ESBD_368508_1721247712873_2024 RE-ENROLLMENT SUPPORT SYSTEM.pdf

RFP-2024 RE-ENROLLMENT SUPPORT SYSTEM

ANGELINA COLLEGE

REQUEST FOR PROPOSAL

FOR

RE-ENROLLMENT SUPPORT SYSTEM

DUE: AUGUST 13, 2024 10:00 AM

INDEX

KEY DATES AND MEETINGS 1

GENERAL INFORMATION 2

COMPANY PROFILE 3

INSTRUCTIONS TO PROPOSERS 4

PROPOSAL SIGNATURE FORM 6

REFERENCE FORM 7

INVITATION TO BID 8

REQUIREMENTS/SPECIFICATIONS 9

COMPLIANCE AFFIDAVIT 12

FELONY CONVICTION NOTICE 13

CONFLICT OF INTEREST QUESTIONNAIRE 14

W-9 16

DEVIATIONS/SIGNATURE 17

HOLD HARMLESS AGREEMENT 18

AFFIDAVIT OF NON-COLLUSION, NON-CONFLICT OF INTEREST, ANTI-

LOBBYING 19

NON-DISCRIMINATORY EMPLOYMENT SUSPENSION AND DEBARMENT

CERTIFICATION 20

ANGELINA COLLEGE PURCHASING DEPARTMENT CHAPTER 2252

CERTIFICATION 21

PROHIBITION ON CONTRACTS WITH COMPANIES BOYCOTTING ISRAEL 22

KEY DATES

SUBMISSION DEADLINE

AND PUBLIC OPENING: AUGUST 13, 2024 10:00 AM

PUBLIC OPENING LOCATION: Angelina College Student Center Conference Room-209 3500 S First Street Lufkin, Texas 75902

DELIVERY LOCATION: Business Office: Purchasing

2024 RE-ENROLLMENT SUPPORT SYSTEM

RFP Open AUGUST 13, 2024 10:00 AM Angelina College

PROJECT NAME: RE-ENROLLMENT SUPPORT SYSTEM

GENERAL INFORMATION

Angelina College (the "College") is a two-year community College serving Angelina County of Texas.

This request for proposal (“RFP”) is to provide proposals for a Temporary Personnel Services for Angelina College.

The College is an equal opportunity employer and does not discriminate in awarding of contracts or employment of persons because of their race, color, age, national origin, religion, sex, disability, sexual orientation, or any other characteristic protected by law. The College requires companies with which it conducts business to be equal opportunity employers and comply with all applicable federal, state and local laws and regulations regarding contracting and employment practices.

The objective of this RFP is for all companies to base their Proposals on the same criteria. Unless specifically requested otherwise herein, Proposals based on criteria other than as listed in this RFP are not to be submitted and will not be considered.

THE COLLEGE RESERVES THE RIGHT TO ACCEPT OR REJECT ANY OR ALL PROPOSALS OR PARTS

THEREOF, WAIVE TECHNICALITIES AND NEGOTIATE AND AWARD A CONTRACT TO BEST SERVE THE

INTERESTS OF THE COLLEGE.

DEFINITION OF TERMS

(a) The College refers to Angelina College, a political subdivision of the State of Texas.

(b) Proposer or Company refers to a company, which chooses to submit a Proposal to provide equipment or service to the College.

(c) College or Site may mean any or all of the College’s campuses or other facilities located within the boundaries of Angelina County of Texas

(d) Contractor or Vendor refers to the company awarded the contract to provide services as specified in this proposal.

(e) Proposal Documents refer collectively to this RFP and all addenda, Proposer’s Proposal, and the like attached hereto or incorporated herein as if attached hereto.

(f) Service refers to the services to be provided by the Contractor.

ALL QUESTIONS RELATED TO THIS PROPOSAL ARE TO BE DIRECTED TO

KRISTA BROWN AT 936.639.1301 OR VIA EMAIL KBROWN@ANGELINA.EDU

mailto:KBROWN@ANGELINA.EDU

COMPANY PROFILE

FULL LEGAL NAME OF COMPANY STREET ADDRESS CITY/STATE/ZIP

PROPOSAL REQUEST OR PURCHASE ORDER ADDRESS STREET ADDRESS CITY/STATE/ZIP

REMITTANCE ADDRESS STREET ADDRESS CITY/STATE/ZIP

OWNERS, PARTNERS OR PRINCIPAL OFFICERS TITLE TELEPHONE NUMBER

PRIMARY CONTACT PERSON TITLE TELEPHONE NUMBER FAX NUMBER

Email Address:

BUSINESS CLASSIFICATION

( ) SOLE PROPRIETORSHIP ( ) PARTNERSHIP ( ) CORPORATION

YEAR ESTABLISHED/INCORPORATED

TYPE OF BUSINESS (CHECK ALL THAT APPLY)

( ) RETAIL ( ) WHOLESALE ( ) SERVICE ( ) CONSTRUCTION ( ) MANUFACTURING ( ) FRANCHISE ( ) BROKER ( ) DISTRIBUTOR

FEDERAL TAX PAYER I.D. NUMBER

ANNUAL GROSS SALES

FOR LAST CALENDAR YEAR

TOTAL NUMBER OF

FULL-TIME EMPLOYEES

MAJOR CUSTOMER REFERENCES CITY/STATE CONTACT NAME & TITLE TELEPHONE NUMBER ANNUAL SALES AMOUNT

(WHO CAN ADDRESS YOUR PERFORMANCE)

ATTACH REFERENCES ON A SEPARATE SHEET

NAME OF PARENT COMPANY STREET ADDRESS OR P. O. BOX CITY/STATE/ZIP

MAJOR PRODUCTS OR SERVICES PROVIDED. (Product line sheets may be attached)

( ) YES ( ) NO TO THE BEST OF YOUR KNOWLEDGE, ARE ANY FULL OR PART TIME EMPLOYEES, OWNERS, OFFICERS, DIRECTORS, STOCKHOLDERS, SUBCONTRACTORS, OR MEMBERS OF THEIR

IMMEDIATE FAMILY, OF THIS COMPANY, ALSO A MEMBER OF THE COLLEGE’S BOARD OF TRUSTEES OR AN EMPLOYEE OF THE COLLEGE? IF YES, ATTACH DETAILS.

( ) YES ( ) NO COMPANY HAS WORKERS COMPENSATION, PERSONAL INJURY AND PROPERTY DAMAGE LIABILITY INSURANCE.

( ) YES ( ) NO HAVE THE OWNER(S) OR OPERATOR(S) OF THE BUSINESS ENTITY BEEN CONVICTED OF, OR CURRENTLY CHARGED WITH, A FELONY? IF YES, ATTACH A GENERAL DESCRIPTION OF

THE CONDUCT RESULTING IN THE CHARGE OR CONVICTION. THIS DOES NOT APPLY TO A PUBLICLY HELD CORPORATION.

( ) YES ( ) NO UPON REQUEST WILL YOU PROVIDE INFORMATION THAT SHOWS YOUR FINANCIAL AND OTHER RESOURCE CAPABILITIES?

( ) YES ( ) NO IS COMPANY CERTIFIED AS BEING A MINORITY OR WOMAN OWNED BUSINESS? IF YES, ATTACH A COPY OF YOUR CERTIFICATION

TO THE BEST OF MY KNOWLEDGE, I CERTIFY TO CISCO COLLEGE THAT THE INFORMATION ON THIS FORM IS TRUE AND ACCURATE.

SIGNATURE PRINTED NAME OFFICER TITLE DATE

NOTICE: The College is committed to equitable and competitive access to companies that can fulfill our requirements for products and services used in our business activities. However, submittal of this form to the College is not a guarantee that your company will be selected to participate in our business activities. Additional information may be required if your company is selected to provide goods or services.

(REV 1-29-14)

INSTRUCTIONS TO PROPOSERS

1. Sealed Proposals under the RFP referenced herein will be received by the College until the date and time shown on the sheet titled KEY DATES at which time they will be publicly opened.

2. ONE (1) ORIGINAL PLUS ONE (1) ELECTRONIC COPY (USB) OF THE PROPOSAL ARE TO BE

DELIVERED TO THE COLLEGE AT ONE LOCATION ONLY, AS FOLLOWS:

BUSINESS OFFICE-PURCHASING

RE-ENROLLMENT SUPPORT SYSTEM

Open AUGUST 13, 2024 10:00 AM Angelina College

3. Proposals, including all required data shall be delivered in a sealed envelope, which shall be properly identified with the Proposal number, project name, proposal due date with time, and the name and address of Proposer.

4. PROPOSALS WILL NOT BE ACCEPTED THAT ARE: NOT SIGNED; DELIVERED TO THE BUSINESS

OFFICE AFTER THE SPECIFIED DATE AND TIME; OR SUBMITTED VIA FACSIMILE

TRANSMISSION.

5. Proposers shall carefully examine the Proposal Documents and shall have become fully informed as to the nature of the Services to be provided and all other matters that may affect the cost and time of completion of the Services. If the Proposer finds that any portion of the RFP requires further information, Proposer must seek such information prior to submitting a Proposal. Failing to do so, Proposer must abide by the decision of the College, should the necessity for a decision arise after acceptance of the Proposal.

6. Any clarifications or interpretations will be given to all known Proposers in addendum form, and such addenda will be included as part of the Proposal Documents. Proposers shall acknowledge receipt of addenda in the spaces provided on the Proposal Form. Only written interpretations or corrections by means of an addendum shall be binding. No Proposer shall rely upon any information given by any other method.

7. Fee estimates for the services submitted on the Proposal shall be considered an irrevocable offer for a period of ninety days from the date of the Proposal opening and may not be withdrawn during that period without consent of the College due to grants funds for this project will be disbursed in sections.

8. Provide detailed information showing the projected costs for providing the Services. Please be specific about the various categories of work, the associated cost and proposed payment schedule. NOTE: THIS

PRICING INFORMATION IS TO BE INCLUDED WITH YOUR PROPOSAL IN A SEPARATE,

SEALED ENVELOPE. DO NOT INCLUDE ANY PRICING INFORMATION ELSEWHERE IN YOUR

PROPOSAL.

9. Each Proposal is to include a description of the types and amounts of insurance that the Proposer will provide.

10. If Proposer fails to submit a contract and provide the required insurance information within ten (10) calendar days after receipt of notice of an award, such failure may be construed by the College as abandonment of the Proposal, and the College may annul the award.

11. The Vendor shall not sell, assign, transfer or convey this contract, in whole or in part, without the prior written consent of the College.

12. The College may make such investigations and conduct interviews as may be deemed necessary to determine the ability of Proposer to provide satisfactory performance in accordance with Proposal documents, and Proposer shall furnish to the College, as designated, all such information and data for this purpose as the College may request. The College reserves the right to reject any Proposal if evidence submitted by a Proposer, or investigation of a Proposer’s qualifications, fails to satisfy the College that the Proposer is properly qualified to carry out the obligations of the contract and to complete the Services contemplated therein.

13. It shall be clearly understood that any costs incurred by the Proposer in responding to this RFP is at the

Proposer’s own expense as a cost of doing business and the College is not liable for reimbursement to the Proposer for any expense so incurred, regardless of whether or not the Proposal is accepted.

14. Neither the Proposer nor the selected Contractor shall offer, give, agree to give to any person, or solicit, demand, accept, or agree to accept from another person, a bribe, or unlawful gift, benefit, advantage, gratuity, payment or an offer of employment in connection with or arising from this RFP or subsequent contract.

15. All Proposers must disclose the name(s) of any of its employees, officers, directors, subcontractors, or agents who may also be a member of the Board of Trustees, or an employee or agent of the College. Further, all Proposers must disclose the name of any College employee, or Board of Trustees member, who has, directly or indirectly, any financial interests in the Proposer’s firm or any of its branches. Submit this information on an attachment to the Proposal Form which is to be titled "Disclosure of Interest" and include the person's name, position, and the extent of financial or other interest the person(s) has in Proposer’s business affairs.

16. Proposers are hereby notified that in accordance with Section 44.034 of the Texas Education Code, a person or business entity that enters into a contract with Angelina College must give advance notice to the College if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony. Furthermore, the College may terminate a contract with a person or business entity if the College determines that the person or business entity failed to give this notice or misrepresented the conduct resulting in the conviction. This requirement does not apply to a publicly held corporation.

PROPOSAL SIGNATURE FORM

PROPOSAL OF:

(Name of Company)

TO: BUSINESS OFFICE-PURCHASING

RE-ENROLLMENT SUPPORT SYSTEM

Open AUGUST 13, 2024 10:00 AM Angelina College 3500 S. First Street

PROJECT: RE-ENROLLMENT SUPPORT SYSTEM

The undersigned Proposer, having carefully examined the RFP documents and being familiar with all requirements and conditions affecting the Services to be provided hereby offers to provide the Services at the rates attached hereto, in strict conformance with the RFP documents.

AGREEMENT Proposer acknowledges that time is of the essence for this project and, if awarded the contract, Proposer agrees to enter into a written agreement with the College within ten (10) calendar days following receipt of the signature copies of the agreement from the College.

COLLEGE’S RIGHTS. Proposer understands and acknowledges the College’s right to accept or reject any or all Proposals or parts thereof, waive technicalities and negotiate and award a contract to best serve the interests of the College.

EXCEPTIONS: In submitting a Proposal, unless otherwise stipulated, Proposer affirms acceptance of the provisions and requirements of this RFP including the draft agreement. Any variances or exceptions, which Proposer wishes to note with respect to any of the provisions or requirements of this RFP, must be stated in an attachment to the Proposal Form and titled "Exceptions." Check one of the following as applicable:

NO EXCEPTIONS EXCEPTIONS ARE ATTACHED

PROPOSAL CERTIFICATION. The undersigned, on behalf of the Proposer, certifies that this Proposal is made without previous understanding, agreement or connection with any person or corporation making a Proposal on the same project, and is in all respects fair and without collusion, fraud or unlawful acts.

It is further certified that the person whose signature appears below is legally empowered to bind the company in whose name the Proposal is entered.

Submitted this day of , 2024 by and for the Company identified as follows:

Company:

Street Address:

City/State/Zip:

Signature:

Printed Name:

Officer Title:

Telephone #:

Facsimile #: Email Address ___________________

REFERENCES

PROPOSER MUST PROVIDE FIVE (5) CLIENT REFERENCES for which services of a comparable nature, scope and complexity have been completed by Proposer. References must be for services performed in the name of the company submitting the Proposal; work performed by Proposer’s employees, subcontractors or representatives while engaged by another company does not qualify as an acceptable reference. Projects for client references should have occurred within the last three (3) years.

The College seeks a competent, qualified and experienced Contractor and reference information is a critical factor in determining to whom the contract will be awarded. FAILURE TO PROVIDE ALL OF THE REQUESTED REFERENCE INFORMATION WITH YOUR PROPOSAL MAY RESULT IN THE DISQUALIFICATION OF YOUR PROPOSAL. The College is under no obligation to provide Proposers a second opportunity to provide references.

Proposer may submit its references on this sheet or on sheet prepared by the Proposer that has a like format.

Company Name

Contact Person

Telephone Number

Contract Value

Completion Date

INVITATION TO BID

JULY 12, 2024

Ladies and Gentlemen, You are invited to submit proposals on the services thereof shown on the attachment.

1.) Bids should quote prices delivered to Angelina College, 3500 South First Street in Lufkin, TX 75902.

2.) Bid list with specifications is attached hereto.

3.) Bids must be received by: 10:00 AM Lufkin, TX. time on TUESDAY, AUGUST 13, 2024

4.) Sealed bids should be addressed to Purchasing, Angelina College, 3500 South First Street, Lufkin, TX 75902-1768, in an opaque envelope marked “RE-ENROLLMENT SUPPORT SYTEM RFP, Open AUGUST 13, 2024 10:00 AM.) Angelina College reserves the right to reject any and/or all bids, to waive technicalities and/or informalities in the bid or bidding process, and to accept the bid deemed best.

6.) Angelina College expressly reserves the right to award the contract to other than the low bidder after consideration of other factors such as past experience, quality of product, etc. For best value to college.

7.) Anticipated delivery date(s) should be shown and the period of time for which the bid prices(s) is/are guaranteed should be indicated.

8.) Angelina College shall be the sole judge of equality of products when and “or equal” item is bid.

9.) Bids will be publicly opened and read at the time and on the date shown in number 3 as seen above.

Awards will be made as soon as possible after official bid opening.

10.) The attached affidavit must be completed, notarized, and returned with your bid or your bid will be disqualified.

Sincerely, Chris Sullivan Vice President of Business Affairs

Overview The information presented below has been gathered from Requests for Proposals (RFPs) issued by public institutions seeking services aimed at re-enrolling and supporting students who have discontinued their studies. Highlighted here are examples of Scope of Work descriptions and Technical Questions/Requirements.

This includes the most frequently asked thematic questions and a categorized list of sample questions. Please note that this summary does not cover RFP compliance, standard reference requests, terms and conditions, or timelines.

Scope of Work Description The college seeks a qualified, comprehensive vendor to provide services aimed at identifying, engaging, and supporting students who have discontinued their studies, helping them to re-enroll and successfully complete their education. This vendor should have a track record of re-enrolling recent stop-outs as well as effectively supporting learners who have been away from their studies for up to 25 years.

The vendor will offer a complete solution incorporating advanced technology, artificial intelligence, multi-channel marketing, personalized individual coaching, and data analytics. The supplier will utilize the most recent technology and data analysis techniques to create profiles of students who have discontinued their studies, and will use this information to tailor a multi-channel communication strategy at different levels. The supplier will personalize messages and their timing for each student, and will also update student contact information using data enrichment provided by the college.

The vendor plans to use predictive analytics tools and data to manage enrollment processes efficiently and improve re-enrollment rates. The model will consider a range of behaviors such as lifestyle choices, psychographic data, purchasing habits, and marketing channel preferences. This information will be crucial in forming a persona-based view of students who have left the college, as well as in developing affinity models and identifying, scoring, and targeting specific former students for outreach. Moreover, the college requires modern outreach methods, including email, digital media, geo-fencing, and mobile-optimized personalized recruitment, to boost student engagement. Personalized outbound marketing is deemed vital to maximize interest and engagement among all students who have stopped out.

The vendor aims to provide personalized coaching to identify and address challenges that could hinder students from re-enrolling. Their experienced coaches will receive training on the college's specific policies and procedures, working closely with college personnel to assist students. Additionally, the vendor must demonstrate successful engagements and favorable results in re-enrollment, student retention, and graduation rates. Moreover, they are expected to offer recommendations to enhance the overall student journey and promote ongoing enrollment.

Technical Requirements Requirements/Criteria:

1. Revenue Share Model: The cost for services will be determined using a revenue-sharing model. This approach aligns the vendor's interests with achieving successful outcomes, while also reducing the college’s upfront financial burden. The revenue share will be calculated based on net tuition and mandatory fees for students who are re-enrolled as of the census date. Provisions will be made for refunding the revenue share if students do not fully settle their student accounts by the end of the term.

2. Professional Coaching: Provide specialized professional coaching services to students to help them determine whether to resume their education.

3. Student Life Cycle Engagement: Ensure the ability to recognize, engage, involve, and support students who have paused their academic journey at various stages, from considering and applying to enrolling, registering, re-enrolling, and graduating.

4. Comprehensive Campaigns: Develop a strategic plan for integrated campaigns by incorporating both innovative and established messaging. Ensure that campaign strategies are smoothly coordinated across all media and response channels, such as geo-targeting, websites, emails, CTAs, and social media.

5. Compelling Messages: Develop impactful communication by harnessing data gathered from initial outreach and surveys. Tailor these messages to resonate with diverse target audiences across various platforms.

Additional requirements:

1. Mobile Optimization: Enhance communication for different mobile devices like smartphones, tablets, and laptops.

2. Data Security: The vendor is required to have a robust data security program that encompasses a secure file transfer protocol (SFTP) system. Kindly furnish details regarding the company's protocol.

Questions by Categories I. Background A. What is your previous experience in assisting students with re-enrollment and providing support to ensure their successful completion of higher education programs?

B. What your background in working with public colleges or universities, higher education systems, and government sectors in a collaborative capacity?

C. Provide data indicating the Proposer's successful engagements with institutions of a similar size to our own.

D. Provide the names and brief resumes of the specific individuals who will be responsible for the proposed work.

E. Outline your approach for acquainting yourself with our institution in order to provide informed advice and analysis on enhancing student engagement specifically for those who have taken a break from their studies.

A. What are the strengths of your company?

B. What sets your company apart in terms of the student re-engagement services it offers?

C. How do you gauge client success?

D. What is your main approach to communicating with your clients?

E. Provide an overview of your hiring approach.

I II. Company Information

III. Offering A. What is the profile of students that you work with?

B. How will the vendor use their platform to re-enroll students at scale versus what we can deploy ourselves?

C. Describe your firm’s ability and expertise in developing persona-based, personalized and targeted outreach to stopped out students.

D. Has the vendor established a methodology for recruiting, coaching, enrolling, and retaining stopped out students?

E. Does the vendor offer data enrichment services to update contact information for our outdated stop out list?

F. What communication channels are utilized to engage stop-outs?

G. What is the outreach and communication channels deployed to engage stop-outs?

H. How are predictive models employed to bolster our re-enrollment strategy? Provide a specific successful instance of using predictive modeling for re-enrollment efforts.

I. What ways will this partnership elevate re-enrollment metrics and persistence rates?

J. Explain the approach to one-on-one coaching and its alignment with the institution.

K. How does the vendor ensure continuous support for re-enrolled students until completion? Is support discontinued at the point of registration?

L. Can the vendor offer actionable insights and recommendations that will ignite impactful change in the student experience? Please share concrete examples

ANGELINA COUNTY JUNIOR COLLEGE DISTRICT COMPLIANCE AFFIDAVIT TEXAS FAMILY

CODE SECTION 14.52

The Texas State Legislature has added a provision to the Texas Family Code, Section 14.52, under which a child support obligor who is thirty (30) or more days’ delinquent in paying child support under a court order or written repayment agreement is not eligible to submit a bid or enter into a contract to provide property, materials, or services to the state. A sole proprietorship, partnership, corporation or other entity in which a sole proprietor, partner, majority shareholder, or an owner of 10% or more of another business entity is a delinquent obligor is thus ineligible to submit a bid to or enter into a contract with the State of Texas. ANY CORPORATION, THAT DOES NOT HAVE A MAJORITY SHAREHOLDER WHO IS A NATURAL PERSON CAPABLE OF BEING A CHILD SUPPORT OBLIGOR, AND GOVERNMENTAL ENTITIES ARE NOT SUBJECT TO SECTION 14.52 OF THE TEXAS FAMILY CODE. IF A

BIDDER IS SUCH A CORPORATION, PLEASE CHECK BELOW.

corporation without natural person-majority shareholder

To comply with Section 14.52, the Texas General Services Commission requires that this affidavit be signed by an authorized representative of the firm named below. THIS AFFIDAVIT MUST BE NOTARIZED AND RETURNED WITH EACH BID AND FAILURE TO DO SO WILL RESULT IN DISQUALIFICATION OF THE BID. Copies will be acceptable. Bidders may submit a copy of this notarized affidavit with each bid submitted for a bid opening date scheduled within thirty (30) calendar days of the notarization date. BIDDERS MUST ALSO SIGN THE INVITATION

TO BID FORM WHICH ACCOMPANIES THE AFFIDAVIT.

Affidavit

“I Am authorized to sign this bid on behalf of Name and Title

Name of Bidder which is a: sole proprietorship partnership corporation with natural person-majority shareholder other type of business entity: ___________________________________________

Identity entity type I certify that NO (Sole proprietor for sole proprietorship, partner for partnership, majority shareholder for a corporation, or 10% or more owner for other entity) is 30 days or more delinquent in child support payments required by court order or written repayment agreement.

Date Signature _______________________________

Title ________________________________

SWORN AND SUBSCRIBED before me the undersigned Notary Public on

20 . ________________________________________

Notary Public Signature

IF AFFIDAVIT IS COPIED OR FAXED, THE NOTARY SEAL MUST BE LEGIBLE TO BE CONSIDERED.

Special note: Failure to complete this affidavit and submit with the bid will result in disqualification of the bid.

FELONY CONVICTION NOTICE

State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection a), states “a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony.”

Subsection (b) states “a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract.” This notice is not required of a publicly-held corporation.

I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge.

Vendor’s Name: ________________________________________________________

Authorized Company Official’s Name (please print) ______________________________________________

A. My firm is a publicly-held corporation; therefore, this reporting requirement is not applicable:

Signature of Company Official: _____________________________Date: ___________

B. My firm is not owned or operated by anyone who has been convicted of a felony.

Signature of Company Official: _____________________________ Date: __________

C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony:

Name of Felon(s): _______________________________________________________

Details of Conviction(s)___________________________________________________

Signature of Company Official: _____________________________ Date: __________

Contractor is responsible for the performance of the persons, employees and/or subcontractors Contractor assigns to provide services for Angelina College pursuant to this contract on any and all Angelina College campuses or facilities. Contractor will not assign individuals to provide services at a Angelina College campus or facility who have a history of violent, unacceptable, or grossly negligent behavior or who have a felony conviction, without the prior written consent of the Angelina College Purchasing Department. If at any time during performance of this contract, there is a change in felony status of any persons, employees, and/or subcontractors providing services to the Angelina College, Contractor will immediately update the above form and provide such form to the Angelina College Business Office within five business days of becoming aware of the change in status.

Form provided by Texas Ethics Commission www.ethics.state.tx.usRevised 11/30/2015

CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ

For vendor doing business with local governmental entity

This questionnaire reflects changes made to the law by H.B. 23, 822nd Leg., Regular Session. This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as defined by Section 176.001 (1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).

By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.

A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a misdemeanor.

OFFICE USE ONLY

Date Received

Name of vendor who has a business relationship with local governmental entity.

Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)

3 Name of local government officer about whom the information is being disclosed.

Name of Officer

4 Describe each employment or other business relationship with the local government officer, or a family member of the officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary.

A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor?

B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity?

5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more.

6 Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).

Signature of vendor doing business with the governmental entity Date

Form provided by Texas Ethics Commissionwww.ethics.state.tx.us Revised 11/30/2015

CONFLICT OF INTEREST QUESTIONNAIRE

For vendor doing business with local governmental entity

A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/ Docs/LG/htm/LG. 176.htm. For easy reference, below are some of the sections cited on this form.

Local Government Code § 176.001 (1-a): "Business relationship" means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on:

(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an agency of a federal, state, or local governmental entity;

(B) a transaction conducted at a price and subject to terms available to the public; or

(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to, that agency.

Local Government Code § 176.003(a)(2)(A) and (B):

(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:

(2) the vendor:

(A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that

(i) a contract between the local governmental entity and vendor has been executed; or

(ii) the local governmental entity is considering entering into a contract with the vendor;

(B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than $100 in the 12-month period preceding the date the officer becomes aware that:

(i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor.

Local Government Code § 176.006(a) and (a-I)

(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and:

(1) has an employment or other business relationship with a local government officer of that local governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);

(2) has given a local government officer of that local governmental entity, or a family member of the officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any gift described by Section 176.003(a-1 ); or

(3) has a family relationship with a local government officer of that local governmental entity.

(a-I) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of:

(1) the date that the vendor:

(A) begins discussions or negotiations to enter into a contract with the local governmental entity;

or

(B) submits to the local governmental entity an application, response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity; or

(2) the date the vendor becomes aware:

(A) of an employment or other business relationship with a local government officer, or a family member of the officer, described by Subsection (a);

(B) that the vendor has given one or more gifts described by Subsection (a); or (C) of a family relationship with a local government officer.

Deviations/Signature Page

In the event the undersigned intends to deviate from the general terms, conditions, or specifications listed within this document, all such deviations must be listed on this page with complete and detailed conditions and information also being attached, if necessary. Angelina College will be the sole judge to determine if deviations are acceptable in meeting the needs of the college and participating members.

DEVIATIONS:

Our response is submitted according to:

___ NO DEVIATIONS: In the presence of any deviation entry on this form, the Vendor assures Angelina College of their compliance with the Terms, Conditions, Specifications, and information contained within this document.

___ DEVIATIONS LISTED ABOVE

Signature

Printed Name

Title

HOLD HARMLESS AGREEMENT

The Contractor shall defend, indemnify, and hold harmless, Angelina College and all of its trustees, officers, agents, and employees from and against all suits, actions, or claims of any character brought for or on account of any injuries or damages (including death) received or sustained by any person or property on account of, arising out of, or in connection with, any negligent act or omission of Contractor or any agent, employee, subcontractor, or supplier of Contractor in the execution or performance of the Contract.

The Contractor shall also defend, indemnify and hold harmless, Angelina College and all of its trustees, officers, agents, and employees, from and against claims by any subcontractor, supplier, laborer, materials, or mechanic for payment for work or materials provided on behalf of the Contractor in the performance of the Contract and all such claimants shall look solely to Contractor and not to Angelina College for satisfaction of such claims.

This Hold Harmless Agreement shall be binding upon the undersigned, and its successors, legal representatives, heirs and assigns.

Dated this ________ day of __________________, 20______

Signature of Authorized Official

STATE OF _______________________ COUNTY OF _________________________

This instrument was acknowledged before me on ________ by ___________________ (Date) (Name of Company Representative) as ____________________ for ____________________________ (Title of Representative) (Name of Entity/Company Represented)

____ Personally Known ____ Produced Identification

(Signature of Notary)

(Printed or Typed Name of Notary)

AFFIDAVIT OF NON-COLLUSION, NON-CONFLICT OF INTEREST, ANTI-LOBBYING

By submission of this response, the undersigned certifies that:

1. Neither the Respondent nor any of its officers, partner, owners, agents, representatives, employees, or parties in interest, has in any way colluded, conspired, or agreed, directly or indirectly with any person, firm, corporation or other Respondent or potential Respondent or given any money or other valuable consideration for assistance in procuring or attempting to procure a contract or fix the prices in the attached response or the response of any other Respondent, and further states that no such money or other reward will be hereinafter paid.

2. No attempt has been or will be made by this firm’s officers, employees, or agents to lobby, directly or indirectly, the District’s Board of Trustees between response submission date and award by the College’s Board of Trustees.

3. No officer, or stockholder of Respondent is a member of the staff, or related to any employee of Angelina College except as noted below:

4. The bidder or proposer has not offered, conferred, or agreed to confer any pecuniary benefit, as defined by Penal Code, Chapter 36, or any other thing of value, as consideration for the receipt of information or any special treatment or advantage relating to this bid or proposal;

5. The bidder or proposer has not offered, conferred, or agreed to confer any pecuniary benefit or other thing of value as consideration for the recipient’s decision, opinion, recommendation, vote, or other exercise of discretion concerning this bid or proposal;

6. The bidder or proposer has not violated any state, federal, or local law, regulation, or ordinance relating to bribery, improper influence, collusion, or the like, and that the bidder or proposer will not in the future offer, confer, or agree to confer any pecuniary benefit or other thing of value to any officer, Trustee, agent, or employee of Angelina College in return for the person’s having exercised official discretion, power, or duty with respect for this bid or proposal;

7. The bidder or proposer has not and will not in the future offer, confer, or agree to confer a pecuniary benefit or other thing of value to any officer, Trustee, agent, or employee of Angelina College in connection with information regarding this bid or proposal, the submission of this bid or proposal, the award of this bid or proposal, or the performance, delivery, or sale pursuant to this bid or proposal.

The undersigned certifies that he/she is fully informed regarding the accuracy of the statements contained in this certification, and that the penalties herein are applicable to the Respondent as well as to any person signing on its’ behalf.

Signature of Authorized Official ___________________________________________________

Printed Name _________________________________________________________________

Title _________________________________________________ Date __________________

AFFIDAVIT OF NON-DISCRIMINATORY EMPLOYMENT

This company, Contractor, or Subcontractor agrees to refrain from discrimination in terms and conditions of employment on the basis of race, color, religion, sex, national origin, or handicap and agrees to take affirmative action as required by Federal Statutes and rules and regulations issued pursuant thereto in order to maintain and insure non-discriminatory employment practices.

Signature

Printed Name & Title

Company Name

SUSPENSION AND DEBARMENT CERTIFICATION

Federal Law (A-102 Common Rule and OMB Circular A-110) prohibits non-federal entities from contracting with or making sub-awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Angelina College does not do business with parties that have been suspended or debarred. Firms receiving individual awards and all sub-recipients must certify that their organization and its principals are not suspended or debarred by a federal agency.

Before an award can be made to your firm, you must certify that your organization and its principals are not suspended or debarred by a federal agency.

I, the undersigned agent for the firm named below, certify that neither this firm nor its principals are suspended or debarred by a federal agency.

Name of Firm

Signature of Authorized Official

ANGELINA COLLEGE PURCHASING DEPARTMENT

CHAPTER 2252 CERTIFICATION

On this day, I ______________________________________________, the Purchasing Agent for Angelina College, pursuant to Texas Government Code, Chapter 2252, Section 2252.152 and Section 2252.153, certify that I did review the website of the Comptroller of the State of Texas concerning the listing of companies that is identified under Section 806.051, Section 807.051 or Section 2253.253 and I have ascertained that the below-named company is not contained on said listing of companies which do business with Iran, Sudan or any Foreign Terrorist Organization.

Company Name

RFP or PO number

CERTIFICATION CHECK PERFORMED BY:

PURCHASING AGENT

DATE

Prohibition On Contracts with Companies Boycotting Israel

Pursuant to Section 2270.002 of the Texas Government Code, Respondent certifies that either (i) it meets an exemption criterion under Section 2270.002; or (ii) it does not boycott Israel and will not boycott Israel during the term of the contract resulting from this solicitation. Respondent shall state any facts that make it exempt from the boycott certification in its Response.

Exemption criteria includes the following:

1. Company is a sole proprietorship;

2. Company employs less than 10 full-time employees;

3. Value of the contract is less than $100,000

“Boycott Israel” is defined to mean refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. “Company” is defined to mean a for-profit sole proprietorship, organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority-owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit.

I, , the

(Name of Certifying Official) (Title or Position of Certifying Official) of , (Name of Company) does hereby verify on behalf of said company to Angelina College that said company: (check one)

___ 1) does not Boycott Israel and will not Boycott Israel (as that term is defined in Texas Government Code

Section 808.001) during the term of this contract;

___ 2) Company is a sole proprietorship;

___ 3) Company employs less than 10 full-time employees;

___ 4) Value of the contract is less than $100,000

Signature of Certifying Official

Date of Certification

INSTRUCTIONS TO PROPOSERS