Exhibit_I_Proposers_Response_Form_Fillable.pdf

South County Area Collection RFP Exhibit I

EXHIBIT I:

COUNTY OF SACRAMENTO

RFP FOR SOUTH COUNTY AREA COLLECTION SERVICES

PROPOSERS RESPONSE FORM, p.1

SECTION 1: COMPANY INFORMATION

Please provide information about your company in this section.

Company Name

Address

City, ZIP

Phone

Contact Person

Title

E-mail address

Federal ID #

Year Organized

Number of employees

Other or former company names used and dates of operation:

PROPOSERS RESPONSE FORM, p. 2

SECTION 2: CORPORATE INFORMATION

Complete the sections below as applicable to your company.

Type of company Corporation Partnership

Individual Joint Venture Parent Company Name (if applicable)

Address

City, ZIP

Phone

State in which parent company is based:

Date of incorporation

Partnership Companies General Limited

Contact Information of Partners or Joint Venture Firms

REQUEST FOR PROPOSALS RESPONSE FORM, p.3

SECTION 3: COUNTY CONTRACT REQUIREMENT CHECKLIST

The purpose of this checklist is to determine Respondents’ ability and willingness to comply with the County Contract Requirements by checking the boxes below. Please refer to RFP attachment section 3.2.2 page 14 before completing this section.

General Liability Insurance Automobile Liability Insurance Worker’s Compensation Insurance

Employer’s Liability Insurance

Contractor’s Pollution Liability

Proposer’s Bond - See Vendor Submission Question 3.1

Performance Bond

Special Business License Exhibit H SBL#

SECTION 4: CHECKLIST OF SERVICES & EXPERIENCE

Please fill in the relevant boxes for the types of services provided by your company.

See RFP attachment page 15 Section 3.2.2

Service: Number of years:

Curbside Garbage Collection (cart based)

Curbside Recycling Collection (cart based)

Curbside Organics Collection (cart based)

Household Hazardous Waste (HHW) Collection

Used Oil, Oil Filters Collection & Recycling/Processing

White goods Collection Services

Bulky goods Collection Services

Other:

Describe Experience Here:

REQUEST FOR PROPOSALS RESPONSE FORM, p.4

SECTION 5: REFERENCES

Include references for both the submitting entity and any proposed subcontractors in this part of the Statement of Proposals.

Attach additional pages as necessary

A. Public Entity Contracts:

Public Entity Name Contact Name &

Phone Number Type of Service Provided

B. Private Entity Contracts:

Private Entity Name Contact Name &

Phone Number Type of Service Provided

C. Contract Default/Early Termination:

Please list all contract defaults and early terminations within the last 10 years beginning with the most recent.

Entity Name Contact Name & Phone Number Type of Service Provided Explanation

REQUEST FOR PROPOSALS RESPONSE FORM, p.5

SECTION 6: SERVICE FEE PROPOSAL

The undersigned, having examined the specifications and all conditions affecting the cost, hereby propose to furnish equipment, labor, transportation, disposal and materials necessary for the completion of the specified contract.

Example Formula for calculating Contractor service fee:

Current County curbside rate effective FY24: $39.41 (60 gallon cart) Less County Administrative Fee: - 1.84

$37.57 Less service fee: -10% (proposed below by respondent) Final price for 60 gallon cart: $33.81 per household

Service Cost 1: Service Fee without cost of new carts purchased and deployed.

Contractor shall be liable for all costs associated with collection, transportation, hauling, tipping, disposal, and any and all other costs as detailed in the RFP. Fee for collection services includes all garbage, organics, recycling materials, bulky waste, and used oil and filters.

On-going Contractual Services: without new cart costs

________ % Service Fee without cart cost [% of the net of County curbside rate less admin fee] One-time Contractual Services: new cart cost (include costs to purchase and deploy). See Section 2.2 of RFP.

$____________________ Total New Cart Cost

Service Cost 2: Service Fee with cost of new carts purchased and deployed.

Contractor shall be liable for all costs associated with collection, transportation, hauling, tipping, disposal, purchasing and deploying all new carts per County specifications and any and all other costs as detailed in the RFP. Fee for collection services includes all garbage, organics, recycling materials, bulky waste, and used oil and filters.

On-going Contractual Services: with new cart costs amortized over the duration of the contract

________ % Service Fee with cart costs [% of the net of County curbside rate less admin fee]

PROPOSERS RESPONSE FORM, p. 6

SECTION 7: CONTRACTOR ACKNOWLEDGEMENT FORM

Has your company petitioned for bankruptcy within the last 7 years?

Yes No (If yes, enter the date): _______________________________

Has your company ever been involved in litigation with Sacramento County?

Yes No

If Yes, Identify lawsuits by name, number, parties, and your claim or participation on separate sheets.

Has your company filed any claim(s) per Gov. Code Sections 810, et seq. in excess of $100,000, which was disputed by a public entity?

Yes No (If yes, enter the date): _______________________________ If Yes, Identify claims by name, number, parties, and your claim or participation on separate sheets.

AUDITED FINANCIAL STATEMENTS

Attach a summary of your organizations’ audited financial statements for the recent two years in the Vendor Submissions - Vendor Questionnaire 3.9 - Confidential Sections of Proposal.

ACKNOWLEDGMENT/AUTHORIZATION FORM

The undersigned acknowledges familiarity with all of the requirements set forth in the Request for Proposals, and authorizes and requests any person, firm, agency, or corporation to furnish any information requested by the County in verification of the recitals comprising this Statement of Proposals and also hereby authorizes the County to contact such persons, firms, etc., in order to obtain information regarding the undersigned.

I certify under penalty of perjury under California law that the foregoing is true and correct, that the bid of my firm is made in good faith and did not involve any communications with other potential bidders on this proposal, and am willing to sign the required contract with minimal or no change.

Print Name of Authorized Representative Name of Organization

Signature of Authorized Representative Date Location Where Signed

Exhibit I Proposers Response Form Pricing Fillable