2-02 - Required Documentation.pdf

CITY OF LEWISVILLE

PURCHASING DIVISION

ADDITIONAL TERMS

ANTI-LOBBYING PROVISION

During the period between proposal / sealed bid submission date and the contract award, proposers, including their agents and representatives, shall not directly discuss or promote their proposal with any member of the City of Lewisville City Council or City staff except during City-Sponsored inquiries, briefings, interviews, or presentations, unless requested by the City.

This provision is not meant to preclude offerors from discussing other matters with City Council members or City staff. This policy is intended to create a level playing field for all potential offerors, assure that contract decisions are made in public, and to protect the integrity of the RFP Bid Evaluation process. Violation of this provision may result in rejection of the offeror’ s proposal.

LAWS AND ORDINANCES

Laws and Ordinances: The Contractor shall always observe and comply with all Federal, State and local laws, ordinances and regulations which in any manner affect the Contract or the work and shall indemnify and save harmless the City against any claim arising from the violation of any such laws, ordinances and regulations whether by the Contractor or his employees.

PROTECTION OF RESIDENT WORKERS

Protection of Resident Workers: The City of Lewisville actively supports the Immigration and Nationality Act (INA) which includes provisions addressing employment eligibility, employment verification, and nondiscrimination. Under the INA, employers may hire only persons who may legally work in the United States (i.e., citizens and nationals of the U.S.) and aliens authorized to work in the U.S. The employer must verify the identity and employment eligibility of anyone to be hired, which includes completing the Employment Eligibility Verification Form (I-9). The Contractor and its Subcontractors shall establish appropriate procedures and controls so no services or products under the Contract Documents will be performed or manufactured by any worker who is not legally eligible to perform such services or employment. The City reserves the right to audit Contractor’ s or Subcontractor’ s employment records to verify the existence of a completed Employment Eligibility Verification Form ( I-9) for every worker performing services or manufacturing products under the Contract Documents. The audit will be at the City’s expense.

IMMIGRATION REFORM AND CONTROL ACT

Immigration Reform and Control Act (8 U.S.C. §1324a): The City of Lewisville supports the Immigration Reform and Control Act ( IRCA) which is a comprehensive scheme prohibiting the employment of unauthorized aliens in the United States. The Contractor shall submit a declaration signed under penalty of perjury of the laws of the State of Texas stating that it has not been found in violation of IRCA by the United States Attorney General or Secretary of Homeland Security in the preceding five (5) years. The Contractor shall ensure that its Subcontractors submit a declaration signed under penalty of perjury of the laws of the State of

Texas stating that they have not been found in violation of IRCA by the United States Attorney General or Secretary of Homeland Security in the preceding five (5) years. The Contractor and its Subcontractors shall at all times during the term of the contract with the City comply with the requirements of IRCA and shall notify the City within fifteen (15) working days of receiving notice of a violation of IRCA. The City may terminate a contract with the Contractor if the City determines that (a) the Contractor or its Subcontractors have been untruthful regarding IRCA violations in the preceding five (5) years; ( b) if the Contractor fails to ensure that its Subcontractors submit the aforementioned declaration; or (c) the Contractor or its Subcontractors fail to timely notify the City of an IRCA violation.

Contractor Name Authorized Signature

Date

CITY OF LEWISVILLE

DISCLOSURE OF INTEREST

Pursuant to Chapter 176 of the Texas Local Government Code, a person or agent of a person who contracts or seeks to contract with the City of Lewisville must complete a conflict of interes t questionnaire if the person or agent has an affiliation or business relationship that might cause a conflict of interest with the City. The conflict of interest questionnaire, which is available online at ethics. state. tx.us, must be filed with the City Secretary of the City of Lewisville no later than the seventh ( 7th business day after the person or agent begins contract discussions or negotiations with the City of Lewisville or submits to the City of Lewisville an application, response to a request for proposal or bid, correspondence, or another writing related to a potential agreement with the City of Lewisville. An updated Conflict of Interest Questionnaire must be filed in accordance with Chapter 176 of the Local Government Code.

Seller should consult with legal counsel if they have questions regarding its compliance with the requirements of Chapter 176. It is the responsibility of each person or agent who is contracting or seeking to contract with the City of Lewisville to comply with the filing requirements of Chapter

176.

COL\kbyrd http://ethics.state.tx.us/

REQUEST FOR DISCLOSURE UNDER TEXAS LAW

Request for Qualifications Responses

Qualifications submitted by potential ENGINEERING FIRM candidates in response to the City’ s Request for Qualifications may be subject to disclosure under the Texas Public Information Act ( Texas Government Code, Chapter 552.001, et seq.). The City of Lewisville may request an opinion from the Texas Attorney General concerning any information that is clearly marked as proprietary in your submittal.

However, that information may still be subject to release if it is finally determined not to be proprietary under Texas law.

By having an authorized officer of the company sign below, this ENGINEERING FIRM candidate agrees that the City of Lewisville will not defend the withholding of such information if an attorney general opinion requires its release.

