Club Tex Nebraska.pdf

TABLE OF CONTENTS

INVITATION TO BID FOR COMMODITIES CONTRACT ........................................................................................................................... i

TABLE OF CONTENTS •••••••.••.•................................................................................................................................................................. iii

GL OSSARY OF TERMS ............................................................................................................................................................................. v

ACRONYM LIST ....•...••.............................................................................................................................................................................. ix

I. PROCUREMENT PROCEDURE

A. GENERAL IN FORMATION

B. PROCURING OFFICE AND COMMUN ICATION WITH STATE STAFF AND EVALUATORS

C. SCHEDULE OF EVENTS

D. WRITTEN QUESTIONS AND ANSWERS

E. SECRETARY OF STATEfTA>< COMMISSIONER REGISTRATION REQUIREMENTS (Nonnegotiable)

F. ETHICS IN PUBLIC CONTRACTING

G. DEVIATIONS FROM THE SOLICITATION

H. SUBMISSION OF SOLICITATION RESPONSES

I. SOLICITATION PREPARATION COSTS

J. FAILURE TO COMPLY WITH SOLICITATION

K. SOLICITATION RESPONSE CORRECTION S

L. LATE SOLICITATION RESPONSES

M. BID OPENING

N. SOLICITATION REQUIREMENTS

0 EVALUATION OF S OLICITATION RESPONSES

P BEST AND FINAL OFFER

Q. REFERENCE AND CREDIT CHECKS

R. AWARD

S. LUMP SUM OR "ALL OR NONE' SOLICITATION RESPONSES

T. REJECTION OF SOLICITATION RESPONSES

U. PRICES & COST CLARIFICATION

V. SPECIFICATION S

W. SAMPLES

X. CORE LIST AND CATALOG/N ON-CORE

Y. ALTERNATE/EQUIVALENT SOLICITATION RESPONSES

Z. SOLICITATION TABULATIONS

II. TERMS AND CONDITIONS ........................ , ................. , .............................................................................................................. II A.

B.

c.

D.

E.

F.

G.

H.

I.

J.

K.

L.

M.

N.

0.

P.

Q.

R.

s.

T.

U.

V.

w.

X.

Y.

GENERAL

NOTIFICATION .. .

BUYER·s REPRESENTATIVE GOVERNING LAW (Nonnegotiable)

AMENDMEN T

CHANGE ORDERS OR SUBSTITUTIONS

RECORD OF VENDOR PERFORMANCE

NOTICE OF POTENTIAL VENDOR BREACH

BREACH

NON-WAIVER OF B REACH

SEVERABILITY

.11

INDEMN IFICATION

ATTORNEv·s FEES......................................... ....................... . .................. ·············· 12

ASSIGNMENT. SALE. OR MERGER

CONTRACTING WITH OTHER POLITICAL SUBDIVISIONS OF THE STATE OR ANOTHER STATE

FORCE MAJEURE

CONFIDENTIALITY

EARLY TER MINATION

CONTRACT CLOS60UT

AMERICANS WITH DISABILITIES ACT

ACCEPTABLE GOODS

DELIVERY ARO

ORDERS.

QUALITY

PACKAGING

Page iii

.. 14

S PB Form 17 I ITB Template I Effective 07192024 z.

AA.

BB.

SAMPLES

PERFORMANCE TESTING

ANNUAL USAGE. ESTIMATED

··················································15

Ill. VENDOR DUTIES .............................................................. , ... , ................ ,, ........................... , A. INDEPENDENT VENDOR/ OBLIGATIONS

B. EMPLOYEE WORK ELIGIBILITY STATUS

C. COMPLIANCE WITH CIVIL RIGHTS LAWS AND EQUAL OPPORTUNITY EMPLOYMENT/ NONDISCRIMINATION

(Nonnegoliable)

D. COOPERATION WITH OTHER VENDORS

E. DISCOUNTS

G. PERMITS, REGULATIONS, LAWS .. 18

H. ANTITRUST

I. CONFLICT OF INTEREST

J. ADVERTISING

K. DISASTER RECOVERY/BACK UP PLAN

L. DRUG POLICY

M. WARRANTY

N. TIME IS OF THE ESSENCE

0. USAGE REPORT

P. AUTHORIZED DEALER & WARRANTY

a. DELIVERY LOCATIONS/ INSTRUCTIONS

IV. PAYMENT

A. PROHIBITION AGAINST ADVANCE PAYMENT (Nonnegotiable) B. TAXES (Nonnegotiable) C. INVOICES (Nonnegotiable)

D. INSPECTION AND APPROVAL

E. PAYMENT (Nonnegotiable) F LATE PAYMENT (Nonnegotiable) G. SUBJECT TO FUNDING/ FUNDING OUT CLAUSE FOR LOSS OF APPROPRIATIONS (Nonnegotiable)

H. RIGHT TO AUDIT (First Paragraph is Nonnegotiable)

V. TECHNICAL SPECIFICATIONS

A. VENDOR INSTRUCTIONS

B. NON-COMPLIANCE STATEMENT....... .. ...................... ,

C. TECHNICAL SPECIFICATION: T130 SHEETING MATERIAL

D. TECHNICAL SPECIFICATION: T180 SHEETING MATERIAL ................................................................................. , .. 22

E. TECHNICAL SPECIFICATION: SHIRT FABRIC - WOVEN SHIRT TWILL

F. TECHNICAL SPECIFICATION, PANT FABRIC -TWILL

G. TECHNICAL SPECIFICATION: FLAT FINISHED SHEET

H. TECHNICAL SPECIFICATION: FINISHED PILLOWCASE

TECHNICAL SPECIFICATION: INVENTORY AND DELIVERY REQUIREMENTS

Page iv SPB Form 1711TB Template I Effective 07192024

GLOSSARY OF TERMS

Acceptan'7e Te■t Proc�dure: Benchmarks and other performance criteria, developed by the State or other sources oftestino standards.

for measuring the effectiveness of products or goods and the means used for tasting such performance

Addeftdum: A written correction or alteretion to a document during the eoticltetlon prooes■ (e.g., Queation■ and An1wera, Revlaed

Schedule of Events, Addendum to Contract Award).

Agency: All officers of the state. departments. bureaus. boards, commissions, councils. and institutions receiving legislative appropriations

Agent/Representative: A person authorized to act on behalf of another

Amend: To alter or change by adding. subtracting. or substituting

Amendment: A written correction or alteration to a document

Appropriation: Legislative authorization to expend public funds for a specific purpose; money set apart for a specific use

Automated Clearing House (ACH): Electronic network for financial transactions in the United States

Award: All purchases, leases, or contrects which are based on competitive solicitation■ will be awarded ecoording to the provision• in the solicitation a.et and Final Offer (BAFO): In a competitive ■olioitation, the final offer eubmitted whioh oont•in■ Vendor'■ mo9l favorable term• for price

Bid: See Solicitation Response

Bid Opening: The process of opening correctly submitted solicitation responses at the time and place specified in the written solicitation and in the presence of any bidder who wishes to attend

Bidder: A Vendor who submits a Solicitation Response

Breach: Violation of a contractual obligation by failing to perform or repudiation of one's own promise

Business: Any corporation, partnership, individual, sole proprietorship, joint-stock company, joint venture, or any other private legal entity

Business Day: Any weekday, except State-recognized holidays

Calendar Day: Every day shown on the calendar including Saturdays, Sundays, and State/Federal holidays

Cancellation: To call off or revoke a solicitation, purchase order, or con tract without expectation of conducting or performing at a later time

Catalog/Non.Core: A printed or electronic list of products a Vendor may provide at a discounted rate or discount off list price to the State.

Initial contract award(s} is not based on Catalog/Non-Core items

Central Processing Unit (CPU): Any computer or computer system that is used by the State to store. process. or retrieve data or perform other functions using Operating Systems and applications software

Change Order: Document that provides amendments to an executed purchase order or contract

Collusion: An agreement or cooperation between two or more persons or entibes to accomplish a fraudulent, deceitful, or unlawful purpose

Commodities: Any equipment, material. supply, or goods; anything movable or tangible that is provided or sold

Commodities Description: Detailed descriptions of the items to be purchased; may include informabon necessary to obtain the desired quality, type, color, size, shape, or special characteristics necessary to perform the work intended to produce the desired results

Competition: The effort or action of two or more commercial interests to obtain the same business from third parties

Confidential Information: See Proprietary Information

Contnic:t: An ogreen,ent between two or more partle■ oraating obligation■ that are enforceable or otherwi■e reoogniz■bl• ■t law; th■ writing that sets forth such an agreement

Page v SPB Form 17 11TB Template I Effective 07192024

Contract Administration: The management of the contract which includes and is not limited to contract signing, contract amendments and any necessary legal actions

Contract Award: Document that officially awards a contract to a bidder(s} as the result of a competitive solicitation or a vendor(s) in a contract that qualifioa for an exception or exemption from the competitive bidding requirements of the State Procurement Act.

Contract Management: The management of day-to-day activities at the agency which includes and is not limited to ensuring deliverables are received, specifications are met. handling meetings and making payments to the Vendor

Contract Period: The duration of the contract

Contractor: See Vendor

Cooperative Purchasing: The combining of requirements of two or more political entities to obtain advantages of volume purchases, reduction in administrative expenses or other public benefits

Copyright: A property right in an original work of authorship fixed in any tangible medium of expression. giving the holder the exclusive right to reproduce. adapt and distribute the work

Co•t Sheet: Commoditlee or Services specifically liated within the aolicitation for evaluation

Critical Program Error: Any Program Error. whether or not known to the State. which prohibits or significantly impairs use of the Licensed Software as set forth in the documentation and intended in the contract

Customer Service: The process of ensuring customer satisfaction by providing assistance and advice on those commodities or services provided by a Vendor

Default: The omission or failure to perform a contractual duty

Deviation: Any proposed change(s) or alteration(s) to either the terms and conditions or deliverables within the scope of the written solicitation or contract

Evaluation: The process of examining a solicitation response after opening to determine the bidder's responsibility, responsiveness to requirements. and to ascertain other characteristics of the solicitation response that relate to determination of the successful award

Evaluation Committee: lndividual(s) identified by the agency that leads the solicitation to evaluate solicitation responses

Extension: Continuance of a contract for a specified duration upon the agreement of the parties beyond the original Contract Period; not to be confused with "Renewal Period" free on Board (f.O.B.) Destination: The delivery charges are included in the quoted price and prepaid by the Vendor. Vendor is responsible for all claims associated with damages during delivery of product.

free on Board (f.O.B.) Point of Origin: The delivery charges are not included in the quoted price and are the responsibility of the agency. Agency is responsible for all claims associated with damages during delivery of product

Foreign Corporation: A foreign corporation that was organized and chartered under the laws of another state, government, or country

Goods: See Commodities ln■tallatlon Date: The dato when the procedures described in "lnatallation by Vendor .. and "Installation by State• ea found in tho solicitation or contract are completed

Interested Party: A person acting in their personal capacity or an entity entering into a contract or other agreement creating a legal interest therein

Invitation to Bid (1TB): See SohcItation

Late Solicitation Response: A solicitation response received after the Opening Date and Time

Licensed Software Documentation: The user manuals and any other materials in any form or medium customarily provided by the Vendor to the users of the Licensed Software which will provide the State with sufficient information to operate, diagnose. and maintain the Licensed Software properly, safely, and efficiently

Mandatory: Required, compulsory, or obligatory

May: Discretionary, permitted; used to express possibility

Page vi SPB Form 17 I ITB Template I Effective 07192024

Module (see System): A collection of routines and data structures that perform a specific function of software

Must: See Shall

Natlonal lnetltute for Oov•rnmental Purch■•lng (NIOP): National lnatitut■ of Govarnment■I Puroh■aing - Soun,a uaed fOf'" a■aignm.nt of universal commodity codes to goods and services

Non-core: See Catalog

Non-Responsive Solicitation Response: Any bid that does not comply with the requirements of the solicitation or cannot be evaluated against the other bids

Non-negotiable: These clauses are controlled by state law and are not subject to negotiation

Opening Date and Time: Specified date and time for the opening of received. labeled. and sealed formal solicitation responses

Operating System: The control program in a computer that provides the interface lo the computer hardware and peripheral devices, and the usage and allocation of memory resources, processor resources. input/output resources, and security resources

Outsourcing: The contracting out of a business process that an organization may have previously performed internally or for which an organization has a new need to an independent organization from which the process is purchased back

Payroll & Financial Center (PFC): Electronic procurement system of record

Personal Property: See Commodities

Platform: A specific hardware and Operating System combination that is different from other hardware and Operating System combinaUone to the extent that a different verstOn of the Llcenaed Softweiro product is required to execute properly In the environment establlshed by auch hardware and Operating System combination

Point of Contact (POC): The person designated to receive communications and to communicate

Product: Something that is distributed commercially for use or consumption and that is usually (1) tangible personal property, (2) the result of fabrication or processing, and (3) an item that has passed through a chain of commercial distribution before ultimate use or consumption

Program Error: Code in Licensed Software that produces unintended results or actions or that produces results or actions other than those described in the specifications. A program error includes. without limitation. any Critical Program Error.

Program Set: The group of programs and products. including the Licensed Software specified in the solicitation. plus any additional programs and products licensed by the State under the contract for use by the State

Project: The total acheme. program, or method worked out for the accomplishment of an objective, including all documentation, commodities, and goods to be provided under the contract

Proposal: See Solicitation Response

Proprietary Information: Trade secrets. academic and scientific research work that Is in progress and unpublished or other information that if released would give advantage to business competitors and service no public purpose. Soo Neb. Rcav. Stat. § 84-712.06{3). In accordance with Attorney General Opinions 92088 and 97033, proof that information la proprietary roqu1re■ identification of 1peclfic namod competitor(s) advantaged by release of tho information end the demonstrated advantage the named competitor(&) would gain by the release of information.

Protest/Grievance: A complaint about a governmental action or decision related to the solicitation or resultant contract under SPB's Protest Policy.

Quote: See Solicitation Response

Recommended Hardware Configuration: The data processing hardware (including all terminals. auxiliary storage. communicat1on. and other peripheral devices) to the extent used by the State as recommended by the Vendor

Release Date: The date of public release of the solicitation

Renewal Period: Optional contract periods subsequent to the original Contract Period for a specified duration with previously agreed to terms and conditions; not to be confused with "Extension"

Page vii

ARO - After Receipt of Order

ACH - Automated Clearing House

BAFO - Best and Final Offer

COi - Certificate of Insurance

CPU - Central Processing Unit

CSI - Cornhusker State Industries

DAS - Department of Administrative Services

F.0.8. - Free on Board

ICT - Information and Communication Technology

1TB - Invitation lo Bid

NDCS - Nebraska Department of Correctional Services

NIGP - National Institute for Governmental Purchasing

PA - Participating Addendum

RFP - Request for Proposal

SPB - State Purchasing Bureau

ACRONYM LIST

Page ix SPB Form 17 I ITB Template I Effective 07192024

I. PROCUREMENT PROCEDURE

A. GENERAL INFORMATION

This solicitation is designed to solicit responses from qualified bidders who will be responsible for providing T130 and T180 Sheeting, Shirt and Pant Material at a competitive and reasonable cost.

Solicitation responses shall conform to all instructions, conditions, and requirements included in the solicitation.

Prospective bidders are expected to carefully examine all documents, schedules, and requirements in this solicitation, and respond to each requirement in the format prescribed. Solicitation responses may be found non-responsive if they do not conform to the solicitation.

B. PROCURING OFFICE AND COMMUNICATION WITH STATE STAFF AND EVALUATORS

Procurement responsibilities related to this solicitation reside with the State Purchasing Bureau. The point of contact (POC) for the procurement is as follows:

1TB Number:

Name:

Agency:

Address:

Telephone:

E-Mail:

120862 OR

Vicki Collins, Procurement Contract Officer(s) State Purchasing Bureau 1526 K Street, Suite 130 Lincoln, NE 68508 402-4 71-6500 as.materielpurchasing@nebraska gov

From the date the solicitation is issued until the Intent to Award is issued, communication from the bidder is limited to the POC listed above. After the Intent to Award Is Issued, the Vendor may communicate with individuals the State has designated as responsible for negotiating the contract on behalf of the State. No member of the State Government, employee of the State, or member of the Evaluation Committee is empowered to make binding statements regarding this solicitation. The POC will issue any answera, clarificationa, or amendments regarding thla solicitation in writing. Only the SPB or the awarding agency can award a contract. bidders shall not have any communication with or attempt to communicate or influence any evaluator involved In this aol1citetion.

The following exceptions to these restrictions are permitted:

1. Contact made pursuant to pre-existing contracts or obligations;

2. Contact required by the schedule of events or an event scheduled later by POC: and 3, Contact required for negotiation and execution of the final contract.

The State reserves the right to reject a Vendor's solicitation response. withdraw an Intent to Award. or terminate a contract if the State determines there has been a violation of these procurement procedures.

SPB Form 17 11TB Template I Effective 07192024

C. SCHEDULE OF EVENTS

The State expects to adhere to the procurement schedule shown below, but all dates are approximate and subject to change.

NOTE: All ShareFile links in the Schedule of Events below •re unique links for each schedule etep. Please click the correct link for the upload step you are requesting.

ACTIVITY

1.

2.

3.

4.

5.

6.

7.

8.

Release solicitation Last day to submit written questions

ShareFile link for uploading questions:

btlc:a:ti□�bra��t.1 ::ih�r:gfilg.�2mlr-cSt2JRra2�d,b!4�5:a24ZZQ2�a�z§gt!§

State responds to written questions through a solicitation "Addendum" to be posted to the Internet at:

htt12s://das.nebr-aska.gov/materiel/bido1212s,html

Bid Opening - Online via Webex Meeting

IT IS THE BIDDER'S RESPONSIBIL TY TO UPLOAD ELECTRONIC FILES

BY THE OPENING DATE AND TIME. EXCEPTIONS Will NOT BE MADE

FOR TECHNOLOGY ISSUES.

ShareFile Electronic Solicitation Response Submissions Link:

https://nebraska.sharefile.com/r-rf1 ed20c097f041 d48e 166e 7 4d 1094a4c

Join from the Webex Meeting htt11s://sonv1di10.wetl!lx.@m/sonvideo/i.1Jh1l?MTID-mecf24c724c2ee7�75 llQJ72Ji;!2<!7322l

Join by meeting number Meeting number (access code): 2499 664 1558

Meeting password: CJrNmnnp233

Tap to join from a mobile device (attendees only) +1-408-418-9388 .. 24996641558## United States Toll

Join by phone

+1-408-418-9388 United States Toll Global call-in numbers

Join from a video system or application

Dial 242� 1558®�Qo�tdeQ �bei QQ!n You can also dial 173.243.2.68 and enter your meeting number.

Review for conformance with :solicitation requirements

Evaluation period Post "Intent to Award" to Internet at:

htto.//das.nebraska.no�/materiel/nurchas1nn.html Contract award

DATE/TIME

March 03, 2025

March 1 D. 2025

March 13. 2025

March 31, 2025

2:00 PM

Central Time

TBD

TBD

TBD

TBD

D. WRITTEN QUESTIONS AND ANSWERS

Questions regarding the meaning or interpretation of any solicItat10n provision must be submitted in writing to SPB and clearly marked "Solicitation Number 120862 OR; T130 and T180 Sheeting, Shirt and Pant Material Questions".

POC is not obligated to respond to questions that are received late per the Schedule of Events.

Bidders should submit questions for any items upon which assumptions may be made when preparing a response to the solicitation. Any solicitation response containing assumptions may be deemed non-responsive and may be rejected by the State. Solicitation responses will be evaluated without consideration of any known or unknown assumptions of a bidder. The contract will not incorporate any known or unknown assumptions of a bidder.

Questions should be uploaded using the ShareFile link provided in the Schedule of Events, Section I.C. It is recommended that Vendors submit questions using the following format.

Solicitation Section Solicitation Page Reference Number Question

Written answers will be posted at https://das.nebraska gqv/materiel/bidOOPS-hfrol per the Schedule of Events.

E. Sl!CRETARY OF STATE/TAX COMMISSIONER REGISTRATION REQUIRl!MENTS (Nonnegotiable) All Bidders must be authorized to transact business In the State of Nebraska end comply with all Nebraska Secretary of State Registration requirements. The Bidder who is the recipient of an Intent to Award may be required to certify that it has complied and produce a true and exact copy of its current (Within ninety (90) calendar days of the intent to award) Certificate or Letter of Good Standing, or in the case of a sole proprietorship, provide written documentation of sole proprietorship and the United States Citizenship Attestation Form, available on the DAS website at:

httos://das.nehraska.qov/materiel/docs/pdf/lndiv,dual%20or%20Sole%20Proprietoro/o20United%20States%20Attest at1on%20Form%20Enghsh%20and%20Spanish.odf. This should be accomplished prior to execution of the contract.

F. ETHICS IN PUBLIC CONTRACTING

G.

H.

The State reserves the right to reject solicitation responses. withdraw an intent to award or award, or terminate a contract if an ethical violation has been committed, which includes, but is not limited to:

1. Offering or giving, directly or indirectly, a bribe, fee, commission, compensation, gift, gratuity, or anything of value to any person or entity in an attempt to influence the bidding process;

2. Utilizing the services of lobbyists, attorneys, political activists, or consultants to influence or subvert the bidding process;

3. Being considered for, presently being, or becoming debarred, suspended, ineligible, or excluded from contracting with any state or federal entity:

4. Submitting a solicitation response on behalf of another Party or entity; and

5. Colluding with any person or entity to Influence the bidding pr-oceee, submit sham proposals, preclude bidding, fix pricing or costs, create an unfair advantage. subvert the soliettation response, or prejudice the State.

The bidder shall include this clause in any subcontract entered into for the exclusive purpose of performing this contract.

Bidder shall have an affirmative duty to report any violations of this clause by the bidder throughout the bidding process and throughout the term of this contract for the awarded bidder and their subcontractors.

DEVIATIONS FROM THE SOLICITATION

The requirements contained in the solicitation (Sections II through V) become a part of the terms and conditions of the contract resulting from this sol1c1tat1on. Any dev1at1ons from the solicitation 1n Sections 11 through V must be clearly defined by the bidder in its solicitation response and, if accepted by the State, will become part of the contract. Any specifically defined deviations must not be in conflict with the basic nature of the solicitation, solicitation requirements, or applicable state or federal laws or statutes. '·Deviation", for the purposes of this solicitation, means any proposed changes or alterations to either the contractual language or deliverables within the scope of this solicitation. The State discourages deviations and reserves the right to reject proposed deviations.

SUBMISSION OF SOLICITATION RESPONSES

The State la only accepting electronlc reeponses submitted In accordance with this solicitation. The State will not accept bids by mall, email, voice, or telephone, unless otherwise explicitly stated in writing by the State.

Pages may be consecutively numbered for the entire solicitation response or may be numbered consecutively within sections. Figures and tables should be numbered and referenced in the text by that number. They should be placed as close as possible to the referencing text.

Page3

I. TECHNICAL SPECIFICATION: INVENTORY AND DELIVERY REQUIREMENTS

YES/ NO NO & PROVIDE

ALTERNATIVE

a. Vendors must always maintain one (1) months" worth of khaki twill material within their warehouse. This is approximately 2000 yards.

I Nt- C\_(,t...-

b. Vendor to provide Warehouse address:

Vendor Name:

Cvrr.Ji;�df Physical Address:

I -h 1-rJ. s � lJ,r�I<• City, State and zip code:

C. The bidder will comply with all requirements of Terms and Conditions including Section, II, V. Delivery ARO

d. Alternatives to inventory levels of twill fabric may be a factor in award determination.

II

e. Vendor shall provide a monthly inventory report and submit to the following email address: csi.purchasing@nebraska.gov.

f. Inventory levels of twill fabric will be a key factor in the selection process. Should the proposal include different inventory levels, these variations will be taken into consideration.

NOTES/COMMENTS:

SPB Form 17 / ITB Template I Effective 07192024

CONTRACTUAL AGREEMENT FORM

f11DDFR Ml IS l c~oMPI l::Tf fHf:: Fnu OWING

By signing this Contractual Agreement Form, the bidder guarantees compliance with the provisions stated in this solicitation and agrees to the terms and conditions unless otherwise indicated in writing and certifies that bidder is not owned by the Chinese Communist Party.

Per Nebraska's Transparency in Government Procurement Act, Neb. Rev Stat§ 73-603, DAS is required to collect statistical information regarding the number of contracts awarded to Nebraska Vendors. This information is for statistical purposes only and will not be considered for contract award purposes.

__ NEBRASKA VENDOR AFFIDAVIT: Bidder hereby attests that bidder is a Nebraska Vendor.

"Nebraska Vendor" shall mean any bidder who has maintained a bona fide place of business and at least one employee within this state for at least the six (6) months immediately preceding the posting date of this Solicitation. All vendors who are not a Nebraska Vendor are considered Foreign Vendors under Neb. Rev Stat§ 73-603 (c).

__ I hereby certify that I am a Resident disabled veteran or business located in a designated enterprise zone in accordance with Neb. Rev. Stat.§ 73-107 and wish to have preference, if applicable, considered in the award of this contract.

__ I hereby certify that I am a blind person licensed by the Commission for the Blind & Visually Impaired in accordance with Neb. Rev. Stat. § 71-8611 and wish to have preference considered in the award of this contract.

FORM MUST BE SIGNED MANUALLY IN INK OR BY DOCUSIGN

BIDDER:

COMPLETE ADDRESS:

TELEPHONE NUMBER:

FAX NUMBER:

EMAIL ADDRESS:

DATE:

SIGNATURE:

TYPED NAME & TITLE OF

SIGNER: