2-Attachment A.pdf

AFFIDAVIT

STATE OF ______________________ )

) SS.

COUNTY OF ____________________ )

_________________________________of the city of ________________________________ County of ____________________ State of __________________being duly sworn on her or his oath, deposes and says;

1. That I am the _________________________ (Title of Affiant) of __________________________________(Name of Supplier) and have been authorized by said Supplier to make this Affidavit upon my best information and belief, after reasonable inquiry as to the representations herein.

2. No Officer, Agent or Employee of Jackson County, Missouri is financially interested directly or indirectly what Vendor is offering to sell to the County pursuant to this Invitation (though no representation is made regarding potential ownership of publicly traded stock of supplier).

3. If Supplier were awarded any contract, job, work or service for Jackson County, Missouri, no Officer, Agent or Employee of the County would be interested in or receive any benefit from the profit or emolument of such.

4. Either Supplier is duly listed and assessed on the tax rolls of Jackson County, Missouri and is not delinquent in the payment of any taxes due to the County or Supplier did not have on December 31, 2025, any property subject to taxation by the County and if vendor is duly listed and assessed on the tax rolls of Jackson County, Missouri, supplier agrees to permit an audit of its records, if requested by the Jackson County Director of Assessment, as they relate to the assessment of Business Personal Property.

5. Supplier has not participated in collusion or committed any act in restraint of trade, directly or indirectly, which bears upon anyone's response or lack of response to the Invitation.

6. Supplier certifies and warrants that Supplier or Supplier’s firm/organization is not listed on the General Services Administration's Report of Debarred and/or Suspended Parties.

7. Supplier certifies and affirms its enrollment and participation in a federal work authorization program with respect to the employees working in connection with the contracted services.

8. Supplier certifies and affirms that it does not knowingly employ any person who is an unauthorized alien in connection with the contracted services.

_______________________________ (Name of Supplier)

By: ____________________________ (Signature of Affiant)

_______________________________ (Title of Affiant)

Subscribed and sworn to before me this ______ day of _________________, 20____

NOTARY PUBLIC in and for the County of _______________________________(SEAL)

State of _____________________________

My Commission Expires: ______________________________________________

OFFICE OF THE COUNTY AUDITOR

COMPLIANCE REVIEW OFFICE

415 E 12TH STREET, 2ND FLOOR

KANSAS CITY, MISSOURI 64106

(816) 881-3302

FAX (816) 881-3340

COMPLIANCE@JACKSONGOV.ORG

WWW.JACKSONGOV.ORG/AUDITOR

CERTIFICATE OF COMPLIANCE NOTICE:

All vendors doing business with Jackson County are required to obtain a Certificate of Compliance issued by the Jackson County Compliance Review Office.

A Certificate of Compliance is required to be submitted with any bid response.

Failure to comply with this requirement may result in the REJECTION of a bid.

Vendors may complete a

Certificate of Compliance Application by visiting https://www.jacksongov.org/Government/Departments/Com pliance-Review-Office/Certificate-of-Compliance

A Certificate of Compliance will certify that vendors meet the following requirements:

1. Are duly listed and assessed on the tax rolls of Jackson County and are not delinquent in the payment of any taxes due to the County, or do not have on December 31st of the previous year any property subject to taxation by Jackson

County.

2. Attest and agree to Chapter 6 of the Jackson County Code which prohibits discriminatory practices and promotes Equal Employment Opportunity by contractors doing business with Jackson County.

Certificate of Compliance Application must be submitted five (5) business days prior to a bid response deadline to allow sufficient time to process. A Certificate of

Compliance is not guaranteed if this timeline is not met.

QUESTIONS? Email compliance@jacksongov.org mailto:COMPLIANCE@JACKSONGOV.ORG http://www.jacksongov.org/AUDITOR https://www.jacksongov.org/Government/Departments/Compliance-Review-Office/Certificate-of-Compliance https://www.jacksongov.org/Government/Departments/Compliance-Review-Office/Certificate-of-Compliance mailto:compliance@jacksongov.org

STATEMENT OF CONTRACTOR'S QUALIFICATIONS

(Complete in full, Use attachments if necessary)

Name of Bidder:

Address with Zip Code:

Federal Tax I.D. Number:

Check One: Corporation Partnership Sole Proprietorship If SOLE PROPRIETORSHIP, state name, address, and phone number of owner:

If CORPORATION:

Date of Incorporation:

Name of State(s) in which incorporated:

President's Name:

Vice-President's Name:

Secretary's Name:

Treasurer's Name:

If PARTNERSHIP:

Is the Partnership: General Limited Association (Check one)

Date of Organization:

Name and addresses of all partners:

1.

2.

3.

GENERAL INFORMATION:

Percent of work to be done under the proposed contract by your own staff:

No. of Permanent Employees:

Geographical Limits of Operation:

No. of years in business:

Have you ever done business under a different name: Yes No (Check one) If Yes, give Name and Location:

Has contractor ever withdrawn or defaulted on a contractual obligation: Yes No (Check one) If Yes, state where and why:

STATEMENT OF CONTRACTOR'S QUALIFICATIONS - Continued

Has Contractor ever been sued for breach of any contract? Yes No (Check one) If Yes, Explain:

List Completed Contracts within the Past Three Years, Including Amount of Each:

List of Current Contracts, Including Amount of Each:

Customer Reference (state name, address, and phone number):

List each subcontractor you plan to use if awarded the contract. If no, so state.

SUBCONTRACTOR'S NAME & PHONE

ITEM OF WORK $ AMOUNT OF CONTRACT MBE/WBE

State any other relevant information concerning Contractor's history, credentials, responsibility, and capabilities (If none, so state):

DBE STATUS Indicate status claimed:

1. Minority Owned Business (MBE) YES____ NO____

African American____ Latino____ Native American____ Asian____ Pacific Islander____

2. Woman Owned Business (WBE) YES____ NO____

3. Small Business YES____ NO____

For consideration as an MBE, WBE or Small Business, a copy of any governmental entity or Minority Supplier Council certification must be attached.

Prepared by (print or type):

Title:

Signature:

Date:

Bidder:________________________________________ Jackson County, Missouri Invitation to Bid No. 26-023

Attachment 1 - Bidder's Quotation Sheet Digital Copier-Based Multi-Function Equipment

Features (If the 3 unit levels have options of with and without a feature listed, please include an alternative sheet if needed) Networking & Connectivity Functions Yes No Yes No Yes No

Ethernet networking standard Built-in Wi-Fi Wi-Fi Direct / peer-to-peer printing Mobile printing services (AirPrint, Mopria, Android print) Cloud printing (Google Workspace, Microsoft 365 integration) Remote fleet management portals SNMP management support

Printing Capabilities Yes No Yes No Yes No High-speed output (50-100+ pages per minute) Automatic duplexing (double-sided printing) High-yield toner systems Secure or “pull” printing (PIN or badge release) Large paper capacity (multiple trays, high-capacity feeders) Support for various paper sizes (Letter to 11x17) Envelope and label printing High resolution output (typically 1200 dpi) Advanced color calibration

Copy & Scan Features Yes No Yes No Yes No Duplex scanning (single-pass) High-speed scan (100-300 images per minute) OCR text recognition Scan to email Scan to network folder (SMB, FTP) Scan to cloud (OneDrive, SharePoint, Google Drive) Scan to USB Editable formats (PDF, searchable PDF, Word, Excel) Mixed-media scanning (different paper sizes in the same batch)

Document Finishing Options Yes No Yes No Yes No Stapling (corner, double staple) Saddle-stitch booklet making Folding (tri-fold, z-fold) Hole punching Multi-position stapling and binding Inserter trays for pre-printed covers

User Interface & Usability Yes No Yes No Yes No Large touchscreen display Customizable home screen buttons User profiles Shortcut workflows (e.g., “Scan to Accounting Folder”) Voice guidance / accessibility features

Security Features Yes No Yes No Yes No User authentication (PIN, proximity card, badge readers) Active Directory / LDAP integration Encrypted print jobs Hard drive encryption (AES 256-bit) Data overwrite on job completion Locked print queue Secure boot and firmware verification Administrator access control Audit logs

Lease Price Per Machine Per Month

Base Unit Medium-Duty Unit High-End Unit

Model # & Manufacturer Model # & Manufacturer Model # & Manufacturer

Bidder:________________________________________ Jackson County, Missouri Invitation to Bid No. 26-023

Cloud & Workflow Integration Yes No Yes No Yes No Microsoft 365 workflows (scan to Teams or SharePoint) Google Workspace workflows Document management system connectors (e.g., DocuWare, Laserfiche) Automated routing (barcode separation, file naming rules) Accounting and cost tracking software

Device Management & Maintenance Yes No Yes No Yes No Remote diagnostics Automated supply replenishment alerts Firmware updates over the network Usage tracking and reporting Print quota control Fleet management with dashboard analytics

Hardware Options and Expansion Yes No Yes No Yes No Additional paper decks or high-capacity trays Large-capacity finishers Fiery or similar external print controllers for color accuracy Extra memory or SSD Cabinet or caster stands Envelope feeders

Energy & Environmental Yes No Yes No Yes No Energy Star certification Low-power sleep modes Eco-friendly toner systems Duplex-first defaults Automated power scheduling

COMPANY NAME:

DATE:

PHONE:

MOBILE:

SIGNATURE:

NAME:

TITLE:

EMAIL ADDRESS:

ACKNOWLEDGMENT OF RECEIPT OF ADDENDA

We acknowledge the receipt of Addenda No(s) ______________ for this Invitation to Bid. We understand that additional addenda may be issued up until the Question Response Deadline of 5:00 pm CDT June 9, 2026, and we will be responsible for checking the Bonfire Portal regularly for any new addenda issued.

Signature of Respondent Date

Company Name

Address

City, State, and Zip Phone

Exhibit F

BIDDER'S EXCEPTIONS

TO

SPECIFICATIONS

OF

JACKSON COUNTY, MISSOURI INVITATION TO BID NO. 26-023

Digital Copier-Based Multi-Function Equipment

Bidder’s attention is directed to Paragraph 4 of the General Conditions of this Invitation to Bid. READ THIS PARAGRAPH

CAREFULLY.

The following exceptions to the Specifications of Invitation to Bid No. 26-023 are requested by the undersigned Bidder: (Use additional pages as necessary.)

REFERENCE

PARA # & PAGE #

EXCEPTION REQUESTED

Name of Firm:

Signature of Bidder: