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BENTON COUNTY ROAD DEPARTMENT (2) 19,500 TRUCKS WITH (Benton County Government)

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BENTON COUNTY ROAD DEPARTMENT
(2) 19,500 TRUCKS WITH 9FT FLAT BED BID
RFB Issue/Ad Date(s):
February 4, 2020
RFB Issuing Office:
Benton County Government
Properties Representative:
Terry Lewis
Office Phone: 479-464-6168
Fax: 479-271-1748
E-mail: terry.lewis@bentoncountyar.gov
USPS Mail Address:
(or hand-deliver)
Benton County Administration Building
Properties Office
215 E. Central Ave., Ste. 304
Bentonville, AR 72712
Attention: Terry Lewis
Bids Due / Deadline:
February 18, 2020 @ 10:00 a.m. local
time
Pursuant to Arkansas Code Annotated §22-9-203 Benton County encourages all qualified small,
minority and women business enterprises to bid on and receive contracts for goods, services, and
construction. Also, Benton County encourages all general contractors to subcontract portions of their
contract to qualified small, minority and women business enterprises.
RFB’s shall be submitted in sealed envelopes labeled: (2) 19,500 Trucks with the name and address
of the Bidder.
RFB’s shall be submitted in accordance with the attached Benton County specifications and RFB
documents attached hereto. Each Bidder is required to fill in every blank and shall supply all
information requested; failure to do so may be used as basis of rejection
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 2
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Advertisement
Benton County, Arkansas is requesting bids for (2)-half ton pickups, (4) Graders, (4) Tri-Axle Dump
Trucks, (1) Backhoe, and (2) 19,500 Trucks. To be considered, bid must be received at the Benton
County Administration Building, 215 East Central, Ste. 304, Bentonville, Arkansas before February
18, 2020 @ 10:00 am (local time).
Forms and addendums can be downloaded from the County’s web site at
https://bentoncountyar.gov/accounting/open-bids/. All questions regarding the qualification process
should be directed to Terry Lewis at terry.lewis@bentoncountyar.gov or by telephone at 479-464-
6168. All questions regarding specifications should be directed to Marty McConnell @ 479-271-1052
or via email at marty.mcconnell@bentoncountyar.gov.
Bidders shall be qualified to do business and licensed in accordance with all applicable laws of the
state and local governments where the project is located.
Pursuant to Arkansas Code Annotated §22-9-203 Benton County encourages all qualified small,
minority and women business enterprises to bid on and receive contracts for goods, services, and
construction. Also, Benton County encourages all general contractors to subcontract portions of their
contract to qualified small, minority and women business enterprises.
Benton County reserves the right to reject any and all bids and to waive irregularities therein, and all
Bidders shall agree that such rejection shall be without liability on the part of Benton County for any
damage or claim brought by any Bidder because of such rejections, nor shall the Bidder seek any
recourse of any kind against Benton County because of such rejections. The filing of any bid in
response to this invitation shall constitute an agreement of the Bidder to these conditions.
Ad Dates: February 4, 2020
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 3
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Contents
SECTION
PAGE NUMBER
Cover page
01
Advertisement
02
Contents
03
Section A: General Terms & Conditions
04
Section B: Vendor References
11
Section C: Specifications & Cost Sheet
12
Section D: Statement of Disclosure and Contact Information
14
Section E: Signature Page
15
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 4
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Section A: General Terms & Conditions
1. SUBMISSION OF A BID:
A. Please submit (1) electronically (CD or USB flash drive) in addition to one (1) hard copy. Please
submit your documents on a properly labeled CD or USB flash drive. The use of Adobe PDF
documents is strongly recommended. Files contained on the CD or electronic media shall not be
restricted against saving or printing. The electronic copy shall be identical to the original papers
submitted. Electronic copies shall not be submitted via e-mail to County employees.
B. Bids will be reviewed following the stated deadline, as shown on the cover sheet of this document.
The names of respondents only will be available after the deadline until a contract has been
awarded by the Benton County. All interested parties understand proposal documents will not be
available until after a valid contract has been executed.
C. Bidders shall submit a bid based on documentation published by Benton County.
D. Bids shall be enclosed in sealed envelopes or packages addressed to Benton County, 215 East
Central, Room 304, Bentonville, Arkansas 72712. The name, address of the firm and RFB name
shall be on the outside of the packaging as well as on any packages enclosed in shipping
containers or boxes.
E. Bids must follow the format of the RFB. Bidders should structure their responses to follow the
sequence of the RFB.
F. Bidders shall have experience in work of the same or similar nature, and must provide references
that will satisfy Benton County. Bidder may furnish a reference list, of clients for whom they have
performed similar services and must provide information as requested in this document.
G. Bidder is advised that exceptions to any of the terms contained in this RFB must be identified in its
response to the RFB. Failure to do so may lead the County to declare any such term non-
negotiable. Bidder’s desire to take exception to a non-negotiable term will not disqualify it from
consideration for award.
H. Bids will need to be received by February 18, 2020 @ 10:00 am (local time).
2. WRITTEN REQUESTS FOR INTERPRETATIONS OR CLARIFICATION:
No oral interpretations will be made to any firms as to the meaning of specifications or any other contract
documents. All questions pertaining to the terms and conditions or scope of work of this bid must be sent in
writing via e-mail to the County Properties office. Responses to questions may be handled as an addendum if
the response would provide clarification to the requirements of the bid/proposal. All such addenda shall
become part of the contract documents. The County will not be responsible for any other explanation or
interpretation of the proposed RFB made or given prior to the award of the contract.
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 5
3. RIGHTS OF BENTON COUNTY IN REQUEST FOR BID PROCESS:
In addition to all other rights of Benton County, under state law, the County specifically reserves the following:
A. Benton County reserves the right to rank firms and negotiate with the highest-ranking firm.
B. Benton County reserves the right to select the bid that it believes will serve the best interest of the
County.
C. Benton County reserves the right to accept or reject any and all bids.
D. Benton County reserves the right to cancel the entire request for bid.
E. Benton County reserves the right to remedy or waive technical or immaterial errors in the request
for bid or in bids submitted.
F. Benton County reserves the right to request any necessary clarifications, additional information, or
proposal data without changing the terms of the bid.
G. Benton County reserves the right to make selection of the Bidder to perform the services required
on the basis of the original bid without negotiation.
4. EVALUATION CRITERIA:
The evaluation criteria define the parameters that will be used by the selection committee to evaluate and
score responsive, responsible and qualified bids. The different evaluation parameters are shown in the chart
below:
Item No.
1
2
3
4
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 6
5. COSTS INCURRED BY BIDDERS:
All expenses involved with the preparation and submission of bids to the County, or any work performed in
connection therewith, shall be borne solely by the Bidder(s). No payment will be made for any responses
received, or for any other effort required of, or made by, the Bidder(s) prior to contract commencement.
6. ORAL PRESENTATION:
An oral presentation and/or interview may be requested of any firm, at the selection committee’s discretion.
7. CONFLICT OF INTEREST:
A. The Bidder represents that it presently has no interest and shall acquire no interest, either direct or
indirect, which would conflict in any manner with the performance or services required hereunder, as
provided in Arkansas Code Annotated §14-14-1202.
B. The Bidder shall promptly notify Benton County in writing, of all potential conflicts of interest for any
prospective business association, interest, or other circumstance which may influence or appear to
influence the bidder’s judgment or quality or services being provided. Such written notification shall
identify the prospective business association, interest or circumstance, the nature of which the Bidder
may undertake and request an opinion to the County as to whether the association, interest or
circumstance would, in the opinion of the County; constitute a conflict of interest if entered into by the
Bidder. The County agrees to communicate with the Bidder its opinion via e-mail or first-class mail
within thirty days of receipt of notification.
8. WITHDRAWAL OF BID:
A bid may be withdrawn at any time.
9. LATE BID OR MODIFICATIONS:
A. Bid and modifications received after the time set for the bid submittal shall not be considered.
Modifications in writing received prior to the deadline will be accepted. The County will not be
responsible for misdirected bids. Bidders should contact the County Properties office at (479) 464-
6168 to ensure receipt of their submittal documents prior to opening time and date listed.
B. The time set for the deadline shall be local time for Bentonville, Arkansas on the date listed. All bids
shall be received in the County Properties office BEFORE the stated deadline.
10. LOCAL, STATE AND FEDERAL COMPLIANCE REQUIREMENTS:
A. The laws of the State of Arkansas apply to any purchase made under this request for bid. Bidders
shall comply with all local, state, and federal directives, orders and laws as applicable to this bid and
subsequent contract(s) including but not limited to Equal Employment Opportunity (EEO),
Disadvantaged Business Enterprises (DBE), & OSHA as applicable to this contract.
B. Pursuant to Arkansas Code Annotated §22-9-203 Benton County encourages all qualified small,
minority and women business enterprises to bid on and receive contracts for goods, services, and
construction. Also, Benton County encourages all general contractors to subcontract portions of their
contract to qualified small, minority and women business enterprises.
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 7
11. COLLUSION:
The Bidder, by affixing his or her signature to this bid, agrees to the following: “Bidder certifies that his bid is
made without previous understanding, agreement, or connection with any person, firm or corporation making a
bid for the same item(s) and/or services and is in all respects fair, without outside control, collusion, fraud, or
otherwise illegal action.”
12. RIGHT TO AUDIT, FOIA AND JURISDICTION:
A. Benton County reserves the privilege of auditing a vendor’s records as such records relate to
purchases between the County and said vendor.
B. Freedom of Information Act: County contracts and documents prepared while performing County
contractual work are subject to the Arkansas Freedom of Information Act. If a Freedom of Information
Act request is presented to Benton County, the (Contractor) will do everything possible to provide the
documents in a prompt and timely manner as prescribed in the Arkansas Freedom of Information Act
(§A.C.A. 25-19-101). Only legally authorized photocopying costs pursuant to the FOIA may be
assessed for this compliance.
C. Legal jurisdiction to resolve any disputes shall be Arkansas with Arkansas law applying to the case.
13. COUNTY INDEMNIFICATION:
A. Due to the County statutory tort immunity, it doesn’t carry liability insurance for such claims.
Accordingly, any contract entered into with the successful bidder/candidate may not include a clause in
which the County agrees that it or its’ officials or employees will indemnify the other party.
B. The successful Bidder(s) agrees to indemnify the County and hold it harmless and against all claims,
liability, loss, damage or expense, including but not limited to counsel fees, arising from or by reason of
any actual or claimed trademark, patent or copyright infringement or ligation based thereon, with
respect to the services or any part thereof covered by this order, and such obligation shall survive
acceptance of the services and payment thereof by the County.
14. VARIANCE FROM STANDARD TERMS & CONDITIONS:
All standard terms and conditions stated in this request for bid apply to this contract except as specifically
stated in the subsequent sections of this document, which take precedence, and should be fully understood by
Bidders prior to submitting a bid on this requirement.
15. PAYMENT AND INVOICING:
The Bidder must specify in their bid the exact company name and address which must be the same as
invoices submitted for payment as a result of award of this RFB. Further, the successful Bidder is responsible
for immediately notifying the County Properties office of any company name change, which would cause
invoicing to change from the name used at the time of the original RFB.
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 8
16. CANCELLATION:
A. The County reserves the right to cancel this contract without cause by giving thirty (30) days prior
notice to the Contractor in writing of the intention to cancel or with cause if at any time the Contractor
fails to fulfill or abide by any of the terms or conditions specified.
B. Failure of the contractor to comply with any of the provisions of the contract shall be considered a
material breach of contract and shall be cause for immediate termination of the contract at the
discretion of Benton County.
C. In addition to all other legal remedies available to Benton County, the County reserves the right to
cancel and obtain from another source, any items and/or services which have not been delivered
within the period of time from the date of order as determined by Benton County.
D. Any contract entered into with a successful bidder/candidate extending beyond the current budget
year the County (which is the calendar year) is subject to non-appropriation. Accordingly, any contract
entered into by the County must provide that in the event no funds or insufficient funds are
appropriated for the continuation of the contract, the contract will end as of the last day for which funds
were appropriated without penalty to the county.
17. ASSIGNMENT, SUBCONTRACTING, CORPORATE ACQUISITIONS AND/OR MERGERS:
A. The Contractor shall perform this contract. No assignment of subcontracting shall be allowed without
prior written consent of the County. If a Bidder intends to subcontract a portion of this work, the
Bidder shall disclose such intent in the bid submitted as a result of this RFB.
B. In the event of a corporate acquisition and/or merger, the Contractor shall provide written notice to the
County within thirty (30) calendar days of Contractor’s notice of such action or upon the occurrence of
said action, whichever occurs first. The right to terminate this contract, which shall not be
unreasonably exercised by the County, shall include, but not limited to, instances in which a corporate
acquisition and/or merger represent a conflict of interest or are contrary to any local, state, or federal
laws. Action by the County awarding a bid to a firm that has disclosed its intent to assign or
subcontract in its response to the RFB, without exception shall constitute approval for purpose of this
Agreement.
18. NON-EXCLUSIVE CONTRACT:
Award of this RFB shall impose no obligation on the County to utilize the vendor for all work of this type, which
may develop during the contract period. This is not an exclusive contract. The County specifically reserves
the right to concurrently contract with other companies for similar work if it deems such an action to be in the
County’s best interest. In the case of multiple-term contracts, this provision shall apply separately to each
item.
19. ADDITIONAL REQUIREMENTS:
The County reserves the right to request additional services relating to this RFB from the Bidder. When
approved by the County as an amendment to the contract and authorized in writing prior to work, the
Contractor shall provide such additional requirements as may be necessary.
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 9
20. SERVICES AGREEMENT OR CONTRACT:
A written agreement, in substantially the form attached, incorporating the RFB and the successful bid will be
prepared by the Bidder, signed by the successful Bidder and presented to Benton County for approval and
signature of the County Judge.
21. INTEGRITY OF REQUEST FOR BID DOCUMENTS:
Bidders shall use the original RFB form(s) provided by the County Properties office and enter information only
in the spaces where a response is requested. Bidders may use an attachment as an addendum to the RFB
form(s) if sufficient space is not available on the original form for the Bidder to enter a complete response. Any
modifications or alterations to the original RFB documents by the Bidder, whether intentional or
otherwise, will constitute grounds for rejection of such RFB response. Any such modifications or
alterations a Bidder wishes to propose shall be clearly stated in the Bidder’s RFB response and presented in
the form of an addendum to the original RFB documents.
22. OTHER GENERAL CONDITIONS:
A. Bidder must provide the County with their bids signed by an employee having legal authority to submit
bids on behalf of the Bidder. The entire cost of preparing and providing responses shall be borne by
the Bidder.
B. The County reserves the right to request any additional information it deems necessary from any or all
Bidders after the submission deadline.
C. The request for bid is not to be construed as an offer, a contract, or a commitment of any kind, nor
does it commit the County to pay for any costs incurred by Bidder in preparation. It shall be clearly
understood that any costs incurred by the Bidder in responding to this request for bid is at the Bidder’s
own risk and expense as a cost of doing business. The County shall not be liable for reimbursement
to the Bidder for any expense so incurred, regardless of whether or not the bid is accepted.
D. If products, components, or services other than those described in this bid document are proposed,
the bidder must include complete descriptive literature for each. All requests for additional information
must be received within five working days following request.
E. Any uncertainties shall be brought to the attention of Ms. Terry Lewis immediately via telephone (479)
464-6168 or by e-mail at Terry.Lewis@bentoncountyar.gov. It is the intent and goal of Benton County
to provide documents providing a clear and accurate understanding of the scope of work to be
completed and/or goods to be provided. We encourage all interested parties to ask questions to enable
all bidders to be on equal bid terms.
F. Any inquiries or requests for explanation in regard to the County’s requirements should be made
promptly to Ms. Terry Lewis, Benton County, via e-mail at Terry.Lewis@bentoncountyar.gov or
telephone at (479) 464-6168. No oral interpretation or clarifications will be given as to the meaning of
any part of this request for bid. All questions, clarifications, and requests, together with answers, if
any will be provided to all firms via written addendum. Names of firms submitting any questions,
clarifications, or requests will not be disclosed until after a contract is in place.
G. At the discretion of the County, one or more firms may be asked for more detailed information before
final ranking of the firms, which may also include oral interviews. NOTE: Each Bidder shall submit an
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 10
“Authorized Signature Page” containing the signature of a duly authorized officer or agent of the
Bidder’s company empowered with the right to bind and negotiate on behalf of the Bidder for the
amounts and terms proposed.
H. Any information provided herein is intended to assist the Bidder in the preparation of bid necessary to
properly respond to this RFB. The RFB is designed to provide qualified Bidders with sufficient basic
information to submit bids meeting specifications and/or test requirements, but is not intended to limit a
RFB’s content or exclude any relevant or essential data.
I. Bidders irrevocably consent that any legal action or proceeding against it under, arising out of or in any
manner relating to this Contract shall be controlled by Arkansas law. Bidder hereby expressly and
irrevocably waives any claim or defense in any said action or proceeding based on any alleged
lack of jurisdiction or improper venue or any similar basis.
J. The successful Bidder shall not assign the whole or any part of this Contract or any monies due or to
become due hereunder without written consent of Benton County. In case the successful Bidder
assigns all or any part of any monies due or to become due under this Contract, the Instrument of
assignment shall contain a clause substantially to the effect that is agreed that the right of the assignee
in and to any monies due or to become due to the successful Bidder shall be subject to prior liens of all
persons, firms, and corporations for services rendered or materials supplied for the performance of the
services called for in this contract.
K. The successful Bidder’s attention is directed to the fact that all applicable Federal and State laws,
County and municipal ordinances, and the rules and regulations of all authorizes having jurisdiction
over the services shall apply to the contract throughout, and they will be deemed to be included in the
contract as though written out in full herein. The successful Bidder shall keep himself/herself fully
informed of all laws, ordinances and regulations of the Federal, State, County and municipal
governments or authorities in any manner affecting those engaged or employed in providing these
services or in any way affecting the conduct of the services and of all orders and decrees of bodies or
tribunals having any jurisdiction or authority over same. If any discrepancy or inconsistency should be
discovered in these Contract Documents or in the specifications herein referred to, in relation to any
law, ordinance, regulation, order or decree, he/she shall herewith report the same in writing to Benton
County.
L. All Benton County properties are tobacco-free zones. Bidder, contractor(s), subcontractor(s) and all
hired staff – whether part time or full time – shall abide by County rules. County Property includes
interior of County buildings, exterior yards, lawns, parking lots, and picnic areas.
M. All charges should be included on the Official Bid Sheet(s) which includes all associated costs
(including but not limited to delivery, tax, freight, etc.) for the goods or services being bid.*
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 11
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Section B: Vendor References
The following information is required from all bidders so all bids may be reviewed and properly evaluated:
Company Name________________________________________________________________
Business Address_______________________________________________________________
Number of years in business _________ How long in present location ____________________
Total number of current employees ______________ Full time _________Part time _________
Number of employees you plan to use to service this contract ______ Full time ______Part time ______
Please list local commercial and/or governmental references that you have previously performed similar contract
services for within the past five (5) years:
1
Company Name:
______________________________________________________
City, State, Zip:
______________________________________________________
Contact Person:
______________________________________________________
Telephone:
______________________________________________________
Fax Number:
______________________________________________________
E-Mail Address:
______________________________________________________
2
Company Name:
______________________________________________________
City, State, Zip:
______________________________________________________
Contact Person:
______________________________________________________
Telephone:
______________________________________________________
Fax Number:
______________________________________________________
E-Mail Address:
______________________________________________________
3
Company Name:
______________________________________________________
City, State, Zip:
______________________________________________________
Contact Person:
______________________________________________________
Telephone:
______________________________________________________
Fax Number:
______________________________________________________
E-Mail Address:
______________________________________________________
4
Company Name:
______________________________________________________
City, State, Zip:
______________________________________________________
Contact Person:
______________________________________________________
Telephone:
______________________________________________________
Fax Number:
______________________________________________________
E-Mail Address:
______________________________________________________
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 12
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Section C: Specifications & Cost Sheet
SPECIFICATIONS & COST SHEET
It is the intent of these specifications to describe in sufficient detail to secure bids on comparable items. Any
items not conforming to these specifications will be rejected, and it will be the responsibility of the bidder to
conform to the requirements unless deviations have been specifically cited by the bidder and an acceptance
made on the basis of the exception.
Bid spec for Two (2) New 19,500 GVW truck with Flat Bed
Overview:
• Single cab 4x4, auto tran’s with 9 ft steel flat bed
• All available L.E.D lights, diesel engine with trailer hitch and light plug, and trailer brake
controller
Truck:
• Not less than 330 HP diesel engine
• Not less than 750 ft-lb of torque
• Factory installed trailer brake control
• 6 speed automatic transmission
• Limited slip differential
• Four-wheel drive
• HVAC system with cabin filter
• 40-20-40 split bench seat, with center armrest / console with cup holders
• LH & RH outside rearview mirrors & day / night inside rearview mirror
• Manual windows and door locks
• 4 speaker AM / FM stereo radio
• Halogen headlights that are fully automatic
• Variable intermittent windshield wipers
• Front reading lights
• At least 40-gal fuel tank
• Must have PTO provision
• Must have engine retarder
• ABS
• 4-wheel disc brakes
• LT 225/ 70 SR 19.5 all season tires mounted on steel wheels front & rear with one spare
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 13
Bed:
• 9 feet overall length
• Tapered headboard cab high
• 1/8” diamond plate construction
• 3” cross members
• Painted black
• 2” receiver hitch at rear with 7-way blade type trailer plug
• All L.E.D lights
• Mud flaps
• 2-30” under body toolboxes
**Please include spec sheet for truck**
Cost Sheet
Description
Price of each
Total
(2) new 19,500 GVW Truck with Flat Bed
*Please don’t include tax in the above totals
Notes
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 14
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Section D: Statement of Disclosure & Contact Information
Bidder must disclose any possible conflict of interest with Benton County, including, but not limited to, any
relationship with any Benton County employee. Your response must disclose if a known relationship exists
between any principal or employee of your firm and any Benton County employee or County elected official.
If, to your knowledge, no relationship exists, this should also be stated in your response. Failure to disclose
such a relationship may result in cancellation of a purchase and/or contract as a result of your response. This
form must be completed and returned in order for your bid to be eligible for consideration.
PLEASE CHECK ONE OF THE FOLLOWING AS IT APPROPRIATELY APPLIES TO YOUR FIRM:
No Known Relationship Exists
Relationship Exists (Please Explain Below)
Primary Contact information if different than signature page:
At the discretion of the County, one or more firms may be asked for more detailed information before final
ranking of the firms, which may also include oral interviews. NOTE: Each Bidder shall submit to the County a
primary contact name, e-mail address, and phone number (preferably a cell phone number) so the County
Selection Committee can contact for clarification or interview via telephone.
Name of Primary Contact
Phone #
E-Mail Address
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Page 15
Benton County RFB
2020 (2)19,500 Trucks with Flat Bed Bid
Section E: Signature Page & Primary Contact Information
Bid must be signed to be considered.
The undersigned hereby offers to furnish and deliver the articles or services as specified, at the prices and
terms stated herein, and in strict accordance with the specifications and general conditions of bidding, all of
which are made a part of the offer. This offer is not subject to withdrawal unless upon mutual written
agreement by the Bidder and County Judge. The person that signs this form must be able to legally bind a
contract for this firm.
1. I, as an officer of this organization, or per the attached letter of authorization, am duly authorized to
certify the information provided herein are accurate and true; and
2. My organization shall comply with all State and Federal Equal Opportunity and Non-Discrimination
requirements and conditions of employment.
Date: ___________________
Signature:
X___________________________________
Name:
____________________________________
Company:
____________________________________
Address:
____________________________________
____________________________________
City, State, Zip:
____________________________________
Phone:
____________________________________
Email:
____________________________________
*Please submit (1) original bid and (1) one copy (CD or USB flash drive).
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Completed 25 January 2021

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