27923 TSSCO Bd Package.pdf

DEPARTMENT OF

Washington State

ENTERPRISE SERVICES

EXHIBIT A-i — BIDDER’S CERTIFICATION

Competitive Solicitation: No. 27923— Raised Pavement Markers & Related Products

Contract Categories and N Category 1 — Standard Raised Pavement Markers

Subcategories for which U Subcategory A — Non-Reflective Bidder is submitting a Bid:

Check appropriate box(es) U Subcategory B — Reflective, uncoated

N Subcategory C — Reflective, abrasion resistant (4”x4”)

LI Subcategory D — Reflective, abrasion resistant

(3.2”x4.6”)

LI Subcategory E — Low Profile, reflective, abrasion resistant

LI Category 2— Recessed Pavement Markers

N Category 3—Temporary Flexible Raised Pavement Markers

N Category 4—Preformed Thermoplastic Options

U Subcategory A— Liquid hot Applied Thermoplastic

N Subcategory B — Pre-Formed Fused Thermoplastic with skid optics (white)

N Subcategory C — Pre-Formed Fused Thermoplastic with skid optics (yellow)

N Subcategory D — WA Low Speed Combo Arrow. Pre

Formed Thermoplastic with skid optics 13’4” tall x 3’4” wide

N Subcategory E — WA Low Speed turn arrow. Pre

Formed Thermoplastic with skid optics 8’ tall x 2’S” wide.

N Subcategory F WA Low Speed straight arrow. Pre

Formed Thermoplastic with skid optics 8’ tall x 2’6” wide.

N Subcategory 13- Bicycle symbol. Pre-Formed Thermoplastic with skid optics

N Subcategory H — Railroad crossing kis. PreOFormed Thermoplastic with skid optics

N Subcategory I — Pre-Formed Thermoplastic letter with skid optics.

EXHIBIT A-i — BIDDER’S CERTIFJCATIQN t 27923 RAIsER PAVEMENT MARKERS PAGE i (Rev 2023-12-12)

H Category 5—Adhesive

Bidder Traffic Safety Supply Company

• Type/print full legal name of Bidder

Bidder’s Address: 2324 SE Umatilla St Portland OR 97202 Type/print Bidder’s Address

Corporation: lDomestic EJForeign

Limited Liability Company (LLC): H Domestic H Foreign

Partnership: LDomestic LiForeign

Sole Proprietorship:

I

LI

Bidder Organization Type:

Check appropriate box * Note: A sole proprietorship is an unincorporated business owned and run by an individual with no distinction between the business and the owner. It is not a legal entity. It simply refers to a person who owns the business and is personally responsible for its debts and who pays personal income taxes on profits earned from the business. If you are a bidder who operates a business on your own, you automatically are a sole proprietor unless you have adopted a business structure (eg., corporation, LLC, partnership).

State of Formation for Oregon . Type/print the state where the corporation, LLC, or partnership is formed — e.g., Corp./LLC/Partnershlp : , . ,. .Washington if domestic and the name of the state if Foreign (le. not Washington)

State whether Bidder has been doing business under another name during the past five years:

Z Bidder has NOT done business H Bidder HAS done business

Doing Business Under under another name under another name

Another Name:

Check appropriate box If Bidder HAS done business under another name, provide the name(s) and addresses:

Name:

Address:

Bidder, through the duly authorized undersigned, makes this certification as a required element of submitting a responsive bid. Bidder certifies, to the best of its knowledge and belief that the following are true, complete, correct, and made in good faith:

1. UNDERSTANDiNG. Bidder certifies that Bidder has read, thoroughly examined, and fully understands all of the provisions in the Competitive Solicitation (including all exhibits) and the terms and conditions of the Contract and any amendments or clarifications to the Competitive Solicitation, and agrees to abide by the same.

2. AccuRAcy. Bidder certifies that Bidder has carefully prepared and reviewed its bid and fully supports the accuracy of the same. Bidder further understands and acknowledges that Enterprise Services shall not be responsible for any errors or omission on the part of Bidder in preparing its

PAGE 2EXHIBIT A-i — BIDDER’S CERTIFICATION #27923 RAIsER PAVEMENT MARKERS (Rev 2D23-T2-12) bid. Bidder further certifies that the facts declared here are true and accurate. Bidder further understands and acknowledges that the continuing compliance with these statements and all requirements of the Competitive Solicitation are conditions precedent to the award or continuation of the resulting Contract.

3. No COLLUSION, ANTI-COMPETITIVE PRACTICES, OR SHARING BID INFORMATION. Bidder certifies that Bidder has not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with this Competitive Solicitation. Bidder further certifies that Bidder’s bid prices have been arrived at independently, without engaging in collusion, bid rigging, or any other illegal activity, and without for the purpose of restricting competition any consultation, communication, or agreement with any other bidder or competitor relating to (a) those prices, (b) the intention to submit a bid, or (c) the methods or factors used to calculate the prices offered. Bidder further certifies that Bidder has not been and will not knowingly disclose its bid prices, directly or indirectly, to any other bidder or competitor before award of a Contract, unless otherwise required by law. Bidder further certifies that Bidder has made no attempt and shari not make any attempt to induce any other person or firm to submit or not to submit a bid for the purpose of restricting competition. Bidder, however, freely may join with other persons or organizations for the purpose of presenting a joint bid. Whether done directly or indirectly, communicating bid information with other bidders, collusion, or anti-competitive actions among bidders are prohibited. If there is evidence of such communication, collusion, or anti-competitive activities among bidders, Enterprise Services reserves the right to disqualify such bidders.

4. FIRM OFFER. Bidder certifies that its bid pertaining to the above-referenced Competitive Solicitation is a firm offer which cannot be withdrawn for a time period of ninety (90) days from and after the bid due date specified in the Competitive Solicitation. Enterprise Services may accept such bid, with or without further negotiation, at any time within such period, in the event of a protest, Bidder’s bid shall remain valid for such time period or until the protest and any related court action is resolved, whichever is later.

5. CoNFLICT OF INTEREST. Bidder certifies that, in preparing its bid, Bidder has not been assisted by any current or former employee of the State of Washington whose duties relate (or did relate) to this Competitive Solicitation or prospective Contract and who was assisting in other than the employee’s official, public capacity. Bidder further certifies that no such current or former public employee nor any member of such person’s immediate family have any financial interest in the outcome of Bidder’s bid.

6. No REIMBuRSEMENT. Bidder certifies that Bidder understands that the State of Washington will not reimburse Bidder for any costs incurred in the preparation of Bidder’s bid. All bids become the property of the State of Washington, and Bidder claims no proprietary right to the ideas, writings, items, or samples unless so stated in the bid.

7. PERFORMANCE. Bidder certifies that Bidder understands that its submittal of a bid and execution of this Bidder’s Certification certifies Bidder’s willingness to comply with the Contract, if awarded such. By submitting this bid, Bidder hereby offers to furnish the goods and/or services solicited pursuant to this Competitive Solicitation in compliance with all terms, conditions, and performance requirements contained in this Competitive Solicitation and the resulting Contract or, if applicable, as detailed on a Contract Issues List, if permitted, in this Competitive Solicitation.

8. iNSURANCE. Bidder certifies as follows (must check one):

EXHiBIT A-i — BIDDER’S CERTIFICATION #27923 RAISER PAVEMENT MARKERS PACE 3

BIDDER HAS REQUIRED INSURANCE. Bidder has attached a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract (Note: Bidder must attach the Insurance Certificate).

OR

E BIDDER WILL OBTA/N REQUIRED INSURANCE. Bidder does not have a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract but, if designated as an Apparent Successful Bidder, Bidder will provide such a Certificate of Insurance, without exception of any kind, to Enterprise Services within twenty-four (24) hours of such designation or notification by Enterprise Services or be deemed a nonresponsive bid.

OR

E BIDDER DOES NOT HAVE REQUIRED INsURANCE. As detailed on the attached explanation

(Bidder to provide below), Bidder does not have a current, valid Certificate of Insurance for each and all of the required insurance coverages as specified in the Contract and, if designated as an Apparent Successful Bidder would not be able to provide such a Certificate of Insurance to Enterprise Services within twenty-four (24) hours of such designation.

Bidder must state lawful basis as to why Bidder is NOT required to have listed insurance requirement

Note: The Contract requires proof that the awarded Contractor, unless exempt, has Worker’s Compensation Insurance and Employer’s Liability Insurance. Pursuant to Washington law, certain entities are not required to have Worker’s Compensation Insurance (e.g., entities with no employees). If, under Washington law, bidder is not required to have Worker’s Compensation

Insurance, Bidder must check the following and provide the lawful basis as to why bidder is not required to have Worker’s Compensation Insurance:

E BIDDER IS NOTREQUIRED TO HAVE WORKER’S COMPENSATION INSURANCE. Pursuant to

Washington law, bidder is not required to have Worker’s Compensation Insurance because:

Bidder must state lawful basis as to why Bidder is NOT required to have worker’s compensation Insurance

9. DEBARMENT. Bidder certifies as follows (must check one):

Z No DEBARMENT. Bidder and/or its principals are not presently nor has ever been debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from contracting with any federal, state, or local governmental entity within the United States.

OR

fl DEBARRED, As detailed on the attached explanation (Bidder to provide), Bidder and/or its principals presently are debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from contracting with a federal, state, or local governmental entity within the United States.

10. CRIMINAL OFFENCE. Bidder (including Bidder’s officers) certifies as follows (must check one):

EXHIBIT A-i — BIDDER’S CERTIFICATION tt 27923 RAISER PAVEMENT MARKERS PAGE 4

No CRIMINAL OFFENSE. Bidder has not, within the three (3) year period preceding the date of this Competitive Solicitation, been convicted or had a civil judgment rendered against Bidder for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a governmental contract;

violation of any federal or state antitrust statute; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. Bidder further certifies that it is not presently indicted or otherwise criminally or civilly charged by a governmental entity with commission of any of the offenses enumerated in this paragraph.

OR

D CRIMINAL Offense. As detailed on the attached explanation (Bidderto provide), within the three (3) year period preceding the date of this Competitive Solicitation, Bidder has been convicted or had a civil judgment rendered against Bidder for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a governmental contract; violation of any federal or state antitrust statute; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property.

11. WAGE THEFT PREVENTION. Ridder certifies as follows (must check one):

l No WAGE VIOLATIONS. Bidder has NOT been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and

Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, any provision of RCW 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced Competitive Solicitation date.

OR

D VI0LATI0NS0F WAGE LAWS. Ridder has been determined by a final and binding citation and notice of assessment issued by the Washington Department of Labor and

Industries or through a civil judgment entered by a court of limited or general jurisdiction to have willfully violated, as defined in RCW 49.48.082, a provision of

RCW 49.46, 49.48, or 49.52 within three (3) years prior to the date of the above-referenced Competitive Solicitation date.

12. CIvIL RIGHTS. Bidder certifies as follows (must check one):

COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS. Bidder complies with all applicable requirements regarding civil rights. Such requirements prohibit discrimination against individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

OR

D NON-COMPLIANCE WITH CIVIL RIGHTS REQUIREMENTS. Bidder does not comply with all applicable requirements regarding civil rights.

13. STATuToRY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. Bidder certifies as follows (must check one):

EXHIBIT A-i — BIDDER’S CERTIFICATION #27923 RAISER PAVEMENT MARKERS PAGES

Z COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES FOR STATE CONTRACTS. During the term of an awarded Contract, Bidder, including any subcontractor, shall not discriminate on the bases enumerated at RCW 49.60.530(3). Bidder, including any subcontractor, also shall give written notice of this nondiscrimination requirement to any labor organizations with which Bidder, or subcontractor, has a collective bargaining or other agreement. In addition, Bidder, including any subcontractor, shall cooperate with any Washington state agency investigation regarding any allegation that Bidder, including any subcontractor, engaged in prohibited discrimination set forth in RCW 49.60.530(3).

OR

LI NON-COMPLIANCE WITH STATUTORY NONDISCRIMINATION CLAUSES EOR STATE CONTRACTS.

Bidder does not comply with RCW 49.60.530.

14. WORKERS’ RIGHTS (EXECUTIVE ORDER 18-03). Bidder certifies as follows (must check one):

No MANDATORY INDIVIOUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WAIVERS

FOR EMPLOYEES. Bidder does NOT require its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

OR

D MANDATORY INDIVIDUAL ARBITRATION CLAUSES AND CLASS OR COLLECTIVE ACTION WA VERS FOR

EMPLOYEES. Bidder requires its employees, as a condition of employment, to sign or agree to mandatory individual arbitration clauses or class or collective action waivers.

15. CoNTRAcT TERMINATION FOR DEFAuur OR CAUSE. Bidder certifies as follows (must check one):

No TERMINA TION FOR DEFAULT0R CAuSE. Bidder has not, within the three (3) year period preceding the date of this Competitive Solicitation, had one (1) or more federal, state, or local governmental contracts terminated for cause or default.

OR

LI TERMINATION FOR DEFAULT OR CAUSE. As detailed on the attached explanation (Bidder to provide), within the three (3) year period preceding the date of this Competitive

Solicitation, Bidder has had one (1) or more federal, state, or local governmental contracts terminated for cause or default.

16. TAxES. Bidder certifies as follows (must check one):

TAxESPAI0. Except as validly contested, Bidder is not delinquent and has paid or has arranged for payment of all taxes due to the State of Washington and has filed all required returns and reports as applicable.

OR

LI DELINQUENT TAxES. As detailed on the attached explanation (Bidder to provide), Bidder has not paid or arranged for payment of all taxes due to the State of

Washington and/or has not timely filed all required returns and reports as applicable.

17. FINANcIALLY SOLVENT. Bidder certifies as follows (must check one):

EXHIBIT A-i — BIDDER’S CERTIFICATION #27923 RAISER PAVEMENT MARKERS PAGE 6 Rev 2023-12-12)

FINANCIALLY SOLVENT. Bidder is financially stable and solvent, has adequate cash reserves to meet all financial obligations, has not commenced bankruptcy proceedings voluntarily or otherwise, and is not subject to any judgments, liens, or encumbrances of any kind affecting title to any Goods or Services that are the subject of this Competitive Solicitation.

OR

D NOTFINANCIALLYSOL VENT. As detailed on the attached explanation (Bidder to provide), Bidder is not financially stable and solvent — i.e., Bidder does not have adequate cash reserves to meet all financial obligations, has commenced bankruptcy proceedings voluntarily or otherwise, or is subject to a judgment, lien, or encumbrance that affects title to the Goods or Services that are the subject of this Competitive Solicitation.

18. LAWFUL REGISTRATION. Bidder, if conducting business other than as a sole proprietorship certifies as follows (must check one):

CuRRENTLAwFuL REGISTRATION. Bidder is in good standing in the State of Washington and the jurisdiction where Bidder is organized, including having timely filed all required annual reports.

OR

U DELINQUENT REGISTRATION. As detailed on the attached explanation (Bidder to provide), Bidder currently is not in good standing in the State of Washington and/or the jurisdiction where Bidder is organized.

Note: This certification applies only to bidders who are organized as separate legal entities (e.g., a corporation, partnership, limited liability company). If bidder is a sole proprietor, this certification should not be answered and Bidder should check the following:

U SOLE PROPRIETOR. Bidder is a sole proprietor.

19. REGISTRATION WITH WASHINGTON SECRETARY OF STATE. Bidder certifies as follows (must check one):

BIDDER I5REGISTERED WITH WASHINGT0NSEcRETARY0FSTATE. Bidder is registered with the

Washington Secretary of State, is in good standing, and has the following Unified Business Identifier (UBI) number: : 409 014 202.

OR

LI BIDDER WILL REGISTER WITH WASHINGTON SECRETARY OF STATE. Bidder is not registered with the Washington Secretary of State but, if designated as the/an Apparent Successful Bidder, Bidder will register with the Washington Secretary of State to obtain a UBI number and provide proof of such registration satisfactory to Enterprise Services within twenty-four (24) hours of such designation or notification by Enterprise Services or be deemed a nonresponsive bid.

OR

U BIDDER Is NOT REGISTERED WITH WASHINGTONSECRETARY0FSTATE. Bidder is not registered with the Washington Secretary of State and Bidder declines to register with the Washington Secretary of State. Note: Enterprise Services requires all awarded bidders (including Washington firms and out of state firms) to be registered with the

ExHIB[T A-i — BIDDER’S CERTIFICATION #27923 RAIsER PAVEMENT MARKERS PAGE 7

Washington Secretary of State. Bidders who are not registered will not be awarded a Contract.

Note: This certification applies only to bidders that are organized as separate legal entities (e.g., a corporation, partnership, limited liability company). If bidder is a sole proprietor, this certification should not be answered and Bidder should check the following:

U SOLE PROPRIETOR. Bidder is a sole proprietor.

20. REGIsTRATIoN WITH WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder certifies as follows (must check one):

BIDDER IS REGISTERED WITH WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is registered with the Washington State Department of Revenue, has a business license to do business in Washington, and has the following Unified Business Identifier (UBI) number: 409 014 202.

OR

Li BIDDER WILL REGISTER WITH WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is not registered with the Washington State Department of Revenue but, if designated as the/an Apparent Successful Bidder, Bidder will register with the Washington State Department of Revenue for a business license and provide proof of such registration satisfactory to Enterprise Services within twenty-four (24) hours of such designation or notification by Enterprise Services or be deemed a nonresponsive bid.

OR

Li BIDDER IS NOT REGISTERED WITH WASHINGTON STATE DEPARTMENT OF REVENUE. Bidder is not registered with the Washington State Department of Revenue and Bidder declines to register with the Washington State Department of Revenue. Note: Enterprise

Services requires all awarded bidders (including Washington firms and out of state firms) to be registered with the Washington State Department of Revenue. Bidders who are not registered will not be awarded a Contract.

21. SUBcONTRACTORS. Bidder certifies as follows (must check one):

No SuBcoNTRAcToRs. If awarded a Contract, Bidder will not utilize subcontractors to provide the goods and/or services subject to this Competitive Solicitation.

OR

Li SuBCoNTRAcToRs. As detailed on Exhibit A-2 Bidder’s Profile, if awarded a Contract, Bidder will utilize subcontractors to provide the goods and/or services subject to this

Competitive Solicitation. In such event, Bidder further certifies that, as to the State of Washington, Bidder shall retain responsibility for its subcontractors, including, without limitation, liability for any subcontractor’s acts or omissions. Note: Bidder must provide the precise legal name (including state of organization), business address, and federal tax identification number (TIN) for each subcontractor. Note:

If the TIN is a SSN, do not provide the SSN.

22. WAsHINGToN SMALL BUSINESS. Bidder certifies as follows (must check appropriate boxes):

U WASHINGTON SMALL BUSINESS. Bidder is a Washington Small Business as defined in

RCW 39.26.010. To qualify as a Washington Small Business, Bidder must meet three

(3) requirements:

EXHIBIT A-i — BIDDER’S CERTIFICATION #27923 RAISER PAVEMENT MARKERS PAGE 8 (Rev 2O23-1212)

El Location. Bidder’s principal office/place of business must be located in and identified as being in the State of Washington. A principal office or principal place of business is a firm’s headquarters where business decisions are made and the location for the firm’s books and records as well as the firm’s senior management personnel.

El Size. Bidder must be owned and operated independently from all other businesses and qualify as one of the following:

El Bidder Qualifies as a Small Business — i.e., El Bidder has fifty (50) or fewer employees; or

El Bidder has an annual gross revenue of less than $7,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue over the previous three (3) consecutive years.

El Bidder Qualifies as a Minibusiness — i.e., Bidder has an annual gross revenue of less than $3,000,000, but $1,000,000 or more, as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

El Bidder Qualifies as a Microbusiness — i.e., Bidder has an annual gross revenue of less than $1,000,000 as reported on Bidder’s federal income tax return or its return filed with the Washington State Department of Revenue.

El WEBS Certification. Bidder must have certified its Washington Small Business status in Washington’s Electronic Business Solution (WEBS).

OR

NOT WASHINGTON SMALL BUSINESS. Bidder does not qualify as a Washington Small Business as set forth above.

23. CERTIFIED VETERAN-OWNED BUSINESS. Bidder certifies as follows (must check one):

LI CERTIFIED VETERAN-OWNED BUSINESS. Bidder is a Certified Veteran-Owned Business under RCW 43.6OA.190. To qualify as a Certified Veteran-Owned Business, Bidder must meet four (4) requirements:

51% Ownership. Bidder must be at least fifty-one percent (51%) owned and controlled by:

(a) A veteran as defined as every person who at the time he or she seeks certification has received a discharge with an honorable characterization or received a discharge for medical reasons with an honorable record, where applicable, and who has served in at least one of the capacities listed in

RCW 41.04.007;

EXHIBIT A-i — BIDDER’s cERTIFIcATION #27923 RAISER PAVEMENT MARKERS PAGE 9

(b) A person who is in receipt of disability compensation or pension from the department of veterans affairs; or

(c) An active or reserve member in any branch of the armed forces of the United States, including the national guard, coast guard, and armed forces reserves.

Washington Incorporation/Location. Bidder must be either an entity that is incorporated in the state of Washington as a Washington domestic corporation or, if not incorporated, an entity whose principal place of business is located within the State of Washington.

• WEBS Certification. Bidder must have certified its Veteran-Ovined Business status in Washington’s Electronic Business Solution

(WEBS).

• WDVA Certification. Bidder must have provided certification documentation to the Washington Department of Veterans’ Affairs WDVA) and be certified by WDVA and listed as such on WDVA’s website (WDVA — Veteran-Owned Businesses).

OR

NOT A CERTIFIED VETERAN-OWNED BUSINESS. Bidder does not qualify as a Certified

Veteran-Owned Business as set forth above.

24. REFERENcES. Bidder certifies that the references provided to Enterprise Services have worked with

Bidder and that such individuals and firms have full permission, without any additional requirement or release, to provide such references and information to Enterprise Services. Bidder hereby authorizes Enterprise Services (or its agent) to contact Bidder’s references and others who may have pertinent information regarding Bidder’s prior experience and ability to perform the

Contract, if awarded. Bidder hereby authorizes such individuals and firms to provide such references and release to Enterprise Services information pertaining to the same.

25. PRoMPT PAYMENT DISCOUNT. Bidder certifies as follows (must check one):

A’ BID PREFERENCE. Bidder is seeking a bid preference as set forth in the

Competitive Solicitation and guarantees to provide purchasers a ‘prompt payment discount’ in the amount of 1 % (no less than 1%) off of all purchases if payment is provided within ten (10) days of purchaser’s receipt of the invoice.

OR

C No Bio PREFERENCE. Bidder is NDT seeking a prompt payment discount bid preference.

26. AUTHORIzED DISTRIBUTOR. Bidder certifies as follows (must check one):

B/DOER ISANAUTH0RIZED DISTRIBUTOR. Bidder is a duly authorized distributor of all the manufacturer product lines stated in Exhibit C - Bid Price and, if awarded a Contract, Bidder shall remain an authorized distributor for the term of the Contract. A distributor agreement must be in full force and remain valid during the term of the Contract.

ExHEIT A-i — BIDDER’S CERTIFFCATION #27923 RAISER PAVEMENT MARKERS PAGE 10 lRev 2023-12-12)

OR

LI BIDDER Is NOTAN AUTHORIZED DISTRIBUTOR. Bidder is NOT a duly authorized distributor of all the manufacturer product lines stated in Exhibit C— Bid Price.

OR

LI BIDDER Is THE MANUFACTURER. Bidder is the manufacturer of all the manufacturer product lines stated in ExhibitC—Bid Price.

Bidder further certifies that it shall provide immediate written notice to Enterprise Services if, at any time prior to a Contract award, Bidder learns that any of its certifications set forth herein were erroneous when submitted or have become erroneous by reason of changed circumstances.

hereby certify, under penalty of perjury under the laws of the State of Washington, that the certifications herein are true and correct and that I am duly authorized to make these certifications on behalf of the Bidder listed herein.

TRAFFIC SAFETY SUPPLY COMPANY

BIDDER NAME:

Print Name of Bidder — Print full legal entity name of the firm submitting the Bid If Bidder is a sole proprietor, print t Illegal name of the individual who is the Bidder submitting the Bid

By:

Jeff Parson Signature of Bidder’s authorized person Print Name of person making certifications for Bidder

Title: President Place: Portland, OR Title of person signing certificate Print city and state where signed

Date: May 14, 2024

Return this Bidder’s Certification to Procurement Coordinator at:

DESCo ntractsTea mCedardes.wa .gov

EXHIBIT A-i — BIDDER’S CERTiFICATION #27923 RAISER PAVEMENT MARKERS PAGE 11 Rev 2023-12-12)

DEPARTMENT OF

Washington State

ENTERPRISE SERVICES

EXHIBIT A-2 — BIDDER’S PROFILE

Competitive Solicitation: No. 27923— Raised Pavement Markers & Related Products

Bidder Traffic Safety Supply Company

• Type/print full legal name of Bidder

BIDDER INFORMATION

Legal name of Bidder:

Traffic Safety Supply Company

Address of Bidder: Business Name

• 2324 SE Umatilla St Note: This information must match the information from Address

Bidder’s Business License. Portland, OR 97202 city, state, Zip code

Bidder’s Washington State Department of Revenue Registration Number/Unified Business Identifier (UBI) Number: 409014202 Note: A nine digit UBI number is assigned to each registered businesses in Washington.

Taxpayer Identification No. (TIN):

Note: Your TIN will be either a number issued by the IRS

(e.g., Employer Identification Number, Federal Tax 93-0500143 Identification Number) or a number issued by the Social Security Administration (i.e., your Social Security Number). Do Not provide a Social Security Number.

Is your firm certified as a minority or woman owned Yes El No business with the Washington State Office of Minority & If yes, provide Bidder’s MWBE Women’s Business Enterprises (OMWBE)? certification no.:

Is your firm a self-certified Washington State Small Yes El No Business?

If yes, provide the location for Bidder’s Note: See ExhibitA-1 — Bidder’s Certification for criteria principal place of business:

to qualify as a Washington State Small Business.

Note: Regardless of size, a qualifying business must be streetAddress owned and operated independently from all other . . city, State, Zip code businesses. In regard to size, the gross revenue

EXHIBIT A-2 — BIDDER’S PROFILE: 27923— RAIsED PAVEMENT MARKERS PAGE 1 (Rev 2023-05-15)

BIDDER INFORMATION

thresholds, as reported on Bidder’s tax returns, are as If yes, what is your business size (based follows:

on annual gross revenue)?

• Microbusiness: Annual gross revenue of less than Microbusiness Done million dollars.

• Minibusiness: Annual gross revenue of more than Minibusiness D one million dollars, but less than three million Small Business D dollars.

Small Business: Annual gross revenue of less than seven million dollars over each of the three prior consecutive years.

Is your firm certified as a Veteran-Owned Business with Yes D No the Washington State Department of Veteran Affairs?

If yes, provide Bidder’s WDVA Note: See ExhibitA-1 — Bidder’s Certification for criteria certification no.:

to qualify as a Certified Veteran-Owned Business.

ECONOMIC PRICE ADJUSTMENT— BIDDER’S COST BREAKDOWN

The resulting Contract for this Competitive Solicitation includes an economic price adjustment provision

(see Contract at section 3.3). The table set forth below includes the Producer Price Index (PPI) categories that will be utilized for applicable economic price adjustments.

Instructions: Bidders must complete the right-hand column by providing the percentage breakdowns which, if bidder is awarded a Contract, Enterprise Services will use to weight the various Indices used in the applicable economic price adjustment. The weighted percentage breakdown must total 100%.

ECONOMIC PRICE ADJUSTMENT COST BREAKDOWN

PERCENTAGE BREAKDOWN

DESCRIPTION PPI

(MUST EQUAL 100%)

Thermoplastic resins and plastic materials PCU3252113252111 95

Plastic material and resin manufacturing PCU325211325211

Rail Transportation PCU482---482--

Truck Transportation PCU4S4---484--- S

TOTAL 100

EXHIBIT A-2 — BIDDER’S PROFILE: 27923— RAIsED PAVEMENT MARKERS PAGE 2

C0NTRAC-1- MANAGEMENT POINTS OF CONTACT FOR BIDDER

Authorized Representative Contract Administrator

Name: Jeff Parson Name: Tammy Stonebrink Email: jparson@tssco.com Email: tstonebrink@tssco.com Phone: (800) 547-8518 Phone: (800) 547-8518

Sales Reporting Representative Sales Reporting Alternate

Name: Katie Abbott Name:

Email: kabbott@tssco.com Email Phone: (800) 547-8518 Phone:

Management Fee Representative Management Fee Contact Alternate

Name: Katie Abbott Name:

Email: kabbott(atssco.com Email:

Phone: (800) 547-8518 Phone:

Address for Enterprise Services to send management fee invoices:

Company name: Traffic Safety Supply Company

Attn: Katie Abbott Address: 2324 SE Umatilla St City/State/Zip: Portland, OR 97202

Address for Enterprise Services to send legal notices:

Company name: Traffic Safety Supply Company

Attn: Jeff Parson Address: 2324 SE Umatilla St

City/State/Zip: Portland, OR 97202

Signature Authority (if awarded a contract)

Name: Jeff Parson

Title: President

ORDERING/SALES POINTS OF CONTACT (expand as necessary)

Name Phone Number E-mail Area of Responsibility

Tammy Stonebrink (800) 547-8518 tstonebrink@tssco.co Key Account Manager m

PAGE 3ExHIBE A-2 — BIDDER’S PROFILE: 27923— RAISED PAVEMENT MARKERS

REFERENCES

Provide a minimum of three (3) commercial or government references for which bidder has delivered goods and/or services similar in scope as described in the Competitive Solicitation.

REFERENcE 1

Company Name: City of Eugene

Contact: Matt Chaney

Phone: (541) 682-4968

Email: mchaney(äeucene-orgov

REFERENCE 2

Company Name: Clackamas County

Contact: Sean iewett

Phone: (503) 650-3357

Email: siewetUclackarnas.us

REFERENCE 3

Company Name: Pierce County

Contact: Steve Martin

Phone: (253) 798-8005

Email: steve.martintUpiercecountywa.gov

WILL CALL/SERVICE LOCATIONS

Identify will call or service locations throughout the state.

LOCATION POINT OF CoNTACT PHONE NUMBER AREA(S) OF RESPONSIBILITY

Portland OR Tammy Stonebrink (800) 547-8518 Key Account Manager

PURCHASE CARDS (I.E., CREDIT CARDS)

Please indicate which types of purchasing (credit) cards are accepted (note: any card fees must be included in the unit price of the bid):

Visa Master Card American Express Discover D Dther:

SUBCONTRACTORS

Bidders who, if awarded a Contract, intend to utilize subcontractors to perform the Contract must identify such subcontractors.

Instructions: Bidders who, if awarded a Contract, intend to utilize subcontractors to perform the Contract must complete the table set forth below. Bidders who do NOT intend to utilize subcontractors to perform the Contract should check the box below:

EXHIBIT A-2 — BIDDER’S PRoFILE: 27923— RAIsED PAVEMENT MARKERS PAGE 4

Bidder does NOT intend to utilize subcontractors to perform the Contract. IXJ

SuBc0NTRACroRs (expand as necessary)

BUSINESS NAME UBI # TIN# FUNCTION PERFORMED BY SUBCONTRACTOR

Return this Bidder’s Profile to Procurement Coordinator at:

DESContractsTea rnCeda rdeswa .gov

ExHIBITA-2 — BIODER’s PROFILE: 27923— RAIsED PAVEMENT MARKERS PAGES (Rev 2023-OS-is)

EXHIBIT B – SPECIFICATIONS PAGE 1

EXHIBIT B – TECHNICAL AND ENVIRONMENTAL SPECIFICATIONS

Competitive Solicitation: 27923 Raised Pavement Markers & Related Products

Bidder: Traffic Safety Supply Company Type/print full legal name of Bidder company

Instructions:

1. Add Bidder’s business name above and follow the instructions below. Please note: Not following any of the instructions may result in the bid being deemed to be non-responsive.

2. Bidder Compliance. Review the Mandatory Specifications for Raised Pavement Markers & Related Products and, as appropriate, in the Bidder Compliance column, mark either ‘Yes’ or ‘No’ depending on whether Bidder’s products meet such specification. If Bidder is NOT submitting a bid for the specific category for such specification, mark ‘N/A.’ Bidders must mark a response for each specification. If any specification does not have a response in the Bidder Compliance column, the bid may be considered to be non-responsive.

3. Written Response. If a Bidder can offer an equivalent alternative solution to what a certain specification states, or if Bidder can only partially meet the stated specification, the Bidder must provide a written response that addresses how Bidder meets that specification in the Optional Written Response column.

4. Assessment.

a. Pass/Fail: Bidders must meet each of the Mandatory Minimum Specifications for Raised Pavement Markers & Related Products. If Bidder selects ‘No’ for any of these specifications, or if Bidder’s proposed alternative or partial solution (if applicable) is determined to be insufficient, the bid will be deemed to be non-responsive and the bid will be disqualified from further consideration.

b. In Bidder’s Written Response column, Bidder may provide a written response for any requirement marked ‘No.’ In addition, as applicable, Bidder must use this column to provide Qualified Product List (“QPL”) items (if applicable) and responsive information as directed in the Specifications.

5. Supporting Information. Enterprise Services may request additional information to help verify the information provided by Bidder in this exhibit. A Bidder’s failure to provide requested information to Enterprise Services within two (2) business days may result in disqualification.

6. Bidder’s Commitments. Please note that Bidder’s responses, as applicable, will be added to the resulting Contract. Accordingly, Bidders are cautioned to indicate commitments that they can meet throughout the term of the Contract. If a Bidder/Contractor is not able to honor these commitments throughout the Contract term, Bidder/Contractor may be subject to early Contract termination that could impact their ability to contract with State agencies in the future. Please see Exhibit D – Contract.

7. Submit the exhibit as a Microsoft Word document and without modifying the formatting. If you need to print out this document for any reason, please note this document is size Legal 8.5” x 14”.

EXHIBIT B – SPECIFICATIONS PAGE 2

REQ

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

1.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 1 – Standard Raised Pavement Markers: All subcategories Category 2 – Recessed Pavement Markers Category 3 –Temporary Flexible Raised Pavement Markers

GENERAL SPECIFICATIONS FOR RAISED PAVEMENT MARKERS:

Raised Pavement Markers shall be of uniform composition and free from surface irregularities, cracks, checks, chipping, peeling, spalling, crazing, and other physical damage interfering with appearance, application, or durability.

Raised Pavement Markers shall be precast in the form of a single based spheroidal segment terminating in a rounded or squared shoulder.

Raised Pavement Markers shall be white or yellow.

Raised Pavement Markers shall meet the following requirements*:

Property Unit Thermoplastic Markers Plastic Markers Mass Grams N/A 125 min.

Height Inches 0.65-0.75 0.65-0.78 Diameter/Width Inches 3.85-4.05 3.85-4.05 Shoulder height Inches 0.08-0.22 0.08-0.22 Planeness of base:

Concavity Inches 0.05 max. 0.05 max.

Reflectance (white only) %MgO 80 min. 80 min.

Impact resistance Inch-pound 15 min. 15 min.

Titanium Dioxide (white only) % by weight N/A 21 in.

*Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☒ Yes ☐ No ☐ N/A

EXHIBIT B – SPECIFICATIONS PAGE 3

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

2.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 1 – Standard Raised Pavement Markers: All subcategories Category 2 – Recessed Pavement Markers

SPECIFICATION*:

Except for Category 1 subcategory A (Non-Reflective), all Raised Pavement Markers in Category 1 and

Category 2 (all subcategories, except subcategory A): The Raised Pavement Marker housing shall contain reflective faces to reflect incident light from either a single or opposite directions

All Raised Pavement Markers in Category 1 and Category 2 (all subcategories): Raised Pavement Marker shall meet the requirements of ASTM D 4280 including Flexural strength requirements

*Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☒ Yes

3.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 1 – Standard Raised Pavement Markers:

SPECIFICATION*: Shall meet the requirements of ASTM D 4280 with the following additional requirement:

The coefficient of luminous intensity of the markers shall be measured after subjecting the entire lens surface to the test described in ASTM D 4280 Section 9.5 using a sand drop apparatus.

After the exposure described above, retroreflected values shall not be less than 0.5 times a nominal unblemished sample *Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☒ Yes

EXHIBIT B – SPECIFICATIONS PAGE 4

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

4.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 2 – Recessed Pavement Markers

SPECIFICATION*: Shall be extruded from high impact thermoplastic material which has been ultra-violet radiation stabilized and shall meet the following requirements:

Impact resistance 15 inch-lbs, min.

Reflectance (White Only) 80 percent min.

Concavity & Convexity

Transverse 1/16-inch, max.

Longitudinal 1/8-inch, max

Base Width 4″ Length 6″, 8″, 10″ or 12″ Height 0.60-0.75″ Shoulder height 0.08-0.20 The ends shall be beveled from the top of the shoulder edge at a slope of 1:1 nominal

*Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☐ Yes

☒ N/A

EXHIBIT B – SPECIFICATIONS PAGE 5

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

5.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 3 –Temporary Flexible Raised Pavement Markers

SPECIFICATION*:

The marker body shall be made from 0.060- inch minimum thick polyurethane.

The top of the vertical leg shall be between 1.75 and 2.0 inches high and shall be approximately

4 inches wide.

The base width shall be approximately 1.125 inches wide.

The base shall have a pressure sensitive adhesive material, a minimum of 0.125 inch thick with release paper.

The reflective tape shall be a minimum of 0.25 inch high by 4 inches wide. The reflective tape shall have a minimum reflectance of 3.5 candlepower per foot-candle for white and 2.5 candlepower per footcandle for yellow measured at 0.2-degree observation angle and 0-degree entrance angle.

*Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☒ Yes

EXHIBIT B – SPECIFICATIONS PAGE 6

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

6.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

• Category 4 - Preformed Thermoplastic Options: All subcategories

SPECIFICATION*:

• Type A – Liquid Hot Applied Thermoplastic o Must conform to the requirements of AASHTO M 249 and the following:

Resin – The resin shall be alkyd or hydrocarbon.

Retroreflectance – ASTM E1710 o Type B – Pre-Formed Fused Thermoplastic The material shall conform to AASHTO M 249, with the exception of the relevant differences for the materials being applied in the pre-formed state and the following:

• Resin – The resin shall be alkyd or hydrocarbon.

• Retroreflectance – ASTM E1710

*Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☒ Yes

7.

This Mandatory Specification applies to bids for the following contract categories/subcategories:

Category 5 – Adhesive

SPECIFICATION*:

Hot-Applied Bituminous Marker Adhesive

Type I – ASTM D4280 and D4383 Type II - Adhesive for Pavement Markers in the annexes of ASTM D4280 and D4383

Hot-Applied Flexible Pavement Marker Adhesive Type II - Meet or exceed specification for Asphalt (Bituminous) Adhesive for Pavement Markers

ASTM D4280 and D4383 *Items approved on the Qualified Product List (“QPL”) may be considered as meeting the specifications, at the discretion of the Washington State Department of Transportation. If Bidder compliance for meeting/exceeding any of the above specifications is based on Bidder’s item(s) being listed on the QPL, Bidder must list such item(s) being bid for evaluation in the right-hand column (Written Response).

☐ Yes

EXHIBIT B – SPECIFICATIONS PAGE 7

ID MANDATORY SPECIFICATIONS FOR RAISED PAVEMENT MARKERS & RELATED PRODUCTS

BIDDER

COMPLIANCE BIDDER’S WRITTEN RESPONSE

8.

This Mandatory Specification applies to bids for the following contract category:

Category 5 – Adhesive (Flexible Bituminous Adhesive for Pavement Markers)

SPECIFICATION: ADHESIVES MUST HAVE GREEN PRODUCT CERTIFICATION

Adhesives must meet at least one of the following green product certifications:

Cradle to Cradle Silver or higher Green Seal UL EcoLogo UL GREENGUARD Gold

Note: The UL Spot Database contains products certified to the UL Greenguard standard as well as UL Greenguard Gold standard, and ONLY products meeting the Gold standard meet the requirements of this specification.

Other: Bidder to include Other Certification Note: Any such other green product certification must be substantially similar to the certifications listed above.

Note: Bidder must identify the applicable green product certification(s) in the right-hand column (Bidder’s Written Response).

☐ Yes ☐ No

List the applicable certification(s):

Return this exhibit to Procurement Coordinator at:

DESContractsTeamCedar@des.wa.gov mailto:DESContractsTeamCedar@des.wa.gov