g e

10 s. Staff Capabilities: the intermediary s staff must have the appropriate analytical skills (e.g., financial modeling), cultural sensitivities (e.g., local relationships and knowledge), and project management capabilities (e.g., stakeholder management) i. Identify key project implementation staff highlighting their relevant qualifications and skills t. Ability to Attract, Develop, and Retain Staff: To effectively manage the Pay for Success project, the intermediary may have to add capacity. i. Describe your organization s ability to attract, develop, and retain relevant talent. u. Internal Financial Management Capabilities: Intermediary must have demonstrated effective management of a multiyear budget. i. Describe your internal financial planning and management. v. Strength of Administration and Program Functions: intermediaries are required to have high functioning, effective and efficient administration and program management to ensure interventions are effectively implemented (e.g., communication, HR, IT, legal) i. Describe your organizations capacity in administration and program management. w. Capacity: Please provide information demonstrating your ability and capacity to provide services requested, including a list of current and future projects that may limit your ability to provide services to the State. x. Experience and References: Please provide a list of current client for whom you are providing similar services and include with that list no fewer than three (3) references, including and telephone contact information. C. The contents of this RFP and the submitted proposal of the successful Intermediary may become part of the awarded contract. Failure by any responder to include the following information or statements in the proposal may result in its being declared unacceptable or non-responsive, and it may receive no further consideration. At a minimum, the following must be incorporated into your proposal: a. Transmittal Letter. A transmittal letter must accompany the proposal. The letter must be in the form of a standard business letter and be signed, in ink, by an individual authorized to legally bind the contractor. b. Narrative: Twenty page maximum (8.5 x 11 papers, single side printing) excluding required attachments. Provide five copies of your proposal. c. Font: 12 point type with appropriately legible line spacing. D. Response Forwarding Instructions and Format 1. Address: Connie J. Christenson MN DEED s Office of Innovation and Strategic Alliances Suite E200 First National Bank Building 332 Minnesota Street St. Paul, MN P a g e

11 2. A cover sheet with the following information is to be attached to the proposal. This cover sheet does not count towards maximum page limit. a. Name of Responder s Firm b. Federal Tax Identification Number c. Minnesota Tax Identification Number d. Corporate status. If non-profit, please provide your IRS letter of authorization (will not count against maximum page limit) e. Principal Place of Business f. Address g. City h. State and Zip i. Contact Person j. Title k. Telephone l. address 3. The technical proposal should be packed in a sealed envelope with the title of the RFP, and the respondent s name and address clearly displayed on the exterior of the envelope. RFP Timetable: Late proposals will not be considered. Event Day / Date Time Solicitation Release Date MN State Register 10/08/2012 Deadline for Vendor Questions 10/19/ :00 AM CST Deadline for Answers to Vendor Questions 10/22/ :00 AM CST Deadline for Submission of Mandatory Intent to Bid 10/29/2012 4:00 PM CST Deadline for Submission of Offer 10/31/2012 4:00 PM CST Estimated End of Evaluation & Selection Process 11/09/2012 All costs incurred in responding to this RFP will be borne by the responder. Please Note: Any agreement resulting from this RFP will require the final approval of the Minnesota Office of the Attorney General and the Commissioner of the Department of Employment and Economic Development. D. Cost Detail Identify the financial requirements to provide the requested level of service outlined in III.A. Identify the level of the Department s participation in the contract, as well 11 P a g e

12 as any other services to be provided by the department and details of cost allowances for this participation. For the purpose of your response, please identify the fixedprice cost and cost based on percentage taken as a fee for service for the following federal grant award amounts, as set forth below: Grant Amount Awarded Fixed Price Fee Percentage Fee $2,000,000 $6,000,000 $12,000,000 Please make sure to submit your cost proposal in a separate, sealed envelope. 1. Submit the following forms as attachments to your cost proposal: i. Certification Regarding Lobbying ii. Affirmative Action Certificate iii. Affidavit of Non-Collusion iv. Veteran-Owned Preference Form (if applicable) E. General Requirements All responses and accompanying documentation will become the property of the Minnesota Department of Employment and Economic Development and will not be returned. The content of each responder's response will be held in strict confidence during the bid evaluation process, and no details of the response will be discussed outside of the evaluation process. Please note, however, that in some circumstances contents of a responder s response may be disclosed in conjunction with Minnesota s Freedom of Information Law. The successful responder's response and portions of the RFP deemed applicable by the Minnesota Department of Employment and Economic Development will be made part of the contract. Therefore, an official authorized to commit the company to a contract must sign the response. IV. Selection Process and Criteria A. Evaluation of Responses All responses received by the deadline will be evaluated by a Technical Review Committee consisting of representatives of the Department of Employment and Economic Development and internal and external content specialists. Proposals will first be reviewed for responsiveness to determine if the minimum requirements have been met. Proposals that fail to meet minimum requirements will not advance to the next phase of the evaluation. DEED reserves the right, based on the scores of the proposals, to create a short-listing of vendors who have received the highest scores to be interviewed for further presentation to the Technical Review Committee. DEED reserves the right to seek the best and final offers from one or more responders. A 100-point scale will be used to create the final evaluation 12 P a g e

13 recommendation with the technical portion of the rating criteria weighted at 100% of the total. DEED reserves the ability to re-score a proposal upon completion of the personal interview and presentation. B. Evaluation Process The evaluation process will be conducted as follows: All responses received by the deadline will be evaluated by representatives of the Department of Employment and Economic Development. Proposals will first be reviewed for responsiveness to determine if the minimum requirements have been met. Proposals that fail to meet minimum requirements will not advance to the next phase of the evaluation. The State reserves the right, based on the scores of the proposals, to create a short-listing of vendors who have received the highest scores to interview, or conduct demonstrations/presentations. The state reserves the right to seek best and final offers from one or more responders. C. Method of Selection The method of selection will be based on a point system with the technical portion of the rating criteria weighted at 100% of the total. D. Evaluation Factors: Score is based on percentages as indicated. The factors and weighting on which proposals will be judged are: 1. Expressed understanding and plan for providing requested services based on responses to Article III.A; including but not limited to (Section III (A)(a-v)): (60%) Program structure and management Feasibility study of potential investor pool and proposed level of investment Plan for service providers working capital needs during the pendency of the pilot project Financing plan and budget for required RFP services 2. Demonstration of ability and capacity to provide services requested as demonstrated by client experience and references (Section III(A)(w-x)). (10%) 3. Cost Detail (30%) 4. Presentations and Interviews. The Technical Review Committee (TRC) reserves the right to conduct an interview and receive a presentation from the top scoring Responders. The TRC may provide the finalists with a set of questions in advance of the presentation. Finalists may be asked to submit additional information. The TRC may re-score based on the above described requirements. The Commissioner, or an authorized designee, will review the award decisions and may accept or reject the recommendation of the TRC. DEED reserves the 13 P a g e

14 V. General Requirements right to make an award without further clarification of the proposal received. Therefore, it is important that each proposal be submitted with the most complete manner possible. Only the top proposals will advance. Affidavit of Non-collusion Each responder must complete the attached Affidavit of Non-collusion and include it with the response. Conflicts of Interest Responder must provide a list of all entities with which it has relationships that create, or appear to create, a conflict of interest with the work that is contemplated in this request for proposals. The list should indicate the name of the entity, the relationship, and a discussion of the conflict. Proposal Contents By submission of a proposal, Responder warrants that the information provided is true, correct and reliable for purposes of evaluation for potential contract award. The submission of inaccurate or misleading information may be grounds for disqualification from the award as well as subject the responder to suspension or debarment proceedings as well as other remedies available by law. Disposition of Responses All materials submitted in response to this RFP will become property of the State and will become public record in accordance with Minnesota Data Practices Act, Chapter 13, after the evaluation process is completed. Pursuant to the statute, completion of the evaluation process occurs when the government entity has completed negotiating the contract with the selected vendor. If the Responder submits information in response to this RFP that it believes to be trade secret materials, as defined by the Minnesota Data Practices Act, Chapter 13, the Responder must: clearly mark all trade secret materials in its response at the time the response is submitted, include a statement with its response justifying the trade secret designation for each item, and defend any action seeking release of the materials it believes to be trade secret, and indemnify and hold harmless the State, its agents and employees, from any judgments or damages awarded against the State in favor of the party requesting the materials, and any and all costs connected with that defense. This indemnification survives the State s award of a contract. In submitting a response to this RFP, the Responder agrees that this indemnification survives as long as the trade secret materials are in possession of the State. The State will not consider the prices submitted by the Responder to be proprietary or trade secret materials. Notwithstanding the above, if the State contracting party is part of the judicial branch, the release of data shall be in accordance with the Rules of Public Access to Records of the Judicial 14 P a g e

15 Branch promulgated by the Minnesota Supreme Court as the same may be amended from time to time. Contingency Fees Prohibited Pursuant to Minnesota Statutes Section 10A.06, no person may act as or employ a lobbyist for compensation that is dependent upon the result or outcome of any legislation or administrative action. Sample Contract You should be aware of the State s standard contract terms and conditions in preparing your response. A sample State of Minnesota Professional/Technical Services Contract is attached for your reference. Much of the language reflected in the contract is required by statute. If you take exception to any of the terms, conditions or language in the contract, you must indicate those exceptions in your response to the RFP; certain exceptions may result in your proposal being disqualified from further review and evaluation. Only those exceptions indicated in your response to the RFP will be available for discussion or negotiation. Reimbursements Reimbursement for travel and subsistence expenses actually and necessarily incurred by the contractor as a result of the contract will be in no greater amount than provided in the current "Commissioner s Plan promulgated by the commissioner of Employee Relations. Reimbursements will not be made for travel and subsistence expenses incurred outside Minnesota unless it has received the State s prior written approval for out of state travel. Minnesota will be considered the home state for determining whether travel is out of state. Organizational Conflicts of Interest The responder warrants that, to the best of its knowledge and belief, and except as otherwise disclosed, there are no relevant facts or circumstances which could give rise to organizational conflicts of interest. An organizational conflict of interest exists when, because of existing or planned activities or because of relationships with other persons, a vendor is unable or potentially unable to render impartial assistance or advice to the State, or the vendor s objectivity in performing the contract work is or might be otherwise impaired, or the vendor has an unfair competitive advantage. The responder agrees that, if after award, an organizational conflict of interest is discovered, an immediate and full disclosure in writing must be made to the Assistant Director of the Department of Administration s Materials Management Division ( MMD ) which must include a description of the action which the contractor has taken or proposes to take to avoid or mitigate such conflicts. If an organization conflict of interest is determined to exist, the State may, at its discretion, cancel the contract. In the event the responder was aware of an organizational conflict of interest prior to the award of the contract and did not disclose the conflict to MMD, the State may terminate the contract for default. The provisions of this clause must be included in all subcontracts for work to be performed similar to the service provided by the prime contractor, and the terms contract, contractor, and contracting officer modified appropriately to preserve the State s rights. Preference to Targeted Group and Economically Disadvantaged Business and Individuals In accordance with Minnesota Rules, part , subpart B and Minnesota Rules, part , certified Targeted Group Businesses and individuals submitting proposals as prime contractors will receive a six percent preference in the evaluation of their proposal, and 15 P a g e

16 certified Economically Disadvantaged Businesses and individuals submitting proposals as prime contractors will receive a six percent preference in the evaluation of their proposal. Eligible TG businesses must be currently certified by the Materials Management Division prior to the solicitation opening date and time. For information regarding certification, contact the Materials Management Helpline at , or you may reach the Helpline by at mmdhelp.line@state.mn.us. For TTY/TDD communications, contact the Helpline through the Minnesota Relay Services at Veteran-Owned Preference In accordance with Minnesota Statute 16C.16, subd. 6a, veteran-owned businesses with their principal place of business in Minnesota and verified as eligible by the United States Department of Veterans Affairs Center for Veteran Enterprises (CVE Verified) will receive up to a 6 percent preference in the evaluation of its proposal. Eligible veteran-owned small businesses include CVE verified small businesses that are majorityowned and operated by either recently separated veterans, veterans with service-connected disabilities, and any other veteran-owned small businesses (pursuant to Minnesota Statute 16C.16, subd. 6a). Information regarding CVE verification may be found at Eligible veteran-owned small businesses should complete and sign the Veteran-Owned Preference Form in this solicitation. Only eligible, CVE verified, veteran-owned small businesses that provide the required documentation, per the form, will be given the preference. Human Rights Requirements For all contracts estimated to be in excess of $100,000, responders are required to complete the attached Affirmative Action Data page and return it with the response. As required by Minnesota Rule , It is hereby agreed between the parties that Minnesota Statute 363A.36 and Minnesota Rule are incorporated into any contract between these parties based upon this specification or any modification of it. A copy of Minnesota Statute 363A.36 and Minnesota Rule are available upon request from the contracting agency. Certification Regarding Lobbying Federal money will be used or may potentially be used to pay for all or part of the work under the contract, therefore the Responder must complete the attached Certification Regarding Lobbying and submit it as part of its proposal. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion. Federal money will be used or may potentially be used to pay for all or part of the work under the contract, therefore the Responder must certify the following, as required by the regulations implementing Executive Order Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -- Lower Tier Covered Transactions Instructions for Certification 16 P a g e

