5-05 Required Form-Conflict of Interest Questionnaire, if applicable.pdf
PDF 430 KB Posted
- Attached to
- Parking Lot Resurfacing & Striping Services
- Solicitation number
- RFP #13-12-26
- Issued by
- Bell County, Texas
About this file
This is a Conflict of Interest Questionnaire form for RFP #13-12-26 issued by the City of Temple, Texas, regarding Parking Lot Resurfacing and Striping Services. The City seeks proposals from qualified vendors to establish an annual contract for parking lot resurfacing and striping services at various City facilities on an as-needed basis, including city buildings, parks, libraries, fire stations, and athletic complexes. Parking lot sizes vary depending on location. The form references Section 4.2 regarding conflict of interest disclosure requirements and outlines when completion and submission of the questionnaire is necessary for bidders.
The document details numerous federal compliance requirements and contract conditions applicable to this procurement, including termination for cause or convenience provisions for contracts exceeding $10,000 using federal funds, Equal Employment Opportunity compliance under 41 CFR Part 60, Davis-Bacon Act requirements for prime construction contracts exceeding $2,000, the Copeland Anti-Kickback Act, Contract Work Hours and Safety Standards Act compliance for contracts over $100,000, Clean Air Act and Federal Water Pollution Control Act standards for contracts exceeding $150,000, debarment and suspension verification through the System for Award Management (SAM), and Byrd Anti-Lobbying Amendment certification for awards exceeding $100,000. All contractors are required to certify compliance with applicable federal, state, and local laws, rules, regulations, and ordinances.
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RFP #13-12-26 Parking Lot Resurfacing and Striping Services 24
FORM 5.4. - CONFLICT OF INTEREST QUESTIONNAIRE
See Section 4.2. Conflict of Interest, for information regarding when it is necessary to complete and submit this form.
RFP #13-12-26 Parking Lot Resurfacing and Striping Services 25
RFP #13-12-26 Parking Lot Resurfacing and Striping Services 26
| b. Termination for Cause or Convenience for Contracts Exceeding $10,000 |
| For any City purchases or contracts in excess of $10,000 made using federal funds, Contractor agrees that the following terms and conditions shall apply: |
| c. Equal Employment Opportunity |
| Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause provided under 41 CFR 60-1.4(b), in a... |
| d. Davis-Bacon Act |
| Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime construction contracts in excess of $2,000, Contractor shall comply with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemente... |
| The City must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. Contractor agrees that for any purchase to which this requirement applies, the award is conditioned upon Contractor’s accep... |
| Contractor further agrees that it shall comply with the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Who... |
| e. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708) |
| Where applicable, all contracts awarded by the City in excess of $100,000 that involve the employment of mechanics or laborers, Contractor agrees to comply with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5... |
| f. Rights to Inventions Made Under a Contract or Agreement |
| If the Federal award meets the definition of “funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business company or nonprofit organization regarding the substitution of parties, a... |
| g. Clean Air Act and Federal Water Pollution Control Act |
| Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended. Where applicable, all contracts awarded by the City in excess of $150,000, Contractor agrees to comply with all applicable standards, ... |
| h. Debarment and Suspension |
| Debarment and Suspension (Executive Orders 12549 and 12689). A contract award (see 2 CFR 180.220) must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2... |
| i. Byrd Anti-Lobbying Amendment |
| Byrd Anti-Lobbying Amendment (31 U.S.C. 1352). Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pa... |
| Contractor agrees to comply with all federal, state, and local laws, rules, regulations, and ordinances, as applicable. It is further acknowledged that Contractor certifies compliance with all provisions, laws, acts, regulations, etc. as specifically ... |
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