Fort Bend Independent School District (FBISD) RFP Cover Sheet
Transcription
Fort Bend Independent School District (FBISD) RFP Cover Sheet
Fort Bend Independent School District (FBISD) RFP Cover Sheet RFP No.: 12-024KB Due Date: January 10, 2012 DUE NO LATER THAN 2:00 P.M. LATE BIDS WILL NOT BE ACCEPTED Request For Proposal (RFP) : P.E. Uniforms, Spirit Wear, and Related Items PLEASE NOTE Carefully read entire proposal document and specifications. Complete all forms Submit your proposal with all appropriate attachments. Please submit your hard copy proposal in a sealed envelope with RFP no., description, and marked “SEALED PROPOSAL”. RETURN BID TO: Attn: Kathleen Booker– Purchasing Fort Bend Independent School District 555 Julie Rivers Drive Sugar Land, TX 77478 For additional information contact Kathleen Booker at 281-634-1805. You must sign below in INK, failure to sign WILL disqualify the offer. All prices and responses must be typewritten or written in ink Company Name: Company Address: City, State, & Zip: Taxpayer I.D. #: Telephone #: Fax # ______________ E-mail Print Name: Signature: Your signature attests to your offer to provide the goods and/or services in this proposal according to the published provisions of this proposal. Contract is not valid until FBISD Board has approved the award. RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 1 of 24 SPECIFICATIONS P.E. Uniforms, Spirit Wear, and Related Items BACKGROUND FBISD is a K-12 public school district in Fort Bend County serving a student enrollment of over 69,000. The district currently consists of seventy-four (74) campuses and fourteen (14) administrative sites. The intention of this Request for Proposal (RFP) is to solicit proposals for P.E. Uniforms, Spirit Wear, and Related Items for FBISD. GENERAL TERMS & CONDITIONS FOR SOLICITATION This solicitation shall be governed by the following documents which are incorporated by reference only, and are not part of this Solicitation. A copy may be obtained at www.fortbendisd.com/docs/purchasing/general-provisions-for-purchasing-solicitations-and-contracts.pdf or by contacting Kathleen Booker at 281-634-1805 (kathleen.booker@fortbend.k12.tx.us). Any exception to the Terms and Conditions must be included in the Bidder’s response. Texas Education Code 44.031 Purchasing and Acquisition, FBISD Policy CH (Legal) Purchasing and Acquisition, FBISD Policy CH (Local) RESPONSE REQUIREMENTS FBISD will accept sealed proposals either by mail or hand delivery until Tuesday, January 10, 2:00 PM CST. Proposals received after the opening date and time will not be accepted and will be returned unopened. DESCRIPTION Fort Bend ISD intends to purchase school P.E. Uniforms and Spirit Wear for students and staff of various FBISD schools, organizations, clubs, and departments on an “as needed” basis. This is not for fundraisers, which are handled separately. All vendors submitting a proposal shall be established vendors whose primary business is the sale of T-Shirts, polo shirts, etc. Most of these items will be imprinted with an embroidered logo, sewn-on patch, screen printing, etc. Related Items is defined as those other items not listed in the proposal, but may be purchased such as sweatshirts, golf shirts, long sleeve shirts, etc. Vendors can bid a range i.e. 5-10% off everything, percentage off categories, or manufacturers. Vendors must enter a discount even if the discount is 0%. Leaving the Related Items discount blank will be a considered a No Bid. Samples of all items your company is bidding must be included with your proposal package. Samples must be in appropriate colors and at no cost to Fort Bend ISD. No late samples will be accepted. Please mark samples with your company’s name. It is the responsibility of the all vendors to pick up their samples when FBISD has finished the proposal review. Samples must be picked up no later than four (4) weeks after the awarded date. Page 2 of 24 DESCRIPTION (Continued) Fort Bend ISD reserves the right to make a single or multiple award of this contract where it is deemed in the best interest of the District. This proposal will be for one (1) year period with an option to renew up to four (4) additional years. Prices must be firm for one (1) year from date of Board approval. SPECIAL TERMS & CONDITIONS 1. All items shall be new and unused. 2. Any items that cannot be provided or discounted by the bidder must be clearly indicated as a “No Bid” or “N/A”. 3. FBISD will not be responsible for any goods delivered, or services performed without a properly executed purchase order. 4. Each carton shall be marked with the proper Fort Bend ISD purchase order number. Any item received without a purchase order number may be returned to the vendor at their expense. Invoice numbers are unacceptable. 5. Changes in prices must be provided by the awarded vendor(s) and will be valid for one (1) year from award date. Failure to notify FBISD of price changes will allow purchases to be made at the last quoted prices. 