RFP - Belly Dump .pdf

i

TULARE COUNTY

TRUCKING SERVICES – BELLY DUMP

REQUEST FOR PROPOSAL (RFP) NO. 26-018

Issued: October 30, 2025

All materials submitted with this Proposal are subject to The Public Records Act

(California Government Code sections 6250-6276.48)

PROPOSAL NO-26-018 – TRUCKING SERIVECS - BELLY DUMP

ii

TULARE COUNTY

REQUEST FOR PROPOSAL (RFP): NO. 26-018

INVITES PROPOSALS TO CONTRACT FOR

TRUCKING SERIVES – BELLY DUMP

The County of Tulare invites proposals for offer of a contract to be submitted to the Purchasing Agent to supply TRUCKING SERVICES – BELLY DUMP for RESOURCE MANAGEMENT AGENCY – ROAD DEPARTMNET. Such contract will be for a period of ONE (1) YEAR effective JANUARY 1, 2026 and ending DECEMBER 31, 2026. However, the County of Tulare reserves the right to terminate the Contract, with or without cause, by giving a thirty (30) day written notice of intent to terminate.

VENDOR'S QUESTIONS: Vendors may submit questions pertaining to this Request for Proposal to the Purchasing Division via submission to: BidnetDirect.com. Any and all questions must be submitted by NOVEMBER 12, 2025, by 5:00 p.m. PT in order to be considered. A response to all questions will be prepared and posted on the Bidnet website for all Vendors to clarify substantive items raised. No changes and/or additions will be made to this RFP within five (5) business days of its closing date and time.

Proposals will be received by Tulare County Purchasing Agent via electronic submission to BidnetDirect.com until 5:00 p.m. PT on NOVEMBER 25, 2025.

AWARD OF PROPOSAL: If awarded, the County shall award a contract to the proposal that best serves the County's interests.

NOTE: This is not a bid request and therefore is not governed by bid procedure formalities.

THE FOLLOWING SIGNATURE PAGE MUST BE COMPLETED AND SIGNED BY THE VENDOR

AND SUBMITTED WITH THE VENDOR’S PROPOSAL.

iii

RETURN PROPOSAL WITH THIS FORM.

Signature Page

VENDOR TO COMPLETE THIS PAGE

PARTICIPATION

The County is currently a member of the Central Valley Purchasing Group which consists of Fresno, Kern, Kings and Tulare Counties, and the Political Subdivision, Municipalities and Tax Supported Agencies within these County boundaries. Whenever possible, these entities wish to co-op (piggy-back) on existing proposals. Please state if your proposal will or will not be extended to these entities under the same terms and conditions as stated in this proposal.

Select YES or NO.

YES NO

Undersigned agrees to furnish the commodities and/or services as stipulated in this REQUEST FOR PROPOSAL at the prices/fees, terms, and conditions stated.

Company:

Address: County:

City: State: Zip: Phone No:

Signed By:

Title: Date:

Email Address:

Note: This signature page must be turned in with your Proposal iv

TABLE OF CONTENTS

RFP Summary ............................................................................................................................. ii

Signature Page ............................................................................................................................ iii

Section I - Timeline

Section II - Contract Proposal

Section III - Specifications

Section IV - Instructions for Preparing Written Proposal

Section V - Selection Criteria

Section VI - Award of Contract

EXHIBITS

EXHIBIT A - Instructions for Certification Regarding Debarment

EXHIBIT B - Insurance Requirements

EXHIBIT C – Chart for Billing in Tenths of An Hour

EXHIBIT D – Sample Agreement

EXHIBIT E - Campaign Contribution Disclosure Information And Form

EXHIBIT F – Contractor and Grantee Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine

Section I - Timeline (Dates and Times Subject to Change)

Awarding Agency: County of Tulare

Date of Issuance: October 30, 2025

Vendor Questions Due: November 12, 2025 @ 5:00 p.m. PT

Tulare County Purchasing Division Submit to BidnetDirect.com

Deadline for Submitting Proposals: *November 25, 2025 @ 5:00 p.m. PT Tulare County Purchasing Division Submit to BidnetDirect.com

*NO PROPOSALS RECEIVED AFTER THIS DATE AND TIME WILL BE CONSIDERED

Number of Copies One signed electronic submission

Contract Awarded by Tulare County: Tentative – Week of December 15, 2025

Vendor Begins Providing Services: Tentative – Week of January 1, 2026

Section II - Contract Proposal

GENERAL CONDITIONS

1. PREPARATION OF PROPOSALS

A. All information requested of the Vendor shall be entered in the appropriate space(s) on the form. Failure to do so may disqualify your proposal.

B. Any Attachments and/or Exhibits are herewith made a part of this Request for Proposal.

C. All information shall be typewritten or clearly printed. Mistakes may be crossed out and corrections inserted before submission of your Proposal. Corrections must be initialed in ink by the person signing the Proposal. Proposals may be completed manually and scanned for submission. Proposals are submitted electronically.

D. Proposals will not be accepted unless signed (not typed) or electronically signed in the appropriate space(s) by an authorized officer or employee of the Vendor.

E. To be considered, proposals must be submitted and received by the Purchasing Division through submission to BidnetDirect.com on or before the Deadline for Submitting Proposals listed on page 1 and 7 of this RFP.

F. BidnetDirect.com will not allow proposals to be entered after the deadline. The County is not responsible for late submissions due to delays in the electronic delivery/submission.

G. Each Proposal and related fee schedule shall remain valid subject to acceptance for ninety (90) days after proposal closing date.

H. Fees proposed are considered accurate and cannot be withdrawn or adjusted after the Proposal is received.

I. Upon submission of proposal documents, all such documents shall become the property of the County.

J. Submissions may provide additional information not specifically requested that may be considered by the Purchasing Agent. (Purchasing Agent is not obligated to consider any information not specifically requested in this proposal request.)

K. Tulare County Purchasing Agent reserves the right to:

1. Reject any or all submissions,

2. Request clarification of any submitted information,

3. Waive any informalities or irregularities in any qualification statement,

4. Not enter into any contract,

5. Not to select any firm,

6. Cancel this process at any time,

7. Amend this process at any time,

8. Interview firms prior to award,

9. Enter into negotiations with one or more firms,

10. Award more than one contract if it is in the best interest of the County,

11. Issue similar RFPs or RFQs in the future, or

12. Request additional information.

2. TAXES

A. Tulare County is exempt from payment of Federal Excise Tax. No Federal Tax should be included in the price. Exemption Certificates will be furnished when applicable and upon request.

B. Unless otherwise specified, the unit price stated herein does not include California State Sales Tax.

3. VOLUME OF SERVICES

Any estimated volume of services provided is based on the experience of the past twelve (12) month period or are estimated requirements for one (1) year. It is not expressly implied, nor guaranteed, that the amounts shown will be utilized in the next contract period, and as such, the right is reserved to decrease or increase the services needed as may be required. However, it is to be understood that these figures are quite realistic and will be considered in making an award.

Actual usage whether lesser or greater than estimated shall not affect the fees as proposed and accepted by the County.

4. LITERATURE

Vendors may submit literature which fully describes items on which they are proposing, no later than the closing date of this Proposal.

5. PROPOSAL EVALUATION AND AWARD PROCESS

Complete Submissions shall consist of the Proposal, vendor qualifications/experience, previous experience, references, and other required documentation as set out in this proposal. The County shall evaluate Proposals and make the Award to the Proposal which is determined to be in the best interest of the County. Please see Section V, Selection Criteria, for detailed scoring information. The County shall be the sole judge in making this determination.

6. INDEPENDENT CONTRACTOR STATUS

This Contract is entered into by both parties with the express understanding that Vendor will perform all services required under this Contract as an Independent Contractor. See sample contract for complete Independent Contractor Status provision.

7. RIGHT TO AUDIT

The County of Tulare reserves the right to verify, by examination of the successful Vendor's records, all invoiced amounts when firm prices are not set forth in the agreement resulting from this Proposal.

8. LIABILITIES

The successful Vendor will be required to indemnify and hold harmless the County as set out in the indemnification provisions of the contract. See sample agreement attached to this proposal.

9. DEFAULT BY SUCCESSFUL VENDOR

A. Rights and remedies of County for default: In case of default by successful Vendor, the

County may procure service(s) from another source and may recover any penalties, fees, or any other cost in the event of Vendor’s default occasioned thereby from any unpaid balance due the successful Vendor by proceeding against the successful Vendor's performance bond, if any, or by suit against the successful Vendor. The prices paid by the County shall be considered the prevailing market price(s) at the time such purchase(s) is made.

10. FEES

During the period under any agreement resulting from this Proposal, fees shall remain firm for the term of Contract unless stated by Contractor. At no time shall the fees charged to the County exceed the contracted fee schedule.

11. RESPONSIBILITY FOR GOVERNMENTAL ENTITIES OTHER THAN THE COUNTY

If any government entity, other than the County and its departments, is listed in this Request for Proposal or who have subsequently signified their intention to participate in the Tulare County agreement resulting from this proposal, their participation will not impose any responsibility for payment of claims or any responsibility whatsoever on the Tulare County Board of Supervisors or the County Purchasing Agent.

Each such governmental entity will be billed separately, and payments will be made by warrants drawn on the appropriate funds for the governmental entity.

12. DEBARMENT

Contractor must sign and submit the attached federal debarment certification. See Exhibit A, attached with instructions and signature page.

13. INFORMATION ON RESULTS

Information regarding the results of any proposal may be obtained from the Tulare County Purchasing Division, 2637 W. Burrel Avenue, Suite 200, Visalia, CA 93291 for a period of one hundred eighty (180) days from the opening date of the Proposal. Proposal scoring tabulations will be available for review and request following notification of the successful vendor and can be obtained from the Purchasing Division via TC_Purchasing@tularecounty.ca.gov. Please reference the Proposal Number in your request.

14. AGREEMENT FOR SERVICES

The terms contained in the awarded Agreement for Services supersede the General Conditions of this proposal to the extent of any inconsistency between them.

15. HEADINGS:

Headings are provided for organizational purposes only and do not in any manner affect the scope, meaning, or intent of the provisions under the headings.

16. INSURANCE

The successful Vendor awarded the Contract must provide insurance evidence as stated in

EXHIBIT B.

mailto:TC_Purchasing@tularecounty.ca.gov

Section III – Specifications

TRUCK SPECIFICATIONS: BELLY DUMP TRUCKS AND TRAILERS

STATE COMPLIANCE

AND/OR SPECIFICATIONS

1. Truck tractor must have a minimum of 350 horsepower engine and be capable of hauling a minimum of 24.5 tons.

2. Operator must be able to spread materials from 75 feet to 225 feet. (If unable to make the spread correctly, the truck may be released from haul.)

3. Trailers must have smooth interior walls to allow for easy dumping of materials.

4. All equipment must have a current CHP Basic Inspection of Terminals (BIT) certification. A copy of the current BIT inspection report shall be submitted with the proposal.

5. Equipment must be capable of operating in mountainous terrain, turning on roadways, and climbing steep grades.

6. Hauls will originate from various pits and plants and deliver to multiple locations throughout Tulare County.

7. Truck tractor must be California Air Resources Board (CARB) compliant — provide a valid Certificate for Reporting Completion (Truck and Bus Regulations) as of January 1, 2014.

PRICE PER HOUR: $____________

Number of Belly Dump Trucks Proposed (Maximum 6):

License Numbers of Trucks:

Section IV - Instructions for Preparing Written Proposal

1. PROPOSAL REQUIREMENTS

In order for your Proposal to be considered complete, it must contain all information requested. Proponents that do not address each of the items requested will receive no further consideration. Your Proposal must include, in the order listed, the following:

A. CERTIFICATE OF INSURANCE:

Prior to approval of a contract by COUNTY, CONTRACTOR shall file with the Purchasing Agent evidence of the required insurance as set forth in EXHIBIT B attached.

Insurance policies shall not be used to limit CONTRACTOR’S liability or to limit the indemnification provisions and requirements of this contract or act in any way to reduce the policy coverage and limits available from the insurer(s).

B. STATE REQUIREMENTS:

1. Copy of DOT Random Drug Testing Program.

2. Copy of DMV Motor Carriers Permit with CA number & expiration date.

3. Copy of Driver’s License and Medical Card.

4. Worker’s Compensation Insurance Certificate, if driver is employed by Contractor.

5. Copy of Air Resource Board (ARB) California Certificate of Reporting Completion Truck and

Bus Regulation.

C. HOURLY RATE CHARGES:

Hourly rate charges shall commence at the time when being loaded and end when signed out by County, plus travel back to loading site. THE HOURLY RATE SHALL BE CHARGED TO THE NEAREST 0.10 (ONE TENTH) OF AN HOUR. See Exhibit C, attached.

D. FUEL SURCHARGE:

The contracts issued to successful vendor will contain a fuel surcharge. The County, at the beginning of Contract period of January 1, 2026, will set a diesel fuel cost (including taxes) from County sources for compensation to the hourly rate for Trucking Services. If fuel costs increase or decrease by ten cents ($0.10), or more, per gallon from the first of the contract month to the first of each proceeding month during the contract period, the hourly rate will be increased or decreased by ½% for every ten cent ($0.10) increase or decrease. The County will be the sole judge in determining the increase and/or decrease of hourly rates as the result of the ½% Fuel Surcharge.

E. USAGE ESTIMATE:

Approximately 1100 hours for contract period.

F. INTERNET SOURCE:

Energy Information Administration

Website Address: https://www.eia.gov/petroleum/gasdiesel/ https://www.eia.gov/petroleum/gasdiesel/

No Contact It is the desire of Tulare County that the evaluation and award process for these services be impartial and that contacts between potential vendors, the County Purchasing agent and staff, County employees, elected officials, and staff regarding the pending award of County contracts be limited to those necessary to make a responsive proposal. Improper political lobbying may disqualify a proponent.

All information submitted in response to this RFP. will be a matter of public record. All proposals requesting information submitted be kept confidential will be returned to the proponent.

Questions/Clarification Proposers should submit requests for clarifications or interpretations regarding this RFP and the Contract only by submission to BidnetDirect.com. The Purchasing Division will not respond to questions via phone call or email.

The responses to requests for clarification, interpretation, and/or additional information will be posted as addenda to this RFP on the BidnetDirect.com site available to all potential proposal responders. All responses to this RFP should acknowledge full consideration of the addenda issued up to the Last Numbered Addenda by signing and including each addenda signature page with your response.

All proposals must be received by submission to BidnetDirect.com no later than 5 p.m. PT on November 25, 2025. Late proposals will not be accepted. All proposals, whether selected or rejected, will not be considered confidential and will become the property of the County of Tulare.

EXHIBITS TO REQUEST FOR PROPOSAL

Exhibit A - Debarment (Instruction for Certification) To be returned signed with Request for Proposal

Exhibit B - Insurance Requirements To be returned with Request for Proposal

Exhibit C - Chart for Billing in Tenths of An Hour Exhibit D - Sample Agreement-For reference only

Exhibit E – Campaign Contribution Disclosure Information & Form-To be returned with Request for Proposal

Exhibit F - Contractor and Grantee Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine- For reference only

Section V - Selection Criteria

A. EVALUATION AND AWARD

The County shall evaluate Proposals and Award that Proposal in the County's best interest.

Such evaluation shall be in accordance with the following criteria:

Debarment (Exhibit A) Mandatory

Campaign Contribution Disclosure Form

(Exhibit E Mandatory

State Requirements Page 6, Items B, 1-5 25 Points

Equipment BIT Certified 10 Points

Previous Experience with the County 15 Points

Hourly Rate Page 5 25 Points

California Air Resources Board Certification:

Reporting Completion Truck and Bus Regulation

10 Points

Insurance (Exhibit B) 15 Points

Overall Value/Points 100

The County shall be the sole judge in making this determination.

Section VI - Award of Contract

1. All of the above criteria will be used to evaluate all proposals; the County reserves the right to award one or more agreements to the Contractor(s) who will best serve the interests of the County, considering the demonstrated competence, professional qualifications, and suitability for the project in general.

The County anticipates making final selections and awards on or about December 15, 2025. In addition, negotiations may or may not be conducted with candidates; therefore, the Proposal submitted should contain your most favorable terms and conditions since the selection and award may be made without further discussion or negotiation.

The County intends to contract with the successful proponent(s) for a term of ONE (1) year with a provision for TWO (2) extensions of ONE (1) year time period, each. County will retain the right to terminate the Agreement upon giving the Contractor thirty (30) days advance written notification.

Proposals must be submitted to BidnetDirect.com. The County of Tulare review committee will evaluate all the proposals and consider only those that meet all the requirements described within this request for Proposal. The County will conduct site visits with only those administrators deemed overall best able to meet the criteria requested.

The County of Tulare reserves the right to reject any and all proposals submitted and to negotiate with proponents or non-proponents. Award of the Contract will be made to the firm, in the judgment and opinion of the County of Tulare review committee that will provide service that best meets the needs of the County.

In addition, negotiations may or may not be conducted with candidates; therefore, the Proposal submitted should contain your most favorable terms and conditions since the selection and award may be made without further discussion or negotiation.

Please be aware, however, that award may be made without candidate visits, interviews, or further discussions or negotiations.

EXHIBITS

EXHIBIT A - Instructions for Certification Regarding Debarment

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER

RESPONSIBILITY MATTERS-–PRIMARY COVERED TRANSACTIONS

1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below.

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 shall submit an explanation of why it cannot provide the certification set out below. 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 shall 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 shall 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. 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 proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, 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 proposal that it will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction”, 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 it is not proposed for debarment under 48 CFR part 9, subpart 9.4, 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 List of Parties Excluded from Federal Procurement and Nonprocurement Programs.

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 proposed for debarment under 48 CFR part 9, subpart 9.4, 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.

CERTIFICATION

(1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals:

(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency.

(b) Have not within a three-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 statues or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

(c) Are not presently indicated 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 (1)(b) of this certification; and

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

(2) 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.

Signature Date

Printed Name & Title Name of Agency or Company

NON-PROFESSIONAL SERVICES

INSURANCE REQUIREMENTS

CONTRACTOR shall provide and maintain insurance for the duration of this Agreement against claims for injuries to persons and damage to property which may arise from, or in connection with, performance under the Agreement by the CONTRACTOR, his agents, representatives, employees and subcontractors, if applicable.

A. Minimum Scope & Limits of Insurance

1. Commercial General Liability coverage of $1,000,000 on an occurrence basis, including products and completed operations, property damage, bodily injury and personal & advertising injury (occurrence Form CG 00 01). If a general aggregate applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit must be no less than $2,000,000.

2. Insurance Services Office Form Number CA 00 01 covering Automobile Liability, (any auto) of no less than $1,000,000 per accident for bodily injury and property damage. If an annual aggregate applies it must be no less than 2,000,000.

3. Workers’ Compensation insurance as required by the State of California, with Statutory Limits, and Employer’s Liability Insurance with limit of no less than $1,000,000 per accident for bodily injury or disease.

B. Specific Provisions of the Certificate

1. If any of the required insurance is written on a claims made form, the retroactive date must be before the date of the contract or the beginning of the contract work and must be maintained and evidence of insurance must be provided for at least three (3) years after completion of the contract work.

2. CONTRACTOR must submit endorsements to the General Liability reflecting the following provisions:

a. The COUNTY OF TULARE, its officers, agents, officials, employees and volunteers are to be covered as additional insureds as respects: liability arising out of work or operations performed by or on behalf of the Contractor including materials, parts, or equipment furnished in connection with such work or operation.

b. For any claims related to this project, the CONTRACTOR’s insurance coverage shall be primary insurance as respects the COUNTY, its officers, agents, officials, employees and volunteers. Any insurance or self-insurance maintained by the COUNTY, its officers, agents, officials, employees or volunteers shall be excess of the CONTRACTOR’s insurance and shall not contribute with it.

c. Each insurance policy required by this agreement shall provide that coverage shall not be canceled, except with written notice to the COUNTY.

d. CONTRACTOR hereby grants to COUNTY a waiver of any right to subrogation which any insurer of the CONTRACTOR may acquire against the COUNTY by virtue of the payment of any loss under such insurance. CONTRACTOR agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation, but this provision applies regardless of whether or not the COUNTY has received a waiver of subrogation endorsement from the insurer.

3. The Workers’ Compensation policy shall be endorsed with a waiver of subrogation in favor of the COUNTY for all work performed by the CONTRACTOR, its employees, agents and subcontractors.

CONTRACTOR waives all rights against the COUNTY and its officers, agents, officials, employees and volunteers for recovery of damages to the extent these damages are covered by the workers compensation and employers liability.

C. Deductibles and Self-Insured Retentions Deductibles and Self-insured retentions must be declared and any deductible or self-insured retention that exceeds $100,000 will be reviewed by the COUNTY Risk Manager for approval.

D. Acceptability of Insurance Insurance must be placed with insurers with a current rating given by A.M. Best and Company of no less than A-:VII and a Standard & Poor’s rating (if rated) of at least BBB and from a company approved by the Department of Insurance to conduct business in California. Any waiver of these standards is subject to approval by the County Risk Manager.

E. Verification of Coverage Prior to approval of this Agreement by the COUNTY, the CONTRACTOR shall file with the submitting department, certificates of insurance with original endorsements effecting coverage in a form acceptable to the COUNTY. Endorsements must be signed by persons authorized to bind coverage on behalf of the insurer.

The COUNTY reserves the right to require certified copies of all required insurance policies at any time.

WAIVERS:

I represent and attest that I am a person authorized to make representations on behalf of the CONTRACTOR, and represent the following:

(mark X if applicable)

Automobile Exemption: I certify that ___________________ does not own nor use vehicles in the performance of the agreement for which this insurance requirement is attached.

Workers’ Compensation Exemption: I certify that ___________________ is not required to carry workers’ compensation coverage or has filed an exemption with the State of California as required by law.

I acknowledge and represent that we have met the insurance requirements listed above.

Print Name _____________________________________________ Date: ___________________

Contractor Name__________________________________________

Signature________________________________________________

Rev. 12-18

EXHIBIT C – Chart for Billing in Tenths of An Hour

Minutes Decimal (Hours)

1–6 0.1

7–12 0.2

13–18 0.3

19–24 0.4

25–30 0.5

31–36 0.6

37–42 0.7

43–48 0.8

49–54 0.9

55–60 1.0

EXHIBIT D - Sample Agreement

THIS AGREEMENT (“Agreement”) is entered into as of ________________, between the COUNTY OF TULARE, a political subdivision of the State of California (“COUNTY”), and _________________, (“CONTRACTOR”). COUNTY and CONTRACTOR are each a “Party” and together are the “Parties” to this Agreement, which is made with reference to the following:

A. COUNTY issued Request for Proposal (“RFP”) No. 23-004 on July 22, 2022 for Workers’ Compensation Third Party Administrator and Managed Care Program Services.

B. CONTRACTOR submitted a Proposal on ___________________ (“Proposal”) and was awarded the contract on ____________________to provide the COUNTY’s Workers’ Compensation Third Party Administrator and Managed Care Services, C. COUNTY and CONTRACTOR wish to enter into an Agreement consistent with the Proposal for Workers’ Compensation Third Party Administrator and Managed Care Services.

THE PARTIES AGREE AS FOLLOWS:

1. TERM: This Agreement becomes effective as of _____________ and expires at 11:59 PM on _______________ unless earlier terminated as provided below, or unless the Parties extend the term by a written amendment to this Agreement.

2. SERVICES: CONTRACTOR shall provide COUNTY with the services shown on the attached Exhibit A.

[EXHIBIT A WILL BE DERIVED FROM SECTION III, SCOPE OF WORK, IN THE RFP.]

3. PAYMENT FOR SERVICES: As consideration for the services provided by CONTRACTOR hereunder, COUNTY shall pay CONTRACTOR in accordance with the attached Exhibit B.

[EXHIBIT B WILL BE DERIVED FROM SELECTED VENDOR’S RESPONSE TO EXHIBIT D to the RFP.]

4. INSURANCE: Before approval of this Agreement by COUNTY, CONTRACTOR must file with the Clerk of the Board of Supervisors evidence of the required insurance as set forth in the attached Exhibit C.

5. GENERAL AGREEMENT TERMS AND CONDITIONS: COUNTY’S “General Agreement Terms and Conditions (Form revision approved as of 01/01/2021)” are hereby incorporated by reference and made a part of this Agreement as if fully set forth herein. COUNTY’S “General Agreement Terms and Conditions” can be viewed at http://tularecountycounsel.org/default/index.cfm/public-information/

A COPY OF THE COUNTY’S GENERAL AGREEMENT TERMS AND CONDITIONS REFERENCED IN THE LINK

ABOVE ARE ATTACHED FOLLOWING THIS SAMPLE AGREEMENT

6. ADDITIONAL EXHIBITS: CONTRACTOR shall comply with the terms and conditions of the Exhibits listed below and identified with a checked box, which are by this reference made a part of this Agreement.

Exhibit __ http://tularecountycounsel.org/default/index.cfm/public-information/

7. NOTICES: (a). Except as may be otherwise required by law, any notice to be given must be written and must be either personally delivered, sent by facsimile transmission or sent by first class mail, postage prepaid and addressed as follows:

COUNTY: With a Copy to:

TULARE COUNTY RISK MANAGEMENT

2900 W. Burrel Ave.

Visalia, CA 93291 Phone No.: 559-636-4950 Fax No.: 559-

COUNTY ADMINISTRATIVE OFFICER

2800 W. Burrel Ave.

Visalia, CA 93291 Phone No.: 559-636-5005 Fax No.: 559- 733-6318

CONTRACTOR:

Name Address City State Zip Phone No.:

Fax No.:

(b). Notice personally delivered is effective when delivered. Notice sent by facsimile transmission is deemed to be received upon successful transmission. Notice sent by first class mail will be deemed received on the fifth calendar day after the date of mailing. Either Party may change the above address by giving written notice under this section.

8. AUTHORITY: CONTRACTOR represents and warrants to COUNTY that the individual(s) signing this Agreement on its behalf are duly authorized and have legal capacity to sign this Agreement and bind CONTRACTOR to its terms. CONTRACTOR acknowledges that COUNTY has relied upon this representation and warranty in entering into this Agreement.

9. COUNTERPARTS: The Parties may sign this Agreement in counterparts, each of which shall be deemed an original and all of which taken together form one and the same agreement. A signed copy or signed counterpart of this Agreement delivered by facsimile, email, or other means of electronic transmission shall be deemed to have the same legal effect as delivery of a signed original or signed copy of this Agreement.

10. MANUAL OR ELECTRONIC SIGNATURES: The Parties may sign this Agreement by means of manual or electronic signatures. The Parties agree that the electronic signature of a Party, whether digital or encrypted, is intended to authenticate this Agreement and to have the same force and effect as a manual signature. For purposes of this Agreement, the term “electronic signature” means any electronic sound, symbol, or process attached to or logically associated with this Agreement and executed and adopted by a Party with the intent to sign this Agreement, including facsimile, portable document format, or email electronic signatures, pursuant to the California Uniform Electronic Transactions Act (Cal. Civ. Code §§

1633.1 to 1633.17), as it may be amended from time to time.

THE PARTIES, having read and considered the above provisions, indicate their agreement by their authorized signatures below.

CONTRACTOR

Date: By

Print Name

Title

Date: By

Print Name

Title

[Pursuant to Corporations Code section 313, County policy requires that contracts with a Corporation be signed by both (1) the chairman of the Board of Directors, the president or any vice-president (or another officer having general, operational responsibilities), and (2) the secretary, any assistant secretary, the chief financial officer, or any assistant treasurer (or another officer having recordkeeping or financial responsibilities), unless the contract is accompanied by a certified copy of a resolution of the corporation’s Board of Directors authorizing the execution of the contract. Similarly, pursuant to California Corporations Code section 17703.01, County policy requires that contracts with a Limited Liability Company be signed by at least two managers, unless the contract is accompanied by a certified copy of the articles of organization stating that the LLC is managed by only one manager.]

COUNTY OF TULARE

Date: By Chair, Board of Supervisors

ATTEST: JASON T. BRITT

County Administrative Officer/Clerk of the Board of Supervisors of the County of Tulare

By Deputy Clerk

Approved as to Form

COUNTY COUNSEL

By Deputy

Matter No.

PROPOSAL NO-26-018 – TRUCKING SERIVECS- BELLY DUMP

EXHIBIT E - Campaign Contribution Disclosure Information and Form

All bidders (potential contractors) must complete and submit with their bid, the Campaign Contribution Disclosure Form. See below, attached with instructions, information, and a disclosure form that must be signed and returned. For additional information, please refer to:

Government Code section 84308 https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=GOV&sectionNum=84308

FPPC Regulations 18438.1 through 18438.8 https://govt.westlaw.com/calregs/Browse/Home/California/CaliforniaCodeofRegulations?guid=I76245C705A0A11 EC8227000D3A7C4BC3&originationContext=documenttoc&transitionType=Default&contextD%20ata=%28sc.De fault%29&contextData=%28sc.Default%29

COUNTY OF TULARE

CAMPAIGN CONTRIBUTION DISCLOSURE INFORMATION

The attached Campaign Contribution Disclosure Form must be completed by applicants for, or persons who are the subject of any proceeding involving a license/permit, or other entitlement for use, including most contracts and franchises pending before the Board of Supervisors ("Board") of the County of Tulare or any of its affiliated agencies.

IMPORTANT NOTICE

Government Code section 84308 (also known as the "Levine Act") contains requirements that are summarized generally as follows:

A. If you are an applicant for, or the subject of, any proceeding involving a license, permit, or other entitlement for use, you are prohibited from making a campaign contribution of more than $250 to any member of the Board of Supervisors or other County official who may participate in your proceeding.

This prohibition begins on the date your application is filed or the proceeding is otherwise initiated, and the prohibition ends 12 months after a final decision is rendered by the Board of Supervisors or other County officer. In addition, no Board member or other County official or alternate who may participate in your proceeding may solicit or accept a campaign contribution of more than $250 from you during this period.

B. These prohibitions also apply to your agents, and, if you are a closely held corporation, to your majority shareholder as well. These prohibitions also apply to your subcontractor(s), joint venturer(s),and partner(s) in this proceeding. Also included are parent companies and subsidiary companies directed and controlled by you, and political action committees directed and https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=GOV&sectionNum=84308 https://govt.westlaw.com/calregs/Browse/Home/California/CaliforniaCodeofRegulations?guid=I76245C705A0A11EC8227000D3A7C4BC3&originationContext=documenttoc&transitionType=Default&contextD%20ata=%28sc.Default%29&contextData=%28sc.Default%29 https://govt.westlaw.com/calregs/Browse/Home/California/CaliforniaCodeofRegulations?guid=I76245C705A0A11EC8227000D3A7C4BC3&originationContext=documenttoc&transitionType=Default&contextD%20ata=%28sc.Default%29&contextData=%28sc.Default%29 https://govt.westlaw.com/calregs/Browse/Home/California/CaliforniaCodeofRegulations?guid=I76245C705A0A11EC8227000D3A7C4BC3&originationContext=documenttoc&transitionType=Default&contextD%20ata=%28sc.Default%29&contextData=%28sc.Default%29 controlled by you.

C. You must file the attached disclosure form and disclose whether you or your agent(s) have in the aggregate contributed more than $250 to any Board member or other County officer who may participate in your proceeding during the 12-month period preceding the filing of the application or the initiation of the proceeding.

D. If you or your agent have in the aggregate contributed more than $250 to any individual Board member or other County officer who may participate in your proceeding during the 12 months preceding the decision on the application or proceeding, that Board member or other County officer must disqualify himself or herself from the decision. However, disqualification is not required if the Board member or other County official returns the campaign contribution within 30 days from the time the member or official knows, or should have known, about both the contribution and the fact that you are a Party in the proceeding. The Campaign Contribution Disclosure Form should be completed and filed with your application or proposal, or with the first written document you file or submit after the proceeding commences.

1. A proceeding involving "a license, permit, or other entitlement for use" includes all business, professional, ,trade and land use licenses and permits, and all other entitlements for use, including all entitlements for land use, all contracts (other than competitively bid, labor or personal employment contracts),and all franchises.

2. Your "agent" is someone who represents you in connection with a proceeding involving a license, permit or other entitlement for use. If an individual acting as an agent is also acting in his or her capacity as an employee or member of a law, architectural, engineering, consulting firm, or similar business entity, both the business entity and the individual are "agents" for purposes of these rules.

3. To determine whether a campaign contribution of more than $250 has been made by you, campaign contributions made by you within the preceding 12 months must be aggregated with those made by your agent within the preceding 12 months or the period of the agency relationship, whichever is shorter. Contributions made by your majority shareholder (if a closely held corporation), your subcontractor(s), your joint venturer(s), and your partner(s) in this proceeding must also be included as part of the aggregation. Campaign contributions made to different Board of Supervisors members or other County officer who may participate in your proceeding are not aggregated with contributions to the first Board member but are aggregated as to each Board member or other County officer who may participate in your proceeding.

4. A list of the Board of Supervisors members and other County officials is listed below.

Board of Supervisors:

Larry Micari, Supervisor, First District Pete Vander Poel, Supervisor, Second District Amy Shuklian, Supervisor, Third District Eddie Valero, Supervisor, Fourth District Dennis Townsend, Supervisor, Fifth District

Elected County Officers:

Tara K. Freitas, Assessor/Clerk-Recorder Cass Cook, Auditor-Controller/Treasurer-Tax Collector Timothy Ward, District Attorney Michael Boudreaux, Sheriff-Coroner

This notice summarizes the major requirements of Government Code section 84308 of the Political Reform Act and California Code of Regulations, Title 2 sections 18438.1-18438.8.

COUNTY OF TULARE - CAMPAIGN CONTRIBUTION DISCLOSURE FORM

Application or Solicitation Number:

Application or Solicitation Title:

Was a campaign contribution, regardless of the dollar amount, made to any member of the Tulare County Board of Supervisors or to any County Officer on or after January 1, 2023, by the applicant, or, if applicable, any of the applicant's proposed subcontractors or the applicant's agent or lobbyist?

Yes ___ No

If no, please sign and date below.

If yes, please provide the following information:

Applicant's Name:

Contributor or Contributor Firm's Name:

Contributor or Contributor Firm's Address:

Is the Contributor: (check applicable boxes)

The Applicant Yes No Subcontractor Yes No The Applicant's agent/ or lobbyist Yes No

Note: Under California law as implemented by the Fair Political Practices Commission, campaign contributions made by the Applicant and the Applicant's agent/lobbyist who is representing the Applicant in this application or solicitation must be aggregated together to determine the total campaign contribution made by the Applicant.

Identify the Board of Supervisors Member(s) and County Agency Officer(s) to whom you, your subcontractors, and/or agent/lobbyist made campaign contributions on or after January 1, 2023, the name of the contributor, the dates of contribution(s) and dollar amount of the contribution. Each date must include the exact month, day, and year of the contribution.

Name of Board of Supervisors Member or County Agency Officer:

Name of Contributor: Date(s) of Contribution(s)

Amount(s):

(Please add an additional sheet(s) to identify additional Board Members or County Agency Officer to whom you, your subconsultants and/or agent/lobbyist made campaign contributions)

By signing below, I certify that the statements made herein are true and correct. I also agree to disclose to the County any future c o n t r i b u t i o n s made to Board Members or County Agency Officers by the applicant, or, if applicable, any of the applicant's proposed subcontractors or the applicant's agent or lobbyist after the date of signing this disclosure form, and within 12 months following the approval, renewal, or extension of the requested license, permit, or entitlement to use.

Date Signature of Applicant

Print Firm Name if applicable Print Name of Applicant

This Form Must Be Completed & Returned with Proposal

ATTENTION ALL COUNTY OF TULARE

CONTRACTORS AND GRANTEES

Contractor and Grantee Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions in response to Russian aggression in Ukraine. The EO is located at https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-

Order.pdf

The EO directs all agencies and departments that are subject to the Governor’s authority to take certain immediate steps, including notifying all contractors and grantees of their obligations to comply with existing economic sanctions imposed by the U.S. government in response to Russia's actions in Ukraine, as well as any sanctions imposed under state law.

This correspondence serves as a notice under the EO that as a contractor or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury website

(https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants, as applicable.

As a reminder, agreements with the County of Tulare include portions which require compliance with all local, state, and federal laws and directives which includes Executive Orders such as the

EO discussed here. The EO may not apply to or effect your agreement with the County. Please reach out to our department in order to seek clarification should you have any questions.

Please note that for any agreements or grants valued at $5 million or more, a separate notification will be sent outlining additional requirements specified under the EO.

Exhibit F https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions