DeKalb County
Department of Purchasing and Contracting
Maloof Administration Building, 1300 Commerce Drive, 2
nd
Floor,
Decatur, Georgia 30030
December 16, 2019
INVITATION TO BID (ITB) NO. 19-101183
FOR
HOT ASPHALTIC MIX
(ANNUAL CONTRACT WITH 2 OPTIONS TO RENEW)
DEKALB COUNTY, GEORGIA
Procurement Agent:
Angel Frazier
Phone:
404-371-0814
Email:
amfrazier@dekalbcountyga.gov
Mandatory DeKalb First LSBE Meeting:
(Bidders must attend 1 meeting on either
of the dates listed in person or via video
conference.)
December 18, 2019 & December 26, 2019
4572 Memorial Drive, Decatur, Georgia 30032
Main Conference Room - A
(Meetings are held at 10:00 a.m. and 2:00 p.m.)
Video Conference: Utilize the link supplied on our webpage
labeled “DeKalb First LSBE Video Meeting”
Pre-Bid Conference and Site Visit:
N/A
Deadline for Submission of Questions:
5:00 P.M. ET, January 9, 2020
Bid Opening:
3:00 P.M. ET, January 23, 2020
Price Schedule Opening:
3 5 Business days after Bid Opening
FIRM’S NAME AND ADDRESS:
(Street, City, State and Zip Code. Type or print):
Federal Tax ID No. ______________________________
ARE YOU A DEKALB COUNTY FIRM? Yes ____ No ____
TELEPHONE AND FAX NUMBERS WITH AREA
CODE:
Phone: ________________________________________
Fax: __________________________________________
E-mail: ________________________________________
SIGNATURE OF PERSON AUTHORIZED
TO SIGN BID AND DATE:
_______________________________________________
SIGNER’S NAME AND TITLE (Type of Print):
_______________________________________________
THE RESPONSIBILITY FOR SUBMITTING A RESPONSE TO THIS BID TO THE
DEPARTMENT OF PURCHASING AND CONTRACTING OF DEKALB COUNTY
GOVERNMENT ON OR BEFORE THE STATED DATE AND TIME WILL BE SOLELY AND
STRICTLY THE RESPONSIBILITY OF THE BIDDER.
Cathryn G.
Horner
Digitally signed by
Cathryn G. Horner
Date: 2019.12.09
11:24:12 -05'00'
click to sign
signature
click to edit
Page 2 of 45
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TABLE OF CONTENTS
FOR
INVITATION TO BID NO. 19-101183
INVITATION TO BID OVERVIEW ............................................................................................... 3
INVITATION TO BID PROCEDURES .......................................................................................... 5
GENERAL TERMS AND CONDITIONS ....................................................................................... 9
MINIMUM SPECIFICATIONS ..................................................................................................... 20
PRICE SCHEDULE ......................................................................................................................... 24
BID ACKNOWLEDGEMENT FORM .......................................................................................... 26
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INVITATION TO BID OVERVIEW
A. PURPOSE:
DeKalb County Government (the County) is soliciting bids for ITB No. 19-101183 Hot Asphaltic
Mix (Annual Contract with 2 Options to Renew) from responsible bidders.
B. GENERAL INFORMATION:
1. BID TIMETABLE:
The anticipated schedule for the bid process is as follows:
Date Issued:
December 16, 2019
Mandatory DeKalb First LSBE Meeting:
(Bidders must attend 1 meeting on either
of the dates listed.)
December 18, 2019 & December 26, 2019
4572 Memorial Drive, Decatur, Georgia 30032 Main
Conference Room - A
(Meetings are held at 10:00 a.m. and 2:00 p.m.)
Pre-Bid Conference and Site Visit:
N./A
Deadline for Submission of Questions:
5:00 P.M. ET, January 9, 2020
Bid Opening:
3:00 P.M. ET, January 23, 2020
Price Schedule Opening:
3 5 Business days after Bid Opening
Bids Valid Until:
Bids shall be valid for 90 days from and including the
bid opening date.
Sealed bids are to be addressed and delivered to:
DeKalb County Department of Purchasing and Contracting
Maloof Administration Building
1300 Commerce Drive, 2
nd
Floor
Decatur, Georgia 30030, not later than 3:00 P.M. ET, January 23, 2020.
***NEW–PRICE SCHEDULE MUST BE SUBMITTED IN A SEPARATE SEALED
ENVELOPE OR BIDDER WILL BE DEEMED NON-RESPONSIVE AND WILL
NOT BE CONSIDERED FOR AWARD***
Submit one original bid package (inclusive of the entire Invitation to Bid document and
required documents with the exception of the price schedule) stamped “Original” and two
sealed identical copies stamped “Copy” of the bid package to the address listed above.
2. CONTACT PERSON:
The contact person for this bid is Angel Frazier, Procurement Agent. General inquiries
concerning the meaning or interpretation of this Invitation to Bid (ITB) may be requested from
the contact person via telephone at 404-371-0814 or via email at
amfrazier@dekalbcountyga.gov. Questions and requests for information or clarification
concerning the specifications in this ITB must be submitted to the above listed contact person
via email no later than the date and time listed in the bid timetable. Questions and requests
received after the above stated time or sent to anyone other than the listed contact person will
not receive a response or be the subject of addenda.
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3. QUESTIONS:
All requests must be in writing. Any explanation desired by a bidder regarding the meaning
or interpretation of the Invitation to Bid, drawings, specifications, requirements, etc., must be
requested in writing and with sufficient time allowed for a reply to reach bidders before the
submission of their bids. If any statement in the bidding documents, specifications, plans, etc.,
appear ambiguous to the Bidder, Bidder is specifically instructed to make a written request to
the Department of Purchasing and Contracting as outlined in the preceding sentence. Any
information given to a prospective bidder concerning an Invitation to Bid will be furnished to
all prospective bidders, as an addenda to the Invitation, if such information is necessary to
bidders in submitting bids on the Invitation or if the lack of such information would be
prejudicial to uninformed bidders. Oral explanations or instructions given before the award of
the contract will not be binding. Questions must be submitted no later than 5:00 pm EST
on “January 9, 2020.
4. ADDITIONAL INFORMATION/ADDENDA:
The County will issue responses to inquiries and any other corrections or amendments it deems
necessary in written addenda issued prior to the bid opening date. Bidders should not rely on
any representations, statements or explanations other than those made in this ITB or in any
addendum to this ITB. Where there appears to be a conflict between the ITB and any addenda
issued, the last addendum issued will prevail. It is the responsibility of the Bidder to ensure
awareness of all addenda issued for this solicitation. Please acknowledge the addenda and
submit to the DeKalb County Department of Purchasing and Contracting as requested. Bidders
may contact the above listed contact person to verify the number of addenda prior to
submission. Addenda issued for this ITB will be posted on DeKalb County’s website,
www.dekalbcountyga.gov/formalbids. Bidder should regularly check the County’s website for
addenda.
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INVITATION TO BID PROCEDURES
BIDDER INFORMATION:
1. FAILURE TO SUBMIT THE PRICE SCHEDULE IN A SEPARATE SEALED
ENEVELOPE SHALL DEEM THE BID NON-RESPONSIVE. INCLUDING THE
PRICE SCHEDULE IN ANY AREA OUTSIDE OF ITS SEPARATE, SEALED
ENVELOPE WILL RESULT IN BIDDER’S BID BEING DEEMED NON-
RESPONSIVE.
2. Failure to return all pages of this Invitation to Bid may result in bid being deemed non-
responsive.
3. Minimum specifications are intended to be open and non-restrictive. Contractors are
invited to inform the DeKalb County Department of Purchasing and Contracting whenever
specifications or procedures appear not to be fair and open. Such information should be
supplied as early in the procurement process as possible. Information received in less than
five (5) days prior to the scheduled bid opening will not be acted upon unless the DeKalb
County Department of Purchasing and Contracting rules that it is in the best interest of the
County to consider.
4. Brand names and numbers when provided in solicitations are for reference and to establish
a quality standard. Any reference to a brand name shall not be construed as restricting
Bidders to that manufacturer (unless “no substitutes” is stated). Bids on equal items will
be considered, provided the bid clearly describes the article offered and it is equal or
better in quality and function and fully compatible with this requirement.
5. By submitting a bid, Bidder warrants that any goods or services supplied to DeKalb
County Government meet or exceed the specifications set forth in this solicitation.
6. If any supplies, materials, and equipment are provided to the County under this
solicitation, then such items shall be new and in first-class condition unless the
solicitation specifically allows offers of used, reconditioned, or remanufactured items. If
newly manufactured products are specified, such products shall be of recent origin and
not previously used. No equipment of any type is acceptable if serial numbers or any other
manufacturer’s identification labels or marks have been removed, obliterated, or changed
in any way. A Contractor delivering any such equipment to the County will be deemed to
have breached the contract and appropriate action will be taken by the DeKalb County
Government Purchasing and Contracting Department.
7. Time of delivery is a part of the solicitation and an element of the contract that is to be
awarded. If the Bidder cannot meet the required service delivery dates, a bid should not
be submitted. Failure to deliver in accordance with the contract could result in the
Contractor being declared in default.
8. Bid Withdrawal
Bids may be withdrawn at any time prior to the bid opening. After bids have been publicly
opened, withdrawal of bids shall be based upon Part 3, Section IV, F. within the DeKalb
County Purchasing Policy.
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9. Expenses of Preparing Responses to this ITB
The County accepts no responsibility for any expenses incurred by Bidders who submit
bids in response to this ITB. Such expenses are to be borne exclusively by the Bidders.
10. It is the responsibility of each Bidder to ensure that its submission is received by 3:00 p.m.
on the bid due date. The time/date stamp clock located in the Department of Purchasing
& Contracting shall serve as the official authority to determine lateness of any bid. The bid
opening time shall be strictly observed. Be aware that visitors to our offices will go
through a security screening process upon entering the building. Bidders should plan
enough time to ensure that they will be able to deliver their submission prior to our deadline.
Late submissions, for whatever reason, will not be evaluated. Bidders should plan their
deliveries accordingly. Telephone or fax bids will not be accepted.
11. Price Schedule openings shall be conducted in the Department of Purchasing and
Contracting three (3) to five (5) days after the bid opening. Only the Price Schedules of
responsive bidders shall be opened. The County reserves the right to decide which bid(s)
will be deemed responsive and said determination shall be made in accordance with the
requirements stated in this solicitation.
12. Federal Work Authorization
Pursuant to O.C.G.A. §13-10-91, the County cannot enter into a contract for the physical
performance of services unless the Contractor, its Subcontractor(s) and sub-
subcontractor(s), as that term is defined by state law, register and participate in the Federal
Work Authorization Program to verify specific information on all new employees. The
Bidder certifies that he/she has complied and will continue to comply throughout the
contract term with O.C.G.A. §13-10-91 and any related and applicable Georgia
Department of Labor Rule. Contractor agrees that in the event it employs or contracts
with any Subcontractor(s) in connection with this contract, Contractor will secure from
each Subcontractor an affidavit that certifies the Subcontractor’s current and continuing
compliance with O.C.G.A. §13-10-91 throughout the contract term. Each Subcontractor
agrees that in the event it employs or contracts with any sub-subcontractor(s), each
Subcontractor will secure from each sub-subcontractor an affidavit that certifies the sub-
subcontractor’s current and continuing compliance with O.C.G.A. §13-10-91 throughout
the contract term.
13. LSBE Information
a. It is the objective of the Chief Executive Officer and Board of Commissioners
of DeKalb County to provide maximum practicable opportunity for all
businesses to participate in the performance of government contracts. The
current DeKalb County List of Certified Vendors may be found on the County
website at http://www.dekalbcountyga.gov/purchasing/pdf/supplierList.pdf
b. It is required that all responding Bidders attend the mandatory LSBE meeting
within two-weeks of the solicitation’s advertisement, and comply, complete and
submit all LSBE forms with the Bidder’s response in order to remain
responsive. Attendance can be in person, via video conference and
teleconference. Video conferencing is available
through Skype/Lync. Instructions for attendance via video conference can be
found on the County’s website at https://www.dekalbcountyga.gov/purchasing-
contracting/dekalb-first-lsbe-program.
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c. For further details regarding the DeKalb First Local Small Business Enterprise
Ordinance, contact the LSBE Program representative, Felton Williams at
fbwilliams@dekalbcountyga.gov or (404) 371-6312.
14. First Source Jobs Information
The DeKalb County First Source Jobs Ordinance requires contractors or beneficiaries
entering into any type of agreement with the County, including purchase orders,
regardless of what they may be called for the procurement or disposal of supplies,
services, construction projects, professional or consultant services, which is funded in
whole or part with County funds or County administered funds in which the contractor
is to receive $50,000 or more in County expenditures or committed expenditures and
recipient of urban redevelopment action grants or community development block funds
administered in the amount of $50,000 or more make a good faith effort to hire
DeKalb County residents for at least 50% of jobs using the First Source Registry
(candidate database). The work to be performed under this contract is subject to the
provisions of the DeKalb County First Source Jobs Ordinance.
For more information on the First Source Jobs Ordinance requirement, please contact
WorkSource DeKalb at www.dekalbworkforce.org or 404-687-3400.
15. Attention to General Terms and Conditions
Bidders are cautioned to thoroughly understand and comply with all matters covered
under the General Terms and Conditions section of this ITB. The successful Bidder(s)
will enter into a contract approved by the County. The County’s ITB document and
attachments, subsequent County addenda, and the Bidder’s response documents are
intended to be incorporated into a contract. All Bidders should thoroughly review this
document prior to submitting a bid. Any proposed revisions to the terms or language of
this document must be submitted in writing with the bid. Since proposed revisions may
result in a bid being rejected if the revisions are unacceptable to the County, bidders
should review any proposed revisions with an officer of the firm having authority to
execute the contract. No alterations can be made in the contract after award is made.
16. Required Signatures
Bids must be signed by an officer or agent of the firm having the authority to execute
contracts.
17. Ethics Rules
Bidders are subject to the Ethics provision within the DeKalb County Purchasing Policy;
the Organizational Act, Section 22A, the Code of DeKalb County; and the rules of
Executive Order 2014-4. Any violations will be addressed, pursuant to these policies and
rules.
To the extent that the Organizational Act, Section 22A, the Code of DeKalb County, and
the rules of Executive Order 2014-4 allow a gift, meal, travel expense, ticket, or anything
else of value to be purchased for a CEO employee by a contractor doing business with
the County, the contractor must provide written disclosure, quarterly, of the exact nature
and value of the purchase to the Chief Integrity Officer, if created, or the Finance
Director or his/her designee. Every contractor conducting business with the County
will receive a copy of these ethical rules at the time of execution of the contract.
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18. Business License
Bidders shall submit a copy of its current, valid business license with its Bid or upon award.
Georgia companies are to submit a valid county or city business license. Contractors that
are not Georgia companies are to provide a certificate of authority to transact business in
the State of Georgia and a copy of a valid business license issued by its home jurisdiction.
If Bidder holds a professional certification which is licensed by the state of Georgia, then
Bidder may submit a copy of its valid professional license with Bidder’s bid or upon award
unless the Minimum Specifications require submittal with the bid. Any license submitted
in response to this ITB shall be maintained by the Contractor for the duration of the
contract.
BID SUBMITTAL:
1. All bids should be completed in ink or typewritten. Errors should be crossed out and
corrections entered in ink or typewritten adjacent to the error. The person signing
the bid should initial corrections in ink.
2. Bidders shall complete and submit Attachment A - Required Documents Checklist and all
documents responsive to this requirement with the bid submittal.
3. If applicable, provide evidence that the Bidder is a DeKalb County Firm.
4. Bids must be submitted in a sealed envelope(s) or box(es) with the Bidder’s name and
ITB No. 19-101183 Hot Asphaltic Mix on the outside of each envelope or box. All
Bidders delivering submittals via delivery services, please place the sealed bid
envelope(s) or box(es) inside the delivery service envelope(s) or box(es). Bidders are
responsible for informing any delivery service of all delivery requirements. No
responsibility shall attach to the County for the premature opening of a submission not
properly addressed and/or identified. The Decatur postmaster will not deliver certified
or special delivery mail to specific addresses within DeKalb County Government.
C. Contract Award:
1. Bids submitted will be evaluated and recommended for award to the lowest, responsive,
and responsible Bidder(s).
2. The intent of this bid is to make an all-award; however, the County reserves the right to
award by line item or multiple awards. The County may accept any item or group of items
on any bid, whichever is in the best interest of DeKalb County.
3. The County reserves the right to reject any and all bids, to waive informalities, and to re-
advertise.
4. The judgment of DeKalb County Purchasing and Contracting on matters, as stated above,
shall be final. The County reserves the right to decide which Bid will be deemed lowest,
responsive and responsible.
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GENERAL TERMS AND CONDITIONS
A. In the event of a conflict between any provisions contained in any of the documents
governing this transaction, the following shall be the order of precedence: Change
Orders or modifications; the Bidder’s accepted bid; and the County’s ITB.
B. The Bidder’s services shall include all things, personnel, and materials necessary to provide
the goods or services that are in compliance with the specifications as authorized by the
County.
C. Bidder extends to the County the option to renew the contract for two (2) additional one
year terms, under the same price(s), terms and conditions, and in accordance with
Paragraph L, Term.
D. DELIVERY:
It is anticipated that the County will routinely pick-up the hot mix asphaltic concrete from the
vendor’s plat; however, during emergency situations immediate delivery may be required,
after receipt of order, to specific jobsites within the County.
Bidder state agreement: Yes_____________ No______________
Contact Person:
Telephone Number: ____________________Cellular Phone Number: ________________
Address:
Delivery to Public Works – Roads & Drainage Division shall be made Monday through
Friday between the hours of 7:00am and 3:00pm. (727 Camp Road, Decatur, GA 30032;
(404) 297-3840
The contractor shall give a 24-hour notice of delivery, when applicable, and must ask for
caller’s telephone number as well as Purchase Order number and address.
E. DELIVERIES BEYOND THE CONTRACTUAL PERIOD:
This contract covers all requirements that may be ordered, as distinguished from delivered,
during the contract term. This is for the purpose of providing continuity of supply by
permitting the County to place orders as requirements arise in the normal course of supply
operations. Accordingly, any order mailed (or received, if forwarded by other means than
through the mail) to the Contractor on or before the expiration date of the contract, and
providing for delivery within the number of days specified in the contract, shall constitute
a valid order.
F. FOREIGN PRODUCTS:
DeKalb County prefers to buy items produced and/or manufactured in the United States of
America; however, foreign products may be considered provided it is so stated. Bidder
certifies that items offered on this bid is/are manufactured and produced in the United States.
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Yes ______ No _____
If “No”, state the exact location of plant or facility where items will be produced:
G. COUNTY REQUIREMENT:
The contract will be an Indefinite Quantity” type with County requirements to be satisfied
on an “as ordered” basis. The County makes no promise, real or implied, to order any
quantity whatsoever. This invitation and resulting contract will provide for the normal
requirements of DeKalb County, and contracts will be used as primary sources for the
articles or services listed herein. Articles or services will be ordered from time to time in
such quantities as may be needed. As it was impossible to determine the precise quantities
of items described in this invitation that will be needed during the contract term, each
contractor is obligated to deliver all articles and services that may be ordered during the
contract term.
H. WARRANTY AND/OR GUARANTY:
Contractor warrants that its services under this Agreement shall be free of defects in materials
and workmanship for a period of ninety (90) days. The Contractor shall not be liable for
indirect, special, or exemplary damages. The Contractor shall be liable for direct damages.
I. SAMPLES & TESTING:
Samples of items, when required, must be submitted within the time specified, and unless
otherwise specified by the County, at no expense to the County. If not destroyed by testing,
samples will be returned at bidder's request and expense, unless otherwise specified by the
Invitation to Bid. Since tests may require several days for completion, the County reserves
the right to use a portion of any supplies before the results of the tests are known, without
prejudice to any final adjustments, rejecting the unused portion of the delivery and payment
will be made on an adjusted basis for the used portion. The costs of inspections and tests of
any item which fails to meet the advertised specifications shall be borne by the bidder.
J. LITERATURE:
When the bidder proposes to furnish another product, he is required to furnish, with his bid,
literature describing the item(s) being offered. Failure to furnish this literature may result in
the bid being deemed non-responsive.
K. SILENCE OF SPECIFICATIONS:
The apparent silence of these specifications and any supplemental specifications as to any
details, or the omission from it of a detailed description concerning any point, shall be
regarded as meaning that only the best commercial practices are to prevail and that only
materials of first quality and correct type, size and design are to be used. All workmanship
is to be first quality. All interpretations of this specification shall be made upon the basis
of this statement, with County interpretation to prevail.
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L. TERM:
The Contractor shall commence the Work under this Contract within ten (10) days from the
acknowledgement of receipt of the Notice to Proceed (“Commencement Date”). The Initial
Term of this Agreement shall be for twelve (12) calendar months, beginning on the
Commencement Date. This annual contract comes with two (2) options to renew. Prior to
the expiration of the Initial Term, the parties have the option to renew this agreement for a
First annual Renewal Term of twelve (12) calendar months. Prior to the expiration of the
First annual Renewal Term, the parties have the option to renew this Agreement for a
Second annual Renewal Term of twelve (12) calendar months. Without further action by
either party, this Agreement will terminate at the end of the Initial Term or at the end of
each annual Renewal Term. Each option to renew must be exercised prior to the beginning
of each annual Renewal Term and, is only effective upon adoption and approval by the
DeKalb County Governing Authority and the Contractor in accordance with the terms of
this Contract.
M. PRICING:
Alterations to the Price Schedule may result in the Bidder being deemed non-responsive and
its bid may be rejected.
1. Price Reductions: If at any time after the date of award, the Contractor makes a
general price reduction in the comparable price of any article or service covered by
the contract to customers generally, an equivalent price reduction based on similar
quantities and/or considerations shall apply to the contract for the duration of the
contract period (or until the price is further reduced). Such price reduction shall be
effective at the same time and in the same manner as the reduction in the price to
customers generally. An occasional sale at a lower price, or sale of distressed
merchandise at a lower price, would not be considered a general price reduction
under this paragraph. For purposes of this paragraph, a general price reduction shall
mean any reduction in the price of an article or service offered:
To Contractor's customers.
In the Contractor's price schedule for the class of customers; i.e.,
wholesalers, jobbers, retailers, etc., which was used as the basis for
bidding on this contract.
The Contractor shall invoice the County at such reduced price indicating on the
invoice that the reduction is pursuant to General Terms and Conditions, paragraph I.
as stated within the ITB.
2. Price Escalation Clause: During the life of the contract, the awarded bidder shall
furnish price lists to the County for increases, and those of the bidder’s supplier (e.g.
factory) increases, as prices change. The bidder must also provide a list of the
supplier’s (e.g. factory’s) previous price(s) to the County for purposes of
comparison. Price changes will be in effect only after receipt and approval by the
Director of the Department of Purchasing and Contracting. Price lists and changes
thereto are to be furnished under the contract and without charge to the County.
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Catalogue(s) or Price List(s) must be submitted to the Department of Purchasing and
Contracting, Maloof Administration Building, 1300 Commerce Drive, 2
nd
Floor,
Decatur, Georgia 30030.
3. By submission of this bid, the bidder certifies, and in the case of a joint bid each
party thereto certifies as to its own organization that in connection with this
procurement:
The prices in this bid have been arrived at independently, without
consultation, communication, or agreement, for the purpose of restricting
competition, as to any matter relating to such prices with any other bidder or
with any competitor,
Unless otherwise required by law, the prices which have been quoted in this
bid have not been knowingly disclosed by the bidder and will not knowingly
be disclosed by the bidder prior to opening, directly or indirectly to any other
bidder or to any competitor: and
No attempt has been made or will be made by the bidder to induce any other
person or firm to submit or not to submit a bid for the purpose of restricting
competition.
N. PAYMENT:
1. The County shall pay the Contractor based upon the accepted bid prices
submitted by Bidder. Invoices should be signed by the Bidder or authorized
delegate and must contain the authorizing DeKalb County Purchase Order (PO)
and/or Contract Purchase Agreement (CPA) Number in order for payment to be
processed. PO Number must also be on the delivery ticket.
A Contract Purchase Agreement is being issued in lieu of a formal contract. Any
reference to a
contract refers to the CPA.
2. Original invoice(s) must be submitted to:
Public Works – Roads and Drainage
727 Camp Road
Decatur, GA 30032
Attn: Fiscal Officer
(404) 297-3867
a. Upon award, Prime Contractor(s) with Local Small Business Enterprise
(LSBE) Subcontractor(s) shall enter utilization reports electronically at
www.dekalblsbe.info. Proof of payment to the LSBE Subcontractor must be
uploaded and submitted. LSBE Subcontractors shall confirm receipt of
payment from the Prime, electronically also, at www.dekalblsbe.info.
3. The County’s official payment terms are Net 30. Payment dates that fall on a
weekend or on a holiday will be issued on the County’s next business day.
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O. ACCURACY OF WORK:
The Contractor shall be responsible for the accuracy of the Work and any error and/or
omission made by the Contractor in any phase of the Work under this Agreement.
P. ADDITIONAL WORK:
The County shall in no way be held liable for any work performed under this section which
has not first been approved in writing by the County in the manner required by applicable
law and/or the terms of this Contract. The County may at any time order changes within
the scope of the Work without invalidating the Contract upon seven (7) days written notice
to the Contractor. The Contractor shall proceed with the performance of any changes in the
Work so ordered by the County unless such change entitles the Contractor to a change in
Contract Price, and/or Contract Term, in which event the Contractor shall give the County
written notice thereof within fifteen (15) days after the receipt of the ordered change, and
the Contractor shall not execute such changes until it receives an executed Change Order
from the County. No extra cost or extension of time shall be allowed unless approved
by the County and authorized by execution of a Change Order. The parties’ execution of
any Change Order constitutes a final settlement of all matters relating to the change in the
Work which is the subject of the Change Order. The County shall not be liable for payment
for any work performed under this section which has not first been approved in writing
by the County in the manner required by applicable law and/or the terms of this Contract.
Q. OWNERSHIP OF DOCUMENTS:
All documents, including drawings, estimates, specifications, and data are and remain the
property of the County. The Contractor agrees that the County may reuse any and all
plans, specifications, drawings, estimates, or any other data or documents described herein
in its sole discretion without first obtaining permission of the Contractor and without any
payment of any monies to the Contractor therefore. Any reuse of the documents by the
County on a different site shall be at its risk and the Contractor shall have no liability where
such documents are reused.
R. RIGHT TO AUDIT:
The County shall have the right to audit all books and records, including electronic records,
relating or pertaining to this contract or agreement, including but not limited to all financial
and performance related records, property, and equipment purchased in whole or in part with
County funds and any documents or materials which support whose records, kept under the
control of the Contractor, including but not limited to those kept by the Contractor’s
employees, agents, assigns, successors and subcontractors. The County also has the right to
communicate with Contractor’s employees related to the audited records.
The Contractor shall maintain such books and records, together with such supporting or
underlying documents and materials, for the duration of this contract and for seven (7) years
after termination or expiration, including any and all renewals thereof. The books and
records, together with supporting documents and materials shall be made available, upon
request to the County or its designee, during normal business hours at the Contractor’s office
or place of business. In the event that no such locations is available, then the books, records
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and supporting documents shall be made available for audit at a time and location which is
convenient for the County.
S. SUCCESSORS AND ASSIGNS:
The Contractor agrees it shall not sublet, assign, transfer, pledge, convey, sell, or otherwise
dispose of the whole or any part of this Contract or his right, title, or interest therein
to any person, firm, or corporation without the previous written consent of the County.
If the County consents to any such assignment or transfer, then the Contractor binds
itself, its partners, successors and assigns to all covenants of this Contract. Nothing
contained in this Contract shall create, nor be interpreted to create privity, or any other
relationship whatsoever, between the County and any person, or entity or than
Contractor.
T. REVIEWS AND ACCEPTANCE:
Work performed by the Contractor shall be subject to review and acceptance in stages as
required by the County. Acceptance shall not relieve the Contractor of its professional
obligation to correct, at his own expense, any errors in the Work.
U. TERMINATION OF AGREEMENT:
The Contractor understands and agrees that the date of the beginning of Work, rate of
progress, and time for completion of the Work are essential conditions of this Contract.
Both parties may, for its own convenience and at its sole option, without cause and
without prejudice to any other right or remedy of the party, elect to terminate the Contract
by delivering to the other party, at the address listed in the Notices article of this
Contract, a written notice of termination specifying the effective date of termination.
Such notice shall be delivered to the other party at least thirty (30) days prior to the
effective date of termination. If Contractor’s services are terminated by the County, the
termination will not affect any rights or remedies of the County then existing or which
may thereafter accrue against Contractor or its surety. In case of termination of this
Contract before completion of the Work, Contractor will be paid only for the portion of
the Work satisfactorily performed through the effective date of termination as determined
by the County. Neither party shall be entitled to recover lost profits, special, consequential
or punitive damages, attorney’s fees or costs from the other party to this Contract for any
reason whatsoever. This Contract shall not be deemed to provide any third-party with
any remedy, claim, right of action, or other right. The parties’ obligations pursuant to
this Section shall survive any acceptance of Work, or termination or expiration of this
Contract.
V. INDEMNIFICATION AGREEMENT:
The Contractor shall be responsible from the execution date or from the time of the
beginning of the Work, whichever shall be the earlier, for all injury or damage of any
kind resulting from the Work, to persons or property, including employees and property
of the County. The Contractor shall exonerate, indemnify, and save harmless the County,
its elected officials, officers, employees, agents and servants, hereinafter collectively
referred to in this Section as “the County Indemnitees,” from and against all claims or
actions based upon or arising out of any damage or injury (including without limitation
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any injury or death to persons and any damage to property) caused by or sustained in
connection with the performance of this Contract or by conditions created thereby or
arising out of or any way connected with Work performed under this Contract, as well as
all expenses incidental to the defense of any such claims, litigation, and actions.
Furthermore, Contractor shall assume and pay for, without cost to the County Indemnitees,
the defense of any and all claims, litigation, and actions suffered through any act or omission
of the Contractor, or any Subcontractor, or anyone directly or indirectly employed by or
under the supervision of any of them. Notwithstanding any language or provision in this
Contract, Contractor shall not be required to indemnify any County Indemnitee against
claims, actions, or expenses based upon or arising out of the County Indemnitee’s sole
negligence. As between the County Indemnitees and the Contractor as the other party, the
Contractor shall assume responsibility and liability for any damage, loss, or injury, including
death, of any kind or nature whatever to person or property, resulting from any kind of
claim made by Contractor’s employees, agents, vendors, Suppliers or Subcontractors
caused by or resulting from the performance of Work under this Contract, or caused by or
resulting from any error, omission, or the negligent or intentional act of the Contractor,
vendors, Suppliers, or Subcontractors, or any of their officers, agents, servants, or
employees. The Contractor shall defend, indemnify, and hold harmless the County
Indemnitees from and against any and all claims, loss, damage, charge, or expense to which
they or any of them may be put or subjected by reason of any such damage, loss, or injury.
The Contractor expressly agrees to provide a full and complete defense against any claims
brought or actions filed against the County Indemnitees, where such claim or action
involves, in whole or in part, the subject of the indemnity contained in this Contract,
whether such claims or actions are rightfully or wrongfully brought or filed. The County
has the sole discretion to choose the counsel who will provide the defense. No provision of
this Contract and nothing herein shall be construed as creating any individual or personal
liability on the part of any elected official, officer, employee, agent or servant of the
County, nor shall the Contract be construed as giving any rights or benefits hereunder
to anyone other than the parties to this Contract. The parties’ obligations pursuant to this
Section shall survive any acceptance of Work, or termination or expiration of this Contract.
W. INSURANCE:
Insurance must meet the County’s requirements and will be furnished by the successful
Bidder(s) upon award.
1. Successful Bidder(s) will advise their insurance agent of the County’s requirements as
listed below and that they may not proceed with any work until insurance is provided
that is in compliance with these requirements.
2. Contractor’s insurance company or agent must mail, email, or bring an original
certificate of insurance and applicable declarations or endorsements to the DeKalb
County address listed within this Insurance provision. Insurance must be from
companies able to do business in Georgia and acceptable to the County as follows:
a. Certificates must cover:
i. Statutory Workers Compensation
(1) Employer’s liability insurance by accident, each accident $1,000,000
(2) Employer’s liability insurance by disease, policy limit $1,000,000
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(3) Employer’s liability insurance by disease, each employee $1,000,000
ii. Business Auto Liability Insurance with a minimum $500,000
Combined Single Limit/Each Occurrence (Including operation of
non-owned, owned, and hired automobiles).
iii. Commercial General Liability Insurance
(1) Each Occurrence - $1,000,000
(2) Fire Damage - $250,000
(3) Medical Expense - $10,000
(4) Personal & Advertising Injury - $1,000,000
(5) General Aggregate - $2,000,000
(6) Products & Completed Operations - $1,500,000
(7) Contractual Liability where applicable
b. DeKalb County, GA shall be named as Additional Insured under any General
Liability, Business Auto and Umbrella Policies. Coverage shall apply as
Primary and non-contributory with Waiver of Subrogation in favor of DeKalb
County, Georgia. Such additional insured coverage shall be endorsed to
Contractor’s policy by attachment of ISO Additional Insured Endorsement
forms CG 20 10 10 01 (ongoing operations) and CG 20 37 10 01 (products-
completed operations), or form(s) providing equivalent coverage.
c. This insurance for the County as the additional insured shall be as broad as the
coverage provided for the named-insured Contractor. It shall apply as primary
insurance before any other insurance or self-insurance, including any
deductible, non-contributory, and waiver of subrogation provided to the
County as the additional insured.
d. Contractor agrees to waive all rights of subrogation and other rights of recovery
against the County and its elected officials, officers, employees or agents, and
shall cause each Subcontractor to waive all rights of subrogation for all
coverages.
e. Certificates shall state that the policy or policies shall not expire, be
cancelled or altered without at least sixty (60) days prior written notice to
the County.
f. Contractor understands and agrees that the purchase of insurance in no
way limits the liability of the Contractor.
g. The insurance carrier must have a minimum A.M. Best rating of not less than
“A” (Excellent) with a Financial Size Category of VII or better.
h. Certificates to contain policy number, policy limits and policy expiration date
of all policies issued in accordance with this contract.
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i. Certificates to contain the location and operations to which the insurance applies.
j. Certificates to contain successful contractor’s protective coverage for any
subcontractor’s operations. If this coverage is included in General Liability,
please indicate on the Certificate of Insurance.
k. Certificates to contain successful contractor’s contractual insurance
coverage. If this coverage is included in the General Liability, please
indicate this on the Certificate of Insurance.
l. Certificates shall be issued and delivered to the County and must identify
the “Certificate Holder” as follows:
DeKalb County, Georgia
Director of Purchasing and
Contracting
Maloof Administration Building
1300 Commerce Drive, 2nd Floor
Decatur, Georgia 30030
m. The successful contractor shall be wholly responsible for securing
certificates of insurance coverage as set forth above from all subcontractors
who are engaged in this work.
X. GEORGIA LAWS GOVERN:
The laws of the State of Georgia shall govern the construction of this Contract without
regard for conflicts of laws. Should any provision of this Contract require judicial
interpretation, it is agreed that the court interpreting or construing the same shall not apply
a presumption that the terms hereof shall be more strictly construed against one party, by
reason of the rule of construction, that a document is to be construed more strictly against
the party who itself or through its agent prepared same; it being agreed that the agents of
all parties have participated in the preparation hereof, and all parties have had an
adequate opportunity to consult with legal counsel. In interpreting this Contract in its
entirety, the printed provisions of this Contract, and any additions written or typed
hereon, shall be given equal weight, and there shall be no inference by operation of law
or otherwise; that any provision of this Contract shall be construed against either party
hereto.
Y. VENUE:
This Agreement shall be deemed to have been made and performed in DeKalb County,
Georgia. For the purposes of venue, all suits or causes of action arising out of this
Agreement shall be brought in the courts of DeKalb County, Georgia.
Z. COUNTY REPRESENTATIVE:
The County may designate a representative through whom the Contractor will contact the
County. In the event of such designation, said representative shall be consulted and his
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written recommendation obtained before any request for extra work is presented to the
County. Payments to the Contractor shall be made only upon itemized bill submitted to and
approved by said representative.
AA. CONTRACTOR’S STATUS:
The Contractor will supervise and direct the Work, including the Work of all
Subcontractors. Only persons skilled in the type of work which they are to perform shall
be employed. The Contractor shall, at all times, maintain discipline and good order among
his employees, and shall not employ any unfit person or persons or anyone unskilled in the
work assigned him. The relationship between the County and the Contractor shall be that
of owner and independent contractor. Other than the consideration set forth herein, the
Contractor, its officers, agents, servants, employees, and any Subcontractors shall not be
entitled to any County employee benefits including, but not limited to social security,
insurance, paid annual leave, sick leave, worker's compensation, free parking or
retirement benefits. All services provided by Contractor shall be by employees of
Contractor or its Subcontractors and subject to supervision by Contractor. No officer
or employee of Contractor or any Subcontractor shall be deemed an officer or employee of
the County. Personnel policies, tax responsibilities, social security payments, health
insurance, employee benefits and other administrative policies, procedures or
requirements applicable to the Work or services rendered under this Contract shall be those
of the Contractor, not the County.
BB. SOLE AGREEMENT:
This Contract constitutes the sole contract between the County and the Contractor. The
terms, conditions, and requirements of this Contract may not be modified. No verbal
agreement or conversation with any officer, agent, or employee of the County, either before
or after the award of the Contract, shall affect or modify any of the terms or obligations
herein contained. No representations, oral or written, shall be binding on the parties unless
expressly incorporated herein.
CC. SEVERABILITY:
If any provision of this Contract or the application thereof to any person or circumstance
shall to any extent be held invalid, then the remainder of this Contract or the application of
such provision to persons or circumstances, other than those as to which it is held invalid,
shall not be affected thereby, and each provision of this Contract shall be valid and enforced
to the fullest extent permitted by law.
DD. NOTICES:
Any notice or consent required to be given by or on behalf of any party hereto to any other
party hereto shall be in writing and shall be sent to the Director of the Department of
Purchasing and Contracting or to the Contractor or his authorized representative on the
work site by (a) registered or certified United States mail, return receipt requested, postage
prepaid, (b) personal delivery, or (c) overnight courier service. All notices sent to the
addresses listed below shall be binding unless said address is changed in writing no less
than fourteen days before such notice is sent. Future changes in address shall be
effective upon written notice being given by the Contractor to the Director of the
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Department of Purchasing and Contracting or by the County to the Contractor’s authorized
representative via certified first class U.S. mail, return receipt requested. Such notices will
be addressed as follows:
If to the County:
Chief Procurement Officer
Department of Purchasing and Contracting
Maloof Administration Building
1300 Commerce Drive, 2
nd
Floor
Decatur, Georgia 30030
If to the Contractor:
Notices shall be sent to the contact information that is listed in
the Bidder’s Response to the ITB.
EE. Georgia Open Records Act:
Without regard to any designation made by the person or entity making a submission, DeKalb
County considers all information submitted in response to this invitation or request to be a
public record that will be disclosed upon request pursuant to the Georgia Open Records Act,
O.C.G.A. §50-18-70 et seq., without consulting or contacting the Responder person or entity
making the submission, unless a court order is presented with the submission. Bidders or
Responders may wish to consult an attorney or obtain legal advice prior to making a
submission.
FF. Cooperative Procurement
The County through the Department of Purchasing & Contracting may permit piggybacks to
this contract from other city, county, local authority, agency, or board of education if the
vendor will extend the same prices, terms, and conditions to the city. Piggybacking shall only
be available where competition was used to secure the contract and only for a period of 12-
months following entry, renewal or extension of the contract. This provision shall not apply to
any contract where otherwise prohibited or mandated by state law.
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MINIMUM SPECIFICATIONS
I. GENERAL REQUIREMENTS:
The Contractor shall:
1. Supply Hot Mix Asphaltic Concrete for DeKalb County Public Works - Roads & Drainage.
Hot mixes shall be in accordance with the following specifications:
a. Georgia Department of Transportation (GDOT) Standard Specifications for
Construction of Transportation Systems, Section 828.2.04 Fine-Graded
Mixtures
(http://www.dot.ga.gov/PartnerSmart/Business/Source/specs/DOT2013.pdf).
b. GDOT Section 400.3.05 – Hot Mix Asphaltic Concrete Construction.
c. Current State Highway Department of Georgia Standard Specifications in
regard to gradation and AC content if ordered with lime.
2. Work DeKalb County trucks into the truck loading services in the order in which they
arrive, preventing loading delays.
3. Be responsible for reviewing and verifying Public Works - Roads & Drainage employee
identification and ensure that the vehicle picking-up mix is a DeKalb County Roads &
Drainage vehicle to prevent unauthorized use of the contract.
4. Issue tickets for actual amount loaded onto trucks. Tickets must indicate truck number and
include the driver’s signature and County identification number.
A. GDOT STANDARD SPECIFICATIONS:
1. Supplemental Specifications 828.2.04/Fine-Graded Mixtures
Fine-Graded Mixtures A. Requirements Design gyrations (Ndes) for fine-graded mixes shall be 50 gyrations.
Ensure that fine-graded mixtures meet the following mixture control tolerances and design limits:
ASPHALTIC CONCRETE - 4.75 mm Mix
Sieve Size
Mixture Control Tolerance
Design Gradation Limits, %
passing
1/2 in (12.5 mm) sieve
0.0
100
3/8 in (9.5 mm) sieve
5.6
90-100
No. 4 (4.75 mm) sieve
5.7
75-95
No. 8 (2.36 mm) sieve
4.6
60-65
No. 50 (300 mm) sieve
3.8
20-50
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No. 200 (75 mm) sieve
2.0
4-12
Range for % AC
±0.4
6.00 – 7.50
Design optimum air voids (%)
4.0 – 7.0
% Aggregate voids filled with AC
50 – 80
2. 400.3.05 Subparagraphs B and C, [Hot Mix Asphaltic Concrete] Construction (Excerpt)
B. Prepare Bituminous Material Uniformly heat the bituminous material to the
temperature specified in the job mix formula with a tolerance of ± 20 °F (± 10 °C).
C. Prepare the Aggregate Prepare the aggregate as follows:
(1) Heat the aggregate for the mixture, and ensure a mix temperature within the limits
of the job mix formula.
(2) Do not contaminate the aggregate with fuel during heating.
(3) Reduce the absorbed moisture in the aggregate until the asphalt does not separate
from the aggregate in the prepared mixture. If this problem occurs, the Engineer
will establish a maximum limit for moisture content in the aggregates. When this
limit is established, maintain the moisture content below this limit.
D. Prepare the Mixture Proportion the mixture ingredients as necessary to meet the
required job mix formula. Mix until a homogenous mixture is produced.
(1) Add Mineral Filler
When mineral filler is used, introduce it in the proper proportions and as specified
in 400.3 Construction Requirements Subsection 400.3.02.B.5, ―Mineral Filler
Supply System.
(2) Add Hydrated Lime
When hydrated lime is included in the mixture, add it at a rate specified in Standard
Specifications Construction of Transportation Systems, 2013 Ed., Section 828
Hot Mix Asphaltic Concrete Mixtures and the job mix formula. Use methods and
equipment for adding hydrated lime according to Subsection 400.3.02.B.6,
―Hydrated Lime Treatment System. Add hydrated lime to the aggregate by using
Method A or B as follows: Method ADry FormAdd hydrated lime in its dry
form to the mixture as follows, according to the type of plant:
a. Batch Type Asphalt Plant: Add hydrated lime to the mixture in the weigh
hopper or as approved and directed by the Engineer.
b. Continuous Plant Using Pugmill Mixer: Feed hydrated lime into the hot
aggregate before it is introduced into the mixer so that dry mixing is complete
before the bituminous material is added.
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c. Continuous Plant Using Drier-Drum Mixer: Add hydrated lime so that the lime
will not become entrained into the air stream of the drier and so that thorough
dry mixing will be complete before the bituminous material is added.
Method B—Lime/Water SlurryAdd the required quantity of hydrated lime
(based on dry weight) in lime/water slurry form to the aggregate. This solution
consists of lime and water in concentrations as directed by the Engineer. Equip the
plant to blend and maintain the hydrated lime in suspension and to mix it with the
aggregates uniformly in the proportions specified.
(3) Add Stabilizing Fiber
When stabilizing fiber is included in the mixture, add it at a rate specified in Section
828 and the Job Mix Formula. Introduce it as specified in Subsection 400.3.02.B.8,
―Fiber Supply System.‖
(4) Add Gilsonite Modifier
When required, add the Gilsonite modifier to the mixture at a rate such that eight
percent by weight of the asphalt cement is replaced by Gilsonite. Use either PG 64-
22 or PG 67-22 asphalt cement as specified in Subsection 820.2.01. Provide suitable
means to calibrate and check the rate of Gilsonite being added. Introduce Gilsonite
modifier by either of the following methods.
a. For batch type plants, incorporate Gilsonite into the pugmill at the beginning of
the dry mixing cycle. Increase the dry mix cycle by a minimum of 10 seconds
after the Gilsonite is added and prior to introduction of the asphalt cement. For
this method, supply Gilsonite in plastic bags to protect the material during
shipment and handling and store the modifier in a waterproof environment. The
bags shall be capable of being completely melted and uniformly blended into
the combined mixture.
3. Special Provision (Superpave Design) as shown below:
1993 Standard Specifications
(Marshall Design)
Current 400/402/828 Special Provision
(Superpave Design)
G Mix
4.75 mm
H Mix
9.5 mm Type I
F Mix
9.5 mm Type II
E Mix and B Modified Mix
12.5 mm
B Mix
19.0 mm
A Base Mix
25.0 mm
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C. QUALIFICATION REQUIREMENTS:
The Contractor shall:
1. Have a plant location for hot mix asphaltic concrete pick-up within DeKalb County or
located no further than a fifteen (15) mile radius outside of DeKalb County.
2. Be able to provide the hot mix asphaltic concrete as outlined in this bid document to the
County Monday through Saturday from 7:00 a.m. to 5:00 p.m., and on Sunday from 7:00
a.m. to 5:00 p.m. for emergency situations only.
3. Provide at least three (3) references for projects similar in size and scope to the project
specified herein using the Contractor Reference and Release Form attached hereto as
Attachment B.
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PRICE SCHEDULE
***NEW – PRICE SCHEDULE MUST BE SUBMITTED IN A SEPARATE SEALED
ENVELOPE OR BIDDER WILL BE DEEMED NON-RESPONSIVE AND WILL
NOT BE CONSIDERED FOR AWARD. INCLUDING THE PRICE SCHEDULE IN
ANY AREA OUTSIDE OF THE SEPARATE SEALED ENVELOPE WILL RESULT
IN THE BID BEING DEEMED NON-RESPONSIVE.***
PRICE SCHEDULE
ITEM
NO.
ITEM DESCRIPTION
ESTIMATED
NUMBER
OF UNITS
UNIT
UNIT PRICE
EXTENDED
PRICE
Bidder enter pricing to include labor for loading all items onto County trucks as the plant location
1.
A-Base/Private 25 mm
55
Ton
$ ________
$ ________
2.
B-Binder/Private 19 mm
2200
Ton
$ ________
$ ________
3.
Private B-Mod
2200
Ton
$ ________
$ ________
4.
E-Top/Private 12.5 mm
1000
Ton
$ ________
$ ________
5.
F-Top/Private 9.5 mm TP2
110
Ton
$ ________
$ ________
6.
H-Top/Private 9.5 mm TP1
3000
Ton
$ ________
$ ________
7.
G-Mix/Private 4.75 mm
1000
Ton
$ ________
$ ________
8.
Lime additives to make
lines 1 through 7 meet the
current GDOT
Specification.
1
Ton
$ ________
$ ________
9.
Emergency Delivery Fee
1
Mile
$ ________
$ ________
10.
Emergency Pick-Up Fee
(Only to apply to hours
outside of plant’s normal
hours of operation)
1
Hour
$ ________
$ ________
Bidder enter total amount for all line items:
$ _________
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Bidder state normal plant hours:
______________________________________________________________________________
If applicable, Bidder state price/credit per ton for broken asphalt that can be recycled:
$_______________________
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BID ACKNOWLEDGEMENT FORM
I, the undersigned, acknowledge that I have read the Bid Document in its entirety and agree to conform
to its every requirement. I further acknowledge that failure to prepare, submit, or execute this bid in
the exact manner requested will be just cause to reject my entire bid.
Name of Business Entity Submitting Bid Print Name and Title of Authorized Signer
Business Entity Street Address Authorized Signature
Business Entity City, State and Zip Code Contact Person’s Phone Number
Business Entity County Contact Person’s E-mail Address
Bidder acknowledges addendum(s): No. 1__, No. 2__, No. 3__ (
If Applicable
) ________(
Initial
)
Bidder acknowledges that this bid is valid for 90 days from and including ________ (
Initial
)
the bid opening date.
Bidder acknowledges that bid meets or exceeds minimum specifications. ________ (
Initial
)
Any deviation from minimum specifications must be explained, in detail,
by bidder as to how the bid does not meet the exact specifications.
Bidder acknowledgement of Revisions to the above Terms and Conditions:
No revisions ________ (
Initial
)
There are revisions and they are included with the bid submittal ________ (
Initial
)
The above acknowledgment must be properly signed and firmly attached to your bid. The
acknowledgment becomes a part of your bid and without it your bid is not be complete and will be
subject to rejection.
THIS PAGE MUST BE RETURNED WITH YOUR BID. FAILURE TO SUBMIT THIS
COMPLETED FORM WILL RESULT IN YOUR BID BEING DEEMED NON-
RESPONSIVE.
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ATTACHMENT A
REQUIRED DOCUMENTS CHECKLIST
Bidder shall complete and submit the following documents with their bid:
Bid Page No. Title
Check This Box If
Included With Bid
26 Bid Acknowledgement Form*
27 Required Documents Checklist
28 Contractor Reference and Release Form*
29 Subcontractor Reference and Release Form, if applicable**
31 Contractor Affidavit*
32 Subcontractor Affidavit, if applicable**
33-41 LSBE - Exhibits A and/or B of Attachment G*
42 First Source Jobs Acknowledgement Form
43 New Employee Tracking Form
*If these mandatory forms are not completed and submitted with the bid, the bidder
will be deemed non-responsive.
**These forms are applicable if a subcontractor will be utilized to fulfill the
requirements of this contract. If these forms are applicable, they must be completed
and submitted along with the bid. Failure to submit these forms, if applicable, will
result in the bidder being deemed non-responsive.
I, the undersigned, acknowledge that I have included the requested documents as listed above.
______________________________
Printed Name Signature
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ATTACHMENT B
CONTRACTOR REFERENCE AND RELEASE FORM
List below at least three (3) references, including company name, contact name, address, email address,
telephone numbers and contract period who can verify your experience and ability to perform the type(s)
of product(s)/ service(s) listed in the solicitation.
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
REFERENCE CHECK RELEASE STATEMENT
You are authorized to contact the references provided above for purposes of this ITB.
Signed_______________________________________ Title___________________________
(Authorized Signature of Bidder)
Company Name _____________________________________Date ____________________
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ATTACHMENT C
SUBCONTRACTOR REFERENCE AND RELEASE FORM
List below at least three (3) references, including company name, contact name, address, email address,
telephone numbers and contract period who can verify your experience and ability to perform the type(s)
of product(s)/ service(s) listed in the solicitation.
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
Company Name
Contract Period
Contact Person Name and Title
Telephone Number (include area code)
Complete Primary Address
City
State
Zip Code
Email Address
Fax Number (include area code)
Project Name and Description
REFERENCE CHECK RELEASE STATEMENT
You are authorized to contact the references provided above for purposes of this ITB.
Signed_______________________________________ Title___________________________
(Authorized Signature of Bidder)
Company Name _____________________________________Date ____________________
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ATTACHMENT D
CONTRACTOR & SUBCONTRACTOR EVIDENCE OF COMPLIANCE:
(1)
County contracts for the physical performance of services within the state of Georgia shall
include the following provisions:
1
a. the contractor has registered with and is authorized to use the federal work authorization
program to verify information on all newly hired employees or subcontractors;
b. by affidavit, the contractor must attest to the contractor’s name, address, user
identification number, date of authorization, and verification of the continual
participation throughout the contract period, and
c. the affidavit shall become a part of the covered contract and must be attached.
(2) No contractor or subcontractor who enters into a contract with the County shall enter into such
a contract or subcontract in connection with the physical performance of services within
Georgia unless the contractor or subcontractor registers and participates in the federal work
authorization program to verify information of all newly hired employees. Any employee,
contractor, or subcontractor of such contactor or subcontractor shall also be required to satisfy
the requirements of O.C.G.A. § 13-10-91, as amended.
(3) Upon contracting with a new subcontractor, a contractor or subcontractor shall, as a condition
of any contract or subcontract entered into pursuant to O.C.G.A. § 13-10-91, as amended,
agree to provide the County with notice of the identity of any and all subsequent subcontractors
hired or contracted by the contractor or subcontractor. Such notice shall be provided within
five (5) business days of entering into a contract or agreement for hire with any subcontractor.
Such notice shall include an affidavit from each subsequent contractor attesting to the
subcontractor’s name, address, user identification number, and date of authorization to use the
federal work authorization program.
(4) An affidavit shall be considered an open public record; provided, however, that any
information protected from public disclosure by federal law or by Article 4 of Chapter 28 of
Title 50 shall be redacted. Affidavits shall be maintained by the County for five years from
the date of receipt.
(5) To verify compliance, the contractor agrees to participate in random audits conducted by the
Commissioner of the Georgia Department of Labor. The results of the audits shall be
published on the www.open.georgia.gov website, and on the Department of Labor’s website
no later than December 31 of each year.
(6) Any person who knowingly and willfully makes a false, fictitious, or fraudulent statement in
an affidavit submitted pursuant to O.C.G.A. § 13-10-91 shall be guilty of a violation of Code
§ 16-10-20 and, upon conviction, shall be punished as provided in such section. Contractors
and subcontractors convicted for false statements based on a violation of such section shall be
prohibited from bidding on or entering into any public contract for twelve (12) months
following such conviction.
_______________________
1
O.C.G.A. § 13-10-91, as amended
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ATTACHMENT E
CONTRACTOR AFFIDAVIT
By executing this affidavit, the undersigned verifies its compliance with O.C.G.A. § 13-10-91, as
amended, stating affirmatively that the individual, firm or corporation which is contracting with DEKALB
COUNTY, GA, a political subdivision of the State of Georgia, has registered with and is participating in a
federal work authorization program* [any of the electronic verification of work authorization programs
operated by the United States Department of Homeland Security or any equivalent federal work authorization
program operated by the United States Department of Homeland Security to verify information of newly hired
employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603, in accordance
with the applicability provisions and deadlines established in O.C.G.A. § 13-10-91, as amended]. The affiant
agrees to continue to use the federal work authorization program throughout the contract period.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in
connection with the physical performance of services pursuant to this contract with the COUNTY, contractor
will secure from such subcontractor(s) similar verification of compliance with O.C.G.A. § 13-10-91, as
amended, on the Subcontractor Affidavit form. Contractor further agrees to maintain records of such
compliance and provide a copy of each such verification to the COUNTY, within five (5) days from when the
subcontractor(s) is retained to perform such service.
BY: Authorized Officer or Agent Federal Work Authorization
(Bidder’s Name) Enrollment Date
Title of Authorized Officer or Agent of Bidder Identification Number
Printed Name of Authorized Officer or Agent
Address (* do not include a post office box)
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
_______________ DAY OF _______________________, 20__
____________________________________________________
Notary Public
My Commission Expires: _______________________________
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ATTACHMENT F
SUBCONTRACTOR AFFIDAVIT
By executing this affidavit, the undersigned verifies its compliance with O.C.G.A. § 13-10-91, as
amended, stating affirmatively that the individual, firm, or corporation which is engaged in the physical
performance of services under a contract with _________________________________name of contractor) on
behalf of DEKALB COUNTY, GA, a political subdivision of the State of Georgia, has registered with and is
participating in a federal work authorization program* [any of the electronic verification of work authorization
programs operated by the United States Department of Homeland Security or any equivalent federal work
authorization program operated by the United States Department of Homeland Security to verify information
of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603,
in accordance with the applicability provisions and deadlines established in O.C.G.A. § 13-10-91, as amended].
The affiant agrees to continue to use the federal work authorization program throughout the contract period.]
______________________________________________ ____________________________
BY: Authorized Officer or Agent Federal
Work Authorization
(Bidder’s Name) Enrollment Date
______________________________________________ ____________________________
Title of Authorized Officer or Agent of Bidder Identification Number
______________________________________________
Printed Name of Authorized Officer or Agent
______________________________________________
Address (* do not include a post office box)
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
_______________ DAY OF _______________________, 20__
____________________________________________________
Notary Public
My Commission Expires: _______________________________
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ATTACHMENT G
DEKALB FIRST LSBE INFORMATION
WITH EXHIBITS A – B
SCHEDULE OF LOCAL SMALL BUSINESS ENTERPRISE PARTICIPATION
OPPORTUNITY TRACKING FORM
The Chief Executive Officer and the Board of Commissioners of DeKalb County believe that it is important
to encourage the participation of small and local businesses in the continuing business of County
government; and that the participation of these types of businesses in procurement will strengthen the
overall economic fabric of DeKalb County, contribute to the County’s economy and tax base, and provide
employment to local residents. Therefore, the Chief Executive Officer and the Board of Commissioners
have made the success of local small businesses a permanent goal of DeKalb County by implementing the
DeKalb First Local Small Business Enterprise Ordinance.
PROVISIONS OF DEKALB FIRST LOCAL SMALL BUSINESS ENTERPRISE (LSBE)
ORDINANCE
Percentage of LSBE Participation Required
20% of Total Award
Certification Designation
Request For Proposals
(RFP)
LSBE Within DeKalb (LSBE-
DeKalb)
Ten (10) Preference
Points
LSBE Outside DeKalb (LSBE-
MSA)
Five (5) Preference Points
Demonstrated GFE
Two (2) Preference Points
Certified Local Small Business Enterprises (LSBEs) located within DeKalb County and prime contractors
utilizing LSBEs that are locally-based inside DeKalb County shall receive ten (10) points in the initial
evaluation of their response to any Request for Proposal. Certified LSBEs located outside of DeKalb
County but within the nine (9) County Metropolitan Statistical Area (MSA) consisting of Cherokee,
Clayton, Cobb, Douglas, Fayette, Fulton, Gwinnett, Henry and Rockdale Counties shall receive five (5)
points in the initial evaluation of their response to any Request for Proposal. Prime Contractors who
demonstrate sufficient good faith efforts in accordance with the requirements of the ordinance shall be
granted two (2) points in their initial evaluation of responses to any Request for Proposal. Pro-rated points
shall be granted where a mixture of LSBE-DeKalb and LSBE MSA firms are utilized. Utilization of each
firm shall be based upon the terms of the qualified sealed solicitation.
Prime Contractor(s) deemed responsible and remains responsive to an Invitation to Bid (ITB) because they
are either a certified LSBE-DeKalb or LSBE-MSA firm or has obtained 20% participation of an LSBE-
DeKalb or LSBE-MSA firm, submits the lowest bid price shall be deemed the lowest, responsive and
responsible bidder.
Prime Contractor(s) deemed responsible and remains responsive to an Invitation to Bid (ITB) and
documented good faith efforts, submits a lower bid price than a Prime Contractor that achieved 20% LSBE
participation, or otherwise required benchmark, then the Prime Contractor who actually met the benchmark
will be given the opportunity to match the lowest bid price of the Prime Contractor who only made good
faith efforts. Prime Contractor(s) who choose not to match the lowest bid price, then the Prime Contractor
who made the good faith efforts will be deemed the lowest, responsive and responsible bidder.
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For all qualified sealed solicitations, the Director of Purchasing and Contracting, DeKalb County
Government, shall determine if the bidder/proposer has included written documentation showing that at
least twenty percent (20%) of the total contract award will be performed by a certified LSBE. This written
documentation shall be in the form of a notarized Schedule of LSBE Participation (Attached hereto as
“Exhibit A”.) For all contracts, a signed letter of intent from all certified LSBEs describing the work,
material, equipment and/or services to be performed or provided by the LSBE(s) and the agreed upon
percentage shall be due with the bid or proposal documents and included with “Exhibit A”. The certified
vendor list establishes the group of Certified LSBE’s from which the bidder/proposer must solicit
subcontractors for LSBE participation. This list can be found on our website
https://www.dekalbcountyga.gov/purchasing
or obtained from the Special Projects LSBE Program team.
Prime Contractors failing to meet the LSBE benchmark must document and demonstrate Good Faith
Efforts in accordance with the attached “Checklist for Good Faith Efforts” portion of “Exhibit A.” The
notarized Schedule of LSBE Participation shall be due and submitted with each bid or proposal. Failure to
achieve the LSBE benchmark or demonstrate good faith efforts shall result in a bid or proposal being
rejected. Prime Contractors that fail to attend the mandatory LSBE meeting in person or via video
conference shall mean that the Prime Contractor has not demonstrated sufficient good faith efforts and its
bid or proposal if submitted, shall be deemed non-responsive without any further review.
Upon award, Prime Contractors are required to submit a report detailing LSBE Sub-Contractor usage with
each request for payment and not less than on a monthly basis. Prime Contractors shall ensure that all
LSBE sub-contractors have been paid within seven (7) days of the Prime’s receipt of payment from the
County. Failure to provide requested reports/documentation shall constitute a material breach of contract,
entitling the County to terminate the Contract for default or pursue other remedies. LSBE sub-contractors
must confirm payments received from the Prime(s) for each County contract they participate in.
For eligible bids/proposals valued over $5,000,000.00, the Mentor-Protégé provision of the Ordinance
shall apply. Prime Contractors must agree to become mentors and take on an LSBE protégé in an effort to
enhance the potential of future LSBEs. Qualifying projects shall be performed by both Mentor and Protégé
through a subcontract between both parties. This requirement is in addition to all other applicable sections
of the DeKalb First Ordinance. Please review the ordinance, section 2-214 or contact the LSBE Program
Representative for detailed information regarding this initiative.
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EXHIBIT A
SCHEDULE OF DEKALB FIRST LOCAL SMALL BUSINESS ENTERPRISE PARTICIPATION
OPPORTUNITY TRACKING FORM
As specified, Bidders and Proposers are to present the details of LSBE participation below:
PRIME BIDDER/PROPOSER___________________________________________________________
SOLICITATION NUMBER: 19-101183
TITLE OF UNIT OF WORK Hot Asphaltic Mix
1. My firm, as the prime bidder/proposer on this unit of work, is a certified (check all that apply):
____LSBE-DeKalb ____LSBE-MSA
2. If you are a Certified LSBE-DeKalb or MSA, please indicate below the percentage of that your
firm will carry out directly: ____________________________________.
3. If the prime bidder/proposer is a joint venture, please describe below the nature of the joint venture
and level of work and percentage of participation to be provided by the LSBE-DeKalb or MSA
joint venture firm.
________________________________________________________________________
________________________________________________________________________
4. List the LSBE-DeKalb or MSA subcontractors and/or firms (including suppliers) to be utilized in
of this contract, if awarded. No changes can be made in the subcontractors listed below without
the prior written approval of the County. Please attach a signed letter of intent from all certified
LSBEs describing the work, materials, equipment or services to be performed and/or provided and
the agreed upon percentage of work to be performed. A Letter of Intent form is attached hereto as
“Exhibit B”.
Name of Company
Address
Telephone
Fax
Contact Person
Indicate certification status and attach proof of
certification:
LSBE-DeKalb/LSBE-MSA
Description of services to be performed
Percentage of work to be performed
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Name of Company
Address
Telephone
Fax
Contact Person
Indicate certification status and attach proof
of certification:
LSBE-DeKalb/LSBE-MSA
Description of services to be performed
Percentage of work to be performed
Name of Company
Address
Telephone
Fax
Contact Person
Indicate certification status and attach proof
of certification:
LSBE-DeKalb/LSBE-MSA
Description of services to be performed
Percentage of work to be performed
Name of Company
Address
Telephone
Fax
Contact Person
Indicate certification status and attach proof
of certification:
LSBE-DeKalb/LSBE-MSA
Description of services to be performed
Percentage of work to be performed
Name of Company
Address
Telephone
Fax
Contact Person
Indicate certification status and attach proof
of certification:
LSBE-DeKalb/LSBE-MSA
Description of services to be performed
Percentage of work to be performed
Please attach additional pages, if necessary.
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EXHIBIT A, CONT’D
DEKALB COUNTY
CHECKLIST FOR GOOD FAITH EFFORTS
A bidder/proposer that does not meet the County’s LSBE participation benchmark is required to submit
documentation to support all “Yes” responses as proof of “good faith efforts.” Please indicate whether or
not any of these actions were taken:
Yes
No
Description of Actions
1.
Prime Contractors shall attend a MANDATORY LSBE Meeting in
person or via video conference within two-weeks of advertisement
of the solicitation.
2.
Provide a contact log showing the company’s name, contact person,
address, email and contact number (phone or fax) used to contact the
proposed certified subcontractors, nature of work requested for
quote, date of contact, the name and title of the person making the
effort, response date and the percentage of work.
3.
Provide interested LSBEs via email, of any new relevant
information, if any, at least 5 business days prior to submission of
the bid or proposal.
4.
Efforts made to divide the work for LSBE subcontracting areas
likely to be successful and to identify portions of work available to
LSBEs consistent with their availability. Include a list of divisions
of work not subcontracted and the corresponding reasons for not
including them. The ability or desire of a bidder/proposer to perform
the contract work with its own organization does not relieve it of the
responsibility to make good faith efforts on all scopes of work
subject to subcontracting.
5.
Efforts were made to assist potential LSBE subcontractors meet
bonding, insurance, or other governmental contracting requirements.
Where feasible, facilitating the leasing of supplies or equipment
when they are of such a specialized nature that the LSBE could not
readily and economically obtain them in the marketplace.
6.
Communication via email or phone with DeKalb First Program Staff
seeking assistance in identifying available LSBEs. Provide DeKalb
First Program Staff representative name and title, and date of
contact.
7.
For all contracts, a signed letter of intent from all certified LSBEs
describing the work, materials, equipment or services to be
performed or provided by the LSBE(s) and the agreed upon LSBE
participation percentage shall be due with the bid or proposal
documents.
8.
Other Actions, to include Mentor/Protégé commitment for
solicitations $5M and above (specify):
Please explain all “no” answers above (by number):
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This list is a guideline and by no means exhaustive. The County will review these efforts, along with
attached supporting documents, to assess the bidder/proposer’s efforts to meet the Countys LSBE
Participation benchmark. If you require assistance in identifying certified, bona fide LSBEs, please contact
the Purchasing and Contracting Department - DeKalb First Program, Felton Williams, Procurement
Projects Manager at 404-371-6312.
click to sign
signature
click to edit
Page 39 of 45
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EXHIBIT A, CONT’D
DEKALB FIRST LOCAL SMALL BUSINESS ENTERPRISE SCHEDULE OF
PARTICIPATION
OPPORTUNITY TRACKING FORM
Bidder/Proposer Statement of Compliance
Bidder(s)/Proposer(s) hereby state that they have read and understand the requirements and
conditions as set forth in the objectives and that reasonable effort were made to support the County in
providing the maximum practicable opportunity for the utilization of LSBEs consistent with the
efficient and economical performance of this contract. The Bidder and any subcontractors shall file
compliance reports at reasonable times and intervals with the County in the form and to the extent
prescribed by the Director of DeKalb County Purchasing and Purchasing and Contracting Department.
Compliance reports filed at such times as directed shall contain information as to the employment
practices, policies, programs and statistics of Contractors and their subcontractors.
1. Non-Discrimination Policy
a. During the performance of this agreement, Contractor agrees to conform to the
following Non-Discrimination Policy adopted by the County.
b. Contractor shall not discriminate against any employee or applicant for employment
because of race, color, religion, sex, national origin, or disability. The Contractor will
take action to ensure that applicants are employed, and the employees are treated during
employment without regard to their race, color, religion, sex, national origin, or
disability. Such action shall include, but not be limited to, the following:
(1) Employment, upgrading, demotion or transfer; recruitment or recruitment
advertising; layoff or termination; rates of pay or other forms of compensation;
and selection for training, including apprenticeship. Contractor agrees to post
in conspicuous places available to employees and applicants for employment,
notices to be provided setting forth provisions of this non-discrimination clause.
(2) Contractor shall, in all solicitations or advertisements for employees placed by
or on behalf of Contractor, state that all qualified applicants will receive
consideration for employment without regard to race, color, religion, sex,
national origin, or disability.
c. Without limiting the foregoing, Contractor shall not discriminate on the basis of
disability in the admission or access to, or treatment or employment in, the programs
and activities, which form the subject of the contract. The Contractor will take action
to ensure that applicants for participation in such programs and activities are considered
without regard to disability. Such action shall include, but not be limited to, the
following:
(1) Contractor agrees to post in conspicuous places available to participants in its
programs and activities notices to be provided setting forth the provisions of
this non-discrimination clause.
(2) Contractor shall, in all solicitations or advertisements for programs or activities,
which are the subject of the contract, state that all qualified applicants will
receive consideration for participation without regard to disability.
2. Commitment
The undersigned certifies that he/she has read, understands, and agrees to be bound by the bid
specifications, including the accompanying Exhibits and other terms and conditions of the
Invitation to Bid and/or Request for Proposal regarding LSBE utilization. The undersigned
click to sign
signature
click to edit
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further certifies that he/she is legally authorized by the bidder or responder to make the
statements and representations in Exhibit A and that said statements and representations are
true and correct to the best of his/her knowledge and belief. The undersigned will enter into
formal agreement(s) with the LSBE(s) listed in this Exhibit A, which are deemed by the owner
to be legitimate and responsible LSBEs. Said agreement(s) shall be for the work and contract
with the Prime Contractor. The undersigned understands and agrees that if any of the
statements and representations are made by the Bidder knowing them to be false, or if there is
a failure of the successful Bidder (i.e., Contractor) to implement any of the stated agreements,
intentions, objectives, goals and commitments set forth herein without prior approval of the
County, then in any such events the contractor’s act or failure to act, as the case may be, shall
constitute a material breach of contract, entitling the County to terminate the Contract for
default. The right to so terminate shall be in addition to, and not in lieu of, any other rights
and remedies the County may have for other defaults under the Contract. Additionally, the
Contractor will be subject to the loss of any future contract awards by the County for a period
of one year.
Firm Name (Please Print):
_________________________________________________________________
Firm’s Officer:
_________________________________________________________________
(Authorized Signature and Title Required) Date
Sworn to and Subscribed to before me this ____ day of_______________, 201__.
_________________________________________________________________
Notary Public
My Commission Expires:_____________________________________________
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EXHIBIT B
LETTER OF INTENT TO PERFORM AS A SUBCONTRACTOR
PROVIDING MATERIALS OR SERVICES
Instructions:
1. Complete the form in its entirety and submit with bid documents.
2. Attach a copy of the LSBE’s current valid Certification Letter.
To:______________________________________________________________________________
(Name of Prime Contractor Firm)
From: ________________________________________ LSBE DeKalb LSBE MSA
(Name of Subcontractor Firm) (Check all that apply)
ITB Number: 19-101183 ______________
Project Name: Hot Asphaltic Mix__________________________________________________
The undersigned subcontractor is prepared to perform the following described work or provide
materials or services in connection with the above project (specify in detail particular work items,
materials, or services to be performed or provided).
Description of Materials or Services
Project/Task Assignment
% of
Contract
Award
Prime Contractor Sub-contractor
Signature:_________________________ Signature:______________________________
Title:_____________________________ Title:__________________________________
Date:_____________________________ Date: __________________________________
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FIRST SOURCE JOBS ORDINANCE
INFORMATION (WITH EXHIBITS 1 – 4)
EXHIBIT 1
FIRST SOURCE JOBS ORDINANCE ACKNOWLEDGEMENT
The DeKalb County First Source Ordinance requires contractors or beneficiaries of eligible projects entering
into any type of agreement with the County, including purchase orders, regardless of what they may be called,
for the procurement or disposal of supplies, services, construction projects, professional or consultant services,
which is funded in whole or part with County funds or County administered funds in which the contractor is to
receive $50,000 or more in County expenditures or committed expenditures and recipient of urban
redevelopment action grants or community development block funds administered in the amount of $50,000 or
more to make a good faith effort to hire DeKalb County residents for at least 50% of jobs created using the First
Source Registry (candidate database) within one hundred twenty (120) days of contract execution. The work to
be performed under this contract is subject to the provisions of the DeKalb County First Source Jobs Ordinance.
All contractors will be asked to submit an Employment Roster and/or copies of active payroll registers on a
monthly basis to verify compliance. The undersigned acknowledges and agrees to comply with the provisions
of the DeKalb County First Source Jobs Ordinance.
CONTRACTOR OR BENEFICIARY INFORMATION:
Contractor or Beneficiary Name (Signature)
Contractor or Beneficiary Name (Printed)
Title
Telephone
Email
_______________________________________
Name of Business
Please answer the following questions:
1. How many job openings do you anticipate filling related to this contract? _____
2. How many incumbents/existing employees will retain jobs due to this contract?
DeKalb Residents: _____ Non-DeKalb Residents: _____
3. How many work hours per week constitutes Full Time employment? ______
Please return this form to WorkSource DeKalb, (404)687-3900 or email to
fkadkins@dekalbcountyga.gov, malee@dekalbcountyga.gov, vlnicksion@dekalbcountyga.gov, or
jmjones@dekalbcountyga.gov
WorkSource DeKalb (WSD) is an EEO/M/F/D/V employer/program. Auxiliary aids/services are available upon request to individuals
with disabilities. Persons with hearing impairments may call 1-800-255-0135 or 711 TTY for assistance. WSD is 100% funded by the
U. S. Department of Labor and is a proud partner of the American Job Center Network. Revised March 2018
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FIRST SOURCE JOBS ORDINANCE
INFORMATION
EXHIBIT 2
NEW EMPLOYEE TRACKING FORM
Name of Bidder______________________________________________________________________
Address_____________________________________________________________________________
E-Mail______________________________________________________________________________
Phone Number_______________________________________________________________________
Fax Number_________________________________________________________________________
Do you anticipate hiring from the First Source Candidate Registry? Y or N (Circle one)
If so, the approximate number of employees you anticipate hiring: _____________________________
Type of Position (s) you anticipate hiring:
(List position title, one position per line)
Attach job description per job title:
The number you
anticipate hiring:
Timeline
Please return this form to WorkSource DeKalb, fax (404) 687-4099 or email to
FirstSourceJobs@dekalbcountyga.gov.
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FIRST SOURCE JOBS ORDINANCE INFORMATION
EXHIBIT 3
BUSINESS SERVICE REQUEST FORM
Please note: We need one form completed for each position that you have available.
DATE: FEDERAL TAX ID:
COMPANY NAME: WEBSITE:
ADDRESS:
(WORKSITE ADDRESS IF DIFFERENT):
CONTACT NAME:
CONTACT PHONE: CONTACT FAX:
CONTACT E-MAIL ADDRESS:
Are you a private employment agency or staffing agency? YES NO
JOB DESCRIPTION: (PLEASE INCLUDE A COPY OF JOB DESCRIPTION)
POSITION TITLE:
NUMBER OF POSITIONS AVAILABLE:_________ TARGET START DATE:__________
WEEKLY WORK HOURS: 20-30 hours 30-40 hours Other
SPECIFIC WORK SCHEDULE:
SALARY RATE(OR RANGE):
PERM TEMP TEMP-TO-PERM SEASONAL
PUBLIC TRANSPORTATION ACCESSIBILITY YES NO
IF SCREENINGS ARE REQUIRED, SELECT ALL THAT APPLY:
CREDIT DRUG MVR BACKGROUND OTHER
__________________________
Please return form to: Business Solutions Unit (First Source)
774 Jordan Lane Bldg. #4
Decatur, Ga. 30033
Phone: (404) 687-3400
FirstSourceJobs@dekalbcountyga.gov
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FIRST SOURCE JOBS ORDINANCE INFORMATION
EXHIBIT 4
EMPLOYMENT ROSTER
DeKalb County
Contract Number: ______________________
Project Name:________________________
Contractor: ___________________________ Date: _______________________
Name
Position:
Start
Date
Hourly
Rate of
Pay
Hired
for this
Project?
(yes/no)
Anticipated
Length of
Employment
(Months)
% of
Time
Dedicated
to the
Project
Full or
Part
Time?
(No. of
Hours)
Georgia
County of
Residency