7-SubmittalSection-071525.docx

PROPOSAL SUBMITTAL SECTION

Company Information

Company Name: ________________________________________ EIN: __________________

Unique Entity Identification Number: __________________________________________

Company Name as filed with the Secretary of State, if corporate entity: ______________________________________ (Colorado Secretary of State Website, for reference purposes, is http://www.sos.state.co.us/ )

Phone Number: _________________________ Fax Number: ____________________________

Company Address: ________________________________________

Authorized Signature: ______________________________________________________________

Printed Name and Title: __________________________________________________________

E-mail Address: _________________________________________________________________

Date: _______________

Submittal Checklist The following documents are to be returned with your proposal.

PLACE A CHECK () BY EACH ITEM SUBMITTED

1. Submit the following copies of all information requested herein, including all attachments, unless otherwise indicated:

ONE (1) electronic copy of the technical proposal submitted on the Rocky Mountain E-Purchasing System at www.RockyMountainBidSystem.com

ONE (1) electronic copy of the cost proposal in a separate document on the Rocky Mountain E-Purchasing System

2. This completed and signed Proposal Submittal Section.

3. List of three (3) references for services provided to governmental agencies or other organizations requiring similar services.

Reference #1 entity name_____________________

Reference contact name__________________ Contact phone number____________

Reference email address__________________________________

Reference #2 entity name_____________________

Reference contact name__________________ Contact phone number____________

Reference email address__________________________________

Reference #3 entity name_____________________

Reference contact name__________________ Contact phone number____________

Reference email address__________________________________

3. Attachments for Item #VI. as follows:

#A Retail Establishment Food License

4. Authorized Signatory pages, if applicable (Refer to Authorized Signatory Section for details)

5. Exceptions sheet, if applicable.

6. W-9 for firm submitting the proposal.

7. Acknowledgement of Receipt of Addenda below, if applicable.

Note: Be advised that the successful firm, if a corporate entity, will be required to provide evidence of current good standing with the Colorado Secretary of State after acceptance of proposal.

Authorized Representative Indicate the name of the Authorized Representative who will be assigned to this project:

Phone Number: _________________________ Email Address:__________________________________________

Performance Period

Refer to page 2 of the sample contract.

Key Notices Refer to page 8 of the sample contract.

Indicate the name and title of the individual who will receive Key Notices____________________________________

Company E-mail Address_______________________________________________________________________

Mailing Address_______________________________________________________________________________

Telephone Number_____________________________________________________________________________

Authorized Signatory for Contract Refer to page 14 of the sample contract.

Name and Title of Authorized Signatory: ________________________________________________________

The County accepts the signatures on contracts from the following individuals:

A. Corporation (For-Profit or Non-Profit) – President or Vice President

B. Limited Liability Company (LLC) - Manager or Member*

C. General Partnership, Limited Partnership (LP), Limited Liability Partnership (LLP), Limited Liability Limited Partnership (LLLP) - General Partner*

*Note: If the organization falls into categories B or C, you are required to provide a copy of the front page, signature page and the section of the Operating Agreement, or Partnership Agreement that defines who in the organization has contract signature authority.

Award Proposals submitted which do not meet the requirements of this Request may be considered nonresponsive and may not receive further consideration. (Follow-up calls for missing or incomplete information may not be made.)

All responsive proposals received for this project will be reviewed and ranked on a basis which would best serve the interests of Jefferson County and in accordance with the criteria listed in the RFP.

The firm(s) which is/are selected will be that/those which best serve the interests of Jefferson County and will be given the first right to negotiate an agreement acceptable to the County. In the event that an agreement satisfactory to the County cannot be reached, the County may enter into contract negotiations with one or more of the remaining qualified firms.

Insurance and Other Questions The successful Contractor shall be required to furnish the County with certificates of insurance for the insurance types and limits as detailed on the attached insurance exhibit prior to performing any activity on this project. Jefferson County, Colorado shall be the Certificate Holder and shall be named as Additional Insured. All subcontractors must meet the same insurance requirements unless a deviation has been approved.

Indicate your ability to comply with the following requirements:

a. Your firm agrees to meet all insurance requirements. If no, provide details on Exceptions sheet.

Yes No

b. The County shall be added as an Additional Insured to all liability policies:

Yes No

c. Your property and liability insurance company is licensed to do business in Colorado:

Yes No

d. Indicate the name of your property and liability insurance company here:

Name: ________________________________________________________

e. Your property and liability insurance company has an AM Best rating of not less than A- and/or VII:

Yes No

Provide a response to the following:

Are any lawsuits; Federal, State or Local Tax Liens; or any potential claims or liabilities pending against you, your firm, or the officers of the firm at this time?

Yes No If yes, provide details on a separate piece of paper and attach to your proposal.

Has your firm filed for bankruptcy or corporate protection under applicable federal or state laws in the last seven (7) years?

Yes No

Are you or your firm currently debarred or have any exclusions from receiving federal funds according to the System for Award Management (SAM) at https://sam.gov/search/?index=_all&page=1&pageSize=25&sort=modifiedDate&sfm%5Bstatus%5D%5Bis_active%5D=true&sfm%5Bstatus%5D%5Bis_inactive%5D=null

Yes No

Does your firm have an Unique Entity Identifier (UEI) and an active registration according to the System for Award Management (SAM) at System for Award Management (SAM) at https://sam.gov/search/?index=_all&page=1&pageSize=25&sort=modifiedDate&sfm%5Bstatus%5D%5Bis_active%5D=true&sfm%5Bstatus%5D%5Bis_inactive%5D=null

Yes No

Does your firm have a minimum of one (1) year of experience providing similar services?

Yes No

Does your firm have a current Retail Food Establishment License?

How long has your firm been in business?___________________

Does your firm have the capacity to add these services to your workload? Please explain:

Indicate the category/categories of meal(s) your company is quoting:

Breakfast Lunch Dinner

Jefferson County is requesting proposals for services provided to County Government Departments and Divisions. Pricing may also be utilized by the following cities, towns and school districts located within Jefferson County:

City of Arvada

Indian Hills

Applewood

Kittredge

Evergreen

Pine

Please indicate if you agree to extend the prices and terms of the resulting award to other local government agencies in the event they would have need for your product/services:

Exceptions

Are there any exceptions taken to any of the terms, conditions, or specifications of these proposal documents or contract?

Yes No

If there are exceptions taken to any of the terms, conditions, or specifications of these proposal documents or contract, they must be clearly stated on a separate sheet of paper, attached to this sheet and returned with your proposal. (Reference PROPOSAL INFORMATION Item 11.)

Acknowledgment of Receipt of Addenda Your acknowledgment of any addendum issued for this RFP shall be noted by signing below. This will serve as your acknowledgment that these clarifications/revisions have been taken into consideration during the preparation of your proposal.

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________

Addendum Number: ____ Date: __________ Acknowledged by: __________________________________