Section 6 Required Forms- Form One

BID SUBMISSION FORM ITB # 269-2015-073

LOCKS, CYLINDERS & KEY SYSTEM PARTS

This Bid is submitted by:

Company Name:

Representative (printed): 1\\cdoJie \/eoero

Representative (signed):

Address:

City/State/Zip:

Telephone:

(Area Code) Telephone Number

Facsimile:

(Area Code) Fax Number

E-Mail Address:

It is understood by the Vendor that the City reserves the right to reject any and all Bids, to make awards on all items or on any items according to the best interest of the City, to waive formalities, technicalities, to recover and re-bid this ITB. Bids are valid for one hundred twenty (120) calendar days from Bid Opening. _ 1:: LGc:n:oN I<::_ 1\Q.C.G-SS :SPEC..\ AUSP

cVwo... r5~\Ythern loc.ti C>JB!j co.,re. Company Name

5)15/~DI5 Date

Authorized Signature~ Please type or print name

ITB 269-2015-073 APRIL 30, 2015 29

Section 6 Required Forms - Form Two

Addenda Acknowledgement I Exceptions Form ITB # 269-2015-073

Locks, Cylinders & Key System Parts

Bid/Bid Submission Check List: Confirm by placing a check mark in the space provided that as the bidder or proposer the information listed below has been reviewed and complied with in the submission of a response to this Invitatz to Bid/Request for Bids.

(A) . Addenda acknowledgement. Please contact the Procurement Management Division representative to verify the number of addenda issued.

(B)

(C)

(D)

I L L

Procurement Management Rep. Name David Tate

Telephone Number 704-336-5669

Addenda Receipt: The following confirms receipt of any and all addenda issued for this Invitation to Bid/Request for Bids:

Addendum# Date Issued 1. 5/ P./).Df.)

Bid/Bid document has been signed by authorized bidder/proposer official.

Bid/Bid package has been properly labeledper the instructions. (See Section 1.9, pages 4-5)

Bid/Bid Response Package Forms • Bid Submission- Form One • Addenda Acknowledgement/Exceptions -Form Two • Pricing Sheet- Form Three • Non-Discrimination Certification- Form Four • E-Verify Certification- Form Five • CCPA Plan, Section 4.1 -Attachment One • Pricing Full Catalog, Section 4.6- Attachment Two • Customer Service Representative, Section 4.1 I -Attachment Three • Vendor References -Attachment Four

2. Exceptions: The undersigned Bidder agrees to provide all Products and Services requested in the ITB for the price(s) set forth in the Pricing Sheet, all in strict confonnance with the tenus, conditions and specifications set forth in the ITB (including any addenda or amendments), subject only to the exceptions stated in the chart below. Exceptions representing material changes to Bid terms are grounds for rejection of the Bidder's Bid.

ITB 269-2015-073 APRIL 30, 2015 30

ITB Section Number

ITB Section Title

Section 6 Required Forms - Form Two

Exception and Proposed Change to ITB

The signature below certifies that: (a) the Bidder's Bid complies with therequirements of this Invitation to Bid; (b) that items !(A) through !(D) of the above checklist have been verified as complete, and (c) that the Bidder takes no exception to the terms of the ITB other than those listed in the chart contained in this Form.

t: L E:[_\Qol\l lC lltcLf:;sS S fltci l\ll STS

Date: 5) iJI J015 Bidder: d/o~ f)oUTt~GQ~ Ln::X:j- j:;fR'f CO. jr\f.:., Print name of Bidder

By: Signature: _'_lfu-'-".=.GW==~-----"=c.=~----

ITB 269-2015-073 APRIL 30, 2015 31

PRICING SHEET ITB # 269c2015-073

Section 6 Required Forms- Form Three

LOCKS, CYLINDERS & KEY SYSTEM PARTS

The undersigned proposes to furnish the following items in strict conformance to the bid specifications and bid invitation issued by the City of Charlotte for this bid. Any exceptions are clearly marked in the attached copy of bid specifications.

BIDS ARE DUE NO LATER THAN 1:30 P.M., MAY 19,2015

SEE ATTACHED PRICING SHEET- REQUEST IN EXCEL FORMAT VIA EMAIL TO DAVID TATE AT DTATE@CHARLOTTENC.GOV.

PRICING SHALL BE SUBMITTED IN HARD COPY AND EXCEL FORMAT ON A COMPACT DISC OR FLASH DRIVE

Total Bid Price must include all equipment, labor, delivery, installation, consultation, vendor profit and all other costs associated with this project. No additional cost will be allowed.

Administrative Fees: Per Section 3.13, the Service Provider shall pay the City of Charlotte ("CLT") an administrative fee of I % (minimum of I% ) based on all CLT and Participating Public ---Agency sales volumes within 30 days of the end of each calendar quarter set forth in the subsequent Contract. It is the responsibility of the bidder to set the Administrative Fee.

Pricing Incentives and Rebates: Per Section 4.6, Bidders shall identify any incentives and rebates offered based on volume, dollar amotmts, electronic ordering or other criteria:

Reference the Charlotte Cooperative Purchasing Alliance (CCPA) website at httn://www .charlottealliance.org/

The City reserves the right to award multiple Contracts for the Products and Services required by this ITB if the CLT deems multiple Contracts to be in the City's and other Participating Public Agencies best interest.

Paym~tTerms: ____ ~N~B~rr~~~3~()~-------------------------------

The undersigned hereby certifies the Bidder has read the terms of this bid document, including the sample contract (Section 7) and is authorized to bind the firm to the information herein set forth. <>r<:c

t;LEc::T120Nl C Acs::.GsS uftCJAt..,\...,, __, Date: 5j 15/ ;:)015 d/b/a_ '5cc:rrr-tte... LDd._ i & 'fPLV Co l ;::,c..

' Legal Name of Firm

By: wa.Qu=t)OJY\Qj)bJ Nelh\lt:: \leoem Corllicd 8\d A(Jc:hb Name and Title of Person Signing (please print)

ITB 269-2015-073 APRIL 30, 2015 32

r;;:\..(~NIC AC.£f.:SS 5PEC F\\.\.s-1...5 <i~

'''"'"'m' BMJ}J132N \ tOUt~'/ 269-2015-673

CCPA ·LOCKS, CYLINDERS AND KEY SYSTEM PARTS PRICING SHEET

~>i,"- >-·.::; -_- ,1 .-: - .-: ___ ·;(:~ - cq•s -. -G_~sto~ Item M;~n~a,ct:~~-r -- Urd,t.O!_ _ Pack· ~si:i~~1:ed- . EC:::::::~~--

1., .,-, -__ N~me~- ,. ' .-.;·.v.-·,;: _· M~~ur~ _'_,QT)" - . An~u~l,~ Arlrlual :fL., -_~u~ntlty_ · ii1i~ritii-i/

4 HZ, 6 Pin Ke Blanks 5 C lindrical Lever I 6 C lindrical Lever I 7 Cylindrical Lever I

8

11 Mortise lock storeroorr 12 Mortise lock passage function

B Mortise lot 14 H12, 6 Pin

~ l4, 6 Pin Key Blanks 16

17

18 Key Code Machine 19 Electronic Combination lock/ E-PLEX 2000

20 Outside Drive Sleeve

21 Combination Chamber

23 24

.22_ 26

27

:! Stop plate __

n lock

ion lock ion lock

n lock

~ lcloser

~ 30 31

32 33

34

~ 36

37

38

39 40

41

Closer I Drop Plate for alum doorS­

Closer

l Padlock, less cylinder

I switch Accessory Pack

t Lock

·cabinet Lock

Cam Lock

IHA, 6 Pin Key Blanks

tlindrical Lever locksets- passage

Corbin Russwin

Corbin Russwin

-------Corbin Russwin Corbin Russwin

Corbin Russwin Corbin Russwin

ba Simplex

ba Simplex

1ba Simplex

~ba Simplex

I Kaba Simplex

IKaba Simplex

,ba Simplex

.eN

.CN

I Master Lock

Olympus

Olvmpus

Sargent

IHZ-5 pin-lOB

iCL331

iCi33i !CL3351 NZD 6251

~ IML205 m#32 LWM 626

"m#32LWM 626 B3LWM 626 W/ c_q

Trim#32l'lfo[M 626

IL4-6 pin-108

1200CM

-01

t041-EOA-TB Al

4111EDA AL LH

lnwo SW-1

II( 771C-OR K­

IL92V- 260

ZP--rr-.:1--

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Each

Each

[E_ooh __ [E;d; rw_ ~ Bo> Bo>

Bo'

JUlsLL 260 Each

fsargent i28-10U6S LL 260 Each

43 icylindrical Lever locksets- office !Sargent 28-LC-10G37 LL260 Each

44 Cylindrical Lever locksets- storeroom Sargent 28-LC-10G04 LL 260 Eac

45 Mortise lock storeroom function Sargent B-P-8204 260/TR-8204LNB 260 -- WIC\J\1. _fE~ 46 Mortise lock entry function Sargent BP-820S 260/ TR-8204 LN8 260

47 Mortise lock office function Sargent BP-82SS 260/TR-8204 LNB 260 WICUL lEach

48 Mortise lock storeroom w/deadbolt function Sargent BP-8224 260/ TR-8224 LNB 260 \VI. CJ.l\_ Each

49 Mortise lock passage function Sargent BP-8215 260/TR-8215 LNB 260 Each

.2'!_ so

50 so

10

1(

--"­so

30

25

--'-'! 10

10•

"' 20

Section 6

Required Forms- Form Three

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FL.:Et:::Tl2.bl\J\C:. ~c_ess S(ketAl.HSP d~c... mddecNom,S~ \ ()(iL ~ ~l~j 269-2015-Q73

CCPA -lOCKS, CYUNOERS AND KEY SYSTEM PARTS PRICING SHEET

Section 6

Required Forms- Form Three

. _CLT~-~ ·.<~~::-. ·--_<·_.-.'.> :··-, Pi:ick' Estimated .-·xt:' · --· __ d __ ._:d·• .- ~" -

---· ·- .,-_ ·, ., ... · · -- ···- -· en e ncel .:; _Nurn~e_r_.'- ::Meas:u~e ,_ Qry': .Ara.n_ ~_al_ , ___ . ·_•.•_·_·._-<:_'·'_::-_·_:::_· .-::_.:~;: ::-_··. Quantity·- _,., -:._- , .. _ ,_- ·

'"" , · · · · ' J51. o?> -51 Sargent Each 50 $ a'5?.C1 52 6 Pin Key Blanks Restricted keyway Sargent S0-6275-RGXC Each 50 :; :l'ir.ff

53 6 Pin Key Blanks Restricted keyway Sargent 50-6275-RHXC

54 LK, 6 Pin Key Blanks Sargent

55 LN, 6 Pin Key Blanks Sargent

56 HJ, 6 Pin Key Blanks Sargent

57 HK, 6 Pin Key Blanks Sargent

58 HL, 6 Pin Key Blanks Sargent

59 HM, 6 Pin Key Blanks Sargent

60 HN, 6 Pin Key Blanks Sargent

61 Primus IC Core- various keyways Schl

62 Padlock, less cylinder Schlage

63 Entry Function Lever Set Schlage

64 Primus Keys- various keyways Schlage

65 AD Series Cylindrical lock Schlage

D Trim for Von Duprin

67 AD Series Mortise lock

68 AD Series Mortise lock

69 AD Series Cvllndricallock

70 AD Series Mortise lock

71 AD Trim for Von Duprin 99 exit c

72 AD Series Cvlindricallor_k

73

74

75 76 77

78

79

80 81 82

83

~ 85

87

1r Von Duprin 99 exit,

rface Module for RS-485 comm.

12VDC Power Supply

Mortise lock nas.'><~Q:P fu

Mortise lock

Mortise lock

Mortise lock storeroom I

Mortise lock entrance fu

Mortise lock storeroom '

Mortise lock privacy w/ occupied indicator

Exit Device Exit Device

"t Device

lschlage Schlage Schlage

Schlage

Schlage

Von Duprin

Von Duprin

Von Duprin

Von Duprin

50-621

50-6275-HL

lzo-740 626 LKB

) RH 88

KATH 1

K ATH626 JD RH 88

< ATH626 JD LH 88 JRH N>.IA

< ATH626 JD RH

AD300993R70MTK ATH 626 JD LHR & AD400CY70MTK ATH62.6 JD RH SB

AD400MS70MTK ATH626 JD_~~

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Section 6 Required Forms- Form Four

NON-DISCRIMINATION PROVISION

Project: LOCKS, CYLINDERS & KEY SYSTEM PARTS

All requests for bids or Bids issued for City contracts shall include a certification to be completed by the Bidder or Proposer in substantially the following form: ·

The undersigned Bidder or Proposer hereby certifies and agrees that the following information is correct:

1. In preparing it's the enclosed bid or Bid, the Bidder or Proposer has considered all bids and Bids submitted from qualified, potential subcontractors and suppliers, and has not engaged in discrimination as defined in Section 2.

2. For purposes of this section, discrimination means discrimination in the solicitation, selection, or treatment of any subcontractor, vendor, supplier or commercial customer on the basis of race, ethnicity, gender, age, religion, national origin, disability or any otherwise unlawful form of discrimination. Without limiting .the foregoing, discrimination also includes retaliating against any person or other entity for reporting any incident of discrimination.

3. Without limiting any other remedies that the City may have for a false certification, it is understood and agreed that, if this certification is false, such false certification will constitute grounds for the City to r~ect the bid or Bid submitted with this certification, and terminate any contract awarded based on such bid or Bid It shall also constitute a violation of the City's Commercial Non-Discrimination Ordinance and shall subject the Bidder or Proposer to any remedies allowed thereunder, including possible disqualification from participating in City contracts or bid processes for up to two years.

4. As a condition of contracting with the City, the Bidder or Proposer agrees to promptly provide to the City all information and documentation that may be requested by the City from time to time regarding the solicitation and selection of suppliers· and subcontractors in connection with this solicitation process. Failure to maintain or failure to provide such information shall constitute grounds for the City to reject the bid or Bid and to any contract awarded on such bid or Bid. It shall also constitute a violation of the City's Cmrunercial Non-Discrimination Ordinance, and shall subject the Bidder or Proposer to any remedies that are allowed thereunder.

5. As part of its bid or Bid, the Bidder or Proposer shall provide to the City a list of all instances within the past ten years where a complaint was filed or pending against Bidder or Proposer in a legal or administrative proceeding alleging that Bidder or Proposer discriminated against its subcontractors, vendors, suppliers, or connnercial customers, and a description of the status or resolution of that complaint, including any remedial action taken.

6. As a condition of submitting a bid or Bid to the City, the Bidder or Proposer agrees to comply with the City's Commercial Non-Discrimination Policy as described in Section 2, Article V of the Charlotte City Code, and consents to be bound by the award of any arbitration conducted thereunder.

&l0C1l20NlC At'cE:SS 0C::C-t:14USf$ d;b/0-.. NAMEOFCOMPANY: 50\.lTHeeN LCCL <\; St)Pf\?'/ co 11\lC

NQto.\ie_ \le0£1D TITLE Cc.aja;clBd ~-t vCb tuOw:J lQ"l\9!1 t3

BY:

SIGNATURE OF AUTHORIZED OFFICIAL:

DATE: SIISIJols •

ITB 269-2015-073 APRIL 30, 2015 33

Section 6 Required Forms - Form Five

E-VERIFY CERTIFICATION

This E-Verify Certification is provided to the City of Charlotte (the "City") by the company signing below ("Company") as a prerequisite to the City considering Company for award of a City contract (the "Contract").

I. Company understands that:

a. E-Verify is the federal program operated by the United States Department of Homeland Security and other federal agencies to enable employers to verify the work authorization of employees pursuant to federal law, as modified from time to time.

b. Article 2 of Chapter 64 of the North Carolina General Statutes requires employers that transact business in this state and employ 25 or more employees in this state to: (i) verify the work authorization of employees who will be performing work in North Carolina through E-Verify; and (ii) maintain records of such verification (the "E-Verify Requirements").

c. North Carolina General Statute 160A-20.l(b) prohibits the City from entering into contracts unless the contractor and all subcontractors comply with theE-Verify Requirements.

2. As a condition of being considered for the Contract, Company certifies that:

a. If Company has 25 or more employees working in North Carolina (whether now or at any time during the term of the Contract), Company will comply with the E-Verify Requirements in verifying the work authorization of Company employees working in North Carolina; and

b. Regardless of how many employees Company has working in North Carolina; Company will take appropriate steps to ensure that each subcontractor performing work on the Contract that has 25 or more employees working in North Carolina will comply with the E-Verify Requirements.

3. Company acknowledges that the City will be relying on this Certification in entering into the Contract, and that the City may incur expenses and damages if the City enters into the Contract with Company and Company or any subcontractor fails to comply with theE-Verify Requirements. Company agrees to indemnify and save the City harmless from and against all losses, damages, costs, expenses (including reasonable attorney's fees) obligations, duties, fines and penalties (collectively "Losses") arising directly or indirectly from violation of the E-Verify Requirements by Company or any of its subcontractors, including without limitation any Losses incurred as a result of the Contract being deemed void.

Signature of Company's Authorized Representative

Print Name and Title:

ITS 269-2015-073

N o...,-\-a.he. \J e()e/0 C'of\-tVo.o<t 'Bid A(jen t

APRIL 30, 2015 34

Attachment 1

CCPA PLAN, SECTION 4.1

Bids must include or address the following information regarding the CCPA plan as Attachment 1.

4.1.1 Bids must include in detail how the Bidder plans to service all Participating Public Agencies as it relates to the CCP A. Currently the CCPA has approximately 225 registered Participating Public Agencies in California, Georgia, Michigan, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia. Please address the following in your bid response as Attachment #1:

4.1.1.1 Ability to provide Products/Services to any Participating Public Agencies in the contiguous 48 states; and the ability to deliver Products/Services in Alaska and Hawaii; and

4.1.1.2 Address if the Bidder has a national sales force, dealer network or distributor with the ability to serve Participating Public Agencies in all 50 U.S. states.

4.1.2 Bids must include in detail how the Bidder will monitor and report all spend by CL T/Participating Public Agencies to the CLT for auditing purposes as Attachment #1.

4.1.3 The City of Charlotte will post all awarded contracts on the CCPA website, along with the respective vendor information. Please address the following in your bid response:

4.1.3.1 Indicate if the Bidder will allow the City to utilize their organization's logo on the CCPA website;

4.1.3.2 Address if the Bidder will advertise the CCPA logo and website on their organization's website; and

4.1.3.3 Bids must include in detail how the Bidder plans to market the Contract(s) as a result of this ITB as Attachment #1.

ITB # 269-2015-073 ATTACHEMENT 1

4.1.1

ElECTRONIC ACCESS SPECIAliSTS d/b/a SOUTHERN LOCK & SUPPLY CO IS ABLE TO

PROVIDE PRODUCTS/SERVICES TO ANY PARTICIPATING PUBliC AGENCIES IN THE

CONTIGUOUS 48 STATES AS WELL AS IN AlASKA & HAWAII. QUOTES CAN BE

PROVIDED AS WELL AS ORDERS PROCESSED AND FILLED, SHIPPED AND BILLED.

4.1.2

ELECTRONIC ACCESS SPECIAliSTS d/b/a SOUTHERN LOCK & SUPPLY CO Will BE ABlE

TO MINITOR AND REPORT All SPEND BY CLT/PARTICIPATING PUBLIC AGENCIES TO

THE CLT FOR AUDITING PURPOSES BY TAGGING ALL RELATED ORDERS WITH THE BID

NUMBER AND RUNNING MONTHLY REPORTS.

4.1.3

ELECTRONIC ACCESS SPECIALISTS d/b/a SOUTHERN lOCK & SUPPLY CO WILL ALLOW

UTILIZATION OF THEIR ORGANIZATIN'S LOGO ON TH CCPA WEBSITE AS WELL AS

ADVERTISE THE CCPA LOGO AND WEBSITE ON THIER WEBSITE. ALSO SAME WILL

MARKET CONTRACTS AS A RESULT OF ITB ON THEIR WEBSITE

1

Attachment 2

PRICING, SECTION 4.6

Bids must include or address the following for the full line catalog as Attachment 3:

Pricing: The City is requesting a fixed percentage discount from the Retail List Price (list price less discount) included in the Bidder's most current full line catalog for the items included in Section 6 Form 3. Pricing under this contract shall include all shipping and handling, delivery, vendor markup/profit, and storage. No other charges will be allowed. Bidders shall provide a copy of the full line catalog with the bid submission. The full line catalog shall be submitted as a hard copy or electronically via CD or flash drive, with electronic being the preferred method, as Attachment# 2.

ITB # 269-2015-073 ATTACHEMENT 2

.L.j~ % OFF LIST ABUS

30 % OFF LIST ASSA

55 % OFF LIST CORBIN

5 %OFF liST HPC

Lf~ % OFF LIST KABA SIMPLEX

1~ % OFF LIST KABA E-PLEX

4'1 % OFF LIST LCN

Lf'g' % OFF LIST MASTER

i..f'il %OFF LIST OLYMPUS

55 % OFF LIST SARGENT

5o % OFF LIST SCHLAGE

L.fi % OF LIST VON DUPRIN

1

Attachment 3

CUSTOMER SERVICE REPRESENTATIVE, SECTION 4.11

Bids must include or address the following information for the customer service representative as Attachment 2.

Customer Service Representative: The Company must dedicate a Full-Time "Account Executive" for servicing the City. The account executive must be available by cell phone. The cell phone must be operational at all times. All communicational contact, either via phone, email, etc. must be addressed with a response within two (2) business days. The account executive must be available to attend meetings regarding Locks, Cylinders & Key System Parts issues upon request. The account executive will be responsible for providing immediate response and quick resolution of all the service issues and complaints of City personae!. The account executive must have an in-depth knowledge of all items provided in this bid and have immediate access to manufacturers providing the Locks, Cylinders & Key System Parts items. He or she must have the ability and authority to make decisions on behalf of their employer enabling them to provide both normal and emergency service as necessary. Bidders must identify the Account Executive in Attachment #3.

ITB # 269-2015-073 ATTACHEMENT 3

ACCOUNT EXECUTIVE:

TIMTWINAM

TIMTWINAM@SOUTHERNlOCK.COM

PH: 800-282-2837 EXT 1152

CELL: 727-204-2797

1

Attachment 4

REFERENCES . _ dJ,-,~ L .

Company Name: GLeC1£orl\c Acce:ss 5A=CiALIST '1Q 5N±b6<n ocJc.iSo~Ly co ri\C. List three (3) clients excluding the City of Charlotte/Mecklenburg County, for whom you have provided services similar to those outlined in this Invitation to Bid, for reference check:

NAME OF FIRM: 6Pi DADe GDJNiiL\ ADDRESS OF FIRM: \YtlAm] ¥L

CONTACT PERSON: 10M DDN&S TELEPHONE NUMBER: ·Ct:f5~ Cf1'5- TI'6l FAX NUMBER: .?o5 -CM5 -1q 13 NAME OF FIRM:

efl f1e0(A\ .Ae() Col.lf\l1\-J ADDRESS OF FIRM: Fr 1 aililfde.le.. M_,

CONTACT PERSON: Ko:+hu C'wN TELEPHONE NUMBER: ·1st+- ?.21 -Y~SL\ FAX NUMBER: 'l 54 <3-:GI - i4Tll NAME OF FIRM:

tlPl Pouc ('CU'JT'/ ADDRESS OF FIRM: 5Qell)W ~L

CONTACT PERSON: Lo 'I Co f\()-ei

TELEPHONE NUMBER: '8'lo ~- '53'-l -CPOO! FAX NUMBER: ~ta3 -'534- cQO~