important submittal information - pearlandisd.org · purchasing department at 281-485-3203. ... •...

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************ IMPORTANT SUBMITTAL INFORMATION ************ Please duplicate the appropriate label and affix to the outside of your sealed submittal envelope. Vendor’s name and return address should be printed on the submittal envelope. FOR U.S. MAIL FOR HAND DELIVERY/COURIER SERVICES It is your responsibility to meet the submittal requirements. We recommend that you verify the label data with the title page; the latter prevails. A PRE-PROPOSAL CONFERENCE to discuss the RFP, answer any questions or concerns, will be held on Thursday, April 5, 2018 at 10:00 a.m. and 1:30 p.m. at the ESC Boardroom, 1928 N Main, Pearland, TX 77581. Attending the pre-proposal conference is optional. For further information or directions, please contact the Purchasing Department at 281-485-3203. Please review Pearland ISD General Terms and Conditions at: http://www.pearlandisd.org/Page/194 PEARLAND ISD PURCHASING DEPARTMENT P O BOX 7 PEARLAND, TX 77588-0007 RFP #18-0419-15 – Catalog and Store/Shelf Discount DO NOT OPEN UNTIL: 3:00 p.m., April 19, 2018 PEARLAND ISD PURCHASING DEPARTMENT 1928 N. MAIN PEARLAND, TX 77581 RFP #18-0419-15 – Catalog and Store/Shelf Discount DO NOT OPEN UNTIL: 3:00 p.m., April 19, 2018 __________________________________________ ,,,/: _________ _ I------------------------------------------------------1 __________________________________________________ ;/:_ __ I------------------------------------------------------1

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************ IMPORTANT SUBMITTAL INFORMATION ************ Please duplicate the appropriate label and affix to the outside of your sealed submittal envelope. Vendor’s name and return address should be printed on the submittal envelope.

FOR U.S. MAIL

FOR HAND DELIVERY/COURIER SERVICES

It is your responsibility to meet the submittal requirements. We recommend that you verify the label data with the title page; the latter prevails. A PRE-PROPOSAL CONFERENCE to discuss the RFP, answer any questions or concerns, will be held on Thursday, April 5, 2018 at 10:00 a.m. and 1:30 p.m. at the ESC Boardroom, 1928 N Main, Pearland, TX 77581. Attending the pre-proposal conference is optional. For further information or directions, please contact the Purchasing Department at 281-485-3203.

Please review Pearland ISD General Terms and Conditions at: http://www.pearlandisd.org/Page/194

PEARLAND ISD PURCHASING DEPARTMENT P O BOX 7

PEARLAND, TX 77588-0007 RFP #18-0419-15 – Catalog and Store/Shelf Discount DO NOT OPEN UNTIL: 3:00 p.m., April 19, 2018

PEARLAND ISD PURCHASING DEPARTMENT 1928 N. MAIN

PEARLAND, TX 77581

RFP #18-0419-15 – Catalog and Store/Shelf Discount DO NOT OPEN UNTIL: 3:00 p.m., April 19, 2018

__________________________________________ ,,,/: _________ _

I ------------------------------------------------------1 __________________________________________________ ;/:_ __

I ------------------------------------------------------1

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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PURCHASING DEPARTMENT

1928 N. Main, Pearland, TX 77581 PO Box 7, Pearland, Texas 77588-0007 Phone 281-485-3203 / Fax 281-412-1306

March 21, 2018

NOTICE

Sealed Proposals addressed to the Pearland Independent School District, Attention: Enrique Kladis, Director of Purchasing, will be received in the Purchasing Department at 1928 N. Main, Pearland, Texas 77581 until:

3:00 p.m., April 19, 2018 for RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT Proposal submittal envelopes must be plainly marked with the RFP number, name and deadline. Please duplicate the label shown on the cover page and affix to the outside of your sealed submittal envelope. Any proposal received later than the specified time, whether delivered in person or mailed, shall be disqualified and returned to the vendor unopened. A PRE-PROPOSAL CONFERENCE to discuss the RFP, answer any questions or concerns, will be held on Thursday, April 5, 2018 at 10:00 a.m. and 1:30 p.m. at the ESC Boardroom, 1928 N Main, Pearland, TX 77581. Attending the pre-proposal conference is optional. For further information or directions, please contact the Purchasing Department at 281-485-3203. Pearland ISD reserves the right to reject any or all bids and to accept any bid deemed most advantageous to the Pearland Independent School District and to waive any informality. ___________________________________ Enrique Kladis, Director of Purchasing

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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DO NOT SEND ANY CATALOGS

WITH YOUR PROPOSAL.

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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NOTICE OF NO SUBMISSION FORM Dear Vendor:

Please check the appropriate box below, complete the remainder of this form and return it by the scheduled Date and Time: Our company cannot provide the products, supplies and/or services listed in this request. Please MOVE our name and address to the following category (ies) so that we may propose at a later date:

Category(ies):____________________________________________________ We have chosen NOT to submit a bid at this time, but would like to remain on your

list for this bid category. We did not submit a bid because: Reason(s):______________________________________________________

______________________________________________________

Please REMOVE our name from all Pearland ISD lists until further notice.

Reason(s):______________________________________________________

PLEASE RETURN THIS FORM TO: Pearland ISD Purchasing Department

Notice of "No-Submission" – RFP #18-0419-15 - CATALOG AND STORE/SHELF DISCOUNT

1928 N. Main Pearland, TX 77581 Company Name:________________________________________________________ Representative: (please print)_______________________________________________ Address: ______________________________________ Phone ( ) _______________ City:___________________________ State:______________________ Zip: _______ Authorized Signature:_____________________________________________________ Title:___________________________________________ Date:___________________ Thank you for your time and assistance. VENDORS WHO RESPOND TO THIS INVITATION WITH A COMPLETED BID FORM WILL REMAIN ON OUR MAILING LIST. VENDORS MAKING NO RESPONSE AT ALL WILL BE REMOVED FROM THAT LISTING.