6. Fort Bend ISD prefers orders be shipped complete rather than partial. Therefore, there shall be no more than three (3) shipments to complete any purchase order. Shipments from two (2) or more locations at similar time periods will be considered one (1) shipment. Split shipments shall be indicated on the packing slip. 7. When multiple purchase orders are shipped, Fort Bend ISD receiving clerks shall sign only the vendor/shipper manifest which should contain the total amount of containers and the total listing of purchase order numbers. One (1) signature shall be required and not one (1) signature per purchase order. 8. There will be no product substitutions without prior written approval by an authorized representative of FBISD. For information regarding the proposal process, contact Kathleen Booker of the Purchasing Department at (281) 634-1805. Page 3 of 24 TIME TABLE FBISD anticipates following the time table listed below for this bid: Item Activity Date 1 Proposal to advertise (1st run) 12/14/2011 2 Proposal advertises (2nd run) 12/19/2011 3 Proposals open 1/10/2012 4 Estimated Award date Tabulations and Awards posted to www.fortbend.k12.tx.us/finance/bid_awards.cfm 2/27/2012 5 2/28/2012 The time table above is only an estimate and actual dates may vary. Evaluation Criteria: Proposal shall be evaluated using the evaluation criteria listed below. FBISD reserves the right to award contract as best meets the District’s needs such as per section, groups, or all. Evaluation Criteria 1 2 3 4 5 6 Page 4 of 24 the purchase price the reputation of the vendor and of the vendor’s goods or services the extent to which the goods or services meet the district’s needs the vendor’s past relationship with the district, which includes the vendor’s history of prompt, accurate, and efficient billing practices the long-term cost to the district to acquire the vendor’s goods or services ability to service our accounts with proper staff and insurance requirements TOTAL Point System 40 15 20 5 5 15 100 points PRICE DELIVERY INFORMATION Bidder must complete the open boxes using information supplied in the description section listed below. All pricing should be inclusive of freight charges. DO NOT ALTER PRICE DELIVERY FORM OR WRITE IN SHADED AREAS. PLEASE USE DEVIATIONS FORM. Section I: P.E. Uniforms- T-Shirts Item Description Price 1 100% pre-shrunk cotton with round taped athletic neck and set-in sleeves, shall be available in all school colors and in all sizes Youth Small – Adult XL A. Base Price $ B. Name or Logo, One Color Print/Per Dz. $ C. Name or Logo, Two Color Print/Per Dz. $ D. Size XXL or XXXL/Per Dz. $ E. Size XXL or XXXL/Each Price $ 2 100% pre-shrunk cotton, Athletic Grey color, with area for student to write in their name, sizes Youth Small – Adult XL A. Base Price $ B. Name or Logo, One Color Print/Per Dz. $ C. Name or Logo, Two Color Print/Per Dz. $ D. Size XXL or XXXL/Per Dz. $ E. Size XXL or XXXL/Each Price $ RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 5 of 24 PRICE DELIVERY INFORMATION (Continued) DO NOT ALTER PRICE DELIVERY FORM OR WRITE IN SHADED AREAS. PLEASE USE DEVIATIONS FORM. Section II: P.E. Uniforms- Shorts Item Description Price 3 Micro mesh 100% polyester shorts with front drawstring, shall be available in all school colors and 5” – 8” inseam lengths, sizes Youth Small – Adult XL A. Plain- No print/Per Dz. $ B. Name or Logo One Color Print/Per Dz. $ C. Name or Logo Two Color Print/Per Dz. $ D. School Name Only, No Logo/Per Dz. $ E. 5” Inseam/Per Dz. $ F. 6” Inseam/Per Dz. $ G. 7” Inseam/Per Dz. $ H. 8” Inseam/Per Dz. $ I. Size XXL or XXXL/Per Dz. $ J. $ 4 Size XXL or XXXL/Each Price 100% pre-shrunk cotton, full athletic cut with double needle stitching and drawstring, shall be available in all school colors and 5” – 8” inseam lengths, sizes Youth Small – Adult XL A. Plain, No Print/Per Dz. $ B. Name or Logo One Color Print/Per Dz. $ C. Name or Logo Two Color Print/Per Dz. $ RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 6 of 24 PRICE DELIVERY INFORMATION (Continued) DO NOT ALTER PRICE DELIVERY FORM OR WRITE IN SHADED AREAS. PLEASE USE DEVIATIONS FORM. Item Description Price D. School Name Only, No Logo/Per Dz. $ E. 5” Inseam/Per Dz. $ F. 6” Inseam/Per Dz. $ G. 7” Inseam/Per Dz. $ H. 8” Inseam/Per Dz. $ I. Size XXL or XXXL/Per Dz. $ J. Size XXL or XXXL/Each Price $ Section III: Spirit Wear Shirts Item Description Price 5 Screen printed T-Shirt, 100% pre-shrunk cotton, 6.1 oz. with one (1), two (2), or three (3) color imprint on front only, shall be in various colors and sizes Youth Small – Adult XL A. Base Price $ B. One Color/Per Dz. $ C. Two Color/Per Dz. $ D. Three Color/Per Dz. $ E. Size XXL or XXXL/Per Dz. $ F. Size XXL or XXXL/Each Price $ RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 7 of 24 PRICE DELIVERY INFORMATION (Continued) DO NOT ALTER PRICE DELIVERY FORM OR WRITE IN SHADED AREAS. PLEASE USE DEVIATIONS FORM. Item Description Price 6 100% cotton Polo collar style sport shirt with an embroidered logo on the left chest, shall be available in various colors and size XS – XL/Per Dz. $ A. Size XXL or XXXL/Per Dz. $ B. Size XXL or XXXL/Each Price $ C. $ 7 Set-up fee for custom embroidered logo (if applicable) Athletic Coaches Polo, with an embroidered logo on the left chest (optional),“breathable” fabric with moisture control, shall be available in various styles and colors, Men’s and Women’s sizes XS - XL/Each Price Reference: Under Armor®, Adidas®, Nike®, etc. $ A. Size XXL or XXXL/Each Price $ B. Size 4XL or 5XL/Each Price $ C. Set-up fee for custom embroidered logo (if applicable) $ Section IV: Related Items Item Description 8 Related Items Discount % RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 8 of 24 DEVIATIONS FORM If the undersigned Bidder intends to deviate from the Special Conditions or Specifications set forth by utilizing any different materials, items, treatments, finishes, tailoring details, under-construction, etc., contrary to those listed as standards in the specifications, the Bidder must list all deviations on this form. In the event that there are no deviations, the Bidder shall enter “NO DEVIATIONS” on this form and, thus, assures Fort Bend ISD of the Bidder’s full compliance with the specifications and conditions set forth. This Deviation Form must be completed, signed and submitted with your bid whether you have deviations or not. Failure to comply will cause the disqualification of your bid. SPEC.# DEVIATION . | | | | | | | | | | | | | | | | | | | | Signature of Authorized Company Representative Print Name and Title RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 9 of 24 CERTIFICATE OF RESIDENCY The State of Texas has passed a law concerning non-resident contractors. This law can be found in Texas Education Code under Chapter 2252, Subchapter A. This law makes it necessary for FBISD to determine the residency of its bidders. In part, this law reads as follows: “Section: 2252.001 (3) ‘Non-resident bidder’ refers to a person who is not a resident. (4) ‘Resident bidder’ refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state. Section: 2252.002 A governmental entity may not award a governmental contract to a nonresident bidder unless the nonresident underbids the lowest bid submitted by a responsible resident bidder by an amount that is not less than the amount by which a resident bidder would be required to underbid the nonresident bidder to obtain a comparable contract in the state in which the nonresident’s principal place of business is located.” I certify that (Name of Company Bidding) is, under Section: 2252.001 (3) and (4), a Resident Bidder Non-resident Bidder My or Our principal place of business under Section: 2252.001 (3) and (4), is in the city of in the state of Signature of Authorized Company Representative Print Name Title Date RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 10 of 24 HUB OR MINORITY OWNED BUSINESS (Tracking purposes only) 1. Is your company owned (51% or more) by an individual or individuals designated as minority, woman-owned or handicapped? YES___NO___ 2. If you answered yes to question number (1), please submit a copy of the applicable certification with your proposal document. Fort Bend Independent School District does not currently maintain set-asides or give preference to HUB proposals. The above information is solicited for the purpose of statistical tracking only. The Fort Bend Independent School District’s Supplier Diversity Program ensures that the District will use its best efforts to inform small, women-owned, and minority businesses of current and future purchasing activities. The District encourages the participation of these businesses in purchasing of all goods and services. This information can be found at: http://www.fortbend.k12.tx.us/finance/Supplier%20Diversity%20updated%20072710.pdf. FORT BEND INDEPENDENT SCHOOL DISTRICT Affidavit of Non-Discriminatory Employment This company, Contractor, or Subcontractor agrees to refrain from discrimination in terms and conditions of employment on the basis of race, color, religion, sex, or national origin, and agrees to take affirmative action as required by Federal Statutes and rules and regulations issued pursuant thereto in order to maintain and insure non-discriminatory employment practices. _____________________________________ Signature _____________________________________ Printed Name & Title _____________________________________ Company Name RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 11 of 24 MWBE Registration Application (Tracking purposes only) Fort Bend Independent School District- Purchasing Department 555 Julie Rivers Drive Sugar Land, TX 77478 (281) 634-1801 Fax: (281) 634-1829 Instructions: To become registered with FBISD as a certified minority and/or woman owned business enterprise (MWBE) firm, complete this application, and attach a copy of your MWBE certificate. Mail or fax to the Purchasing Office at the above address. Name of Company: Mailing Address: ________________________ City/State: Fax: Telephone Number: Remit to Address: (if different from above) Mailing Address: City/State: Federal I.D. No. : E-mail Address: Owner’s Name: Please Check the Block That Applies Business Code: 10 30 Sole Proprietorship Corporation 20 40 Partnership Joint Venture 100 300 500 African-American Asian Native American 200 400 600 Hispanic Asian Indian White Female 100 Male 200 Female 100 300 Houston Out of State (HQ) 200 400 Texas Fort Bend County MWBE Ownership: Gender: Business Location: Certification Affiliation: Houston Minority Business Council Women’s Business Enterprise Alliance City of Houston HUB (State of Texas) Historically Underutilized Businesses Signature of Authorized Agent: Title: Date: RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 12 of 24 FELONY CONVICTION NOTIFICATION State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states “a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony”. Subsection (b) states “a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The District must compensate the person or business entity for services performed before the termination of the contract”. This Notice is Not Required of a Publicly-Held Corporation. I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge. Vendor’s Name: Authorized Company Official’s Name (Printed): A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. Signature of Company Official: B. My firm is not owned or operated by anyone who has been convicted of a felony. Signature of Company Official: C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony: Name of Felon(s): Details of Conviction(s): Signature of Company Official: RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 13 of 24 FORM CIQ CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person meets requirements under Section 176.006(a). Date Received By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person knowingly violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1 2 Name of person who has a business relationship with local governmental entity. Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3 Name of local government officer with whom filer has employment or business relationship. Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? Yes No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each employment or business relationship with the local government officer named in this section. _____________________________________________ ________________ Signature of person doing business with the governmental entity _____________________________________________ Name of Company/Business RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 14 of 24 Date CERTIFICATION REGARDING LOBBYING CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: 1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of a Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying”, in accordance with its instruction. 3) The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub grants and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, US Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. __________________________________ Company ___________________________________ Authorized Representative (Print) __________________________________ Signature ____________________________________ Date RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 15 of 24 VENDOR DEBARMENT STATEMENT I have read the conditions and specifications provided in the proposal document attached. I affirm, to the best of my knowledge, the company I represent has not been debarred or suspended from conducting business with school districts in the State of Texas. This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Section 3017.510, Participants’ responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulation may be obtained by contacting the Department of Agriculture Agency with which this transaction originated. ______________________________________________________________________ NAME OF COMPANY (Please Type) ____________________________________________________________________ MAILING ADDRESS CITY STATE ZIP ______________________________________________________________________ PREPARED BY (Please Type) ________________________ ___________________________________________ SIGNATURE TITLE ____________________ TELEPHONE NUMBER ____________________________________________ FAX NUMBER DATE Check here if you have an address or telephone number change: Yes____ No____ RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 16 of 24 RETURN ONLY IF YOU CHOOSE NOT TO SUBMIT A RESPONSE TO THIS SOLICITATION NO RESPONSE FORM RFP NO. 12-024KB P.E. Uniforms, Spirit Wear, and Related Items for FBISD Please Print Whereas on the ___________ day of ____________________, 2011/2012 (print name of company) __________________________________________________________________________ has reviewed FBISD’s solicitation RFP No. 12-024KB, and elects not to submit a proposal: State Reason for no response:________________________________________________________ _____________________________________________________________________________ ______________________________________________ Street Address ______________________________________________ City, State, Zip Code ______________________________________________ Telephone/Fax Number ______________________________________________ Name of Authorized Individual ___________________________________________ Signature of Authorized Individual Page 17 of 24 REFERENCES Please provide at least five (5) school district (campus) references that have used your company for the same goods or services FBISD is requesting in this proposal. Please include contact name, school district, address, telephone number, and e-mail address. A valid e-mail address is required. Please make sure the e-mail address is legible and current. 1. E-mail: 2. E-mail: 3. E-mail: 4. E-mail: 5. E-mail: RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 18 of 24 PROPOSAL SUBMISSION FORM RFP NO. _12-024KB P.E. Uniforms, Spirit Wear, and Related Items for FBISD Please Print Whereas on the _____________ day of __________________________, 2011/2012 (print name of company) ___________________________________________________________________________ has reviewed RFP No. 12-024KB and has responded in accordance with the terms and conditions which are incorporated by reference only, and are not attached as part of this Solicitation. A copy may be obtained at www.fortbend.k12.tx.us/finance/FBISDTermsConditions.pdf or by contacting Kathleen Booker at 281-634-1805 (kathleen.booker@fortbend.k12.tx.us). Any exception to the Terms and Conditions must be included in the Bidder’s response. Texas Education Code 44.031 Purchasing and Acquisition, FBISD Policy CH (Legal) Purchasing and Acquisition, FBISD Policy CH (Local) ______________________________________ _____________________________________ Street Address City, State, Zip Code ______________________________________ _____________________________________ Telephone Number Fax Number ______________________________________ ______________________________________ Name of Authorized Individual Signature of Authorized Individual RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 19 of 24 CONTRACTOR CERTIFICATION Introduction: Texas Education Code Chapter 22 requires entities that contract with school districts to obtain criminal history records on covered employees. Covered employees with disqualifying criminal histories are prohibited from serving at a school district. Contractors must certify to the district that they have complied and must obtain similar certifications from their subcontractors. Definitions:Covered individuals: Individual who have or will have continuing duties related to the service to be performed and have or will have direct contact with students. The District will be the final arbiter of what constitutes direct contact with students. Disqualifying criminal history: (1) a conviction or other criminal history information designated by the District; (2) a felony or misdemeanor offense that would prevent a person from obtaining certification as an educator under Texas Education Code § 21.060, including 19 Tex. Admin. Code §249.16; or (3) one of the following offenses, if at the time of the offense, the victim was under 18 or enrolled in a public school: (a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required to register as a sex offender under Chapter 62, Texas Code of Criminal Procedure; or (c) an equivalent offense under federal law or the laws of another state. On behalf of _________________________________________________ (“Contractor”), I certify that [check one]: [ ] Or [ ] None of Contractor’s employees are covered individuals, as defined above. If this box is checked, I further certify that Contractor has taken precautions or imposed conditions to ensure that Contractor’s students will not become covered individuals. Contractor will maintain these precautions or conditions throughout the time the contracted services are provided. Some or all of Contractor’s employees are covered individuals. If this box is checked, I further certify that: 1. Contractor has obtained all required criminal history record information regarding its covered individuals. None of the covered individuals has a disqualifying criminal history. 2. If Contractor receives information that a covered individual subsequently has a reported criminal history, Contractor will immediately remove the covered individual from contract duties and notify the District in writing within three business days. 3. Upon request, Contractor will provide the District with the name and any other requested information of covered individuals so that the District may obtain criminal history record information on the covered individuals. 4. If the District objects to the assignment of a covered individual on the basis of the covered individual’s criminal history record information, Contractor agrees to discontinue using the covered individual to provide services at the District. Noncompliance or misrepresentation regarding this certification may be grounds for contract termination. _____________________ Signature ___________________ Date RETURN THIS DOCUMENT IN THE BID/PROPOSAL PACKAGE Page 20 of 24 QUESTIONNAIRE (Add additional pages if needed) 1. What will be your normal delivery time after receipt of purchase order? ________________________________________________________________________ 2. Does your company have a minimum dollar order amount on orders and reorders? ________________________________________________________________________ 3. Will there be any miscellaneous charges such as delivery, handling or surcharges? If yes, how NO ____________________________________ are they calculated? YES ________________________________________________________________________ 4. Does your company have on-line ordering capabilities? If so, please tell us about the system and if it will accept school district purchase orders when on-line orders are placed. ________________________________________________________________________ ________________________________________________________________________ 5. Are you a member of a cooperative? If so, please provide the name of the cooperative and contract number. _________________________________________________________________________ _________________________________________________________________________ 6. Please list your representative’s contact information that will be designated to service FBISD (i.e. name, position, address, phone, fax, and e-mail). _________________________________________________________________________ _________________________________________________________________________ RETURN THIS DOCUMENT IN BID/PROPOSAL PACKAGE Page 21 of 24 FORT BEND ISD INSURANCE REQUIREMENTS Contractor shall maintain insurance coverage in the amounts specified below and furnish to District. If any work provided for or to be performed under any Specifications is sub-let (as otherwise permitted by the terms of such Specifications), the contractor shall require the subcontractor to maintain and furnish him with satisfactory evidence of Workers Compensation, Employer’s Liability and such other forms and amounts of insurance which the contractor deems reasonably adequate. Certificates of Insurance on the current ACORD form shall be issued to District showing all required insurance coverage. Insurance Required Automobile Liability insurance covering Any Auto Limit Required $1,000,000 Combined Single Limit Comprehensive (Commercial) General Liability insurance including Products, Completed Operations, Independent Contractors, Broad Form Property Damage, Pollution and Blanket Contractual Liability coverage. XCU exclusions to be removed when underground work is performed. $2,000,000 Aggregate, Occurrence and Personal Injury $ 500,000 Fire Damage $ 5,000 Medical Payments Professional Errors & Omissions Liability insurance may be required from all contractors and licensed or certified as professionals; e.g., engineers, architects, insurance agents, physicians, attorneys, banks, financial consultants, etc. Per Project Aggregate Evidence of coverage must be shown on certificates of insurance. Consultant on a limited basis with the district in the area of student support and staff development; $1,000,000 One time project limit all other consulting services; $2,000,000 Occurrence & Aggregate minimum, $5,000,000 Maximum Limit $50,000 Deductible Retroactive Date preceding date of contract must be shown Extended Reporting Period three years past completion of contract Workers Compensation insurance with limits to comply with the requirements of the Texas Workers' Compensation Act. Statutory Limits Employers Liability insurance $1,000,000 Umbrella or Excess Liability insurance (excess of primary General Liability, Automobile Liability and WC Coverage B) One time contract amount for all contracts exceeding: Contract Limit $100,000 - $2,000,000 total limit $500,000 - $10,000,000 total limit $1,000,000 (plus)- $25,000,000 total limit Page 22 of 24 FORT BEND ISD INSURANCE REQUIREMENTS (Continued) Limits for primary policies may differ from those shown when Umbrella or Excess Liability insurance is provided. Insurance Conditions All insurance coverage shall be issued on an Occurrence basis (except Professional Liability) by companies acceptable to District and licensed to do business in the State of Texas by the Texas Department of Insurance. Such companies shall have a Best's Key rating of at least "A- X". All certificates must include: 1. The location or description and the bid number, CSP number or Purchase Order number 2. A 60 day notice of cancellation of any non-renewal, cancellation or material change to any of the policies 3. "Additional Insured" on the Property, General Liability, Automobile Liability and Umbrella (Excess) Liability policies naming the District. 4. A "Waiver of Subrogation" clause in favor of the District will be attached to the Workers Compensation, General Liability, Automobile Liability, Umbrella Liability and the Property insurance policies. 5. In addition to certificates of insurance, copies of policy endorsements must be provided (a) listing the District as Additional Insured, and (b) showing waivers of subrogation in favor of the District: CG2010, CG2037, CG2404, CA0070, CA0032, WC0003 or their equivalents. All insurance must be maintained for one year following substantial completion with Certificates of Insurance provided. Contractor shall be responsible for payment of all deductibles; the District shall approve the deductibles selected. If any policy has aggregate limits, a statement of claims against the aggregate limits is required. The District reserves the right to review the insurance requirements during the effective period of any contract to make reasonable adjustments to insurance coverage and limits when deemed reasonably prudent by District based upon changes in statutory laws, court decisions or potential increase in exposure to loss. Fort Bend Independent School District 555 Julie Rivers Drive Sugar Land, TX 77479 Page 23 of 24 FBISD DISTRIBUTION CENTER MAP Page 24 of 24