1-B. Band Tower for Kell HS, B26068 Required Documents fillable.pdf

IFB B26068, Band Tower for Kell HS

COBB COUNTY SCHOOL DISTRICT

MARIETTA, GEORGIA

PROCUREMENT SERVICES DEPARTMENT

ACKNOWLEDGEMENT AND AGREEMENT

Invitation for Bid B24022, Band Tower for Kell HS

This Acknowledgement and Agreement must be properly signed and firmly attached to your quote response. The acknowledgement becomes a part of your quote response and without it your quote response is not complete and will be subject to rejection.

I, the undersigned, have carefully examined and fully understand the CCSD General Terms and Conditions and this solicitation in its entirety and agree to conform to every requirement. I certify that I am authorized to sign this quote for the vendor. I further acknowledge that failure to prepare, submit, or execute this quote in the exact manner requested will be just cause to reject any or all of my quote submission.

Withdrawals, cancellations, etc., will not be accepted unless authorization is given by the Director of Procurement Services. In the event my company fails to comply, my company may be removed from the vendors’ list.

Failure to respond using the most recent forms/information posted to the CCSD Current Solicitations website may be cause for rejection. It is my company’s responsibility to check the CCSD Current Solicitations website for any addenda, responses to vendor questions, or other communications, which may be necessary during the solicitation period. I acknowledge and incorporate each applicable Addendum number listed below in my company’s response:

Check all that apply: Addendum No. 1 _____, Addendum No. 2 _____, Addendum No. 3 _____, Addendum No. 4 _____, No Addenda

Prices must remain firm as specified on the award notification letter

Company Name Representative’s Name (type or print)

Address Representative’s Signature (must be signed in ink)

City, State, and Zip Code E-Mail Address

Date Telephone Number and Extension

Terms (Net 30 days unless early payment discount Fax Number is submitted and accepted by the CCSD.)

Signing the Agreement affirms that the original Request for Quote document has not been altered in any way.

MARIETTA, GEORGIA

GEORGIA SECURITY & IMMIGRATION COMPLIANCE ACT DOCUMENTS

Determine how to comply with the GA Security & Immigration Compliance Act This section of the Agreement is related to the Georgia Security and Immigration Compliance Act, O.C.G.A. § 13-10-90 et seq. The chart below may assist the Contractor in determining which affidavit(s) must be provided as a provision of entering into this Agreement. If in doubt as to whether a document should be completed and submitted, it is recommended that the Contractor submit the information.

Does the

Contractor provide services?

Initial line 2(b) on the next page; complete the Affidavit of Exception and provide driver’s license as requested therein.

No affidavits are required. Employee(s) will perform the work.

Initial lines 2(a), 3 and 5 of the next page; and completion of the

Contractor Affidavit is required. Initial lines 2(a), 4 and 5 of the next page; completion of the

Contractor Affidavit and Subcontractor Affidavit are required.

STOP

Does the Contractor have employees and/or subcontractors or plan to hire employees and/or subcontractors to perform the work?

Subcontractor(s) will perform the work.

Both subcontractor(s) and employee(s) will perform the work.

YES

NO

NO

YES

STOP

STOP

STOP

Is the contract valued over $2,499?

YES

NO

Initial line 2(c) on the next page. complete the Affidavit of

Exception

STOP

MARIETTA, GEORGIA

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT OF 2006, AS AMENDED BY

THE ILLEGAL IMMIGRATION REFORM ACT OF 2011, OCGA 13-10-90, ET SEQ.

TO ALL PROSPECTIVE CONTRACTORS:

If you are providing services to the Cobb County School District, this completed document, as well as the applicable Georgia Security and Immigration Compliance forms and affidavits referenced herein must be completed, signed, notarized, and submitted with your bid, proposal, quote, contract, or vendor registration.

1) The Cobb County School District shall comply with the Georgia Security and Immigration Compliance Act, as amended, O.C.G.A. § 13-10-90 et seq.

2) In order to ensure compliance with the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603 and the Georgia Security and Immigration Compliance Act of 2006, as amended by the Illegal Immigration Reform Act of 2011, O.C.G.A. § 13-10-90 et seq. (collectively the “Act”) the contractor (“Contractor”) MUST INITIAL the statement applicable to Contractor below:

(a) (Initial here) Contractor represents and warrants that Contractor has registered at https://e-verify.uscis.gov/enroll/ to verify information of all new employees in order to comply with the Act; is authorized to use and uses the federal authorization program; and will continue to use the authorization program throughout the contract period. Contractor further represents, warrants and agrees that it shall execute and return any and all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10-1-.01 et seq. in accordance with the terms thereof; (Complete and submit the Contractor Affidavit and Agreement); OR

(b) (Initial here) The Contractor is a sole proprietor with no employees, subcontractors, or sub-subcontractors, and it will not use or hire employees, subcontractors, or sub-subcontractors for any work performed for the District under the contract. This requires submission of a Georgia driver’s license or a license from an approved state. (Complete and submit the Affidavit of Exception); OR

(c) (Initial here) The Contractor will provide goods only to the District and will not render any services to the District. If your company provides goods along with ancillary services, such as maintenance, repairs, help desk support, customer support, technological support, or any other ancillary services, your company cannot file an Affidavit of Exception and must register with E-Verify. (Complete and submit the Affidavit of Exception); OR

(d) (Initial here) The Contractor is a foreign company and the work performed under the contract will be done in a foreign country by residents of that country. Contractor must comply with any other laws required to perform services in the United States, including but not limited to having an appropriate visa. (Complete and submit the Affidavit of Exception); OR

(e) (Initial here) The Contractor is an individual who is licensed pursuant to Official Code of Georgia Title 26 or Title 43, or by the State Bar of Georgia; whose license is in good standing, and the Contractor is the individual who will be performing the services under the contract. (Complete and submit the Affidavit of Exception)

3) (Initial here) Contractor will not employ or contract with any subcontractor in connection with a covered contract unless the subcontractor is registered, is authorized to use, and uses the federal work authorization program and provides Contractor with all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10- 1-.01 et seq.

4) (Initial here) Contractor covenants and agrees that, if Contractor employs or contracts with any subcontractor in connection with the covered contract under the Act and DOL Rule 300-10-1-.02, then in such event Contractor will secure from each subcontractor at the time of the subcontract, the subcontractor’s name and address, the employer identification number/taxpayer identification number applicable to the subcontractor; the date the authorization to use the federal work authorization program was granted to subcontractor; the subcontractor’s attestation of the subcontractor’s compliance with the Act and Georgia Department of Labor Rule 300-10-1-.2.; and the subcontractor’s agreement not to contract with subcontractors unless the subcontractor is registered, authorized to use, and uses the federal work authorization program; and provides subcontractor with all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10-1-.01 et seq. (Complete and submit the Subcontractor Affidavit and Agreement)

5) (Initial here) Contractor agrees to provide the Cobb County School District with all affidavits of compliance as required by the Act and Georgia Department of Labor Rule 300-10-1-.02, 300-10-1-.03, 300-10-1-.07 and 300-10-1-.08 within five (5) business days of its receipt of any such documents.

Company Name:

https://e-verify.uscis.gov/enroll/

MARIETTA, GEORGIA

CONTRACTOR AFFIDAVIT PROVIDED PURSUANT TO O.C.G.A. § 13-10-91(b)(1) The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use, and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify public employer Cobb County School District in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contractor’s contract with Cobb County School District;

e) The Contractor will subcontract for the performance of services in satisfaction of such contract only with subcontractors who complete, sign, notarize, and present an affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c) prior to beginning the performance of services;

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to public employer Cobb County School District within five (5) business days of receipt.

Federal Work Authorization User Identification Number (4 to 7 Digit Number)

Date of Authorization

Name of Contractor

Email Address

Name of Project/Contract

Telephone Number

Name of Public Employer Cobb County School District

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on , 20 in (city), (state).

Signature of Authorized Officer or Agent of Contractor

Printed Name and Title of Authorized Officer or Agent

NOTARY INFORMATION

Subscribed and Sworn before me this the day of , 20 .

Notary Public Signature

My Commission Expires: ___________________________ _

Affix Notarial Seal Here

MARIETTA, GEORGIA

SUBCONTRACTOR AFFIDAVIT PURSUANT TO O.C.G.A. § 13-10-91(b)(3)

By executing this affidavit, the undersigned subcontractor (hereinafter the “Subcontractor”), which is engaged in the physical performance of services under a contract with ________________________________ (name of contractor) on behalf of public employer Cobb County School District, verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the Subcontractor has registered with, is authorized to use, and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the Subcontractor covenants that it will continue to use the federal work authorization program throughout the contract period, that the Subcontractor will contract for the physical performance of services in the performance of such contract only with sub-subcontractors who present an affidavit to the Subcontractor with the information required by O.C.G.A. § 13-10-91(b), and that the Subcontractor shall forward notice of receipt of any sub-subcontractor’s affidavit to the contractor and School District, together with a copy of such affidavit, within five (5) business days of its receipt of the same. If the Subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted sub-subcontractor, the Subcontractor must forward, within five (5) business days of receipt, a copy of the notice, together with copies of such affidavits, to the contractor.

Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization

User Identification Number

(4 to 7 Digit Number)

Date of Authorization

Name of Subcontractor

Email Address

Name of Project/Contract

Telephone Number

Name of Public Employer Cobb County School District

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on , 20 in (city), (state).

Signature of Authorized Officer or Agent of Subcontractor

Printed Name and Title of Authorized Officer or Agent

Subscribed and Sworn before me this the day of , 20 .

My Commission Expires: ____________________________

MARIETTA, GEORGIA

AFFIDAVIT OF EXCEPTION PURSUANT TO O.C.G.A. § 13-10-91(b)(5) The undersigned, in connection with a proposed contract or subcontract with the Cobb County School District (the “School District”) for the physical performance of services in the State of Georgia (the “Contract”), hereby affirms and certifies under penalties of perjury that I am exempt from providing a Contractor Affidavit of E-Verify Compliance to the School District pursuant to O.C.G.A. § 13-10-91, as amended, for one of the following reasons:

(a) I am a sole proprietor with no employees, subcontractors, or sub-subcontractors, and I will not use or hire employees, subcontractors, or sub-subcontractors for any work performed for the School District;

In order to be exempt from compliance under the above exception, in addition to this affidavit you must provide a copy of your State of Georgia driver’s license. If you do not have a Georgia license, please see:

https://law.georgia.gov/sites/law.georgia.gov/files/related_files/site_page/List%20of%20States.pdf for a list of driver’s licenses from alternative states that can be submitted in lieu of a Georgia driver’s license.

If at any time hereafter I determine that I will need to hire employees to satisfy or complete the physical performance of services under the Contract, then before hiring any employees, I will:

(i.) Immediately notify the School District and all higher tier contractors (if any) in writing; and (ii.) Register with, participate in and use, a federal work authorization program operated by the United States Department of Homeland

Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986, P.L. 99-603, in accordance with the applicability provisions and deadlines established in O.C.G.A. § 13-10-90; and

(iii.) Provide the School District with all affidavits required by O.C.G.A. § 13-10-90 et seq. and Georgia Department of Labor Rule 300-10- 1-.01 et seq.

OR

(b) The Contractor will provide goods only to the District and will not render any services to the District. If your company provides goods along with ancillary services, such as maintenance, repairs, help desk support, customer support, technological support, or any other ancillary services, your company cannot file an Affidavit of Exception and must register with E-Verify;

OR

(c) The Contractor is a foreign company, and the work performed under the contract will be done in a foreign country by residents of that country;

OR

(d) The Contractor is an individual who is licensed pursuant to Official Code of Georgia Title 26 or Title 43, or by the State Bar of Georgia; whose license is in good standing, and the Contractor is the individual who will be performing the services under the contract.

Print Company Name / Name of Sole Proprietor

Name of Project/Contract

BY: Signature of Authorized Officer/Agent of Company/Sole Proprietor Date

Sworn to before me this day of , 20

My Commission Expires: ____________________________ https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Flaw.georgia.gov%2Fsites%2Flaw.georgia.gov%2Ffiles%2Frelated_files%2Fsite_page%2FList%2520of%2520States.pdf&data=05%7C01%7Cbarbara.bates%40cobbk12.org%7Ca952715535a94721667a08da59e2a3a3%7C2fce1dfb919f4938aab8c47f0fc9182d%7C0%7C0%7C637921127365270197%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=aCcBtrByQMYy7bHouMQdrsb1w%2BIwQ8qw2LF0v%2BVdi3g%3D&reserved=0

MARIETTA, GEORGIA

DISCLOSURE OF LOBBYING ACTIVITIES

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient, at the initiation or receipt of a covered federal action, or a material change to a previous filing pursuant to Title 31 U.S.C. Section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered federal action.

Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered federal action.

2. Identify the status of the covered federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered federal action.

4. Enter the full name, address, city, state and zip code of the reporting entity. Include congressional district, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organization filing the report in Item 4 checks “subawardee”, then enter the full name, addressee, city, state and zip code of the prime federal recipient. Include congressional district, if known.

6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the federal program name or description for the covered federal action (Item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grant, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate federal identifying number available for the federal action identified in Item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application proposal control number assigned by the federal agency). Include prefixes, e.g., “RFP-DE-90-001.”

9. For a covered federal action where there has been an award or loan commitment by the federal agency, enter the federal amount of the award/loan commitment for the prime entity identified in Item 4 or 5.

10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action.

(b) Enter the full names of the individual(s) performing services and include full address if different from 10(a). Enter last name, first name, and middle initial.

11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10).

Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.

12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment.

13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.

14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with federal officials. Identify the federal official(s) or employee(s) contacted or the officer(s), employee(s), or member(s) of Congress that were contacted.

15. Check whether or not a Continuation Sheet(s) is attached.

16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503.

FORM (Rev. 5/17)

MARIETTA, GEORGIA

DISCLOSURE OF LOBBYING ACTIVITIES

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See bottom for public burden disclosure.)

Approved by OMB 0348-0046

1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. Contract

b. grant

c. cooperative agreement

d. loan

e. loan guarantee

f. loan insurance

a. bid/offer/application

b. initial award

c. post-award

a. initial filing

b. material change

For Material Change Only:

year_______ quarter_______ date of last report_________

4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime: Prime Subawardee

Tier______, if known:

Congressional District, if known: Congressional District, if known:

6. Federal Department/Agency: 7. Federal Program Name/Description:

NSLP SBP SFSP SMP CACFP

Code of Federal Domestic Assistance (CFDA) Number, if applicable:

8. Federal Action Number, if known: 9. Award Amount, if known:

10. a. Name and Address of Lobbying Entity (if individual, last name, first name, Middle initial):

b. Individuals Performing Services (including address if different from No.

10.a.)

(last name, first name, middle initial):

11. Amount of Payment (check all that apply):

$_________________ actual planned

13. Type of Payment (check all that apply):

a. retainer

b. one-time fee

c. commission

d. contingent fee

e. deferred

f. other, specify: __________________________

12. Form of Payment (check all that apply):

a. cash

b. in-kind; specify: nature ___________________ value ____________________

14. Brief description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment indicated in 11:

(attach Continuation Sheet(s) SF-LLL-A, if necessary)

15. Continuation sheet(s) attached: Yes No

16. Information requested through this form is authorized by title 31 U.S.C. section 1352.

This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection.

Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature:

Print Name:

Title:

Telephone No.: Date:

Federal Use Only: Authorized for Local Reproduction

Standard Form - LLL

FORM (Rev. 5/17)

(Attach Continuation Sheet(s) SF-LLL-A if necessary)

MARIETTA, GEORGIA

VENDOR QUESTIONNAIRE

Company Name:

1. Provide complete contact information for each of the following. If no information is provided below, the information on the Acknowledgement and Agreement Form will be used.

NOTE: An IRS W-9 form should be submitted with response.

Service Representative This person will be responsible for answering CCSD questions related to products, billing issues, etc. during term of contract.

Company Name:

Address:

City: State: Zip:

Contact Name:

Telephone: Fax:

Contact Email:

Purchase Order Address

Address:

City: State: Zip:

Contact Name:

Telephone: Fax:

Contact Email:

Indicate whether purchase orders are to be sent via fax or email. □ Fax or □ Email (preferred)

PO Fax: PO Email Address:

Payment (Remit) Address

Address:

City: State: Zip:

Contact Name:

Telephone: Fax:

Contact Email:

Checks should be made payable to: