9-CSP Required Forms 2024.pdf

Statute / District Required Forms:

• No Response Form (Optional)

• Contractor Informational Form (Required)

• Contractor Questionnaire (Required)

• Bonding Capacity Certification Letter (Required)

• Proposal Submission Form (Required)

• Non-Collusion Certification (Required)

• Certificate of Residency (Required)

• Affidavit of Non-Discriminatory Employment (Required)

• Contractor Certification (Required)

• Felony Conviction Notification (Required)

• Vendor Debarment Statement (Required)

• Conflict of Interest Questionnaire (Required)

• Certification regarding Lobbying (Required)

• Confidential Copyrighted Information (Required)

• Owner(s) Name of Business (Required)

• Delinquent Taxpayers (Required)

• Fort Bend ISD Contractor and Subcontractor

Participation Form (submit with SBE Requirements)

• Certificate of Interested Parties (Required) o INSTRUCTIONS for Form 1295 (Certificate of Interested Parties)

• Forms Certification (Required)

• Per Govt. Code 2270.002, written verification that the company does not boycott Israel and will not during the term of the contract (Required)

• Addendum Acknowledgment Form (Required)

RETURN THIS DOCUMENT IN FRONT OF ORIGIONAL SUBMISSION PACKAGE

006000.01 – PROJECT

FORMS Page 2 of 20

No Response Form (Optional)

RETURN ONLY IF YOU CHOOSE NOT TO SUBMIT A RESPONSE TO THIS

SOLICITATION

CSP ________________

TITLE of CSP _____________________________________________________________________

Please Print

Whereas on the ___________ day of ____________________, 2024 (print name of company) has reviewed FBISD’s solicitation and elects not to submit a bid:

State Reason for no bid:________________________________________________________

Street Address

City, State, Zip Code

Telephone/Fax Number

Name of Authorized Individual

Signature of Authorized Individual

FORMS Page 3 of 20

Contractor Informational Form (Required)

CONTRACTOR IS:

An Individual

By __________________________________________________________________________ Individual's Name

A Partnership

Firm Name

By ___________________________________________________________________________ General Partner Authorized to Sign

A Corporation

By ___________________________________________________________________________ Corporation Name

State of Incorporation

By ___________________________________________________________________________ Name of Person Authorized to Sign

Title

(Corporate Seal)

Attest ________________________________________________________________________ Secretary

FORMS Page 4 of 20

Contractor Questionnaire (Required)

Bidder:

1. Are you using subcontractors? Yes No

2. Have you ever performed work for Fort Bend ISD or other ISDs as a subcontractor? Yes ______ No_____.

If the answer is yes, please provide name of Contractor and Project(s) you were subcontracted to.

3. Can you provide proof of liability and worker’s compensation coverage? Yes No

4. Did you include the most recent up to date references in this packet? Yes No

5. Please include similar projects that you have completed for Texas ISDs in the past 12 months.

FORMS Page 5 of 20

PROPOSAL SUBMISSION FORM

CSP __________________

Title of CSP____________________________________________

Please Print

Whereas on the _____________ day of _____________________________, 2024

(print name of company) _______________________________________________ has reviewed

CSP # _______________________________________________

A copy may be obtained at http://www.fortbendisd.com/docs/purchasing/general-provisions-for-purchasing-solicitations-and-contracts.pdf or by contacting the Fort Bend ISD Buyer listed on the cover sheet. Any exception to the terms and conditions must be included in the Proposer’s response.

Texas Education Code 44.031(a)(5); Texas Government Code 2269 Purchasing and Acquisition, FBISD Policy CH (Legal) Purchasing and Acquisition, FBISD Policy CH (Local) Facilities and Construction, FBISD Policy CV (Legal) Facilities and Construction, FBISD Policy CV (Local)

Street Address City, State, Zip Code

Telephone Number Fax Number

Name of Authorized Individual Signature of Authorized Individual

FORMS Page 6 of 20

Non-Collusion Certification (Required)

The undersigned affirms that he or she is duly authorized to execute this questionnaire, that this company, corporation, firm, partnership, or individual has not prepared this submission in collusion with any other person, firm, or entity making or considering making a submission to FBISD for any of the future District projects, and that the contents of this submission as to prices, terms or conditions of said submission have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business prior to the official opening of this submission.

The foregoing is true and correct. FBISD, or any authorized representative of FBISD, is authorized by the undersigned to contact any firm, institution, or person listed above to obtain information which FBISD might determine as being desirable.

Firm:

Address:

City/State/Zip:

Phone No:

Fax No:

Signature:

Typed Name:

Date:

FORMS Page 7 of 20

Certificate of Residency (Required)

The State of Texas has passed a law concerning non-resident contractors. This law can be found in Texas Government Code under Chapter 2252, This law makes it necessary for FBISD to determine the residency of its proposers. In part, this law reads as follows:

“Section: 2252.001

(3) ‘Non-resident bidder’ refers to a person who is not a resident.

(4) ‘Resident bidder’ refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state.

Section: 2252.002 A governmental entity may not award a governmental contract to a nonresident bidder unless the nonresident underbids the lowest bid submitted by a responsible resident bidder by an amount that is not less than the amount by which a resident bidder would be required to underbid the nonresident bidder to obtain a comparable contract in the state in which the nonresident’s principal place of business is located.”

I certify that (Name of Company Bidding) is, under Section: 2252.002, 003 and 004, a

Resident Bidder Non-resident Bidder

My or Our principal place of business under Section: 2252.002, 003, and 004, is in the city of in the state of

Signature of Authorized Company Representative

Print Name

Title Date

006000.01 –PROJECT

FORMS Page 8 of 20

Affidavit of Non-Discriminatory Employment (Required) (Tracking purposes only)

FORT BEND INDEPENDENT SCHOOL DISTRICT

This company, Contractor, or Subcontractor agrees to refrain from discrimination in terms and conditions of employment on the basis of race, color, religion, sex, or national origin, and agrees to take affirmative action as required by Federal Statutes and rules and regulations issued pursuant thereto in order to maintain and insure non-discriminatory employment practices.

Signature

Printed Name & Title

Company

FORMS Page 9 of 20

Contractor Certification (Required)

Introduction: Texas Education Code Chapter 22 requires entities that contract with school districts to obtain criminal history records on covered employees. Covered employees with disqualifying criminal histories are prohibited from serving at a school district. Contractors must certify to the district that they have complied and must obtain similar certifications from their subcontractors.

Definitions:

Covered individuals: Individual who have or will have continuing duties related to the service to be performed and have or will have direct contact with students. The District will be the final arbiter of what constitutes direct contact with students.

Disqualifying criminal history: (1) a conviction or other criminal history information designated by the District; (2) a felony or misdemeanor offense that would prevent a person from obtaining certification as an educator under Texas Education Code § 21.060, including 19 Tex. Admin. Code §249.16; or (3) one of the following offenses, if at the time of the offense, the victim was under 18 or enrolled in a public school: (a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required to register as a sex offender under Chapter 62, Texas Code of Criminal Procedure; or (c) an equivalent offense under federal law or the laws of another state.

On behalf of _________________________________________________ (“Contractor”), I certify that [check one]:

[ ] None of Contractor’s employees are covered individuals, as defined above. If this box is checked, I further certify that Contractor has taken precautions or imposed conditions to ensure that Contractor’s employees will not become covered individuals. Contractor will maintain these precautions or conditions throughout the time the contracted services are provided.

Or [ ] Some or all of Contractor’s employees are covered individuals. If this box is checked, I further certify that:

1. Contractor has obtained all required criminal history record information regarding its covered individuals. None of the covered individuals has a disqualifying criminal history.

2. If Contractor receives information that a covered individual subsequently has a reported criminal history, Contractor will immediately remove the covered individual from contract duties and notify the District in writing within three business days.

3. Upon request, Contractor will provide the District with the name and any other requested information of covered individuals so that the District may obtain criminal history record information on the covered individuals.

4. If the District objects to the assignment of a covered individual on the basis of the covered individual’s criminal history record information, Contractor agrees to discontinue using the covered individual to provide services at the District.

Noncompliance or misrepresentation regarding this certification may be grounds for contract termination.

Signature Date

FORMS Page 10 of 20

Felony Conviction Notification (Required)

State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states “a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony”.

Subsection (b) states “a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The District must compensate the person or business entity for services performed before the termination of the contract”.

This Notice is Not Required of a Publicly-Held Corporation.

I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge.

Vendor’s Name:

Authorized Company Official’s Name (Printed):

A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable.

Signature of Company Official:

B. My firm is not owned or operated by anyone who has been convicted of a felony.

Signature of Company Official:

C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony:

Name of Felon(s):

Details of Conviction(s):

Signature of Company Official:

FORMS Page 11 of 20

Vendor Debarment Statement (Required)

I have read the conditions and specifications provided in the bid document attached.

I affirm, to the best of my knowledge, the company I represent has not been debarred or suspended from conducting business with school districts in the State of Texas. This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Section 3017.510, Participants’ responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulation may be obtained by contacting the Department of Agriculture Agency with which this transaction originated.

NAME OF COMPANY (Please Type)

MAILING ADDRESS CITY STATE ZIP

PREPARED BY (Please Type)

SIGNATURE TITLE

TELEPHONE NUMBER FAX NUMBER DATE

Check here if you have an address or telephone number change: Yes____ No____

FORMS Page 12 of 20

Conflict of Interest Questionnaire (Required) COMPLETE AND SIGN EVEN IF NO CONFLICT EXISTS

CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ

For vendor or other person doing business with local governmental entity

This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.

This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person meets requirements under Section 176.006(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.

OFFICE USE ONLY

Date Received

Name of vendor who has a business relationship with local governmental entity.

Check this box if you are filing an update to a previously filed questionnaire.

(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)

Name of local government officer about whom the information is being disclosed.

Name of Officer

This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.

A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the vendor?

Yes No

B. Is the vendor of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity?

Yes No

C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of one percent or more?

Yes No

D. Describe each employment or business relationship with the local government officer named in this section.

Signature of vendor doing business with the governmental entity Date

FORMS Page 13 of 20

Certification regarding Lobbying (Required)

CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE

AGREEMENTS

The undersigned certifies, to the best of his or her knowledge and belief, that:

1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of a Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying”, in accordance with its instruction.

3) The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub grants and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, US Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Company Authorized Representative (Print)

006000.01–PROJECT

FORMS Page 14 of 20

Confidential Copyrighted Information (Required)

General Provisions Part III Paragraph 13

FBISD is a governmental body subject to the Texas Public Information Act. Solicitation Responses submitted to FBISD as a result of this Solicitation may be subject to release as public information after contracts are executed or the procurement is terminated. If a Vendor believes that its Solicitation Response, or parts of its Solicitation Response, may be exempted from disclosure under Texas law, the Vendor must specify page-by-page and line-by-line the parts of the Solicitation Response which it believes are exempt. In addition, the Vendor must specify which exception(s) to the Texas Public Information Act are applicable and provide detailed reasons to substantiate the exception(s). Vague or general claims to confidentiality will not be accepted. FBISD assumes no obligation or responsibility relating to the disclosure or nondisclosure of information submitted by Vendor.

By signing below, the Bidder agrees, if a bid is, or parts of bid is confidential, the bidder has specified by stamping in bold letters the term “CONFIDENTIAL” on all or the confidential part of the bid. The bid may be considered public information even though all or parts are marked confidential. Furthermore, Bidder agrees a copyrighted bid is unacceptable and will be disqualified as unresponsive.

Company Authorized Representative (Print)

FORMS Page 15 of 20

Owner(s) Name of Business (Required)

Bidder certifies the owner(s) name of the business submitting bid is/are: (Please print name(s) below. If not applicable, please indicate N/A.)

Name Title

FORMS Page 16 of 20

Delinquent Taxpayers (Required)

In accordance with law, the District shall not enter into a contract or other transaction with a person indebted to the District, nor shall the District award a contract to or enter into a transaction with an apparent low bidder or successful proposer indebted to the District.

[ ] I am not a delinquent taxpayer to Ft Bend ISD

[ ] I am a delinquent taxpayer to Ft Bend ISD (your bid may be disqualified if your debt is not cleared prior to award.)

Signature

Printed Name & Title

Company

006000.01 – PROJECT FORMS

FORMS Page 18 of 20

FBISD CERTIFICATE OF INTERESTED PARTIES – FORM 1295

Certificate of Interested Parties (Form 1295 – must be filled out electronically with the Texas Ethics Commission’s online filing application, printed out, signed, notarized, and attached to vendor’s response to this solicitation.)

Fort Bend ISD (“FBISD”) is required to comply with House Bill 1295, which amended the Texas Government Code by adding Section 2252.908, Disclosure of Interested Parties. Section 2252.908 prohibits FBISD from entering into a contract resulting from this RFP with a business entity unless the business entity submits a Disclosure of Interested Parties (Form 1295) to FBISD at the time business entity submits the signed contract.

The Texas Ethics Commission has adopted rules requiring the business entity to file Form 1295 electronically with the Texas Ethics Commission.

“Interested Party” means a person:

a) who has a controlling interest in a business entity with whom FBISD contracts; or

b) who actively participates in facilitating the contract or negotiating the terms of the contract, including a broker, intermediary, adviser, or attorney for the business entity.

“Business Entity” means an entity recognized by law through which business is conducted, including a sole proprietorship, partnership, or corporation.

“Controlling Interest” means (1) an ownership interest or participating interest in a business entity by virtue of units, percentage, shares, stock, or otherwise that exceeds 10 percent; (2) membership on the board of directors or other governing body of a business entity of which the board or other governing body is composed of not more than 10 members; or (3) service as an officer of a business entity that has four or fewer officers, or service as one of the four officers most highly compensated by a business entity that has more than four officers.

As a “business entity,” all vendors must electronically complete, print, sign, notarize, and submit Form 1295 with their proposals even if no interested parties exist.

Proposers must file Form 1295 electronically with the Texas Ethics Commission using the online filing application, which can be found at https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm.

Proposers must use the filing application on the Texas Ethics Commission’s website to enter the required information on Form 1295. Proposers must print a copy of the completed form, which will include a certification of filing containing a unique certification number. The Form 1295 must be signed by an authorized agent of the business entity, and the form must be notarized.

The completed Form 1295 with the certification of filing must be filed with FBISD by attaching the completed form to the vendor’s solicitation response.

FBISD must acknowledge the receipt of the filed Form 1295 by notifying the Texas Ethics Commission of the receipt of the filed Form 1295 no later than the 30th day after the date the contract binds all parties to the contract. After FBISD acknowledges the Form 1295, the Texas Ethics Commission will post the completed Form 1295 to its website with seven business days after receiving notice from FBISD.

FORMS Page 19 of 20

Forms Certification (Required) I, the undersigned authorized agent for the company named below, certify that the information concerning notification of felony convictions, Owner(s) Name of Business and Delinquent Taxpayers has been reviewed by me and the information furnished is true to the best of my knowledge. I further certify that I agree to comply with Section 22.0834.

Criminal History Record Information Review of Certain Contract Employees, Texas Education Code if awarded a contract through this solicitation, the 31 U.S.C. 6101, note, E.O. 12549, E.O. 12689, 48 CFR 9.404 in relation to the Lists of Parties Excluded from Federal Procurement or Non Procurement Program, and Copyright/Confidential Information.

COMPANY NAME:_______________________________________________________________________________

AUTHORIZED AGENT’S NAME (PRINTED):__________________________________________________________

SIGNATURE OF COMPANY OFFICIAL:______________________________________________________________

006000.01–PROJECT

FORMS Page 20 of 20

Provision Required in Contract (Govt. Code 2270.002) (Required)

RELATIONSHIPS WITH FOREIGN ENTITIES

During the 85th Legislative Session (2017), the State of Texas enacted two additional requirements affecting all government contracts for goods and services.

All government contracts for goods and services signed after September 1, 2017 must include required provisions from HB 89 (Certification Regarding Israel), and language to implement SB 252 (Verification Regarding Terrorist Organizations).

Therefore, in compliance with HB 89 and SB 252 of the 85 th Texas Legislative Session, Contractor agrees that:

In accordance with Texas Government Code Chapter 2252, Subchapter F, Contractor certifies that it is not a company identified on the Texas Comptroller’s list of companies known to have contracts with, or provide supplies or services to, the Government of Iran, the Government of Sudan, or a foreign organization designated as a Foreign Terrorist Organization by the U.S. Secretary of State.

Contractor further certifies and verifies that, pursuant to Texas Government Code Chapter 2270, neither Contractor, nor any affiliate, subsidiary, or parent company of Contractor, if any (the “Contractor Companies”), boycotts Israel, and Contractor agrees that Contractor and Contractor Companies will not boycott Israel during the term of Agreement with Fort Bend

ISD.

Name of Vendor (“Contractor”)

Mailing Address City State Zip

Prepared by Title

Addenda Acknowledgement (Required)

I acknowledge the receipt of Addenda # through # , and my submittal reflects the contents of those addenda.

Name:

Signature:

Date: