BCCHS_Pool_Resurfacing_Attachments_A_1.pdf

ATTACHMENT SECTION A

BATTLE CREEK PUBLIC SCHOOLS

BATTLE CREEK CENTRAL HIGH SCHOOL POOL RESURFACING

PROJECT NUMBER 24.004

Battle Creek Public Schools Facilities and Operations

315 W. Goodale Ave Battle Creek, MI 49037

OCTOBER 16, 2023

ATTACHMENT A1- INTENT TO RESPOND

DATE SUBMITTED:

COMPANY:

PROJECT NAME: BATTLE CREEK CENTRAL HIGH SCHOOL POOL RESURFACING

CONTACT NAME:

CONTACT EMAIL:

CONTACT PHONE:

INTENT TO RESPOND SUMMARY

CONTACT NAME (PRINT):

CONTACT OFFICIAL SIGNATURE:

ATTACHMENT A2- REQUEST FOR INFORMATION (RFI)

DATE SUBMITTED: COMPANY:

PROJECT NAME: BATTLE CREEK CENTRAL HIGH

SCHOOL POOL RESURFACING

CONTACT NAME:

SECTION REFERENCED: CONTACT EMAIL:

RFI SUBJECT:________________________________________________________________________

REQUEST

RESPONSE

ATTACHMENT A3- FAMILIAL RELATIONSHIP DISCLOSURE

AFFIDAVIT OF ______________________________ STATE OF ________________

(insert name of affiant) COUNTY OF _________________

I, ___________________________(insert name of affiant), makes this Affidavit under oath and states as follows:

1. I am a/the:

□ President □ Member

□ Vice-President □ Partner

□ Owner □ Other (please specify): ____________

□ Chief Executive Officer of ________________ [insert name of firm], a bidder for Districtwide Custodial Services for Battle Creek Public Schools.

2. I have personal knowledge and/or I have personally verified that the following are all of the familial relationships existing between the owner(s) and the employee(s) of the aforementioned firm and the school district's superintendent and/or board members:

3. I have authority to bind the aforementioned contractor with the representations contained herein, and I am fully aware that the school district will rely on my representations in evaluating bids for tech design services.

4. I declare the above information to be true to the best of my knowledge, information and belief. I could completely and accurately testify regarding the information contained in this affidavit if requested to do so.

__________________________________________ (signature of affiant) Date: _______ of Subscribed and sworn before me in _________________ County, ___________ State, on the ___ day of _________________, 2023 ____________________________________________(signature) _____________________________________________ (printed) Notary public, State of ___________, County of ________________ My Commission expires on _____________________________ Acting in the County of ________________________________

ATTACHMENT A4- IRAN ECONOMIC SANCTIONS

I am the _______________ (insert title) of ______________________________ (insert name of firm) (“Bidder”), with authority to submit a binding bid for the provision of Districtwide Custodial Services to Battle Creek Public Schools. I have personal knowledge of the matters described in this Certification, and I am familiar with the Iran Economic Sanctions Act, MCL 129.311, et seq. ("Act"). I am fully aware that the school district will rely on my representations in evaluating bids.

I certify that Bidder is not an Iran-linked business, as that term is defined in the Act. I understand that submission of a false certification may result in contract termination, ineligibility to bid for three (3) years, and a civil penalty of $250,000 or twice the bid amount, whichever is greater, plus related investigation and legal costs.

(SIGNATURE)

(PRINTED)

(DATE)

ATTACHMENT A5-NON-COLLUSION AFFIDAVIT

NON-COLLUSION AFFIDAVIT

__________________________(insert name of affiant) makes this Affidavit under oath and states as follows:

1. I am a/the:

□ President □ Member □ Vice President □ Other (specify below)

□ Chief Executive Officer □ Partner □ Owner ________________________________ of _________________________________ (insert name of contractor), a bidder for construction services for Battle Creek Public Schools.

2. I certify that this bid is made without prior understanding, agreement, or connection with any corporation, firm or person submitting a bid for the same materials, supplies, equipment, or service, that it meets or exceeds all specifications contained herein, and is in all respects fair and without collusion or fraud.

3. I understand collusive bidding is a violation of state and local law and can result in fines, prison sentences and civil damage awards.

4. I agree to abide by all conditions of this bid and certify that I am authorized to sign for the vendor.

Vendor:__________________________________________ Fax Number:___________________________________________

Vendor Address:__________________________________ Name: ________________________________________________

Phone Number:___________________________________ Title: _________________________________________________

Date Certified:____________________________________ Web Site:______________________________________________

E-Mail Address: __________________________________________________________________________________________

STATE OF ____________ COUNTY OF ______________________ Signature Of Affiant: _________________________________

Subscribed and sworn before me in _________________ County, __________ State, on the ___ day of _________________, 2023 ____________________________________________(signature) _____________________________________________ (printed) Notary public, State of _____________, County of ________________ My Commission expires on _____________________________ Acting in the County of ________________________________

ATTACHMENT A6- BID PROPOSAL EXCEPTION

DATE SUBMITTED: COMPANY:

PROJECT NAME: BATTLE CREEK CENTRAL HIGH

SCHOOL POOL RESURFACING

CONTACT NAME:

SECTION REFERENCED: PAGE REFERENCED:

CONTACT EMAIL:

SUBJECT: _____________________________________________________________________________

BID EXCEPTIONS

ATTACHMENT A7- OFFICIAL SIGNATURE PAGE

My signature below is the guarantee from my firm that I have carefully read, with complete understanding, all the provisions contained herein, and that I have had the opportunity to ask questions before bidding. I submitted my quote in strict accordance with all those provisions.

I hereby state that I have the authority to submit this quote, which will become a binding contract, if awarded by the District.

FIRM NAME: __________________________________________________________________

NAME OF REPRESENTATIVE: _____________________________________________________

SIGNATURE OF REPRESENTATIVE: _________________________________________________

TITLE OF REPRESENTATIVE: ______________________________________________________

EMAIL ADDRESS: _____________________________________________________________

PHONE NUMBER: ______________________________________________________________

DATE: ________________________________________________________________________

BIDDER SIGNATURE _________________________ DISTRICTSIGNATURE_______________________

ATTACHMENT A8- OFFICIAL BID FORM/ PROPOSAL SUMMARY

A. TARGET PRICE - BASE BID- BATTLE CREEK CENTRAL HIGH SCHOOL POOL RESURFACING

All materials necessary to complete the project shall be the responsibility of the awarded contractor.

Single Prime (All Trades) Contract: The undersigned Bidder, having carefully examined the Bidding and Contract Requirements, Conditions of the Contract, Drawings, Specifications, and all subsequent Addenda, all as issued by the Owner, having visited the site, and being familiar with all conditions and requirements of the Work, hereby agrees to furnish all material, labor, equipment and services as described in the above documents, without exception, including all scheduled allowances and permits if any, necessary to complete the above named project according to requirements of the procurement and contracting documents for the stipulated sum of:

B. Contractor’s License

The undersigned further states that he is a duly licensed Contractor, for the type of work proposed, in the State of Michigan and that all fees, permits, etc., pursuant to the submission of this proposal have been paid in full.

C. Acknowledgement of Addenda (To be acknowledged via email within 2 business days)

The undersigned Bidder acknowledges receipt of and use in the preparation of this quote of the following Addenda in the preparation of this Quote:

Addendum No. 1, dated ________ Addendum No. 2, dated ______ Addendum No. 3, dated ______ Addendum No. 4, dated ________ Addendum No. 5, dated ______ Addendum No. 6, dated ______

List any Addendums Not Received. ______________________

D. Signature Guarantee

My signature below is the guarantee from my firm that I have carefully read, with complete understanding, all the provisions contained herein, and that I have had the opportunity to ask questions before bidding. I submitted my quote in strict accordance with all those provisions.

I hereby state that I have the authority to submit this quote, which will become a binding contract, if awarded by the District.

FIRM NAME: __________________________________________________________________________________

SIGNED: _______________________________________ DATE: ________________________________________

NAME: _______________________________________ TITLE: ________________________________________

EMAIL: _______________________________________ PHONE: ______________________________________

ATTACHMENT A10- SAMPLE CERTIFICATE OF LIABILITY INSURANCE