Addendum_1.pdf
PDF 264 KB Posted
- Attached to
- CDBG Public Services Program State and local contract opportunity
- Solicitation number
- RFA-5-25-11
- Issued by
- Brevard County, Florida
About this file
This document is an Addendum (Addendum 1) issued by the Brevard County Housing and Human Services Department for the FY 2025-26 Community Development Block Grant (CDBG) Public Services Program, Request for Application (RFA) number 5-25-11. The addendum, dated June 9, 2025, notifies prospective contractors that the original application package is being supplemented with two missing attachments: a Conflict of Interest Certification and a Program Certification. The application opening date remains unchanged, scheduled for June 26, 2025, at 10:30 am. If questions are received by June 13 at 5:00 PM, a second addendum with responses will be posted.
The attached Conflict of Interest Certification form requires potential contractors to disclose any financial interests of Brevard County Board of County Commissioners officials in their company, with two sections allowing for either a declaration of no conflict or a detailed listing of officials with financial interests. The Program Certification form requires the applicant to certify the accuracy of their application, confirm the project's alignment with their organization's mission, commit to proper fiscal control and program compliance, and verify that the requested funds will not supplant existing funding. Both forms require signature and authorization from an official representative of the applying organization.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| Notice_of_Award.pdf | ||
| RFA_Selection_Committee_Consolidated_Evaluation_Scoresheet.pdf | ||
| REVISED_Public_Meeting_Notice.pdf | ||
| REVISED_Public_Meeting_Notice.pdf | ||
| Public_Meeting_Notice.pdf | ||
| Public_Meeting_Notice.pdf | ||
| RFA_Tabulation_-_Names_Only.pdf | ||
| RFA_Tabulation_-_Names_Only.pdf | ||
| Addendum_2.pdf | ||
| Addendum_2.pdf | ||
| Addendum_1.pdf | ||
| RFA-5-25-11_Inv_&_Specs.pdf | ||
| RFA-5-25-11_Inv_&_Specs.pdf | ||
| RFA-5-25-11_Inv_&_Specs.pdf | ||
| Attachment_A_-_CDBG_Public_Services_Program_Fund_Application.pdf | ||
| Attachment_A_-_CDBG_Public_Services_Program_Fund_Application.pdf | ||
| Attachment_A_-_CDBG_Public_Services_Program_Fund_Application.pdf |
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Text version
Purchasing Services 2725 Judge Fran Jamieson Way
Building C, Room 303 Viera, Florida 32940
CDBG Public Services Program
RFA# 5-25-11
June 9, 2025 Addendum 1
TO ALL PROSPECTIVE CONTRACTORS
This is an Addendum to and shall be considered as part of the original Application package for the above-mentioned Request for Application. Contractors are requested to acknowledge receipt of this Addendum with their Application.
NOTE: The Addendum includes the Conflict of Interest Certification and Program Certification, which were missing from the Application (Attachment A).
Please note that the application opening date and time remains June 26, 2025 @ 10:30 am.
If questions are received on or before Friday, June 13 at 5:00 PM, an Addendum 2 will be posted with responses.
All other terms and conditions remain unchanged.
Sincerely, Mary Bowers Purchasing Manager
END OF ADDENDUM NO. 1
HOUSING AND HUMAN SERVICES DEPARTMENT
FY 2025-26 COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICES
RFA-5-25-11
CONFLICT OF INTEREST CERTIFICATION
Applicant must execute either Section I or Section II relative to Florida Statute 112.313(12).
Failure to execute the appropriate section may result in rejection of this proposal.
Section I
I hereby certify that no official or employee of the Brevard County Board of County Commissioners requiring the goods for services described in these specifications has a material financial interest in this company.
Company Name: ____________________________________________________________
Business Address: ___________________________________________________________
Type or Printed Name of Official: ________________________________________________
Signature: __________________________________________________________________
Section II
I hereby certify that the following named Brevard County Board of County Commissioner’s official(s) and employee(s) having material financial interest(s) (in excess of 5%) in this company and have filed Conflict of Interest statements with the Brevard County Housing and Human Services Department, prior to bid opening.
Employee Name: _____________________________________________________
Title or Position: _____________________________________________________
Date of Filing: _____________________________________________________
Employee Name: _____________________________________________________
Title or Position: _____________________________________________________
Date of Filing: _____________________________________________________
Company Name: ____________________________________________________________
Business Address: ___________________________________________________________
Type or Printed Name of Official: ________________________________________________
Signature: __________________________________________________________________
HOUSING AND HUMAN SERVICES DEPARTMENT
FY 2025-26 COMMUNITY DEVELOPMENT BLOCK GRANT PUBLIC SERVICES
RFA-5-25-11
PROGRAM CERTIFICATION
PROGRAM CERTIFICATION
I do hereby certify that all facts, figures, and representations made in the application are true and correct, and that the purpose of this request is consistent with our organization’s Article of Incorporation, By-Laws and Mission. Furthermore, all applicable statutes, terms, conditions, regulations and procedures for program compliance and fiscal control will be implemented to ensure proper accountability of grant funds. I certify that the funds requested in this application will not supplant funds that would otherwise be used for the purposes set forth in this project.
The filing of this application has been authorized by the Agency Board of Directors, and I have been duly authorized to act as the representative of the agency in all matters in connection with this application. I also agree to follow all terms, conditions, and applicable federal and state statutes.
Type or Print Authorized Official’s Name Authorized Official’s Title
Authorized Official’s Signature Date
| CDBG Public Services Program |
| RFA# 5-25-11 |
| June 9, 2025 |
| Addendum 1 |
| TO ALL PROSPECTIVE CONTRACTORS |
| NOTE: The Addendum includes the Conflict of Interest Certification and Program Certification, which were missing from the Application (Attachment A). |
| Company Name: |
| Business Address: |
| Type or Printed Name of Official: |
| Housing and Human Services Department prior to bid opening 1: |
| Housing and Human Services Department prior to bid opening 2: |
| Housing and Human Services Department prior to bid opening 3: |
| 1: |
| 2: |
| 3: |
| Company Name_2: |
| Business Address_2: |
| Type or Printed Name of Official_2: |
| Type or Print Authorized Officials Name: |
| Authorized Officials Title: |
| Date: |
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