6 Voice Communication System Requirements and ResponsibilitiesThis section outlines corporate and technical requirements for the Voice Communication System Project. 6.1 Corporate The following corporate requirements shall be completed by all RFP Proponents. Requirement Requirement Identifier Description Structure: The RFP Proponent shall identify its ownership and structure. It must provide an organization chart illustrating its corporate structure. The following shall be provided: − A description including its legal status as a corporation; − Its place and date of incorporation and registration; − The identification of its officers and directors; CR-01 − The extent that it is a wholly owned or partly owned subsidiary of a parent company; − The nature of its business; − The identity of any ultimate shareholders or partners with more than a 10% equity or voting interest; and − Lead team member name, title, address, telephone, facsimile number and e-mail address. Financials: RFP Proponent shall provide Financial Statements for the most recent three (3) fiscal years and include: − Any events subsequent to the latest Required Financial Statement (including major proposals, commitments or project completions) which might materially affect this financial evaluation of their capabilities; − If an RFP Proponent has not been in its current legal form for three years, the RFP Proponent shall provide the required financial CR-02 statements and other financial information, for the predecessor entities, together with explanatory information as to the nature of the change of reporting entities; and − The RFP Proponent shall confirm that it does not have liabilities, contingent liabilities, obligations, charges, and liens, covenants, off- balance sheet financing arrangements, defaults, litigation, claims, or other matters that might prevent the RFP Proponent from completing the scope as outlined herein in a timely manner, other than as disclosed in the RFP Submission (Note: As part of the evaluation of RFP Submissions, the possible impact - financial, legal and otherwise -
of any such disclosure may be considered). Industry Leverage: The RFP Proponent shall describe why it is a benefit to the CPHC to enter into a Contract with its organization. − Identify rebate, price incentive programs that exist that may be ofCR-03 benefit to the CPHC. − List existing channel/contract relationships that give the RFP Proponent leverage to negotiate attractive equipment purchase and maintenance service contracts. Experience: The RFP Proponent shall describe their previous experience Implementing similar Solutions. The RFP Proponent shall explain the experiences gained Implementing like voice communications solutions inCR-04 other projects for similar types of environments. The RFP Proponent shall provide details on how the experience gained during these projects will enhance the successful delivery of this Solution. References: The RFP Proponent shall provide information on three reference sites whose requirements are similar to the voice communications solutionCR-05 the CPHC is requesting. Describe the components and/or functionality of the solution that has been deployed elsewhere. Escalation: The RFP Proponent shall provide a support model, escalation process and contact information to be used in the event of problems (duringCR-06 Implementation and post-Implementation of the VCS) or any other CPHC requests. The RFP Proponent shall keep the process and contact information current and update the CPHC accordingly. Quality Systems: The RFP Proponent shall provide a description of theCR-07 systems they use to manage service delivery and product quality (e.g. TL 9000, ISO 9000, and ITIL). Schedule Delivery: The CPHC places a high degree of importance upon the adherence to the Implementation schedule for this project. Within any agreement that results from this RFP, the CPHC will include a contractual obligation on the Successful RFP Proponent to compensate the CPHC, of a reasonable value, when the Schedule Delivery levels are not met. RFPCR-08 Proponents shall indicate their willingness to agree to late delivery discount provisions, as finally negotiated during contract award. The terms of the late delivery discount clauses will be finalized with the Successful RFP Proponent during the contract negotiation period. Section 5.8 provides a framework for the compensation. Price Competiveness: The RFP Proponent shall apply similar discounts levelsCR-09 used in their pricing of this RFP to other Equipment and Services for out-of- scope changes necessary to meet the CPHC requirements. The discounts shall
be valid from one-year of Contract Agreement signing and validated using the manufactures price book as reference. Deliverable-Based Payments: The RFP Proponent shall agree to a payment CR-10 schedule based on achieving major milestones during the Implementation of the VCS.6.2 Voice Communication System Technical RequirementsThe following technical requirements shall be completed by all RFP Proponents. 6.2.1 General Requirement Requirement Identifier Description Voice Communication System General: The RFP Proponent shall Implement a Mitel-(or equivalent) based Voice Communication System to connect to the TR-01 PSTN and meet the capacity, functionality and feature requirements outlined in this section 6.2. All equivalents must be clearly explained and demonstrated in the Proponent’s Submission. Brockville Location: The RFP Proponent shall Implement a fully functional Mitel 3300 MXe III Controller and virtual MCD Controller configured with the MCD Enterprise PBX software with the following specifications: 100 MCD Enterprise User Licenses 120 MCD Mailbox Licenses 20 Dynamic Extension Dual T1 PSTN Connectivity TR-02 12 Analogue User Devices The RFP Proponent shall include the: Add/remove price for Enterprise User Licenses Add/remove price for Voice-mail Licenses Add/remove price for Dynamic Extension Note: the RFP Proponent shall provide the virtual server specifications for the virtual MCD. Gananoque Family Health Team Location (338 Herbert St., Gananoque, ON, K7G 3G3) : The RFP Proponent shall Implement a fully functional Mitel 3300 Mitel CXi II Controller configured with the MCD Enterprise PBX software with the following specifications: 16 MCD Enterprise User Licenses TR-03 16 MCD Mailbox Licenses 4 Loop Start Trunks for WAN connectivity 4 Analogue User Devices The RFP Proponent shall include the: Add/remove price for Enterprise User Licenses
Add/remove price for Voice-mail Licenses Satellite Locations: The RFP Proponent shall Implement a virtual Mitel Border Gateway (vMBG) Teleworker service, for the following locations: 12 Wellington St., Athens, ON, K0E 1B0 / x users 15 Bates Dr., Carleton Place, ON, K7C 4J8/ x users TR-04 740 King St. West, Gananoque, ON, K7G 2H5/ x users 2790A Hwy 15, Portland, ON, K0G 1V0/ x users 555 King St. West, Prescott, ON, K0E 1T0/ x users Note: the RFP Proponent shall provide the virtual server specifications for the vMBG.6.2.2 Base Functionality and Configuration Requirement Requirement Identifier Description Paging: The RFP Proponent shall Implement the VCS to support paging TR-05 through the desk-phones. The RFP Proponent shall collaborate with the CPHC on the final programming and configuration of the paging system. Call Recording: The RFP Proponent shall Implement the VCS to support call TR-06 recording. The RFP Proponent shall collaborate with the CHPC on Implementing a solution to archive call recordings. Auto Attendant: The RFP Proponent shall Implement an auto attendant on TR-07 the VCS to meet the requirements of the CPHC.6.2.3 Messaging Services (Voice-Mail, Facsimile, E-Mail) Requirement Requirement Identifier Description Multiple Greetings: The RFP Proponent shall Implement the VCS to allow the TR-08 user to store multiple voice mail greetings (e.g., internal, external). Voice-Mail to E-Mail: The RFP Proponent Implement the VCS to support TR-09 voice-mail media redirect to a specified user e-mail account. IP Fax and Fax to E-Mail: The RFP Proponent shall Implement the VCS to support IP fax: media redirect to a specified user e-mail account and desktop TR-10 faxing. To meet this requirement and save on costs, it is recommended the RFP Proponent to propose an off-board fax server solution (e.g., RightFax). The fax solution shall be formally interoperability tested with the VCS.6.2.4 Conferencing Requirement Requirement Identifier Description Conferencing: The RFP Proponent shall describe the native conferencing TR-11 capability of the VCS. TR-12 Additional Conferencing: The RFP Proponent shall describe additional
conferencing capability that is available from the manufacturer (e.g., NuPoint). The RFP Proponent shall include in their response to this requirement the cost to Implement this additional capability. These costs are not to be included in the financial proposal.6.2.5 Operators Requirement Requirement Identifier Description Operators Solutions: The RFP Proponent shall describe what solutions TR-13 related to the VCS are available for operators. Monitoring Extensions: The RFP Proponent shall describe the supervisor TR-14 listen and silent monitor features of the VCS.6.2.6 Reporting Requirement Requirement Identifier Description Call Information: The RFP Proponent shall collaborate with the CPHC to TR-15 Implement a data feed of VCS station message detail recordings (SMDR) to CPHC IT systems.6.2.7 Other Requirement Requirement Identifier Description Miscellaneous Equipment: The RFP Proponent shall be responsible for providing all miscellaneous Equipment (e.g., power cables (refer to CPHC-01 for receptacle types) mounting hardware, equipment specific patch panels, TR-16 patch cables) necessary to Implement the VCS. Note: The RFP Proponent shall ensure this equipment is included in their costs. Lifecycle: The RFP Proponent shall, for each applicable system component of the VCS, provide the manufacturers’ life expectancy and policy of the TR-17 Equipment; specifically the expected manufacturers’ discontinued (MD) date, the end-of-support date, and the end-of-life (EOL) date of the Equipment. Equipment List: The RFP Proponent shall provide a list of all Equipment and TR-18 services to be delivered as part of the VCS. Manufacturers’ Terms and Conditions: The RFP Proponent shall provide all TR-19 manufacturers’ terms and conditions for all Equipment Implemented as part of the VCS. Manufacturers’ Specifications: The RFP Proponent shall include all relevant TR-20 information (e.g., specifications, data sheets, overviews) for the VCS.
6.2.8 QoS, Reliability and Resiliency Requirement Requirement Identifier Description Quality of Service: The RFP Proponent shall describe how QoS for prioritizing and high-quality delivery of voice traffic is accomplished by the VCS. Included TR-21 in this shall be the VLAN requirement(s) the RFP Proponent requires to deliver voice services. Single Points of Failure: The RFP Proponent shall highlight any single points of failure, for major components, in the VCS and the strategy for the expeditious resolution of failures of these system components. Note: a single TR-22 point of failure is a component of the VCS which can fail causing service unavailability to a user. The RFP Proponent shall provide details on the MTBF of any major component highlighted as a single point of failure. Recovery: The RFP Proponent shall describe the process (including durations) TR-23 to recover the VCS from a complete power outage situation. Hardware Replacement: The RFP Proponent shall describe the impact to TR-24 end-user service availability when replacing faulty major VCS hardware components.6.2.9 Administration and Network Management Requirement Requirement Identifier Description Network Management: The RFP Proponent shall provide and describe all TR-25 systems necessary to manage the VCS. Administration: The RFP Proponent shall ensure that the network TR-26 management system of the VCS is implemented to allow for role based system administration. The RFP Proponent shall describe this capability. Remote Support and Configuration: The RFP Proponent shall confirm that the major components of the VCS shall have the capability to be monitored, configured and supported remotely; the RFP Proponent shall include a TR-27 complete list of VCS components and whether or not the components can be supported and configured remotely. The RFP Proponents shall briefly describe this capability. Monitoring and Diagnostics: The RFP Proponent shall ensure that the VCS network management system is Implemented to continuously (24 hours/day TR-28 x 7 days/week), in real-time, monitor the network, network usage/traffic and anomalies. The RFP Proponent shall provide details of the reports available to view the monitoring results. Back-up Files: The RFP Proponent shall describe, for each major component of the VCS, the mechanism (and storage medium) for backing-up the TR-29 software and configuration files; the time (duration) of the back-up shall also be included. The RFP Proponent shall describe how the VCS is restored from back-up files. The RFP Proponent shall include Implementation services to
assist the CPHC in setting up these back-ups; using existing CPHC data storage equipment.6.2.10 Training and Documentation Requirement Requirement Identifier Description Training: The RFP Proponent shall provide training to the CPHC to manage the VCS (e.g., configure, operate). The RFP Proponent will recommend and price a low cost training end-user device program. The training shall include, TR-30 but not limited to: device, call control preferences, voice-mail, conferencing, dynamic extension - personal ring groups/external hot-desking, recording calls, and other features referenced in this RFP. Manuals: The RFP Proponent shall include all manuals necessary to manage TR-31 (e.g., configure, operate) the VCS.6.2.11 Warranty and Maintenance Requirement Requirement Identifier Description Warranty: The RFP Proponent shall describe the warranty program included TR-32 as part of the VCS. Maintenance: The RFP Proponent shall be responsible for maintaining all VCS Equipment and any Equipment added to the network during the life of the TR-33 contract. The RFP Proponent shall describe and include the cost of a 5-year maintenance program (hardware and software). Scheduled Maintenance: The RFP Proponent shall list, for each major system component of the VCS, the expected scheduled maintenance activity and the impact to service or service feature availability of this activity. The RFP Proponent shall include the estimated time and/or manual effort involved in the scheduled maintenance activity in question. TR-34 The CPHC expects scheduled/routine maintenance, such as, but not limited to, software upgrades, software fix/feature applications, hardware replacement/upgrades, and configuration changes of the VCS not to cause a service outage or degradation. RFP Proponents shall indicate separate costs to provide this functionality in their financial proposal. Software Upgrades: The RFP Proponent shall be responsible for all VCS TR-35 software upgrades (features and fixes) for the term of the contract. Hardware Upgrades: The RFP Proponent shall be responsible for all VCS TR-36 hardware upgrades (features and fixes) for the term of the contract. Firmware Upgrades: The RFP Proponent shall be responsible for all VCS TR-37 firmware upgrades (features and fixes) for the term of the contract.
6.2.12 Devices Requirement Requirement Identifier Description Phone Devices: The RFP Proponent shall provide the unit price and specification sheet of the following models of Mitel phones and accessories: 5304, 5312, 5324, 5320, 5320e, 5330e, 5340e, 5360, 5540, Unified Communication Express (UCX) softphone, 5310, Line Interface TR-38 Module Note: it is the CPHC’s intention to purchase over 100 phone devices for this project. The financial evaluation will be based on the total price of one hundred (100) 5340e IP desk-phones.6.2.1 Design Requirement Requirement Identifier Description Design: The RFP Proponent shall ensure the VCS is designed to manufactures’ TR-39 specification, industry standards, and/or local codes. The design will be reviewed by the CPHC before any Equipment is procured. Design Service: The RFP Proponent shall include the cost of services to design TR-40 the VCS. Hi-Level Design: The RFP Proponent shall provide, as part of their RFP TR-41 Proposal, a high level design of the VCS.6.2.2 Implementation and Acceptance Requirement Requirement Identifier Description Implementation Phases: The RFP Proponent shall agree with, or provide TR-42 modifications to the Implementation Phases outlined in Section 5.1.3 Resources: The RFP Proponent shall ensure the VCS is Implemented by TR-43 manufacturer certified technicians or specialists. Installation: The RFP Proponent shall ensure the VCS is installed to TR-44 manufactures’ specification, industry standards, and/or local codes. Configure: The RFP Proponent shall ensure the VCS is configured to TR-45 manufactures’ specification, industry standards, and/or local codes. Programming: The RFP Proponent shall be responsible for all initial costs to TR-46 program the VCS for Phase 1 and Phase 2 CPHC operations. Test: The RFP Proponent shall ensure the VCS is tested to manufactures’ TR-47 specification, industry standards, and/or local codes. Testing Process: The RFP Proponent shall have a test methodology and TR-48 documented process for testing the VCS; the RFP Proponent shall provide a
high-level test plan including the types of tests and measurements that will be performed to validate the VCS. Included in the test plan shall be the expected outcome of the tests to be performed. Note: Stress tests shall be included using traffic generation equipment so the VCS is validated under load conditions. Test Results: All test results will be reviewed by the CPHC before VCS TR-49 Acceptance. A copy of the test results shall remain the property of the CPHC. Commissioning: The RFP Proponent is responsible for commissioning the VCS TR-50 to ensure the overall Implementation meets the expectations of the CPHC. Commissioning Process: The RFP Proponent shall have a methodology and documented process for commissioning the VCS. The RFP Proponent shall TR-51 provide a high-level plan including the types of activities that will be performed to commission the VCS. Included in the commissioning plan shall be the expected outcome of the activities to be performed. Commissioning Results: All commissioning results will be reviewed by the TR-52 CPHC before VCS acceptance. A copy of the commissioning results shall remain the property of the CPHC. Acceptance: The RFP Proponent shall provide the CPHC with positive, industry standard test and commissioning results, before the VCS is deemed TR-53 “production”. The acceptance criteria will be delivered to and reviewed by the CPHC before the VCS is used for live traffic.6.2.3 Project Management Requirement Requirement Identifier Description Project Management: The RFP Proponent shall provide a dedicated project manager for the duration of the Implementation of the VCS; The RFP TR-54 Proponent shall provide references of similar complexity projects that the project manager has been involved with. High Level Project Plan: The RFP Proponent shall provide a project plan, TR-55 showing the high level activities, key dates, time frames, resources and dependencies for procuring and Implementing the VCS. Certifications: The RFP Proponent shall ensure all resources directly TR-56 responsible for managing the Implementation of the VCS portion are certified project managers or have equivalent experience. Planning Collaboration: The RFP Proponent shall collaborate with the CPHC, TR-57 including the CPHC contractors, and any others to develop a master schedule for the Implementation of the VCS.6.2.4 Equipment Handling Requirement Requirement Identifier Description TR-58 Shipping/Receiving: The RFP Proponent shall adhere to the CPHC’s direction
with respect to shipping/receiving and storage logistics of VCS Equipment intended to be sent to the CPHC. Insurance: The RFP Proponent shall be responsible for all insurance on the TR-59 Equipment until the Equipment has been accepted by the CPHC (refer to TR- 53). 6.2.5 Site Requirement Requirement Identifier Description Site Access: The RFP Proponent shall adhere to the CPHC rules for accessing TR-60 the CPHC locations for VCS Implementation. Integrity: The RFP Proponent shall ensure any VCS Implementation activities do not compromise the integrity of CPHC property. Any costs to repair TR-61 damages made to the CPHC property by the RFP Proponent will be borne by the RFP Proponent. 6.2.6 WAN Design Requirement Requirement Identifier Description Initial Design: The RFP Proponent shall provide an initial design for the wide- area-network (PSTN and/or Internet) to meet the requirements of the CPHC. TR-62 The RFP Proponent shall use reasonable call volume levels based on their experience with this type of environment. Design Modification: The RFP Proponent shall work with the CPHC to modify TR-63 the WAN design during the post-award implementation planning sessions.6.3 Financial Proposal Requirements Requirement Requirement Identifier Description RFP Proponents shall provide an all-inclusive lump sum price for each of the items listed below for the VCS that meets the requirements of this RFP. The base costs shall include, but no limited to: − Equipment including miscellaneous equipment − Implementation services − Network management system TR-64 − Training − Licensing − Warranty and maintenance (5-years, hardware and software) Note: The RFP Proponent shall include any other costs they consider relevant to the CPHC for the successful Implementation of the VCS base configuration. Note: All costs given will be used by the CPHC to evaluate the RFP. Provide your financial proposal by using the financial template in section 7.
END OF SECTION(Requirements CR-01 to CR-10 and TR-01 to TR-64)
6.4 Responsibilities 6.4.1 CPHC Responsibilities Responsibility Responsibility Identifier Description Equipment Power: The CPHC shall be responsible for providing power to all Equipment proposed by the RFP Proponent. For greater clarity, the CPHC will be providing all power receptacles for the Equipment. This does not include power cords or any other power related Equipment necessary for CPHC-01 Implementation of the VCS. Note: the power receptacles provided are as follows: 15/208V C-13 and 20/208V C-19 WAN – The CPHC shall be responsible for providing the RFP Proponent CPHC-02 connectivity into the WAN/Internet. CPHC-03 Equipment Space – The CPHC will provide rack space for all equipment. Testing: All test cases will be validated by the CPHC during the design phase. CPHC-05 All test case results will be reviewed by the CPHC before VCS Acceptance. A copy of the test results shall remain the property of the CPHC. Commissioning Results: All commissioning results will be reviewed by the CPHC-06 CPHC before VCS acceptance. A copy of the commissioning results shall remain the property of the CPHC. Acceptance: The acceptance criteria will be reviewed by the CPHC before CPHC-07 VCS Implementation.
Financial proposal (IN CANADIAN DOLLARS) All-inclusive lump Line Description sum prices Item (excluding taxes) Equipment – provide the itemized cost for the following: VCS and miscellaneous equipment (e.g., software, 1 $ hardware) 2 Network management system $ 3 One Hundred (100) Mitel 5340E IP-Phones $ Total for all Equipment (items 1 to 3) $ 5 Implementation Services $ 6 Licensing $ 7 Training (system and user) $ Warranty and maintenance (5-years, hardware and 8 $ software) 9 Other cost: (if any, please describe) $ Sub-total $ OHST 13% Grand Total $ Company name: Name of authorized person: Signature: Date:
RFP Submission Form Date: _______________________ Submitted By: ______________________________________________ ______________________________________________ “RFP Proponent” To: CPHC Project Management GBA Development and Project Management c/o Ms. Tracey Shipman 1339 Wellington Street, Suite 204 Ottawa, ON K1Y 3B8 1. In this RFP Submission Form defined words and expressions shall have the same meanings as are respectively assigned to them in the RFP document. 2. The undersigned acknowledges receipt of the addenda listed hereafter: Addenda/Q&A No. Date of Issue __________________ _______________________ __________________ _______________________ __________________ _______________________ 3. Pursuant to and in compliance with the RFP document and the addenda listed above, the undersigned, being familiar with the RFP document, the CPHC environment, the character of equipment and materials needed to perform the work contemplated within the RFP, and all relevant laws, rules, notices, directives, standards, orders and regulations, licensing and permit requirements, labour markets and other circumstances which may affect its RFP Submission, hereby submit an RFP Submission to supply Equipment and Services in support of the CPHC’s VCS Project. 4. The RFP Proponent warrants and declares: a) that it has complied with the instructions; b) that it accepts all of the terms, provisions, stipulations and requirements set out in the RFP; c) that it is not relying on any information other than that set out in the RFP and addenda issued pursuant to by the CPHC d) that all statements and information set out in its RFP Submission Form or otherwise provided to the CPHC in connection with the RFP, including statements and information hereafter provided, are and will be true, accurate and complete, not misleading and in accordance with the principles of full, true and plain disclosure.
5. Where an RFP Proponent is comprised of more than one person, all persons comprising the RFP Proponent shall be jointly and severely liable. EXECUTION BY RFP PROPONENTIN WITNESS WHEREOF, the undersigned has executed this RFP Submission Form.Execution by RFP Proponent:__________________________________ _______________________________Printed Name and Position Signature__________________________________ _______________________________Printed Name and Position Signature__________________________________ _______________________________Date WitnessNote: When these documents are signed under an embossed Company Seal it is not mandatory to havesignature(s) witnessed. When these documents are not signed under embossed Company Seal it ismandatory that all signatures be witnessed.
RFP Proponent Declaration Form This Declaration is required with the RFP Submission(Capitalized terms have the meanings ascribed thereto in the RFP)On behalf of and with the authority of the RFP Proponent I/we: 1. hereby apply to be selected as the Preferred RFP Proponent to provide Equipment and Services for the VCS Project in accordance with the provisions and terms and conditions of the RFP and in accordance with applicable legislation, regulations and standards as amended and issued from time to time; 2. certify, represent and warrant that the information the RFP Proponent has supplied in support of this RFP Submission is true, correct and complete in every respect and remains valid, accurate and complete through to the end of the Contract Agreement negotiations unless the CPHC is otherwise notified; 3. acknowledge that the RFP Submission submitted with this declaration is only one stage of procurement and the CPHC may terminate the RFP process at any time; 4. acknowledge that in the event that I/we are selected as the Preferred or Alternate RFP Proponents I/we will be required to attend further information sessions, tours, question and answer meetings, undertake our own process of due diligence and continue in the process all at our own cost and without claim against or indemnity from the CPHC, the Board and staff; 5. consent, pursuant to section 17(3) of the Freedom of Information and Protection of Privacy Act (the “Act”), if applicable, to the disclosure on a confidential basis of the RFP Submission by the CPHC to such individuals or other parties may be required for the purpose of reviewing the RFP Submission to administer the RFP process; 6. consent to the public disclosure of all information listed in the RFP Submission by the RFP Proponent as information which may be disclosed to the public; 7. consent to the disclosure, on a confidential basis, of information held by a third party (including a municipality or other government) regarding the RFP Submission to the CPHC as the CPHC may require, for the purpose of reviewing the RFP Submission to administer the selection process; and 8. agree that i) it has read and understood all of the elements of the RFP; ii) it agrees to comply with the RFP requirements and agrees to negotiate in good faith to finalize the terms of the Contract Agreement; iii) it has undertaken its due diligence and accepts the characteristics and constraints of VCS Project and objectives of the CPHC; and iv) it waives any claim as a result of not having undertaken sufficient due diligence.Signed, Sealed and Delivered in thePresence of ______________________________________ Name of Corporation
_____________________________ ______________________________________Witness Signature of Authorized Signing Officer_____________________________ ______________________________________Date Print Name ______________________________________ Title ______________________________________ Date[If second signature required]Signed, Sealed and Delivered in thePresence of ______________________________________ Name of Corporation_____________________________ ______________________________________Witness Signature of Authorized Signing Officer_____________________________ ______________________________________Date Print Name ______________________________________ Title ______________________________________ Date[Additional Signature lines may be added] END OF RFP DECLARATION FORM
Conflict of Interest Declaration FormThis Declaration is required with the RFP Submission(Capitalized terms have meanings ascribed thereto in the RFP)On behalf of and with the authority of the RFP Proponent I/we confirm as follows: (i) Strike out paragraph (a) or (b), whichever does not apply: a) The RFP Proponent does not and will not have any conflict of interest, actual or potential, in submitting its RFP Submission or, if selected, with the contractual obligations of the RFP Successful RFP Proponent under the proposed Technology Services Agreement and does not and will not have any current or former business interests that are or potentially are in conflict;or b) The following is a list of situations, each of which may be a conflict of interest or an instance of unfair advantage, or appears as potentially a conflict of interest or unfair advantage in submitting the RFP Submission or performing or observing the contractual obligations under any eventual Technology Services Agreement. I/we submit the following situations for review and decision by the CPHC and agree to abide by the CPHC’s decision as to whether the conflict or advantage or potential conflicts or advantage, is of sufficient character as to disqualify our RFP Submission. (ii) The RFP Proponent has not knowingly hired or retained an employee or former employee of the CPHC or the CPHC’s consultants or advisors involved in the development of the CPHC’s RFP process; and (iii) The RFP Proponent do/do not have/have not [strike out the inappropriate portions] had access to any confidential information of the CPHC other than confidential information disclosed to RFP Proponents in the normal course of the RFP process , where the confidential information is relevant to the services required by the RFP process, or the RFP assessment process and where the disclosure of the confidential information could result in prejudice to the CPHC or an unfair advantage to the RFP Proponent. (iv) The following people participated in the preparation of the RFP Submission Name Address Telephone Number 1.
2. 3. 4. 5. (v) The following is a list of individuals who are former employees of the CPHC, the CPHC consultants or advisors whom the RFP Proponent, has either currently appointed to its Board of Directors or currently employed: Name of Individual Job Classification of last Position Last Date of Employment 1. 2. 3. 4. 5.Dated at: ___________________________this___________day of_______________, 20___. If second signature is required:____________________________________ ____________________________________Name of Corporation Name of Corporation____________________________________ ____________________________________(Signature of Authorized Signing Officer) (Signature of Authorized Signing Officer)____________________________________ ____________________________________Title Title____________________________________ ____________________________________Print Name Print Name____________________________________ ____________________________________Phone Number Phone Number