2026-109 911 Tower HVAC Service.pdf

PURCHASING

P: 315- 376- 5144 | F: 315- 376- 4917

Brian Hanno

Director brianhanno @lewiscounty.ny.gov

7660 North State Street ● Lowville, NY 13367 ● 315- 377- 2000 ● lewiscounty ny .gov

Lewis County is an equal opportunity provider and employer. Complaints of discrimination should be made known to the Lewis County Board of Legislators.

REQUEST FOR PROPOSAL

NO. 202 6 - 10 9 LEWIS COUNTY 911 TOWER SHELTER BUILDINGS HVAC

SERVICE AND MAINTENANCE

Date: September 9, 2026

To Whom It May Concern:

Lewis County is currently seeking a proposal for bi-annual HVAC service for each of its (10) 911 tower shelter sites.

All proposals to be mailed to:

Clerk of the Board County Courthouse, 2nd Floor, Room 225 7660 North State Street Lowville, New York 13367 or delivered in person between the hours of 8:30 A.M. and 4:30 P.M., Monday through Friday. Electronic submissions will also be accepted through the County’s Planet Bids portal. https://vendors.planetbids.com/portal/76952/portal-home

All proposals must be received on or before 10:30 a.m. on, Thursday October 1, 2026. Late proposals will not be considered.

Lewis County reserves the right to forego any formalities and reject any or all proposals.

Lewis County is an Equal Opportunity Employer.

This RFP can be found on and downloaded from the Lewis County Website:

www.lewiscountyny.gov

Sincerely, Brian Hanno Lewis County Purchasing Director 7660 North State Street Lowville, NY 13367 https://vendors.planetbids.com/portal/76952/portal-home http://www.lewiscountyny.gov/

Introduction

1.1 Purpose/Objective

The Scope of Work is to establish the requirements for providing preventive maintenance, inspection, testing, troubleshooting, repair, and emergency HVAC services for heating, ventilation, and air-conditioning equipment serving County 911 tower shelter buildings.

The HVAC systems at these facilities are critical to maintaining appropriate environmental conditions for telecommunications, radio, dispatch, electrical, and other equipment. The Contractor shall provide all labor, supervision, tools, equipment, transportation, materials, and incidental services necessary to maintain the HVAC systems in safe, reliable, and operational condition.

More information is described in section 2.1.

The county intends to open the bid responses to this RFP on Thursday October 1, 2026, at 10:30 a.m., and to select a qualified firm, if any.

1.2 Inquiries

Any questions related to this RFP should be directed to Brian Hanno, Purchasing Director, by email at brianhanno@lewiscounty.ny.gov.

1.3 Minority, Women - owned Enterprises and Service - Disabled Veteran - Owned Businesses

The County strongly encourages firms with MWBE certification to submit bids for this proposal however there are no MWBE requirements.

1.4 Taxes

No charge will be allowed for federal, state, sales, and excise taxes from which the County is exempt. Exemption Certificates will be provided upon request.

1.5 New York State Prevailing Wage Rates

If any portion of work being bid is subject to the prevailing wage rate provisions of the NYS Labor Law, the successful bidder is responsible for complying with all current labor rates and regulations throughout the duration of any contract resulting from this bid and will conduct his business in strict compliance with County Law, New York State Labor Laws, Federal OSHA Laws, and all other laws that apply. The current schedule(s) of the prevailing rates and hourly supplements for this project may be accessed at the New York State Department of Labor website @ www.labor.state.ny.us.

All contractors and subcontractors submitting bids or performing construction work on public work projects or private projects covered by Article 8 of the Labor Law are required to register with the NYS Department of Labor (DOL) under Labor Law Section 220-i.

mailto:brianhanno@lewiscounty.ny.gov http://www.labor.state.ny.us/

General Description or Required Performance Outcomes:

2.1 Project Goals

Provide scheduled preventive maintenance, emergency repairs, and system upgrades for HVAC units at all 911 tower shelter sites. Services must ensure reliable climate control for critical telecom equipment, maintaining optimal temperature and humidity

A. Preventive Maintenance

• Quarterly inspections and maintenance of all HVAC units (rooftop, split, DX, etc.).