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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GENERAL TERMS AND CONDITIONS

Please review Pearland ISD General Terms and Conditions at: http://www.pearlandisd.org/Page/194

SCOPE Pearland Independent School District is requesting competitive sealed proposals for discounts off catalog and store/shelf prices of the following items, including sole source vendor items:

Office Supplies, Equipment & Furniture

Groceries, Snacks & Paper Goods Promotional, Embroidery, and Screen Printing Products and Services

Health/Athletic Training Supplies Instructional Supplies/Teaching Aids & Printing Materials

Library/Classroom Books & Library Supplies

SPECIAL CONDITIONS

1. Firm prices are requested for the first year following the awarding of the proposal.

2. This agreement shall commence upon approval by Pearland ISD Board of Trustees, which is

anticipated on or about June 12, 2018 with an effective date of July 1, 2018 through June 30, 2019 with an option to extend, if agreed upon by the District and the Supplier, for additional four (4) one (1) year terms at the end of any subsequent one (1) year extension shall be agreed upon by both parties.

3. The District reserves the right to award to multiple vendors. 4. Awarded vendors may not assign this contract and/or may not subcontract to another party for

performance of the terms and conditions of this RFP. 5. Purchase Orders will be issued on an as-needed basis. The District will not be responsible for

any products and/or services rendered without a Pearland ISD purchase order electronically signed by authorized District personnel and/or proper authorization by the District's Purchasing Department.

6. Insurance

To protect Pearland ISD, representatives, and employees against liability loss or expense on account of damage to property or injury or death to any person or persons arising in any way out of or in connection with or resulting from the work provided here under, Contractor shall procure and maintain, at its sole expense and until acceptance of the work by the Owner, insurance as hereinafter enumerated in policies which shall be subject to the Owner’s approval as to form, amount and issuing company. Pearland ISD shall be named as Additional Insured on all applicable policies that apply to work performed for the District. In addition, a Waiver of Subrogation in favor of the District is required.

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The following amounts of coverage are to be considered minimum requirements:

A. Worker’s Compensation i. State: Texas – Statutory ii. Applicable Federal: Statutory iii. Employer’s Liability:

$1,000,000 per Accident $1,000,000 per Disease, Policy Limit $1,000,000 per Disease, Each Employee

iv. Provision shall be included for Waiver of Subrogation

B. Commercial General Liability i. Bodily Injury and Property Damage Combined and Errors and Omissions:

$1,000,000 Each Occurrence $2,000,000 Aggregate

ii. PISD shall be named as an additional insured. iii. Provision shall be included for Waiver of Subrogation

C. Business Auto Liability (including owned, non-owned and hired vehicles):

i. Bodily Injury and Property Damage combined: $1,000,000 Each Occurrence

ii. PISD shall be named as an additional insured. iii. Provision shall be included for Waiver of Subrogation.

D. Umbrella Liability Insurance:

i. Limits: $1,000,000 Aggregate ii. PISD shall be named as an additional insured. iii. This shall provide coverage over the workman’s compensation,

comprehensive general liability and comprehensive general liability and comprehensive automobile liability (covering all owned, non-owned and hired automobiles).

Pearland ISD must be given 30 days written notice of any cancellation.

Provision shall be included for Waiver of Subrogation

7. The Deviation Form is an integral and required part of the official bid submitted. The Deviation Form must be completed and returned with the proposal even if no deviations are proposed. In the event that the vendor intends to deviate from the specifications by utilizing any materials or processes different from those listed, all such deviations are to be stated on the form.

8. Proposal Submission - All proposals must be submitted with the following forms: • Certification Sheet • References and Contact Information • Deviation Form • Felony Conviction Notification • Criminal History Background Search Form • Acknowledgement Form • EDGAR Certification • Completed W-9

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• CIQ • Form 1295 • Proposal Form

Additional information as desired by vendor to demonstrate product quality or service capabilities 9. PROPOSAL EVALUATION – Proposals will be evaluated per the following criteria:

• The purchase price • The reputation of the vendor and the vendor’s goods or services • The quality of the vendor’s goods and services • The extent to which the goods or services meet the District’s needs • The vendor’s past relationship with the District or District of similar size • The impact on the ability of the District to comply with laws and rules relating to

historically underutilized businesses • The long-term cost to the District to acquire the vendor’s goods or services • Whether the vendor or the vendor’s ultimate parent company or majority owner has its

principal place of business in this state or employs at least 500 persons in this state

As a general rule, Pearland ISD may not apply a geographic preference for procurement involving federal funds See 2. C.F.R. 200.319. However, PISD may apply an optional geographic preference in the procurement of unprocessed locally grown or locally raised agricultural products for use in a Child Nutrition Program. See 2 C.F.R. 210 (National School Lunch Program), 215 (Special Milk Program for Children), 220 (School Breakfast Program), 225 (Summer Food Service Program), 226 (Child and Adult Care Food Program).

PISD includes the criteria for local preference, but it does not place a value in the determination of the weighted value in order to meet both state and federal laws.

10. All invoices (in duplicate) will be sent to:

Pearland Independent School District Accounts Payable Department P.O. Box 7

Pearland, TX 77588-0007 11. Pearland ISD will have the right to cancel any contract entered into under the terms and

conditions of the proposal for any reason at any time with thirty days written notice. 12. Violation of any part of the Terms and Conditions listed may be cause for termination of the

contract by Pearland Independent School District. 13. Deviations to any/all requested options in this proposal are subject to approval by the Pearland

ISD prior to any resultant proposal award. 14. Substitutions will not be allowed on any item without the prior approval from the Pearland ISD

Director of Purchasing (or designee) in conjunction with the “user” department. 15. Questions concerning this contract should be addressed, in writing, to Enrique Kladis at fax 281-

412-1306 or e-mail [email protected].

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16. We will not award the proposal to any one company, but will make your proposal discount available to our schools and departments. Purchases will be made as needed based upon selection, quality, price and service.

17. ALL PROPOSALS SUBMITTED TIMELY AND WITH ALL REQUIRED FORMS COMPLETED

AND SIGNED WILL BE RECOMMENDED FOR AWARD.

- END, SPECIAL CONDITIONS -

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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IF YOU WISH TO SUBMIT A BID:

RETURN THE FOLLOWING PAGES

COMPLETED & SIGNED

IF YOU DO NOT WISH TO SUBMIT A BID:

RETURN THE

NOTICE OF NO SUBMISSION FORM (page 2)

TO REMAIN ON OUR VENDOR LIST

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FORMS CHECKLIST □ Completed – Certification Sheet □ Completed – References and Contact Information □ Completed – Deviation Form □ Completed – Felony Conviction Notification □ Completed – Criminal History Background Search Form □ Completed – Acknowledgement Form □ Completed – EDGAR Certification (all sections must be acknowledged) □ Completed – Completed W-9 □ Completed – Completed Form CIQ □ Completed – Form 1295 (completed, signed and notarized) □ Completed – Financial Proposal Forms

or

□ Notice of No Submission

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CERTIFICATION SHEET

In order for a bid to be considered, the following information must be provided. FAILURE TO COMPLETE MAY RESULT IN DISQUALIFICATION

Company Name _________________________________________________________________________________ Mailing Address ________________________________________________________________________________ City________________________________________________State__________________________Zip_________ Telephone ____________________________ Fax ___________________________Email address _______________________________________ In business under present name ___________ years and ___________ months

COMPLETE THE APPROPRIATE SECTION BELOW:

RESIDENT BIDDER

"Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state.

I CERTIFY THAT MY COMPANY IS A "RESIDENT BIDDER": MR. MRS. MS. _______________________________________________________________________________________________ (Circle One) NAME (PLEASE PRINT) POSITION _____________________________________________________________________________________________________ SIGNATURE ____________________________________________ DATE _______________________________________________

OR

NONRESIDENT BIDDER "Nonresident bidder" refers to a person who is not a resident. IF YOU QUALIFY AS A "nonresident bidder", you must furnish the following information: What is your resident state? (The state your principal place of business is located.) _______________________________________ Does your "residence state" require bidders whose principal place of business is in Texas to underbid vendors whose residence state is the same as yours by a prescribed amount or percentage to receive a comparable contract? "Residence state" means the state in which the principal place of business is located.

YES _______ NO _______ If “YES”, What is that amount or percentage? _____________ % I CERTIFY THAT MY COMPANY IS A “NONRESIDENT BIDDER” AND THE ABOVE INFORMATION IS TRUE AND CORRECT: MR. MRS. MS. _______________________________________________________________________________________________ (Circle One) NAME (PLEASE PRINT) POSITION _____________________________________________________________________________________________________ SIGNATURE _______________________________________________________ DATE ____________________________________

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REFERENCES FINANCIAL STABILITY-must be demonstrated by each Bidder as well as a reliable delivery record to include a list of at least three (3) similar accounts that have utilized their products for a minimum of one year. 1._________________________ ______________________ _________________________________________ NAME OF FIRM TELEPHONE REPRESENTATIVE 2._________________________ ______________________ __________________________________________ NAME OF FIRM TELEPHONE REPRESENTATIVE 3._________________________ ______________________ __________________________________________ NAME OF FIRM TELEPHONE REPRESENTATIVE

4._________________________ ______________________ __________________________________________ NAME OF FIRM TELEPHONE REPRESENTATIVE

5._________________________ ______________________ __________________________________________ NAME OF FIRM TELEPHONE REPRESENTATIVE

CONTACT INFORMATION ADDRESS TO SEND ORDERS: REMIT TO ADDRESS: (If different from order address) ____________________________ _____________________________ Company Name Company Name ____________________________ _____________________________ Address Address ____________________________ _____________________________ City, State, Zip City, State, Zip ____________________________ _____________________________ Phone # Phone # ________________________________________ _____________________________ Fax # Fax # ____________________________ _____________________________ Contact name/department Contact name/department

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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DEVIATION FORM

All deviations to the Specifications must be noted on this sheet. In the absence of any entry on this Deviation Form, the Vendor assures the Buyer of their full compliance with the Specifications and Conditions. The form may be duplicated as needed. THIS DEVIATION FORM MUST BE SIGNED BY EACH VENDOR WHETHER THERE ARE DEVIATIONS LISTED OR NOT, AND SUBMITTED WITH THIS BID. Page/Item# DEVIATION ________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

If Bid contains no deviations, please check the box.

___________________________________ ________________________________________________ COMPANY NAME AUTHORIZED SIGNATURE DATE

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Agreement with Pearland Independent School District Regarding Criminal History Background Searches with Vendors/Contractors

Pearland Independent School District has provided me with the information to be in compliance with the Senate Bill 9 mandate in regards to required background searches for all companies working with Pearland ISD as a vendor or contractor. My signature indicates that I will comply with Senate Bill 9 by conducting background searches and have employees fingerprinted with the DPS- Fingerprint-based Applicant Clearinghouse of Texas- FACT. ____________________________________ __________________________________ Print Name Signature ____________________________________ __________________________________ Company Name Date Attached: Copy of Information from Texas Education Agency and State Board of Education: Instructions to School District Contractors Regarding Criminal History Background Searches Under Senate Bill 9 Senate Bill 9 directs school district contractors to obtain state and national criminal history background searches on their employees who will have direct contact with students, and to receive those results through the DPS criminal history clearinghouse (Fingerprint-based Applicant Clearinghouse of Texas –FACT). In order for contractors to receive the information through FACT, they must first establish an account with the DPS for FACT clearinghouse access. The Company owner must sign a user agreement with the DPS. To obtain the user agreement and more information, please contact:

Access and Dissemination Bureau Texas Department of Public Safety Crime Records Service P. O. Box 149322 Austin, Texas 78714-9322 Email: [email protected] Phone: (512) 424-2365

For fastest service, please email or call. State in the message that you are a school district contractor and need to have an account established for DPS FACT clearinghouse access. Please include:

Company Name Company Address Company Phone Name of Company point of contact Phone of Company point of contact Company email to be used for notification of FACT records and messages

The information in the DPS FACT Clearinghouse is confidential, and access must be restricted to the least number of persons needed to review the records. The account must include at least one designated supervisor to make necessary changes and to monitor the site’s security and the access to the criminal history data retrieved. Additional users must be limited to those who need to request, retrieve, or evaluate data regarding the individual applicants. PLEASE NOTE: After you sign the DPS User Agreement for FACT, DPS will provide you with a revised FAST Fingerprint Pass that you will have to provide to your employees and applicants. Your employees and applicants will use that FAST Fingerprint Pass when scheduling their FAST fingerprinting.

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Felony Conviction Notification

I, the undersigned for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information

furnished is true to the best of my knowledge. Please select ONE choice below: My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. My firm is not owned or operated by anyone who has been convicted of a felony. My firm is owned or operated by the following individuals who has/have been convicted of a felony.

Name of individual (s): _______________________________________________

Details of conviction (s): ______________________________________________

_________________________________________________________________

Please complete the information below: Name of Vendor: _________________________________________________________________ (please type or print) Name of Company Official: ________________________________________________________

(please type or print) Signature of authorized agent: _________________________________________ Date: _______

State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states “a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or owner or operator of the business entity has been convicted of a felony.” The notice must include a general description of the conduct resulting in the conviction of a felony. Subsection (b) states “a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract.

This notice is not required of a publicly held corporation

• • •

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ACKNOWLEDGEMENT FORM

Having carefully read the Standard Terms and Conditions and any Special Conditions listed in this document, the undersigned hereby agrees to furnish all goods and services specified on the Pearland ISD Proposal Form at the prices and transportation costs as proposed. By submission of this proposal, the undersigned certifies that:

a. This proposal has been independently arrived at without collusion with any other bidder or any other competitor;

b. This proposal has not been knowingly disclosed and will not be knowingly disclosed, to any

other bidder, competitor or potential competitor, prior to the opening of bids, or proposals for his project;

c. No attempt has been or will be made to induce any other person, partnership or corporation

to submit or not submit a proposal;

d. The undersigned certifies that he is fully informed regarding the accuracy of the statements contained in this certification, and the penalties herein are applicable to the bidder as well as to any person signing in his/her behalf;

e. Vendor warrants it has no interest, and shall acquire no interest that would directly or indirectly

conflict in any manner or degree with the performance of this proposal. For violation or breach of this warranty, Pearland ISD shall have the right to annul this contract without liability;

f. As required by Local Government Code 176.006, the undersigned acknowledges the requirement of filing a Conflict of Interest Questionnaire if there are any facts that would require such to be filed, and acknowledges the fact that the CIQ form is available for download at http://www.ethics.state.tx.us/forms/CIQ.pdf or can be obtained directly from the Pearland ISD Purchasing Office, 1928 N. Main, Pearland, Texas 77581.

g. The undersigned certifies that to his/her knowledge no Pearland ISD employee has any personal or beneficial interest whatsoever in this service or property described herein.

h. The undersigned acknowledges that this document, as well as any submitted documents and any negotiations, when properly accepted by the District will be an integral part of any contract awarded as a result of the response submitted.

i. Contractor hereby certifies that it is not a company identified on the Texas Comptroller’s list of companies known to have contracts with, or provide supplies or services to, a foreign organization designated as a Foreign Terrorist Organization by the U.S. Secretary of State. Contractor further certifies and verifies that neither Contractor, nor any affiliate, subsidiary, or parent company of Contractor, if any (the “Contractor Companies”), boycotts Israel, and Contractor agrees that Contractor and Contractor Companies will not boycott Israel during the term of this Agreement. For purposes of this Agreement, the term “boycott” shall mean and include terminating business activities or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory.

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Respondent acknowledges receipt of Addenda number ___ through ___ and has incorporated the provisions therefore into this proposal. ___________________________________ _________________________________________ AUTHORIZED SIGNATURE PRINT NAME ____________________________________ _________________________________________ TITLE DATE

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EDGAR CERTIFICATIONS

ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT TO WHOM IT MAY CONCERN: Pearland ISD (PISD) is in the process of ensuring that all policies and procedures involving the expenditure of federal funds are compliant with the new Education Department General Administrative Guidelines (“EDGAR”). Part of this process involves ensuring that all current vendors agree to comply with EDGAR. You must complete this form and return to PISD along with your proposal. The following certifications and provisions are required and apply when PISD expends federal funds for any contract resulting from this procurement process. Pursuant to 2 C.F.R. § 200.326, all contracts, including small purchases, awarded by the District and the District’s subcontractors shall contain the procurement provisions of Appendix II to Part 200, as applicable.

REQUIRED CONTRACT PROVISIONS FOR NON-FEDERAL ENTITY CONTRACTS UNDER FEDERAL

AWARDS APPENDIX II TO 2 CFR PART 200

(A) Contracts for more than the simplified acquisition threshold currently set at $150,000, which is the

inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.

Pursuant to Federal Rule (A) above, when PISD expends federal funds, PISD reserves all rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(B) Termination for cause and for convenience by the grantee or sub-grantee including the manner by

which it will be effected and the basis for settlement. (All contracts in excess of $10,000)

Pursuant to Federal Rule (B) above, when PISD expends federal funds, PISD reserves the right to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a breach or default of the agreement by Vendor in the event Vendor fails to: (1) meet schedules, deadlines, and/or delivery dates within the time specified in the procurement solicitation, contract, and/or a purchase order; (2) make any payments owed; or (3) otherwise perform in accordance with the contract and/or the procurement solicitation. PISD also reserves the right to terminate the contract immediately, with written notice to vendor, for convenience, if PISD believes, in its sole discretion that it is in the best interest of PISD to do so. Vendor will be compensated for work performed and accepted and goods accepted by PISD as of the termination date if the contract is terminated for convenience of PISD. Any award under this procurement process is not exclusive and PISD reserves the right to purchase goods and services from other vendors when it is in PISD’s best interest.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

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(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR part 60, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.”

Pursuant to Federal Rule (C) above, when PISD expends federal funds on any federally assisted construction contract, the equal opportunity clause is incorporated by reference herein.

Does Vendor agree to abide by the above? YES _____ Initials of Authorized Representative of Vendor

(D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation,

all prime construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction”). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non- Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or sub-recipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non-Federal entity must report all suspected or reported violations to the Federal awarding agency.

Pursuant to Federal Rule (D) above, when PISD expends federal funds during the term of an award for all contracts and sub-grants for construction or repair, Vendor will be in compliance with all applicable Davis-Bacon Act provisions.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all

contracts awarded by the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

Pursuant to Federal Rule (E) above, when PISD expends federal funds, Vendor certifies that Vendor will be in compliance with all applicable provisions of the Contract Work Hours and

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Safety Standards Act during the term of an award for all contracts by PISD resulting from this procurement process.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition

of “funding agreement” under 37 CFR §401.2 (a) and the recipient or sub-recipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that “funding agreement,” the recipient or sub-recipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any implementing regulations issued by the awarding agency.

Pursuant to Federal Rule (F) above, when federal funds are expended by PISD, the vendor certifies that during the term of an award for all contracts by PISD resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (F) above.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-

1387), as amended—Contracts and sub-grants of amounts in excess of $150,000 must contain a provision that requires the non- Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251- 1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).

Pursuant to Federal Rule (G) above, when federal funds are expended by PISD, the vendor certifies that during the term of an award for all contracts by PISD member resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (G) above.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(H) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR

180.220) must not be made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), “Debarment and Suspension.” SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.

Pursuant to Federal Rule (H) above, when federal funds are expended by PISD, the vendor certifies that during the term of an award for all contracts by PISD resulting from this procurement process, the vendor certifies that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal department or agency.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

(I) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award

exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in

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connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award.

Pursuant to Federal Rule (I) above, when federal funds are expended by PISD, the vendor certifies that during the term and after the awarded term of an award for all contracts by PISD resulting from this procurement process, the vendor certifies that it is in compliance with all applicable provisions of the Byrd Anti-Lobbying Amendment (31 U.S.C. 1352). The undersigned further certifies that:

(1) No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, to 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 the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of a Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to 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 this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying”, in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all covered sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all sub-recipients shall certify and disclose accordingly.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS

When federal funds are expended by PISD for any contract resulting from this procurement process, Vendor certifies that it will comply with the record retention requirements detailed in 2 CFR § 200.333. The Vendor further certifies that Vendor will retain all records as required by 2 CFR § 200.333 for a period of five years after grantees or sub-grantees submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

____________________________________________________________________________ CIVIL RIGHTS/DISCRIMINATION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS

When federal funds are expended by PISD for any contract resulting from this procurement process, Vendor certifies that it will comply with Title VI of the Education Amendments of 1972; Section 504 of the Rehabilitation Act of 1973; the Age Discrimination Act of 1975; Title 7 CFR Parts 15, 15a, and 15b; the Americans with Disabilities Act; and FNS Instruction 113-1, Civil Rights Compliance and Enforcement -Nutrition Programs and Activities. This applies to contracts using federal funds and prohibits the discrimination to all eligible program participants on the basis of age, color, disability, national origin, race, and gender.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

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SMALL AND MINORITY FIRMS, WOMEN’S BUSINESS ENTERPRISE AND LABOR SURPLUS AREA FIRM REQUIREMENTS INVOLVING FEDERAL FUNDS

When federal funds are expended by PISD for any contract resulting from this procurement process, Vendor certifies that it will take the necessary affirmative steps to procure from minority firms, women’s business enterprise and labor surplus area firms whenever possible. Contractors are required to encourage and facilitate participation by small businesses, minority-owned firms, and women’s business enterprises whenever to the maximum extent possible.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

HEALTH AND SAFETY CERTIFICATIONS, LICENSING OR REGULATIONS REQUIREMENTS When federal funds are expended by PISD for any contract resulting from this procurement process, Vendor certifies that all contractors will meet applicable local, state, and federal health and safety certifications, licensing, or regulations which include, but are not limited to, facility use, food establishment, and authorized providers.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

CERTIFICATION OF COMPLIANCE WITH THE COPELAND ANTI-KICKBACK ACT When PISD expends federal funds for any contract resulting from this procurement process, Vendor certifies that construction contracts using federal funds, prohibits a contractor or subcontractors from inducing kickbacks from employees in compliance with the Copeland Anti-Kickback Act (18 U.S.C. 874 as supplemented in Department of Labor regulations 29 CFR Part 3).

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

CERTIFICATION OF COMPLIANCE WITH THE SOLID WASTE DISPOSAL ACT

When PISD expends federal funds for any contract resulting from this procurement process, Vendor certifies that contracts exceeding $10,000, using federal funds, requires contractors to maximize energy and resource recovery by using recycled materials and/or recycling waste products when reasonable, cost appropriate and available in compliance with the Solid Waste Disposal Act (Section 6002 as amended by the Resource Conservation and Recovery Act).

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT When PISD expends federal funds for any contract resulting from this procurement process, Vendor certifies that it will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18).

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

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CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS Vendor certifies that Vendor is in compliance with all applicable provisions of the Buy America Act. Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling for free and open competition.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. §200.336 Vendor agrees that the Inspector General of the District or any of their duly authorized representatives shall have access to any books, documents, papers and records of Vendor that are directly pertinent to Vendor’s discharge of its obligations under the Contract for the purpose of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access to Vendor’s personnel for the purpose of interview and discussion relating to such documents.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor

CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS Vendor agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.

Does Vendor agree? YES _____ Initials of Authorized Representative of Vendor Vendor agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that vendor certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above. Vendor’s Name:_______________________________________________________________

Address, City, State, and Zip Code: _______________________________________________

Phone Number: ____________________________ Fax Number: _____________________

Printed Name and Title of Authorized Representative: ________________________________

Email Address: _______________________________________________________________

Signature of Authorized Representative: _______________________________

Date: ______________

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Form W-9 Request for Taxpayer Give Form to the

(Hev. November 20 I 7) Identification Number and Certification requester. Do not send to the IRS. Dop(,trrcnl of tho T rcasuy

lnlen~ Revenue Servir::e • Go to www.iis.gov/FonnW9 for instructions and the latest infonnation.

1 Name (as shown on your income tax return). Name IS required on thlS line; do not leave this line blarl<.

2 Business name/disregarded entity name, if different from above

('O 3 Check appropriate box for federal tax ctassificabon of the person whose name IS entered on lone I Check only one of the 4 Exen1p1ic,ns (codes apply o riy tu

Q)

"' foilc,,1ing seven boxes. cEWtam entmes, not 1ndtv1duals; see "' inslrU(;li<n":- cm µage 3): Cl.

D C Corporatim D S Corporatia1 D Partnership D TrusVestatc C: 0 lndividuaVsole proprietor or 0 . ,,, single-member LI C Exempt payee code jf any)

a, C ---~-2 .. 'G 0 Lim~ed liability company. Enter the tax classificatia1 (C-C caporatia1, S-S co,paation, P-Par1ncrsl1ip) •---~::, 0 ~ Note: Check the appropriate box 1n the line abo,e for the tax class1f1cabon of the srngle-member c,,mer. Do not check Cxempt1on from r Al CA reporbng .. ;; -~ C:

LLC If the LLC IS classified as a smgle-membet LLC that IS disregarded from the c,,,ner Ll11e<s the owner of the LLC IS <X>de (of any)

a:~ another LLC that is not disregarded from the ovmer fa· U.S. federal tax puposes. Othc<wisc, a single-member LLC that

~ is disregarded rron1 the <.wmer should d ied<.' the appropriate box for lhe lax dassiftcation ori1s owner.

0 Other (see 1nstrucborrs) • (N:pliOSfOIIOCOlinlsf/NMl>Jf.o4""""1efr,,U.S/ Cl) 0. 5 Address (numbOt', street, and apt. or sutc no.) Sec instructims. Rcquesta's name and address (optia1aO Cl) Q)

"' (/) -6 City, state, and ZIP code

7 List acrot11t nt111ber(s) here (optionaij

DUI Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number I

' . ' . ' . ' ' . backup withholding. For 1nd1V1duals, this 1s generally your social secunty number (SSN). However, for a DJ] [D I I I I I resident alien, sole proprietor. or disregarded entity, see the instructions for Part I, later. For other - -entities, It is your employer identification number (EIN). tt you do not have a number, see How to get a . . . . . TIN, later. or Note: If the account is in more than one name, see the instructions for line 1 ftlso see What Name and rl E~m- p~l-oye- r~ide~nti~-fi~c-•~~-on-n-un-,~be-r---~ Number To Give the Requester for guidelines on whose number to enter.

Certification Under 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 wlthholding, 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); and

4. The FATCA code(s) entered on this form (If any) indicating that I am exempt from FAT CA reporting is correct.

Certification instructions. You must cross out rtem 2 above rt you have been notified by the IRS that you are currenUy sul:\ject to backup ~ thholding 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 dell!, contlibutions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the cattification, but you must provide your conect TIN. See the instn.1ctions for Part II, later.

Sign Here

I Signatl.-eof U.S. person•

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

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FonnW9.

Purpose of Form AA individual or entity (Form W-9 requester) who is required to file an information retum with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN). individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid)

Cat. No. 10231X

Date• • Form 1099-DIV (dividends, including those from stocks or mutual funds)

• Form 1 099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers)

• Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition)

• Form 1 099-C (canceled debt) • Fo1m 1099-A (acquisition or abandonment of seC1.1red property)

Use Form W-9 only if you are a U.S. person Oncluding a resident alien), to provide your correct TIN.

If you do not retum Fo,m W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.

Form W-9 (RC\I. 11 201n

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CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor doing business with local governmental entity

This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFACE USE ONLY

This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.00S(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not later than di e 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.

L!..J Name of vendor who has a business relationship with local governmental entity.

~o Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed quest ionnaire with the appropriate filing authority not later than the 7th business day after the date on w hich you became aware that the originally f iled questionnaire was incomplete or inaccurate.)

w Name of local government officer about whom the information is being disclosed.

Name of Officer

l!l Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary.

A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?

O ves • No

B. Is the vendor receiving or likely to receive taxable income, other than investment income, f rom or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity?

O ves D No

L?J Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more.

~ D Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts

as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1 ).

lZ..I

Signature of vendor doing business with the governmental entity Date

Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11130/2015

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PEARLAND ISD CERTIFICATE OF INTERESTED PARTIES - FORM 1295

Certificate of Interested Part.ies (Form 1295-must be filled out electronically with the Texas Et.hies Commission's onlinc filing application, print.L'<I out, signed, notarized, and submitted with proposal to Pearland ISD.

Pearland ISD is required to comply with House Bill 1295, which amended the Texas Government Code by adding Section 2252.908, Disclosure of Interested Parties. Section 2252.908 prohibits Pearland ISD from entering into a contract resulting from this solicitation with a business entity unless the business entity submits a Disclosure of Interested Parties (Form 1295) to Pearland ISD at the time business entity submit5 the signed contract/proposal. The Texas Ethics Commission has adopted rules requiring the business entity to file form 1295 electronically with the Texas Ethics Commission.

''.Interested Party" means a person: a) who has a controlling interest in a business entity with whom Pearland ISD contracts;

or b) who actively patticipates in facilitating the contract or negotiating the tenns of the

contract, including a broker, inte1mediary, adviser, or attomey for the business entity.

"Business Entity" means an entity recognized by law through which business is conducted, including a sole proprietorship, paitnership, or corporation.

As a "business entitv,'' all vendors must electronically complete, print, sign, notarize, and submit Form 1295 with their proposals even ifno interested parties exist.

Proposers must fil e Fom1 1295 electronically with the Texas Ethics Commission using the on line filing application, which can be found at https://www.ethics.statc.tx.u5/whatsncw/clf info fonn 1295.htm. Proposers must use the filing application on the Texas Ethics Commission's website to enter the required information on Fo1m 1295. Proposers must print a copy of the completed fonn, which will include a certification of filing containing a unique certification number. The Form 1295 must be signed by an authorized agent of the business entity, and the form must be notarized.

The completed Fo,m 1295 with the ce,tification of filing must be filed with Pearland ISD by attaching the completed fom1 to the vendor's proposal.

Pearland ISD must acknowledge the receipt of the filed Fo1m 1295 by notifying the Texas Ethics Commission of the receipt of the filed Form 1295 no later than the 30th day after the date the contract binds all parties to the contract. After Pearland ISD acknowledges the Form 1295, the Texas Ethics Commission will post the completed Fo1m 1295 to its website with seven business days after receiving notice from Pearland ISD.

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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CERTIFICATE OF INTERESTED PARTIES FORM 1295

OFFICE USE ONLY Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.

~~0 1 Name of business entity filing form, and the city, state and country of the business entity's place of business.

~ 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. '5

. .J. • ... -3 Provide the identification number used by the governmental entity or state agency to w,i ~ dentify the contract,

and provide a description of the services, goods, or other property to be provided ~ t e contract.

_xt?f. 4 " ::)N-ature of Interest (check applicable) City, State, Country

Name of Interested Party (place of business) ... c~~ Controlling Intermediary

~' "(0-

... ~ -~-~' ... ·v ,~

~,~ ..,

5 &' Check only if there terested Party. • 6 UNSWORN DE~L~ N

My name is ~ and my date of birth is

Myaddre~ , ___ , ~ (street) (city) (state) (zip code) (country)

~ der penalty of perjury that the foregoing is true and correct.

Executed in County, State of , on the ___ day of , 20 __ .

(month) (year)

Signature of authorized agent of contracting business entity (Declarant)

ADD ADDITIONAL PAGES AS NECESSARY

Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 12/22/2017

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PROPOSAL FORM

CATALOG AND STORE/SHELF DISCOUNTS - OFFICE SUPPLIES, EQUIPMENT & FURNITURE

DUE APRIL 19, 2018 Pearland ISD is requesting a proposal for discounts off catalog/shelf prices of office supplies, office equipment, and office furniture from your company for purchases by Pearland ISD employees. These purchases will be on an individual basis by our staff. Purchases under this proposal will begin July 1, 2018 and continue through June 30, 2019, with option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our staff. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR PRINTED CATALOG OR SHELF PRICE TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019.

1. Discount off catalog/shelf price to our district for office supplies, equipment, and furniture —items classified as warehouse stock …………………………… _______%

2. Catalog prices include shipping? Yes___ No ____ Shipping charges are … _______%

3. Discount off catalog price to our district for “Factory Ship” items, which include furniture and equipment or “Direct Ship” items ……………………. _______%

Shipping costs on “Factory Ship” items …………………………………….. _______%

4. Are your catalog prices guaranteed for all of 2018/2019 with discounts to be taken from your printed catalog price? …… Yes ____ No _____

5. Early payment cash discount _______%. Other special discounts ____________________ _________________________________________________________________________

6. List any products/”lines” not included in discount above, or other exceptions: __________ __________________________________________________________________________

Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581 COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE____________________________________________________DATE_____________________

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PROPOSAL FORM

CATALOG AND STORE/SHELF DISCOUNTS – PROMOTIONAL, EMBROIDERY AND SCREEN PRINTING PRODUCTS AND SERVICES

DUE APRIL 19, 2018

Pearland ISD is requesting a proposal for discount off store shelf prices and/or catalog prices from your company for purchases by Pearland ISD employees. These purchases for materials and supplies will be on an individual basis, by our schools and departments. Purchases under this proposal will begin July 1, 2018 and continue through June 30, 2019, with option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our schools and departments. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR STORE SHELF PRICE (OR PRINTED CATALOG PRICE) TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019. 1. Discount (percentage) off shelf/catalog price to our district in-stock items. . . . _______% List any exceptions:_______________________________________________ 2. Shipping Charges……………………………………………………………… _______% 3. Discount on special order items ……………………………………………….. _______% 4. Special discounts, other than above …………………………………………… _______% _______________________________________________________________ 5. Early payment cash discount _________% Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581

COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE________________________________________________________DATE_________________

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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PROPOSAL FORM

CATALOG AND STORE/SHELF DISCOUNTS- GROCERIES, SNACKS AND PAPER GOODS

DUE APRIL 19, 2018

Pearland ISD is requesting a proposal for discount off store shelf prices and/or catalog prices from your company for purchases by Pearland ISD employees. These purchases for materials and supplies will be on an individual basis, by our schools and departments. Purchases under this proposal will begin July 1, 2018 and continue through June 30, 2019, with option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our schools and departments. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR STORE SHELF PRICE (OR PRINTED CATALOG PRICE) TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019.

1. Discount (percentage) off shelf/catalog price to our district in-stock items. . . . _______% List any exceptions:_______________________________________________

2. Discount on special order items ……………………………………………….. _______%

3. Special discounts, other than above …………………………………………… _______% _______________________________________________________________ 4. Early payment cash discount _________%

Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581 COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE________________________________________________________DATE_________________

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

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PROPOSAL FORM

CATALOG AND STORE/SHELF DISCOUNTS – HEALTH/ATHLETIC TRAINING SUPPLIES

DUE APRIL 19, 2018 Pearland ISD is requesting a proposal for discounts off catalog/shelf prices of health/nurse supplies and/or training supplies from your company for purchases by Pearland ISD employees. Purchases will be made on an individual basis by our schools and departments. Purchases under this proposal will begin July 1, 2018, and continue through June 30, 2019, with an option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our staff. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR PRINTED CATALOG/SHELF PRICE TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019.

1. Discount off catalog/shelf price to our district for Health/Training Supplies items classified as warehouse stock………………………………………_______%

2. Catalog prices include shipping? Yes __ No __ Shipping charges………_______%

3. Discount off catalog price to our district for “Factory Ship” items,

which include furniture and equipment or “Direct Ship” items …………_______% Shipping costs on “Factory Ship” items …………………………………._______%

4. Are your catalog prices guaranteed for the year 2018/2019, with discounts to be

taken from your printed catalog price? ……Yes ____ No ____

5. Early payment cash discount _______% Other special discounts _____________________ __________________________________________________________________________

6. List any products/”lines” not included in discount above, or other exceptions:

__________________________________________________________________________ Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581 COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE________________________________________________________DATE_________________

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

31

PROPOSAL FORM

CATALOG AND STORE/SHELF DISCOUNT –INSTRUCTIONAL SUPPLIES/TEACHING AIDS & PRINTING MATERIALS

DUE APRIL 19, 2018

Pearland ISD is requesting a proposal for discounts off store shelf prices and/or catalog prices of instructional supplies/ teaching aids & materials from your company for purchases by Pearland ISD employees. These purchases will be on an individual basis by our schools and departments. Purchases under this proposal will begin July 1, 2018 and continue through June 30, 2019, with option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our schools and departments. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR STORE SHELF PRICE (OR PRINTED CATALOG PRICE) TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019.

1. Discount off shelf/catalog price to our district for in-stock items …………… _______% List any exceptions: ______________________________________________

2. Discount on special order items …………………………………………….… _______%

3. Special discounts, other than above ………………………………………….. _______% 4. Delivery charges: _____________________ or …………………………….. _______% 5. Early payment cash discount _______%. Other special discounts ____________________

Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581 COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE______________________________________________________DATE___________________

Pearland ISD RFP #18-0419-15 – CATALOG AND STORE/SHELF DISCOUNT

32

PROPOSAL FORM

CATALOG DISCOUNT – LIBRARY/CLASSROOM BOOKS & LIBRARY SUPPLIES

DUE APRIL 19, 2018 Pearland ISD is requesting a proposal for discounts off catalog prices of library/classroom books and materials & supplies from your company for purchases by Pearland ISD employees. These purchases will be on an individual basis by our schools and departments. Purchases under this proposal will begin July 1, 2018 and continue through June 30, 2019 with option to renew for a second and third year upon agreement of both parties. If you already extend our district a discount or cannot offer any discount at this time, we would appreciate it if you would indicate this and return the proposal for our records. We will not award the proposal to any one company, but will make your proposed discount available to our schools and departments. Purchases will be made as needed based upon selection, quality, price, and service. WE ARE REQUESTING A DISCOUNT TO BE OFFERED OFF YOUR PRINTED CATALOG PRICE TO BEGIN JULY 1, 2018 AND CONTINUE THROUGH JUNE 30, 2019.

1. Discount off PUBLISHERS PRICE to our district for LIBRARY/CLASSROOM BOOKS …………………………………………………………………………. _______%

2. Catalog prices include shipping? Yes___ No ____ Shipping charges are … _______% 3. Discount off catalog price to our district for GENERAL SUPPLIES……………. _______%

Shipping costs on GENERAL SUPPLY items …………………………………. _______% 4. Are your catalog prices guaranteed for all of 2018/2019 with discounts to be taken? from your printed catalog price? …… Yes ____ No _____ 5. Early payment cash discount _______%. Other special discounts ____________________ _________________________________________________________________________

6. Discount off allowed by TOTAL DOLLAR amount ordered by PISD: Over $_________________ _______% Over $_________________ _______% Over $_________________ _______% Per purchase: Yes _____ No _____ Per accumulative total for year: Yes _____ No _____

7. List any products/ “lines” not included in discount above or other exceptions: __________ __________________________________________________________________________

Return Sealed Proposal to: Enrique Kladis, Director of Purchasing

Pearland Independent School District 1928 North Main, Pearland, TX 77581 COMPANY NAME_________________________________________________________________________ REPRESENTATIVE NAME & TITLE________________________________________________________ ADDRESS & ZIP___________________________________________________________________________ TELEPHONE _________________ FAX__________________E-MAIL______________________________ SIGNATURE_____________________________________________________DATE___________________