1-RFP Architectural Engineering Services w attachments - 2-27-2026 (978436965.1).pdf

Request for Proposal

Architectural / Engineering Services

HOUSING AUTHORITY OF MONROE COUNTY

Housing Authority of Monroe County 1055 Main Street Stroudsburg, PA 18360-1427

(570) 421-7770

Table of Contents Request for Proposal

Purpose

Background

Description of the Properties

Scope of Work/Technical Specifications

MBE/WBE/DBE

Fees

Additional Services

Projects and Tasks

Minimum Requirements

Fee Proposal

Contract Term

Response Time Frame And Other Information

Proposal Content & Format

Evaluation Method

Proposal Evaluation

Contract Award

Post Contract Award Requirements

Invoicing and Payments

Form of Contract

Forms required to be completed and returned:

• Form of Proposal

• Vendor Information Form

• HUD 5369-A

• HUD 50071

Informational Forms Only:

• HUD 5369-B

• HUD 5370-C Section I

• Sample Form of Contract

Request for Proposal

The Housing Authority of Monroe County (HAMC) seeks proposals for consultants to provide architectural and engineering services for our affordable housing units.

All submissions must be uploaded to the E-Procurement website no later than 12:00 noon, , 2026. Fax submissions or emails will not be accepted.

RFP documents will be available , 2026, electronically at www.housingauthoritymonroecounty.org. To submit a proposal, vendors must register with our E- Procurement website (PennBid) and upload the documents electronically no later than 12:00 noon, , 2026.

Questions and requests for information about the content of the documents shall be directed, in writing, to via the E-Procurement web site, no later than 12:00 noon, , 2026.

HHA reserves the right to reject any or all proposals and waive any informalities.

HOUSING AUTHORITY OF MONROE COUNTY

http://www.housingauthoritymonroecounty.org/

Purpose

The Housing Authority of Monroe County (HAMC) and its affiliates are seeking proposals for architectural and engineering consulting services from qualified firms. HAMC seeks consulting services to assist in the revitalization and redevelopment of its properties, and development of new units expanding its affordable housing portfolio. The consultant will provide expert guidance in providing services for projects that HAMC may develop and/or for improvements to existing projects owned and operated by HAMC and its affiliates.

Background

The HAMC is a governmental entity enabled under the laws of Pennsylvania, whose primary contracts are with the U.S. Department of Housing and Urban Development (HUD). HAMC was organized for the acquisition, development, modernization, operation, and administration of affordable housing programs.

The primary purpose of HAMC is to provide safe, decent, sanitary, and affordable housing to the elderly and low-income families in Monroe County and to operate housing programs in accordance with federal legislation. HAMC currently owns and manages approximately 300 Low Income Public Housing units within 7 properties, manages 117 low income housing tax credit properties within 3 properties, and administers over 1,000 Housing Choice Voucher Program units.

HAMC is governed by a Board of Commissioners appointed by Monroe County. The Board of Commissioners of HAMC are responsible for policy development and oversight.

Description of the Properties

Name of Development # Units Type of Units Location Normal Hill and Taylor Street 60 Duplex East Stroudsburg, PA

Hawthorne Terrace 28 Duplex Stroudsburg, PA

Garden Street 28 Duplex Stroudsburg, PA

Avon Court 40 Garden East Stroudsburg, PA

Barnum Lenox and Kistler 45 Townhome East Stroudsburg, PA

Westgate Apartment 99 Highrise Stroudsburg, PA

Total Units

Scope of Work/Technical Specifications

The HAMC is seeking proposals from qualified, licensed and bonded entities to provide the following detailed Architectural / Engineering Design Services:

General Specifications. The HAMC intends to award a contract to a firm to provide architectural design services (A/E) for various projects the HAMC may develop or improve. Services will include, but are not limited to A/E services pertaining to:

a. Site planning;

b. Structural, mechanical, electrical and civil engineering;

c. Landscaping;

d. Cost estimating; and

e. Construction contract administration.

Phases of the A/E Services shall consist of:

a. Schematic Design / Preliminary Study Phase;

b. Design Development Phase;

c. Bidding, Construction and Contract Document Phase;

d. Bidding and Award Phase;

e. Construction Phase; and

f. Post Completion / Warranty Phase.

Design Product. The design product shall meet all Monroe County and Pennsylvania State requirements as well as all International Building Code requirements and shall conform with all applicable local codes, ordinances and all HUD requirements.

MBE/WBE/DBE

HAMC supports the effort and goals to further contracting opportunities to traditionally disadvantaged firms. As a part of its efforts, HAMC strongly encourages the participation of these firms and/or the partnering with MBE/DBE/WBE firms in this proposal process.

Fees

Pursuant to HUD regulations, HAMC is prohibited from entering into contracts for a percentage of any project or pay expenses with a "cost-plus" mark up. HAMC will accept any non-prohibited proposal;

however, the responder must include an hourly rate schedule in their proposal.

HAMC reserves the right to reject the fixed or retainer fee approach and contract with the selected Firm solely on the basis of an hourly rate schedule.

Invoices shall be presented monthly and clearly designate task order numbers or descriptive task information. HAMC shall be allowed a minimum of thirty (30) days to tender payments due.

Additional Services

Should any additional services be required that have not been allocated to a particular service area, HAMC shall have the sole and exclusive right to allocate the service to a firm already under contract.

Projects and Tasks

HAMC will assign tasks on an as needed basis. HAMC may request a "cost" or "hourly" estimation for the task. HAMC shall reserve the right to mandate strict adherence to any cost estimation or number of hours projected on a task by the firm.

At no cost to HAMC, the firm may be asked to provide a project schedule and plan that will be followed during the course of the project, and periodic status reports.

Minimum Requirements

The Respondent must meet the following minimum requirements to be considered:

• Must meet the appropriate state licensing requirements.

(Please attach proof of your firm meeting the appropriate State of Pennsylvania Licensing requirements; a photocopy of your certificate, license or permit will serve this purpose)

• Must have a record of responsible comparable work.

• Must comply with applicable requirements for continuing professional education.

(Please attach proof)

• Must certify that no member of, or delegate to Congress of the United States or Municipal Official shall be admitted to any share or part of this contract or to any benefit that may arise here forth.

• Must warrant that he/she has not employed any person to solicit or secure this contract upon any agreement for a commission, percentage, brokerage or contingent fee. Breach of this warranty shall give HAMC the right to terminate this contract, or, in its discretion, to deduct from the fee the amount of such commission, percentage, brokerage or contingent fee.

• Must certify that he/she will not assign or transfer any interest in this contract except that claims for monies due or to become due from HAMC under the contract may be assigned to a bank, trust company, or other financial institution. If the Respondent is a partnership, this contract shall inure to the benefit of the surviving or remaining member(s) of such partnership.

• Must certify that he/she will not discriminate against any employee or applicant for employment because of race, color, religion, sex, age or national origin. The Respondent must certify that it shall take affirmative action to ensure that applicants are employed, and employees are treated during employment, without regard to race, color, religion, sex, age or national origin. Such action, shall include, but not be limited to the following: employment, upgrading, demotion or transfer;

recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship.

Fee Proposal

Complete and include the cost schedule for all proposed engagement team members. Also include estimated fees for travel costs (lodging, airfare, rental vehicle/mileage), if necessary, as well as any other expenses anticipated in the performance of the Contract. The form for the Fee Proposal is attached.

Contract Term

The Contract is effective for a period of three (3) years, commencing on the date the Contract is completely executed, unless properly amended or terminated as provided here. The Contract may be renewed by mutual written agreement upon it expiration with two (2) additional one (1)-year renewal periods.

Prior to the execution of this Contract, the Contractor shall have no authority to begin work under this Contract. HAMC's Contracting Officer and/or designee shall not authorize any payments to the Contractor prior to such award, nor shall HAMC incur any liability to reimburse the Contractor regarding any expenditure for the purchase of materials or the payment for Services prior to commencement of this Contract. The Contract shall not become effective until the Contract has been approved and signed by the Board of Commissioners of HAMC.

Response Time Frame and Other Information

Response submission period:

Questions/Answer period:

Evaluation period:

Interviews (if required):

Award:

, 2026 through , 2026 Responses due by 12:00 noon, , 2026

, 2026 through , 2026 @ 12:00 noon (via PennBid web site)

, 2026 through

, 2026 through , 2026 (if necessary)

(to conform with the Board of Commissioners’ Meeting)

Proposals must comply with regulations and statutes relating to procurement in the Commonwealth of Pennsylvania, HUD and the policies of the HAMC. The person submitting the proposal must have the authority to bind the organization in a contract. Late submissions will not be considered.

All responses must be submitted electronically through the PennBid website.

All costs directly or indirectly related to the preparation of a response to this RFP shall be the sole responsibility of and shall be borne by the respondent.

Requests for all other information must be in writing, via the PennBid. Questions and responses will then be made available to all respondents.

It is the expressed policy of the HAMC that parties responding to this request refrain from initiating any direct contact or communication with HAMC staff or members of the Board of Commissioners with regard to this Request for Proposals during the selection process. Any violation of this policy will be considered a basis for disqualification.

HAMC reserves the right to waive any minor informality in any proposal when these actions appear to be in the HAMC's best interest, cancel the RFP, reject any or all proposals, make an award based solely on the proposals, or to negotiate further with one or more firms. HAMC also reserves the right to reject the proposal of any firm that has previously failed to perform satisfactorily, or has failed to complete, on time, a contract or contracts of a similar nature. HAMC also reserves the right to select the proposal designed to deliver the most favorable overall impact upon HAMC and the right to ask questions, interview or negotiate the services and price before awarding the contract. HAMC reserves the right to withdraw this solicitation at any time.

All proposals received will become a part of HAMC's official files without any obligation on HAMC's part to return submitted material.