17 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meaning set out in the Definitions and Coverage s sections of rules implementing Executive Order You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion--Lower Tier Covered Transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Non-procurement Programs 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 C.F.R. 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions 17 P a g e

18 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Insurance Requirements A. Contractor shall not commence work under the contract until they have obtained all the insurance described below and the State of Minnesota has approved such insurance. Contractor shall maintain such insurance in force and effect throughout the term of the contract. B. Contractor is required to maintain and furnish satisfactory evidence of the following insurance policies: 1. Workers Compensation Insurance: Except as provided below, Contractor must provide Workers Compensation insurance for all its employees and, in case any work is subcontracted, Contractor will require the subcontractor to provide Workers Compensation insurance in accordance with the statutory requirements of the State of Minnesota, including Coverage B, Employer s Liability. Insurance minimum limits are as follows: $100,000 Bodily Injury by Disease per employee $500,000 Bodily Injury by Disease aggregate $100,000 Bodily Injury by Accident If Minnesota Statute exempts Contractor from Workers Compensation insurance or if the Contractor has no employees in the State of Minnesota, Contractor must provide a written statement, signed by an authorized representative, indicating the qualifying exemption that excludes Contractor from the Minnesota Workers Compensation requirements. If during the course of the contract the Contractor becomes eligible for Workers Compensation, the Contractor must comply with the Workers Compensation Insurance requirements herein and provide the State of Minnesota with a certificate of insurance. 2. Commercial General Liability Insurance: Contractor is required to maintain insurance protecting it from claims for damages for bodily injury, including sickness or disease, death, and for care and loss of services as well as from claims for property damage, including loss of use which may arise from operations under the Contract whether the operations are by the Contractor or by a subcontractor or by anyone directly or indirectly employed by the Contractor under the contract. Insurance minimum limits are as follows: $2,000,000 per occurrence $2,000,000 annual aggregate $2,000,000 annual aggregate Products/Completed Operations 18 P a g e

19 The following coverage shall be included: Premises and Operations Bodily Injury and Property Damage Personal and Advertising Injury Blanket Contractual Liability Products and Completed Operations Liability State of Minnesota named as an Additional Insured 3. Commercial Automobile Liability Insurance: Contractor is required to maintain insurance protecting it from claims for damages for bodily injury as well as from claims for property damage resulting from the ownership, operation, maintenance or use of all owned, hired, and non-owned autos which may arise from operations under this contract, and in case any work is subcontracted the contractor will require the subcontractor to maintain Commercial Automobile Liability insurance. Insurance minimum limits are as follows: $2,000,000 per occurrence Combined Single limit for Bodily Injury and Property Damage In addition, the following coverage should be included: Owned, Hired, and Non-owned Automobile 4. Professional/Technical, Errors and Omissions, and/or Miscellaneous Liability Insurance This policy will provide coverage for all claims the contractor may become legally obligated to pay resulting from any actual or alleged negligent act, error, or omission related to Contractor s professional services required under the contract. Contractor is required to carry the following minimum limits: $2,000,000 per claim or event $2,000,000 annual aggregate Any deductible will be the sole responsibility of the Contractor and may not exceed $50,000 without the written approval of the State. If the Contractor desires authority from the State to have a deductible in a higher amount, the Contractor shall so request in writing, specifying the amount of the desired deductible and providing financial documentation by submitting the most current audited financial statements so that the State can ascertain the ability of the Contractor to cover the deductible from its own resources. The retroactive or prior acts date of such coverage shall not be after the effective date of this Contract and Contractor shall maintain such insurance for a period of at least three (3) years, following completion of the work. If such insurance is discontinued, extended reporting period coverage must be obtained by Contractor to fulfill this requirement. 19 P a g e

20 C. Additional Insurance Conditions: Contractor s policy(or policies) shall be primary insurance to any other valid and collectible insurance available to the State of Minnesota with respect to any claim arising out of Contractor s performance under this contract; If Contractor receives a cancellation notice from an insurance carrier affording coverage herein, Contractor agrees to notify the State of Minnesota within five (5) business days with a copy of the cancellation notice, unless Contractor s policy(policies) contain a provision that coverage afforded under the policy(policies) will not be cancelled without at least thirty (30) days advance written notice to the State of Minnesota; Contractor is responsible for payment of Contract related insurance premiums and deductibles; If Contractor is self-insured, a Certificate of Self-Insurance must be attached; Contractor s policy(policies) shall include legal defense fees in addition to its liability policy limits, with the exception of B.4 above; Contractor shall obtain insurance policy(policies) from insurance company(companies) having an AM BEST rating of A- (minus); Financial Size Category (FSC) VII or better, and authorized to do business in the State of Minnesota; and An Umbrella or Excess Liability insurance policy may be used to supplement the Contractor s policy limits to satisfy the full policy limits required by the Contract. D. The State reserves the right to immediately terminate the contract if the contractor is not in compliance with the insurance requirements and retains all rights to pursue any legal remedies against the contractor. All insurance policies must be open to inspection by the State, and copies of policies must be submitted to the State s authorized representative upon written request. E. The successful responder is required to submit Certificates of Insurance acceptable to the State of MN as evidence of insurance coverage requirements prior to commencing work under the contract. E-Verify Certification (In accordance with Minn. Stat. 16C.075) By submission of a proposal for services in excess of $50,000, Contractor certifies that as of the date of services performed on behalf of the State, Contractor and all its subcontractors will have implemented or be in the process of implementing the federal E-Verify program for all newly hired employees in the United States who will perform work on behalf of the State. In the event of contract award, Contractor shall be responsible for collecting all subcontractor certifications and may do so utilizing the E-Verify Subcontractor Certification Form available at All subcontractor certifications must be kept on file with Contractor and made available to the State upon request. 20 P a g e

21 CERTIFICATION REGARDING LOBBYING For State of Minnesota Contracts and Grants over $100,000 The undersigned certifies, to the best of his or her knowledge and belief that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, A Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans and cooperative agreements) and that all sub recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Organization Name Name and Title of Official Signing for Organization By: Signature of Official Date 21 P a g e

22 State Of Minnesota Affirmative Action Certification If your response to this solicitation is or could be in excess of $100,000, complete the information requested below to determine whether you are subject to the Minnesota Human Rights Act (Minnesota Statutes 363A.36) certification requirement, and to provide documentation of compliance if necessary. It is your sole responsibility to provide this information and if required to apply for Human Rights certification prior to the due date of the bid or proposal and to obtain Human Rights certification prior to the execution of the contract. The State of Minnesota is under no obligation to delay proceeding with a contract until a company receives Human Rights certification. BOX A For companies which have employed more than 40 full-time employees within Minnesota on any single working day during the previous 12 months. All other companies proceed to BOX B. Your response will be rejected unless your business: has a current Certificate of Compliance issued by the Minnesota Department of Human Rights (MDHR) or has submitted an affirmative action plan to the MDHR, which the Department received prior to the date the responses are due. Check one of the following statements if you have employed more than 40 full-time employees in Minnesota on any single working day during the previous 12 months: We have a current Certificate of Compliance issued by the MDHR. Proceed to BOX C. Include a copy of your certificate with your response. We do not have a current Certificate of Compliance. However, we submitted an Affirmative Action Plan to the MDHR for approval, which the Department received on (date). Proceed to BOX C. We do not have a Certificate of Compliance, nor has the MDHR received an Affirmative Action Plan from our company. We acknowledge that our response will be rejected. Proceed to BOX C. Contact the Minnesota Department of Human Rights for assistance. (See below for contact information.) Please note: Certificates of Compliance must be issued by the Minnesota Department of Human Rights. Affirmative Action Plans approved by the Federal government, a county, or a municipality must still be received, reviewed, and approved by the Minnesota Department of Human Rights before a certificate can be issued. BOX B For those companies not described in BOX A Check below. We have not employed more than 40 full-time employees on any single working day in Minnesota within the previous 12 months. Proceed to BOX C. BOX C For all companies By signing this statement, you certify that the information provided is accurate and that you are authorized to sign on behalf of the responder. You also certify that you are in compliance with federal affirmative action requirements that may apply to your company. (These requirements are generally triggered only by participating as a prime or subcontractor on federal projects or contracts. Contractors are alerted to these requirements by the federal government.) Name of Company: Authorized Signature: Printed Name: For assistance with this form, contact: Minnesota Department of Human Rights, Compliance & Community Relations Date Telephone number: Mail: The Freeman Building 625 Robert Street North, Saint TC Metro: (651) Toll Free: Paul, MN Web: Fax: (651) TTY: (651) compliance.mdhr@state.mn.us Title: Affirmative Action Certification Page, Revised 6/11 - MDHR