2-RFP 26-49-2520 Hazard Mitigation Plan Solicitation final.pdf

Forsyth County Procurement Department

514 West Maple Street, Suite 104 Cumming, GA 30040 | Phone 770.888.8872

REQUEST FOR PROPOSAL

RFP NO. 26-49-2520

Forsyth County Multi-Jurisdictional Hazard

Mitigation Plan Update

Forsyth County, Georgia Cumming, Georgia

Closing Date and Time:

April 30, 2026 / 2:00 p.m.

FORSYTH COUNTY, GEORGIA

Request for Proposal No. 26-49-2520

Forsyth County Multi-Jurisdictional Hazard Mitigation Plan Update

PURPOSE OF THE REQUEST FOR PROPOSAL

Forsyth County, Georgia (the “County”), is soliciting Proposals from qualified firms to provide professional services for the update and development of the Forsyth County Multi- Jurisdictional Hazard Mitigation Plan. The selected consultant will assist the County in updating the existing Hazard Mitigation Plan in accordance with the Disaster Mitigation Act of 2000 and FEMA requirements under 44 CFR §201.6, ensuring continued eligibility for federal hazard mitigation assistance programs. The project will include coordination with participating jurisdictions, public outreach, hazard risk assessment, development of mitigation strategies, and preparation of FEMA-compliant plan for review, adoption, and final approval.

It is the County’s intent that this Request for Proposal (“RFP”) permit competition. It shall be the Proposer’s responsibility to advise the Procurement Agent, in writing, if any language, specification, etc., or any combination thereof, inadvertently restricts or limits the requirements stated in this RFP to a single source. Such notification must be received by the Procurement Agent not later than ten (10) days prior to the date set for acceptance of the proposal.

While every effort has been made to ensure the accuracy and completeness of information in the RFP we recognize that the information may not be complete in every detail and that all work may not be expressly mentioned in these specifications. It is the responsibility of the proposing company to include in their proposal all pertinent information in accordance with the objectives of the County.

GENERAL INFORMATION

Proposals MUST be submitted in the format prescribed herein. Failure to comply with the directions listed in this RFP, or omission of requested information could result in disqualification of your firm’s proposal.

Forsyth County uses a procurement portal powered by EUNA Procurement (“EUNA”) for accepting and evaluating bids, statements of qualification, and proposals digitally, found by using the link: https://www.forsythco.com/Departments-Offices/Procurement/Bids-Results

RFPs shall only be accepted online through the EUNA due at 2:00 p.m., April 30, 2026.

Names of submitting firms will then be read aloud at 2:30 p.m., April 30, 2026. All interested parties and the general public are invited to attend at Freedom Park Campus 2435 Freedom Parkway, Cumming, GA 30041. Liberty/Freedom Training Room 1010.

https://www.forsythco.com/Departments-Offices/Procurement/Bids-Results

ALL QUESTIONS are to be asked via EUNA under Opportunity Q&A. Responses to substantive questions will be provided as written Addenda and will be posted under Public Files in EUNA.

The deadline for questions is 12:00 p.m. Monday, April 20, 2026.

CHANGES

No change will be made to this RFP except by written modification by the County Procurement Office. Requests for interpretation or changes must be in writing and received at least seven (7) calendar days prior to the time set for opening of the proposals.

COST OF PROPOSAL

The County assumes no responsibility or liability for the costs incurred by the submitting firm to prepare and/or submit a proposal. The entire cost of preparing and submitting Proposals and Pricing Information, or any work in connection therewith will be borne by the Proposer.

RESPONSIBILITY OF PROPOSER

Proposals must be signed by an authorized official to bind the Proposer and it shall contain a statement to the effect that the Proposal is firm for a period of at least one-hundred and twenty (120) days from the closing date for submission.

CONNECTIVITY

The County shall not be responsible for errors of any kind or nature occurring in the transmission or downloading/uploading of any documents from the County’s website or procurement portal (the “Website”). The County does not guarantee continuous, uninterrupted, or secure access to the website. Operation of the Website may be affected from time to time by numerous factors outside of the County’s control. Site problems, user problems, internet problems, power outages, or routine maintenance may interrupt or prevent access to information, documents, and/or proposal submission capabilities.

PROHIBITION OF GRATUITIES

Proposers shall not offer any gratuities, favors, or anything of monetary value to any official, employee, or agent of the County for the purpose of influencing consideration of any proposal.

CONTACT

To ensure all prospective respondents have the same level of knowledge relative to the project, as well as ensuring any additional data is made available to all Proposers, no Proposers shall contact or discuss any aspect of this Request for Proposal with any Forsyth County employee or elected official, selection committee member, or project team member, during the RFP process up until award has been made. If contact is made, that Proposer may be disqualified from the process. All questions in regard to this Request for Proposal are to be submitted via EUNA under Opportunity Q&A as detailed in the general information section of this document. Any information obtained about this solicitation through any means other than the solicitation itself or the addendums thereunto is not valid and should not be considered in any response to this solicitation.

OWNERSHIP OF MATERIAL

Ownership of all data, material, and documentation originated and prepared for the County pursuant to this project shall belong exclusively to the County.

Proposals and Pricing information received will become the property of Forsyth County and shall be used as the County sees fit. All information contained in the Proposals and Pricing Information will remain confidential until after the award and signing of the contract.

Forsyth County reserves the right to cancel the Request for Proposal or to reject any and all responses received, to waive any technicalities or other minor informalities if it determines, in its sole discretion, that such cancellation or rejection is in the best interests of Forsyth County.

SELECTION, NOTIFICATION, AND SERVICES AGREEMENT

The selected contractor(s) will be given written notification of being selected by the County.

The selected contractor shall execute a Services Agreement with the County prior to the beginning of the actual services. Attached to this RFP is a draft form of services agreement which contains terms and conditions of the contractual arrangement for the services. Such form of agreement may be modified as appropriate, on the County’s discretion, to include additional project-specific terms. Forsyth County reserves the right to cancel the Request for Proposal or to reject any and all responses received, to waive any technicalities or other minor informalities if it determines, in its sole discretion, that such cancellation or rejection is in the best interests of Forsyth County conditions of the contractual arrangement for the services. Such form of agreement will be modified as appropriate, on the County’s discretion, to include any additional specific terms related to the services being provided. Any questions regarding the form of services agreement must be submitted in writing by the deadline for questions specified in this RFP. The resulting contract will include all provisions required under 2 CFR Part 200, Appendix II, as applicable.

WITHDRAWAL OF PROPOSAL

Proposals may be withdrawn by written request only if the request is received prior to the time and date set for the opening of proposals. Negligence on the part of the Proposer in preparing his proposal confers no right of withdrawal or modification of his proposal after proposal has been opened. No proposal may be withdrawn for a period of sixty (60) days after time has been called on the date of opening.

EXCEPTIONS TO SPECIFICATIONS

Any award resulting from this RFP shall bind the Proposer to all terms, conditions and specifications set forth in this RFP. Proposers whose proposals do not conform should note on separate page if necessary and/or on the Proposal Schedule. While the County reserves the right to make an award to a nonconforming Proposer when in the best interest of the County, such awards will not be readily made, and Proposers are urged to conform to the greatest extent possible. No exceptions will be considered to have been taken by a Proposer unless it is properly set out as provided above. No exception will be deemed to have been taken by the County unless incorporated in an award resulting from this RFP and so stated.

ANTI DISCRIMINATION CLAUSE

Forsyth County does not discriminate against any person because of race, color, religion, national origin, sex, age, or disabilities in employment or services provided, or contracts awarded.

REGULATORY AGENCIES

Successful Proposer will be responsible for all required permits or license required by any regulatory agency of the city, county, state or federal governments. Further, successful Proposer will be responsible for meeting all requirements of any regulation(s) or guideline(s) of any of the said governments or any independent agency recognized by said governments as publisher of any such regulation(s) or guideline(s).

INDEPENDENT CONTRACTORS

The Proposer represents to Forsyth County that it is fully experienced and properly qualified to perform the functions provided for herein and that it is properly equipped, organized and financed to perform such functions. The Proposer shall finance its own operations hereunder, shall operate as an independent contractor and not as the agent of Forsyth County.

TERM

The contract resulting from this RFP shall begin upon execution of the agreement and issuance of a Notice to Proceed and shall remain in effect until completion of the project and acceptance of all deliverables by the County. The project shall be considered complete upon final approval of the Hazard Mitigation Plan by the Federal Emergency Management Agency

(FEMA).

CANCELLATION / REJECTION OF PROPOSALS

The County, in its sole discretion and in serving the County’s best interests, reserves the right to cancel the RFP, reject any and all proposals submitted, reject any portion thereof, or to waive any technicalities or minor informalities, irregularity, or administrative requirement.

