RESPONSIBLE CONTRACTOR

DOCUMENTATION

BUCKS COUNTY

RCO-1 Page 1

RESPONSIBLE CONTRACTORS ORDINANCE

The County of Bucks has enacted Ordinance 162, setting forth certain provisions to ensure that contractors and subcontractors performing work valued at over $250,000 on any public works project undertaken by the County for the construction, demolition, alteration, renovation, repair, service or maintenance work are qualified, responsible contractors and subcontractors having sufficient capabilities in all respects to successfully perform the contracts on which they are engaged, including the necessary experience, equipment, technical skills and qualifications and organizational, financial and personnel resources.

A bidder proposing to submit a bid on such projects is required to be pre-qualified in accordance with Ordinance 162, by submitting a Contractor Responsibility Certification Form at least 14 calendar days prior to the specified bid submission date. Ordinance 162 and the Contractor Responsibility Certification Form as included in this Section.

Following review of the certification, the County will notify a prospective bidder within seven calendar days prior to the bid submission date of its determination as to the prospective bidder’s qualifications.

Any subcontractor on the project is likewise required to submit the Contractor Responsibility Certification Form once the Contractor receives a notice of intent to award the contract. A contractor may not divide divisions of work among multiple subcontractors performing the same work so as to avoid the $250,000 threshold for applicability of Ordinance 162.

Instructions for submission of the Contractor Responsibility Certification Form:

- Bidder shall complete the Contractor Responsibility Certification Form in it’s entirety. Bidder is required to check all the boxes on the form.

- Bidder shall email the completed form to RCOcertification@buckscounty.org no later than 14 calendar days prior to the specified bid submission date.

- The County will acknowledge receipt of the form.

- The County will review the form and within seven calendar days prior to the bid submission date, will notify the Bidder its determination of the Bidders qualifications.

- The County will only consider bid responses from Bidders it has determined to be qualified.

mailto:RCOcertification@buckscounty.org

County of Bucks Contractor Responsibility Certification Form

Contractor Name: Date: , 20

Contractor Address:

, Zip Code

Contact Name: E-mail

Contact Direct Phone No.: Fax No.:

Project Name , Spec # _______

To be certified, Contractor is required to check all the following boxes: Yes No

1. Does the Contractor and its employees have all valid, effective licenses, registrations or certificates required by federal, state, county, or local law, including, but not limited to, licenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform? These shall include, but not limited to, licenses, registrations or certificates for any type of construction or maintenance trade work or specialty work which the firm proposes to self-perform.

2. Does the Contractor meet the bonding requirements for the contract, as required by applicable law or contract specifications and any insurance requirements, as required by applicable law or contract specifications, including general liability insurance, workers compensation insurance and unemployment insurance?

3. Has the Contractor been debarred by any federal, state or local government agency or authority in the past three (3) years?

4. Has the Contractor defaulted on any project in the past three (3) years?

5. Has the Contractor had any type of business, contracting or trade license revoked or suspended by any government agency or authority in the past three (3) years?

6. Has the Contractor or its principals/owners been convicted of any crime relating to the contracting business in the past ten (10) years?

7. Has the Contractor within the past three (3) years been found in violation of any law applicable to its contracting business, including, but not limited to, licenses laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $1,000 or more?

8. The Contractor will pay all craft employees that it employs on the project the current wage rates and fringe benefits as required under applicable federal, state or local wage laws.

9. All craft labor that will be employed by the Contractor for the project have completed at least the OSHA 10-hour training course for safety established by the U.S.

Department of Labor, Occupational Safety & Health Administration.

County of Bucks Contractor Responsibility Certification Form

Yes No

10. The Contractor will employ craft employees in all classifications and individual trades required to successfully perform the work related to this project.

11. The Contractor participates in a Class A Apprenticeship Training Program, as defined below, for each separate trade or classification in which it employs craft employees.

This apprenticeship requirement assures that workers in each trade or craft employed are graduates of an apprenticeship training program in each trade or craft in which their services are utilized.

A. For purposes of this section, a Class A Apprenticeship Program is an apprenticeship program that is currently registered with and approved by the U.S.

Department of Labor or a state apprenticeship agency and has graduated apprentices to journeyperson status for at least three of the past five years. This may be an apprenticeship program that is subject to the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. (“ERISA”), or a non- ERISA program.

B. To demonstrate compliance with this section, the firm shall provide, with this certification, a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A Apprenticeship Program for each trade or classification listed.

12. The Contractor has all other technical qualifications and resources, including equipment, personnel and financial resources, to perform the referenced contract, or will obtain same through the use of qualified, responsible Contractors.

13. The Contractor will maintain all qualifications, resources and capabilities referenced in this certification throughout the duration of the project

14. The Contractor shall notify the County within seven days of any material changes to all matters attested to in this certification.

15. The firm understands that the Contractor Responsibility Certification required by this section shall be executed by a person who has sufficient knowledge to address all matters in the certification and shall include an attestation stating, under the penalty of perjury, that the information submitted is true, complete and accurate.

Upon receipt of a Notice of Intent to Award Contract, the Contractor will provide the Owner with subcontractor list and subcontractor information as specified in the Responsible Contractor Resolution

ATTACH ADDITIONAL SHEETS IF NECESSARY.

Contractors Authorized Representative:

Signature:

Title: Date:

CHESTER COUNTY

CONTRACTOR RESPONSIBILITY CERTIFICATION

Firm Name:

Firm Address:

Contact Name:

Telephone #:

Email:

Project Name:

Project Number:

(Bid-Trade Number)

The submitting firm is required to certify compliance with the contractor responsibility standards set forth below by checking appropriate boxes. Specifically, to perform work for the County of Chester. Contractor is required to check all the following boxes:

(1) Does the firm have, or will it obtain all valid, effective licenses, registrations or certificates required by federal, state, county, or local law, including, but not limited to, licenses, registrations or certificates required to:

(a) Do business in the designated locale: and

(b) Perform the contract work it seeks to perform. These shall include, but not be limited to, licenses, registrations, or certificates for any type of trade work or specialty work which the firm proposes to self-perform?

Yes No

(2) Does the firm meet the bonding requirements for the contract, as required by applicable law or contract specifications and any insurance requirements, as required by applicable law or contract specifications, including general liability insurance, workers compensation and unemployment insurance requirements?

(3) Has the firm been debarred or suspended on any project by any federal, state, or local government agency or authority in the past three (3) years?

If yes, please explain.

(4) Has the firm defaulted on any project in the past three (3) years?

(5) Has the firm had any type of business, contracting or trade license, registration, or other certification suspended or revoked in the past three (3) years?

(6) Has the firm committed or been cited for a willful violation of federal or state safety laws as determined by a final decision of a court or government agency in the past three (3) years?

(7) Has the firm or its owners been convicted of any crime relating to the contracting business as determined by a final decision of a court or government agency in the past ten (10) years?

(8) Has the firm, in the past three (3) years, been found by a final decision of a court or government agency in violation of any law applicable to its contracting business, including, but not limited to, licensing laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $1,000.00 or more?

(9) The firm and its owners have not declared bankruptcy in the past three (3) years.

(10) Does the firm agree to pay all employees that it employs on the project the current wage rates and benefits as required under applicable local, state, or federal law for the duration of the referenced project?

(11) Does the firm agree all employees that it employs on the project will have completed at least the

OSHA 10-hour training course for safety established by the U.S. Department of Labor, Occupational Safety & Health Administration?

(a) If the firm is a prime contractor, does the firm also agree that at least one person on the project has completed the OSHA 30-hour construction training course established by the U.S.

Department of Labor?

(12) Does the firm participate in a Class A Apprenticeship Program as defined below, for each separate trade or classification in which it employs craft employees and shall continue to participate in such program or programs for the duration of the referenced project?

(a) For purposes of this section a “Class A Apprenticeship Program” is an apprenticeship program that is currently registered with and approved by the U.S. Department of Labor or a state apprenticeship agency and has graduated apprentices to journeyperson status for at least three years of the past five years. This may be an apprenticeship program subject to the Employee Retirement Income Security Act of 1974, 29 U.S.C. 1001 et seq. (ERISA) or non- ERISA program.

(b) To demonstrate compliance with this section, the firm shall provide, with this certification, a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A Apprenticeship Program for each trade or classification listed.

(c) The requirements under this section and section 13 of this form help ensure that the bulk of the craft labor workforce employed on the project will have sufficient skills and training to correctly perform work assigned to them.

(13) Does the construction manager, general contractor or other lead or prime contractor responsible for the project shall ensure that at least 70 percent of the craft labor workers employed on the project shall be comprised of either journeyperson workers who have successfully completed a Class A Apprenticeship Program as defined in Section 12 of this form or apprentices registered in such programs. The apprenticeship participation of specified by this section must be in the same trade or craft for which workers are employed on the project. To demonstrate compliance with this section, the firm shall provide, with this certification, a list of all qualified workers and proof from either the Commonwealth of Pennsylvania or the US Department of Labor of graduation from or enrollment in a Class A Apprenticeship Program.

