Filter First-Healthy Hydration Project - ES MS and HS - 6-12-25.doc

Richmond Community Schools Request for Proposals (RFP) Filter first/Healthy hydration project The Board of Education of Richmond Community Schools (the “School District”) is accepting firm, sealed Proposals for the filter first/healthy hydration project. The Project RFP may be found on the District’s website, www.richmond.k12.mi.us under the Bids tab.

Proposal MUST be submitted in a sealed envelope (box) and clearly marked, “filter first/healthy hydration project”. The School District requests two (2) original, signed proposals.

All Proposals must be delivered no later than 3:00 pM EST, friday, june 27, 2025 (the “Due Date”) to:

Richmond Community Schools

Board of Education and Administrative Offices

C/O Tammie Schadd, Director of Business & Management Services 35276 Division

Richmond, MI 48062.

All Proposals will be publicly opened immediately thereafter. Proposals received after the Due Date will not be considered or accepted. Facsimile, oral, and other electronic proposals are not acceptable.

A pre-proposal meeting and facility walk-through is scheduled for wednesday, june 18, at 2:30 PM EST at the Board of Education & Administrative Offices (Enter Door #13 at the back of the Middle School), 35276 Division, Richmond, MI 48062 The purpose of this meeting is to walk through each building, Will L. Lee Elementary School, Richmond Middle School, and Richmond High School, to see each filtered faucet and bottle filling station that need an inline filter and answer any questions regarding the RFP.

A bid bond executed by a U.S. Treasury Listed Surety Company acceptable to Richmond Community Schools or a cashier’s check in the amount of at least 5% of the sum of the proposal payable to Richmond Community Schools shall be submitted with each proposal in excess of $30,512. All proposals shall be firm for a period of sixty (60) days.

Successful bidders whose proposals are $50,000 or more will be required to furnish a U.S. Treasury Listed Company Performance and Payment Bond in the amount of 100% of their bid. The cost of the Bond shall be included in each proposal.

All Proposers submitting Proposals must provide a sworn and notarized statement disclosing any familial relationship that exists between the owner or key employee of the Proposer submitting a Proposal and any member of the Richmond Community School District Board of Education and the Richmond Community School District Superintendent. Any Proposal that does not include this sworn and notarized disclosure statement will not be accepted.

All Proposers submitting Proposals must provide a sworn and notarized statement disclosing compliance with the Iran Economic Sanctions Act. Any Proposal that does not include this sworn and notarized disclosure statement will not be accepted.

The School District reserves the right, in its sole and absolute discretion (for this provision and all other provisions contained in this RFP), to accept or reject, in whole or in part, any or all Proposals with or without cause. The School District further reserves the right to waive any irregularity or informality in the RFP process or any Proposal, and the right to award the Contract to other than the Proposer submitting the best financial Proposal (low bidder). The School District reserves the right to request additional information from any or all Proposers. The School District reserves the right to negotiate with the Proposers concerning their Proposals.

The date and time for receipt of Proposals is:

3:00 pM EST, friDAY, june 27, 2025 (the “Due Date”) Proposal Envelope: An opaque envelope containing your Proposal must be marked in the lower left-hand corner as follows:

SEALED PROPOSAL ENCLOSED

filter first/healthy hydration project [Proposer’s Name] [Proposer’s Address] [Proposer’s Telephone Number] The envelope must also be addressed and delivered as follows:

RICHMOND COMMUNITY SCHOOLS

BOARD OF EDUCATION AND ADMINISTRATIVE OFFICES

C/O tammie schadd, director of business & management services

35276 DIVISION

RICHMOND, MI 48062

Late Proposals: Each Proposer is responsible for submission of its Proposal. Proposals or Proposal revisions received after the due date will not be accepted or considered. The School Districts shall not be liable to Proposer for any delivery or postal delays.

Returned Proposals: All Proposals received after the Due Date will be returned to the Proposer unopened.

Signed Original Proposal: Each Proposal must be an original and hard copy, and signed by an authorized member of the Proposer’s Firm. This member should be the highest-ranking officer at the local level. NO ORAL, FAX or E-MAILED Proposals will be accepted. Each Proposal must be submitted on the Proposal Forms attached to this RFP. Original Proposals must be clearly indicated.

Copies of Proposal: The Proposer shall also submit with the signed originals of its Proposal one (1) complete copy of the signed original Proposal.

Opening of Proposals: In the Conference Room of the Board of Education & Administrative Offices, at 3:00 pM EST, friDAY, june 27, 2025, all submitted Proposals shall be publicly opened and dated. Any interested parties may attend. No immediate decision will be rendered.

E-Mail Clarifications: The School District intends to communicate with Proposers via e-mail (e.g., RFP clarifications and Addenda). Except for the delivery of the Proposal itself, references in this RFP to “written” form of communications, include e-mail.

Intent to Respond: Each Proposer who intends to submit a Proposal in response to this RFP shall submit an “Intent to Respond” via e-mail to Tammie Schadd at tschadd@richmond.k12.mi.us on or before noon on Thursday, june 19, 2025. The Intent to Respond shall include the name of the Proposer, the name of a contact person and that person’s e-mail address. Enter “Intent to Respond – Filter First/Healthy Hydration Project” in the Subject line of the email.

Additional Requests for Clarification: Prospective Proposers may request the School District clarify information contained in this RFP. All such requests or questions regarding this RFP must be received no later than noon on friday, june 20, 2025.

Questions must be submitted via email to Preston Treend at ptreend@richmond.k12.mi.us, or to the attention of Preston Treend at Richmond Community Schools, 35276 Division, Richmond, MI 48062, in writing, or via the business office facsimile at 586-727-2098. Enter “Question(s) – filter first/healthy hydration project” in the Subject line of the email. No response will be made to oral questions. All questions and answers will be sent to all prospective proposers via e-mail. It is the Proposer’s responsibility to check their e-mail prior to the RFP Due Date to ensure that it has received all information, including, but not limited to all addenda to this RFP.

Restrictions On Communication: From the issue date of the RFP until a Contractor is selected and selection announced, a Proposer shall not communicate about the subject of the RFP or a Proposer’s Proposal with the School District, the Board of Education, or any individual member, administrators, faculty, staff, students, or employees, except for Pre-Proposal Meeting/Facility Walk-Through, or additional Requests For Clarification in accordance with language found within this RFP.

Addenda to the RFP: If it becomes necessary to revise any part of the RFP, notice of the revision will be e-mailed in the form of an Addendum to all parties that submitted an ”Intent to Respond” and/or attended the Pre-Proposal Meeting. All Addenda shall become a part of the RFP. Each Proposer must in its Proposal, to avoid any miscommunication, acknowledge all Addenda which it has received, but the failure of a Proposer to receive, or acknowledge receipt of, any Addendum shall not relieve the Proposer of the responsibility for complying with the terms thereof.

RFP/Proposal Information Controlling: The School District intends that all Proposers shall have equal access to information relative to this RFP, and that this RFP contains adequate information. No information communicated, either verbally or in writing, to or from a Proposer shall be effective unless confirmed by written communication contained in this RFP, an Addendum to this RFP, a Request for Clarification or other written response thereto, or in the Proposal. It is the policy of the School District to not release Request for Proposals in a changeable format (i.e. Word or Excel files). Accordingly, neither this RFP nor subsequent addenda, if any, nor any Responses to Clarifications will be released in other than hard copy or .pdf format.

Finality of Decision: Any decision made by the School District, including selection of Contractor(s), shall be final.

Reservation of Rights: The School District reserves the right, in its sole and absolute discretion (for this provision and all other provisions contained in this RFP), to accept or reject, in whole or in part, any or all Proposals with or without cause. The School District further reserves the right to waive any irregularity or informality in the RFP process or any Proposal, and the right to award the Contract to other than the Proposer submitting the best financial Proposal (low bidder). The School District reserves the right to request additional information from any or all Proposers. The School District reserves the right to negotiate with the Proposers concerning their Proposals. The School District may select one or more Firms to perform the Project on behalf of the School District.

Release of Claims: Each Proposer by submitting its Proposal releases the School District from any and all claims arising out of, and related to, the RFP process and selection of Contractor(s).

Proposer Bears Proposal Costs: A recipient of this RFP is responsible for any and all costs incurred by it or others acting on its behalf in preparing or submitting a Proposal, or otherwise responding to this RFP, or any negotiations incidental to its Proposal or this RFP.

Irrevocability of Proposals: Proposers may withdraw their Proposal, if so desired, any time before the Due Date. All Proposals submitted shall not be withdrawn and shall be irrevocable for a minimum period of one hundred eighty (180) calendar days following the Due Date.

Collusive Bidding: The Proposer certifies that their Proposal is made without any previous understanding, agreement or connection with any person, firm or corporation making a Proposal for the same project and is in all respects fair, without outside control, collusion, fraud, or otherwise illegal action.

Objective of RFP: The objective of this RFP is to offer experienced professional firms the opportunity to present a thoroughly detailed Proposal of their expertise and qualifications to the School District. The Proposal will detail the Proposer’s experience and expertise in assisting school districts of similar size and scope as the School District with their Project.

This RFP specifically requests that all Proposers present their qualifications and experiences in similar Projects (please see Proposal Requirements and Proposal Format).

The School District will select the Proposal, if any, that it deems most qualified to serve the best interests of the School District, in its sole and absolute discretion.

Purpose: The purpose of this RFP is to establish a contractual relationship with an experienced and qualified Firm to provide and install inline filters for healthy hydration from filtered faucets and bottle filling stations in all three (3) schools in the School District in the most efficient and cost-effective manner possible while, at the same time, maintaining quality of service, safety, and reliability.

Term of Contract: Installation should be completed by May 1, 2026.

Selection Timeline:

The School Districts’ anticipated timeline for its selection process is:

PLEASE NOTE: The School District reserves the right, in their sole and absolute discretion, to change any or all portions of the above-identified selection timeline as determined to be in their best interest.

Proposal Requirements: This outlines the information that must be provided by the Proposer and the required format for the Proposal. Any Proposal not providing the required information, or not conforming to the format specified, may be disqualified. Please refer also to the Proposal Format section of the RFP for additional Proposal requirements.

Proposals must demonstrate an understanding of the scope of work and the ability to accomplish the tasks set forth herein and must include information that will enable the School District to determine the Proposer’s overall qualifications. Each Proposal shall also include any other information that the Proposer feels is significant with respect to the School District making informed decisions relative to the Proposal.

Any exceptions to the terms and conditions contained in this RFP or any other special considerations or conditions requested or required by the Proposer MUST be specifically enumerated by the Proposer and be submitted as part of its Proposal, together with an explanation as to the reason such terms and conditions cannot be met. Each Proposer shall be required and expected to meet the RFP requirements in their entirety, except to the extent exceptions are expressly noted in its Proposal and those exceptions are expressly accepted by the School District. All pricing factors must be clearly indicated in the Proposer’s Proposal Form provided as part of its Proposal.

Include any other public K-12 school districts in which your Firm has contracted to complete similar projects. Proposers must provide a Bid Bond in the amount equal to 5% of the total Contract.

Proposers shall meet all regulatory laws, codes, licensing and permitting requirements of Local, State, and Federal law that apply to Michigan public school districts and Project Services, including, but not limited to, the Michigan Revised School Code (MCL 380.1 et seq.).

References – Proposers must provide K-12 public school references, including contact name, address, phone number and scope of services.

Proof of Qualifications: The School District will ensure compliance with the above by checking references listed in the Proposals.

Oral Interview: The School District may require qualified Proposers to participate in oral presentations to answer any questions the School District may have regarding the RFP and Proposer’s Proposal. In that case, the School District will notify the Proposer’s contact name as listed in its Proposal. In accordance with the RFP selection timeline, interviews will be scheduled after Wednesday, June 25, 2025, on a date to be determined.

District-Contractor Communications: The Contractor shall designate a liaison to be available to communicate with the School District at all times.

Definitions of this RFP and Subsequent Contract:

“Contract” “Contract” means the negotiated contract, if any, resulting in the School District’s acceptance of the Contractor’s Proposal, to the satisfaction of the School District, which incorporates this RFP and the Contractor’s Proposal.

“Contractor” “Contractor” shall mean the Firm(s) awarded a Contract to complete Project for the School District in accordance with this RFP and the successful Proposer’s Proposal.

“Project” “Project” means the project as described in this RFP.

“Proposal” “Proposal” means a response to the RFP submitted by a Proposer.

“Proposer” “Proposer” means any Firm submitting a Proposal to the School District by the specified due date in accordance with this RFP.

General Conditions:

(Applicable to all Bid Items)

A.

The Contractor shall be deemed to be aware of, and include the cost for, all state and local laws, codes, ordinances, building rules and regulations, and other statutory provisions, all as are or may become applicable to the Work.

B.

Contractor shall coordinate with other trades that affect the installation of the Work, and with the District.

C.

Bidders shall exclude costs of testing from bid unless required by the proposal form or the trade specification, and shall cooperate with testing agency hired by the District.

D.

Each Trade Contractor shall cooperate and coordinate with other contractors for expedient completion of the Work of this project.

E.

The Scope of Work for each Bid Item includes any hoisting, delivery, handling, and/or storage requirements.

F.

Schedule and sequence manpower loading, and prefabrication and erection of work shall be in accordance with the construction completion dates.

G.

The Scope of Work for each Bid Item includes cleaning and maintaining streets free of dirt, mud, gravel, and other debris caused by the Work of that Bid Item. Contractors are cautioned that local authorities intend to enforce local ordinances in this regard, and violators will be ticketed and prosecuted.

H.

Each Contractor shall review existing building and site conditions prior to commencing the Work and advise District of any claim to changes in the Work within three (3) calendar days therefore, or waive its right for claim for changes in the existing site condition. Each Contractor shall be responsible for restoring site to its original conditions upon completion of its work.

I.

All excess materials shall be legally disposed of offsite unless otherwise indicated in the contract documents.

J.

All bidders are required to review and provide pricing for (where applicable) the alternate work itemized on the Bid Proposal Form with their bids. Material and equipment suppliers are requested to list the total State of Michigan sales and use tax included in their proposal.

K.

The apparent low bidders shall furnish a list of subcontractors and suppliers, completed form W-9, and Certificate of Insurance within 3 days of request for same.

L.

The Contractor is committed to nondiscrimination in employment. All qualified applicants are welcome to apply for jobs with the Contractor. The Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, age, physical impairment, national origin, height, weight, or marital status.

M.

Summary.

All bidders are expected to familiarize themselves with the RFP. The following proposal sheets summarize the general scope of work in an attempt to help define the work of the separate trade contractors. The ensuing individual trade proposal forms are a guide to the scope of work, but are not intended to be all inclusive of the work to be covered.

N. After receiving formal notification that the successful Contractor was awarded a Contract, the Contractor shall furnish the District with installation and estimated completion dates.

Federal, State and Local Law Compliance, and School District Policies: The Contractor shall comply with any and all laws, rules, ordinances, policies and regulations, including any licensing and permitting requirements, applicable to completing the project anticipated in this RFP including, but not limited to, building permits, building codes, safety regulations, licenses, etc. The Contractor, including its employees and agents, shall be responsible for knowing the School District’s policies concerning appropriate behavior of persons in its Facilities and, on its properties, including for example, the prohibitions of sexual harassment and smoking, and shall comply with all such policies. The School District shall use its best efforts, as reasonably requested by the Contractor, to assist the Contractor to comply with any and all applicable federal, state, or local laws, rules, and regulations. The Contractor by providing its Proposal to the School District represents and warrants that it shall at all times be in compliance with any and all applicable federal and state laws, rules, ordinances, policies and regulations and licensing and permitting requirement applicable to completing the project anticipated in this RFP. The Contractor shall in the performance of such work pursuant to this RFP, its Proposal and the Contract, fully comply with any and all applicable federal, state, or local laws, rules and regulations, and shall indemnify, defend and hold the School District harmless from any liability from its failure to so comply.

Governing Law: The Contract shall be governed by and construed in accordance with the laws of the State of Michigan. The parties hereby agree to the exclusive jurisdiction and venue of courts sitting in Macomb County, Michigan.

Repairs to Property Damage: Damage to any School District Facilities or properties caused by the Contractor, its agents or employees shall be repaired so that facilities or properties are in as good condition as before entering into the Contract. All repairs shall be accomplished at no cost to the School District.

OSHA Compliance: All services to be furnished by the Contractor, and the Contractor’s working conditions and employment practices shall comply with all applicable state and federal requirements, including, but not limited to, the Occupational Safety and Health Act.

Proposal Form Proposer (Company/Firm/Name):

Contact Name:

Title:

Address:

City/State:

Phone:

Alternate Phone:

Facsimile:

Electronic Mail Address:

The undersigned understands the School District reserves the right to accept or reject in whole or in part any and all Proposals and to waive informalities and irregularities therein.

The undersigned hereby acknowledges that his proposal, as stated below, includes all the labor and services required and only those materials in compliance with the specifications.

The undersigned acknowledges that he has carefully examined the specifications and visited the site to fully inform himself of all existing conditions and limitations, and that his proposal includes a sum to cover the cost of all items included in the contract.

The undersigned further agrees to commence work on the project for completion by May 1, 2026, and to coordinate, properly schedule and complete his portion of the work in compliance with the project schedule.

