13-Administrative Requirements Packet (0505-2026-08-RFP).pdf

A dm in is tr at iv e

Re qu ire m en ts

Administrative Requirements

Forms and explanatory documents for each of the following administrative requirements are identif ied below and are included in the respective sections of this package. Also included, as the final section, is a checklist to assist with your proper completion of the required forms prior to bid/proposal submittal. Please note that all documents must be signed by the duly authorized representative of the entity or sole proprietor. In the event of a Joint Venture (JV), officers authorized by each entity must sign and submit a separate set of the following documents:

• Vendor ID Form

• Affidavit of Non-Collusion

• Bidder Contributions CEC Form 55

• Equal Benefits Ordinance Compliance Affidavit

• Municipal Lobbying Ordinance Bidder Certif ication CEC Form 50

The following administrative requirements may refer to the Los Angeles City Charter (LACC), Los Angeles Municipal Code (LAMC), or Los Angeles Administrative Code (LAAC).

For further information or assistance regarding all administrative requirements, contact:

Los Angeles World Airports Procurement Services Division P O Box 92216 Los Angeles, CA 90009-2216 Phone: (424) 646-7392 E-mail: sourcing@lawa.org Internet: https://www.lawa.org/en/lawa-businesses/ lawa-administrative-requirements

1. VENDOR ID FORM

The Vendor ID form requires general information about a bidder/proposer’s business as well as the Seller’s Permit and the Business Tax Registration Certif icate (BTRC) numbers, Payment Terms, Equal Employment Opportunity Officer contact information, and data on the firm’s City of Los Angeles contracts (if applicable).

• Seller’s Permit Number

The Seller’s Permit Number is required if the vendor is engaged in business in California;

intends to sell or lease tangible personal property that would ordinarily be subject to sales tax if sold at retail; will make sales for a temporary period, normally lasting no longer than 30 days at one or more locations. The enforcing agency for this requirement is the Board of Equalization, the Sales and Use Tax Department. Additional information regarding this requirement can be found at http://www.cdtfa.ca.gov/services/permits-licenses.htm.

• Business Tax Registration Certificate mailto:ProcurementRequirements@lawa.org https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements http://www.boe.ca.gov/sutax/sutprograms.htm http://www.boe.ca.gov/sutax/sutprograms.htm http://www.cdtfa.ca.gov/services/permits-licenses.htm

Pursuant to the LAMC, Chapter 2, Article 1, Section 21.03, persons engaged in any business or occupation within the City of Los Angeles are required to register and pay the required tax.

Businesses, including vendors, subject to this tax are issued a Business Tax Registration Certif icate (BTRC) or a Vendor Registration Number (VRN).

Information regarding this requirement may be obtained at Office of Finance, Tax & Permit Division, 200 N. Spring St., Room 101, Los Angeles, CA 90012, Phone: (844) 663-4411, Web:

http://f inance.lacity.org.

• Out-of-state Vendors The State of California requires the City of Los Angeles (City) to withhold income taxes from payments to out-of-state vendors for services performed within California unless the vendor submits one of the required forms. The tax withholding rate is seven percent (7%) of payments subject to withholding.

If you are out-of-state vendor, please return one of the following forms to help the City clarify your non-resident tax withholding status:

• Form 590, Withholding Exemption Certif icate, certifying exemption from the withholding requirement.

• Form 587, Nonresident Income Allocation Worksheet, which allocates the expected income under the City contract for work completed within and outside of California

• Notice from the CA Franchise Tax Board (CAFTB) that a withholding waiver was authorized (you must first f ile CA Form 588, Nonresident Withholding Waiver Request to the CAFTB)

• Notice from CAFTB that a reduced withholding request was authorized (you must first f ile CA Form 589 Nonresident Reduced Withholding Request to CAFTB)

2. AFFIDAVIT OF NON-COLLUSION

Pursuant to the LAAC, Division 10, Chapter 1, Article 2, Section 10.15, each bid/proposal must include the attached affidavit of the Bidder/Proposer that the bid/proposal is genuine, and not a sham or collusive, or made in the interest or on behalf of any person, and that the Bidder/Proposer has not directly or indirectly induced or solicited any other Bidder/Proposer to submit a sham bid, or any other person, firms, or corporation to refrain from bidding, and that the Bidder/Proposer has not sought by collusion to secure for himself/herself an advantage over any other Bidder/Proposer.

Bidders/Proposers must complete, notarize, and submit the attached “Affidavit to Accompany Proposals or Bids” with the bid/proposal.

Failure to include an Affidavit with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

Attachment:

• Affidavit of Non-Collusion http://finance.lacity.org/

3. BIDDER CONTRIBUTIONS CEC FORM 55 (CONTRACT BIDDER CAMPAIGN

CONTRIBUTION AND FUNDRAISING RESTRICTIONS)

Persons who submit a response to this Request for Bid/Proposal/Qualif ications are subject to Charter section 470(c)(12) and related ordinances. As a result, bidders/proposers/respondents may not make campaign contributions to and or engage in fundraising for certain elected City officials or candidates for elected City office from the time they submit the response until either the contract is approved or, for successful bidders/proposers/respondents, 12 months after the contract is signed. The bidder's/proposer’s/respondents’ principals and subcontractors performing $100,000 or more in work on the contract, as well as the principals of those subcontractors, are also subject to the same limitations on campaign contributions and fundraising.

Bidders/Proposers/Respondents must submit CEC Form 55 (attached) to LAWA with their bid/proposal/Statement of Qualif ications. The form requires bidders to identify their principals, their subcontractors performing $100,000 or more in work on the contract, and the principals of those subcontractors. Bidders/Proposers/Respondents must also notify their principals and subcontractors in writing of the restrictions and include the notice in contracts with subcontractors. Responses submitted without a complete CEC Form 55 shall be deemed non-responsive. Bidders/Proposers/Respondents who fail to comply with City law may be subject to penalties, termination of contract, and debarment.

Additional information regarding this requirement may be obtained at:

200 N. Spring Street City Hall, 24th Floor Los Angeles, California 90012

(213) 978-1960

(213) 978-1988 [Fax] ethics.commission@lacity.org Web: http://ethics.lacity.org

Attachments:

• Bidder Contributions CEC Form 55

• Los Angeles City Ethics Commission Special Bulletin, available at http://ethics.lacity.org/pdf/pressrelease/press_042511_New_Charter_Amend_Limits_Bidder_Bulletin.pdf

4. EQUAL BENEFITS ORDINANCE

Any contract awarded pursuant to this procurement process shall be subject to the applicable provisions of the Los Angeles Administrative Code Section 10.8.2.1, Equal Benefits Ordinance (EBO). The EBO requires City contractors who provide benefits to employees with spouses provide the same benefits to employees with domestic partners. Domestic partners are defined as two adults living together, jointly responsible for living expenses, committed to an intimate and caring relationship and registered as domestic partners with a governmental entity.

Bidder/Proposer/Lessees must submit the Equal Benefits Ordinance Compliance Affidavit (2 pages) with Bid/Proposal/Lease.

http://ethics.lacity.org/ http://ethics.lacity.org/pdf/pressrelease/press_042511_New_Charter_Amend_Limits_Bidder_Bulletin.pdf

The Equal Benefits Ordinance Compliance Affidavit shall be valid for a period of twelve months.

Bidders/Proposers/Lessees do not need to submit supporting documentation with their bids or proposals or leases. However, the City may request supporting documentation to verify that the benefits are provided equally as specified on the Equal Benefits Ordinance Compliance Affidavit.

Bidders/Proposers/Lessees seeking additional information regarding the requirements of the Equal Benefits Ordinance may visit the Bureau of Contract Administration’s web site at http://bca.lacity.org or call Procurement Services at (424) 646-5380.

Attachment:

• EBO Compliance Affidavit

5. INSURANCE

Pursuant to LAAC, Division 11, Chapter 2, Article 2, Section 11.47 and the Risk Management Policy (Council File #79-3194-S1) adopted by Los Angeles City Council on March 1, 1991, the City of Los Angeles is to be protected to the maximum extent feasible, against loss or losses which would significantly affect personnel, property, f inances, or the ability of the City to continue to fulf ill its responsibilities to taxpayers and the public. Consequently, prior to the commencement of this contract, the selected Bidder/Proposer must provide evidence of insurance that conforms to the insurance requirements of the bid/proposal. Insurance requirements which specifically outline the types and amount of coverage required for this project are explained in detail in the attached language and “Insurance Requirement Sheet”.

Successful Bidder/Proposer must provide acceptable evidence of insurance as explained in the attachments prior to the commencement of the contract. Said acceptable evidence of insurance must remain current throughout the term of the contract and be on file with the Insurance Compliance Unit in order to receive payment under any contract with the City of Los Angeles.

Attachments:

• Insurance Requirement Sheet

• General Insurance Provisions

Additional information is available at www.lawa.org -> Administrative Requirements -> Insurance.

6. MUNICIPAL LOBBYING ORDINANCE

The City's Municipal Lobbying Ordinance, Los Angeles Municipal Code, Section 48.09 requires certain individuals and entities to register with the City Ethics Commission and requires public disclosure of certain lobbying activities, including money received and spent. Additionally, for all construction contracts, public leases, or licenses of any value and duration; goods or service contracts with a value greater than $25,000 and a term of at least three months, each bidder/proposer must submit with its bid a certif ication, on a form (CEC Form 50) proscribed by the City Ethics Commission, that the bidder acknowledges and agrees to comply with the disclosure requirements and prohibitions established in the Los Angeles Municipal Lobbying Ordinance, if the bidder qualif ies as a lobbying entity.

http://bca.lacity.org/ http://www.lawa.org/

Failure to submit the Bidder Certification CEC Form 50 with the bid/proposal will render the bid/proposal non-responsive.

Additional information regarding this requirement may be obtained at:

200 N. Spring Street City Hall, 24th Floor Los Angeles, California 90012

(213) 978-1960

(213) 978-1988 [Fax] ethics.commission@lacity.org Web: http://ethics.lacity.org

Attachments:

• Municipal Lobbying Ordinance, available at http://www.lawa.org/welcome_LAWA.aspx?id=586

• Bidder Certif ication CEC Form 50, available at http://www.lawa.org/welcome_LAWA.aspx?id=586

ADMINISTRATIVE REQUIREMENTS THAT DO NOT REQUIRE FORMS

The following administrative requirements are language only. Submit any questions you may have regarding these ordinances to the LAWA Procurement Services Division at sourcing@lawa.org or at (424) 646-7392.

• Affirmative Action

• Alternative Fuel Vehicle Requirement Program (LAX Only)

• Assignment of Anti-Trust Claims

• Child Support Obligations

• Federal Requirements – Title VI

• First Source Hiring (LAX Only)

• Living Wage Ordinance http://ethics.lacity.org/ http://www.lawa.org/welcome_LAWA.aspx?id=586 mailto:ProcurementRequirements@lawa.org

C he ck lis t

Administrative Requirements Checklist

BIDDERS/PROPOSERS (PRIME CONTRACTORS) MUST SUBMIT THE FOLLOWING SIGNED

DOCUMENTS, WITH THEIR PROPOSAL, AS INDICATED

1. VENDOR ID FORM

Is the required Vendor ID Form completed?

Is the BTRC/VRN number provided?

Is the Form enclosed in the Packet?

2. AFFIDAVIT OF NON-COLLUSION

Is the “Affidavit to Accompany Proposals or Bids” completed and signed?

Is the Affidavit notarized?

Is the Affidavit enclosed in the Packet?

Failure to include an Affidavit with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

3. BIDDER CONTRIBUTIONS

Is the required Bidder Contribution CEC Form 55 completed and signed?

Schedule A - Please list all principals on Schedule A.

Schedule B - Please list all subcontractors and their principals on Schedule B (If you check “Yes”) Is the Form enclosed in the Packet?

Failure to include the Bidder Contribution CEC Form 55 with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

4. EQUAL BENEFITS ORDINANCE

Is the EBO Compliance Affidavit Form completed and signed?

Is the Form enclosed in the Packet?

5. MUNICIPAL LOBBYING ORDINANCE

Is the required Bidder Certif ication CEC Form 50 completed and signed?

Is the Form enclosed in the Packet?

Failure to include the Bidder Certification CEC Form 50 with the bid/proposal will render the bid/proposal non-responsive and will result in its rejection.

THE FOLLOWING REQUIREMENTS DO NOT REQUIRE THE COMPLETION OF FORMS

BUT MAY BE INCORPORATED AS PROVISIONS OF THE CONTRACT:

6. AFFIRMATIVE ACTION

Have you read and agreed with the City of Los Angeles’ Non-discrimination, Equal Employment and Affirmative Action provisions?

7. ASSIGNMENT OF ANTI-TRUST CLAIMS

Have you read and agreed with California Government Code Sections 4550 – 4554?

8. CHILD SUPPORT OBLIGATIONS

Have you read and agreed with Child Support Obligations provisions?

9. FIRST SOURCE HIRING PROGRAM (LAX ONLY)

Have you read and agreed with First Source Hiring Program provisions?

10. LIVING WAGE ORDINANCE

If you are claiming exemption from said Ordinances:

Is the appropriate Exemption form completed and signed?

Is the Exemption form enclosed in the Packet?

IF YOU ARE AWARDED THE CONTRACT AND PRIOR TO EXECUTION OF THE

CONTRACT:

Prime contractors are required to submit to LAWA forms pertaining to the following requirements:

• Business Tax Registration Certif icate

• Insurance

V en do r I de nt ifi ca tio n

Fo rm

VENDOR IDENTIFICATION FORM

ALL FIELDS MUST BE COMPLETED. INCOMPLETE FORMS MAY BE REJECTED AND RESUBMITTED.

GENERAL INFORMATION

Entity type (code)

Individual/Proprietor (I)

Corporation (C or S)

Partnership (P)

BUSINESS ADDRESS

Fax

Airport Concessions Disadvantaged Business Enterprise (ACDBE)

Disadvantaged Business Enterprise (DBE)

Disabled Veteran Business Enterprise (DVBE) (LAWA)

Local Business Enterprise (LBE)

Minority Business Enterprise (MBE)

Minority Women Business Enterprise (M/WBE)

Small Business Enterprise* (Proprietary)

Local Small Business (LSB) (formerly SLB)

Women Business Enterprise (WBE) *Per SBA or DGS criteria verification

CERTIFICATION

The undersigned declares and certifies that all statements on this form are true and correct. I agree to notify Strategic Sourcing Division immediately of any changes to the information contained herein. I have read and agreed with the administrative requirements set for this project and have been provided as a checklist in the bid/proposal package. If selected, I/We will comply with these requirements for the duration of the contract.

DateAuthorized Signature

Title

For instructions and additional information, please click LAWA, call 424-646-7392, or email Los Angeles World Airports Procurement Services Division at sourcing@lawa.org

Form VIF 04082025 LM

For LAWA use only:

Contact Person:

F-590 F-589F-588

BUSINESS CERTIFICATION

(Check all that apply - If required, attach copies of all applicable certifications)

F-587

Phone No:

CALIFORNIA FRANCHISE TAX BOARD (FTB)

Click FTB Publication 1017 for further information

City of Los Angeles Office of Finance (OOF) BTRC/VRN No.

Government

LLC (enter entity code below) BTRC/VRN application pending (attach proof of submission)

An FTB form is required from all vendors with a payment address outside of California. Submit form 587 or 590 or proof of submission of form 588 or 589:

For foreign vendors, click Foreign Entity for related instructions

Legal Name

IRS Taxpayer ID No.

