2024_02_13_RFQ_SPLOST_STSC_2024_RFQ Addendum 2.pdf

REQUEST FOR QUALIFICATIONS

To Provide

Engineering and Design Services For

Broad Street Streetscape

RFQ-SPLOST-STSC-2024

Statements of Qualifications Due: March 19 ,2024

City of Chamblee

3518 Broad Street

Chamblee, GA 30341

Broad St. Streetscape

Events Schedule

EVENTS DATE TIME

RFQ Release Date 02/01/2024

Pre-Bid Meeting (Not Mandatory)

City Hall

3518 Broad Street

Chamblee, GA 30341

02/22/2024 10:00 A.M.

Deadline for submission of written questions and clarifications 03/1/2024 5:00 P.M.

City response to questions 03/08/2024 5:00 P.M.

Statements of Qualifications Due (Bid Opening Meeting)

3518 Broad Street

03/19/2024 10:00 A.M

Contact for Proposal:

Cynthia Edwards

Capital Projects Manager

3518 Broad Street procurement@chambleega.gov mailto:procurement@chambleega.gov

Introduction and Purpose:

The City of Chamblee (CITY) is soliciting Statement of Qualifications (SOQs) from qualified firm(s) or organization(s) to provide consultant services for

• Engineering

• Design

• Construction Administration

This Request for Qualifications (RFQ) seeks to identify potential providers for the Scope of Services for the project/contract listed in Exhibit I. The CITY reserves the right to reject any or all Statements of Qualifications or Technical Approach, and to waive technicalities and informalities at the discretion of the CITY.

Qualifications/Experiences

The City is seeking a Consultant that possesses the strongest combination of the following qualifications and experience listed below. Consultants should provide project information for similar tasks, to include scope, size, cost, time to complete along with verifiable references with contact information.

1. Experience working with transformational town centers with open-air, high quality, aesthetically pleasing and pedestrian-scale/walkable retail, restaurant, and entertainment districts in jurisdictions in the Atlanta metro region or southeastern United States.

2. Experience in infrastructure and utility coordination or relocation and the development of storm water detention facilities, especially those utilizing best practices for environmental impact and water quality.

3. Experience in working with mixed-use residential projects within multiple jurisdictions throughout the Atlanta metro region, particularly in urban locations which are comparable to downtown Chamblee.

Scope of Work

The City of Chamblee is soliciting qualification statements for professional services for engineering, design, cost estimating and construction administration for a streetscape project to be in the vicinity of the New City Hall located at 3518 Broad Street, Chamblee, GA 30341.

Services to be provided will include but not limited to:

1. Design documents based on the approved concept plan, See Exhibit I

2. Designing system improvements and construction engineering.

3. Design based on boundary, topography underground utility survey.

4. Design of drainage requirements and improvements.

5. Obtain all permitting required for the proper design and construction for this project.

6. Provide construction plans and specifications.

7. The Consultant shall engage the services of the following but not limited to design professionals as required: Land Surveyor, Structural Engineer, Mechanical, Electrical, Utilities, Plumbing, Fire Protection, Security, Low Voltage, Landscape

Architect, Civil Engineer etcetera. These subconsultants shall be identified in the response to the RFQ.

8. Assisting the City with the construction bid package in conformance with applicable federal requirements and supervising the bid advertising, tabulation, and award process, including preparing the advertisements for bid solicitation, conducting the bid opening, and issuing the notice to proceed.

9. Assist in conducting the preconstruction conference.

10. Field staking, on-site supervision of construction work, and preparing inspection reports.

11. Reviewing and approving all contractor requests for payment and submitting approved requests to the governing body.

12. Providing reproducible plan drawings to the City upon project completion.

13. Prepare operating and maintenance manuals.

14. Conducting final inspection and testing.

Proposal Requirements

A. Pre-Bid Meeting

A Pre-Bid Meeting will be held on (Thursday, February 22, 2024 @ 10:00 A.M) at

City Hall, 3518 Broad Street, Chamblee, GA 30341 to review the scope of work, schedule, and budget to ensure mutual understanding and to coordinate the work. A representative of all interested firms is encouraged to attend to examine the job site as an opportunity to identify and understand tasks and determine schedules. A representative from the city will be there to answer any preliminary questions. This meeting is not mandatory to submit a Statement of Qualifications.

B. Questions

All questions must be submitted in writing to procurement@chambleega.gov and the RFQ# (RFQ-SPLOST-STSC_2024) should be listed in the subject line. The deadline for all questions and inquiry submissions regarding this RFQ is (Friday, March 1, 2024 @ 5:00 P.M.). The city will respond to questions via the Georgia

Procurement Registry and City website on (Friday March 8, 2024 @ 5:00 P.M.)

C. Schedule

Provide an estimated schedule to complete the identified scope of work.

D. Proposal Deliverables:

• Submit five (5) copies of the SOQ.

• Proposals are due on or before the submission deadline (Tuesday, March 19, 2024 @ 10:00 A.M) as noted in the schedule of events above.

• All proposal packages should be marked on the outside as “RFQ-SPLOST-

STSC-2024, Broad Street Streetscape”, sealed and delivered to City Hall.

• Proposals may also be emailed in a pdf format to procurment@chambleega.gov . The subject line of the email must include the RFQ number (RFQ-SPLOST-STSC-2024_Broad St Streetscape). Facsimiles will not be accepted.

• The results of the bid will be posted on the City’s website and the Georgia

Procurement Registry once the bid is awarded.

• All SOQs must be good for 90 calendar days.

• All costs related to the preparation, submittal, and/or presentation of this RFQ are the responsibility of the Consultant and will not be assumed in full or in part by the City.

• Additional supplemental information may be submitted under a separate cover to aid in the selection process (example: resumes, description of similar projects, references, and a description of the conceptual approach to meeting project requirements.

mailto:procurment@chambleega.gov

• The City will not accept any proposal submitted after the deadline regardless of postal or carrier delivery issues, weather or any other reasons that may cause your proposal to be late.

• The City reserves the right to reject any and all proposals and reserves the right to waive any and all proposal formalities. The City also reserves the right to make changes to this RFQ at any time by issuance of a written addendum or clarification.

Project Requirements

A. Certifications and Permits The contractor will be responsible for obtaining all certifications and permits necessary for completion of the project from the appropriate regulatory agencies including any applicable permitting fees normally issued by the City.

B. Responsibility for Temporary Facilities The contractor will be responsible for all temporary facilities necessary to successfully complete the project – to include, but not limited to, portable restrooms, site fencing, site security, etc.

C. Safety Provide information regarding firm’s safety record and describing the specific safety measures/plan to be used in this project to protect personnel, public, structures and infrastructure.

D. Price It is the City’s intent to select a contractor(s) that will, in the City’s sole determination, provide the best proposal at the least cost. Price must include any/all fees related to the project requirements.

Evaluation Criteria

The City intends to award the contract to the consultant deemed most qualified and responsive to the requirements of the project. The selection of a consultant shall be based on qualifications submitted as well as project references, staff capacity and overall project cost. Criteria for selection will include the following:

1. Project Understanding and Approach 20 points

2. Project Team, Professional Qualifications and Technical

Competence

40 points

3. Quality of Response 10 points

4. Financial Proposal and Financial Stability (audit report or tax returns)

20 points

5. Project Team similar work experience 10 points

Total Points 100 points

Selection Process

Following receipt of the proposals, an evaluation committee will review and evaluate all proposals. The proposals will be initially evaluated based on the written material provided and the results of reference evaluations. The evaluation committee may invite finalists for an in-person or virtual presentation for the purpose of introducing key members of the project team and allowing the City to fully understand the firm’s ability to meet the project requirements.

All expenses of interviews and presentations will be the sole responsibility of any expenses incurred by a responder under this document.

The award of the contract shall be at the sole discretion of the City. The City intends to award the contract to the consultant deemed most qualified and responsive to the requirements of the project. The City reserves the right to award the contract without further discussion of the proposals submitted. Therefore, the proposal should be submitted initially on the most favorable terms which the offeror can propose. The City reserves the right to reject any and all proposals without explanation.

Proposal Checklist

The Proposal shall be no larger than (8.5” by 11”) and may be printed on the front and back. Up to five (3) one-page resumes of key staff may be included as Appendices and are not counted in the page limit. Offerors are asked to address each evaluation criterion and to be specific in presenting their qualifications in a straightforward, detailed, and concise manner. Your proposal should provide all the information considered pertinent to your qualifications for this project. Each response to this RFQ shall include the information described in this section. Failure to include all the elements specified may be cause for rejection. Additional information may be provided but should be succinct and relevant to the goals of this RFQ. Respondents are cautioned to follow and clearly mark each section of the response according to the sections below.

1. Project Understanding & Vision: Provide a narrative regarding the vision for the Town Center streetscape and a recommended development program for the Project Site that demonstrates your understanding and response to development issues and the project, in general.

2. Project Approach & Implementation Plan: Describe your approach to the

Town Center streetscape project. The response should include a description of how you would work with The Parties to develop a Master Plan based on previous concepts provided in the Town Center LCI Master Plan streetscape plan. In addition, attention should be given to how the walkable, mixed-use components would be implemented into the streetscape plan, and any other matters that you wish to call to the attention of the Parties. An overall anticipated timeline should also be provided.

3. Key Entity / Team: Identity of the entity that would be the engineer of the project: Company name, legal status, address, phone, email, and the primary contact for this solicitation. If a joint venture, provides information for each member of the venture, an indication of the lead entity for the project, and each entity’s project role.

4. Background and Experience: Overall background and experience of the firm (and any joint ventures) and statement as to why that entity is best qualified to undertake this project.

5. Completed Projects: Identify at least three (3) completed projects that best exemplify your company’s capabilities to successfully complete the streetscape project. For each project, provide the following: Name, location, designers/architects, Provide photographs or other renderings and public agency contacts, if applicable.

6. Key Personnel: Identify key personnel who would be involved in the project and their proposed roles. Provide resumes and professional references.

7. References: Provide five references, including two public sector references who can attest to the ability of your group to implement this project. Include name, contact information, and nature of the association. At least two of the references provided should be for individuals associated with any of the three projects noted in item 4, above.

Cover Letter – The cover letter should express interest and highlight relevant qualifications. The cover letter shall be signed by a person with the corporate authority to enter into any contract which results from the RFQ.

Consultant Information must include Name, Address, Phone Number and

Primary Contact

Corporation or Limited Liability Certificate – this is required for all individual firms even if entering into a joint venture.

Firm Qualifications – provide a brief description of the firm – size, history, location, and other pertinent information.

Key Team Members – Provide an organizational chart with key team members indicating their role and their office location. One-page resumes may be provided for up to 5 key team members as an Appendix that is not counted in the 20-page limit.

Evidence of Insurance –

Evidence of Financial Stability – (audit report or tax returns)

Related Experience – Descriptions of similar work performed on different projects. Identify key team members that worked on each project. Provide references with contact information (telephone numbers and e-mail addresses).

Project Understanding – Describe how you propose to do the work. Identify critical issues and how they will be addressed. Suggest changes to the work as proposed in the Technical Memorandum.

Proposed Schedule – Firms should provide a detailed project schedule phased by the scope of work above as part of the submittal in response to this

RFQ. The schedule for this project should reflect adequate time for all required services.

Verifiable References – Using the Proposal Form in Appendix A, the offeror shall include a list of five (5) references related to projects completed within the last four (4) years.

Fee Proposal

Fee Proposals

Fee proposals shall be SEALED in a separate envelope, which will not be opened until after other criteria have been considered. The fee should include (1) A total cost estimate; (2) A rate schedule for computing work, including hourly rates for all positions plus unit costs for incidental expenses. The costs will be scored with the lowest cost receiving the maximum number of points and the highest cost receiving the minimum number of points and each price in between allocated points based on a sliding scale.

The City of Chamblee reserves the right to negotiate costs with any and all Firms that may be awarded work under this Request for Proposals. Additionally, the City of

Chamblee reserves the right to negotiate parity at any and all costs with any and all

Firms. Such negotiations are at the discretion of the City of Chamblee.

References

All Offerors shall include a list of three (3) references from similar projects that the firm completed within the past four (4) years and that have involved the staff proposed to work on this project. The project owners should be able to attest to the firm’s knowledge, quality of work, timeliness, diligence, flexibility, and overall expertise.

Include names, contact persons, and phone numbers of all references on the attached

Reference Form.

References may or may not be reviewed or contacted at the discretion of the City. The

City reserves the right to contact references other than, and/or in addition to, those furnished by an Offeror.

Instructions For Offerors

Proposals will only be accepted from responsible and responsive companies that have an established reputation.

No proposal may be withdrawn for a period of ninety (90) days after the proposal submission date.

A responsible offeror means an offeror who has the capability in all respects to perform fully the requirements mentioned in the proposal document and the integrity and reliability which will assure good faith performance.

A responsive offeror means an offeror who has submitted a proposal which conforms in all respects to the request for proposal requirements.

DISPUTES: In cases of disputes as to whether an item or service quoted or delivered meets scope of work, the decision of the City of Chamblee shall be final and binding on all parties.

DEVIATIONS: Any deviations from the scope of work contained herein must be noted in detail in the respondent’s response for the City of Chamblee’s consideration.

CHANGES: Any changes in this request for proposal after the purchase order/contract agreement has been awarded must be with the written consent of the City Manager;

otherwise, the responsibility for such changes lies with the company. Any changes to the scope of work in this request for proposal package should be in writing and an addendum will go out to all prospective respondents so each respondent can compete equitably.

QUESTIONS AND INQUIRIES: The deadline for the submission of all questions and inquiries concerning this RFQ is March 01, 2024 @ 5:00 P.M. All questions must be directed to Cynthia Edwards in writing and e-mailed to procurement@chambleega.gov .

Business License Requirement

Entities that provide goods and services within the City limits are required to have a business license. The successful contractor/company will be required to acquire a business license which will be valid during the term of the contract.

Professional Insurance Requirements And Indemnification

Other Than Professional Services: With respect to all acts or omissions of the selected company, or any individual or entity directly or indirectly employed by the selected company to perform any of the work or anyone for whose acts, errors, or omissions the selected company may be liable, which do not arise out of or result from the performance of professional services, and which may be covered by employer’s liability insurance, commercial general liability insurance, automobile liability insurance, or other general liability insurance, the selected company shall indemnify and hold the City of Chamblee, Georgia, its elected and appointed officials, officers, and employees,, harmless from and against judgments, liabilities, damages, losses, costs, and expenses (including, but not limited to, reasonable attorneys' fees and costs but only to the extent otherwise authorized by law) to the extent caused by or arising out of the selected company’s negligent acts of commission or omission (or those of or any individual or entity directly or indirectly employed by the selected company to perform any of the work or anyone for whose actions or failure to act the selected company may be liable) during the performance of this Agreement.

The selected company shall require any subconsultants and subcontractors to purchase and maintain insurance with limits not less than those required above to be purchased and maintained by the selected company. In addition, the selected company shall require any subconsultants and subcontractors to assume the selected company’s indemnification obligations under any contract resulting from this RFQ to the extent they relate to the sub consultant’s or subcontractor’s obligations under any contract with the selected company.

The successful contractor will be notified by the City and will be expected to execute a Contract within five (5) days following Notice to Proceed.

The contractor shall furnish a bond in the total amount of the Proposal guaranteeing both the performance of the work and the payment for all labor and materials related to the work.

The contractor shall furnish proof of insurance coverage in the following amounts upon execution of the contract and shall maintain such policies throughout the term of the agreement:

Insurance Requirements:

A. Statutory Workers Compensations Insurance Employers Liability

Bodily Injury Accident - $100,000 Each Accident

Bodily Injury by Disease - $500,000 Policy Limit

Bodily Injury by Disease - $100,000 Each Employee

B. Comprehensive General Liability Insurance: $500,000 Limit of Liability per

Occurrence for bodily injury and property damage.

C. Auto Liability Insurance: $500,000 Limit of liability per occurrence for bodily injury and property damage. Comprehensive form covering all owned, non-owned and hired vehicles.

D. Umbrella Liability Insurance- $1,000.00 limit of liability.

The Contractor shall indemnify and hold harmless the City and its elected and appointed officials and its agents and employees from and against all claims, damages, losses, and expenses, including attorneys’ fees and litigation expenses, arising out of or relating to the performance of the work, provided that any such claim, damage, loss or expense is:

a) Attributable to bodily injury, sickness, disease, or death, or to injury to or destruction of tangible property, including the loss of use resulting therefrom, and

b) Caused in whole or in part by any negligent act or omission, or by any breach of the provisions of the Contract Documents, of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, regardless of whether or not it is caused in part by a party indemnified under this indemnity provision.

In any and all claims against the City or any of its agents or employees by any employee of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, the indemnification obligation shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or for the

Contractor or any subcontractor under worker’s compensation acts, disability benefits acts or other employee benefit acts.

Company History and References:

a. Company Name: ___________________________________________________

b. List five (5) references for whom you have provided similar services in the last four

(4) years:

Contact Person/Title Company Relevant Project

Name

Contact Phone

& Email

1.

2.

3.

4.

5.

c. Subcontractors: Please list any subcontractors to be used on the job with a summary of their role. List whether any of these contractors meet the WBE/FBE fair share requirements.

d. Describe efforts to achieve Fair Share WBE/MBE requirements.

Subcontractor Name Role

Bid Form for Professional Services.

Contractor Name Date

We the undersigned, do hereby declare that we have carefully examined the site(s) of the proposed Work and the Contract Documents. We do hereby agree to furnish all material, transportation, equipment, apparatus systems, labor, and supervision required to do all work in strict accordance with the Contract

Documents for the Total price indicated below:

See Specifications for scope of work details.

LUMP SUM Estimate: This is an estimate for a Lump Sum Contract to be awarded to the most responsible bidder (s) in the manner that best benefits the City of

Chamblee.

Total Estimate price for all specified work, complete, in accordance with the

Contract Documents for the address listed below:

Engineering and Design Services Preliminary Estimate

1 $

Total $

If awarded a contract, the contractor will provide permits, license certificates, inspections (permanent and temporary) and occupational tax certificates, and proof of insurance before any work can commence.

Authorized Signature Tax ID #

Address City State Zip

Estimated Time of Completion Telephone# Fax#

Seal (If Incorporated) Email Address

Proposal Form

The contractor in compliance with the Request for Qualifications to provide engineering and design services for the Broad St Streetscape project. I have examined the RFQ documents and being familiar with the site of the proposed project, hereby proposes to furnish all labor, materials, tools, equipment, machinery, and all services to provide work described herein in accordance with the RFQ documents for the amounts stated below.

I have reviewed the proposal to ensure that it is verified for completeness and accuracy.

Offeror’s Certifications:

1. Offeror has examined the site of the work and is familiar with any and all conditions affecting the cost of the design work and with all requirements of the

RFQ documents including any addenda, and agrees to furnish all labor, materials, and equipment required to successfully complete the scope of work.

2. Offeror has reviewed the Contract provisions and is able to enter into a contract, without modifications, if selected through this RFQ process by the City.

3. Offeror acknowledges that the terms, conditions, and certifications contained in this section are applicable to all subcontractors and Contractor agrees to ensure compliance therewith by all subcontractors involved with the project.

The City will strictly enforce compliance with the terms of all proposals accepted.

Company:

Address:

City/State:

Signature

Name:

Please Print Title

Phone:

Email Address:

Proposal Fee Form

Fee proposals shall be SEALED in a separate envelope, which will not be opened until after other criteria have been considered.

Total estimated Fee for Engineering and Design Servies for the Broad St Streetscape project $_______________

Assumptions or Conditions of Fee:

Unit Prices for Additional Services that may be needed under this Contract

Pricing shall remain firm for a minimum of two (2) years. Any and all requests for pricing adjustments shall not exceed The Bureau of Labor Statistics Consumer Price Index (CPI) data.

Additional pages may be attached as needed.

Employee Name and/or Labor Category and/or ODC category Hourly Rate/ Unit Rate

4.

5.

6.

7.

8.

9.

10.

Georgia Security and Immigration Compliance Act Affidavit

CONTRACTOR’S 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 contracting with the City of Chamblee has registered with, is participating in, uses, and will continue to use for the duration of the contract, the federal work authorization program - EEV/Basic Pilot Program operated by the U. S. Citizenship and Immigration

Services Bureau of the U.S. Department of Homeland Security, in conjunction with the

Social Security Administration (SSA), commonly known as E-Verify, in accordance with the applicability provisions established in O.C.G.A. 13-10-91.

The undersigned further agrees that, in connection with the physical performance of services pursuant to this contract with the City of Chamblee, the contractor will only employ or contract with subcontractor(s), who can present a similar affidavit verifying the subcontractor’s compliance with O.C.G.A. 13-10-91. The contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the City of Chamblee within five days of the subcontractor(s) presenting such affidavit(s) to the contractor.

EEV / Basic Pilot Program* User Identification Number

Enter four-to-six-digit numbers

BY: Authorized Officer or Agent Date

(Contractor Name)

Title of Authorized Officer or Agent of Contractor

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS

THE ______ DAY OF __________ 20_____.

Notary Public My Commission Expires

Subcontractor Affidavit and Agreement

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 the City of Chamblee has registered with, is participating in, uses, and will continue to use for the duration of the contract the federal work authorization program - EEV/Basic Pilot Program operated by the U. S. Citizenship and Immigration Services Bureau of the U.S. Department of

Homeland Security, in conjunction with the Social Security Administration (SSA), commonly known as E-Verify, in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.

The undersigned further agrees that, in connection with the physical performance of services pursuant to this contract for the Broad St Streetscape Engineering and Design project on behalf of the City of Chamblee, the subcontractor will only employ or contract with sub-subcontractor(s), who can present a similar affidavit verifying the sub-subcontractor’s compliance with O.C.G.A.13-10-91. The undersigned further agrees that the Subcontractor will maintain records of such compliance and provide a copy of each such verification to the Contractor within five days of the sub-subcontractor(s) presenting such affidavit(s) to the Sub-contractor.

EEV / Basic Pilot Program* User Identification Number

Enter four-to-six-digit number

BY: Authorized Officer or Agent Date

(Subcontractor Name)

Title of Authorized Officer or Agent of Subcontractor

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _____ DAY OF __________20___.

Notary Public My Commission Expires

Non-Collusion Oath

COUNTY OF:

STATE OF:

Before me, the Undersigned Bidder being duly sworn on oath, a Notary Public, for and in the County and State aforesaid, personally appeared ________________________and made oath that the Contractor herein, his agents, servants, and/or employees, to the best of his knowledge and belief, have not in any way colluded with anyone for and on behalf of the Contractor, or themselves, to obtain information that would give the

Contractor an unfair advantage over others, nor have they colluded with anyone for and on behalf of the Contractor, or themselves, to gain any favoritism in the award of the contract herein.

He or she further states that no person or person, firms, or corporation has, have, or will receive directly or indirectly, any rebate, fee gift, commission, or thing of value on account of such sale.

Oath and Affirmation

I hereby affirm under the penalties for perjury that the facts and information contained in the foregoing bid for public works are true and correct.

Dated this day of ___________, 2023.

Authorized Signature for Contractor: ___________________________

Title: ________________________________________________________

Contractor's name (print): ________________________________________

SWORN TO BEFORE ME THIS_________DAY OF__________________, 2023.

NOTARY PUBLIC FOR THE STATE OF _________________________________

My Commission Expires: _____________________________________

Notary Public Signature: _____________________ Printed Name: _________________

Address: _______________________________________________ Phone: ________________

(Note: Notary Seal required for foreign Contractor)

Drug Free Workplace Certification

DRUG FREE WORKPLACE REQUIREMENTS: The Contractor will provide the following certification that a Drug Free Workplace will be provided on the Project.

The undersigned certifies that the provisions of Code Sections 50-24-1 through 50-24-6 of the Official Code of Georgia Annotated, relating the "Drug Free Workplace Act", have been complied with in full. The undersigned further certifies that:

1. A drug free workplace will be provided for the Contractor’s employees during the performance of the Contract; and

2. Each Contractor who hires a Subcontractor to work in a drug free workplace shall secure from that Subcontractor the following written certification:

COMPANY NAME:

AUTHORIZED REPRESENTATIVE NAME:

TITLE:

SIGNATURE:

DATE: