3-03 - Exhibit A - 33-203.pdf

PDF 214 KB Posted

Attached to
McKinney Urban Transit District – Shared Ride/On-Demand Service
Solicitation number
2098066
Issued by
Dallas County, Texas

About this file

Summary

This is an Exhibit A Representations and Certifications form for a federally assisted supply/service contract issued by the Dallas Area Rapid Transit Authority (DART) under Solicitation No. 2098066. The form applies to a contract opportunity with the McKinney Urban Transit District (MUTD) for a turnkey Software as a Service (SaaS) solution to manage the operations of a shared ride/on-demand service. Offerors must complete and return this representations and certifications form with their offer. The document does not specify quantities, response dates, due dates, site visits, bidders' meetings, award dates, or contract term information, as these details would be contained in other solicitation documents.

The form requires offerors to make representations regarding affirmative action compliance, contingent fees, gratuities, disadvantaged business enterprise (DBE) status, public official conflicts of interest, parent company ownership, previous contract participation, and business type. Offerors must also provide certifications addressing Buy America/Build America compliance, board member and employee restrictions, Davis-Bacon Act eligibility, independent price determination, non-segregated facilities, lobbying restrictions, debarment status, environmental compliance, communications policies, conflict of interest, energy company boycotts, Israel boycotts, firearm entity discrimination, DBE goals compliance, and drug-free workplace programs. The form contains no information regarding pricing terms, set-asides, incumbent contractors, funding sources, or contract amounts.

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Text version

Solicitation No. 2098066

Form 33.203 (05/25) Page 1 of 10 Exhibit A

DALLAS AREA RAPID TRANSIT AUTHORITY

EXHIBIT A

REPRESENTATIONS AND CERTIFICATIONS

(FEDERALLY ASSISTED SUPPLY/SERVICE CONTRACT)

** NOTE: THIS FORM MUST BE COMPLETED AND RETURNED WITH THE OFFER **

TABLE OF CONTENTS

REPRESENTATIONS

1. Affirmative Action Compliance (A-107, JAN 94)

2. Contingent Fee (A-103, AUG 02)

3. Covenant Against Gratuities (A-105, JAN 94)

4. Disadvantaged Business Enterprise (DBE) (A-102, NOV 99)

5. Interest of Public Officials (A-104, JAN 94)

6. Parent Company and Identifying Data (A-108, JAN 05)

7. Previous Contracts and Compliance Reports (A-106, JAN 94)

8. Type of Business (A-101, DEC 04)

CERTIFICATIONS

9. Buy America/Build America (BABA) Compliance (A-132, MAY25)

10. Certificate Concerning Board Members and Employees of the Authority (A-116, MAY 22)

11. Certification of Eligibility (A-118, JAN 94)

12. Certification of Independent Price Determination (A-109, JAN 94)

13. Certification of Non-Segregated Facilities (A-113, JAN 94)

14. Certification of Restrictions on Lobbying (A-114, NOV 04)

15. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion (A-126, NOV 12)

16. Clean Air and Water Certification (A-112, JAN 94)

17. Communication Policy and Certification (A-129, FEB 19)

18. Conflict of Interest Certification (A-117, JAN 94)

19. Contractor Certification Regarding Boycotting Certain Energy Companies (A-133, MAY25)

20. Contractor Certification Regarding Boycotting Israel (A-131, DEC 18)

21. Contractor Certification Regarding Discrimination Against Firearm Entity or Firearm Trade Association (A-134, MAY25)

22. Disadvantaged Business Enterprise Goals (A-110, APR 04)

23. Drug-Free Workplace Program Certification (3-803.03, OCT 24)

REPRESENTATIONS

1. Affirmative Action Compliance (A-107, JAN 94)

(a) The offeror represents as part of its offer that it has a workforce of (# of employees):

(b) It (Mark one with an "X"):

has developed and has on file has not developed and does not have on file at each establishment, affirmative action programs required by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or it (Mark one with an "X"):

has has not previously had contracts subject to the written affirmative action programs requirement of the rules and regulations of the Secretary of Labor.

Form 33.203 (05/25) Page 2 of 10 Exhibit A

2. Contingent Fee (A-103, AUG 02)

Except for full-time bona fide employees working solely for the offeror, the offeror represents as part of its offer that it (Mark one with an "X"):

has has not employed or retained any company or persons to solicit or obtain this contract, and (Mark one with an "X"):

has has not paid or agreed to pay any person or company employed or retained to solicit or obtain this contract any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.

3. Covenant Against Gratuities (A-105, JAN 94)

The offeror represents as part of its offer that neither it nor any of its employees, representatives or agents have offered or given gratuities (in the form of entertainment, gifts or otherwise) to any director, officer or employee of the Authority with the view toward securing favorable treatment in the awarding, amending, or the making of any determination with respect to the performing of the contract. See the General Provisions Clause entitled "Interest of Public Officials."

4. Disadvantaged Business Enterprise (DBE) (A-102, NOV 99)

The offeror represents as part of its offer that it (Mark one with an "X"):

is is not a disadvantaged business enterprise (DBE). A DBE is defined as "a for-profit small business concern which is at least 51 percent owned by one or more socially and economically disadvantaged individuals, or in case of any publicly owned business, at least 51 percent of the stock is owned by one or more socially and economically disadvantaged individuals and whose management and daily business operations are controlled by one or more of the socially and economically disadvantaged individuals who own it." For purposes of this definition, socially and economically disadvantaged individuals include Black Americans, Hispanic Americans, Asian-Pacific Americans, Subcontinent Asian Americans, Native Americans; women; and any additional groups whose members are designated as socially and economically disadvantaged by the Small Business Administration (SBA), at such time as the SBA designation becomes effective.

5. Interest of Public Officials (A-104, JAN 94)

The offeror represents and warrants that no employee, official, or member of the Board (Executive Committee) of the Authority is or will be pecuniarily interested or benefited directly or indirectly in this contract.

6. Parent Company and Identifying Data (A-108, JAN 05)

(a) The offeror represents as part of its offer that it (Mark one with an "X"):

is is not owned or controlled by a parent company. A parent company, for the purpose of this provision, is one that owns or controls the activities and basic business policies of the offeror. To own the offering company means that the parent company must own more than 50 percent of the voting rights in that company. A company may control an offeror as a parent even though not meeting the requirements for such ownership if the company is able to formulate, determine, or veto basic policy decisions of the offeror through the use of dominant minority voting rights, use of proxy voting, or otherwise.

(b) If the offeror is not owned or controlled by a parent company, it shall insert its own Employer's Identification

Number below:

Form 33.203 (05/25) Page 3 of 10 Exhibit A

(c) If the offeror is owned or controlled by a parent company, it shall enter in the blocks below the name and main office address of the parent company, and the parent company's Employer's Identification Number.

NAME OF PARENT COMPANY AND MAIN OFFICE ADDRESS

(include ZIP and phone): PARENT COMPANY'S EMPLOYER'S IDENTIFICATION #:

7. Previous Contracts and Compliance Reports (A-106, JAN 94)

(a) The offeror represents as part of its offer that it (Mark one with an "X"):

has has not participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this solicitation, the clause originally contained in Section 310 of Executive Order Number 10925, or the clause contained in Section 201 of Executive Order Number 11114; and

(b) It (Mark one with an "X"):

has has not filed all required compliance reports.

(c) Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained before subcontractor awards.

8. Type of Business (A-101, DEC 04)

(a) The offeror represents as part of its offer that it operates as (Mark one with an "X"):

an individual a sole proprietorship a partnership a corporation another entity ________________________.

(b) If incorporated, under the laws of the State of:

(c) Age of the firm: ____ years, ____ months

(d) Previous year’s annual gross receipts:

less than $500K $500K - $2 mil. $2 mil. - $5 mil. more than $5 mil.

Form 33.203 (05/25) Page 4 of 10 Exhibit A

CERTIFICATIONS

9. Buy America/Build America (BABA) Compliance (A-132, MAY25)

The Contractor certifies that all work performed under this contract complies with the provisions and certifications required by FAR 25.1101, Acquisition of Supplies, FAR 25.1102, Acquisition of Construction, and FAR 25.1103, Other Provisions and Clauses, including but not limited to, the requirements and certifications of the Buy America/Build America (BABA) included with the Infrastructure and Investment Jobs Act (IIJA), dated November 2021.

SIGNATURE BLOCK FOR ALL

REPRESENTATIONS & CERTIFICATIONS

NAME OF OFFEROR & ADDRESS (Include ZIP & phone)

OFFERORS MUST SET FORTH FULL, ACCURATE AND

COMPLETE INFORMATION AS REQUIRED BY THIS

SOLICITATION (INCLUDING THIS ATTACHMENT).

FAILURE TO DO SO MAY RENDER THE OFFER

NONRESPONSIVE OR UNACCEPTABLE.

A FALSE STATEMENT IN ANY OFFER SUBMITTED

TO THE AUTHORITY MAY BE A CRIMINAL

OFFENSE IN VIOLATION OF SECTION 37.10 OF

THE TEXAS PENAL CODE.

Signature: Date:

TYPE NAME:

10. Certificate Concerning Board Members and Employees of the Authority (A-116, MAY 22)

The Dallas Area Rapid Transit Authority (DART) has adopted Rules of Procedure for DART Board members and DART personnel policies for employees that prohibit their participation in contractual or employment relationships for certain periods after their relationship with DART ends. These prohibitions may be found in Board Resolution No.

190033, approved March 12, 2019, and the relevant DART personnel policy, respectively. These restrictions also apply to the spouses of former Board members and former employees.

For former Board members, the prohibition is for a period of two years following the end of the member's term or the date of his/her resignation, and applies to participation as a principal in a DART contract or first-tier subcontract, or as an employee of a DART contractor or first-tier subcontractor. For former DART employees, the prohibition is for one year after leaving DART, and relates to participation in any contract or employment relationship that results in an assignment to work on any DART project for which the employee had significant responsibilities. (A copy of Board Resolution No. 190033 and the relevant DART personnel policy may be obtained from the DART Contracting Officer.)

The Board of Directors may waive the above prohibitions, by a two-thirds vote, for a particular person and/or relationship if it determines that it is in the best interest of DART to do so.

(a) By submission of this offer the offeror hereby certifies that, to the best of his/her knowledge and belief, with the exception of any information described in this certification or attached hereto, the offeror has no information concerning a violation or possible violation of the DART Board Rules of Procedures as established in Resolution No. 190033, approved March 12, 2019, or the above DART personnel policy for former employees, which would result if the Authority awards a contract based upon this offer.

Form 33.203 (05/25) Page 5 of 10 Exhibit A

(b) Violations or possible violations. (Continue on plain bond paper and label Certificate Concerning Former Board Member and Employees of the Dallas Area Rapid Transit Authority, Continuation Sheet.) CHECK "NONE" IF NONE

EXISTS.

NONE

(Please make entry in this space if applicable)

VIOLATIONS OR POSSIBLE VIOLATIONS:

(c) This certification concerns a material representation of fact upon which reliance will be placed in awarding a contract. If it is later determined that the offeror knowingly rendered an erroneous certification, in addition to any other remedies the Authority may have, the Contracting Officer may terminate the contract resulting from this solicitation for default and/or recommend that the offeror be debarred or suspended from doing business with the Authority in the future in accordance with the procedures set forth in the DART Procurement Regulations.

(d) The offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, he/she learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(e) The offeror further agrees by submitting this bid/offer that it will include this Certificate, without modification, in all first-tier subcontracts. The offeror shall be responsible for compliance by any first-tier subcontractor with the provisions set forth in this Certificate.

11. Certification of Eligibility (A-118, JAN 94)

(a) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(b) No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(c) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001.

12. Certification of Independent Price Determination (A-109, JAN 94)

(a) By submission of this offer, the offeror certifies, and in the case of a joint offer, each party thereto certifies as to its own organization, that in connection with this procurement:

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

(2) Unless otherwise required by law, the prices which have been quoted in this offer have not been knowingly disclosed by the offeror and will not knowingly be disclosed by the offeror prior to the opening (in the case of an advertised procurement) or prior to award (in the case of a negotiated procurement), directly or indirectly to any other offeror or to any competitor; and

(3) No attempt has been made or will be made by the offeror to induce any other person or firm to submit or not to submit an offer for the purpose of restricting competition.

Form 33.203 (05/25) Page 6 of 10 Exhibit A

(b) Each person signing this offer certifies that:

(1) He is the person in the offeror's organization responsible within that organization for the decision as to the prices being offered herein and that he has not participated, and will not participate, in any action contrary to (a)(1) through (a)(3) above; or

(2) He: (i) is not the person in the offeror's organization responsible within that organization for the decision as to the prices being offered herein but that he has been authorized in writing to act as an agent for the persons responsible for such decision in certifying that such persons have not participated, and will not participate, in any action contrary to (a)(1) through (a)(3) above, and as their agent does hereby so certify;

and (ii) has not participated, and will not participate, in any action contrary to (a)(1) through (a)(3) above.

13. Certification of Non-Segregated Facilities (A-113, JAN 94)

(a) By the submission of this offer, the offeror certifies that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location under its control, where segregated facilities are maintained.

(b) The offeror agrees that a breach of this certification is a violation of the Equal Opportunity Clause in the contract.

(c) As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees that are segregated by explicit directive or are in fact segregated on the basis of race, color, religion or nation origin, because of habit, local custom or otherwise.

(d) It further agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will:

(1) obtain identical certifications from proposed subcontractors before the award of subcontracts under which the subcontractor will be subject to the Equal Opportunity clause;

(2) Retain such certifications in its files; and

(3) Forward the following notice to the proposed subcontractors (except if the proposed subcontractors have submitted identical certifications for specific time periods).

NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENTS FOR CERTIFICATIONS OF

NONSEGREGATED FACILITIES

A Certification of Nonsegregated Facilities must be submitted before the award of a subcontract under which the subcontractor will be subject to the Equal Opportunity clause. The certification may be submitted either for such subcontract or for all subcontracts during a period (i.e., quarterly, semiannually or annually).

Note: the penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.

14. Certification of Restrictions on Lobbying (A-114, NOV 04)

This Certification is applicable if the offer exceeds $100,000.

(a) By submission of this offer, the offeror certifies, to the best of his or her knowledge or belief, that:

(1) No Federal appropriated funds have been paid, or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, or the entering into of any cooperative agreement; and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

Form 33.203 (05/25) Page 7 of 10 Exhibit A

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form- LLL, Disclosure of Lobbying Activities, in accordance with its instructions [as amended by “Government-wide Guidance for New restrictions on Lobbying,” Fed. Reg. 1413 (1/19/96)].

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

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

15. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion (A-126, NOV 12)

(a) Primary Covered Transactions. [This certification applies to the offer submitted in response to this solicitation and will be a continuing requirement throughout the term of the prime contract.]

(1) In accordance with the provisions of Appendix A to 49 Code of Federal Regulations (CFR) Part 29, the offeror certifies to the best of its knowledge and belief, that it and its principals:

(i) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;

(ii) Have not within a three-year period preceding this offer 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 statutes, or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(iii) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(ii) of this Certification; and

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

(2) Where the offeror is unable to certify to any of the statements in this certification, the offeror shall attach an explanation to this offer.

(b) Lower Tier Covered Transactions. [This certification applies to a subcontract at any tier expected to equal or exceed $25,000 and will be a continuing requirement throughout the term of the prime contract.]

(1) In accordance with the provisions of Appendix B to 49 Code of Federal Regulations (CFR) Part 29, the prospective lower tier participant (subcontractor) certifies, by submission of this offer, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.

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

(c) The Certification required by subparagraph (b), above, shall be included in all applicable subcontracts and a copy kept on file by the prime contractor. The prime contractor shall be required to furnish copies of certifications to the Contracting Officer upon the Contracting Officer's request.

Form 33.203 (05/25) Page 8 of 10 Exhibit A

16. Clean Air and Water Certification (A-112, JAN 94)

Applicable if the offer exceeds $100,000, or the Contracting Officer believes that orders under an indefinite contract in any year will exceed $100,000, or a facility to be used has been the subject of a conviction under the Air Act [42 U.S.C.

7413(c)(1)] or the Water Act [33 U.S.C. 1319 (c)], and is listed by the Environmental Protection Agency (EPA) as a violating facility, and the acquisition is not otherwise exempt.

By submission of this offer, the offeror certifies that:

(a) Any facility to be used in the performance of this proposed contract (Mark one with an "X"):

is is not listed on the EPA List of Violating Facilities;

(b) It will immediately notify the Contracting Officer, before award, of the receipt of any communication from the Administrator, or a designee of the EPA, indicating that any facility which it proposes to use for the performance of the contract is under consideration to be listed on the EPA List of Violating Facilities; and

(c) It will include a certification substantially the same as this certification, including this paragraph (c), in every nonexempt subcontract.

17. Communication Policy and Certification (A-129, FEB 19)

(a) All oral and written communications with DART regarding this solicitation should be exclusively with, or on subjects and with persons approved by, the person identified in Block 3 of the solicitation cover sheet. Discussions or communications with any other person could result in disclosure of proprietary or other competitive sensitive information or otherwise create the appearance of impropriety or unfair competition and, thereby, compromise the integrity of DART's procurement system. If competition issues cannot be resolved through normal communication channels, the DART Procurement Regulations contain protest provisions for actual or prospective competitors claiming any impropriety in connection with this procurement.

(b) By submission of this offer, the offeror certifies that it has not, and will not prior to contract award, communicate orally or in writing with any DART employee or other representative (including DART Board members, DART contractors, or DART consultants) other than the individual, or person(s) and on subjects approved by the individual, named in Block 3 of the solicitation cover sheet, except as described below: (CHECK "NONE" IF NONE

EXISTS.)

NONE

Name of DART Representative

Date and Subject of Communication

{provide attachment, if necessary}

(c) This certification concerns a material representation of fact upon which reliance will be placed in awarding a contract. If it is later determined that the offeror knowingly rendered an erroneous certification, in addition to any other remedies the Authority may have, the Contracting Officer may terminate the contract resulting from this solicitation for default and/or recommend that the offeror be debarred or suspended from doing business with the Authority in the future in accordance with the procedures set forth in DART's Procurement Regulations. In addition, a false entry could be a violation of Texas Penal Code paragraph 37.10.

(d) The offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, he/she learns that its certification was, or a subsequent communication makes, the certification erroneous.

Form 33.203 (05/25) Page 9 of 10 Exhibit A

18. Conflict of Interest Certification (A-117, JAN 94)

By submission of this bid/proposal, I certify that:

(a) I have read and understand the General Provisions clause entitled "Interest of Public Officials" that will be incorporated into any contract resulting from this solicitation. I further understand that the pecuniary interest in that clause includes employment relationships.

(b) I understand the Authority has an internal conflict of interest policy for its employees (including temporary, part-time, and seconded employees), members of its employees’ immediate family (the employee’s spouse, children, stepchildren, mother, father, brother, sister or any other relative residing in the employee’s household), agents of the Authority (including contractors or organizations which represent or act on behalf of the Authority), and agents of the Authority employees or employees’ immediate family. This includes as any actual or potential conflict of interest whether or not a member of the employee's immediate family works for a firm doing, or seeking to do, business with the Authority.

(c) Mark one with an "X":

To the best of my knowledge and belief, no employee of my firm has a direct or indirect financial, business, or close personal relationship with any Authority employee, any members of their immediate families, agents of the Authority, or agents of Authority employees or their immediately families, nor are any Authority employees or any member of their immediate family considering an offer of employment or is actively seeking employment with my firm ; or

An employee of my firm is related to an Authority employee and a letter to the Contracting Officer explaining that relationship is attached to this Exhibit A

(d) The requirement of this certification has been passed through to all first-tier subcontractors or subconsultants anticipated to be used at the time of the submission of my proposal.

19. Contractor Certification Regarding Boycotting Certain Energy Companies (A-133, MAY25)

Texas Government Code Chapter 2276.002 prohibits DART from entering into a contract with a company for the purchase of goods or services unless the contract contains a written verification from the company that it:

(a) Does not boycott energy companies; and

(b) Will not boycott energy companies during the term of the contract.

“Boycott energy companies” and “company” have the meaning assigned by §809.001. “Governmental entity” has the meaning assigned by §2251.001 of the Texas Government Code.

By submission of this offer, the offeror certifies that it does not boycott certain energy companies as defined in Texas Government Code, §809.001 as amended, and will not boycott certain energy companies during the term of the contract.

If DART determines the offeror/contractor has violated these terms, the Authority may pursue any legal claims it may have against the offeror/contractor, including termination of the contract for default.

20. Contractor Certification Regarding Boycotting Israel (A-131, DEC 18)

Texas Government Code Chapter 2270 prohibits DART from entering into a contract with a for-profit company for goods or services unless the contract contains a written verification from the company that it:

(a) Does not boycott Israel; and

(b) Will not boycott Israel during the term of the contract.

Boycotting Israel includes refusing to deal with, terminating business activities with, or otherwise taking any action intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or with an Israeli-controlled territory, but does not include an action made for ordinary business purposes.

Form 33.203 (05/25) Page 10 of 10 Exhibit A

By submission of this offer, the offeror certifies that it does not boycott Israel as defined in Texas Government Code Section 808.001, as amended, and will not boycott Israel during the term of the contract.

If DART determines the offeror/contractor has violated these terms, the Agency may pursue any legal claims it may have against the offeror/contractor, including termination of the contract for default.

21. Contractor Certification Regarding Discrimination Against Firearm Entity or Firearm Trade Association (A-

134, MAY25)

Texas Government Code Chapter 2274.02 prohibits DART from entering into a contract with a company for the purchase of goods or services unless the contract contains a written verification from the company that it:

(a) Does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and

(b) Will not discriminate during the term of the contract against a firearm entity or firearm trade association.

“Company” and “discrimination against firearm entity or firearm trade association” and “firearm entity” and “firearm trade association” have the meaning assigned by §2274.001 of the Texas Government Code. “Governmental entity” has the meaning assigned by §2251.001 of the Texas Government Code.

By submission of this offer the offeror certifies that it does not discriminate against any firearm entity or firearm trade association as defined in Texas Government Code, §2274.00.001 as amended, and will not discriminate any firearm entity or firearm trade association during the term of the contract.

If DART determines the offeror/contractor has violated these terms, the Authority may pursue legal claims it may have against the offeror/contractor, including termination of the contract for default.

22. Disadvantaged Business Enterprise Goals (A-110, APR 04)

If goals have been established, by submission of this offer, the offeror certifies that it will comply with the provisions of Exhibit G entitled "Disadvantaged Business Enterprise Provisions," and will meet such goals as are established in any ensuing contract.

23. Drug-Free Workplace Program Certification (3-803.03, OCT 24)

This certification applies to certain commercial products and services contracts as well as to all construction contracts with the Authority. The Contractor shall comply with all applicable local, state, and federal laws, standards, rules and regulations concerning Substance Abuse Programs, including, but not limited to Federal Acquisition Regulation (FAR) 52.226-7, “Drug-Free Workplace”, 49 CR Part 655, “Prevention of Alcohol Misuse and Prohibited Drug Use in Transit Operations” and 49 CFR Part 40, “Procedures for Transportation Workplace Drug and Alcohol Testing Programs.

(a) By submission of an offer, the offeror certifies and agrees that, with respect to the offeror and all employees of the offeror to be utilized in the performance of any contract resulting from this solicitation, it will establish a drug-free workplace program that complies with the provisions of the Drug-Free Workplace Program Clause of the General Provisions.

(b) Failure of the offeror to have the drug-free workplace program complying with this certification and the Drug- Free Workplace Program Clause of the General Provisions available for the Authority's review and approval as part of the Authority's pre-award responsibility survey will be deemed a lack of responsibility rendering the offeror unqualified and ineligible for award.

TABLE OF CONTENTS
REPRESENTATIONS
1. Affirmative Action Compliance (A-107, JAN 94)
(a) The offeror represents as part of its offer that it has a workforce of (# of employees):
(b) It (Mark one with an "X"):
has developed and has on file
has not developed and does not have on file
at each establishment, affirmative action programs required by the rules and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or it (Mark one with an "X"):
has has not
2. Contingent Fee (A-103, AUG 02)
has has not
has has not
3. Covenant Against Gratuities (A-105, JAN 94)
4. Disadvantaged Business Enterprise (DBE) (A-102, NOV 99)
is is not
5. Interest of Public Officials (A-104, JAN 94)
6. Parent Company and Identifying Data (A-108, JAN 05)
(a) The offeror represents as part of its offer that it (Mark one with an "X"):
is is not
(b) If the offeror is not owned or controlled by a parent company, it shall insert its own Employer's Identification Number below:
(c) If the offeror is owned or controlled by a parent company, it shall enter in the blocks below the name and main office address of the parent company, and the parent company's Employer's Identification Number.
7. Previous Contracts and Compliance Reports (A-106, JAN 94)
(a) The offeror represents as part of its offer that it (Mark one with an "X"):
has has not
participated in a previous contract or subcontract subject either to the Equal Opportunity clause of this solicitation, the clause originally contained in Section 310 of Executive Order Number 10925, or the clause contained in Section 201 of Executive...
(b) It (Mark one with an "X"):
has has not
filed all required compliance reports.
(c) Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained before subcontractor awards.
8. Type of Business (A-101, DEC 04)
(a) The offeror represents as part of its offer that it operates as (Mark one with an "X"):
an individual a sole proprietorship
a partnership a corporation
another entity ________________________.
(b) If incorporated, under the laws of the State of:
(c) Age of the firm: ____ years, ____ months
(d) Previous year’s annual gross receipts:
CERTIFICATIONS
9. Buy America/Build America (BABA) Compliance (A-132, MAY25)
10. Certificate Concerning Board Members and Employees of the Authority (A-116, MAY 22)
(a) By submission of this offer the offeror hereby certifies that, to the best of his/her knowledge and belief, with the exception of any information described in this certification or attached hereto, the offeror has no information concerning a viola...
(b) Violations or possible violations. (Continue on plain bond paper and label Certificate Concerning Former Board Member and Employees of the Dallas Area Rapid Transit Authority, Continuation Sheet.) CHECK "NONE" IF NONE EXISTS.
NONE
(c) This certification concerns a material representation of fact upon which reliance will be placed in awarding a contract. If it is later determined that the offeror knowingly rendered an erroneous certification, in addition to any other remedies th...
(d) The offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, he/she learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances.
(e) The offeror further agrees by submitting this bid/offer that it will include this Certificate, without modification, in all first-tier subcontracts. The offeror shall be responsible for compliance by any first-tier subcontractor with the provision...
11. Certification of Eligibility (A-118, JAN 94)
(a) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the Contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a...
(b) No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).
(c) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 U.S.C. 1001.
12. Certification of Independent Price Determination (A-109, JAN 94)
(a) By submission of this offer, the offeror certifies, and in the case of a joint offer, each party thereto certifies as to its own organization, that in connection with this procurement:
(1) The prices in this offer have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other offeror or with any competitor.
(2) Unless otherwise required by law, the prices which have been quoted in this offer have not been knowingly disclosed by the offeror and will not knowingly be disclosed by the offeror prior to the opening (in the case of an advertised procurement) o...
(3) No attempt has been made or will be made by the offeror to induce any other person or firm to submit or not to submit an offer for the purpose of restricting competition.
(b) Each person signing this offer certifies that:
(1) He is the person in the offeror's organization responsible within that organization for the decision as to the prices being offered herein and that he has not participated, and will not participate, in any action contrary to (a)(1) through (a)(3) ...
(2) He: (i) is not the person in the offeror's organization responsible within that organization for the decision as to the prices being offered herein but that he has been authorized in writing to act as an agent for the persons responsible for such ...
13. Certification of Non-Segregated Facilities (A-113, JAN 94)
(a) By the submission of this offer, the offeror certifies that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform th...
(b) The offeror agrees that a breach of this certification is a violation of the Equal Opportunity Clause in the contract.
(c) As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinki...
(d) It further agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will:
(1) obtain identical certifications from proposed subcontractors before the award of subcontracts under which the subcontractor will be subject to the Equal Opportunity clause;
(2) Retain such certifications in its files; and
(3) Forward the following notice to the proposed subcontractors (except if the proposed subcontractors have submitted identical certifications for specific time periods).
14. Certification of Restrictions on Lobbying (A-114, NOV 04)
(a) By submission of this offer, the offeror certifies, to the best of his or her knowledge or belief, that:
(1) No Federal appropriated funds have been paid, or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congr...
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employ...
(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all...

(b) This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31 U

15. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion (A-126, NOV 12)
(a) Primary Covered Transactions. [This certification applies to the offer submitted in response to this solicitation and will be a continuing requirement throughout the term of the prime contract.]
(1) In accordance with the provisions of Appendix A to 49 Code of Federal Regulations (CFR) Part 29, the offeror certifies to the best of its knowledge and belief, that it and its principals:
(i) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;
(ii) Have not within a three-year period preceding this offer 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 (Fed...
(iii) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(ii) of this Certification; and
(iv) Have not within a three-year period preceding this offer had one or more public transactions (Federal, State, or local) terminated for cause or default.

(2) Where the offeror is unable to certify to any of the statements in this certification, the offeror shall attach an explanation to this offer.

(b) Lower Tier Covered Transactions. [This certification applies to a subcontract at any tier expected to equal or exceed $25,000 and will be a continuing requirement throughout the term of the prime contract.]
(1) In accordance with the provisions of Appendix B to 49 Code of Federal Regulations (CFR) Part 29, the prospective lower tier participant (subcontractor) certifies, by submission of this offer, that neither it nor its principals is presently debarr...
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

(c) The Certification required by subparagraph (b), above, shall be included in all applicable subcontracts and a copy kept on file by the prime contractor. The prime contractor shall be required to furnish copies of certifications to the Contracting ...

16. Clean Air and Water Certification (A-112, JAN 94)
(a) Any facility to be used in the performance of this proposed contract (Mark one with an "X"):
is is not listed on the EPA List of Violating Facilities;
(b) It will immediately notify the Contracting Officer, before award, of the receipt of any communication from the Administrator, or a designee of the EPA, indicating that any facility which it proposes to use for the performance of the contract is un...
(c) It will include a certification substantially the same as this certification, including this paragraph (c), in every nonexempt subcontract.
17. Communication Policy and Certification (A-129, FEB 19)
(a) All oral and written communications with DART regarding this solicitation should be exclusively with, or on subjects and with persons approved by, the person identified in Block 3 of the solicitation cover sheet. Discussions or communications with...
(b) By submission of this offer, the offeror certifies that it has not, and will not prior to contract award, communicate orally or in writing with any DART employee or other representative (including DART Board members, DART contractors, or DART cons...
NONE
(c) This certification concerns a material representation of fact upon which reliance will be placed in awarding a contract. If it is later determined that the offeror knowingly rendered an erroneous certification, in addition to any other remedies th...
(d) The offeror shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, he/she learns that its certification was, or a subsequent communication makes, the certification erroneous.
18. Conflict of Interest Certification (A-117, JAN 94)
(a) I have read and understand the General Provisions clause entitled "Interest of Public Officials" that will be incorporated into any contract resulting from this solicitation. I further understand that the pecuniary interest in that clause includes...
(b) I understand the Authority has an internal conflict of interest policy for its employees (including temporary, part-time, and seconded employees), members of its employees’ immediate family (the employee’s spouse, children, stepchildren, mother, f...
(c) Mark one with an "X":
To the best of my knowledge and belief, no employee of my firm has a direct or indirect financial, business, or close personal relationship with any Authority employee, any members of their immediate families, agents of the Authority, or agents of A...
An employee of my firm is related to an Authority employee and a letter to the Contracting Officer explaining that relationship is attached to this Exhibit A
(d) The requirement of this certification has been passed through to all first-tier subcontractors or subconsultants anticipated to be used at the time of the submission of my proposal.
19. Contractor Certification Regarding Boycotting Certain Energy Companies (A-133, MAY25)
(a) Does not boycott energy companies; and
(b) Will not boycott energy companies during the term of the contract.
20. Contractor Certification Regarding Boycotting Israel (A-131, DEC 18)
(a) Does not boycott Israel; and
(b) Will not boycott Israel during the term of the contract.
21. Contractor Certification Regarding Discrimination Against Firearm Entity or Firearm Trade Association (A-134, MAY25)
(a) Does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and
(b) Will not discriminate during the term of the contract against a firearm entity or firearm trade association.
22. Disadvantaged Business Enterprise Goals (A-110, APR 04)
23. Drug-Free Workplace Program Certification (3-803.03, OCT 24)
(a) By submission of an offer, the offeror certifies and agrees that, with respect to the offeror and all employees of the offeror to be utilized in the performance of any contract resulting from this solicitation, it will establish a drug-free workpl...
(b) Failure of the offeror to have the drug-free workplace program complying with this certification and the Drug-Free Workplace Program Clause of the General Provisions available for the Authority's review and approval as part of the Authority's pre-...

File details come from the government source that posted it. Updated .