housing authority of the city and county of...

HOUSING AUTHORITY OF THE CITY AND COUNTY OF DENVER

SOLICITATION TYPE: Request For Proposal

SOLICITATION NUMBER: 14-002

DESCRIPTION: Public Relations Services

ISSUE DATE: February 6, 2014

WRITTEN QUESTIONS DUE: February 13, 2014 at 4:00pm

Submit to [email protected]

DUE DATE: February 20, 2014

DUE TIME: 4:00pm

SUBMITTAL PLACE: Denver Housing Authority

Procurement Services

777 Grant Street, 1st Floor

Denver, Colorado 80203

DIRECT INQUIRIES TO: Nicole Williams

(720)932-3071

[email protected]

Important Notice: In order to receive future notifications pertaining to this solicitation and

notice of future business opportunities of upcoming solicitations from DHA, please register your

company on DHA’s E-Procurement website by going to

http://www.denverhousing.org/procurement and completing the registration form. Any questions

regarding the E-Procurement website link, please call 720-932-3070.

mailto:[email protected]


http://www.denverhousing.org/procurement

OFFEROR’S CHECK LIST

The following checklist should be used to ensure required documentation is attached to the

proposal. If a document is not required for your proposal, write N/A in the blank.

1. Have you signed the front page (Section A) of the proposal? ________

2. Have you reviewed all Fees? ________

3. Have you checked unit costs, extensions and totals? ________

4. Have you included manufacturers’ names & reference numbers

as applicable? ________

5. Have you supplied any substitute ‘or equals’

brochures, technical literature, & samples where applicable? ________

6. Have you filled in Contractors name and address in Paragraph

#19 of Section ‘K’? ________

7. Have you filled out, signed and enclosed Section ‘N’ Form

Representations, Certifications, and Other Statements of Offerors ________

8. Have you filled out, signed and enclosed the DHA

Vendor Qualification Form and Business Concern Affidavit? ________

9. Have you filled out, signed and enclosed the

W-9 Form? ________

10. Are Bid Bonds enclosed (construction efforts)? ________

11. Are Amendments to the Solicitation acknowledged

(when applicable)? ________

12. Have you filled out, signed and enclosed the ASSET Plan and

Section 3 Business Concern Affidavit? ________

13. Have you filled out, signed and enclosed the Worker’s Status

Affidavit? ________

NO OFFER FOR THE REASONS CHECKED

CANNOT COMPLY WITH THE SPECIFICATIONS. CANNOT MEET DELIVERY REQUIREMENTS.

UNABLE TO IDENTIFY THE ITEM(S). DO NOT REGULARLY MANUFACTURE OR SELL THE TYPES OF ITEM(S) INVOLVED.

OTHER (SPECIFY)

WE DO WE DO NOT DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF ITEM(S) INVOLVED.

NAME AND ADDRESS OF FIRM: SIGNATURE:

TYPE OR PRINT NAME AND TITLE OF SIGNER:

(Fold and Mail to The Address Below)

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- FROM: AFFIX STAMP HERE

TO: DENVER HOUSING AUTHORITY PROCUREMENT SERVICES 777 GRANT STREET DENVER, CO 80203 SOLICITATION NO. RFP 14-002 Public Relations Services DATE AND TIME DUE: February 20, 2014 at 4:00pm

1

SECTION A

SOLICITATION/OFFER/AWARD

Solicitation Number:

RFP 14-002 Solicitation Type:

Request for Proposal

Date Issued:

February 6, 2014

Issued By:

Housing Authority of the City and County of Denver

777 Grant Street

Denver, CO 80203

SOLICITATION Sealed offers in one (1) original and three (3) copies for furnishing the services or supplies in the attached solicitation will be

received at the address specified above until 4:00pm local time on February 20, 2014. Offerors should note the provision entitled

LATE SUBMISSIONS ... in the Instructions to Offerors. All Offers are subject to all terms and conditions contained in this

solicitation.

For Information Contact: Nicole Williams

Telephone Number: 720-932-3071

OFFER In compliance with the above, the undersigned agrees, if the offer is accepted within 60 calendar days from the date for receipt of

offers specified above, to furnish any and all items at the prices offered.

The Offeror acknowledges amendments through by signing below.

Name and Address of Offeror:

Name and Title of Person Authorized to Sign Offer:

Telephone Number: Signature: Date:

AWARD

(For DHA Use Only) Contract Number:

Contract Amount: Effective Date:

End Date:

Supplies or Services: Public Relations Services

SIGNATURES CONTRACTOR: (Negotiated Procurement Only)

Signature:

Name:

Title:

Date:

AUTHORITY:

Signature:

Name:

Title:

Date:

2

SUPPLY/SERVICE

SOLICITATION/CONTRACT

TABLE OF CONTENTS

SECTION TITLE PAGES

Offeror’s Checklist

No Offer Form

A Solicitation/Contract Form 1

Table of Contents 2

B Supplies or Services and Prices 3-17

C Description/Specifications/Statement of Work 18-24

D Instructions to Offerors 25-26

E Evaluation Factors for Award 27

F ASSET Plan (Section 3) 28

G Packaging and Marking 29

H Inspection and Acceptance 30

I Deliveries or Performance 31

J Contract Administration Data 32

K Special Contract Requirements 33-38

L Contract Clauses 39

M List of Documents and Other Attachments 40

N Representations, Certification and Other 41-42

Statements of Offerors

Note: Sections D, E, F and N will be physically removed from any resultant award, but will be deemed to be

incorporated, by reference, in that award.

3

SECTION B

SUPPLIES OR SERVICES AND PRICES

FEE SCHEDULE – BASE YEAR

Contractor shall furnish all facilities, labor, materials, equipment, and perform all work as specified in the

Specifications, Section C of the solicitation.

A detailed cost proposal identifying hourly billable rate(s), inclusive of profit, overhead, and other cost factors for

staff positions assigned to each activity.

Staff Positions Hourly Rate

Activity One: Strategic Media and Public Relations Outreach

$

Activity Two: Develop & Produce Public Relations Collateral Media Events, Public

Relations Events

$

Activity Three: Media Events, Public Relations Events

$

*Please add lines as needed for additional staff positions*

4

SECTION B


FEE SCHEDULE – BASE YEAR cont.


Activity Four: Branding

$

Activity Five: Crisis Media

$

Activity Six: On-Call Media/Public Relation Services

$

Activity Seven: Media Training (can include social media training/web design)

$


5

SECTION B


FEE SCHEDULE – BASE YEAR cont.


Activity Eight: Photography, Graphics & Video, Multimedia

$


6

SECTION B


FEE SCHEDULE – OPTION YEAR ONE







$


Relations Events

$


$


7

SECTION B


FEE SCHEDULE – OPTION YEAR ONE cont.



$


$


$


$


8

SECTION B


FEE SCHEDULE – OPTION YEAR ONE cont.



$


9

SECTION B


FEE SCHEDULE – OPTION YEAR TWO







$


Relations Events

$


$


10

SECTION B


FEE SCHEDULE – OPTION YEAR TWO cont.



$


$


$


$


11

SECTION B


FEE SCHEDULE – OPTION YEAR TWO cont.



$


12

SECTION B


FEE SCHEDULE – OPTION YEAR THREE







$

Activity Two: Develop & Produce Public Relations Collateral

$


$


13

SECTION B


FEE SCHEDULE – OPTION YEAR THREE cont.



$


$


$


$


14

SECTION B


FEE SCHEDULE – OPTION YEAR THREE cont.



$


15

SECTION B


FEE SCHEDULE – OPTION YEAR FOUR







$


$


$


16

SECTION B


FEE SCHEDULE – OPTION YEAR FOUR cont.



$


$


$


$


17

SECTION B


FEE SCHEDULE – OPTION YEAR FOUR cont.



$


18

SECTION C

DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

1. SPECIFICATIONS/STATEMENT OF WORK

Specifications that are applicable are listed below

A. Introduction.

The purpose of this contract is to provide Public Relations/Media Relations services to the Denver Housing

Authority.

The mission of the Denver Housing Authority (DHA) is to provide a variety of affordable housing

opportunities for low and moderate-income people within the City and County of Denver. DHA receives

Department of Housing and Urban Development (HUD) funding in order to carry out its’ mandate. DHA

was created in 1938 as a quasi-municipal corporation governed by a nine-member Board of Commissioners

appointed to term by the Mayor of Denver. DHA has a portfolio of over 4,900 Public Housing, Section 8,

and Workforce rental units. DHA administers over 5,900 Section 8 Vouchers and has an annual operating

budget of over $140MM, making it the largest housing authority in the Rocky Mountain region. DHA has

undertaken an ambitious plan to transform public housing in Denver, creating vibrant, sustainable, mixed-

income communities of choice, offering empowerment and opportunity, and a first-class housing

organization serving the City of Denver and the families who call it home.

B. Scope of Work.

The Consultant shall provide Public Relations/Media Relation services as requested, by Denver Housing

Authority by devising custom plans to achieve our public relations goals. PR services could involve, but

not be limited to exclusively, interfacing with the following entities:

Department of Housing and Urban Development

Local Policy Makers (e.g. Mayor, City Council, Governor, Colorado Legislature, Congressional

Offices, etc.);

Board of Commissioners;

DHA resident populations, DHA staff and personnel;

National, Regional and Local media venues

Private Sector

General Public

Public Relations activities include (please see following page):

19

SECTION C

DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK cont.


Provide, develop, foster and create positive media and public relations outreach, campaigns,

message that result in national, regional and local media coverage. Create and ensure positive

news coverage of DHA activities in most effective and cost-efficient manner on DHA’s innovative

projects, transit-oriented, sustainable developments, education and job training initiatives, etc.

Activity to be carried out under the direction and in coordination with Community Affairs Officer,

Executive Director and designated representatives (i.e., Senior Staff/ project manager, etc.).

Including: - background research, planning and development.

ITEM

DESCRIPTION

1. Background Research

Conduct necessary research on DHA, including

DHA’s innovative projects, transit-oriented,

sustainable developments, education and job training

initiatives. 2 meetings @1-2.5 Hrs. w/appropriate 2-

30 DHA Staff.

2. Planning Meet as necessary with Executive Director and

DHA staff in planning to provide, develop, foster

and create positive media and public relations

outreach, campaigns, message that result in national,

regional and local media coverage. 4 meetings @ 1-

2.5 Hrs.

3. Materials Develop story lines, message, articles, features,

press releases and press packets. And, as appropriate

assist DHA assigned staff (1-3) @ 1-15 Hrs.


Develop agency information materials, brochures/collateral, booklets, newsletter(s), and/or flyers for the,

under the direction and in coordination with the Community Affairs Officer Executive Director and

designated representatives (i.e., Senior Staff/Resident Community Services/Section 8/Housing

Management Division/Real Estate Division. All deliverables/materials /photographs and graphics will be

color or black &white in print, electronic, website and social media quality. Deliverables/materials must be

culturally/linguistic sensitive and bilingual in the majority second language (i.e., Spanish). Collateral must

be state of the art including housing and community development design elements, terminology, images,

photographs, images and graphics, etc. Collateral developed in forms which have multi use – print,

electronic transmission, video technology and web based, and social media quality, etc. This cost includes

all materials, labor and proof work.

ITEM

DESCRIPTION

1. Informational Material 2,500 @1-15 pages as requested (i.e., 6 mos.)

2. Brochures/Collateral 2,500 @1-4 pages as requested (i.e., 6 mos.)

3. Booklets – Executive Department 2,500 @1-15 pages as requested (i.e., 4 mos.)

20

4. Newsletter –Agency-wide news, Resident Community

Services, Section 8, Housing Management Division Develop format, structure, and content for community wide

DHA, or special projects newsletter, Monthly (12) or

Quarterly (4) distribution of, 500 @ 1-8 pages each edition.

Including format for posting on Website.

5. Strategic Planning, Strategic Plan & Strategic Plan

Summary. Under the direction of Community Affairs Officer,

Executive Director plan, facilitate, develop and update

annual Strategic Plan, including meetings with appropriate

2-20 meeting with DHA executive staff/management

staff/Board/Union, etc. @1-2.5 hrs. per meeting.

Strategic Plan of 500 copies @ 35-40 pages annually.

Executive Summary of 500 copies @ 6-8 pages annually.

Including format for posting on Website & social media.

6. Annual Report – Bi-Annual Report Under the direction of Community Affairs Officer,

Executive Director or his designee develop Agency Annual

Plan or Bi-Annual Report 500 @1-10 pages annually.

Including format for posting on Website & social media.

7. Fact Sheets/Project Sheets

Under the direction of Community Affairs Officer, or

designee develops or updates agency, project or property

fact sheet 100 @1-4 pages/fold outs annually.


Develop, plan, organize, and execute successful DHA media events and special events. Ensure

media coverage for DHA events, including new development opportunities, new innovative

initiatives, vendor outreach, job fairs, environmental, complex financial management and

human interest stories. Activities to be carried out, under the direction and in coordination with

Community Affairs Officer, Executive Director and designated representatives (i.e., Senior

Staff/ project manager, etc.).

ITEM

DESCRIPTION

1. Planning Plan, organize, and execute successful DHA media

events and special events. Ensure media coverage

for DHA events. Meet as necessary with Executive

Director and DHA staff in planning events that

result in national, regional and local media coverage.

4 meetings @ 1-2.5 Hrs. and/or as needed per event.

2. Materials Develop media contacts, media advisory, press releases,

and follow-up with media outlets. And, as appropriate


21

SECTION C



Assess, review and recommend new branding opportunities for DHA developments, new projects,

community revitalization initiatives in a cohesive and succinct manner. Explore new DHA agency

branding/logo under the direction and in coordination with Community Affairs Officer, Executive

Director and designated representatives (i.e., Senior Staff/ project manager, etc. Including but not

limited to: background research, planning and development. This cost includes all materials, labor,

proof work, and final work files for DHA records/rights. Any agency or special project branding may

be conducted in a phased approach, contingent up funding and work schedule of agency/project.

ITEM

DESCRIPTION

1. Background Research

Conduct necessary research on DHA, such as

DHA’s strategic planning, transformation as agency,

innovative projects, transit-oriented, sustainable

developments, resident programs and its affiliates,

partnerships, etc., 2 meetings @1-2.5 Hrs.

w/appropriate 2-30 DHA Staff.

2. Planning Meet as necessary with Community Affairs Officer,

Executive Director and designated DHA Department

staff in planning to conceptualize branding/logo.

Plan branding/logo process: focus group, analysis,

recommendations, drafts, and/ or testing, for final. 4

meetings @ 1-2.5 Hrs.

3. Materials Develop Branding and logo(s). And, as appropriate


Activity Five: Crisis Media (Image Re-Build as necessary)

Develop crisis media/communication plan. Ensure ability to carry out crisis media plan and

execution of effective crisis communications. Advise, guide, control, carry out and follow-up on

crisis media communications should they occur. Provide advice on any agency rebuilding

media strategies as necessary.

ITEM

DESCRIPTION

1. Planning and Development Meet as necessary with Community Affairs Officer,

Executive Director and DHA staff to develop crisis

media/communications plan. 3 meetings @ 1-2.5

Hrs.

2. Materials and Implementation As appropriate, be available to consult, assist DHA

assigned staff or manage crisis media 1-3 @ 1-15

Hrs.

22

SECTION C



Provide on call media/public relations services. Hours will be negotiated. Task order(s) will be

defined upon initiation of work at hourly rate. Activities carried out under the direction and in

coordination with Community Affairs Officer, Executive Director and/or designated representative

(i.e., Senior Staff/ project manager, etc.).

ITEM

DESCRIPTION

1. On-Call Media/Public Relations

Provide on call media/public relations services.

Activity Seven: Media Training

As necessary, develop and provide media training to DHA senior staff/housing management staff

on interview techniques, editorial boards and/or preparedness for one-on-one investigative

journalist interviews. Media training shall include large and small, mainstream, bilingual and

community news media. This cost includes all materials, labor and proof work. Including social

media use, marketing, new social media channels and may include web design. Recommend,

develop and provide state of the social media communication training to improve usability,

accessibility and consistency of information. Provide recommendations to integrate social

networking services in DHA public relations strategies. Activity carried out under the direction

and in coordination with Community Affairs Officer, Executive Director and designated

representatives (i.e., Senior Staff/ project manager, etc.). Including: - planning and development.

This cost includes all materials, labor and proof work.

ITEM

DESCRIPTION

1. Planning Meet as necessary with Community Affairs Officer,

Executive Director, Housing Management

Staff/field staff and DHA staff in media training

planning. 2 meetings @ 1-2.5 Hrs.

2.

Materials and Training Develop DHA Media training curriculum and

provide individual and group. And, as appropriate


3. Social Media / Web Page Planning Meet as necessary with Community Affairs Officer,

Management Information Systems Manager,

Executive Director and DHA staff in social media

training for improved DHA web communications or

social networking. 4 meetings @ 1-2.5 Hrs.

4. Social Media / Web Page Training Develop and conduct social media training and as

appropriate assist DHA assigned staff (1-3) @ 1-15

Hrs.

23

SECTION C



Deliverables of state of the art photography of DHA events, developments, architectural photos, projects,

etc. graphic, video and multi-media services for multi-use and incorporated in to media relations

activities as required. Deliverables/materials must be culturally/linguistic sensitive and bilingual in the

majority second language (i.e., Spanish). This cost would include all materials, labor and proof work.

ITEM

DESCRIPTION

1. Photographs Photos of DHA projects, developments, and special

activities, other as requested.

2. Graphics Graphic, images, chip art, other as requested.

3. Video Services

Hi-Definition videotape and disc formats of any

duplication company in the Southeast. With the

addition of HDCAM SR, HDCAM, HDV, and HD

DVC Pro machines, to accommodate nearly any Hi-

Definition tape duplication, encoding, transfer or

editing projects, web communication posting, other as

requested.

4. Multi-media services

Including still images or the combination of text,

sound, and/or motion video, other as requested.

Potential activities/tasks, are to be done, but not limited to Hourly rate for Base Year; each year renewal, up

to maximum of five years.

C. Reimbursable.

DHA will pay the Consultant for the reimbursable expenses listed below. The DHA Contracting Officer’s

Representative must approve reimbursable expenses. Reimbursable are in addition to the hourly billable

rates for basic services and are for certain actual expenses incurred by the Consultant in connection with the

project as enumerated below:

Travel Cost. The reasonable expense of travel costs incurred by the Consultant when requested by

Owner to travel to a location that lies outside of a 45 mile radius of the Project site, Consultant’s

office(s), and Owner’s office.

Long Distance Telephone Costs. Long distance telephone calls and long distance telefax costs.

Delivery Costs. Courier services and overnight delivery costs.

Reproduction Costs. Reproduction and postage costs of required drawings, templates, specifications,

Bidding and Contract documents, excluding the cost of reproductions for the Consultant or

Subcontractor’s own use.

Additional Reimbursable. The Consultant and Owner may agree in an addendum or amendment to this

Agreement to include certain other expenses not enumerated above as Reimbursable Expenses. A

separate Maximum Amount for this Reimbursable shall be established.

24

SECTION C


D. Deliverables

Marketing materials, including but not limited to: brochures, booklets, newsletters, photography, premium

items, annual report, strategic plan document, development and production costs are reimbursable upon

written approval by the DHA Contracting Officer’s Representative in accordance with HUD and DHA

allowable costs.

All original and master deliverables shall be the property of DHA and must be submitted to DHA at the

termination of this contract, or upon request by DHA. Any other use of, other than the intended use of any

deliverable produced under this contract must have the written permission of DHA.

E. Task Order Issuance Procedures.

For individual task orders under $2,000 DHA reserves the right to issue work at its own discretion.

For individual task orders over $2,000 DHA will implement the following procedure:

DHA staff will provide the contracted firms an invitation for quote. The contracted firms

will review the information contained in the project package and submit a corresponding

proposal. Authorized DHA staff will review the submittals and award the work in the form

of a Purchase Order to the most responsive firm based on the following criteria:

Evaluation Criteria Points

1. Cost 50

2. Capacity 25

3. Readiness/Availability 25

Total Points 100

25

SECTION D

INSTRUCTIONS TO OFFERORS

1. INSTRUCTIONS TO OFFERORS

See HUD Form 5369-B immediately following this section.

2. SUBMISSION OF OFFERS

a. All proposals shall be enclosed in an envelope, sealed, and clearly labeled as follows:

PROPOSAL DOCUMENTS

Name of Contractor

RFP Number

Date and Time Due

b. All proposals transmitted by mail shall be addressed with the same information above and mailed to:




Denver, CO 80203

c. All proposals hand delivered shall be addressed with the same information above and hand delivered to:




Denver, CO 80203

The Clock in the 1st Floor Lobby shall be used to determine the time proposals/offers are received by the

Authority.

3. REQUIRED DOCUMENTS

The following documents are required to be submitted with the Proposal:

a. Section A, Solicitation/Offer/Award Form

b. Section B, Fee Schedule

c. Section F, ASSET Plan

d. Section K, Paragraph 19

e. Section N, Representations and Certifications including HUD Form 5369C

f. Vendor Qualification Form and all attachments (Prime Only)

g. Disclosure of Lobbying Activities (if applicable)

h. All Amendments Signed (if applicable)

i. At least three (3) references shall be provided with email addresses

4. PRE-PROPOSAL CONFERENCE – NOT APPLICABLE

A pre-proposal conference will be held at the following location:

Location:

Date/time:

26

5. MINORITY AND WOMEN OWNED BUSINESS PARTICIPATION

a. The Authority's Board of Commissioners has set an overall goal of 20% Minority Business Enterprise and

6% Women Business Enterprise participation in the procurement of supplies and services. All offerors are

encouraged to present a team approach that meets or exceeds our goals.

b. Firms submitting proposals are encouraged to consider subcontracting portions of the engagement to firms

owned and controlled by socially and economically disadvantaged individuals. If this is to be done, the

name(s) of the proposed subcontracting firms, must be clearly indicated in the proposal. Following the award

of the contract, no additional subcontracting will be allowed without the express prior written approval of the

Contracting Officer.

6. MATERIAL PRODUCT APPROVAL (OR EQUAL) – NOT APPLICABLE

All offerors must submit a sample and product data for all proposed "or-equal" items no later than ____

calendar days prior to solicitation due date.

7. QUESTIONS AND ANSWERS FOR THIS REQUEST FOR PROPOSAL

All questions must be submitted via email to [email protected] by February 13, 2014 at

4:00pm. Questions will be answered via amendment by February 18, 2014. No other questions will be

answered beyond this period.

8. PROPOSAL PREPARATION INSTRUCTIONS

a. All proposals shall be submitted in the following format and sequence:

i) Cover Page

ii) A detailed response to each evaluation criteria indicated in Section E (At least one paragraph per

criteria).

iii) All required documents (Section D, Paragraph 3)

iv) Provide a breakdown of percentage of the contract to be assigned to Minority Business

Enterprises and Women Business Enterprises (See Section D, Paragraph 5).

b. Proposals shall be submitted in one (1) original and three (3) copies. Each set should not exceed fifteen

(15) pages, not including the required documents (Section D, Paragraph 3)

c. All proposals shall be enclosed in an envelope, sealed, and labeled (See Section D, Paragraph 2a).

9. DEBRIEFING

Debriefing sessions are available on an “As Requested” basis after contract award. Debriefing sessions provide

valuable insight on how to make your proposal more competitive for future procurement activity.


27

SECTION E

EVALUATION FACTORS FOR AWARD

1. EVALUATION FACTORS

a. Award will be made to the single responsive, responsible offeror who submits the most technically

acceptable proposal.

b. Multiple awards may be made as a result of this solicitation.

o Companies may respond to one or more, or all of the activities/tasks as outlined in this IDIQ.

o DHA reserves the right to award multi award to qualified companies for one or more of the

outlined activities/tasks under this IDIQ and meeting evaluation criteria.

c. A review committee consisting of members, appointed by DHA, will make recommendations to DHA

management, and the DHA Board of Commissioners. The evaluation is based on the firms qualifications.

d. The evaluation criteria is listed below in descending order of importance:

Evaluation Criteria Points

1) Relevant Media and Public Relations Experience

for the Past Three Years

25

2) Capacity – Staffing, Skills, Resources: Sample Listing, Technology and Equipment, Assets,

Resumes

25

3) Experience working with Government Entities for

the Past Three Years: By Entity and Number of Years

15

4) Costs 20

5) ASSET Plan (Section 3) 15

Total 100

28

SECTION F

ASSET PLAN (SECTION 3)

1. ASSET PLAN (SECTION 3)

Please complete the ASSET Plan form immediately following this section. If you require any assistance with this form,

please contact the individuals listed in the form.

1/1/2014

Denver Housing Authority

Education & Employment Program

Our Philosophy:

Denver Housing Authority is deeply committed to and energetically supports HUD’s Resident Employment

& Opportunity Program. DHA’s Education & Employment Program has been designed to support the

Section 3 regulations of 24 CFR Part 135. DHA strives to create sustainable economic opportunities for

public housing residents through partnerships with our contractors.

All DHA contracts over $25,000 are required to comply Section 3 regulations with participation in the DHA

Education & Employment Program. Contractors will work with the DHA Education & Employment

Program to create new job opportunities in collaboration with vendors and subcontractors. The completion of

the attached Form will assist with monitoring progress in the program.

The goal of the Education & Employment Program is to invest in the community as partners with our vendors

and subcontractors. Our greatest investment is more than the structures and edifices that are left when the

project is completed – our greatest investment is the people.

Available Contractor Support:

The DHA Education & Employment Program addresses the main issues facing businesses today:

Proper Selection of Potential Employees

Training of Employees

Tax Benefits

Possible Wage Assistance

Employee Retention

DHA will provide the following for companies in support of the Education & Employment Plan:

A staff person to assist your firm in designing a successful program that effectively meets the training

and short and long term staffing needs of your company.

Assistance with job referrals and job placement support.

Preference when competing for DHA contracts.

DHA works closely with program candidates in order to provide the following soft skills training:

Job Readiness Training

Resume Writing & Interview Basics

Barrier Assessment

DHA recognizes that trained and qualified candidates are needed to fill these various positions. DHA works

closely with community training partners so that candidates have access to the latest technologies and

training. Candidates are encouraged to have ongoing training so that skills are current. DHA currently works

with the following providers who provide training in emerging industries:

Red Rocks Community College

Arapahoe Community College

Mile High Youth Corps

OED Workforce Centers

1/1/2014

Competitive Advantage:

Companies that have included a Education & Employment Program Implementation Plan as part of their

proposal for a DHA contract receive a preference based on the following evaluation criteria:

Provides economic opportunities for low income residents of the Denver Housing Authority.

Participates in the DOL sponsored YouthBuild program in metropolitan Denver.

Provides economic opportunities for low and very low income persons residing with the metropolitan

area (or non-metropolitan county) in which the assistance is provided.

Employs more than 30% of low and very low income workers.

Subcontracts 25% of contract efforts to any of the above priority categories.

DHA will work with your company to ensure the successful implementation of your Plan. The successful

implementation of the Education & Employment Program will be highlighted in our contractor performance

evaluation files. This maximizes your company’s competitive position on future DHA procurement efforts.

1/1/2014



Section 3 Resident Definitions

Section 3 represents a Federal regulation that addresses job training, employment and contracting

opportunities for residents residing in low income areas. All contractors receiving housing or

community development funds must ensure that employment, training and other economic

activities, to the greatest extent feasible, will be directed to low and very low income persons

who reside in targeted Section 3 areas (Section 3 residents). Low income is defined as family

(including single persons) income that does not exceed 80% of the median income for the area.

Very low-income is defined as family income that does not exceed 50% of the median income

for the area.

Section 3 Residents

Categories – A Section 3 resident is a low or very low income individual who:

a. Category One - is a DHA resident and lives in close proximity to the construction

site.

b. Category Two – is a resident of other housing developments managed by DHA.

c. Category Three – are participants in HUD Youthbuild Program located in Metro

Denver

d. Category Four – is a resident of the City and County of Denver.

Number of Persons in the Family: Very Low Income Limit: Lower Income Limit:

One $27,250.00 $43,600.00

Two $31,150.00 $49,500.00

Three $35,050.00 $56,050.00

Four $38,900.00 $62,250.00

Five $42,050.00 $67,250.00

Six $45,150.00 $72,250.00

Seven $48,250.00 $77,200.00

Eight $51,350.00 $82,200.00

*2013 Denver Figures

1/1/2014

Education & Employment Plan Denver Housing Authority

RFP/Quote#:

Company Name:

Address:

Contact Name:

Title/Position:

Telephone:

Email:

Discuss Your Company’s Commitment to the Education & Employment Program:

Job Openings Expected during Term of Contract:

Job Title Total New Hires Minimum Qualifications Anticipated

Date of Hire

Are you a signatory to a labor agreement for this contract?

________% (# of Section 3 hires divided by the # of new hires) is the anticipated goal for Section 3 hires

for this contract.

Training Opportunities Expected during Term of Contract:

Training

Total Number Trained

Anticipated Date of

Training

Please contact a Denver Housing Authority representative to discuss anticipated job openings and training

opportunities:

Lynne Picard 720-932-3052

Damon McIntyre 720-956-3824

1/1/2014



Section 3 Business Concern Definitions

Section 3 Business Concern Representation:

The offeror represents and certifies as part of its offer that it:

( ) Is a Section 3 Business Concern as indicated below (check applicable box):

( ) Category 1 Business – 51% or more owned by residents of the housing development or

developments for which the Section 3 covered assistance is expended or whose full-time,

permanent workforce includes 30% of such residents as employees.

( ) Category 2 Business - 51% or more owned by residents of other housing

development or developments managed by the housing authority that is expending the

Section 3 covered assistance is expended or whose full-time, permanent workforce

includes 30% of such residents as employees.

( ) Category 3 Business – An entity selected to carry out a Youthbuild program in the

metropolitan area, or nonmetropolitan county, in which the section 3 covered funding is

expended.

( ) Category 4 Business – 51% or more owned by Section 3 Residents or whose full

time, permanent workforce includes no less than 30% Section 3 residents or that will

subcontract in excess of 25% of the total amount of subcontracts to Category 1, 2 or 3

Section 3 businesses as identified above.

( ) Is not a Section 3 Business

If vendor has checked one of the above boxes, please complete the Section 3 Business Concern

Affidavit.

1/1/2014

SECTION 3 BUSINESS CONCERN AFFIDAVIT

_________________________________________________________________________

AFFIDAVIT OF __________________________________ (Name) _________________________________________________________________________

STATE OF )

) ss.

COUNTY OF )

I, , first being duly sworn, state as follows:

I am over the age of 18 years.

1. I am the ____________________________________________________(Title) of,

______________________________________________________ (Complete legal

name of Company), which is located at __________________________________

_________________________________________________________________

_________________________________(Street Address, City, State, Zip Code).

2. ___________________________________________ ___________(Name of Company) is a

____________________________________________(Type of Business i.e. corporation,

partnership, sole proprietorship, joint venture, limited liability company).

3. The Company is a Section 3 Business Concern as defined below (check all that apply):

____ A business that is fifty-one percent (51%) or more owned by Section 3 residents; or

____ A business whose permanent, full-time employees include persons, at least thirty

percent (30%) of whom are currently Section 3 residents, or within three (3) years of

the date of first employment with the business concern were Section 3 residents; or

____ A business that provides evidence of a commitment to subcontract in excess of

twenty-five percent (25%) of the dollar award of all subcontracts to be awarded to

business concerns that meet the qualifications set forth in paragraphs (1) and (2)

above.

4. I have read and understand the definitions contained herein.

5. The Company hereby agrees to provide within thirty (30) days, upon request, any documents

DHA requires to verify the information provided herein.

1/1/2014

6. I understand and acknowledge that the following penalties will apply if DHA determines that

the Company has submitted a false Section 3 Business Concern Affidavit:

A. If discovered prior to any contract being awarded, the Company will be ineligible for

award of the contract, and will be permanently placed on the DHA debarment list; or

B. If discovered during the term of the contract, the contract will immediately be

terminated, and the Company will be permanently placed on the DHA debarment list;

or

C. If discovered after the completion of the contract, the Company will be permanently

placed on the DHA debarment list.

7. I am the ____________________________________________________(Title) of the

Company, and I am authorized to execute this affidavit on its behalf, and to bind the

Company regarding the matters contained herein. I have personal knowledge of the

statements made in this affidavit and state that the same are true.

FURTHER Affiant sayeth naught.

Signature

Subscribed and sworn to before me this ___ day of ______________, 20___ by

_______________________________________.

WITNESS my hand and official seal.

My commission expires: _________________________________________

_________________________________________

[SEAL]

29

SECTION G

PACKAGING AND MARKING

1. MARKING REQUIREMENTS – NOT APPLICABLE

All shipments shall include the purchase order number on the mailing label and the packing slip/invoice.

30

SECTION H

INSPECTION AND ACCEPTANCE

1. INSPECTION AND ACCEPTANCE

Inspection and acceptance will be at destination. Executive Department is designated as the office responsible

for inspecting the work while the Contracting Officer is responsible for final acceptance of the work.

2. RISK OF LOSS – NOT APPLICABLE

The contractor agrees to bear all risk of loss, injury, or destruction of goods and materials ordered as a result

of the contract which occur prior to delivery to the Authority; and such loss, injury, or destruction shall not

release the Contractor from any obligations hereunder.

3. DEFECTIVE MATERIAL – NOT APPLICABLE

The contractor shall agree to accept, for full credit and returns, including shipping charges, the return of any

item received which is found to be defective in quality of packaging so as to render the item unusable for its

intended purpose. Material designated shall be replaced at the full expense of the Contractor within ten (10)

calendar days after return.

31

SECTION I

DELIVERIES OR PERFORMANCE

1. HOURS OF WORK

a. The normal work hours at the site are from 8:00 am to 4:30 p.m., Monday through Friday, excluding

holidays. Access to the work site may be restricted to these hours and days. Request for work during other

than normal hours must be coordinated and approved in advance with the Contracting Officer.

b. DHA recognizes the following holidays: New Year's Day, Martin Luther King Jr.'s Birthday (3rd Monday

in January), President's Day, Memorial Day, Independence Day, Labor Day, Veteran's Day, Thanksgiving

Day, Day after Thanksgiving, Christmas Eve, and Christmas Day. If a holiday falls on a Sunday, the

following Monday will be observed. If a holiday falls on a Saturday, the preceding Friday will be observed.

2. TERM OF CONTRACT

The term of the contract is one (1) year from date of award or the Effective Date, whichever is later. The

Authority reserves the right to extend the term of this contract for the period specified in Section K, "Option to

Extend the Term of the Contract".

3. DELIVERY LOCATION(S) – NOT APPLICABLE

The delivery location(s) will be various warehouses or developments located throughout the City and County

of Denver. The actual location of delivery will be specified on each purchase order.

4. WAREHOUSE DELIVERIES – NOT APPLICABLE

Deliveries to the Central Warehouse 5000 E. 41st Avenue, Unit A shall be made between the hours of 8:00

a.m. and 2:30 p.m. on the Authority's normal working days.

5. REQUIRED DELIVERY SCHEDULE – NOT APPLICABLE

All items ordered under this contract shall be delivered to the designated delivery location within ____

calendar days after receipt of the purchase order.

6. FOB POINT – NOT APPLICABLE

Unless otherwise stated, all shipments shall be F.O.B. destination. The Authority shall not be liable for any

delivery, storage, demurrage, accessorial, or other charges involved before actual delivery of the supplies to

the destination unless such charges are caused by an act or order of the Authority acting in its contractual

capacity.

7. PLACE OF PERFORMANCE

The services required under this contract shall be provided at the locations listed below or as outlined in the

Statement of Work.

8. REQUIRED REPORTS

The Contractor shall, at such times and in such forms as the Authority may require, furnish such reports

concerning the status of the project, and such statements, certificates, approvals, copies, and other information

relative to the project, as may be requested by the Authority. The Contractor shall furnish the Authority, upon

request, with copies of all documents and other materials prepared or developed in relation to or as part of the

project.

32

SECTION J

CONTRACT ADMINISTRATION DATA

1. CONTRACT ADMINISTRATION OFFICE

The following office is responsible for administration of the contract:



777 Grant Street


2. INVOICING AND PAYMENTS

The Contractor shall submit invoices to:


Attn: Accounts Payable

777 Grant Street, 4th Floor


Each invoice shall reference the purchase order number. Unless otherwise stated, the Authority will process payments

to the Contractor Net 30 days from receipt of the invoice. The Authority will consider prompt payment discounts

offered by the Contractor.

