TOWN OF WOODSTOCK, VIRGINIA

REQUEST FOR PROPOSAL (RFP)

Engineering Design, Permitting, and Construction Documents for Removal of the Woodstock Dam (NID #171004)

RFP Number: FY27_RFP_001

Issue Date: August 24, 2026

Proposal Due Date:

September 25, 2026 at 1:00 PM Local Time

SECTION 1 — OFFEROR CONTACT INFORMATION

Complete all fields. This cover sheet must be signed and returned with your proposal.

Legal Name of Firm (as listed on W-9)

DBA / Trade Name (if applicable)

Street Address City, State, ZIP

Primary Contact Name Title

Phone Number Email Address

SECTION 2 — ATTESTATIONS

By signing this cover sheet, the authorized representative of the firm named above attests and certifies to the following:

□ Years in Business: The firm has been in continuous operation as a legal business entity for a minimum of five (5) years. Year business established: ___________

□ No Pending Litigation: The firm has no current pending litigation that would materially affect its ability to perform the services described in this RFP, and no judgments have been entered against the firm in the past three (3) years that remain unsatisfied.

SECTION 3 — ADDENDUM ACKNOWLEDGMENT

The Town will complete this table as each addendum is issued and will distribute an updated cover sheet with each addendum. Offerors must initial each row to acknowledge receipt, and should confirm with the Town's website or eVA immediately prior to submission that no additional addenda have been issued. Proposals submitted without acknowledgment of all issued addenda may be deemed non-responsive. If no addenda have been issued as of the due date, write "None" in the table below.

Addendum No. Date Issued Subject / Description Initial

FY27_RFP_001

SECTION 4 — AUTHORIZED REPRESENTATIVE SIGNATURE

The undersigned, being duly authorized to act on behalf of the firm identified above, certifies that all information provided in this proposal is true, accurate, and complete, that all attestations in Section 2 are correct, and that the firm agrees to be bound by the terms and conditions of this RFP and any resulting contract.

Printed Name of Authorized Representative Title

Signature of Authorized Representative Date

This cover sheet must be signed and submitted as the first page of your proposal.

Request for Proposal (RFP) Engineering Design, Permitting, and Construction Documents for Removal of the Woodstock Dam (NID #171004) This Request for Proposal (RFP) plus the resulting contracts shall be consistent with and governed by the Town’s procurement policy and has been prepared in accordance with the Virginia Public Procurement Act.

The Town’s Point of Contact for this project is:

Jill Jefferson, Project Point of Contact Town of Woodstock 135 N. Main St.

Woodstock, VA 22664 Ph: 540-459-3450 Email: JJefferson@woodstockva.gov

Offerors may submit proposals electronically through eVA or by mail/hand delivery in a sealed envelope. See Proposal Submission Requirements below for complete instructions.

Potential Offerors are required to submit all questions in writing by email directly to the listed point of contact no later than September 11, 2026 at 5:00 PM. Written responses, including the questions, will be provided to all Offerors via an official Addendum and posted on the Town’s website.

The successful offeror must warrant that it will not discriminate against any employee, or other person, on account of race, color, sex, religious creed, ancestry, age, national origin, other non-job related factors or any basis prohibited by law. To the extent required by law and upon request of the Town, the successful offeror must agree to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

I. Project Background The Town of Woodstock (the “Town”) owns the Woodstock Dam, also referred to as the West End Dam, a 44-foot concrete gravity dam located on Little Stoney Creek in Shenandoah County, Virginia, within the George Washington and Jefferson National Forests. The dam is listed in the National Inventory of Dams as a High Hazard potential structure (NID #171004). Completed in 1957, the dam originally impounded a drinking-water reservoir for the Town until the 1970s, when a water treatment facility was constructed closer to Woodstock and the dam was removed from active service in the Town’s water supply system.

The dam no longer serves a beneficial purpose and represents an ongoing public-safety and financial liability. Engineering studies have determined that the structure lacks adequate factors of safety against overturning and that its spillway cannot safely pass the required Spillway Design Flood. The most recent analysis indicates the spillway can convey only approximately 51 percent of the Probable Maximum Flood (PMF) before the earthen abutments overtop, a condition that would likely result in failure of the dam. Approximately 84 residential structures lie within the dam-break inundation mailto:JJefferson@woodstockva.gov zone, including roughly 20 homes located within two miles downstream along Millertown Road, where limited time would be available for evacuation in the event of a failure.

After more than five years of planning and coordination with downstream property owners, stakeholders, and resource agencies, the Town has elected to remove the dam and restore the natural stream channel, floodplain, and associated habitat. Dam removal is identified as a priority in the Town’s Comprehensive Plan, Capital Improvement Plan, and Strategic Plan, and is supported by a Memorandum of Agreement among the Town, the Virginia State Historic Preservation Office, and the George Washington and Jefferson National Forests, as well as by numerous agencies and organizations, including the Virginia Department of Wildlife Resources, the Virginia Department of Conservation and Recreation, the U.S. Fish and Wildlife Service, the U.S. Forest Service, Trout Unlimited, American Rivers, the Alliance for the Shenandoah Valley, and others. In addition to eliminating the risk of dam failure, the project will reconnect and restore aquatic habitat on National Forest lands, benefiting native Brook trout, American eel, and other species.

The Town has been awarded a grant from the Virginia Department of Conservation and Recreation (DCR) Dam Safety, Flood Prevention, and Protection Assistance Fund under Project Type 2 (Design, Repair, Removal, and Safety Modifications). Through this solicitation, the Town seeks a qualified engineering and design firm (the “Offeror” or, once selected, the “Contractor”) to perform the assessment, hydrologic and hydraulic analysis, design, permitting, and public outreach necessary to produce construction documents for removal of the Woodstock Dam and restoration of the affected reach of Little Stoney Creek. The selected firm will be retained in accordance with the Town’s procurement policy and the Virginia Public Procurement Act.

II. Pre-Proposal Meeting A pre-proposal meeting is not required for this solicitation. Prospective Offerors who wish to observe the dam and the downstream project area may attend an optional site visit on September 9, 2026 at 9:30 AM. Offerors should meet at the Woodstock Town Office located at 135 N Main Street, Woodstock, VA 22664 and plan to travel separately to the dam site. Any substantive information conveyed during a site visit, and any questions and responses, will be documented and issued to all Offerors by official Addendum and posted on the eVirginia (eVA) portal and the Town’s website. Offerors are responsible for their own arrangements, safety, and access coordination for any site visit from the Town Office to the dam.

III. Procurement Schedule The table below summarizes the anticipated schedule of events for this solicitation. All deadlines and times are Eastern Time. This schedule is subject to change at the Town’s discretion.

RFP Issued August 24, 2026 Optional Site Visit (Beginning at Woodstock Town Office) September 9, 2026, 9:30 AM

Deadline for Written Questions (by email) September 11, 2026, 5:00 PM Proposal Due Date September 25, 2026, 1:00 PM

IV. Project Scope and Requirements The Town seeks professional engineering and design services to advance the removal of the Woodstock Dam from the assessment phase through completed construction documents and permitting. The scope of work combines dam-safety engineering with natural channel design methodology to safely remove the existing structure and restore the stream channel, floodplain, and associated habitat. The selected Contractor shall perform detailed hydrologic and hydraulic modeling in coordination with field assessments, utilizing existing studies and data where feasible, and shall prepare dam-safety documentation, including an alteration and/or decommissioning plan, in coordination with the required environmental permits and construction documents.

The overall project proposes removal of the dam except for those remnants required to be retained in conformance with the Memorandum of Agreement with the Virginia State Historic Preservation Office. The project also contemplates river restoration and the eventual replacement of downstream concrete ford crossings that currently impede aquatic organism passage; the specific tasks funded under this solicitation are described below. The Contractor shall provide all labor, materials, equipment, and professional services necessary to complete the following tasks.

Task 1 – Stream Assessment and Survey Field data collection, stream assessments, and surveying to establish existing conditions for design.

This task includes a topographic survey of the dam area and downstream channel (approximately 1,500 linear feet) to supplement existing data, survey of two downstream road crossings for hydraulic modeling, wetland delineation, and geomorphic assessment of the stream channel within the survey area.

I. Deliverable: An existing-conditions graphic prepared on 24″ x 36″ plan sheet(s).

II. Exclusions: Bathymetry, sediment analysis, and boundary survey, which are anticipated to be provided by others under separate scope.

Task 2 – Hydrologic and Hydraulic Analysis Preparation of pre- and post-project hydraulic models using HEC-RAS (or equivalent) to evaluate the dam removal across a range of design storm events, including the bankfull (channel-forming) discharge and the 10-, 50-, 100-, and 500-year events, the Spillway Design Flood (SDF), and the Probable Maximum Flood (PMF). The Contractor shall review existing studies and incorporate existing data where practicable, and shall complete a Fish Passage Assessment to evaluate movement of targeted species upon removal of the dam.

III. Deliverable: A hydrologic and hydraulic analysis summary report with modeling results and summary graphics depicting the pre- and post-project floodplain conditions.

IV. Exclusions: The scope assumes the design can be produced with no adverse impact to downstream properties or the floodplain. FEMA coordination is not included and may be provided under separate scope if required.

Task 3 – Dam Removal Plans Preparation of construction documents for dam removal, including plan, profile, and cross sections of the proposed channel and floodplain geometry with associated notes, details, and specifications.

Milestone submittals shall be provided at 35 percent (concept plan), 65 percent (design development), and 95 percent and 100 percent (construction documents). The plans shall include a phased Erosion and Sediment Control plan and construction-level notes and details.

V. Deliverable: Construction documents (24″ x 36″ plan sheets or equivalent) and specifications for dam removal and restoration of the stream reach.

VI. Exclusions: Detailed design of demolition of ancillary structures (e.g., chlorination building, water tank) and associated disposal permitting; such structures will be depicted on the demolition plan but detailed demolition design may be provided under separate cover.

Task 4 – Permitting Preparation of permit applications and associated agency coordination and submittal. The Contractor shall prepare the applications necessary to authorize the dam removal and stream restoration as described herein.

VII. Deliverable: Preparation of a Nationwide Permit (Joint Permit Application), a Dam Alteration Permit (DCR), an Abandonment Plan (USFS) and/or Decommissioning Permit, a Land Disturbance Permit application, a Water Quality Impact Assessment, and a SWPPP.

VIII. Exclusions: NEPA documentation and any additional impact studies not specifically referenced herein. Should an Individual Permit be determined to be required, additional permitting effort would be authorized under separate scope.

Task 5 – Project Coordination and Outreach Continued coordination with the Town, downstream property owners, stakeholders, and committees as the design develops, including attendance at and presentation during public meetings.

IX. Deliverable: Routine project coordination (including conference calls) and participation in up to two (2) public meetings.

X. Exclusions: No guarantee of permit approval is stated, implied, or intended.

Schedule and Milestones The design and permitting effort is anticipated to require approximately 1.5 to 2 years to complete, with critical milestones organized around the Assessment, Design, and Permitting phases.

Construction-document milestone submittals shall be provided at the 35, 65, 95, and 100 percent stages to allow for review, contractor input, and coordination. The Offeror shall propose a detailed project schedule consistent with these milestones and with the period of performance required by the DCR grant award. Construction funding will be sought separately; the Town reserves the right to reallocate construction-document effort toward proposal-package preparation or construction technical support if warranted by design constraints identified during the work.

Fee Negotiation

Consistent with Va. Code § 2.2-4302.2, Offerors shall not submit cost or fee information with their proposal. Following evaluation and ranking as described under Selection of Contractor, the Town will negotiate a not-to-exceed fee, including a task-level cost breakdown, with the Offeror ranked most qualified.

V. Selection of Contractor An evaluation committee will review all proposals. Because this solicitation is for professional engineering services, the Town will follow the competitive negotiation procedure required by Va.

Code § 2.2-4302.2 for architectural and engineering services: the committee will engage in individual discussions with two or more Offerors deemed fully qualified, responsible, and suitable to perform the required services, with emphasis on professional competence, and may conduct repetitive informal interviews.

Proposals will be evaluated and ranked by the evaluation committee based on the following weighted criteria. Consistent with Va. Code § 2.2-4302.2, cost and fee information is not requested with initial proposals and is not a factor in this ranking; fee is negotiated later, as described below.

I. Qualifications and Experience – demonstrated experience of the firm and key personnel with dam removal, stream and floodplain restoration, hydrologic and hydraulic analysis, fish passage and aquatic organism passage design, and permitting before Virginia DCR Dam Safety and related agencies. (40%)

II. Project Approach and Understanding – understanding of the project objectives and demonstrated, well-organized methodology for completing each task in the Project Scope and Requirements, including coordination, quality control, and use of existing data. (35%)

III. Schedule and Capacity – ability to perform the work and meet the milestone submittals within the period of performance required by the DCR grant award. (25%)

At the conclusion of the evaluation described above, the committee will select, in order of preference, two or more Offerors whose professional qualifications and proposed services are deemed most meritorious. Negotiations will then be conducted beginning with the Offeror ranked first, including negotiation of a not-to-exceed fee and any exceptions to the Town's proposed contract terms and conditions. If a contract satisfactory and advantageous to the Town cannot be negotiated with the Offeror ranked first at a price considered fair and reasonable, negotiations with that Offeror will be formally terminated and negotiations will be conducted with the Offeror ranked second, and so on, until a contract can be negotiated. Should the Town determine, in writing and in its sole discretion, that only one Offeror is fully qualified or that one Offeror is clearly more highly qualified and suitable than the others under consideration, a contract may be negotiated and awarded to that Offeror without further competition. The work funded under this solicitation is supported in part by the DCR Dam Safety, Flood Prevention, and Protection Assistance Fund, and the selected Contractor will be expected to support the Town's grant-reporting and reimbursement requirements.

The approving authority for this RFP is the Town of Woodstock, Virginia. This RFP does not commit the Town of Woodstock to award a contract or to pay costs or expenses incurred in the preparation of responses to this RFP. The Town of Woodstock reserves the right, at any time prior to award of the contract, to reject any and all proposals, or any part thereof, to make no award, and/or to issue a new RFP, or make modifications, corrections, or additions to the information contained herein. Offerors are cautioned this is an RFP, not a request for contract.

Based on the results of proposal evaluation by the Selection Committee, the highest rated Offerors may be invited by the Town to make oral presentations to the Selection Committee. Such presentations may include, but are not necessarily limited to, explanations of the proposed approach, work plan, and qualifications of the Offeror. There is no specified number of Offerors that may be selected for interview.

VI. Proposal Submission Requirements Offerors may submit their proposal using either of the following methods:

Electronic Submission via eVA – Proposals may be submitted electronically through eVA (www.eva.virginia.gov), in accordance with the instructions provided on the eVA solicitation posting.

Mail or Hand Delivery – Proposals may be submitted in a sealed envelope, marked with the RFP title, “Woodstock Dam Removal – Design, Permitting, and Construction Documents,” and delivered to the project point of contact at the address listed above.

Regardless of the method used, proposals must be received by the Town no later than the Proposal Due Date and time specified in this RFP. Proposals received after that date and time will not be considered.

Prior to submitting a proposal, it is the offeror’s responsibility to check the Town’s website https://www.woodstockva.gov/Bids or eVA for any addenda associated with this RFP.

Any costs or expenses of any kind incurred by an offeror in preparing or submitting proposals are the offeror’s sole responsibility. The Town of Woodstock will not reimburse any offeror for any costs or expenses incurred because of the preparation of this RFP.

All proposals should include the following:

Proposals should be concise and should not exceed twenty (20) pages, excluding resumes and required forms (cover sheet and Attachment A). At a minimum, each proposal shall include the following:

A. The completed cover page of this RFP (cover sheet), including the firm's legal name and address, primary contact information, required attestations, and addendum acknowledgment, signed by an authorized representative.

B. A description of the firm, including its background and relevant experience with dam removal, stream and floodplain restoration, hydrologic and hydraulic analysis, fish passage, and Virginia permitting.

C. Identification of the proposed project team and key personnel, with roles, responsibilities, and resumes, including any subconsultants and their qualifications.

D. References for at least three (3) comparable projects completed within the last ten (10) years, with contact information.

E. The firm’s proposed method and approach to the scope of work, addressing each task described in the Project Scope and Requirements.

F. A proposed project schedule showing key milestones, including the 35, 65, 95, and 100 percent design submittals, consistent with the grant period of performance.

https://www.woodstockva.gov/Bids

G. Attachment A: Proof of Authority to Transact Business in Virginia: Pursuant to Virginia Code §2.2-4311.2, an offeror organized or authorized to transact business in the Commonwealth pursuant to Title 13.1 or Title 50 of the Code of Virginia shall include in its proposal the identification number issued to it by the State Corporation Commission

(“SCC”).

VII. General Terms and Conditions A. Once an Offeror is tentatively selected based on the “Evaluation Criteria" detailed in this solicitation, the Town reserves the right to conduct further discussions/negotiations with the selected Offeror. As a result of this discussion and negotiation, the Town may propose, in writing, a contract that amends the scope of the RFP or the Offeror's proposal prior to signing the contract.

B. This document will form part of the contract between the successful offeror and the Town.

The terms of this document are subject to the Request for Proposal, which shall control in the event of conflict.

C. This solicitation is subject to the provisions of the procurement policy for the Town and any revisions thereto, which are hereby incorporated into this contract in their entirety. A copy of the manual is available for review at Town Office.

D. This solicitation and any resulting contract shall be governed in all respects by the laws of the Commonwealth of Virginia and any litigation with respect thereto shall be brought in the courts of the Commonwealth in Shenandoah County, Virginia. The contractor shall comply with all applicable federal, state and local laws, rules and regulations.

E. The Offeror shall provide the Town with documents bound and suitable for distribution. In addition, all electronic copies of documents shall be provided in a format compatible with the Town's word processing hardware and software.

F. All documents, including electronic copies, submitted in response to this solicitation shall become the property of the Town. All documents, including electronic copies, prepared in conjunction with, and relating to, the work detailed in this solicitation and resulting Contract shall become the property of the Town upon final payment of all fees to the Contractor as set forth in the contract.

G. The successful Offeror (Contractor) shall assume full responsibility for the complete effort as required by this RFP. The selected Offeror shall be the sole point of contact for the Town regarding all contractual responsibilities.

H. By submitting their proposals, offerors certify to the Town that they will conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of 1975, as amended, where applicable, the Virginians With Disabilities Act, the Americans With Disabilities Act and 2.2-4311 of the Virginia Public Procurement Act.

I. The successful offeror must warrant that it will not discriminate against any employee, or other person, on account of race, color, sex, religious creed, ancestry, age, national origin, other non-job related factors or any basis prohibited by law. To the extent required by law and upon request of the Town, the successful offeror must agree to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

J. No offeror shall modify, revise, edit or make any unauthorized change(s) to the original Request for Proposal (RFP). The Official solicitation document and the addenda(s) are the documents posted on the Town of Woodstock’s web site and/or eVA. Any such violation as stated above may result in rejection of the RFP response. In addition, violations may result in the debarment of the offeror by the Town of Woodstock.

K. If any prospective offeror has questions about the specifications or other solicitation documents, the prospective offeror should contact the person whose name appears on the face of the solicitation. Any revisions to the solicitation will be made only by addendum issued by the buyer.

L. Any proposal resulting from this solicitation shall be valid for (30) days. At the end of the

(30) days the proposal may be withdrawn at the written request of the Offeror. If the proposal is not withdrawn at that time it remains in effect until an award is made or the solicitation is canceled.

M. The Town may make such reasonable investigations as deemed proper and necessary to determine the ability of the offeror to perform the services/furnish the goods and the offeror shall furnish to the Town all such information and data for this purpose as may be requested. The Town further reserves the right to reject any proposal if the evidence submitted by, or investigations of, such offeror fails to satisfy the Town that such offeror is properly qualified to carry out the obligations of the contract and to provide the services and/or furnish the goods contemplated therein.

N. The Town shall not be in default of any failure in performance of this agreement in accordance with its terms if such failure arises out of causes beyond its reasonable control and without the fault of or negligence of the Town. Such causes may include but are not restricted to acts of God or the public enemy, fires, flood, epidemics, quarantine restrictions, strikes, freight embargoes, and unusually severe weather, but in every case the failure to perform must be beyond the reasonable control and without the fault or negligence of the Town.

O. In case of failure to deliver goods or services in accordance with the contract terms and conditions, the Town, after 21 days advance written notice, if the failure is not cured, may procure them from other sources and hold the contractor responsible for any resulting additional direct and indirect costs. This remedy shall be in addition to any other lawful remedies, which the Town may have.

P. As authorized in Section 2.2-4304 of the Code of Virginia, this procurement is being conducted on behalf of and may be used by public bodies, agencies, institutions, and localities of the Commonwealth of Virginia with the consent of the successful Offeror.

Q. The Town may terminate any agreement resulting from this solicitation at any time, for any reason or for no reason, upon thirty days advance written notice to the Contractor. In the event of such termination the Contractor shall be reasonably compensated for services and work performed prior to termination.

R. The contractor shall be responsible for all property damage, accidents, injury, death, and other liabilities incurred while performing contractual duties for the Town and will hold the Town harmless for all resulting damages, including reasonable attorneys’ fees. This duty of indemnification shall include the right of the Town to select its legal counsel in any such situation.

S. Changes can be made to the contract in any of the following ways:

a. The parties may agree in writing to modify the scope of the contract. An increase or decrease in the price of the contract resulting from such modification shall be agreed to by the parties as a part of their written agreement to modify the scope of the contract.

b. The Town delegated agent may order changes within the general scope of the contract at any time by written notice to the Contractor. Changes within the scope of the contract include, but are not limited to, things such as services to be performed, the method and the place of delivery. The Contractor shall comply with the notice upon receipt. The Contractor shall be compensated for any reasonable additional costs incurred as the result of such order and shall give the Town a credit for any savings.

T. It is mutually understood and agreed that the Contractor shall not assign, transfer, convey, or otherwise dispose of this contract or its interest therein, or its power to execute such contract, to any other person, firm, or corporation, without the prior specific written consent of an authorized representative of the Town of Woodstock; but in no case shall such consent relieve the Contractor from his obligations or change the terms of the contract.

U. All parties performing services for the Town shall comply with all Occupational Safety and Health Administration (OSHA), State Occupational Health Standards, and any other applicable rules and regulations. All parties shall be held responsible for the training, supervision, and safety of their employees. Any unsafe acts or hazardous conditions that may cause injury or damage to any persons or property within and around the work site areas under this contract shall be remedied per the regulatory agency’s guidelines.

V. The Town shall not indemnify or hold harmless any Contractor or other third party. The Town does not waive any right or release any party from liability, whether on its own behalf or on behalf of any boards, employees, or agents. The Town does not waive the right to trial by jury for any cause of action arising from the contract but may at its option submit any contract claim to binding arbitration, binding mediation, or mediation. In such event, the mediator/arbitrator shall be selected by mutual agreement of the parties and failing such agreement, then by the Circuit Court of Shenandoah County upon proper petition and notice. The Town shall not be liable to Contractor for any special, punitive, or exemplary damages arising from the performance of the contract, including, but not limited to, incidental damages, and lost profit and lost wages, even if such special damages are reasonably foreseeable. Any provision(s) in the contract contrary to these statements is/are hereby deleted and rendered void.

W. All proposals submitted shall have included in price the cost of any business or professional licenses, permits or fees required by the Town of Woodstock or the Commonwealth of

Virginia. The offeror must have all necessary licenses to perform the services in Virginia and, if practicing as a corporation, be authorized to do business in the Commonwealth of VA.

X. Pursuant to Code of VA 2.2-4311.2 subsection B, an offeror organized or authorized to transact business in the Commonwealth pursuant to Title 13.1 or Title 50 is required to include in its proposal the identification number issued to it by the State Corporation Commission (SCC). Any offeror that is not required to be authorized to transact business in the Commonwealth as a foreign business entity under Title 13.1 or Title 50 or as otherwise required by law is required to include in its proposal statement describing why the offeror is not required to be so authorized. Link to the SCC site is http://www.scc.virginia.gov.

http://www.scc.virginia.gov/

ATTACHMENT A

PROOF OF AUTHORITY TO TRANSACT BUSINESS IN VIRGINIA

THIS FORM MUST BE SUBMITTED WITH YOUR PROPOSAL. FAILURE TO

INCLUDE THIS FORM SHALL RESULT IN REJECTION OF YOUR PROPOSAL.

Pursuant to Virginia Code § 2.2-4311.2, an offeror organized or authorized to transact business in the Commonwealth pursuant to Title 13.1 or Title 50 of the Code of Virginia shall include in its proposal the identification number issued to it by the State Corporation Commission ("SCC"). Any offeror that is not required to be authorized to transact business in the Commonwealth shall include in its proposal a statement describing why authorization is not required.

NOTE: The SCC number is NOT your federal ID number or business license number.

Please check the applicable box:

A. [ ] Offeror is a Virginia business entity organized and authorized to transact business in Virginia by the SCC. SCC Identification Number: _____________________

B. [ ] Offeror is an out-of-state (foreign) business entity authorized to transact business in Virginia by the SCC. SCC Identification Number: _____________________

C. [ ] Offeror is not required to be authorized to transact business in Virginia for the following reason(s):

Legal Name of Company (as on W-9)

Authorized Signature

Print Name and Title

Date