(EIN or SSN)

Doing Business As (DBA)

If applicable:

CA SOS Entity/Registration No.

For further information click Office of Finance

Contact Street

Phone

Email

EIN - Employer Identification number SSN - Social Security Number

Print Name

Submit IRS W9 form (required)

SOS - California Secretary of State VRN - Vendor Registration Number

Zip Code

City

State/ Region

Remittance address:Country

Legend:

BTRC - Business Tax Registration Certificate DTFA - California Department of Tax & Fee Administration

CA DTFA Seller Permit No.

(If different from above)

Is the vendor providing healthcare/medical or legal services?

Requesting Division:

https://www.lawa.org/en/lawa-businesses/lawa-administrative-requirements https://www.ftb.ca.gov/forms/misc/1017.html?_sm_au_=isV6qr3j1DZSWN7sFVjLLLQ6vMVN1 https://finance.lacity.org https://www.irs.gov/forms-pubs/about-form-w-9 https://www.irs.gov/forms-pubs/about-form-w-8 https://www.irs.gov/forms-pubs/about-form-w-9 https://www.sos.ca.gov/business-programs/business-entities?adlt=strict https://www.cdtfa.ca.gov/taxes-and-fees/faqseller.htm www.lawa.org/en/lawa-businesses/lawa-administrative-requirements or further information

Vendor ID Form - Attach Back-Up Documents Instructions

If applicable, Attach Forms in Bonfire

IRS W9 Form (Required) California Franchise Tax Board (FTB) Form is required from all vendors with a payment address outside of California.

Copy of Business Tax Registration Certificate or copy of application submitted to the Office of Finance

A ffi da vi t o f N on -C ol lu si on

ENG. 3--1M--4-59---(R)

AFFIDAVIT TO ACCOMPANY PROPOSALS OR BIDS

STATE OF CALIFORNIA )

) ss.:

COUNTY OF )

being first duly sworn, deposes and says:

(Type or print name) that he or she is the of (Type or print title)

, who submits herewith ( Type or print name of company/firm) to the Board of Airport Commissioners the attached bid/proposal; that he or she is the person whose name is signed to the attached bid/proposal; that said bid/proposal is genuine; that the same is not sham or collusive; that all statements of fact therein are true; and that such bid/proposal was not made in the interest or behalf of any person, partnership, company, association, organization, or corporation not herein named or disclosed.

Affiant further deposes and says: that the bidder/proposer has not directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interests of the public body which is to award the contract, or of any other bidder/proposer, or anyone else interested in the proposed contract; and that the bidder/proposer has not in any manner sought by collusion to secure for himself/herself/itself/themselves, an advantage over any other bidder/proposer.

Affiant further deposes and says that prior to the public opening and reading of bids/proposals, said bidder/proposer:

(a) did not, directly or indirectly, induce or solicit anyone else to submit a false or sham bid/proposal;

(b) did not, directly or indirectly, collude, conspire, connive or agree with any one else that said bidder/proposer or anyone else would submit a false or sham bid, or that anyone should refrain from bidding or withdraw their bid/proposal;

(c) did not, in any manner, directly or indirectly, seek by agreement, communication or conference with anyone to raise or fix the bid price of said bidder/proposer or of anyone else, or to raise or fix any overhead, profit or cost element of their price or of that of anyone else;

(d) did not, directly or indirectly, submit their bid/proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association organization, bid depository, or to any member or agent, thereof, or to any individual or group of individuals, except to the awarding authority or to any person or person who have a partnership or other financial interest with said bidder/proposer in their business.

Signed:

Name:

Title:

Subscribed and sworn to (or affirmed) before me on this day of , 20 , by

, proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.

Notary Public Signature (Notarial Seal)

B id de r C on tri bu tio n C

EC

F or m

ATTENTION:

The following CEC Form 55 must be signed on page 1 and you are required to list all principals on Schedule A. Please refer to the attached instructions.

If you fail to sign the form or if you submit an incomplete CEC Form 55, your proposal/bid may be deemed non-responsive.

FORM Prohibited Contributors

(Bidders)

Revised Los Angeles City Charter § 470(c)(12), Los Angeles Municipal Code §§ 49.7.35(B)(3), (4) Page 1 of 3 ethics.lacity.org

This form must be completed in its entirety and submitted with your bid or proposal to the City department that is awarding the contract. Failure to submit a completed form may affect your bid or proposal. If you have questions about this form, please contact the Ethics Commission at (213) 978-1960.

Original Filing Amendment: Date of Signed Original ________________. Date of Last Amendment _________________.

Schedule Summary

Please complete all three of the following:

1. SCHEDULE A — Bidder’s Principals (check one) The bidder has one or more PRINCIPALS, as defined in LAMC § 49.7.35(A)(6).

At least one principal is required for entities. (If you check “Yes”, Schedule A is required.)

2. SCHEDULE B — Subcontractors and Their Principals (check one) The bidder has one or more SUBCONTRACTORS on this bid or proposal with subcontracts worth $100,000 or more. (If you check “Yes”, Schedule B is required.)

3. TOTAL NUMBER OF PAGES SUBMITTED (including this cover page): _______

Yes No

Yes No

Certification

Name Signature

Title Date

I certify the following under penalty of perjury under the laws of the City of Los Angeles and the state of California:

A) I understand, will comply with, and have notified my principals and subcontractors of the requirements and restrictions in Los Angeles City Charter § 470(c)(12) and any related ordinances; B) I understand that I must amend this form within ten business days if any information changes; C) I am the bidder named above or I am authorized to represent the bidder named above, and my name appears below; and D) The information provided in this form is true and complete to the best of my knowledge and belief.

Reference Number (Bid, Contract, or A ): ___ ______________________ Date Bid Submitted: ________________ __

Contract Description (Title of the RFP or City contract solicitation and description of the services to be provided):

Awarding Authority (Department awarding the contract): ________________________________________________________

Bidder Name: ____________________________________________________________________________________________________

Bidder Address: _________________________________________________________________________________________________

Bidder Email Address: __________________________________________ Bidder Phone Number: ________________________

(Bidders)

Revised Los Angeles City Charter § 470(c)(12), Los Angeles Municipal Code §§ 49.7.35(B)(3), (4) Page 2 of 3 ethics.lacity.org

Please identify the names and titles of all the bidder’s principals (attach additional sheets if necessary). Principals include a bidder’s board chair, president, chief executive officer, chief operating officer, and individuals who serve in the functional equivalent of one or more of those positions. Principals also include individuals who hold an ownership interest in the bidder of at least 20 percent and employees of the bidder who are authorized by the bid or proposal to represent the bidder before the City.

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Schedule A - Bidder’s Principals

Check this box if additional Schedule A pages are attached.

(Bidders)

Revised Los Angeles City Charter § 470(c)(12), Los Angeles Municipal Code §§ 49.7.35(B)(3), (4) Page 3 of 3 ethics.lacity.org

Please identify all subcontractors whose subcontracts are worth $100,000 or more. Separate Schedule B pages are required for each subcontractor who meets the threshold.

Schedule B - Subcontractors and Their Principals

Subcontractor’s Name

Subcontractor’s Address

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Name: _______________________________________________________________ Title: _____________________________________________________

Address: _______________________________________________________________________________________________________________________

Please check one of the following options:

This subcontractor has one or more principals. Yes* No

Each principal’s name and title must be identified below. Attach additional sheets if necessary. Principals include a subcontractor’s board chair, president, chief executive officer, chief operating officer, and individuals who serve in the functional equivalent of one or more of those positions. Principals also include individuals who hold an ownership interest in the subcontractor of at least 20 percent and employees of the subcontractor who are authorized by the bid or proposal to represent the subcontractor before the City.

Check this box if additional Schedule B pages are attached.

Form 55 Instructions | Revised February 2022

Form 55 Instructions

TABLE OF CONTENTS

INTRODUCTION

CONTACT INFORMATION

BIDDER RESPONSIBILITIES

PAGE 1: COVER PAGE AND BIDDER INFORMATION

Original or Amended Filing

Reference Number

Date Bid Submitted

Contract Description

Awarding Authority

Bidder Information

Schedule Summary

Certification

PAGE 2: SCHEDULE A – BIDDER’S PRINCIPALS

PAGE 3: SCHEDULE B – SUBCONTRACTORS AND THEIR PRINCIPALS

Form 55 Instructions | Revised February 2022 Page | 1

INTRODUCTION

Bidders who respond to certain City contract solicitations are limited by City law in their ability to spend money in connection with City elections. They are prohibited from making campaign contributions to and engaging in prohibited fundraising activity for City candidates and officeholders. They are also required to disclose their identities and the identities of their subcontractors and principals. Form 55 must be used for that purpose, and these instructions provide information about how to complete the form.

CONTACT INFORMATION

All questions about Form 55 and the laws regarding bidders and contractors should be directed to the Los Angeles City Ethics Commission:

ethics.commission@lacity.org

(213) 978-1960 phone

(213) 978-1988 fax

Whistleblower Hotline: (800) 824-4825

200 North Spring Street City Hall 24th Floor, Suite 2410

Los Angeles CA 90012 ethics.lacity.org https://ethics.lacity.org/

Form 55 Instructions | Revised February 2022 Page | 2

BIDDER RESPONSIBILITIES

A bidder is any person who bids on or submits a proposal or other response to a City contract solicitation, whether it involves a competitive or a non-competitive selection process.

You are a bidder required to complete Form 55 when all of the following apply:

• You submit a response or proposal for an RFP (request for proposals), RFQ (request for qualifications), RFB (request for bids), or any other written or verbal request to enter into a competitive or non-competitive City contract; and

• The contract is expected to be valued at $100,000 or more; and

• The contract must be approved by an elected office (City Council, Mayor, City Controller, or City

Attorney).

For purposes of Form 55, a contract is any agreement, franchise, lease, non-regulatory permit, land use license or easement, or concession with the City that meets the qualifications listed above. This includes an agreement for the performance of any work, service, or construction; the provision of any materials, goods, or equipment; the sale or purchase of property; and the making of grants. This also includes the selection of a pre-qualified list of persons to contract with the City if the RFQ’s not-to-exceed amount is at least $100,000 and the list selection requires approval by an elected City office. The definition does not include a contract with another government agency or a contract between a City proprietary department and an underwriting firm for a noncompetitive sale of revenue bonds.

Form 55 is used to disclose information about the following individuals and entities:

• You (the bidder);

• Your principals;

• Your subcontractors with subcontracts valued at $100,000 or more; and

• The principals of those subcontractors.

The campaign finance restrictions and requirements in Los Angeles City Charter § 470(c)(12) and Los Angeles Municipal Code § 49.7.35 apply to all of those individuals and entities. They are subject to the laws because of the positions they hold in relation to a City bid, not because they are disclosed on your Form 55. See section G for more information.

You are required to do all of the following:

1. Submit a completed Form 55 with your bid or proposal documents to the City department awarding the contract.

2. Amend your Form 55 within 10 business days if the information in the form changes after you submit it with your bid or proposal.

3. Notify your principals and subcontractors of the campaign finance restrictions and requirements that apply to them.

https://codelibrary.amlegal.com/codes/los_angeles/latest/laac/0-0-0-1874 https://codelibrary.amlegal.com/codes/los_angeles/latest/lamc/0-0-0-224321

Form 55 Instructions | Revised February 2022 Page | 3

PAGE 1: COVER PAGE AND BIDDER INFORMATION

You must complete all sections on the cover page.

ORIGINAL OR AMENDED FILING

ORIGINAL FILING

Check this box if this is the first time you are submitting a Form 55 in connection with the City contract that you are currently seeking or have been awarded.

AMENDMENT

Check this box if you are making changes to a Form 55 that you previously submitted in connection with the same City contract that you are seeking or have been awarded. For an amended filing, you must provide the later of:

• The date that your original Form 55 submission was signed; or

• The date that your most recent amendment was signed.

Example 1: Your law firm submitted a Form 55 last month when responding to an RFP from the City Attorney’s Office for legal services. Your law firm is now responding to an RFP with the Port of Los Angeles for a different contract to provide legal services. Check the “Original Filing” box on the Form 55 submitted to the Port, because this is the first time your firm is submitting Form 55 in connection with the contract with the Port.

Example 2: Your company submitted a Form 55 last week when responding to an RFP from the Department of Water and Power (DWP) for construction services. This week, your company moved its offices to a new location. Your company is required to update its contact information on the Form 55 submitted with its proposal. On a new Form 55, check the “Amendment” box, because your company is submitting an updated version of the Form 55 that was already submitted in connection with the construction services contract.

REFERENCE NUMBER

If applicable, provide the bid number, contract number, RAMP ID, or other identifying number or code assigned to the bid or contract that you seek. You can usually find this number on the City solicitation package (e.g., the RFP documents). However, not all solicitations have a reference number.

If there is no reference number for the bid or contract, enter “N/A” in this box.

DATE BID SUBMITTED

Enter the date that you submit your bid or response documents to the City department that will be awarding the contract.

Form 55 Instructions | Revised February 2022 Page | 4

CONTRACT DESCRIPTION

Provide the following information in this section:

• Title of the RFP, RFQ, or RFB, as listed on the City solicitation documents; and

• Description of the services to be provided under the contract.

A brief description of the contract is usually given in the RFP, RFQ, RFB, or solicitation documents. If you cannot find one, describe what will be performed under the contract.

AWARDING AUTHORITY

Provide the name of the City department that will be awarding the contract you seek.

BIDDER INFORMATION

Provide all of the following information:

• Bidder’s full legal name;

• Bidder’s business address;

• Bidder’s phone number; and

• Bidder’s email address.

The email address and telephone number provided in this section will be used to contact you if there are questions about the information provided in your Form 55.

Remember to amend your Form 55 to keep this information current.

SCHEDULE SUMMARY

ITEM 1: BIDDER’S PRINCIPALS

Indicate whether you have one or more principals. Check only one box (“Yes” or “No”).

A principal is any of the following:

• Board chair;

• President;

• Chief executive officer;

• Chief operating officer;

• An individual who serves in the functional equivalent of any of the above positions;

• An individual who holds an ownership interest of 20% or more; or

• An employee authorized to represent you before the City regarding this contract.

Form 55 Instructions | Revised February 2022 Page | 5

Example 1: You are putting together a proposal for a City contract on behalf of your employer, ABC, Inc. The proposal must include a Form 55. Because ABC, Inc. is an entity, you must check the “Yes” box and disclose ABC, Inc.’s principals on attached Schedule A pages.

Example 2: You are an individual submitting a proposal for a City contract and must complete a Form 55. You have two employees who are authorized to represent you before the City on this proposal. You must check the “Yes” box and disclose yourself and those employees as your principals on attached Schedule A pages.

All bidders who are entities are required to complete Schedule A. Most bidders are entities, so most bidders must check the “Yes” box and attach Schedule A pages to the cover page.

Attach to the cover page as many Schedule A pages as necessary to identify all of your principals.

ITEM 2: SUBCONTRACTORS AND THEIR PRINCIPALS

Indicate whether you have one or more subcontractors with subcontracts valued at $100,000 or more on the City contract you seek. Check only one box (“Yes” or “No”).

Example 1: Your construction company is submitting a response to a City RFP to provide construction services on a development project and must submit a Form 55. For the proposed project, you expect to hire ABC Company as a subcontractor that will perform $50,000 worth of work and XYZ Corporation as another subcontractor that will perform $200,000 worth of work.

Check the “Yes” box and attach Schedule B pages to disclose XYZ Corporation and its principals.

Example 2: Your architecture firm is submitting a response to a City RFP to provide landscape design services at a new park, and a Form 55 is required. For the proposed project, you expect to hire two subcontractors: More Sunshine, Inc., which will provide consulting services worth $30,000;

and Beautiful Parks Company, which will perform $85,000 worth of the work. Check the “No” box, indicating that you do not have any subcontractors with subcontracts valued at $100,000 or more.

Attach to the cover page as many Schedule B pages as necessary to identify all of your subcontractors and their principals.

ITEM 3: TOTAL NUMBER OF PAGES SUBMITTED

Enter the total number of Form 55 pages that you are submitting, including the cover page and all attached Schedule A and B pages.

CERTIFICATION

Form 55 must be signed by an authorized representative of the bidder. By signing this section, you are certifying under penalty of perjury all of the following:

• You understand and will comply with the requirements and restrictions in Los Angeles City Charter § 470(c)(12) and Los Angeles Municipal Code § 49.7.35;

• You have notified your principals and subcontractors of the requirements and restrictions; and

• The information you provided in the Form 55 and all attached pages is true and complete to the best of your knowledge and belief.

https://codelibrary.amlegal.com/codes/los_angeles/latest/laac/0-0-0-1874 https://codelibrary.amlegal.com/codes/los_angeles/latest/laac/0-0-0-1874

Form 55 Instructions | Revised February 2022 Page | 6

PAGE 2: SCHEDULE A – BIDDER’S PRINCIPALS

You must complete this section if you have principals. If you are an entity, this section is required. You must disclose the name, title, and business address for each of your principals. For a definition of “principal”, see the instructions for Page 1, Section G.

If you need more space, mark the box indicating that you are attaching additional Schedule A pages. You may attach as many additional Schedule A pages as necessary to disclose all of your principals.

Remember to include all Schedule A pages in the total page count on your cover page and attach them to the cover page.

PAGE 3: SCHEDULE B – SUBCONTRACTORS AND THEIR PRINCIPALS

You must complete this section if you will have subcontractors with subcontracts worth $100,000 or more.

You must disclose the names and business addresses of those subcontractors and the names, titles, and business addresses of their principals. For a definition of “principal”, see the instructions for Page 1, Section G.

You must submit at least one Schedule B page for each subcontractor. Provide the name and business address of the subcontractor, and then mark the appropriate box to indicate whether the subcontractor has principals.

If a subcontractor has more principals than will fit on one page—or if you have multiple subcontractors to disclose—mark the box indicating that you are attaching additional Schedule B pages. You may attach as many additional Schedule B pages as necessary to disclose all of your subcontractors with subcontracts worth $100,000 or more and all of their principals.

Remember to include all Schedule B pages in the total page count on your cover page and attach them to the cover page.

Eq ua l B en ef its O rd in an ce

C om pl ia nc e

Af fid av it

LAWA EBO COMPLIANCE

Form OCC/LAWA EBO-Affidavit (Rev 09/22/2023)

FOR LAWA CONTRACTORS ONLY

City of Los Angeles Department of Pubic Works

Bureau of Contract Administration Office of Contract Compliance

1149 S. Broadway, Suite 300, Los Angeles, CA 90015 Phone: (213) 847-2625 Email: bca.eeoe@lacity.org

EQUAL BENEFITS ORDINANCE COMPLIANCE AFFIDAVIT

Prime contractors must certify compliance with Los Angeles Administrative Code (LACC) Section 10.8.2.1 et seq.

prior to the execution of a City agreement subject to the Equal Benefits Ordinance (EBO).

SECTION 1. CONTACT INFORMATION

Company Name:

Company Address:

City:

State: Zip:

Contact Person:

Phone: Email:

Approximate Number of Employees in the United States:

Approximate Number of Employees in the City of Los Angeles:

SECTION 2. EBO REQUIREMENTS

The EBO requires City Contractors who provide benefits to employees with spouses to provide the same benefits to employees with domestic partners. Domestic Partner means any two adults, of the same or different sex, who have registered as domestic partners with a governmental entity pursuant to state or local law authorizing this registration, or with an internal registry maintained by the employer of at least one of the domestic partners.

Unless otherwise exempt, the contractor is subject to and shall comply with the EBO as follows:

A. The contractor’s operations located within the City limits, regardless of whether there are employees at those locations performing work on the City Contract; and

B. The contractor’s operations located outside of the City limits if the property is owned by the City or the City has a right to occupy the property, and if the contractor’s presence at or on the property is connected to a Contract with the City; and

C. The Contractor’s employees located elsewhere in the United States, but outside of the City limits, if those employees are performing work on the City Contract.

A Contractor must post a copy of the following statement in conspicuous places at its place of business available to employees and applicants for employment:

“During the performance of a Contract with the City of Los Angeles, the Contractor will provide equal benefits to its employees with spouses and its employees with domestic partners.”

mailto:bca.eeoe@lacity.org

LAWA EBO COMPLIANCE

Form OCC/LAWA EBO-Affidavit (Rev 09/22/2023)

SECTION 3. COMPLIANCE OPTIONS

I have read and understand the provisions of the Equal Benefits Ordinance and have determined that this company will comply as indicated below:

I have no employees.

I provide no benefits.

I provide benefits to employees only. Employees are prohibited from enrolling their spouse or domestic partner.

I provide equal benefits as required by the City of Los Angeles EBO.

I provide employees with a “Cash Equivalent.” Note: The “Cash Equivalent” is the amount of money equivalent to what your company pays for spousal benefits that are unavailable for domestic partners, or vice versa.

All or some employees are covered by a collective bargaining agreement (CBA) or union trust fund. Consequently, I will provide Equal Benefits to all non-union represented employees, subject to the EBO, and will propose to the affected unions that they incorporate the requirements of the EBO into their CBA upon amendment, extension, or other modification of the CBA.

Health benefits currently provided do not comply with the EBO. However, I will make the necessary changes to provide Equal Benefits upon my next Open Enrollment period which begins on (Date) .

Our current company policies, i.e., family leave, bereavement leave, etc., do not comply with the provisions of the EBO. However, I will make the necessary modifications within three (3) months from the date of this affidavit.

SECTION 4. DECLARATION UNDER PENALTY OF PERJURY

I understand that I am required to permit the City of Los Angeles access to and upon request, must provide certified copies of all company records pertaining to benefits, policies and practices for the purpose of investigation or to ascertain compliance with the Equal Benefits Ordinance. Furthermore, I understand that failure to comply with LAAC Section 10.8.2.1 et seq., Equal Benefits Ordinance may be deemed a material breach of any City contract by the Awarding Authority. The Awarding Authority may cancel, terminate or suspend in whole or in part, the contract; monies due or to become due under a contract may be retained by the City until compliance is achieved. The City may also pursue any and all other remedies at law or in equity for any breach. The City may use the failure to comply with the Equal Benefits Ordinance as evidence against the Contractor in actions taken pursuant to the provisions of the LAAC Section 10.40, et seq., Contractor Responsibility Ordinance.

will comply with the Equal Benefits Ordinance requirements as (Company Name) indicated above prior to executing a contract with the City of Los Angeles and will comply for the entire duration of the contract(s).

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I am authorized to bind this entity contractually.

Executed this day of , in the year , at , .

(City) (State)

Signature Mailing Address

Name of Signatory (please print) City, State, Zip Code

Title EIN / TIN

In su ra nc e

LAWA Special Insurance Provisions, Page 1 of 2 (Version 09/2025)

Name: RFP / ON-CALL ART HANDLING SERVICES Agreement/Activity: Seeking Experienced Fine Art Service Providers, Professional Art Handlers and Preparators, Skilled in Installation, Archival Packaging, Moving, and storage of Artworks for LAWA’s LAX Art Exhibitions Program for LAX and VNY

Division: Planning and Design Division, Public Arts Program Contract/Project No. TBD Term: Three (3) years

The following Primary and Ancillary Insurance is required for this contract with minimum limits outlined and is subject to the terms and conditions set forth in Section 10 of the

General Insurance Provisions in the Contract.

Primary Insurance

(X) Required Workers Compensation, Statutory Limits

Employer Liability

$1,000,000 each accident

$1,000,000 each employee by disease

$1,000,000 policy limit by disease

(X) Required General Liability

$1,000,000 per occurrence

$2,000,000 general aggregate

$1,000,000 personal and advertising injury

$2,000,000 products/completed operations

(X) Required Commercial Auto Liability $1,0000,000 combined single limit

() Required Excess Liability Coverage –

Underlying Commercial Auto, Commercial General liability

$per occurrence $ general aggregate

LAWA Special Insurance Provisions, Page 2 of 2 (Version 09/2025)

Ancillary Insurance, as Required Below

() Required Professional Liability $per occurrence and $aggregate

() Required

(refer to Specific coverage required)

Property Insurance, All Risk/Special Form Coverage

()Tenant Contents Coverage for Personal Property (Renters’ Insurance) ()Tenant improvements - if applicable () Earthquake coverage limit: - Replacement Value () Flood coverage limit: - Replacement Value () Terrorism coverage () Builder's Risk Insurance – if applicable

() Required Installation Floater -When Applicable

() Required Pollution Legal Liability – Must meet policy limits.

$per occurrence and $per aggregate

() Required Network Security and Privacy Liability (Cyber Liability)

$ per incident and $ annual aggregate

() Required Aircraft and Passenger Liability - Limit of Liability must meet Federal Requirements or as follows, whichever is greater:

Commuters with 60 or fewer passengers or Cargo only / with payload Less than 18,000 lbs.: $50,000,000 per occurrence/per passenger

Air Carriers with more than 60 passengers or Cargo only / with payload Greater than 18,000 lbs.: $200,000,000 CSL per occurrence/per passenger

() Required Garage Keeper’s Liability

$ per occurrence and $ annual aggregate

() Required Hangar Keeper’s Liability

$ per occurrence and $ annual aggregate

Required

Liquor Liability

$ per occurrence and $ annual aggregate

() Required Crime Insurance or Fidelity Bond

$ Theft, dishonesty, disappearance, forgery, alteration, and destruction

Once the contract is awarded, evidence of Contractor’s insurance, including all required endorsements, must be uploaded into Contractor’s insurance profile at PinsAdvantage.com, before a Notice to Proceed NTP) can be issued. Please upload these Special Insurance Requirement with your evidence of responsible for your contract if you have questions.

11/2025

10. General…