Bid Form 2082-01 - Distributed.pdf

BOSTON HOUSING AUTHORITY

INVITATION FOR BIDS – BHA Job No.: 2082-01

Purchasing Department of the Boston Housing Authority invites sealed bids to furnish and deliver Wipes, Tissues, Towels & Rags. Bids will be received until September 19, 2022 at 11:30 a.m. at the Boston Housing Authority, Purchasing Department, 6th floor, 52 Chauncy Street, Boston, MA 02111 at which time and place all bids received will be publicly opened and read aloud. The project is estimated at $66,000.00. There is no charge for the specifications and bidding documents, which are available for download at www.commbuys.com. All inquiries regarding this bid shall be directed to Procurement Department at, bids@bostonhousing.org. Bids will be subject to approval and award by the Executive Committee of the Boston Housing Authority. Bids will be irrevocable for a period of 60 days from the date of bid opening. The Boston Housing Authority reserves the right to reject any and all bids and to waive any informality.

http://www.commbuys.com/ mailto:bids@bostonhousing.org

Any changes to the official printed language of this form shall be void. The official form or document of record shall be the form posted on

Comm-Pass or COMMBUYS for the solicitation.

Bid and Award Contract Form - Page 1 of 2

BOSTON HOUSING AUTHORITY

52 CHAUNCY STREET

BOSTON, MA 02111

BID AND AWARD

(Materials and Supplies)

BHA Bid No. _______________

Bid Title:________________________________________________________________________________________

Opening Date: ________________________ Time: ________________________

Bid Deposit Required Bid Deposit Not Required

BID

The undersigned offers and agrees, if this bid be accepted within sixty (60) days from the date of bid opening, to furnish and deliver all items upon which prices are herein quoted in compliance with all terms, conditions and requirements specified in this bid solicitation. The undersigned certifies under penalties of perjury that this bid or proposal is in all respect bona fide, fair and without collusion or fraud with any other person. By executing this Contract, the Contractor under the pains and penalties of perjury, makes all certifications required by law and certifies that it shall comply with the following requirements: that the

Contractor is qualified and shall at all times remain qualified to perform this Contract; that performance shall be timely and meet or exceed industry standards, including obtaining requisite licenses, permits and resources for performance; that the

Contractor and its subcontractors are not currently debarred; that the Contractor has reviewed the General Conditions for

Procurement Contracts (including hyperlinks), Special Conditions for Term Contracts, Bid Form and Technical Specifications, and Instructions to Bidders; that the terms of this Contract shall survive its termination for the purpose of resolving any claim, dispute or other Contract action, or for effectuating any and all representations, warranties and guarantees made or supplied by the Contractor or its subcontractors.; The Contractor further agrees that all terms governing performance of this Contract and doing business in Massachusetts are attached to this Contract or incorporated by reference herein, including the following requirements: all relevant Massachusetts state and federal laws, regulations, Executive Orders, treaties, the General Conditions for Procurement Contracts, Special Conditions for Term Contracts, Bid Form and Technical Specifications, and Instructions to

Bidders, the Request for Proposals (RFP) or solicitation/Invitation for Bids, the Contractor’s response to the RFP or solicitation

(if applicable), and any additional stipulated provisions. As used in this certification, the word "person" shall mean any natural person, joint venture, partnership, corporation, or other business or legal entity.

Authorized Signature Bidder’s Name

Printed Name, Title Address

City, State, Zip Code Date

Phone Number Fax Number

Email Address Contract Manager

Contract No.

Any changes to the official printed language of this form shall be void. The official form or document of record shall be the form posted on

Comm-Pass or COMMBUYS for the solicitation.

Bid and Award Contract Form - Page 2 of 2

GENERAL INSTRUCTIONS

1. Sealed bids will be received by the Purchasing Department, Boston Housing Authority until the date and time specified above, at which time they will be publicly opened and read aloud. All interested parties are invited to be present.

2. It is bidder's sole responsibility to ensure timely delivery of the bid. Late bids will not be considered and will be returned unopened.

3. All bids shall be submitted in the envelope provided or in a sealed, opaque envelope bearing the bidder's return address, clearly marked with the words "Bid Documents" and designating the bid title, date, and time set for bid opening.

INSTRUCTIONS FOR COMPLETING THE BID AND AWARD CONTRACT FORM:

AUTHORIZED SIGNATURE: Authorization Signature of Contracting Entity (Individual or Firm) as it appears on Contractor Authorized Signature

Verification Form

PRINTED NAME, TITLE: Name and Title of person signing the Contract.

BIDDER’S NAME: Enter the full legal name of the Contractor's business as it appears on the Contractor's W-9 Form. If Contractor also has a “doing business as” name, both the legal name and the “d/b/a” name must appear in this section.

PHONE/FAX/E-MAIL ADDRESS: Identify the phone, fax number(s) and electronic mail (e-mail) address of the Contract Manager.

BUSINESS MAILING ADDRESS: Enter the address (Street Address, City, State, and Zip code) where all correspondence to the Contract Manager must be sent. Unless otherwise specified in the Contract, legal notice sent or received by the Contractor’s Contract Manager (with confirmation of actual receipt) through the listed fax number(s) or electronic mail address will meet any requirements for written notice under the Contract.

CONTRACT MANAGER: Identify the authorized Contract Manager who will be responsible for managing the Contract.

NOTICE

This procurement and the contract resulting from an award of this procurement are subject to the requirements contained in the following laws and/or regulations unless otherwise indicated: Chapter 30B of the Massachusetts General Laws and Title 24, Section

85.36 of the Code of Federal Regulations.

To Be Completed by BHA:

AWARD

AWARD DATE: CONTRACT TERM CONTRACT AMOUNT:

FROM TO $

Accepted as to items numbered: Boston Housing Authority

By: Kathryn Bennett

Administrator

Item BHA Stock

Nos. Numbers Quantity Description Brand/Model Unit Price Total

1. J-02-760 250 cs Toilet Tissue, 1 Ply

Heavenly Soft #410002

Wrapped, 1000 Shts, 96 rls/cs

2. J-02-770 1000 cs Towels, Paper Fold

Big Fold, Fort James

#00887, 2200/cs or GP20887

3. J-02-772 125 cs Towels, Scott High Capacity

Roll, White 1.75"Core, 8"x950'

6 rl/cs Kimberly-Clark #KC-02000

Grand Total:

Item BHA Stock

Nos. Number Quantity Description Brand/Model Unit Price Total

1. J-02-500 504 cs Disposable Wipes

12x12 Smooth, White or Blue Premium

Made From Polyester & Wood Pulp Grand Total:

100% Lint Free, Sontara 500 wipes/cs

Item BHA Stock

Nos. Number Quantity Description Brand/Model Unit Price Total

1. J-02-450 125 bx Colored Wipe Rag

50 lb/bx, 85% Cotton

New Washed, Absorbent

Color Mill End Wipes Grand Total:

Item BHA Stock

Nos. Number Quantity Description Brand/Model Unit Price Total

1. J-02-762 175 cs Toilet Tissue, Jumbo

Roll, 9" - 2 Ply, Roses

# TT2P9Z - 12rls/cs Grand Total:

or Marcal Pro #60100

Bid Title: WIPES, TISSUES, TOWELS & RAGS Bid Opening Date: September 19, 2022

Time: 11:30 a.m.

Vendor Name

Authorized Signature

Boston Housing Authority

Bid Form 2082-01

Section 4:

Section 1:

Section 2:

Section 3:

The following required documents have been completed and are submitted herewith.

Cover Sheet (Bid and Award)

Bid Form

Bid Deposit (if required)

Representations and Certifications of Bidders (HUD Form 5369-A)

Corporate Certificate (if a Corporation)

Reap Certificate

W-9 Form, Verification of Taxation Reporting Information

NOTE: Bidders are cautioned to be sure their bids are submitted complete with all attachments. Failure to submit any required document WITH THE BID will be grounds for rejection of the bid without further review.

BIDDER'S CHECKLIST

form HUD-5369-A (11/92)Previous edition is obsolete

Representations, Certifications, and Other Statements of Bidders

Public and Indian Housing Programs

U.S. Department of Housing and Urban Development Office of Public and Indian Housing

Representations, Certifications, and Other Statements of Bidders Public and Indian Housing Programs

Table of Contents

Clause Page

1. Certificate of Independent Price Determination 1

2. Contingent Fee Representation and Agreement 1

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions 1

4. Organizational Conflicts of Interest Certification 2

5. Bidder's Certification of Eligibility 2

6. Minimum Bid Acceptance Period 2

7. Small, Minority, Women-Owned Business Concern Representation 2

8. Indian-Owned Economic Enterprise and Indian Organization Representation 2

9. Certification of Eligibility Under the Davis-Bacon Act 3

10. Certification of Nonsegregated Facilities 3

11. Clean Air and Water Certification 3

12. Previous Participation Certificate 3

13. Bidder's Signature 3

1. Certificate of Independent Price Determination

(a) The bidder certifies that--

(1) The prices in this bid have been arrived at independently, without, for the purpose of restricting competition, any consultation, communication, or agreement with any other bidder or competitor relating to (i) those prices, (ii) the intention to submit a bid, or (iii) the methods or factors used to calculate the prices offered;

(2) The prices in this bid have not been and will not be knowingly disclosed by the bidder, directly or indirectly, to any other bidder or competitor before bid opening (in the case of a sealed bid solicitation) or contract award (in the case of a competitive proposal solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the bidder to induce any other concern to submit or not to submit a bid for the purpose of restricting competition.

(b) Each signature on the bid is considered to be a certification by the signatory that the signatory--

(1) Is the person in the bidder's organization responsible for determining the prices being offered in this bid or proposal, and that the signatory has not participated and will not participate in any action contrary to subparagraphs (a)(l) through (a)(3) above; or

(2) (i) Has been authorized, in writing, to act as agent for the following principals in certifying that those principals have not participated, and will not participate in any action contrary to subparagraphs (a)(l) through (a)(3) above.

_______________________________________________ [insert full name of person(s) in the bidder's organization responsible for determining the prices offered in this bid or proposal, and the title of his or her position in the bidder's organization];

(ii) As an authorized agent, does certify that the principals named in subdivision (b)(2)(i) above have not participated, and will not participate, in any action contrary to subparagraphs (a)(1) through (a)(3) above; and

(iii) As an agent, has not personally participated, and will not participate in any action contrary to subparagraphs (a)(1) through (a)(3) above.

(c) If the bidder deletes or modifies subparagraph (a)2 above, the bidder must furnish with its bid a signed statement setting forth in detail the circumstances of the disclosure.

[ ] [Contracting Officer check if following paragraph is applicable]

(d) Non-collusive affidavit. (applicable to contracts for construction and equipment exceeding $50,000)

(1) Each bidder shall execute, in the form provided by the PHA/ IHA, an affidavit to the effect that he/she has not colluded with any other person, firm or corporation in regard to any bid submitted in response to this solicitation. If the successful bidder did not submit the affidavit with his/her bid, he/she must submit it within three (3) working days of bid opening. Failure to submit the affidavit by that date may render the bid nonresponsive. No contract award will be made without a properly executed affidavit.

(2) A fully executed "Non-collusive Affidavit" [ ] is, [ ] is not included with the bid.

2. Contingent Fee Representation and Agreement

(a) Definitions. As used in this provision:

"Bona fide employee" means a person, employed by a bidder and subject to the bidder's supervision and control as to time, place, and manner of performance, who neither exerts, nor proposes to exert improper influence to solicit or obtain contracts nor holds out as being able to obtain any contract(s) through improper influence.

"Improper influence" means any influence that induces or tends to induce a PHA/IHA employee or officer to give consideration or to act regarding a PHA/IHA contract on any basis other than the merits of the matter.

(b) The bidder represents and certifies as part of its bid that, except for full-time bona fide employees working solely for the bidder, the bidder:

(1) [ ] has, [ ] has not employed or retained any person or company to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any person or company employed or retained to solicit or obtain this contract any commission, percentage, brokerage, or other fee contingent upon or resulting from the award of this contract.

(c) If the answer to either (a)(1) or (a)(2) above is affirmative, the bidder shall make an immediate and full written disclosure to the PHA/IHA Contracting Officer.

(d) Any misrepresentation by the bidder shall give the PHA/IHA the right to (1) terminate the contract; (2) at its discretion, deduct from contract payments the amount of any commission, percentage, brokerage, or other contingent fee; or (3) take other remedy pursuant to the contract.

3. Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (applicable to contracts exceeding $100,000)

(a) The definitions and prohibitions contained in Section 1352 of title 31, United States Code, are hereby incorporated by reference in paragraph (b) of this certification.

Page1 of 3

6. Minimum Bid Acceptance Period

(a) "Acceptance period," as used in this provision, means the number of calendar days available to the PHA/IHA for awarding a contract from the date specified in this solicitation for receipt of bids.

(b) This provision supersedes any language pertaining to the acceptance period that may appear elsewhere in this solicitation.

(c) The PHA/IHA requires a minimum acceptance period of [Contracting Officer insert time period] calendar days.

(d) In the space provided immediately below, bidders may specify a longer acceptance period than the PHA's/IHA's minimum require-ment. The bidder allows the following acceptance period:

calendar days.

(e) A bid allowing less than the PHA's/IHA's minimum acceptance period will be rejected.

(f) The bidder agrees to execute all that it has undertaken to do, in compliance with its bid, if that bid is accepted in writing within (1) the acceptance period stated in paragraph (c) above or (2) any longer acceptance period stated in paragraph (d) above.

7. Small, Minority, Women-Owned Business Concern Representation

The bidder represents and certifies as part of its bid/ offer that it --

(a) [ ] is, [ ] is not a small business concern. "Small business concern," as used in this provision, means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding, and qualified as a small business under the criteria and size standards in 13 CFR 121.

(b) [ ] is, [ ] is not a women-owned business enterprise. "Women-owned business enterprise," as used in this provision, means a business that is at least 51 percent owned by a woman or women who are U.S. citizens and who also control and operate the business.

(c) [ ] is, [ ] is not a minority business enterprise. "Minority business enterprise," as used in this provision, means a business which is at least 51 percent owned or controlled by one or more minority group members or, in the case of a publicly owned business, at least 51 percent of its voting stock is owned by one or more minority group members, and whose management and daily opera-tions are controlled by one or more such individuals. For the purpose of this definition, minority group members are:

(Check the block applicable to you)

[ ] Black Americans [ ] Asian Pacific Americans

[ ] Hispanic Americans [ ] Asian Indian Americans

[ ] Native Americans [ ] Hasidic Jewish Americans

8. Indian-Owned Economic Enterprise and Indian Organization Representation (applicable only if this solicitation is for a contract to be performed on a project for an Indian Housing Authority)

The bidder represents and certifies that it:

(a) [ ] is, [ ] is not an Indian-owned economic enterprise.

"Economic enterprise," as used in this provision, means any com-mercial, industrial, or business activity established or organized for the purpose of profit, which is at least 51 percent Indian owned.

"Indian," as used in this provision, means any person who is a member of any tribe, band, group, pueblo, or community which is recognized by the Federal Government as eligible for services from the Bureau of Indian Affairs and any "Native" as defined in the Alaska Native Claims Settlement Act.

(b) [ ] is, [ ] is not an Indian organization. "Indian organization," as used in this provision, means the governing body of any Indian tribe or entity established or recognized by such governing body.

Indian "tribe" means any Indian tribe, band, group, pueblo, or

(b) The bidder, by signing its bid, hereby certifies to the best of his or her knowledge and belief as of December 23, 1989 that:

(1) No 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 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 the awarding of a contract resulting from this solicitation;

(2) If any funds other than Federal appropriated funds (includ-ing profit or fee received under a covered Federal transaction) have been paid, or will be paid, 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, the bidder shall complete and submit, with its bid, OMB standard form LLL, "Disclosure of Lobbying Activities;" and

(3) He or she will include the language of this certification in all subcontracts at any tier and require that all recipients of subcontract awards in excess of $100,000 shall certify and disclose accordingly.

(c) Submission of this certification and disclosure is a prerequisite for making or entering into this contract imposed by section 1352, title 31, United States Code. Any person who makes an expenditure prohibited under this provision or who fails to file or amend the disclosure form to be filed or amended by this provision, shall be subject to a civil penalty of not less than $10,000, and not more than $100,000, for each such failure.

(d) Indian tribes (except those chartered by States) and Indian organizations as defined in section 4 of the Indian Self-Determina-tion and Education Assistance Act (25 U.S.C. 450B) are exempt from the requirements of this provision.

4. Organizational Conflicts of Interest Certification The bidder certifies that to the best of its knowledge and belief and except as otherwise disclosed, he or she does not have any organizational conflict of interest which is defined as a situation in which the nature of work to be performed under this proposed contract and the bidder's organizational, financial, contractual, or other interests may, without some restriction on future activities:

(a) Result in an unfair competitive advantage to the bidder; or,

(b) Impair the bidder's objectivity in performing the contract work.

[ ] In the absence of any actual or apparent conflict, I hereby certify that to the best of my knowledge and belief, no actual or apparent conflict of interest exists with regard to my possible performance of this procurement.

5. Bidder's Certification of Eligibility

(a) By the submission of this bid, the bidder certifies that to the best of its knowledge and belief, neither it, nor any person or firm which has an interest in the bidder's firm, nor any of the bidder's subcon-tractors, is ineligible to:

(1) Be awarded contracts by any agency of the United States Government, HUD, or the State in which this contract is to be performed; or,

(2) Participate in HUD programs pursuant to 24 CFR Part 24.

(b) The certification in paragraph (a) above is a material represen-tation of fact upon which reliance was placed when making award.

If it is later determined that the bidder knowingly rendered an erroneous certification, the contract may be terminated for default, and the bidder may be debarred or suspended from participation in HUD programs and other Federal contract programs.

community including Native villages and Native groups (including corporations organized by Kenai, Juneau, Sitka, and Kodiak) as defined in the Alaska Native Claims Settlement Act, which is recognized by the Federal Government as eligible for services from the Bureau of Indian Affairs.

9. Certification of Eligibility Under the Davis-Bacon Act (applicable to construction contracts exceeding $2,000)

(a) By the submission of this bid, the bidder certifies that neither it nor any person or firm who has an interest in the bidder's firm is a person or firm ineligible to be awarded contracts by the United States Government by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(b) No part of the contract resulting from this solicitation shall be subcontracted to any person or firm ineligible to be awarded contracts by the United States Government by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(c) The penalty for making false statements is prescribed in the U.

S. Criminal Code, 18 U.S.C. 1001.

10. Certification of Nonsegregated Facilities (applicable to contracts exceeding $10,000)

(a) The bidder's attention is called to the clause entitled Equal Employment Opportunity of the General Conditions of the Con-tract for Construction.

(b) "Segregated facilities," as used in this provision, means any waiting rooms, work areas, rest rooms and wash rooms, restaurants and other eating areas, time clocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees, that are segregated by explicit directive or are in fact segregated on the basis of race, color, religion, or national origin because of habit, local custom, or otherwise.

(c) By the submission of this bid, the bidder certifies that it does not and will not maintain or provide for its employees any segregated facilities at any of its establishments, and that it does not and will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The bidder agrees that a breach of this certification is a violation of the Equal Employment Opportunity clause in the contract.

(d) The bidder further agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) prior to entering into subcontracts which exceed $10,000 and are not exempt from the requirements of the Equal Employment Opportunity clause, it will:

(1) Obtain identical certifications from the proposed subcon-tractors;

(2) Retain the certifications in its files; and

(3) Forward the following notice to the proposed subcontrac-tors (except if the proposed subcontractors have submitted identical certifications for specific time periods):

Notice to Prospective Subcontractors of Requirement for Certifications of Nonsegregated Facilities A Certification of Nonsegregated Facilities must be submitted before the award of a subcontract exceeding $10,000 which is not exempt from the provisions of the Equal Employment Opportunity clause of the prime contract. The certification may be submitted either for each subcontract or for all subcontracts during a period (i.e., quarterly, semiannually, or annually).

Note: The penalty for making false statements in bids is prescribed in 18 U.S.C. 1001.

11. Clean Air and Water Certification (applicable to con-tracts exceeding $100,000)

The bidder certifies that:

(a) Any facility to be used in the performance of this contract [ ] is, [ ] is not listed on the Environmental Protection Agency List of Violating Facilities:

(b) The bidder will immediately notify the PHA/IHA Contracting Officer, before award, of the receipt of any communication from the Administrator, or a designee, of the Environmental Protection Agency, indicating that any facility that the bidder proposes to use for the performance of the contract is under consideration to be listed on the EPA List of Violating Facilities; and,

(c) The bidder will include a certification substantially the same as this certification, including this paragraph (c), in every nonexempt subcontract.

12. Previous Participation Certificate (applicable to construction and equipment contracts exceeding $50,000)

(a) The bidder shall complete and submit with his/her bid the Form HUD-2530, "Previous Participation Certificate." If the successful bidder does not submit the certificate with his/her bid, he/she must submit it within three (3) working days of bid opening. Failure to submit the certificate by that date may render the bid nonresponsive.

No contract award will be made without a properly executed certifi-cate.

(b) A fully executed "Previous Participation Certificate"

[ ] is, [ ] is not included with the bid.

13. Bidder's Signature The bidder hereby certifies that the information contained in these certifications and representations is accurate, complete, and current.

(Signature and Date)

(Typed or Printed Name)

(Title)

(Company Name)

(Company Address)

CORPORATE CERTIFICATE

I, ___________________________________________, certify that I am the Secretary of the Corporation named in the attached proposal; that _______________________________________ who signed said proposal on behalf of the Contractor was then of said corporation; that I know his/her signature; that his/her signature thereto is genuine and that said proposal was duly signed, sealed and executed for and in behalf of said Corporation by authority of its governing body.

Signed under the pains and penalties of perjury.

(CORPORATE SEAL)

(Secretary)

, 20__

REAP CERTIFICATE

REAP CERTIFICATION

Pursuant to M.G.L. Chapter 62 ( c ), Section 49 (a), the individual signing this document on behalf of the Bidder, hereby certifies, under the penalties of perjury, that to the best of his/her knowledge and belief the Bidder has complied with any and all applicable state tax laws.

SIGNED

BY: ______________________________

DATE: ________________________

Company Name

Address

Town, State and Zip Code http://www.mass.gov/legis/laws/mgl/62c-49a.htm

Form BHA- W-9 (Rev. October 2004)

Form W-9 (BHA Substitute W-9 Form)

Rev. October 2004

Request for Taxpayer Identification Number and Certification

Completed form should be given to the requesting department or the department you are currently doing business with.

Name ( List legal name, if joint names, list first & circle the name of the person whose TIN you enter in Part I-See Specific Instruction on page 2)

Business name, if different from above. (See Specific Instruction on page 2)

Check the appropriate box: □ Individual/Sole proprietor □ Corporation □ Partnership □ Other ►-----------------------------------------------

Legal Address: number, street, and apt. or suite no. Remittance Address: if different from legal address number, street, and apt. or suite no.

City, state and ZIP code City, state and ZIP code

Phone # ( ) Fax # ( ) Email address:

Part I Taxpayer Identification Number (TIN) f Enter your TIN in the appropriate box. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instruction on page 2. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 2.

Note: If the account is in more than one name, see the chart on page 2 for guidelines on whose number to enter.

Social security number

OR

Employer identification number

Part II Certification f Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Services (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and

3. I am an U.S. person (including an U.S. resident alien).

4. I am currently a Boston Housing Authority Employee: (check one): No____ Yes _____ Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.

Sign Here Authorized Signature ► Date ►

Purpose of Form A person who is required to file an information return with the IRS must get your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or debt, or contributions you made to an IRA.

Use Form W-9 only if you are a U.S. person (including a resident alien), to give your correct TIN to the person requesting it (the requester) and , when applicable, to:

1. Certify the TIN you are giving is correct (or you are waiting for a number to be issued).

2. Certify you are not subject to backup withholding

If you are a foreign person, use the appropriate Form W-8. See Pub 515, Withholding of Tax on Nonresident Aliens and Foreign Corporations.

What is backup withholding? Persons making certain payments to you must withhold a designated percentage, currently 29% and pay to the IRS of such payments under certain conditions. This is called “backup withholding.”

Payments that may be subject to backup withholding include interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding.

If you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return, payments you receive will not be subject to backup withholding. Payments you receive will be subject to backup withholding if:

1. You do not furnish your TIN to the requester, or

2. You do not certify your TIN when required (see the Part II instructions on page 2 for details), or

3. The IRS tells the requester that you furnished an incorrect TIN, or

4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends only), or

5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only).

Certain payees and payments are exempt from backup withholding. See the Part II instructions on page 2.

Penalties

Failure to furnish TIN. If your fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information.

Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of Federal law, the requester may be subject to civil and criminal penalties.

P le a s e p ri n t o r ty p e

Form BHA- W-9 (Rev. October 2004)

Specific Instructions Name. If you are an individual, you must generally enter the name shown on your social security card. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name.

If the account is in joint names, list first and then circle the name of the person or entity whose number you enter in Part I of the form.

Sole proprietor. Enter your individual name as shown on your social security card on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name” line.

Limited liability company (LLC). If you are a single-member LLC (including a foreign LLC with a domestic owner) that is disregarded as an entity separate from its owner under Treasury regulations section 301.7701-3, enter the owner’s name on the “Name” line. Enter the LLC’s name on the “Business name” line.

Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8.

Other entities. Enter your business name as shown on required Federal tax documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name” line.

Part I - Taxpayer Identification

Number (TIN)

Enter your TIN in the appropriate box.

If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below.

If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN.

However, the IRS prefers that you use your

SSN.

If you are an LLC that is disregarded as an entity separate from its owner (see Limited liability company (LLC) above), and are owned by an individual, enter your SSN (or “pre-LLC” EIN, if desired). If the owner of a disregarded LLC is a corporation, partnership, etc., enter the owner’s EIN.

Note: See the chart on this page for further clarification of name and TIN combinations.

How to get a TIN. If you do not have a

TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office. Get Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can get Forms W-7 and SS-4 from the IRS by calling 1-800-TAX-FORM (1-800-829- 3676) or from the IRS’s Internet Web Site www.irs.gov.

If you do not have a TIN, write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments.

The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester.

Note: Writing “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon.

Part II - Certification

To establish to the paying agent that your TIN is correct or you are a U.S. person, or resident alien, sign Form W-9.

For a joint account, only the person whole TIN is shown in Part I should sign (when required).

Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to give your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA or MSA. The IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and criminal litigation, and to cities, states, and the District of Columbia to carry out their tax laws

You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold a designated percentage, currently 29% of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.

What Name and Number to Give the Requester

For this type of account: Give name and SSN of:

1. Individual

2. Two or more individuals (joint account)

3. Custodian account of a minor (Uniform Gift to Minors Act)

4. a. The usual revocable savings trust (grantor is also trustee)

b. So-called trust account that is not a legal or valid trust under state law

5. Sole proprietorship

The individual The actual owner of the account or, if combined funds, the first individual on the account 1

The minor 2

The grantor-trustee 1

The actual owner 1

The owner 3

For this type of account: Give name and EIN of:

6. Sole proprietorship

7. A valid trust, estate, or pension trust

8. Corporate

9. Association, club, religious, charitable, educational, or other tax-exempt organization

10. Partnership

11. A broker or registered nominee

12. Account with the

Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments

The owner 3

Legal entity 4

The corporation The organization

The partnership The broker or nominee

The public entity

1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished.

2 Circle the minor’s name and furnish the minor’s SSN.

3 You must show your individual name, but you may also enter your business or “DBA” name. You may use either your SSN or EIN (if you have one).

. List first and circle the name of the legal trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.)

Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.

If you have questions on completing this form, please contact the BHA Procurement Department.

(617) 988-4038.

Upon completion of this form, please submit it with your bid or proposal response.

http://www.irs.gov/

Any changes to the official printed language of this form shall be void. The official form or document of record shall be the form posted on Comm-Pass or COMMBUYS for the solicitation.

INSTRUCTIONS TO BIDDERS

1. Failure to examine any specifications, drawings, instructions or conditions will be at bidder's risk and will not relieve successful bidder of his/her obligation to fully carry out and implement all provisions of the contract at the price stated on the bid form.

2. All bids must be submitted in duplicate on the bid forms provided. Forms may be reproduced as necessary. All entries must be either in ink or typewritten, or entered electronically utilizing downloaded forms. No pencil figures or erasures are permitted.

Mistakes may be crossed out with corrections inserted adjacent thereto, and initialed by the person signing bid. Corrections made with correction tape or fluid are also to be initialed.

Bidders are cautioned not to make changes to downloaded solicitation forms except as necessary to enter requested information. Changes to the text of solicitation forms may result in bid rejection.

3. Bidders are cautioned to insure that their bids are complete, correct and accurate.

Clerical errors or irregularities discovered after bid opening are subject to correction only with the concurrence of the Authority and in compliance with applicable State or Federal regulation.

Negligence on the part of the bidder in preparing a bid confers no right of withdrawal or modification of said bid after it has been opened.

4. If the solicitation requires bidding on all items, failure to do so will disqualify the bid. If bidding on all items is not required, the words "No Bid" should be inserted in the space provided for any item not quoted. In the case of discrepancy between the unit price and extension, unit price shall prevail. In case of discrepancy between the total price shown on the bid form and the actual sum of the item totals, the actual sum of the item totals shall prevail.

5. If so specified in the Invitation for Bids, a bid deposit shall be included with the bid when submitted. Said bid deposit shall be in the amount of 5% of the highest possible total of all prices bid, and shall consist of a certified or cashier's check, or surety bond, drawn on a bank or surety company approved for such transactions in the Commonwealth of Massachusetts by the Division of Insurance and made payable to: “BOSTON HOUSING AUTHORITY”. Cash is acceptable but not preferred.

6. The Boston Housing Authority is exempt from Federal and State Sales and Excise Taxes and prices invoiced must not include those taxes. Exemption certificates will be provided on request.

7. HUD Form 5369 "Instructions to Bidder for Contracts" appended hereto is incorporated and made a binding part of this contract with the following clarifications: submission of bid by telegraph or facsimile machine (paragraph 1g) is not allowed. Acknowledgement of amendments (paragraph 3b), modifications of bids (paragraph 5b), and withdrawal of bids (paragraph 5g) via telegram or facsimile transmission is allowed. Paragraphs 10, "Assurance of Completion"; 11, "Preconstruction Conference"; and 12, "Indian Preference Requirements" do not apply to this contract.

http://www.hudclips.org/sub_nonhud/html/pdfforms/5369.pdf

Any changes to the official printed language of this form shall be void. The official form or document of record shall be the form posted on Comm-Pass or COMMBUYS for the solicitation.

8. HUD Form 5369-A "Representations, Certifications and Other Statements of Bidders", appended hereto must be completed, signed and returned with the bid. Entries are required in

Sections 1, 2, 4, 7 and may be required in Sections 11, 12. Questions regarding the proper execution of this form should be clarified with the Boston Housing Authority Purchasing Department before submitting bid. Please note the following: a duly authorized signature on the cover sheet of this bid certified this bid was prepared without collusion; a separate non-collusive affidavit is not required. Sixty (60) calendar days is established as the minimum period of acceptance in paragraph 6(c).

9. The Corporate Certificate or Contractor Authorized Signature Verification Form included herein shall be signed, sealed and returned with the bid. All bidders shall sign and return the Reap Certificate and W-9 Form (Verification of Taxation Reporting Information) also included herein. Bidders are cautioned to review the Bidder's Checklist. Failure to submit all required documents may result in rejection of the bid.

10. Registration of Foreign Corporations

If the selected Bidder (the Contractor) is a foreign corporation, then prior to award of the contract, the Contractor shall demonstrate current registration as a foreign corporation with the Massachusetts Secretary of the Commonwealth pursuant to M.G.L.c.156D, section 15.07 or other applicable statute.

Information about foreign (out of state) corporation regulations and filing forms may be found at http://www.sec.state.ma.us/cor/corpweb/corfor/forinf.htm http://www.commbuys.com/ http://portal.hud.gov/hudportal/documents/huddoc?id=5369-a.pdf http://www.sec.state.ma.us/cor/corpweb/corfor/forinf.htm

Any changes to the official printed language of this form shall be void. The official form or document of record shall be the form posted on Comm-Pass or COMMBUYS for the solicitation.

Special Instructions - Page 1 of 1

SPECIAL CONDITIONS FOR TERM CONTRACTS

1. This bid is for a term contract for a period of one (1) year with an option to renew in accordance with Item 2, below. Material will be ordered on an as needed basis during the contract term.

2. Quantities shown on the bid form are estimates only of the Authority’s requirements during the contract term. The Authority may purchase any, all, or none of the quantity specified or may increase the quantity specified in accordance with its actual requirements. The dollar value of the contract may, with bidder’s consent, be increased by an amount not to exceed twenty-five percent of the contract total. The term of the contract may at the sole discretion of the BHA, be extended for up to an additional six months in the event the dollar value of the contract has not exceeded 125% of the original bid amount at the end of the initial one year term.

3. Bids must remain firm throughout the contract term. No increase in the unit price bid once accepted and awarded will be permitted. No substitution for the brand/model bid once accepted and awarded will be permitted without prior approval of the Authority.

4. The Authority will attempt to order material in reasonable lots, however the minimum acceptable order shall be one each of the unit of measure shown on the bid form.

5. Prices bid shall be net, FOB destination and include sidewalk delivery, freight allowed to Central Stores, 125 Amory Street (rear) Jamaica Plain, MA or such other locations within the City of Boston as directed when orders are placed. Cash, trade and quantity discounts must be calculated in the prices quoted.

6. Delivery of items ordered will be required within five (5) working days after receipt of order. At least twenty-four (24) hours prior to delivery, awarded bidder shall notify

Central Stores at (617) 988-5127.

7. Each Section of the Bid Form will be considered separately for contract award. The

Authority may award a contract for any Section independently pending evaluation and award of other Sections. All bids for any Section may be rejected in their entirety without prejudice to the Authority’s right to award other Sections of the bid. Bidders must quote on every item within a Section. Failure to do so may be grounds for rejection of the bid for that Section.

8. The Authority is comprised of several distinct Operational Divisions. During the term of this contract, the vendor may be required to establish separate billing accounts in order to differentiate between Divisions and to expedite vendor payment at the request of the

Authority. This requirement is an integral component of the bid price. Failure by the successful bidder(s) to comply with this requirement shall be grounds for termination of the contract in accordance with Article 10.1 of the General Conditions.

Any changes to the official printed language of this form shall be void. The official form or document of record shall be

GENERAL CONDITIONS FOR

PROCUREMENT CONTRACTS

The Boston Housing Authority, hereinafter referred to as the Authority, does hereby establish the following General Conditions, applicable to this Solicitation and any subsequent purchase order or contract resulting therefrom.

1.0 Award

1.1 The Authority reserves the right to accept or reject any or all bids or portion thereof and to waive informalities or minor irregularities in bids received where such acceptance, rejection, or waiver is deemed to be in the best interest of the Authority.

1.2 Except as otherwise stated in the bidding documents, the Authority may accept any item or group of items of any bid unless qualified by specific limitation of the bidder.

1.3 Award will be made to the lowest responsive and responsible bidder. A responsive bidder is one who promises to supply the specified supply and/or service and whose bid is properly and completely submitted. A responsible bidder is one who possesses the necessary resources, ability and integrity to fully perform the contract.

1.4 To determine resources, ability and integrity, elements considered will include but not limited to: whether the bidder a) maintains a permanent place of business, b) has an adequate plan and the equipment to do the work properly and expeditiously, c) has a suitable financial status to meet the obligations incident to the work, d) has appropriate technical experience. The

Authority reserves the right to request additional information from any bidder in order to evaluate his/her resources, ability and integrity and to reject a bid where the information submitted does not satisfy the Authority that the bidder is qualified to carry out the details of the contract.

1.6 An award mailed (or otherwise furnished) to the successful bidder within the time for acceptance specified in the bid results in a binding contract without further action by either party. The contract shall be interpreted, construed, and given effect in all respects according to the laws of the Commonwealth of Massachusetts.

2.0 Specifications

2.1 All specifications included as a part of this Invitation are designed to set forth the level of quality and performance desired by the Authority, and are intended to be…