1-02 RFP 26-003 Proposal Form.pdf

EL PASO COUNTY COMMUNITY COLLEGE DISTRICT

REQUEST FOR PROPOSALS

RFP #26-003

NURSING PROGRAM TESTING AND LEARNING SYSTEM, AND NCLEX® PREPARATION

REVIEW COURSES

PROPOSAL FORM

Proposal of

(hereinafter called "Respondent") organized and existing under laws of the State of doing business as ( ) a Corporation, ( ) a Limited Liability Corporation, ( ) a Partnership, ( ) an Individual/Sole Proprietor ( ) or Other _________________________________ .

In Compliance with your advertisement for proposals, Respondent hereby promises to provide the goods or services contained herein, in strict accordance with Contract Documents, at the prices stated below.

By submission of this Proposal, each Respondent certifies that this Proposal has been arrived at independently, without consultation, communication or agreement as to any matter relating to this Proposal with any other Respondent or with any competitor.

Further, I affirm under penalty of perjury of the laws of the State of Texas that:

(1) I am duly authorized to execute this contract on my own behalf or on behalf of the company, corporation, firm, partnership or individual (hereinafter referred to as “Company”) listed below;

(2) In connection with this Proposal, neither I nor any representative of the Company have violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15;

(3) In connection with this Proposal, neither I nor any representative of the Company have violated any federal antitrust law; and

(4) Neither I nor any representatives of the Company have directly or indirectly communicated any of the contents of this Proposal to a competitor of the Company or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Company.

Respondent agrees to provide all the goods or services described in the contract documents.

RFP #26-003 Proposal Form

I. Forms

Each of the following items listed below must be included in your response packet. Forms should be completed and bear the respondent’s signature(s) in ink where required:

• Proposal Form – Signature Required

• Attachment A – References

• Attachment B – Organization Details

• Texas Family Code Form – Signature and SSN or Federal Tax ID Number Required

• Required Contract Clauses Form (NON-Federal Funds) – Signatures Required

• Conflict of Interest Questionnaire – Name of Vendor, Signature and Date Required

• Confidentiality Agreement – Date, Signature and Title Required

Refer to Section V. Proposal Response (pages 24-26) of the RFP for any additional items to be included with your proposal response.

II. Additional Vendor Information

1. Where is the principal place of business for your organization’s parent company or majority owner?

2. How many persons does your organization employ in Texas?

3. Provide information on the impact on the ability of the District to comply with laws and rules relating to historically underutilized businesses that a contract with your organization would have:

4. Respondent shall state whether it has any legal complaints filed against it or state “none” as applicable.

If so, describe in detail the circumstances and the outcome of the proceedings, include the names and docket number linked to the case. Respondent must also include detailed information on any litigation that it was a party to in the last five (5) years or state "none" as applicable.

5. In responding to this RFP, I certify that my business is in compliance with all city, state, and federal laws, including all other applicable codes, ordinances, and regulations.

Initial one: Yes No

III. Addenda (If applicable)

Receipt of the following listed addenda to RFP #26-003 is acknowledged:

Addendum Number Date Addendum Number Date

Addendum Number Date Addendum Number Date

The respondent acknowledges their understanding that this is a Request for Proposals and as such, the El Paso Community College District will award according to the criteria contained herein. By signing below, respondent agrees to all the terms and conditions contained herein and further, that they have the authority to contractually bind the Company. No additional costs will be accepted by the District, beyond what respondent submits with proposal response for the specific goods and/or services described herein.

Respondents shall only submit offers through this process as requested by the District. Any secondary, additional or alternate offer will only be considered if it has been requested by the District herein. Such unsolicited offers will not be considered by the District.

Furthermore, by signing below, Respondent certifies that neither they nor the firm, corporation, partnership or institution represented by the signatory or anyone acting for the firm submitting this proposal has violated the antitrust laws of the State of Texas, codified at Section 15.01, et seq., Texas Business and Commerce Code, or the Federal antitrust laws, nor communicated directly or indirectly the proposal made to any competitor or any other person engaged in the same line of business, nor has the signatory or anyone acting for the firm, corporation or institution submitting an offer committed any other act of collusion related to the development and submission of this proposal. Moreover, Respondent declares that its proposal is in all respects fair and without collusion or fraud, and that no trustee of the District, no officer of the District, and no person employed by the District is directly or indirectly interested in the proposal or in any portion of the profits that might result from this Request for Proposals.

Company Name (Signature)

Company Headquarters’ Physical Address Name (Printed)

City, State, Zip Code Title

Telephone Number E-mail Address

Federal Tax ID Number Web Address (if available)

Date