If award is made to our Firm based upon our Proposal, we agree to enter into the form of Contract with the School District in strict accordance with this Request for Proposal and our Proposal.

My signature certifies that the Proposal as submitted complies with all terms and Conditions as set forth in this Request for Proposal, unless specifically enumerated as an exception.

I hereby certify that I am authorized to sign as a Representative for the Firm.

Name, title and signature of individual duly authorized to execute contracts:

Signature:

By:

Date:

Vendor Profile

Proposer (Company/Firm/Name):

Location of service facility nearest to Richmond Community Schools that will provide support and respond to trouble calls.

Years in Business ______

Number of Employees ______

Number of Service Staff ______

References

(1) _________________________________________________________________

(2)

(3)

Signature and Title:

PRICING SUMMARY

PROPOSAL A:

Will L. Lee Elementary School

GENERAL SCOPE:

33 Consumptive Fixtures The work of this proposal includes, but is not limited to, the following items:

1. Approved filters must be installed and operational in the Child Care classrooms and hallway by Friday, October 10, 2025, to ensure that any water furnished to children is from a filtered source by Friday, October 24, 2025.

2. Approved filters must be installed and operational throughout the remainder of the building by the project completion date, May 1, 2026.

3. The following is the Consumptive Fixture Inventory for Will L. Lee Elementary School. Upon project completion, a completed Filtered Fixture Inventory shall be provided to the District with the Filter Brand & Model # and Category of Fixture columns completed for each fixture location.

The CDWAA requires every consumptive fixture in a building to be identified and location recorded. The category of each consumptive fixture should be specified as a filtered bottle-filling station or filtered faucet. “Number” is the order of sampling starting at the fixture closest to the water POE into the building. List here, include additional pages if needed, update as needed and keep a copy for your records.

Fixture Type Codes: Classroom faucet (CF), Drinking fountain (DF), Kitchen faucet (KF), and Teachers’ Lounge faucet (TL) Table 1: Filtered Fixture Inventory

4. Work on school days must be arranged in advance with the District’s contact person, Preston Treend, and may begin after the end of classes at approximately 2:50 PM.

5. Daily construction / final clean up by contractor is required.

PROPOSAL A:

Will L. Lee Elementary School

UNIT PRICES:

Filtered Faucet and installation $

Filtered bottle-filling station and installation $

Name of Contractor:

PROPOSAL A BASE BID: $

PROPOSAL B:

Richmond Middle School

GENERAL SCOPE:

22 Consumptive Fixtures The work of this proposal includes, but is not limited to, the following items:

1. Approved filters must be installed and operational throughout the building by the project completion date, May 1, 2026.

2. The following is the Consumptive Fixture Inventory for Richmond Middle School. Upon project completion, a completed Filtered Fixture Inventory shall be provided to the District with the Filter Brand & Model # and Category of Fixture columns completed for each fixture location.

The CDWAA requires every consumptive fixture in a building to be identified and location recorded. The category of each consumptive fixture should be specified as a filtered bottle-filling station or filtered faucet. “Number” is the order of sampling starting at the fixture closest to the water POE into the building. List here, include additional pages if needed, update as needed and keep a copy for your records.

Fixture Type Codes: Bottle fill outlet (BF), Classroom faucet (CF), Drinking fountain (DF), Ice machine (IM), Kitchen faucet (KF), and Teachers’ Lounge faucet (TL)

Table 1: Filtered Fixture Inventory

3. Work on school days must be arranged in advance with the District’s contact person, Preston Treend, and may begin after the end of classes at approximately 2:40 PM.

4. Daily construction / final clean up by contractor is required.

PROPOSAL B:

Richmond Middle School

UNIT PRICES:

Filtered Faucet and installation $

Filtered bottle-filling station and installation $

Name of Contractor:

PROPOSAL B BASE BID: $

Proposal C:

Richmond High School

GENERAL SCOPE:

20 Consumptive Fixtures The work of this proposal includes, but is not limited to, the following items:

1. Approved filters must be installed and operational throughout the building by the project completion date, May 1, 2026.

2. The following is the Consumptive Fixture Inventory for Richmond High School. Upon project completion, a completed Filtered Fixture Inventory shall be provided to the District with the Filter Brand & Model # and Category of Fixture columns completed for each fixture location.

The CDWAA requires every consumptive fixture in a building to be identified and location recorded. The category of each consumptive fixture should be specified as a filtered bottle-filling station or filtered faucet. “Number” is the order of sampling starting at the fixture closest to the water POE into the building. List here, include additional pages if needed, update as needed and keep a copy for your records.

Fixture Type Codes: Bottle fill outlet (BF), Classroom faucet (CF), Drinking fountain (DF), Ice machine (IM), Kitchen faucet (KF), and Teachers’ Lounge faucet (TL)

Table 1: Filtered Fixture Inventory

3. Work on school days must be arranged in advance with the District’s contact person, Preston Treend, and may begin after the end of classes at approximately 2:40 PM.

4. Daily construction / final clean up by contractor is required.

Proposal C:

Richmond High School

UNIT PRICES:

Filtered Faucet and installation $

Filtered bottle-filling station and installation $

Name of Contractor:

PROPOSAL C BASE BID: $

DISCLOSURE STATEMENT – FAMILIAL RELATIONSHIP

Pursuant to MCL 380.1267, a sworn and notarized statement disclosing any familial relationship that exists between the owner and any employee of the vendor/contractor and any member of the Richmond Community School District Board of Education or the Richmond Community School District Superintendent must be accompanied with the bid/proposal.

Bids and Proposals without this disclosure statement will not be accepted.

The members of the Richmond Community School District Board of Education are Deborah Michon, Margaret Teltow, Sandra Fortuna, Candess Cunningham, Danielle Sutton, Sarah Gillies, and Raymond Stier. The Richmond Community School District Superintendent is Brian Walmsley.

□ The following are the familial relationship(s):

Owner/Employee Name Related to: Relationship_________

1. _______________________ ________________________ ___________________________

2. _______________________ ________________________ ___________________________

3. _______________________ ________________________ ___________________________

4. _______________________ ________________________ ___________________________

Attach additional pages if necessary to disclose all familial relationships.

□ There are no familial relationships that exist between the owner and any employee of the vendor/contractor and any member of the Richmond Community School District Board of Education or the Richmond Community School District Superintendent.

The undersigned, the owner or authorized representative of bidder (insert name) _________________________ does hereby represent and warrant that the disclosure statements herein contained are true.

Print Name

Signature of Bidder Representative

Title

STATE OF MICHIGAN

) ss

COUNTY OF ______________)

This instrument was acknowledged before me on the _____ day of _________________, _______, by ______________________________________________.

________________________________________, Notary Public _________________County, Michigan

My commission expires: ____/____/____ Acting in the County of: _____________

AFFIDAVIT OF COMPLIANCE – IRAN ECONOMIC SANCTIONS ACT

Michigan Public Act No. 517 of 2012 The undersigned, the owner and or authorized officer of the below named contractor (the “Contractor”), pursuant to the compliance certification requirement provided in the Richmond Community Schools’ (the “School District”) Request For Proposals For Custodial Services (the “RFP”), hereby certifies, represents and warrants that the Contractor (including its officers, directors and employees) is not an “Iran linked business” within the meaning of the Iran Economics Sanctions Act, Michigan Public Act No. 517 of 2012 (the “Act”), and that in the event Contractor is awarded a contract as a result of the aforementioned RFP, the Contractor will not become an “Iran linked business” at any time during the course of performing the Work or any services under the contract.

The Contractor further acknowledges that any person who is found to have submitted a false certification is responsible for a civil penalty of not more than $250,000.00 or 2 times the amount of the contract or proposed contract for which the false certification was made, whichever is greater, the cost of the School District’s investigation, and reasonable attorney fees, in addition to the fine. Moreover, any person who submitted a false certification shall be ineligible to bid on a request for proposal for three (3) years from the date that it is determined that the person has submitted the false certification.

CONTRACTOR:

Name of Representative

Name of Contractor

Title

Date

STATE OF MICHIGAN

) ss

COUNTY OF ______________)

This instrument was acknowledged before me on the _____ day of _________________, _______, by ______________________________________________.

________________________________________, Notary Public _________________County, Michigan

My commission expires: ____/____/____ Acting in the County of: _____________

Intent to Respond Form Proposer (Company/Firm/Name):

Contact Name:

Title:

Address:

City/State:

Phone:

Alternate Phone:

Facsimile:

Electronic Mail Address:

The signature below indicates the Proposer’s intention to submit a Proposal in response to the filter first/healthy hydration project RFP.

I hereby certify that I am authorized to sign as a Representative for the Firm.

Name, title and signature of individual duly authorized to execute contracts:

Signature:

By:

Date: