2-Form B Acknowledgement Of State , Local and Federal Certifications.pdf

FORM B: ACKNOWLEDGEMENT OF STATE, LOCAL & FEDERAL CERTIFICATIONS

Please read all certification and notification statements below. Each statement should be initiated by an authorized representative to indicate compliance. Failure to comply may result in disqualification. Exceptions should be noted separately.

A. Felony ConvictionNotification: StateofTexasLegislativeSenateBill No.1,Section44.034,NotificationofCriminalHistory, Subsection(a),states:“apersonorbusinessentitythatentersintoacontractwithaschooldistrictmustgiveadvancenoticeto thedistrictifthePersonoranowneroroperatorofthebusinessentityhasbeenconvictedofafelony. Thenoticemustinclude a general description of the conduct resulting in the conviction of a felony.” Subsection (b) states “a school district may terminateacontractwithapersonorbusinessentityif thedistrictdeterminesthatthepersonorbusinessentityfailedtogive noticeasrequiredbySubsection(a)ormisrepresentedtheconductresultingintheconviction. TheDistrictmustcompensate thepersonorbusinessentityforservicesperformedbeforetheterminationofthecontract.” Thisnoticeisnotrequiredofa publicly held corporation.

Please check the appropriate line below:

_______ My firm is a publicly-held corporation; therefore, this reporting requirement is not applicable.

_______ My firm is not owned or operated by anyone who has been convicted of a felony.

_______ My firm is owned or operated by the following individual(s) who has/have been convicted of a felony:

Name of Felon(s):____________________________________________________

Details of Conviction(s)_________________________________________________

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Criminal History Notification: Texas Education CodeChapter 22 requires entities that contract with school districts to obtain criminal history records on covered employees. Covered employees with disqualifying criminal histories are prohibited from serving at a school district. Contractors must certify to the district that they have complied and must obtain similar certifications from their subcontractors. Certification forms, found on the PfISD Purchasing Department web page located athttps://www.pfisd.net/about-us/departments/procurement-and-auxiliary-services/information-for-vendors/bidding-opportunities

B. must be completed and submitted to the PfISD Purchasing Department prior to commencement of the contract.

CoveredEmployeesisdefinedas: Employeesofacontractorwhohaveorwillhavecontinuingdutiesrelatedtotheserviceto be performed at the District and have or will havedirectcontactwithstudents. TheDistrictwill bethefinalarbiterofwhat constitutes continuing duties or direct contact with students.

Disqualifying Criminal Historyis defined as:

(1) a conviction or other criminal history information designated by the District;

(2) a felonyormisdemeanoroffensethatwouldpreventapersonfromobtainingcertificationasaneducatorunder

Texas Education Code 21.060, including an offense listed at 19 Tex. Admin. Code 249.16; or

(3) one of the following offenses, if at the time of the offense, the victim was under 18 or enrolled in a public school:

(a) a felony offense under Title 5, Texas Penal Code;

(b)anoffenseforwhichadefendantisrequiredtoregisterasasexoffenderunderChapter62,TexasCode of Criminal Procedure;

(c) an equivalent offense under federal law or the laws of another state.

Initial ________ https://www.pfisd.net/about-us/departments/procurement-and-https://www.pfisd.net/about-us/departments/procurement-and-auxiliary-services/information-for-vendors/bidding-opportunities

C. CertificateofResidency: The1985TexasLegislaturepassedHouseBill620(nowChapter2252ofTexasGovernmentCode) relative to the award of contracts to nonresident bidders (out-of-state bidders whosecorporateofficesorprincipalplaceof business are outside the State of Texas). This law provides that, in order to be awarded a contract as low bidder, a nonresidentbidder’sresponseforconstruction,improvements,suppliesorservicesinTexasbebidinamountlowerthanthe lowestTexasresidentbidderbythesameamountthataTexasresidentbidderwouldberequiredtounderbidanonresident bidder in order to obtain a comparable contract in the state in which the nonresident’s principal place of business is located.

______ I certify that my company is a “resident bidder” meaning a vendor whoseprincipalplaceofbusinessisinTexas, including a vendor whose ultimate parent company or majority owner has its principal place of business in Texas.

______ Icertifythatmyfirmisa“nonresidentbidder”meaningavendorwhoseprincipalplaceofbusinessisnotinTexas,but excludes a vendor whose ultimate parent company or majority owner has its principal place of business in Texas. My company’s principal place of business is in: _____________________________________, ___________.

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D. Non-Collusion, Non-Conflict of Interest, Anti-Lobbying Affidavit:

By submission of this response, the undersigned certifies that:

1. NeithertheRespondentnoranyofitsofficers,partner,owners,agents,representatives,employees,orpartiesininterest, hasinanywaycolluded,conspired,oragreed,directlyorindirectlywithanyperson,firm,corporationorotherRespondent orpotentialRespondentorgivenanymoneyorothervaluableconsiderationforassistanceinprocuringorattemptingto procureacontractorfixthepricesintheattachedresponseortheresponseofanyotherRespondent,andfurtherstates that no such money or other reward will be hereinafter paid.

2. No attempt has been or will be made by this firm’s officers, employees, or agents to lobby, directly or indirectly, the District’s Board of Trustees between response submission date and award by the District’s Board of Trustees.

3. No officer, or stockholder of Respondent is a member of the staff, or related to any employee of the Pflugerville Independent School District except as noted below:

4. Thebidderorproposerhasnotoffered,conferred,oragreedtoconferanypecuniarybenefit,asdefinedbyPenalCode, Chapter 36, or any other thing of value, as consideration for the receipt of information or any special treatment or advantage relating to this bid or proposal;

5. The bidder or proposer hasnotoffered,conferred,oragreedtoconferanypecuniarybenefitorotherthingofvalueas consideration fortherecipient’sdecision,opinion,recommendation,vote,orotherexerciseofdiscretionconcerningthis bid or proposal;

6. The bidder or proposer has not violated any state, federal, or local law, regulation, or ordinance relating to bribery, improper influence, collusion, or the like, and thatthebidderorproposerwill notinthefutureoffer,confer,oragreeto confer any pecuniary benefit or other thing of value to any officer, Trustee, agent, or employee of the Pflugerville IndependentSchoolDistrictinreturnfortheperson’shavingexercisedofficialdiscretion,power,ordutywithrespectfor this bid or proposal;

7. Thebidderorproposerhasnotandwillnotinthefutureoffer,confer,oragreetoconferapecuniarybenefitorotherthing of value to any officer, Trustee, agent, or employee of the Pflugerville Independent School District in connection with informationregardingthisbidorproposal,thesubmissionofthisbidorproposal,theawardofthisbidorproposal,orthe performance, delivery, or sale pursuant to this bid or proposal.

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E. Non-DiscriminatoryEmployment: Vendoragreestorefrainfromdiscriminationintermsandconditionsofemploymentonthe basis of race, color, religion, sex, national origin, or handicap and agreestotakeaffirmativeactionasrequiredbyFederal Statutes and rules and regulations issued pursuant thereto in order tomaintainandinsurenon-discriminatoryemployment practices.

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F. Suspension and Debarment: Federal Law prohibits non-federal entitiesfromcontractingwithormakingsub-awardsunder covered transactions to parties that are suspended or debarred or whoseprincipalsaresuspendedordebarred. Covered transactionincludeprocurementofgoodsof$50,000ormoreascoveredbystatelaworprofessionalservicesequaltoorin excessof$100,000. Contractorsreceivingindividualawardsof$100,000ormoreandallsub-recipientsmustcertifythatthe organizations anditsprincipalsarenotsuspendedordebarred. PflugervilleISDdoesnotdobusinesswithpartiesthat havebeensuspendedordebarred. Theprospectivevendorcertifies,bysubmissionofthisproposal,thatneitheritnorits principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by a Federal department or agency.

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G. CleanAirandWaterAct: I,theVendor,amincompliancewithallapplicablestandards,ordersorregulationsissuedpursuant totheCleanAirActof1970,asAmended(42U.S.C.1857(h)),Section508oftheCleanWaterAct,asamended(33U.S.C.

1368), Executive Order 117389 and Environmental Protection AgencyRegulation,40CFRPart15asrequiredunderOMB Circular A-102.

AttachmentO,Paragraph14(1)regardingreportingviolationstothegrantoragencyandtotheUnitedStatesEnvironmental Protection Agency Assistant Administrator for the Enforcement.

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H. HoldHarmlessAgreement: TheContractorshalldefend,indemnify,andholdharmless,PflugervilleISDandallofitstrustees, officers,agents,andemployeesfromandagainstallsuits,actions,orclaimsofanycharacterbroughtfororonaccountofany injuries or damages (including death) received or sustained by any person or property on account of, arisingoutof,orin connectionwith,anynegligentactoromissionofContractororanyagent,employee,subcontractor,orsupplierofContractor intheexecutionorperformanceoftheContract. TheContractorshallalsodefend,indemnifyandholdharmless,Pflugerville ISD and allofitstrustees,officers,agents,andemployees,fromandagainstclaimsbyanysubcontractor,supplier,laborer, materials, or mechanic for payment for work or materials provided on behalf of the Contractor in the performance of the ContractandallsuchclaimantsshalllooksolelytoContractorandnottoPflugervilleISDforsatisfactionofsuchclaims. This Hold Harmless Agreement shall be binding upon the undersigned, and its successors, legal representatives, heirs and assigns.

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I. Pursuant to Section 2270.001 of Texas Government Code, the Contractor affirms that it:

1. Does not currently boycott Israel; and

2. Will not boycott Israel during the term of the contract

Pursuant to Section 2270.001 of Texas Government Code:

1. “Boycott Israel” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes; and

2. “Company” means a for-profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or any limited liability company, including a wholly owned subsidiary, majority-owned subsidiary, parent company or affiliate of those entities or business associations that exist to make a profit.

J. PursuanttoTexasSB252,thecontractoraffirmsthatit isnotidentifiedontheComptroller'slistofcompaniesknowntohave contactswithorprovidesuppliesorservicestoaforeignorganizationdesignatedasaForeignTerroristOrganizationbythe US Secretary of State

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REQUIRED CONTRACT PROVISIONS FOR FEDERALLY FUNDED PURCHASES

The following provisions apply when federal funds are used to make district purchases. Please read all certification and notification statements below. Each statement should be initiated by an authorized representative to indicate compliance. Failure to comply may result in disqualification. Exceptions should be noted separately.

K. Pursuant to federal law, when federal funds are expended bythedistrict,PflugervilleISDreservesallrightsandprivileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party.

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L. Pursuant to Federal law,whenfederalfundsareexpendedbythedistrict,PflugervilleISDreservestherighttoimmediately terminateanyagreementinexcessof$10,000resultingfromthisprocurementprocessintheeventofabreachordefaultof the agreement by Vendor, in the event vendorfailsto:(1)meetschedules,deadlines,and/ordeliverydateswithinthetime specified in the procurement solicitation, contract, and/orapurchaseorder;(2)makeanypaymentsowed;or(3)otherwise perform in accordance with the contract and/or the procurement solicitation. Pflugerville ISD also reserves the right to terminate the contract immediately,withwrittennoticetothevendor,forconvenience,if PflugervilleISDbelieves,initssole discretion, that it is in the best interest of the district to do so. The vendor will be compensated for work performed and acceptedandgoodsacceptedbyPflugervilleISDasoftheterminationdateifthecontractisterminatedforconveniencebythe district.AnyawardunderthisprocurementprocessisnotexclusiveandPflugervilleISDreservestherighttopurchasegoods and services from other vendors when it is in the best interest of the district.

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M. EqualEmploymentOpportunity.(A)Exceptasotherwiseprovidedunder41CFRPart60,allcontractsthatmeetthedefinition of“federallyassistedconstructioncontract”in41CFRPart60‐ 1.3mustincludetheequalopportunityclauseprovidedunder 41CFR60‐1.4(b),inaccordancewithExecutiveOrder11246,“EqualEmploymentOpportunity”(30FR12319,12935,3CFR Part,1964‐1965Comp.,p.339),asamendedbyExecutiveOrder11375,“AmendingExecutiveOrder11246RelatingtoEqual EmploymentOpportunity,”andimplementingregulationsat41CFRpart60,“OfficeofFederalContractCompliancePrograms, Equal Employment Opportunity, Department of Labor.”

Pursuant to Federal Rule (A) above, when federal funds are expended by Pflugerville ISD on any federally assisted construction contract, the equal opportunity clause is incorporated by reference herein.

N. Davis‐Bacon Act,asamended(40U.S.C.3141‐3148).WhenrequiredbyFederalprogramlegislation,all primeconstruction contractsinexcessof$2,000awardedbynon‐FederalentitiesmustincludeaprovisionforcompliancewiththeDavis‐Bacon Act (40 U.S.C. 3141‐3144, and 3146‐ 3148) as supplemented by DepartmentofLaborregulations(29CFRPart5,“Labor Standards Provisions Applicable to ContractsCoveringFederallyFinancedandAssistedConstruction”).Inaccordancewith thestatute,contractorsmustberequiredtopaywagestolaborersandmechanicsataratenotlessthantheprevailingwages specifiedinawagedeterminationmadebytheSecretaryofLabor.Inaddition,contractorsmustberequiredtopaywagesnot lessthanonceaweek.Thenon‐ Federalentitymustplaceacopyofthecurrentprevailingwagedeterminationissuedbythe Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptanceofthewagedetermination.Thenon‐Federalentitymustreportall suspectedorreportedviolationstotheFederal awardingagency.ThecontractsmustalsoincludeaprovisionforcompliancewiththeCopeland“Anti‐Kickback”Act(40U.S.C.

3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public BuildingorPublicWorkFinancedinWholeorinPartbyLoansorGrantsfromtheUnitedStates”).TheActprovidesthateach contractor or sub recipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any partofthecompensationtowhichheorsheisotherwiseentitled.The non‐Federal entity must report all suspected or reportedviolations to the Federal awarding agency.

PursuanttoFederalRule(B)above,whenfederalfundsareexpendedbyPflugervilleISD,duringthetermofanawardforall contracts and sub grants for construction or repair, the vendor will be in compliance with all applicable Davis‐Bacon Act provisions.

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O. (C) Contract Work Hours andSafetyStandardsAct(40U.S.C.3701‐3708).Whereapplicable,all contractsawardedbythe non‐Federalentityinexcessof$100,000thatinvolvetheemploymentofmechanicsorlaborersmustincludeaprovisionfor compliancewith40U.S.C.3702and3704,assupplementedbyDepartmentofLaborregulations(29CFRPart5).Under40 U.S.C.3702oftheAct,eachcontractormustberequiredtocomputethewagesofeverymechanicandlaboreronthebasisof a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that theworkeris compensatedatarateofnotlessthanoneandahalftimesthebasicrateofpayforallhoursworkedinexcessof40hoursin the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. Theserequirementsdonotapplytothepurchasesofsuppliesormaterialsorarticlesordinarilyavailableonthe open market, or contracts for transportation or transmission of intelligence.

PursuanttoFederalRule(C)above,whenfederalfundsareexpendedbyPflugervilleISD,thevendorcertifiesthatduringthe termofanawardforallcontractsbyPflugervilleISDresultingfromthisprocurementprocess,thevendorwillbeincompliance with all applicable provisions of the Contract Work Hours and Safety Standards Act.

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P. (D) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of “funding agreement”under37CFR§401.2(a)andtherecipientorsubrecipientwishestoenterintoacontractwithasmallbusiness firmornonprofitorganizationregardingthesubstitutionofparties,assignmentorperformanceofexperimental,developmental, orresearchworkunderthat“fundingagreement,”therecipientorsubrecipientmustcomplywiththerequirementsof37CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any implementing regulations issued by the awarding agency.

Pursuant to Federal Rule (D) above, when federal funds are expended by Pflugerville ISD, the vendor certifies that during the term of an award for all contracts by Pflugerville ISD resulting from this procurement process, the vendor agrees to comply with all applicable requirements as referenced in Federal Rule (D) above.

Q. (E)BuyAmericanProvision(FederalRequirement).Vendorcertifiesthatvendorisincompliancewithallapplicableprovisions oftheBuyAmericaAct.PurchasesmadeinaccordancewiththeBuyAmericaActmuststillfollowtheapplicableprocurement rules calling for free and open competition.

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R. (F) Clean Air Act (42 U.S.C. 7401‐7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251‐1387), as amended—Contractsandsubgrantsofamountsinexcessof$150,000mustcontainaprovisionthatrequiresthenon‐Federal awardtoagreetocomplywithall applicablestandards,ordersorregulationsissuedpursuanttotheCleanAirAct(42U.S.C.

7401‐7671q)andtheFederalWaterPollutionControlActasamended(33U.S.C.1251‐1387).Violationsmustbereportedto the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).

PursuanttoFederalRule(F)above,whenfederalfundsareexpendedbyPflugervilleISD,thevendorcertifiesthatduringthe term of an award forall contractsbyPflugervilleISDresultingfromthisprocurementprocess,thevendoragreestocomply with all applicable requirements as referenced in Federal Rule (F) above.

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S. (G)ByrdAnti‐LobbyingAmendment(31U.S.C.1352)—Contractorsthatapplyorbidforanawardexceeding$100,000must filetherequiredcertification.EachtiercertifiestothetierabovethatitwillnotandhasnotusedFederalappropriatedfundsto payanypersonororganizationforinfluencingorattemptingtoinfluenceanofficeroremployeeofanyagency,amemberof Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non‐FederalfundsthattakesplaceinconnectionwithobtaininganyFederalaward.Suchdisclosuresareforwardedfromtier to tier up to the non‐Federal award.

PursuanttoFederalRule(G)above,whenfederalfundsareexpendedbyPflugervilleISD,thevendorcertifiesthatduringthe termandaftertheawardedtermofanawardforall contractsbyPflugervilleISDresultingfromthisprocurementprocess,the vendorcertifiesthatit isincompliancewithall applicableprovisionsoftheByrdAnti‐LobbyingAmendment(31U.S.C.1352).

The undersigned further certifies that:

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

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attemptingtoinfluenceanofficeroremployeeofanyagency,aMemberofCongress,anofficeroremployeeofcongress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersignedshallcompleteandsubmitStandardForm‐LLL,“DisclosureFormtoReportLobbying”,inaccordancewithits instructions.

(3) Theundersignedshallrequirethatthelanguageofthiscertificationbeincludedintheawarddocumentsforall covered sub‐awards exceeding $100,000 in Federal funds at all appropriate tiers and that all sub recipients shall certify and disclose accordingly.

T. Record Retention Requirements. When federal funds areexpendedbyPflugervilleISDforanycontractresultingfromthis procurement process, the vendor certifies that it will comply with the record retention requirements detailed in 2 CFR § 200.333.Thevendorfurthercertifiesthatvendorwill retainall recordsasrequiredby2CFR§200.333foraperiodofthree years after grantees or sub granteessubmitfinalexpenditurereportsorquarterlyorannualfinancialreports,asapplicable, and all other pending matters are closed.

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U. Compliance with the Energy Policy and Conservation Act. When federal funds are expended by Pflugerville ISD for any contract resulting from this procurement process, the vendor certifiesthatthevendorwill beincompliancewithmandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliancewiththeEnergyPolicyandConservationAct(42U.S.C.6321,etseq.;49C.F.R.Part18;Pub.L.94‐163,89Stat.

871).

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V. Vendorcertifiesunderpenaltyofperjurythatitsresponsetothisprocurementsolicitationisinallrespectsbonafide,fair,and made without collusion or fraud with any person, joint venture, partnership, corporation or other business or legal entity.

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Vendor agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that vendor certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above.

Name of Company: ___________________________________________________________________________

Printed Name and Title of Representative: _________________________________________________________

Signature Date