• Clean and replace filters, check refrigerant levels, inspect electrical connections, calibrate controls, and test system performance.

• Provide written reports after each visit, noting equipment condition and recommendations.

B. Emergency Service

• 24/7 response for HVAC failures or alarms.

• Maximum response time: [e.g., 4 hours].

• Temporary cooling solutions if repairs cannot be completed immediately.

C. Repairs and Upgrades

• Replace failed components with equivalent or approved alternatives.

• Secure mounting, electrical work, and safe disposal of old units.

• Provide training for site staff on preventive maintenance and system operation.

D. Equipment Specifications

• Maintain and service all installed HVAC types: packaged rooftop units, split systems, through-wall units, and direct-expansion systems.

• Equipment must meet or exceed manufacturer specifications for telecom shelters, including redundancy and energy efficiency

E. Monitoring and Data Analytics

• Support integration with remote monitoring systems for real-time performance and predictive maintenance.

• Provide data reports on system status, energy consumption, and maintenance history

The 911 Towers are located at the address below.

1) PSB 911 Tower

5252 Outer Stowe St Lowville, NY 13367

2) #3 Rd 911 Tower

7830 #3 Rd Lowville, NY 13367

3) Montague 911 Tower

6574 Sears Pond Rd Montague, NY 13367

4) Copenhagen 911 Tower

1720 Hayes Rd Copenhagen, NY 13626

5) Croghan 911 Tower

8679 Long Pond Rd Croghan, NY 13327

6) Harrisville 911 Tower

8153 State Rt 3 Harrisville, NY 13648

7) Gomer Hill 911 Tower

4805 Brenon Rd Turin, NY 13473

8) Lyonsdale 911 Tower

3895 Marmon Rd Lyons Falls, NY 13368

9) NYPA 911 Tower

5861 Ziegler Rd West Leyden, NY 13489

10) Osceola 911 Tower

1276 Osceola Rd Redfield, NY 13437

3.1 The Contractor/ firm agrees to provide services to the County as an independent contractor and not as an employee, as those terms are understood for New York and Federal law purposes. The Contractor/Firm agrees to provide for, secure, and/or be solely responsible for any and all required fees, permits, Workers Compensation coverage, Unemployment Insurance, Disability Insurance, Social S e c u r i t y contributions, i n c o m e tax w i t h h o l d i n g and a n y other insuran ce or t a x e s , including but not limited to Federal and New York taxes, for any persons performing services pursuant to a subsequent agreement, including the Contractor, and any employees of the selected Firm. The Contractor agrees to indemnify the County and hold the Country harmless from any claims, suits, losses, or damages, including reasonable attorney’s fees, resulting from any failure on the part of the contractor to satisfy its obligations as states herein.

3.2 The Contractor acknowledges and agrees to purchase, register, and insure any and all necessary equipment and vehicles to provide the scope of services identified. Automobile liability insurance must have a minimum limit for bodily injury and property damage of $1,000,000 /$2,000,000.

3.3 The C o ntractor acknowledges and agrees to purchase comprehensive general liability insurance with minimum liability limits of $1,000,000 / $2,000,000 for personal injury and property damage, and $2,000,000 aggregate to protect against claims brought against the County, which may arise from the provision of services under a subsequent agreement. Contractor agrees to name the County as an additional primary insured.

3.4 The Contractor agrees to indemnify the County and hold the County harmless from any claims (including but not limited to claims under Labor Law Section 240, if applicable), suits, losses, or damages resulting from or relating to any services provided by the Contractor and/or equipment or materials used by the Contractor, or any other person performing services pursuant to a subsequent agreement. The Contractor shall be liable to the County for any loss, damage or destruction of any property, materials, goods, documents, or other items, including reasonable attorney’s fees, resulting from or related to the negligence, or other wrongful acts of the Contractor, the Contractor’s employees, or any other person performing services pursuant to a subsequent agreement. The amount of general liability insurance.

3.5 The Contractor may not assign, transfer, sublet or otherwise dispose of the Agreement without the prior written consent of the County.

3.6 The County reserves its right to require additional contractual provisions it deems appropriate to give effect to this Proposal.

ELIGIBLE APPLICANTS

4. To be deemed an eligible applicant, you must have at least three (3) years’ experience in HVAC installation and service and provide a minimum of three (3) customers as references.

PROPOSAL FORMAT

5. To be submitted on your own forms, but must include the bid page, the non-collusion form, anti-sexual harassment form, corporate attestation form, and Iran Divestment Act set forth at the end of this RFP. Vendors now have the option to submit their proposals electronically also.

BASIS OF AWARD:

6.1 All proposals will be evaluated to determine if they meet the requirements of the Request for Proposal. The County may, as it deems necessary, conduct discussions with the contractor(s) it deems reasonably suspected of being selected for award, for the purpose of clarification and responsiveness to requirements. The County may assign varying weight to criteria and reserves its right to make an award based upon said criteria, including “best value”, if applicable.

6.2 Information gathered by the County from the RFP, during any interviews, and any other information and factors deemed relevant by the County may be considered in a final award.

Some additional information and criteria the County may consider includes but is not limited to the bidder’s commitment to Lewis County, reputation of the contractor, commitment to quality of services, responsiveness.

6.3 The County reserves the right to accept or reject any and all Proposals.

6.4 The Award may be made to the most responsible bidder whose proposal is determined to be in the best interest of Lewis County and deemed to best serve the County’s needs and requirements, based on the evaluation of all relevant criteria and information provided including an interview with Contractor and the Award Committee.

6.5 A successful bidder is encouraged by the County to use in-county and/or local vendors, supply entities and labor force, if possible, in providing the services under the contract awarded for this project, but is not required to do so, nor is same a criteria in the award determination.

6.6 The Award Committee will consist of the General Services Legislative Committee, County Manager, Director of Buildings and Grounds, and the County Attorney. The County reserves the right to reject any and all bids and to waive any informality in bids received whenever such rejection or waiver is in the interest of the County. Price will not necessarily be the determining factor in the award of the contract. The Award Committee will make its recommendation to the full Board of Legislators for their approval. Contract award will be made by resolution of the Board of Legislators.

6.7 Contractors will be notified in writing of the successful award after formal acceptance by the Lewis County Legislature.

CONTRACT PERIOD:

7.1 The intent of the County is to award this contract on November 3 ,2026 for a 5 year contract.

GENERAL INFORMATION:

8.1 Your p roposal m ust in c lude the follo w ing to be c onsid ere d:

1. Name, Address, Contact Person.

2. Telephone Number/Fax Number/E-mail Address.

3. Detailed description of the proposed services to be provided based on vendor’s recommendation to accomplish scope of work detailed above for this project.

4. Essential information about the company providing the service including the correct and full legal name of the business, tax identification number, and a listing of all personnel involved in the proposal.

5. Proposed compensation plan or fee structure.

8.2 PROPOSAL REQUI R E MENTS:

a) Proposals must be accompanied by a signed Proposal Form, Signed Non-Collusion Statement, Signed Anti-Sexual Harassment statement, and signed Attestation of Good Standing if corporate entity, and signed Iran Divestment Act. These forms can be found at the end of these specifications.

b) Provider must submit their written proposal on their own forms.

c) One original and one copy of the proposal must be provided.

d) Read all documents contained in the proposal package.

e) Proposals must be submitted to:

Clerk of the Board Lewis County Courthouse 7660 North State Street Lowville, New York 13367

To be considered, the proposal must be received no later than 10:30AM on October 1, 2026. No proposals will be accepted after the designated time. Bid packages will be opened on said date and time in the Courthouse Building, Second Floor Chambers, 7660 North State Street, Lowville, NY 13367.

Providers shall indicate on the outside of their sealed proposal the following information:

• Title of Proposal and Proposal Number if any

• Date and Time of Proposal Opening

• Company Name / Bidders Name

Failure to do so may result in the rejection of the proposal as being unresponsive.

No Bidder may withdraw their proposal within ninety (90) days after the actual date of opening thereof.

8.3 LATE PROPOSALS:

Proposals received in the Clerk of the Board’s Office after the date and time prescribed shall not be considered for contract award and shall be returned, unopened, to the Contractor.

NOTE: Any delay due to traffic, weather, mail or express delivery is not an exception to the deadline for receipt of proposals. Please plan accordingly.

8.4 NON - COLLUSION STATEMENT; SEXUAL HARASSMENT POLICY

STATEMENT:

Non-Collusion Statement and Sexual harassment compliance statements shall be returned with your proposal.

8.5 PROPOSAL CONTENT:

All information required by these specifications must accompany the proposal or the provider may be disqualified.

8.6 ADDENDA:

Addenda are written instruments issued by the County prior to the date for receipt of offers which modify or interpret the specification document by addition, deletion, clarification or correction. The addenda will be e-mailed to all who are known by the County to have received a complete set of specification documents. The addenda will also be posted on the Lewis County website, www.lewiscountyny.gov.

Copies of the addenda will also be made available for inspection at Purchasing Director’s Office located in the County Courthouse Building. No addendum will be issued later than forty-eight (48) hours prior to the date and time for the receipt of offers, except an addendum withdrawing the RFP, or an addendum including postponement.

8.7 PROPOSAL RECEIPT BY A THIRD PARTY:

Any Contractor submitting a proposal based on incomplete or inaccurate information resulting from documentation received from any third party shall not have cause for relief from award or completion of a contract in accordance with the official documents on file with the County of Lewis. It is STRONGLY suggested that all Contractors interested in participating in this proposal, contact the Lewis County Purchasing Department directly to assure they have received the most accurate and up to date material concerning this contract. The County does not offer or supply anyone the list of people that have obtained a copy of these RFP specifications for the project prior to the opening of the RFP. NO

EXCEPTIONS ARE MADE TO THIS POLICY.

8.8 FREEDOM OF INFORMATION LAW (FOIL)

All material submitted in response to this Bid becomes the property of the County, with same being considered public records after the award of the contract, subject to confidentiality and exemptions set forth in the Public Officers Law. Proposals will not be shared with any competing offerors during the selection phase of this procurement, however, after award of the contract to the successful offeror, proposals and/or lawful parts of proposals received in response to this RFP may be subject to disclosure under the Freedom of Information Act.

Information in proposals that is clearly identified as proprietary will not be disclosed at any time. Blanket statements that all contents of the proposal are confidential and proprietary will not be honored by the County. The New York State Freedom of Information Law (FOIL), as set forth in Article 6 of the Public Officers Law mandates public access to certain government records. Generally, proposals submitted in response to this Bid may constitute government records subject to FOIL.

Proposals may contain, among other things, certain technical, financial, or other data and information that constitute trade secrets if publicly disclosed. To protect this information from disclosure under FOIL, Proposers should specifically identify the pages of the proposal that contain such information by properly marking the top of the applicable pages with “ with the notation: “CONFIDENTIAL” and inserting the following statement in the front of its proposal: “The information or data on pages of this proposal, identified on the top thereof as “CONFIDENTIAL”, contain financial, technical, or other information which constitute government records subject to FOIL.” Bidder should explain, among other things, certain technical, financial, or other data and information that constitute trade secrets, if publicly disclosed, that could cause substantial injury to the commercial enterprise’s competitive position, and request that the County use such information only for the evaluation of this proposal.

http://www.lewiscountyny.gov/

Bidder must understand that the County is required to comply with the provisions of the New York State Freedom of Information Law (FOIL), and that public disclosure of the information contained in this proposal whether or not marked as “CONFIDENTIAL” may be required.

Bidder shall make no claim for any damages as a result of any such disclosure by the County pursuant to FOIL. In the event the County receives a FOIL request for disclosure of information marked as “CONFIDENTIAL”, the Proposer/Bidder shall be notified of the request and may expeditiously submit a detailed statement and explanation indicating the reasons it has for believing that the information requested is exempt from disclosure under the law. This detailed statement and explanation shall be used by the County in making its determination as to whether disclosure is required under the law.

8.9 TERMINATION

When an award is made and an Agreement is executed with the awarded contractor, the County may, by written notice to the contractor, effective upon mailing, terminate the Agreement in whole or in part at any time (1) for the County’s convenience, (2) upon the failure of contractor to comply with any of the terms or conditions of the agreement, (3) upon the contractor becoming insolvent or bankrupt, and pursuant to the specific termination conditions set forth in the final Agreement.

Upon termination of the Agreement, the contractor shall comply with any and all County closeout procedures, including, but not limited to:

A. Accounting for and refunding to the County within thirty (30) days, any unexpended funds which have been paid to Contractor pursuant to this agreement; and

B. Furnishing within thirty (30) days an inventory to the County of all equipment, appurtenances and property purchased by contractor through or provided under the Agreement, and carrying out any County directive concerning the disposition thereof.

In the event the County terminates the Agreement, in whole or in part, as provided in this Article, the County may procure upon such terms and in such manner as deemed appropriate, services similar to those so terminated, and the contractor shall continue the performance of this Agreement to the extent not terminated hereby. If the Agreement is terminated in whole or in part for other than the convenience of the County, any services procured by the County to complete the Services herein will be charged to contractor and/or set off against any sums due to the contractor.

Notwithstanding any other provisions of the Agreement, the contractor shall not be relieved of liability to the County for damages sustained by the County by virtue of contractor’s beach of the Agreement or failure to perform in accordance with applicable standards, and the County may withhold payments to contractor for the purposes of set-off until such time as the exact amount of damages due to the County from the contractor is determined.

The rights and remedies of the County provided herein shall not be exclusive and are in addition to any other rights and remedies provided by law or by the Agreement.

Contractor shall not have any right to terminate this agreement for convenience. If Contractor violates same, Contractor shall remain obligated to the County for any and all reasonable costs and expenses incurred by the County in order to complete the services abandoned by the Contractor.

In the event of a default in payment by the County to the Contractor, the Contractor shall notify the County in writing of same within 60 days of the alleged default. The County shall have 30 days to dispute same and to pay over any amount due to Contractor at that time prior to any action by the Contractor to terminate the Agreement.

9. CONFLICTING TERMS

9.1 The requirements provided in the “specification” portion of these documents shall govern in any conflict with any other language provided in the general “Terms and Conditions” or any other boilerplate type information. Any conflict between the specification language and any boilerplate language will be resolved in favor of the specification language.

10. EXECUTORY CLAUSE:

10.1 Any contract offered in response to this RFP shall contain the following clause: “This Contract shall be deemed executory only to the extent of funds appropriated by the Lewis County Board of Legislators and available for the purposes of this Agreement; and no liability on account thereof shall be incurred by Lewis County beyond the amount of such funds.”

11. NO JOINT BIDS

11.1 Joint Bids will not be accepted. For purposes of the specifications, the term joint Bid shall include, but is not limited to, any Bid submitted jointly by two or more Contractors in the name of partnership, joint venture or other legal entity formed for the purpose of submitting such a Bid or to be formed for the purpose of entering into a contract pursuant to such Bid/RFP.

12. PAYMENTS UNDER CONTRACT AWARD:

12.1 Payment for services shall be following receipt of vendor claims and invoices in accordance with Lewis County accounting/payment practices. Any claim against the contractor may be deducted by the County from any money due him in the same or other transactions. In any case where a question of non-performance of a contract arises, payment may be withheld in whole or in part at the discretion of the County as compensation for any loss, damage, or cost incurred by the County as a result of said non-performance.

