COUNTY OF MADISON,

VIRGINIA

Invitation for Bids

Madison County Sheriff’s Office

Mobile Command Unit

Issue Date: June 8, 2026 Questions Due By: June 15, 2026

Question Responses By: June 22, 2026 Due Date and Time: July 6, 2026, at 2:00 PM

Anticipated Interview Date: July 15, 2026 Anticipated Award Decision Date: July 21, 2026

Anticipated Implementation Date: November 1, IFB #: 260ΣΜΥ

Issuing Agency: Madison County

Procurement Contact:

Brian Gordon; Deputy County Administrator

414 N. Main Street Madison, VA 22727

Phone: (540) 948-7500 Email: bgordon@madisonco.virginia.gov

Bids may be submitted to the above address or via electronic submission through EVA

Questions shall be submitted to Brian Gordon electronically via email; a list will be complied with answers and the circulated as an addendum in EVA.

IFB 20260608 is a request for an electronic sealed bid; therefore, bids submitted outside of the eVA system, such as via e-mail, mail, fax or hand delivery WILL NOT be accepted.

Electronic sealed bids will be received until the closing date and time provided in the solicitation.

Prior to the due date, Bidders should:

• Check the status of the solicitation on eVA at www.eva.virginia.gov by clicking on

Business Opportunities and then click on Virginia Business Opportunities (VBO) for any updates, changes, amendments, cancellations, etc.;

• Check the Solicitation in VBO for all attachments and documents to be completed and submitted; and

• Complete all attachments, amendments, exhibits, product information, etc. and attach electronically to the Bidder’s electronic submission.

Bidders are solely responsible for reviewing, complying, and returning a complete and responsive bid. Failure to submit any of the required information may result in the bid being deemed non-responsive. Changes to the solicitation’s forms or formats are prohibited except where clearly instructed and permitted.

Bid Submission:

Electronic bid submission with required documents attached is required. Bidders must be registered in eVA in order to submit an electronic bid. Bidders must submit one (1) complete copy of the bid and all required documents and/or attachments.

The following are instructions for submitting an electronic bid:

a. Go to www.eva.virginia.gov;

b. Click on “I Sell To Virginia”;

c. Click on “eVA Supplier Training”; and

d. Click on “Viewing and Responding to Solicitations Video”.

Note: Bidders need to ensure that they submit their electronic response to the latest version of the solicitation.

If a Bidder needs assistance submitting an electronic response, the Bidder must contact eVA Customer Care at 866-289-7367 or email eVACustomerCare@dgs.virginia.gov.

http://www.eva.virginia.gov/ http://www.eva.virginia.gov/ mailto:eVACustomerCare@dgs.virginia.gov

Invitation for Bids (IFB)

Medium-Duty 4x4 Vehicle Chassis with Integrated Mobile Operations Build

1. Introduction and Instructions Madison County is soliciting proposals for a medium-duty mobile operations vehicle. The vehicle is grant funded and we anticipate the funds being available November 1, 2026. All bids must be submitted with appendices A, B, and F-(1-8), failure to submit all documents may result in a deemed incomplete submission at the sole discretion of Madison County.

2. Required Specifications (Minimum)

Chassis & Powertrain

• Chevrolet 6500 or equivalent

• Two axles

• 4x4 drivetrain

• Diesel engine

Technology & Power

• Starlink power connection ports and direct network connection ports

• Half serer rack with CAT6 to 10 jacks; minimum 12U - Itemized bid option

• 20 power receptacles - Itemized bid option

• Shore power + battery conditioning

• 6–8kW generator with the exterior power receptacles

Communications

• Two APX8500 radio locations, radios to be supplied by customer

• Antenna + wiring channels (antenna to be supplied by customer)

• Smart board connections (interior/exterior)

Interior

• Desktop workspace

• Storage for tables/chairs

Exterior

• 360-degree camera system, provided as an option

• Awning

• USB-A and USB-C charging (both sides) - Itemized bid option

• Lettering and striping to be designed by the vendor and approved by the customer

Lighting

• Emergency lighting

• 360° scene lighting

• No light tower

3. General Terms and Conditions - See Appendix A

4. Submission Requirements

• Technical proposal

• Pricing

• Timeline

• Warranty

• Exceptions

5. Evaluation Criteria

• Compliance - The extent to which the offeror meets standards provided in the required specifications

- 10% Weight

• Cost - Total cost of the project- 25% Weight

• Delivery and Training - Extent to which the offeror plant to deliver the vehicle and provide training to County personnel- 15% Weight

• Experience - The experience of the offeror in building the desired vehicle - 25% Weight

• Support - Extent to which the offeror will support the Madison County Team - 25% Weight

Appendix A: General Terms and Conditions for Non-Professional Services Contracts

A. APPLICABLE LAW AND COURTS: This solicitation and any resulting contract shall be governed in all respects by the laws of the Commonwealth of Virginia and any litigation with respect thereto shall be brought in the Madison County courts. The contractor shall comply with all applicable federal, state and local laws, rules and regulations. This solicitation is also governed by provisions of County ordinances on procurement and any revisions thereto, as well as procurement policies, which are hereby incorporated into this contract by reference.

B. ANTI-DISCRIMINATION: By submitting their (bids/proposals), (bidders/offerors) certify to the County that they will conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of 1975, as amended, where applicable, the Virginians With Disabilities Act, the Americans With Disabilities Act and § 2.2-4311 of the Virginia Public Procurement Act. If the award is made to a faith-based organization, the organization shall not discriminate against any recipient of goods, services, or disbursements made pursuant to the contract on the basis of the recipient's religion, religious belief, refusal to participate in a religious practice, or on the basis of race, age, color, gender or national origin and shall be subject to the same rules as other organizations that contract with public bodies to account for the use of the funds provided; however, if the faith-based organization segregates public funds into separate accounts, only the accounts and programs funded with public funds shall be subject to audit by the public body. (Code of Virginia, § 2.2-4343.1E). In every contract over $10,000 the provisions in 1. and 2.

below apply:

1. During the performance of this contract, the contractor agrees as follows:

a. The contractor will not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to discrimination in employment, except where there is a bona fide occupational qualification reasonably necessary to the normal operation of the contractor. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

b. The contractor, in all solicitations or advertisements for employees placed by or on behalf of the contractor, will state that such contractor is an equal opportunity employer.

c. Notices, advertisements and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting these requirements.

2. The contractor will include the provisions of 1. above in every subcontract or purchase order over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

Appendix A - Page 1 of 7

C. ETHICS IN PUBLIC CONTRACTING: By submitting their (bids/proposals), (bidders/offerors) certify that their (bids/proposals) are made without collusion or fraud and that they have not offered or received any kickbacks or inducements from any other (bidder/offeror), supplier, manufacturer or subcontractor in connection with their (bid/proposal), and that they have not conferred on any public employee having official responsibility for this procurement transaction any payment, loan, subscription, advance, deposit of money, services or anything of more than nominal value, present or promised, unless consideration of substantially equal or greater value was exchanged.

D. IMMIGRATION REFORM AND CONTROL ACT OF 1986: By submitting their (bids/proposals), (bidders/offerors) certify that they do not and will not during the performance of this contract employ illegal alien workers or otherwise violate the provisions of the federal Immigration Reform and Control Act of 1986.

E. DEBARMENT STATUS: By submitting its proposal, the Offeror certifies that it is not currently debarred from submitting proposals or bids on contracts by any agency of the Commonwealth of Virginia.

F. ANTITRUST: By entering into a contract, the contractor conveys, sells, assigns, and transfers to the County all rights, title and interest in and to all causes of action it may now have or hereafter acquire under the antitrust laws of the United States and the Commonwealth of Virginia, relating to the particular goods or services purchased or acquired by the County under said contract.

G. MANDATORY USE OF COUNTY FORM AND TERMS AND CONDITIONS

FOR IFBs AND RFPs:

1. (For Invitation For Bids): Failure to submit a bid on the official County form provided for that purpose shall be a cause for rejection of the bid. Modification of or additions to any portion of the Invitation for Bids may be cause for rejection of the bid; however, the County reserves the right to decide, on a case by case basis, in its sole discretion, whether to reject such a bid as nonresponsive. As a precondition to its acceptance, the County may, in its sole discretion, request that the bidder withdraw or modify nonresponsive portions of a bid which do not affect quality, quantity, price, or delivery. No modification of or addition to the provisions of the contract shall be effective unless reduced to writing and signed by the parties.

2. (For Request For Proposals): Failure to submit a proposal on the official County form provided for that purpose may be a cause for rejection of the proposal. Modification of or additions to the General Terms and Conditions of the solicitation may be cause for rejection of the proposal; however, the County reserves the right to decide, on a case by case basis, in its sole discretion, whether to reject such a proposal.

H. CLARIFICATION OF TERMS: If any prospective (bidder/offeror) has questions about the specifications or other solicitation documents, the prospective (bidder/offeror) should contact the procurement agent no later than five working days before the due date. Any revisions to the solicitation will be made only by addendum issued by the County.

Appendix A - Page 2 of 7

I. PAYMENT:

1. To Prime Contractor:

a. Invoices for items ordered, delivered and accepted shall be submitted by the contractor directly to the payment address shown on the purchase order/contract. All invoices shall show the County contract number and/or purchase order number.

b. Any payment terms requiring payment in less than 30 days will be regarded as requiring payment 30 days after invoice or delivery, whichever occurs last. This shall not affect offers of discounts for payment in less than 30 days, however.

c. All goods or services provided under this contract or purchase order, that are to be paid for with public funds, shall be billed by the contractor at the contract price, regardless of which County department is being billed.

d. The following shall be deemed to be the date of payment: the date of postmark in all cases where payment is made by mail, or the date of offset when offset proceedings have been instituted as authorized under the Virginia Debt Collection Act.

e. Unreasonable Charges. Under certain emergency procurements and for most time and material purchases, final job costs cannot be accurately determined at the time orders are placed. In such cases, contractors should be put on notice that final payment in full is contingent on a determination of reasonableness with respect to all invoiced charges. Charges which appear to be unreasonable will be researched and challenged, and that portion of the invoice held in abeyance until a settlement can be reached. Upon determining that invoiced charges are not reasonable, the County shall promptly notify the contractor, in writing, as to those charges which it considers unreasonable and the basis for the determination. A contractor may not institute legal action unless a settlement cannot be reached within thirty (30) days of notification. The provisions of this section do not relieve a department of its prompt payment obligations with respect to those charges which are not in dispute (Code of Virginia, § 2.2-4363).

2. To Subcontractors:

a. A contractor awarded a contract under this solicitation is hereby obligated:

1. To pay the subcontractor(s) within seven (7) days of the contractor's receipt of payment from the County for the proportionate share of the payment received for work performed by the subcontractor(s) under the contract;

or

2. To notify the department and the subcontractor(s), in writing, of the contractor's intention to withhold payment and the reason.

Appendix A - Page 3 of 7

b. The contractor is obligated to pay the subcontractor(s) interest at the rate of one percent per month (unless otherwise provided under the terms of the contract) on all amounts owed by the contractor that remain unpaid seven (7) days following receipt of payment from the County, except for amounts withheld as stated in (2) above. The date of mailing of any payment by U. S. Mail is deemed to be payment to the addressee. These provisions apply to each sub-tier contractor performing under the primary contract. A contractor's obligation to pay an interest charge to a subcontractor may not be construed to be an obligation of the County.

J. PRECEDENCE OF TERMS: Paragraphs A-J of these General Terms and Conditions shall apply in all instances. In the event there is a conflict between any of the other General Terms and Conditions and any Special Terms and Conditions in this solicitation, the Special Terms and Conditions shall apply.

K. QUALIFICATIONS OF (BIDDERS/OFFERORS: The County may make such reasonable investigations as deemed proper and necessary to determine the ability of the (bidder/offeror) to perform the services/furnish the goods and the (bidder/offeror) shall furnish to the County all such information and data for this purpose as may be requested. The County reserves the right to inspect (bidder's/offeror's) physical facilities prior to award to satisfy questions regarding the (bidder's/offeror's) capabilities. The County further reserves the right to reject any (bid/proposal) if the evidence submitted by, or investigations of, such (bidder/offeror) fails to satisfy the County that such (bidder/offeror) is properly qualified to carry out the obligations of the contract and to provide the services and/or furnish the goods contemplated therein.

L. TESTING AND INSPECTION: The County reserves the right to conduct any test/inspection it may deem advisable to assure goods and services conform to the specifications.

M. ASSIGNMENT OF CONTRACT: A contract shall not be assignable by the contractor in whole or in part without the written consent of the County.

N. CHANGES TO THE CONTRACT: Changes can be made to the contract in any of the following ways:

1. The parties may agree in writing to modify the scope of the contract.

An increase or decrease in the price of the contract resulting from such modification shall be agreed to by the parties as a part of their written agreement to modify the scope of the contract.

2. The County Administrator may order changes within the general scope of the contract at any time by written notice to the contractor.

Changes within the scope of the contract include, but are not limited to, things such as services to be performed, the method of packing or shipment, and the place of delivery or installation. The contractor shall comply with the notice upon receipt. The contractor shall be compensated for any additional costs incurred as the result of such order and shall give the County a credit for any savings. Said compensation shall be determined by one of the following methods:

a. By mutual agreement between the parties in writing; or

Appendix A - Page 4 of 7

b. By agreeing upon a unit price or using a unit price set forth in the contract, if the work to be done can be expressed in units, and the contractor accounts for the number of units of work performed, subject to Madison County's right to audit the contractor's records and/or to determine the correct number of units independently; or

c. By ordering the contractor to proceed with the work and keep a record of all costs incurred and savings realized. A markup for overhead and profit may be allowed if provided by the contract.

The same markup shall be used for determining a decrease in price as the result of savings realized. The contractor shall present the County with all vouchers and records of expenses incurred and savings realized. The County shall have the right to audit the records of the contractor as it deems necessary to determine costs or savings. Any claim for an adjustment in price under this provision must be asserted by written notice to the County within thirty (30) days from the date of receipt of the written order from the County. If the parties fail to agree on an amount of adjustment, the question of an increase or decrease in the contract price or time for performance shall be resolved in accordance with the procedures for resolving disputes provided by the Disputes Clause of this contract or, if there is none, in accordance with the disputes provisions of the Commonwealth of Virginia Vendors Manual. Neither the existence of a claim nor a dispute resolution process, litigation or any other provision of this contract shall excuse the contractor from promptly complying with the changes ordered by the County or with the performance of the contract generally.

O. DEFAULT: In case of failure to deliver goods or services in accordance with the contract terms and conditions, the County, after due oral or written notice, may procure them from other sources and hold the contractor responsible for any resulting additional purchase and administrative costs.

This remedy shall be in addition to any other remedies which the County may have.

P. TAXES: The County reserves the right to conduct any test/inspection it may deem advisable to assure goods and services conform to contract specifications.

Q. USE OF BRAND NAMES: Unless otherwise provided in this solicitation, the name of a certain brand, make or manufacturer does not restrict (bidders/offerors) to the specific brand, make or manufacturer named, but conveys the general style, type, character, and quality of the article desired.

Any article which the County, in its sole discretion, determines to be the equal of that specified, considering quality, workmanship, economy of operation, and suitability for the purpose intended, shall be accepted. The (bidder/offeror) is responsible to clearly and specifically identify the product being offered and to provide sufficient descriptive literature, catalog cuts and technical detail to enable the County to determine if the product offered meets the requirements of the solicitation. This is required even if offering the exact brand, make or manufacturer specified. Normally in competitive sealed bidding only the information furnished with the bid will be considered in the

Appendix A - Page 5 of 7 evaluation. Failure to furnish adequate data for evaluation purposes may result in declaring a bid nonresponsive. Unless the (bidder/offeror) clearly indicates in its (bid/proposal) that the product offered is an equal product, such (bid/proposal) will be considered to offer the brand name product referenced in the solicitation.

R. TRANSPORTATION AND PACKAGING: By submitting their (bids/proposals), all (bidders/offerors) certify and warrant that the price offered for FOB destination includes only the actual freight rate costs at the lowest and best rate and is based upon the actual weight of the goods to be shipped. Except as otherwise specified herein, standard commercial packaging, packing and shipping containers shall be used. All shipping containers shall be legibly marked or labeled on the outside with purchase order number, commodity description, and quantity.

S. INSURANCE: By signing and submitting a bid or proposal under this solicitation, the bidder or offeror certifies that if awarded the contract, it will have the following insurance coverages at the time the contract is awarded.

For construction contracts, if any subcontractors are involved, the subcontractor will have workers' compensation insurance in accordance with §§ 2.2-4332 and 65.2-800 et seq. of the Code of Virginia. The bidder or offeror further certifies that the contractor and any subcontractors will maintain these insurance coverages during the entire term of the contract and that all insurance coverages will be provided by insurance companies authorized to sell insurance in Virginia by the Virginia State Corporation Commission.

INSURANCE COVERAGES AND LIMITS REQUIRED:

1. Workers' Compensation - Statutory requirements and benefits.

2. Employer's Liability - $100,000.

3. Commercial General Liability - $500,000 combined single limit.

Commercial General Liability is to include Premises/Operations Liability, Products and Completed Operations Coverage, and Independent Contractor's Liability or Owner's and Contractor's Protective Liability. The County must be named as an additional insured when requiring a Contractor to obtain Commercial General Liability coverage.

4. Automobile Liability - $500,000 - Combined single limit. (Only used if motor vehicle is to be used in the contract.)

T. ANNOUNCEMENT OF AWARD: Upon the award or the announcement of the decision to award a contract over $10,000, as a result of this solicitation, the County may publicly post such notice on the County's website for a minimum of 10 days.

U. DRUG-FREE WORKPLACE: During the performance of this contract, the contractor agrees to (i) provide a drug-free workplace for the contractor's employees; (ii) post in conspicuous places, available to employees and applicants for employment, a statement notifying employees that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violations of such prohibition; (iii) state in all solicitations or advertisements for

Appendix A - Page 6 of 7 employees placed by or on behalf of the contractor that the contractor maintains a drug-free workplace; and (iv) include the provisions of the foregoing clauses in every subcontract or purchase order of over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

For the purposes of this section, "drug-free workplace" means a site for the performance of work done in connection with a specific contract awarded to a contractor, the employees of whom are prohibited from engaging in the unlawful manufacture, sale, distribution, dispensation, possession or use of any controlled substance or marijuana during the performance of the contract. (Code of Virginia, § 2.2-4312)

V. NONDISCRIMINATION OF CONTRACTORS: A bidder, offeror, or contractor shall not be discriminated against in the solicitation or award of this contract because of race, religion, color, sex, national origin, age, or disability, or against faith-based organizations. If the award of this contract is made to a faith-based organization and an individual, who applies for or receives goods, services, or disbursements provided pursuant to this contract objects to the religious character of the faith-based organization from which the individual receives or would receive the goods, services, or disbursements, the County shall offer the individual, within a reasonable period of time after the date of his objection, access to equivalent goods, services, or disbursements from an alternative provider.

Appendix A - Page 7 of 7

Appendix B: Proposal Cover Sheet

County of Madison Virginia IFB 260608

Madison County Sheriff’s Office Mobile Command Post

Issue Date: June 8, 2026

Due Date & Time: July 6, 2026, at 2:00 PM

(COMPLETE THIS SHEET AND RETURN AS A COVER PAGE FOR THE PROPOSAL)

GENERAL INFORMATION FORM

QUESTIONS: All inquiries for information regarding this solicitation should be directed to Brian J. Gordon at bgordon@madisonco.virginia.gov at least seven days before the deadline. Answers will be posted to all offers via email from Brian Gordon.

ADDRESS: Proposals should be mailed, or hand delivered to: Brian Gordon; Madison County; 414 N. Main Street / P.O. Box 705;

Madison VA 22727. Reference the Due Date and Hour and RFP number in the lower left corner of the return envelope or package.

COMPANY INFORMATION/SIGNATURE: In compliance with the Request For Proposals and to all conditions imposed herein and hereby incorporated by reference, the undersigned offers and agrees to furnish the services and goods in accordance with the attached signed proposal or as mutually agreed upon by subsequent negotiation.

FULL LEGAL NAME FEDERAL TAXPAYER NUMBER (ID#)

NAME AND LOCATION OF LOCAL OFFICE MAILING ADDRESS CORPORATE HOME OFFICE ADDRESS

CONTACT NAME/TITLE SIGNATURE (INK) DATE

TELEPHONE NUMBER EMAIL ADDRESS TOLL FREE NUMBER

References:

Organization: _________________________Contact Name/Phone #: _____________________Scope of Work: _____________

Organization: _________________________Contact Name/Phone #: _____________________Scope of Work: _____________

Organization: _________________________Contact Name/Phone #: _____________________Scope of Work: _____________

Organization: _________________________Contact Name/Phone #: _____________________Scope of Work: _____________

Nondiscrimination and Drug Fee Statement

(THIS COMPLETED DOCUMENT MUST ACCOMPANY BID)

F-1

CERTIFICATION OF NONDISCRIMINATION AND DRUG-FREE WORKPLACE

By submitting their bids, all bidders certify to Madison County, Virginia, in that they will conform to the provisions of the Federal Civil Rights Act of 1964, as amended, as well as the Virginia Fair Employment Contracting Act of

1975, as amended, where applicable, the Virginian’s with Disabilities Act, and the Americans with Disabilities Act.

In every contract over $10,000, the provisions below apply:

1.1. During the performance of this contract, the contractor agrees as follows:

a. The contractor will not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to discrimination in employment, except where there is bona fide occupational qualification reasonably necessary to the normal operation of the contractor. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

b. The contractor, in all solicitations or advertisements for employees placed by or on behalf of the contractor, will state that such contractor is an equal opportunity employer.

c. Notices, advertisements and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting the requirements of this section.

1.2. The contractor will include the provisions of the foregoing paragraphs a, b, and c in every subcontract or purchase order of over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

1.3. During the performance of this contract, the contractor agrees to (I) provide a drug-free workplace for the contractor’s employees; (ii) post in conspicuous places, available to employees and applicants for employment, a statement notifying employees that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the contractor’s workplace and specifying the actions that will be taken against employees for violations of such prohibition; (iii) state in all solicitations or advertisements for employees placed by or on behalf of the contractor that the contractor maintains a drug-free workplace; and (iv) include the provisions of the foregoing clauses in every subcontract or purchase order of over $10,000, so that the provisions will be binding upon each subcontractor or vendor.

For the purposes of this section, “drug-free workplace” means a site for the performance of work done in connection with a specific contract awarded to a contractor in accordance with this chapter, the employees of whom are prohibited from engaging in the unlawful manufacture, sale, distribution, dispensation, possession or use of any controlled substance or marijuana during the performance of the contract.

Certified by: (Corporate Seal)

Date:

Subscribed and sworn to before me this day of , 20

NOTARY PUBLIC

MY COMMISSION EXPIRES , 20

END OF DOCUMENT

Equal Opportunity Statement

F-2

EQUAL OPPORTUNITY REPORT STATEMENT

The bidder shall complete the following statement by checking the appropriate blank as follows.

The bidder has has not participated in a previous contract subject to the non-discrimination clause prescribed by Executive Order 10925, dated March 6, 1961, or Executive Order

11114 dated June 22, 1963, and Executive Order 11246 dated September 24, 1965.

In conjunction with the goals established for this project for minority and women business enterprises, the bidder has solicited quotations for labor, material, and/or services from the following:

Name of Firm Person(s) Contacted Date

Of those listed above, we intend, at this time, to utilize the following in the completion of the work required by this contract:

“This firm assures that it will give its best efforts to utilize disadvantaged business enterprises wherever possible.”

Certified by: (Signature)

(Typed/Printed Name & Title)

Bidder’s Name:

IRS Number:

Anti-Collusion Statement

F-3

ANTI-COLLUSION STATEMENT

In the preparation and submission of this proposal on behalf of , we did not either directly or indirectly enter into any combination or arrangement with any person, firm or corporation, or enter into any agreement, participate in any collusion, or otherwise take any action in the restraint of free competition in violation of the Sherman Anti-Trust Act, 15 USC Sections 1 et seq; the

Virginia Antitrust Act, Virginia Code Sections 59.1-9.1 through 59.19.18, and the Conspiracy to Rig Bids to Government Statutes, Virginia Code Sections 59.1-68.6 through 59.1-68.8.

The undersigned Contractor hereby certifies that this agreement, or any claims resulting there from, is not the result of, or affected by, any act of collusion with, or any act of, another person or persons, firm or corporation engaged in the same line of business or commerce; and that no person acting for, or employed by, the Madison County, Virginia, has an interest in, or is concerned with, this proposal; and, that no person or persons, firm or corporation, other than the undersigned, have or are interested in this proposal.

Certified by: (Corporate Seal)

Acknowledged before me this day of , Notary Public

F-4

DOCUMENT 00 45 33 - NON-SEGREGATED FACILITIES AFFIDAVIT

Non-Segregated Facilities Affidavit

NON-SEGREGATED FACILITIES AFFIDAVIT

This is to certify that all facilities which are the responsibility of this person/firm/corporation are non-segregated facilities.

Name of Official

Title

Signature/Date

Firm or Corporation

Compliance Statement

F-5

COMPLIANCE STATEMENT

Consistent with Code of Virginia Section 2.-4311, the contract is or shall be authorized to transact business in the Commonwealth as a domestic or foreign business entity if so required by Title 13.1 or

Title 50 or as otherwise required by law.

State Corporation Number:

Immigration Statement

F-6

IMMIGRATION STATEMENT

Consistent with Code of Virginia Sec 2.2-4311.1, the contractor does not, and shall not during the performance of the contract for goods and services in the Commonwealth, knowingly employ an unauthorized alien as defined in the federal Immigration Reform and Control Act of 1986.

Faith-Based Non-Discrimination Statement

F-7

FAITH-BASED NON-DISCRIMIANTION STATEMENT

Consistent with Code of Virginia, Sec 2.2-4343.1, Madison County does not discriminate against faith-based organizations on the basis of the organization's religious character or (ii) impose conditions that (a) restrict the religious character of the faith-based organization, except as provided in subsection F of 2.2-

4343.1, or (b) impair, diminish, or discourage the exercise of religious freedom by the recipients of such goods, services, or disbursements.

F-8

Contractor Bid Qualification Statement

CONTRACTOR BID QUALIFICATION CERTIFICATION

This is to certify that this person/firm/corporation has not been barred from bidding on contracts by any agency of the Commonwealth of Virginia, nor is this person/firm/corporation a part of any firm/corporation that has been barred from bidding on contracts by any agency of the

Commonwealth of Virginia. This is also to certify that no subcontractors or suppliers intended for use on this project by this person/firm/corporation have been barred from bidding on contracts by any agency of the Commonwealth of Virginia.

Name of Official

Title

Signature/Date

Firm or Corporation

IFB 20260608 .pdf