33

SECTION K

SPECIAL CONTRACT REQUIREMENTS

1. INSURANCE

Before commencing work, the Contractor shall furnish the Authority with certificates of insurance showing

that the following insurance is in force and will insure all operations under the Contract:

a. Worker's Compensation, in accordance with the State of Colorado Worker's Compensation laws.

b. Commercial General Liability of not less than $1,000,000 per occurrence limit and $2,000,000

general aggregate limit to protect the Contractor and each subcontractor against claims for bodily

injury or death and damage to the property of others. This shall cover the use of all equipment,

hoists, and vehicles on the site(s) not covered by Automobile Liability under (c) below. If the

Contractor has a "claims made" policy, then the following additional requirements apply: the policy

must provide a "retroactive date" which must be on or before the execution date of the Contract; and

the extended reporting period may not be less than five years following the completion date of the

Contract.

c. The Authority waives the Automobile Liability requirement for contractors that provide professional

services such as lawyers, consultants, accountants, auditors or architects. However, these contractors

will need to add a rider to their Commercial General Public Liability insurance for “Hired non-

owned Coverage” in the amount of $1,000,000.00. Proof of this rider should be included on the

certificate for their Commercial General Public Liability.

d. Proof of insurance shall be provided to the Authority upon execution of this Contract. Contractor

shall provide The Authority certified copies of such policy or policies. Any payment due under this

contract shall be withheld until Contractor has provided such proof of insurance. Each such policy

will not be canceled or materially changed or altered without first giving thirty (30) days' written

notice thereof to the Director of Procurement Services and Special Projects, 777 Grant Street,

Denver, Colorado 80203, sent by certified mail, return receipt requested.

e. Each such policy shall contain a valid provision or endorsement stating, "This policy will not be

canceled without first giving thirty (30) days written notice thereof to the Authority's Director of

Procurement Services and Special Projects, 777 Grant Street, Denver, Colorado 80203, sent by

Certified mail, return receipt requested."

f. The Contractor shall insert the substance of this clause, including this paragraph, in subcontracts

under this contract that require work on the Authority's property and shall require subcontractors to

provide and maintain the insurance required in the schedule or elsewhere in the contract. The

Contractor shall maintain a copy of all subcontractor's proofs of required insurance, and shall make

copies available to the Contracting Officer upon request.

34

2. INDEMNIFICATION

(a) To the fullest extent permitted by law, Contractor shall release, indemnify and save harmless the

Authority, its commissioners, officers, employees, servants and agents from and against any and all

loss of or damage to property or injuries to or death of any person or persons, including property and

employees or agents of the Authority, and shall defend, indemnify and save harmless the Authority,

its commissioners, members, officers, employees, servants and agents from any and all claims,

demands, damages, suits, costs, expenses, liabilities, actions or proceedings of any kind or nature

whatsoever, including worker's compensation claims of or by anyone, in any way, resulting from, or

arising out of, directly or indirectly, the performance of services pursuant to this Contract; provided,

however, the Contractor shall not be required to defend, indemnify and save harmless the Authority,

its commissioners, officers, employees, servants and agents from claims, suits or expenses, including

worker's compensation claims resulting from the sole negligence or fault of the Authority, its

commissioners, officers, employees, servants or agents. Insurance coverage specified herein

constitutes the minimum requirements, and said requirements shall in no way lessen or limit the

liability of Contractor under the terms of the contract. Contractor shall procure and maintain, at its

own expense and cost, any additional kinds and amounts of insurance that, in its judgment, may be

necessary for its proper protection in the prosecution of the services hereunder.

(b) Contractor shall defend the Authority, its commissioners, officers, employees, servants, and agents

from and against any and all claims, demands, damages, suits, costs, expenses, liabilities, actions or

proceedings of any kind or nature whatsoever, including worker's compensation claims of or by

anyone, in any way, resulting from, or arising out of, directly or indirectly, the performance of

services pursuant to this Contract.

The Authority shall notify the Contractor of the existence of any claim, demand, or other matter to

which the Contractor’s indemnification obligations would apply. The Authority shall select counsel

to represent the Authority, whose selection shall be approved by the Contractor. Such approval shall

not be unreasonably withheld. The Contractor shall pay all reasonable attorney’s fees of the

Authority’s counsel, relating to defense of the action. If the Contractor shall fail to pay the attorney’s

fees and costs of the Authority’s defense, within a reasonable time after notice, the Authority shall

undertake its defense and the Contractor shall pay all attorney’s fees and costs expended in the

Authority’s defense of itself including, but not limited to, all attorney’s fees and costs associated with

the Authority’s enforcement of the indemnification and/or duty to defend provisions set forth herein.

(c) The obligations to indemnify and to defend the Authority shall survive expiration or earlier

termination of this Contract.

(d) The Authority by this Contract does not agree to indemnify, hold harmless, exonerate or assume the

defense of Contractor or any other persons or entity whatsoever, for any purpose whatsoever.

3. COMPLIANCE WITH LAWS AND REGULATIONS

All materials and supplies furnished pursuant to the Specifications shall be in compliance with the ordinances

of the City and County of Denver, the laws and regulations of the State of Colorado and the United States of America.

Contractor shall, if requested by the Authority, supply certification and evidence of such compliance. The Contract

shall be construed pursuant to the laws of the State of Colorado.

4. CONFLICT OF INTEREST

Neither the contractor nor their subcontractors may enter into any contract, subcontract, or arrangement in

connection with this contract in which any of the following classes of people has an interest, direct or indirect,

during his or her tenure or for one year thereafter:

35

(i) Any present or former member or officer of the governing body of the Housing Authority, or any member

of the officer’s immediate family. There shall be excepted from this prohibition any present or former

tenant commissioner who does not serve on the governing body of a resident corporation, and who

otherwise does not occupy a policymaking position with the resident corporation, the Housing Authority or

a business entity.

(ii) Any employee of the Housing Authority who formulates policy or who influences decisions with respect to

the contract, or any member of the employee’s immediate family, or the employee’s partner.

(iii) Any public official, member of the local governing body, or State or local legislator, or any member of

such individuals’ immediate family, who exercises functions or responsibilities with respect to the contract

or the Housing Authority.

(iv) For purposes of this paragraph, the term “immediate family member” means the spouse, mother, father,

brother, sister, or child of a covered class member (whether related as a full blood relative, or as a “half” or

“step” relative, e.g., a half brother or stepchild.)

5. SEVERABILITY

If any part, portion or provision of this Contract shall be found or declared null, void, or unenforceable for any

reason whatsoever by any court of competent jurisdiction or any governmental agency having authority thereover, only

such part, portion, or provision shall be affected thereby and all other parts, portions and provisions of this Contract

shall remain in full force and effect.

6. CONTRACT AS COMPLETE INTEGRATION; AMENDMENTS

This Contract is intended as the complete integration of all understandings between the parties. No prior or

contemporaneous addition, deletion, or other amendment shall have any force or effect, unless embodied herein in

writing. Amendments to this Contract will become effective when approved by both parties and executed in the same

manner as this Contract.

7. VENUE

a. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the

interpretation, execution and enforcement of this Contract. Any legal action resulting from the performance of this

Contract shall be instituted in the District Court for the City and County of Denver.

b. Any provision of this Contract, which is otherwise in conflict with said laws, rules and regulations, shall be

considered null and void. Nothing contained in any exhibit incorporated herein by reference which purports to negate

any other provision in this Contract, shall be valid or enforceable or available in any action at law whether by way of

complaint, defense or otherwise. Any provision rendered null and void by the operation of this provision will not

invalidate the remainder of this Contract to the extent that the Contract is capable of execution.

8. TAXES

The Authority is exempt from State of Colorado, RTD, and Cultural District sales and use taxes. It is

understood that the Price shall not include these taxes. Exemption certificates and numbers are available at the

Procurement Services Office of the Authority.

9. PARAGRAPH HEADINGS

The captions and headings set forth herein are for convenience of reference only, and shall not be construed so

as to define or limit the terms and provisions hereof.

36

10. NO THIRD PARTY BENEFICIARIES:

It is expressly understood and agreed that enforcement of the terms and conditions of this Contract and all rights of

action relating to such enforcement, shall be strictly reserved to the Authority and the Contractor, and nothing

contained in this Contract shall give or allow any such claim or right of action by any other or third person on such

Contract. It is the express intention of the Authority and the Contractor that any person other than the Authority or the

Contractor receiving benefits under this Contract shall be deemed to be an incidental beneficiary only.

11. VALIDITY OF CONTRACT

Work or services performed, or costs and expenses incurred prior to the execution of the Contract shall not be

reimbursable and are not eligible expenditures under the terms and conditions of this Contract. "Execution" shall be

defined as the Contract having been signed by both parties.

12. PARTIES RELATIONSHIP

a. The parties to this Contract intend that the relationship between them contemplated by this Contract is that

of client/independent Contractor; not that of employer and employee. No employee, agent, servant or subconsultant of

the Contractor shall be or shall be deemed to be an employee, agent, servant or subconsultant of the Authority. The

Contractor shall be solely and entirely responsible for its acts and the acts of its employees, agents, servants and

subconsultants, if any, during the performance of this Contract.

b. Additionally, the Contractor shall be responsible for meeting all obligations of employers with respect to

its own employees, and for payment of all taxes including federal, state, and local taxes arising out of any of the

Contractor's activities in accordance with this Contract.

13. CONFIDENTIALITY OF RECORDS

Unless otherwise provided, and where appropriate:

a. In the event the Contractor shall obtain access to any records or files of the Authority in connection with

this Contract or in connection with the performance of its obligations under this Contract, the Contractor shall keep

such records and information confidential and shall comply with all laws and regulations concerning the confidentiality

of such records.

b. Any breach of confidentiality by the Contractor or third party agents of the Contractor shall constitute good

cause for the Authority to cancel this Contract, without liability; any and all information delivered to the Contractor

shall be returned to the Authority.

c. Any Authority waiver of an alleged breach of confidentiality by the Contractor or third party agents of the

Contractor is not to imply a waiver of any subsequent breach.

14. RECORDS AND INSPECTION

a. The Contractor shall maintain a complete file of all records, documents, communications and other

materials which pertain to the operation of programs or the delivery of services under this Contract. Such materials

shall be sufficient to properly reflect all direct and indirect costs of labor, materials, equipment, supplies and services,

and other costs of whatever nature for which a Contract payment was made. Accounting records shall be maintained

according to generally accepted accounting principles and shall be easily separable from other Contractor's records.

b. All such records, documents, communications, and other materials shall be the property of the Authority

and shall be maintained by the Contractor, in a central location and custodian, on behalf of the Authority for a period of

three (3) years from the date of final payment under this Contract, or for such further period as may be necessary to

resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If

37

an audit by or on behalf of the federal government has begun but is not completed at the end of the three (3) year

period, the materials shall be retained until the resolution of the audit findings.

c. The Authority, the Department of Housing and Urban Development, and the Comptroller General of the

United States, shall have free access at all times to such reports, and the right to examine and audit the same and to

make transcripts therefrom, and to inspect all project data, documents, proceedings, and activities.

15. OPTION TO EXTEND THE TERM OF THE CONTRACT

a. The Authority may extend the term of this contract, in one (1) year increments, by written notice to the

Contractor by the expiration date of the contract or within 30 days after funds are made available for

exercising the option, whichever is later.

b. If the Authority exercises this option, the extended contract shall be considered to include this option

provision.

c. The total duration of this contract, including the exercise of any option under this clause, shall not exceed

five (5) years.

16. TYPE OF CONTRACT – INDEFINITE QUANTITY

a. This is an Indefinite-quantity contract for the supplies or services specified and effective for the period

stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only

and are not purchased by this contract.

b. Delivery or performance shall be made only as authorized by orders issued in accordance with the contract.

The Contractor shall furnish to the DHA, when and if ordered, the supplies or services specified in the

Schedule up to and including the quantity designated as the “maximum.” The DHA shall order at least the

quantity of supplies or services designated at the “minimum.”

c. Except for any limitations on quantities in the Schedule, there is no limit on the number of orders that may

be issued. The DHA may issue orders requiring delivery to multiple destinations or performance at multiple

locations.

d. Any orders issued during the effective period of this contract and not completed within that period shall be

completed by the Contractor within the time specified in the order. The contract shall govern to Contractor’s

and the DHA’s rights and obligations with respect to that order to the same extent as if the order were

completed during the contract’s effective period.

e. Minimum/Maximum order quantities.

(1) Minimum Order Quantity $100.00 per total duration

(2) Maximum Order Quantity $500,000.00 per total duration

17. SERVICE OF SUMMONS, COMPLAINT, VERIFIED STATEMENT OF CLAIM AND OTHER LEGAL

DOCUMENTS

The Contractor understands and acknowledges that the Housing Authority is not an agency of the City and

County of Denver, but is a separately created quasi-municipal corporation. Consequently, service of a summons,

complaint, verified statement of claim or any other legal document upon the Mayor, City Attorney, Clerk or any

other officer, agent or employee of the City and County of Denver is not effective service of process upon the

Housing Authority. All legal documents must be served upon the Legal Department at 777 Grant Street, Denver,

Colorado 80203. Contractor shall include the terms and conditions of this clause in every subcontract or purchase

38

order so that these terms and conditions will be binding upon each subcontractor or vendor. Failure to ensure that

your subcontracts or purchase orders contain this clause shall be considered a material breach of this contract

18. 24 CFR 85.36 CONTRACT PROVISIONS

The contract provisions required by 24 CFR 85.36 are hereby incorporated by reference.

19. NOTICE

All notices required and permitted pursuant to this contract shall be in writing and shall be deemed given

when personally served or three (3) days after deposit in the United States mail, postage prepaid, registered or certified,

return receipt requested, and addressed to the following parties or to such other address as has been designated by a

notice complying with the foregoing requirements.

The Housing Authority of the City and County of Denver:

Loretta Lovell

Director of Procurement Services/Special Projects

777 Grant Street


Contractor:

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

39

SECTION L

CONTRACT CLAUSES

1. GENERAL CONDITIONS OF THE CONTRACT

See HUD Form 5370C Section I immediately following this section.

Section I - Page 1 of 6 form HUD-5370-C (10/2006)

General Conditions for Non-Construction Contracts Section I – (With or without Maintenance Work)

U.S. Department of Housing and Urban Development Office of Public and Indian Housing Office of Labor Relations OMB Approval No. 2577-0157 (exp. 01/31/2014)

Public Reporting Burden for this collection of information is estimated to average 0.08 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management Officer, Office of Information Policies and Systems, U.S. Department of Housing and Urban Development, Washington, D.C. 20410-3600; and to the Office of Management and Budget, Paperwork Reduction Project (2577-0157), Washington, D.C. 20503. Do not send this completed form to either of these addressees.

Applicability. This form HUD-5370-C has 2 Sections. These Sections must be inserted into non-construction contracts as described below:

1) Non-construction contracts (without maintenance) greater than $100,000 - use Section I;

2) Maintenance contracts (including nonroutine maintenance as defined at 24 CFR 968.105) greater than $2,000 but not more than $100,000 - use Section II; and

3) Maintenance contracts (including nonroutine maintenance), greater than $100,000 – use Sections I and II.

Section I - Clauses for All Non-Construction Contracts greater than $100,000

1. Definitions

The following definitions are applicable to this contract: (a) 'Authority or Housing Authority (HA)' means the

Housing Authority. (b) 'Contract' means the contract entered into between the

Authority and the Contractor. It includes the contract form, the Certifications and Representations, these contract clauses, and the scope of work. It includes all formal changes to any of those documents by addendum, Change Order, or other modification.

(c) 'Contractor' means the person or other entity entering into the contract with the Authority to perform all of the work required under the contract.

(d) 'Day' means calendar days, unless otherwise stated. (e) 'HUD' means the Secretary of Housing and Urban

development, his delegates, successors, and assigns, and the officers and employees of the United States Department of Housing and Urban Development acting for and on behalf of the Secretary.

2. Changes

(a) The HA may at any time, by written order, and without notice to the sureties, if any, make changes within the general scope of this contract in the services to be performed or supplies to be delivered.

(b) If any such change causes an increase or decrease in the hourly rate, the not-to-exceed amount of the contract, or the time required for performance of any part of the work under this contract, whether or not changed by the order, or otherwise affects the conditions of this contract, the HA shall make an equitable adjustment in the not-to-exceed amount, the hourly rate, the delivery schedule, or other affected terms, and shall modify the contract accordingly.

(c) The Contractor must assert its right to an equitable adjustment under this clause within 30 days from the date of receipt of the written order. However, if the HA decides that the facts justify it, the HA may receive and act upon a

proposal submitted before final payment of the contract.

(d) Failure to agree to any adjustment shall be a dispute under clause Disputes, herein. However, nothing in this clause shall excuse the Contractor from proceeding with the contract as changed.

(e) No services for which an additional cost or fee will be charged by the Contractor shall be furnished without the prior written consent of the HA.

3. Termination for Convenience and Default

(a) The HA may terminate this contract in whole, or from time to time in part, for the HA's convenience or the failure of the Contractor to fulfill the contract obligations (default). The HA shall terminate by delivering to the Contractor a written Notice of Termination specifying the nature, extent, and effective date of the termination. Upon receipt of the notice, the Contractor shall: (i) immediately discontinue all services affected (unless the notice directs otherwise); and (ii) deliver to the HA all information, reports, papers, and other materials accumulated or generated in performing this contract, whether completed or in process.

(b) If the termination is for the convenience of the HA, the HA shall be liable only for payment for services rendered before the effective date of the termination.

(c) If the termination is due to the failure of the Contractor to fulfill its obligations under the contract (default), the HA may (i) require the Contractor to deliver to it, in the manner and to the extent directed by the HA, any work as described in subparagraph (a)(ii) above, and compensation be determined in accordance with the Changes clause, paragraph 2, above; (ii) take over the work and prosecute the same to completion by contract or otherwise, and the Contractor shall be liable for any additional cost incurred by the HA; (iii) withhold any payments to the Contractor, for the purpose of off-set or partial payment, as the case may be, of amounts owed to the HA by the Contractor.

(d) If, after termination for failure to fulfill contract obligations (default), it is determined that the Contractor had not failed, the termination shall be deemed to have been effected for the convenience of the HA, and the Contractor shall been titled to payment as described in paragraph (b) above.

(e) Any disputes with regard to this clause are expressly made subject to the terms of clause titled Disputes herein.

4. Examination and Retention of Contractor's Records

(a) The HA, HUD, or Comptroller General of the United States, or any of their duly authorized representatives shall, until 3 years after final payment under this contract, have access to and the right to examine any of the Contractor's directly pertinent books, documents, papers, or other records involving transactions related to this contract for the purpose of making audit, examination, excerpts, and transcriptions.

Section I - Page 2 of 6 Form HUD-5370-C (10/2006)

(b) The Contractor agrees to include in first-tier subcontracts under this contract a clause substantially the same as paragraph (a) above. "Subcontract," as used in this clause, excludes purchase orders not exceeding $10,000.

(c) The periods of access and examination in paragraphs (a) and (b) above for records relating to: (i) appeals under the clause titled Disputes; (ii) litigation or settlement of claims arising from

the performance of this contract; or, (iii) costs and expenses of this contract to which the

HA, HUD, or Comptroller General or any of their duly authorized representatives has taken exception shall continue until disposition of such appeals, litigation, claims, or exceptions.

5. Rights in Data (Ownership and Proprietary Interest)

The HA shall have exclusive ownership of, all proprietary interest in, and the right to full and exclusive possession of all information, materials and documents discovered or produced by Contractor pursuant to the terms of this Contract, including but not limited to reports, memoranda or letters concerning the research and reporting tasks of this Contract.

6. Energy Efficiency

The contractor shall comply with all mandatory standards and policies relating to energy efficiency which are contained in the energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub.L. 94-163) for the State in which the work under this contract is performed.

7. Disputes

(a) All disputes arising under or relating to this contract, except for disputes arising under clauses contained in Section III, Labor Standards Provisions, including any claims for damages for the alleged breach there of which are not disposed of by agreement, shall be resolved under this clause.

(b) All claims by the Contractor shall be made in writing and submitted to the HA. A claim by the HA against the Contractor shall be subject to a written decision by the HA.

(c) The HA shall, with reasonable promptness, but in no event in no more than 60 days, render a decision concerning any claim hereunder. Unless the Contractor, within 30 days after receipt of the HA's decision, shall notify the HA in writing that it takes exception to such decision, the decision shall be final and conclusive.

(d) Provided the Contractor has (i) given the notice within the time stated in paragraph (c) above, and (ii) excepted its claim relating to such decision from the final release, and (iii) brought suit against the HA not later than one year after receipt of final payment, or if final payment has not been made, not later than one year after the Contractor has had a reasonable time to respond to a written request by the HA that it submit a final voucher and release, whichever is earlier, then the HA's decision shall not be final or conclusive, but the dispute shall be determined on the merits by a court of competent jurisdiction.

(e) The Contractor shall proceed diligently with performance of this contract, pending final resolution of any request for relief, claim, appeal, or action arising under the contract, and comply with any decision of the HA.

8. Contract Termination; Debarment

A breach of these Contract clauses may be grounds for termination of the Contract and for debarment or denial of participation in HUD programs as a Contractor and a subcontractor as provided in 24 CFR Part 24.

9. Assignment of Contract

The Contractor shall not assign or transfer any interest in this contract; except that claims for monies due or to become due from the HA under the contract may be assigned to a bank, trust company, or other financial institution. If the Contractor is a partnership, this contract shall inure to the benefit of the surviving or remaining member(s) of such partnership approved by the HA.

10. Certificate and Release

Prior to final payment under this contract, or prior to settlement upon termination of this contract, and as a condition precedent thereto, the Contractor shall execute and deliver to the HA a certificate and release, in a form acceptable to the HA, of all claims against the HA by the Contractor under and by virtue of this contract, other than such claims, if any, as may be specifically excepted by the Contractor in stated amounts set forth therein.

11. Organizational Conflicts of Interest

(a) The Contractor warrants that to the best of its knowledge and belief and except as otherwise disclosed, it does not have any organizational conflict of interest which is defined as a situation in which the nature of work under this contract and a contractor's organizational, financial, contractual or other interests are such that: (i) Award of the contract may result in an unfair

competitive advantage; or (ii) The Contractor's objectivity in performing the contract

work may be impaired. (b) The Contractor agrees that if after award it discovers an

organizational conflict of interest with respect to this contract or any task/delivery order under the contract, he or she shall make an immediate and full disclosure in writing to the Contracting Officer which shall include a description of the action which the Contractor has taken or intends to take to eliminate or neutralize the conflict. The HA may, however, terminate the contract or task/delivery order for the convenience of the HA if it would be in the best interest of the HA.

(c) In the event the Contractor was aware of an organizational conflict of interest before the award of this contract and intentionally did not disclose the conflict to the Contracting Officer, the HA may terminate the contract for default.

(d) The terms of this clause shall be included in all subcontracts and consulting agreements wherein the work to be performed is similar to the service provided by the prime Contractor. The Contractor shall include in such subcontracts and consulting agreements any necessary provisions to eliminate or neutralize conflicts of interest.

12. Inspection and Acceptance

(a) The HA has the right to review, require correction, if necessary, and accept the work products produced by the Contractor. Such review(s) shall be carried out within 30 days so as to not impede the work of the Contractor. Any


product of work shall be deemed accepted as submitted if the HA does not issue written comments and/or required corrections within 30 days from the date of receipt of such product from the Contractor.

(b) The Contractor shall make any required corrections promptly at no additional charge and return a revised copy of the product to the HA within 7 days of notification or a later date if extended by the HA.

(c) Failure by the Contractor to proceed with reasonable promptness to make necessary corrections shall be a default. If the Contractor's submission of corrected work remains unacceptable, the HA may terminate this contract (or the task order involved) or reduce the contract price or cost to reflect the reduced value of services received.

13. Interest of Members of Congress

No member of or delegate to the Congress of the United States of America or Resident Commissioner shall be admitted to any

share or part of this contract or to any benefit to arise there from, but this provision shall not be construed to extend to this contract if made with a corporation for its general benefit.

