BI25-002 - Sections I II III - 8-28-2025.pdf

Bid No.: BI25-002 Bid Title: Quarterly Maintenance and Service of Buxton Model 2 Cage/Rack and Bottle Washer

INFORMAL BID WORKSHEET

Bid No. BI25-002

Bid Title Quarterly Maintenance and Service of Buxton Model 2 Cage/Rack and Bottle Washer

Bid Opening Date and Time

September 11, 2025 at 11:30 AM

Contact Seema Menon

E-mail Address menons@sunysuffolk.edu

BID INVITATION:

This is an invitation to submit bids for furnishing the materials and/or services specified herein subject to the terms and conditions defined in the solicitation documents.

BID SUBMISSION INSTRUCTIONS:

Please refer to Section II – Bid Requirements, Item 2 – Bid Submission Instructions

The undersigned bidder affirms and declares that s/he has carefully examined the invitation for bids, the bid terms and conditions and detailed specifications and certifies that this bid is signed with full knowledge and acceptance of all the provisions thereof and offers and, if this bid is accepted within 90 days from the bid opening date, the undersigned offers and agrees to furnish any of the items in which prices are quoted at the price and delivery time indicated, subject to all the terms and conditions herein.

BID MUST BE SIGNED BY SOLE PROPRIETOR, PARTNER OR OFFICER AUTHORIZED TO SIGN FOR CORPORATION

NAME OF BIDDER

ADDRESS

CITY STATE ZIP CODE

PHONE NO. E-MAIL ADDRESS

FEDERAL TAX IDENTIFICATION NUMBER

SIGNATURE OF AUTHORIZED INDIVIDUAL TITLE OF SIGNER

PRINT OR TYPE NAME OF SIGNER DATE

mailto:menons@sunysuffolk.edu

Table of Contents

Section I Bid Terms and Conditions

Section II Bid Requirements

1. Intent

2. Award

3. Payment Terms

4. Specifications

5. Site Visit

Section III Bid Prices

Section IV Model Agreement

SECTION I

BID TERMS AND CONDITIONS

1. The following conditions apply to this bid: (a) Late bids will NOT be accepted. Bidders are urged to submit bids early to assure delivery on time. (b) Bids must be received by the Procurement Office on or before the specified bid opening date and time. (c) Prices MUST be inserted with typewriter or ink. Entries with white-out or cross-outs MUST be initialed or that entry may be disqualified. (d) Bidders should submit Unit Price in appropriate column on bid pages or forms attached hereto. In the event of a discrepancy between the Unit Price and the Extension Price, the Unit Price shall govern. (e) Bidders should retain one (1) copy of bid forms and applicable attachments.

2. Bidder declares that the bid is made without any connection with any other Bidder submitting a bid for the same items, and is in all respects fair and without collusion or fraud.

3. INDEPENDENT CONTRACTOR The Contractor is an independent contractor of the College or County. The Contractor shall not, nor shall any officer, director, employee, servant, agent or independent contractor of the Contractor (a “Contractor Agent”), be (i) deemed a College or County employee, (ii) commit the College or County to any obligation, or (iii) hold itself, himself, or herself out as a College or County employee or Person with the authority to commit the College or County to any obligation. As used in any Agreement awarded as a result of this bid the word “Person” means any individual person, entity (including partnerships, corporations and limited liability companies), and government or political subdivision thereof (including agencies, bureaus, offices and departments thereof).

4. BIDDERS’ EXCEPTIONS Bidders may take exception to paragraphs of this bid under a separate cover letter to be attached to this bid, indicating specific bid page, paragraph, and the exception(s). An “exception” is defined as the Bidder’s inability or unwillingness to meet a term, condition, specification, or requirement in the manner specified in the bid document including the Model Agreement attached to this Bid. Any exceptions regarding the specifications, requested pricing, methodology, or any documents (terms and conditions, insurance requirements, compliance requirements, etc.) submitted for bidding purposes, are to be explicitly noted in the bid response referencing the relevant sections being addressed. In the absence of any defined exceptions, bids will be considered as is and in acceptance of all bid requirements/specifications/methodologies/pricing structures set forth herein. The Director will consider whether or not to accept a Bidder’s exception(s). In any event, the decision of the Director will be final.

5. DETAILED SPECIFICATIONS Proposals submitted hereunder shall be in accordance with detailed specifications set forth on bid pages or as attached and made part hereof.

6. The College reserves the right to cancel this solicitation and reject any and all offers, when it is in the public interest to do so.

7. COLLEGE SEXUAL HARASSMENT POLICY: Bidder’s are advised that the College’s Sexual Harassment Policy can be accessed using the following link: https://www.sunysuffolk.edu/legalaffairs/documents/equal-opportunity-anti-discrimination-policy.pdf

End of Section I https://www.sunysuffolk.edu/legalaffairs/documents/equal-opportunity-anti-discrimination-policy.pdf https://www.sunysuffolk.edu/legalaffairs/documents/equal-opportunity-anti-discrimination-policy.pdf

SECTION II

BID REQUIREMENTS

1. Intent:

Suffolk County Community College (College) is seeking to engage the services of a qualified Contractor to provide quarterly maintenance and services on its Buxton Model 2 Cage/Rack and Bottle Washer used by the Veterinary Science Department, in accordance with the requirements defined herein.

2. Bid Submission Instructions and Bid Opening:

Bid can be submitted by one of the following methods:

• Emailed to menons@sunysuffolk.edu

• Mailed to the following address: Suffolk County Community College Procurement Office 533 College Road Selden, NY 11784

• Dropped off in the drop box set up to receive bids

Instructions for drop-off and overnight mailing are provided below.

Bids are due by the bid submission due date and time of September 11, 2025 at 11:00 AM. The College retains the right to reject late bids.

• For bids that are submitted by mail or dropped off in the drop box, the bid must be signed in ink, and the sealed bid envelope must reference the Name and Address of Bidder, Bid Number, Title, and Bid Opening Date and Time.

• Bids must be received by the Procurement Office on or before the bid submission due date and time.

Bids will be opened on September 11, 2025 at 11:30 AM

Any questions or communications pertaining to the bid, the bid process, etc., must be emailed to Seema Menon, Associate Administrative Director of Business Operations in the Procurement Office at menons@sunysuffolk.edu. Communication with any other College or County employee, any member of the College, or any incumbent company for the goods and services being procured pursuant to the bid solicitation may be cause for disqualification from the bid process.

DROP BOX SUBMISSION

The College has set up a drop box by the Public Safety Booth for the purpose of physically dropping off bid submissions. The Public Safety Booth is located at the College entrance off College Road on Washington Ave. All bids being physically dropped off shall be submitted by 11:00 AM to this drop-box. If the Contractor is waiting on line at 11:00 AM to drop off their bid, the Contractor will be allowed to drop off the bid. If Contractor is not on line as of 11:00 AM and a bid is brought for drop-off after this time, it will be strictly rejected without exception.

Upon arrival at the College, bidder shall approach the Public Safety Booth at the bid drop off checkpoint, and drop the bid in the box.

OVERNIGHT DELIVERY

Alternatively, Contractors are welcome to send the bid in using overnight mail. Please note that overnight delivery service carriers have different schedules when coming on Campus, as do the College’s mailroom services. Below are the timelines in which overnight deliveries are made to the College’s mailroom by various carriers:

FedEx: 10:30 AM for Priority Packages 3:00 PM for Standard Overnight Packages

UPS: There is no scheduled delivery time. However, the carrier offers next day overnight shipping for 10:30 AM or 12:00 PM.

USPS: The Post Office does not make deliveries to the College. The College’s mailroom staff makes two pickups per day, at 7:00 AM and 3:00 PM, to collect mail and deliveries from the Post Office.

When submitting bids using this method, please ensure bids that are mailed, are done so in sufficient time to reach the College’s mailroom, undergo processing, and then be delivered to the Procurement Office by the bid submission due date and time. The College will not be responsible for bid packages that are misdirected due to above-indicated information missing from the bid mailing envelope, resulting in bids not being received by the Procurement Office in a timely fashion.

3. Award:

Award, if any, will be made to the responsive and responsible low Bidder, who, in the opinion of the College, meets the specifications stated herein, and submits the lowest Annual Maintenance Fee. The award will be in the form of a contract which, when issued and executed by both parties, will enable the successful Bidder to perform the services specified herein for the period indicated and at the prices bid upon receipt of a signed Purchase Order.

4. Term of Agreement:

Period covered shall be for three (3) years from the date of an award.

5. Prices:

Prices shall remain firm for the first year of the contract and no upward escalation will be permitted. Thereafter, increases in labor and/or material costs may be considered on the anniversary of the contract execution date, provided they are based on certified labor contracts, uncontrollable material costs which can be verified in national publications or other increases auditable by the College. The burden of proof for such increases shall be upon the Contractor and shall be formally directed to the Director. The decision as to whether or not such increases will be granted shall be made by the Vice President of Business and Financial Affairs and shall be final.

In the event an increase is not granted when requested, the Contractor may elect to continue at the bid prices or give written notice of termination, upon receipt of which the Agreement be rebid.

6. Payment Terms:

For each month in which Contractor performs work under the contract, Contractor shall prepare and present a monthly invoice to: Suffolk County Community College, Accounts Payable Department Attn: Sal Arnold PO Box 2280 Selden, NY 11784

Invoices can also be emailed to cboap@sunysuffolk.edu. Payment will be made within forty (45) days after approval of invoice by the College unless an early payment discount is adopted. Invoice must reference the mailto:cboap@sunysuffolk.edu purchase order number and be itemized in detail so that anyone reading same may readily understand the kind, quantity, quality and prices. Cash discount terms, where applicable, must be indicated on the invoice. By submitting an invoice, Contractor certifies that all items or services were delivered or rendered as set forth on the invoice; that the prices charged are in accordance with the referenced purchase order, delivery order or contract; that the claim is just, true and correct; that the balance stated herein is actually due and owing and has not been previously claimed; that no taxes from which the County/College is exempt are included.

Incomplete invoices will be returned to the Contractor unpaid.

7. Deficient Service Procedure:

The Contractor agrees that in the event any of the services provided for under the terms of this contract should in any way be omitted or unsatisfactorily performed by the Contractor and/or his employees, the College shall so notify the Contractor verbally and follow with a written notification of the deficient services for immediate correction.

8. Disclaimer:

The contract executed as a result of this bid will establish terms and conditions pursuant to which certain materials and/or services are to be supplied or performed, from time to time, for a specified period. The Model Agreement is attached hereto in Section IV and is made part hereof the Solicitation Documents. The contract is non-exclusive and the College is not bound to request any service.

9. E-Procurement:

The College has implemented an e-Procurement solution, named SharkMart, with the objective of streamlining processes and gaining operational efficiencies.

Bidders identified for a contract award will be required to register in SharkMart. The Procurement office will send an email to the Bidder’s contact that will include a SharkMart link to start the registration process. This process involves the completion of a company and tax profile (W9). The registration process must be completed before any purchase orders are issued.

Registering is completely free of charge and will enable your firm to benefit from the following functionality:

1. Receive orders electronically

2. Manage your company profile electronically and provide timely updates as needed

3. Ability to receive, send and respond to order emails

4. Submit electronic invoices with the “order to invoice” functionality

5. Ability to view all on-line orders, invoices and the invoice status

10. Specifications:

MINIMUM REQUIREMENTS

• Contractor shall have been in business under the same name for the past 5 years providing maintenance and repair services of similar scope and complexity identified herein for the equipment owned by the College.

The College requires the Contractor to provide quarterly maintenance and services for its Buxton Model 2 Cage/Rack and Bottle Washer (Serial No. 897220-2, 319280-10 located in Paumonok Hall, Sanitization Room in the Animal Care Facility.

The annual expenditure under this contract shall not exceed $20,000.

A. QUARTERLY MAINTENANCE SERVICES:

The Contractor shall provide preventative maintenance services for the Buxton Model 2 Cage/Rack and Bottle Washer used by the Veterinary Science Department four (4) times a year on a quarterly basis. The College Department will reach out to the Contractor to schedule the preventive maintenance visits, which will typically occur in November, February, May, and August. Maintenance will be completed within the first 21 days of each month indicated.

Each preventative maintenance visit shall include:

• complete assessment of the unit

• Any necessary repairs, adjustments, or replacement of worn parts

• Lubrication

• labor involved in repairing or replacing worn parts

• Service Report

The quarterly maintenance services shall not include work on or material for, service lines, shutoff valves, disconnect switches, or fitting furnished or installed by other than the manufacturer of said equipment.

These services, if authorized by the College, shall be billed at the appropriate billable hourly rates reflected in Section III – Bid Prices.

The Contractor shall provide a completed Maintenance Report to the department for approval/signature.

The Report shall include:

• date of service

• description of service provided, including replacement of all worn parts

• name and signature of service technician

• location of equipment

• make, model and serial number for each equipment that passed inspection

• description of all noted deficiencies and suggested corrective action

• labor hours, if any, expended for repair services for each equipment outside of maintenance requirements

• parts required, if any, for each equipment outside of those necessitated under the maintenance requirements.

• signature of authorized College representative certifying the indicated services were performed

If at the time of maintenance, Contractor identifies repairs outside of those covered under the basic maintenance, but necessary for the optimal operation of the equipment, Contractor may be required to provide a cost estimate at no additional cost to the College for said repairs inclusive of a description of the work proposed. Upon written approval from the College to commence with repairs, Contractor shall perform any and all necessary repairs, and replacing all parts requiring replacement. Repair services will be paid based on the applicable hourly rate identified in Section III – Bid Prices, under 2. Billable Hourly Labor Rates for Repair Services.

If, during the course of services, Contractor discovers that any of the equipment does not meet operating standards, the Contractor shall submit to the College appropriate supporting documentation indicating that the equipment is no longer operable and needs to be disposed of.

B. REPAIR SERVICES:

On an as-needed basis, the Contractor may be required to provide repair services for the unit identified in this bid. Repair services shall be scheduled during normal business hours, and set for a mutually convenient time.

When performing repair services, Contractor will be reimbursed based on the billable hourly for the appropriate title performing the work, as identified in Section III – Bid Prices.

(i) The Contractor shall provide repair services on an as-needed basis to enable the College to maintain its equipment in fully operational condition.

(ii) The Contractor may be required to perform same day emergency repair services on the equipment that resulted from the wear or breakdown from normal use.

(iii) If, for some reason, the repair cannot be performed immediately, Contractor shall work with the requesting Department to schedule the repair as soon as possible.

(iv) In the event equipment must be removed from College premises for repair or diagnoses, the

Contractor must obtain prior approval from the College department. The Contractor shall be responsible for pickup and delivery to and from the College premises at no additional cost to the College.

(v) Upon completion of repair, the Contractor shall notify the College to schedule a delivery date and time. Under no circumstances shall equipment removed from College premises be kept by the Contractor longer than five (5) working days, unless the Contractor has obtained prior written permission from the College department.

(vi) Contractor may be required to submit a budget cost estimate at no cost to the College before any work is started. Contractor shall begin work only after written approval from the College.

(vii) Contractor shall be reimbursed for repair services beginning at the time when the service technician begins the actual repair services on the equipment and ends when the repair work stops for each day the Contractor is on site. The Contractor will not be compensated for any travel time.

(viii) The College assumes no responsibility for any work commenced by the Contractor and will not reimburse the Contractor for any work performed prior to approval by the College department managing the equipment.

(ix) This agreement includes replacement of all parts that become worn or inoperable, or that otherwise affects the equipment’s operability in any way. The parts replacement also includes all safety equipment needed to operate the equipment.

(x) Parts shall be billed at the Contractor’s certified cost plus ten percent (10%). Contractor certified cost will be the actual cost paid to the manufacturer and must be backed by a copy of the manufacturer’s invoice. Receipts for any shipping must be provided if paid outside of the manufacturer’s invoice, and will be paid at direct cost.

(xi) The Contractor shall generate and provide to the College, a Service Report following completion of the repair which details, the issues identified, the specific work completed, and any parts/material used in completing the work.

(xii) The College will retain the right to purchase repair part(s) independently. The College assumes no responsibility and will not reimburse the Contractor for parts that were ordered or installed prior to the written approval from the College. The parts shall also be identified on the Service Report that is generated after the repair service. Invoices will only be paid if accompanied by the Service Report approved by the College department.

C. GENERAL REQUIREMENTS:

Normal working hours are 8:00 AM to 3:00 PM Monday through Friday. Work shall be performed during normal working hours. No overtime shall be authorized under this contract.

The Contractor shall provide the College with the name and contact information of the Contractor’s staff who will be servicing the College’s account. In addition, Contractor shall provide an emergency phone number for the College to use in the event of any unanticipated repair services.

Contractor shall respond to non-emergency service calls within twenty four (24) hours of notification, and respond to emergency service calls within four (4) hours.

Contractor shall acquaint himself with conditions found at the site. In the event that there is a need to temporarily move and/or relocate equipment, Contractor shall assume responsibility for the placement and reinstallation of the equipment and systems in the appropriate locations in working order.

Contractor’s personnel shall have all the tools and equipment necessary to perform the required work.

The College will not pay for any rental or replacement expenses associated with the necessary tools or equipment required to perform the work.

Contractor shall maintain an adequate level of inventory of new, original manufacturer’s parts and materials to ensure prompt repairs on a short notice. Contractor shall use the most up-to-date materials being manufactured. No obsolete materials will be allowed. All parts shall be new and must be equal or better that the original equipment. Rebuilt parts may be used only with prior approval of the College.

Only factory-built replacement parts will be accepted. All materials used in the installation shall be of the highest quality and shall be free from any and all defects. The College reserves the right to furnish parts and materials if deemed to be in the best interest of the College. All parts replaced under this contract shall become the property of the College and shall be left at the site unless directed otherwise by an authorized representative of the College.

Contractor shall perform work so as to cause the least inconvenience to the College and with proper consideration to other contractors or workmen. Contractor shall properly supervise the work being performed at the College and shall perform repairs and services as promptly and expeditiously as possible. The College reserves the right to assign its personnel to assist contractor's technicians.

Contractor shall furnish adequate protection from damage for all work and shall repair damages of any kind for which the Contractor’s staff is responsible.

Contractor shall perform all work in the best workmanlike manner and shall clean up and remove all debris and rubbish generated as a result of the work. Upon completion of the work, the premises shall be left in a neat, unobstructed condition, the building broom clean and the work site in satisfactory repair and order.

Except for emergency work, Contractor may be required to submit a budget cost estimate before any work is started. Cost estimates shall be provided by the Contractor within two (2) business days at no cost to the College. Submission of a cost estimate does not guarantee that College will move forward with the estimated work. The College may choose to not move forward with the projects due to funding or other planning changes. Cost estimates shall be prepared in a manner consistent with the pricing structure of the contract which includes the following:

• Labor hours required to complete the work

• Billable Hourly Rate

• Anticipated parts and materials with associated cost, and mark-up of 10%

• Shipping costs associated with the purchasing of parts by the Contractor will be reimbursed at direct cost with no mark-up

If the College moves forward with the repair(s), compensation will be based on actual time spent on the job multiplied by the Technician’s Billable Hourly Rate reflected in Section III – Bid Price.

For emergency work, Contractor may be required to submit a budget estimate within forty eight (48) hours of the work being started.

Parts used when performing repairs services shall be billed at the Contractor’s certified cost plus ten percent (10%). Contractor certified cost will be the actual cost paid to the manufacturer and must be backed by a copy of the manufacturer’s invoice. Receipts for any shipping must be provided if paid outside of the manufacturer’s invoice.

No travel time will be paid to the Contractor. Payments will be made only for time on the job.

When submitting requests for payment, any and all invoices must be accompanied by the information identified below.

• The Purchase Order number under which work was being performed

• Reference equipment make, model, and serial # on which work was completed

• Copy of service ticket that clearly and legibly reflects the arrival and departure times on the date(s) the Contractor’s personnel was on site to perform the services. Service ticket must include the countersignature of the College’s representative from the Department that requested the service under the specific PO. The service ticket shall be the basis for payment, and service ticket(s) not submitted in a timely fashion will result in payments being held up.

• Should repair work need to be completed on the Contractor’s site, provide a summary for the labor spent on each job which includes the following:

o Name of Employee(s) o Date(s) each employee performed work o Identify by date, the start and end times the Contractor’s employee(s) work on the College’s equipment.

• Service Report. Invoices will only be paid when accompanied by the completed/approved service report prepared as indicated herein.

• Description of the actual work that was completed

• Manufacturer’s invoice for materials/parts

• Receipts for shipping, if applicable and paid outside of the manufacturer’s invoice

All labor shall be guaranteed for a period of one (1) year from the date of acceptance. All parts shall be guaranteed for a minimum of ninety (90) days or in accordance with the manufacturer’s warranty, if greater than ninety (90) days.

Under this contract, subcontracting is not permitted without the prior written authorization of the College. If so authorized, the Contractor will be compensated for all services provided with its own forces or by a subcontractor in accordance with Section III – Bid Prices with no additional mark-up.

The award of the contract to the successful bidder does not grant the Contractor exclusive rights to all jobs.

The College reserves the right to bid separately any job if it is determined to be in the College’s best interest.

If such a situation arises, the contracted vendor has the right to bid on all such jobs.

11. Site Visit:

NA

End of Section II

SECTION III

BID PRICES

Bidder shall submit and indicate that the following information has been submitted with its bid:

(1) The phone number and email address of the primary contact who shall be the contract liaison with the

College

(2) A completed W-9 form

(3) Documentation demonstrating that the technician(s) assigned to the College’s account is authorized to perform quarterly maintenance inspections and services on the equipment specified herein

Following the College’s verification of the calculations, award, if any, will be made to the lowest responsible Bidder, who, in the opinion of the College, meets the specifications and qualifications stated herein, and submits the lowest Annual Maintenance Fee. If the College determines that any of the bid prices submitted under any of the categories below are unbalanced, the College reserves the right to deem the bid non-responsive.

Please note that pricing for all line items must be filled in. Failure to do so may deem the bid invalid and ineligible for award.

All prices must be all inclusive, and include all labor, materials, tools, equipment, fuel and transportation, any administrative tasks such as billing, and report writing, as well as the Contractor’s profit and overhead, necessary to complete the required services. No travel time will be paid. The College will not reimburse the Contractor for any additional costs (i.e., mileage, tolls, telephone calls, etc.) beyond the amounts indicated in this Section III – Bid Prices.

The College will not reimburse the Contractor for any additional costs beyond the amounts indicated in this Section III – Bid Prices.

Materials: shall be billed at the Contractor’s certified cost plus ten percent (10%). Contractor certified cost will be the actual cost paid to the manufacturer and must be backed by a copy of the manufacturer’s invoice. Receipts for any shipping must be provided if paid outside of the manufacturer’s invoice.

I. Quarterly Maintenance Inspections

Bidders shall multiply the “Quarterly Inspections” by the “Quarterly Maintenance Fee” to calculate the Annual Maintenance Fee.

Description of Equipment Quarterly Inspections Quarterly

Maintenance Fee Annual

Maintenance Fee

Buxton Model 2 Cage Washer 4 $ $

II. Billable Hourly Rates for Repairs

The “Estimated Weighted Percent of Work Per Year” of each title reflected in the Billable Hourly Straight Time Rate section has been established to assign greater weight to the titles and locations more heavily used, and to make a determination of low bid.

The “Estimated Weighted Percent of Work Per Year” for each title reflected in the following table are based on historical data. The actual utilization of title and location of work may vary depending on the actual needs of the College during the contract term.

Bidders shall multiply the “Estimated Weighted Percent of Work Per Year” by the “Billable Hourly Rate” to calculate the “Extended Labor Rate.” The sum of the Extended Labor Rates shall be the “Total Extended Labor Rate.”

Upon contract award, the College will typically require services to be performed during normal working hours as identified in the bid document, and will compensate the Contractor in accordance with the Billable Hourly Rate set forth in Section III – Bid Prices.

Title Estimated

Weighted Percent of Work Per Year

Billable Hourly Rate

Extended Labor Rate (Estimated Weighted

Percent of Work Per Year x Billable Hourly Rate)

Technician 0.8 $ $

Emergency Service Technician

0.15 $ $

PLC/HMI Programming 0.05 $ $

TOTAL EXTENDED LABOR RATE $

I. Early Payment Discounts

The standard payment term is NET 45. Bidders can provide an early payment discount as follows:

NET 30: %

NET 15: %

NET 10: %

The early payment discount will be applied to the total invoice amount for both maintenance and repair services.

End of Section III

REFERENCES (Three required)

REFERENCE NUMBER 1

A. Firm name and address:

B. Contact person and title:

C. Email and Telephone number (Telephone number must be current or reference will be ignored.):

D. Number of year’s Contractor has performed services for this organization:

E. Dates contracts were in effect:

F. Total dollar amount for each contract:

G. Job description and locations:

H. If location where services were performed is different from above address, please indicate location where services were performed:

REFERENCE NUMBER 2

H. If location where services were performed is different from above address, please indicate location where

REFERENCE NUMBER 3

H. If location where services were performed is different from above address, please indicate location where