City Hall Design Build RFP Draft.docx

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City Hall Design Build RFP
Solicitation number
PE-66652-NONST-2025-000000008
Issued by
Hall County, Georgia

About this file

This is a Request for Qualifications/Proposal (RFP) issued by the City of Greensboro, Georgia for Design-Build services for a new City Hall Building Project. The project involves demolishing the current City Hall and constructing a new 10,700-square-foot facility on the same site at 212 North Main Street. Proposals are due by March 25, 2025, at 2:00 PM EST, with questions due by March 7, 2025. The selected Design-Builder will be responsible for facility assessment, project design, permitting, project management, pre-construction, construction, and warranty phase services. The scope includes complete site work and building construction, with services encompassing design development, value engineering, scheduling, safety planning, and subcontractor management.

The project has a total budget of $3.5 million, with the contract structured as an Actual Cost plus Fixed Fee not to exceed the Guaranteed Maximum Price (GMP). The Design-Builder must demonstrate sufficient bonding capacity, maintain an Experience Modification Rate (EMR) of 1.0 or less over the past three years, and hold appropriate Georgia state licensing. The selection will be based on multiple criteria including firm stability (10 points), experience and qualifications (25 points), project team qualifications (25 points), preconstruction/design approach (15 points), management plan (15 points), and statement of suitability (10 points). The contract will use the "Consensus Doc" form agreement between Owner and Design-Builder.

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212 North Main Street Greensboro, Georgia 30642

MEMORANDUM

TO: Qualified Design-Build Contractors

FROM: City of Greensboro, Georgia

SUBJECT: Qualifications for General Contractor to provide Design Build Services for City Hall Building Project

Date: February 12, 2025

Enclosed is a Request for Qualifications/Proposal from qualified general contractors interested in working with City of Greensboro, Georgia (or officially, the City of Greensboro Government or Greensboro Mayor & City Council, hereinafter referred to collectively as the City), in its effort to manage design and construction delivery for City Hall Building Project for the City of Greensboro, Georgia.

To be considered, proposals must be received by 2p.m., March 25, 2025, at City of Greensboro, Georgia, Attn: Autron Hayes, City Manager or hand delivered to 212 North Main Street, Greensboro, Georgia 30642. All proposals must be sealed and should be clearly labeled. Proposals received after the specified date and time will not be considered.

The selected general contractor will be expected to work with the City of Greensboro to manage all phases of design and construction delivery for construction on the “City Hall Building Project” to and for the City of Greensboro. The estimated Budget for this contract is $3,500.00.00 (Three and a Half Million Dollars).

Please direct all questions to Autron Hayes at 706-453-7967 or via email provided herein.

Enclosure

REQUEST FOR QUALIFICATIONS/PROPOSAL

GENERAL CONTRACTOR TO PROVIDE DESIGN BUILD SERVICES

FOR CITY HALL PROJECT GREENSBORO GEORGIA.

Table of Contents

1. GENERAL PROJECT INFORMATION

2. CONTRACT INFORMATION

3. DESIGN-BUILDER SCOPE OF SERVICES

4. SCHEDULE OF EVENTS

5. SUBMITTAL OF QUESTIONS AND REQUESTS FOR CLARIFICATION

6. SUBMITTAL REVIEW PROCESS

7. INSTRUCTIONS FOR PREPARING SUBMITTAL

8. SUBMITTAL OF STATEMENT OF QUALIFICATIONS AND FEE PROPOSAL

REQUEST FOR QUALIFICATIONS

CONSTRUCTION MANAGER TO PROVIDE DESIGN BUILD SERVICES

FOR CITY HALL PROJECT GREENSBORO GEORGIA

The City of Greensboro as (“Owner”), is soliciting proposals from firms interested in providing construction management at-risk services for the construction of City Hall project. This Request for Proposals (RFP) seeks to identify potential providers of the above-mentioned services. Some firms that respond to this RFP, who are determined by the Owner to be especially qualified, may be deemed eligible and may be invited to interview if deemed necessary; however, it is the intent of the Owner to award the contract based upon the selection criteria, taking all written, oral, and related information into consideration. All respondents to this RFP are subject to instructions communicated in this document and are cautioned to completely review the entire RFP and follow instructions carefully. The Owner reserves the right to reject any or all proposals, and to waive technicalities and informalities at their discretion

Project Title for Identification Purposes

CITY HALL PROJECT

1. General Project Information Project Description The project involves demolishing the current City Hall, design and constructing a new, purpose-built 10,700-square-foot City Hall facility on the same site.

Project Delivery Method The delivery method for the projects will be Design-Build.

During all phases of the project, the Design-Builder will be responsible for the design, pricing, value engineering as well as maintainability and constructability issues.

Project Budget/ Time Sequence

1. A total budget of $3,500.00.00 (Three and a Half Million Dollars) over timeframe to be determined.

Contract Information This is a Design Build Contract. The contract format will be an Actual Cost plus a Fixed Fee not to exceed the Guaranteed Maximum Price (GMP) agreement. The Design-Builder will be responsible for design, pricing, value engineering, scheduling, safety and maintainability and constructability issues. The Design-Builder shall select all construction sub-contractors by competitive selection using cost and other factors, with owner approval of each sub-contractor.

Form of Agreement The agreement between the Owner and Design-Builder shall be the “Consensus Doc” Form agreement between Owner and Design-Builder whereas basis of payment shall be Cost of Work Plus a Fee with a Guaranteed Maximum Price.

Design-Builder Scope of Services

Design-Builder's services are to include facility assessment, project design, permitting, project management, pre-construction, construction, and warranty phase services for a complete project including site work and building construction. The Design-Builder managing the design-build process will be responsible for assuming design and construction risk from the owner. The services described below represent the minimum services required but are not a comprehensive listing of all services required.

A. Design Services

a. Provide a pre-construction assessment of facility needs, site surveys (as needed), and define project specific goals

b. Provide a design in compliance with all state, local and federal regulations.

c. Secure all necessary permits and clearances as applicable to comply with state and federal mandates. Plans and design drawings should reflect current design standards.

d. Develop preliminary building drawings into detailed building design and schematics.

B. Pre-Construction Services

a. Provide and manage required budgets throughout all stages of design

b. Provide team with value engineering options

c. Develop requirements to assure time, cost and quality control during construction

d. Assemble bid packages for sub-contractor bidding

e. Identify bidders and generate bidder interest

f. Review and analyze bids and recommend awards

g. Assemble Guaranteed Maximum Price (GMP)

C. Construction Services

a. Complete construction management services including supervision/administration of construction, review and submission of payment requests, change orders, and other coordination with the construction team, including all subcontractors.

b. Maintain staff for construction.

c. Coordination of all onsite activities with City of Greensboro, Georgia staff.

D. Closeout / Warranty Services

a. Provide all required close-out documents for the project including as-builts and O&M manuals.

b. Provide owner training on all major building systems

c. Promptly respond to warranty related requests.

d. Perform an 11-month warranty inspection.

2. Schedule of Events The following Schedule of Events represents City of Greensboro, Georgia’s best estimate of the schedule that will be followed. Unless specified, the time of the day for the following events shall be between 8 00a.m. and 4: 30 p.m. Eastern Time. City of Greensboro, Georgia reserves the right, at its sole discretion, to adjust this schedule, as it deems necessary. Notification of any adjustment to the Schedule of Events shall be provided to all Proposers by way of addendum.

RFP SCHEDULE OF EVENTS

EVENT
DATE
TIME
Advertisement of RFP
February 21, 2025
Deadline for questions & clarifications
March 7, 2025
2:00 pm
Due Date for submission of DB Proposals
March 25, 2025
2:00 pm
Oral Presentation (If deemed necessary)
TBD
------
Proposal evaluation, notify firms of award (EST.)
TBD
------

***If deemed necessary by City of Greensboro, Georgia, interviews of responsive firms may be required.

3. Request for Clarification Questions are allowed and encouraged in order to clarify the contents of this RFP. City of Greensboro WILL NOT accept telephone calls or visits regarding this RFP. No interpretation shall be binding unless in writing from the City of Greensboro, Georgia, Government. Requests for additional information or questions should be submitted in writing via letter or email to City of Greensboro, Georgia, Government: Attention Autron Hayes, City Manager or Corey Williams, Mayor, prior to the deadline stated above in the RFP Schedule of Events. E-Mail for Mr. Hayes is ahayes@greensboroga.gov and Mayor Williams is mayorwilliams@greensboroga.gov. Deadline to submit questions is March 7, 2025, by 2:00pm.

Any possible exceptions to the proposal and/or terms and conditions should be addressed during this phase. These requests will be answered in an addendum if such information is necessary so that all potential proposers will have the information. Deadline for first addendum, if required, posted on the City of Greensboro website:

https://www.greensboroga.gov/rfps 2:00p.m. March 7, 2025. The posting of additional addenda may be required, and it is the responsibility of the proposer to ensure that they review the City’s website for any additional addenda, and that they submit acknowledgement of all applicable addenda (on the included form) with their solicitation. Proposers should not expect to be individually notified by City of Greensboro.

It is the responsibility of the Proposers to examine the entire request, seek clarification and review for accuracy before submitting to the City of Greensboro, Georgia, Government. Once the deadline has passed, all proposal submissions will be final. The City of Greensboro, Georgia, Government reserves the right to ask for additional information from any Proposer having submitted a response to this RFP.

4. Submittal Review Process Qualifications Review This RFQ is issued for the purpose of acquiring Statements of Qualifications and Proposals from prospective Design-Build firms. The selection Committee will receive, and review Statements of Qualifications and Proposals submitted in response to this RFQ. To be deemed eligible for evaluation, firms must meet the following minimum qualifications:

Minimum Qualifications Required

· The Firm nor its principals are not currently ineligible, debarred, suspended, or otherwise excluded from bidding or contracting by any state or federal agency, department, or authority; and

· Firm must have sufficient bonding capacity for anticipated total cost of work. Provide a letter or other supporting documentation from a bonding company indicating the firm’s capacity to bond the project; and

· The firm must demonstrate a commitment to safety as it relates to Worker’s Compensation by having an Experience Modification Rate (EMR) over the past three years of 1.0 or less; and

· The firm must be a licensed State of Georgia Contractor

· The firm must provide design services by a registered architect holding an active professional license and certificate of authorization issued by the Georgia Architects Board; and

· The firm must provide engineering and surveying services by a professional engineer or professional surveyor holding an active professional license and certificate of authorization issued by the Georgia Engineers and Surveyors; and ENGINEER & SURVEYOR can be on the "TEAM" and/or FIRM. May not be employee of the Construction Company.

Once the Statement of Qualifications of all submitting firms have been reviewed, the Selection Committee will then evaluate the Proposal submittals which have met the above minimum qualifications. Criteria for the evaluation are listed below:

Criteria for Evaluation of RFP Responses (Proposals)

· Stability of the firm, including the firm’s corporate history, years in business, resources, form of ownership, litigation history, financials.

· Firm’s relevant project Experience and Qualifications, including the demonstrated ability of firm to effectively manage the construction of facilities comparable in complexity and function, for public owners.

· Firm’s Suitability to provide services for project, including the firm’s apparent fit to the project type, delivery method, any unique qualifications for the project. Additional factors for a firm’s suitability will include the construction manager’s office location/proximity to the project, and current/recent project workload.

· Proposed Project Team’s Relevant Experience and Qualifications: Experience of the Design Professional, Project Manager(s) and Superintendent on completed projects of similar type, and complexity; Assigned team’s experience with effective budget and schedule control plans for this project; percentage of time each team member will be committed to this project and duties/responsibilities for their role.

· Proven Ability to Provide Preconstruction Services: The Firm’s ability to provide a high level of preconstruction services with the client’s best interest in mind, such as budgeting, value- engineering options, scheduling, bid package development, procurement and workforce planning, and assuring local contractor opportunity.

· Quality of Proposed Management Plan: The firm’s cost and schedule management plans; Firm’s approach for managing changes within the stated cost and schedule limitations; Firm’s approach for competitively administering and evaluating bid packages; The firm’s subcontractor management plan; The firm’s quality assurance program and plan; The firm’s close-out plan; The firm’s work force plan; The firm’s safety plan and site logistics plan for proposed project.

5. INSTRUCTIONS FOR PREPARING SUBMITTAL

Each submittal shall be identical and include a transmittal letter. A Cover Letter introducing your firm and describing your interest in this project should precede all sections of the Proposal. Submittals must be typed on standard (8- 1/2” x 11”) paper. The pages must be numbered. A table of contents, with corresponding tabs, must be included to identify each section. Responses are limited to forty (40) double- sided pages or less using a minimum of an 11-point font. A “page” is defined as a physical sheet, with content on neither, one or both sides. Any exhibits, affidavits or other enclosure information called for may be included in an appendix and will not count toward the limit. Tab sheets also do not count toward limit. Each submittal shall be prepared simply and economically, providing straightforward, concise delineation of respondent’s capabilities. Emphasis must be on completeness, relevance, and clarity to content.

To expedite the review of submittals, it is essential that respondents follow the format and instructions outlined below. The content of all Proposal submittals must be categorized and numbered as outlined below and be responsive to all requested information:

PROPOSAL SUBMITTAL

A. Stability of Firm

1. Provide basic company information: Company name, address, name of primary contact, telephone number, fax number, e-mail address, and company website (if available). If the firm has multiple offices, include information about the parent company and branch office separately. Identify the office from which project will be managed and proximity to the project site. Provide form of ownership, including state of residency or incorporation, and number of years in business under current business name. For joint venture entities that have not undertaken at least two projects together, each firm should submit its qualifications separately. Joint submittals are subject to the same submittal page limit.

2. Briefly describe the history of your firm(s). Provide general information about the firm's establishment, personnel resources, including disciplines and numbers and classifications of employees, and locations and staffing of offices that will be directly involved with this Project.

3. Please disclose whether or not the firm has been involved in any litigation with an Owner or Architects during the past five (5) years. List any active or pending litigation and provide a thorough explanation of its scope. List any claims against your firm or against Owners where your firm is named.

4. List the firm’s annual average gross revenue for each of the past 5 years. Supply main financial and banking references.

5. Please provide information as to whether or not your firm has ever been removed from a contract for cause OR failed to complete a contract as awarded?

6. The firm, in order to be deemed eligible for further evaluation, will issue the following Statement of Qualifications asserting that the firm meets the minimum qualifications required for this project (supporting information is requested and can be included as an Appendix in the Proposal Submittal). The SIGNED statement shall read as follows:

a) We certify our firm, or its principals are not currently ineligible, debarred, suspended, or otherwise excluded from bidding or contracting by any state or federal agency, department, or authority.

b) We certify that our firm has sufficient bonding capacity for anticipated total cost of work. Provide a letter or other supporting documentation from a bonding company indicating the firm’s capacity to bond the project.

c) We certify a commitment to safety in regard to Worker’s Compensation by having an Experience Modification Rate (EMR) over the past three years of 1.0 or less. Firm must provide a letter from their insurance agent or other supporting documentation.

d) We certify our firm(s) has all necessary, valid and current licenses to do business in the State of Georgia. Provide a copy of your GC license, business license and Georgia Certificate of Existence. Architects, Engineers and Surveyors are to provide their active professional license from the state of Georgia.

B. Experience and Qualifications Provide examples of your recent experience as CM or Design-Builder in constructing facilities of similar function, and complexity (similar type of construction). Describe 3-5 projects, in order of most relevant to least relevant, which demonstrate the firm's capabilities to perform the project. For each project, provide the following information:

a) Project name, location and dates during which services were performed.

b) Brief description of project and physical description (delivery method, cost, square footage, number)

c) Services performed by your firm

d) Provide any Owner- written letters of reference/recommendation about the firm’s performance on the project.

e) Owner/Architect contact information.

f) Explanation as to how the highlighted project relates to the current Project being considered.

If the firm has multiple offices, indicate the office responsible for each highlighted project.

C. Qualifications and Experience of Proposed Project Team

1. Project Team Organizational Chart. Provide an organizational chart showing the lines of responsibility and accountability for your project team. At minimum, the project team should include a: project executive/project director, design professional, project manager, superintendent, and cost estimator, who will manage the project. Please designate the specific individuals to fill the following key roles on your team:

a) Superintendent(s)

b) Project Executive / Project Director

c) Project Manager

d) Cost Estimator

e) Design Professional

f) Other (please describe, if applicable)

2. Project Team Resumes. Please provide, for each of the above personnel, a current resume listing relevant project experience, percentage of the person’s time to be committed to this project, current and projected workloads, and his/her office location in relation to project location.

3. Project Leader/Main Point of Contact. Please identify the individual who, from project start to finish, will be the leader of your construction team and the principal point of contact between your firm and the Owner, the Architect, and other consultants. Provide detailed information on the qualifications of this individual and the direction, authority, and management tools that will be provided to the individual by the firm. Provide information on his/her current and projected workloads, and his/her office location in relation to project location. This individual’s competence, his/her leadership, location, and his/her ability to achieve customer satisfaction will be heavily considered in the selection of a construction management firm.

4. Project Experience. Provide examples of your recent experience as CM or Design-Builder in constructing facilities similar to this including the following:

a) Provide photographs of similar projects your firm/team completed in the past five (5) years.

b) Provide a written reference from the Architect/Owner (with current contact information) familiar with your performance on each of the above projects. Provide a Program Manager reference (if applicable).

c) List the individuals who served as the Designer/Architect, Project Executive/Director, Project Manager, Superintendent, and Cost Estimator on the projects. Please note whether these individuals are still employed with your firm.

D. Approach to Preconstruction/Design

1. Provide a brief explanation of your design team’s design philosophy and design approach that would be used for this type of project.

2. Provide a brief explanation of your team’s preconstruction services and processes.

3. Provide a brief explanation of your team’s ability to coordinate and communicate with multiple end users (municipalities, Regulatory Agencies, etc.) Also describe any processes used to creatively engage stakeholders in all stages of design.

E. Management Plan

1. With regard to your firm’s expected role in the project, please provide:

a) a statement of your definition of the role,

b) your anticipated level of management responsibility and accountability for project concerns.

2. Describe your process for efficiently resolving issues and maintaining the project commitments while working collaboratively with the Architect, Owner, and other stakeholders as applicable.

3. Describe your procedures for routine solving of complex project issues without compromising your team commitments.

4. Provide your proposed methods and plans of Design-Builder communication.

5. Describe your firm’s approach to providing pre-construction services on this project.

6. Provide your cost management plan for controlling costs on this project within the GMP during construction. Describe your systems and procedures for controlling costs during construction.

7. Provide your change order management plan for managing cost and schedule exposures within the stated limitations.

8. Provide your procurement and workforce plan including details on your plan to assure local contractor opportunity. Describe how your firm intends to arrange the construction into bid packages in order to maintain The Owner’s schedule and budget objectives.

9. Provide your schedule management plan for this project during construction. Describe systems and procedures your firm uses to manage the project schedule. Describe alternatives that may be explored to shorten the schedule.

10. Provide your subcontractor management plan including, contract document compliance procedures, project accounting procedures, issue resolution and compliance with Security and Immigration Compliance Act OCGA13-10-91 – as it relates to subcontractor compliance with the requirements set forth therein ensuring compliance with the federal work authorization program.

11. Provide your closeout management plan for this project. Describe your systems and procedures for your closeout plan. Describe your approach to Warranty.

12. Provide your quality assurance plan for this project. Describe your firm’s approach for validating compliance with the construction documents. Explain your process for ensuring quality workmanship.

13. Describe any additional services offered by your firm and the benefits they may provide the owner on this project.

F. Statement of Suitability Provide any information that may serve to differentiate your firm from other firms regarding suitability for the project. Suitability may include, but is not limited to, the firm’s fit to the project and/or needs of the Owner, any special or unique qualifications for the project, current and projected workloads, the proximity of main office to project location, and any techniques or methodologies offered by the firm that may be particularly suitable for this project type.

6. SUBMITTAL OF STATEMENTS OF QUALIFICATIONS AND FEE PROPOSAL

All responses must be sealed in an opaque envelope or box, and reference City of Greensboro City Hall Building Project, Greensboro, Georgia on envelopes or boxes and addressed to the addresses below. Statements of Qualifications and Proposals must be physically received by the Owner prior to the deadline indicated in the Schedule of Events at the exact address below:

Proposers should deliver one (1) original and three (3) hard copies and one (1) electronic copy (.pdf format on a USB Jump Drive) of their Statement of Qualifications submittal to:

City of Greensboro, Georgia, 212 North. Main Street, Greensboro, Georgia 30642 Attention: Autron Hayes, City Manager

It is the sole responsibility of the Proposers to assure delivery to the noted locations by the specified deadlines; the Owner cannot accept responsibility for incorrect delivery, regardless of reason. No Qualifications submittals will be accepted after the time stipulated above. Qualifications submittals will not be accepted via facsimile or e-mail.

It is the responsibility of the Proposers to examine the entire Request, seek clarification in writing, and review their qualifications for accuracy before submitting a response. Once the deadline has passed, all submittals will be final.

All expenses for preparing and submitting responses are the sole cost of the party submitting the response. The Owner is not obligated to any party to reimburse such expenses. All submittals upon receipt become the property of the Owner. Labeling information provided in submittals “proprietary” or “confidential” or any other designation of restricted use will not protect the information from public view. Subject to the provisions of the Open Records Act, the details of the proposal documents will remain confidential until final award.

7. EVALUATION CRITERIA

Major Category Available Points

A. Stability of Firm10
B. Experience and Qualifications25
C. Qualifications and Experience of Project Team25
D. Approach to Preconstruction/Design15
E. Management Plan15
F. Statement of Suitability10

Disclaimer: City of Greensboro, Georgia, Government reserves the right to accept or reject any or all proposals.

City of Greensboro, Georgia is an Equal Opportunity Employer.

Upon completion of submittal evaluations, the owner will enter direct fee negotiations with the highest rank proposer. If fees cannot be agreed on, then the owner reserves the right to negotiate with the next highest rank proposer.

Insert Fee Proposal

Addendum Acknowledgment Page

The Supplier has examined, carefully studied, and hereby acknowledges the Specifications and any Addenda and agrees to provide the required services in accordance with this proposal. The Supplier further certifies that they are not currently debarred from submitting proposals by any agency of the State of Georgia or the federal government.

Addendum No. _____ dated _________ Acknowledgement _______________ Addendum No. _____ dated _________ Acknowledgement _______________ Addendum No. _____ dated _________ Acknowledgement _______________ Responses which fail to acknowledge the Supplier’s receipt of any addendum would result in the rejection of the proposal if the addendum contained information which substantively changes the City’s requirements.

PROPOSAL RESPONSE SIGNATURE

Name of Company: ____________________________________________________________________

Mailing Address: ____________________________________________________________________________

City/State/Zip: ______________________________________________________________________________

Phone (including area code): __________________________Email: ___________________________________

Authorized Signature Title

Name (Printed) Title (Printed)

Company Information

Company Company/Individual Name: ________________________________________________ Physical Address: ________________________________________________________ Mailing Address (if different): ______________________________________________ Employer Federal ID # ______________________ SSN __________________________ Authorized Representative

Signature: _______________________________________________________________
Printed or Typed Name: ____________________________________________________
Title: ___________________________________________________________________
Email address: ___________________________________________________________
Phone number: _______________________Fax: _________________________

Project Contact Person

Printed or Typed Name: ____________________________________________________
Title: ___________________________________________________________________
Office Number: __________________Cellular Number: _____________________
Email address: ___________________________________________________________

CONTRACTOR FIRM CERTIFICATION STATEMENT

I (we) certify that the information contained herein is true and correct to the best of my (our) knowledge, and that the person submitting the RFP on behalf of the proposer has the authority to submit this RFP and make all representations contained herein. I (we) understand that the inclusion of false information may result in rejection of the proposal submitted in response to this RFP.

______________________________________________________
Contractor Firm NameDate

Signature of Preparer

SWORN TO AND SUBSCRIBED BEFORE ME THIS ________ day of ____________________ 20 _____.

Notary Public in and for the State of ___________________

(seal)

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT AND AGREEMENT

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of the City of Greensboro has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization/ E-Verify User Identification Number

Date of Authorization

Name of Contractor

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on __________________, _____, 20 _____ in ___________________ (city), _____________ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE ______ DAY OF ______________,20 _____.

NOTARY PUBLIC

My Commission Expires:

NON-CONFLICT OF INTEREST

By submitting an offer in response to this solicitation, the Firm represents that in the preparation and submission of this proposal, said Firm did not either directly or indirectly, enter into any combination or arrangement with any person, Proposer, Corporation or enter into any agreement, participate in any collusion, or otherwise take any action in the restraint of free, competitive bidding in violation of the Sherman Act (15 U.S.C. Section I or Section 59.1-9.1 through 59.1-9.17 or Sections 59.1 – 68.6 through 59.68.8). Collusion and fraud in proposal preparation shall be reported to the State of Georgia Attorney General and the United States Justice Department.

______________________________________ (Officer of Firm) certifies that to the best of our knowledge, no circumstances exist which shall cause a conflict of interest in performing services for the City of Greensboro, and that no company or person other than bona fide employees working solely for our firm has been employed or retained to solicit or secure an agreement resulting from this request for proposal.

Signature:

Type Name:

Title:

Firm Address:

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