1-RFP 2026-49 Forms for Submission.pdf

Signature Page City of Allentown BID No. 2026-49 Purchasing Office 435 Hamilton Street Page A Allentown, PA 18101

Proposals must be accompanied by the Signature Page. Failure to sign and submit the Signature Page with the bid will result in the bid being rejected as non-responsive.

To: The City of Allentown, Pennsylvania

CONSTRUCTION INSPECTION & MANAGEMENT SERVICES

The Undersigned, having examined the Specifications, Standard Requirements and all other documents and being familiar with the various conditions under which these services and/or supplies are to be used, agrees to all terms and conditions set forth in the bid and to furnish all labor, material, tools, equipment and services to furnish the requirements called for in the bid, for the prices stated.

The Undersigned hereby certifies that this response is genuine and not fraudulent or made in the interest of or on behalf of any person, firm, or corporation, not herein named, and that the undersigned has not, directly or indirectly, induced or solicited any Bidder to submit a false or fraudulent bid or prohibited any other person, firm or corporation from bidding and that the undersigned has not, in any manner, sought by collusion to secure for himself any advantage over any Bidder.

A signed Bid/quote submitted to the City obligates the bidder to all terms and conditions stated within the bid/quote document.

Company Name

Address

Signature Printed Name ____________

Title

Email

Phone FAX No.

TRADING AND DOING BUSINESS AS (Check One)

{ } Individual

{ } Partnership

{ } Corporation

Federal I.D.# or Social Security # ___________

Addendum #1 (date)

Addendum #2 (date)

Addendum #3 (date)

(Seal)

Page B

Pursuant to the City’s Administrative Code Section 130.16 (H), for all non-competitive RFP contracts or financial assistance in excess of $2,500, an individual or business (including: family members with a financial interest in the business, business associates, subcontractors, contribution to a PAC which makes a candidate contribution, consultants) shall not make a contribution in excess of $250.00 inclusive of in-kind services in the aggregate, to a candidate for any elective City office or to an elected City office incumbent during the incumbent’s term of office.

VENDOR INFORMATION

Name_______________________________________________________________________ Address_____________________________________________________________________ City_____________________________________________State__________Zip___________

CONTRIBUTION DISCLOSURE

Contributor Name Recipient Name Date Dollar Amount

Check here if the information is continued on subsequent page (s).

SUB-CONTRACTOR/CONSULTANT IDENTIFICATION

Name Employer Address

Check here if the information is continued on subsequent page(s).

I certify that NO contributions in the aggregate total over Two Hundred Fifty ($250.00) Dollars were made to an applicable public official by me, a family member or representative. I understand that this certification applies for the length of this contract, and that breach of such contribution rules shall be cause for the void of this contract. I further understand that I will be liable for liquidated damages of 10% of the maximum payment made to me should this contract be voided due to my breach of such contribution rules.

Read and accepted by:

Signature

Printed Name and Title/Position

Date: ___________________________________

IBE Preference City of Allentown BID No. 2026-49 Purchasing Office 435 Hamilton Street Page C Allentown, PA 18101

Request for Proposal Page 26

Article 815B of the Home Rule Charter of the City of Allentown requires that bids received from an Identified Business Enterprise, i.e. Small Business, Small diverse Business, and Veteran Business, will receive 10 points towards their final score. In order to qualify for the preference, the IBE must be properly licensed to do business in the City of Allentown and in compliance with all City Ordinances and regulations.

BIDDERS SHALL COMPLETE THE FOLLOWING:

________ We qualify for the IBE Preference because:

________ We do not qualify for the IBE Preference.

FAILURE TO RESPOND AFFIRMATIVELY TO THE ABOVE WILL IN NO WAY HAVE A NEGATIVE

IMPACT ON YOUR BID.

FIRM NAME:

BY:

PRINTED:

TITLE:

Page D

CITY OF DEPARTMENT OF COMMUNITY & ECONOMIC DEV.

MWBE-9-08 - (9-08) (PLEASE PRINT)

MINORITY & WOMEN’S BUSINESS ENTERPRISE

PRIME CONTRACTOR’S QUARTERLY UTILIZATION REPORT

(This form should be returned within 10 working days at the end of each quarter.)

PRIME CONTRACTOR’S FIRM NAME REPORTING PERIOD

ADDRESS CONTRACT NUMBER

TELEPHONE

CONTACT PERSON DATE RECEIVED (Office use Only)

List State certified minority and/or women-owned businesses whose services and/or supplies you have purchased in reference to this contract.

COMPANY NAME ADDRESS TELPHONE

NUMBER

MBE

(X)

WBE

(X)

TRANSACTION

DATE

PAID

MBE/WBE

ACTUAL

DOLLARS*

SUB

CONTRACT

(X)

SUPPLIES

(X)

Prepared By: Title: Phone No: E-Mail Address:

SUBMITTALS CHECKLIST

To help ensure that you include all the submittals necessary to complete a thorough evaluation of your bid proposal, we suggest that you use this checklist as a reminder to yourself, by placing a check in each box in the Verified column indicating that the items are completed and/or enclosed with your bid proposal packet.

VERIFIED DESCRIPTION OF SUBMITTAL REF PAGE NO.

Signature Page Page A

Political Contribution Disclosure Form Page B

IBE Preference Form Page C

MBE/WBE Commitment Form Page M1

MBE/WBE Prime Contractor Form Page D

Remember to attach a copy of your most recent W-9 Form.

Remember to direct any/ all bid questions using the PennBid Website. Utilizing this site will guarantee questions are documented and answered quickly and promptly electronically or responded to in form of an addendum.

Remember to check PennBid for any Addenda that may have been issued regarding this bid.

Remember that when submitting your sealed bid to clearly label your submission with your company name, bid number and title.

Remember to check that there is NO COST in your technical proposal. The inclusion of cost proposal information in the technical proposal will cause the entire proposal to be disqualified.