MadisonCounty_RFP_Dishwasher_2024.pdf

MADISON COUNTY SCHOOLS

REQUEST FOR PROPOSALS (RFP)

DISHMACHINE

MADISON COUNTY PRIMARY SCHOOL

RFP NO. SNP-24302

Madison County Charter School System (MCCSS) is requesting proposals from contractors that have the capability to provide and install a commercial dish machine at Madison County Primary School.

LOCATION:

Madison County School Nutrition Program

PO BOX 37

800 Madison St.

Danielsville, GA 30633

REQUEST FOR PROPOSAL TIMELINE

Proposal Issue Date: November 1, 2024

Optional Site Visit: November 12, 2024 2:00 pm

Final Date for Written Questions:

November 15, 2024 badair@madison.k12.ga.us

Proposal Due Date:

December 2, 2024 Madison County Charter School System PO Box 37 800 Madison St.

Danielsville, GA 30633 badair@madison.k12.ga.us

BOE Info Item: December 10, 2024

Anticipated Earliest Start Date: March 30, 2024

Deadline to Complete Work: June 30, 2024 mailto:badair@madison.k12.ga.us Barbara Adair Cross-Out November 1

Barbara Adair Inserted Text

Contents

INTRODUCTION

INSTRUCTIONS

Pre-Proposal Meeting

Errors in Proposals

Compliance with Laws

Withdrawal of Proposal

Confidentiality of Documents

Compensation

Rejecting Proposals

Conflict of Interest

Affirmation

Notification

PROPOSAL REQUIREMENTS

EVALUATION

PAYMENTS

Tax Exempt Status

TERMS AND CONDITIONS

Termination for Cause and Convenience

Equal Employment Opportunity Compliance Statement

Procurement Of Recovered Materials

PROPOSAL REQUIREMENTS AND FORMAT

Checklist for Supplier

MADISON COUNTY SCHOOLS

PROPOSAL FORM

MADISON COUNTY PRIMARY DISH MACHINE SPECIFICATIONS

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND

VOLUNTARY EXCLUSION

CIVIL RIGHTS ASSURANCE

INTRODUCTION

This document contains a Request for Proposal (RFP) for providing and installing a replacement dish machine for Madison County Middle School. This RFP sets forth the terms and conditions applicable to the proposed procurement.

INSTRUCTIONS

Interested parties are to submit a sealed proposal to Madison County Charter School System (MCCSS) as required by this RFP. It is the intent of MCCSS to award the contract to the vendor that clearly demonstrates the ability to provide these services to high professional standards.

All questions about this RFP must be submitted by email to Barbara Adair, School Nutrition Director, badair@madison.k12.ga.us by November 15, 2024. Questions will be posted at www.madison.k12.ga.us under the “Menus” section.

One (1) digital copy of your proposal must be submitted by Monday December 2, 2024 at 1:00 PM to:

ADDRESS: Barbara Adair, SNP PO Box 37 800 Madison St.

Danielsville, GA 30633

Submitters are encouraged to EMAIL submissions with a read receipt to:

badair@madison.k12.ga.us

All proposals must be clearly marked on the outside: "PROPOSAL FOR MADISON COUNTY MIDDLE SCHOOL DISH MACHINE". All proposals received after the designated time and date of the proposal opening will not be considered.

All proposals received after the designated time and date of the proposal opening will not be considered. Proposers are encouraged to carefully review all provisions and attachments of this document prior to submission.

To minimize the cost to the proposer in responding to this solicitation, you are encouraged to be brief and succinct, avoiding extravagant covers, bindings, and photographs. MCCSS will not be responsible for any cost incurred by proposers in responding to this solicitation.

MCCSS reserves the right to reject any and all proposals, to evaluate proposals, and to accept portions of any proposal, and accept any proposal, which in its opinion, may be in the best interest of the MCCSS and reserves the right to waive any and all formalities.

Pre-Proposal Meeting

There will be an Optional Pre-Proposal meeting at Madison County Middle School Cafeteria on Tuesday November 12, 2024 at 2:00 PM for prospective mailto:badair@madison.k12.ga.us http://www.madison.k12.ga.us/ bidders to familiarize themselves with the site. Technical questions relating to the RFP may be directed in writing via email to: Barbara Adair, Director of School Nutrition, badair@madison.k12.ga.us.

Errors in Proposals Proposers or their authorized representatives are expected to fully inform themselves as to the conditions, requirements, and specifications before submitting proposals.

Failure to do so will be at the Proposer's own risk.

Compliance with Laws The Proposer shall obtain and maintain all applicable contractor's licenses, a minimum of $1,000,000 in liability insurance, $1,000,000 General Aggregate Insurance, and worker's compensation insurance as required by MCCSS financial policies. The Proposer will comply with any and all other standards or regulations required by federal or state statutes or any ordinances and rules during the performance of any contract between the Proposer and MCCSS.

Withdrawal of Proposal Any proposal may be withdrawn by written request received by MCCSS before the time fixed for receipt of proposals. Withdrawal of your proposal will not prejudice the right of the proposer to submit a new proposal, providing the latter is timely received as provided herein.

Confidentiality of Documents Upon receipt of a proposal by MCCSS, the proposal shall become the property of MCCSS without compensation to the proposer, for disposition or usage by MCCSS at its discretion. The details of the proposal documents will remain confidential to the extent possible until the final award.

Compensation MCCSS has attempted to provide as much information about the scope of services as possible to enable firms to structure a most productive and cost-effective offer. The subsequent contract between Madison County Schools and the winning proposer will define compensation payments based upon the amount negotiated and term agreements between Madison County Schools and the successful proposer. The winning proposal will result in a contract between the contractor and MCCSS. There will be only one contract with the winning proposer and that winning proposer will be responsible for paying any subcontractors and purchasing materials as outlined in the submitted proposal.

Rejecting Proposals MCCSS reserves the right to reject any or all proposals and is not bound to accept any proposal if that proposal is contrary to the best interest MCCSS. Similarly, MCCSS is not bound to accept the lowest dollar proposal if the offer is not considered in MCCSS best interest.

mailto:badair@madison.k12.ga.us

Conflict of Interest All respondents must provide a statement of disclosure, which will allow MCCSS to evaluate possible conflicts of interest. No person involved in making procurement decisions may have personal investments in any business entity which will create a substantial conflict between their private interests and their public duties.

Affirmation All proposals must clearly state and affirm by signature that the proposer has read the RFP document, fully understands the requirements, has familiarized themselves with the conditions of the work, and will comply with these requirements, if awarded this work.

Notification MCCSS will evaluate all the proposals and quickly select the winning proposal for approval by the Madison County Board of Education at the December Board of Education Meeting. All proposers will be notified by December 11, 2024.

PROPOSAL REQUIREMENTS

All Proposals shall be submitted using the attached Proposal Form in the attachments section. In addition, responses shall include the following:

1. VENDOR QUALIFICATIONS

To ensure the integrity of the purchased products, only the manufacturer of the specified equipment or an authorized reseller of this manufacturer will be acceptable. If you are a reseller you must submit a letter from the manufacturer specifying your status as an authorized reseller.

2. COST PROPOSAL /FEE

MCCSS requires a total cost or fee for this project in addition to the itemized list. A lump sum cost proposal to supply all equipment, materials, supplies, labor to complete the project, unless specifically noted to not be part of the project.

MCCSS requests a price breakdown with each proposal to generally follow those enumerated items in the project scope, plus any additional charges or items by the contractor. However, the bid must be a lump sum cost.

3. CONTACT INFORMATION

All proposals must include the following contact and authorization information:

• Company Name

• Mailing Address

• Street Address

• Office and Cell Phone

• Fax Number

• Email Address

• Authorized Signee and Title

• Printed Name and Title

• Signature of Authorized Signee and Date Affirming the Proposal

4. SPECIFICATIONS

All proposals must include the items listed in the specifications section of this

RFP.

EVALUATION

All bids submitted before the deadline will be evaluated based on the criteria listed in this RFP. If any of the required elements are missing, inaccurate, or altered, the entire submittal will be rejected as incomplete.

Evaluation is a three-step process. The first step involves ascertaining if the submittal is complete, accurate, and meets the requirements. The second step is comparing the value of the proposed solutions which have successfully passed the first step process. Although the price is the most important factor in comparing value, it is not the only factor: comparison of the vendors’ service proposals, quality of proposed solution, reference checks, vendor reputation, and other intangible factors are used. All decisions made by the School Nutrition Department in the evaluative process are final.

PAYMENTS

All requests for payment must be made to the Madison County School Nutrition for review, for approval, and for payment. All invoices must include “Net 30” terms.

Tax Exempt Status The District is exempt from the payment of State Sales Tax. No such taxes should be included in the bid.

TERMS AND CONDITIONS

Termination for Cause and Convenience Immediate Termination - This contract will terminate immediately and absolutely if the SFA determines that adequate funds are not appropriated or granted or funds are de-appropriated such that the SFA cannot fulfill its obligations under the Contract, which determination is at the SFA’s sole discretion and shall be conclusive. Further, the SFA may terminate the contract for any one or more of the following reasons effective immediately without advance notice:

• In the event the Contractor is required to be certified or licensed as a condition precedent to providing goods and services, the revocation or loss of such license or certification may result in immediate termination of the Contract effective as of the date on which the license or certification is no longer in effect;

• The SFA determines that the actions, or failure to act, of the Contractor, its agents, employees or subcontractors have caused, or reasonably could cause, life, health or safety to be jeopardized;

• The Contractor fails to comply with confidentiality laws or provisions; and/or

• The Contractor furnished any statement, representation, or certification in connection with the Contract or the proposal process, which is materially false, deceptive, incorrect or incomplete.

Termination for Cause- All contracts in excess of $10,000 must address termination for cause and for convenience by the nonfederal entity including the manner by which it will be affected and the basis for settlement. The occurrence of any one or more of the following events shall constitute cause for the School Food Authority (SFA) to declare the Contractor in default of its obligation under the Contract:

• The Contractor fails to deliver or has delivered nonconforming goods or services or fails to perform, to the SFA’s satisfaction, any material requirement of the Contract or is in violation of a material provision of the Contract, including, but without limitation, the express warranties made by the Contractor;

• The SFA determines that satisfactory performance of the Contract is substantially endangered or that a default is likely to occur;

• The Contractor fails to make substantial and timely progress toward performance of the Contract;

• The Contractor becomes subject to any bankruptcy or insolvency proceeding under federal or state law to the extent allowed by applicable federal or state law including bankruptcy laws;

• The Contractor terminates or suspends its business; or the SFA reasonably believes that the Contractor has become insolvent or unable to pay its obligations as they accrue consistent with applicable federal or state law;

• The Contractor has failed to comply with applicable federal, state and local laws, rules, ordinances, regulations and orders when performing within the scope of the Contract;

• The Contractor has engaged in conduct that has or may expose the SFA to liability, as determined in the SFA’s sole discretion and/or

• The Contractor has infringed any patent, trademark, copyright, trade dress or any other intellectual property rights of the SFA, the state, or a third party.

Notice of Default- If there is a default event caused by the Contractor; the SFA shall provide written notice to the Contractor requesting that the breach or noncompliance be remedied within the time-period specified in the SFA’s written notice to the Contractor.

If the breach or noncompliance is not remedied within the period of time specified in the written notice, the SFA may:

• Immediately terminate the Contract without additional written notice; and/or

• Procure substitute goods or services from another source and charge the difference between the Contract and the substitute contract to the defaulting Contractor, and/or,

• Enforce the terms and conditions of the Contract and seek any legal or equitable remedies.

Termination upon Notice- Following thirty (30) days’ written notice, the SFA may terminate the Contract in whole or in part without the payment of any penalty or incurring any further obligation to the Contractor. Following termination upon notice, the Contractor shall be entitled to compensation, upon submission of invoices and proper proof of claim, for goods and services provided under the Contract to the SFA up to and including date of termination.

Termination Due to Change in Law- The SFA shall have the right to terminate this Contract without penalty by giving thirty (30) days’ written notice to the Contractor as a result of the following:

• The SFA’s authorization to operate is withdrawn or there is a material alternation in the programs administered by the SFA; and/or

• The SFA’s duties are substantially modified.

Payment Limitation in Event of Termination- In the event of termination of the Contract for any reason the SFA shall pay only those amounts, if any, due and owing to the Contractor for goods and services actually rendered up to and including the date of termination of the Contract and for which the SFA is obligated to pay pursuant to the Contract or Purchase Instrument. Payment will be made only upon submission of invoices and proper proof of the Contractor’s claim. This provision in no way limits the remedies available to the SFA under the Contract in the event of termination. The SFA shall not be liable for any costs incurred by the Contractor in its performance of the Contract, including, but not limited to, startup costs, overhead or other costs associated with the performance of the Contract.

The Contractor’s Termination Duties- Upon receipt of notice of termination or upon request of the SFA, the Contractor shall:

• Cease work under the Contract and take all necessary or appropriate steps to limit disbursements and minimize costs, and furnish a report within thirty (30) days of the date of notice of termination, describing the status of all work under the Contract, including, without limitation, results accomplished, conclusions resulting there from, and any other matters the SFA may require;

• Immediately cease using and return to the SFA, any personal property or materials, whether tangible or intangible, provided by the SFA to the Contractor;

• Comply with the SFA’s instructions for the timely transfer of any active files and work product by the Contractor under the Contract;

• Cooperate in good faith with the SFA, its employees, agents, and contractors during the transition period between the notification of termination and the substitution of any replacement contractor; and

• Immediately return to the SFA any payments made by the SFA for goods and services that were not delivered or rendered by the Contractor.

Equal Employment Opportunity Compliance Statement In accordance with Federal Law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call toll free (866) 632-9992. (Voice) Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or

(800) 845-6136 (Spanish). USDA is an equal opportunity provider and employer.

(Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause provided under 41 CFR 60- 1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 FR 12319, 12935, 3 CFR Part, 1964- 1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR part 60, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.”)

Procurement Of Recovered Materials An GCSS and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines

PROPOSAL REQUIREMENTS AND FORMAT

Please provide descriptions and answers to the following:

1) Equipment

a) Provide detail equipment information

b) Warranty terms and conditions

2) Cost

a) Provide pricing for warranties as described above

b) Provide detailed pricing for the equipment, services, and fees

3) Support

a) Describe support processes and/or procedures for handling both warranty and non-warranty claims

b) Describe any training that can be made available to School Nutrition staff

c) Logistical, warehousing, and delivery capabilities

d) Requirements for self-maintenance option

3) Delivery

a) Delivery of devices will take place at Madison County Middle School’s Cafeteria

Checklist for Supplier The following documents are attached to and made part of the Proposal:

□ Madison County Schools Proposal Form

□ Madison County Middle School Dish Machine Specifications

□ Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion

□ Civil Rights Assurance

MADISON COUNTY CHARTER SCHOOL DISTRICT

PROPOSAL FORM

Project Name: Madison County Middle School Dish Machine

RFP Number: 240302

In compliance with your Advertisement for Proposal and the Proposal Documents, the undersigned Proposer, Legal Name of Proposer

Address of Proposer

Address of Proposer

Telephone of Proposer having carefully examined the site and Proposal Documents, including any Addenda thereto, for the: Madison County Middle School Dish Machine, proposes and agrees, if this proposal is accepted, to enter into a contract with the SFA to perform the Work including all services, supervision, labor, equipment and material in conformance with the contract documents, in the time stated therein, for the lump sum of:

A. LUMP SUM PROPOSAL:

__________________________________________________dollars [written in words]

The undersigned Proposer hereby acknowledges receipt of the following

Addenda Date Initial Received:

By submission of this Proposal, the Proposer certifies that this Proposal has been derived independently, without consultation, communication, or agreement as to any matter relating to this Proposal with any other Proposer or with any competitor. The Proposer hereby certifies that this Proposal is made without prior understanding, agreement or connection with any corporation, firm or person submitting a proposal for the same Work and is in all respects fair and without collusion or fraud. The Proposer agrees to abide by all conditions of the Proposal.

Respectfully submitted, Typed Name of Proposer

Title of Proposer

By __________________________________ [Seal] Signature

Georgia License No

Date of Execution

MADISON COUNTY PRIMARY DISH MACHINE SPECIFICATIONS

Madison County School Nutrition Program

Dishwasher, Conveyor Type

Replace Current corner machine with new dish tables and a 86” machine with a 30” side loader that will accept sheet pans. This unit will require new dish tables and modifications to the existing vent ducts to accept the new machine. KEC to furnish turn key installation including venting modifications. The school system must provide water, power and drain connections within 5 feet of the machine.

ITEM # 1 SOILED DISHTABLE

Quantity: One (1) Manufacturer: Titan Stainless Model: 221SDT-R o One (1) Model 221SDT-R Soiled Dishtable, straight design, 221"W, right to left operation, 20" x 20" x 8"D pre-rinse sink, 16/300 stainless steel top, stainless steel H-frame legs, NSF o One (1) Model SB Scrap Basket, small, 19-1/2"W x 19-1/2"D x 6"H, 16/300 stainless steel construction o One (1) Model PRUD Provisions for Roll Up Door o Eight (8) Model WF Window Frame, up to 60"H o Eight (8) Model PTLD Pass-thru Window Ledge (priced per foot) o (10) Model TUS Tubular Undershelf, 1-5/8" dia. tubular stainless steel construction

(priced per foot)

ITEM # 2 DISHWASHER, CONVEYOR TYPE

Quantity: One (1) Manufacturer: Hobart Model: CL86-BAS+BUILDUP o One (1) Model CL86-BAS+BUILDUP Conveyor Dishwasher, (2) tank, with power scrapper; (342) racks/hour, .33 gallon/rack, Complete Delime with Booster Guard, Touch Screen Controls with diagnostics, troubleshooting, and SmartConnect App, capless wash arms, NSF Pot & Pan mode, pumped rinse, insulated hinged doors, cULus, NSF o One (1) Standard warranty - 1-Year parts, labor & travel time during normal working hours within the USA o One (1) Model CL86BAS-HTE15K Electric tank heat 15kW o One (1) Model CL86BAS-ELE0CD 480v/60/3-ph

Single point connection standard (field convertible to dual point) o One (1) Model CL86BAS-HGTHTS Higher than Standard 24”H x22”W opening, fits large oval trays, tall drink dispensers o One (1) Model CL86BAS-ERH24K With 24 kW Booster (default) o One (1) Model CL86BAS-DIR0RL Right to left operation o One (1) Model SL30/E-NOHDRL SL30 side loader RL E-Series (installation priced separately) o One (1) Model WS80-NOINSTALL Water softening system 4,818 grains/lb capacity, 14 gallons regeneration volume, salt alarm, holds 2 bags of salt.

o Two (2) Model VNTHD/E-ADJ E-series vent hood domestic (adjustable) o Five (5) Model SHTPAN-RACK Rack, 6 sheet pan o One (1) Model TBLLIM-CL Table limit switch for CL & CLEN series o One (1) Model CL86EN-BASFETSTD Standard feet

ITEM # 3 CLEAN DISHTABLE

Quantity: One (1) Manufacturer: Titan Stainless Model: 83CDT-L o One (1) Model 83CDT-L Clean Dish table, straight design, 83"W, right to left operation, 16/300 stainless steel top, stainless steel H-frame legs, NSF Installation of both options to be performed by Hobart Sales and Service. End user must provide power, water and a drain within 5 feet of the machine. Once this is provided. Hobart service will handle all connections of the new machine including modifications to existing vent ducts to accommodate the new machine. Installation by Hobart service will provide an extended 6 month warranty to the machine to make a 18 month total warranty.

AD-1047 OMB No. 0505-0027 Expiration Date: 09/30/2025

Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions

The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. § 552a, as amended). This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, and 2 CFR § 180.335, Participants' responsibilities. The regulations were amended and published on August 31, 2005, in 70 Fed. Reg. 51865-51880. Copies of the regulations may be obtained by contacting the Department of Agriculture agency offering the proposed covered transaction.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0505-0027. The time required to complete this information collection is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The provisions of appropriate criminal or civil fraud, privacy, and other statutes may be applicable to the information provided.

(Read instructions on page two before completing certification.)

A. The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals:

1. Are not presently debarred, suspended, or proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;

2. Have not within a 3-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

3. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (A.2.) of this certification; and

4. Have not within a 3-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default.

B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

ORGANIZATION NAME PR/AWARD NUMBER OR PROJECT NAME

NAME(S) AND TITLE(S) OF AUTHORIZED REPRESENTATIVE(S)

SIGNATURE DATE

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.

https://www.usda.gov/oascr/how-to-file-a-program-discrimination-complaint mailto:program.intake@usda.gov

Instructions for Certification

(1) By signing and submitting this form, the prospective primary participant is providing the certification set out on page 1 in accordance with these instructions.

(2) The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant must submit an explanation of why it cannot provide the certification set out on this form. The certification or explanation will be considered in connection with the Department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation will disqualify such person from participation in this transaction.

(3) The certification in this clause is a material representation of fact upon which reliance was placed when the Department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department or agency may terminate this transaction for cause or default.

(4) The prospective primary participant must provide immediate written notice to the Department or agency to which this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances.

(5) The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549, at 2 CFR Parts 180 and 417. You may contact the Department or agency to which this proposal is being submitted for assistance in obtaining a copy of those regulations.

(6) The prospective primary participant agrees by submitting this form that, should the proposed covered transaction be entered into, it may not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Department or agency entering into this transaction.

(7) The prospective primary participant further agrees by submitting this form that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions," provided by the Department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.

(8) A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the General Services Administration’s System for Award Management Exclusions database.

(9) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.

(10) Except for transactions authorized under paragraph (6) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the Department or agency may terminate this transaction for cause or default.

Form AD-1047 (REV 12/22)

This institution is an equal opportunity provider.

CIVIL RIGHTS ASSURANCE

The entire Civil Rights Assurance Statement must be included on all contracts, agreements, solicitations. Modify the assurance to specify your school district. The full assurance statement is as follows:

Madison County Schools hereby agrees that it will comply with:

i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.);

ii. Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.);

iii. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794);

iv. Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.);

v. Title II and Title III of the Americans with Disabilities Act (ADA) of 1990 as amended by the ADA Amendment Act of 2008 (42 U.S.C. 12131-12189);

vi. Executive Order 13166, "Improving Access to Services for Persons with Limited English

Proficiency." (August 11, 2000);

vii. All provisions required by the implementing regulations of the Department of Agriculture

(USDA) (7 CFR Part 15 et seq.);

viii. Department of Justice Enforcement Guidelines (28 CFR Parts 35, 42 and 50.3);

ix. Food and Nutrition Service (FNS) directives and guidelines to the effect that, no person shall, on the grounds of race, color, national origin, sex, age, or disability, be excluded from participation in, be denied the benefits of, or otherwise be subject to discrimination under any program or activity for which the Program applicant receives Federal financial assistance from USDA; and hereby gives assurance that it will immediately take measures necessary to effectuate this Agreement.

x. The USDA non-discrimination statement that in accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the

USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs).

This assurance is given in consideration of and for the purpose of obtaining any and all Federal financial assistance, grants, and loans of Federal funds, reimbursable expenditures, grant, or donation of Federal property and interest in property, the detail of Federal personnel, the sale and lease of, and the permission to use Federal property or interest in such property or the furnishing of services without consideration or at a nominal consideration, or at a consideration that is reduced for the purpose of assisting the recipient, This institution is an equal opportunity provider.

or in recognition of the public interest to be served by such sale, lease, or furnishing of services to the recipient, or any improvements made with Federal financial assistance extended to the Program applicant by USDA. This includes any Federal agreement, arrangement, or other contract that has as one of its purposes the provision of cash assistance for the purchase of food, and cash assistance for purchase or rental of food service equipment or any other financial assistance extended in reliance on the representations and agreements made in this assurance.

By accepting this assurance, Madison County Charter School System agrees to compile data, maintain records, and submit records and reports as required, to permit effective enforcement of nondiscrimination laws and permit authorized USDA personnel during hours of program operation to review and copy such records, books, and accounts, access such facilities and interview such personnel as needed to ascertain compliance with the nondiscrimination laws. If there are any violations of this assurance, the Department of Agriculture, FNS, shall have the right to seek judicial enforcement of this assurance. This assurance is binding on Madison County Charter School System, its successors, transferees and assignees as long as it receives assistance or retains possession of any assistance from

USDA. The person or persons whose signatures appear below are authorized to sign this assurance on behalf of Madison County Charter School System.

11/1/2024

Signature(s) Date

Barbara J Adair

Printed Name

School Nutrition Director

Title