IFQ 25-021 Case Management Database.pdf

Established in 1938, the Housing Authority of the City and County of Denver (DHA) is one of the nation’s most successful authorities, providing housing to low-and middle-income Denver residents.

To further it's goals, DHA is issuing an Invitation for Quote for Case management database as listed in the scope of work. The award will be made to the most responsive, responsible offeror who submits the most technically acceptable proposal and meets the overall criteria.

Quote Number: 25-021 Direct Questions to : Site Walk:

Issue Date: Name Site Walk: No Due Date: Date: January 0, 1900 Due Time: 4:00 PM MST e-mail: Time: Select One

Address:

Due: Mountain Standard Time Time:

Scope Of Work:

Contractor shall furnish all facilities, labor, materials, equipment and perform all services per the attached scope-of-work.

Proposal Instructions:

This is not a low bid procurement, award will be based on the evaluation factors listed below. Firms are to submit a detailed proposal addressing each of the evaluation factors, complete the vendor information below, fill out all attached DHA forms and submit the information on or before

Evaluation Factors:

Points

Special Requirements:

List of Attachments: Vendor Information:

Please fill out the following and return with your quote

Firm Name

Title Phone Email

Signature Date

Award (For DHA Use Only)

Name Title

Signature Date

Effective Date Contract Number Contract Amount End Date

DHA will not answer any telephone inquiries about this IFQ. All inquiries must be submitted in writing. DHA shall not be bound by and the Offeror shall not request or rely on any oral interpretation or clarification of this solicitation. Answers to questions will be issued by September 24th, 2025 at 4PM MST.

Submission Instructions In Quote Document

4PM MST

procurement@denverhousing.org

October 1, 2025

Invitation for Quote

4:00 PM Mountain Standard Time

Factors

September 22, 2025

September 10, 2025 October 1, 2025

Sarah VanDermyden https://www.bidnetdirect.com/colorado/denverhousingauthority

Cost/price Demonstrated understanding of requirements

Scope of Work

Vendor Letter

Contract Requirements Vendor Qualification Form & W9 Worker Status Affidavit Business Status Affidavit

System functionality - usability, case management, group tracking, and reporting Compliance with desired specificiations Demonstrated experience and expertise in performing similar work Technical support and training options

Doing Business with DHA: In order to receive notice of future business opportunities of upcoming solicitations from DHA, please register your company on Rocky Mountain E-Purchasing (BidNet) by going to:

https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority https://www.bidnetdirect.com/colorado/denverhousingauthority

Scope of Work

1. Overview

Denver Housing Authority (DHA) seeks to procure a cloud-based case management software solution intended for social service database tracking. This software will support resident service programs with capabilities for tracking, management, and reporting of resident outcomes, including HUD’s Standards for Success, Family Self-Sufficiency (FSS), and Jobs Plus Program initiatives. Contract would start in August 2026.

2. Project Objectives

• Implement social service database software with 30 active user accounts for Human Services Coordinators. In addition, provide supplementary supervisor accounts for reviewing and pulling data.

• Allow for individual and group tracking of services provided across unique properties.

• Enable automated reporting for HUD’s Standards for Success, FSS, and Jobs Plus Program requirements.

• Ensure continuity of service and fixed pricing throughout the up to 5-year procurement cycle ending in 2031.

3. Scope of Services

The vendor will provide the following:

Software Licensing and Access

• Annual licenses for 30 Human Services Coordinator user account, with flexibility to add or remove accounts as needed.

• Complimentary user access for supervisors and quality assurance roles.

Implementation and Setup

• Functional implementation of social services case management software within DHA’s service delivery ecosystem.

• Complete setup and onboarding of all user accounts and properties.

• Complete any necessary data imports/data transfers.

• Integrate reporting for HUD’s Standards for Success framework for eleven active ROSS and MFSC grants, one active FSS grant, and one active Jobs Plus Program grant.

System Functionality

• Allow for individual and group tracking of services provided across unique properties that meet Standards for Success tracking needs.

• Ability to track individuals’ progress on customized goals and finances (savings, debt, bank accounts, credit scores) for the Family Self-Sufficiency (FSS) program.

• Reporting features that allow for overview of grant progress for HUD programs (ROSS, MFSC, FSS, JPP) and case tracking.

• Report features that allow overview of services provided by property, by service provided, by case manager provided, etc.

Integration with HUD Reporting

• System able to integrate with HUD Grant Solutions to submit ROSS and MFSC grant reports annually in the appropriate Standards for Success format.

• System able to format reporting for other HUD programs, such as FSS and Jobs Plus Program, to align with current HUD standards and requirements.

Customization and Development

• Customization available for any additional tracking, features, reports, or forms, as needed.

• Supplementary project management, design, and training support for customized work.

Training and Support

• Live technical support.

• All training and technical onboarding included in implementation.

• Ongoing software maintenance and user support throughout the contract period.

I. CONTRACT REQUIREMENTS

a. Type of Contract

i. Firm Fixed Price

1. The Housing Authority will award a firm fixed price contract as a result of

b. Payments

i. The Authority will not pay retainers, finance charges for late payments or pre-payments for work that has not occurred.

c. Contract Term

i. The term of the contract is one (1) year per the awarded vendors proposal from date of award or the Effective Date, whichever is later. The Authority reserves the right to extend the term of this contract for the period specified in Section I, Contract Requirements, Paragraph d, "Option to Extend the Term of the

Contract".

d. Option to Extend the Term of the Contract

i. The Authority may extend the term of this contract, in one (1) year increments, by notice to the Contractor by the expiration date of the contract or within 30 days after funds are made available for exercising the option, whichever is later.

ii. If the Authority exercises this option, the extended contract shall be considered to include this option provision.

iii. The total duration of this contract, including the exercise of any option under this clause, shall not exceed 5 years.

e. Contract Administration

i. Resident and Community Connections is designated as the office responsible for inspecting the work while the Contracting Officer is responsible for final acceptance of the work.

f. 2 CFR 200.327 Contract Provisions

i. The contract provisions required by 2 CFR 200.327 are hereby incorporated by reference.

g. Contract General Conditions

i. Please visit the below link for general conditions for this solicitation.

1. HUD 5370 C Section I

h. Insurance Requirements

i. Before commencing work, the Contractor shall furnish the Authority with certificates of insurance showing that the following insurance is in force and will insure all operations under the Contract:

1. Worker’s Compensation:

a. Worker's Compensation, in accordance with the State of Colorado

Worker's Compensation Laws. The policy or policies shall name the Authority as a certificate holder.

b. Sole Proprietor’s and Contractor’s that do not have any employees that are exempt from workers compensation will be required to submit an Independent Contractors Form to the Authority.

2. Commercial General Liability:

a. Commercial General Liability of not less than $2,000,000 per occurrence limit and $2,000,000 general aggregate limit to protect https://www.hud.gov/sites/dfiles/OCHCO/documents/5370C1.pdf the Contractor and each subcontractor against claims for bodily injury or death and damage to the property of others. This shall cover the use of all equipment, hoists, and vehicles on the site(s) not covered by Automobile Liability under (c) below. If the

Contractor has a "claims made" policy, then the following additional requirements apply: the policy must provide a

"retroactive date" which must be on or before the execution date of the Contract; and the extended reporting period may not be less than five years following the completion date of the Contract.

Maximum deductible is $10,000 and the deductible should be issued on a per occurrence basis in lieu of a per claim basis. The amounts of such insurance required hereunder shall be subject to adjustment from time to time as requested by the Authority based upon the Authority’s determination as to the amount of such insurance generally required at such time.

b. As an alternative, the Contractor may provide Commercial

General Liability in the amount of $1,000,000 per occurrence and

$2,000,000 general aggregate and $1,000,000 under an

Umbrella/Excess Liability policy.

c. The policy or policies shall name the Authority as an additional insured.

3. Automobile Liability:

a. Automobile Liability on owned and non-owned motor vehicles used on the site(s) or in connection therewith of not less than

$1,000,000 per occurrence limit. Such insurance shall cover all work of the Contractor and shall be issued by an insurer acceptable to the Authority.

b. The policy or policies shall name the Authority as a certificate holder.

Professional Liability:

c. Professional Liability insurance coverage is only applicable to professional services such as lawyers, consultants, accountants, auditors or architects and engineers and shall consist of not less than

$2,000,000.00 per occurrence and $2,000,000 in the aggregate. The lawyers, accountants, auditors or architects and engineers and their sub-contractors shall confirm that the professional liability policy includes errors and omissions insurance to insure the adequate performance of all professional activities. The professional errors and omissions insurance coverage specified herein may be structured to provide coverage on a "claims made" basis or on an

"occurrence" basis; provided, however, that the Contractor shall be required to maintain and keep in effect said professional errors and omissions insurance coverage for the period set out in Colorado law as amended. Maximum deductible is $10,000 and the deductible should be issued on a per occurrence basis in lieu of a per claim basis. The amounts of such insurance shall be subject to adjustment from time to time as requested by the Authority based upon the

Authority’s determination as to the amounts of such insurance generally required at such time for such activities or services.

d. The policy or policies shall name the Authority as a certificate holder.

4. Builder's Risk Insurance:

a. Builder's Risk Insurance is only applicable to Construction

Contractors for scope of work in excess of the small purchase threshold currently set at $250,000. The contractor will carry the builders risk for the specific project and scope of work as required under Article 36(b) of the General Conditions. The deductible limit of such insurance up to $1,000 per claim shall be the responsibility of the Contractor if the claim arises out of default or neglect of

Contractor, its subcontracts or any other party for whose act it is responsible; otherwise, the deductible limit of such insurance shall be the responsibility of the Authority.

b. The policy or policies shall name the Authority as an additional insured.

5. Policies and Evidence of Coverage:

a. All policies shall be issued by carriers having ratings of Best’s

Insurance Guide A- and VIII, or better, and admitted to engage in the business of insurance in Colorado. All policies must be endorsed to be primary and noncontributing with the policies of the

Authority being excess, secondary and non-contributing. Any policy or endorsement form must be approved in advance by the

Authority. No policy will be canceled, non-renewed or materially modified without thirty (30) days prior written notice by insurance carrier to the Authority. Contractor must immediately notify the

Authority, in writing, if any aggregate limit is reduced below seventy-five percent (75%) of the limit required by this subparagraph because of losses paid. No policy will contain a deductible or self-insured retention in excess of the amounts listed under each coverage, without the prior written approval of the

Authority. If the forms of policies, endorsements, certificates, or evidence of insurance required by these provisions are superseded or discontinued, the Authority shall have the right to require other equivalent or better forms.

b. Each such policy shall contain a valid provision of endorsement stating, “This policy will not be cancelled without first giving thirty

(30) days written notice thereof to the Authority’s Procurement

Manager, PO Box 40305, Denver, Colorado 80204, sent by certified mail, return receipt requested.”

c. Evidence of the insurance coverage required to be maintained by

Contractor under this section, represented by certificates of insurance issued by the insurance carrier, must be furnished to the

Authority prior to Contractor receiving payment for any services, and at least thirty (30) days prior to the expiration of current policies. Copies of all endorsements required must accompany the certificates delivered to the Authority and name the Authority as the certificate holder. The certificates will state the amounts of all deductibles and self-insured retentions and that the Authority will be notified in writing thirty (30) days prior to cancellation, material change, or non-renewal of insurance. Proof of insurance shall be provided to the Authority upon execution of this Contract. If requested, Contractor shall provide the Authority copies of such policy. Any payment due under this Contract shall be withheld until

Contractor has provided such proof of insurance.

d. The Contractor shall insert the substance of this clause, including this paragraph, in subcontracts under this contract that require work on the Authority's property and shall require subcontractors to provide and maintain the insurance required in the schedule or elsewhere in the contract. The Contractor shall maintain a copy of all subcontractor's proofs of required insurance, and shall make copies available to the Contracting Officer upon request.

6. Minimum Requirements:

a. Insurance coverage specified herein constitutes the minimum requirements, and said requirements shall in no way lessen or limit the liability of Contractor under the terms of the Contract.

Contractor shall procure and maintain, at its own expense and cost, any additional kinds and amounts of insurance that, in its judgment, may be necessary for its proper protection in the prosecution of the services hereunder.

i. INDEMNIFICATION

i. To the fullest extent permitted by law, Contractor and all of its officers, directors, employees, contractors, agents, successors and assigns, jointly and severally, agree and hereby shall release, indemnify, protect, hold harmless and defend the

Authority, its commissioners, officers, employees, servants and agents from and against any and all claims, demands, suits, liabilities, damages, penalties, fines, judgments, obligations, causes of action, charges, administrative or judicial proceedings and orders, remedial action requirements, enforcement actions of any kind, and all costs and expenses incurred in connection therewith (including, but not limited to, attorneys’ fees and expenses),resulting from, whether foreseeable or unforeseeable, arising directly or indirectly, in whole or in part, out of, or in any way related to or connected with any of the following: the performance of services pursuant to this Contract including but not limited to worker’s compensation claims of or by anyone, in any way and any personal injury (including but not limited to wrongful death) or property damage (real or personal) arising out of, or in any way related resulting from, or arising out of, directly or indirectly, the performance of services pursuant to this Contract by

Contractor or any of its employees, contractors, agents, invitee, successors or assigns; provided, however, the Contractor shall not be required to defend, indemnify and save harmless the Authority, its commissioners, officers, employees, servants and agents from claims, suits or expenses, including worker's compensation claims resulting from the sole negligence or fault of the

Authority, its commissioners, officers, employees, servants or agents. Insurance coverage specified herein constitutes the minimum requirements, and said requirements shall in no way lessen or limit the liability of Contractor under the terms of the contract. Contractor shall procure and maintain, at its own expense and cost, any additional kinds and amounts of insurance that, in its judgment, may be necessary for its proper protection in the prosecution of the services hereunder.

ii. Contractor and all of its officers, directors, employees, contractors, agents, successors and assigns, jointly and severally, agree and hereby shall release, indemnify, protect, hold harmless and defend the Authority, its commissioners, officers, employees, servants, and agents from and against any and all claims, demands, damages, suits, costs, expenses, liabilities, penalties, fines, judgments, obligations, causes of action, charges, administrative or judicial proceedings and orders, remedial action requirements, enforcement actions or proceedings of any kind or nature whatsoever, including but not limited to worker's compensation claims of or by anyone, in any way, resulting from, or arising out of, directly or indirectly, the performance of services pursuant to this Contract.

iii. The Authority shall notify the Contractor of the existence of any claim, demand, or other matter to which the Contractor’s indemnification obligations would apply. The Authority shall select counsel to represent the Authority, whose selection shall be approved by the Contractor. Such approval shall not be unreasonably withheld. The Contractor shall pay all reasonable attorney’s fees of the Authority’s counsel, relating to defense of the action. If the Contractor shall fail to pay the attorney’s fees and costs of the Authority’s defense, within a reasonable time after notice, the Authority shall undertake its defense and the

Contractor shall pay all attorney’s fees and costs expended in the Authority’s defense of itself including, but not limited to, all attorney’s fees and costs associated with the Authority’s enforcement of the indemnification and/or duty to defend provisions set forth herein.

iv. The obligations to indemnify and to defend the Authority shall survive expiration or earlier termination of this Contract.

v. The Authority by this Contract does not agree to release, indemnify, protect, hold harmless, exonerate, defend, or assume the defense of Contractor or any other persons or entity whatsoever, for any purpose whatsoever.

SUBCONTRACTOR AND SUPPLIER PLAN

Please complete this list of any proposed subcontractors and suppliers that you may have under this contract. Please note that all subcontractors must complete a Business Status Affidavit.

LIST OF PROPOSED SUB-CONTRACTORS AND SUPPLIERS

The Offeror proposes to subcontract with the following subcontractors for this Contract. The Offeror acknowledges that all subcontractors and suppliers regardless of tier are to be listed on this form. Each subcontractor listed must complete the Business Status Affidavit.

Business Name: _______________________________________________________________

Address: _____________________________________________________________________

Type of Service: _____________________________________________________________

Contact Person _______________________________________________________________

Dollar Amount: _______________________ Percent of Contract: __________________

____Section 3 Business ____SBE ____ Subcontractor ___Supplier

Proposed Subcontractors

Dollar Amount: _______________________ Percent of Contract __________________

(Duplicate this page if additional sheets are required)

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one paragraph per criteria). Duplicate this page if additional sheets are required.

Criteria 1: Cost/Price

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one

Criteria 2: Demonstrated understanding of requirements

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one

Criteria 3: System Functionality – usability, case management, group tracking, and reporting

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one

Criteria 4: Compliance with desired specifications

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one

Criteria 5: Demonstrated experience and expertise in performing similar work

Please provide a detailed response to each evaluation criteria indicated on the solicitation cover page (At least one

Criteria 6: Technical support and training options

Proposal Submission Instructions

(Electronic Response Submission Through BidNet)

All proposals and required forms transmitted electronically through BidNet shall be addressed with the same information above and electronically submitted to:

Allow ample time for the electronic submission of your proposal. Below is a link to a BidNet Electronic

Bid Submission (EBS) FAQ site. DHA strongly encourages offerors to review this information prior to starting your submission in addition to starting the submission process at least one business day prior to the proposal due date. DHA will not extend the submission deadline due to any technical issues or outages you may experience. Questions can be directed to the BidNet Vendor Support team in the below link.

http://faq.bidnetdirect.com/electronic-bid-submission/

The electronic date and time stamp via the BidNet site shall be used to determine the time electronic proposals/offers are received by the Authority.

After you register on BidNet, you must register in eComply (https://prod.ecomply.us) (see attachment) to be added to DHA’s S3B public registry/directory, Certified Payroll and Section 3 Labor Hour submissions. Please see the Business Status Affidavit to determine if your business qualifies as a Section

3 Business Concern.

Service of Protest

(1) In accordance with DHA Procurement Policy and Protest Guidelines, any protest against the solicitation must be received before the due date for receipt of bids or proposals, and any protest against the award of the contract, pursuant to this solicitation, shall be served on the

Authority within five (5) business days of the date provided on the written notice of contract award from DHA, or the protest will not be considered. All bid protests shall be in writing.

Protests must be received by 4:00 pm on the fifth business day.

(2) Protestors are required to submit protests in writing to Housing Authority of the City and

County of Denver, Procurement Manager, 1035 Osage Street, Denver, CO 80204 by some form of certified mail or hand delivered. The protest must be printed, typewritten, or otherwise duplicated in a legible form. The content of the written notice must contain:

a. The name, address and phone number of the person filing the protest and an explanation of how their substantial interests have been affected by the Authority’s determination;

b. The solicitation number and/or project title;

c. A statement of how and when the person filing the protest received notice of the

Authority’s determination;

d. A statement of all issues of disputed material fact. If there are none, the protest must so indicate;

e. A concise statement of the facts alleged, as well as the Authority’s policies which entitle the person filing the protest to relief;

f. A demand for relief to which the person deems themselves entitled; and;

g. Any other information the person contends is material to the protest.

(3) The DHA Contracting Officer’s designee will provide a written decision on the matter within twenty (20) calendar days of receipt of the protest. If a final determination cannot be made https://www.bidnetdirect.com/colorado/denverhousingauthority http://faq.bidnetdirect.com/electronic-bid-submission/ https://prod.ecomply.us/ within twenty (20) days, a written notice will be provided to the protester with an estimated date that the decision should be made and a reason for the extension.

(4) This decision will be final unless within five (5) business days of receipt of the written decision the protester appeals to the Contracting Officer. The appeal shall be in writing, sent via email to procurement@denverhousing.org and certified mail, or by hand‐delivery to the

Procurement Manager as stated above. Appeals should contain a statement of the factual and legal grounds on which reversal or modification of the decision is deemed warranted, specifying any errors of law made or information not previously considered.

mailto:procurement@denverhousing.org

THACCD #238 (Rev 6/15)

VENDOR QUALIFICATION FORM

All questions must be answered and the data given must be clear and comprehensive.

Please PRINT or TYPE

1. Legal Business Name: __________________________________________________________

DBA Name, if applicable: _______________________________________________________ (DBA-Doing Business As) (if more than one location, please list all locations)

2. Business Office Address: ___________________________________________________

Second Address: _____________________________________________________________

City, State, Zip: _____________________________________________________________

Phone Number /Area Code: ___________________________________________________

Fax Number /Area Code______________________________________________________

Email Address: _____________________________________________________________

(Local Contact person):

Name: _____________________________________________________________________

Phone number/area code: _____________________________________________________

3. Registered agent or other person authorized to accept service of process:

Name: ______________________________________________________________________

Address (if different than above):_______________________________________________

4. Remittance address if different than above:

Phone number/area code: _______________Fax number/area code: ___________________

Email Address: ________________________________________________________________

5. Effective Date Business Organized? ________________________________________________

6. Business Status: _____Corporation _____ Partnership _____ Individual/Sole proprietor _____ Other. Please describe_____________________

7. How many years have you been engaged in the business under your present name?

8. What other names(s) if any has your business/company operated under and taxpayer number used?

9. Have you ever refused to sign a contract? yes ( ) no ( ) If "yes", attach explanation.

10. List and state the background and experience of the principal members of your personnel, including all officers (include attachments if necessary).

11. Has any officer or partner of your organization ever been an officer or partner of another organization that failed to complete a contract within the last five (5) years? yes ( ) no( ) If "yes", attach explanation.

12. Has the firm or any partner or officers ever been involved in any bankruptcy action?

yes ( ) no ( ). If "yes", attach explanation.

13. Are you presently involved in litigation? yes( ) no( ) If "yes" explain type, kind, plaintiff, defendant, etc., and state the current status and attach to this form.

14. Will you, upon request, furnish any other information that may be required by the Housing

Authority of the City and County of Denver Colorado? yes ( ) no ( ) If "no", attach explanation.

15. Please list the names of your personnel authorized to sign legal and binding proposal and contract documents.

16. List three (3) companies including address, phone number, email address, and contact person that you are currently supplying goods or services to.

1. Name of Firm _______________________________________________________________

Address ______________________________________________________________________

City/State/Zip__________________________________________________________________

Contact person: __________________________ Phone Number ________________________

Email address: ________________________________________________________________

2. Name of Firm _______________________________________________________________

Address ______________________________________________________________________

City/State/Zip__________________________________________________________________

Contact person: _________________________ Phone Number_________________________

Email address: ________________________________________________________________

3. Name of Firm _______________________________________________________________

Address ______________________________________________________________________

City/State/Zip__________________________________________________________________

Contact person: _______________________ Phone Number___________________________

Email Address: ________________________________________________________________

17. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the Housing Authority of the City and County of Denver to verify the foregoing information.

Vendor is responsible for providing DHA with any changes to the information submitted on this form and the failure to do so could result in the termination of contract awarded. A Vendor Qualification Update Form will be required annually.

Name of Vendor:

By: __________________________________ Title: _________________________________________

Signature Date

THE NEXT PAGE (W-9) MUST BE COMPLETED IN ORDER TO

BECOME A QUALIFIED VENDOR

WORKER STATUS AFFIDAVIT

AFFIDAVIT OF (Name of Individual)

I, , first being duly sworn, state as follows:

1. I am over the age of 18 years.

2. I am the (Title) of, (Complete legal name of

Company), which is located at

(Street Address, City, State, Zip Code).

3. (Name of Company) is a

(Type of Business i.e. corporation, partnership, sole proprietorship, joint venture, limited liability company).

4. On behalf of the Company, I certify the following:

A. The Company will participate in the E-Verify Program in order to confirm the employment eligibility of all employees who are newly hired for employment to perform work under this contract.

B. The Company has confirmed the employment eligibility of all employees who are newly hired for employment to perform work under this contract.

C. To the extent required by law or legal process, the Company will comply with a reasonable request by the Department of Labor and Employment made in the course of an investigation undertaken by it to determine compliance with this affidavit.

5. I have read and understand the certifications contained herein.

6. ☐ This contract does not exceed $150,000. (Proceed to 7)

☐ This contract exceeds $150,000 and I acknowledge and agree, pursuant to 48 CFR 22.1803 and 48

CFR 52.222-54, that:

(a) Definitions. As used in this clause:

Commercially available off-the-shelf (COTS) item

(1) Means any item of supply that is:

(i) A commercial product (as defined in paragraph (1) of the definition of

“commercial product” at Federal Acquisition Regulation (FAR) 2.101);

(ii) Sold in substantial quantities in the commercial marketplace; and

(iii) Offered to the Government, without modification, in the same form in which it is sold in the commercial marketplace; and

(2) Does not include bulk cargo, as defined in 46 U.S.C. 40102(4), such as agricultural products and petroleum products. Per 46 CFR 525.1(c)(2), “bulk cargo” means cargo that is loaded and carried in bulk onboard ship without mark or count, in a loose unpackaged form, having homogenous characteristics. Bulk cargo loaded into intermodal equipment, except LASH or Seabee barges, is subject to mark and count and, therefore, ceases to be bulk cargo.

Employee assigned to the contract means an employee who was hired after November 6, 1986

(after November 27, 2009, in the Commonwealth of the Northern Mariana Islands), who is directly performing work, in the United States, under a contract that is required to include the clause prescribed at 22.1803. An employee is not considered to be directly performing work under a contract if the employee:

(1) Normally performs support work, such as indirect or overhead functions; and

(2) Does not perform any substantial duties applicable to the contract.

Subcontract means any contract, as defined in 2.101, entered into by a subcontractor to furnish supplies or services for performance of a prime contract or a subcontract. It includes but is not limited to purchase orders, and changes and modifications to purchase orders.

Subcontractor means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime Contractor or another subcontractor.

United States, as defined in 8 U.S.C. 1101(a)(38), means the 50 States, the District of Columbia, Puerto Rico, Guam, the Commonwealth of the Northern Mariana Islands and the U.S. Virgin Islands.

(b) Enrollment and verification requirements.

(1) If the Contractor is not enrolled as a Federal Contractor in E–Verify at time of contract award, the Contractor shall—

(i) Enroll. Enroll as a Federal Contractor in the E–Verify program within 30 calendar days of contract award;

(ii) Verify all new employees. Within 90 calendar days of enrollment in the E–Verify program, begin to use E–Verify to initiate verification of employment eligibility of all new hires of the Contractor, who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (b)(3) of this section); and

(iii) Verify employees assigned to the contract. For each employee assigned to the contract, initiate verification within 90 calendar days after date of enrollment or within 30 calendar days of the employee's assignment to the contract, whichever date is later (but see paragraph (b)(4) of this section).

(2) If the Contractor is enrolled as a Federal Contractor in E–Verify at time of contract award, the Contractor shall use E–Verify to initiate verification of employment eligibility of:

(i) All new employees. (A) Enrolled 90 calendar days or more. The Contractor shall initiate verification of all new hires of the Contractor, who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (b)(3) of this section); or (B) Enrolled less than 90 calendar days. Within 90 calendar days after enrollment as a Federal Contractor in E–Verify, the Contractor shall initiate verification of all new hires of the Contractor, who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (b)(3) of this section); or

(ii) Employees assigned to the contract. For each employee assigned to the contract, the Contractor shall initiate verification within 90 calendar days after date of contract award or within 30 days after assignment to the contract, whichever date is later (but see paragraph (b)(4) of this section).

(3) If the Contractor is an institution of higher education (as defined at 20 U.S.C. 1001(a));

a State or local government or the government of a Federally recognized Indian tribe; or a surety performing under a takeover agreement entered into with a Federal agency pursuant to a performance bond, the Contractor may choose to verify only employees assigned to the contract, whether existing employees or new hires. The Contractor shall follow the applicable verification requirements at (b)(1) or (b) (2), respectively, except that any requirement for verification of new employees applies only to new employees assigned to the contract.

(4) Option to verify employment eligibility of all employees. The Contractor may elect to verify all existing employees hired after November 6, 1986 (after November 27, 2009, in the

Commonwealth of the Northern Mariana Islands), rather than just those employees assigned to the contract. The Contractor shall initiate verification for each existing employee working in the Islands), within 180 calendar days of:

(i) Enrollment in the E–Verify program; or

(ii) Notification to E–Verify Operations of the Contractor's decision to exercise this option, using the contact information provided in the E–Verify program Memorandum of

Understanding (MOU).

(5) The Contractor shall comply, for the period of performance of this contract, with the requirements of the E–Verify program MOU.

(i) The Department of Homeland Security (DHS) or the Social Security

Administration (SSA) may terminate the Contractor's MOU and deny access to the E–Verify system in accordance with the terms of the MOU. In such case, the Contractor will be referred to a suspending and debarring official.

(ii) During the period between termination of the MOU and a decision by the suspending and debarring official whether to suspend or debar, the Contractor is excused from its obligations under paragraph (b) of this clause. If the Contractor is not suspended, debarred, or subject to a voluntary exclusion, then the Contractor must reenroll in E–Verify.

(c) Web site. Information on registration for and use of the E–Verify program can be obtained via the Internet at the Department of Homeland Security Web site: https://www.e–Verify.gov.

(d) Individuals previously verified. The Contractor is not required by this clause to perform additional employment verification using E–Verify for any employee:

(1) Whose employment eligibility was previously verified by the Contractor through the

E–Verify program;

(2) Who has been granted and holds an active U.S. Government security clearance for access to confidential, secret, or top secret information in accordance with the National Industrial Security Program Operating

Manual; or

(3) Who has undergone a completed background investigation and been issued credentials pursuant to Homeland Security Presidential Directive (HSPD)–12, Policy for a Common

Identification Standard for Federal Employees and Contractors.

(e) Subcontracts. The Contractor shall include the requirements of this clause, including this paragraph (e) (appropriately modified for identification of the parties), in each subcontract that—

(1) Is for—

(i) Services (except for commercial services that are part of the purchase of a COTS item (or an item that would be a COTS item, but for minor modifications), performed by the COTS provider, and are normally provided for that COTS item); or

(ii) Construction;

(2) Has a value of more than $3,500; and

(3) Includes work performed in the United States.

7. I am the (Title) of the Company, and I am authorized to execute this affidavit on its behalf, and to bind the Company regarding the matters contained herein. I have personal knowledge of the statements made in this affidavit and state that the same are true.

Affiant Signature

STATE OF )

) ss.

COUNTY OF )

Subscribed and sworn or affirmed before me this _____day of _________________, 20____ by

Witness my hand and official seal.

My Commission expires: ______________________.

Notary Public

BUSINESS STATUS AFFIDAVIT

AFFIDAVIT OF __________________________________ (Name of Individual)

STATE OF )

) ss.

COUNTY OF )

I, , first being duly sworn, state as follows:

I am over the age of 18 years.

1. I am the ____________________________________________________(Title) of, ______________________________________________________ (Complete legal name of Company), which is located at __________________________________

_________________________________(Street Address, City, State, Zip Code).

2. ______________________________________________________(Name of

Company) is a _____________________________________________(Type of

Business i.e. corporation, partnership, sole proprietorship, joint venture, limited liability company).

3. The Company is a (Check all that apply):

Small Business Enterprise

A small business enterprise is defined as a business, which is:

independently owned; not dominant in its field of operation; and not an affiliate or subsidiary of a business dominant in its field of operation. The size standards in 13 CFR 121 shall be used unless the Authority determines that their use is inappropriate.

Category 1 Section 3 Business

A business that is fifty-one percent (51%) owned and controlled by low or very low-income persons

Category 2 Section 3 Business

Over seventy-five percent (75%) of the labor hours performed for the business over the prior three-month period are performed by Section 3

Workers (see below definition)

Category 3 Section 3 Business

A business that is fifty-one percent (51%) owned and controlled by current public housing residents or residents who currently live in Section-8 assisted housing.

Definition of Section 3 Workers:

Categories – A Section 3 Worker is any worker who currently fits or when hired within the past five years fit at least one of the following categories, as documented:

a. Category One - is a low or very low-income individual (income for the previous or annualized calendar year is below income limit established by HUD:

https://www.huduser.gov/portal/datasets/il.html)

b. Category Two – is employed by a Section 3 Business Concern

c. Category Three – is a participant in HUD Youthbuild Program

Definition of Targeted Section 3 Workers:

d. Category Four - is employed by a Section 3 Business Concern

e. Category Five – Is a resident of public housing or participant in the

Housing Choice Voucher (Section 8) program (currently or within the past five years of hire)

f. Category Six – Lives within the service area or the neighborhood of the project (currently or within the past five years of hire)

g. Category Seven – is a participant in HUD Youthbuild Program

4. I have read and understand the definitions contained herein.

5. The Company hereby agrees to provide within thirty (30) days, upon request, any documents DHA requires to verify the information provided herein.

6. I understand and acknowledge that the following penalties will apply if DHA determines that the Company has submitted a false Business Status Affidavit:

A. If discovered prior to any contract being awarded, the Company will be ineligible for award of the contract, and will be permanently placed on the

DHA debarment list; or

B. If discovered during the term of the contract, the contract will immediately be terminated, and the Company will be permanently placed on the DHA debarment list; or

C. If discovered after the completion of the contract, the Company will be permanently placed on the DHA debarment list.

https://www.huduser.gov/portal/datasets/il.html

7. I am the ____________________________________________________(Title) of the Company, and I am authorized to execute this affidavit on its behalf, and to bind the Company regarding the matters contained herein. I have personal knowledge of the statements made in this affidavit and state that the same are true.

FURTHER Affiant sayeth naught.

Signature __________________________________

Subscribed and sworn to before me this ___ day of ______________, 20___ by

WITNESS my hand and official seal.

My commission expires: ____________________________________

[SEAL]