14. Interest of Members, Officers, or Employees and Former Members, Officers, or Employees

No member, officer, or employee of the HA, no member of the governing body of the locality in which the project is situated, no member of the governing body in which the HA was activated, and no other pubic official of such locality or localities who exercises any functions or responsibilities with respect to the project, shall, during his or her tenure, or for one year thereafter, have any interest, direct or indirect, in this contract or the proceeds thereof.

15. Limitation on Payments to Influence Certain Federal Transactions

(a) Definitions. As used in this clause: "Agency", as defined in 5 U.S.C. 552(f), includes Federal

executive departments and agencies as well as independent regulatory commissions and Government corporations, as defined in 31 U.S.C. 9101(1).

"Covered Federal Action" means any of the following Federal actions:

(i) The awarding of any Federal contract; (ii) The making of any Federal grant; (iii) The making of any Federal loan; (iv) The entering into of any cooperative agreement; and, (v) The extension, continuation, renewal, amendment, or

modification of any Federal contract, grant, loan, or cooperative agreement.

Covered Federal action does not include receiving from an agency a commitment providing for the United States to insure or guarantee a loan.

"Indian tribe" and "tribal organization" have the meaning provided in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450B). Alaskan Natives are included under the definitions of Indian tribes in that Act.

"Influencing or attempting to influence" means making, with the intent to influence, any communication to or appearance before an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any covered Federal action.

"Local government" means a unit of government in a State and, if chartered, established, or otherwise recognized by a State for the performance of a governmental duty, including a local public authority, a special district, an intrastate district, a council of governments, a sponsor group representative organization, and any other instrumentality of a local government.

"Officer or employee of an agency" includes the following individuals who are employed by an agency:

(i) An individual who is appointed to a position in the Government under title 5, U.S.C., including a position under a temporary appointment;

(ii) A member of the uniformed services as defined in section 202, title 18, U.S.C.;

(iii) A special Government employee as defined in section 202, title 18, U.S.C.; and,

(iv) An individual who is a member of a Federal advisory committee, as defined by the Federal Advisory Committee Act, title 5, appendix 2.

“Person" means an individual, corporation, company, association, authority, firm, partnership, society, State, and local government, regardless of whether such entity is operated for profit or not for profit. This term excludes an Indian tribe, tribal organization, or other Indian organization with respect to expenditures specifically permitted by other Federal law.

"Recipient" includes all contractors, subcontractors at any tier, and subgrantees at any tier of the recipient of funds received in connection with a Federal contract, grant, loan, or cooperative agreement. The term excludes an Indian tribe, tribal organization, or any other Indian organization with respect to expenditures specifically permitted by other Federal law.

"Regularly employed means, with respect to an officer or employee of a person requesting or receiving a Federal contract, grant, loan, or cooperative agreement, an officer or employee who is employed by such person for at least 130 working days within one year immediately preceding the date of the submission that initiates agency consideration of such person for receipt of such contract, grant, loan, or cooperative agreement. An officer or employee who is employed by such person for less than 130 working days within one year immediately preceding the date of submission that initiates agency consideration of such person shall be considered to be regularly employed as soon as he or she is employed by such person for 130 working days.

"State" means a State of the United States, the District of Columbia, the Commonwealth of Puerto Rico, a territory or possession of the United States, an agency or instrumentality of a State, and a multi-State, regional, or interstate entity having governmental duties and powers. (b) Prohibition.

(i) Section 1352 of title 31, U.S.C. provides in part that no appropriated funds may be expended by the recipient of a Federal contract, grant, loan, or cooperative agreement to pay any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any of the following covered Federal actions: the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(ii) The prohibition does not apply as follows:


(1) Agency and legislative liaison by Own Employees.

(a) The prohibition on the use of appropriated funds, in paragraph (i) of this section, does not apply in the case of a payment of reasonable compensation made to an officer or employee of a person requesting or receiving a Federal contract, grant, loan, or cooperative agreement, if the payment is for agency and legislative activities not directly related to a covered Federal action.

(b) For purposes of paragraph (b)(i)(1)(a) of this clause, providing any information specifically requested by an agency or Congress is permitted at any time.

(c) The following agency and legislative liaison activities are permitted at any time only where they are not related to a specific solicitation for any covered Federal action:

(1) Discussing with an agency (including individual demonstrations) the qualities and characteristics of the person's products or services, conditions or terms of sale, and service capabilities; and,

(2) Technical discussions and other activities regarding the application or adaptation of the person's products or services for an agency's use.

(d) The following agency and legislative liaison activities are permitted where they are prior to formal solicitation of any covered Federal action:

(1) Providing any information not specifically requested but necessary for an agency to make an informed decision about initiation of a covered Federal action;

(2) Technical discussions regarding the preparation of an unsolicited proposal prior to its official submission; and

(3) Capability presentations by persons seeking awards from an agency pursuant to the provisions of the Small Business Act, as amended by Public Law 95-507 and other subsequent amendments.

(e) Only those activities expressly authorized by subdivision (b)(ii)(1)(a) of this clause are permitted under this clause.

(2) Professional and technical services. (a) The prohibition on the use of appropriated

funds, in subparagraph (b)(i) of this clause, does not apply in the case of-

(i) A payment of reasonable compensation made to an officer or employee of a person requesting or receiving a covered Federal action or an extension, continuation, renewal, amendment, or modification of a covered Federal action, if payment is for professional or technical services rendered directly in the preparation, submission, or negotiation of any bid, proposal, or application for that Federal action or for meeting requirements imposed by or pursuant to law as a condition for receiving that Federal action.

(ii) Any reasonable payment to a person, other than an officer or employee of a

person requesting or receiving a covered Federal action or an extension, continuation, renewal, amendment, or modification of a covered Federal action if the payment is for professional or technical services rendered directly in the preparation, submission, or negotiation of any bid, proposal, or application for that Federal action or for meeting requirements imposed by or pursuant to law as a condition for receiving that Federal action. Persons other than officers or employees of a person requesting or receiving a covered Federal action include consultants and trade associations.

(b) For purposes of subdivision (b)(ii)(2)(a) of clause, "professional and technical services" shall be limited to advice and analysis directly applying any professional or technical discipline.

(c) Requirements imposed by or pursuant to law as a condition for receiving a covered Federal award include those required by law or regulation, or reasonably expected to be required by law or regulation, and any other requirements in the actual award

documents. (d) Only those services expressly authorized by

subdivisions (b)(ii)(2)(a)(i) and (ii) of this section are permitted under this clause.

(iii) Selling activities by independent sales representatives.

(c) The prohibition on the use of appropriated funds, in subparagraph (b)(i) of this clause, does not apply to the following selling activities before an agency by independent sales representatives, provided such activities are prior to formal solicitation by an agency and are specifically limited to the merits of the matter: (i) Discussing with an agency (including individual

demonstration) the qualities and characteristics of the person's products or services, conditions or terms of sale, and service capabilities; and

(ii) Technical discussions and other activities regarding the application or adaptation of the person's products or services for an agency's use.

(d) Agreement. In accepting any contract, grant, cooperative agreement, or loan resulting from this solicitation, the person submitting the offer agrees not to make any payment prohibited by this clause.

(e) Penalties. Any person who makes an expenditure prohibited under paragraph (b) of this clause shall be subject to civil penalties as provided for by 31 U.S.C. 1352. An imposition of a civil penalty does not prevent the Government from seeking any other remedy that may be applicable.

(f) Cost Allowability. Nothing in this clause is to be interpreted to make allowable or reasonable any costs which would be unallowable or unreasonable in accordance with Part 31 of the Federal Acquisition Regulation (FAR), or OMB Circulars dealing with cost allowability for recipients of assistance agreements. Conversely, costs made specifically unallowable by the requirements in this clause will not be made allowable under any of the provisions of FAR Part 31 or the relevant OMB Circulars.


16. Equal Employment Opportunity

During the performance of this contract, the Contractor agrees as follows:

(a) The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin.

(b) The Contractor shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to (1) employment; (2) upgrading; (3) demotion; (4) transfer; (5) recruitment or recruitment advertising; (6) layoff or termination; (7) rates of pay or other forms of compensation; and (8) selection for training, including apprenticeship.

(c) The Contractor shall post in conspicuous places available to employees and applicants for employment the notices to be provided by the Contracting Officer that explain this clause.

(d) The Contractor shall, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin.

(e) The Contractor shall send, to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, the notice to be provided by the Contracting Officer advising the labor union or workers' representative of the Contractor's commitments under this clause, and post copies of the notice in conspicuous places available to employees and applicants for employment.

(f) The Contractor shall comply with Executive Order 11246, as amended, and the rules, regulations, and orders of the Secretary of Labor.

(g) The Contractor shall furnish all information and reports required by Executive Order 11246, as amended and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto. The Contractor shall permit access to its books, records, and accounts by the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders.

(h) In the event of a determination that the Contractor is not in compliance with this clause or any rule, regulation, or order of the Secretary of Labor, this contract may be canceled, terminated, or suspended in whole or in part, and the Contractor may be declared ineligible for further Government contracts, or federally assisted construction contracts under the procedures authorized in Executive Order 11246, as amended. In addition, sanctions may be imposed and remedies invoked against the Contractor as provided in Executive Order 11246, as amended, the rules, regulations, and orders of the Secretary of Labor, or as otherwise provided by law.

(i) The Contractor shall include the terms and conditions of this clause in every subcontract or purchase order unless exempted by the rules, regulations, or orders of the Secretary of Labor issued under Executive Order 11246, as amended, so that these terms and conditions will be binding upon each subcontractor or vendor. The Contractor shall take such action with respect to any subcontractor or purchase order as the Secretary of Housing and Urban Development or the Secretary of Labor may direct as a means of enforcing such provisions, including sanctions for noncompliance; provided that if the

Contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction, the Contractor may request the United States to enter into the litigation to protect the interests of the United States.

17. Dissemination or Disclosure of Information

No information or material shall be disseminated or disclosed to the general public, the news media, or any person or organization without prior express written approval by the HA.

18. Contractor's Status

It is understood that the Contractor is an independent contractor and is not to be considered an employee of the HA, or assume any right, privilege or duties of an employee, and shall save harmless the HA and its employees from claims suits, actions and costs of every description resulting from the Contractor's activities on behalf of the HA in connection with this Agreement.

19. Other Contractors

HA may undertake or award other contracts for additional work at or near the site(s) of the work under this contract. The contractor shall fully cooperate with the other contractors and with HA and HUD employees and shall carefully adapt scheduling and performing the work under this contract to accommodate the additional work, heeding any direction that may be provided by the Contracting Officer. The contractor shall not commit or permit any act that will interfere with the performance of work by any other contractor or HA employee.

20. L i e n s

The Contractor is prohibited from placing a lien on HA's property. This prohibition shall apply to all subcontractors.

21. Training and Employment Opportunities for Residents in the Project Area (Section 3, HUD Act of 1968; 24 CFR 135)

(a) The work to be performed under this contract is subject to the requirements of section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3). The purpose of section 3 is to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted projects covered by section 3, shall, to the greatest extent feasible, be directed to low- and very low-income persons, particularly persons who are recipients of HUD assistance for housing.

(b) The parties to this contract agree to comply with HUD's regulations in 24 CFR Part 135, which implement section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are under no contractual or other impediment that would prevent them from complying with the Part 135 regulations.

(c) The contractor agrees to send to each labor organization or representative of workers with which the contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor organization or workers' representative of the contractor's commitments under this section 3 clause, and will post copies of the notice in conspicuous places at the work site where both employees and applicants for training and employment positions can see the notice. The notice shall describe the section 3 preference, shall set forth minimum number and job titles subject to hire, availability of


apprenticeship and training positions, the qualifications for each; and the name and location of the person(s) taking applications for each of the positions; and the anticipated date the work shall begin.

(d) The contractor agrees to include this section 3 clause in every subcontract subject to compliance with regulations in 24 CFR Part 135, and agrees to take appropriate action, as provided in an applicable provision of the subcontract or in this section 3 clause, upon a finding that the subcontractor is in violation of the regulations in 24 CFR Part 135. The contractor will not subcontract with any subcontractor where the contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24 CFR Part 135.

(e) The contractor will certify that any vacant employment positions, including training positions, that are filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than those to whom the regulations of 24 CFR Part 135 require employment opportunities to be directed, were not filled to circumvent the contractor's obligations under 24 CFR Part 135.

(f) Noncompliance with HUD's regulations in 24 CFR Part 135 may result in sanctions, termination of this contract for default, and debarment or suspension from future HUD assisted contracts.

22. Procurement of Recovered Materials

(a) In accordance with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, the Contractor shall procure items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition. The Contractor shall procure items designated in the EPA guidelines that contain the highest percentage of recovered materials practicable unless the Contractor determines that such items: (1) are not reasonably available in a reasonable period of time; (2) fail to meet reasonable

performance standards, which shall be determined on the basis of the guidelines of the National Institute of Standards and Technology, if applicable to the item; or (3) are only available at an unreasonable price.

(b) Paragraph (a) of this clause shall apply to items purchased under this contract where: (1) the Contractor purchases in excess of $10,000 of the item under this contract; or (2) during the preceding Federal fiscal year, the Contractor: (i) purchased any amount of the items for use under a contract that was funded with Federal appropriations and was with a Federal agency or a State agency or agency of a political subdivision of a State; and (ii) purchased a total of in excess of $10,000 of the item both under and outside that contract.

40

SECTION M

LIST OF DOCUMENTS AND OTHER ATTACHMENTS

(all listed attachments are at the end of this document)

ATTACH NO. TITLE

1. Vendor Qualification Form and attachments (W9 Form, Section 3 Business Concern Affidavit)

2. Disclosure of Lobbying Activities

41

SECTION N

REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS

1. REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS

See HUD Form 5369C immediately following this section.

2. NON-COLLUSIVE AFFIDAVIT (applicable to contracts for construction and equipment exceeding $50,000)

In making its offer, the offeror represents that such proposal is genuine and not collusive or sham; that said

offeror has not colluded, conspired, connived, or agreed, directly or indirectly, with any offeror or person, to

put in a sham proposal or to refrain from offering, and has not in any manner directly or indirectly sought by

agreement or collusion or communication or conference, with any person, to fix the proposed price of affiant

or of any other offeror, or to fix any overhead, profit or cost element of said price or of that of any other

offeror, or to secure any advantage against the Denver Housing Authority or any person interested in the

proposed contract; and that all statements in said proposal are true.

3. DISCLOSURE OF LOBBYING ACTIVITIES - SF FORM LLL (applicable to contracts exceeding $100,000)

Refer to Representations, Certifications, and Other Statements of Offerors/Bidders for applicability.

4. WORKER STATUS CERTIFICATION

The Offeror certifies the following:

A. At present, the Offeror does not knowingly employ or contract with an illegal alien who will

perform work under this contract.

B. The Offeror shall not, hereafter, knowingly employ or contract with an illegal alien to perform

work under this contract.

C. The Offeror shall not, hereafter, enter into a contract with a subcontractor that fails to certify to the

Offeror that the subcontractor shall not knowingly employ or contract with an illegal alien to

perform work under this contract.

D. The Offeror will participate in the E-Verify Program, as defined in C.R.S. § 8-17.5-101(3.7), or

the Colorado Department of Labor and Employment Program (“Department Program”), as defined

in C.R.S. § 8-17.5-101(3.3), in order to confirm the employment eligibility of all employees who

are newly hired for employment to perform work under this contract.

E. The Offeror has confirmed the employment eligibility of all employees who are newly hired for

employment to perform work under this contract.

5. BUSINESS ENTERPRISE CERTIFICATION

The Offeror is a (Check all that apply):

Small Business Enterprise

A small business enterprise is defined as a business, which is: independently owned; not

dominant in its field of operation; and not an affiliate or subsidiary of a business dominant in its

field of operation. The size standards in 13 CFR 121 shall be used unless the Authority

determines that their use is inappropriate.

Minority-Owned Business Enterprise

A minority-owned business enterprise is defined as a business which is at least 51% owned by one

or more minority group members; or, in the case of a publicly-owned business, one in which at

42

least 51% of its voting stock is owned by one or more minority group members, and whose

management and daily business operations are controlled by one or more such individuals.

Minority group members include, but are not limited to Black Americans, Hispanic Americans,

Native Americans, Asian Pacific Americans and Asian Americans.

Women’s Business Enterprise

A women’s business enterprise is defined as a business that is at least 51% owned by a woman or

women who are U.S. citizens and who also control or operate the business.

form HUD-5369-C (8/93)ref. Handbook 7460.8Previous edition is obsolete page 1 of 2

1. Contingent Fee Representation and Agreement

(a) The bidder/offeror represents and certifies as part of its bid/offer that, except for full-time bona fide employees workingsolely for the bidder/offeror, the bidder/offeror:

(1) [ ] has, [ ] has not employed or retained any person orcompany to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any personor company employed or retained to solicit or obtain thiscontract any commission, percentage, brokerage, or otherfee contingent upon or resulting from the award of thiscontract.

(b) If the answer to either (a)(1) or (a) (2) above is affirmative,the bidder/offeror shall make an immediate and full writtendisclosure to the PHA Contracting Officer.

(c) Any misrepresentation by the bidder/offeror shall give thePHA the right to (1) terminate the resultant contract; (2) at itsdiscretion, to deduct from contract payments the amount of anycommission, percentage, brokerage, or other contingent fee; or(3) take other remedy pursuant to the contract.

2. Small, Minority, Women-Owned Business Concern Rep-resentation

The bidder/offeror represents and certifies as part of its bid/ offerthat it:

(a) [ ] is, [ ] is not a small business concern. “Small businessconcern,” as used in this provision, means a concern, includ-ing its affiliates, that is independently owned and operated,not dominant in the field of operation in which it is bidding,and qualified as a small business under the criteria and sizestandards in 13 CFR 121.

(b) [ ] is, [ ] is not a women-owned small business concern.“Women-owned,” as used in this provision, means a smallbusiness that is at least 51 percent owned by a woman orwomen who are U.S. citizens and who also control andoperate the business.

(c) [ ] is, [ ] is not a minority enterprise which, pursuant toExecutive Order 11625, is defined as a business which is atleast 51 percent owned by one or more minority groupmembers or, in the case of a publicly owned business, at least51 percent of its voting stock is owned by one or moreminority group members, and whose management and dailyoperations are controlled by one or more such individuals.

For the purpose of this definition, minority group members are:

(Check the block applicable to you)

[ ] Black Americans [ ] Asian Pacific Americans

[ ] Hispanic Americans [ ] Asian Indian Americans

[ ] Native Americans [ ] Hasidic Jewish Americans

3. Certificate of Independent Price Determination

(a) The bidder/offeror certifies that—

(1) The prices in this bid/offer have been arrived at indepen-dently, without, for the purpose of restricting competi-tion, any consultation, communication, or agreementwith any other bidder/offeror or competitor relating to (i)those prices, (ii) the intention to submit a bid/offer, or(iii) the methods or factors used to calculate the pricesoffered;

(2) The prices in this bid/offer have not been and will not beknowingly disclosed by the bidder/offeror, directly orindirectly, to any other bidder/offeror or competitor be-fore bid opening (in the case of a sealed bid solicitation)or contract award (in the case of a negotiated solicitation)unless otherwise required by law; and

(3) No attempt has been made or will be made by the bidder/offeror to induce any other concern to submit or not tosubmit a bid/offer for the purpose of restricting competition.

(b) Each signature on the bid/offer is considered to be a certifi-cation by the signatory that the signatory:

(1) Is the person in the bidder/offeror’s organization respon-sible for determining the prices being offered in this bidor proposal, and that the signatory has not participatedand will not participate in any action contrary to subpara-graphs (a)(l) through (a)(3) above; or

(2) (i) Has been authorized, in writing, to act as agent for thefollowing principals in certifying that those principalshave not participated, and will not participate in anyaction contrary to subparagraphs (a)(l) through (a)(3)above (insert full name of person(s) in the bidder/offeror’sorganization responsible for determining the prices of-fered in this bid or proposal, and the title of his or herposition in the bidder/offeror’s organization);

(ii) As an authorized agent, does certify that the princi-pals named in subdivision (b)(2)(i) above have not par-ticipated, and will not participate, in any action contraryto subparagraphs (a)(l) through (a)(3) above; and

U.S. Department of Housingand Urban DevelopmentOffice of Public and Indian Housing

Certifications andRepresentationsof OfferorsNon-Construction Contract

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searchingexisting data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

This form includes clauses required by OMB’s common rule on bidding/offering procedures, implemented by HUD in 24 CFR 85.36, and those requirementsset forth in Executive Order 11625 for small, minority, women-owned businesses, and certifications for independent price determination, and conflict of interest.The form is required for nonconstruction contracts awarded by Housing Agencies (HAs). The form is used by bidders/offerors to certify to the HA's ContractingOfficer for contract compliance. If the form were not used, HAs would be unable to enforce their contracts. Responses to the collection of information arerequired to obtain a benefit or to retain a benefit. The information requested does not lend itself to confidentiality.

form HUD-5369-C (8/93)ref. Handbook 7460.8Previous edition is obsolete page 2 of 2

(iii) As an agent, has not personally participated, and willnot participate in any action contrary to subparagraphs(a)(l) through (a)(3) above.

(c) If the bidder/offeror deletes or modifies subparagraph (a)2above, the bidder/offeror must furnish with its bid/offer asigned statement setting forth in detail the circumstances ofthe disclosure.

4. Organizational Conflicts of Interest Certification

(a) The Contractor warrants that to the best of its knowledge andbelief and except as otherwise disclosed, it does not have anyorganizational conflict of interest which is defined as asituation in which the nature of work under a proposedcontract and a prospective contractor’s organizational, fi-nancial, contractual or other interest are such that:

(i) Award of the contract may result in an unfair competi-tive advantage;

(ii) The Contractor’s objectivity in performing the con-tract work may be impaired; or

(iii) That the Contractor has disclosed all relevant infor-mation and requested the HA to make a determinationwith respect to this Contract.

(b) The Contractor agrees that if after award he or she discoversan organizational conflict of interest with respect to thiscontract, he or she shall make an immediate and full disclo-sure in writing to the HA which shall include a description ofthe action which the Contractor has taken or intends toeliminate or neutralize the conflict. The HA may, however,terminate the Contract for the convenience of HA if it wouldbe in the best interest of HA.

(c) In the event the Contractor was aware of an organizationalconflict of interest before the award of this Contract andintentionally did not disclose the conflict to the HA, the HAmay terminate the Contract for default.

(d) The Contractor shall require a disclosure or representationfrom subcontractors and consultants who may be in a positionto influence the advice or assistance rendered to the HA andshall include any necessary provisions to eliminate or neutralizeconflicts of interest in consultant agreements or subcontractsinvolving performance or work under this Contract.

5. Authorized Negotiators (RFPs only)

The offeror represents that the following persons are authorizedto negotiate on its behalf with the PHA in connection with thisrequest for proposals: (list names, titles, and telephone numbersof the authorized negotiators):

6. Conflict of Interest

In the absence of any actual or apparent conflict, the offeror, bysubmission of a proposal, hereby warrants that to the best of itsknowledge and belief, no actual or apparent conflict of interestexists with regard to my possible performance of this procure-ment, as described in the clause in this solicitation titled “Orga-nizational Conflict of Interest.”

7. Offeror's Signature

The offeror hereby certifies that the information contained inthese certifications and representations is accurate, complete,and current.

Signature & Date:

Typed or Printed Name:

Title:

43

ATTACHMENTS (PER SECTION M)

Please see attached documents

VENDOR QUALIFICATION FORM All questions must be answered and the data given must be clear and comprehensive.

Please PRINT or TYPE 1. Legal Business Name: __________________________________________________________ DBA Name, if applicable: _______________________________________________________ (DBA-Doing Business As) (if more than one location, please list all locations) 2. Business Office Address (1):___________________________________________________ Second Address: _____________________________________________________________ City, State, Zip: _____________________________________________________________ Phone Number /Area Code: ___________________________________________________ Fax Number /Area Code______________________________________________________ Email Address: _____________________________________________________________ (Local Contact person): Name: _____________________________________________________________________ Phone number/area code: _____________________________________________________ 3. Registered agent or other person authorized to accept service of process: Name: ______________________________________________________________________ Address (if different than above):_______________________________________________ _______________________________________________ _______________________________________________ 4. Remittance address if different than above: _____________________________________________________________________________ Phone number/area code: _______________Fax number/area code: ___________________ Email Address: ________________________________________________________________

1

777 Grant Street · Denver, CO 80203 720-932-3070 · Fax: 720-932-3007 · [email protected]

THACCD #238 (Rev 6/11)


2

5. Effective Date Business Organized? ________________________________________________ 6. Business Status: _____Corporation _____ Partnership _____ Individual/Sole proprietor _____Other. Please describe_____________________ 7. How many years have you been engaged in the business under your present name?

_____________________ 8. What other names(s) if any has your business/company operated under and taxpayer number

used? ________________________________________________________________________________ ________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________

9. Have you ever refused to sign a contract? yes ( ) no ( ). If "yes", attach explanation. 10. List and state the background and experience of the principal members of your personnel,

including all officers (include attachments if necessary).

______________________________________________________________________________ ________________________________________________________________________________ ______________________________________________________________________________ ________________________________________________________________________________

11. Has any officer or partner of your organization ever been an officer or partner of another organization that failed to complete a contract within the last five (5) years? yes ( ) no( ). If "yes", attach explanation. 12. Has the firm or any partner or officers ever been involved in any bankruptcy action? yes ( ) no ( ). If "yes", attach explanation. 13. Are you presently involved in litigation with an owner, architect or engineer? yes( ) no( ) If "yes" explain type, kind, plaintiff, defendant, etc., and state the current status and attach to this form. 14. Will you, upon request, furnish any other information that may be required by the Housing

Authority of the City and County of Denver Colorado? yes ( ) no ( ). If "no", attach explanation.

15. Please list the names of your personnel authorized to sign legal and binding proposal and

contract documents. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ________________________________________________________________________________


3

16. List three (3) companies including address, phone number, email address, and contact person that you are currently supplying goods or services to. 1. Name of Firm _______________________________________________________________ Address ______________________________________________________________________ City/State/Zip__________________________________________________________________ Contact person: __________________________ Phone Number ________________________ Email address: ________________________________________________________________ 2. Name of Firm _______________________________________________________________ Address ______________________________________________________________________ City/State/Zip__________________________________________________________________ Contact person: _________________________ Phone Number_________________________ Email address: ________________________________________________________________ 3. Name of Firm _______________________________________________________________ Address ______________________________________________________________________ City/State/Zip__________________________________________________________________ Contact person: _______________________ Phone Number___________________________ Email Address: ________________________________________________________________ 17. To Comply with Executive Order No. 11246 of September 24, 1965, please indicate whether

your firm is a minority vendor _____ Black Male _____ Black Female _____ Asian Male _____ Asian Female _____ Hispanic Male _____ Hispanic Female _____ American Indian Male _____ American Indian Female _____ Women Owned

*Prior to contract award, a Business Enterprise Affidavit must be completed and notarized to validate business enterprise status.


4

18. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish

any information requested by the Housing Authority of the City and County of Denver to verify the foregoing information.

Name of Vendor: ____________________________________________________________________________________ By: __________________________________ Title: _________________________________________ ______________________________________ __________________________ Signature Date

THE NEXT PAGE (W-9) MUST BE COMPLETED IN ORDER TO BECOME A QUALIFIED VENDOR


Form W-9(Rev. December 2011)Department of the Treasury Internal Revenue Service

Request for Taxpayer Identification Number and Certification

Give Form to the requester. Do not send to the IRS.

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2.

Name (as shown on your income tax return)

Business name/disregarded entity name, if different from above

Check appropriate box for federal tax classification:

Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶

Other (see instructions) ▶

Exempt payee

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Requester’s name and address (optional)

List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.

Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.

Social security number

– –

Employer identification number

–

Part II CertificationUnder penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am a U.S. citizen or other U.S. person (defined below).

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4.

Sign Here

Signature of U.S. person ▶ Date ▶

General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.

Purpose of FormA person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA.

Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.

Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien,

• A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States,

• An estate (other than a foreign estate), or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.

Cat. No. 10231X Form W-9 (Rev. 12-2011)

Form W-9 (Rev. 12-2011) Page 2

The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases:

• The U.S. owner of a disregarded entity and not the entity,

• The U.S. grantor or other owner of a grantor trust and not the trust, and

• The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust.

Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities).

Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items:

1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption from tax.

5. Sufficient facts to justify the exemption from tax under the terms of the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption.

If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8.

What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.

Payments you receive will be subject to backup withholding if:

1. You do not furnish your TIN to the requester,

2. You do not certify your TIN when required (see the Part II instructions on page 3 for details),

3. The IRS tells the requester that you furnished an incorrect TIN,

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or

5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).

Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9.

Also see Special rules for partnerships on page 1.

Updating Your InformationYou must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies.

PenaltiesFailure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.

Specific InstructionsNameIf you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name.

If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form.

Sole proprietor. Enter your individual name as shown on your income tax return on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name/disregarded entity name” line.

Partnership, C Corporation, or S Corporation. Enter the entity's name on the “Name” line and any business, trade, or “doing business as (DBA) name” on the “Business name/disregarded entity name” line.

Disregarded entity. Enter the owner's name on the “Name” line. The name of the entity entered on the “Name” line should never be a disregarded entity. The name on the “Name” line must be the name shown on the income tax return on which the income will be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a domestic owner, the domestic owner's name is required to be provided on the “Name” line. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on the “Business name/disregarded entity name” line. If the owner of the disregarded entity is a foreign person, you must complete an appropriate Form W-8.

Note. Check the appropriate box for the federal tax classification of the person whose name is entered on the “Name” line (Individual/sole proprietor, Partnership, C Corporation, S Corporation, Trust/estate).

Limited Liability Company (LLC). If the person identified on the “Name” line is an LLC, check the “Limited liability company” box only and enter the appropriate code for the tax classification in the space provided. If you are an LLC that is treated as a partnership for federal tax purposes, enter “P” for partnership. If you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation, enter “C” for C corporation or “S” for S corporation. If you are an LLC that is disregarded as an entity separate from its owner under Regulation section 301.7701-3 (except for employment and excise tax), do not check the LLC box unless the owner of the LLC (required to be identified on the “Name” line) is another LLC that is not disregarded for federal tax purposes. If the LLC is disregarded as an entity separate from its owner, enter the appropriate tax classification of the owner identified on the “Name” line.


Other entities. Enter your business name as shown on required federal tax documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name/disregarded entity name” line.

Exempt Payee If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the “Exempt payee” box in the line following the “Business name/disregarded entity name,” sign and date the form.

Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends.

Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding.

The following payees are exempt from backup withholding:

1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2),

2. The United States or any of its agencies or instrumentalities,

3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities,

4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or

5. An international organization or any of its agencies or instrumentalities.

Other payees that may be exempt from backup withholding include:

6. A corporation,

7. A foreign central bank of issue,

8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States,

9. A futures commission merchant registered with the Commodity Futures Trading Commission,

10. A real estate investment trust,

11. An entity registered at all times during the tax year under the Investment Company Act of 1940,

12. A common trust fund operated by a bank under section 584(a),

13. A financial institution,

14. A middleman known in the investment community as a nominee or custodian, or

15. A trust exempt from tax under section 664 or described in section 4947.

The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 15.

IF the payment is for . . . THEN the payment is exempt for . . .

Interest and dividend payments All exempt payees except for 9

Broker transactions Exempt payees 1 through 5 and 7 through 13. Also, C corporations.

Barter exchange transactions and patronage dividends

Exempt payees 1 through 5

Payments over $600 required to be reported and direct sales over $5,000 1

Generally, exempt payees 1 through 7 2

1 See Form 1099-MISC, Miscellaneous Income, and its instructions.2 However, the following payments made to a corporation and reportable on Form

1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney, and payments for services paid by a federal executive agency.

Part I. Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN.

If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN.

Note. See the chart on page 4 for further clarification of name and TIN combinations.

How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester.

Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon.

Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8.

Part II. CertificationTo establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, below, and items 4 and 5 on page 4 indicate otherwise.

For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on the “Name” line must sign. Exempt payees, see Exempt Payee on page 3.

Signature requirements. Complete the certification as indicated in items 1 through 3, below, and items 4 and 5 on page 4.

1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification.

2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form.

3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.


4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations).

5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.

What Name and Number To Give the RequesterFor this type of account: Give name and SSN of:

1. Individual The individual2. Two or more individuals (joint

account)The actual owner of the account or, if combined funds, the first individual on the account 1

3. Custodian account of a minor (Uniform Gift to Minors Act)

The minor 2

4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law

The grantor-trustee 1

The actual owner 1

5. Sole proprietorship or disregarded entity owned by an individual

The owner 3

6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulation section 1.671-4(b)(2)(i)(A))

The grantor*

For this type of account: Give name and EIN of:

7. Disregarded entity not owned by an individual

The owner

8. A valid trust, estate, or pension trust Legal entity 4

9. Corporation or LLC electing corporate status on Form 8832 or Form 2553

The corporation

10. Association, club, religious, charitable, educational, or other tax-exempt organization

The organization

11. Partnership or multi-member LLC The partnership12. A broker or registered nominee The broker or nominee

13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

The public entity

14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section 1.671-4(b)(2)(i)(B))

The trust

1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished.

2 Circle the minor’s name and furnish the minor’s SSN.

3 You must show your individual name and you may also enter your business or “DBA” name on the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN.

4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1.

*Note. Grantor also must provide a Form W-9 to trustee of trust.

Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

Secure Your Tax Records from Identity TheftIdentity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund.

To reduce your risk:

• Protect your SSN,

• Ensure your employer is protecting your SSN, and

• Be careful when choosing a tax preparer.

If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter.

If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039.

For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance.

Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059.

Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft.

The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS, forward this message to [email protected]. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at: [email protected] or contact them at www.ftc.gov/idtheft or 1-877-IDTHEFT (1-877-438-4338).

Visit IRS.gov to learn more about identity theft and how to reduce your risk.

Privacy Act NoticeSection 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

SECTION 3 BUSINESS CONCERN AFFIDAVIT _________________________________________________________________________ AFFIDAVIT OF __________________________________ (Name) _________________________________________________________________________ STATE OF ) ) ss. COUNTY OF ) I, , first being duly sworn, state as follows: I am over the age of 18 years. 1. I am the ____________________________________________________(Title) of,

______________________________________________________ (Complete legal name of Company), which is located at __________________________________ _________________________________________________________________ _________________________________(Street Address, City, State, Zip Code).

2. ______________________________________________________(Name of

Company) is a _____________________________________________(Type of Business i.e. corporation, partnership, sole proprietorship, joint venture, limited liability company).

3. The Company is a Section 3 Business Concern as defined below (check all that

apply):

A business that is fifty-one percent (51%) or more owned by Section 3 residents; or

A business whose permanent, full-time employees include persons, at least thirty percent (30%) of whom are currently Section 3 residents, or within three (3) years of the date of first employment with the business concern were Section 3 residents; or

A business that provides evidence of a commitment to subcontract in excess of twenty-five percent (25%) of the dollar award of all subcontracts to be awarded to business concerns that meet the qualifications set forth in paragraphs (1) and (2) above.

4. I have read and understand the definitions contained herein. 5. The Company hereby agrees to provide within thirty (30) days, upon request, any

documents DHA requires to verify the information provided herein.

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6. I understand and acknowledge that the following penalties will apply if DHA determines that the Company has submitted a false Section 3 Business Concern Affidavit:

A. If discovered prior to any contract being awarded, the Company will be

ineligible for award of the contract, and will be permanently placed on the DHA debarment list; or

B. If discovered during the term of the contract, the contract will immediately be terminated, and the Company will be permanently placed on the DHA debarment list; or

C. If discovered after the completion of the contract, the Company will be permanently placed on the DHA debarment list.

7. I am the ____________________________________________________(Title)

of the Company, and I am authorized to execute this affidavit on its behalf, and to bind the Company regarding the matters contained herein. I have personal knowledge of the statements made in this affidavit and state that the same are true.

FURTHER Affiant sayeth naught. Signature Subscribed and sworn to before me this ___ day of ______________, 20___ by _______________________________________. WITNESS my hand and official seal. My commission expires: _________________________________________ _________________________________________ [SEAL]