13. CONFLICTS OF INTEREST

13.1 In executing and submitting this Bid, the bidder represents and warrants that no person who is an elected official, officer, or employee of Lewis County, nor any person whose salary is payable, in whole or in part, by the County, or any corporation, partnership or association in which such official, officer or employee is directly interested, shall have a direct financial interest, in the contract to be awarded hereunder or in the proceeds thereof, unless such person completes and submits a Disclosure Form, on a form acceptable to the County, disclosing their interest or seeks a formal opinion from the Lewis County Ethics Board as to whether or not a conflict of interest exists. For a breach or violation of such representations or warranties, the County shall have the right to annul this Agreement without liability entitling the County to recover all monies paid hereunder and Contractor shall not make claim for, or be entitled to recover, any sum or sums otherwise due under any contract awarded hereunder.

14. IRANIAN ENERGY SECTOR DIVESTMENT:

14.1 Contractor hereby represents that said Contractor is in compliance with New York State General Municipal Law Section 103-g entitled “Iranian Energy Sector Divestment”, in that said Contractor has not: a. Provided goods and services of $20 Million or more in the energy sector of Iran including but not limited to the provision of oil or liquified natural gas tankers or products used to construct or maintain pipelines used to transport oil or liquified natural gas for the energy sector of Iran; or b. Acted as a financial institution and extended $20 Million or more in credit to another person for forty-five days or more, if that person’s intent was to use the credit to provide goods or services in the energy sector in Iran. Any Contractor who has undertaken any of the above and is identified on a list created pursuant to Section 165-a (3)(b) of the New York State Finance Law as a person engaging in investment activities in Iran, shall not be deemed a responsible Bidder pursuant to Section 103 of the New York State General Municipal Law. Except as otherwise specifically provided herein, every Contractor submitting a bid in response to this Request for Bids must certify and affirm that it is not on the list created pursuant to NYS Finance Law Section 165-1 (3)(b), as set forth on one of the required forms located at the end of this RFP.

BID PROPOSAL PAGE

REQUEST FOR PROPOSAL No. 2026-109

Lewis County 911 Tower Shelter Buildings HVAC Service and Maintenance

YOU MUST RETURN THIS SHEET WITH YOUR PROPOSAL

Service Year 1 _______________________________

Service Year 2 _______________________________

Service Year 3 _______________________________

Service Year 4 _______________________________

Service Year 5 _______________________________

S IGNATURE PAGE

REQUEST FOR PROPOSAL No. 2026-109

TO: Clerk of the Board, County of Lewis

THE UNDERSIGNED PROPOSES TO PROVIDE THE GOODS AND SERVICES required as set forth in the referenced Request for Proposal. If successful, the Bidder hereby agrees to furnish the goods and services in accordance with all terms, conditions and specifications contained within referenced Request for Proposal, at prices submitted in referenced specifications. I certify that I am authorized to sign this proposal, myself or on behalf of the company or firm I represent, and to enter into a binding contract with Lewis County. This signed proposal will become part of a binding contract after award by the Lewis County Legislature to the successful bidder.

NOTE: By signing and submitting the proposal form for consideration by the Lewis County Legislature, the Contractor acknowledges they have read, understood, and agree to all aspects of the specifications as presented without reservation or alteration.

Legal name of person/firm/corporation Authorized Signature/ Position

Address Typed Name

City/State/Zip Title

Date Telephone No. Fax No.

E-mail address

NON - COLLUSION FORM

No. 2026-109

By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, as to its own organization, under penalty or perjury, that to the best of his or her knowledge and belief:

1. The prices in this bid have been arrived at independently without collusion, consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor.

2. Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and

3. No attempt has been made or will be made by the bidder to induce any other person, partnership, or corporation to submit or not to submit, a bid for the purpose of restricting competition.

4. No person, broker or selling agent has been employed or retained by the bidder to solicit or secure this award upon an agreement or upon an understanding for a commission, percentage, a brokerage fee, contingent fee or any other compensation. The bidder further represents and warrants that no payment, gift or thing of value has been made, given or promised to obtain this or any other agreement between the parties.

In compliance with this invitation for bids, and subject to the conditions thereof, the undersigned offers and agrees, if this bid is accepted within forty-five (45) days from the date of opening, to furnish any and all of the items upon which prices are submitted.

Legal name of firm/corporation Authorized Signature

AFFIRMATION STATEMENT ON SEXUAL HARASSMENT

In compliance with State Finance Law § 139-l, the undersigned bidder hereby certifies and affirms under penalty of perjury:

By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bide each party thereto certifies as to its own organization, under penalty of perjury, that the bidder has and has implemented a written policy addressing sexual harassment prevention training to all of its employees. Such policy shall, at a minimum, meet the requirements of section two hundred one-g of the labor law.

Note: Pursuant to State Finance Law §139-l 3, if the Bidder cannot make the foregoing certification and, such bidder shall so state and shall furnish with the bid a signed statement which sets forth in detail the reasons, therefore.

YOU MUST RETURN THIS SHEET WITH YOUR BID

CO R P O R ATE AP P L I C A N T/ENTITY A T T E STATION OF

G OOD STA ND I N G

REQUEST FOR PROPOSAL

As a duly authorized official of the Applicant Entity identified below, I certify and attest that the following conditions are true and accurate:

The applicant is not currently the subject of an enforcement action related to an investigation by a State or Federal agency.

The applicant corporate entity is in good standing and is in compliance with required corporate filings.

YOU MUST RETURN THIS SHEET WITH YOUR BID

CERTIFICATION OF COMPLIANCE WITH THE IRAN

DIVESTMENT ACT

REQUEST FOR PROPOSAL

As a result of the Iran Divestment Act of 2012 the Office of General Service must develop a list of persons who are engaged in certain investment activities in Iran. Contracts cannot be awarded to persons or entities on that list, with some exceptions. All bidders are required to execute the following statement:

By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of its knowledge and belief that each bidder is not on the list created pursuant to Paragraph (b) of Subdivision 3 of Section 165a of the State Finance Law.

Corporate or Company Name

BY:

Signature

Title

NOTE: If the bidder cannot make the above certification, it shall so state and furnish with the bid a signed statement which sets forth in detail the reason for that.

RECEIPT OF ADDENDUM ACKOWLEDGMENT

No. 2026-109

ADDENDUM NO.

Please acknowledge the receipt of the above ADDENDUM issued by the County of Lewis, by signature and recording the date of receipt below.

Bidder:

Authorized Signatory: Date:

**NOTE: This form must be included in your bid documents if any Addendum is issued

NON - BIDDER’S RESPONSE

For the purpose of maintaining accurate Bidder’s lists and facilitating your firm’s response to our invitation for bid, the County of Lewis in interested in ascertaining reasons for prospective Bidder’s failure to respond to invitations for bids. If your firm is not responding to this bid, please indicate the reason(s) by checking any appropriate item(s) below and returning this form to the Lewis County Purchasing Director, 7660 North State Street, Lowville, New York 13367. This form may be returned by mail or fax. Faxes may be sent to 315-376-4917. Failure to submit either a bid proposal or return this form will result in removal of your firm’s name from our Bidder’s lists. Thank you for your cooperation.

We are not responding to this invitation for bid for the following reason(s)

Items or materials requested not manufactured by us or not available to our company.

Our items or materials do not meet specifications.

Specifications not clearly understood or applicable (too vague, too rigid, etc.)

Quantities too small.

Insufficient time allowed for preparation of bid.

Incorrect address used. Correct mailing address is:

Our branch/division handles this type of bid.

Correct name and mailing address is:

We are unable to bid but would like to continue to receive invitations for bids.

We are unable to bid and wish to be removed from the Bidder’s list.

Name Of Firm:

Mailing Address:

City/State/Zip Code

BY:

Signature of Representative

DATE:

Document Number: