19097_RFP.pdf

DTMB-0430 billable rate UP Use (R 07/17)

MINOR STATE CAPITAL OUTLAY PROJECTS

REQUEST FOR PROPOSALS

FROM

PROFESSIONAL SERVICE CONTRACTORS

(Authority PA 431 of 1984)

For Not-to-Exceed Fee, Billable-Rate

Professional Services For

FILE NO. 472/19097.TAP – INDEX NO. 472LMFMainProj

DEPARTMENT OF CORRECTIONS

Various HVAC Boiler Upgrades and Replacements – Chippewa Correctional Facility Kincheloe, Michigan

PROPOSAL DUE DATE: Thursday, March 28, 2019, 2:00 p.m., Local Time

ISSUING OFFICE

U.S. & Express Mail Address

Department of Technology, Management & Budget State Facilities Administration

Design and Construction Division

ATTN: ANNE WATROS

3111 West St. Joseph Street Lansing, MI 48917

Minor State Capital Outlay Projects

REQUEST FOR PROPOSALS

Part I - Technical Proposal Part II – Cost Proposal

Professional Services for

FILE NO. 472/19097.TAP – INDEX NO. 472LMFMainProj Various HVAC Boiler Upgrades and Replacements – Chippewa Correctional Facility

Kincheloe, Michigan

SECTION I GENERAL INFORMATION

I-1 Purpose

This Request for Proposals provides the prospective professional service contractor (Professional) with information to enable preparation of a professional services proposal for various HVAC boiler upgrades and replacements at the Chippewa Correctional Facility, Munising, Michigan. The service to be completed should encompass as a minimum the following phase(s) from the Department of Technology, Management and Budget's (DTMB’s) Sample Standard Contract for Professional Services:

Phase 500 Final Design 600 Construction Administration - Office Services 700 Construction Administration - Field Services

The minimum professional qualifications to complete the scope of work for this project are demonstrated experience in the successful planning and execution of similar projects in full accordance with all applicable Local, State, and Federal regulations.

I-2 Project/Program Statement

See attached project/program statement for more detailed information. The Professional, by submitting a Technical (Part I) and Cost (Part II) Proposal to DTMB for evaluation, states that they can and will provide a complete design based on the approved project/program statement. No increase in compensation to the Professional will be allowed unless there is a material change made to the scope of work of the project/program statement and the change to the project/program statement is approved in writing by State Facilities Administration (SFA), Design and Construction Division (DCD).

I-3 Issuing Office

This Request for Proposals is issued by the Department of Technology, Management and Budget (DTMB), on behalf of the Client Agency. PROPOSALS SHALL BE RETURNED TO THE ISSUING OFFICE – ATTN: ANNE WATROS.

1 PROPOSAL SHALL BE SUBMITTED VIA:

http://sigma.michigan.gov/weball/PRDVSS2X1/AltSelfService/

4 HARD COPIES and 2 ELECTRONIC PDF FILE COPIES ON AN EXTERNAL USB DRIVE SHALL BE RETURNED TO:

U.S Mail Address Express Mail Address Department of Technology, Management, and Budget Department of Technology, Management, and Budget State Facilities Administration State Facilities Administration Design and Construction Division Design and Construction Division ATTN: Anne Watros ATTN: Anne Watros P.O. Box 30026 3111 West St. Joseph Street Lansing, MI 48909 Lansing, MI 48917

The point of contact for this Request for Proposal is:

Tom Pawlowski, Project Director Department of Technology, Management and Budget State Facilities Administration, Design and Construction Division P.O. Box 30026 Lansing, MI 48909 Telephone Number: (517) 242-0973 Email: pawlowskit@Michigan.Gov

I-4 Contract Award

The professionals will be evaluated based on their Technical Proposal - Part I, and Cost Proposal - Part II. Proposals will be evaluated by an Ad Hoc Advisory Committee based on the Technical Portion - Part I eighty percent (80%) and the Cost Proposal - Part II twenty percent (20%).

DTMB will offer a contract to the professional firm that has been recommended by the Ad Hoc Advisory Committee after their evaluation of the combined Part I - Technical and Part II - Cost Proposals. Recommendation is expected within thirty

(30) days following the due date of the proposal. The list of sample contracts can be viewed at our website:

http://www.michigan.gov/dmb/0,4568,7-150-41516-269818--,00.html

Professional firms must complete and sign the attached Certification of Michigan Based Business and Responsibility Certification forms.

I-5 Rejection of Proposals

The state reserves the right to reject any or all proposals, in whole or in part, received as a result of this Request for Proposals.

I-6 Incurring Costs

The state is not liable for any cost incurred by the Professional prior to acceptance of a proposal and the award and execution of a contract and issuance of the state's contract order.

I-7 Mandatory Preproposal Meeting

A MANDATORY PRE-PROPOSAL MEETING will be conducted by the Issuing Office for this Request for Proposal at March 14, 2019; 9 AM local time; Chippewa Correctional Facility, 4269 West M-80, Kincheloe, MI 49784

Questions that arise as a result of this RFP MUST BE SUBMITTED IN WRITING to the issuing office no later than March 21, 2019 by 5PM Eastern Time. In the event that it becomes necessary to amend any part of this RFP, addenda will be posted on the SIGMA-VSS website.

I-8 Economy of Preparation

Proposal should be prepared simply and economically, providing a straightforward, concise description of the professional's ability to meet the requirements of the Request for Proposal. Fancy bindings, three-ring binders, colored displays, promotional materials, and so forth, are not desired. Emphasis should be on completeness and clarity of content.

I-9 Responsibilities of Professional

The Professional will be required to assume responsibility for all professional services offered in their proposal whether or not they possess them within their organization. Further, the state will consider the Professional to be the sole point of contact with regard to contractual matters, including payment of any and all charges resulting from the contract. The prime professional shall possess a license to practice in the State of Michigan pursuant to the Occupational Code (PA 299 of 1980).

http://www.michigan.gov/dmb/0,4568,7-150-41516-269818--,00.html

I-10 Proposals

The professional must submit a complete response to this Request for Proposals. The proposal must be submitted in four (4) hard and two (2) electronic PDF format (Jump Drive), copies to the issuing office. No other distribution of proposals will be made by the Professional. Part I and Part II of the proposal should be submitted at the same time. To be considered, proposals must arrive at the issuing office on or before 2:00 p.m., local time, on Thursday, March 28, 2019. Allow normal delivery time to ensure timely receipt of proposals. Proposals received after this time will be returned unopened. The outside envelope should be clearly marked "Proposal – Various HVAC Systems Upgrades – Chippewa Correctional Facility." Proposal must be signed by an official authorized to bind the professional firm to its provisions. NO FACSIMILES OR E-MAILS OF THE REQUEST FOR PROPOSAL WILL

BE ACCEPTED.

NOTE: Security measures may affect the delivery time of mail and packages sent via UPS, Fed Ex, and Airborne Express. Those hand-delivering their proposal should be prepared to present a pictured identification to the security guard on duty in the lobby of the building and allow extra time for their proposal to reach the DCD. It remains the responsibility of the Professional to submit proposals as specified. Please allow ample mailing time for packages to arrive at the office prior to the 2:00 p.m. deadline.

SECTION II PROPOSAL FORMAT - PART I - TECHNICAL

The proposal must be submitted in the format outlined below. Paginate proposals and ensure that the proposals refer specifically to the project at hand. Proofread proposals for language and mathematical errors. The items shown below are considered in the Ad Hoc Committee proposal review of technical qualifications.

II-l General Information and Project Team

State the full name, address, and federal I.D. number of the organization and, if applicable, the branch office, consultants or other subordinate elements that will provide or assist in providing the service. Indicate whether you operate as an individual, partnership, or corporation. If a corporation, include the state in which you are incorporated. State whether you are licensed to operate and practice in the State of Michigan.

II-2 Understanding of Project and Tasks

The Professional must understand the project being considered and the professional services needed to achieve the state’s goal. State your understanding of the project requirements and summarize your plan for accomplishing the project.

Outline your experience with similar projects, sites, and clients as examples. Explain how your firm or project team is the best suited to provide the services required for this project and would provide the best value to the State of Michigan for this work.

II-3 Personnel

The Professional must be able to staff a project team that has the qualifications and expertise necessary to undertake the project. Include the full names of all personnel by classification that will be employed in the project. Indicate which of these individuals you consider to be "Key Personnel" for the successful completion of the project, identify them by name and position/classification, and provide their resumes. Provide an organization chart outlining authority and communication lines for each professional firm, including Key Personnel, including sub-consultants, client agency, and

DTMB.

II-4 Management Summary, Work Plan, and Schedule

The Professional must outline their work plan and methodology so that it is understood what services and deliverables will be provided, and the quality of the services and deliverables as well. Describe in detailed narrative form your plan for accomplishing the project. Describe clearly and concisely each professional task, event, and deliverable required for project completion. Do not simply reiterate language and tasks from the DTMB Professional Services Contract. Describe your constructability review and quality control plan. Include a detailed time sequenced-related but undated schedule, showing each event, task and phase in your work plan. Allow time in the schedule for Owner’s review.

II-5 Budget Analysis

Analyze the proposed project budget for adequacy versus the outlined program or project statement. If your professional opinion is that the proposed budget is inadequate provide the basis for your opinion and offer suggestions for managing the issue. This will not adversely affect review of the proposal.

II-6 References

Provide references, with contact information, of previous clients, particularly for similar projects. Outline your experience with similar projects, sites, and clients.

SECTION III PROPOSAL FORMAT - PART II - COST

III-1 Instructions and Information – Billable Rate

The Part II - Cost Proposal shall carefully interface with all phases/tasks of the work plan identified in the Part I - Technical

Proposal. The fee requested shall be estimated using billable hourly rates and the hours expected to be necessary by particular staff to complete the phases of work. If sub-consultants are used, their fees shall be provided. A mark-up of the consultants’ fees or billing rates will be allowed; indicate the percentage of the mark-up within the tables, not to exceed 5%.

Reimbursable Expenses: The DTMB will reimburse the Professional for the actual cost of printing and reproduction of project deliverables such as survey and/or study report and bidding documents (drawings and specifications). DTMB will also reimburse for U.S. Mail regular shipping or postage, soil borings, site surveys and any required laboratory testing. A mark-up of reimbursable expenses will be allowed; indicate the percentage of the mark-up within the tables, not to exceed 5%.

All other costs, such as fringe benefits, vacations, sick leave, insurance, meals, lodging, travel, all computer time, and clerical/secretarial services (not project related), telephone services, miscellaneous travel, reproduction services for other than bid documents, employees not providing a direct service, other indirect costs, overhead and profit, shall be included in the calculation of the Professional's billing rates.

If the project is further than 100 miles one-way from the Professional firm’s office, travel expenses to the project site will be allowed as a reimbursable expense at the State of Michigan’s rates. Mileage allowed will be actual, less 100 miles each way. Other travel expenses are not to be included, unless specifically authorized in writing. Provide an estimated allowance of reimbursable costs for travel expenses to the project site, in your proposal response.

Completeness of Proposal: The design phase services shall cumulatively include any services required for subsequent issuing and processing of bulletins arising from, but not limited to, design errors and/or omissions, code compliance (precipitating either from plan review or on-site/field observations), or modification of existing structures or systems necessary to achieve the intent of the project statement.

The design phase services shall include, either by cumulative allowance or by specific task, the furnishing of all project data and services necessary to legally implement the project. This includes but may not be limited to, code reviews and/or interpretations, project meetings, presentations, hearings, utility allocations requests, and/or connections, easements, or permits.

Any contract issued by the state pursuant to this proposal anticipates that the Professional will provide, but shall not seek compensation for, services necessary to respond to and resolve contractor claims arising wholly or in part from the Professional's design errors or omissions or other aspects of the design or for any aspect of the professional's performance which is inconsistent with the professional or construction contracts. No task or part thereof may include costs for such efforts.

Cost Review: Cost Proposals are reviewed on Interface and Total Fee. Interface refers to how the effort proposed (defined as the numbers of hours per phase, considered with the staff and classification assigned to that phase) relates to the effort the DTMB and the Client Agency expect or estimate to be required in order to deliver the project successfully.

Total Fee refers to the total of the prime Professionals’ fee, sub-consultants, travel, and other reimbursable expenses.

III-2 Identification of Personnel and Estimated Compensation

Provide compensation information for the Professional as well as any Sub-consultants. Note that employees of a separate professional firm or consultant, if proposed, should also be included and noted.

A. Primary Professional and Sub-consultant(s) – Position, Classification & Employee Billable Rate Information

Using the format of Form III-2-A (attached), identify the service being provided and the Professional’s or Sub-consultant’s employee(s) names and position classifications. List their current hourly billable rate range from the beginning to the end of the project, by year, based on the professional's estimated schedule duration. This range of current and anticipated hourly billing rates shall include any anticipated pay increases over the life of the Professional’s or consultant's estimated project schedule. Sub-consultant billable rate information is required in case of changes in scope; sub-consultant fees will be included in the contract as not-to-exceed reimbursable amounts, including a reasonable mark-up. Mark-up not to exceed 5%.

To determine your current billing rates, use the attached guideline page for information regarding the “overhead Items used for Professional Firm’s billing Rates Calculation,” and the web-link to “Sample Standard Contract for Professional Services,” Article 2 – Compensation. Consultants providing professional services must submit separate billing rates for services that they will provide. A reasonable mark-up of the consultants billing rates, not to exceed 5%, will be allowed. ALL other costs, such as indirect labor, telephones, miscellaneous reproduction, travel, etc. shall be included in the professional’s billing rate.

Identify, for each task, the estimated cost. The combination of all phases/tasks shall become the professional’s maximum not-to-exceed cost for all services. Compensation for each phase will be in accordance with the “Sample Standard Contract for Professional Services,” Article 2 – Compensation.

B. Fee with Anticipated Hours by Phase

Using the format of Form III-2-B, identify for each phase the estimated hours for each employee and include the billable rate for each employee. Provide totals.

C. Reimbursable Expenses

Using the format of Form III-2-C, identify the phase number, firm name and description of sub-consulting services expressed as a not-to-exceed amount. Identify the phase number, firm name, and description of all reimbursable direct expenses expressed as a not-to-exceed amount (travel over 100 miles one-way, printing, tests, etc.). Note the mark-up(s) for handling reimbursable expenses, not to exceed 5%. Provide totals.

D. Total, Summarized by Phase

Using the format of Form III-2-D, provide a total of the fees and reimbursable expenses, by phase, as outlined in items B and C above. The total of all phases shall become the Professional's maximum not-to-exceed contract for all design services. Compensation for each phase will be in accordance with the "Sample Standard Contract for Professional Services."

Use the attached forms to establish your total compensation and trade contract reimbursables.

http://www.michigan.gov/dmb/0,4568,7-150-41516-269818--,00.html

The following instructions are to be used by the Professional Services Contractor firm’s to determine the hourly billing rate to use on State of Michigan Projects.

The Professional’s Consultant must submit a separate hourly billing rate for the professional Consultant services they will provide for State of Michigan Projects. A moderate mark-up of the Professional’s Consultant services hourly billing rates, not to exceed 5%, will be allowed.

The Department will reimburse the Professional for the actual cost of printing and reproduction of the Contract Bidding Documents, soil borings, surveys and any required laboratory testing services and use of field equipment. No mark-up of these Project costs will be allowed.

2018 HOURLY BILLING RATE

Based on 2017 Expenses

OVERHEAD ITEMS ALLOWED FOR THE PROFESSIONAL SERVICES CONTRACTOR

FIRM’S HOURLY BILLING RATE CALCULATION

SALARIES:

Principals (Not Project Related) Clerical/Secretarial Technical (Not Project Related) Temporary Help Technical Training Recruiting Expenses

OFFICE FACILITIES:

Rents and Related Expenses Utilities Cleaning and Repair

SUPPLIES:

Postage Drafting Room Supplies General Office Supplies Library Maps and Charts Magazine Subscriptions

SERVICES (PROFESSIONAL):

Accounting Legal Employment Fees Computer Services Research

FINANCIAL:

Depreciation

EQUIPMENT RENTALS:

Computers Typewriter Bookkeeping Dictating Printing Furniture and Fixtures Instruments Holidays

TRAVEL:

All Project-Related Travel

MISCELLANEOUS:

Professional Organization Dues for Principals and Employees Licensing Fees

SERVICES (NONPROFESSIONAL):

Telephone and Telegram Messenger Services

TAXES:

Franchise Taxes Occupancy Tax Unincorporated Business Tax Property Tax Single Business Tax Income Tax

INSURANCE:

Professional Liability Insurance Flight and Commercial Vehicle Valuable Papers Office Liability Office Theft Premises Insurance Key-Personnel Insurance

EMPLOYEE BENEFITS:

Hospitalization Employer's F.I.C.A. Tax Unemployment Insurance Federal Unemployment Tax Disability Worker's Compensation Vacation

Sick Pay Medical Payments Pension Funds Insurance - Life Retirement Plans

PRINTING AND DUPLICATION:

Specifications (other than Contract Bidding Documents) Drawings (other than Contract Bidding Documents) Xerox/Reproduction Photographs

LOSSES:

Bad Debts (net) Uncollectible Fee Thefts (not covered by Project/Contract bond) Forgeries (not covered by Project/Contract bond)

III-2-A. Position, Classification and Employee Billing Rate Information

Firm Name XYZ, Inc.

Yearly Hourly Billing Rate Increase ≈5%

Employee(s) Name Position/Classification

Year 2012 Year 2013 Year 2014 Year 2015 Robert J. Hafel Principal/Project Manager** $100.00 $105.00 $110.00 $116.00

Donald E. McReynolds Senior Architect $100.00 $105.00 $110.00 $116.00

William King Quality Control/Assurance $100.00 $105.00 $110.00 $116.00

Ruby D. Riley Licensed Surveyor** $90.00 $95.00 $99.00 $104.00

Charles D. Gibson Project Engineer** $90.00 $95.00 $99.00 $104.00

William D. Murphy Mechanical Engineer** $90.00 $95.00 $99.00 $104.00

Robert L. Hunter Sr. Structural Engineer $80.00 $84.00 $88.00 $92.00

Carolyn M. Phillips Electrical Engineer $80.00 $84.00 $88.00 $92.00

Kathleen C. Wilson Scientist/Surveyor $65.00 $68.00 $71.00 $75.00

Jeffrey W. Bennett Staff Engineer $65.00 $68.00 $71.00 $75.00

Scott A. Smith Staff geologist $65.00 $68.00 $71.00 $75.00

Arnold T. Ross CAD Operator $75.00 $79.00 $83.00 $87.00

Jennifer M. Dole Technician $65.00 $68.00 $71.00 $75.00

Brian G. Brown Field Technician $50.00 $53.00 $56.00 $59.00

As Selected Technical Support $35.00 $37.00 $39.00 $41.00

*Billing Rate will be in accordance with the attached guideline page for instructions regarding the "Overhead Items used for Professional Billing Rate Calculation," and the "Sample Standard Contract for Professional Services," Article 5, Compensation Text.

** Key Project Personnel

III-2-B. Fee with Anticipated Hours and Billing Rate

TOTAL

HOURS

BILLING RATE

EMPLOYEE NAME POSITION/ CLASSIFICATION

Robert J. Hafel Principal/Project Manager 30 100.00 3,000.00 Donald McReynolds Senior Architect 17 100.00 1,700.00 William King Quality Control/Assurance 2 100.00 200.00 Ruby D. Riley Licensed Surveyor 9 90.00 810.00 Charles D. Gibson Project Engineer 8 90.00 720.00 William D. Murphy Mechanical. Engineer 8 90.00 720.00 Robert L. Hunter Sr. Structural Engineer 8 80.00 640.00 Carolyn M. Phillips Electrical Engineer 22 80.00 1,760.00 Arnold T. Ross CAD Operator 42 75.00 3,150.00 As Selected Technical Support 40 35.00 1,400.00

SUBTOTAL

$14,100.00

III-2C. Authorized Reimbursables -- Sub-consultants, Testing and Expenses

*Firm’s Mark-Up Percentage: (not to exceed 5%)

PHASE

NAME OF FIRM

DESCRIPTION OF SERVICES PROVIDED

AMOUNT*

(including mark-up)

Phase 400 Forrest T. Arrea, Landscape Architect, Howell, Michigan Design of Stormwater Management Rain Garden 1,000.00

Phase 500 XYZ Productions, Inc.

Lansing, Michigan Printing and reproduction of bidding documents

500.00

Phase 500 Forrest T. Arrea, Landscape Architect, Howell, Michigan Design of Stormwater Management Rain Garden 500.00

Phases 500, 700 Travel Allowance Travel between office and project (site over 100 miles one-way from office) 1,000.00

SUBTOTAL

$ 3,000.00

III-2D. Total, Summarized By Phase

PHASE Phase 300 Phase 400 Phase 500 Phase 600 Phase 700

Professional Fee 1,597.50 2,820.00 3,970.00 1,120.00 1,160.00 10,667.50 Reimbursable Expenses 0.00 1,000.00 1,250.00 0.00 750.00 3,000.00

SUB-TOTAL 1,597.50 3,820.00 5,220.00 1,120.00 1,910.00

TOTAL CONTRACT AMOUNT $ 13,667.50

R 12/16/13

DEPARTMENT OF TECHNOLOGY, MANAGEMENT AND BUDGET

Design & Construction Division

Certification of a Michigan Based Business

(Information Required Prior to Contract Award for Application of State Preference/Reciprocity Provisions)

To qualify as a Michigan business:

Vendor must have, during the 12 months immediately preceding this bid deadline:

or

If the business is newly established, for the period the business has been in existence, it has:

(check all that apply):

Filed a Michigan single business tax return showing a portion or all of the income tax base allocated or apportioned to the State of Michigan pursuant to the Michigan Single Business Tax Act, 1975 PA 228, MCL �˜208.1 – 208.145; or

Filed a Michigan income tax return showing income generated in or attributed to the State of Michigan;

or

Withheld Michigan income tax from compensation paid to the bidder’s owners and remitted the tax to the Department of Treasury; or

I certify that I have personal knowledge of such filing or withholding, that it was more than a nominal filing for the purpose of gaining the status of a Michigan business, and that it indicates a significant business presence in the state, considering the size of the business and the nature of its activities.

I authorize the Michigan Department of Treasury to verify that the business has or has not met the criteria for a Michigan business indicated above and to disclose the verifying information to the procuring agency.

Bidder shall also indicate one of the following:

Bidder qualifies as a Michigan business (provide zip code: )

Bidder does not qualify as a Michigan business (provide name of State: ).

Principal place of business is outside the State of Michigan, however service/commodity provided by a location within the State of Michigan (provide zip code: )

Bidder:

Authorized Agent Name (print or type)

Authorized Agent Signature & Date

Fraudulent Certification as a Michigan business is prohibited by MCL 18.1268 § 268.

A BUSINESS THAT PURPOSELY OR WILLFULLY SUBMITS A FALSE CERTIFICATION

THAT IT IS A MICHIGAN BUSINESS OR FALSELY INDICATES THE STATE IN WHICH IT

HAS ITS PRINCIPAL PLACE OF BUSINESS IS GUILTY OF A FELONY, PUNISHABLE BY

A FINE OF NOT LESS THAN $25,000 and subject to debarment under MCL 18.264.

R 12/16/13

DEPARTMENT OF TECHNOLOGY, MANAGEMENT AND BUDGET

Design & Construction Division

Responsibility Certification

The bidder certifies to the best of its knowledge and belief that, within the past three (3) years, the bidder, an officer of the bidder, or an owner of a 25% or greater interest in the bidder:

(a) Has not been convicted of a criminal offense incident to the application for or performance of a contract or subcontract with the State of Michigan or any of its agencies, authorities, boards, commissions, or departments.

(b) Has not had a felony conviction in any state (including the State of Michigan).

(c) Has not been convicted of a criminal offense which negatively reflects on the bidder’s business integrity, including but not limited to, embezzlement, theft, forgery, bribery, falsification, or destruction of records, receiving stolen property, negligent misrepresentation, price-fixing, bid-rigging, or a violation of state or federal anti-trust statutes.

(d) Has not had a loss or suspension of a license or the right to do business or practice a profession, the loss or suspension of which indicates dishonesty, a lack of integrity, or a failure or refusal to perform in accordance with the ethical standards of the business or profession in question.

(e) Has not been terminated for cause by the Owner.

(f) Has not failed to pay any federal, state, or local taxes.

(g) Has not failed to comply with all requirements for foreign corporations.

(h) Has not been debarred from participation in the bid process pursuant to Section 264 of 1984 PA 431, as amended, MCL 18.1264, or debarred or suspended from consideration for award of contracts by any other State or any federal Agency.

(i) Has not been convicted of a criminal offense or other violation of other state or federal law, as determined by a court of competent jurisdiction or an administrative proceeding, which in the opinion of DTMB indicates that the bidder is unable to perform responsibly or which reflects a lack of integrity that could negatively impact or reflect upon the State of Michigan, including but not limited to, any of the following offenses under or violations of:

i. The Natural Resources and Environmental Protection Act, 1994 PA 451, MCL 324.101 to 324.90106.

ii. A persistent and knowing violation of the Michigan Consumer Protection Act, 1976 PA 331, MCL 445.901 to

445.922.

iii. 1965 PA 166, MCL 408.551 to 408.558 (law relating to prevailing wages on state projects) and a finding that the bidder failed to pay the wages and/or fringe benefits due within the time period required.

iv. Repeated or flagrant violations of 1978 PA 390 MCL 408.471 to 408.490 (law relating to payment of wages and fringe benefits).

v. A willful or persistent violation of the Michigan Occupational Health and Safety Act, 1974, PA 154, MCL 408.10001 to 408.1094, including: a criminal conviction, repeated willful violations that are final orders, repeated violations that are final orders, and failure to abate notices that are final orders.

vi. A violation of federal or state civil rights, equal rights, or non-discrimination laws, rules, or regulations.

vii. Been found in contempt of court by a Federal Court of Appeals for failure to correct an unfair labor practice as prohibited by Section 8 of Chapter 372 of the National Labor Relations Act, 29 U. s. C. 158 (1980 PA 278, as amended, MCL 423.321 et seq).

(j) Is NOT an Iran linked business as defined in MCL 129.312.

I understand that a false statement, misrepresentation, or concealment of material facts on this certification may be grounds for rejection of this proposal or termination of the award and may be grounds for debarment.

Bidder:

Authorized Agent Name (print or type)

Authorized Agent Signature & Date

I am unable to certify to the above statements. My explanation is attached.