REQUEST FOR PROPOSALS
RFP#
08-27-13-01,
WORKERS’
COMPENSATION
INSURANCE
Website: http://www.dcschools.com DATE: August 12, 2013
CONTACT PERSON: Alan Hagy, at 214-944-4522, or [email protected]
Request for Proposal submittals are due on or before TUESDAY, AUGUST 27, 2013, at 10:30 a.m. All submittals must be signed and emailed to [email protected]. Hard copies are not to be submitted.
NOTES TO ALL VENDORS:
1. RFP is for the solicitation of submittals for Worker’s Compensation Insurance. 2. RFP-Insurance Coverage-Attachment 1 and Attachment 2 are
part of this Request for Proposal and can be downloaded from the Dallas County Schools BIDDING OPPORTUNITIES,
http://www.dcschools.com/index.php?id=24, or by emailing [email protected] .
3. Vendor must keep Dallas County Schools (“DCS”) advised of any changes in status.
4. All questions regarding this Request for Proposals must be in writing and be emailed to Alan Hagy, at [email protected]. Questions by phone or emailed to anyone else will not be considered.
5. All items purchased from this solicitation must meet all applicable local, state, and federal rules and regulations.
6. Proposers must make entire submittal in email and attachments to [email protected].
7. RFP, Addendums, Attachments or any other specifications will be posted on http://www.dcschools.com/index.php?id=24.
8. Submittals may include one or more options for rates, and may include programs that may benefit Dallas County Schools and other related entities, as they may utilize any award(s) made.
9. Proposal prices must be firm for a minimum of 60 days from the proposal opening. 10. The effective date of the coverage will be September 1, 2013 and expire August
31, 2017.
11. DCS reserves the right to renew coverage up to an additional two years with the same terms and conditions.
Submission of this proposal shall serve as evidence that the offeror understands and agrees to all conditions of the Request for Proposals. Faxed proposals will not be considered. All offerors must complete all attached forms. Failure to submit all required forms may result in disqualification of your proposal.
______________________________________________________________________ NAME OF VENDOR PRINTED NAME OF REPRESENTATIVE
______________________________________________________________________ PHYSICAL ADDRESS
______________________________________________________________________ MAILING ADDRESS, IF DIFFERENT
______________________________________________________________________ PHONE, CELL PHONE, & E-MAIL ADDRESS
______________________________________________________________________
INSTRUCTIONS/GENERAL INFORMATION 1. Contract Documents:
a. DCS’ expectations with respect to the performance by each Vendor in connection with this purchase are set out in the “Contract Documents,” which consist of this Request for Proposal (“RFP”), any award letter(s), any purchase order(s), and any final contract to be negotiated by the parties. Vendors who fail to examine the Contract Documents do so at their own risk. 2. Preparation and Submission of Proposals:
a. Any explanation desired by a vendor regarding the meaning or interpretation of any portion of the Contract Documents must be requested in writing to the Purchasing Department in a timely manner to allow for a reply to reach vendors before the submission of their proposals. Oral explanations or instructions given before the award of the contract will not be binding. Any information given to one prospective vendor will be furnished to all prospective vendors as a Proposal Addendum, if such information is necessary to vendors in submitting their proposals or if the lack of such information would be prejudicial to an uninformed vendor.
b. Proposals must be delivered by email only. The email address is [email protected]. Proposals are due on or before:
TUESDAY, AUGUST 27, 2013 at 10:30 a.m. Proposals received after the time and date of the opening may not be considered and may be returned. c. Proposals may be modified or withdrawn by written or telegraphic (including
facsimile) notice received by DCS prior to the exact hour and date specified for receipt of proposals. A proposal may also be withdrawn in person by a vendor or an authorized representative, provided his/her identity is made known and he/she signs a receipt for the proposal, but only if the withdrawal is made prior to the exact hour and date set for the receipt of proposals.
3. Vendor Information:
a. Each vendor shall furnish the information required by the Contract Documents.
b. The vendor shall sign the proposal, all addenda, and the proposal sheet. The person signing the proposal must initial erasures or other changes. Proposals signed by an agent must be accompanied by evidence of the agent’s authority unless such evidence has been previously furnished to DCS.
c. If the vendor anticipates a price change due to economic conditions, vendor must give thirty (30) days written notice to DCS. Approval from DCS must be obtained before any price change is effective.
d. Proposals submitted on forms other than the DCS’ forms or with different terms or provisions may be considered as non-responsive proposals.
e. DCS expects that all proposals will remain valid for the term of this proposal. f. The vendor shall certify that no federal or state suspension or debarment is in
place, which would preclude receiving a state or federally funded award. g. Reservations - DCS expressly reserves the right to:
i. Waive minor deviations from the specifications when it is determined that the total cost to DCS of the deviating proposal is lower than the lowest conforming proposal which meets all aspects of the specifications, and the overall function of the goods or services, or both, specified in the deviating proposal is equal to or greater than that of the conforming proposal.
ii. Waive any defect, irregularity or informality in any proposal procedure. iii. Reject any or all proposals.
iv. Amend a proposal prior to proposal opening date to extend or make changes to specification.
v. Procure any item by other means.
vi. Increase or decrease the quantity specified in the proposal, unless the offeror specifies otherwise.
vii. Consider and accept an alternate proposal as provided herein when most advantageous to DCS.
4. Evaluation Criteria:
DCS shall evaluate responsive proposals in accordance with Texas Education Code Section 44.031(b) and the following factors:
a) The purchase price.
b) The reputation of the Vendor and of the Vendor’s goods and services. c) The quality of the Vendor’s goods or services.
d) The extent to which the goods or services meet the Buyer’s needs. e) The Vendor’s past relationship with the Buyer.
f) The impact on the ability of the Buyer to comply with laws and rules relating to Historically Underutilized Businesses.
g) The total long-term cost to the Buyer to acquire the Vendor’s goods or services.
h) Vendor’s service capabilities.
i) Any other relevant factor specifically listed in the request for proposals.
5. Insurance Specifications:
a) Dallas County Schools is seeking proposals for a fully insured or partially insured workers’ compensation insurance program. Proposal may quote an “Occurrence” based program. Options for a Deductible/Self Insured Retention (SIR) with Cash Flow provision for the first and subsequent years should also be offered. Pricing should be based on the SIR option level of $500,000 per occurrence. DCS is not seeking an aggregate stop loss. b) Proposal includes a program with a “Cash Flow Endorsement” option,
please provide sufficient detail to clearly describe the number of years the cash flow endorsement is spread over and the amount of deductible/SIR the District is responsible for each year.
c) Statutory limits above the SIR are required.
d) The effective date of the coverage will be September 1, 2013 and expire August 31, 2017. DCS reserves the right to renew coverage up to an additional two years.
e) The vendor awarded the contract must agree by policy endorsement not to cancel or to decline to renew any policy without 90 days written notice.
f) Although proposals will be accepted from carriers regardless of their Best’s Rating, more favorable consideration will be given to those proposals submitted by carriers with ratings of A-, VII or above.
g) Insures shall be duly licensed in the State of Texas and comply with all applicable Texas insurance laws and requirements of the Texas Board of Insurance.
h) Surplus lines quotes must include all applicable taxes and policy fees as part of the quote. All participants must clearly indicate the applicable fees and or commissions.
i) Proposals shall be all inclusive so DCS will not incur additional expenses for program administration such as reports, meetings, photocopies, etc. The
type of reports and the frequency at which reports are to be generated shall be based on the need as determined by DCS.
j) Proposal shall provide an explanation of the total cost of the proposal by detailing the cost for agency commissions, insurance/reinsurance, administration, loss control, claims, legal, etc…
k) All participants are expected to comply with all Federal and State insurance laws and regulations relative to the preparation and submission of insurance proposals. All proposals submitted will be presumed to be in compliance with all applicable laws.
6. Attachments Include the Following Information: a) Dallas County Schools’ 10 year loss history,
b) Dallas County Schools’ Large Loss History - $50,000 and greater – last 5 years,
c) Dallas County Schools’ payroll history,
d) Dallas County Schools’ projected payroll by workers’ classification codes, e) Employee Concentration numbers will be provided after a provider has been
selected.
7. Contract Term: The effective date of the coverage will be September 1, 2013 and expire August 31, 2017. DCS reserves the right to renew coverage up to an additional two years with the same terms and conditions.
8. Price Increases:
Prices for this type of contract are firm for the term of the negotiated contract. Prices may be decreased at any time after award. Throughout the term of the contract, charges shall not exceed the contract prices. If prices are affected by statute, regulation, administrative or judicial order, vendors may not include additional costs in billing to the end user. Vendors must first provide DCS written justification for increase and DCS must make a determination of applicability of the increase to the contract. In the event a vendor offers or provides a decrease in rates to its customers or potential customers for the same services provided for DCS pursuant to its contract, the vendor must provide the same decrease in rates for DCS. It is recommended that the vendor provide said rate decreases voluntarily. If DCS learns of a decrease in rates from a source other than the vendor, the vendor shall credit DCS with the difference between DCS' contracted rate and the decreased rate from the date of said decrease or the vendor's contract will be subject to cancellation at the discretion of DCS. Any charges not proposed but required to make this service
viable will be considered a hidden cost and will be provided by the vendor at no additional cost to DCS for the term of the contract.
9. Pricing:
Proposals must include specific unit rates for DCS, price extensions, and specific one-time costs. Pricing provided by a vendor’s schedules of services will not be considered as responsible bid. All pricing and any award under this RFP shall be good for DCS and any other DCS related entity.
10. General Information:
Name of company: ______________________________________________________ Address of principal location:_______________________________________________ Phone:__________________________ Fax:____________________________ Form of Business Organization: ____________________________________________ Responsible contact personnel:
Name___________________ Phone:________________ Email:__________________ Name___________________ Phone:________________ Email:__________________ Name___________________ Phone:________________ Email:__________________ How many years has your company been in business in its current capacity? ________ How many years has your organization been in business under its present name? ____ Under what other or former names has your company operated? ______________________________________________________________________ Claims and lawsuits (if the answer to any of the questions below is yes, please attach details).
Has your company ever failed to complete any work awarded to it?_________________ Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your management or company?______________________________________ Has your company filed any lawsuits or requested arbitration or mediation with regard to contracts or awards within the last fifteen years?_______________________________
Within the last fifteen years, has any manager or principal of your company ever been a manager or principal of another organization when it failed to complete a contract or award?________________________________________________________________ Are there any judgments, claims, arbitration proceedings or suits pending or outstanding against your company?___________________________________________________ 11. Experience:
Vendor shall provide a list of three (3) projects of similar type, size and complexity. State the project (customer) name, description of work, dollar value, public entity, yes or no, and date using the format below. Projects listed must have been performed within the last five (5) years. Please include additional information with proposal if available.
12. References:
Proposal shall provide up to six (6) references from company owners or management personnel from projects listed above. There must be at least one (1) reference for each project listed.
13. Certifications:
Employees’ certifications pertaining to work are to be included in submittal. 14. Minimum Insurance Requirements:
Prior to performing any services, vendor shall procure, maintain and provide any applicable insurance certificates, policies and endorsements, in at least the following amounts, to protect vendor and DCS from claims arising out of the performance of the services under this RFP and caused by any error, omission, negligent act or omission, or design defect by vendor, such insurance to be in a form approved by DCS, with an effective date prior to the beginning date of services. Such insurance shall be written on an occurrence basis, if available, and on a claims-made basis, if occurrence basis insurance is not available. Vendor shall maintain its insurance in full force and effect and uninterrupted during the term of the agreement and after the
Project Name
Description of Work
Dollar Value Public Entity Yes or No
completion of services until the completion of any applicable statute of limitations. Vendor shall furnish to DCS insurance certificates, policies and endorsements upon request at any time. Vendor shall name DCS as an additional insured under his policies for comprehensive general liability and comprehensive automotive liability. Insurance shall be obtained from companies licensed to do business in the State of Texas by the Texas Department of Insurance. The policies shall include a waiver of subrogation in favor of DCS. Any deviation from these requirements can only be approved by DCS. Any nonconformity may be grounds for termination or modification of the agreement. To the extent that vendor is unable to procure the insurance designated herein because the insurance is not reasonably available or is cost-prohibitive, then vendor shall provide written notice to DCS. Said lack of insurance may then be grounds for termination or modification of this agreement.
a) Errors and Omissions Insurance $ 1 Million
b) Umbrella Excess Liability Coverage Policy $ 1 Million per occurrence
STANDARD TERMS AND CONDITIONS
These standard terms and conditions are requirements that are binding upon the Vendor awarded the proposal and form a part of all contract documents and/or purchase orders for items included in the specifications and proposal forms issued herewith. They communicate Dallas County Schools’ (“DCS” or “Buyer”) expectations in regards to the Vendor’s performance in connection with any DCS purchase. To the extent any terms and conditions in this Request for Proposal conflict with DCS Policy Chapter 21 - Purchasing and Acquisition, or state or federal law, including but not limited to Texas Education Code Chapter 44, DCS Policy Chapter 21 and state and federal law supersedes these terms and conditions. In accordance with Texas Education Code § 44.0312 and DCS Policy Chapter 21, all authority of the Board of Trustees with respect to procurement matters is delegated to the Superintendent or his designee.
I. CONTRACT/INVOICES
1. Final Contract: The final terms and conditions for this project may be set forth in a contract signed by the Vendor and the DCS Superintendent. Any such contract expressly incorporates all terms and conditions set forth in this RFP. Any deviations from this must be in writing signed by the DCS Superintendent.
2. Invoices and Payments:
a. Successful responsive bidder shall submit invoices, in duplicate, as specified in the final contract. Invoices shall not be due before thirty (30) days.
b. Mail to: Dallas County Schools, Attn: Accounts Payable, P.O. Box 227177, Dallas, Texas 75222. Payment shall not be due until the above instruments are submitted after delivery. Suppliers should keep the Purchasing Department advised of any changes in remittance address
c. Do not include Federal Excise, State or City Sales Tax. Buyer shall furnish tax exemption certificate, if required. If it is determined that tax is included in Proposal, it will disqualify the Vendor.
II. PROPOSALS, PRICING & VENDOR REQUIREMENTS.
a. The Vendor warrants that no person or selling agency has been employed or retained to solicit or secure this contract upon an agreement or understanding for commission, percentage, brokerage, or contingent fee excepting bona fide employees of bona fide established commercial or selling agencies maintained by the Vendor for the purpose of securing
business. For breach or violation of this warranty, the Buyer shall have the right in addition to any other right or rights to cancel this contract without liability and to deduct from the contract price, or otherwise recover the full amount of such commission, percentage, and brokerage or contingent fee. 3. Advertising: Vendor shall not advertise or publish, without Buyer's prior written
consent, the fact that Buyer has entered into this contract, except to the extent necessary to comply with proper requests for information from an authorized representative of the federal, state or local government. Written requests from Vendor must be sent to the Purchasing Department for approval or disapproval. 4. Insurance: Vendor shall maintain insurance in the types and amounts set forth
above, as applicable. Buyer shall be listed as an additional insured under each such policy, and Vendor shall forward to Buyer a certificate of insurance verifying such insurance upon request.
5. Indemnity: The Vendor shall, in connection with any contract awarded under this Request for Proposal and all purchases thereunder, hold harmless and indemnify Buyer, its Board of Trustee officers, employees, and agents from and against any and all claims, liabilities, losses, judgments, expenses, and/or damages resulting from or attributable to any act or omission of the Vendor and its agents and employees, including for any acts constituting negligence.
6. Compliance with Law: Vendor shall, and shall cause its representatives and agents to, follow and abide by all applicable federal, state and local ordinances and laws relating to or regulating the goods and services to be provided under this Request for Proposal.
7. Right to Audit: Vendor shall establish a reasonable accounting system, which enables ready identification of Vendor’s cost of goods and use of funds. Buyer may audit Vendor’s records anytime throughout the term of this contract and for a period of three years after final payment to verify Buyer’s payment obligation and use of Buyer’s funds. Buyer also has the right to examine the books and records of the Vendor to assure that the Vendor has complied with the contract and that no employee of the Buyer received any funds either directly or indirectly. This right to audit shall include subcontractors in which goods or services are subcontracted by Vendor. Vendor shall insure Buyer has these rights with subcontractor(s). Vendor warrants that no gifts or gratuities were or will be given to any of Buyer’s employees either directly or indirectly to obtain this contract. 8. Vendor Qualifications: Vendors not on DCS’ current vendor list, may be
required to prove their qualifications concerning the following criteria: a. Financial capabilities.
c. Quality and stability of product and sources.
d. Vendor must provide copies of current certification and/or licenses, when applicable with proposal.
9. Proposal Evaluations: Proposals shall be evaluated in accordance with Texas Education Code § 44.031(b) and the factors set forth above.
10. Proposal Forms:
a. Proposals included in this packet must be completed in their entirety and returned along with any and all other information requested.
b. Proposals must show the full name and address of the Vendor. Failure to manually sign proposal will disqualify it.
III. TERMINATION & DEFAULT
11. Gratuities: The Buyer may, by written notice to the Vendor, cancel this contract without liability to Vendor if it is determined by Buyer that gratuities, in the form of entertainment, gifts, economic opportunity, future employment, loan, gratuity, special discount, trip, favor, service or otherwise, were offered or given by the
Vendor, or any agent, or representative of the Vendor, to any officer or employee of Buyer with a view toward securing a contract or securing favorable treatment with respect to the awarding or amending or the making or any determinations with respect to the performing of such a contract. In the event Buyer cancels this contract pursuant to this provision, Buyer shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by Vendor in providing such gratuities.
12. Cancellation: Buyer shall have the right to cancel for default, all or any part of the undelivered portion of the contract if Vendor breaches any of the terms hereof, including warranties of Vendor or if the Vendor becomes insolvent or commits acts of bankruptcy. Such right of cancellation is in addition to and not in lieu of any other remedies, which Buyer may have in law or equity.
13. Termination: The performance of work under this contract may be terminated in whole or in part by the Buyer for any reason upon thirty (30) days’ advance notice. Termination of work hereunder shall be effected by the delivery to the Vendor of a "Notice of Termination" specifying the extent to which performance of work under the contract is terminated and the date upon which such termination becomes effective. Such right of termination is in addition to and not in lieu of Buyer’s other rights of cancellation set forth herein.
14. Force Majeure: Neither party shall be deemed in violation of the contract if either is prevented from performing any of the obligations hereunder by reason of, for or through strikes, stoppage of labor, riot, flood, storm, invasion, insurrection, accident, order of court, judge or civil authority, government regulation, an act of God, or any cause reasonably beyond the party’s control and not attributable to its neglect. In the event of such an occurrence, the time for performance of such obligations or duty shall be suspended until such time that such disability to perform, for which the party is not responsible or circumstance beyond its control, shall be removed. The party claiming the suspension shall give written notice of such impediment or delay in performance to the other party within ten (10) days of the knowledge of such occurrence. Each party shall make all reasonable efforts to mitigate the effects of any suspension.
15. Right to Assurance: Whenever one party to this contract in good faith has reason to question the other party's intent to perform he/she may demand that the other party give written assurance of his/her business intent to perform. In the event that a demand is made and no assurance is given within five (5) business days, the demanding party may treat this failure as an anticipatory repudiation of the contract.
16. Penalties for Non-Performance: If, at any time, the Vendor fails to fulfill or abide by the terms, conditions, or specifications of the contract, Buyer reserves the right to:
a. Purchase on the open market and charge the Vendor the difference between contract and actual purchase price;
b. Deduct such charges from existing invoice totals due at the time;
c. Cancel the contract within thirty (30) days written notification of intent; or d. Re-propose the contract due to price increase(s) or any variation from
specifications.
IV. MISCELLANEOUS CONTRACT TERMS
17. Assignment & Binding Effect: No right or interest in this contract shall be assigned or delegation of any obligation made by Vendor without the written permission of the Buyer. Any attempted assignment or delegation by Vendor shall be wholly void and totally ineffective for all purposes unless made in conformity with this paragraph. Vendor understands and agrees that in the event that all or substantially all of its assets are acquired by another entity, that it or its successor in interest will remain obligated to fulfill the terms and conditions of this agreement.
18. Waiver: No claim or right arising out of a breach of this contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved.
19. Modifications: This contract can be modified or rescinded only by a writing signed by both parties to the contract or their duly authorized agents. Any and/or all contract changes must be made through the Purchasing Department and signed by the DCS Superintendent.
20. Interpretation Parole Evidence: This writing is intended by the parties as a final expression of their agreement and is intended also as a complete and exclusive statement of the terms of their agreement. No course of prior dealings between the parties and no usage of the trade shall be relevant to supplement or explain any term used in this agreement. Acceptance or acquiescence in a course of performance rendered under this agreement shall not be relevant to determine the meaning of this agreement even though the accepting or acquiescing party has knowledge of the performance and opportunity for objection. Whenever a term defined by the Uniform Commercial Code is used in this agreement, the definition contained in the Code is to control.
21. Applicable Law: This agreement shall be governed by Texas law and any applicable provisions of the Uniform Commercial Code. Wherever the term "Uniform Commercial Code" is used, it shall be construed as meaning the Uniform Commercial Code as adopted in the State of Texas, effective and in force on the date of this agreement.
22. Venue: Both parties agree that venue for any litigation arising from this contract shall lie in a state or federal court in Dallas County, Texas.
23. Prohibition Against Personal Interest in Contracts: Vendors and applicable DCS officials and employees shall comply with Texas Local Government Code Chapters 171 and 176, as applicable.
24. Governmental Immunity: This Agreement and all purchases are expressly made subject to Buyer’s governmental immunity under the Texas Civil Practice and Remedies Code and all applicable state and federal law. The parties hereto expressly agree that no provision of this Agreement is in any way intended to constitute a waiver of any immunities from suit or from liability that Buyer has by operation of law.
25. Fiscal Funding: Notwithstanding any provision contained herein to the contrary, the obligations of the Buyer under this agreement are expressly contingent upon the availability of funding for each item and obligation contained herein. The Buyer shall make any payments required under this agreement from current revenue available to the Buyer. The Vendor shall not have a right of action
against the Buyer in the event Buyer is unable to fulfill its obligations under this agreement as a result of lack of sufficient funding to pay for its obligations hereunder from any source utilized to fund this agreement or from failure to budget or authorize for this agreement during the current or any future fiscal year. In the event Buyer is unable to fulfill its obligations under this agreement as a result of lack of sufficient funding, or if funds become unavailable, Buyer, at its sole discretion, may provide funds from a separate source or may otherwise terminate this agreement by written notice to the Vendor at the earliest possible time prior to the end of the fiscal year; provided, however, Buyer shall be required to pay any expenses already incurred pursuant to this agreement as of the time Buyer provides such notice. In the event that Buyer is unable to fulfill its obligations under this agreement as a result of lack of sufficient funding, Vendor may immediately terminate this Agreement.
26. Prompt Payment Act: Vendor agrees that a temporary delay by the Buyer in making payments under this agreement due to the Buyer’s accounting disbursement procedures shall not place the Buyer in default of this agreement and shall not render the Buyer liable for interest or penalties, provided such delay does not exceed thirty (30) days after receipt of an invoice. Any undisputed payment not made by the Buyer within thirty (30) days after receipt of the invoice shall bear interest in accordance with Chapter 2251 of the Texas Government Code, as amended.
NO PROPOSAL FORM
(TO BE RETURNED TO DCS IF APPLICABLE) No Proposal Acknowledgement Form:
The undersigned affirms that they are an authorized representative of the company, corporation, firm or partnership stated below and wishes not to submit a proposal at this time, but wishes to remain on the potential vendors list:
Vendor __________
Street Address ____ _____ _____
City, State, ZIP _____
Phone Fax Number _____
________________________________ Signature of Company Official Authorizing This “No Proposal”
________________________________ Name of Company Official (Please Print) Title
Date _____________________________________
Area(s) of Interest
P
PRROOPPOOSSAALL FFOORRMMSS
MUST BE RETURNED TO DCS WITH PROPOSAL TO BE CONSIDERED. PROPOSALS SUBMITTED WITHOUT THIS FORM WILL BE CONSIDERED NULL
AND VOID, AND THEREFORE UNACCEPTABLE
PROPOSAL ACKNOWLEDGMENT FORM:
"The undersigned affirms that they are duly authorized to execute this contract, that this company, corporation, firm, partnership or individual has not prepared this proposal in collusion with any other vendor, and that the contents of this proposal as to prices, terms or conditions of said proposal have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business prior to the official opening of this proposal."
Vendor __________
Street Address _____ _____
City, State, ZIP _____
Phone Fax Number _____
______________________________________________________________________ Signature of Company Official Authorizing This Proposal
______________________________________________________________________ Name of Company Official (Please Print) Title
MUST BE RETURNED TO DCS WITH PROPOSAL TO BE CONSIDERED. PROPOSALS SUBMITTED WITHOUT THIS FORM WILL BE CONSIDERED NULL
AND VOID AND THEREFORE UNACCEPTABLE. 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)
______________________________________________________________________ Signature of Company Official
Select One:
______ My firm is a publicly held corporation; therefore, this reporting requirement is not applicable.
______ My firm is not owned or operated by anyone who has been convicted of a felony.
______ 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): (additional sheets may be attached)
____ _____
SUSPENSION OR DEBARMENT CERTIFICATE
Non-Federal entitles are prohibited from contracting with or making sub-awards under covered transaction to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement for goods or services equal to or in excess of $100,000.
Vendors receiving individual awards for $100,000 or more and all sub-recipients must certify that the organization and its principals are not suspended or debarred.
By submitting this offer and signing this certificate, this vendor:
Certifies that they are not debarred or suspended, or otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 12549. See OMB Circular A-102.
NON-COLLUSION DISCLOSURE
I am an authorized agent or officer of the vendor submitting this proposal, and I have full knowledge of the relations of the vendor with the other firms in this same line of business, and the vendor is not a member of any trust, pool, or combination to control the price of supplies, materials and/or services bid on, or to influence any person to bid or not to bid thereon.
I further affirm that the vendor has not given, offered to give, nor intends to give at any time hereafter any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant in connection with the submitted proposal.
______________________________________________________________________ Vendor’s Name
______________________________________________________________________ Authorized Company Official’s Name and Title (Printed)
______________________________________________________________________ Signature of Company Official
