Attachment I.1 Questionnaire for Federal Contracts.docx

Attachment J: City of Seattle Vendor Questionnaire

ATTACHMENT J

City of Seattle Required Form: Vendor Questionnaire

City of Seattle Vendor Questionnaire—Federal Aid Contracts Only

Please have an officer or person eligible to represent the Vendor firm fill out and sign this form. Submittal of this Vendor Questionnaire with your bid or proposal is an attestation that the information in this Vendor Questionnaire and within your submittal documents are true and valid. Provide prompt notice to the City if, at any time prior to contract award, any facts need to be corrected.

INSTRUCTIONS: This is a mandatory form. Submit this form with your response. Provide information to the extent information is available. If your response is incomplete or requires further description, the City may request additional information within a specified deadline, or may determine the missing information is immaterial.

Vendor Information

Vendor Billing Contact Person: Identify the person who will prepare and manage your invoices. This helps the City contract manager offer instructions that ensure your invoices are promptly paid.

Emergency Contact Information Certain contract products or services may be valuable during a 24-hour emergency. If you have alternative contact information for emergency response during non-business hours, please provide below.

Vendor Registration with City of Seattle

Type of business (check one):

|_| Sole proprietorship, partnership, corporation, limited liability company, subsidiary, parent, holding company, or affiliate of another firm?

If checked, identify type and name of principal(s):

|_| Other including non-profit, charitable foundation, governmental agency, etc. Specify type:

Does your firm comply – to the extent required - with the following City of Seattle Labor Standards requirements from Seattle Municipal Code Chapter 14:

1) City Paid and Sick Time labor standards, providing paid sick and safe time to eligible employees? Most employers must provide employees who have work hours in Seattle, with accrued paid sick and safe time. Payment of prevailing wages does not ensure compliance (SMC 14.16).

2) Minimum Wage labor standards which set wages for employees working within city limits (SMC 14.19).

3) Wage Theft labor standards which establish basic requirements for payment of wages and tips for employees working within city limits, including providing various payment documentation to employees (SMC 14.20).

If “No” please provide an explanation of the circumstances. The City may audit payroll records or interview workers to ensure compliance. For more information regarding these requirements, see Municipal Code Chapter 14or http://www.seattle.gov/laborstandards, or call the Office of Labor Standards at 206.684.4500.

Yes |_| No |_|

If No, explain:

Not applicable |_|

Not applicable |_|

If Yes, explain:

Vendor has not paid, nor will pay, federal appropriated funds (including profit or fee received under a covered federal transaction), 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 on his or her behalf in connection with this solicitation. If the Offeror has engaged in any lobbying activities, the Offeror shall notify the City of Seattle and complete and submit, with its offer, OMB standard form LLL, Disclosure of Lobbying Activities.

Agree |_|

Disagree |_|

Vendor has not, directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of competitive pricing in the preparation and submission of its Offer;

Agree |_|

Disagree |_|

Provide and/or attach a sampling of contracts you have held in the past five years, sufficient for the City to understand the depth and breadth of your experience, with a particular emphasis on contracts with public agencies. The City may use this to assess your capability and experience at this particular type of product provision or service work. Specify the name/contact that can serve as a reference for each.

· If you have many such contracts, you can provide a brief summary.

· If you are a subsidiary of a national firm, summarize the contracts that represent your local office.

Proposal Expiration

The Vendor understands that it’s Offer is valid until the date the City awards a Vendor Contract or rejects all offers.

By signing below the Vendor certifies that its responses contained herein are accurate to the best of its knowledge.

Print Name and Title of Signor

Signature of Authorized Representative of Vendor:

City Non Disclosure Request

If you believe any statements or items you submit to the City as part of this bid/response are exempt from disclosure under the Washington Public Records Act, RCW Chapter 42.56, you must identify and list them below and provide the City with a copy of your bid/response with those portions redacted. Should the City receive a public records request for your bid/response, the City will first release the redacted version of the proposal to the requester. Requesters may accept the redacted proposal or decide to challenge all or some of the exemptions applied by the vendor. If the requestor challenges the exemptions, the City provides you with notice and up to ten days to seek an injunction to prevent the release of the challenged portion of the record. This notice is a courtesy and not a legal obligation. Only records properly listed on this form and redacted will be protected and withheld for notice. All other records will be considered fully disclosable upon request.

The City will not withhold information or provide notice simply because your document is marked with a document header or footer, page stamp, or a generic statement that a document is non-disclosable, exempt, confidential, proprietary, or protected. You must very clearly and specifically identify each statement or item and the corresponding RCW exemption that applies. You may not identify the entire page, unless the entire page is within the exemption scope.

|_| I do not request any information be withheld.

|_| I request the following specific information be withheld. I understand that all other information will be considered public information. For each statement or item you intend to withhold, you must fill out every box below. You should not require an entire page withheld; only request the specific portion subject to the exemption.

Document Page:

Specify the page number on which the material is located within your submittal package Statement:

Repeat the text you request to be held as confidential, or attach a redacted version.

RCW Exemption:

Specify the RCW exemption including the subheading

For this request to be valid, you must specify the RCW provision or other State or Federal law that designates the documents as exempt from disclosure. Please refer to Chapter 42.56 of the Revised Code of Washington for the exemptions.

Equal Benefits Compliance Declaration

Please declare one (1) option from the list below that describes the Contractor’s intent to comply with Seattle Municipal Code Chapter 20.45 should you win the contract.

Equal Benefits applies to any contractor location in the United States where substantive contract work is being performed (work directly related in a substantial way to the contract scope and deliverables).

|_| Option A The Contractor makes, or intends to make before contract execution, all benefits available on an equal basis to its employees with spouses and its employees with domestic partners, and to the spouses and the domestic partners of employees, in every location within the United States where substantial work on contract will be performed.

|_| Option B The Contractor does not make benefits available to either the spouses or the domestic partners of its employees.

|_| Option C The Contractor has no employees.

|_| Option D Collective Bargaining Delay. Benefits are available on an equal basis to non-union workers, but union workers are subject to a collective bargaining agreement that does not provide equal benefits.

|_| Option E Open Enrollment Delay. The first open enrollment period for implementing Equal Benefits is not available until after contract execution

|_| Option F Cash Equivalent Payment. The Contractor intends to provide a cash equivalent payment to eligible employees in lieu of making benefits available. The cash equivalent is the amount of money equal to the amount paid by the contractor for the benefit given to the spouse of a similarly situated employee during the term of the contract. Cash equivalent is only what the company pays for benefits provided to spouses, and does not include what the employee contributes. To the extent that a Contractor limits the availability of any benefit to the spouses of employees, or vice versa, the availability of a cash equivalent may be similarly limited. The cash equivalent shall be paid by the contractor to employees with domestic partner either on the same schedule as the contractor uses for the benefit given to employees with spouses, or, if no such schedule exists, on another schedule so long as such payment is made no less than once per month. No cash equivalent payment will be required where a contractor demonstrates that making such a payment would violate federal or state law.

|_| No United States Presence The Contractor does not perform substantial work for the contract in any United State location.

|_| Non-Compliant The Contractor does not comply and does not intend to comply, and refuses all options provided above.

Equal Benefits Instructions Seattle Municipal Code Chapter 20.45 (SMC 20.45) requires companies executing a City contract to provide health and benefits that are the same or equivalent to domestic partners of employees as to spouses of employees, and of their dependents and family members.

1. Carefully fill out the Equal Benefits Declaration. It is essential to your standing in the evaluation process, so it is important to understand and complete the declaration properly.

2. The Buyer or Coordinator for the solicitation can answer many questions. However, you may call the general office at 206-684-0444. Call before you submit your bid to ensure you’ve filled out the form correctly.

3. "Domestic Partner" is any person who is party to a same-sex marriage that is legally recognized in the place of jurisdiction of the marriage, or as a Domestic Partner with the employer or with a government registry established by state or local law. If the employer does not have a registration system and does not intend to implement one, the City of Seattle has a registration system as an option: http://www.seattle.gov/leg/clerk/dpr.htm The City will review your responses and make a final determination. If the information you supply is conflicting or not clearly supported by the documentation that the City receives, the City may reject your entire submittal (bid or proposal) or may seek clarification to ensure the City properly classifies your compliance.

Companies that select “Non Compliant” will be rejected, unless there is no competitor that is compliant, responsive and responsible. The City may also find a Bidder “Non Compliant” upon inspection of their program. Be prepared with documentation to support your declaration. All contracts awarded by the City may be audited for equal benefits compliance. Non-compliance may result in the rejection of a bid or proposal, or termination of the contract.

FAS Revised 8/4/2025