RFP _26_007 ROADWAY_DESIGN_ENGINEERING SERVI.pdf

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Attached to
26-007 Roadway/Design/Engineering Services for Mango Road Improvements Project
Solicitation number
PE-65700-NONST-2026-000000082
Issued by
Fayette County, Georgia

About this file

This is a Request for Proposal (RFP) issued by the Floyd County Board of Commissioners Purchasing Department in Rome, Georgia, for roadway design and engineering services related to the Mango Road Improvements Project. Floyd County seeks qualified firms with extensive highway and road design experience to provide comprehensive design services including preliminary engineering, conceptual design, final roadway design, construction documents, bidding assistance, and construction administration and inspection. The project involves modifications to Mango Road, an existing county roadway, to create a typical Floyd County road section along with associated storm drain and utility work, extending approximately 0.34 miles from the intersection with Calhoun Road NE to a point approximately 1,770 feet east. The project includes modifications to the Mango Road and Calhoun Road NE intersection to address lane configuration and traffic signal installation for safe and efficient travel. Proposals must be received no later than March 24, 2026, at 2:00 p.m. local time through the Bonfire platform. The deadline for written questions is March 17, 2026, at 2:00 p.m. All inquiries should be directed to Randy E. Self, Purchasing Director, at randy.self@floydcountyga.org or (706) 291-5118. The successful firm may be required to participate in a detailed oral interview with the evaluation team.

Pricing proposals must be submitted as a separate attachment in the Bonfire platform and will be evaluated as 20% of the selection criteria, alongside project timeliness (20%), project history (20%), addressing RFP requirements (20%), and references (20%). Firms must provide a lump sum fee for listed services and indicate any expense reimbursement multiples, along with a fee schedule for additional work that may be requested. The successful respondent must provide proof of professional liability insurance in the amount of two million dollars before work begins. Funds for expenditure are projected to be available in 2026 and 2027, derived from a special tax approved by Floyd County voters in 2023 for the Mango Road Improvements Project. The project is structured as a design/bid/build delivery method. All documents generated by the engineering firm, including drawings and specifications, become the property of Floyd County Georgia upon completion. Invoices for services rendered in each phase will be processed through the Purchasing Department, with payment made by check within 30 days of invoice approval. Firms must submit required certifications including non-discrimination, non-collusion, E-Verify compliance (or S.A.V.E. compliance if fewer than 10 employees), drug-free workplace, and a W-9 form.

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RFP 26-007

Floyd County Board of Commissioners

Request for Proposal

(RFP No. 26-007)

Roadway/Design/Engineering Services for Mango Road Improvements Project

Rome, Georgia 30161

Issue Date: February 23, 2026

All communication concerning this project must be directed to the Purchasing Office until the bid is awarded. Vendors should not have contact with the Departments.

FLOYD COUNTY BOARD OF COMMISSIONERS

PURCHASING DEPARTMENT

TWELVE EAST 4th AVENUE, SUITE 106

ROME, GA 30161

NOTICE TO ROADWAY DESIGN/ENGINEERING FIRMS

REQUEST FOR PROPOSALS FOR ROADWAY DESIGN/ENGINEERING SERVICES FOR

THE FLOYD COUNTY BOARD OF COMMISSIONERS,

MANGO ROAD IMPROVEMENT PROJECT

Floyd County is requesting proposals from qualified Roadway Design/Engineering firms with extensive Highway/Road Design experience to provide Highway/Road Design services for Mango Road Improvements Project, Rome, Georgia 30161. Services to include all facets of roadway design and construction, bid documents, contract administration, construction management, testing, etc. The property is owned by Floyd County.

Proposals must be received no later than March 24, 2026, at 2:00 p.m. Late proposals will not be considered.

If you have any questions concerning this package, contact:

Randy E. Self, Purchasing Director Floyd County Board of Commissioners Twelve East 4th Avenue, Suite 106 Rome, Georgia 30161 Phone: (706) 291-5118 Randy.self@floydcountyga.org

Please submit questions in writing to randy.self@floydcountyga.org the deadline for questions is 2:00 PM, March 17, 2026.

mailto:randy.self@floydcountyga.org

1. SERVICES OVERVIEW:

DESIGN CONCEPTUALIZATION, DESIGN DOCUMENTS AND CONTRACT

ADMINISTRATION FOR THE CONSTRUCTION OF THE MANGO ROAD IMPROVEMENTS

PROJECT. SERVICES INCLUDE ALL FACETS OF HIGHWAY/ROADWAY PLANNING, DESIGN

AND CONSTRUCTION COST ESTIMATING, CONSTRUCTION OVERSITE, ETC.

2. BACKGROUND:

IN 2023 THE PEOPLE OF FLOYD COUNTY VOTED POSITIVELY TO IMPOSE A SPECIAL TAX

FOR THE MANGO ROAD IMPROVEMENTS PROJECT. THE BOARD OF COMMISSIONER

HAVE ALLOCATED FUNDS TO ACQUIRE THE SERVICES OF

ROADWAY/HIGHWAY/DESIGN SERVICES.

IT IS ANTICIPATED THAT BASED ON THE REVIEW OF SUBMISSIONS A

RECOMMENDATION WILL BE SUBMITTED TO THE FLOYD COUNTY BOARD OF

COMMISSIONERS AT A FUTURE REGULAR MEETING.

EXPENDITURE OF FUNDS FOR THE SELECTED ROADWAY/HIGHWAY DESIGN SERVICE

PROJECTED TO BE AVAILABLE IN 2026 AND 2027. THIS PROJECT IS EXPECTED TO BE A

DESIGN/BID/BUILD PROJECT.

PURPOSE AND OBJECTIVE: THE PURPOSE OF THIS REQUEST FOR PROPOSAL (RFP) IS

TO OBTAIN PROPOSALS FROM QUALIFIED DESIGN FIRMS FOR ROADWAY/HIGHWAY

DESIGN.

THE PROJECT CONSISTS OF MODIFICATIONS TO MANGO ROAD (AN EXISTING FLOYD

COUNTY ROADWAY) TO CREATE TYPICAL FLOYD COUNTY ROAD SECTION ALONG

WITH ASSOCIATED STORM DRAIN AND UTILITY WORK, FROM THE INTERSECTION WITH

CALHOUN ROAD NE TO THE PROJECT TERMINUS APPROXIMATELY 1770 FEET EAST OF

SAID INTERSECTION. TOTAL LENGTH OF PROJECT IS APPROXIMATELY 0.34 MILES AND

INCLUDES MODIFICATIONS TO INTERSECTION WITH CALHOUN ROAD.

ADDITIONALLY, THE DESIGN SHOULD INCLUDE MODIFICATIONS TO MANGO ROAD AT

THE INTERSECTION WITH CALHOUN ROAD, NE (BOTH LANE CONFIGURATION AND

SIGNAL INSTALLATION) TO PROVIDE SAFE AND EFFICIENT TRAVEL THROUGH THE

INTERSECTION.

TIME IS OF THE ESSENCE. PROPOSAL SHALL INCLUDE TIMELINE FOR:

• NOTICE TO PROCEED TO PRELIMINARY DESIGN COMPLETION

• NOTICE TO PROCEED TO COMPLETION OF REQUIRED RIGHT OF WAY

ACQUISITION DOCUMENTS FOR THOSE PARCELS THAT WILL REQUIRE SUCH

• TIMELINE FROM OWNER’S COMMENTS ON PRELIMINARY DESIGN TO COMLETION

OF PLANS.

SPECIFICATIONS AND BID DOCUMENTS. (DUE TO ESCALATION OF CONSTRUCTION

COSTS LIQUIDATED DAMAGES MAY BE IMPOSED FOR FAILURE TO MEET PROPOSED

TIMELINES AS PART OF YOUR RFP SUBMITTAL.)

THE COST AND DETAILS FOR THE FOLLOWING ITEMS MUST BE ADDRESSED

WITHIN THE PROPOSAL:

• PRELIMINARY ENGINEERING PHASE

• RIGHT OF WAY & CONSTRUCTION EASEMENT DOCUMENTS

• FINAL ROADWAY DESIGN

• CONSTRUCTION SPECIFICATIONS

• BID PHASE DOCUMENTS – INCLUDING MATERIAL QUANTITIES

• CONSTRUCTION PHASE SERVICES/CONSTRUCTION INSPECTION – AS AN

ALTERNATE.

THE PROPOSAL SHOULD ALSO ADDRESS THE FOLLOWING:

• EXAMPLES OF SIMILAR SIZED PROJECTS COMPLETED BY YOUR FIRM.

• LIST OF REFERENCES

• COMPANY INFORMATION – PROJECT LEAD, SURVEYOR, ETC.

PROPOSAL WILL BE EVALUATED ON THE FOLLOWING CRITERIA:

• PROJECT TIMELINESS 20%

• PROJECT HISTORY 20%

• ADDRESSING RFP REQUIREMENTS 20%

• REFERENCES 20%

• PRICING PROPOSAL 20% (PLEASE NOTE: THE PRICING PROPOSAL AND RATE

SCHEDULE SHOULD BE PROVIDED AS A SEPARATE PAGE/ATTACHMENT IN THE

BONFIRE PLATFORM FOR SUBMISSION)

NOTE: FIRMS SUBMITTING A PROPOSAL MUST PROVIDE AN APPROXIMATION OF

TIME REQUIRED TO START AND COMPLETE TASKS AS IDENTIFIED.

I. PROCUREMENT PROCESS AND INSTRUCTIONS

The evaluation and selection of the successful Roadway Design Services firm and the negotiations and procurement of services will proceed as follows:

Submission of Proposals: Roadway Design firms that wish to participate must submit responses as directed in this Design Services package. All costs related to the preparation, submittal and presentation of the response package are the sole responsibility of the responding firm and will not be assumed in whole or in part by Floyd County.

Proposal must be received no later than March 24, 2026 at 2:00 p.m., local time. Proposals received after this date will not be considered.

All proposals must be submitted through www.floycountyga.bonfirehub.gov .

Any inquiries regarding the Road/Highway Design Services package shall be in writing and addressed to Randy E. Self at randy.Self@floydcountyga.org .

Contents of Proposals:

Floyd County intends to award a contract for Road/Highway Design Services to the qualified firm whose response, together with any information developed in any follow-up oral interview, provides the greatest value to Floyd County. Firms responding will be evaluated based on information provided in their response (together with any such interview), which response shall, at a minimum, include the following information:

1. Firm name, address, nature of entity (partnership, corporation, joint venture, etc.), and general background.

2. Organization profile including, without limitation, the following:

• Organizational chart

• A list of your present employees who will oversee this project for Floyd County. For each employee, include his/her resume which includes education, related road/ highway design experience, other pertinent information, and the names, addresses and project contacts for projects on which the individual performed the same, or similar, roles to those proposed for the Chulio Road Improvements Project.

• The total number of full-time employees in the organization is broken down by position categories.

3. Provide a summary of three (3) representative jobs of similar scope and cost previously completed by your firm. Provide the name of the owner, contact person and telephone number, e-mail address approximate contract value, and name of person responsible in your firm. Was each of the projects listed completed on time and within budget?

http://www.floycountyga.bonfirehub.gov/ mailto:randy.Self@floydcountyga.org

4. Have you ever been sued or subjected to arbitration by an owner or a contractor? If so, state the name and address of the party asserting a claim against you, and the nature and outcome of the dispute.

5. Have you ever filed for bankruptcy, been declared insolvent, or otherwise been involved in insolvency proceedings?

6. State your total annual sales for the two most recent years.

7. The successful respondent must provide proof of professional liability in the amount of two (2) million dollars before any work can begin.

8. State a lump sum fee for listed services. Indicate whether you charge a multiple when seeking reimbursement of expenses, and if so, what is it?

9. Provide an estimated schedule of deliverables. Proposed schedule provided.

10. Provide a fee schedule for all positions for any additional work that may be requested.

11. Provide all additional information which you believe is pertinent to your evaluation by the

Road/Highway Design Services Evaluation Team.

II. PROPOSAL REVIEW AND EVALUATION

Floyd County will establish a Road/Highway Design Services Evaluation Team consisting of staff members to review and evaluate the written responses to this request. One or more firms may be selected for further competition and may be required to participate in a detailed oral interview to answer questions from the Road/Highway Design Services Evaluation Team. All people with major responsibilities for design, management, construction administration or contract negotiations should be present at the interview. (The interview may be held via Zoom)

Upon completion of the foregoing process, the Road/Highway Design Services Evaluation Team will rank firms based on the factors below so that negotiations may proceed with the top-ranked firm. Floyd County reserves the right to reject any and all submissions and its decision to do so shall be final.

III. EVALUATION FACTORS

Proposals submitted will be subject to the following evaluation process:

1. All proposals will be evaluated individually on their technical merits prior to examining price.

2. The technical evaluation will consist of a qualitative review of the following factors, each with a

20-point maximum:

• Abilities and experience of the individuals and/or firms that will be performing the services.

• Capability to provide services in a timely manner.

• Budget Viability/Cost

• Certified statement that the offeror is not debarred, suspended, or otherwise prohibited by any Federal, State, or local agency. Provide the State of Georgia License number (if applicable) of any team member that will be participating in this project. Provide name, address, and Georgia License number of the proposed engineers to be used.

• Any specialized experience. Road/Highway, Design / Construction Administration etc.

performed on at other similar projects.

The offeror is encouraged to submit references, resumes, examples of work or other data that will help the review panel make objective determinations of the above.

IV. ADDITIONAL INFORMATION & REQUIREMENTS

Cost will be a factor but may not be the primary factor in this decision.

Minimum Services to be provided between Owner and Engineering Group. These Contract Administration Service limits are to be included in the base proposal:

a. Minimum of two reviews of shop drawings

b. Six construction site visits

c. Two inspections for portions substantially complete

d. Two inspections for final completion.

The following services shall be included in the proposal:

1. Project Development and Monitoring

2. Highway/ Design

3. Cost and quantities calculations

4. Detailed Cost budgeting

5. On-Site Project Representation

6. Start-up Assistance

7. Provide two (2) complete sets of completion drawings.

A separate cost should be provided for “on site” project representation services including items 5, 6 and

7. It is expected that the successful firm, beginning at groundbreaking, would provide an “on site” visit and a written report of work progress/problems, etc. at least once per week.

A separate complete fee schedule of all services available should be provided in the event that additional services are to be required.

V. PROJECTED SCOPE OF SERVICES

The following projected scope of design services, including preliminary design, right of way acquisition, if any. Construction easement documents, Bid documents, estimation of materials quantities, Construction services. Construction Inspection shown as a separate cost.

• PHASE I

Preliminary Engineering Phase: The selected firm will conduct detailed site visits of the location and participate and follow directives conveyed in work sessions in collaboration with Floyd County Engineering Department.

• PHASE II

Conceptual/Schematic Design Phase-Preliminary Design Complete: Refine preliminary design and project scope.

• Phase III

Final Roadway Design Phase (Phase III) After approval and acceptance by the County of the end product from Phase II, the successful firm will work to create detailed plans for all components of the roadway as described in this RFP and define the final design specifications.

• Phase IV

Construction Documents (Phase IV) After approval and acceptance of the end product from Phase III by the County. Successful firm will be responsible for preparation of the required roadway design drawings and bid documents, e.g., roadway details, cross sections, plans and profile drawings, topography, rights of way plans.

After final approval of the Engineering/Design Drawings and Plan documents by the County the successful firm will create final construction and bid documents for bidding purposes.

• Phase V

Bidding & Contract Award

The Design/ Engineering firm will assist the Floyd County Purchasing Department in bidding the project to prospective prime contractors. Services will include assisting with formulating responses to prospective bidders’ questions, issuing addendums (if necessary), attendance at the pre- bid meetings and bid opening, and providing the County with a recommendation for prime contract awards.

• Phase VI

Construction Administration & Project Closeout (This may be submitted as an alternate) The Design/Engineering firm shall be a representative of and shall advise and consult with the

County during construction until the final payment to prime contractors is due and during the correction period.

a. Plan Approvals -The Design/Engineering firm along with the County is responsible for acquiring the approval of the Georgia Department of Transportation of all design and drawings .

b. Construction Related Services –The Design/ Engineering firm will provide, on the County’s behalf, construction administration and inspection services. At a minimum, services to be provided consist of coordinating regular progress meetings with the Floyd County Project Management Team.

c. The Design/Engineering firm in conjunction with the Floyd County Project Management Team, shall provide updated budgetary cost estimates during each phase of the design process.

d. All documents generated by the Design/Engineering firm including all drawings at the conclusion of services become the property of Floyd County Georgia.

1. PAYMENT OF SERVICES

a. As services are rendered in each phase of the contract by the awarded Design/Engineering firm an invoice will be submitted to the Floyd County Purchasing Department (randy.self@floydcounty.ga.org) for review and to proceed with the payment process.

b. Payment of said correct invoice shall include:

1. Date

2. Purchase Order Number

3. Invoice Number

4. Itemized list of services rendered

5. Total

c. Payment in the form of a check shall be made within 30 days and mailed to the successful Engineering firm.

CHECK LIST

Required Document for Submission

All documents listed below are required to be completed and submitted as one attachment under Required Documents and scope of work on https://floydcountyga.bonfirehub.com. The pricing sheet should be submitted separately under Bid Pricing and not included with the required documentation.

___ Bidders Declaration Page

___ Vendor Information

___ Certificate of Non-Discrimination

___ Certificate of Non-Collusion

___ Contractor’s Affidavit/E-Verify (if you have 10 or more employees)

___ S.A.V.E. Compliance (if you have 10 or less employees)

___ Drug Free Workplace Certificate

___ W-9

___ Bidders Addenda Acknowledgement

___ Pricing Submission (to be scanned as a separate attachment in Bonfire)

The documents above are included within this Invitation to bid. Addendums will be available when issued.

https://floydcountyga.bonfirehub.com/

BIDDERS DECLARATION

The bidder understands, agrees and warrants:

• That the bidder has carefully read and fully understands the full scope of the specifications.

• That the bidder has the capability to successfully undertake and complete the responsibilities and obligations in said specifications.

• That this bid may be withdrawn by requesting such withdrawal in writing at any time prior to March 24, 2026 at 2:00 PM (local time) but may not be withdrawn after such date and time.

• That Floyd County reserves the right to waive compliance from any applicant with any provision contained in this request whenever the County in its sole discretion believes such waiver is in the County’s best interests

• That by submission of this quote the bidder acknowledges that Floyd County has the right to make any inquiry or investigation it deems appropriate to substantiate or supplement information supplied by the bidder.

• That the accompanying bid is not the result of or affected by, any act of collusion with another person or company engaged in the same line of business or commerce, or any other fraudulent act punishable under Georgia or United States law.

BIDDER:

Company Name: _________________________________________

Phone: _________________________________________________

Name Print: _____________________________________________

Signature: ______________________________________________

Email: _________________________________________________

Date: __________________________________________________

VENDOR INFORMATION

PROPOSAL FORM

TO: Floyd County Board of Commissioners – Purchasing Department 12 E 4th Ave. Rome, GA 30161 - via https://floydcountyga.bonfirehub.com/

RFP #26-007: Mango Road Improvements Project

Firm Name: ______________________________________________

All proposals submitted shall be subject to acceptance or rejection and the Floyd County Board of Commissioners specifically reserves the right to accept or reject any or all proposals, to waive any technicalities and formalities in the RFP process.

The undersigned understands that any conditions stated above, clarifications made to the above or information other than that requested should be under separate cover and to be considered only at the discretion of the Purchasing Department.

Contractor: _________________________________________

Address: ___________________________________________

City, State, Zip Code: _________________________________

Phone Number: ______________________________________

Email Address: ______________________________________

Print Name: _________________________________________

Signature: ___________________________________________

This proposal shall be signed by a representative who is authorized to contractually bind the contractor

Please Attach Company Contact’s Business Card:

https://floydcountyga.bonfirehub.com/

CERTIFICATE OF NON-DISCRIMINATION

In connection with the performance of work under this contract, the bidder agrees as follows:

The bidder agrees not to discriminate against any employee or applicant for employment because of race, creed, color, sex, national origin, ancestry, or disability. The vendor shall take affirmative action to ensure that employees are treated without regard to their race, creed, color, sex, national origin, ancestry, or disability. Such actions shall include, but not be limited to the following: employment, upgrading, demotion, transfer, recruiting, or recruitment, advertising, lay-off or termination, rates of pay or other compensation and selection for training, including apprenticeship.

In the event of the bidder’s non-compliance with this non-discrimination clause, the contract may be canceled or terminated by Floyd County Board of Commissioners. The bidder may be declared, by Floyd County, ineligible for further contracts with Floyd County until satisfactory proof of intent to comply shall be made by the vendor.

The bidder agrees to include this non-discrimination clause in any sub-contracts connected with the performance of this agreement.

BIDDER ____________________________________

SIGNATURE ____________________________________

TITLE ____________________________________

CERTIFICATE OF NON-COLLUSION

By responding to this Solicitation, the supplier understands and agrees to the following:

1. That the submitted response constitutes an offer, which when accepted in writing by Floyd County, and subject to the terms and conditions of such acceptance, will constitute a valid and binding contract between the undersigned and Floyd County; and

2. That the supplier has read the specifications and requirements shown or referenced in the solicitation and that the supplier’s response is made in accordance with the provisions of such specifications and requirements except as expressly stated otherwise in the supplier’s response; and

3. That the supplier guarantees and certifies that all items included in the supplier’s response meet or exceed all such stated specifications and requirements of the solicitation except as expressly stated otherwise in the supplier’s response; and

4. That, if awarded a contract, the supplier will deliver goods and or services that meet or exceed the specifications and requirements of the solicitation except as expressly stated otherwise in the supplier’s response, and

5. That the response submitted by the supplier shall be valid and held open for a period of one hundred and twenty

(120) days (or such other period as identified in the solicitation) from the final solicitation closing date and that the response may be held open for an additional period subject to the supplier’s consent; and

6. That the supplier’s response is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and is in all respects fair and without collusion or fraud. The supplier understands and agrees that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards; and

7. That the provisions of the Official Code of Georgia Annotated, Sections 36-91 have not been violated and will not be violated in any respect.

DO NOT MODIFY THE BID/PROPOSAL CERTIFICATION TERMS IN ANY WAY. THIS FORM MUST BE

COMPLETED, SIGNED AND SUBMITTED WITH YOUR RESPONSE.

(PLEASE PRINT OR TYPE):

Contractor’s Full Legal Name _________________________________________________

Authorized Signature: ________________________________________________________

Name and Title of Person Signing: ______________________________________________

Company Address: ___________________________________________________________

Phone: ________________________ E-MAIL: ___________________________________

Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1)

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of Floyd County Georgia has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number (please note: this is NOT an FID number)

Date of Authorization

Name of Contractor

Address of Contractor

Name of Project

___FLOYD COUNTY GEORGIA________________

Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on _________, ___ in 202__ in____________________(city), ________(state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE ______DAY OF___________________, 202__.

NOTARY PUBLIC

My Commission Expires:

(Notary Seal or Stamp Required)

SAVE COMPLIANCE AFFIDAVIT

O.C.G.A § 50-36-1(e) (2) Affidavit

By executing this affidavit under oath, as an applicant for a (n) Contract or Services, as referenced O.C.G.A. C. § 50-36-1, for Floyd County Board of Commissioners, Georgia, the undersigned applicant verifies one of the following with respect to my application for a public benefit:

1) __________ I am a United State citizen.

2) __________ I am a legal permanent resident of the United States

3) __________ I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by the Department of Homeland Security or other federal immigration agency.

My alien number issued by the Department of Homeland Security or other federal immigration agency is: ____________________.

The undersigned applicant also hereby verifies that he or she is 18 years of age or older and has provided at least one secure and verifiable document, as required by O.C.G.A. § 50-36-1(e) (1), with this affidavit.

The secure and verifiable document provided with this affidavit can best be classified as:

In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties as allowed by such criminal statute.

Executed in _______________ (city), _____________ (state).

Signature of Applicant Name of Company

Printed Name of Applicant Street Address of Company

Title of Applicant City, State, Zip Code of Company

SUBSCRIBED AND SWORN

BEFORE ME ON THIS THE

_______DAY OF __________________, 20______

NOTARY PUBLIC

My Commission Expires:

FLOYD COUNTY BOARD OF COMMISSIONERS

DRUG-FREE WORKPLACE CERTIFICATE

By signature on this certificate, the Vendor certifies that the provisions of O.C.G.A. Section 50-24-1 through 50-24-6 related to the “Drug-Free Workplace Act” have been complied with in full. The Vendor further certifies that:

1. A drug-free workplace will be provided for the Vendor’s employees during the performance of the contract; and

2. Each Vendor who hires a sub-Vendor to work in a drug-free workplace shall secure from that sub-vendor the following written certification: “As part of the subcontracting agreement with (Vendor’s name), (sub-Vendor’s name) certifies to the Vendor that a drug-free workplace will be provided for the sub-Vendor’s employees during the performance of this contract pursuant to O.C.G.A. Section 50-24-3(b)(7).”

By signature on this certificate, the Vendor further certifies that it will not engage in the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana during the performance of this contract.

Vendor: _______________________________________________________

By: ___________________________________________________________

Name Printed: __________________________________________________

Title: __________________________________________________________

Date: __________________________________________________________

BIDDERS ADDENDA ACKNOWLEDGEMENT

Bidder acknowledges receipt of the following addenda:

Addendum No. Date

Signed this _________day of _______________ 202___

Signature: ________________________________________________

Title: ___________________________________________________

Company: ________________________________________________

Floyd County Board of Commissioners
Request for Proposal
(RFP No. 26-007)

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