6-Administrative Forms - Attachment 1-11.pdf

Attachment 1

SOLICITATION ACKNOWLEDGMENT FORM

Solicitation Number: ___________

Solicitation Title: ______________________

Submittal Statements must be received by Atlanta Public Schools, Procurement Services Department, by the due date and time as indicated. Electronic submittals shall be accepted only through Bonfire by the due date and time. Late submissions are not acceptable.

In addition, the representative below is duly authorized to sign this acknowledgment form on behalf of the Respondent, company, or corporation and fully understands that executing and returning this Submittal Acknowledgement Form represents complete and unconditional acceptance of the requirements, terms, and conditions of this proposal and all appendices and any addendums released hereto.

Please be advised that if this form is not signed, the submission will be deemed invalid and not considered for review.

I hereby certify that I have read and understand the requirements of this proposal and that I, as a duly authorized representative, will comply with all requirements of this offer and any contract(s) and/or other transactions required by this award.

Company Name State of Incorporation:

Authorized Signature:

Name:

Title:

Mailing Address Taxpayer ID Number:

City State Zip Telephone:

Fax:

Contact Person Name:

Direct Number:

E-Mail Address Company Web Site:

Date Receipts of the following web posted Addenda are hereby acknowledged: (List all attached Addenda) Addendum No. ______ Dated ____________ Addendum No. ______ Dated ____________ Addendum No. ______ Dated ____________ Addendum No. ______ Dated ____________ Addendum No. ______ Dated ____________ Addendum No. ______ Dated ____________

Thank you for your interest in doing business with Atlanta Public Schools.

Attachment 2

OFFEROR COMPLIANCE FORM

(This form must be completed and returned with your response)

Is your company a Minority/Women Owned Business Enterprise (MWBE)? Yes No

Is your company certified; if yes, please indicate what certification you possess and through which agency you are certified:

Does the company utilize an Affirmative Action Plan for Equal Employment Opportunity? Yes No , if yes, please describe:

Has the company implemented a compliance program in accordance with the Americans with Disabilities Act?

Yes No

Has the company placed any conditions or restrictions on this proposal that would cause it to be declared non-responsive? Yes No , if yes, please explain:

If recommended for the award, will the company provide proof of insurance as required? Yes No

Is the company currently debarred from doing business with any federal, state, or local agency? If YES, please provide details and submit them on a separate sheet. Yes No

Has the company ever defaulted on a contract or been denied a contract due to inability to perform? If YES, please provide details on a separate sheet. Yes No

Does the company accept payment by credit card? Yes No

Is the company registered as a vendor with Atlanta Public Schools? Yes No If YES, please provide the APS vendor number:

Is the company registered as a vendor with the State of Georgia? Yes No If YES, please attach a copy of your state of Georgia business license.

Attachment 3

OFFEROR INCLUSION FORM

The intent of this form is to provide APS with information on the commitment your company has taken to ensure Supplier Diversity in your operations. The answers provided on this document will not be used as part of the Evaluation or Award Criteria, however, failure to complete and return this form may result in your submittal being deemed non-responsive.

Solicitation Name:

Solicitation Number:

Question 1:

Does your company have a general policy or plan to include Minority-Owned Business Enterprises (MBEs), Women-Owned Business Enterprises(WBEs), and/or Small Business Enterprises (SBEs) in your subcontracting opportunities? If so, please attach a copy of your plan. Examples of possible plan elements include but are not limited to the following:

a. Scheduled or planned pre-proposal meeting(s) targeting M/WBEs and SBEs.

b. Advertising subcontracting opportunities that your company has (traditional media, social media, emails, phone calls, etc.).

c. Maintaining an internal list of M/WBEs and/or Small Business Enterprises that are available to work with your firm as subcontractors and suppliers.

d. Documenting that M/WBEs and/or SBEs have been directly solicited for subcontracting opportunities on specific projects (e.g., through email).

e. Identifying portions of contracts that can be performed by M/WBEs and/or SBEs in a manner that will increase the likelihood of M/WBE and SBE participation. This might include breaking out contract work items into economically feasible units and providing delivery schedules that encourage M/WBE and SBE participation.

f. Any assistance your company gives M/WBEs and/or SBEs in removing barriers to participation on contracts, such as waiving or assisting with bonding requirements, helping to obtain lines of credit and insurance, helping to obtain sources of equipment and materials, allowing reimbursement for mobilization, and providing for prompt payment.

g. Explain how our company plans to ensure to negotiate in good faith in regards to M/WBEs and SBEs, and make every effort possible to vet the qualification of M/WBEs and SBEs for inclusion on this project. Please attach a written list of the M/WBEs and SBEs with whom good-faith negotiations were conducted.

Question 2:

If you have such a policy or plan, did you or are you implementing it regarding this specific APS solicitation?

If yes, please attach a brief explanation of what was or is being done.

Question 3:

If your company does not have a plan to include the use of Minority-Owned Business Enterprises (MBEs), Women-Owned Business Enterprises (WBEs), and/or Small Business Enterprises (SBEs) in subcontracting opportunities, are you willing to coordinate and work with APS’ Office of Business Diversity to identify potential M/WBEs and SBEs for subcontracting opportunities.

Attachment 4

PRIMARY VENDOR / SUBCONTRACTOR UTILIZATION

Solicitation Number:

Primary Vendor Name:

If subcontractors will not be used check this box:

List all subcontractors to be used during the performance of this contract. Submit additional forms if needed.

Company Name:

Street Address:

City, State, Zip:

Telephone: ( ) Fax: ( )

Primary Contact:

E-mail Address:

Services to be provided:

Company Name:

Street Address:

City, State, Zip:

Telephone: ( ) Fax: ( )

Primary Contact:

Street Address:

City, State, Zip:

Telephone: ( ) Fax: ( )

Primary Contact:

Attachment 5

PROMISE OF NON-DISCRIMINATION

In consideration of, and as condition precedent, the right and privilege to bid on construction projects and other procurement contracts of the APS, each potential vendor shall be required to submit to the APS Office of Contract Administration, a duly executed and attested Promise of Non-Discrimination, enforceable at law, which by agreement, affidavit or other written instrument acceptable to the General Counsel for APS, shall contain promises, averments and/or affirmations voluntarily made by the bidder.

“Know All Men by These Presents, that I/We, in consideration of the privilege to bid on contracts funded in whole or in part by Atlanta Independent School System (hereinafter, “APS”), hereby consents, covenants and agrees as follows:

(1) No person shall be excluded from participation in, denied the benefit of, or otherwise discriminated against based on race, color, sex, religion, national origin, marital status, sexual orientation, age, or disability in connection with any bid submitted to APS, or the performance of any contract resulting there from.

(2) That it is and shall be the policy of Company to provide equal opportunity to all businesspersons seeking to contract or otherwise interested in contracting with this Company, including those companies owned and controlled by racial minorities, cultural minorities and females:

(3) That the promises of non-discrimination as made and set forth herein shall be continuing in nature and shall remain in full force and effect without interruption for so long as any contract between Company and APS remains in force and effect;

(4) That the promises of non-discrimination as made and set forth herein shall and are hereby deemed to be made a part of, and incorporated by reference into, any contract or portion thereof which the Company may hereafter obtain with APS; and

(5) That the failure of this company to satisfactorily discharge any of the promises of non-discrimination as made and set forth herein shall constitute a material breach of contract entitling the APS to declare the contract in default and to exercise any and all applicable rights and remedies including but not limited to cancellation of the contract, termination of the contract, suspension and debarment from future contracting opportunities, and withholding and/or forfeiture of compensation due and owing on a contract

Solicitation No:

Address

Authorized Company Representative Name Authorized Company Representative Signature

Title Date

Business Telephone Number Fax

Attachment 6

E-VERIFY COMPLIANCE AND E-VERIFY AFFIDAVIT INSTRUCTIONS

In order to conduct business with Atlanta Public Schools (APS), the Contractor must complete the Contractor Affidavit of Compliance form and the Subcontractor Affidavit of Compliance form, if applicable. If the Contractor is exempt from E- Verify compliance under O.C.G.A. 13-10-90, et seq., the Contractor must complete the Contractor Affidavit of Exception form. Below are the instructions on how to complete the forms.

Contractor Affidavit of Compliance - In order to comply with State law, regulations, and APS policies and procedures, APS requires a completed, signed, and notarized Contractor Affidavit of Compliance confirming E-Verify compliance from any vendor providing labor or services in an amount that exceeds $2,499. The E-Verify program is a federal program operated by the US Customs & Immigration Services branch of the Department of Homeland Security.

a) First, register your company at: https:/www.e-verify.gov/e-verify-enrollment if you have not already done so.

• For questions regarding E-Verify - visit: https://www.e-verify.gov/contact-us or email E-verify@dhs.gov or call

888-464-4218

b) Log in to your registration account at: https://e-verify.uscis.gov/web/Login.aspx and view your Memorandum of Understanding (MOU).

• Your company ID Number is listed at the top of every page.

• This is NOT your E-Verify user ID, APS Vendor ID, or Tax ID.

c) Complete, sign, and notarize the attached Contractor Affidavit of Compliance and e-mail the document to your Buyer in Procurement.

• Please make sure the Notary seal is legible.

• “Name of Contractor or subcontractor” is same as Vendor’s Name.

• “Name of Project” – This can be left blank.

• “Date of Authorization” is the date you registered for E-Verify.

• “Federal Work Authorization User Identification Number” is a six or seven digit number.

Subcontractor Affidavit of Compliance – If the Contractor is using a subcontractor to perform the services under this contract, the Subcontractor must register and participate in E-Verify and sign, notarize, and submit the Subcontractor Affidavit of Compliance, as well.

Contractor Affidavit of Exception – If the Contractor meets the following exceptions for E-Verify compliance under O.C.G.A. 13-10-90, et seq., the Contractor must fill out, sign, notarize, and submit the Affidavit of Exception form. Exceptions include:

a) The Contractor is a sole proprietor with no employees, subcontractors, or sub-subcontractors, and it will not use or hire employees, subcontractors, or sub-subcontractors for any work performed for APS under the contract. This requires submission of a Georgia driver’s license or a license from an approved state.

b) The Contractor will provide goods only to Atlanta Public Schools and will not render any services to Atlanta Public

Schools. If your company provides goods along with ancillary services, such as maintenance, repairs, help desk support, customer support, technological support, or any other ancillary services, your company cannot file an Affidavit of Exception and must register with E-Verify.

c) The Contractor is a foreign company, and the work performed under the contract will be done in a foreign country by residents of that country.

d) The Contractor is an individual who is licensed pursuant to Official Code of Georgia Title 26 or Title 43, or by the State Bar of Georgia; whose license is in good standing, and the Contractor is the individual who will be performing the services under the contract.

https://www.e-verify.gov/e-verify-enrollment https://www.e-verify.gov/contact-us mailto:E-verify@dhs.gov https://e-verify.uscis.gov/web/Login.aspx

Attachment 6A

E-VERIFY AFFIDAVIT

Contractor Affidavit under O.C.G.A. § 13-10-91(b)(l)

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to each, every, and any contract to which Contractor is a party with Atlanta Public Schools that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use, and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify Atlanta Public Schools in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contractor’s contract with Atlanta Public Schools;

e) The Contractor will subcontract for the performance of services in satisfaction of such contract only with subcontractors who complete, sign, notarize, and provide the Subcontractor Affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c) prior to beginning the performance of services;

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into each, every, and any contract(s) with Atlanta Public Schools subject to the provisions of O.C.G.A. § 13-10- 91 to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to Atlanta Public Schools within five business days of receipt.

Federal Work Authorization User Identification Number Date of Authorization

Name of Contractor

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on , , 20 in (city), (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE DAY OF , 20 .

NOTARY PUBLIC

My Commission Expires:

Affix Notarial Seal Here

A

Attachment 6B

E-VERIFY AFFIDAVIT

Subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(3)

By executing this affidavit, the undersigned subcontractor (hereinafter the “Subcontractor”), which is engaged in the physical performance of services under a contract with (name of Contractor) on behalf of Atlanta Public Schools, verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the Subcontractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the Subcontractor will continue to use the federal work authorization program throughout the contract period, and the Subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the Subcontractor with the information required by O.C.G.A. § 13-10-91(b).

Additionally, the Subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the Contractor within five business days of receipt. If the Subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted sub-subcontractor, the Subcontractor must forward, within five business days of receipt, a copy of the notice to the Contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number

Date of Authorization

Name of Subcontractor

Name of Project/Contract

Executed on , , 20 in (city), (state).

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE DAY OF ,20 .

NOTARY PUBLIC

Attachment 6C

AFFIDAVIT OF EXCEPTION

I attest that I am exempt from providing a Contractor Affidavit of E-Verify Compliance to Atlanta Public Schools pursuant to O.C.G.A. § 13-10-91, as amended, for one of the following reasons:

I am a sole proprietor with no employees, subcontractors, or sub-subcontractors, and I will not use or hire employees, subcontractors, or sub-subcontractors for any work performed for Atlanta Public Schools under the contract.

In order to be exempt from compliance under the above exception, in addition to this affidavit you must provide a copy of your State of Georgia driver’s license. If you do not have a Georgia license, please see:http://www.georgia.gov/vgn/images/portal/cit_1210/50/35/173461453Lists_of_states_that_verify_im migration_status_7_26_11.pdf for a list of driver’s licenses from alternative states that can be submitted in lieu of a Georgia driver’s license.

My company/firm will provide goods only to Atlanta Public Schools and will not render any services to Atlanta Public Schools. If your company provides goods along with ancillary services, such as maintenance, repairs, help desk support, customer support, technological support, or any other ancillary services, your company cannot file an Affidavit of Exception and must register with E-Verify.

My company is a foreign company, and the work performed under the contract will be done in a foreign country by residents of that country.

I am an individual who is licensed pursuant to Official Code of Georgia Title 26 or Title 43, or by the State Bar of Georgia; my license is in good standing, and I am the individual who will be performing the services under the contract.

Vendor Name:

Name of Project:

Executed on , 20 in (city), (state).

Printed Name and Title of authorized Officer or Agent

Subscribed and Sworn Before Me

On This the Day Of , 20 .

Notary Public http://www.georgia.gov/vgn/images/portal/cit_1210/50/35/173461453Lists_of_states_that_verify_immigration_status_7_26_11.pdf http://www.georgia.gov/vgn/images/portal/cit_1210/50/35/173461453Lists_of_states_that_verify_immigration_status_7_26_11.pdf

Attachment 7

JOINT VENTURE AFFIDAVIT

Primary Vendor Name:

If this is not a joint venture, check this box:

Solicitation Name:

Solicitation Number:

State of:

County of:

We, the undersigned, being duly sworn according to law, upon our respective oaths depose and say that:

1. The following named contractors/companies have entered into a joint venture for the purpose of carrying out all the provisions of the Contract for the above named solicitation:

Joint Venture Company “A”

Company Name Federal ID No.

Address:

City: State: Zip:

Check all that apply:

Sole Proprietorship Partnership Corporation N/A, other

Joint Venture Company “B”

Company Name Federal ID No.

Address:

City: State: Zip:

Check all that apply:

Sole Proprietorship Partnership Corporation N/A, other

2. The contractors/companies, under whose names we have affixed our respective signatures, have duly authorized and empowered us to execute this Joint Venture Statement in the name of and on behalf of such contractors for the purpose hereinbefore stated.

Under the provision of such Joint Venture, the assets of each of the contractors named in Paragraph 1 hereof, and in case any contractor so named above is in partnership, the assets of the individual members of such partnership, will be available for the performance of such Joint Venture and liable therefore and for all obligations incurred in connection therewith.

This Joint Venture Statement is executed so that the named contractors/companies, as one organization, may under such joint venture, bid upon said contract, and be awarded the contract if they should become the successful bidder therefore, any bid, bond and agreement relating to joint venture and each and every contractor name herein, severally and jointly. Simultaneous with the execution of the contract, the contractors entering into this joint venture shall designate and appoint a project manager to act as their true and lawful agent with full power and authority to do and perform any and all acts or things necessary to carry out the work set forth in said contract.

The Joint Venture shall be known as:

Principal Office Address:

City: State: Zip:

Telephone: ( ) Fax: ( )

3. On a separate sheet provide the following information and reference the section number:

A. Describe the capital contributions by each joint venture and accounting therefore.

B. Describe the financial controls of the joint venture. Will a separate cost center be established?

Which joint venture company will be responsible for keeping the books? How will the expenses be reimbursed? What is the authority of each joint venture company to commit or obligate the other?

C. Describe any ownership, options for ownership, or loans between the joint ventures. Identify terms thereof.

D. Describe the estimated contract cash flow for each joint venture company. .

E. How and by whom will the on-site work be supervised?

F. How and by whom will the administrative office be supervised?

G. Which joint venture company will be responsible for material purchases including the estimated cost thereof? How will the purchases be financed?

H. Which joint venture company will provide equipment? What is the estimated cost thereof? How will the equipment be financed?

I. Describe the experience and business qualifications of each joint venture company.

J. Submit a copy of all joint venture agreements and evidence of authority to do business in the

State of Georgia as well as locally, to include all necessary business licenses.

Joint Venture Affidavit updated 9/2019

JOINT VENTURE AFFIDAVIT

In connection with any work that these firms, as a joint venture, might be authorized to perform in connection with the above-captioned contract, we each do hereby authorize representatives of the APS, Department of Purchasing and Warehouse Operations Services, Office of Contract Administration, to examine, from time to time, the books, records and files to the extent that such relate to this APS solicitation.

We bind the contractors for whom we respectively execute this Joint Venture Statement in firm agreement with the APS, that each of the representations herein set forth is true.

Subscribed and sworn before me this day of 20 .

(A) Name of Contractor/Company A

My commission expires: By: (L.S.)

Notary Public Print Name

Subscribed and sworn before me this day of 20 .

(B) Name of Contractor/Company B

My commission expires: By: (L.S.)

Notary Public Print Name

Attachment 8

CONTRACT EXCEPTIONS

I acknowledge that I have read the contract template as provided herein. I acknowledge that any proposed changes to the terms and conditions of the contract must be listed below and returned with my proposal. APS is not obligated to accept my proposed changes, and will attempt, in good faith, to negotiate exceptions listed herein. I acknowledge that any contract exception requested after submittal of my bid/proposal will not be considered by APS.

My company takes NO exception to any APS contract terms and conditions.

My company takes exceptions to the following terms and conditions and proposes the changes as listed below:

(Attach additional pages as needed)

Attachment 9

NO INFLUENCE AND NON – COLLUSION AFFIDAVIT

COMPLIANCE WITH LAWS OF GEORGIA

The undersigned hereby certifies that this proposal is in compliance with O.C.G.A.

36-91-21(e) and no violation of O.C.G.A. 36-91-21(e) has occurred.

[SUBMITTING COMPANY NAME]

[AUTHORIZED INDIVIDUAL NAME AND TITLE]

[SIGNATURE]

[DATE]

Attachment 10

Local Preference

Local Area The chart below shows the counties and cities considered local for preference purposes. A business must have been registered in one of the below jurisdictions for at least 12 months to receive local preference.

County Cities Clayton Forest Park, Jonesboro, Lake City, Lovejoy, Morrow, Riverdale Cobb Acworth, Austell, Kennesaw, Mableton, Marietta, Powder Springs, Smyrna, Vinings

DeKalb

Atlanta, Avondale Estates, Brookhaven, Chamblee, Clarkston, Decatur, Doraville, Dunwoody, Lithonia, Pine Lake, Stonecrest, Stone Mountain, Tucker

Fulton

Alpharetta, Atlanta, Chattahoochee Hills, College Park, East Point, Fairburn, Hapeville, Johns Creek, Milton, Mountain Park, Palmetto, Roswell, Sandy Springs, South Fulton, Union City

Gwinnett Berkeley Lake, Buford, Dacula, Duluth, Grayson, Lawrenceville, Lilburn, Loganville, Norcross, Snellville, Peachtree Corners, Sugar Hill, Suwanee

Certification Local businesses that wish to receive preferential consideration shall submit a copy of one or more valid Occupational Tax Registration Certificate(s) issued by Clayton, Cobb, DeKalb, Fulton or Gwinnett counties or by a city government located within the five-county metro area (e.g.

Atlanta, Decatur, Marietta) covering the last 12 month period to certify qualification for the preference as part of each proposal or response.

Procedures for local preference Request for Proposals (RFP) – If a local business meets the quality standards established for the RFP process, the local business shall be awarded five (5) additional points in the total evaluation.

The evaluation and scoring of all proposals shall be conducted in accordance with departmental procedures issued by the Chief Financial Officer or his/her designee.

Invitations for Bid (IFB) – In general, price is the deciding factor in APS invitation to bid processes.

In cases when two or more responses offer the same price to the district, local preference will be used as a tiebreaker.

In order to qualify for local preference based on the requirements listed above, you must UPLOAD a copy of your Occupational Tax Registration Certificate.

Company Qualifies for Local Preference: Yes No

Solicitation # Solicitation Name

Proposed Team Availability:

Please list team members and their estimated availability to provide services to Atlanta Public School by percentage at the intervals listed below.

Team Members Current Availability Availability in 6 months Availability in 12 months

Name of Project Client Construction Value

% of Completion

Estimated Completion

Date

Attachment 11

Current and Future Workload