Attachment_D.pdf

GREENVILLE COUNTY REDEVELOPMENT

AUTHORITY

ATTACHMENT D – REQUIRED FORMS PACKET

Request for Proposals: Design and Construction of Two Single-Family Homes (Modular or Site-Built)

Lots 12 and 13, Spring Street, City of Greer, South Carolina

Funded with HOME Investment Partnerships Program (HOME) Funds

Complete, sign, and upload each form with the proposal under Tab 9 – Required Forms.

Form Title RFP Attachment B Item

D-1 Offeror Information, Bonding Commitment, and Addenda Acknowledgment 2 (also referenced in items 3 and 12)

D-2 Non-Collusion Affidavit 4

D-3 Certification Regarding Debarment, Suspension, and Other Responsibility Matters

D-4 Certification Regarding Lobbying 6

D-5 Conflict-of-Interest Disclosure 7

D-6 Immigration Compliance Certification (S.C. Illegal Immigration Reform Act)

D-7 Nondiscrimination Certification (S.C. Code § 11-35-5300) 9

Each form must be signed by a person authorized to bind the offeror. Unsigned or incomplete forms may cause the proposal to be found nonresponsive.

Form D-1 – Offeror Information, Bonding Commitment, and Addenda Acknowledgment

Legal name of offeror: ____________________________________________________________

Doing business as (if different): ____________________________________________________

Street address: ___________________________________________________________________

City, state, ZIP: __________________________________________________________________

Federal tax ID (EIN): ________________________________

SAM.gov Unique Entity ID (UEI): ________________________________

Type of organization (check one): ☐ Corporation ☐ LLC ☐ Partnership ☐ Sole proprietor ☐ Other: __________

State of incorporation or organization: ________________________

Registered to do business in South Carolina: ☐ Yes ☐ No

South Carolina license type and number: ____________________________________________

Construction method proposed (check one): ☐ Modular ☐ Site-built

Lot(s) proposed (check all that apply): ☐ Lot 12 ☐ Lot 13

Modular manufacturer (if applicable): ____________________________________________

Primary contact for this proposal:

Name and title: ______________________________________________________________

Phone: ____________________________ Email: ____________________________________

Business classifications (check all that apply): ☐ Small business ☐ Minority-owned business ☐ Women-owned business ☐ None of these (for GCRA outreach records only; not scored)

Bonding Commitment (RFP Section 9.2)

If awarded a contract over $50,000, the offeror agrees to furnish, before the notice to proceed, a performance bond and a payment bond, each equal to one hundred percent (100%) of the contract price, issued by a surety licensed in South Carolina with a minimum “A” A.M. Best rating and listed in U.S. Treasury Circular 570, or secured by cash.

The payment bond is required by S.C. Code § 29-6-250.

☐ The offeror agrees to furnish 100% performance and payment bonds as stated above.

☐ The total proposed price exceeds $350,000, and a 5% bid guarantee (bid bond or certified check) is included with the proposal (Attachment B, item 3).

Surety company, agent, and phone: ____________________________________________________

The surety named above must provide the letter required by Attachment B, item 12.

Acknowledgment of Addenda

The offeror acknowledges receipt of the following addenda to this RFP. If no addenda were issued, write “None.”

Addendum No. Date Issued Initials

Signature

By signing below, I certify that I am authorized to submit this proposal and bind the offeror, and that the information in this proposal is true and complete.

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 2

Form D-2 – Non-Collusion Affidavit

State of ______________________

County of ______________________

I, ______________________________ (printed name), being first duly sworn, state that:

I am the ______________________________ (title) of ______________________________________ (offeror), and I am authorized to make this affidavit on behalf of the offeror.

The attached proposal is genuine and is not made in the interest of or on behalf of any undisclosed person, firm, or corporation.

The offeror has not, directly or indirectly, colluded, conspired, or agreed with any other offeror or person to submit a sham proposal, to refrain from submitting a proposal, or to fix the price or any other term of any proposal.

The prices in the proposal were arrived at independently, without consultation, communication, or agreement with any other offeror or competitor.

The prices in the proposal have not been knowingly disclosed to any other offeror or competitor before the proposal due date, and will not be knowingly disclosed before award.

No attempt has been made or will be made to induce any other person or firm to submit or not submit a proposal for the purpose of restricting competition.

No officer, employee, or agent of GCRA, and no member of the GCRA Board of Commissioners, has received or will receive any payment, gift, or other thing of value from the offeror in connection with this RFP.

Signature of affiant: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

Sworn to and subscribed before me this ______ day of ____________________, 20____.

Notary Public signature: ______________________________________

Notary Public for the State of ______________________

My commission expires: ______________________

(Notary seal)

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GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 3

Form D-3 – Certification Regarding Debarment, Suspension, and Other Responsibility Matters

This certification is required by the federal nonprocurement debarment and suspension regulations at 2 CFR Part 180, as adopted by HUD at 2 CFR Part 2424, for contracts paid in whole or in part with HOME funds.

The offeror certifies, by submitting this proposal, that neither it nor any of its principals:

Is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency;

Has, within the three years before this proposal, been convicted of or had a civil judgment rendered against it for fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract; for violation of federal or state antitrust statutes; or for embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

Is presently indicted for or otherwise criminally or civilly charged by a governmental entity with any of the offenses listed in item 2; or

Has, within the three years before this proposal, had one or more public transactions (federal, state, or local) terminated for cause or default.

The offeror further certifies that:

It is not listed as excluded in the System for Award Management (SAM.gov).

It will not enter into any subcontract under this project with a person or firm that is debarred, suspended, or otherwise excluded, and will check SAM.gov before awarding any subcontract.

It will notify GCRA immediately in writing if it learns that this certification was wrong when submitted or has become wrong because of changed circumstances.

☐ The offeror is able to certify to all statements above.

☐ The offeror is unable to certify to one or more statements above. An explanation is attached.

The offeror understands that this certification is a material representation of fact on which GCRA will rely in awarding the contract. If it is later determined that the offeror knowingly made a false certification, GCRA may terminate the contract and pursue other remedies available to it and to the federal government.

Offeror: ______________________________________________________________

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

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GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 4

Form D-4 – Certification Regarding Lobbying

This certification is required by Section 1352 of Title 31, U.S. Code (the Byrd Anti-Lobbying Amendment) and HUD’s regulations at 24 CFR Part 87 for contracts over $100,000 paid with federal funds.

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

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 any federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, or the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

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 federal agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with this contract, the undersigned will complete and submit Standard Form LLL, “Disclosure of Lobbying Activities,” in accordance with its instructions.

The undersigned will require that the language of this certification be included in all subcontracts over $100,000 at all tiers, and that all subcontractors certify and disclose accordingly.

This certification is a material representation of fact on which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction under 31 U.S.C. 1352. Any person who fails to file the required certification is subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

☐ No lobbying activities are reported (Standard Form LLL not required).

☐ Standard Form LLL, Disclosure of Lobbying Activities, is attached.

Offeror: ______________________________________________________________

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

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GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 5

Form D-5 – Conflict-of-Interest Disclosure

Federal and HOME program rules prohibit conflicts of interest in the award and administration of contracts paid with HOME funds, including 2 CFR 200.318(c) and 24 CFR 92.356. Under 24 CFR 92.356, no employee, agent, consultant, officer, or elected or appointed official of GCRA or Greenville County who exercises any functions or responsibilities for HOME activities, or who is in a position to participate in decision-making or gain inside information, may obtain a financial interest or benefit from a HOME-assisted activity, or have an interest in any contract for it, for themselves or those with whom they have family or business ties, during their tenure or for one year afterward.

Disclosure

Does any owner, officer, director, partner, employee, or proposed subcontractor of the offeror, or any member of their immediate family or anyone with whom they have business ties:

Question Yes No

1. Currently serve, or within the past 12 months served, as an employee, officer, agent, consultant, or board member of GCRA?

2. Currently serve, or within the past 12 months served, as an elected or appointed official or employee of Greenville County with responsibilities related to HOME-funded activities?

3. Have a family relationship (spouse, parent, child, sibling, or in-law) with any GCRA employee, officer, or board member?

4. Have a business or financial relationship with any GCRA employee, officer, or board member? ☐ ☐

5. Have any other relationship or interest that could create a real or apparent conflict of interest in this procurement?

If “Yes” is checked for any question, describe the relationship, the names and positions of the persons involved, and any steps taken to avoid the conflict (attach additional pages if needed):

Gifts and Gratuities

The offeror certifies that it has not offered or given, and will not offer or give, any gift, gratuity, favor, entertainment, loan, or other thing of monetary value to any GCRA employee, officer, agent, board member, or evaluation committee member in connection with this RFP or any resulting contract.

Continuing Obligation

The offeror agrees to notify GCRA promptly in writing if any conflict of interest arises after this disclosure is submitted, including during performance of the contract. The offeror understands that failure to disclose a conflict may result in disqualification of the proposal or termination of the contract.

Offeror: ______________________________________________________________

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 6 https://www.law.cornell.edu/cfr/text/2/200.318 https://www.law.cornell.edu/cfr/text/24/92.356

Form D-6 – Immigration Compliance Certification

This certification is required by the South Carolina Illegal Immigration Reform Act, Title 8, Chapter 14 of the South Carolina Code. Under S.C. Code Section 8-14-20(B), a public employer may not enter into a services contract for the physical performance of services in South Carolina unless the contractor agrees to register and participate in the federal work authorization program (E-Verify) to verify the employment authorization of all new employees, and requires its subcontractors and sub-subcontractors to do the same. Under Section 8-14-40, GCRA meets this requirement by obtaining this written certification from the contractor.

Certification

The undersigned, on behalf of the offeror, certifies and agrees that the offeror:

Will comply with the requirements of Title 8, Chapter 14 of the South Carolina Code for any contract awarded under this RFP.

Is registered and participates in the federal E-Verify work authorization program, or will register and participate before performing any work under the contract, and will verify the employment authorization of all new employees.

Will require each subcontractor, and through the subcontractors each sub-subcontractor, to agree in writing to register and participate in E-Verify and verify the employment authorization of all new employees.

Will comply with Title 41, Chapter 8 of the South Carolina Code and with federal law prohibiting the employment of unauthorized workers (8 U.S.C. 1324a).

Will provide GCRA, on request, any documentation needed to establish either that the Act applies to the offeror, its subcontractors, and sub-subcontractors, or that they comply with it.

Understands that failure to comply may result in termination of the contract and other penalties provided by law.

E-Verify Information

E-Verify company ID number: ________________________________

Date of E-Verify enrollment: ________________________________

☐ The offeror is not yet enrolled in E-Verify and will enroll before performing any work under the contract.

The offeror understands that this certification is a material representation of fact relied upon by GCRA in making any award, and that a false certification may result in disqualification, termination of the contract, and other remedies available to GCRA.

Offeror: ______________________________________________________________

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

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GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 7 https://www.scstatehouse.gov/code/t08c014.php https://www.scstatehouse.gov/code/t08c014.php

Form D-7 – Nondiscrimination Certification (S.C. Code § 11-35-5300)

Under S.C. Code § 11-35-5300, a public entity, including any political subdivision of the State, may not enter into a contract worth $10,000 or more with a business to acquire or dispose of supplies, services, information technology, or construction unless the contract includes a representation that the business is not currently engaged in, and an agreement that it will not engage in, the boycott of a person or entity based in or doing business with a jurisdiction with whom South Carolina can enjoy open trade. Under the statute, “boycott” means to blacklist, divest from, or otherwise refuse to deal with a person or firm when the action is based on race, color, religion, gender, or national origin of the targeted person or entity.

Certification

The undersigned, on behalf of the offeror, represents and agrees that the offeror:

Is not currently engaged in the boycott of a person or entity based in or doing business with a jurisdiction with whom South Carolina can enjoy open trade, as defined in S.C. Code § 11-35-5300.

Will not engage in such a boycott during the term of any contract awarded under this RFP.

Will notify GCRA promptly in writing if it becomes unable to make this representation at any time during the contract.

The offeror understands that this representation is a material condition of any contract awarded under this RFP.

Offeror: ______________________________________________________________

Authorized signature: ______________________________________ Date: ______________

Printed name: ______________________________ Title: ______________________________

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GCRA RFP – Spring Street Lots 12 and 13 – Attachment D | Page 8 https://www.scstatehouse.gov/code/t11c035.php