Biosolids Handling and Disposal Engineering Services.pdf

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Attached to
Engineering Services for Biosolids Handling and Disposal Assessment
Solicitation number
06-101426
Issued by
Guilford County, North Carolina

About this file

This is an engineering services scope of work document for the City of High Point, North Carolina, addressing biosolids handling and disposal assessment at municipal wastewater treatment facilities. The City seeks qualified professional engineering firms to provide comprehensive assessment services for biosolids storage, dewatering, handling, processing, and disposal systems at both the Eastside and Westside Wastewater Treatment Plants. The scope of work encompasses evaluation of existing biosolids management infrastructure, identification of operational inefficiencies, and recommendations for system improvements or alternative disposal methods. Engineering firms must be capable of conducting site assessments, reviewing current operational procedures, analyzing regulatory compliance status, and preparing detailed engineering reports with cost-benefit analyses for proposed solutions. The contract requires firms to have demonstrated experience with municipal wastewater treatment plant biosolids management and familiarity with applicable state and federal environmental regulations governing biosolids handling and disposal.

The engagement will require selected firms to provide preliminary assessment findings, preliminary engineering reports, and final comprehensive engineering reports documenting existing conditions, identified deficiencies, and recommended improvements with associated cost estimates. Qualified firms must submit statements of qualifications demonstrating relevant experience with similar municipal biosolids assessment projects, professional certifications of key personnel, and evidence of prior work with North Carolina municipalities or comparable jurisdictions. The City will evaluate submissions based on firm qualifications, relevant project experience, technical approach, and proposed staffing. This engagement represents a professional services contract for assessment and consulting rather than construction, with deliverables focused on engineering analysis and recommendations to inform the City's future biosolids management strategy and capital planning.

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REQUEST FOR QUALIFICATIONS

Biosolids Handling and Disposal Engineering Services

September 10, 2026

Due Date:

and time:

Wednesday, October 14, 2026 2:00 PM Eastern Time

RFQ Number: 06-101426

Mailing Address: PO Box 230 High Point NC 27261

Delivery Address: 816 East Green Drive Purchasing Division High Point, NC 27260

Purchasing Contact:

E-mail:

Phone:

Fax:

Greg Parret greg.parret@highpointnc.gov 336-883-4795 336-883-3248

IF YOU NEED ANY REASONABLE ACCOMMODATION FOR ANY TYPE OF DISABILITY

IN ORDER TO PARTICIPATE IN THE PROCUREMENT, PLEASE CONTACT PURCHASING

AS SOON AS POSSIBLE

FIRM NAME: ________________________________________________

(Please include this cover page in your Proposal.)

Join: Teams Meeting Link Meeting ID: 216 627 944 037 264 Passcode: Jk64KV7X

Virtual Pre-Proposal Teams Meeting Link:

mailto:greg.parret@highpointnc.gov mailto:greg.parret@highpointnc.gov Join: https://teams.microsoft.com/meet/216627944037264?p=Cr79ie7Hor2h1pp4Mq

NOTICE TO CONSULTANTS

Biosolids Handling and Disposal Engineering Services

RFQ 06-101426

The City of High Point, North Carolina, is seeking Statements of Qualifications from qualified professional engineering firms to provide engineering and consulting services related to the assessment of the City's biosolids storage, dewatering, handling, processing, and disposal systems at the Eastside and Westside Wastewater Treatment Plants.

Proposals will be received electronically until 2:00PM EST Wednesday, October 14, 2026.

Proposals are to be emailed to Greg Parret, Buyer at greg.parret@highpointnc.gov the document should be titled “RFQ # 06-101426, Biosolids Handling and Disposal Engineering Services” and provided in the subject line of the email submittal.

An electronic copy of the Request for Qualifications may be obtained from the City of High Point located under Bid Opportunities at https://www.highpointnc.gov/Bids.aspx. Proposers can download a copy of the solicitation and all addenda.

Questions pertaining to this RFQ are due in writing via e-mail by Wednesday, September 30, 2026, at 12:00PM to greg.parret@highpointnc.gov.

The selected firm(s) must register with the City of High Point using the City’s on-line vendor registration process at https://www.highpointnc.gov/1068/New-Supplier-Registration. The City reserves the right to accept or reject, in whole or in part, such proposals as appears in its judgment to be in the best interest of the City.

The successful proposer shall be required to comply with all applicable equal employment opportunity laws and regulations, and all other applicable governmental laws and regulations as set forth by the City of High Point and the State of North Carolina.

The meeting facilities of the City of High Point are accessible to people with disabilities. If you need special accommodations, call 336-883-3298, TDD # 336-883-8517, or the North Carolina Relay System (TDD #1-800-735-2962).

In accordance with the Federal “Americans with Disabilities Act” (the Act), the City of High Point will not discriminate against individuals with disabilities and will not do business with vendors who discriminate against such individuals in violation of the Act. “Equal Opportunity Employer, Male/Female/Handicap” mailto:candy.harmon@highpointnc.gov https://www.highpointnc.gov/Bids.aspx mailto:candy.harmon@highpointnc.gov https://www.highpointnc.gov/egov/vendor/

City of High Point | P.O. BOX 230, High Point, NC 27261 | 336.883.3219

Engineering & Consulting Services Biosolids Handling and Disposal

1) General

The City of High Point (“City”) Water Resources Department is issuing this Request for Qualifications (RFQ) to provide professional engineering services in the assessment of the storage, dewatering, handling, and disposal of biosolids. Much of the City’s biosolids handling equipment is reaching the end of its useful life and will require replacement or extensive rehabilitation in the coming years. The City would like to evaluate options for all aspects of its biosolids program including but not limited to, location, equipment technology and final disposition. Consideration will be given to capital and life cycle costs, physical implementation feasibility (e.g. available facility footprint or maintenance of plant operations), prevalence of equipment in the industry, permitting requirements and sustainability.

2) Background Information

The City of High Point owns and operates two wastewater treatment plants (WWTP), named Eastside WWTP and Westside WWTP. Eastside WWTP was originally constructed in 1928 and has gone through various upgrades over the years. The wastewater plant was last upgraded in 2004 from a 16 MGD Activated Sludge Treatment Facility to a 26 MGD 5- Stage Biological Nutrient Removal (BNR) Facility. Westside WWTP was constructed in 1929 and has a capacity of 10 MGD with similar treatment technology. Biosolids are currently dewatered at each facility via centrifuges and processed via a fluidized bed incinerator at Eastside WWTP (dewatered solids are trucked from Westside WWTP to Eastside WWTP).

The Eastside WWTP produces approximately 48 million gallons of sludge per year and the Westside WWTP produces 12 million gallons of sludge per year. Biosolids are typically dewatered to an average solids concentration of approximately 22% to 26% at both wastewater plants. The incinerator ash is pumped to two lagoons where it is later dredged and hauled to the landfill. The City has a Title V air quality permit for the operation of the incinerator.

3) Scope of Services

The City of High Point is hereby seeking qualifications statements from consulting firms with proven experience and expertise in facility assessment, alternatives analysis, regulatory assessment, life cycle cost analysis, design, and construction administration related to municipal wastewater biosolids processing and disposal.

4) Notices and Standards

General: This RFQ does not commit the City to enter into agreement to pay any costs incurred in the preparation and submittal of a proposal in response to this request or in subsequent interviews and negotiations, or to procure a contract for the project. The city will require the selected consultant(s) to negotiate the fees for the project and submit a scope, technical, and/or other revisions to the proposals, as needed. The city reserves the right to perform all or some of the services described in the document with its own workforce. The city also reserves the right to issue future RFQs, as needed, and solicit responses from firms not selected as a part of this process.

In general, the City will be seeking to select a firm that possesses the following minimum qualifications:

• A minimum of 5 (five) years of extensive experience in wastewater treatment consulting

• A minimum of 5 (five) years of extensive experience in multiple biosolids processing and disposal methods including but not limited to incineration and dryer technologies

• A thorough knowledge and understanding of federal and state regulatory permitting requirements for biosolids handling alternatives

• Extensive experience in and understanding of capital and life-cycle cost analysis, project phasing and implementation

• Demonstrates financial and staffing capacity to undertake a project of this magnitude

Qualifications-Based Selection Criteria: Qualifications Statements are traditionally evaluated and ranked based upon objective Qualifications-Based criteria. The City reserves the right to request an interview with any Consultant during the selection process. Should the City see the need to interview Consultants, the Consultant will be notified as early as possible in the proposal review process. The selection criteria are as follows:

a. Overall content and quality of the submitted Qualifications Statement

b. Relevant experience, expertise, and qualifications of the project team

c. Overall technical capabilities

d. Project management (strength and experience on similar projects)

e. Track record on past projects in delivering quality professional services in a timely manner

f. Consultant’s performance on previous North Carolina municipal projects based on information gathered by the City and/or through the references provided by the Consultant

g. Firm’s proximity to the City

h. Any special or unusual terms and conditions for the contract

i. Information obtained through interviews with short-listed consultants

Rating and Selection Team: A selection committee has been established to review and evaluate all documentation submitted in response to this. The committee will conduct a preliminary evaluation of all documentation to determine that firms are qualified to perform the required services.

To be considered for this project, each submittal must contain the information indicated in this RFQ. It is the intent of the City to make a selection in a timely manner following the submittal date. The City reserves the right to reject any or all qualifications or to waive any and all formalities and the right to disregard all non-conforming or conditional qualifications and to enter into a contract with the firm or firms that will serve in the best interest of the City. The City is not legally required to enter into a contract as a result of this RFQ. All deliverables will become the property of the City.

Interviews may be required for this process. The selection committee may elect to short list firms to conduct an informal interview to discuss any innovative project approach, schedule, and/or to meet key members of the proposed project team. All firms submitting qualifications will be notified in writing as to the outcome of the selection process.

Qualification Based Selection Criteria Possible Points Assigned Points Professional Experience of Firm 25 Professional Experience of Proposed Project Team 25 History of Similar Projects 25 References 15 Content and Quality of Submitted Proposal 10

Total available points 100

Anticipated Schedule for Selection Process Milestone Date RFQ Issue Date Virtual Pre-Proposal Conference:

Questions Due to Purchasing Responses Provided via addendum Qualifications Statement Submittal Due Date

5) Submission Guidelines

To facilitate the City’s objective review of the RFQs, the consultants are requested to organize the main document using a standardized format. Each Qualifications Statement should contain the following:

I. A cover letter on company letterhead signed by a principal or other member of the firm authorized to commit the firm to contract for professional services.

II. Information on the following topics:

September 9, 2026

October 2, 2026 - 4:00 PM October 14, 2026 - 2:00 PM

September 30, 2026 - 12:00 PM September 21, 2026 - 11:00 AM

a) Statement of Qualifications: Identify and describe the qualifications of the firm and professional services that may be provided by the consultant or consultant team in response to this request. Discuss the project team’s ideology, methodology and unique approach to similar projects.

b) Project Team & Project Management: Identify the proposed project team (including any sub consultants) and key personnel for the successful completion of projects in partnership with the City. Include brief resumes of the project manager and up to four

(4) project team members including office location, years of experience, certifications, and education. Identify the project manager or primary contact and any other team leaders proposed and briefly describe how projects will be successfully managed. It is expected that the team members proposed will be those assigned to work on the project for the City. Also describe the firm’s quality assurance / quality control methods.

c) Relevant Project Experience and References: Project reference list describing projects completed within the past five years that represent the strengths and unique qualifications of the firm and team members as they relate to this RFQ. The list should contain project titles, locations, start and end dates, project scope, Consultants project manager, and name, phone number, and email address of owner references.

The reference contact person should be capable of speaking to the firm’s and team’s ability to finish projects within the project timeframe and the firm’s demonstrated ability to respond to the proposed project.

d) Project Schedule: Describe the planned and envisioned workload of the proposed team members for the timeframe of this contract and verify that proposed staff will be prepared for timely completion of projects under a potential contractual agreement with the City.

e) Terms and Conditions of the Contract: The City proposes to use a standard City of High Point contract for professional services. This information will be provided to the selected consultant(s) during contract and scope negotiations. Should the consultant have any special or unusual contract conditions or limitations, the City should be advised of these in this section of the RFQ.

f) Format: Qualifications Statements must be submitted electronically and be 12pt font size and limited to no more than 20 pages (8 ½ x 11) excluding cover page, cover letter, and any section dividers. The proposal shall be submitted by an official authorized to bind the submitter to its provisions and who is authorized to negotiate the final scope of work and fees for inclusion in a later Supplemental Professional Services Agreement with the City.

g) Questions: Any questions regarding this RFQ requiring responses prior to due date are to be submitted in writing by no later than 9/30/26, by 12:00 PM to the attention of: Greg Parret greg.parret@highpointnc.gov

Responses will be provided via Addendum by 10/2/26, by 4:00 PM

6) General Requirements

a) If selected, the consultant(s) shall be registered through the NC Department of the Secretary of State and the City of High Point.

b) Insurance Requirements: Proposals shall include information certifying that the consulting firm is capable of providing the following minimum insurance coverage prior to execution of a professional services agreement. A copy of firm’s Certificate of Insurance (COI) will be required at the time of selection. A copy may be provided along with submittal.

c) Insurance Amount

(a) Workers’ Compensation $500,000

(b) Employers’ Liability $500,000

(c) General Liability $1,000,000

(d) Automobile Liability $1,000,000

(e) Umbrella $1,000,000

(f) Professional Liability $1,000,000

d) E-Verify Affidavit

Under North Carolina law, the E-Verify requirement applies to private employers doing business in this state that have 25 or more employees working in this state. If contractors are individuals who are self-employed (i.e., one employee), or with a business with less than 25 employees, that individual/business is not subject to the E- Verify requirements. It is the City’s responsibility to comply with E-Verify, the successful bidder/consultant will be required to submit the completed E-Verify affidavit at execution of this contract.

Submission Date Firms are invited to submit letters of interest and qualifications to the City of High Point Purchasing Department by 2:00 P.M. on 10/14/26. Letters of interest and qualifications submitted after this deadline will not be considered.

Electronic Submittals Electronic submittals will be accepted, and firms should submit one electronic (PDF) version of the proposal via email to greg.parret@highpointnc.gov

Firms submitting proposals are encouraged to carefully check them for conformance to the requirements stated above. If submittals do not meet these requirements, they will be disqualified. No exception will be granted. Cost or fee proposals shall not be submitted.

greg.parret@highpointnc.gov

Submittals shall be provided to Greg Parret greg.parret@highpointnc.gov

Debarment, Submittals, Ineligibility and Voluntary Exclusion

The Contractor shall comply with the U.S. Office of Management and Budget (U.S. OMB) “Guidelines to Agencies on Governmentwide Debarment and Suspension (Non-procurement),” 2 C.F.R. 180. These provisions apply to each contract at any tier for a federally required audit (irrespective of the contract amount) and to each contract at any tier that must be approved by an U.S. or State of North Carolina Department official irrespective of the contract amount. As such, the Contractor shall verify that its principals, affiliates and subcontractors are eligible to participate in this federally or state funded contract and are not presently declared by any Federal or State department or agency to be:

a. Debarred from participation in any federally or state assisted award;

b. Suspended from participation in any federally or state assisted award;

c. Proposed for debarment from participation in any federally or state assisted award;

d. Declared ineligible to participate in any federally or state assisted award;

e. Voluntarily excluded from participation in any federally or state assisted award;

f. Disqualified from participant in any federally or state assisted award.

Iran Divestment Act

As provided in G.S. 147-86.59, any person identified as engaging in investment activities in Iran, determined by appearing on the Final Divestment List created by the State Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North Carolina or any political subdivision of the State.

[END OF REQUEST FOR QUALIFICATIONS]

ATTACHMENT A

REFERENCES

Biosolids Handling and Disposal Engineering Services

RFQ 06-101426

1. Vendor Name: _____________________________________________________________

Vendor Contact: ___________________________________________________________

Vendor Phone Number: _____________________________________________________

Vendor Address: ___________________________________________________________

Type of Project: ____________________________________________________________

Length of Project: __________________________________________________________

2. Vendor Name: _____________________________________________________________

Vendor Contact: ___________________________________________________________

Vendor Phone Number: _____________________________________________________

Vendor Address: ___________________________________________________________

Type of Project: ____________________________________________________________

Length of Project: __________________________________________________________

3. Vendor Name: _____________________________________________________________

Vendor Contact: ___________________________________________________________

Vendor Phone Number: _____________________________________________________

Vendor Address: ___________________________________________________________

Type of Project: ____________________________________________________________

Length of Project: __________________________________________________________

ATTACHMENT B

FINANCIAL STABILITY

Each Vendor shall certify it is financially stable by completing ATTACHMENT B: CERTIFICATION OF FINANCIAL CONDITION. The City of High Point is requiring this certification to minimize potential issues from Contracting with a Vendor that is financially unstable. From the date of the Certification to the expiration of the Contract, the Vendor shall notify the City of High Point within thirty (30) days of any occurrence or condition that materially alters the truth of any statement made in this Certification.

ATTACHMENT B: CERTIFICATION OF FINANCIAL CONDITION

Name of Vendor: __________________________________________________________________________

The undersigned hereby certifies that: [check all applicable boxes]

The Vendor is in sound financial condition and received an unqualified audit opinion for the latest audit of its financial statements.

Date of latest audit: __________________________

The Vendor has no outstanding liabilities to the Internal Revenue Service or other government entities.

The Vendor is not the subject of any current litigation or findings of noncompliance under federal or state law.

The Vendor has not been the subject of any past litigation or findings of any past litigation or findings of noncompliance under federal or state law that may impact in any way its ability to fulfill the requirements of this Contract.

He or she is authorized to make the foregoing statements on behalf of the Vendor.

If any one or more of the foregoing boxes is NOT checked, explain the reason in the space below or add additional pages.

Authorized Signature Printed Name and Title

ATTACHMENT C

STATE OF NORTH CAROLINA

AFFIDAVIT

CITY OF HIGH POINT

I, ____________________________ (the individual attesting below), being duly authorized by and on behalf of

________________________________ (the entity bidding on project hereinafter "Employer") after first being duly sworn hereby swears or affirms as follows:

1. Employer understands that E-Verify is the federal E-Verify program operated by the United States Department of

Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS §64-25(5).

2. Employer understands that Employers Must Use E-Verify. Each employer, after hiring an employee to work in the

United States, shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a).

3. Employer is a person, business entity, or other organization that transacts business in this State and that employs

25 or more employees in this State. (Mark Yes or No)

a. YES _____, or

b. NO _____

4. Employer's subcontractors comply with E-Verify, and if Employer is the winning bidder on this project Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer.

This ____ day of _______________, 20__.

Signature of Affiant Print or Type Name: _________________________

State of ______________ County of ____________________

Signed and sworn to (or affirmed) before me, this the _____ day of ________________, 20__.

My Commission Expires:

Notary Public

(Affix O fficial/N otarial Seal)

NOTICE TO BIDDERS
9. TERMINATION
The City may terminate this agreement at any time by 60 days’ notice in writing from the City to the Contractor. If the contract is terminated by the City as provided herein, the Contractor shall be paid for services satisfactorily completed, less pa...
ATTACHMENT C: CERTIFICATION OF FINANCIAL CONDITION
Portion of the Work to be performed by Minority Firms
CANCELLATION: The City of High Point may terminate/cancel this contract at any time by providing written notice to the bidder at least thirty (30) days before the effective date of termination/cancellation.
SPECIAL INTEREST GROUP DEFINITIONS:
GENERAL TERMS AND CONDITIONS
The bidder shall not construe this paragraph as inviting deviation or implying that any deviation will be acceptable.
1. Accident Prevention
2. Environmental Protection
3. Employee Education and Training
12. INFORMATION AND DESCRIPTIVE LITERATURE: Bidders are to furnish all information requested and, in the spaces, provided on the bid form. Further, as may be specified elsewhere, each bidder must submit with his proposal: cuts, sketches, descriptive l...
13. PROMPT PAYMENT DISCOUNTS: Bidders are urged to compute all discounts into the price offered. If a prompt payment discount is offered, it will not be considered in the award of the contract except as a factor to aid in resolving cases of identical ...
14. AWARD OF CONTRACT: As directed by statute, qualified bids will be evaluated and acceptance made of the lowest, responsible responsive and best bid most advantageous to the City of High Point as determined upon consideration of such factors as: pri...
15. GOVERNMENTAL RESTRICTIONS: In the event any Governmental restrictions may be imposed which would necessitate alteration of the material, quality, workmanship or performance of the items offered on this proposal prior to their delivery, it shall be...
16. M/WBE: Pursuant to General Statute 143-48 and Executive Order #77, the City of High Point invites and encourages participation in this procurement process by businesses owned by minorities, women, and the handicapped. Only businesses certified by ...
17. INSURANCE:
18. PATENTS AND COPYRIGHTS: The Bidder shall hold and save the City of High Point, its officers, agents, and employees, harmless from liability of any kind, including costs and expenses on account of any patented or unpatented invention, articles, dev...
Any and all copy, art, designs, negatives, photographs, or other tangible items created pursuant to bidder's performance of this project shall be the property of City of High Point and shall be delivered to City upon completion of the project. Such pr...
In addition, the copyright in and to any copyrightable work, including, but not limited to, copy, art, negatives, photographs, designs, text, software, or documentation created as part of the bidder's performance of this project shall vest in the Cit...
19. PATENT AND COPYRIGHT INDEMNITY: BIDDER will defend or settle, at its own expense, any action brought against Customer to the extent that it is based on a claim that the product(s) provided pursuant to this agreement infringe any U.S. copyright or ...
20. ADVERTISING: Bidder agrees not to use the existence of this contract or the name of the City of High Point as a part of any commercial advertising without prior approval of the City of High Point Purchasing Department.
21. EXCEPTIONS: All proposals are subject to the terms and conditions outlined herein. All responses will be controlled by such terms and conditions and the submission of other terms and conditions, price catalogs, and other documents as part of a Bid...
22. CONFIDENTIAL INFORMATION: As provided by statute and rule, the City of High Point will consider keeping trade secrets which the bidder does not wish to be DISCLOSED confidential. Each page shall be identified in boldface at the top and bottom as "...
23. ASSIGNMENT: No assignment of the bidder's obligations nor the bidder's right to receive payment hereunder shall be permitted. However, upon written request approved by the City of High Point Purchasing Department, solely as a convenience to the bi...
24. ACCESS TO PERSONS AND RECORDS: The City Auditor shall have access to persons and records as a result of all contracts or grants entered into by the City in accordance with General Statute 147-64.7.
25. INSPECTION AT BIDDER'S SITE: The City of High Point reserves the right to inspect, at a reasonable time, the equipment/item, plant or other facilities of a prospective bidder prior to contract award, and during the contract term as necessary for ...
26. AVAILABILITY OF FUNDS: Any and all payments of compensation of this specific transaction, its continuing or any renewal or extension are dependent upon and subject to the allocation of appropriation of funds to the City for the purpose set forth i...
28. ADMINISTRATIVE CODE: Bids, proposals, and awards are subject to applicable provisions of the North Carolina Administrative Code.
29. EXECUTION: Failure to sign under EXECUTION section will render bid invalid.
30. ORDER OF PRECEDENCE: In cases of conflict between specific provisions in this bid, the order of precedence shall be (1) special terms and conditions specific to this bid, (2) specifications, (3) City of High Point General Contract Terms and Condit...
31. CLARIFICATIONS/INTERPRETATIONS: Any and all questions regarding this document must be addressed to the City named on the cover sheet of this document. Do not contact the user directly. Any and all revisions to this document shall be made only by w...
AGREEMENT FOR SERVICES
SECTION I. ENGAGEMENT OF SERVICE PROVIDER
SECTION II. PROVISION OF THE SERVICES
SECTION III. RESPONSIBILITIES OF SERVICE PROVIDER AND CITY
SECTION IV. TERM
SECTION V. COMPENSATION AND PAYMENT
SECTION VI. INSURANCE AND INDEMNIFICATION
SECTION VII. TERMINATION
SECTION VIII. SERVICE PROVIDER’S REPRESENTATIONS, WARRANTIES, AND COVENANTS
SECTION IX. MEETINGS
SECTION X. MISCELLANEOUS
Untitled
Untitled
ADP7F77.tmp
2) Background Information
Please include this cover page in your Proposal:
Vendor Name:
Vendor Contact:
Vendor Phone Number:
Vendor Address:
Type of Project:
Length of Project:
Vendor Name_2:
Vendor Contact_2:
Vendor Phone Number_2:
Vendor Address_2:
Type of Project_2:
Length of Project_2:
Vendor Name_3:
Vendor Contact_3:
Vendor Phone Number_3:
Vendor Address_3:
Type of Project_3:
Length of Project_3:
undefined:
undefined_2:
The Vendor has no outstanding liabilities to the Internal Revenue Service or other government entities:
undefined_3:
undefined_4:
If any one or more of the foregoing boxes is NOT checked explain the reason in the space below or add:
additional pages:
Printed Name and Title:
I:
the entity bidding on project hereinafter Employer after first being duly sworn:
a YES:
b NO:
This:
day of:
Print or Type Name:
day of_2:
Notary Public:
Signature1_es_:signer:signature:
Signature2_es_:signer:signature:
Signature3_es_:signer:signature:
Signature4_es_:signer:signature:

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