Required Submittals

RFP #3935

RFP #3935 PRICE FORM

CONTRACTOR BUSINESS NAME: ________________________________________

Section 1. Pricing Breakdown

Item Description Pricing

1. Dry Carpet Cleaning $ _______ / sq ft

2. Dry Carpet Cleaning

3. As-Needed Chair Cleaning $ _____ _ / chair

Section 2. Scheduled Carpet Cleaning Pricing

Item Location Sq Ft Pricing

1. Operations & Maintenance Center 29,351 $ _______ / mo

2. Administration Center 57,481 $ _____ _ / mo

3. Customer Service Call Center 10,646 $ _____ _ / qtr

$ _______ / hr

All prices proposed shall be all-inclusive and final. Pricing must account for and include all costs necessary to perform the work as specified in the scope of services, including but not limited to: labor, materials, equipment, transportation, overhead, profit, insurance, applicable sales and use taxes, tariffs, licenses, permits, travel, incidentals, and any other cost or fee reasonably expected to be incurred in fulfilling the contract requirements.

Should a proposer fail to incorporate any cost that would reasonably be expected as part of the work outlined in the existing scope, Eastern Municipal Water District (EMWD) shall not be responsible for additional compensation. The proposer shall bear the full cost of such omissions and will be required to complete the work at no additional charge to EMWD.

EMWD encourages and will give consideration to early payment discounts during proposal evaluation. If a discount is offered, the terms must be clearly stated as follows:

% discount if paid in full within days.

By submitting a proposal, the undersigned Proposer certifies that this proposal is genuine and not made in the interest of or on behalf of any undisclosed person, firm, or corporation and is not submitted in collusion with any other party. The Proposer further certifies that they have fully read and understood all proposal documents and agree to comply with all specifications, terms, conditions, unit pricing, and delivery requirements unless clearly stated otherwise in the “exceptions” section of the proposal.

Name of Offeror (Firm): Title:

Authorized Signature: Date:

Printed/Typed Name:

Mailing Address:

City: State: Zip:

Fax No.: E-mail:

Page 3 of 13 Required Submittals

Page 1 of 1 PROPOSER’S BUSINESS INFORMATION Business Information

Legal Business Name: Date:

Address: _____________ Street Address Suite #

City State ZIP Code

Contact: Title:

Phone: Email:

Length of time in business:

Length of time at current location:

Federal Tax No.:

Names and titles of officers of the Business:

Is your firm incorporated? No ☐ Yes ☐

Name and remittance address that will appear on invoices:

Is your firm a sole proprietorship doing business under a different name? No ☐ Yes☐

If yes, please indicate sole proprietorship name and the name you are doing business under:

California State Contractor’s License No.:

Department of Industrial Relations Registration No.:

Page 1 of 1 BUSINESS REFERENCES Business References for

Proposer Business Name: Date:

Proposer shall provide a minimum of three (3) customer references with five (5) or more years’ experience with the Proposer. Preferred references should be similar in size, scope, and complexity to the contract requirements.

Reference 1 Name of Firm: Phone:

Address: Contact:

Project Approx. Contact Title: Cost: $ Email:

Project Descript.:

Project Project Start: End:

Reference 2

Firm: Phone:

Address: Contact:

Project Approx. Contact Title: Cost: $ Email:

Project Descript.:

Reference 3

Firm: Phone:

Address: Contact:

Project Approx. Contact Title: Cost: $ Email:

Project Descript.:

Page 1 of 1 LIST OF SUBCONTRACTORS

Subcontractor #1 Information Legal CSLB DIR Reg.

Business Name: No.: No.:

Street Address: Suite:

Subcontract Description:

Subcontractor #2 Information Legal CSLB DIR Reg.

Business Name: No.: No.:

Street Address: Suite:

Subcontractor #3 Information Legal CSLB DIR Reg.

Business Name: No.: No.:

Street Address: Suite:

ADDITIONS, DELETIONS AND/OR EXCEPTIONS

Please state any and all Additions, Deletions and Exceptions that you are taking to any portion of this proposal. If not addressed below, then Eastern Municipal Water District (EMWD) assumes that the vendor will adhere to all terms and conditions listed.