(14) Does the firm have all other technical qualifications and resources, including equipment, personnel, and financial resources, to perform the referenced contract, or agree that it will obtain same through the use of qualified, responsible subcontractors?

(15) Does the firm ensure it will provide a workforce comprised of at least 25% Chester County residents

For purposes of this section, “Chester County resident” means an individual whose primary residence is within Chester County boundaries, as evidenced by valid government-issued ID or other County-approved documentation. Subcontractor hours may be included in this calculation. If the firm is unable to meet this requirement, an explanation must be provided. Failure to meet this requirement will not automatically prevent the selection of the firm.

(16) Has the firm ever operated under another name or controls or is controlled by another company or business entity or in the past five (5) years controlled or was controlled by another company or business entity, whether as a parent company, subsidiary or in any other business relation? If so, it shall attach a separate statement to its contractor responsibility certification that explains in detail the nature of any such relationship. Additional information may be required from such an entity if the relationship in question could potentially impact contract performance.

(17) The Department of Procurement and General Services must be notified, in writing, within seven (7) days of any material change to any of these required certifications.

(18) Contractor responsibility certifications shall be executed by a person who has sufficient knowledge to address all matters in the certification and shall include an attestation stating, under the penalty of perjury, that all information submitted is true, complete, and accurate.

Subcontractor Listing:

The below listed subcontractors will be utilized on this project. A completed Responsibility Certification form is required for any subcontractor. Attach a separate sheet if additional space is required.

Subcontractor #1:

Name: Phone #:

Address:

Type of Work:

License Number:

Subcontractor #2:

Name: Phone #:

Address:

Type of Work:

License Number:

Subcontractor #3:

Name: Phone #:

Address:

Type of Work:

License Number:

Subcontractor #4:

Name: Phone #:

Address:

Type of Work:

License Number:

In executing this Responsibility Certification, the submitting firm understands and agrees that if the Owner determines that this certification contains false or misleading material information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard of the truth, the firm may be prohibited from performing work for the County of Chester for a period of three (3) years.

Such firms may also be subject to any other penalties and sanctions, including contract termination, available to the County of Chester under law. A contract terminated under these circumstances shall further entitle the County of Chester to withhold payment of any monies due to the firm as damages.

I certify that the foregoing representations regarding the past performance and present qualifications of the undersigned firm are true and correct.

Signature of Authorized Official

Typed Name & Title of Authorized Official

Name of Firm

Date

Subscribed and sworn before me this day of ,2025

Notary Public My Commission Expires:

Revised 10/2025

DELAWARE COUNTY

J-RCO Certification (contractor) v3

Contractor Responsibility Certification

Chapter 29 of the Delaware County Code requires that as a condition of performing work on certain public works contracts, a firm seeking award of a contract shall submit a Contractor Responsibility

Certification. Delaware County has determined that the contract subject to this solicitation is covered by Chapter 29, and that firms responding to this solicitation must submit this form and otherwise comply with the provisions of Chapter 29 as well as Delaware County Resolution Number 2022-3

(Regarding Goals for Diversity in Public Works Contracting).

In order for this Contractor Responsibility Certification to be considered validly submitted, it must be properly signed by the firm or an officer or employee of the Contractor authorized to make it.

Contractor Responsibility Certifications that are not properly signed will not be considered as responsive to the requirements of the Delaware County Code. If a firm fails to provide a Contractor Responsibility

Certification required by this section, it may be disqualified from bidding/responding. No action of any nature shall lie against Delaware County because of its refusal to accept a bid/response for this reason.

Execution of this Contractor Responsibility Certification shall not establish a presumption of contractor responsibility, and Delaware County may require any additional information it deems necessary to evaluate a firm's status as a responsible contractor, including information regarding the firm's technical qualifications, financial capacity or other resources and performance capabilities.

If Delaware County determines that a Contractor Certification, Subcontractor List or Subcontractor

Responsibility Certification contains false or misleading information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard of the truth, the firm for which the certification was submitted shall be disqualified from the project and shall be prohibited from performing work for Delaware County for a period of three years. Delaware County may withhold payment of any monies due to the firm as damages and impose other applicable penalties and sanctions, including contract termination, as permitted by law or contract.

I hereby represent, warrant and agree on behalf of the firm indicated below that:

Acknowledged*

(1) The firm and its employees have all licenses, registrations, certificates or other credentials required by federal and state law and the laws of Delaware County with respect to the contract work it seeks to self-perform.

(2) The firm meets the bonding requirements for the contract required by law or contract specifications, as well as applicable insurance requirements for the contract, including general liability, workers compensation and unemployment insurance.

(3) The firm has not been debarred or suspended by any federal, state or local government agency or authority in the past three years.

(4) The firm has not defaulted on any project in the past three years. □

(5) The firm has not had any type of business, contracting or trade license, registration or certification revoked or suspended in the past three years.

(6) The firm and its principals/owners have not been convicted of any crime relating to its contracting business in the past ten years.

(7) Within the past three years, the firm has not been found in violation of any law applicable to its contracting business, including, but not limited, to licensing laws, tax laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $5,000) or more.

(8) Has the firm operated under a different name in the last ten (10) years? If yes, please provide prior name(s).

(9) Have the principals of the firm operated a business under a different name in the last ten (10) years? If yes, please provide name(s) of such businesses.

(10) The firm will employ a sufficient number of craft labor personnel required to successfully perform any project work it self-performs or shall use qualified subcontractors to meet this requirement and shall assign workers to perform only work in their respective craft or trade for which they have sufficient skills and training, or shall use qualified subcontractors to meet this requirement.

(11) The firm will pay all craft employees on the project, at a minimum, the applicable wage and fringe benefit rates, as established for the classification in which the worker is employed, in accordance with the Pennsylvania Prevailing Wage Act (43

P.S. § 165-1 et seq.).

(12) The firm will ensure that all craft labor it employs on the project will have completed, prior to working on the project the OSHA 10-hour training course for safety established by the U.S. Department of Labor. If the firm is a prime contractor, it shall also ensure that at least one person on the project has completed the OSHA 30-hour construction training course established by the U.S. Department of Labor

(13) The firm participates in a Class A Apprenticeship Training Program for each separate trade or classification in which it employs craft employees.

(a) A “Class A Apprenticeship Program” is an apprenticeship program registered with and approved by the U.S. Department of Labor or a state apprenticeship agency and has graduated apprentices to journey person status for at least three of the past five years. This may be an apprenticeship program subject to the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1001 et seq. ("ERISA"), or a non-ERISA program.

(b) To demonstrate compliance with this section, the firm shall provide, with this certification, a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A

Apprenticeship Program for each trade or classification listed. See

Attachment 1.

(14) The construction manager, general contractor or other lead or prime contractor responsible for the project shall ensure that at least 70 percent of the craft labor workers employed on the project shall be comprised of either journeyperson workers who have successfully completed a Class A Apprenticeship Program or apprentices registered in such programs. The apprenticeship participation of specified by this section must be in the same trade or craft for which the workers are employed on the project.

(15) The firm shall assign craft labor personnel only work in the craft or trade in which they are employed.

(16) The firm has all other technical qualifications and resources, including equipment, personnel and financial resources, to successfully perform the referenced contract and shall maintain such capabilities throughout the duration of the project, or will obtain same through the use of qualified, responsible subcontractors or vendors

(17) The firm shall notify Delaware County within seven days of any material changes in its operation that relate to any matter attested to in this certification.

(18) If the submitting firm has ever operated under another name or is controlled by another company or business entity or in the past five years controlled or was controlled by another company or business entity, whether as a parent company, subsidiary or in any other business relation, it shall attach as Attachment 2 hereto that explains in detail the nature of any such relationship. Additional information may be required from such an entity if the relationship in question could potentially impact contract performance.

(19) Please include a proposed Subcontractor List as Attachment 3. If the firm receives a Notice of Intent to Award Contract, it agrees to: (a) provide Subcontractor

Responsibility Forms and any required subcontractor information within fourteen days

(Director of Public Works may extend such deadline upon good justification by firm);

and (b) provide any reasonably requested supporting documentation as part of

Delaware County’s contractor responsibility review process.

(20) The firm and its owners have not declared bankruptcy in the past three (3) years. □

(21) The firm has not committed or been cited for a willful violation of federal or state safety laws as determined by a final decision of a court or government agency in the past three (3) years.

(22) The firm will notify, in writing, the Delaware County Department of Public Works within seven (7) days of any material change to any of the above certifications.

*Please check each box to acknowledge that you have read the corresponding representation/warranty/agreement.

By executing below, you declare and certify that:

(A) You are an employee or officer of the firm who is duly authorized to execute this

Contractor Responsibility Certification.

(B) Have sufficient knowledge to address all matters in this Contractor Responsibility

Certification and attest that all information submitted is true, complete and accurate.

This attestation is made subject to the penalties and provisions of 18 Pa. C.S.A. §4904 relating to unsworn falsification to authorities.

Name of Firm: _____________________________

By: ___________________________________________

Name:

Title:

Date:

Exhibit A

Diversity Goal Contract Provisions

Pursuant to Delaware County Resolution Number 2022-3 Regarding Goals for Diversity in Public Works

Contracting, the following provisions will be required in any contract resulting from this solicitation.

a. The contractor will make a good faith effort to employ local residents for completion of the project, when it has a need for new employees, in an effort to meet a goal of 10% local worker participation on the project. Good faith effort shall include, but not be limited to: hosting a public job fair prior to the commencement of the Project open to residents of Delaware County, posting of available employment opportunities with the Delaware County Workforce

Development Board and its PACareerLink offices, providing employment and training services, advertisement of employment opportunities in a newspaper of general circulation throughout

Delaware County, and internet advertisements.

b. The contractor will make a good faith effort to employ minority and female craftspeople for completion of the qualified project when such contractor has a need for new employees to complete the project, in an effort to meet the goal of having 10% minority and female participation on the project. Good faith effort shall include, but not be limited to: hosting a public job fair prior to the commencement of the Project open to all applicants in an attempt to identify, hire and utilize minority and female craftspeople, the posting of available employment opportunities with the Delaware County Workforce Development Board and its PACareerLink offices, providing employment and training services, advertisement of employment opportunities in a newspaper of general circulation throughout Delaware County, and internet advertisements.

c. The contractor shall, as a material condition of the contract, make a good faith effort to utilize veteran owned businesses, minority owned businesses, women owned businesses and small business enterprises on the qualified project. “Minority owned business” shall mean that at least 51% of the business is owned by an individual who is a United States citizen or permanent resident alien who has and can demonstrate membership in one of the following groups: Black persons having origins in any of the Black African racial groups; Hispanic persons of Mexican, Puerto Rican, Dominican, Cuban, Central or South American Descent of either Indian or Hispanic origin, regardless of race; Native American or Alaskan native persons having origins in any of the original peoples of North America; Asian and Pacific Islander persons having origins in any of the

Far East countries, South East Asia, the Indian subcontinent or the Pacific Islands. “Small business enterprise” shall mean a business with an annual gross income which is determined by the United States Small Business Administration to qualify it as a small business enterprise.

Attachment 1

Class A Apprenticeship Program

[Firm to attach a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A Apprenticeship Program per paragraph 11(b).]

Attachment 2

Prior Names/Organization Changes

[Firm to attach additional information if required under Paragraph (16).]

Attachment 3

Subcontractor List

[Must include name, phone number, address and type of work to be performed for each subcontractor].

J- RCO Certification (subcontractor) v3

Subcontractor Responsibility Certification

Chapter 29 of the Delaware County Code requires that as a condition of performing work on certain public works contracts, a firm seeking award of a contract shall submit Subcontractor Responsibility

Certification for all identified subcontractors. Delaware County has determined that the contract subject to this solicitation is covered by Chapter 29, and that firms responding to this solicitation must submit this form for all subcontractors.

In order for this Subcontractor Responsibility Certification to be considered validly submitted, it must be properly signed by the subcontractor or an officer or employee of the subcontractor authorized to make

it. Subcontractor Responsibility Certifications that are not properly signed will not be considered as responsive to the requirements of the Delaware County Code.

Execution of this Subcontractor Responsibility Certification shall not establish a presumption of subcontractor responsibility, and Delaware County may require any additional information it deems necessary to evaluate a subcontractor’s status as a responsible contractor, including information regarding the firm's technical qualifications, financial capacity or other resources and performance capabilities.

If Delaware County determines that a Subcontractor Responsibility Certification contains false or misleading information that was provided knowingly or with reckless disregard for the truth or omits material information knowingly or with reckless disregard of the truth, the firm for which the certification was submitted shall be disqualified from the project and shall be prohibited from performing work for Delaware County for a period of three years. Delaware County may withhold payment of any monies due to the firm as damages and impose other applicable penalties and sanctions, including contract termination, as permitted by law or contract.

I hereby represent, warrant and agree on behalf of the firm indicated below that:

Acknowledged*

(1) The subcontractor and its employees have all licenses, registrations, certificates or other credentials required by federal and state law and the laws of

Delaware County with respect to the contract work it seeks to self-perform.

(2) The subcontractor meets the bonding requirements for the contract required by law or contract specifications, as well as applicable insurance requirements for the contract, including general liability, workers compensation and unemployment insurance.

(3) The subcontractor has not been debarred or suspended by any federal, state or local government agency or authority in the past three years.

(4) The subcontractor has not defaulted on any project in the past three years. □

(5) The subcontractor has not had any type of business, contracting or trade license, registration or certification revoked or suspended in the past three years.

(6) The subcontractor and its principals/owners have not been convicted of any crime relating to its contracting business in the past ten years.

(7) Within the past three years, the subcontractor has not been found in violation of any law applicable to its contracting business, including, but not limited, to licensing laws, tax laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $5,000) or more.

(8) Has the firm operated under a different name in the last ten (10) years? If yes, please provide prior name(s).

(9) Have the principals of the firm operated a business under a different name in the last ten (10) years? If yes, please provide name(s) of such businesses.

(10) The subcontractor will employ a sufficient number of craft labor personnel required to successfully perform any project work and shall assign workers to perform only work in their respective craft or trade for which they have sufficient skills and training.

(11) The subcontractor will pay all craft employees on the project, at a minimum, the applicable wage and fringe benefit rates, as established for the classification in which the worker is employed, in accordance with the Pennsylvania Prevailing Wage

Act (43 P.S. § 165-1 et seq.).

(12) The subcontractor will ensure that all craft labor it employs on the project will have completed, prior to working on the project the OSHA 10-hour training course for safety established by the U.S. Department of Labor.

(13) The subcontractor participates in a Class A Apprenticeship Training Program for each separate trade or classification in which it employs craft employees.

(a) A “Class A Apprenticeship Program” is an apprenticeship program registered with and approved by the U.S. Department of Labor or a state apprenticeship agency and has graduated apprentices to journey person status for at least three of the past five years. This may be an apprenticeship program subject to the Employee Retirement Income

Security Act of 1974, 29 U.S.C. § 1001 et seq. ("ERISA"), or a non-ERISA program.

(b) To demonstrate compliance with this section, the subcontractor shall provide, with this certification, a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A Apprenticeship Program for each trade or classification listed. See Attachment 1.

(14) The subcontractor shall assign craft labor personnel only work in the craft or trade in which they are employed.

(15) The subcontractor has all other technical qualifications and resources, including equipment, personnel and financial resources, to successfully perform the referenced contract and shall maintain such capabilities throughout the duration of the project, or will obtain same through the use of qualified, responsible subcontractors or vendors

(16) The subcontractor shall notify Delaware County within seven days of any material changes in its operation that relate to any matter attested to in this certification.

(17) If the submitting subcontractor has ever operated under another name or is controlled by another company or business entity or in the past five years controlled or was controlled by another company or business entity, whether as a parent company, subsidiary or in any other business relation, it shall attach as Attachment 2 hereto that explains in detail the nature of any such relationship. Additional information may be required from such an entity if the relationship in question could potentially impact contract performance.

(18) If you are organized as a sole proprietorship owned and operated by a single person, to ensure that you are a legitimate business entity and not a misclassified employee, you must submit as Attachment 3 your Employer Identification Number and copies of any license, certificate or registration you are required to maintain in to do business in the state in which it is located.

(19) The subcontractor and its owners have not declared bankruptcy in the past three (3) years.

(20) The subcontractor has not committed or been cited for a willful violation of federal or state safety laws as determined by a final decision of a court or government agency in the past three (3) years.

(21) The subcontractor will notify, in writing, the Delaware County Department of

Public Works within seven (7) days of any material change to any of the above certifications.

*Please check each box to acknowledge that you have read the corresponding representation/warranty/agreement.

By executing below, you declare and certify that:

(A) You are an employee or officer of the subcontractor who is duly authorized to execute this Contractor Responsibility Certification.

(B) Have sufficient knowledge to address all matters in this Contractor Responsibility

Certification and attest that all information submitted is true, complete and accurate.

This attestation is made subject to the penalties and provisions of 18 Pa. C.S.A. §4904 relating to unsworn falsification to authorities.

Name of Subcontractor: _____________________________

By: ___________________________________________

Name:

Title:

Date:

Attachment 1

Class A Apprenticeship Program

[Subcontractor to attach a list of all trades or classifications of craft employees it will employ on the project and documentation verifying it participates in a Class A Apprenticeship Program per paragraph

11(b).]

Attachment 2

Prior Names/Organization Changes

[Subcontractor to attach additional information if required under Paragraph (15).]

Attachment 3

Sole Proprietorship Information

[Subcontractor to attach additional information if required under Paragraph (16).]

MONTGOMERY COUNTY

Responsible Contractor/Subcontractor Certification Cover Sheet

GENERAL INFORMATION

Company Name:

Address:

City:

Telephone Number: Fax Number:

Ownership Structure (Please check one):

Sole Proprietorship Partnership Corporation Joint Venture Other

Description of Services(s) Provided: __________________________________________________________________

Contractor’s License No.: _____________________________________________

RESPONSIBLE CONTRACTOR STATUS

Please check one of the following boxes:

1. Meets all Responsible Contractor requirements (see below)

2. Meets none of the Responsible Contractor requirements

3. Meets certain of the Responsible Contractor requirements (provide explanation below)

If you have checked box 3 above, please provide an explanation below (attach additional pages if necessary):

Explanation:

RESPONSIBLE CONTRACTOR REQUIREMENTS CHECKLIST

Review the attached checklist and return a completed copy, along with any documents requested therein.

A full list of the Responsible Contractor Requirements is linked here, and can also be found on Montgomery County’s website (montgomerycountypa.gov) under Administration County Procurement Policy.

By signing this form, it is assumed that contractors have fully reviewed the Responsible Contractor Requirements.

CERTIFICATION OF RESPONSIBLE CONTRACTOR STATUS

On behalf of the above-named company, the undersigned certifies that the information and responses provided herein are true, complete and accurate as of this date, and he/she is aware that any intentionally misrepresented or falsified information may result in disqualification from future contracting opportunities.

Further, the above-named company certifies it can provide sufficient written proof that it and all subcontractors comply with the Responsible Contractor Requirements above within five (5) calendar days upon request.

Signature: _____________________________________

Name and Title (please print): _____________________________

A copy of this form must be signed and provided to the County before any firm, including sub-contractors if requested, may be considered for award of this contract.

https://montgomerycountypa.gov/DocumentCenter/View/2382

Attachment – Responsible Contractor/Subcontractor Certification Checklist

Complete the following and provide the documents highlighted below with your bid. If you answer “no” to any of the below, please provide a detailed explanation on the cover sheet as to why your firm does not meet the requirement.

For all contractors and subcontractors:

Requirement Response

1. My firm and its employees shall have all valid and effective licenses, registrations, or other credentials required by federal, state, county, or local law. I will provide electronic copies of the relevant credentials.

Y: ____

N: ____

2. My firm meets the bonding requirements for the contract, as well as applicable insurance requirements. I will provide electronic copies of these documents, as well as a hard copy of the bond.

3. My firm has not been debarred or suspended by any federal, state, or local government agency or authority within the past three (3) years.

4. My firm has not defaulted on any project within the past three (3) years.

5. My firm has not had any type of license, registration, or other certification revoked or suspended within the past three (3) years.

6. My firm and its principals and owners have not been convicted of any crime relating to their contracting business within the past ten (10) years.

7. My firm has not been found in violation of any law applicable to its contracting business within the past three (3) years.

8. My firm will employ a sufficient number of craft labor personnel or shall use qualified subcontractors to meet the personnel requirement.

9. My firm will pay all craft employees on the project, at a minimum, the applicable wage and fringe benefit rates as established for the classification in which the worker is employed.

10. My firm will ensure that all craft labor it employs on the project will have completed, prior to working on the project, the OSHA 10-hour training course for safety. I will provide electronic copies of the training certification documents.

11. My firm participates in a bona fide apprenticeship program which is registered with and approved by the U.S. Department of Labor or a state apprenticeship agency and has graduated apprentices to journeyperson status for at least three (3) of the past five (5) years. I will provide (1) a list of all trades or classifications of craft employees my firm will employ on the project and (2) documentation verifying that my firm actively participates in a bona fide apprenticeship program, including the name, state, and registration number of the program.

12. My firm shall assign craft labor personnel only to work in the craft or trade in which they are employed.

13. My firm has all other technical qualifications and resources, including equipment, personnel, and financial resources, to successfully perform the contract and shall maintain such capabilities throughout the duration of the project.

14. My firm shall notify the County within seven (7) days of any material changes in its operation related to any matter attested to in this certification.

15. My firm will execute this Contractor Responsibility Certification by a person who has sufficient knowledge to address all matters in this certification.

16. If my firm has ever operated under another name, or currently controls or is controlled by another company, or has controlled or was controlled by another company within the past 5 years, whether as a parent company, subsidiary, or other business relation, I will provide a written statement explaining in detail the nature of any such relationship.

If my firm is the construction manager, general contractor, or other lead or prime contractor on this project:

Requirement Response

1. My firm will ensure that at least seventy (70) percent of all craft labor workers on the project shall be comprised of either journeyperson workers who have successfully completed a bona fide apprenticeship program or apprentices registered in such programs, and that the apprenticeship participation is in the same trade or craft for which the workers are employed on the project. I will identify on payroll documents whether employees are journeyperson workers, apprentices, or neither.

2. My firm will ensure that at least one person on the project will have completed, prior to working on the project, an OSHA 30-hour training course. I will provide an electronic copy of the training certification documents.

If my firm will be subcontracting work to other firms:

1. My firm will provide a Subcontractor List within seven (7) days of receiving a Notice of Intent to Award Contract which includes the names and business addresses of the subcontractors it intends to use on the project and the scope of the work assigned to each subcontractor.

2. My firm will submit Subcontractor Responsibility Certifications and all supporting information for all entities listed on the Subcontractor List.

3. My firm shall determine whether any firm on its Subcontractor List is organized as a sole proprietorship owned and operated by a single person. For any such entity, my firm will require the subcontractor to supplement its Subcontractor Certification with its Employer Identification Number in addition to the other information required by this certification.

4. My firm agrees that it shall not be permitted to use a subcontractor on any work performed for the County unless it has identified the subcontractor on its Subcontractor List and has provided a Subcontractor Responsibility Certification.

If my firm is working on a project subject to a Community Participation Goal:

1. My firm will make a good-faith effort to meet the Community Participation Goal of 15 percent of total project dollars spent for contracted work paid to local businesses, 5 percent paid to disadvantaged businesses, and 3 percent of total labor hours to individuals residing in zip codes no more than five miles from the boundary of the 19401 zip code.

2. My firm will provide a commitment to meet the Community Participation Goal, demonstrated by describing how my firm will proactively seek to accomplish the Community Participation Goal.

3. My firm will maintain documentation of its good-faith efforts and will promptly and accurately disclose any changes to its plans to comply with the Community Participation Goal.

County of Montgomery

5. Responsible Contractor Requirements.

a. To obtain true economy, the County must minimize the possibility of a subsequent default by the contractor, late deliveries, or other unsatisfactory performance which may result in additional administrative costs. Prior to any contract award, there must first be a written determination that the bidder or offeror will be a responsible contractor.

b. This Policy shall apply to all public works projects undertaken by the County for construction, demolition, alteration, renovation service or maintenance of buildings, structures, or facilities valued at or above $250,000.00 1 and shall apply to any and all contractors and subcontractors of any tier that perform work on such projects.

c. All firms engaged in public works contracts subject to this Policy, including general contractors, construction managers, other lead or prime contractors, and subcontractors at any level, shall be qualified, responsible contracting firms that have sufficient capabilities in all respects to successfully perform contracts on which they are engaged, including the necessary experience equipment, technical skills and qualifications and organizational, financial and personnel resources. Firms bidding or otherwise participating in public works contracts shall also be required to have a satisfactory past performance record and a satisfactory record of law compliance, integrity, and business ethics.

6. Contractor Responsibility Certifications.

a. As a condition of performing work on a public works contract subject to this Policy, a general contractor, construction manager or other lead or prime contractor seeking award of a contractor shall submit a Contractor Responsibility Certification.

b. The Contractor Responsibility Certification shall be completed on a form provided by the County and shall reference the project for which a bid is being submitted by name, the solicitation number and contract or project number.

c. In the Contractor Responsibility Certification, the construction manager, general contractor, or other lead or prime contractor shall confirm the following facts regarding its past performance and work history and its current qualifications and performance capabilities:

1) The firm and its employees shall have all valid, effective licenses, registrations, certificates, or other credentials required by federal, state, county, or local law, including, but not limited to, licenses, registrations or certificates required to: (a) do business in the designated locale; and (b) perform the contract work it seeks to perform.

These shall include, but not limited to, licenses, registrations, or certificates for any type of construction or maintenance trade work or specialty work that the firm proposes to self-perform.

2) The firm meets the bonding requirements for the contract, as required by applicable law or contract specifications, as well as applicable insurance requirements for the contract including general liability insurance, workers compensation insurance and unemployment insurance.

3) The firm has not been debarred or suspended by any federal, state, or local government agency or authority in the past three (3) years.

4) The firm has not defaulted on any project in the past three (3) years.

5) The firm has not had any type of business, contracting or trade license, registration, or other certification revoked or suspended in the past three (3) years.

6) The firm and its Principals/Owners have not been convicted of any crime relating to its contracting business in the past ten (10) years.

7) Within the past three years, the firm has not been found in violation of any law applicable to its contracting business, including, but not limited to, licensing laws, tax laws, prompt payment laws, wage and hour laws, prevailing wage laws, environmental laws or others, where the result of such violation was the payment of a fine, back pay damages or any other type of penalty in the amount of $5,000 or more.

8) The firm will employ a sufficient number of craft labor personnel required to successfully…