REQUIRED FORMS

All Proposing Firms will be required to complete, execute, and submit with its proposal the following:

Affidavit of Non-Collusion Contractor Affidavit and Agreement Subcontractor Affidavit (if applicable) Addendum Acknowledgement Debarment & Suspension Byrd Anti-Lobbying Amendment

INSPECTION OF RECORDS

The records of the Procurement Office are open and accessible to the public in accordance with the provisions of the Georgia Open Records Act. Requests for inspection of records, must be in writing, must be reasonable, must contain sufficient information to facilitate retrieval, and must not interfere with the orderly operation of the Procurement Office.

Proposers are cautioned that any documentation submitted with or in support of a proposal may become subject to public inspection under the Georgia Open Records Act. Labeling such information “Confidential”, “Proprietary”, or in any other manner will not protect this material from public inspection.

There will be a charge assessed to any party requesting copies of records.

TRADE SECRETS

Careful consideration should be given before submitting confidential information to the County. County’s disclosure of records and documentation is governed by the Georgia Open Records Act, which permits public scrutiny of most materials collected as part of this process.

If Proposer submits information that contains trade secret information and if Proposer wishes to keep such information confidential, Proposer must submit and attach to such information an affidavit affirmatively declaring that specific information constitutes trade secrets pursuant to the Georgia Trade Secrets Act of 1990, O.C.G.A. §10-1-760 et seq., and the Proposer and County will follow the requirements of O.C.G.A. § 50-18-72(a)(34) related thereto.

EVALUATION METHOD AND CRITERIA:

The County will evaluate all responsive proposals to determine which proposals best meet the needs of the County based on the evaluation criteria. The County shall be the sole judge of its own best interest, the proposals, and the resulting agreement. Evaluation will be made by a evaluation committee established for this purpose. Award will be based on a review of all information submitted. Proposing firms may be asked to appear before the evaluation committee. Pricing information will be opened for all firms after the RFP submission deadline has passed.

Proposals determined to be Responsive and Responsible will be evaluated on the following criteria:

• Cover/Transmittal Letter and Requested Forms – Pass/Fail

• Project Understanding and Approach – 25 Points

• Experience with Hazard Mitigation Planning – 30 Points

• Project Team Qualifications – 20 Points

• Past Performance and References – 10 Points

• Cost Proposal – 15 Points

(Remainder of page intentionally left blank)

SCOPE OF SERVICES

1. Project Overview

Forsyth County (“County”) is seeking proposals from qualified consulting firms to develop and/or update the County’s Multi-Jurisdictional Multi-Hazard Mitigation Plan (MJMHMP) in accordance with the Disaster Mitigation Act of 2000 and 44 CFR §201.6 – Local Mitigation Plans.

The updated plan shall reduce long-term risk to people, property, and critical infrastructure from the effects of natural and man-made hazards within the Forsyth County operational area.

The planning process shall include participation from multiple jurisdictions and stakeholders, including but not limited to:

• Forsyth County

• City of Cumming

• Forsyth County School District

• Other operational area partners and stakeholders

The consultant shall complete all work necessary to produce a FEMA-approvable plan that maintains the County’s eligibility for FEMA Hazard Mitigation Assistance programs including but not limited to:

• Hazard Mitigation Grant Program (HMGP)

• Building Resilient Infrastructure and Communities (BRIC)

• Flood Mitigation Assistance (FMA)

The plan shall assess risks from all hazards, evaluate vulnerabilities of assets, and assist participating jurisdictions in identifying and prioritizing mitigation strategies. The current plan may be viewed here: forsythco.com/Portals/0/DeptDoc/EMA/Emergency Management Plans/Forsyth County Hazard Mitigation Plan - Final.pdf

2. Scope of Work

The selected consultant shall perform the following tasks and provide the associated deliverables.

Task 1 – Organize Resources and Convene Planning Team

• The consultant shall coordinate with local, regional, state, and federal stakeholders as necessary throughout the planning process.

• Confirm planning area and participating jurisdictions

• Identify available data, resources, and stakeholder roles

• Establish a multi-jurisdictional planning team and meeting cadence

• Collect and review existing plans, reports, GIS data, and relevant documentation

• Facilitate planning team meetings throughout the project duration.

Task 2 – Public Outreach and Community Engagement

• Develop and implement a multi-jurisdictional outreach strategy https://www.forsythco.com/Portals/0/DeptDoc/EMA/Emergency%20Management%20Plans/Forsyth%20County%20Hazard%20Mitigation%20Plan%20-%20Final.pdf https://www.forsythco.com/Portals/0/DeptDoc/EMA/Emergency%20Management%20Plans/Forsyth%20County%20Hazard%20Mitigation%20Plan%20-%20Final.pdf

• Establish a whole-community engagement approach

• Provide opportunities for input from residents, businesses, and vulnerable populations

• Document outreach activities and results

Task 3 – Community Capability Assessment

• Evaluate existing programs, plans, ordinances, staffing, funding, and coordination

• Document NFIP participation and identify CRS opportunities

• Identify capability gaps and strengths

Task 4 – Hazard Identification and Risk Assessment

• Identify hazards affecting the planning area

• Analyze impacts to population, infrastructure, and critical facilities

• Assess vulnerability of assets

• Evaluate future conditions that may influence hazard frequency and severity

Task 5 – Mitigation Strategy Development

• Facilitate development of mitigation goals

• Identify mitigation actions for each jurisdiction

• Ensure alignment with risk assessment findings and stakeholder priorities

Task 6 – Mitigation Action Plan and Implementation Strategy

• Prioritize mitigation actions

• Identify funding opportunities (e.g., HMGP, BRIC, FMA)

• Identify integration opportunities with existing plans and programs

Task 7 – Plan Maintenance Procedures

• Develop plan monitoring and evaluation procedures

• Establish update procedures for the five-year lifecycle

• Include ongoing public engagement strategies

Task 8 – Draft Plan Development and Review

• Prepare administrative and public draft plans

• Produce professional-quality documents suitable for public distribution

• Incorporate feedback from stakeholders and the public

Task 9 – State and FEMA Review Coordination

• Prepare and submit FEMA review documentation, including the FEMA Plan Review Tool (crosswalk)

• Respond to State and FEMA comments

• Support the County through “Approvable Pending Adoption” to final approval

Task 10 – Plan Adoption

• Provide adoption materials and guidance

• Track jurisdictional adoption progress

• Submit adoption documentation to the

Additional Requirements

• Ensure compliance with the Disaster Mitigation Act of 2000 and 44 CFR §201.6

• Maintain eligibility for FEMA programs including HMGP, BRIC, and FMA

• Identify opportunities to maximize CRS credit

• Complete all work within the County-established timeline

• Provide milestone-based billing tied to deliverables

3. Project Completion

The project shall be considered complete only when the Multi-Jurisdictional Hazard Mitigation Plan receives final approval from FEMA.

All revisions required by the State or FEMA to obtain final approval shall be provided by the consultant at no additional cost to the County.

4. Ownership of Work Products

All data, reports, plans, maps, documents, and electronic files produced under this contract shall become the property of Forsyth County.

All final deliverables shall be provided in both editable electronic format and PDF format.

The final plan shall:

• Be professionally formatted for public distribution

• Include maps, graphics, and tables as appropriate

• All digital deliverables shall comply with WCAG 2.1 AA and Section 508 accessibility requirements, as applicable.

5. Deliverables

The Consultant shall provide deliverables for each task, including but not limited to:

• Planning team documentation and work plan

• Public engagement plan and documentation

• Capability assessment

• Risk assessment (maps, analysis, summaries)

• Mitigation goals and action worksheets

• Implementation strategy

• Plan maintenance procedures

• Draft and final plan documents

• FEMA submittal package and crosswalk

• Adoption documentation and final FEMA-approved plan

• All GIS data, mapping files, and supporting datasets shall be provided in an editable format compatible with County systems.

6. County Responsibilities

Forsyth County will:

• Coordinate planning team membership

• Facilitate participation of local jurisdictions

• Assist with scheduling meetings

• Support coordination with participating agencies

• Coordinate formal adoption of the FEMA-approved plan

7. Proposal Requirements

Proposers shall submit a complete proposal that includes the following information in the order listed below. Failure to provide the required information may result in the proposal being deemed non-responsive.

A. Cover Letter

• A cover letter signed by an authorized representative of the firm, including the firm’s name, address, phone number, and email address.

B. Firm Qualifications

• Provide a description of the firm, including years in business, areas of expertise, and experience providing hazard mitigation planning services.

C. Project Understanding and Approach

• Provide a detailed description of the proposer’s understanding of the project and the proposed methodology to complete the Scope of Services. Include descriptions of key tasks, deliverables, and approach to stakeholder coordination and public engagement.

D. Relevant Experience

• Provide examples of at least three (3) similar projects, preferably involving

FEMA-approved Hazard Mitigation Plans. Include project descriptions, client names, and outcomes.

E. Project Team and Key Personnel

• Identify key personnel who will be assigned to the project, including their roles, qualifications, and relevant experience. Include resumes for key staff.

F. Project Schedule

• Provide a proposed project schedule, including major milestones and deliverable timelines.

G. References

• Provide a minimum of three (3) references for similar projects completed within the last five (5) years. Include contact name, title, organization, phone number, and email.

H. Cost Proposal

• Provide a detailed cost proposal as outlined in the Cost Proposal section. Cost proposals shall be submitted separately from the technical proposal, if required by the County.

I. Required Forms and Certifications

• Include all required forms, Non-Collusion Affidavit, Contractor Affidavit and

Agreement, Subcontractor Affidavit (if applicable), Certificate of Insurance, and Addendum Acknowledgement (if issued).

J. Federal Requirements

• 2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and

Audit Requirements for Federal Awards

• Debarment and Suspension (Executive Orders 12549 and 12689)

• Byrd Anti-Lobbying Amendment (31 U.S.C. §1352)

• Equal Employment Opportunity (41 CFR Part 60)

• Copeland “Anti-Kickback” Act (as applicable)

8. Evaluation Method and Criteria

All proposals will be evaluated by a selection committee based on the following criteria:

Project Understanding and Approach – 25 Points Demonstrated understanding of the project scope, FEMA requirements, and quality of the proposed methodology.

Experience with Hazard Mitigation Planning – 30 Points Demonstrated experience in developing FEMA-compliant Hazard Mitigation Plans, particularly multi-jurisdictional plans.

Project Team Qualifications – 20 Points Qualifications, experience, and availability of key personnel assigned to the project.

Past Performance and References – 10 Points Quality of past performance on similar projects and feedback from provided references.

Cost Proposal – 15 Points Reasonableness and competitiveness of the proposed cost.

Total – 100 Points

The County reserves the right to conduct interviews with selected proposers, request additional information, and negotiate with the highest-ranked firm.

9. Federal Requirements This project is funded in whole or in part by federal grant funds. The selected proposer shall comply with all applicable federal laws, regulations, and requirements, including but not limited to:

• 2 CFR Part 200 – Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards

• Debarment and Suspension (Executive Orders 12549 and 12689)

• Byrd Anti-Lobbying Amendment (31 U.S.C. §1352)

• Equal Employment Opportunity (41 CFR Part 60)

The proposer must not be debarred or suspended from participation in federally funded contracts and must be registered in the System for Award Management (SAM).

By submitting a proposal, the proposer certifies compliance with all applicable federal requirements.

The resulting contract shall include all applicable provisions under 2 CFR Part 200, Appendix II – Contract Provisions for Non-Federal Entity Contracts Under Federal Awards. These provisions shall be incorporated into the final agreement and are binding on the selected proposer.

Proposers must be registered and maintain an active registration in the System for Award Management (SAM.gov). The selected proposer must have an active SAM registration at the time of award and throughout the term of the contract. The County reserves the right to verify SAM registration status prior to award.

The proposer certifies that neither it nor its principals are debarred, suspended, or otherwise excluded from participation in federally funded contracts. This requirement shall apply to all subcontractors.

The selected proposer shall ensure that all applicable federal requirements, including those set forth in 2 CFR Part 200, are included in all subcontracts and agreements with subcontractors.

The Contractor shall provide access to records related to this contract to the County, the Federal Emergency Management Agency (FEMA), the U.S. Department of Homeland Security, and the Comptroller General of the United States for the purpose of audit, examination, and compliance review.

Cost Proposal

Proposers shall provide a lump sum cost to complete all services described in the Scope of Services.

The County shall pay the Contractor a lump sum amount for completion of all services described in this Agreement.

The Contractor shall provide a detailed cost breakdown by task as follows:

Task 1 – Project Initiation & Planning (Planning Team, Data Collection, Work Plan)

Task 2 – Public Outreach & Community Engagement

Task 3 – Community Capability Assessment

Task 4 – Hazard Identification & Risk Assessment

Task 5 – Mitigation Strategy Development

Task 6 – Mitigation Action Plan & Implementation Strategy

Task 7 – Plan Maintenance Procedures

Task 8 – Draft Plan Development & Review

Task 9 – State & FEMA Review Coordination

Task 10 – Plan Adoption Support

TOTAL LUMP SUM CONTRACT AMOUNT: $________________

Payment shall be made based on completion of milestones and acceptance of deliverables by the County. The Contractor shall submit invoices tied to task completion or milestone progress, subject to County approval.

The total compensation includes all labor, materials, travel, overhead, and incidentals necessary to complete the Work. No additional compensation shall be paid unless authorized through a written change order executed by the County.

All costs must be allowable, allocable, and reasonable in accordance with 2 CFR Part 200.

Cost proposals shall be submitted separately from the technical proposal.

Printed Name Title

Signature Date

Company Name

NON-COLLUSION AFFIDAVIT

PROPOSAL DATE: April 30, 2026

PROJECT DESCRIPTION: Forsyth County Multi-Jurisdictional Hazard Mitigation Plan Update

STATE OF ________________}

COUNTY OF ______________}

__________________________________________, being first duly sworn, deposes and says that (s)he is ______________________________________ (the sole owner, a partner, president, secretary, etc.) of ______________________________________________________ the party making the foregoing Proposal; that such Proposal is genuine and not collusive or a sham;

that said Proposer has not colluded, conspired, connived, or agreed, directly or indirectly, with any Proposer or person, to put in a sham Proposal, or that such other person refrain from bidding, and has not in any manner, directly or indirectly sought by agreement or collusion, or communication or conference, with any person, to fix the Proposal Price of affiant or any other Proposer, or to fix any overhead, profit or cost element of said Proposal Price, or that of any other Proposer, or to secure any advantage against Forsyth County, or any person interested in the proposed Contract; and that all statements in said Proposal are true; and further, that such Proposer has not, directly or indirectly submitted this Proposal, or the contents thereof, or divulged information or data relative thereto, to any association or to any member or agent thereof.

Affiant:__________________________________________ Date: _____________________

Signed and sworn to (or affirmed) before me on ___________________, 202____ by _____________________________________________________________, Printed name(s) of individual(s) making statement who proved to me on the basis of satisfactory evidence to be the person who appeared before me.

(check one)

Personally Known Or Produced Identification (ID)

ID Type __________________________ ID # (last 4 digits) ______________ ID Expiration Date _____________________

Notary Public My Commission Expires: ________________

(NOTARY SEAL)

CONTRACTOR AFFIDAVIT AND AGREEMENT

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A.

§ 13-10-91, stating affirmatively that the individual, firm, or corporation which is engaged in the physical performance of services on behalf of Forsyth County, Georgia, has registered with, is authorized to use, and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91.

Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period, and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b).

Contractor agrees that the employee-number category designated below is applicable to the Contractor:

□ 500 or more employees □ 100 or more employees □ Fewer than 100 employees

Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

E-Verify Company ID Number

E-Verify Enrollment Date

Name of Contractor

Forsyth County Multi-Jurisdictional Hazard Mitigation Plan Update Name of Project

Forsyth County, Georgia Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on _________________, 202__ in _______________________ (city), _____ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON

THIS ______ DAY OF _______________, 202__.

Notary Public My Commission Expires: __________________

[NOTARY SEAL]

SUBCONTRACTOR AFFIDAVIT

By executing this affidavit, the undersigned subcontractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services under a contract with ( ) on behalf of Forsyth County, Georgia has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned subcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. § 13-10-91(b). Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the contractor within five business days of receipt. If the undersigned subcontractor receives notice of receipt of an affidavit from any sub-subcontractor that has contracted with a sub-subcontractor to forward, within five business days of receipt, a copy of such notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

E-Verify Company ID Number

E-Verify Enrollment Date

Name of Subcontractor

Forsyth County Multi-Jurisdictional Hazard Mitigation Plan Update Name of Project

Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on ___________________, 202___ in ________________________ (city), ______ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

Signed and sworn to (or affirmed) before me on this ______ day of _______________, 202___.

Notary Public My Commission Expires:

[NOTARY SEAL]

Addendum Acknowledgement

Proposer acknowledges that the following addenda have been received and included in the proposal:

Addendum No.

Date Issued Addendum No.

Date Issued Addendum No.

Date Issued

I hereby acknowledge receipt of the following checked Addendum of the RFP, Plans, Specifications, and/or other documents pertaining to the Project.

I understand that failure to confirm the receipt of addendum is cause for rejection of Proposal. It is the responsibility of the Proposer to ensure receipt of all addenda.

Authorized Signature: Date:

DEBARMENT CERTIFICATION FORM

The Contractor certifies that, neither the Contractor firm nor any County, partner, director, officer, or principal of the Contractor, nor any person in a position with management responsibility or responsibility for the administration of federal funds:

(a) Is presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from covered transactions by any federal or state department/agency.

(b) Has within a three-year period preceding this certification been convicted of or had a civil judgment rendered against it for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public transaction or contract (federal, state, or local); violation of federal or state antitrust statutes; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(c) Is presently indicted for or otherwise criminally or civilly charged by a governmental entity (federal, state, or local) with commission of any of the offenses enumerated in paragraph (b) above; or

(d) Has within a three-year period preceding this certification had one or more public transactions or contracts (federal, state, or local) terminated for cause or default.

(e) The contractor is “Actively” registered with SAMS (Service for Award Management) and has been assigned the following DUNS Number: __________________________.

The Contractor further certifies that it shall not knowingly enter into any transaction with any subcontractor, material supplier, or vendor who is debarred, suspended, declared ineligible, or voluntarily excluded from covered transactions by any federal or state department/agency.

Dated this ___________________ day of _______________, 20 __________

By__________________________________________________________

Authorized Signature for Contractor

CONFLICT OF INTEREST DISCLOSURE FORM

Note: A potential or actual conflict of interest exists when commitments and obligations are likely to be compromised by the nominator(s)’other material interests, or relationships (especially economic), particularly if those interests or commitments are not disclosed.

This Conflict-of-Interest Form should indicate whether the nominator(s) has an economic interest in, or acts as an officer or a director of, any outside entity whose financial interests would reasonably appear to be affected by the addition of the nominated condition to the newborn screening panel. The nominator(s) should also disclose any personal, business, or volunteer affiliations that may give rise to a real or apparent conflict of interest. Relevant Federally and organizationally established regulations and guidelines in financial conflicts must be abided by. Individuals with a conflict of interest should refrain from nominating a condition for screening.

Date: __________________________________________________________________

Name: _________________________________________________________________

Position: _______________________________________________________________

Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a conflict of interest:

_____ I have no conflict of interest to report.

_____ I have the following conflict of interest to report (please specify other nonprofit and for-profit boards you (and your spouse) sit on, any for-profit businesses for which you or an immediate family member are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own:

1. ___________________________________________________________________________________

2.___________________________________________________________________________________

3.___________________________________________________________________________________

I hereby certify that the information set forth above is true and complete to the best of my knowledge.

Signature: __________________________________________________________________________

Date: ______________________

LOBBYING CERTIFICATION

LOBBYING CERTIFICATION FOR CONTRACTS GRANTS, LOANS AND COOPERATIVE

AGREEMENTS (Pursuant to 49 CFR Part 20, Appendix A)

The undersigned certifies, to the best of their knowledge and belief, that:

(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any 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 making lobbying contacts to an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form--LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions and as amended by “Government wide Guidance for New Restrictions on Lobbying,” 61 Fed. Reg. 1413 (1/19/96).

(3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

The Proposer, _____________________________________(Company), certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Proposer understands and agrees that the provisions of 31 U.S.C. A 3801, et. seq.

apply to this certification and disclosure, if any.

Signature of Authorized Official ____________________________________________

Name and Title of Authorized Official ________________________________________

Date __________________

CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS

The grantee certifies that it will provide a drug-free workplace by:

(a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition;

(b) Establishing a drug-free awareness program to inform employees about—

(1) The dangers of drug abuse in the workplace;

(2) The grantee’s policy of maintaining a drug-free workplace;

(3) Any available drug counseling, rehabilitation and employee assistance programs, and

(4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace.

(c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a);

(d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will—

(1) Abide by the terms of the statement; and

(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after each conviction;

(e) Notifying the agency within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction;

(f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted—

(1) Taking appropriate personnel action against such an employee, up to and including termination; or

(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency;

(g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f).

Typed Name and Title of Certification Official

Signature Date