HAMC is an equal opportunity employer. The award will be made without regard to race, color, religion, gender, age, mental or physical disability (or history thereof), marital or family status, beliefs, and national origin.

Proposal Content & Format

Proposal Submittal: HAMC intends to retain the successful Respondent pursuant to a "Best Value" basis, not necessarily a "Low Bid" basis. Therefore, so that HAMC can properly evaluate the offers received, all proposals submitted in response to this RFP must be formatted in accordance with the sequence noted as following. None of the proposed services may conflict with any requirement HAMC has published herein or has issued by addendum.

Form of Proposal: This Form is attached to this RFP document. This 1-page Form must be completed and executed where provided thereon and submitted under this tab as a part of the proposal submittal.

Form HUD-5369-A, Representations, Certifications, and Other Statements of Bidders: This Form is attached to this RFP document. This form must be fully completed, executed where provided thereon and submitted under this tab as a part of the proposal submittal.

Vendor Information Form: The Vendor Information Form is attached to this RFP document. This form must be fully completed, executed and submitted under this tab as a part of the proposal submittal.

NOTE: Insurance policies to be supplied upon request only.

Proposed Services: The successful responder must demonstrate their ability to perform these services in an efficient, timely and independent manner. The description of the responder's proposal and experience shall indicate possession of a broad and practical knowledge of HUD rules, regulations and requirements, and federal law and applicable procedure pertaining to public housing grants.

To that end, this section is for the responder to provide the following:

• A summary of your proposed approach

• Detail the level of assistance you would require of HAMC's staff to conduct said services

Managerial Capacity/Financial Viability: This is the section reserved for demonstrating the qualifications and technical ability of the staff member(s) who will conduct the services. Please include a company biography. The respondent must submit under this tab a concise description of its managerial and financial capacity to deliver the proposed services, including brief professional resumes for the principles, as well as those individuals assigned to the engagement team.

Client Information: The Respondent shall submit a listing of at least 3 former or current clients for whom the Respondent has, within the preceding 24 months, performed similar or like services to those being proposed herein. The list shall, at a minimum, include:

• The name of the firm;

• The client's contact name;

• The client's telephone number;

• A brief description and scope of the service{s) provided.

Equal Employment Opportunity: The Respondent shall submit under this tab a copy of its Equal Opportunity Employment Policy, and any documentation it believes substantiates practice and history of employing minorities and/or women in professional positions. This tab should also include any certification of Minority Business Enterprise {MBE) and/or Woman Business Enterprise {WBE).

Section 3 Documentation: For any Respondent claiming a Section 3 Preference, he/she shall include a Section 3 statement explaining Section 3 participation.

Proposal: Shall be submitted on the Fee form provided, indicating hourly fees for each identified staff person. Also indicate any travel/lodging fees, reimbursable fees and other associated costs and fees.

Other Information (Optional Item): The Respondent may include hereunder any other general information that the Respondent believes is appropriate to assist HAMC in its evaluation.

Evaluation Method

Initial Evaluation: Each proposal received will first be evaluated for responsiveness (i.e. meets the minimum of the requirements).

Evaluation Summary: The HAMC will complete a summary of responses from the evaluators. Final recommendation of the firm presenting the best value will be submitted to the Board of Commissioners of HAMC for approval at a public meeting.

Proposal Evaluation

The Evaluation Committee will review the Proposals in accordance with the following evaluation criteria:

1. Technical Competence and Methods 0 to 30 Points

Verifiable experience within the service area and degree of housing and/or public entity representation experience, references, integrity, compliance with public policy, record of past performance, and financial and technical resources.

2. Narrative Response to RFP 0 to 25 Points

The narrative should address the scope of service and describe the approach or management structure/style that will be taken, and the staff that will be assigned to the tasks.

3. Proposed Contract Price (e.g. Fee Schedule) 0 to 25 Points

The Respondent will be evaluated based on the proposal fee schedule as it pertains to services as delineated by this RFP. Based upon this proposed fee structure, an assessment will be made concerning the reasonableness of the fee proposal for accomplishing the proposed scope of work.

4. Involvement of SBE, MBE, WBE Enterprises and

a. Certified Section 3 business, plan, training education fund or dedicated staff

b. MBE/WBE/DBE participation (attach copy of appropriate certification)

0 to 15 Points

0 - 5 Points

0 - 10 Points

5. Community Service 0 to 5 Points

The Respondent will be evaluated based on the Firm's involvement in community service and volunteering activities.

TOTAL POINTS 100 Points

Contract Award

If a contract is awarded as a result of this RFP, the following procedures will be followed:

The Executive Director of HAMC shall take the award recommendation to the HAMC Board of Commissioners at a scheduled Board of Commissioners meeting for approval. The HAMC Board will then make its determination of whether or not to follow the recommendation. If the recommendation is followed and the top-rated Respondent is approved for award, all Respondents will receive an announcement of award. Contract price negotiations may, at HAMC's option, be conducted prior to or after the Board approval. In the event the Board does not approve the recommendation, HAMC reserves the right to re-evaluate, rebid or cancel the solicitation.

• Contract Conditions: The following provisions are considered mandatory conditions of any contract award made by HAMC pursuant to this RFP:

• Contract Form: HAMC will not execute a contract on the successful Respondent's form.

Contracts will only be executed on the sample Professional Services Contract (attached) and by submitting a proposal the successful Respondent agrees to initialize the sample contract.

• General Conditions: HUD Form 5370-C, Section I is made part of this contract.

• Assignment of Personnel: HAMC shall retain the right to demand and receive a change in personnel assigned to the work if HAMC believes that such change is in the best interest of HAMC and the completion of the contracted work.

• Unauthorized Sub-Contracting Prohibited: The successful Respondent shall not assign any right, nor delegate any duty for the work proposed pursuant to this RFP (including, but not limited to, selling or transferring the contract) without the prior written consent of HAMC. Any purported assignment of interest or delegation of duty, without the prior written consent of HAMC shall be void and may result in the cancellation of the contract with HAMC, or may result in the full or partial forfeiture of funds paid to the successful Respondent as a result of the proposed contract; either as determined by HAMC.

• Contract Period: The HAMC will award a three-year contract to the successful Respondent to perform Architectural / Engineering Services.

• Work made for hire: All work performed pursuant to this agreement specifically including all deliverables developed or prepared for HAMC is the exclusive property of HAMC. All right, title and interest in and to said property shall vest in HAMC and shall be deemed to be a work made for hire and made in the course of the services rendered pursuant to this agreement.

Post Contract Award Requirements

Prior to award (but not as part of the submission of the proposal), the successful Respondent will be required to produce the following:

• An original certificate evidencing the Respondent's current (workers compensation) insurance carrier and coverage amount;

• An original certificate, naming HAMC as an additional insured, showing the entity's general liability insurance coverage (minimum of $1,000,000 each occurrence, general aggregate minimum limit of $2,000,000), with a deductible of not greater than $1,000;

• An original certificate showing the Respondent's professional liability and/or errors and omissions" coverage (minimum of $1,000,000 each occurrence, general aggregate minimum limit of $2,000,000, with a deductible of not greater than $1,000);

• W-9 form. Info available at: http://www.irs.gov/pub/irs-pdf/fw9.pdf

Invoicing and Payments

Contractor shall submit detailed billing to HAMC within thirty (30) days of job completion. To receive any payment due, submit invoices of completed work to the headquarters address of HAMC, 1055 Main Street, Stroudsburg, PA 18360-1427.

HAMC is tax exempt. A tax exemption certificate will be furnished upon request.

Payment terms for approved invoices are on a net/30-day basis, and shall be formatted as follows:

■ Company name, address, and telephone number;

■ Invoice number, HAMC purchase order, contract number, and task order number;

■ If applicable, attach the completed Request For Service (RFS) form, with approval/signature by HAMC staff of satisfactory completion. This is the form initiated by HAMC requesting the contractor's services.

http://www.irs.gov/pub/irs-pdf/fw9.pdf

Form of Proposal

Instructions: The items listed below must be completed and included in the Proposal unless otherwise specifically noted. Please complete this form by marking X, where the referenced information has been included.

SUBMITTAL ITEMS

X = ITEM (One original and five copies of each Proposal)

INCLUDED

Form of Proposal Form HUD-5369-A Vendor Information Form Proposed Services Managerial Capacity / Financial Viability Client Information Equal Employment Opportunity Statements Section 3 Documentation (Optional) Fee Proposal Other Information (Optional)

Proposer's Statement

The undersigned proposer hereby states that by completing and submitting this Form and all other documents within this submittal, he/she is verifying that all information provided herein is, to the best of his/her knowledge, true and accurate, and that if HAMC discovers that any information entered herein is false, that shall entitle HAMC to not consider or make award or to cancel any award with the undersigned party. Further, by completing and submitting the proposal submittal, the undersigned proposer is thereby agreeing to abide by all terms and conditions pertaining to this RFP as issued by HAMC. Pursuant to all RFP Documents, the Form of Proposal, and all attachments, the undersigned proposes to supply HAMC with the services described herein for the fees as agreed by the HHA and proposer.

By: Date:

Name:

Title:

Company Address:

REQUEST FOR PROPOSAL (RFP) FOR ARCHITECTURAL / ENGINEERING SERVICES

RFP Title: Architectural / Engineering Services

RFP Response Due Date and Time: , 2026 Issue Date: , 2026

ISSUING AGENCY INFORMATION

Housing Authority of Monroe County 1055 Main Street

Stroudsburg, PA 18360 Attn: Linda Kaufman, Executive Director

(570) 421-7770 LKaufman@housingauthoritymonroecounty.org

PLEASE COMPLETE THE FOLLOWING

Consultant / Firm Name:

Address:

Telephone Number:

Email Address:

Type of Entity:

By:

RETURN THIS COVER SHEET WITH RFP RESPONSES

mailto:LKaufman@housingauthoritymonroecounty.org

REQUEST FOR PROPOSAL – ARCHITECTURAL / ENGINEERING SERVICES

SERVICES OFR FISCAL YEARS 2026, 2027 & 2028

FEE PROPOSAL FORM

Progress Payments

HAMC agrees to pay all fees related to services rendered within thirty (30) days of its receiving submitted invoices

Fees for 2026, inclusive of all costs and expenses, must be broken down into the following applicable components:

YEAR 2026 – Architectural / Engineering Services

1. Positions of Employees: $ per hour $ per hour $ per hour $ per hour

2. Other Work (list): $ per hour

3. Other Charges: $ per hour

Describe what “Other Work” expenses represent:

State any adjustments to the above rates for Years 2027 and 2028:

AGREEMENT FOR ARCHITECTURAL / ENGINEERING SERVICES

FY2026, FY2027, and FY2028

THIS AGREEMENT dated , 2026, by and

BETWEEN

HOUSING AUTHORITY OF MORNOE COUNTY, (hereinafter called “HAMC”) of 1055 Main Street, Stroudsburg, Pennsylvania 18360-1427.

AND

(hereinafter called “Consultant”), of , Pennsylvania.

W I T N E S S E T H:

WHEREAS, HAMC currently manages and operates a number of housing projects for low and moderate income families and elderly in Monroe County; and

WHEREAS, the said Consultant is and has been engaged in the practice of architectural and engineering in the County of Monroe and maintains an office in , Pennsylvania; and

WHEREAS, HAMC recognizes that it must employ a Consultant to supervise and provide continuing architectural and engineering services which will be required in connection with the operation and management of its projects and other projects subsequently constructed or otherwise acquired by HAMC; and

WHEREAS, HAMC is desirous of contracting with the Consultant for the supervision and performance of the aforementioned services; and

WHEREAS, the parties hereto desire to fix in writing their respective rights and obligations:

NOW THEREFORE, the parties agree as follows:

1. HAMC hereby engages Consultant to supervise and provide architectural and engineering services to HAMC, Consultant accepts the assignment under the terms and conditions set forth in this Agreement.

2. Consultant shall perform all the necessary services provided under this Agreement in connection with the work required by HAMC in the management and operation of its housing projects and shall do, perform, and carry out in satisfactory and proper manner so long as this Agreement remains in effect, consulting services to assist in the revitalization and redevelopment of its properties, and development of new units expanding its affordable housing portfolio. The Consultant will provide expert guidance in providing services for projects that HAMC may develop and/or for improvements to existing projects owned and operated by HAMC and its affiliates.

3. Consultant shall be reimbursed for services at the rates identified in the Fee Proposal forms, submitted with their proposal which are incorporated into this Agreement.

4. No member, officer, or employee of HAMC, no member of the governing body of the locality in which the project is situated, no member of the governing body of the locality in which the Consultant was activated, and no other public official of such locality or localities who exercises any functions or responsibilities with respect to the project, shall during his tenure, or for one year thereafter, have any interest, direct or indirect, in this contract or the proceeds thereof.

5. No Member of or Delegate to the Congress of United States of America or resident Commissioner shall be admitted to any share or part of this Contract or to any benefits, which arise there from.

6. During the performance of this Agreement, Consultant agrees not to discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer;

recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation;

and selection for training, including apprenticeship.

7. This Agreement shall be effective , 2026, and through , 2028. Either party may terminate and cancel this contract upon thirty (30) days notice to the other and in such event the Consultant shall be entitled to receive compensation as specified herein for all work completed and accepted prior to such termination or cancellation and in addition to equitable adjustment shall be made as to compensation for any substantial amount of work or services performed by it to the date of such termination or cancellation but not accepted by HAMC.

This Agreement shall be subject to and incorporate HUD 5369-A, Representations, Certifications, and all other provisions of the Requests for Proposal submitted by HAMC.

IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first above written.

WITNESS: HOUSING AUTHORITY OF MONROE COUNTY

WITNESS: , Consultant

Representations, Certifications, and Other Statements of Bidders Public and Indian Housing Programs

Table of Contents

Clause Page

1. Certificate of Independent Price Determination 1

2. Contingent Fee Representation and Agreement 1

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions

4 . Organizational Conflicts of Interest Certification 2

5. Bidder's Certification of Eligibility 2

6. Minimum Bid Acceptance Period 2

7. Smal l, Minority, Women-Owned Business Concern Representation 2

8. Indian-Owned Economic Enterprise and Indian Organization Representation 2

9. Certification of Eligibility Under the Davis-Bacon Act 3

10. Certification of Nonsegregated Facilities

11 . Clean Air and Water Certification

12. Previous Participation Certificate

13. Bidder's Signature

1. Certificate of Independent Price Determination

(a) The bidder certifies that--

(1) The prices in this bid have been arrived at independently, without, for the purpose of restricting competition , any consultation , communication , or agreement with any other bidder or competitor relating to (i) those prices, (ii ) the intention to submit a bid, or (iii ) the methods or factors used to calculate the prices offered ;

(2) The prices in th is bid have not been and will not be knowingly disclosed by the bidder, directly or indirectly, to any other bidder or competitor before bid opening (in the case of a sealed bid solicitation ) or contract award (in the case of a competitive proposal sol icitation ) unless otherwise required by law; and

(3) No attempt has been made or will be made by the bidder to induce any other concern to submit or not to submit a bid for the purpose of restricting competition .

(b) Each signature on the bid is considered to be a cert ification by the signatory that the signatory--

(1) Is the person in the bidder's organization respons ible for determining the prices being offered in this bid or proposal , and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)( I) through (a)(3) above; or

(2) (i) Has been authorized , in writing , to act as agent for the following principals in certify ing that those principals have not participated , and will not participate in any action contrary to subparagraphs (a)(I) through (a)(3) above.

[insert full name of person(s) in the bidder's organ ization responsible for determining the prices offered in this bid or proposal , and the title of his or her position in the bidder's organization] ;

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)( i) above have not participated , and will not participate, in any action contrary to subparagraphs (a)( 1) through (a)(3) above; and

(iii ) As an agent, has not personally participated , and will not participate in any action contrary to subparagraphs (a)(1) th rough (a)(3) above.

(c) If the bidder deletes or modifies subparagraph (a)2 above , the bidder must furn ish with its bid a signed statement setting forth in detail the circumstances of the disclosure .

[ ] [Contracting Officer check if following paragraph is appl icable]

(d) Non-collusive affidavit. (applicable to contracts for construction and equipment exceeding $50,000)

( 1) Each bidder shall execute, in the form provided by the PHA/ IHA, an affidavit to the effect that he/she has not colluded with any other person, firm or corporat ion in regard to any bid submitted in response to this solicitation . If the successful bidder did not submit the affidavit with his/her bid , he/she must submit it within th ree (3) working days of bid opening . Failure to submit the affidavit by that date may render the bid non responsive . No contract award wil l be made without a properly executed affidavit.

(2) A fully executed "Non-collusive Affidavit" [ ] is, [ ] is not included with the bid .

2. Contingent Fee Representation and Agreement

(a) Definitions. As used in th is provision :

"Bona fide employee" means a person , employed by a bidder and subject to the bidder's superv ision and control as to time, place, and manner of performance, who neither exerts , nor proposes to exert improper influence to solicit or obtain contracts nor holds out as being able to obtain any contract(s) through improper influence.

"Improper influence" means any influence that induces or tends to induce a PHA/IHA employee or officer to give consideration or to act regarding a PHA/IHA contract on any basis other than the merits of the matter.

(b) The bidder represents and certifies as part of its bid that, except for full-t ime bona fide employees working sole ly for the bidder, the bidder:

(1) [ ] has, [ ] has not employed or retained any person or company to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any person or company employed or retained to solicit or obtain this contract any commission , percentage , brokerage, or other fee contingent upon or resulting from the award of this contract.

(c) If the answer to either (a)( 1) or (a)(2) above is affirmative , the bidder shall make an immediate and full written disclosure to the PHA/IHA Contracting Officer.

(d) Any misrepresentation by the bidder sha ll give the PHA/IHA the right to (1) terminate the contract; (2) at its discretion , deduct from contract payments the amount of any commission , percentage, brokerage , or other contingent fee ; or (3) take other remedy pursuant to the contract.

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (applicable to contracts exceeding $100,000)

(a) The definitions and prohibitions conta ined in Section 1352 of title 31 , United States Code, are hereby incorporated by reference in paragraph (b) of this certification

Previous edition is obsolete Page1 of 3 form HUD-5369-A (11 /92)

(b) The bidder, by signing its bid , hereby certifies to the best of his or her knowledge and belief as of December 23, 1989 that:

(1) No Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with the awarding of a contract resulting from this solicitation ;

(2) If any funds other than Federal appropriated funds (includ ing profit or fee received under a covered Federal transaction) have been paid , or will be paid , to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress on his or her behalf in connection with this sol icitation , the bidder shall complete and submit, with its bid, 0MB standard form LLL, "Disclosure of Lobbying Activities ;" and

(3) He or she will include the language of this certification in all subcontracts at any tier and require that all recipients of subcontract awards in excess of $100 ,000 shall certify and disclose accordingly .

(c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section 1352, title 31 , United States Code. Any person who makes an expenditure proh ibited under this provision or who fails to file or amend the disclosure form to be filed or amended by this provision , shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure .

(d) Indian tribes (except those chartered by States) and Indian organizations as defined in section 4 of the Indian Self-Determina tion and Education Assistance Act (25 U.S.C. 450B) are exempt from the requirements of this provision .

4. Organizational Conflicts of Interest Certification The bidder certifies that to the best of its knowledge and belief and except as otherwise disclosed , he or she does not have any organizational conflict of interest which is defined as a situation in which the nature of work to be performed under this proposed contract and the bidder's organizational , financial , contractual , or other interests may, without some restriction on future activities:

(a) Result in an unfair competitive advantage to the bidder; or,

(b) Impair the bidder's objectivity in performing the contract work.

[ ] In the absence of any actual or apparent conflict, I hereby certify that to the best of my knowledge and belief, no actual or apparent conflict of interest exists with regard to my possible performance of th is procurement.

5. Bidder's Certification of Eligibility

(a) By the submission of this bid , the bidder certifies that to the best of its knowledge and belief, neither it, nor any person or firm which has an interest in the bidder's firm , nor any of the bidder's subcon tractors , is inel igible to :

(1) Be awarded contracts by any agency of the United States Government, HUD, or the State in which this contract is to be performed ; or,

(2) Participate in HUD programs pursuant to 24 CFR Part 24.

\b) 1ne certiiication in paragraph (a) above is a materialrnpresen tation oi iact upon which reliance was placed when mal@g award .

If it is later determined that the bidder knowingly rendered an erroneous certification , the contract may be terminated for de.fault , and the bidder may be debarred or suspended from part1c1pat1on 1n HUD programs and other Federal contract programs.

6. Minimum Bid Acceptance Period

(a) "Acceptance period ," as used in this prov ision , means the number of calendar days available to the PHA/IHA for awarding a contract from the date specified in this solicitation for rece ipt of bids.

(b) This provision supersedes any language pertaining to the acceptance period that may appear elsewhere in this solicitation .

(c) The PHA/IHA requires a minimum acceptance period of [Contracting Officer insert time period] calendar days.

(d) In the space provided immediately below, bidders may specify a longer acceptance period than the PHA's/lHA's minimum require ment. The bidder al lows the fo llowing acceptance period :

calendar days.

(e) A bid allowing less than the PHA's/lHA's minimum acceptance period will be rejected .

(f) The bidder agrees to execute all that it has undertaken to do, in compliance with its bid , if that bid is accepted in writing within ( 1) the acceptance period stated in paragraph (c) above or (2) any longer acceptance period stated in paragraph (d) above.

7. Small, Minority, Women-Owned Business Concern Representation

The bidder represents and cert ifies as part of its bid/ offer that it --

(a) [ ] is , [ ] is not a small business concern. "Small business concern ," as used in this provision , means a concern, including its affil iates, that is independently owned and operated , not dominant in the field of operation in which it is bidd ing , and qualified as a small business under the criteria and size standards in 13 CFR 121 .

(b) [ ] is , [ ] is not a women-owned business enterprise. "Women owned business enterprise," as used in this provision , means a business that is at least 51 percent owned by a woman or women who are U.S. citizens and who also control and operate the business.

(c) [ ] is , [ ] is not a minority business enterprise. "Minority business enterprise," as used in this provision , means a business which is at least 51 percent owned or controlled by one or more minority group members or, in the case of a publicly owned business, at least 51 percent of its voting stock is owned by one or more minority group members, and whose management and daily opera tions are controlled by one or more such ind ividuals. For the purpose of this definition, minority group members are :

(Check the block appl icable to you)

[ ] Black Americans [ ] Asian Pacific Americans

[ ] Hispanic Americans

[ ] Native Americans

[ ] Asian Indian Americans

[ ] Hasidic Jewish Americans

8. Indian-Owned Economic Enterprise and Indian Organization Representation (applicable only if this solicitation is for a contract to be performed on a project for an Indian Housing Authority)

The bidder represents and certifies that it:

(a) [ ] is , [ ] is not an Indian-owned economic enterprise.

"Economic enterprise," as used in this provision, means any com mercial , industrial , or business activity establ ished or organ ized for the purpose of profit, which is at least 51 percent Indian owned.

"Indian ," as used in this provision , means any person who is a member of any tr\be , band , group , pueblo , or community which is recognized by the Federal Government as eligible for services from the Bureau of Indian Affairs and any "Native" as defined in the Alaska Native Claims Settlement Act

(b) [ ] is, [ J is not an Indian organization : "Indian organizatio.n," as used in this provision , means the governing body of a.ny Indian tribe or entity established or recognized by such governing body.

Indian "tribe" means any Indian tribe , band , group, pueblo, or

Previous edition is obsolete form HUD-5369-A (11 /92) community including Native villages and Native groups (including corporations organized by Kenai , Juneau , Sitka , and Kodiak) as defined in the Alaska Native Claims Settlement Act , which is recognized by the Federal Government as eligible for services from the Bureau of Indian Affairs .

9. Certification of Eligibility Under the Davis-Bacon Act (applicable to construction contracts exceeding $2,000)

(a) By the submission of this bid , the bidder certifies that neither it nor any person or firm who has an interest in the bidder's firm is a person or firm ineligible to be awarded contracts by the United States Government by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(b) No part of the contract resulting from this solicitation shall be subcontracted to any person or firm ineligible to be awarded contracts by the United States Government by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1 ).

(c) The penalty for making false statements is prescribed in the U.

S. Criminal Code , 18 U.S.C. 1001 .

10. Certification of Nonsegregated Facilities (applicable to contracts exceeding $10,000)

(a) The bidder's attention is called to the clause entitled Equal Employment Opportunity of the General Conditions of the Con tract for Construction.

(b) "Segregated facilities," as used in this provision , means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks , locker rooms and other storage or dressing areas, parking lots, drinking fountains , recreation or entertainment areas, transportation , and housing facilities provided for employees, that are segregated by explicit directive or are in fact segregated on the basis of race , color, religion , or national origin because of habit, local custom , or otherwise.

(c) By the submission of this bid , the bidder certifies that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location under its control where segregated facilities are maintained . The bidder agrees that a breach of this certification is a violation of the Equal Employment Opportunity clause in the contract.

(d) The bidder further agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) prior to entering into subcontracts which exceed $10,000 and are not exempt from the requirements of the Equal Employment Opportunity clause, it will :

(1) Obtain identical certifications from the proposed subcon tractors ;

(2) Retain the certifications in its files ; and

(3) Forward the following notice to the proposed subcontrac tors (except if the proposed subcontractors have submitted identical certifications for specific time periods):

Notice to Prospective Subcontractors of Requirement for Certifications of Nonsegregated Facilities A Certification of Nonsegregated Facilities must be submitted before the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Employment Opportunity clause of the prime contract. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e ., quarterly, semiannually , or annually) .

Note: The penalty for making false statements in bids is prescribed in 18 U.S.C. 1001 .

11. Clean Air and Water Certification (applicable to con-tracts exceeding $100,000)

The bidder certifies that:

(a) Any facility to be used in the performance of this contract is , [ ] is not listed on the Environmental Protection Agency List of Violating Facilities:

(b) The bidder will immediately notify the PHNIHA Contracting Officer, before award , of the receipt of any communication from the Administrator, or a designee , of the Environmental Protection Agency , indicating that any facility that the bidder proposes to use for the performance of the contract is under consideration to be listed on the EPA List of Violating Facilities; and ,

(c) The bidder will include a certification substantially the same as this certification , including this paragraph (c) , in every nonexempt subcontract.

12. Previous Participation Certificate (applicable to construction and equipment contracts exceeding $50,000)

(a) The bidder shall complete and submit with his/her bid the Form HUD-2530, "Previous Participation Certificate ." If the successful bidder does not submit the certificate with his/her bid , he/she must submit it within three (3) working days of bid opening . Failure to submit the certificate by that date may render the bid non responsive .

No contract award will be made without a properly executed certifi cate .

(b) A fully executed "Previous Participation Certificate"

[ ] is , [ ] is not included with the bid .

13. Bidder's Signature The bidder hereby certifies that the information contained in these certifications and representations is accurate , complete , and current.

(Signature and Date)

(Typed or Printed Name)

(Title)

(Company Name)

(Company Address)

Previous edition is obsolete Page 3 of3 form HUD-5369-A (11 /92)

Certification of Payments to Influence Federal Transactions

U.S. Department of Housing and Urban Development Office of Public and Indian Housing

Public reporting burden for 1.his information collection is estimated to average 30 minutes:including tht! time for revie\ving instmctions. searching existing data sources, gathering and maintaining tht!' data needt!'d, and complet ing and re,·iewing the co lle1.:: tion of informa1ion. Tht information requested is rt!quired to obtain a benefit. This form is used to <!nsurc federal funds are not used to influt:nce membc!rs of Congress. There are no assurances of confidentiality. H U11 may not conduct or sponsor, and an applicant is not re;:quired to respond to a i.:ollt!'ction of information un less it displays a curren tly valid OM A control number. Comments regarding the accuracy of [h is burden estimate: and any suggc:stions for n:ducing this burdcn can be sen t to the Rc:jX>rls Managc:mc:nt Officc:r, Offire of Policy Dc:,·.:lopmentand Res<:arch, REF., Dc:pa11men1 of Housing and Urban 11er.:lopm~nt, 451 7th St SW, Room 41 76, Washinb10n, DC 2114 I 0-5ililil. \\'hen prO\ iuing commenL<, please reler to 0MB Appro,·al No. 2577-11157.

Applicant Name

Program/Activity Receiving Federal Grant Funding

The undersigned certifies, to the best of his or her knowledge and belief, that:

(I) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connec tion with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influenc ing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan. or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, Disclosure Form to Report Lobbying, in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civi l penalty of not less than $10,000 and not more than $100,000 for each such failure.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate.

Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalt ies . (18 U.S.C. 1001, 1010, 1012; 31 u.s.c. 3729, 3802)

Ttlle Name of…