Bid Notice.pdf

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COUNTY OF PUTNAM - PURCHASING

40 Gleneida Ave.-1st Floor-Room 105, Carmel, NY 10512

TELEPHONE: 845-808-1088

ON CALL EMERGENCY REPAIR SERVICES FOR TRAFFIC SIGNAL

EQUIPMENT

BID NUMBER: RFB-29-26

INVITATION TO BID

BIDDER’S NAME: __________________________________________________________________________________________

PHYSICAL ADDRESS: _______________________________________________________________________________________ Bidders must list a physical address

MAILING ADDRESS : ___________________________________________________________________________________________

(P.O. BOX NUMBER, IF APPLICABLE)

Bids for the above referenced bid number and title will be received until 1:00 PM on Wednesday, September 30, 2026 at the Putnam County Purchasing Department, 40 Gleneida Ave, Room 105, Carmel, NY 10512, at which time and place bids will be publicly opened and read. Specifications and bid forms may be downloaded at:

www.empirestatebidsystem.com.

TERMS: October 1, 2026 – September 30, 2027 (Three – one year renewal options)

DELIVERY: See Particular Specifications

Prices are to be quoted F.O.B. DESTINATION, FREIGHT PREPAID AND ALLOWED (SHIPPING INCLUDED) with deliveries to be made as per specifications included within, unless otherwise noted in the specifications.

IMPORTANT NOTICE – Bid Distribution:

The County of Putnam officially distributes bidding documents from the Purchasing Department Office or through the Empire State Municipal Purchasing Group’s Regional Bid Notification System. Copies of bidding documents obtained from any other source are not considered official copies. Only those vendors who obtain bidding documents from either the Purchasing Department Office or the Regional Bid Notification System are guaranteed to receive addendum information, if such information is issued. Appendix A – General Terms and Conditions for all Purchasing Contracts is a separate attachment. Bidders shall download, read, and acknowledge acceptance of Appendix A on the “Bid Acknowledgement” form.

If you have obtained this document from a source other than the Putnam County Purchasing Department or the ESMPG Regional Bid Notification System, it is recommended that you obtain an official copy.

NOTE:

Proposals are to be enclosed in a sealed envelope marked: RFB-29-26 – ON CALL EMERGENCY REPAIR SERVICES FOR TRAFFIC SIGNAL EQUIPMENT and shall be addressed to the Putnam County Purchasing Director, at the above address.

The proposal of each bidder shall contain the certification to non-collusive bidding as set forth in section 103-d of the General Municipal Law included in the specifications. This requirement must be strictly complied with.

The undersigned reserves the right to reject any and all proposals and to accept any proposal or proposals as submitted, or as modified, which in the opinion of the undersigned will be in the best interests of the County of Putnam.

DATED: 9/8/26 COUNTY OF PUTNAM, CARMEL, NY BY: JOHN TULLY, PURCHASING DIRECTOR

http://www.empirestatebidsystem.com/

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BIDDER’S CHECK LIST

Your response to this bid may be considered unresponsive and may be rejected if the following forms are not included at the time of the bid opening.

BID DEPOSIT

Bid Security If required, each bid shall be accompanied by a certified check made payable to the County of Putnam in the amount indicated below. In lieu of such check, the bidder may furnish a bid bond in the same amount and having as surety thereon a surety company licensed to do business in the State of New York and approved by the County Attorney. Checks or bid bonds of all formal bidders will returned after an award has been made.

The amount of the bid deposit required for this bid is:

$500.00 5% of Total Bid Waived Other: $5,000.00

FORMS

STATEMENT OF REQUIRED DISCLOSURES, REPRESENTATIONS AND

CERTIFICATIONS

Experience/Reference Form Certificate of Equipment Form Proposal Pages

INSURANCE INFORMATION

Per the specifications, the County of Putnam requires a current insurance certificate, with the County of Putnam listed as additional insured, to be on file in the Purchasing Department. You will be given five (5) business days from notice of award to supply this form or the bid will be rescinded. Please note if the excess/umbrella clause is required.

The contractor shall furnish a performance bond in a sum equal to 100% of the contract, renewable annually for the term of the contract as applicable, should the contract value exceed $250,000.

PREVAILING WAGES

Article 8 Article 9 PRC# 2026026170

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Receipt Confirmation Form

PLEASE COMPLETE AND RETURN THIS CONFIRMATION FORM

WITHIN 5 WORKING DAYS OF RECEIVING BID PACKAGE TO:

ALEXIS HAWLEY

County of Putnam

Tele. (845) 808-1088 Email: alexis.hawley@putnamcountyny.gov

Failure to return this form may result in no further communication or addenda regarding this Bid.

Company Name: ________________________________________________________________________

Address: ______________________________________________________________________________

City: ______________________________________________ State: _________ Zip Code: ________

Contact Person: _________________________________________________________________________

Phone Number: ______________________________EXT:_____ Fax Number: ______________________

Email: _____________________________________

I have received a copy of the above noted BID.

______ We will be submitting a Bid

______ We will NOT be submitting a Bid – (please indicate reason)

I authorize the County of Putnam to send further correspondence that the County deems to be of an urgent nature by the following method:

Courier Collect: _______________________________ Mail _________________________________

Signature:______________________________________________________________________________

Title:__________________________________________________________________________________

If a bidders meeting has been arranged for this Bid, please indicate if you plan to attend: Yes / No

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**********"New Requirement"********** NYSDOL Launches an Accessible Online Electronic Certified Payroll Records Database

The New York State Department of Labor (NYSDOL) announced that starting January 1, 2026, contractors and subcontractors working in New York State must use the Electronic Certified Payroll Submissions system (https://dol.ny.gov/Electronic-Payroll) to report payrolls for any project covered by Article 8 of NYS Labor Law.

This includes, but is not limited to, public work projects, privately owned projects covered by prevailing wage requirements (Section 224-a) and certain renewable energy system projects (Section 224-d). Payrolls must be submitted at least every 30 days starting from the project start date for the length of the covered project. Failing to submit on time may result in penalties of up to $100 per day following a 14-day grace period.

REMINDER - Public Work Contractor and Subcontractor Registry

All contractors and subcontractors submitting bids or performing construction work on public work projects or private projects covered by Article 8 of the Labor Law are required to register with the New York State Department of Labor (NYSDOL} under Labor Law Section 220-i.

https://dol.ny.gov/contractor-and-subcontractor-landing

The law defines a "contractor" as any entity entering into a contract to perform construction, demolition, reconstruction, excavation, rehabilitation, repair, installation, renovation, alteration, or custom fabrication. The law defines "subcontractor" as any entity subcontracting with a contractor to perform construction, demolition, reconstruction, excavation, rehabilitation, repair, installation, renovation, alteration, or custom fabrication, which is subject to Article 8 of the Labor Law. Contractors are responsible for verifying that any subcontractors they work with are registered:

Contractors need to register before submitting any new bids or commencing new work on a covered project on or after December 30, 2024. Subcontractors need to register before commencing new work on a covered project on or after December 30, 2024. NYSDOL encourages all contractors and subcontractors to register as soon as possible to obtain a Certificate of Registration to avoid negatively impacting a bidding period or project schedule.

The Bureau of Public Work & Prevailing Wage Enforcement at the New York State Department of Labor is responsible for enforcing prevailing wage laws in New York State.

The Bureau of Public Work & Prevailing Wage Enforcement publishes the annual prevailing wage schedule every year on July 1. To find information about the prevailing wage rate for your area, or to find contact information for your local Public Works and Prevailing Wage Enforcement District Office, please visit Bureau of Public Work and Prevailing Wage Enforcement website or send an email to labor.sm.pwask@labor.ny.gov.

https://dol.ny.gov/Electronic-Payroll https://dol.ny.gov/Electronic-Payroll mailto:labor.sm.pwask@labor.ny.gov

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PURCHASES BY OTHER LOCAL GOVERNMENTS OR SCHOOL DISTRICTS

APPLICABLE YES NO NOT APPLICABLE

As per the New York State General Municipal Law, all political subdivisions of New York State are allowed to make purchases through the resulting contract(s).

1. The County of Putnam shall make all contract award information available to other political subdivisions through our website: www.putnamcountyny.com

2. Any other political subdivision will issue purchase orders directly to vendors within the specified contract period referencing the County’s contract and shall be liable for any payments due on such purchase orders;

and shall accept sole responsibility for any payment due.

3. All purchases shall be subject to audit and inspection by the other political subdivisions for which the purchase was made.

4. No officer, board or agency of a county, town, village, or school district shall make any purchase through the County when bids have been received for such purchase by such officer, board or agency, unless such purchase may be made upon the same terms, conditions and specifications at a lower price through the County.

5. All Bidders shall be on notice that as a condition of the award of a County contract, the successful bidder shall accept the award of a similar contract with any other political subdivision in New York State, if called upon to do so. The County, however, will not be responsible for any debts incurred by the participants pursuant to this or any other agreement.

6. Necessary deviations from the County’s specifications in the award of a participant contract, whether such deviations relate to quantities, or delivery points shall be resolved between the successful bidder and the other political subdivisions.

http://www.putnamcountyny.com/

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PUTNAM COUNTY INSURANCE REQUIREMENTS

The following must appear on each Certificate of Insurance

UNDER THE CERTIFICATE HOLDER SECTION OF THE FORM:

County of Putnam Attn: Mat C Bruno Sr / Law Dept.

48 Gleneida Avenue Carmel, NY 10512

Additionally, in the space on the document noted- Description of Operations/Locations- please note the following:

“ Putnam County is included as the additional insured except for Professional Liability and Workers Compensation.”

It is the requirement of the County of Putnam that for work performed under contract and/or permit authorized by the County and/or the County Departments and/or any performance conducted on county property that the contractor or permitee procure and maintain at their own expense and without expense to the county, until final acceptance of the work by the County, the insurances listed below.

BEFORE COMMENCEMENT of any work, event or performance, a certificate(s) of insurance ( known as an Accord Form ) must be furnished to the County and/or the County Departments in forms satisfactory to the County.

All insurance coverages must be from an A.M. Best Rated “ secured” ( B+ A++ ) NYS admitted insurer.

All certificates of insurance must ensure that the policy or policies shall not be changed or canceled until at least THIRTY (30) DAYS prior written notice has been given to the County and/or DPW.

When required by Department of Public Works ( hereinafter DPW ) the “XCU” exclusion of the policy or policies shall be eliminated or show proof that “XCU” is covered.

THE CONTRACTOR SHALL PROVIDE AND MAINTAIN, AT ITS OWN EXPENSE, THE FOLLOWING MINIMUM

INSURANCE COVERAGES:

A. Workers Compensation Insurance: - This is statutorily required and is required for all contracts. Each policy must cover all operations, and all locations involved in the contract. If applicable, the policy should also include NYS Disability Benefits. Proof of Workers Compensation Insurance is required and should be received by Putnam County on a C105.2 form, SI 12 form, CE-200 form or a U-26.3 form.

B. Commercial General Liability: - Covering all operations and all locations involved in the contract including the following coverages:

$2,000,000 General Aggregate $10,000 Medical Expense Limit $2,000,000 Personal and Advertising Limit $2,000,000 Each Occurrence $2,000,000 Products/ Completed Operations Aggregate $100,000 Fire Damage Legal Liability Limit

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C. Commercial Automobile Liability: - Covering all operations and locations involved in the contract, including the following coverages:

1. Owned Automobiles

2. Hired Automobiles

3. Non-Owned Automobiles

Unless specifically required, each policy shall provide limits of not less than $1,000,000 combined single limits for bodily injury and property damage.

D. If applicable, Professional Liability ( error and omissions ) in the amount of at least $1,000,000 per claim.

E. Excess Liability and/or Umbrella Policy: Limits are depending on the following contract size:

Contract size of $100,000 to $250,000 - must have $1Million of coverage Contact size of $250,001 to $500,000 - must have $5Million in coverage Contract size of $500,001 or greater - must have $10Million in coverage

F. Bid, Performance/Payment, Labor and Material Bonds:

Required for any contract in excess of $250,000. These bonds shall be provided by a NYS admitted surety company in good standing. Only the (AIA)- The American Institute of Architects- A313 from will be accepted. In addition, pursuant to NYS Insurance Law, Section 1111- All bonds must include a certificate of solvency for the surety which shall be updated annually. In addition, the Surety must be on the U.S Treasury ( Circular 570 ) of acceptable sureties.

STANDARD INSURANCE REQUIREMENTS AND INDEMNIFICATION REQUIRMENT

All policies and certificates of insurance of the contractor shall contain the following clauses:

1. Putnam County is named as an additional insured and as the Certificate Holder. Insurers shall have no right to recovery or subrogation against the County of Putnam (including its agents and agencies), it being the intention of the parties that the insurance policies so effected shall protect both parties and be primary coverage for any and all losses covered by the law above-described insurance.

2. The Clause “other insurance provisions” in a policy in which the County of Putnam is named as an additional insured, shall not apply to the County of Putnam.

3. The insurance companies issuing the policy or policies shall have no recourse against the County of Putnam (including its agents and agencies) for payment of any premiums or for assessments under any form of policy.

4. Any and all deductibles in the above-described insurance policies shall be assumed by and be for the account of, and at the risk of the contractor.

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SPECIFICATIONS

INTRODUCTION

The County is seeking a qualified vendor to provide all tools, equipment, materials, supplies, labor and supervision necessary to perform emergency repair services for traffic signals and/or flashing beacon lights and all associated components, on an as-needed, emergency basis. The County will make the sole determination as to what constitutes an emergency.

QUALIFICATIONS/PERSONNEL

Contractor shall demonstrate that they have the appropriate licenses, certifications, resources, experience, skills, facilities and personnel necessary to perform this scope of work.

Contractor and Contractor’s personnel shall have a minimum of five (5) years of experience providing emergency and non-emergency traffic signal repair services to municipalities.

Contractor shall ensure that its staff are qualified to diagnose and make all necessary repairs to the County’s traffic signals and/or flashing beacon lights and all associated components. Each Contractor submitting a bid must include a list of its personnel capable of diagnosing, repairing, and programming traffic signals along with prior similar experience of each.

Contractor shall ensure that all diagnostic and repair work required under this contract is performed by a Putnam County Licensed Electrician. Each Contractor submitting a bid must include a copy of the license for each member of its staff who is a Licensed Electrician. Failure to provide a Licensed Electrician throughout the contract term will be cause for termination of the contract.

SERVICES

Contractor shall require and ensure that all services are performed in compliance with all applicable Federal, New York State, County, and Local laws, rules, regulations, codes, and ordinances, as may be amended from time to time.

Contractor shall perform all repairs in accordance with the manufacturer’s specifications. Descriptions of and locations of equipment include, but are not limited to, those locations listed in Exhibit A. The County reserves the right to remove signals/equipment from this contract during the contract term. The County also reserves the right to add additional signals/equipment to this contract during the contract term.

Notification of emergency conditions will generally be by telephone. The Contractor shall respond to a notice from the County of required emergency work with trained and qualified personnel on site no more than two (2) hours from the time the County makes the initial call to the Contractor or their answering service. This includes responding 24 hours a day/7 days per week/365 days per year including evenings, weekends and Holidays. The time of the call from the County will be considered as when notification has been made. The County reserves the right to perform services and/or to hire others to perform services if Contractor is unable to perform same in the required timeframe.

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Contractor shall assign a representative and/or live answering service to serve as their main point of contact for the County, who will be available 24 hours a day/7 days a week/365 days per year including evenings, weekends and Holidays. Contractor shall provide the County with contact information for said representative and/or answering service and promptly update this information as necessary during the contract term.

Once the Contractor arrives at the location requiring emergency repair, that repair must be completed prior to departing the location unless specific permission has been obtained from an authorized DPW representative.

PARTS & EQUIPMENT

The Contractor is responsible for providing all tools and equipment necessary to efficiently perform all work in a professional and workmanlike manner.

The Contractor shall obtain replacement parts and equipment to make necessary repairs to all automatic signals and traffic signals owned and/or utilized by the County when necessary using available original manufacturer’s specified repair parts, rebuild kits, or approved equal replacement components. All replacement parts utilized by Contractor must be new and unused. Reconditioned parts will NOT be acceptable to the County.

The Contractor shall maintain a reasonable and complete stock of repair and replacement parts at their shop for all equipment listed in Exhibit A. The stock shall be sufficient to ensure efficient and prompt maintenance under the terms of this contract.

Additionally, the Contractor’s personnel must be properly trained to address any software/firmware issues that may arise for the equipment listed in Exhibit A.

MAINTENANCE AND PROTECTION OF TRAFFIC

The Contractor is responsible for all maintenance and protection of traffic (MPT) procedures in accordance with the National Manual on Uniform Traffic Control Devices and the NYS Supplement (latest editions). Vehicular and pedestrian traffic must be maintained while protecting them from hazards. Use of safety vests and hardhats are required at all times while working within the highway right-of-way, including when outside of the travel lanes.

SAFETY

The safety of workers is the responsibility of the Contractor. Due to electrical, vehicular and other hazards involved in the work under this contract, the Contractor shall exercise care to ensure the safe completion of work. A licensed electrician is required as noted under the “Qualifications/Personnel” section above. All OSHA regulations must be followed and adhered to. If underground work is necessary, NYS Code Rule 753 must be followed.

INVOICING AND PAYMENT

Invoices shall be submitted for payment processing to Putnam County Department of Public Works, 842 Fair Street, Carmel, NY 10512, Attention: Accounts Payable. Electronic submission of invoices is not allowed.

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The County offers two payment methods: Electronic Fund Transfer (EFT) via Automated Clearing House (ACH) or USPS mailed hard copy check. Awarded Contractor will be provided with an EFT form to complete should they wish to receive payment electronically.

Invoices must include a report that includes the following: Location and scope of work performed; Date and time of repair; County personnel making notification and time of notification; Breakdown of labor charges; Breakdown of equipment charges; Breakdown of materials/parts used. All materials/parts utilized in repairs or services shall be invoiced at markup or discount as awarded. Documentation of actual material costs to Contractor (receipts, invoices, etc.) must be provided with the invoice so that markup or discount invoiced can be verified.

Any freight/shipping charges on parts will only be reimbursed at the actual cost upon proof of invoice from Contractor showing what the actual freight/shipping charges were. No additional markup will be allowed. No handling, fuel, inflation, or other surcharges will be accepted or reimbursed by the County.

Travel time is EXCLUDED from all billing. The rates provided on Contractor’s Proposal Page shall include any fuel/costs/fees/expenses including, but not limited to, travel to/from the site where the services are to be performed. Contractor will be paid labor and/or equipment rates only from the time they arrive on site to the time they leave the site.

Sales tax shall not be collected from the County, which is tax exempt, for any product or service provided hereunder.

The County will provide a tax-exempt certificate upon request.

Payments will be processed upon submission of a written invoice in a form satisfactory to the County inclusive of all information and requirements above.

LABOR AND EQUIPMENT PRICE ADJUSTMENTS

The proposed labor and equipment rates shall remain firm through the first contract period with no adjustments allowed. If the County exercises any of the option years of the contract, Vendor may submit a request for adjustment on the yearly anniversary date of the contract. Any request for price adjustment shall be submitted thirty (30) days in advance in writing to the Director of Purchasing. Any and all price adjustments will be limited to the percentage increase in the CPI Index – All Urban Consumers for the preceding 12 months. The County reserves the right to reject any request for price increase deemed excessive.

AWARD

Low bidder will be determined by adding the TOTAL BASE BID for labor & the TOTAL MARKED UP OR DISCOUNTED PRICE for parts. Award will be made to the lowest responsive, responsible bidder meeting the requirements of this bid.

The estimated quantities on the proposal page are for bidding purposes only and are not binding guarantees of work to be done under the contract. Actual amounts may be more or less than those used on the proposal page for evaluation purposes.

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INFORMATION TO BIDDERS

OBLIGATION OF BIDDERS

A Contractor shall not plead misunderstanding or deception because of estimates of quantities, character, location, or other conditions surrounding the same. Permission will not be given to withdraw, or modify, or explain any proposal or bid after it has been opened.

The proposal shall specify the costs, in the manner hereafter described for which the items will be supplied according to the specifications, together with a unit price for each of the separate items as called for. Any proposal shall be deemed informal which does not contain prices set opposite to each of the several items for which there is a quantity exhibited in the itemized proposal.

AWARD OF CONTRACT

Award of contract will be made to the lowest responsible, qualified bidder whose proposal shall comply with all of the provisions required to render it formal. The County or the Director of Purchasing reserves the right to waive any informality or to reject any or all proposals and may advertise for new proposals, if the best interest of the county will be served. The County or the Director of Purchasing may require any or all bidders to present evidence of experience, ability and financial standing as well as a statement as to the equipment which the bidder will have available for the executing of this contract.

The county reserves the right to award this contract either on an item-by-item basis or as a total award of all items in combination.

INSURANCE & BONDS

The bidder whose proposal is accepted will be required to furnish bonds and evidence of insurance within five days from date of Notice of Award. In case of failure or refusal on the part of the bidder to furnish bonds, if required, within the set period, the amount of deposit may be forfeited to the County and the contract may be awarded to the next lowest responsible bidder. Upon the notification of award and approval of the bond, the deposit will be returned to the proposer. The deposit of persons other than the one to whom an award is made will be returned to the person or persons making the proposal immediately after the contract and bonds have been executed.

NONRESTRICTIVE USE OF BRAND NAME OR EQUAL SPECIFICATIONS

The use of a brand name is for the purpose of describing the standard of quality, performance, and characteristics desired and are not intended to limit or restrict competition.

FORM OF PROPOSAL

All proposals shall be made upon forms furnished by the Purchasing Department of the County of Putnam and shall be contained in sealed envelopes addressed to JOHN TULLY, Purchasing Director, County of Putnam, 40 Gleneida Ave. – Room 105, Carmel, NY 10512.

Form of proposal as issued by the county shall be completely filled in, in ink or typing. No bid will be accepted which contains any changes, additions, omissions or erasures.

EXPERIENCE & EQUIPMENT

Bidder shall submit with the proposal a Certificate of Experience for the past three (3) years. Certificate of Experience is included in these documents, if applicable.

EXCULPATORY CLAUSE

The Contractor agrees to make no claim for damages for delay in the performance of this contract occasioned by any act or omission to act of the County or any of its representatives and agrees that any such claim shall be fully compensated for by an extension of time to complete performance of the work as provided herein.

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ALL QUESTIONS PERTAINING TO THIS SOLICITATION MUST BE

SUBMITTED IN WRITING

Questions should be emailed to Alexis Hawley at alexis.hawley@putnamcountyny.gov.

The RFB # must appear in the subject line of the email. All questions must be submitted within seven (7) business days prior to the scheduled close date and time of the solicitation.

mailto:alexis.hawley@putnamcountyny.gov

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REPRESENTATIONS AND CERTIFICATIONS

INSTRUCTIONS:

• THE FOLLOWING FORMS MUST BE COMPLETED AND

SUBMITTED WITH YOUR BID

• A NOTARY IS ONLY REQUIRED FOR ONE PAGE

• PLEASE INITIAL PAGES WHERE REQUIRED

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BID ACKNOWLEDEMENT

Upon receipt of all required approvals a Contract shall be deemed executed and created with the successful Bidder(s) upon the Commissioner’s mailing or electronic communication to the address on the bid of: i) a Letter of Acceptance; or ii) a fully executed contract; or iii) a Purchase Order authorized by the Commissioner.

Print Name: _________________________________________________ Name of person responsible for this solicitation

By signing this solicitation, I acknowledge that I have downloaded, read, and accept Appendix A – General Terms and Conditions for this solicitation

I acknowledge the receipt of _________________________ addendums

Signature: ____________________________________________________

Email Address: ________________________________________________

Direct Phone Number: __________________________________________

Fax Number: __________________________________________________

Date: __________________________________________________

NOTE: The County of Putnam dispatches authorized Purchase Orders through its eProcurement system via email.

Please provide below a valid business email address to receive Purchase Orders

PLEASE PRINT CLEARLY

THIS FORM MUST BE SUBMITTED WITH YOUR RFB/RFP PROPOSAL

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AFFIDAVIT OF NON-COLLUSION

I hereby attest that I am the person responsible within my firm for the final decision as to the prices(s) and amount of this bid or, if not, that I have written authorization, enclosed herewith, from that person to make the statements set out below on his or her behalf and on behalf of my firm.

I further attest that:

1. The price(s) and amount of this bid have been arrived at independently, without consultation, communication or agreement for the purpose of restricting competition with any other contractor, bidder or potential bidder.

2. Neither the price(s), nor the amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder on this project, and will not be so disclosed prior to bid opening.

3. No attempt has been made or will be made to solicit, cause or induce any firm or person to refrain from bidding on this project, or to submit a bid higher than the bid of this firm, or any intentionally high or non-competitive bid or other form of complementary bid.

4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or inducement from any firm or person to submit a complementary bid.

5. My firm has not offered or entered into a subcontract or agreement regarding the purchase of materials or services from any other firm or person, or offered, promised or paid cash or anything of value to any firm or person, whether in connection with this or any other project, in consideration for an agreement or promise by any firm or person to refrain from bidding or to submit a complementary bid on this project.

6. My firm has not accepted or been promised any subcontract or agreement regarding the sale of materials or services to any firm or person, and has not been promised or paid cash or anything of value by any firm or person, whether in connection with this or any project, in consideration for my firm’s submitting a complementary bid, or agreeing to do so, on this project.

7. I have made a diligent inquiry of all members, officers, employees, and agents of my firm with responsibilities relating to the preparation, approval or submission of my firm’s bid on this project and have been advised by each of them that he or she has not participated in any communication, consultation, discussion, agreement, collusion, act or other conduct inconsistent with any of the statements and representations made in this affidavit.

The person signing this bid, under the penalties of perjury, affirms the truth thereof.

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RELATIONSHIPS TO PUTNAM COUNTY

NAME OF REPORTING ENTITY: ___________________________________________________________________________

ADDRESS: _______________________________________________________________________________________________

TELEPHONE NO.: ________________________EXT:_____ TELEFAX NO.: __________________________________

THE REPORTING ENTITY IS (Check one of the following):

____________ AN INDIVIDUAL ____________ A PARTNERSHIP ______________ A CORPORATION

A.) Related Employees

1. Are any of the employees that you will use to carry out this contract with Putnam County also an officer or employee of Putnam County, or the spouse, or the child or dependent of such Putnam County officer or employee?

Yes _______ No______

If yes, please provide details:

B.) Related Owners

1. If you are the owner of the Contractor, are you or your spouse, an officer or employee of the County?

Yes _______ No______

If yes, please provide details:

To answer the following question, the following definition of the word “interest” shall be used:

Interest means a direct or indirect pecuniary or material benefit accruing to a county officer or employee, his or her spouse, child or dependent, whether as the result of a contract with county or otherwise. For the purposes of this chapter, a county officer or employee shall be deemed to have an “interest” in the contract of:

i. His/her spouse, children and dependents, except a contract of employment with the County;

ii. A firm, partnership or association of which such officer or employee is a member or employee:

iii. A corporation of which such officer or employee is an officer, director or employee; and

iv. A corporation of which more than five (5) percent of outstanding capital stock is owner by any of the aforesaid parties.

2. Do any officers or employees of the County of Putnam have an interest in the Contractor or in any subcontractor that will be used for this contract?

Yes _______ No______

If yes, please provide details:

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CERTIFICATION OF COMPLIANCE LABOR REGULATIONS

The contractor named below certifies compliance with all applicable labor laws and regulations of the State of New York and the United States of America including the following:

1. Prevailing Wage Rate

The contractor agrees to comply with the schedule of wages applicable to the performance of the said contract and the statutory requirements and rules of the State of New York.

• Where delivery and installation of material is required, the contractor agrees to comply with Article 8-Public Work, of the NYS Labor Law and its current prevailing wage schedule.

• Where delivery in place is required, the contractor agrees to comply with Article 9, Prevailing Wages for Building Service Employees, of the NYS Labor Law and its current prevailing wage schedule.

• The contractor acknowledges their obligation and agrees to furnish Certified Payrolls with each and every invoice requesting payment to the County Department that utilized the services of the contractor. Filing of the required Certified Payrolls is a condition of payment. No payment will be made to the contractor without receipt of the required Certified Payrolls.

• The contractor and all subcontractors agree to provide written notice to all laborers, workers, or mechanics of the prevailing wage rate for their particular job classification on each pay stub*. The contractor and subcontractors also agree to post a notice at the beginning of the performance of every public work contract on each job site that includes the telephone number and address for the New York State Department of Labor and a statement informing laborers, workers, or mechanics of their right to contact the Department of Labor if he/she is not receiving proper prevailing wage rates and/or supplements for his/her job classification.

*In the event that the required information will not fit on the pay stub, an accompanying sheet or attachment of the information will suffice.

2. Social Security Taxes

The contractor promises and agrees to pay the taxes measured by the wages of their employees required by the Federal Social Security Act and all amendments thereto, and to accept the exclusive liability for said taxes.

3. Labor Laws

The contractor certifies compliance with all the provisions of laws in the State of New York and the United States of America which affect municipalities and municipal contracts, and more particularly the Labor Law, the Immigration and Naturalization Laws and Regulations, the General Municipal Law, the Workers Compensation Law, the Lien Law, Personal Property Law, State Unemployment Insurance Law, Federal Social Security Law, State, Local and Municipal Health Laws, and any and all regulations promulgated by the State of New York, insofar as the same shall be applicable to the contract awarded to the contractor.

****CERTIFICATE OF REGISTRATION NUMBER (for Public Work Contractor and Subcontractor Registry)****

PRIME:________________________________

SUB NAME & REG #:___________________________________(if using)

PAGE: 18

AFFIDAVIT OF COMPLIANCE

WITH THE REQUIREMENTS OF

8 U.S.C. SECTION 1324a

WITH RESPECT TO LAWFUL HIRING OF EMPLOYEES

_________________________, being duly sworn, deposes and says:

(print name of deponent)

1. I am the owner/authorized representative of _________________________________.

(circle one) (name of corp., business, company)

2. I certify that I have complied, in good faith, with the requirements of Title 8 of the United States Code

(U.S.C.) Section 1324a (Aliens and Nationality) with respect to the hiring of covered employees and with respect to the alien and nationality status of the owners thereof, as set forth in Putnam County Code Chapter 134.

PAGE: 19

CERTIFICATION OF COMPLIANCE WITH THE IRAN DIVESTMENT ACT

Pursuant to State Finance Law §165-a, on August 10, 2012, the Commissioner of the Office of General Services (OGS) posted a prohibited list of “persons” who are engaged in “investment activities in Iran” (both are defined terms in the law) on the OGS website at: http://www.ogs.ny.gov/about/regs/docs/ListofEntities.pdf.

By submitting a bid in response to this solicitation or by assuming the responsibility of a Contract awarded hereunder, each Bidder/Contractor, any person signing on behalf of any Bidder/Contractor and any assignee or subcontractor and, in the case of a joint bid, each party thereto, certifies, under penalty of perjury, that once the Prohibited Entities List is posted on the OGS website, that to the best of its knowledge and belief, that each Bidder/Contractor and any subcontractor or assignee is not identified on the Prohibited Entities List created pursuant to SFL § 165-a(3)(b).

Additionally, Bidder/Contractor is advised that once the Prohibited Entities List is posted on the OGS Website, any Bidder/Contractor seeking to renew or extend a Contract or assume the responsibility of a Contract awarded in response to this solicitation must certify at the time the Contract is renewed, extended or assigned that it is not included on the Prohibited Entities List.

During the term of the Contract, should the County receive information that a Bidder/Contractor is in violation of the above-referenced certification, the County will offer the person or entity an opportunity to respond. If the person or entity fails to demonstrate that he/she/it has ceased engagement in the investment which is in violation of the Act within 90 days after the determination of such violation, then the County shall take such action as may be appropriate including, but not limited to, imposing sanctions, seeking compliance, recovering damages or declaring the Bidder/Contractor in default.

The County reserves the right to reject any bid or request for assignment for a Bidder/Contractor that appears on the Prohibited Entities List prior to the award of a contract and to pursue a responsibility review with respect to any Bidder/Contractor that is awarded a contract and subsequently appears on the Prohibited Entities List.

(Please check box)

1. The subscriber below, authorized on behalf of the Reporting Entity in the title/position indicated herein, certifies that he/she is neither the Bidder/Contractor nor any proposed subcontractor as identified on the Prohibited Entities List.

PAGE: 20

DISCLOSURE OF SUPPLIER RESPONSIBILITY STATEMENT

1. List any convictions of any person, subsidiary, or affiliate of the company, arising out of obtaining, or attempting to obtain a public or private contract, or subcontract, or in the performance of such contract or subcontract.

2. List any convictions of any person, subsidiary, or affiliate of this company for offenses such as embezzlement, theft, fraudulent schemes, etc. or any other offense indicating a lack of business integrity or business honesty which affect the responsibility of the contractor.

3.List any convictions or civil judgments under state or federal antitrust statutes

4. List any violations of contract provisions such as knowingly (without good cause) to perform, or unsatisfactory performance, in accordance with the specifications of a contract.

5. List any prior suspensions or debarments by any government agency.

6. List any contracts not completed on time.

7. List any documented violations of federal or state labor laws, regulations or standards, or occupational safety and health rules.

PAGE: 21

NOTARY PAGE FOR FORMS

State of _________________________) )ss:

County of _______________________)

All statements, disclosures and representations stated hereinabove this, Representations and Certifications, comprised of the preceding 8 pages and this page, are based upon my personal review of the books and records of the reporting entity. I declare, under oath or affirmation that all of the foregoing information, as well as any supplemental responses and statements that may be attached hereto are true to the best of my knowledge. I make these statements under the penalty of perjury, in my position/title held at the above-named Reporting Entity.

BY: ____________________________________

(Signature) (Print Name and Title/position)

Sworn to before me this

___________day of_____________, 20

Notary Public

PAGE: 22

CERTIFICATION OF EXPERIENCE

(THIS FORM MUST BE FILLED IN BY VENDOR)

I _____________________________________________ HEREBY CERTIFY THAT (COMPANY) ____________________________

_____________________________________ HAS PERFORMED THE FOLLOWING WORK WITHIN THE LAST THREE YEARS:

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ___________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ___________________________________

TYPE OF WORK: _________________________________________ EMAIL ADDRESS: __________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ___________________________________

TYPE OF WORK: _________________________________________ EMAIL ADDRESS: __________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ___________________________________

TYPE OF WORK: _________________________________________ EMAIL ADDRESS: __________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ___________________________________

TYPE OF WORK: _________________________________________ EMAIL ADDRESS: __________________________________

NAME OF BIDDER: _____________________________________________

BY: ___________________________________________________

TITLE: __________________________________________________ WITNESS: _____________________________________________

PAGE: 23

CERTIFICATE OF EQUIPMENT

(THIS FORM MUST BE FILLED IN BY VENDOR)

I, _______________________________________________________________, hereby certify that ________________________________________________________________ is the owner or leasee of the equipment necessary for the execution of this Contract, and further certify that _______________________________________________________________________ is fully prepared with the necessary capital, material and machinery to conduct this work as herein specified. The equipment available for the execution of this contract is listed below:

NAME OF BIDDER: _____________________________________________

BY: ___________________________________________________

TITLE: ________________________________________________________

WITNESS: _____________________________________________

PAGE: 24

PROPOSAL

ITEM DESCRIPTION RATE PER HOUR

ESTIMATED TIME TO

COMPLETE TYPICAL REPAIR

(for bid evaluation ONLY)

TOTAL

1 Hourly Rate 7:00 am to 3:30 pm, Monday through Friday 1a Foreman $ 2 hours $ 1b Electrician $ 2 hours $ 1c Journeyman $ 2 hours $ 1d Laborer $ 2 hours $

1e Bucket Truck $ 2 hours $ 1f Box Truck $ 2 hours $ 1 Pickup/Service Truck $ 2 hours $

1h Work Van $ 2 hours $ 2 Hourly Rate 3:30 pm to 7:00 am, Monday through Friday; 3:30 pm Friday to 11:59 pm Saturday

2a Foreman $ 2 hours $ 2b Electrician $ 2 hours $ 2c Journeyman $ 2 hours $ 2d Laborer $ 2 hours $

2e Bucket Truck $ 2 hours $ 2f Box Truck $ 2 hours $ 2g Pickup/Service Truck $ 2 hours $ 2h Work Van $ 2 hours $ 3 Hourly Rate midnight to 11:59 pm Sunday and County observed holidays

3a Foreman $ 2 hours $ 3b Electrician $ 2 hours $ 3c Journeyman $ 2 hours $ 3d Laborer $ 2 hours $

3e Bucket Truck $ 2 hours $ 3f Box Truck $ 2 hours $ 3g Pickup/Service Truck $ 2 hours $ 3h Work Van $ 2 hours $

TOTAL BASE BID: $

CONTINUED ON NEXT PAGE

PAGE: 25

PARTS – FIXED PERCENTAGE EST QTY (for bid evaluation only)

TOTAL MARKED UP OR

DISCOUNTED PRICE

$1000.00 – (%*$1000) discount or $1000.00 + (%*$1000) markup

☐ Markup ☐ Discount

(check one box) If no markup or no discount is offered, place a zero on the provided line and do not check either box.

$1000.00 $______________

PLEASE NOTE: The percentage markup or discount provided will remain constant and in effect for the entire contract term, including any option years, if exercised.

END OF PROPOSAL