RFP TEMPLATE

[Instructions for developing an RFP are in red and in brackets.

Saple language is in red onl!. All red te"t s#ould be deleted before finali$ing t#e RFP.%
Minnesota &epartent of Regulator! Services
Pro'ect (vervie)
[Describe why the department is requesting proposals and give background on the project.]
Sample Statement:
The Department of Regulatory Services requests proposals to create and assist in implementing a
plan for informing the public through the statewide print media about a consecutive series of
eight reports to be issued by the Department of Regulatory Services Blue Ribbon Task Force
*oal
[Give the outcome of the work you are advertising.]
Sample Statement:
!t is the goal of this pro"ect that #innesota residents will have the opportunity to be informed
about the Department of Regulatory Services Blue Ribbon Task Force and its recommendations
to the governor$ so that they may participate in informed discussions about the recommendations
Saple Tasks
+. [List the tasks to be completed and the specific outcomes epected]
Sample Statement:
Become knowledgeable about the task force and its findings$ conclusions$ and
recommendations by reading background material
!nterview key persons on the task force and staff to gather ideas$ a list of needs$ and other
elements of communicating about the task force%s recommendations
Draft a communication plan$ indicating tasks and responsible persons$ for approval by
Blue Ribbon Task Force e&ecutives
'oordinate news conferences releasing each report
(rrange for interviews of task force representatives by newspaper editorial board
members
(rrange individual interviews with reporters
)repare fact sheets on each report
Rev *+,-
The contractor will work closely with task force and other department personnel !t is possible
that the contractor will prepare outlines or rough drafts of certain products$ which will be
completed by task force or department staff
The contract will begin on the date stated in the contract or upon full e&ecution of the contract$
whichever is later$ and will be completed by .une -/$ 0/,1
,. [!or contracts involving ongoing work where the agency anticipates etension options may be
eercised" it is important to indicate this information in the #!$ so that responders are aware of
the full potential scope of the contract.]
Sample Statement:
The term of this contract is anticipated to run from .uly ,$ 0/,- to .une -/$ 0/,1$ with the option
to e&tend an additional - years in increments determined by the State
-. [%ou may want the responder to propose additional tasks you may not have thought of" but have
them separate those items from the required items in the cost proposal%
Sample Statement:
Responders are encouraged to propose additional tasks or activities if they will substantially
improve the results of the pro"ect These items should be separated from the required items on
the cost proposal
.. [%ou must add a statement that issuing the #!$ doesn&t require the state to select a vendor or start
the project]
This request for proposal does not obligate the state to award a contract or complete the pro"ect$
and the state reserves the right to cancel the solicitation if it is considered to be in its best interest
/. ['here is a good chance that responders will have questions about the content of the #!$ or the
project( you should have them put their questions in writing and submit them to the contact
person. 'he contact person should answer all questions in writing making sure that everyone who
requested a copy of the #!$ receives a copy of the answers. 'o assure that answers to the
questions are received by all the potential responders at the same time" you should issue the
responses to the questions via an addendum to the #!$. %ou might want to set a date by which all
questions must be received and provide the answers with enough time left so the responders have
opportunity to review the answers when writing the proposal. #emember all answers must be sent
to all firms requesting proposals. )veryone must be on a level playing field with the same
information.]
Sample Statement:
)rospective responders who have any questions regarding this request for proposal may contact:
)aul )lain$ )ro"ect 'oordinator
Department of Regulatory Services
,0- 2est State Street$ St )aul$ #3 44444
paulplain5statemnus
Other personnel are NOT authorized to discuss this request for
proposal with responders, before the proposal submission deadline.
Rev *+,-
Contact regarding this RFP with any personnel not listed above could
result in disqualication.
Proposal 0ontent
[%ou have to determine what you want to evaluate in the proposal and then tell the responders what
they must include in their proposals. #emember" if you don&t ask for it" you may not get the
information and this will create a problem when you begin the evaluation process.]
Sample Statement:
Responders must submit the following information:
, ( statement of the ob"ectives$ goals$ and tasks to show or demonstrate the responder%s view
and understanding of the nature of the contract
0 ( description of the deliverables to be provided by the responder along with a detailed work
plan that identifies the ma"or tasks to be accomplished and be used as a scheduling and
managing tool$ as well as the basis for invoicing
- (n outline of the responder%s background and e&perience with e&amples of similar work done
by the responder and a list of personnel who will conduct the pro"ect$ detailing their training$
and work e&perience Resumes or other information about pro"ect personnel should not$ if
possible$ contain personal telephone numbers$ home addresses or home email addresses !f it
is necessary to include personal contact information$ please clearly indicate in the proposal
that personal contact information is being provided
1 (ccessibility 6!f you have determined that the accessibility standards apply to this
procurement you must include this language7 ( completed response to the attached 8oluntary
)roduct+Service (ccessibility Template9s: The response must contain adequate information
to evaluate the responsiveness to the accessibility standards 9ie a completed 8)(T or
equivalent:
4 'ost detail 9See instructions below for submission of pricing information: !dentify the level
of the Department%s participation in the contract$ as well as any other services to be provided
by the department$ and details of cost allowances for this participation 6#ake sure to ask for
cost details in a manner that permits appropriate comparison between responders For
e&ample$ you may wish to ask specifically for fi&ed price or hourly rates$ or be specific about
whether travel costs are included7
; Submit the following forms:
( (ffidavit of 3on 'ollusion
B 'ertificate Regarding <obbying 9if proposal e&ceeds =,//$///$ including e&tension
options:
' (ffirmative (ction 'ertification 9if proposal e&ceeds =,//$///$ including e&tension
options:
D 8eterans )reference Form 9if applicable:
> Resident 8endor Form 9if applicable:
Proposal Instructions
Rev *+,-
[%ou must have a specific delivery point and time for proposals to be submitted.]
Sample Statement:
(ll proposals must be sent to:
Department of Regulatory Services
)aul )lain$ )ro"ect 'oordinator
,0- 2 State St
St )aul$ #3 44444
(ll proposals must be received not later than 0:-/ pm$ 'entral Time$ 3ov 0/$ 0/,-$ as indicated
by a notation made by the Receptionist$ -rd Floor$ ,0- 2est State Street$ St )aul$ #3
[%ou should allow a minimum of *+ days from the date the #!$ will be published in the ,tate #egister
for the responses to be due. %ou want good responses" so you need to let potential responders have a
reasonable period of time to develop them.]
Late proposals )ill not be considered.
(ll costs incurred in responding to this RF) will be borne by the responder
Fa& and email responses will not be accepted or considered
[-ndicate how many copies of the proposal you need and how you want them received.]
Sample Statement:
Submit three copies of the proposal )roposals are to be sealed in mailing envelopes or packages
with the responder%s name and address written on the outside >ach copy of the proposal must be
signed in ink by an authori?ed member of the firm
)rovide one copy of the cost proposal in a separately sealed envelope clearly marked on the
outside @'ost )roposalA along with the firmBs name For purposes of completing the cost
proposal$ the state does not make regular payments based upon the passage of time$ it only pays
for services performed or work delivered after it is accomplished
)roposals will be evaluated on @best valueA as specified below The cost proposal will not be
opened by the review committee until after the qualifications points are awarded
[%ou may want to give the contractor an indication of the range or upper dollar limit of the contract.
.owever history has shown that by giving this number the proposals will come in close to that figure.
'here may be a time when you have an absolute maimum you can spend on a contract and you don&t
want to waste time by receiving proposals that are over that dollar limit.]
Sample Statement:
The department has estimated that the cost of this contract should not e&ceed =,4$/// )rice will
be a significant factor in the evaluation of proposals
Proposal Evaluation
(ll responses received by the deadline will be evaluated by representatives of the 6!nsert Department
name7 )roposals will first be reviewed for responsiveness to determine if the minimum requirements
have been met )roposals that fail to meet minimum requirements will not advance to the ne&t phase
Rev *+,-
of the evaluation The State reserves the right$ based on the scores of the proposals$ to create a shortC
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 ( ,//Cpoint scale 6Dou may choose to utili?e a ,///Cpoint scale if it is preferred by
the agency7 will be used to create the final evaluation recommendation
Mandator! Re1uireents 2Scored as Pass3Fail4
The following will be considered on a pass+fail basis:
+. )roposals must be received on or before the due date and time specified in this solicitation
,. [Insert ot#er Pass3Fail criteria !ou a! #ave suc# as iniu nuber of !ears5
e"perience6 iniu nuber of references re1uired6 etc. 7e sure t#at t#ese
pass3fail re1uireents are ob'ective so t#at !ou can deterine if t#e re1uireent is
et or not.%
-. [For IT8related RFP5s )#ere t#e IT Accessibilit! Standards appl!6 !ou ust select
and include an Accessibilit! (ption belo)6 and reove t#e non8selected options.%
[(ption + 9 Full accessibilit! is a pass3fail for all applicable re1uireents%
Deliverables and services offered must comply with all of the @(pplicableA !T (ccessibility
Standards as identified in the attached 8oluntary )roduct+Service (ccessibility Templates
98)(Ts: Deliverables or services that do not fully comply with the identified standards will be
re"ected and will receive no further consideration
[(ption , 9 Partial accessibilit! is a pass3fail 2i.e.6 : of +; re1uireents%
Deliverables and services offered must comply with EEE9insert number: of EEE9insert number: of
the @(pplicableA !T (ccessibility Standards as identified in the attached 8oluntary
)roduct+Service (ccessibility Templates 98)(Ts: Ff the EEE9insert number G same as first one:
requirements that must be met$ the following must be included: 6!dentify which are mandatory7
63FT>: the preceding sentence is optional$ but recommended There will be standards that are
more significant or applicable than others and some that you would not want the contractor to opt
not to select7 Deliverables or services that do not meet the required number of standards or the
specific standards required will be re"ected and will receive no further consideration 63FT>:
This language needs to be provided for each section of the standards7
[(ption - 9 &ual responses are obtained for coparison%
This option contemplates that dual Requests for Bids will be conducted 9one with accessibility
requirements and one without for the purpose of conducting a comparison: This option is not
applicable to instances where an RF) is being used and would not be used in a )T process
[(ption . 9 Full3partial accessibilit! is a pass3fail and is furt#er scored as a < of points%
Deliverables and services offered must comply with all of the @(pplicableA !T (ccessibility
Standards as identified in the attached 8oluntary )roduct+Service (ccessibility Templates
98)(Ts: )roposals meeting this and other pass+fail criteria will be further evaluated based on the
evaluation criteria specified in this RF) 6Below$ in the @>valuation FactorsA section$ you must
add evaluation criteria for accessibility Dou could title it @(ccessibility of Services or )roducts
)rovidedA and indicate a weight for this criteria7

Rev *+,-
[(ption / 9 Accessibilit! is not scored as a pass3fail6 but as a percentage of points%
This option does not include accessibility as a pass+fail$ so there would be nothing in this section
regarding accessibility 6Be sure to include accessibility as one of your evaluation criteria below
along with a specified weight7
[(ption = 9 Proposals are s#ortlisted prior to scoring accessibilit! as a < of points%
The language for this option related to shortClisting is already present in the generic @)roposal
>valuationA language above So$ there is nothing about accessibility in this pass+fail section that
you need to add if you are using this option Be sure to include accessibility as one of your
evaluation criteria below along with a specified weight

Evaluation Factors 2Scored based on percentage or points as indicated4 [>ote6 t#e evaluation
criteria indicated belo) are e"aples onl!. ?ou s#ould tailor !our evaluation criteria to atc#
)#at is iportant to !our specific procureent.%
Sample Statement:
The factors and weighting on which proposals will be "udged are:
, >&pressed understanding of pro"ect ob"ectives EEH
0 Deliverables and work plan EEH
- Iualifications+e&perience of personnel working on the pro"ect EEH
1 'ost detail -/H
4 >&tent to which services will be performed within the JSK EEH
; 6!f option 1$ 4 or ; above is selected7 (ccessibility of Services
or )roducts )rovided 6other percentage points need to be read"usted7 EE H
/0ote1 !or procurements eceeding 233*"444" member countries of the 5orld 'rade 6rgani7ation&s
Government $rocurement 8greement must be treated on the same basis as 9.,. companies under the
terms of the treaty. 'herefore" agencies are not advised use this as an evaluation factor for
procurements over the 5'6 threshold.
!t is anticipated that the evaluation and selection will be completed by [insert date]
*eneral Re1uireents
['he following" unless specified as optional or otherwise qualified" are required clauses in all #!$s]
Affidavit of >oncollusion
>ach responder must complete the attached (ffidavit of 3oncollusion and include it with the
response
0onflicts 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 0ontents
Rev *+,-
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 sub"ect the
responder to suspension or debarment proceedings as well as other remedies available by law
&isposition of Responses
(ll materials submitted in response to this RF) will become property of the State and will become
public record in accordance with #innesota Statutes$ section ,-4L,$ after the evaluation process is
completed )ursuant to the statute$ completion of the evaluation process occurs when the government
entity has completed negotiating the contract with the selected vendor !f the Responder submits
information in response to this RF) that it believes to be trade secret materials$ as defined by the
#innesota Movernment Data )ractices (ct$ #innesota Statute N ,--O$ 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 "ustifying 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 "udgments 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 StateBs award of a contract !n
submitting a response to this RF)$ 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
3otwithstanding the above$ if the State contracting party is part of the "udicial branch$ the release of
data shall be in accordance with the Rules of )ublic (ccess to Records of the .udicial Branch
promulgated by the #innesota Supreme 'ourt as the same may be amended from time to time
0ontingenc! Fees Pro#ibited
)ursuant to #innesota Statutes Section ,/(/;$ 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
Saple 0ontract
Dou should be aware of the StateBs standard contract terms and conditions in preparing your response
( sample State of #innesota )rofessional+Technical Services 'ontract is attached for your reference
#uch of the language reflected in the contract is required by statute !f you take e&ception to any of
the terms$ conditions or language in the contract$ you must indicate those e&ceptions in your response
to the RF)P certain e&ceptions may result in your proposal being disqualified from further review and
evaluation Fnly those e&ceptions indicated in your response to the RF) will be available for
discussion or negotiation
Reiburseents
Reimbursement for travel and subsistence e&penses actually and necessarily incurred by the
contractor as a result of the contract will be in no greater amount than provided in the current
Q'ommissionerBs )lanA promulgated by the commissioner of >mployee Relations Reimbursements
will not be made for travel and subsistence e&penses incurred outside #innesota unless it has
received the StateBs prior written approval for out of state travel #innesota will be considered the
home state for determining whether travel is out of state
(rgani$ational 0onflicts of Interest
Rev *+,-
The responder warrants that$ to the best of its knowledge and belief$ and e&cept as otherwise
disclosed$ there are no relevant facts or circumstances which could give rise to organi?ational
conflicts of interest (n organi?ational conflict of interest e&ists when$ because of e&isting 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 vendorBs ob"ectivity 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 organi?ational conflict of interest is discovered$ an
immediate and full disclosure in writing must be made to the (ssistant Director of the Department of
(dministrationBs #aterials #anagement Division 9@##DA: which must include a description of the
action which the contractor has taken or proposes to take to avoid or mitigate such conflicts !f an
organi?ation conflict of interest is determined to e&ist$ the State may$ at its discretion$ cancel the
contract !n the event the responder was aware of an organi?ational conflict of interest prior to the
award of the contract and did not disclose the conflict to ##D$ 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$A
@contractor$A and @contracting officerA modified appropriately to preserve the StateBs rights
['he following clause is required when the project is fully funded with state funds. -f federal funding
is used for this project" this language is required unless the project is either :+; subject to federal
disadvantaged business enterprise :D<); requirements or :*; prohibited by the federal government. -f
federal D<) requirements apply" replace the language below with the appropriate D<) requirements.]
Preference to Targeted *roup and Econoicall! &isadvantaged 7usiness and Individuals
!n accordance with #innesota Rules$ part ,0-/,*,/$ subpart B and #innesota Rules$ part
,0-/,*-/$ certified Targeted Mroup Businesses and individuals submitting proposals as prime
contractors will receive a si& percent preference in the evaluation of their proposal$ and certified
>conomically Disadvantaged Businesses and individuals submitting proposals as prime contractors
will receive a si& percent preference in the evaluation of their proposal >ligible TM businesses must
be currently certified by the #aterials #anagement Division prior to the solicitation opening date and
time For information regarding certification$ contact the #aterials #anagement Relpline at
;4,0L;0;//$ or you may reach the Relpline by email at mmdhelpline5statemnus For TTD+TDD
communications$ contact the Relpline through the #innesota Relay Services at ,*//;0O-40L
@eteran8()ned Preference
!n accordance with #inn Stat N ,;',;$ subd ;a$ 9a: >&cept when mandated by the federal
government as a condition of receiving federal funds$ the commissioner shall award up to a si&
percent preference on state procurement to certified sall businesses that are a'orit!8o)ned and
operated b!:
9,: recently separated veterans who have served in active military service$ at any time on or after
September ,,$ 0//,$ and who have been discharged under honorable conditions from active
service$ as indicated by the person%s Jnited States Department of Defense form DDC0,1 or by
the commissioner of veterans affairsP
90: veterans with serviceCconnected disabilities$ as determined at any time by the Jnited States
Department of 8eterans (ffairsP or
9-: any other veteranCowned small businesses certified under section ,;',L$ paragraph 9d:
!n accordance with #inn Stat N ,;',L 9d:$ a veteranCowned small business$ the principal place of
business of which is in #innesota$ is certified if it has been verified by the Jnited States Department
of 8eterans (ffairs as being either a veteranCowned small business or a service disabled veteranC
Rev *+,-
owned small business$ in accordance with )ublic <aw ,/LC1;, and 'ode of Federal Regulations$ title
-*$ part O1
To receive a preference the veteranCowned small business must meet the statutory requirements above
by the solicitation opening date and time
!f you are claiming the veteranCowned preference$ attac# docuentation6 sign and return t#e
@eteran8()ned Preference For )it# !our response to t#e solicitation. Fnly eligible veteranC
owned small businesses that meet the statutory requirements and provide adequate documentation
will be given the preference
[6ptional language when agency determines to preclude foreign outsourcing. 06')1 =ust not be
used to prohibit 5'6 member countries from participating in a contract when contract is epected to
be in ecess of the 5'6 threshold of 233*"444 or when it is being considered as part of the contract
award evaluation criteria.]
Foreign (utsourcing of Aork Pro#ibited
(ll services under this contract shall be performed within the borders of the Jnited States (ll
storage and processing of information shall be performed within the borders of the Jnited States
This provision also applies to work performed by subcontractors at all tiers
[#equired for #!$s anticipated to be in ecess of 2+44"444]
Buan Rig#ts Re1uireents
For all contracts estimated to be in e&cess of =,//$///$ responders are required to complete the
attached (ffirmative (ction Data page and return it with the response (s required by #innesota
Rule 4///-;//$ @!t is hereby agreed between the parties that #innesota Statute N -;-(-; and
#innesota Rule 4///-1// C 4///-;// are incorporated into any contract between these parties
based upon this specification or any modification of it ( copy of #innesota Statute N -;-(-; and
#innesota Rule 4///-1// C 4///-;// are available upon request from the contracting agencyA
[#equired in all #!$s anticipated to be in ecess of 2+44"444" where any federal money :+; will be
used or :*; may potentially be used for the contract work.]
0ertification Regarding Lobb!ing
Federal money will be used or may potentially be used to pay for all or part of the work under the
contract$ therefore the )roposer must complete the attached 0ertification Regarding Lobb!ing and
submit it as part of its proposal
0ertification Regarding &ebarent6 Suspension6 Ineligibilit!6 and @oluntar! E"clusion.
Federal money will be used or may potentially be used to pay for all or part of the work under the
contract$ therefore the )roposer must certify the following$ as required by the regulations
implementing >&ecutive Frder ,041L
0ertification Regarding &ebarent6 Suspension6 Ineligibilit! and @oluntar! E"clusion 88 Lo)er
Tier 0overed Transactions
!nstructions for 'ertification
, By signing and submitting this proposal$ the prospective lower tier participant is providing the
certification set out below
0 The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into !f it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification$ in addition to other remedies available
Rev *+,-
to the Federal Movernment$ the department or agency with which this transaction originated may
pursue available remedies$ including suspension and+or debarment
- The prospective lower tier participant shall provide immediate written notice to the person to
which 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
1 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 'overages sections of rules
implementing >&ecutive Frder ,041L Dou may contact the person to which this proposal is
submitted for assistance in obtaining a copy of those regulations
4 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 1* 'FR part L$ subpart
L1$ debarred$ suspended$ declared ineligible$ or voluntarily e&cluded from participation in this
covered transaction$ unless authori?ed by the department or agency with which this transaction
originated
; The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled @'ertification Regarding Debarment$ Suspension$ !neligibility and
8oluntary >&clusionCC<ower Tier 'overed Transaction$A without modification$ in all lower tier
covered transactions and in all solicitations for lower tier covered transactions
O ( 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 1* 'FR part L$
subpart L1$ debarred$ suspended$ ineligible$ or voluntarily e&cluded from covered transactions$
unless it knows that the certification is erroneous ( participant may decide the method and
frequency by which it determines the eligibility of its principals >ach participant may$ but is not
required to$ check the <ist of )arties >&cluded from Federal )rocurement and 3onprocurement
)rograms
* 3othing 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 e&ceed that which is normally possessed by a
prudent person in the ordinary course of business dealings
L >&cept for transactions authori?ed under paragraph 4 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 1* 'FR L$ subpart L1$ suspended$ debarred$ ineligible$ or
voluntarily e&cluded 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
0ertification Regarding &ebarent6 Suspension6 Ineligibilit! and @oluntar! E"clusion 8 Lo)er
Tier 0overed Transactions
, 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
e&cluded from participation in this transaction by any Federal department or agency
0 2here the prospective lower tier participant is unable to certify to any of the statements in this
certification$ such prospective participant shall attach an e&planation to this proposal
[8ll contracts require insurance. 'he insurance requirements below generally represent the
minimums. Depending upon the type of work and the risk involved" other types of insurance may be
necessary :e.g. > cyber insurance;. ?ontact the Department of 8dministration&s #isk =anagement
6ffice" @3+A*4+A*3B+" with any questions you may have.]
Rev *+,-
Insurance Re1uireents
( 'ontractor shall not commence work under the contract until they have obtained all the insurance
described below and the State of #innesota has approved such insurance 'ontractor shall
maintain such insurance in force and effect throughout the term of the contract

B 'ontractor is required to maintain and furnish satisfactory evidence of the following insurance
policies:
, Aorkers5 0opensation InsuranceC >&cept as provided below$ 'ontractor must provide
2orkersB 'ompensation insurance for all its employees and$ in case any work is
subcontracted$ 'ontractor will require the subcontractor to provide 2orkersB 'ompensation
insurance in accordance with the statutory requirements of the State of #innesota$ including
'overage B$ >mployerBs <iability !nsurance iniu limits are as follows:
=,//$/// G Bodily !n"ury by Disease per employee
=4//$/// G Bodily !n"ury by Disease aggregate
=,//$/// G Bodily !n"ury by (ccident
!f #innesota Statute ,O;/1, e&empts 'ontractor from 2orkersB 'ompensation insurance or
if the 'ontractor has no employees in the State of #innesota$ 'ontractor must provide a
written statement$ signed by an authori?ed representative$ indicating the qualifying e&emption
that e&cludes 'ontractor from the #innesota 2orkersB 'ompensation requirements
!f during the course of the contract the 'ontractor becomes eligible for 2orkersB
'ompensation$ the 'ontractor must comply with the 2orkersB 'ompensation !nsurance
requirements herein and provide the State of #innesota with a certificate of insurance
0 0oercial *eneral Liabilit! InsuranceC 'ontractor is required to maintain insurance
protecting it from claims for damages for bodily in"ury$ 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 'ontract whether the operations are by the
'ontractor or by a subcontractor or by anyone directly or indirectly employed by the
'ontractor under the contract !nsurance iniu limits are as follows:
=0$///$/// G per occurrence
=0$///$/// G annual aggregate
=0$///$/// G annual aggregate G )roducts+'ompleted Fperations
The following coverages shall be included:
)remises and Fperations Bodily !n"ury and )roperty Damage
)ersonal and (dvertising !n"ury
Blanket 'ontractual <iability
)roducts and 'ompleted Fperations <iability
FtherP if applicable$ please listEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
State of #innesota named as an (dditional !nsured$ to the e&tent permitted by law
- 0oercial Autoobile Liabilit! InsuranceC 'ontractor is required to maintain insurance
protecting it from claims for damages for bodily in"ury as well as from claims for property
damage resulting from the ownership$ operation$ maintenance or use of all owned$ hired$ and
Rev *+,-
nonCowned autos which may arise from operations under this contract$ and in case any work
is subcontracted the contractor will require the subcontractor to maintain 'ommercial
(utomobile <iability insurance !nsurance iniu limits are as follows:
=0$///$/// G per occurrence 'ombined Single limit for Bodily !n"ury and )roperty Damage
!n addition$ the following coverages should be included:
Fwned$ Rired$ and 3onCowned (utomobile
.. Professional3Tec#nical6 Errors and (issions6 and3or Miscellaneous Liabilit! Insurance
6>(TE T( A*E>0IESC Your agency will need to determine whether to include or exclude
provision B. 4. based on the nature of the contract. A professional is someone who possesses
expertise on a certain subject and performs work for the state related to that expertise, such
as design work. ervice and maintenance work are typically not considered professional
work even though they may entail some level of expertise. !f professional work will not be
performed, remove provision B.4. and also amend the fifth bullet in the Additional !nsurance
"onditions to read# $!nclude legal defense fees in addition to its liability policy limits.% &or
assistance with determining if provision B. 4. should be included or excluded, please contact
the 'epartment of Administration(s )isk *anagement +ffice at ,-./0 12/31.4/.7
This policy will provide coverage for all claims the contractor may become legally obligated
to pay resulting from any actual or alleged negligent act$ error$ or omission related to
'ontractorBs professional services required under the contract
'ontractor is required to carry the following iniu limits:
=0$///$/// G per claim or event
=0$///$/// G annual aggregate
(ny deductible will be the sole responsibility of the 'ontractor and may not e&ceed =4/$///
without the written approval of the State !f the 'ontractor desires authority from the State to
have a deductible in a higher amount$ the 'ontractor 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
'ontractor 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
'ontract and 'ontractor shall maintain such insurance for a period of at least three 9-: years$
following completion of the work !f such insurance is discontinued$ e&tended reporting
period coverage must be obtained by 'ontractor to fulfill this requirement
' (dditional !nsurance 'onditions:
'ontractorBs policy9ies: shall be primary insurance to any other valid and collectible
insurance available to the State of #innesota with respect to any claim arising out of
'ontractorBs performance under this contractP
Rev *+,-
!f 'ontractor receives a cancellation notice from an insurance carrier affording coverage
herein$ 'ontractor agrees to notify the State of #innesota within five 94: business days
with a copy of the cancellation notice$ unless 'ontractorBs policy9ies: contain a provision
that coverage afforded under the policy9ies: will not be cancelled without at least thirty
9-/: days advance written notice to the State of #innesotaP
'ontractor is responsible for payment of 'ontract related insurance premiums and
deductiblesP
!f 'ontractor is selfCinsured$ a 'ertificate of SelfC!nsurance must be attachedP
'ontractorBs policy9ies: shall include legal defense fees in addition to its liability policy
limits$ with the e&ception of B1 aboveP
'ontractor shall obtain insurance policy9ies: from insurance company9ies: having an
@(# B>STA rating of (C 9minus:P Financial Si?e 'ategory 9FS': 8!! or better$ and
authori?ed to do business in the State of #innesotaP and
(n Jmbrella or >&cess <iability insurance policy may be used to supplement the
'ontractorBs policy limits to satisfy the full policy limits required by the 'ontract
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 (ll insurance policies must be open to inspection by the State$ and copies of policies
must be submitted to the StateBs authori?ed representative upon written request
> The successful responder is required to submit 'ertificates of !nsurance acceptable to the State of #3
as evidence of insurance coverage requirements prior to commencing work under the contract
E8@erif! 0ertification 2In accordance )it# Minn. Stat. D+=0.;:/4
By submission of a proposal for services in e&cess of =4/$///$ 'ontractor certifies that as of the date
of services performed on behalf of the State$ 'ontractor and all its subcontractors will have
implemented or be in the process of implementing the federal >C8erify program for all newly hired
employees in the Jnited States who will perform work on behalf of the State !n the event of contract
award$ 'ontractor shall be responsible for collecting all subcontractor certifications and may do so
utili?ing the >C8erify Subcontractor 'ertification Form available at
http:++wwwmmdadminstatemnus+doc+>verifySub'ertFormdoc (ll subcontractor certifications
must be kept on file with 'ontractor and made available to the State upon request
Rev *+,-
0ERTIFI0ATI(> RE*AR&I>* L(77?I>*
For State of #innesota 'ontracts and Mrants over =,//$///
The undersigned certifies$ to the best of his or her knowledge and belief that:
9,: 3o 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 'ongress$ an officer or
employee of 'ongress$ or an employee of a #ember of 'ongress 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
e&tension$ continuation$ renewal$ amendment$ or modification of any Federal contract$ grant$ loan$ or cooperative
agreement
90: !f 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$ ( #ember of 'ongress$ an officer or employee of 'ongress$
or an employee of a #ember of 'ongress in connection with this Federal contract$ grant$ loan$ or cooperative agreement$
the undersigned shall complete and submit Standard FormC<<<$ Disclosure Form to Report <obbying in accordance with
its instructions
9-: The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers 9including subcontracts$ subgrants$ and contracts under grants$ loans and cooperative agreements:
and that all subrecipients 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 -,
JS' ,-40 (ny person who fails to file the required certification shall be sub"ect to a civil penalty of not less than
=,/$/// and not more than =,//$/// for each such failure
EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
Frgani?ation 3ame
EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
3ame and Title of Ffficial Signing for Frgani?ation
By:EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
Signature of Ffficial
EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
Date
State (f Minnesota 9 Affirative Action 0ertification
If !our response to t#is solicitation is or could be in e"cess of E+;;6;;;$ complete the information requested below to determine whether you are sub"ect to the
#innesota Ruman Rights (ct 9#innesota Statutes -;-(-;: certification requirement$ and to provide documentation of compliance if necessary It is !our sole
responsibilit! to provide t#is inforation andFif re1uiredFto appl! for Buan Rig#ts certification prior to t#e due date of t#e bid or proposal and to obtain
Buan Rig#ts certification prior to t#e e"ecution of t#e contract. T#e State of Minnesota is under no obligation to dela! proceeding )it# a contract until a
copan! receives Buan Rig#ts certification.
BOX A For copanies )#ic# #ave eplo!ed ore t#an .; full8tie eplo!ees )it#in Minnesota on an! single
)orking da! during t#e previous +, ont#s. All ot#er copanies proceed to BOX B.
Dour response will be re"ected unless your business:
has a current 'ertificate of 'ompliance issued by the #innesota Department of Ruman Rights 9#DRR:
GorG
has submitted an affirmative action plan to the #DRR$ which the Department received prior to the date
the responses are due
'heck one of the following statements if you have employed more than 1/ fullCtime employees in #innesota on any
single working day during the previous ,0 months:
2e have a current 'ertificate of 'ompliance issued by the #DRR Proceed to BOX C Include a cop! of !our
certificate )it# !our response.
2e do not have a current 'ertificate of 'ompliance Rowever$ we submitted an (ffirmative (ction )lan to the
#DRR for approval$ which the Department received on EEEEEEEEEEEEEEEEEE 9date: Proceed to BOX C
2e do not have a 'ertificate of 'ompliance$ nor has the #DRR received an (ffirmative (ction )lan from our
company Ae ackno)ledge t#at our response )ill be re'ected. Proceed to BOX C 0ontact t#e Minnesota
&epartent of Buan Rig#ts for assistance. 9See below for contact information:
Please noteC 'ertificates of 'ompliance must be issued by the #innesota Department of Ruman Rights (ffirmative
(ction )lans approved by the Federal government$ a county$ or a municipality must still be received$ reviewed$ and
approved by the #innesota Department of Ruman Rights before a certificate can be issued
BOX B For t#ose copanies not described in BOX A
'heck below
2e have not employed more than 1/ fullCtime employees on any single working day in #innesota within the previous
,0 months Proceed to BOX C
BOX C For all copanies
By signing this statement$ you certify that the information provided is accurate and that you are authori?ed to sign on
behalf of the responder Dou also certify that you are in compliance with federal affirmative action requirements that may
apply to your company 9These requirements are generally triggered only by participating as a prime or subcontractor on
federal pro"ects or contracts 'ontractors are alerted to these requirements by the federal government:
3ame of 'ompany: Date
(uthori?ed Signature: Telephone number:
)rinted 3ame: Title:
For assistance )it# t#is for6 contactC
#innesota Department of Ruman Rights$ 'ompliance S 'ommunity Relations
#ail: The Freeman Building ;04 Robert Street 3orth$ Saint
)aul$ #3 44,44
T' #etro: 9;4,: 0L;C4;;- Toll Free: *//C;4OC-O/1
2eb: wwwhumanrightsstatemnus Fa&: 9;4,: 0L;CL/10 TTD: 9;4,: 0L;C,0*-
>mail: compliancemdhr5statemnus
(ffirmative (ction 'ertification )age$ Revised ;+,, C #DRR
STATE (F MI>>ES(TA
AFFI&A@IT (F >(>0(LLGSI(>
! swear 9or affirm: under the penalty of per"ury:
, That ! am the Responder 9if the Responder is an individual:$ a partner in the company 9if the Responder is a
partnership:$ or an officer or employee of the responding corporation having authority to sign on its behalf 9if the
Responder is a corporation:P
0 That the attached proposal submitted in response to the EEEEEEEEEEEEEEEEEEEEEEEE Request for )roposals has been
arrived at by the Responder independently and has been submitted without collusion with and without any agreement$
understanding or planned common course of action with$ any other Responder of materials$ supplies$ equipment or
services described in the Request for )roposal$ designed to limit fair and open competitionP
- That the contents of the proposal have not been communicated by the Responder or its employees or agents to any
person not an employee or agent of the Responder and will not be communicated to any such persons prior to the
official opening of the proposalsP and
1 That ! am fully informed regarding the accuracy of the statements made in this affidavit
ResponderBs Firm 3ame:EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
(uthori?ed Representative 9)lease )rint: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
(uthori?ed Signature: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
Date: EEEEEEEEEEEEEEEEEE

Subscribed and sworn to me this EEEEEEEE day of EEEEEEEEEEE
3otary )ublic Signature: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE
#y commission e&pires: EEEEEEEE
STATE (F MI>>ES(TA
@ETERA>8(A>E& PREFERE>0E F(RM
!n accordance with #inn Stat N ,;',;$ subd ;a$ 9a: >&cept when mandated by the federal government as a condition of receiving
federal funds$ the commissioner shall award up to a si& percent preference in the amount bid on state procurement to certified sall
businesses that are a'orit!8o)ned and operated b!:
9,: recently separated veterans who have served in active military service$ at any time on or after September ,,$ 0//,$ and
who have been discharged under honorable conditions from active service$ as indicated by the person%s Jnited States Department of
Defense form DDC0,1 or by the commissioner of veterans affairsP
90: veterans with serviceCconnected disabilities$ as determined at any time by the Jnited States Department of 8eterans
(ffairsP or
9-: any other veteranCowned small businesses certified under section ,;',L$ paragraph 9d:
!n accordance with #inn Stat N ,;',L 9d:$ a veteranCowned small business$ the principal place of business of which is in #innesota$
is certified if it has been verified by the Jnited States Department of 8eterans (ffairs as being either a veteranCowned small business
or a service disabled veteranCowned small business$ in accordance with )ublic <aw ,/LC1;, and 'ode of Federal Regulations$ title -*$
part O1
HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
To receive a preference the veteranCowned small business must meet the statutory requirements above by the solicitation opening date
and time 2hen responding to a Request for Bid 9RFB:$ the preference is applied only to the first =4//$/// of the response 2hen
responding to a Request for )roposal 9RF):$ the preference is applied as detailed in the RF)
!f you are claiming the veteranCowned preference$ attac# docuentation6 sign and return t#is for )it# !our response to t#e
solicitation. Fnly eligible veteranCowned small businesses that meet the statutory requirements and provide adequate documentation
will be given the preference
HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
I BERE7? 0ERTIF? TBAT TBE FIRM LISTE& 7EL(AC
#y firm is a certified small business and it is ma"orityCowned and operated by an eligible person as defined by #inn Stat N ,;',;$
subd ;a
HHH?es HHH>o 9must check yes or no: State t#e t!pe of docuentation attac#edCHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH
&(0GME>TATI(> MGST 7E PR(@I&E& F(R (>E (F TBE F(LL(AI>* REIGIREME>TSC
EEE 9,: recently separated veterans who have served in active military service$ at any time on or after September ,,$ 0//,$
and who have been discharged under honorable conditions from active service$ as indicated by the person%s Jnited
States Department of Defense form DDC0,1 or by the commissioner of veterans affairsP
State t#e t!pe of docuentation attac#edC
EEE 90: veterans with serviceCconnected disabilities$ as determined at any time by the Jnited States Department of 8eterans
(ffairsP
State t#e t!pe of docuentation attac#edC
EEE 9-: any other veteranCowned small businesses certified under #innesota Statute Section ,;',L$ paragraph 9d:
State t#e t!pe of docuentation attac#edC
3ame of 'ompany: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE Date: EEEEEEEEEEEEEEEEEEEEEEEEEEEEE
(uthori?ed Signature: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE Telephone: EEEEEEEEEEEEEEEEEEEEEEEEEEEEE
)rinted 3ame: EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE Title: EEEEEEEEEEEEEEEEEEEEEEEEEEEEE
IF ?(G ARE 0LAIMI>* TBE @ETERA>8(A>E& PREFERE>0E6 ATTA0B &(0GME>TATI(>6 SI*> A>& RETGR>
TBIS F(RM AITB ?(GR RESP(>SE T( TBE S(LI0ITATI(>.
STATE OF MINNESOTA
RESIDENT VENDOR FORM
!n accordance with "aws of #innesota $%&', Chapter &($, )rticle ', *ection &+, amending #inn. *tat. , &+C.%$, subd.
&', a -Resident .endor/ means a person, rm, or corporation that0
1&2 is authorized to conduct business in the state of #innesota on the date a solicitation for a contract is rst
advertised or announced. !t includes a foreign corporation duly authorized to engage in business in #innesota3
1$2 has paid unemployment ta4es or income ta4es in this state during the &$ calendar months immediately
preceding submission of the bid or proposal for which any preference is sought3
1'2 has a business address in the state3 and
1(2 has a5rmatively claimed that status in the bid or proposal submission.
6o receive recognition as a #innesota Resident .endor 1-Resident .endor/2, your company must meet each element of
the statutory denition above by the solicitation opening date and time. !f you wish to a5rmatively claim Resident
.endor status, you should do so by submitting this form with your bid or proposal.
Resident .endor status may be considered for purposes of resolving tied low bids or the application of a reciprocal
preference.
I HEREBY CERTIFY THAT THE COMPANY LISTED BELOW:
1. !s authorized to conduct business in the *tate of #innesota on the date a solicitation for a contract is rst
advertised or announced. (This includes a foreign corporation duly authorized to engage in business in
Minnesota.)
___Yes ___No (must chec !es o" #o$
2. 7as paid unemployment ta4es or income ta4es in the *tate of #innesota during the &$ calendar months
immediately preceding submission of the bid or proposal for which any preference is sought.
___Yes ___No (must chec !es o" #o$
3. 7as a business address in the *tate of #innesota.
___Yes ___No (must chec !es o" #o$
4. )grees to submit documentation, if requested, as part of the bid or proposal process, to verify compliance with
the above statutory requirements.
___Yes ___No (must chec !es o" #o$
BY SI%NIN% BELOW, you are certifying your compliance with the requirements set forth herein and claiming Resident
.endor status in your bid or proposal submission.
8ame of Company0 999999999999999999999999999999999999999999 :ate0 99999999999999999999999999999
)uthorized *ignature0 999999999999999999999999999999999999999999
6elephone0 99999999999999999999999999999
Printed 8ame0 999999999999999999999999999999999999999999 6itle0 99999999999999999999999999999
IF YO& ARE CLAIMIN% RESIDENT VENDOR STAT&S' SI%N AND RET&RN THIS FORM WITH YO&R BID OR
PROPOSAL S&BMISSION(
-f you take eception to any of the terms" conditions or language in the contract" you must indicate those
eceptions in your response to the #!$( certain eceptions may result in your proposal being disqualified
from further review and evaluation. 6nly those eceptions indicated in your response to the #!$ will be
available for discussion or negotiation.
Professional and
Technical Services Contract
State of Minnesota
SWIFT Contract No.:
This Contract is between the State of Minnesota, acting through its _________________________________ (State)
and ________________________________________________ (Contractor).
Recitals
1. Under Minn. Stat. 1.!"1 the State is e#$owered to engage such assistance as dee#ed necessar%.
&. The State is in need of ______________________________________________________________________.
'. The Contractor re$resents that it is du(% )ua(ified and agrees to $erfor# a(( ser*ices described in this Contract to
the satisfaction of the State.
Contract
1. Term of Contract
1.1 Effective date: ___________________________, or the date the State obtains a(( re)uired signatures under
Minn. Stat. 1"C.!, subd. &, whiche*er is (ater. The Contractor #ust not begin wor+ under this Contract unti(
this Contract is fu((% e,ecuted and the Contractor has been notified b% the State-s .uthori/ed 0e$resentati*e to
begin the wor+.
1.2 Expiration date: ___________________________, or unti( a(( ob(igations ha*e been satisfactori(% fu(fi((ed,
whiche*er occurs first.
1.3 Survival of terms: The fo((owing c(auses sur*i*e the e,$iration or cance((ation of this Contract1 2.
3nde#nification4
5. State audits4 1!. 6o*ern#ent data $ractices and inte((ectua( $ro$ert%4 17. 8ub(icit% and endorse#ent4 1.
6o*erning (aw, 9urisdiction, and *enue4 and 1". :ata disc(osure.
&. Contractors duties
The Contractor, who is not a State e#$(o%ee, wi((1
________________________________________________________________________________________
________________________________________________________________________________________
3. Time
The Contractor #ust co#$(% with a(( the ti#e re)uire#ents described in this Contract. 3n the $erfor#ance of this
Contract, ti#e is of the essence.
4. Consideration and payment
4.1 Consideration. The State wi(( $a% for a(( ser*ices $erfor#ed b% the Contractor under this Contract as fo((ows1
(a) Compensation. The Contractor wi(( be $aid ;_____________.
(b) Travel expenses. 0ei#burse#ent for tra*e( and subsistence e,$enses actua((% and necessari(% incurred
b% the Contractor as a resu(t of this Contract wi(( not e,ceed ;______________4 $ro*ided that the
Contractor wi(( be rei#bursed for tra*e( and subsistence e,$enses in the sa#e #anner and in no greater
a#ount than $ro*ided in the current <Co##issioner-s 8(an estab(ished b% the Co##issioner of
Minnesota Manage#ent and =udget which is incor$orated in to this Contract b% reference. The Contractor
wi(( not be rei#bursed for tra*e( and subsistence e,$enses incurred outside Minnesota un(ess it has
recei*ed the State-s $rior written a$$ro*a( for out>of>state tra*e(. Minnesota wi(( be considered the ho#e
state for deter#ining whether tra*e( is out of state.
(c) Total obligation. The tota( ob(igation of the State for a(( co#$ensation and rei#burse#ents to the
Contractor under this Contract wi(( not e,ceed ; _______________.
ADM2-07a 7/6/12 Page 19 of 24
SWIFT Contract No.:
4.2 Payment.
(a) Invoices. The State wi(( $ro#$t(% $a% the Contractor after the Contractor $resents an ite#i/ed in*oice for
the ser*ices actua((% $erfor#ed and the State?s .uthori/ed 0e$resentati*e acce$ts the in*oiced ser*ices.
3n*oices #ust be sub#itted ti#e(% and according to the fo((owing schedu(e1
___________________________________________________________________________________
___________________________________________________________________________________
(b) Retainage. Under Minn. Stat. 1"C.!2, subd. (b), no #ore than 5! $ercent of the a#ount due under this
Contract #a% be $aid unti( the fina( $roduct of this Contract has been re*iewed b% the State-s agenc%
head. The ba(ance due wi(( be $aid when the State-s agenc% head deter#ines that the Contractor has
satisfactori(% fu(fi((ed a(( the ter#s of this Contract.
(c) Federal funds. (@here a$$(icab(e, if b(an+ this section does not a$$(%.) 8a%#ents under this Contract wi((
be #ade fro# federa( funds obtained b% the State through ____________________________________.
The Contractor is res$onsib(e for co#$(iance with a(( federa( re)uire#ents i#$osed on these funds and
acce$ts fu(( financia( res$onsibi(it% for an% re)uire#ents i#$osed b% the Contractor-s fai(ure to co#$(% with
federa( re)uire#ents.
. Conditions of payment
.(( ser*ices $ro*ided b% the Contractor under this Contract #ust be $erfor#ed to the State-s satisfaction, as
deter#ined at the so(e discretion of the State-s .uthori/ed 0e$resentati*e and in accordance with a(( a$$(icab(e
federa(, state, and (oca( (aws, ordinances, ru(es, and regu(ations inc(uding business registration re)uire#ents of the
Affice of the Secretar% of State. The Contractor wi(( not recei*e $a%#ent for wor+ found b% the State to be
unsatisfactor% or $erfor#ed in *io(ation of federa(, state, or (oca( (aw.
!. "ut#ori$ed %epresentative
The State?s .uthori/ed 0e$resentati*e is BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB_______________, or
hisCher successor, and has the res$onsibi(it% to #onitor the Contractor-s $erfor#ance and the authorit% to acce$t
the ser*ices $ro*ided under this Contract. 3f the ser*ices are satisfactor%, the State?s .uthori/ed 0e$resentati*e
wi(( certif% acce$tance on each in*oice sub#itted for $a%#ent.
The Contractor?s .uthori/ed 0e$resentati*e is ______________________________________________, or
hisCher successor. 3f the Contractor-s .uthori/ed 0e$resentati*e changes at an% ti#e during this Contract, the
Contractor #ust i##ediate(% notif% the State.
&. "ssi'nment( amendments( )aiver( and contract complete
&.1 "ssi'nment. The Contractor #a% neither assign nor transfer an% rights or ob(igations under this Contract
without the $rior consent of the State and a fu((% e,ecuted assign#ent agree#ent, e,ecuted and a$$ro*ed b%
the sa#e $arties who e,ecuted and a$$ro*ed this Contract, or their successors in office.
&.2 "mendments. .n% a#end#ent to this Contract #ust be in writing and wi(( not be effecti*e unti( it has been
e,ecuted and a$$ro*ed b% the sa#e $arties who e,ecuted and a$$ro*ed the origina( Contract, or their
successors in office.
&.3 *aiver. 3f the State fai(s to enforce an% $ro*ision of this Contract, that fai(ure does not wai*e the $ro*ision or
its right to enforce it.
&.4 Contract complete. This Contract contains a(( negotiations and agree#ents between the State and the
Contractor. Do other understanding regarding this Contract, whether written or ora(, #a% be used to bind either
$art%.
+. ,ndemnification
3n the $erfor#ance of this Contract b% Contractor, or Contractor-s agents or e#$(o%ees, the Contractor #ust
inde#nif%, sa*e, and ho(d har#(ess the State, its agents, and e#$(o%ees, fro# an% c(ai#s or causes of action,
inc(uding attorne%-s fees incurred b% the State, to the e,tent caused b% Contractor-s1
a) 3ntentiona(, wi((fu(, or neg(igent acts or o#issions4 or
b) .ctions that gi*e rise to strict (iabi(it%4 or
c: =reach of contract or warrant%.
The inde#nification ob(igations of this section do not a$$(% in the e*ent the c(ai# or cause of action is the resu(t of
the State-s so(e neg(igence. This c(ause wi(( not be construed to bar an% (ega( re#edies the Contractor #a% ha*e
for the State-s fai(ure to fu(fi(( its ob(igation under this Contract.
-. State audits
Under Minn. Stat. 1"C.!, subd. , the Contractor-s boo+s, records, docu#ents, and accounting $rocedures and
$ractices re(e*ant to this Contract are sub9ect to e,a#ination b% the State andCor the State .uditor or Eegis(ati*e
ADM2-07a 7/6/12 Page 20 of 24
SWIFT Contract No.:
.uditor, as a$$ro$riate, for a #ini#u# of si, %ears fro# the end of this Contract.
1.. /overnment data practices and intellectual property
1..1 /overnment data practices. The Contractor and State #ust co#$(% with the Minnesota 6o*ern#ent :ata
8ractices .ct, Minn. Stat. ch. 1', (or, if the State contracting $art% is $art of the Fudicia( =ranch, with the 0u(es
of 8ub(ic .ccess to 0ecords of the Fudicia( =ranch $ro#u(gated b% the Minnesota Su$re#e Court as the
sa#e #a% be a#ended fro# ti#e to ti#e) as it a$$(ies to a(( data $ro*ided b% the State under this Contract,
and as it a$$(ies to a(( data created, co((ected, recei*ed, stored, used, #aintained, or disse#inated b% the
Contractor under this Contract. The ci*i( re#edies of Minn. Stat. 1'.!2 a$$(% to the re(ease of the data
go*erned b% the Minnesota 6o*ern#ent 8ractices .ct, Minn. Stat. ch. 1', b% either the Contractor or the
State.
3f the Contractor recei*es a re)uest to re(ease the data referred to in this c(ause, the Contractor #ust
i##ediate(% notif% and consu(t with the State-s .uthori/ed 0e$resentati*e as to how the Contractor shou(d
res$ond to the re)uest. The Contractor-s res$onse to the re)uest sha(( co#$(% with a$$(icab(e (aw.
1..2 ,ntellectual property ri'#ts.
(a) Intellectual property rigts. The State owns a(( rights, tit(e, and interest in a(( of the inte((ectua( $ro$ert%
rights, inc(uding co$%rights, $atents, trade secrets, trade#ar+s, and ser*ice #ar+s in the wor+s and
docu#ents created and $aid for under this Contract. The wor+s #eans a(( in*entions, i#$ro*e#ents,
disco*eries (whether or not $atentab(e), databases, co#$uter $rogra#s, re$orts, notes, studies,
$hotogra$hs, negati*es, designs, drawings, s$ecifications, #ateria(s, ta$es, and dis+s concei*ed,
reduced to $ractice, created or originated b% the Contractor, its e#$(o%ees, agents, and subcontractors,
either indi*idua((% or 9oint(% with others in the $erfor#ance of this Contract. @or+s inc(udes docu#ents.
The docu#ents are the origina(s of an% databases, co#$uter $rogra#s, re$orts, notes, studies,
$hotogra$hs, negati*es, designs, drawings, s$ecifications, #ateria(s, ta$es, dis+s, or other #ateria(s,
whether in tangib(e or e(ectronic for#s, $re$ared b% the Contractor, its e#$(o%ees, agents, or
subcontractors, in the $erfor#ance of this Contract. The docu#ents wi(( be the e,c(usi*e $ro$ert% of the
State and a(( such docu#ents #ust be i##ediate(% returned to the State b% the Contractor u$on
co#$(etion or cance((ation of this Contract. To the e,tent $ossib(e, those wor+s e(igib(e for co$%right
$rotection under the United States Co$%right .ct wi(( be dee#ed to be wor+s #ade for hire. The
Contractor assigns a(( right, tit(e, and interest it #a% ha*e in the wor+s and the docu#ents to the State.
The Contractor #ust, at the re)uest of the State, e,ecute a(( $a$ers and $erfor# a(( other acts necessar%
to transfer or record the State-s ownershi$ interest in the wor+s and docu#ents.
(b) !bligations
(1) Dotification. @hene*er an% in*ention, i#$ro*e#ent, or disco*er% (whether or not $atentab(e) is #ade
or concei*ed for the first ti#e or actua((% or constructi*e(% reduced to $ractice b% the Contractor,
inc(uding its e#$(o%ees and subcontractors, in the $erfor#ance of this Contract, the Contractor wi((
i##ediate(% gi*e the State-s .uthori/ed 0e$resentati*e written notice thereof, and #ust $ro#$t(%
furnish the State-s .uthori/ed 0e$resentati*e with co#$(ete infor#ation andCor disc(osure thereon.
(&) 0e$resentation. The Contractor #ust $erfor# a(( acts, and ta+e a(( ste$s necessar% to ensure that a((
inte((ectua( $ro$ert% rights in the wor+s and docu#ents are the so(e $ro$ert% of the State, and that
neither Contractor nor its e#$(o%ees, agents, or subcontractors retain an% interest in and to the wor+s
and docu#ents. The Contractor re$resents and warrants that the wor+s and docu#ents do not and
wi(( not infringe u$on an% inte((ectua( $ro$ert% rights of other $ersons or entities. Dotwithstanding
C(ause 2, the Contractor wi(( inde#nif%4 defend, to the e,tent $er#itted b% the .ttorne% 6enera(4 and
ho(d har#(ess the State, at the Contractor-s e,$ense, fro# an% action or c(ai# brought against the
State to the e,tent that it is based on a c(ai# that a(( or $art of the wor+s or docu#ents infringe u$on
the inte((ectua( $ro$ert% rights of others. The Contractor wi(( be res$onsib(e for $a%#ent of an% and a((
such c(ai#s, de#ands, ob(igations, (iabi(ities, costs, and da#ages, inc(uding but not (i#ited to,
attorne% fees. 3f such a c(ai# or action arises, or in the Contractor-s or the State-s o$inion is (i+e(% to
arise, the Contractor #ust, at the State-s discretion, either $rocure for the State the right or (icense to
use the inte((ectua( $ro$ert% rights at issue or re$(ace or #odif% the a((eged(% infringing wor+s or
docu#ents as necessar% and a$$ro$riate to ob*iate the infringe#ent c(ai#. This re#ed% of the State
wi(( be in addition to and not e,c(usi*e of other re#edies $ro*ided b% (aw.
11. *or0ers compensation and ot#er insurance
Contractor certifies that it is in co#$(iance with a(( insurance re)uire#ents s$ecified in the so(icitation docu#ent
re(e*ant to this Contract. Contractor sha(( not co##ence wor+ under the Contract unti( the% ha*e obtained a(( the
ADM2-07a 7/6/12 Page 21 of 24
SWIFT Contract No.:
insurance s$ecified in the so(icitation docu#ent. Contractor sha(( #aintain such insurance in force and effect
throughout the ter# of the Contract.
Gurther, the Contractor certifies that it is in co#$(iance with Minn. Stat. 1H".121, subd. &, $ertaining to wor+ers-
co#$ensation insurance co*erage. The Contractor-s e#$(o%ees and agents wi(( not be considered State
e#$(o%ees. .n% c(ai#s that #a% arise under the Minnesota @or+ers- Co#$ensation .ct on beha(f of these
e#$(o%ees or agents and an% c(ai#s #ade b% an% third $art% as a conse)uence of an% act or o#ission on the $art
of these e#$(o%ees or agents are in no wa% the State-s ob(igation or res$onsibi(it%.
12. 1e2arment 2y State( its departments( commissions( a'encies( or political su2divisions
Contractor certifies that neither it nor its $rinci$a(s is $resent(% debarred or sus$ended b% the State, or an% of its
de$art#ents, co##issions, agencies, or $o(itica( subdi*isions. Contractor-s certification is a #ateria(
re$resentation u$on which the Contract award was based. Contractor sha(( $ro*ide i##ediate written notice to the
State-s .uthori/ed 0e$resentati*e if at an% ti#e it (earns that this certification was erroneous when sub#itted or
beco#es erroneous b% reason of changed circu#stances.
13. Certification re'ardin' de2arment( suspension( ineli'i2ility( and voluntary exclusion
Gedera( #one% wi(( be used or #a% $otentia((% be used to $a% for a(( or $art of the wor+ under the Contract,
therefore Contractor certifies that it is in co#$(iance with federa( re)uire#ents on debar#ent, sus$ension,
ine(igibi(it% and *o(untar% e,c(usion s$ecified in the so(icitation docu#ent i#$(e#enting I,ecuti*e Arder 1&75.
Contractor-s certification is a #ateria( re$resentation u$on which the Contract award was based.
14. Pu2licity and endorsement
14.1 Pu2licity. .n% $ub(icit% regarding the sub9ect #atter of this Contract #ust identif% the State as the s$onsoring
agenc% and #ust not be re(eased without $rior written a$$ro*a( fro# the State-s .uthori/ed 0e$resentati*e.
Gor $ur$oses of this $ro*ision, $ub(icit% inc(udes notices, infor#ationa( $a#$h(ets, $ress re(eases, research,
re$orts, signs, and si#i(ar $ub(ic notices $re$ared b% or for the Contractor indi*idua((% or 9oint(% with others, or
an% subcontractors, with res$ect to the $rogra#, $ub(ications, or ser*ices $ro*ided resu(ting fro# this
Contract.
14.2 Endorsement. The Contractor #ust not c(ai# that the State endorses its $roducts or ser*ices.
1. /overnin' la)( 3urisdiction( and venue
Minnesota (aw, without regard to its choice>of>(aw $ro*isions, go*erns this Contract. Jenue for a(( (ega(
$roceedings out of this Contract, or its breach, #ust be in the a$$ro$riate state or federa( court with co#$etent
9urisdiction in 0a#se% Count%, Minnesota.
1!. 1ata disclosure
Under Minn. Stat. &H!C.", subd. ' and other a$$(icab(e (aw, the Contractor consents to disc(osure of its socia(
securit% nu#ber, federa( e#$(o%er ta, identification nu#ber, andCor Minnesota ta, identification nu#ber, a(read%
$ro*ided to the State, to federa( and state agencies, and state $ersonne( in*o(*ed in the $a%#ent of state
ob(igations. These identification nu#bers #a% be used in the enforce#ent of federa( and state (aws which cou(d
resu(t in action re)uiring the Contractor to fi(e state ta, returns, $a% de(in)uent state ta, (iabi(ities, if an%, or $a%
other state (iabi(ities.
1&. Payment to su2contractors
(3f a$$(icab(e) .s re)uired b% Minn. Stat. 1"..1&7, the $ri#e Contractor #ust $a% a(( subcontractors, (ess an%
retainage, within 1! ca(endar da%s of the $ri#e Contractor?s recei$t of $a%#ent fro# the State for undis$uted
ser*ices $ro*ided b% the subcontractor(s) and #ust $a% interest at the rate of one and one>ha(f $ercent $er #onth
or an% $art of a #onth to the subcontractor(s) on an% undis$uted a#ount not $aid on ti#e to the subcontractor(s).
1+. Termination
1+.1 Termination 2y t#e State. The State or Co##issioner of .d#inistration #a% cance( this Contract at an%
ti#e, with or without cause, u$on '! da%s- written notice to the Contractor. U$on ter#ination, the Contractor
wi(( be entit(ed to $a%#ent, deter#ined on a $ro rata basis, for ser*ices satisfactori(% $erfor#ed.
1+.2 Termination for insufficient fundin'. The State #a% i##ediate(% ter#inate this Contract if it does not obtain
funding fro# the Minnesota Eegis(ature, or other funding source4 or if funding cannot be continued at a (e*e(
sufficient to a((ow for the $a%#ent of the ser*ices co*ered here. Ter#ination #ust be b% written or fa, notice
to the Contractor. The State is not ob(igated to $a% for an% ser*ices that are $ro*ided after notice and effecti*e
date of ter#ination. Kowe*er, the Contractor wi(( be entit(ed to $a%#ent, deter#ined on a $ro rata basis, for
ser*ices satisfactori(% $erfor#ed to the e,tent that funds are a*ai(ab(e. The State wi(( not be assessed an%
ADM2-07a 7/6/12 Page 22 of 24
SWIFT Contract No.:
$ena(t% if the Contract is ter#inated because of the decision of the Minnesota Eegis(ature, or other funding
source, not to a$$ro$riate funds. The State #ust $ro*ide the Contractor notice of the (ac+ of funding within a
reasonab(e ti#e of the State-s recei*ing that notice.
1-. 4on5discrimination 6,n accordance )it# 7inn. Stat. 8 1+1.-9
The Contractor wi(( co#$(% with the $ro*isions of Minn. Stat. 121.5 which re)uire1
"#very contract for or on bealf of te state of $innesota, or any county, city, to%n, to%nsip, scool,
scool district, or any oter district in te state, for materials, supplies, or construction sall contain
provisions by %ic te contractor agrees&
(') tat, in te iring of common or s(illed labor for te performance of any %or( under any
contract, or any subcontract, no contractor, material supplier, or vendor, sall, by reason of
race, creed, or color, discriminate against te person or persons %o are citi)ens of te *nited
+tates or resident aliens %o are ,ualified and available to perform te %or( to %ic te
employment relates-
(.) tat no contractor, material supplier, or vendor, sall, in any manner, discriminate against, or
intimidate, or prevent te employment of any person or persons identified in clause (') of tis
section, or on being ired, prevent, or conspire to prevent, te person or persons from te
performance of %or( under any contract on account of race, creed, or color-
(/) tat a violation of tis section is a misdemeanor- and
(0) tat tis contract may be canceled or terminated by te state, county, city, to%n, scool board,
or any oter person autori)ed to grant te contracts for employment, and all money due, or to
become due under te contract, may be forfeited for a second or any subse,uent violation of
te terms or conditions of tis contract.1
23elete tis section if your total Contract value is under 4'55,5556
2.. "ffirmative action re:uirements for contracts in excess of ;1..(... and if t#e Contractor #as more t#an 4.
full5time employees in 7innesota or its principal place of 2usiness
The State intends to carr% out its res$onsibi(it% for re)uiring affir#ati*e action b% its contractors.
2..1 Covered contracts and contractors. 3f the Contract e,ceeds ;1!!,!!! and the Contractor e#$(o%ed #ore
than 7! fu((>ti#e e#$(o%ees on a sing(e wor+ing da% during the $re*ious 1& #onths in Minnesota or in the
state where it has its $rinci$(e $(ace of business, then the Contractor #ust co#$(% with the re)uire#ents of
Minn. Stat. '"'.. '" and Minn. 0. !!!.'7!!>!!!.'"!!. . contractor co*ered b% Minn. Stat. '"'..'"
because it e#$(o%ed #ore than 7! fu((>ti#e e#$(o%ees in another state and does not ha*e a certificate of
co#$(iance, #ust certif% that it is in co#$(iance with federa( affir#ati*e action re)uire#ents.
2..2 7inn. Stat. 8 3!3".3!. Minn. Stat. '"'..'" re)uires the Contractor to ha*e an affir#ati*e action $(an for
the e#$(o%#ent of #inorit% $ersons, wo#en, and )ua(ified disab(ed indi*idua(s a$$ro*ed b% the Minnesota
Co##issioner of Ku#an 0ights (Co##issioner) as indicated b% a certificate of co#$(iance. The (aw
addresses sus$ension or re*ocation of a certificate of co#$(iance and contract conse)uences in that e*ent. .
contract awarded without a certificate of co#$(iance #a% be *oided.
2..3 7inn. %. ....34..5....3!...
(a) 7eneral. Minn. 0. !!!.'7!!>!!!.'"!! i#$(e#ents Minn. Stat. '"'..'". These ru(es inc(ude, but are
not (i#ited to, criteria for contents, a$$ro*a(, and i#$(e#entation of affir#ati*e action $(ans4 $rocedures
for issuing certificates of co#$(iance and criteria for deter#ining a contractor-s co#$(iance status4
$rocedures for addressing deficiencies, sanctions, and notice and hearing4 annua( co#$(iance re$orts4
$rocedures for co#$(iance re*iew4 and contract conse)uences for non>co#$(iance. The s$ecific criteria
for a$$ro*a( or re9ection of an affir#ati*e action $(an are contained in *arious $ro*isions of Minn. 0.
!!!.'7!!>!!!.'"!! inc(uding, but not (i#ited to, Minn. 0. !!!.'7&!>!!!.'!! and !!!.'&>
!!!.'5.
(b) 3isabled 8or(ers. The Contractor #ust co#$(% with the fo((owing affir#ati*e action re)uire#ents for
disab(ed wor+ers.
(1) The Contractor #ust not discri#inate against an% e#$(o%ee or a$$(icant for e#$(o%#ent because of
$h%sica( or #enta( disabi(it% in regard to an% $osition for which the e#$(o%ee or a$$(icant for
e#$(o%#ent is )ua(ified. The Contractor agrees to ta+e affir#ati*e action to e#$(o%, ad*ance in
e#$(o%#ent, and otherwise treat )ua(ified disab(ed $ersons without discri#ination based u$on their
$h%sica( or #enta( disabi(it% in a(( e#$(o%#ent $ractices such as the fo((owing1 e#$(o%#ent,
u$grading, de#otion or transfer, recruit#ent, ad*ertising, (a%off or ter#ination, rates of $a% or other
for#s of co#$ensation, and se(ection for training, inc(uding a$$renticeshi$.
(&) The Contractor agrees to co#$(% with the ru(es and re(e*ant orders of the Minnesota :e$art#ent of
Ku#an 0ights issued $ursuant to the Minnesota Ku#an 0ights .ct.
ADM2-07a 7/6/12 Page 23 of 24
SWIFT Contract No.:
(') 3n the e*ent of the Contractor?s nonco#$(iance with the re)uire#ents of this c(ause, actions for
nonco#$(iance #a% be ta+en in accordance with Minn. Stat. '"'..'", and the ru(es and re(e*ant
orders of the Minnesota :e$art#ent of Ku#an 0ights issued $ursuant to the Minnesota Ku#an
0ights .ct.
(7) The Contractor agrees to $ost in cons$icuous $(aces, a*ai(ab(e to e#$(o%ees and a$$(icants for
e#$(o%#ent, notices in a for# to be $rescribed b% the Co##issioner. Such notices #ust state the
Contractor?s ob(igation under the (aw to ta+e affir#ati*e action to e#$(o% and ad*ance in e#$(o%#ent
)ua(ified disab(ed e#$(o%ees and a$$(icants for e#$(o%#ent, and the rights of a$$(icants and
e#$(o%ees.
() The Contractor #ust notif% each (abor union or re$resentati*e of wor+ers with which it has a co((ecti*e
bargaining agree#ent or other contract understanding, that the Contractor is bound b% the ter#s of
Minn. Stat. '"'..'", of the Minnesota Ku#an 0ights .ct and is co##itted to ta+e affir#ati*e action
to e#$(o% and ad*ance in e#$(o%#ent $h%sica((% and #enta((% disab(ed $ersons.
(c) Conse,uences. The conse)uences for the Contractor-s fai(ure to i#$(e#ent its affir#ati*e action $(an or
#a+e a good faith effort to do so inc(ude, but are not (i#ited to, sus$ension or re*ocation of a certificate of
co#$(iance b% the Co##issioner, refusa( b% the Co##issioner to a$$ro*e subse)uent $(ans, and
ter#ination of a(( or $art of this Contract b% the Co##issioner or the State.
(d) Certification. The Contractor hereb% certifies that it is in co#$(iance with the re)uire#ents of Minn. Stat.
'"'..'" and Minn. 0. !!!.'7!!>!!!.'"!! and is aware of the conse)uences for nonco#$(iance.
21. E5<erify certification 6,n accordance )it# 7inn. Stat. 8 1!C..&9
Gor ser*ices *a(ued in e,cess of ;!,!!!, Contractor certifies that as of the date of ser*ices $erfor#ed on beha(f
of the State, Contractor and a(( its subcontractors wi(( ha*e i#$(e#ented or be in the $rocess of i#$(e#enting the
federa( I>Jerif% 8rogra# for a(( new(% hired e#$(o%ees in the United States who wi(( $erfor# wor+ on beha(f of the
State. Contractor is res$onsib(e for co((ecting a(( subcontractor certifications and #a% do so uti(i/ing the #9:erify
+ubcontractor Certification Form a*ai(ab(e at htt$1CCwww.##d.ad#in.state.#n.usCdocCI*erif%SubCertGor#.doc. .((
subcontractor certifications #ust be +e$t on fi(e with Contractor and #ade a*ai(ab(e to the State u$on re)uest.
LSi'natures as re:uired 2y t#e State.=
ADM2-07a 7/6/12 Page 24 of 24