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Irving 15D

By:

REQUEST FOR QUALIFICATIONS (RFQ)

~ IRVING 1ndt-pcndcnr School District

RFQ #19-35-914

REQUEST FOR QUALIFICATIONS

FOR

ROOF CONSULTANT SERVICES

~p~ Jerome Pilgrim, Director of Purchasing Irving Independent School District 2621 West Airport Freeway Irving, Texas 75062

NOTE: Irving ISD will be closed for Spring Break Holidays from March 11 , 2019 to March 15, 2019.

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You may hand deliver the RFQ response to the Purchasing Office at the following address:

Irving ISD Purchasing Department 2621 West Airport Freeway, Suite 1750 Irving, Texas 75062

or have it delivered by a courier type service, such as FedEX or UPS, etc. , with a recipient's signature and documented time of delivery.

Proposals submitted via the U. S. Postal Service are to be mailed to:

Irving ISD Purchasing Department P.O. Box 152637 Irving , Texas 75050-2637

The U.S. Postal Service mail goes to our warehouse to be processed before delivery to the departments. NOTE: Delivery of Proposal envelope to other Departments within the Irving Independent School District is not considered as delivery to the Purchasing Department. You may mail the response in time, but it may not be received in the Purchasing Office in a timely fashion , and therefore will be rejected.

SUBMIT RESPONSE NO LATER THAN 2:00 P.M. LOCAL TIME ON Friday, March 8, 2019.

Qualification statements are to include the information requested in the Consultant Questionnaire in the sequence and format prescribed . In addition to and separate from the requested information, organizations submitting may provide supplementary materials further describing their capabilities, experience and qualifications.

Additional information may be submitted through email and/or fax if needed. However, the district is not obligated to review that information.

All Required forms must be submitted.

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1. RFQ SCHEDULE

Issuance of RFQ February 21, 2019

Deadline for Questions March 1, 2019

District Responses to Questions Issued March 4, 2019

Proposal Due Dates MArch 8, 2019 by 2:00pm CST

2. Submit one original and two (2) copies of the qualification statements. After opening and evaluation ofresponses, the District will select a firm or firms(s) for additional information, including proposed fees and prices for fulfilling the general conditions.

3. Interviews may be conducted with the short-listed firms prior to final selection. Cost and Fees information will be requested from the short-listed firms.

4. Questions, requests for clarification, additional information, 01mss10ns, or corrections should be addressed in writing to Mr. Jerome Pilgrim, by March 1, 2019, 4:00P.M. You may e-mail this information to jpilgrim@lni'ingisd.net.

5. Irving Independent School District is a public entity subject to the provisions of the Texas Public Infom1ation Act (Texas Government Code Chapter 552). Responses to this Solicitation may be subject to release as public i.luom1ation unless the response or specific parts of the response are accepted from public disclosure under such Act. The District assumes no liability or responsibility for release of any i.luom1ation not properly identified and documented in accordance with the enclosed Confidential Infom1ation Declaration & Copvright Authorization Form - See Required Fonns.

6. The successful company will be required to furnish copies of Professional Licenses and Insurance Certifications, including Professional & General Liability (E&O) for review.

7. PROPOSAL PRESENTATION An authorized representative of the respondent shall sign proposals. Failure to submit all information requested may result in the district requiring prompt submission of missing information and/or giving a lower evaluation of the proposal. The Purchasing office may reject proposals that are substantially incomplete or lack key information.

8. Proposer may include its proposed contract in its response to this RFO. The District ' s key representatives and proposers may enter into discussions and rev1s1ons as necessary. Discussions/negotiations may be conducted with proposers who provide best value to the district and are determined by the district to have a reasonable chance of being awarded a contract.

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Irving ISD Terms and Conditions

In submitting a Response, Consultant understands and agrees to be bound by the following terms and conditions which shall be incorporated into any future contracts, agreements, or purchase orders relating to this RFQ between the firm and the District. Please note any exceptions.

Assignment The successful Consultant may not assign its rights and duties under an award without the written consent of the District. Such consent shall not relieve the assignor of liability in the event of default by its assignee.

Indemnification The Irving ISD is a Texas Political Subdivision and a local governmental entity; therefore, is prohibited from indemnifying third parties pursuant to the Texas Constitution (Article 3, Section 52) except as specifically provided by law or as ordered by a court of competent jurisdiction.

Governing Laws and Venue This Agreement and all of the rights and obligations of the parties hereto and all of the terms and conditions hereof shall be construed, interpreted and applied in accordance with and governed by and enforced under the laws of the State of Texas, and the parties hereto agree that venue shall be in Dallas County, Texas.

Jurisdiction and Service of Process Any Proceeding arising out of or relating to this procurement process or any contract resulting from or any contemplated transaction shall be brought in a court of competent jurisdiction in Dallas County, Texas and each of the parties irrevocably submits to the exclusive jurisdiction of said court in any such proceeding, waives any objection it may now or hereafter have to venue or to convenience of forum, agrees that all claims in respect of the Proceeding shall be heard and determined only in any such court, and agrees not to bring any proceeding arising out of or relating to this procurement process or any contract resulting from or any contemplated transaction in any other court.

Termination Irving ISD shall have the right to terminate for default all or part of a resulting contract if the firm breaches any of the terms hereof or if the firm becomes insolvent or files any petition in bankruptcy. Such right of termination is in addition to and not in lieu of any other remedies which Irving ISD may have in law or equity, specifically including, but not limited to, the right to collect for damages or demand specific performance.

Irving ISD has the right to terminate a resulting contract for convenience, without penalty, for nonappropriation or non-availability of funds by delivery to the offeror of a "Notice of Termination" specifying the extent to which performance hereunder is terminated and the date upon which such termination becomes effective.

Funding Out Clause Pursuant to Texas Local Government Code Sec. 271.903 , any Proposal/Offer accepted by Irving ISD and all contracts to be approved are subject to the budgeting and appropriation of then currently available funds. See statute for specifics or consult your legal counsel.

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Ownership and Use of Documents All documents and materials particular to the Work prepared by Consultant ("Work Material"), are the property of the District and for its exclusive use and re-use at any time without further compensation and without any restrictions.

Except for such Work Material which is intended to be made public as part of the Project, Consultant shall treat all such Work Material as confidential, and Consultant shall neither use any such Work Material or copies thereof on other work nor disclose such material or information to any other party without District's prior written approval.

Conflict of Interest. No employee of District shall have any personal interest, direct or indirect, in this Agreement nor shall any such member, official or employee participate in any decision relating to this Agreement which affects his or her interest or the interests of any corporation, partnership or association in which he or she is directly or indirectly interested.

Felony Conviction Notice: Consultant shall certify compliance with Texas Education Code 22.0834 and Education Commissioner' s rules regarding criminal history record review for all employees, applicants for employment, or agents of the Consultant. Additionally, Consultant must give advance notice to the District if the person or an 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. The District may terminate this Agreement if the District determines that the person or business entity failed to give notice as required by this paragraph or misrepresented the conduct resulting in the conviction. This paragraph requiring advance notice does not apply to a publicly held corporation.

Tax Exempt: Irving ISD is exempt from federal excise taxes, state and local sales taxes and use taxes.

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SCOPE OF SERVICES

The Irving Independent School District (IISD) is soliciting proposals from experienced Roof consultants/finns to provide Roof consultant Services in accordance with the instructions, specifications, terms and conditions, contained in this Solicitation. It is the intent of this RFQ to have the successful firm(s) enter into a Professional Services Contract with the District to provide the services as outlined herein. The firms shall provide Consulting and Engineering service for roof Improvements to ALL IRVING ISD BUILDINGS.

The scope shall include, initial roof investigation, DEVELOPMENT OF PREVENATIVE MAINTENANCE SCHEDULE, DEVELOP INVENTORY OF ALL ROOFS AND PROJECT MANAGEMENT ASSISTANCE WITH HAIL DAMAGED ROOFS AND CLAIMS. After the initial investigation, the consultants shall provide documents for Construction/Repairs. Irving ISD reserves the right to select buildings to be repaired or replaced, depending on overall scope and available budget.

1. Proposer of qualifications should submit their qualifications in any form that allows for Irving ISD evaluation such as a contract, resume, vita, references, web address, or other information that provides a reasonable analysis of the proposer ability.

2. The services that may be requested include writing a Roof Repair Bid or Request for Competitive Sealed Proposal based on the Texas Government Code Requirements for school districts. Services will include consultation with District staff relating to Roof needs of the District.

3. Additional services that may be requested may include the evaluation of any bid or proposal received for Roofing repairs.

4. Proposer must have a track record of performing these types of services for Texas public schools. Proposers should submit their information by 2:00pm, March 8, 2019 to Jerome Pilgrim:

Irving ISD Purchasing Department 2621 West Airport Freeway, Suite 1750 Irving, Texas 75062.

5. Proposals should be sent by a trackable method, such as certified mail. Proposals may be emailed but are not guaranteed to be evaluated since those methods may not be received timely.

6. The IISD Administration reserves the right to request from vendors as part of this proposals qualifications separately.

TERM OF CONTRACT The contract period for the successful Consultant will be from date of award through August 31, 2019. The contract may be renewed upon mutual agreement.

The firms shall provide Consulting and Engineering service for roof Improvements to ALL IRVING ISD BUILDINGS.

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Roofing Inventory:

Consulting Firm shall provide an Inventory of all roof systems.

• Organize the buildings; by reporting requirements. • List Buildings. • List Roofing Systems. • Identify Roofing System Type, assembly construction, detail infonnation including photos. • Make observations of the ctment defects and ctment service life remaining. • Turn observations into recommendations for maintenance, replacement priorities. • Allocate funds to extend the service life; lower the annual cost of a roofing year. • Maintain master records to update condition information as needed. • Plan for the next inspection cycle.

Preventative Maintenance and Replacement schedule

• Establish a Roof Management Plan • Provide inspection, repair, replacement reports. • Recommendations to be completed, in a specific budget year. • Provide urgency level ofreplacement and or repair - low, moderate, high. • Estimate budget amount for repair/replacement. • Provide an explanation of the recommended roofing activity. • Provide any reference documents for the PIM and Replacement.

Project Management Assistance with Hail Damaged Roofs and Claims

• Provide Existing System type. • Provide Core Composition. • Provide Core Photos. • Provide Membrane Defects. • Provide Roof Top Details. • Provide Moisture Surveys. • Provide Recommendations • Provide Project Management Assistance with Hail Claims.

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Other services shall include, but not be limited to:

o Meeting all applicable codes and regulations.

o Attain approvals from historical regulatory agencies, including the Irving ISD

o Landmark Commission and Texas Historical Commission, if required.

o Acquire building permit.

o Cost Estimate

o Prepare Bid documents, Plans and Specifications

o Provide all required insurance.

Refer to Item No. IX of this RFQ for the anticipated schedule.

Respondents submitting proposals shall have demonstrated experience in Engineering and Roofing design of facilities of this type and size.

DEFINITIONS As used in this Request for Qualifications (RFQ), the terms have the meanings set forth below:

A. "Roof Consultant Firm" means a partnership, corporation, or other legal entity or team that includes an engmeer or architect and roofing consultant qualified to engage in building construction in Texas.

B. "Owner" means the Irving ISD

The Scope of work includes provision of Construction Documents, Construction Procurement and Construction Administration Services for the Roof Replacement and Repairs.

The final design services resulting from this selection process will be determined by the Irving ISD and the selected firms. The professional services for this project are to include Roof investigation and Construction documents, Plans and Specifications for Roof Replacement and Repairs. A sample of the Roof Consultant and Engineering Contract is attached to this RFQ.

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SELECTION PROCESS

The selection process will consist of the selection of two or more Consultants through the "Qualification Statement". The Irving ISD selection committee will review all the submitted Qualification Statements, per the criteria listed in the RFQ. The Qualification Statements will be evaluated, and the Irving ISD selection committee will rank the firms in order of preference for determination of the most qualified firm for the Project based on the evaluation criteria established in this Request for Qualifications. The top two or more highest ranked firms will be asked to submit a fee proposal to begin contract negotiations.

Acceptance of evaluation methodology: By submitting its Qualification Statement in response to this RFQ, the respondent accepts the evaluation process and acknowledges and accepts that determination of the most qualified firm may require subjective judgments by the selection committee.

Public information: All information, documentation, and other materials submitted in response to this solicitation are considered non-confidential and/or non-proprietary and are subject to public disclosure under the Texas Public Information Act after the solicitation is completed and contract executed with selected firm.

Firms associating with other firms to bring specific expertise and experience to the Project are encouraged.

The Irving ISD is not responsible for the non-receipt of Submittals sent by mail or courier. Respondents are cautioned to submit a complete response to all requirements.

After the issuance of this RFQ, the Facility Services Department reserves the right to amend it, waive any requirement or irregularity, request modifications to submittals or reject any and all qualification statements for any reason provided that all firms are treated equally.

Award/Evaluation of Proposals

Proposals will be evaluated by the following factors and criteria.

EVALUATION CRITERIA

Ability of the Consultant(s) to meet or exceed the requirements defined in 1 the RFQ including the range of services offered (30 Points)

Experience, qualifications and references, local reputation - Specific expertise 2 in areas pertinent to the project (30 Points)

Capabilities and resources (15 Points) 3

Approach to the project (15 Points) 4

The vendor's past relationship with the district (5 Points) 5

Completeness ofresponse to RFQ as outlined in this solicitation package (5 6 Points)

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SUBMITAL REQUIREMENTS

Submittals should be prepared simply and economically, providing a straightforward, concise description of the Respondent ' s ability to meet the requirements for the Project. Elaborate bindings, colored displays, promotional materials and so forth are not desired. Emphasis should be on completeness and clarity of content.

Respondents are requested to provide their submittals in vertical 8.5" x 11 " format in 1" three-ring binders with the name of the Project, Request for Qualifications (RFQ) for Professional Consulting Sen1ices for Roofing Replacement and Repairs at a ll Ir v ing IS D Fa c i li t y Buildings, and the prime firm's name on the front cover and edge.

Submittals should be organized with tabs by the following:

1. Contact Sheet:

• Legal name of Firm

• Date of firm formation

• Date of opening primary home office, and, if applicable, any branch and local offices

• Contact Person with phone number, fax number and e-mail address

• Alternate Contact Person with phone number, fax number and e-mail address

• Current address of office(s)

• Identify office that will be providing services

• Legal Business Description (Individual, Partnership, Corporation, Joint Venture, etc.)

2. Specific expertise in areas pertinent to the project

3. Capabilities, resources and responsiveness:

a. Staffing size, current workload, availability

b. Staffs areas of expertise.

c. Experience with other similar projects

d. History of meeting deadlines

e . History of staying within budget

f. Expertise of project manager and project team

g. Past performance on Irving ISD and other contracts

h. Current financial capability and business practices

4. Approach to the project:

a. Proper attention given to critical issues

b. Familiarity with circumstances surrounding project

5. Current contracts:

a. Obligations that propose a potential conflict of interest

b. Current Irving ISD contracts in effect

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6. Consultant ' s proposed work plan, special concerns or techniques needed

CONSULT ANT QUESTIONNAIRE

Please provide the following information in the sequence and format prescribed by this questionnaire. Supplemental materials providing additional information may be attached, but the information requested below is to be provided in this format. This information is to be provided as a part of the Step 1 process.

1. Firm Information: Name of firm: Address of principal office: Phone: Fax: Form of Business Organization (Corporation, Partnership, Individual, Joint Venture, Other?): Year founded: Primary individual to contact:

2. Organization: How many years has your organization been in business in Roof consulting services?

3. Licensing: List jurisdictions in which your organization is legally qualified to do business and indicate registration or license numbers, if applicable. List Certification Agencies if you are a Certified Historically Underutilized Business

4. Experience: a. List the major Roof consulting services projects your organization has in progress. b. List major projects (specifically educational) for which your firm has provided Roof consulting

services over the last 5 years. For each project, provide the name, nature of the project/function of the building, size, location, cost, completion date, owner and the manner in which services were carried out.

c. List any experience with Irving I.S.D.

6. Personnel: Identify and Provide a resume for each individual whom would be involved in carrying out services to Irving ISD should your firm be selected.

7. References: For 3 of the projects listed above, identify a representative of the owner (provide name, phone/fax numbers, email addresses) who could be contacted as references regarding your firm's services.

8. State any other costs the District may anticipate relating to the services to be provided.

IF ADDITIONAL INFORMATION IS PROVIDED ON A SEPARATE SHEET FOR ANY OF THE ABOVE ITEMS, CLEARLY SPECIFY ON THIS FORM WHERE IT CAN BE LOCATED IN YOUR PROPOSAL PACKAGE.

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Required Forms

1. Agreement funded by US Federal Grant

2. Deviation/Compliance Signature Form

3. Confidentiality Declaration Form

4. Certification for Criminal History Check

5. Felony Conviction Notification

6. Non-Collusive Bidding Certificate

7. Commitment to Provide Insurance Certificate

8. Hold Harmless Agreement

9. Non-Exclusion Affidavit - Debarment and Suspension

10. Legal Compliance

11. Notification to Contractor - Conflict oflnterest Disclosure Statement

12. Conflict oflnterest Questionnaire

13. Notice of Conflict oflnterest

14. Family Conflict oflnterest Questionnaire

15. HB 1295 Form

16. Chapter 2270 Boycott Verification Form

17. SB252 Certification Form - Texas Government Code 2252 - Prohibition against doing business with

Terrorist Organizations

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ALL REQUIRED FORMS MUST BE COMPLETED, SIGNED, AND RETURNED WITH RESPONSE, OR THE RESPONSE WILL BE DEEMED NONRESPONSIVE.

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Agreement funded by US Federal Grant RFCSP #19-35-914

PROVISIONS FOR CONTRACTS FUNDED BY U.S. FEDERAL GRANT

The Irving Independent School District ("the District") is required to obtain certain certifications from organizations receiving District payments paid from federal funds budgets.

Pursuant to Circular A-110 , all contracts, including small purchases, awarded by the District and the District's subcontractors shall contain the procurement provisions of Appendix A to Circular A-110, as applicable. Accordingly, the parties agree that the following terms and conditions apply to the agreement, dated ___ (the "Agreement"), between the District and ______ ("Vendor") in all situations where the vendor has been paid from federal funds.

1. Equal Employment Opportunity - In fulfilling its obligations under the Agreement, Vendor shall comply with E.O. 11246, "Equal Employment Opportunity," as amended by E.O. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and as supplemented by regulations at 41 CFR part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor."

2. Rights to Inventions Made Under a Contract or Agreement - To the extent that the Agreement requires the performance of experimental , developmental or research work, Vendor agrees that the District shall have rights in any resulting invention in accordance with 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 District from which received financial assistance to carry out the work contemplated by the Agreement.

3. Clean Air Act (42 U.S.C. § 7401 et seq.) and the Federal Water Pollution Control Act (33 U.S.C. § 1251 et seq.), as amended - In the event that the fees payable to Vendor under the Agreement exceed $100,000, Vendor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. § 7401 et seq.) and the Federal Water Pollution Control Act as amended (33 U.S.C. § 1251 et seq.). Violations shall be reported to the Awarding Agency and the Regional Office of the Environmental Protection Agency (EPA).

4. Byrd Anti-Lobbying Amendment (31 U.5.C. § 1352) - In the event that the fees payable to Vendor under the Agreement exceed $100,000 , vendor shall file the certification required under 31 U.S.C. § 1352. Each tier shall certify 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 connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with nonFederal funds that takes place in connection with obtaining any Federal award. Such disclosures shall be forwarded from tier to tier up to the vendor.

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5. Debarment and Suspension (E.O.s 12549 and 12689) - Vendor certifies that it and its principal employees are not listed on the General Services Administration's List of Parties Excluded from Federal Procurement or Non- Procurement Programs in accordance with E.O.s 12549 and 12689, "Debarment and Suspension." This list contains the names of parties debarred , suspended or otherwise excluded by agencies, and contractors declared inelig ible under statutory or regulatory authority other than E.O. 12549. Contractors with awards that exceed the small purchase threshold shall provide the required certification regarding its exclusion status and that of its principal employees.

6. Access to Records - 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 the Vendor that are directly pertinent to Vendor's discharge of its obligations under the Agreement for the purpose of making audits, examinations, excerpts and transcriptions.

7. Applicability to Subcontractors - Vendor agrees that all contracts it awards pursuant to the Agreement shall be bound by the foregoing terms and conditions.

Company Name

Corporate Officer's Signature

Printed Name

Street Address

City, State and Zip Code

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DEVIATION/COMPLIANCE SIGNATURE FORM

RFCSP #19-35-914

Company Name

Address City State Zip

Phone Number Fax Number

If the undersigned bidder intends to deviate from the General Conditions Standard Terms and Conditions or Item Specifications listed in this bid invitation, all such deviations must be listed on this page, with complete and detailed conditions and information included or attached. The District will consider any deviations in its bid award decisions, and the District reserves the right to accept or reject any bid based upon any deviations indicated below or in any attachments or inclusions.

In the absence of any deviation entry on this form, the bidder assures the District of their full compliance with the Standard Terms and Conditions, Item Specifications, and all other information contained in this Bid Invitation.

D No Deviation

D Yes Deviation If yes is checked, please list below:

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CONFIDENTIALITY DECLARATION FORM

CO FIDENTIAL INFORMATION SUBMITTED IN RESPONSE TO COMPETITIVE PROCUREMENT REQUEST FOR IRVING ISD IS GOVERNED BY TEXAS GOVERNMENT CODE, CHAPTER 552

If you consider any portion of your proposal as confidential information and not subject to disclosure pursuant to Chapter 552 Tex. Gov't Code or other laws, you must make a £Qfil'. of all claimed confidential materials within your proposal and put this COMPLETED form as a coversheet to said materials and place this completed form and the copied materials in a separate envelope and include the confidential materials envelope with your proposal submission. (The envelope will not be opened unless a Public Information Request is made. You must include the confidential information in the submitted proposal as well. The copy in the envelope is to show IISD which material in your proposal you deem confidential only in the event of a Public Information Request.) You must place the following wording that is between the dotted lines on the outside of the envelope containing the copies of the confidential materials. You may copy, complete and affix the following to the envelope containing the copies of the confidential materials. Irving ISD will follow procedures of controlling statute(s) regarding any claim of confidentiality. Pricing of solicited products or service may be deemed as public information under Chapter 552 Tex. Gov't Code.

This envelope contains material for our proposal that I classify and deem confidential under Tex. Gov't Code § 552 and I invoke my statutory rights to said confidential treatment of the enclosed materials:

Name of company claiming confidential status of material

Printed Name and Signature of authorized company officer claiming confidential status of material

Address City State Zip Phone

ENCLOSED ARE COPIES OF RFCSP #19-35-914

PAGES OF CONFIDE TIAL MATERIAL FROM OUR RESPONSE TO

Express Waiver: I desire to expressly waive our claim of confidentiality of any information contained within our response to the competitive procurement process by completing the following and submitting this sheet with our response Irving ISD procurement process (e.g. RFP, CSP, Bid, RFCSP, etc.).

Name of company expressly waiving confidential status of material

Printed Name and Signature of authorized company officer expressly waiving confidential status of material

Address City State Zip Phone

TIDS EXPRESS WAIVER IS FOR RESPONE TO RFCSP #19-35-914

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Texas Education Code Chapter 22 Certification for Criminal History Check

Introduction: Texas Education Code Chapter 22 requires entities that contract with school districts to provide services to obtain criminal history record information regarding covered employees. Contractors must certify to the district that they have complied . Covered employees with disqualifying criminal histories are prohibited from serving at a school district.

Definitions: Covered employees: Employees of a contractor or subcontractor who have or will have continuing duties related to the service to be performed at the District and have or will have direct contact with students. The District will be the final arbiter of what constitutes direct contact with students. Disqualifying criminal history: Any conviction or other criminal history information designated by the District, or one of the following offenses, if at the time of the offense, the victim was under 18 or enrolled in a public school: (a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required to register as a sex offender under Chapter 62 , Texas Code of Criminal Procedure; or (c) an equivalent offense under federal law or the laws of another state.

On behalf of ________________________ ("Contractor"), I certify that

[check one]: [ ] None of the employees of Contractor and any subcontractors are covered employees, as defined above. If this box is checked, I further certify that Contractor has taken precautions or imposed conditions to ensure that the employees of Contractor and any subcontractor will not become covered employees. Contractor will maintain these precautions or conditions throughout the time the contracted services are provided. Or [ ] Some or all of the employees of Contractor and any subcontractor are covered employees. If this box is checked, I further certify that:

(1) Contractor has obtained all required criminal history record information regarding its covered employees. None of the covered employees has a disqualifying criminal history.

(2) If Contractor receives information that a covered employee subsequently has a reported criminal history, Contractor will immediately remove the covered employee from contract duties and notify the District in writing within 3 business days.

(3) Upon request, Contractor will provide the District with the name and any other requested information of covered employees so that the District may obtain criminal history record information on the covered employees.

( 4) If the District objects to the assignment of a covered employee on the basis of the covered employee's criminal history record information, Contractor agrees to discontinue using that covered employee to provide services at the District.

Noncompliance or misrepresentation regarding this certification may be grounds for contract termination.

Company Name Printed Name of Company Representative

Signature Date

For additional information on how to comply with this statute, please contact the Irving ISO Purchasing Department, 972-600-5440, 2621 West Airport Freeway, Irving, Texas 75062.


FELONY CONVICTION NOTIFICATION

Texas Government Code, 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 an 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

I, the undersigned agent 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:

CONTRACTOR'S NAME: ------------------------AUTHORIZED COMPANY OFFICIAL'S NAME (printed): _________ _

DATE: _________ , 2019.

A. My firm is a publicly-held corporation , therefore,-this reporting requirement is not applicable

Signature of Company Official: __________________ _

B. My firm is not owned nor operated by anyone who has been convicted of a felony.

Signature of Company Official : -------------------

C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony:

Name of Felon(s): _______________________ _

Details of Conviction(s): _____________________ _

Signature of Company Official : __________________ _

End of Section


NON-COLLUSIVE BIDDING CERTIFICATE

By submission of this bid or proposal, the Bidder certifies that:

1. This bid or proposal has been independently arrived at without collusion with any other Bidder or with any Competitor;

2. This bid or proposal has not been knowingly disclosed and will not be knowingly disclosed, prior to the opening of bids, or proposals for this project, to any other Bidder, Competitor or potential competitor:

3. No attempt has been or will be made to induce any other person, partnership or corporation to submit or not to submit a bid or proposal ;

4. The person signing this bid or proposal certifies that he has fully informed himself regarding the accuracy of the statements contained in this certification , and under the penalties being applicable to the Bidder as well as to the person signing in its behalf.

Signature below certifies accuracy of answers to all sections on this page.

Authorized Signature Printed Name

Company Name and Address

Telephone Number Date


COMMITMENT TO PROVIDE INSURANCE AFFIDAVIT

RFCSP #19-35-914

2019 KITCHEN EQUIPMENT REPLACEMENT

By submitting a proposal response and signing below I Contractor agree to the following : I am aware of all costs to provide the required insurance, will do so pending contract award, and will provide a valid insurance certificate meeting all requirements within ten days of notification of award .

If the above ten day requirement is not met, the Irving ISO Purchasing Department has the right to reject this proposal and award the contract to the next Contractor meeting all requirements. If you have any questions concerning these requirements, please contact the Buyer addressed in this procurement document, Purchasing Department at (972) 600-5440.

Proposer's Signature: _____________ Date: __________ _


INSURANCE REQUIREMENTS

Contractors providing goods and/or services for Irving ISO in response to an RFP must maintain certain minimum amounts of insurance. These requirements vary depending on the type and hazard of work being performed. The contractor's policy must be primary over any other valid and collectible insurance carried by Irving ISO, and Irving ISO must be named as an Additional Insured with respect to work being done/service provided . Any immunity available to Irving ISO shall not be used as a defense by the contractor's insurance policy.

All Contractors who perform contracted services for Irving ISO are required to provide proof of insurance prior to the start of the project.

A schedule of minimum requirements is provided. The coverages and limits are to be considered minimum requirements and in no way limit the liability of the Contractor.

The following shall apply as indicated: (a) Contractor shall procure and maintain at its sole cost and expense for the duration of this

Contract, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by Contractor, its agents, representatives, volunteers, employees or subcontractors. Contractor acknowledges that it has familiarized itself with the extent and scope of work to be performed and certifies that its insurance policies provide coverage for losses that might arise from the types of hazards to be found therein.

i. Contractor's insurance coverage shall be primary and noncontributory with respect to Irving ISO (IISO), its Board , employees and volunteers.

ii. To the extent that subcontractors may be used , Contractor shall include all subcontractors as additional insured 's under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverage for subcontractors shall be subject to all of the requirements stated herein.

iii. Certificates of Insurance and endorsements shall be furnished to IISO and approved by IISO before services are furnished.

iv. The following standard insurance policies shall be required: (a) Commercial General Liability Policy (b) Workers' Compensation Policy (c) Automobile Liability Policy (d) Umbrella or Excess Liability

v. Approval , disapproval or failure to act by IISO regarding any insurance supplied by Contractor shall not rel ieve Contractor of full responsibility or liability for damages and accident as set forth in the contract documents. Neither shall the bankruptcy, insolvency or denial of liability by the insurance company exonerate Contractor from liability.

(b) The following requirements are applicable to all policies: Insurance shall be written by a carrier with an A-: VII or better rating in accordance with current

A.M. Best Key Rating Guide.

i. Only insurance carriers licensed or duly authorized to do business in the State of Texas will be accepted .

ii. Only deductibles applicable to property damage are acceptable; if applicable they must be shown on the certificate of insurance and approved by Texas.

iii. "Claims made" policies will not be accepted.


iv. IISD is to be added as "Additional Insured" to the General Liability and the Automobile Liability policies. The coverage shall contain no special limitations on the scope of protection afforded to IISD, its Board , employees, and volunteers.

v. Each insurance policy shall be endorsed to state that coverage shall not be suspended , voided , canceled , non-renewed or reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail , return receipt requested has been given to IISD.

vi. Upon request, certified copies of all insurance policies shall be furnished to IISD.

(c) COMMERCIAL GENERAL LIABILITY INSURANCE

i. Minimum Limits of $1 ,000,000 per Occurrence with an annual Aggregate of $1 ,000,000 for Bodily Injury, Personal Injury and Property Damage.

ii. Coverage shall be provided for premises/operations and product/completed operations hazards.

iii. Any exclusions, changes or limitations of coverage must be submitted with Contractor's written proposal and must be approved by IISD.

iv. IISD shall be added as an "Additional Insured ." v. A Waiver of Subrogation in favor of IISD must be endorsed to the policy.

(d) WORKERS' COMPENSATION INSURANCE

i. Minimum Employer's Liability limits of: (a) By Accident -- $1 ,000,000 each accident; (b) By Disease -- $1 ,000,000 each Employee and Policy limit.

ii. A Waiver of Subrogation in favor of IISD must be endorsed to the policy.

(e) AUTOMOBILE LIABILITY

i. On Owned , Non-owned or Hired motor vehicles used on the site or in connection therewith , a minimum Combined Single Limit of $1 ,000,000 each Accident for Bodily Injury and Property Damage, to include Uninsured/Underinsured Motorist coverage.

ii. IISD shall be added as an "Additional Insured ." iii. Insurance Services Office Business Auto coverage form or broader with symbol 1, "any auto"

shown in the Covered Autos portion of the declarations page. iv. There shall be no special limitations regarding the scope of protection afforded to IISD, its

Board , employees and volunteers. v. A Waiver of Subrogation in favor of IISD must be endorsed in the policy.

(f) UMBRELLA LIABILITY

i. Minimum Limits of $5,000,000 per Occurrence with an annual Aggregate of $5,000,000. ii. Coverage shall follow form of underlying Commercial General Liability, Workers'

Compensation , and Automobile Liability policies. iii. IISD shall be added as an "Additional Insured." iv. A Waiver of Subrogation in favor of IISD must be endorsed to the policy.

(g) CERTIFICATES OF INSURANCE All Certificates of Insurance shall be prepared and executed by the insurance company or its authorized agent, and shall contain provisions warranting the following :

i. The company is authorized to do business in the State of Texas. ii. The insurance set forth by the insurance company is written on forms approved by the Texas

State Board of Insurance or ISO.


iii. Sets forth all endorsement and insurance coverage according to requirements and instructions contained herein.

iv. Shall specifically set forth the notice of cancellation , termination , or change in coverage provisions to IISD.

v. Original endorsements affecting coverage required by this section shall be furnished with the certificates of insurance.

(h) VERIFICATION OF COVERAGE The following requirement pertains to all Certificates of Insurance. Contractor shall furnish IISD with certificates of insurance and with original endorsements effecting coverage by this clause. The certificates and endorsements for each policy are to be signed by a person authorized by that insurer to bind coverage on its behalf and written on forms that have been approved by the Texas Department of Insurance or Insurance Services Office . They must set forth all coverage and deductibles as well as the notice of cancellation , termination or change in coverage provisions to IISD according to requirements and instructions contained herein Certificates of insurance (or certified copies of policies) and any required endorsements shall be furnished to and approved by IISD before work commences. IISD reserves the right to require complete, certified copies of all required insurance policies at any time

(i) NOTICES All notices pertaining to insurance shall be given to IISD at the following address:

Irving Independent School District Attn : Jerome Pilgrim Director of Purchasing Administration Build ing P.O. Box 152637 Irving , Texas 75015


HOLD HARMLESS AGREEMENT

The Contractor shall defend, indemnify, and hold harmless, Irving Independent School District and all of its trustees, officers, agents, and employees from and against all suits, actions, or claims of any character brought for or on account of any injuries or damages (including death) received or sustained by any person or property on account of, arising out of, or in connection with, any negligent act or omission of Contractor or any agent, employee, subcontractor or supplier of Contractor in the execution or performance of the Contract for:

Project Name: ____________________ _

Designated as Bid No. RFP # ____ _

The Contractor shall also defend, indemnify and hold harmless Irving Independent School District and all of its trustees, officers, agents and employees, from and against claims by any subcontractor, supplier, laborer, materialman or mechanic for payment for work or materials provided on behalf of the Contractor in the performance of the Contract and all such claimants shall look solely to Contractor and not the Irving Independent School District for satisfaction of such claims.

This Hold Harmless Agreement shall be binding upon the undersigned, and its successors, legal representatives, heirs and assigns.

DATED this __ day of __________ , 2019.

CONTRACTOR

By:---------------

Name

Title

STATE OF TEXAS § COUNTY OF DALLAS §

This instrument was acknowledged before me on the ______ day of

____________ , 2019, by ___________ , a Texas

, on behalf of said -------------- -----------

Notary Public, State of Texas


Non-Exclusion Affidavit Regarding Debarment and Suspension

F ederaL state, and local government agencies, not -pro fits, and other organizations that use federal money to fund all or part of any program or project are required to follow specific requirements regarding the use of such federal funds. One of these requirements is that no contract, subcontract, grant, financial assistance, or other forms of assistance provided using federal funds may be awarded to individuals or entities that have been suspended, debarred, or otherwise excluded from participation in federally funded progran1S.

The U.S. federal government maintains a Web site known as the "System for Award Management" (SAM) at \Vww.sam.gov. One of the purposes of the SAM Web site is to provide a comprehensive_list of all individuals, finns, and other entities that have been suspended, debarred, or otherwise excluded from participation in federally funded contracts, subcontracts, grants, etc. SAM provides a simple means of helping government, non-profit agencies, and other organizatio11S e11Sure that they do not award federally-fi.mded grants, contracts, subcontracts, or other financial or non-financial benefits to any individuaL firm, or other entity that has been excluded by any agency from pai1icipation in such federally funded activities.

I, ________________ (Contractor Representative), hereby certify that neither I nor

__________________________ (Name of the company or organization

I represent) nor ai1y subcontractors that I or said company may employ to work on any federally funded activity have

been suspended, debarred, or otherwise excluded by any federal agency from pai1icipation in ai1y federally funded

activity. I fu1iher acknowledge my understanding that, before entering into a contract with me or with the compai1y or

organization I represent, Irving ISO staff will perfonn a search on www.sam.gov to verify whether I, the orgai1ization I

represent, or any subcontractors I may employ to work on any federally funded activity, have been excluded from

participation in any federally funded activity.

Signature of Contractor Representative Date

Sworn to ai1d subscribed before me this __ day of __ , 2019

Notary Public in and for _____ County, ______ (I11Sert State ame)

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LEGAL COMPLIANCE

It is the proposing company's duty and responsibility to have knowledge of and be responsible for the compliance with all applicable laws, rules and regulations as they apply to this procurement process and any subsequen award .

If awarded under this document, does the Contractor agree to comply, in all relevant respects, with all Federal State, and Local laws, rules and regulations related to the performance of services or supply of goods to Irvin~ ISO?

YES __ NO __

Signature below certifies accuracy of answers to all sections on this page.

Authorized Signature Printed Name

Company Name and Address

Telephone Number Date

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Notice to Contractors

Conflict of Interest Disclosure Statements Texas Local Government Code, Chapter 176 Contractors are required to file a Conflict of Interest Questionnaire with the District if a relationship exists between the contractor's company and an officer of the District. Contractors are encouraged to review and become familiar with all disclosure requirements of Texas Local Government Code, Chapter 176.

Conflicts of interest exist if: 1. the person has employment or other business relationship with the local government officer or a family

member resulting in the officer or family member receiving taxable income; or 2. the person has given the local government officer or family member one or more gifts (excluding food ,

lodging , transportation , and entertainment) that have an aggregate value of more than $250 in the twelve month period preceding the date the officer becomes aware of an executed contract or consideration of the person for a contract to do business with the District.

Disclosure is required from contractors regarding each affiliation or business relationship between the contractoI and :

1. an officer of the District; 2. an officer of the District that results in the officer or family member receiving taxable income; 3. an officer of the District that results in the contractor receiving taxable income that does not come from

the District; 4. a corporation or other business entity in wh ich an officer of the District serves as an officer or

director, or holds an ownership interest of 10% or more; 5. an employee or contractor of the District who makes recommendations to an officer of the District

regarding the expenditure of money; 6. an officer of the District who appoints or employs an officer of the District that is the subject of the

questionnaire; and 7. any person or entity that might cause a conflict of interest with the District.

Forms must be filed : 1. No later than the seventh business day after the date that the person begins contract discussions or

negotiations with the government entity, or submits to the entity an application , response to a request for proposal or bid , correspondence, or other writing related to a potential agreement with the entity.

2. The Contractor also shall file an updated questionnaire : a. not later than September 1 of each year in which a covered transaction is pending , and b. the seventh business day after the date of an event that would make a statement in the

questionnaire incomplete or inaccurate.

3. A contractor is not required to file an updated questionnaire if the person had filed an updated statement on or after June 1, but before September 1 of the year.

Officers of the Irving Independent School District are : Randy Randle , Board President (District 7) Dr. Steven Jones, Vice President, (District 1) Nuzhat Hye, Secretary (District 4) Nell Anne Hunt (District 2) Pamela Campbell (District 3) A.O. Jenkins , (District 5) Randy Necessary (District 6) Magda Hernandez, Superintendent of Schools

CONFLICT OF INTEREST QUESTIONNAIRE FORM

For contractor or other person seeking to do business with local governmental entity CIQ (Required Field)

Name of Person Completing Form: (Required Field)

Name of Company Completing Form:

This questionnaire reflects changes made to the law by H.B. 1491 , 80th Leg., Regular Session. OFFICE USE ONLY

This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section 176.001 (1 -a) with a local governmental entity Date Received: I I and the person meets requirements under Section 176.006(a).

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

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

LJJ Name of person who has a business relationship with local governmental entity.

~ Check this box if you are filling an update to a previously filed questionnaire. LJ (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.)

~ Name of local government officer with whom filer has emplovment or business relationship:

I (List Name of Officer in space provided above) If naming government officer above, completion of A, B, C & D below is reauired. If no conflict, check box at line 4 below.

This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has affiliation or business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.

A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, fro~ filer of the questionnaire? D

Yes No

B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of t~cal government officer nam~this section AND the taxable income is not received from the local governmental entity?

Yes No

C. Is the filer of ~ uestionnaire employed by ~oration or other business entity with respect to which the local govern men officer serves as an officer or Irector, or holds an ownership of 10 percent or more?

Yes No

D. Describe each employment or business relationship with the local government officer named in this section.

~ n Check here if you are NOT reporting a conflict with any government officer of Irving ISD

w ~inn~+11ro /0.c.n11irorl\ n,,+o

NOTIFICATION OF NO CONFLICT OF INTEREST RFCSP #19-35-914

Irving ISD 2621 West Airport Freeway Irving, TX 75062

If applicable, please sign and return this form to the attention of:

Jerome Pilgrim, Director of Purchasing (at the above address)

Irving ISO requires this notification to document the Offeror's acknowledgement of requirements of Texas Government Code, Section 176.00 of the Texas Local Government Code for disclosure of Conflicts of Interest. Submission of this form is an affidavit that the Offeror submitting this form is stating that no conflict exists, as detailed in Texas Local Government Code Section 176.006 (a).

This form is in addition to any other reporting requirement required under Texas state law and does not supplant any additional reporting requirements.

Company (Print or Type) Phone

Signature Date

Printed Name & Title of Signature

THIS PAGE MUST BE RETURNED WITH THE RFP (If applicable)


' I G

FAMILYCONFLICTOFINTERESTQUESTIONNAIRERFCSP#l9-35-914

This Questionnaire must be completed by every ind ividual or entity that contracts or seeks to contract with the District for the sale or purchase of property, goods, or services.

The questionnaire(s) required by this policy shall be filed with the Senior Buyer not later than

the seventh (7 TH) business day after the date that the individual or entity begins contracts discussions or negotiations with the District or submits to the District an application , response to a request for proposals or bids, correspondence, or other writing related to a potential agreement with the District. If the individual or entity becomes aware of new facts or change of facts that would make the completed questionnaire(s) inaccurate, the individual or entity shall file an amended questionnaire(s) with in seven (7) days of the date the individual or entity first learned of the new facts or changes in facts.

Family or family relationship means a member of an individual 's immediate family, including spouse, parents, children (whether natural or adopted ), aunts, uncles, and siblings.

For individuals who contract or seek to contract with the District for the sale or purchase of any property, goods, or services: Identify each and every family relationship between yourself (and any member of your family) and any full-time District Employee (and any member of such employee's family) (please include name and sufficient information that will allow proper identification of any named individual): For entities that contract or seek to contract with the District for the sale or purchase of property, goods, or services: Identify each and every full-time District employee (and any member of the employee 's family) who serves as an officer or director of the entity, or holds an ownership interest of 10 per cent or more in the entity (please include name and sufficient information that will allow proper identification of any named individual):

If more space is required please attach a second page. If the answer to any question is none, or not applicable, please write "None" or "Not Applicable" in the space reserved for that · answer. "I certify that the answers contained in this questionnaire are true and correct. "

Individual : _______________ _ Date: ---------

Entity: _________ ____ ___ _

By: ______________ _

Date: ---------

Signature: _______________ _

Title : ________________ _

Instructions - Form 1295


Effective January 1, 2016, a governmental entity may not enter into a contract requiring board approval, unless the business entity submits a Disclosure of Interested Parties (Form 1295) at the t ime the business entity submits the signed contract.

The following definitions apple :

1. "Interested Party" means a person :

a. Who has a controlling interest in a business entity with whom a governmental entity contracts : or

b. Who actively participates in facilitating the contract or negotiating the terms of the contract, including a broker, intermediary, adviser, or attorney for the business entity.

2. "Intermediary" means "a person who actively participates in the facilitation of the contract or negotiating the contract, including a broker, adviser, attorney, or representative of or agent for the business entity who :

a. Receives compensation from the business entity for the person's participation;

b. Communicates directly with the governmental entity or state agency on behalf of the business entity regarding the contract; and

c. Is not an employee of the business entity

3. "Business Entity" means any entity recognized by law through which business is conducted, including a sole proprietorship, partnership, or corporation . "Business entity" includes a for- profit or nonprofit entity. He term does not include a governmental entity or state agency.

4. "Contract" includes an amended, extended, or renewed contract.

5. "Controllinglnterest"ms. AMDL a. An ownership ~r ci ti .il_;;.es · business entity by virtue of units,

REF Bl,1;;:tpith/t oar _

0

r t:i .. et r o:c1!Wg1l oJ'" buTn{s':~'tfyJ"'tf ON ~ or ot r g ern g bo Is o s~ n~l~;~~b~ _l

c. Service as an of icer of a busine en ity that has four or fewer officers, or service as one o the four officers most highly comp by a business entity that has more than four officers."

A business entity must file Form 1295 electronically with the Texas Ethics Commission using the Commission's online filing application, which can be found at:

https://www.ethics.state.tx.us/whatsnew/elf info form 1295.htm

The business entity must print a copy of the completed form , which will include a certification of filing containing a unique certification number. ThefFcl-m 1295 must be signed by an authorized agent of the business entity, and the form must be nc5rarized. The business entity must then submit the completed, signed, notarized Form 1295 to the contracting school district.

Again, inter-local contracts DO NOT REQUIRE a Form 1295 because governmental entities do not fall within the definition of "business entity" . Notably, though, compliance with HB 1295 is required for contracts with nonprofit agencies, such as the Irving Independent School District.

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.

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 .

3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the goods or services to be provided under the contract.

4 Nature of Interest (check applicable) City, State, Country

Name of Interested Party (place of business)

Controlling Intermediary

5 Check only if there is NO Interested Party.

6 AFFIDAVIT I swear, or affirm, under penalty of perjury. that the above disclosure is true and correct.

Signature of authorized agent of contracting business entity

AFFIX NOTARY STAMP / SEAL ABOVE

Sworn to and subscribed before me. by the said , this the day

of ,20 . to certify which. witness my hand and seal of office.

Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath

ADD ADDITIONAL PAGES AS NECESSARY

Form provided by Texas Ethics Commission www.ethics.state.tx.us Adopted 10/5/2015


SB 252 CHAPTER 2252 CERTIFICATION

As per Section 2252.151-154 of the Texas Government Code, added by SB 252, 75th Legislature, R.S. (2017), all bidders must complete the following:

I, the undersigned vendor, do hereby certify that the company I represent, is not identified on the Texas Comptroller's list of companies known to have contracts with or provide supplies or services to a foreign terrorist organization. A "Foreign Terrorist Organization ," means an organization designated as a foreign terrorist organization as defined by the United States Secretary of State as authorized by federal law.

Pursuant to Texas Government Code, Chapter 2252, Section 2252.152 and Section 2252.153, I certify

that the company named below is not listed on the website of the Comptroller of the State of Texas

concerning the listing of companies that are identified under Section 806.051, Section 807.051 or Section

2253.153. I further certify that should the above-named company enter into a contract that is on said listing

of companies on the website of the Comptroller of the State of Texas which do business with Iran,

Sudan or any Foreign Terrorist Organization, I will immediately notify the Irving ISO Purchasing

Department.

!, __________________ __, the undersigned and representative

of ---------------------------------(Company or Business Name)

Name of Company Representative (Print)

Signature of Company Representative

Date


CHAPTER 2270 (BOYCOTT) VERIFICATION FORM:

This form contains a requirement for vendors competing on government contracts to declare that, at

the time of they are seeking to contract with a government entity they 1) do not boycott Israel , and 2)

they will not boycott Israel during the term of the contract with the government entity. "Boycott Israel"

means refusing to deal with, terminating business activities with, or otherwise taking any action that

is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel,

or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not

include an action made for ordinary business purposes; and "Company" means a for-profit sole

proprietorship, organization, association, corporation, partnership, joint venture, limited partnership,

limited liability partnership, or limited liability company, including a wholly owned subsidiary,

majority-owned subsidiary, parent company, or affiliate of those entities or business associations

that exist to make a profit. This requirement became effective on September 1, 2017 resulting from

the passage of House Bill 89. (pursuant to Texas Government Code §2270 and §808.001 ).


~ IRVING 1 n-dtpendent cbool District

PURCHASING DEPARTMENT 2621 West Airport Freeway Irving, Texas 75062-2637 Phone: (972) 600-5440

REQUEST FOR PROPOSALS #19-35-914 for 2019 Kitchen Equipment Replacement

Chapter 2270 (BOYCOTT) VERIFICATION

The undersigned authorized representative of the company named below (hereinafter referred to as Company), pursuant to Texas Government Code Chapter 2270, verifies, represents and warrants to the Irving I.S.D. that the Company:

1. Does not boycott Israel, and; 2. Will not boycott Israel during the term of the contract (if any) between the above-named Company,

business or individual with the Irving Independent School District

This statement will also be included in any contract that may result from this procurement.

Pursuant to Texas Government Code Sections 2270.001 and 808.001 :

1. "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes; and

2. "Company" means a for-profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majorityowned subsidiary, parent company, or affiliate of those entities or business associations that exist to make a profit.

THE COMPANY SHALL INDEMNIFY AND HOLD HARMLESS THE IBYING 1,s,p, IJS OFFICIALS AND EMPLOYEES FROM ANY ANO ALL CLAIMS, DAMAGES, EXPENSES, ANO COSTS OF ANY NATURE BASED upoN IRYING LS,Q,'S REUANCE ON THIS VERIFICATION,

Signature of Company Representative Date

Printed Name Title

Company Name :. _________________________________ _

Address: ---------------------------------------

City :. __________________ State: _________ Zip :. ______ _

Note: I understand that providing false information on this form may be grounds for debarment and discontinuation of all business with IRVING ISO.


AFFIDAVIT

The undersigned swears/affirms that the foregoing information and statements are true and correct and include all material and information necessary to identify and explain the operations of (name of firm) ________________________ _ as well as the ownership thereof.

Further, the undersigned agrees to permit the Irving Independent School District (IISD) to interview owners, principals, officers and employees; and to audit or examine books, records and files of the above firm .

If at any time the IISD has reason to believe that any person or firm has willfully and knowingly provided incorrect information or made false statement, the IISD may refer the matter to its General Counsel or take other action.

NOTE: Under Title 18 U.S.C. Section 1001 and Title 15 U.S.C. Section 645, any person who misrepresents a firm 's status as a small disadvantaged business concern or makes false statements in order to influence the certification process in any way to obtain a government contract, shall be subject to fines of up to $500,000 and imprisonment of up to 10 years, or both.

The burden of proof of control and management of the business is on the applicant. The IISD reserves the right to request any additional information it deemed necessary to determine if a firm is certifiable. Failure to cooperate and/or provide requested information within the time specified is grounds for termination of the processing of your application for certification.

Name Signature

Title Date

Date _______ State of _______ County of ______ _

On this day before me appeared (name) ______________ with proper identification, who being duly sworn, did execute the foregoing affidavit and did aver that he or she was properly authorized by (name of firm) _____________ _ to execute this affidavit and did so as his or her free act/deed.

(SEAL)

Notary Public in and for the State of Texas My Commission Expires:


MWBE/HUB CERTIFICATION Historically Underutilized Business Questionnaire

A bidder/proposer that has been certified as a Minority/Women Business Enterprise (also known as "Historically Underutilized Business" or "HUB" and all referred to in this forma as "MWBE") is encouraged to indicate its MWBE certification status when responding to this Bid/Proposal Invitation.

D I certify that my company has been certified as a MWBE in the following categories (Please check all that apply)

D Minority Owned Business D Women Owned Business

Certificate Number: --------------------Name of Certifying Agency: _______________ _

D My company has NOT been certified as MWBE

By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to make this certification .

Company

Signature of Authorized Company Official

Printed Name