IFB D27 012 Additional Offer Pages.pdf

FURNISH TOTAL MAINTENANCE OF FIRE PROTECTION EQUIPMENT (FPE) AT VARIOUS HAWAII STATE DEPARTMENT OF EDUCATION SCHOOLS AND OFFICES ON THE ISLANDS OF OAHU - CENTRAL DISTRICT, HAWAII - SOUTH HILO, MAUI, MOLOKAI, LANAI, AND KAUAI

IFB D27-012

IFB D27-012 OF-1

OFFER PAGE OF-1

Exact Legal Name of Offeror, including “dba” or “division” of a corporation (furnish the exact legal name of the entity under which an awarded contract, if any, will be executed):

Address:

Principal Place of Business

(may not be a P.O. Box):

Mailing Address (only if different):

Payment Address (only if different)

Offeror’s Primary Contact Person:

Name

Title

Telephone Number Fax Number

Email Address

Federal Tax Identification Number:

State of Hawaii General Excise Tax License Number:

Type of Business Entity (check one):

Sole Proprietor Partnership Corporation Joint Venture Limited Liability Company Other

Names of all Offeror’s parent, affiliate and subsidiary organizations:

Offeror is either:

A Hawaii business incorporated or organized under the laws of the State of Hawaii; OR

A Compliant Non-Hawaii business incorporated or organized under the laws of the State of on (date) _____________, and, if applicable, registered with the State of Hawaii Department of Commerce and Consumer Affairs Business Registration Division to do business in the State of Hawaii.

The undersigned has carefully read and understands the terms and conditions specified herein and hereby submits the following offer to provide the goods and/or perform the work specified herein, all in accordance with the true intent and meaning thereof, and further that the Offeror shall comply with all terms, conditions and requirements of the solicitation. The undersigned further understands and agrees that by submitting this offer, 1) the undersigned is declaring the undersigned’s offer is not in violation of Chapter 84, Hawaii Revised Statutes, concerning prohibited State contracts, and 2) the undersigned is certifying that the price(s) submitted was (were) independently arrived at without collusion.

Authorized (Original in ink) Signature Name (printed)

Title Date

Wage Certificate (Rev. 01.05.2022)

WAGE CERTIFICATE

Subject:

Project Number IFB D27-012

Project Description Furnish Total Maintenance of Fire Protection Equipment (FPE) at Various Hawaii State Department of Education Schools and Offices on the Islands of Oahu - Central District, Hawaii - South Hilo, Maui, Molokai, Lanai, and Kauai

Pursuant to §103-55, HRS, I hereby certify that, if awarded a contract in excess of $25,000.00, the services to be performed will be performed in accordance with the following conditions:

1. The services to be rendered shall be performed by employees paid at wages or salaries not less than wages paid to the public officers and employees for similar work, if similar positions are listed in the classification plan of the public sector.

Services Performed by Laborers and Mechanics:

The Contractor or the Contractor’s subcontractor shall give a copy of the rates of wages to each laborer and mechanic employed under the contract by the Contractor at the time each laborer and mechanic is employed; provided that the Contractor does not have to provide the Contractor’s employees the wage rate schedules where there is a collective bargaining agreement.

2. All applicable laws of the Federal and State governments relating to workers’ compensation, unemployment compensation, payment of wages, and safety will be fully complied with.

Contractor shall be obliged to notify its employees performing work under this contract of the provisions of §103-55, HRS, and the current wage rate for public employees performing similar work. The Contractor may meet this obligation by posting a notice to this effect in the Contractor’s place of business accessible to all employees, or the contractor may include such notice with each paycheck or pay envelope furnished to the employee

I understand that, in addition to the base wages required by §103-55, HRS, all payments required by Federal and State laws that employers must make for the benefit of their employees shall be paid.

Offeror

Signature

Title

Date

EXHIBIT A EX A-1

EXHIBIT A

OFFEROR INFORMATION

Offeror shall provide the Exhibit A, including attachments if applicable, within three (3) working days from STATE’s request.

A. Experience

Offeror or an officer and/or owner of the Offeror shall have a minimum of five (5) consecutive years of experience (immediately prior to the bid opening date) in the field of maintenance and testing of the specified FPE. If Offeror is owned by a parent company in which the parent company has the required five (5) years of experience, the Offeror shall also qualify for the experience required pending verification. Offeror must be able to produce documented maintenance and repair experience to substantiate their claim of experience.

Number of Consecutive Years of Experience in Maintaining FPE Years

B. Office Location and Service Facility

Offeror shall have a permanent office and service facility on the island for which an offer is being submitted from where business is conducted and from where the company is accessible to telephone calls for complaints or requests that need immediate attention. For Molokai and Lanai, an office and service facility in the County of Maui is acceptable. An answering service is not acceptable. Office and service facility shall include warehousing of spare parts and materials required for the maintenance and repair of the specified FPE listed and from where personnel are dispatched to perform the work specified in this Contract.

OAHU (CENTRAL DISTRICT)

Office and Service Facility Address

Office and Service Facility Telephone Number

HAWAII (SOUTH HILO)

MAUI, MOLOKAI, LANAI

KAUAI

EXHIBIT A EX A-2

C1. Personnel

Offeror shall designate at least one (1) employee as the STATE point of contact (POC) for this Contract. This individual shall be based on the island for which an offer is being submitted and available during regular business hours, 7:45 a.m. to 4:30 p.m. Hawaii Standard Time (HST), Monday through Friday, excluding holidays, and shall be capable of answering questions, resolving problems, and providing sales, ordering, and follow-up assistance. For Molokai and Lanai, the POC based in the County of Maui is acceptable.

POC Based in the (State of Hawaii) Yes

Point of Contact (POC) Name

POC Telephone Number

POC Email Address

C2. Licensed Personnel

Offeror shall have licensed personnel assigned to service FPE through this Contract. Licensed personnel must have a current license issued by the Fire Department, Fire Prevention Bureau (FPB) in the County in which an offer is being submitted. Licenses shall be kept in force during the duration of this Contract, including extension options(s), if any. If necessary, attach additional pages.

Name of Licensed Individual

Years of Experience

Years with Current Company

License Number

County License was issued in

License Attached Yes

Years with Current Company

License Number

EXHIBIT A EX A-3

Years with Current Company

License Number

Years with Current Company

License Number

Years with Current Company

License Number

Years with Current Company

License Number

EXHIBIT A EX A-4

D. REFERENCES

Offeror shall provide at least three (3) companies or government agencies in the State of Hawaii for whom Offeror has or is performing maintenance services similar in scope and volume to the services specified herein and who can attest to the quality level and reliability of all aspects of Offeror’s work and service. The STATE reserves the right to contact these references to verify Offeror’s quality level and reliability.

1. Company or Government Agency Yes

Address

Contact Name

Telephone Number

Email Address

Dates of Service

2. Company or Government Agency Yes

Address

Contact Name

Telephone Number

3. Company or Government Agency Yes

Address

Contact Name

Telephone Number