Furthermore, this ENGINEERING FIRM candidate agrees to waive any rights or claims for damages it may have against the City that are caused by or alleged to be caused by the release of said proprietary information.

TYPE OR PRINT:

FIRM NAME AUTHORIZED REPRESENTATIVE &

TITLE

STREET ADDRESS and/ or P.O. BOX NO. PHONE NUMBER

CITY/ STATE/ ZIP CODE E-MAIL ADDRESS

SIGNATURE DATE

9/8/2021

INSURANCE REQUIREMENTS

ENGINEERING/ARCHITECTURE PROJECTS

Vendor shall procure and maintain for the duration of the contract, insurance against claims for injuries to persons or damages to property, which may arise from or in connection with the performance of the work hereunder by the vendor, his agents, representatives, employees or subcontractors. The cost of such insurance shall be included in the Vendor’ s bid.

A. MINIMUM SCOPE OF INSURANCE

Coverage shall be at least as broad as:

1. Insurance Services Office Commercial General Liability coverage “occurrence” form CG 00 01 (10 01). “ Claims Made” form is unacceptable except for professional liability.

2. Workers’ Compensation insurance as required by the Labor Code of the State of Texas, including Employers’ Liability Insurance.

3. Automobile Liability – as required by the State of Texas, covering all owned, hired, or non-owned vehicles. Automobile Liability is only required if vehicle(s) will be used under this contract.

Coverage not required for delivery services.

4. Professional Liability and/or Errors and Omissions Insurance.

B. MINIMUM LIMITS OF INSURANCE

Vendor shall maintain throughout contract limits not less than:

1. Commercial General Liability: $500,000 per occurrence/$1,000,000 aggregate for bodily injury, personal injury and property damage. Policy will include coverage for:

a. Premises – Operations

b. Broad Form Contractual Liability

c. Products and Completed Operations

d. Use of Contractors and Subcontractors

e. Personal Injury

f. Broad Form Property Damage

g. If applicable, Explosion Collapse and Underground (XCU) Coverage (when applicable, Fire Damage, Medical Expense).

NOTE: The aggregate loss limit applies to each project.

2. Workers’ Compensation and Employer’ s Liability: Workers’ Compensation Statutory limits as required by the Labor Code of the State of Texas and Employer’ s Liability minimum limits of 500,000 per injury, $500,000 per occurrence, and $500,000 per occupational disease.

3. Automobile Liability - $500,000 Combined Single Limit. Limits can only be reduced if approved by the HR Director or designee.

4. Professional Liability and/or Errors and Omissions - $ 500,000 per occurrence - $ 1,000,000 Aggregate.

5. Builders’ Risk Insurance (as applicable) – Completed value form, insurance carried must equal the completed value of the structure.

C. DEDUCTIBLES AND SELF-INSURED RETENTIONS

Any deductible or self-insured retentions must be declared to and approved by the City.

D. OTHER INSURANCE PROVISIONS

The policies are to contain, or be endorsed to contain the following provisions:

1. General Liability and Automobile Liability Coverages

a. The City, its officers, officials, employees, Boards and Commissions and volunteers are to be added as “ Additional Insured” as respects liability arising out of activities performed by or on behalf of the vendor, products and completed operations of the vendor, premises owned, occupied or used by the Contractor. The coverage shall contain no special limitations on the scope of protection afforded to the City, its officers, officials, employees or volunteers. It is understood that the business auto policy under “ Who is an Insured” automatically provides liability coverage in favor of the City.

b. The vendor’ s insurance coverage shall be primary and non-contributory insurance as respects the City, its officers, officials, employees and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees or volunteers shall be excess of the vendor’ s insurance and shall not contribute with it.

c. Any failure to comply with reporting provisions of the policy shall not affect coverage provided to the City, its officers, officials, and employees, Boards and Commissions or volunteers.

d. The vendor’ s insurance shall apply separately to each insured against whose claim is made or suit is brought, except to the limits of the insured’ s liability.

2. Waiver of Subrogation – All Coverages except Professional Liability Each insurance policy required by this exhibit except Professional Liability shall waive all rights of subrogation against the City, its officers, officials, employees, and volunteers for losses arising from work performed by the vendor for the City.

3. Notice of Cancellation - All Coverages Each insurance policy required by this exhibit shall be endorsed to state that coverage shall not be suspended, voided, canceled or non-renewed by either party, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given the City, or ten (10) days prior written notice for non-payment of premium.

4. Professional Liability (applicable only to certified or licensed Engineers and or Architects) Claims made” policy is acceptable coverage which must be maintained during the course of the project and up to two (2) years after completion and acceptance of the project by the City.

E. ACCEPTABILITY OF INSURERS

The City prefers that Insurance be placed with insurers with an A.M. Best’ s rating of no less than A-:VI, or, A or better by Standard and Poors. Professional Liability carriers will need to be approved by the HR Director or designee.

F. VERIFICATION OF COVERAGE

Contractor shall furnish the City with certificates of insurance affecting coverage required. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. Certificates of Insurance must be provided on forms approved by the Texas Department of Insurance. City will not accept Memorandums of Insurance or Binders as proof of insurance. The City reserves the right to require complete, certified copies of all required insurance policies at any time.

G. HOLD HARMLESS AND INDEMNIFICATION

THE CONSULTANT AGREES TO DEFEND, INDEMNIFY AND HOLD THE CITY, ITS

OFFICERS, AGENTS AND EMPLOYEES, HARMLESS AGAINST ANY AND ALL CLAIMS,

LAWSUITS, JUDGMENTS, COSTS AND EXPENSES FOR PERSONAL INJURY (INCLUDING

DEATH), PROPERTY DAMAGE OR OTHER HARM FOR WHICH RECOVERY OF

DAMAGES IS SOUGHT, SUFFERED BY ANY PERSON OR PERSONS, TO THE EXTENT

THAT SUCH DAMAGE IS CAUSED BY OR RESULTS FROM ANY ACT OF NEGLIGENCE,

INTENTIONAL TORT, INTELLECTUAL PROPERTY INFRINGEMENT, OR FAILURE TO

PAY A SUBCONTRACTOR OR SUPPLIER COMMITTED BY CONSULTANT, ITS AGENT,

EMPLOYEE, CONSULTANT UNDER CONTRACT, ORANY OTHER ENTITYOVERWHICH

THE CONSULTANT EXERCISES CONTROL, IN THE PERFORMANCE OF THIS

AGREEMENT WITHOUT WAIVING ANY GOVERNMENTAL IMMUNITY AVAILABLE TO

THE CITY UNDER TEXAS LAW AND WITHOUT WAIVING ANY DEFENSES OF THE

PARTIES UNDER TEXAS LAW. THE DUTY TO DEFEND SHALL NOT APPLY IN THE

CASE OF A CLAIM BASED WHOLLY OR PARTLY ON THE NEGLIGENCE OF, FAULT OF,

OR BREACH OF CONTRACT BY THE CITY, ITS AGENTS OR EMPLOYEES, OR OTHER

ENTITY (EXCLUDING THE CONSULTANT OR ITS AGENT, EMPLOYEE, CONSULTANT

UNDER CONTRACT, OR ANY OTHER ENTITY OVER WHICH THE CONSULTANT

EXERCISES CONTROL) OVER WHICH THE CITY EXERCISES CONTROL, IN WHICH

INSTANCE THE CITY’S REASONABLE ATTORNEY’S FEES SHALL BE REIMBURSED BY

CONSULTANT IN PROPORTION TO THE CONSULTANT’ S LIABILITY. THE PROVISIONS

OF THIS PARAGRAPH ARE SOLELY FOR THE BENEFIT OFTHE PARTIES HERETO AND

NOT INTENDED TO CREATE OR GRANT ANY RIGHTS, CONTRACTUAL OR

OTHERWISE, TO ANY OTHER PERSON OR ENTITY.

VENDOR SUPPLEMENTAL INFORMATION

The following information is required for contract development.

1. In what state was your business formed?

2. Provide the following information for the person authorized to execute contracts on behalf of your organization:

Name Title

Email Address Telephone No.

Mailing Address. _ _ City _ _ State Zip

3. Provide the following information for the contact person authorized to implement this contract on behalf of your organization:

Name

Email Address_

Mailing Address

Title

Telephone No

City_ State Ziq

4. Provide the following information for the person authorized to receive notices and communications regarding this contract on behalf of your organization:

Name Title

Email Address Telephone No

Physical Business Address City_ Notices and communications will be mailed to this physical address

5. Select and complete one of the following:

a. Sole Proprietorship

i. Legal name of Sole Proprietor:

ii. Physical business address:

City State

73 General Partnership

i. Legal name of Partnership:

ii. Physical business address:

City_

State_ Zip

State Zip _ _ .

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VENDOR SUPPLEMENTAL INFORMATION

C. Limited Partnership e.

f. o

1. Legal name of Limited Partnership:

ii. General Partner( s):

If a legal entity, name of the entity:.

If an individual, name of the individual:

iii. Physical business address:

City

Corporation

i. Legal name of Corporation:

ii. Physical business address_

City

State

State

Limited Liability Company

i. Legal name of Limited Liability Company:

ii. Physical business address

City State

Other Entity ( not listed)

i. Legal name and type of Company:

ii. Physical business address.

Zip

Zip

Zip

City State_ _ _ Zip

6. Does your business have 10 or more full- time employees? No Yes

7. a. Are you a publicly traded business? No Yes — where traded:

b. Are you a wholly owned subsidiary of a publicly traded business? No Yes — which publicly traded business:_

8. a. Is your business registered with the Texas Secretary of State? No Yes

b. If yes, please provide records or screenshot( s) from the Texas Secretary of State' s website reflecting the name or names for which your business has been registered.

In signing this form, I acknowledge that I have read the above and state that the information contained therein is true and correct.

Signature:

Print Name:

Date:

Print Title:

Updated March 24, 2022 Page 2 of 2