Bid_4083AH_Shoes_Slip_Resistant_-_REQUIRED_FORMS.pdf

An Equal Opportunity School District Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

The School Board of Marion County, Florida Purchasing Department 2091 NE 35th Street Ocala, FL 34479

INVITATION TO BID

BIDDER ACKNOWLEDGEMENT

(Template Rev. 86VL)

Bid Number: 4083AH Posting Date: July 31, 2024

Bid Title: Shoes, Slip Resistant, Eight (8) Months and Twenty-One (21) Days Term Contract Term: October 9, 2024 through June 30, 2025

Deadline for Receipt of Bid Responses: Wednesday, August 28, 2024 at 2:00 PM Board Approval Date: Tuesday, October 8, 2024

Firm Name (Legal Name of Corporation) Fictitious Name or d/b/a

Firm Name - Physical Address to include City, State & Zip Code

Fictitious Name or d/b/a - Physical Address to include City, State & Zip Code

Firm Name - Mailing Address to include City, State & Zip Code

Federal Employee Identification No. or Social Security No.

Area Code/Telephone Number #

Fax No. E-mail Address:

ANTI-COLLUSION: The signed bidder certifies that he or she has not divulged, discussed or compared his or her bid with other bidders and has not colluded with any other bidder or parties to a bid. (NOTE: No premiums, rebates, or gratuities are permitted either with, prior to, or after any delivery of material. Any such violation will result in the cancellation and/or return of materials (as applicable) and the removal from the bid list(s).

I certify that I am the owner or an authorized officer or agent for the above company and that the information supplied herein, including all pages attached, is correct; and that neither the applicant nor any person or concern in any connection with the applicant as a principal officer, so far as is known, is now debarred or otherwise declared ineligible by The School Board of Marion County, Florida (“School Board”), from bidding for furnished materials, supplies or services to the School Board.

The undersigned represents and warrants by signing this document that employee background investigations will be adhered to in accordance with §1012.32, Fla. Stat. (2023).

Authorized Signature (Manual)

Authorized Signature (Type or Printed) and Title

Annette Hagan New Stamp

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

SPECIFICATIONS

Slip-Resistant Shoes Specifications:

Slip-resistant shoes:

Slip-resistant on water, grease, liquefied fats and synthetic lubricants.

Water-resistant, leather/leather-substitute uppers in black.

Closed toe.

Closed heel.

Flexible mid-sole.

Firm foot support.

Laced and slip-on styles.

Padded collar.

Full range of Adult Men’s & Women’s sizes.

Full Range of Adult Widths (including extremes of narrow and wide).

Slip-Resistant Over Shoes:

Black.

Slip on style.

Full range of Adult Men’s & Women’s sizes.

Slip-Resistant Test Results:

Bidder shall provide slip-resistant test results completed by an independent testing facility.

ON-SITE TRAINING:

The successful bidder shall provide adequate on-site training of Food & Nutrition personnel on the use of their online web-based order process system at no additional cost to the district.

An Initial training class will be in person with Food Service Personnel.

Training for Food Service cafeteria personnel will be in person with large or small groups.

Three to Six training classes will be required to reach all assigned school cafeteria personnel.

Online training or additional written resources should be available for assigned school-based personnel.

ORDERING PROCESS:

The successful bidder is required to have a web based online ordering system where:

Orders can be placed utilizing a district purchase order Purchases, ordering history and pending deliveries can be tracked and can be accessed by our Food &

Nutrition Service Department. Data must be available by location and employee.

Direct delivery to employees at various school cafeteria locations is in place.

All orders can be input by the individual school sites, remote locations such as cafeteria staff or the

Food & Nutrition Services Department. Orders will not be filled and sent until approved by the Food & Nutrition Services Representative assigned to review these orders.

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

Will training be provided as outlined on page second page of this attachment?

Yes No

Provide additional details on training, online training, and additional written resources to be provided:

Please provide a contact person and/or alternate contact person that will handle all calls from the

Food & Nutrition Service Department for the duration of this contract and any renewals. Should the contact person change at any time, awarded vendor shall notify the Food & Nutrition Service

Department’s authorized designee if and when this change occurs. The Food & Nutrition Services will provide the name and number of the authorize designee upon the award of the bid.

Contact Person Name: ________________________________________________________

Telephone Number: _________________________________________________________

Cell Phone Number: _________________________________________________________

Email Address: _________________________________________________________

Alternate Contact Person Name: ________________________________________________

Telephone Number: _________________________________________________________

Cell Phone Number: _________________________________________________________

Email Address: _________________________________________________________

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

We, the undersigned, do hereby certify that these prices include all labor and material and will hold the pricing mechanism appearing in this solicitation fixed for a period after School Board approval for eight (8) months and twenty-one (21) days from October 9, 2024 through June 30, 2025. We further realize the estimated quantities given are for evaluation purposes only and no guarantee of purchase is expressed or implied.

Division of Corporations Registration Requirements

Companies incorporated within the State of Florida must furnish their Florida document number. Companies incorporated in any other state must furnish their applicable document number. All corporations or other legal entities must be registered to do business in the State of Florida and have an active status in order to be eligible to do business with the School Board. The specific requirements for registration are found in §607, Fla. Stat. (2023). To register with the State of Florida, visit: www.Sunbiz.org

Company: ________________________________________________

Per: ___________________________________________(Print name)

Authorized Signature: _______________________________________

Address: __________________________________________________

City/State/Zip: ______________________________________________

Dunn & Bradstreet # ________________________________________

Federal I.D. # ______________________________________________

Division of Corporations Registration Number: ___________________

The state incorporated in: _____________________________________

Occupational License Number or Contractor Certification (Only use if required)

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

PURCHASE ORDER MAILING NAME AND ADDRESS

Company Name: ____________________________________________________________________

Mailing Address: ____________________________________________________________________

City: _________________________________ State: __________________ Zip: _________________

Telephone: _______________________________ Fax: _____________________________________

Contact Name: ____________________________ Contact Title: ______________________________

Purchase Order E-mail address: ________________________________________________________

REMITTANCE NAME AND ADDRESS FOR PAYMENT

Company Name: ____________________________________________________________________

Mailing Address: ____________________________________________________________________

City: _________________________________ State: __________________ Zip: _________________

Telephone: _______________________________ Fax: _____________________________________

Contact Name: ____________________________ Contact Title: ______________________________

Contact Email Address: ______________________________________________________________

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

BIDDER’S QUALIFICATION STATEMENT

MUST BE COMPLETED TO BE CONSIDERED A RESPONSIBLE BIDDER

COMPANY NAME: ________________________________________________

1. Bidder has been in business continuously since: ________________________________

2. Bidder has had experience in work comparable with that required under the proposed contract:

As a prime contractor for ___________ years / As a subcontractor for __________ years

3. Following is a partial list of work the bidder has completed in the last five (5) years) which is similar in character and in magnitude to that required in the proposed Contract:

YEAR OWNER LOCATION CONTRACT AMOUNT

4. Furnish references for information concerning the work listed above:

NAME COMPANY TITLE CITY/STATE PHONE #

5. Provide email addresses for each person listed in item 4:

6. List the supervisory personnel to be employed by the bidder and available for work on this project

(Project Manager, Principal Foreman, Superintendents):

NAME TITLE YEARS EXPERIENCE

7. List Subcontractors – Name, address and years of experience, if you will be utilizing subcontractors on any portion of this project.

NAME Address YEARS EXPERIENCE

8. Name and title of person filling out form:

NAME TITLE

If you need additional space, please submit a separate sheet with appropriate headings.

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

CONFIDENTIAL, PROPRIETARY, OR TRADE SECRET MATERIAL STATEMENT

The School Board of Marion County, Florida (“School Board”) takes its public records responsibilities as provided under §119, Fla. Stat. (2023) and Article 1, Section 24 of the Florida Constitution, very seriously.

If Proposer considers any portion of the documents, data or records submitted in response to this solicitation to be confidential, trade secret or otherwise not subject to disclosure pursuant to §119, Fla.

Stat. (2023), the Florida Constitution or other authority, Proposer must also simultaneously provide the School Board with a separate redacted copy of its response. This redacted copy shall contain the School Board solicitation name, number, and the name of the Proposer on the cover, and shall be clearly titled “Redacted Copy.” The Redacted Copy shall be provided to School Board at the same time Proposer submits its response to the solicitation and must only exclude or obliterate those exact portions that are claimed confidential, proprietary, or trade secret. In compliance with §119.07(1)(e), Fla. Stat. (2023), Proposer must “state the basis for the exemption” that he/she “contends is applicable to the record, including the statutory citation to an exemption created or afforded by statute.”

Proposer shall be responsible for defending its determination that the redacted portions of its response are confidential, proprietary, trade secret or otherwise not subject to disclosure. Further, Proposer shall protect, defend, and indemnify the School Board for any and all claims arising from or relating to Proposer’s determination that the redacted portions of its response are confidential, proprietary, trade secret or otherwise not subject to disclosure.

The School Board will make no effort to verify whether or not the redacted material is exempt from §119, Fla. Stat. (2023). That determination is totally the responsibility of the Proposer.

If the Proposer fails to submit a Redacted Copy with its response, the School Board is authorized to produce the entire documents, data or records submitted by Proposer in answer to a public records request for these records.

I have read and understand my responsibilities regarding any purported confidential, proprietary or trade secret material contained in this proposal.

After reading the above statement, please initial next to the appropriate statement below:

__________ I have not included a redacted copy of our proposal.

__________ I have included a redacted copy of our proposal along with this original.

Signature of Proposer Signing Agreement

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

Acknowledgment of Addenda Check: (Yes) or (No)

(Date of Receiving Addendum)

Addendum #1 Yes _____ No _____ Date Received:

Addendum #2 Yes _____ No _____ Date Received:

Addendum #3 Yes _____ No _____ Date Received:

Addendum #4 Yes _____ No _____ Date Received:

Addendum #5 Yes _____ No _____ Date Received:

Company Name

Signature

Address

City State Zip Code

Date

AD-1048 OMB No. 0505-0027 Expiration Date: 09/30/2025

Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions

The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. § 552a, as amended). This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, and 2 CFR §§ 180.300, 180.335, Participants' responsibilities. The regulations were amended and published on August 31, 2005, in 70 Fed. Reg. 51865-51880. Copies of the regulations may be obtained by contacting the Department of Agriculture agency offering the proposed covered transaction.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0505-0027. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of appropriate criminal or civil fraud, privacy, and other statutes may be applicable to the information provided.

(Read instructions on page two before completing certification.)

A. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor 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;

B. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

ORGANIZATION NAME PR/AWARD NUMBER OR PROJECT NAME

NAME(S) AND TITLE(S) OF AUTHORIZED REPRESENTATIVE(S)

SIGNATURE DATE

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

https://www.usda.gov/oascr/how-to-file-a-program-discrimination-complaint mailto:program.intake@usda.gov

Instructions for Certification

(1) By signing and submitting this form, the prospective lower tier participant is providing the certification set out on page 1 in accordance with these instructions.

(2) The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department or agency with which this transaction originated may pursue available remedies, including suspension or debarment.

(3) The prospective lower tier participant must provide immediate written notice to the person(s) to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(4) The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person, ""primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549, at 2 CFR Parts 180 and 417. You may contact the Department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations.

(5) The prospective lower tier participant agrees by submitting this form that, should the proposed covered transaction be entered into, it may not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Department or agency with which this transaction originated.

(6) The prospective lower tier participant further agrees by submitting this form that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

(7) A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the General Services Administration’s System for Award Management Exclusions database.

(8) Nothing contained in the foregoing shall be construed to require establishment of a system of records to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(9) Except for transactions authorized under paragraph (5) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment.

Form AD-1048 (REV 12/22)

This form is available electronically. OMB Control No. 0505-0027

Expiration Date: 04/30/2022

Certification Regarding Drug-Free Workplace Requirements (Grants) AD-1049 Alternative I – For Grantees Other Than Individuals

The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. § 552a, as amended). This certification is required by the regulations implementing §§ 5151-5160 of the Drug-Free Workplace Act of 1998 (Pub. L.100-690, Title V, Subtitle D: 41 U.S.C. § 8101 et seq.), and 2 C.F.R. Parts 182 and 421. The regulations were amended and published on June 15, 2009, in 74 Fed. Reg. 28150-28154 and on December 8, 2011, in 76 Fed. Reg. 76610-76611. Copies of the regulations may be obtained by contacting the Department of Agriculture agency offering the grant.

According to the Paperwork Reduction Act of 1995 an agency may not conduct or sponsor, and a person is not 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 0505-0027. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of appropriate criminal, civil, fraud, privacy, and other statutes may be applicable to the information provided.

(Read instructions on page three before completing certification.)

A. The grantee certifies that it will or will continue to provide a drug-free workplace by:

1. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee’s workplace and specifying the actions that will be taken against employees for violation of such prohibition;

2. Establishing an ongoing drug-free awareness program to inform employees about –

a. The dangers of drug abuse in the workplace;

b. The grantee’s policy of maintaining a drug-free workplace;

c. Any available drug counseling, rehabilitation, and employee assistance programs; and

d. The penalties that may be imposed upon employees for drug-abuse violations occurring in the workplace.

3. Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph A.1.

4. Notifying the employee in the statement required by paragraph A.1 that, as a condition of employment under the grant, the employee will –

a. Abide by the terms of the statement; and

b. Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction;

5. Notifying the agency in writing, within ten calendar days after receiving notice under subparagraph A.4.b from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer on whose grant activity the convicted employee was working, unless the Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant;

6. Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph A.4.b, with respect to any employee who is so convicted –

a. Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or

b. Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or, local health, law enforcement, or other appropriate agency;

7. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs

A.1 through A.6.

B. The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant:

PLACE OF PERFORMANCE (Street Address, City, County, State, Zip Code)

Check if there are workplaces on file that are not identified here.

ORGANIZATION NAME PR/AWARD NUMBER OR PROJECT NAME

NAME(S) AND TITLE(S) OF AUTHORIZED REPRESENTATIVE(S)

SIGNATURE(S) DATE

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint (https://www.ascr.usda.gov/filing-program-discrimination-complaint-usda-customer) and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442.

Form AD-1049 (REV 10/19) https://www.ascr.usda.gov/filing-program-discrimination-complaint-usda-customer https://www.ascr.usda.gov/filing-program-discrimination-complaint-usda-customer

Instructions for Certification

(1) By signing and submitting this form, the grantee is providing the certification set out on pages one and two in accordance with these instructions.

(2) The certification set out on pages one and two is a material representation of fact upon which reliance is placed when the agency awards the grant. If it is later determined that the grantee knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, the agency, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act.

(3) Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee must keep the identity of the workplace(s) on file in its office and make the information available for

Federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee’s drug-free workplace requirements.

(4) Workplace identifications must include the actual address of buildings (or parts of buildings) or other sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles of a mass transit authority or State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios).

(5) If the workplace identified to the agency changes during the performance of the grant, the grantee shall inform the agency of the change(s). If it previously identified the workplaces in question, see paragraph (3) above.

(6) Definitions of terms in the Nonprocurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees’ attention is called, in particular, to the following definitions from these rules:

• “Controlled substance” means a controlled substance in Schedules I through V of the Controlled Substances Act, 21 U.S.C.

§ 812, and as further defined by 21 C.F.R. §§ 1308.11-1308.15.

• “Conviction” means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the Federal or State criminal drug statutes.

• “Criminal drug statute” means a Federal or non-Federal criminal statute involving the manufacture, distribution, dispensing, use, or possession of any controlled substance.

• “Employee” means the employee of a grantee directly engaged in the performance of work under a grant, including: (i) all

“direct charge” employees (ii) all “indirect charge” employees unless their impact or involvement is insignificant to the performance of the grant and, (iii) temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee’s payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement, consultants or independent contractors not on the grantee’s payroll, or employees of subrecipients or subcontractors in covered workplaces).

Form AD-1049 (REV 10/19) http:1308.11-1308.15

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

STATEMENT OF NO BID

If you are not bidding on this service/commodity, please complete and upload to www.myvendorlink.com.

Failure to respond may result in deletion of vendor's name from the bidder's list for The School Board of Marion County, Florida.

COMPANY NAME: _____________________________________________________

ADDRESS: ___________________________________________________________

CITY: ________________ STATE: ________________ ZIP: _____________

CONTACT PERSON: __________________________TELEPHONE: ______________

We, the undersigned, have declined to bid on your Bid No. 4083AH Shoes, Slip Resistant, Term Contract because of the following reasons:

We do not offer this product or the equivalent.

Insufficient time to respond to the invitation to bid.

Remove our name from this bid list only.

Our product schedule would not permit us to perform.

Unable to meet bond requirements.

Other. (Specify below)

REMARKS:

SIGNATURE: _____________________________ DATE: _________________ (m/d/yyyy)

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

PURCHASING DEPARTMENT

2091 NE 35th Street

Ocala, FL 34479

(352) 671-7500

Fax (352) 671-7504

COMMON CARRIER INSURANCE WAIVER REQUEST

Company Name ______________________________________________

Street Address _______________________________________________

City / State __________________________________________________

The above-named company certifies that all items purchased by The School Board of Marion County, Florida, its schools and departments, will be delivered by common carrier and at no time will the employees of said company be on the premises for delivery or installation purposes.

Signed ___________________________________

Print / Type Name _________________________

Title _____________________________________

Bid Number: 4083AH

Bid Name: Shoes, Slip Resistant, Eight (8) Months and Twenty-One (21) Days

Term Contract

Bid 4083AH Shoe, Slip Resistant Rev 86VL – 6-4-2024

PLEASE READ ALL TERMS AND CONDITIONS OF THIS BID SO THAT YOU DO NOT MISS

IMPORTANT INFORMATION THAT MAY AFFECT YOUR BID SUBMISSION.

NOTE: THE LIST BELOW MAY NOT BE INCLUSIVE OF ALL REQUIREMENTS. USE THE BELOW

LIST AS A CHECKOFF LIST TO ENSURE THESE ITEMS ARE NOT MISSING.

REQUIRED:

Invitation to Bid Page (Bidder Acknowledgement Page) __________

Proposal Form(s) __________

Confidential, Proprietary, or Trade Secret Material Statement __________

Acknowledgement of Addenda __________

Drug Free Workplace Certification __________

Certification Regarding Debarment __________

Manufacturer’s Authorization(s) __________

Bidders Qualification Statement __________

W-9 Form (not in packet, must be downloaded) __________

IF REQUIRED BY ORDINANCE:

Occupational License __________

IF APPLICABLE:

Bid or Performance Bond __________

OR:

Statement of No Bid __________