Addendum 2 - COBC Disaster Debris Removal and Disposal RFP.pdf

1901 FIFTH STREET • BAY CITY, TEXAS 77414 • (979) 245-2137 • FAX (979) 323-1626

www.cityofbaycity.org

8/16/2024

CITY OF BAY CITY

CITY COUNCIL

SCOTTY JONES ROBERT K. NELSON BECCA SITZ

INTERIM CITY MANAGER MAYOR MAYOR PRO TEM

ANNE MARIE ODEFEY JEANNA THOMPSON JIM FOLSE

BENJAMIN FLORES

CITY ATTORNEY CITY SECRETARY BRAD WESTMORELAND

BLAYNE FINLAY

Addendum No. 2 - RFP 2024-08.23-269-DRD - Disaster Debris Removal and Disposal Services

Dear Prospective Respondents, To ensure full compliance with federal procurement requirements and Texas state regulations, the City is issuing this addendum to provide additional required forms that must be submitted with your proposal.

Required Forms:

1. Certificate of Liability Insurance (COI) o Instructions: Please provide a current Certificate of Liability Insurance from your insurer.

2. Statement of Conflicts of Interest o Instructions: Please submit a statement disclosing any potential conflicts of interest.

3. System for Award Management (SAM) Search Results o Instructions: Please submit a printout of your current SAM.gov registration status, confirming that your company is registered and not debarred or suspended from federal contracts.

4. Form CIQ: Conflict of Interest Questionnaire o Attached: Please complete and submit the attached Conflict of Interest Questionnaire (Form CIQ) as required under Texas law.

5. Certification Regarding Lobbying o Attached: Please complete and submit the attached Certification Regarding Lobbying to confirm that no federal funds have been used for lobbying activities in connection with this contract.

6. Disclosure Regarding Lobbying Form o Attached: If applicable, please complete and submit the attached Disclosure Regarding Lobbying Form to disclose any lobbying activities funded by other sources.

7. Form 1295: Certificate of Interested Parties o Instructions: The awarded vendor will be required to complete this form online after the contract is awarded. Please be prepared to complete and submit this form as required under Texas Government Code Section 2252.908.

All forms and documents must be completed and submitted along with your proposal. Failure to include these forms may result in the disqualification of your proposal.

Attachments:

Form CIQ: Conflict of Interest Questionnaire Certification Regarding Lobbying Disclosure Regarding Lobbying Form

1901 FIFTH STREET • BAY CITY, TEXAS 77414 • (979) 245-2137 • FAX (979) 323-1626

www.cityofbaycity.org

Thank you for your attention to these requirements. We appreciate your cooperation in ensuring compliance with both federal and state regulations.

Insert Certificate of Insurance

Insert System for Award Management (SAM) record search for company name and company principal

Cer fica on Regarding Lobbying

(To be submi ed with each bid or offer exceeding $100,000)

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

(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or a emp ng to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connec on with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any coopera ve agreement, and the extension, con nua on, renewal, amendment, or modifica on of any Federal contract, grant, loan, or coopera ve agreement.

(b) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or a emp ng 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 connec on with this Federal contract, grant, loan, or coopera ve agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying,” in accordance with its instruc ons.

(c) The undersigned shall require that the language paragraph 1 and 2 of this an -lobbying cer fica on be included in the award documents for all subawards at all ers (including subcontracts, subgrants, and contracts under grants, loans, and coopera ve agreements) and that all subrecipients shall cer fy and disclose accordingly.

This cer fica on is a material representa on of fact upon which reliance was placed when this transac on was made or entered into. Submission of this cer fica on is a prerequisite for making or entering into this transac on imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995).

The Contractor, ___________________, cer fies or affirms the truthfulness and accuracy of each statement of its cer fica on and disclosure, if any. In addi on, the Contractor understands and agrees that the provisions of 31 U.S.C.

§ 3801 et seq., apply to this cer fica on and disclosure, if any.

Signature of Contractor’s Authorized Official

Printed Name and Title of Contractor’s Authorized Official

Date

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the repor ng en ty, whether subawardee or prime Federal recipient, at the ini a on or receipt of a covered Federal ac on, or a material change to a previous filing, pursuant to tle 31 U.S.C. sec on 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying en ty for influencing or a emp ng 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 connec on with a covered Federal ac on. Complete all items that apply for both the ini al filing and material change report. Refer to the implemen ng guidance published by the Office of Management and Budget for addi onal informa on.

1. Iden fy the type of covered Federal ac on for which lobbying ac vity is and/or has been secured to influence the outcome of a covered Federal ac on.

2. Iden fy the status of the covered Federal ac on.

3. Iden fy the appropriate classifica on of this report. If this is a follow-up report caused by a material change to the informa on previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submi ed report by this repor ng en ty for this covered Federal ac on.

4. Enter the full name, address, city, State and zip code of the repor ng en ty. Include Congressional District, if known. Check the appropriate classifica on of the repor ng en ty that designates if it is, or expects to be, a prime or subaward recipient. Iden fy the er of the subawardee, e.g., the first subawardee of the prime is the 1st er.

Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.

5. If the organiza on filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the federal agency making the award or loan commitment. Include at least one organiza onal level below agency name, if known. For example, Department of Transporta on, United States Coast Guard.

7. Enter the Federal program name or descrip on for the covered Federal ac on (item 1). If known, enter the full Catalog of Federal Domes c Assistance (CFDA) number for grants, coopera ve agreements, loans, and loan commitments.

8. Enter the most appropriate Federal iden fying number available for the Federal ac on iden fied in item 1 (e.g., Request for Proposal (RFP) number; Invita ons for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the applica on/proposal control number assigned by the Federal agency).

Included prefixes, e.g., “RFP-DE-90-001.”

9. For a covered Federal ac on where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime en ty iden fied in item 4 or 5.

10. (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995 engaged by the repor ng en ty iden fied in item 4 to influence the covered Federal ac on.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10(a). Enter Last Name, First Name, and Middle Ini al (MI).

11. The cer fying official shall sign and date the form, print his/her name, tle, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the O ice of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503

Approved by OMB

0348-0046 Disclosure of Lobbying Activities

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden disclosure)

Type of Federal Action:

a. contract ____ b. grant

c. cooperative agreement

d. loan

e. loan guarantee

f. loan insurance

Status of Federal Action:

a. bid/o er/application _____ b. initial award

c. post-award

Report Type:

a. initial filing _____ b. material change

Name and Address of Reporting Entity:

____ Prime _____ Subawardee Tier______, if Known:

Congressional District, if known:

If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime:

Congressional District, if known:

Federal Department/Agency:

7. Federal Program Name/Description:

CFDA Number, if applicable: __________________

Federal Action Number, if known:

9. Award Amount, if known:

10. a. Name and Address of Lobbying Registrant (if individual, last name, first name, MI):

b. Individuals Performing Services (including address if di erent from No. 10a) (last name, first name, MI):

11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature: __________________________________

Print Name: _____

Title: _____

Telephone No.: ____________ Date: _______

Federal Use Only

Authorized for Local Reproduction

Standard Form - LLL (Rev. 7-97)