EMWD will issue an Agreement in its standard form to the successful firm(s) for the services contemplated herein; a copy of which is attached hereto and incorporated herein. Any deletion, exception, or modification taken to EMWD contract terms and conditions will be evaluated, in addition to the specified criteria; and may, itself, result in non-acceptance by EMWD. Any request for deletion, exception, or modification, if so taken, must be submitted at the time of proposal. Any asserted trade secrets or other proprietary information must be identified on this exhibit with specific page references within the proposal and/or supplemental information.

QUALIFICATIONS AND EXPERIENCE

PROCESS TO COMPLETE WORK

INSURANCE AFFIDAVIT

I, (Proposer/Company) have reviewed the Insurance Requirements in its entirety and agree to furnish all insurance policies with designated limits, along with full endorsements, and waiver of subrogation, as stated in this Request for Proposal for the full term of the agreement.

I hereby agree to provide copies of insurance certificates, endorsements, and waiver of subrogation within fourteen (14) calendar days of EMWD’s notification of recommendation of award.

I understand and confirm that our firm is able to provide and maintain the coverage as specified.

Failure to maintain said coverage shall be sufficient cause for contract termination and shall result in termination of the awarded contract.

I understand that by signing this document, I (Proposer/Company) agree to all terms and conditions as stated in the Insurance Requirements.

☐ Check here if you DO NOT accept terms and conditions as stated in the Insurance Requirements. Detail all Exceptions in, Additions, Deletions and/or Exceptions Form.

Authorized Representative’s Signature Name Authorized Representative’s Printed Name

Company Name Date

Mailing Address Telephone

City, State, Zip Code Email

CONTRACTOR’S CAL/OSHA COMPLIANCE HISTORY AND SIC CODE

(This document is to be submitted with the proposal package) (rev.

10/08/18)

Date:

Contractor’s Standard Industry Code:

Contractor’s Name:

California State Contractor’s License #:

Address:

Contact Person:

Phone No:

Please answer the following questions:

1. Has the contractor been cited by Cal/OSHA or any regulatory agency for a violation related to safety or environmental issues within the past seven (7) years?

No ☐ Yes ☐

2. Within the past ten (10) years has the contractor had a serious incident or fatality on a job site?

No ☐ Yes ☐

* If yes to # 1 or #2, please provide information specific to the incident(s) and action(s) taken to ensure that there is not a repeat violation, or incident(s) (attach additional sheets if needed)

Contractor’s Representative signature:

FOR EMWD USE ONLY: Purchasing to forward to Risk Management for review

(Risk Management) Approved: No ☐ Yes ☐

Reviewed by (Risk Management)

(signature required)

Contractor Mobile Source Acknowledgement Form

This form and supporting attachments must be completed and included in the bid proposal.

The contractor is responsible for maintaining compliance throughout the contract term and for verifying compliance certificates for any subcontractors or rented equipment used throughout the contract term.

ON-ROAD VEHICLES

CARB ADVANCED CLEAN FLEETS (ACF)

13 CCR 2013 – 2013.4; 13 CCR 2015 – 2015.6

CALIFORNIA AIR RESOURCES BOARD ON-ROAD VEHICLE DISCLOSURE

All on-road vehicles with a GVWR greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets

SIGNED STATEMENT OF ACKNOWLEDGEMENT:

I hereby certify acknowledgement that the contractor understands that the above CARB regulation may apply to the on-road vehicles they operate or hire and direct for this project. I understand that it is the contractor’s responsibility to verify that the on-road vehicles used for this project, including equipment used by subcontractors and/or rental equipment, meet the CARB requirements. The contractor shall be responsible for verifying compliance with the CARB Advanced Fleet Regulations for applicable vehicles they hire and operate or hire and direct the operation of for the project. The contractor is responsible for maintaining compliance for the contract term and for verifying compliance certificates for any subcontractors used throughout the contract term. The contractor shall keep supporting records and documentation to demonstrate compliance and shall provide them to EMWD upon request.

The signature below certifies acknowledgement by the contractor of the requirements above.

Company Name:

Signer’s Name Date:

(PLEASE PRINT)

Signature:

https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets

SUBMITTAL CHECK-OFF LIST

Item Required Submittals Checklist Check Off

RFP Price Form

Proposer’s Business Information

Business References

List of Subcontractors

Additions, Deletions, and/or Exceptions

Qualifications and Experience

Process to Complete Work

Insurance Affidavit

CAL/OSHA Compliance History

CARB Contractor Mobile Source

SUBMITTAL CHECK-OFF LIST