Bid Package.pdf
PDF 20 MB Posted
- Attached to
- E769 #8 River Oaks WSC - Hydropneumatic Tank Replacement State and local contract opportunity
- Solicitation number
- E769 #8
- Issued by
- Kenedy County, Austin City, Austin City, Austin City, Austin City, Texas
About this file
This is a bid package and contract document for Matagorda County in Texas and River Oaks Water Supply Corporation for a hydropneumatic tank replacement project funded through the Texas General Land Office Community Development Block Grant Mitigation (CDBG-MIT) Program (Grant Project #24-065-093-E769). The project involves replacement of an existing 5,000-gallon hydropneumatic pressure tank with a new tank of the same size and capacity, including associated water lines, valves, appurtenances, mobilization, and erosion control measures. The bid package includes base bid items consisting of one completed hydropneumatic tank installation, 4 linear feet of 4-inch ductile iron pipe, 16 linear feet of 8-inch ductile iron pipe, right-of-way preparation, broadcast seeding across 240 square yards, mobilization, and 129 linear feet of temporary sediment control fence installation and removal. Two additive alternates are available: cradle support foundations for the hydropneumatic tank (two each) and replacement gate valves (one 4-inch and one 8-inch). The non-mandatory pre-bid meeting is scheduled for Tuesday, July 28, 2026, at 2:00 p.m. CT at 2200 7th Street, 4th Floor Conference Room in Bay City, Texas. Written questions must be submitted by Thursday, July 30, 2026, at 5:00 p.m. CT through the project portal at www.civcastusa.com. Sealed bids are due by Tuesday, August 11, 2026, at 2:00 p.m. CT at the Matagorda County Auditor's Office, Room 208, 2200 7th Street, Bay City, Texas 77414, with public opening and reading of bids at the same location in the 4th Floor Conference Room at 2:00 p.m. CT on the same date. The contract completion period is 240 consecutive calendar days from Notice to Proceed.
Bidders must submit a bid bond of 5 percent of the total bid amount (for contracts exceeding $100,000), a certified check, or U.S. Government Bonds in lieu thereof. Payment and performance bonds are required for all prime contractors, with payment bonds required within 30 days of Notice of Award. The project is subject to prevailing wage requirements under the Davis-Bacon and Related Acts, with rates specified in the contract documents. All contractors and subcontractors must be cleared through www.sam.gov (not suspended or debarred) prior to contract award. Section 3 compliance is mandatory for all contracts, requiring demonstration of efforts to hire low- and moderate-income residents and engage local and minority business enterprises. Bidders must submit multiple certifications including conflict of interest questionnaires, non-collusion affidavits, equal opportunity and civil rights certifications, local opportunity plans, proposed contract breakdowns, and lobbying disclosures for contracts exceeding $100,000. The project is financed entirely through the GLO CDBG-MIT program and must comply with Build America Buy America (BABA) requirements. Liquidated damages are assessed at $500 per calendar day for failure to complete work by the specified completion date. The County reserves the right to reject any or all bids and has 60 days from bid opening to review bids and investigate bidder qualifications prior to contract award. Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit bids.
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Text version
CONTRACT DOCUMENTS
AND SPECIFICATIONS
MATAGORDA COUNTY &
RIVER OAKS WATER SUPPLY CORPORATION
RIVER OAKS WATER SYSTEM IMPROVEMENTS PROJECT
HYDROPNEUMATIC TANK REPLACEMENT
Texas General Land Office
Community Development Block Grant Mitigation Program Grant Project # 24-065-093-E769
JULY 2026
MATAGORDA CO. COMMISSIONER COURT:
County Judge Bobby Seiferman Commissioner Edward Cook, Pct. 1
Commissioner Mike Estlinbaum, Pct. 2 Commissioner Troy Shimek, Pct. 3 Commissioner Charles Frick, Pct. 4
PREPARED BY:
11612 Bee Cave Rd., Bldg. 1, Ste. 240
Austin, TX 78738 512-252-8634
TBPE FIRM # 13880
7/15/26
TABLE OF CONTENTS
BID DOCUMENTS
1. Advertisement & Invitation for Bids
2. Instructions to Bidders
3. Equal Opportunity Guidelines
4. County Section 3 Policy
BID FORMS (TO BE SUBMITTED WITH BID)
5. Statement of Bidder’s Qualifications
6. Conflict of Interest Questionnaire
7. Certificate of Recovered Materials
8. Non-collusion AfÏdavit of Prime Bidder
9. Certification of Bidder Regarding Civil Rights and Regulations
10. Contractor’s Local Opportunity Plan
11. Proposed Contracts Breakdown
12. Contractor Certification of Efforts to Comply
13. Certification Regarding Lobbying
14. Disclosure of Lobbying Activities and Instructions
15. Bid Bond
16. Bid Proposal
OTHER CONTRACT FORMS
17. Construction Contract
18. General Conditions Part 1……………………………………………………
19. Minority/Female Goals
20. Federal Labor Standards Provisions (HUD 4010 language)
21. Title 29 - Labor
22. Concerning Labor Standards and Prevailing Wage Requirements
23. General Wage Decision
24. GLO Signage Requirements
25. Section 504 Certification
26. Child Support Statement
27. Payment Bond
28. Performance Bond
29. Certificate of Liability Insurance
30. Certificate of Interested Parties Form 1295 and Instructions
31. Section 3 Clause
32. HUD Examples of Efforts to Offer Training
33. GLO New Hires Section 3 Monthly Compliance Report
34. CDBG-MIT HUD Section 3 Brochure Info Sheet
35. GLO Assurances for Construction Programs
36. GLO General AfÏrmations
37. Environmental Checklist with Mitigation Measures
38. Attorney’s Review Certification
39. Final Payment AfÏdavit
SPECIFICATIONS
40. Technical Specifications
CONSTRUCTION DOCUMENTS
41. Sealed Construction Drawings mmcknight Pen mmcknight Pen mmcknight Pen
1. Advertisement & Invitation for Bids 4
Construction Advertisement and Invitation for Bids
Matagorda County will receive bids for River Oaks Water System Improvements Project – Hydropneumatic Tank Replacement included in GLO CDBG-MIT NO. 24-065-093-E769 until 2:00 pm Central Time (CT) on Tuesday, August 11th, 2026, at 2200 7th Street, Room 208, Bay City, TX 77414. Bids must be sealed and addressed to: Matagorda County Auditor’s Office. The bids will be publicly opened and read aloud at 2:00 pm CT on Tuesday, August 11th, 2026, at 2200 7th Street, 4th Floor Conference Room, Bay City, TX 77414.
Bids are invited for several items and quantities of work as follows:
1. River Oaks WSC – Replacement of existing hydropneumatic pressure tank and associated water lines, valves, and appurtenances, mobilization, erosion control.
Bid/Contract Documents, including Drawings and Technical Specifications are available for download at the following Link.
https://www.civcastusa.com/ (Project Title: Matagorda County - E769 #8 River Oaks WSC - Hydropneumatic Tank Replacement)
Please submit questions for this project through www.civcastusa.com in the Q&A portal. All questions are due by Thursday, July 30th, 2026 at 5:00 pm, CT. All addenda issued for this project will be posted on www.civcastusa.com. It is the responsibility of the Contractor bidding to use proper scaling, paper width and length, etc. Failure to do so may result in error in the Unit Bid Quantities and/or Bid Amounts.
A Non-Mandatory Pre-Bid Meeting will be held on Tuesday, July 28th, 2026 at 2:00 pm CT at 2200 7th Street, 4th Floor Conference Room, Bay City, TX 77414.
A bid bond in the amount of 5 percent of the bid issued by an acceptable surety shall be submitted with each bid [for those contracts that exceed $100,000]. A certified check or bank draft payable to Matagorda County or negotiable U.S. Government Bonds (as par value) may be submitted in lieu of the Bid Bond.
The project to be constructed will be financed with assistance from the General Land Office (GLO) under the U.S. Department of Housing and Urban Development Community Development Block Grant - Mitigation (CDBG-MIT) program and is subject to all applicable Federal and State laws and regulations. Attention is called to the fact that not less than, the federally determined prevailing Davis-Bacon and Related Acts wage rate, as issued by the Department of Labor and contained in the contract documents, must be paid on this project. In addition, the successful bidder must ensure that employees and applicants for employment are not discriminated against because of race, color, religion, sex, sexual orientation, gender identity, or national origin. Adherence to Matagorda County Section 3 Policy is required for all contracts.
All contractors and subcontractors must be cleared (not suspended or debarred) prior to any formal action authorizing the award of a contract to the contractor. Minority Business Enterprises, Small Business Enterprises, Women Business Enterprises, and labor surplus area firms are encouraged to submit bids.
Matagorda County reserves the right to reject any or all bids or to waive any informalities in the bidding.
Bids may be held by Matagorda County for a period not to exceed 60 days from the date of the bid opening for the purpose of reviewing the bids and investigating the bidder’s qualifications prior to the contract award.
Matagorda County County Auditor 7/19/2026
2. Instructions to Bidders 5
INSTRUCTIONS TO BIDDERS FOR CONSTRUCTION
The project to be constructed will be financed with assistance from the General Land Office (GLO) under the U.S. Department of Housing and Urban Development Community Development Block Grant - Mitigation (CDBG-MIT) program and is subject to all applicable Federal and State laws and regulations. Matagorda County is the subrecipient of the grant funding and is hereby referred to as “County”.
1. Use of Separate Bid Forms
These contract documents include a complete set of bid and contract forms which are for the convenience of the bidders and are not to be detached from the contract document, completed or executed. Separate bid forms are provided for your use in Bid Proposal section.
2. Interpretations or Addenda
No oral interpretations will be made to any bidder. Each request for clarification shall be made in writing to the County or engineer no less than seven (7) days prior to the bid opening. Each interpretation made will be in the form of an Addendum to the contract documents and will be distributed to all parties holding contract documents no less than seven (7) days prior to the bid opening. It is, however, the bidder's responsibility to make inquiry as to any addenda issued. All such addenda shall become part of the contract documents and all bidders shall be bound by such addenda, whether or not received by the bidders.
If an addendum to the bid package is necessary, it must be distributed to each potential bidder. The distribution of an addendum shall be verified either by statements of receipt or registered/certified mail receipts, which shall be included in the public works construction file. The addendum shall allow adequate time for consideration in bid preparation (usually at least one week). If adequate time is not available, the bid opening date must be extended and the County must republish the invitation for bids containing the place, time, and date for the new bid opening. Note that any change to the original bid opening date will require republication of the invitation for bids at least once in a locally published newspaper. The republished notice will include the place, time and date for the new bid opening and must be published at least seven days prior to the new bid opening date.
3. Inspection of Site
Each bidder should visit the site of the proposed work and should become acquainted with the existing conditions and facilities, the difficulties, and restrictions pertaining to the performance of the contract. The bidder should thoroughly examine and become familiar with the drawings, technical specifications and all other contract documents. The contractor by the execution of the contract shall in no way be relieved of any obligation under it due to failure to receive or examine any form or legal document or to visit the site or the conditions existing at the site. The County will be justified in rejecting any claim based on lack of inspection of the site prior to the bid.
4. Alternate bid items
No alternate bids or bid items will be considered unless they are specifically requested by the technical specifications.
2. Instructions to Bidders 6
5. Bids
a. All bids must be submitted on the forms provided and are subject to all requirements of the Contract Documents, including the Drawings.
b. All bids must be regular in every respect and no interlineation, excisions or special conditions may be made or included by the bidder.
c. Bid documents, including but not limited to the bid, the bid bond(s), the contractor’s certifications, Certification of Bidder Regarding Civil Rights Laws and Regulations, Certification of Efforts to comply with Section 3, Local Opportunity Plan, Conflict of Interest Questionnaire, Non-collusion Affidavit of Prime Bidder, Certification Regarding Lobbying and Disclosure of Lobbying Activities, Proposed Contract Breakdown, Certificate of Recovered Materials, and the Statement of the Bidder’s Qualifications, shall be sealed in an envelope and clearly labeled with the words "Bid Documents”, the project’s contract number, name of bidder and the date and time of bid opening.
d. The County may consider as irregular any bid on which there is an alteration of or departure from the bid form and, at its option, may reject any irregular bid.
e. If a contract is awarded, it will be awarded to a responsible bidder on the basis of the lowest/best bid and the selected alternate bid items, if any. The contract will require the completion of the work in accordance with the contract documents.
6. Bid Modifications Prior to Bid Opening
a. Any bidder may modify its bid by submitting a modification or supplemental bid at any time prior to the scheduled closing time for receipt of bids, provided such modification or supplemental bid is received by the County prior to the closing time. The modification or supplemental bid should not reveal the original bid price but should provide only the addition, subtractions or other modifications to the original bid so that the final prices or terms will not be known by the County until the sealed bid is open.
7. Bid Bond
a. A bid bond in the amount of 5% of the bid issued by an acceptable surety shall be submitted with each bid [for contracts greater than $100,000]. A certified check or bank draft payable to the County or negotiable U.S. Government Bonds (as par value) may be submitted in lieu of the Bid Bond.
b. The bid bond or its comparable, will be returned to the bidder as soon as practical after the opening of the bids.
2. Instructions to Bidders 7
8. Statement of Bidders Qualifications
Each bidder shall submit on the form furnished for that purpose a statement of the bidder's qualifications.
The County shall have the right to take such steps as it deems necessary to determine the ability of the bidder to perform its obligations under the contract, and the bidder shall furnish the County all such information and data for this purpose as it may request. The right is reserved to reject any bid where an investigation of the available data does not satisfy the County that the bidder is qualified to carry out properly the terms of the contract.
9. Unit Price
The unit price for each of the several items in the bid shall include its pro rata share of overhead so that the sum of the products obtained by multiplying the quantity shown for each item by the unit price bid represents the total bid. Any bid not conforming to this requirement may be rejected as informal. Special attention is drawn to this condition, as the unit prices will be used to determine the amount of any change orders resulting from an increase or decrease in quantities.
10. Corrections:
Erasures or other corrections in the bid must be noted over the signature of the bidder.
11. Time for Receiving Bids
Bids received prior to the advertised hour of opening shall be kept securely sealed. The officer appointed to open the bids shall decide when the specified time has arrived and no bid received thereafter will be considered; except that when a bid arrives by mail after the time fixed for opening, but before the reading of all other bids is completed, and it is shown to the satisfaction of the County that the late arrival of the bid was solely due to delay in the mail for which the bidder was not responsible, such bid will be received and considered.
12. Opening of Bids
The County shall, at the time and place fixed for the opening of bids, open each bid and publicly read it aloud, irrespective of any irregularities therein. Bidders and other interested individuals may be present.
13. Withdrawal of Bids
Bidder may withdraw the bid before the time fixed for the opening of bids, by communicating its purpose in writing to the County. Upon receipt of such notice, the unopened bid will be returned to the bidder. The bid guaranty of any bidder withdrawing his bid will be returned promptly.
14. Award of Contract/Rejection of Bids
a. The contract will be awarded to the responsive, responsible Bidder submitting the lowest/best bid. The bidder selected will be notified at the earliest possible date. The County
2. Instructions to Bidders 8 reserves the right to reject any or all bids and to waive any informality in bids received where such rejection or waiver is in its interest.
b. The County reserves the right to consider as unqualified to do the work any bidder who does not habitually perform with his own forces the major portions of the work involved in construction of the improvements embraced in this contract.
15. Execution of Agreement/Performance and Payment Bonds
a. Performance Bonds - Requires all prime contractors which enter into a formal contract in excess of $100,000 with the State, a county, or a municipality; a department, board, or agency of the state, a county, or a municipality; and a school district or a subdivision thereof, to obtain a Performance Bond in the amount of the contract before commencing with work
b. Payment Bonds- Requires all prime contractors which enter into a formal contract with the
State, a county, or a municipality; a department, board, or agency of the state, a county, or a municipality; and a school district or a subdivision thereof, to furnish to the governmental entity a payment bond in the amount of the contract. The payment bond must be filed within
30 days from the date of the Notice of Award:
▪ Municipalities: If the contract is in excess of $50,000, a payment bond is required.
▪ Counties: If the contract is in excess of $25,000, a payment bond is required.
c. The failure of the successful bidder to execute the agreement and supply the required bonds within thirty (30) days from the date of the notice of award-or within such extended period as the County may grant, shall constitute a default and the County may, at its option either award the contract to the next lowest responsible bidder, or re-advertise for bids. In either case, the County may charge against the bidder the difference between the amount of the bid, and the amount for which a contract is subsequently executed irrespective of whether this difference exceeds the amount of the bid bond. If a more favorable bid is received through re-advertisement, the defaulting bidder shall have no claim against the County for a refund.
16. Wages and Salaries
Attention is particularly called to the requirement of paying not less than the prevailing Davis Bacon Related Acts (DBRA) wage rates specified in the Contract Documents. These rates are minimums to be paid during the life of the contract. It is therefore the responsibility of the Bidder to inform themselves as to local labor conditions.
17. Equal Employment Opportunity
Attention is called to the requirements for ensuring that employees and applicants for employment are not discriminated against because of race, color, religion, sex, sexual orientation, gender identity, or national origin, and other civil rights requirements.
2. Instructions to Bidders 9
18. Certification Regarding Lobbying
Contractors who apply or bid for an award of $100,000 or more shall provide the required certification that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer of employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC § 1352.
19. System for Award Management (SAM)
All contractors and subcontractors must be searched on www.sam.gov and cleared (not suspended or debarred) prior to any formal action authorizing the award of a contract to the contractor.
3. Equal Opportunity Guidelines 10
Equal Opportunity Guidelines for Construction Contractors Note: To be included in bid packet and distributed at the preconstruction conference (optional)
1. What are the responsibilities of the offeror or bidder to ensure equal employment opportunity?
For contracts over $ 10,000, the offeror or bidder must comply with the "Equal Opportunity Clause" and the "Standard Federal Equal Opportunity Construction Contract Specifications."
2. Are construction contractors required to ensure a legal working environment for all employees?
Yes, it is the construction contractor's responsibility to provide an environment free of harassment, intimidation, and coercion to all employees and to notify all foremen and supervisors to carry out this obligation, with specific attention to minority or female individuals.
3. To alleviate developing separate facilities for men and women on all sites, can a construction contractor place all women employees on one site?
No, two or more women should be assigned to each site when possible.
4. Are construction contractors required to make special outreach efforts to Section 3 or minority and female recruitment sources?
Yes, construction contractors must establish a current list of Section 3, minority and female recruitment sources. Notification of employment opportunities, including the availability of on-the-job training and apprenticeship programs, should be given to these sources. The efforts of the construction contractors should be kept in file.
5. Should records be maintained on the number of Section 3 residents, minority and females applying for positions with construction contractors?
Yes, records must be maintained to include a current list of names, addresses and telephone numbers of all Section 3, minority and female applicants. The documentation should also include the results of the applications submitted.
6. What happens if a woman or minority is sent to the union by the Contractor and is not referred back to the Contractor for employment?
If the unions impede the construction contractor's responsibility to provide equal employment opportunity, a written notice should be submitted to GLO.
7. What efforts are made by construction contractors to create entry-level positions for Section 3 residents, women and minorities?
Construction contractors are required to develop on-the-job training programs, or participate in training programs, especially those funded by the Department of Labor, to create positions for Section 3 residents, women and minorities and to meet employment needs.
8. Are any efforts made by the Contractor to publicize their Equal Employment Opportunity (EEO) policy?
Yes, the construction contractor is responsible for notifying unions and sources of training programs of their equal employment opportunity policy. Unions should be requested to cooperate in the effort of equal opportunity. The policy should be included in any appropriate manuals, or collective bargaining agreements. The construction contractor is encouraged to publicize the equal employment opportunity policy in the company newspaper and annual report. The Contractor is also responsible to include the EEO policy in all media advertisement.
9. Are any in-service training programs provided for staff to update the EEO policy?
At least annually a review of the EEO policy and the affirmative action obligations are required of all personnel employees of a decision-making status. A record of the meeting including date, time,
3. Equal Opportunity Guidelines 11 location, persons present, subject matter discussed, and disposition of the subject matter should be maintained.
10. What recruitment efforts are made for Section 3 residents, minorities and women?
The construction contractor must notify, both orally and in writing, Section 3, minority and female recruitment sources one month prior to the date of acceptance for apprenticeship or other training programs.
11. Are any measures taken to encourage promotions for minorities and women?
Yes, an annual evaluation should be conducted for all minority and female personnel to encourage these employees to seek higher positions.
12. What efforts are taken to ensure that personnel policies are in accordance with the EEO policy?
Personnel policies in regard to job practices, work assignments, etc. should be continually monitored to ensure that the EEO policy is carried out.
13. Can women be excluded from utilizing any facilities available to men?
No, all facilities and company activities are non-segregated except for bathrooms or changing facilities to ensure privacy.
14. What efforts should be utilized to include minority and female contractors and suppliers?
Take affirmative steps to ensure that small, minority, and women owned businesses are included on all lists for contractors/service providers. Solicit these businesses when issuing RFPs and RFQs and soliciting construction bids. Divide project activities into small tasks to allow participation. Keep records of all offers to minority and female construction contractors.
15. If a construction contractor participates in a business related association that does not comply with equal opportunity affirmative action standards, does that show his/her failure to comply?
No, the construction contractor is responsible for its own compliance.
16. Can a construction contractor hire a subcontractor who has been debarred from government contracts pursuant to EEO?
No. The construction contractor must suspend, terminate or cancel its contract with any Subcontractor who is in violation of the EEO policy.
17. What effort has been taken by the construction contractor to monitor all employment to ensure the company EEO policy is being carried out?
The construction contractor must designate a responsible individual to keep accurate records of all employees that includes specific information required by the government.
5. Statement of Bidder’s Qualifications 13
STATEMENT OF BIDDER'S QUALIFICATIONS
All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate attached sheets. The Bidder may submit any additional information it desires.
Date: ________________________________
Bidder (Legal Name of Firm):
Date Organized:
Name of Owner(s):
Address:
Date Incorporated
Federal ID Number: ____________________________
Number of Years in contracting business under present name
List all other names under which your business has operated in the last 10 years:
Work Presently Under Contract:
Contract Amount $ Completion Date
Type of work performed by your company:
Total Staff employed by Firm (Break down by Managers and Trades on separate sheet):
Have you ever failed to complete any work awarded to you? Yes No
(If yes, please attach summary of details on a separate sheet. Include brief explanation of cause and resolution)
Have you ever defaulted on a contract? Yes No
(If yes, please attach summary of details on a separate sheet.)
Has your organization had any disbarments or suspensions that have been imposed in the past five years or that was still in effect during the five-year period or is still in effect? Yes No
5. Statement of Bidder’s Qualifications 14
(If yes, list and explain; such list must include disbarments and suspensions of officers, principals, partners, members, and employees of your organization.)
List the projects most recently completed by your firm (include project of similar importance):
Project Amount $ Mo/Yr Completed
Major equipment available for this contract:
Are you in compliance with all applicable EEO requirements? Yes No
(If no, please attach summary of details on a separate sheet.))
(Optional) Minority Business Reporting Information:
Owner’s Race: _______________________
Owner’s Ethnicity: _______________________
Owner’s Gender: _______________________
Are you a Section 3 business? (see below) □ Yes □ No
Section 3 Business Concerns:
a) Businesses that are 51 percent or more owned by Section 3 residents;
b) Businesses whose permanent, full-time employees include persons, at least 30 percent of whom are currently Section 3 residents, or within three years of the date of first employment with the firm were Section 3 residents;
c) Businesses that provide evidence of a commitment to subcontract in excess of 25 percent of the dollar amount of all subcontracts to be awarded to businesses that meet the qualifications described above; or
d) Businesses located within the City/County’s jurisdiction that identifies themselves as Section 3 Business Concerns because they provide economic opportunities for low- and very low-income persons.
Bank References
Address: __________________________________ Contact Name: _______________
City & State: _____________________Zip: ____________________Phone Number: _______________
Credit available: $
Has the firm or predecessor firm been involved in a bankruptcy or reorganization? Yes No
(If yes, please attach summary of details on a separate sheet.)
5. Statement of Bidder’s Qualifications 15
List on a sheet attached hereto all judgements, claims, arbitration proceedings, or suits pending or outstanding against bidder over the last five (5) years with amount of claim and brief description.
List on a sheet attached hereto all lawsuits or requested arbitration with regard to construction contracts which bidder has initiated within the last five (5) years and brief explanation of claim and outcome.
Attach resume(s) for the principal member(s) of your organization, including the officers as well as the proposed superintendent for the project.
Signed this ______ day of _______________________, 20____.
Signature
Printed Name and Title
Company Name
Notary Statement:
______________________________. being duly sworn, says that he/she is the _________Position/Title
____________of________________________ (Firm Name), and hereby swears that the answers to the foregoing questions and all statements therein contained are true and correct. He/she hereby authorizes and requests any person, firm, or corporation to furnish any information requested City/County of
_____________________ in verification of the recitals comprising this Statement of Bidder's Qualifications.
Subscribed and sworn before me this _________day of __________, 20____.
Notary Public
Printed Name
My Commission Expires: _______________, The penalty for making false statements is prescribed in the U. S. Criminal Code, 18 U.S.C. 1001.
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
FORM CIQ
OFFICE USE ONLY
Date Received
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information is being disclosed.
Name of Officer
4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?
Yes No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity?
Yes No
5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an
Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
Signature Date ownership interest of one percent or more.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 8/14/2024
Name of signatory
Revised 8/14/2024Form provided by Texas Ethics Commission www.ethics.state.tx.us
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code § 176.001(1-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency.
Local Government Code § 176.003(a)(2)(A) and (B):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code § 176.006(a) and (a-1)
(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental entity; or
(B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a);
(B) that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
7. Certificate of Recovered Materials 18
CONTRACTOR’S CERTIFICATION of RECOVERED MATERIAL
ACKNOWLEDGEMENT
I, ______________________(Principal’s Name) of ____________________________________ (Company Name), (hereinafter called “Contractor”), acknowledge the recovered material bidding requirements found in 2 CFR 200.322 that requires the Contractor to procure those items designated in the guidelines of the Environmental Protection Agency (EPA) at 40 CFR 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition.
I also acknowledge that this requirement shall apply to items purchased (1) where the Contractor purchases in excess of $10,000 of the item under this contract; or (2) where during the preceding fiscal year, the value of the quantity acquired was in excess of $10,000.
Finally, I acknowledge the attached list of recovered materials included in the bid documents.
(For up-to-date listing, please go to https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program#directory)
Date
USE OF RECOVERED MATERIAL
Please check one:
Recovered materials are included in this bid:
Materials included___________________________
Recovered materials are not reasonably available in a reasonable period of time.
Recovered materials fail to meet reasonable performance standards, which are determined on the basis of the guidelines of the National Institute of Standards and Technology, if applicable.
Recovered materials are only available at an unreasonable price.
8. Non-collusion Affidavit 19
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER
State of Texas )
County of )
, being first duly sworn, deposes and says that:
(1) He/She is of , the Bidder that has submitted the attached Bid;
(2) He/She is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid;
(3) Such Bid is genuine and is not a collusive or sham Bid;
(4) Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees or parties in interest, including this affiant, has in any way colluded, conspired, connived or agreed, directly or indirectly with another Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain from bidding in connection with such Contract, or has in any manner, directly or indirectly, sought by agreement or collusion or communication or conference with any other Bidder, firm or person to fix the price or prices in the attached Bid or of any other Bidder, or to fix an overhead, profit or cost element of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against the County of Matagorda, Texas (Local Public Agency) or any person interested in the proposed Contract;
and
(5) The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties in interest, including this affiant.
(Signed)
Title
Subscribed and sworn to me this day of .
By:
Notary Public
My commission expires
9. Certification of Bidder Regarding Civil Rights and Regulations 20
CONTRACTOR CERTIFICATIONS
U.S. Department of Housing and Urban Development
CERTIFICATION OF BIDDER REGARDING CIVIL RIGHTS LAWS AND REGULATIONS
INSTRUCTIONS
CERTIFICATION OF BIDDER REGARDING Executive Order 11246 and Federal Laws Requiring Federal Contractor to adopt and abide by equal employment opportunity and affirmative action in their hiring, firing, and promotion practices. This includes practices related to race, color, gender, religion, national origin, disability, and veterans’ rights.
NAME AND ADDRESS OF BIDDER (include ZIP Code)
CERTIFICATION BY BIDDER
Bidder has participated in a previous contract or subcontract subject to Civil Rights Laws and Regulations.
◻ Yes ◻ No
9. Certification of Bidder Regarding Civil Rights and Regulations 21
The undersigned hereby certifies that: ◻ The Provision of Local Training, Employment, and Business Opportunities clause (Section 3 provision) is included in the Contract. A written Section 3 plan (Local Opportunity Plan) was prepared and submitted as part of the bid proceedings.. ◻ The Equal Opportunity clause is included in the Contract (if bid equals or exceeds $10,000).
Have you ever been or are you being considered for sanction due to violation of Executive Order 11246, as amended?
◻ Yes ◻ No
NAME AND TITLE OF SIGNER (Please type)
SIGNATURE DATE
10. Contractor’s Local Opportunity Plan 22
CONTRACTOR'S LOCAL OPPORTUNITY PLAN
_(name of company) _____________ agrees to implement the following specific affirmative action steps directed at increasing the utilization of lower income residents and businesses within the County of Matagorda .
A. To ascertain from the County’s CDBG program official the exact boundaries of the project area and where advantageous, seek the assistance of local officials in preparing and implementing the affirmative action plan.
B. To attempt to recruit from within the city the necessary number of lower income residents through:
local advertising media, signs placed at the proposed site for the project, and community organizations and public or private institutions operating within and servicing the project area such as Service Employment and Redevelopment (SER), Opportunities Industrialization Center (OIC), Urban League, Concentrated Employment Program, Hometown Plan, or the U.S. Employment Service.
C. To maintain a list of all lower income residents who have applied either on their own or on referral from any source, and to employ such persons, if otherwise eligible and if a vacancy exists.
D. To insert this plan in all bid documents and to require all bidders on subcontracts to submit an affirmative action plan including utilization goals and the specific steps planned to accomplish these goals.
E. To ensure that subcontracts (greater than $10,000), which are typically let on a negotiated rather than a bid basis in areas other than the covered project area, are also let on a negotiated basis, whenever feasible, in a covered project area.
F. To formally contact unions, subcontractors, and trade associations to secure their cooperation in this effort.
G. To ensure that all appropriate project area business concerns are notified of pending sub-contractual opportunities.
H. To maintain records, including copies of correspondence, memoranda, etc., which document that all of the above affirmative action steps have been taken.
I. To appoint or recruit an executive official of the company or agency as Equal Opportunity Officer to coordinate the implementation of this plan.
J. To maintain records concerning the amount and number of contracts, subcontracts, and purchases which contribute to objectives.
10. Contractor’s Local Opportunity Plan 23
K. To maintain records of all projected work force needs for all phases of the project by occupation, trade, skill level, and number of positions and to update these projections based on the extent to which hiring meets these Local Opportunity objectives.
As officers and representatives of (name of company) , we the undersigned have read and fully agree to this Plan and the County’s Section 3 Plan, and become a party to the full implementation of the program and its provisions.
Printed Name
Title
11. Proposed Contracts Breakdown 24
Instructions for Proposed Contracts Breakdown and
Estimated Project Workforce Breakdown
Proposed Contracts Breakdown
Type of Contracts – list all construction, materials, or other types of subcontracts (for example: electrical, plumbing, concrete, boring, etc.)
No. of Contracts – Number of contracts under this category
Approximate Total Dollar Amount – Total amount of each contract
Estimated No. to Local Business – Number of contracts awarded to local businesses and Section 3 businesses
Estimated $ Amount to Local Business - How many dollars will be spent locally for each type of contract?
For example: will you hire any local employees or subcontractors?
Estimated Project Workforce Breakdown
Work Classifications – Classification of project employees as defined on Wage Rate
Total Estimated Positions – List the number employees for each work classification will you need on this project
Number of Positions Currently Filled – List the number of estimated positions you currently have filled
Number of Positions Not Filled – List the number of estimated positions you currently do not have filled
Number of Positions to Fill with Low to Moderate Income (Section 3) Residents – List the number of local residents earning low to moderate incomes that you plan to employ to fill the estimated positions not filled
11. Proposed Contracts Breakdown 25
PROPOSED CONTRACTS BREAKDOWN
Type of Contracts No. of
Contracts
Approx. Total Dollar
Amount
Estimated No. to local
Business
Estimated $ Amount
Local Business
ESTIMATED PROJECT WORKFORCE BREAKDOWN
Work Classifications Total Estimated
Positions
No. of Positions
Currently Filled
No. of Positions not Filled
No. of Positions to fill with LMI Residents
(Section 3)
Totals
12. Contractor Certification of Efforts to Comply 26
12. Contractor Certification of Efforts to Comply 27
13. Certification Regarding Lobbying 28
CERTIFICATION REGARDING LOBBYING
COMPLIANT WITH APPENDIX A TO 24 C.F.R. PART 87*
(To be submitted with each bid or offer exceeding $100,000)
Certification for Contracts, Grants, Loans, and Cooperative Agreements:
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than 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 in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, ‘‘Disclosure Form to Report Lobbying,’’ in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Statement for Loan Guarantees and Loan Insurance:
The undersigned states, to the best of his or her knowledge and belief, that: If any 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 in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, ‘‘Disclosure Form to Report Lobbying,’’ in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
As the duly authorized representative of the Contractor, I hereby certify that the applicant will comply with the above applicable certification.
Signature of Contractor’s Authorized Official
Printed Name and Title of Contractor’s Authorized Official
*24 C.F.R. 87 App. A, available at https://www.gpo.gov/fdsys/granule/CFR-2011-title24-vol1/CFR-2011-title24-vol1-part87-appA. Published Apr. 1, 2011. Accessed Aug. 1, 2018.
14. Disclosure of Lobbying Activities 29
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 in connection with a covered Federal action. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.
1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action.
2. Identify the status of the covered Federal action.
3. Identify the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.
5. If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the prime Federal recipient. Include Congressional District, if known.
6. Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Included prefixes, e.g., “RFP-DE-90-001.”
9. For a covered…
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