25-027 RFQ - One (1) Chevy Traverse.pdf

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VEHICLE – ONE (1) 2024 OR 2025 CHEVY TRAVERSE 2WD
Solicitation number
25-027
Issued by
Tulare County, California

About this file

This document is a Request for Quote (RFQ) 25-027 issued by the Tulare County Purchasing Agent in California for the procurement of one (1) new, unused 2024 or 2025 Chevrolet Traverse 2WD vehicle. The RFQ seeks sealed quotes to be submitted electronically through BidNetDirect by December 10, 2024 at 2:00 PM, with delivery of the vehicle to the Tulare County Motor Pool located at 14097 Avenue 256 in Visalia, CA. The vehicle specifications include 2WD configuration, 4-wheel ABS, Bluetooth, cloth seats, carpet with floor mats, standard AM/FM radio, tinted windows, cruise control, power windows and door locks, keyless entry, and three key fobs. The County reserves the right to award the quote based on vehicle availability and meeting specifications, and the quoted prices shall remain valid for 120 days after award.

The pricing structure includes the base unit price, documentation fee, electronic vehicle registration fee, and vehicle tire fee, with 7.75% California State Sales Tax to be added. The RFQ allows for potential participation by other governmental entities in the Central Valley Purchasing Group, which includes Fresno, Kern, Kings, and Tulare Counties, along with their political subdivisions and tax-supported agencies. Vendors must complete and submit several required forms, including a signature page, specifications, pricing sheet, and a debarment certification (Exhibit A). The County is exempt from federal excise tax, and the awarded vendor will be responsible for providing all necessary documents for vehicle registration with the California Department of Motor Vehicles.

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REQUEST FOR QUOTE

THIS IS NOT AN ORDER

COUNTY OF TULARE

Office of

PURCHASING AGENT

2637 W. Burrel Ave., Ste. 200

Visalia, CA 93291-4593

Quotes will be received by the Tulare County Purchasing Agent until 2:00 PM on December 10, 2024.

Please submit quote to https://www.bidnetdirect.com/california/countyoftulare

Delivery F.O.B. Tulare County Motor Pool ,14097 Avenue 256, Visalia, CA

NOTICE: Quote on each item separately unless instructions read otherwise. Attach complete specifications for any substitutions offered or when clarification is desirable or necessary. The right is reserved to reject any or all quotes.

VEHICLE – ONE (1) 2024 OR 2025 CHEVY TRAVERSE 2WD

The County of Tulare, through its Purchasing Agent, is hereby accepting sealed quotes for the purchase of VEHICLE – ONE (1) 2024 OR 2025 CHEVY TRAVERSE 2WD, NEW, UNUSED per specifications on the attached pages.

Prices as quoted shall exclude all federal excise tax. The County of Tulare is exempt and proper certifications will be issued upon request.

The awarded vendor will provide the County with all required documents for the vehicles to be registered with the California Department of Motor Vehicles.

AWARD: To award the quote on the basis of availability of vehicles meeting specifications.

THE SIGNATURE PAGE AND OTHER ATTACHMENTS BEGINNING ON PAGE 9 MUST BE

COMPLETED AND SIGNED BY THE BIDDER AND SUBMITTED WITH VENDOR’S QUOTE.

Date: November 27, 2024

Req. No. 25070RLS09

REFER TO QUOTE NO.

25-027

Cher Castellini Phone: 559-205-1100 https://www.bidnetdirect.com/california/countyoftulare

RFQ 25-027 VEHICLE –ONE (1) 2024 OR 2025 CHEVY TRAVERSE 2WD NEW, UNUSED

REQUEST FOR QUOTE

GENERAL CONDITIONS

FAILURE TO RESPOND TO QUOTE MAY CONSTITUTE REMOVAL FROM VENDOR’S LIST. If unable to provide the commodities stated herein, Vendor shall return quote PRIOR to closing date stating the reason why unable to provide quote.

1. PREPARATION OF QUOTES

A. All information requested of the Vendor shall be entered in the appropriate space(s) on the form.

Failure to do so may disqualify your offer.

B. All information shall be typewritten or entered in ink. Mistakes may be crossed out and corrections inserted before submission of your quote. Corrections shall be initialed in ink by the person signing the quote.

C. Corrections and/or modifications received after the closing time specified will not be accepted.

D. Quotes will not be accepted unless signed in ink (not typed) or electronically signed in the appropriate space(s) by an authorized officer or employee of the bidder.

E. Quotes must be submitted by the closing date prior to the time specified to be considered. Bids should be submitted electronically via https://www.bidnetdirect.com/california/countyoftulare . No email, telegraphic, facsimile or telephone bids will be accepted.

F. Any quotes received after the closing date will not be accepted.

G. All quote prices shall be Delivery F.O.B. Tulare County Motor Pool ,14097 Avenue 256, Visalia, CA

H. Quote prices shall remain open and valid subject to acceptance for sixty (60) days after quote closing date.

I. Prices quote SHALL remain firm for a minimum of 120 days after award to cover subsequent purchase requirements.

J. Prices quote by Vendor are considered accurate and cannot be withdrawn after the quote is closed.

K. Upon submission of quote documents, all such documents shall become the property of the County.

L. Time of delivery shall be stated as the number of calendar days following receipt of the order by the Vendor, to the receipt of the goods or services by the County. Time of delivery may be a consideration in the award.

M. Prices will be considered as net if no cash discount is shown.

N. Provide any other information not specifically requested which may be considered by the Purchasing Agent. (Purchasing Agent is not obligated to consider any information not specifically requested in this quote request.)

O. Tulare County generally solicits quotes from a wide variety of Vendors which may include retailers, wholesalers, suppliers, distributors, etc.

2. BRAND NAMES/QUALITY

A. Brand names and numbers, when used, are for reference to indicate the character or quality desired.

B. Equal items will be considered, provided your offer clearly describes the article. Offers for equal items shall state the brand and number (or level of quality if item cannot be identified by brand and number)

C. Equal items will not be considered if identical supply has been determined a necessity and the notation NO SUBSTITUTE has been entered.

D. When brand, number, or level of quality is not stated by the Vendor, it is understood the offer is exactly as specified.

E. The Purchasing Agent shall in all instances be the final judge in determining whether the items quoted are acceptable to the County, and whether the items quoted are equal in quality and utility to the specified articles.

3. QUANTITY & QUALITY OF MATERIALS OR SERVICES

The successful vendor shall furnish and deliver the quantities designated by the Purchasing Agent.

Packing slips which clearly identify the merchandise and a listing of the County of Tulare’s Purchase Order number must accompany every delivery. All materials, supplies or services furnished under contract or Purchase Order shall be in accordance with the county specifications. Materials or supplies which, in the opinion of the Purchasing Agent are not in accordance and conformity with such specifications shall be rejected and promptly removed from the County premises at the Vendor’s or contractor’s expense.

4. AWARD

The County of Tulare reserves the right: (1) to award quotes received on the basis of individual items or groups of items, or on the entire list of items; (2) to reject any or all quotes, or any part thereof; (3) to waive any informality in the quotes; and (4) to make partial awards or award to more than one vendor (if Vendor’s quote prices are based only on an “all or none” award, Vendor must so specify within the quote). The Purchasing Agent’s decision shall be final.

A combination of the following factors will be considered in awarding this quote.

A. Prices

B. Vendor’s previous records of performance and service

C. Ability of Vendor to render satisfactory goods or services in this instance

D. Quality and conformance to specifications

The County shall be the sole judge in making this determination.

5. RIGHTS TO REJECT QUOTE

The County of Tulare Purchasing Agent reserves the right to reject any and all quotes and to waive any informalities or irregularities in this quote.

6. TAXES

A. Tulare County is exempt from payment of Federal Excise Tax. No Federal Tax should be included in the price. Exemption Certificates will be furnished when applicable.

B. Unless otherwise definitely specified, the unit price stated herein does not include California State Sales Tax. Lump sum quotes for labor and materials shall include all applicable tax.

7. INDEMNIFICATION

A. The vendor or contractor shall hold the County of Tulare, its officers, agents, and employees harmless from liability of any nature or kind because of the use of any copyrighted composition, secret process, patented or unpatented invention, articles or appliances furnished or used under this quote, and agrees to defend, at Vendor’s own expense, any and all actions brought against the County of Tulare or Vendor because of the unauthorized use of such articles.

B. CONTRACTOR shall hold harmless, defend and indemnify the COUNTY, its agents, officers and employees from and against any liability, claims, actions, costs, damages or losses of any kinds, including death or injury to any person and/or damage to any property, including COUNTY property arising out of the acts or omissions of CONTRACTOR or its agents, officers and employees under this Contract. This indemnification specifically includes any claims that may be made against COUNTY by any taxing authority asserting that an employer-employee relationship exists by reason of this Contract, the cost of any penalty or sanction imposed by any agency with regulatory authority over the activities carried out by CONTRACTOR, and any claims made against COUNTY alleging civil rights violations by CONTRACTOR under Government Code sections 12920 et Seq. (California Fair Employment and Housing Act). CONTRACTOR specifically agrees to hold harmless and indemnify COUNTY for any and all claims arising out of any injury, disability, or death of CONTRACTORS’ employees or agents. This indemnification obligation shall continue beyond the term of this Contract as to any acts or omissions occurring under this Contract for any extension of this Contract.

8. INDEPENDENT CONTRACTOR STATUS

This contract is entered into by both parties with the express understanding that CONTRACTOR will perform all services required under this Contract as an independent contractor. Nothing in this Contract shall be construed to constitute the CONTRACTOR or any of its agents, employees or officers as an agent, employee or officer of COUNTY. CONTRACTOR agrees to advise everyone it assigns or hires to perform any duty under this Contract that they are not employees, agents or officers of COUNTY.

CONTRACTOR shall be solely responsible for determining the means and methods of performing the specified services and COUNTY shall have no right to control or exercise any supervision over CONTRACTOR as to how the services will be performed. As CONTRACTOR is not COUNTY’S employee, CONTRACTOR is responsible for paying all required state and federal taxes. In particular, COUNTY will not:

a. Withhold FICA (Social Security) from CONTRACTOR’S payments.

b. Make state or federal unemployment insurance contributions on CONTRACTOR’S behalf.

c. Withhold state or federal income tax from payments to CONTRACTOR.

d. Make disability insurance contributions on behalf of CONTRACTOR.

e. Obtain unemployment compensation insurance on behalf of CONTRACTOR.

Notwithstanding this independent contractor relationship, COUNTY, through the Purchasing Agent, shall have the right to designate the sites at which services are to be performed, and to monitor and evaluate the performance of CONTRACTOR to assure compliance with this Contract.

9. CASH DISCOUNTS

In connection with any cash discount specified on this quote, time will be computed from the date of complete delivery of the supplies or equipment as specified, or from the date correct invoices are received if the latter date is later than the date of delivery. For the purpose of earning the discount, payment is deemed to be made on the date of mailing of the County warrant or check.

10. DEFAULT BY VENDOR

A. Rights and remedies of County for default: In case of default by Vendor, the County may procure the articles or service from another source and may recover the loss occasioned thereby from any unpaid balance due the Vendor or by proceeding against the Vendor’s performance bond, if any, or by suit against the Vendor. The prices paid by the County shall be considered the prevailing market price at the time such purchase is made.

B. Inspection on deliveries or offers for delivery, which do not meet specifications, will be at the expense of Vendor.

11. CANCELLATION

The County of Tulare reserves the right to cancel all Purchase Orders or agreements with due cause giving a ten-day written notice or may cancel without cause giving a thirty-day written notice. Purchase Orders or agreements which extend into a subsequent fiscal year will automatically cancel if the Tulare County Board of Supervisors does not appropriate funds for the goods and/or services under the Purchase Order or agreement.

12. NON-FUNDING CLAUSE

Funds provided for commodities or services under the terms of this quote are contingent on availability of public funds. Should sufficient funds not be allocated during those terms, amounts due may be modified or terminated at any time by the County upon thirty (30) day notice. Notice shall be fully given in writing or through service in person or by first class mail.

13. RESPONSIBILITY FOR GOVERNMENT ENTITIES OTHER THAN COUNTY

Those governmental entities other than the County who are listed (or who have sub sequentially been included) have signified their intention to participate in the Tulare County agreement or purchase order resulting from this quote. Participation will not impose any responsibility for payment of claims or any responsibility whatsoever on the Tulare County Board of Supervisors or the County Purchasing Agent.

Each such governmental entity will be billed separately, and payments will be made by warrants drawn on the appropriate funds for the governmental entity.

14. INFORMATION

Information regarding the results of any quote may be obtained at the Tulare County Purchasing

Department, 2637 W. Burrel Ste. 200, Visalia, CA 93291 for a period of ninety (90) days from the due date of the quote. Quote tabulations will be made available for review five (5) business days after quote opening date and can be obtained from the Purchasing Department clerical staff.

15. SPECIAL CONDITIONS

Special Conditions attached hereto, supersede the General Conditions to the extent of any inconsistency between them.

16. DEBARMENT

Contractor guarantees that it, its employees, contractors, subcontractors or agents (collectively “Contractor”) are not suspended, debarred, excluded, or ineligible for participation in Medicare, Medi- Cal or any other federal state funded health care program, or from receiving Federal fund as listed in the List of Parties Administration. Contractor must within 30 calendar days advise the County if, during the term of this Agreement, Contractor becomes suspended, debarred, excluded, or ineligible for participation in Medicare, Medi-Cal or any other federal or state funded health care program, as defined by 42. U.S.C. 1320a-7b(f), or from receiving Federal funds as listed in the List of Parties Excluded from Federal Procurement or Non-procurement Programs issued by the Federal General Services Administration. Contractor will indemnify, defend and hold the County harmless for any loss or damage resulting from the conviction, debarment, exclusion or ineligibility of the Contractor.

See Exhibit A, attached with instructions and signature page that must be signed and submitted with this Quote.

17. RUSSIAN SANCTIONS/EXECUTIVE ORDER N-6-22 - NOTICE TO ALL COUNTY

CONTRACTORS, SUPPLIERS AND GRANTEES (POTENTIAL AND EXISTING)

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding.

sanctions in response to Russian aggression in Ukraine. The EO is located at https://www.gov.ca.gov/wp- Content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf.

The EO directs all agencies and departments that are subject to the Governor’s authority to take certain immediate steps, including notifying all contractors and grantees of their obligations to comply with existing economic sanctions imposed by the U.S. government in response to Russia's actions in Ukraine, as well as any sanctions imposed under state law.

This correspondence serves as a notice under the EO that as a contractor or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury website (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-andcountryinformation/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants, as applicable.

As a reminder, agreements with the County of Tulare include portions which require compliance with all local, state, and federal laws and directives which includes Executive Orders (EO) such as the EO discussed here. The EO may not apply to or effect your agreement with the County. Please reach out to our department in order to seek clarification should you have any questions.

Please note that for any agreements or grants valued at $5 million or more, a separate notification will be sent outlining additional requirements specified under the EO. Russian Sanctions N-6-22 can be viewed at https://tularecountycounsel.org/main/contract-exhibits/.

https://www.gov.ca.gov/wp-Content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://www.gov.ca.gov/wp-Content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-andcountryinformation/ukraine-russia-related-sanctions https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-andcountryinformation/ukraine-russia-related-sanctions

18. TULARE COUNTY WORKPLACE VIOLENCE PREVENTION POLICY:

CONTRACTOR shall comply with the terms and conditions of The Tulare County Workplace Violence Prevention Policy which by this reference is made a part of this Bid. Workplace Violence Prevention Policy can be viewed at https://tularecountycounsel.org/main/contract-exhibits/.

[Intentionally left blank below] https://tularecountycounsel.org/main/contract-exhibits/ https://tularecountycounsel.org/main/contract-exhibits/

DEALER REQUIREMENTS

1. SAFETY REQUIREMENTS – All units shall comply with all rules and regulations: CVC (California

Vehicle Code).

2. WHEEL ALIGNMENT – The successful Vendor shall accomplish a wheel alignment check and adjustment for camber, caster toe-in on all vehicles prior to delivery. Certification of Compliance to be furnished on delivery.

3. FUEL – All units shall be delivered with a minimum of ¼ tank of gasoline, and all other fluid reservoirs to standard fill level.

4. ALL EQUIPMENT AND ACCESSORIES CATALOGED AS STANDARD SHALL BE FURNISHED.

A line set ticket showing all options installed on the vehicle shall be furnished with each vehicle at the time of delivery.

5. VEHICLES SHALL BE DEALER SERVICED READY FOR USE. Included shall be standard factory established engine operation and tuning adjustments transmission linkage properly and adjusted for shifting responses, body and chassis components tightened and operating smoothly, all checked for designed operational limits, exterior washed and paint defects corrected, interior trim, upholstery and hardware neatly affixed.

6. THE PRICES AS QUOTE SHALL APPLY TO ANY LIKE ADDITIONAL UNITS WHICH THE COUNTY

OF TULARE MAY DESIRE TO ORDER FOR A PERIOD OF THIRTY (30) DAYS AFTER THE DATE

OF ORIGINAL ORDER PLACEMENT.

7. Delivery F.O.B. Tulare County Motor Pool ,14097 Avenue 256, Visalia, CA

THE ATTACHED FORMS PACKET MUST BE COMPLETED AND SUBMITTED*:

1. SIGNATURE PAGE

2. SPECIFICATIONS

3. PRICING

4. EXHIBIT A, DEBARMENT CERTIFICATION

**NOTE: FAILURE TO SUBMIT THE ABOVE-MENTIONED ITEM AND QUOTE FORM

SHALL CAUSE VENDOR TO BE NON-RESPONSIVE.

FORMS

Signature Page

BIDDER TO COMPLETE THIS PAGE

PARTICIPATION

The County is currently a member of the Central Valley Purchasing Group which consists of Fresno, Kern, Kings and Tulare Counties, and the Political Subdivision, Municipalities and Tax Supported Agencies within these County boundaries. Whenever possible, these entities wish to co-op (piggy-back) on existing bids. Please state if your quote will or will not be extended to these entities under the same terms and conditions as stated in this quote.

Select YES or NO.

YES NO

Undersigned agrees to furnish the commodities and/or services as stipulated in this Request for Quote at the prices, terms, and conditions stated. Complete delivery will be made within ________ calendar days after receipt of order. A cash discount of _____%_____days will apply. Thirty (30) days minimum period considered for award purposes.

Signed By:

Print Name:

Company:

Address:

County:

City:

State:

Zip:

Phone

No:

Title:

Date:

Email Address:

Note: This signature page must be turned in with your Quote

SPECIFICATIONS

VEHICLE – ONE (1) 2024 OR 2025 CHEVY TRAVERSE 2WD, NEW, UNUSED

2024 or 2025 Chevrolet Traverse 2 WD –

STATE COMPLIANCE/

and/or SPECIFICATIONS:

2024 or 2025. Please specify:

2WD

4Wheel ABS

Extra key (3) key fobs

Bluetooth

Cloth Seats

Carpet with floor mats

Standard AM/FM radio

Tinted Windows

Cruise Control

Power Windows and Door Locks

Keyless entry

Interior Color - Gray or Black

Exterior Color – Sterling Silver, Lakeshore Blue or Mosaic Black

Extra Keys 3 key and fobs

F.O.B. Tulare County Motor Pool ,14097 Avenue 256, Visalia, CA

PRICING:

VEHICLE – ONE (1) 2024 CHEVY TRAVERSE 2WD, NEW, UNUSED

UNIT PRICE: $ x 1 = $

Documentation Fee: $ x 1 = $

Electronic Vehicle Registration Fee (non-taxable) $ x 1 = $

Vehicle Tire Fee (non-taxable) $ x 1 = $

Sub-Total

7.75% California State Sales Tax $

GRAND TOTAL $

VEHICLE – ONE (1) 2025 CHEVY TRAVERSE 2WD, NEW, UNUSED

UNIT PRICE: $ x 1 = $

Documentation Fee: $ x 1 = $

Electronic Vehicle Registration Fee (non-taxable) $ x 1 = $

Vehicle Tire Fee (non-taxable) $ x 1 = $

Sub-Total

7.75% California State Sales Tax $

GRAND TOTAL $

EXHIBIT A

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER

RESPONSIBILITY MATTERS-–PRIMARY COVERED TRANSACTIONS

INSTRUCTIONS FOR CERTIFICATION

1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below.

2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction.

3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default.

4. The prospective primary participant shall provide immediate written notice to the department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations.

6. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction.

7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary

Exclusion-Lower Tier Covered Transaction”, provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the List of Parties Excluded from Federal Procurement and Nonprocurement Programs.

9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default.

CERTIFICATION

(1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals:

(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency.

(b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(c) Are not presently indicated 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 (1)(b) of this certification; and

(d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default.

(2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

Signature Date

Printed Name & Title Name of Agency or Company

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