Professional Documents
Culture Documents
Clayton County Telecom RFP
Clayton County Telecom RFP
DATE:
MAILING ADDRESS:
PHONE:
CITY:
FAX:
STATE:
ZIP:
SSN OR FEDERAL
TAX ID:
EMAIL:
TITLE OF AUTHORIZED
REPRESENTATIVE:
PRINTED NAME:
AUTHORIZED SIGNATURE:
If you do not want to respond to this solicitation or would like to be removed from the Proposer
Data Base, mark the appropriate space and return this sheet only and fax/mail to this office
immediately.
__Remove our firm from your Proposers List for this commodity __No Proposal will be submitted
Page 1 of 34
Release Date:
July 12, 2013
Page 2 of 34
SUBMITTAL CHECKLIST
Important Instructions:
I.
To ensure the completeness and responsiveness of your proposal, please use the following checklist to
verify all necessary information is included in your proposal.
II.
Failure to submit any of the items marked below with a check () shall cause rejection of the Proposal
and shall not be considered a minor irregularity.
III. The proposal documents must be submitted as one (1) unbound marked original proposal (not to exceed a
capacity ring binder) with seven (7) bound copies and one (1) CD media in PDF format.
IV. The cost proposal must be submitted in a separate envelope with RFP Pkg. information on outside of
envelope and marked FEE PROPOSAL SHEETS.
DOCUMENTATION DESCRIPTION
ITEMS MARKED WITH A CHECK MUST BE SUBMITTED WITH YOUR RESPONSE
INITIAL
1.
2.
ADDENDA, IF APPLICABLE
3.
4.
W- 9 FORM
5.
6.
7.
8.
9.
10.
11.
12.
***This Checklist is an integral part of RFB #13-41. This Checklist must be completed, signed and attached to the RFP
to acknowledge receipt and compliance with the Countys requirements. ***
______________________________
Signature/Title
______________________________
Company Name
RFP #13-41 TELECOMMUNICATION & DATA SERVICES
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TABLE OF CONTENTS
1
INTENT .......................................................................................................................................... 6
OVERVIEW/BACKGROUND ...................................................................................................... 6
PROPOSAL CONDITIONS........................................................................................................... 8
10
INSURANCE................................................................................................................................ 16
11
12
NON-COLLUSION ...................................................................................................................... 19
13
14
DISCOUNTS ................................................................................................................................ 19
15
16
17
18
19
ASSIGNMENT ............................................................................................................................. 22
20
NONDISCRIMINATION............................................................................................................. 22
21
22
23
24
WAIVER....................................................................................................................................... 24
25
26
INVOICES .................................................................................................................................... 24
27
PAYMENT ................................................................................................................................... 24
28
Page 4 of 34
FORMS:
NON-CONFLICT OF INTEREST ............................................................................................ 26
JOINT VENTURE DISCLOSURE ........................................................................................... 27
CORPORATE CERTIFICATE ................................................................................................. 28
GEORGIA SECURITY & IMMIGRATION COMPLIANCE FORM ..................................... 29
SAVE AFFIDAVIT ................................................................................................................... 30
EXHIBITS:
EXHIBIT A SLBE PROGRAM:
A.1 COVENANT OF NON-DISCRIMINATION FORM ........................................... 34
A.2 STATEMENT OF SUCCESSFUL SUBCONTRACTORS
A.3 STATEMENT OF INTERESTED SUBCONTRACTORS/PROPOSERS
A.4 STATEMENT OF BID PROPOSALS/PRICE QUOTATIONS
A 5 MONTHLY UTILIZATION REPORT
A.6 LETTER OF INTENT
(SEE ATTACHED SPREADSHEETS FOR EXHIBITS A.2-A.5)
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A Non-Mandatory Pre-Proposal Conference will be held on July 25, 2013 at 10:00 AM in the
Central Services Conference Room, 7994 North McDonough Street, Jonesboro, GA 30236.
1.
INTENT
Clayton County Board of Commissioners (the County) is issuing this Request for
Proposals (RFP) seeking proposals from qualified Proposers to procure reliable voice,
telecommunication and data services (Services) for its various departments to conduct
operations and to allow for expansion of its current voice and data network at speeds
acceptable for County business.
2.
3.
OVERVIEW/BACKGROUND
2.1
These Services will replace the Countys existing telecommunications and data
communication services.
2.2
The County has been a user of such Services for many years. The rapid growth of
use, as well as the increased dependence on voice and data connectivity by staff,
administration and the community, has increased the Countys need for
responsiveness, reliability and availability 365 days per year, 24 hours per day.
2.3
The initial contract term shall be two years. By mutual agreement between the
Proposer and the County, the contract may be renewed for three (3) additional one
(1) year periods.
SCOPE OF WORK/SPECIFICATIONS
YOU MUST SUBMIT A SEPARATE TECHNICAL RESPONSE AND FEE COST
FOR EACH SECTION LISTED BELOW
SECTION I TELECOMMUNICATION SERVICES
3.1
Page 6 of 34
The Proposer shall provide Quality of Service (QoS) on all data connections is required.
QoS costs shall be included in the proposal costs.
ADDITIONAL SCOPE OF WORK/SPECIFICATIONS FOR BOTH SECTION I AND II
3.3
3.4
The County will work with the successful Proposer to establish a timeline
for installation of all Services accepted.
3.3.2
3.3.3
The Proposers ability to substantially meet this time frame will be part of
the evaluation criteria.
Availability of Services: The County shall require all Proposers to provide the
following:
3.4.1 Proposer should guarantee the availability of all services (WAN and
Internet) at 99.997% as calculated by the following formula:
(Hours in a Day) x (Days in a Month) x (Number of Sites) (Outage Time in Hours)
(Hours in a Day) x (Days in a Month) x (Number of Sites)
3.4.2
The Proposer shall guarantee the throughput of the network meets the
quoted rate, taking into account normal network overhead, 99.997% of the
time. The Proposer must propose a throughput measurement tool to
measure and ensure compliance with this requirement.
3.4.3
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3.4.6
4.
The pricing and billing of Services are both important components to meet the
expectations of the County. The Proposers appropriate presentment of bills,
easily understood pricing and billing summaries will aid in decreasing
administrative costs incurred by the County.
4.2
Installation Costs: Any and all installation costs (on a line item basis)
will be waived. It is the Countys desire that any make-ready costs are to
be absorbed by the Proposer when possible. At a minimum, Proposer
shall include in its Proposal all make-ready costs for Services on a per
location basis and for the overall network.
4.2.2
Equipment and Costs: The County currently provides and maintains all
equipment necessary to interface to the services subsequent to the
demarcation points (commonly known as Customer Provided Equipment).
This includes all routers, CSU/DSU, DTE, handsets, PBXs, etc. The
ILEC currently being used by the County is provided by AT&T. All
equipment proposed which is necessary to connect to the demarcation
point shall be explicitly set forth in the proposal.
4.2.3
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5.
6.
4.2.4
4.2.5
REJECTION OF PROPOSALS
5.1
The issuance of this RFP and acceptance of proposals does not commit County to
award a contract. County explicitly reserves its right to accept or reject any or all
proposals if it determines it is in its best interest to do so. County will notify all
Proposers in writing, if County rejects all proposals. County also reserves the
right to terminate the RFP process at any time.
5.2
Proposers shall not contact any County officers, elected officials, , or employees
of the County regarding any aspect of this procurement, until after the award of
the contract with the exception of specified persons within Central Services.
Contact with any of the above mentioned individuals shall be grounds for the
rejection of Proposers proposal.
6.2
The Proposers submittal must fully address the requirements listed in this
solicitation and the Proposers degree of experience, knowledge, and ability to
provide experienced and qualified support staff. The proposal submitted by the
Proposer is not to have any exclusions, conditions or provisions applied to the
aforementioned request. It is the Countys intention to select a firm which is the
most qualified to meet its needs. The award shall be based upon the following
factors, including, when applicable, the Proposers past performance in providing
Services to the County:
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Scoring Value
Maximum Points
25
30
25
20
100
15
(possible additional
points if an oral
presentation is
requested)
The Scoring Formula for the above Scoring Value Maximum Points is as follows:
Excellent
.75 - 1.00
Good
.50 - .74
Fair
.25 - .49
Poor
0 - .24
Multiply scoring formula by possible scoring value maximum point allotment. Example: If you
score a firm .6 (Good) on Flexibility of Services and/or Plan for Growth and multiply .60 x 25
(maximum scoring points), this would equal to 15 points.
The County reserves the right to remove the high score and the low score for
each Proposer if deemed necessary.
Page 10 of 34
7.
6.4
The County reserves the right to negotiate the fee and/or Scope of Services with
the highest ranked Proposer. If negotiations cannot be completed successfully,
then the County reserves the right to negotiate with the second highest ranked
firm. Recommendation for an award will be for the Proposer with whom
contract negotiations were successful.
6.5
6.6
Proposers shall not contact any County officers, elected officials, members, or
employees of County regarding any aspect of this procurement, until after the
award of the contract with the exception of specified persons within Central
Services. Contact with the above mentioned individuals shall be grounds for
rejection of proposal.
6.7
The County reserves the right to negotiate adjustments in any and all elements
of the proposals so long as such adjustments do not increase the total
compensation paid by the County over the total proposed price set forth in the
submitted proposals.
6.8
Where the RFP requires the Proposers to submit a number of days, or to submit
a milestone chart, the days used shall be calendar days unless otherwise
specified herein.
6.9
Any proposal submitted shall remain valid for six months after the proposal due
date or until the County executes a contract, whichever is sooner. The County
may, in the event the selected Proposer fails to perform and/or the contract is
terminated within forty-five days of its initiation, request the Proposer
submitting the next acceptable proposal to honor its proposal.
One (1) unbound clearly marked original document (not to exceed a capacity
ring binder), seven (7) bound copies and one (1) CD media in PDF format, must
be provided to Clayton Countys Central Services Department at 7994 N.
McDonough Street, Jonesboro, Georgia, 30236. These documents shall be
delivered in a sealed envelope marked Telecommunication & Data Services
Annual Contract Section I and another separate package for Section II with the
name of the Proposer clearly visible in the upper left hand corner. The Proposer
shall identify their firm on the cover sheet of each proposal (the original and
copies). Proposals are required to be submitted per RFP instructions and must be
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typewritten or printed in ink. Cover page shall have the company name, address
and primary point of contact.
8.
7.2
7.3
Proposer shall offer a written proposal, which presents its qualifications and
understanding of the work to be performed.
7.4
Proposer shall address each item of the required specifications separately and be
specific in presenting qualifications.
7.5
The proposal should provide all the information considered pertinent to your
qualifications for this project.
7.6
By executing the cover sheet, the Proposer acknowledges that it has read the
RFP, understands the provisions, and agrees to be bound by its terms and
conditions.
7.7
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Name, address and telephone number of one (1) individual to whom all
future correspondence and/or communications will be directed.
B.
B.
C.
D.
Explain the Proposers process for ensuring all staff providing Services
will meet all requirements and standards of this RFP.
E.
F.
G.
8.2
Proposer shall provide a detailed price structure for the requested services. (SEE
SECTION 9 MUST SUBMIT A FEE COST SHEET FOR EACH
SECTION)
8.3
References: List all other contracts where Services of the types being proposed
were provided in the past three (3) years by your firm. This should include other
state, county and city governments and and provide up to date contact
information. The County reserves the right to obtain references from any of the
parties listed.
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9.
Company Name:
Address:
_____________________________________________________
_____________________________________________________
_____________________________________________________
Authorized Signature:
_____________________________________________________
Page 14 of 34
_____________________________________________________
_____________________________________________________
_____________________________________________________
Authorized Signature:
_____________________________________________________
Page 15 of 34
10.
INSURANCE
Contractor shall procure and maintain, until all of their obligations including any
warranty periods under this Contract have been satisfied or otherwise discharged,
insurance against claims for injury to persons or damage to property which may arise
from or in connection with the performance of the work hereunder by the Contractor,
contractors agents, representatives, employees or subcontractors.
The insurance requirements herein are minimum requirements for this Contract and in no
way limit the indemnity covenants contained in this Contract. Clayton County in no way
warrants that the minimum limits contained herein are sufficient to protect the Contractor
from liabilities that might arise out of the performance of the work under this contract by
the Contractor, its agents, representatives, employees or subcontractors, and Contractor is
free to purchase additional insurance.
MINIMUM SCOPE AND LIMITS OF INSURANCE (Contractor shall provide coverage
with limits of liability not less than those stated below.)
10.1
$2,000,000
$1,000,000
$1,000,000
$1,000,000
$1,000,000
The policy shall be endorsed to include Clayton County, GA, its appointed and
elected Officials, departments, agencies, boards, commissions, officers, agents,
employees and volunteers as additional insureds with respect to liability arising out
of the activities performed by or on behalf of the Contractor.
10.2
$1,000,000
The policy shall be endorsed to include Clayton County, GA, its appointed and
elected Officials, departments, agencies, boards, commissions, officers, agents,
employees and volunteers as additional insureds with respect to liability arising out
of the activities performed by or on behalf of the Contractor.
Page 16 of 34
10.3
Workers Compensation:
Workers Compensation Coverage:
Requirements.
$1,000,000
$1,000,000
$1,000,000
Policy shall contain a waiver of subrogation in favor of Clayton County, GA, its
appointed and elected Officials, departments, agencies, boards, commissions,
officers, agents, employees and volunteers for losses arising from work performed
by or on behalf of the Contractor.
10.4
10.5
Cancellation Notice: With the exception of (10) day notice of cancellation for nonpayment of premium, any changes material to compliance with this contract in the
insurance policies above shall require (30) days written notice to Clayton County.
Such notice shall be sent directly to Clayton County Risk Management Division Nikki Howard at 770-473-5907 and shall be sent by certified mail, return receipt
requested.
10.6
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10.7
10.8
10.9
11.
11.1
From time to time, Central Services may have to release written changes to a.
The County shall provide notification of any such written addenda to Proposers
who have provided contact information to Central Services. However, it is the
ultimate responsibility of the Proposer to ensure that they have all applicable
addenda prior to its proposal submission. Therefore, we encourage all Proposers
to
frequently
review
the
Countys
web
site:
claytoncountyga.gov/departments/central-services/view-bids-and-proposals.
11.2
All addenda forms must be signed and submitted with the proposal. All addenda
forms must be signed and submitted with the proposal. Failure to respond to any
addenda or requests for clarification may result in a finding of a non-responsive
proposal.
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11.3
12.
The successful firms proposal and all addenda may become a part of the contract
resulting from this RFP Pkg. #13-41.
NON-COLLUSION
By submitting a proposal in response to this solicitation, the Proposer represents that in
the preparation and submission of the proposal, that it did not either directly or
indirectly, enter into any combination or arrangement with any person, other Proposer,
Corporation or enter into any agreement, participate in any collusion, or otherwise take
any action in the restraint of free, competitive bidding in violation of the Sherman Act
(15 U.S.C. Section I or Section 59.1-9.1 through 59.1-9.17 or Sections 59.1 68.6
through 59.68.8). Collusion and fraud in proposal preparation shall be reported to the
State of Georgia Attorney General and the United States Justice Department.
13.
14.
13.2
13.3
Partnership If the Proposer is a partnership, all partners must sign the proposal
with a letter of a partnership certification statement (Appendix A) on company
letterhead that they are all the partners. If all the partners do not sign the
proposal, then the names of all those except limited partners must be furnished on
the proposal and evidence of the authority of the signer(s) to execute the proposal
on behalf of the partnership.
DISCOUNTS
Cash discounts for early payment (i.e. 2%-10) or Net 30 terms should be shown
separately, even if terms are Net.
15.
The County is exempt from Federal Excise Tax or Georgia Sales Tax with regard
to goods and services purchased directly by Clayton County. Exemption
certificates will be furnished upon request.
15.2
The proposal specifications and results will be available on the Countys web site
claytoncountyga.gov/departments/central-services/view-bids-and-proposals.
Page 19 of 34
16.
17.
All permits, fees, arrangements for inspections, licenses, and costs incurred for
the same shall be the sole responsibility of the successful Proposer.
16.2
State Law regarding Worker Verification requires that all who enter into a
contract for the physical performance of services with the County must satisfy
O.C.G.A. 13-10-91 and Rule 300-10-1-.02, in all manner, and such are
conditions of the contract. By submitting a proposal to the County Proposer
certifies that in the event it employs or contracts with any subcontractor(s) in
connection with the contract, the Proposer shall secure from the subcontractor(s)
such subcontractor(s) indication of the employee-number category applicable to
the subcontractor, as well as attestation(s) from such subcontractor(s) that they are
in compliance. Such attestation(s) shall be maintained and may be inspected by
the County at any time. An affidavit of such compliance included with the
proposal, must be signed by the Proposer, and will become part of the contract.
CONTRACT TERM: This initial contract term shall be two (2) years. By mutual
agreement between the Proposer and the County, the contract would be renewable
for three (3) additional one (1) year periods. Renewal of the contract into the
second or third year shall be made sixty (60) days prior to the expiration date. If
needed, the annual contract will be extended 90 days or for such period beyond
the contract expiration date as it may be necessary to afford the County a
continuous supply of the services.
17.2
17.3
17.4
AWARD: The County reserves the right to award one or more contracts to the
responsive and responsible highest scored proposer(s). The County reserves the
right to reject any portion of the proposal or the entire proposal(s), if the Director
of Central Services deems said action to be in the best interest of the County. The
County may waive any technicalities and formalities. The County reserves the
right to cancel the solicitation in its entirety. If the successful Proposer, who is
awarded the contract, cannot provide the Countys requirements to establish an
agreement/contract, the County reserves the right to award the contract to the next
highest scored firm.
17.5
Page 20 of 34
18.2
The successful Proposer will promptly correct all work rejected by the County as
faulty, defective, or failing to conform to the proposal Specifications.
18.3
18.4
Controlling Law, Venue. The terms of any resulting contract shall be governed
by the applicable laws of the County and/or the State of Georgia. Any dispute
arising out of the resulting contract, this proposal solicitation, its interpretations,
or its performance shall be litigated in the Clayton County Judicial circuit.
18.5
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19.
ASSIGNMENT
The contract created by the award to the successful Proposer shall not be sold, not be
assigned or transferred, in whole or any part hereof, by Proposer by process or operation
of law or in any other manner whatsoever, including intra-corporate transfers or
reorganizations between or among a subsidiary of Proposer, or with a business entity
which is merged or consolidated with Proposer or which purchases a majority or
controlling interest in the ownership or assets of Proposer without the prior written
consent of County.
20.
NONDISCRIMINATION
Notwithstanding any other provision of the contract, during its performance Proposer, for
itself, its heirs, personal representatives, successors in interest and assigns, as part of the
consideration of this Agreement does hereby covenant and agree, that:
21.
22.
20.1
No person on the grounds of race, color, religion, sex or national origin shall be
excluded from participation in, denied the benefits of, or otherwise be subjected to
discrimination.
20.2
PERFORMANCE OF CONTRACT
21.1
The County reserves the right to enforce the Proposers performance in any
manner prescribed by law or deemed to be in the best interest of the County in the
event of breach or default of the resulting contract award. It will be understood
that time is of the essence in the Proposers performance.
21.2
The successful Proposer shall execute the entire work described in the Contract
Documents, except to the extent specifically indicated in the Contract documents
to be the responsibility of others.
21.3
The Proposer accepts the relationship of trust and confidence established by the
award of this solicitation. The Proposer covenants with the County to utilize the
Proposers best skill, efforts and judgment in furthering the interest of the County;
to furnish efficient business administration and supervision; to make best efforts
to furnish at all times an adequate supply of workers and materials; and to
perform the work in the best way and most expeditious and economical manner
consistent with the interest of the County.
Termination by County. The agreement resulting from this RFP shall be subject
to termination by the County at any time in the opinion of the County; the
Proposer fails to carry out the contract provisions of any one or more of the
Page 22 of 34
following events:
22.1.1 The default by Proposer in the performance of any of the terms, covenants
or conditions of the Contract, and the failure of Proposer to remedy, or
undertake to remedy with sufficient forces and to the Countys reasonable
satisfaction, the County shall provide the Proposer with notice of any
conditions which violate or endanger the performance of the Agreement.
If after such notice the Proposer fails to remedy such conditions within
thirty (30) days to the satisfaction of the County, the County may exercise
their option in writing to terminate the Agreement without further notice
to the Proposer and order the Proposer to stop work immediately and
vacate the premises, to cancel ordered products and/or services with no
expense to the County.
22.1.2 Proposer files a voluntary petition in bankruptcy, including a
reorganization plan, makes a general or other assignment for the benefit of
creditors, is adjudicated as bankrupt or if a receiver is appointed for the
benefit of creditors, is adjudicated as bankrupt or if a receiver is appointed
for the property or affairs of Proposer and such receivership is not vacated
within thirty (30) days after the appointment of such receiver.
22.1.4 Proposers failure to conduct services according to the approved proposal
specifications.
22.1.5 Proposers failure to keep, perform, or observe any other term or condition
of this Agreement.
22.1.6 Proposers performance of the contract is unreasonably delayed.
22.1.7 Should the successful Proposer fail to provide the commodities or services
when ordered, and in accordance with the General Terms and Conditions,
specifications and any other requirements contained herein are not met,
the County reserves the right to purchase commodities or services covered
by this proposal elsewhere if available from an alternate source.
22.1.8 The Proposer agrees by its proposal submission that the Countys decision
is final and valid.
23.
FORCE MAJEURE
Neither party shall be held to be in breach of the Agreement resulting from this RFP,
because of any failure to perform any of its obligations hereunder if said failure is due to
any act of God, fire, flood, accident, strike, riot, insurrection, war, or any other cause over
which that party has no control. Such party shall give notice and full particulars of such
Force Majeure in writing to the other party within a reasonable time after occurrence of
the event and the obligation of the party giving such notice shall endeavor to remove or
overcome such inability with all reasonable dispatch.
Page 23 of 34
24.
WAIVER
The waiver of any breach, violation or default in or with respect to the performance or
observance of the covenants and conditions contained herein shall not be taken to
constitute a waiver any subsequent breach, violation or default in or with respect to the
same or any other covenant or condition hereof.
25.
PURCHASE ORDER
25.1
26.
INVOICES
26.1
26.2
26.3
Invoices must be in compliance with terms of the Agreement and must include the
following on all invoices:
27.
Invoice number
Contract amount
Individual breakdown of staff time and expenses
An overall earned amount (to date)
The previous invoice amount
Amount earned this invoice
Amount due this invoice
PAYMENT
Payment shall be tendered to the successful Proposer upon acceptance and approval by
the County for satisfactory compliance with the general terms, conditions and
specifications of the Contract; by completed services; verification of delivery of products;
Page 24 of 34
assurance that the product/service performs as specified and warranted; and receipt of a
valid invoice.
28.
Page 25 of 34
NON-CONFLICT OF INTEREST
By submitting a proposal in response to this solicitation, the proposer represents that in
the preparation and submission of this proposal, said Proposer did not either directly or
indirectly, enter into any combination or arrangement with any person, Proposer, Corporation or
enter into any agreement, participate in any collusion, or otherwise take any action in the
restraint of free, competitive bidding in violation of the Sherman Act (15 U.S.C. Section I or
Section 59.1-9.1 through 59.1-9.17 or Sections 59.1 68.6 through 59.68.8). Collusion and
fraud in proposal preparation shall be reported to the State of Georgia Attorney General and the
United States Justice Department.
Proposer certifies that to the best of its knowledge, no circumstances exist which shall
cause a conflict of interest in performing services for Clayton County, and that no company or
person other than bona fide employees working solely for our firm has been employed or
retained to solicit or secure an agreement resulting from this request for proposal.
Signature:
Type Name:
Title:
Firm:
Page 26 of 34
Level of Work
Financial Participation
Signature:
_______________________________
Title: _________________________________
Page 27 of 34
CORPORATE CERTIFICATE
Corporations
I, ______________________________, certify that I am the _____________________
(title) of the Corporation named as Proposer in the forgoing Proposal; that
______________________________, who signed said Proposal on behalf of the Proposer of
said Corporation; that said Proposal was duly signed for and on behalf of said Corporation by
authority of its Board of Directors, and is within the scope of its corporate powers; that said
Corporation is organized under the laws of the State of ____________.
This _________day of ________________, 20 _____.
___________________________________
(Printed Name)
___________________________________
(Signature)
(Corporate Seal must be affixed above)
______________________________________________________________________________
Partnership or other entities:
I, ______________________________________________, certify that I am authorized
to sign to commit _________________________________ named a Proposer in the foregoing
Proposal.
That
said
company
is
formed
under
the
laws
of
the
State
of
_______________________.
This _______________ day of _____________________________, 20 _____.
__________________________________
(Printed Name)
___________________________________
(Signature)
Page 28 of 34
Page 29 of 34
SAVE AFFIDAVIT
CONTRACT WITH A LOCAL GOVERNMENT
STATE OF GEORGIA
CLAYTON COUNTY
By executing this affidavit under oath, as an applicant for a Clayton County, Georgia contract as
referenced in O.C.G.A. 50-36-1 and the August 1, 2010, Report of the Attorney General on Public
Benefits, I am stating the following with respect to my ability to enter into a contract with Clayton
County:
Name of natural person applying on behalf of individual, business, corporation, partnership or other private
entity)
As a representative of:
(Name of the business, corporation, partnership, or other private entity)
(1)
(2)
(3)
(4)
In making the above representation under oath, I understand that any person who knowingly and
willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of
a violation of O.C.G.A. 16-10-20.
This _______ day of _______________, 20_____.
Signature of Applicant: _________________________________________________
Printed Name: _________________________________________________________
Notary Public
My commission expires:
*Note: O.C.G.A. 50-36-1(e) (2) requires that aliens under the Federal Immigration and Nationality Act, Title 8
U.S.C., as amended, provide their Alien Registration Number. Because legal permanent residents are included in
the federal definition of alien, legal permanent residents must also provide their Alien Registration Number.
Qualified aliens that do not have an Alien Registration Number may supply another identifying number:
______________________.
Page 30 of 34
Demonstrates that the firm's gross revenues or number of employees averaged over
the past three years, inclusive of any affiliates as defined by 13 C.F.R. 121.103 et
al., does not exceed the size standards as defined pursuant to 13 C.F.R. 121.201 et
al. which can be found at
http://www.sba.gov/sites/default/files/files/Size_Standards_Table.pdf;
Demonstrates that the net worth of each owner does not exceed $750,000, exclusive
of principal residence and the value of the SLBE;
Provides information regarding the ethnicity and gender of its original owners;
Demonstrates that the firm is located or has an office in Clayton County (inside
Clayton) or in DeKalb, Fayette, Fulton, Henry or Spalding counties (outside
Clayton).
If a firm is locally-based in one of the counties mentioned above, is currently certified as a small
business through the SBA, DeKalb County, Georgia Department of Transportation, or the City of
Atlanta, and can provide evidence of its certification, the firm will be provisionally accepted as a
SLBE, provided that they complete the official certification application for Clayton County
within ten (10) business days following the bid/proposal opening date and prior to contract
award. If a firm meets these qualifications, but is not currently certified as a small business, then
the firm must complete an application for certification with Clayton County no later than seven
(7) business days following the deadline for bid/proposal submission.
Subcontractor participation is required to be submitted as part of the bid/proposal submission by
each bidder/proposer. Award of the contract is conditioned upon satisfaction of the SLBE and
non-discrimination requirements. If the SLBE participation does not meet the goals, the
Bidder/Proposer will be required to submit evidence demonstrating that good faith efforts were
made to meet the goal.
SLBEs must perform a commercially useful function, which means performance or provision of
real and actual services under a contract or subcontract with Clayton County Government.
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Factors such as the nature and amount of work subcontracted; whether the SLBE has the skill
and expertise to perform the work for which it has been certified; whether the SLBE actually
performs, manages or supervises the work; and whether the SLBE intends to purchase
commodities and/or services from a non-SLBE and simply resell them will be considered in
determining if the SLBE is performing a commercially useful function.
This package contains the following forms that Bidders/Proposers are required to submit along
with their bids/proposals:
Covenant of Non-Discrimination
Statement of Successful Subcontractors
Statement of Interested Subcontractors/Proposers
Statement of Bid/Proposal Price Quotations
This package also contains forms that the successful Bidder/Proposer is required to submit:
Monthly Utilization Report-submitted on a monthly basis after the project has begun.
By signing the bid/proposal, the Bidder/Proposer is certifying that it has complied with the
requirements of this program. Please contact the Contract Compliance Division for a list of
certified SLBEs.
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EXHIBIT A.1
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