Fill - Free fillable DeKalb County Department of Purchasing and Contracting February (DeKalb County Government) PDF form

age 1 of 42

Revised 10/23/2018 P&C

DeKalb County

Department of Purchasing and Contracting

Maloof Administration Building, 1300 Commerce Drive, 2

Floor, Decatur, Georgia 30030____

February 17, 2020

INVITATION TO BID (ITB) NO. 20-101231

FOR

DISASTER RECOVERY AND SEWAGE CLEANING SERVICES

(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.)

February 19 & February 26, 2020

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, March 11, 2020

Bid Opening:

3:00 P.M. ET, March 18, 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.

Crystal

Creekmore

Digitally signed by Crystal

Creekmore

Date: 2020.02.10

09:07:27 -05'00'

click to sign

signature

click to edit

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Revised 10/23/2018 P&C

TABLE OF CONTENTS

FOR

INVITATION TO BID NO. 20-101231

TITLE PAGE

NO.

INVITATION TO BID OVERVIEW 3

INVITATION TO BID PROCEDURES 4

GENERAL TERMS AND CONDITIONS 8

MINIMUM SPECIFICATIONS 19

BID SCHEDULE 21

BID ACKNOWLEDGEMENT FORM 23

REQUIRED DOCUMENTS CHECKLIST AND ATTACHMENTS 24

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INVITATION TO BID OVERVIEW

A. PURPOSE:

DeKalb County Government (the County) is soliciting bids for ITB No. 20-101231 Disaster Recovery and

Sewage Cleaning Services (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:

February 17, 2020

Mandatory DeKalb First LSBE Meeting:

(Bidders must attend 1 meeting on either

of the dates listed.)

February 19, 2020 & February 26, 2020

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, March 11, 2020

Bid Opening:

3:00 P.M. ET, March 18, 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

Floor

Decatur, Georgia 30030, not later than 3:00 P.M. ET, March 18, 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.

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

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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 “March 11, 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,

http://www.dekalbcountyga.gov/purchasing/pc_index_formal_solicitations.html. Bidder should

regularly check the County’s website for addenda.

INVITATION TO BID PROCEDURES

A. BIDDER INFORMATION:

1. FAILURE TO SUBMIT THE PRICE SCHEDULE IN A SEPARATE SEALED

ENVELOPE 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.

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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.

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-

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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.

c. For further details regarding the DeKalb First Local Small Business Enterprise Ordinance,

contact our LSBE Program representatives, at DekalbFirstLSBE@dekalbcountyga.gov or

(404) 371-4770.

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.

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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.

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.

B. 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.

20-101231 Disaster Recovery and Sewage Cleaning Services” 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).

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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.

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:

1. Delivery of services or goods will commence within 24 hours upon request. The contractor

must meet on site within two (2) hours of the service call.

Bidder state agreement: Yes_____________ No______________

Contact Person: _______________________________________________________________

Telephone Number: ______________________ Cellular Phone Number: ________________

Address: ____________________________________________________________________

____________________________________________________________________________

Alternate delivery time may be considered provided it is so stated. Bidder state alternate terms

for delivery or services below.

2. All prices are to be firm, F.O.B. Destination, Freight Prepaid and Allowed. This shall include

delivered, unloaded, and placed in designated place. Delivery must be made between 9:00

A.M. and 2:30 P.M. Monday through Friday, unless otherwise required. The successful bidder

shall give a 24-hour prior notice of delivery to Department or Division calling in the order, and

must ask for caller’s telephone number as well as Purchase Order form and address, since 24-

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hour Notice of Delivery is required. The County will unload after prior notice.

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.

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:

The bidder will state below or will furnish a separate letter attachment, which fully explains the

conditions of Warranty and/or Guaranty. If no Warranty and/or Guaranty are applicable, it must be

so stated. NOTE: FAILURE TO RESPOND TO THE REQUIREMENTS OF THIS PARAGRAPH

MAY RESULT IN THE BID BEING DEEMED NON-RESPONSIVE.

___________________________________________________________________________________

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

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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.

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:

1. Alterations to the Price Schedule may result in the Bidder being deemed non-responsive and

its bid may be rejected.

2. 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

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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.

3. 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. Catalogue(s) or Price List(s) must be submitted to the Department of Purchasing and

Contracting, Maloof Administration Building, 1300 Commerce Drive, 2

Floor, Decatur,

Georgia 30030.

4. 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:

a. 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,

b. 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

c. 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. Invoice(s) must be submitted as follows:

a. A copy of the original invoice(s) must be submitted to the department requesting

services.

Department of Watershed Management

1580 Roadhaven Drive

Stone Mountain, GA 30083

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Facilities Management Department

1300 Commerce Dr. 3

Floor

Decatur, GA 30030

b. 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.

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

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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 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.

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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 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

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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

(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.

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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.

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.

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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 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

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to the Director of the 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

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

INDICATE

YES / NO

1. Contractor must provide jpeg photos of each job. Photos must be Digital on a disc. ________________

2. Contractor must provide satisfaction certificate within three (3) days of the ________________

completion of the job.

3. Contractor must be able to perform moisture monitoring at a level appropriate for

the individual job. ________________

4. Contractor must be able to respond to emergency calls within (2) Two hours,

Twenty Four (24) hours a day, Seven (7) days a week, Three Hundred Sixty Five

(365) days a year for Watershed Management. ________________

5. Contractor must be able to respond to emergency calls with 45 minutes,

Twenty-Four (24) hours a day, Seven (7) days a week, Three Hundred Sixty

Five (365) days a year for Facilities Management.

_______________

6. Contractor must provide DeKalb County with a live Twenty Four (24) hour

answering service with e-mail capabilities. ________________

7. Contractor must be able to legally dispose of contaminated items and debris. ________________

8. Contractor must have sufficient personnel and equipment to perform multiple

jobs at multiple DeKalb County locations simultaneously. ________________

9. Contractor must be National Association for Moisture Management certified

in mold /asbestos remediation and possess all necessary equipment to

perform remediation, Contractor must provide a copy of the certification

with bid. ________________

10. Contractor must be Institute of Inspection Cleaning & Restoration Certified

(IICRC) and Contractor must provide a copy of the

certification with bid. ________________

11. Contractor must be able to pack, move and store any customer contents/belongings

in a company owned and insured facility (warehouse) for cleaning and/or repair. ________________

12. Contractor must sign County Asbestos Release. ________________

13. Contractor must be able to perform both residential/commercial services. ________________

14. Contractor must be certified as a plumber provider. Contractor must

provide a copy of certification with bid. ________________

15. Contractor must be certified as a HVAC provider. Contractor must

provide a copy of certification with bid. ________________

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OTHER REQUIREMENTS

To be considered for selection, the service providers must be able to meet the following

minimum requirements:

INDICATE

YES / NO

1. Contractor will furnish all transportation, insurance, materials, parts, supplies,

machinery, testing apparatus, equipment, labor, project management, engineering,

technical knowledge, expertise, and all things necessary to provide disaster

recovery and sewage cleaning services. ______________

2. Contractor cost shall include/reflect all necessary items needed to complete water

extraction. _____________

3. Contractor shall be responsible for all maintenance and repair of rental equipment

listed in the price schedule. _____________

4. Service calls should be referred to as pricing structure that charges a single fixed

fee for a service call not accepted by the customer or the customer has already

called another company to render the service.

_____________

5. Contractor shall make every effort to minimize the down-time of equipment and

services which impact the operation to provide disaster recovery and sewage

cleaning services. _____________

6. Contractor shall thoroughly complete each task in a professional and workmanlike

manner. ______________

7. Contractor

must have a clean appearance. ______________

8. Contractor must wear shirts with the company’s logo. ______________

9. Contractor must

have logo located on company vehicles ______________

10. Contractor must be able to work around the clock in a continuous cycle until _______

the project is completed, or the emergency component of the project has been

mitigated or satisfied.

11. The emergency board up fee is used on sites where either windows, doors, or ______

other areas of a structure or building have been damaged, broken out, or are

otherwise missing and there is a need to have these areas closed up with

wood or other durable materials in an effort to secure the area in an emergency

situation.

12. Business hours are defined as Monday- Friday 8:00AM-5:00PM, after hours are defined as

Monday-Friday after 5:00PM, and weekend hours are defined as Friday after 5:00PM until

Monday 8AM.

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***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.

COMMODITIES OR SERVICES

AMOUNT

Black Water (Sewage) Extraction per Square Foot.

$ ___________________

Clear Water Extraction per Square Foot.

$ ___________________

Treatment (Fungicide/Antimicrobial) per Square Foot.

$ ___________________

Carpet/pad removal per Square Foot.

$ ___________________

Carpet Cleaning per Square Foot.

$ ___________________

Baseboard Cleaning per Linear Foot.

$ ___________________

Vinyl/Tile removal per Square Foot.

$ ___________________

Asbestos removal per Square Foot.

$ ___________________

Furniture Clearing per Hour.

$ ___________________

10.

Miscellaneous Labor per Hour.

$ ___________________

11.

Move/Block Furniture per Hour.

$ ___________________

12.

Cleaning Surfaces per Square Foot.

$ ___________________

13.

Rental of Fans per 24 Hour Day.

$ ___________________

14.

Plumbing per Hour.

$ ___________________

15.

Rental of Dehumidifiers per 24 Hour Day.

$ ___________________

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16.

Rental of Air Scrubber per 24 Hour Day.

$ ___________________

17.

Disposal Fee.

$ ___________________

18.

Service Call Charges. (See Other Requirements # 4).

$ ___________________

19.

Trip Charge.

$ ___________________

20.

Cost per Hour HVAC Repair.

$ ___________________

21.

Cost per Hour Plumbing.

$ ___________________

22.

Cost for Storage per 24 Hour Day.

$ ___________________

23.

Parts and Material Cost: Bidder state percentage above

invoice cost for parts and materials required.

$ ___________________

24.

Emergency Board Up Fee. (See specs for description)

$ ___________________

25.

Emergencies During Business Hours

$ ___________________

26.

Emergencies During Weekends

$ ___________________

27.

Emergencies After Hours

$ ___________________

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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

23 Bid Acknowledgement Form*

24 Required Documents Checklist

25 Contractor Reference and Release Form*

26 Subcontractor Reference and Release Form, if applicable**

28 Contractor Affidavit*

29 Subcontractor Affidavit, if applicable**

30-38 LSBE - Exhibits A and/or B of Attachment G*

39 First Source Jobs Acknowledgement Form

40 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:

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.

_______________________

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: ______________________________

Page 29 of 42

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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: _______________________________

Page 30 of 42

Revised 10/23/2018 P&C

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.

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

Page 31 of 42

Revised 10/23/2018 P&C

(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 http://www.dekalbcountyga.gov/purchasing-contracting/about-purchasing-and-contracting

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.

Page 32 of 42

Revised 10/23/2018 P&C

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: 20-101231

TITLE OF UNIT OF WORK – Disaster Recovery and Sewage Cleaning Services

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

Name of Company

Address

Telephone

Fax

Contact Person

Page 33 of 42

Revised 10/23/2018 P&C

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.

Page 34 of 42

Revised 10/23/2018 P&C

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

Description of Actions

Prime Contractors shall attend a MANDATORY LSBE Meeting in

person or via video conference within two-weeks of advertisement of

the solicitation.

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.

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.

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.

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.

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.

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.

Other Actions, to include Mentor/Protégé commitment for solicitations

$5M and above (specify):

Please explain all “no” answers above (by number):

Page 35 of 42

Revised 10/23/2018 P&C

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 County’s 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.

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Page 36 of 42

Revised 10/23/2018 P&C

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 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

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Page 37 of 42

Revised 10/23/2018 P&C

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:_____________________________________________

Page 38 of 42

Revised 10/23/2018 P&C

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: 20-101231 ____________

Project Name: Disaster Recovery and Sewage Cleaning Services _______________________________

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: __________________________________

Page 39 of 42

Revised 10/23/2018 P&C

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

_______________________________________

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

Page 40 of 42

Revised 10/23/2018 P&C

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.

Page 41 of 42

Revised 10/23/2018 P&C

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

Page 42 of 42

Revised 10/23/2018 P&C

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

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