November 17, 2022

REQUEST FOR PRE-QUALIFICATIONS

CDBG-DR OWNER OCCUPIED

REHABILITATION/ELEVATION/RECONSTRUCTION

Ref. #23-049

The City of Albany Procurement Division, 222 Pine Avenue, Albany, Georgia, will receive sealed proposals on behalf of the Dougherty County Board of Commissioners, until 5:00 pm EST, on DECEMBER 19, 2022, for developing and pre-qualifying a pool of contractors interested in making proposals for the provision of construction/rehabilitation services.

Dougherty County strongly encourages Small Business firms to participate in this RFPQ. All Corporations should provide corporate seal, a copy of the Secretary of State’s Certificate of Incorporation, and a listing of the principals of the corporation with their response.

Firms that wish to join in a consortium must designate one firm as the principal or lead firm. Consortiums will be evaluated according to the same requirements as a single firm.

Any interested and qualified firm and/or party is requested to make a response to accomplish the Scope of Services described herein. The response is to be signed by a duly authorized official of the firm and must be submitted in the time, manner and form prescribed. No reimbursement will be made by The City of Albany for any costs incurred prior to a formal notice to proceed should an award of contract result from this solicitation.

Dougherty County reserves the right to reject any and all responses and to waive technicalities as deemed to be in the best interest of the County. Dougherty County reserves the right to request additional information from a respondent(s) as deemed necessary to analyze responses.

INQUIRIES OR QUESTIONS: Should be submitted in writing to Christina (Tina) Strassenberg, Buyer, at the Procurement Division Office no later than 5:00 p.m., December 6, 2022; electronic inquiries are acceptable at cstrassenberg@albanyga.gov, cc: jswilliams@albanyga.gov. Replies of substance will be in writing, in the form of an addendum, and made available to all potential respondents.

City of Albany, Exylyn Mitchell

Exylyn Mitchell Interim Director

C E N T R A L S E R V I C E S

P.O. BOX 447 ALBANY, GA 31702 | PHONE: 229.431.3211 | FAX: 229.431.2184 | www.albanyga.gov

RFPQ #23-049 Page 1 of 2

DOUGHERTY COUNTY

PROCUREMENT DIVISION

ALBANY, GEORGIA

INSTRUCTION TO PROPOSERS

These instructions will bind proposers to terms and conditions herein set forth, except as specifically qualified in special bid and contract terms issued with any individual proposal.

PROCUREMENT FORM – REVISED 3/28/18

INTRODUCTION

Dougherty County is seeking highly skilled general contractors to perform rehabilitation, elevation, and re-construction of residential structures damaged by the 2017 Tornado, 2017 Straight-line Winds, and Hurricane Irma, and who continue to have unmet recovery needs. The work must be completed in compliance with all federal, state and local rules and regulations governing The U. S. Housing and Urban Development’s (HUD) Community Development Block Grant Disaster Recovery (CDBG-DR) funding and local building codes.

Dougherty County’s prequalification of Contractors is intended to create a qualified list of Contractors to bid on construction related recovery projects for the Homeowner Rehabilitation & Reconstruction Program (HRRP). Dougherty County will issue bids to prequalified contractors and will make assignments based on the lowest price from a responsive bid.

Dougherty County encourages all qualified Contractors with the requisite experience to seek prequalification by responding to this RFPQ. Contractors are not required to demonstrate in-house competence for the full scope of services listed below and may utilize subcontractors as needed. All applicants must have proper licensing, bonding capabilities, and insurance.

BACKGROUND

The Community Development Block Grant Disaster Recovery (CDBG-DR) program focuses on covering essential expenses for efforts related to disaster relief, long-term recovery, restoration of infrastructure and housing, and economic revitalization in the most impacted and distressed areas. Funding comes from the Department of Housing and Urban Development (HUD). In 2017, severe weather events caused extensive damage in Georgia, resulting in three Presidential declarations of a major disaster: two due to southwest Georgia tornadoes and one in the wake of Hurricane Irma. The money is used to assist communities left devastated by these natural disasters. Counties that received public and individual assistance are also eligible. Funds will be prioritized for use in the most impacted and distressed areas to facilitate long-term recovery through restoration of infrastructure and housing, mitigation to protect from predictable future damage, and economic revitalization.

Dougherty County has accepted a federal subaward from the Georgia Department of Community Affairs as a sub-recipient to administer the Homeowner Rehabilitation & Reconstruction Program (HRRP).

DESCRIPTION OF THE PROGRAM

Rehabilitation consists of non-emergency repairs or renovation of a limited specified area or portion of a housing structure. Rehabilitation includes bringing repaired portions of properties into compliance with federal, state, and local building codes and adhering to minimum property standards established by the program. The Minimum Property Standards are based on HUD’s decent, safe, and sanitary (DSS) Standards and the HUD Green Building Retrofit Checklist, where applicable. Rehabilitation will be limited to stick-built and modular structures that have been deemed feasible for repair or Mobile/Manufactured Home Units (MHUs) that are less than five years old and have less than $15,000 worth of rehabilitation (hard and soft costs combined).

Reconstruction includes the demolition, removal, and disposal of an existing housing unit and the replacement of that unit on the same lot, and in the same footprint, with a new unit that complies with the International Residential Codes (IRC) as required by State Minimum Standard Codes. The number of units on the lot may not increase and the total square footage of the original, principal residence structure to be reconstructed may not be substantially exceeded, however, the number of rooms in a unit may be increased or decreased based upon family size.

Replacement is the demolition, removal, and replacement of a damaged MHU with a new MHU in substantially the same footprint, or at a new location if the original damaged unit was on leased land and the MHU owner must relocate to a new property.

ELIGIBLE REPAIRS

All property improvements must be for unmet housing needs resulting from the 2017 Tornado, 2017 Straight-line Winds, or Hurricane Irma.

For eligible units, the HRRP will fund additional repairs not directly caused by the storms but needed to meet current building codes or to make the property more resilient against future disasters.

Eligible repairs include but are not limited to:

· Roofs

· Interior and exterior walls

· Foundations

· Framing and structural support components

· Critical systems including HVAC, water heaters, water pumps, and related systems

· Interior flooring

· Doors/windows

· Electrical

· Plumbing

· Well,/Septic repairs (when necessary)

· Interior and exterior finishes

· Replacement of appliances (if applicable)

· Any necessary or required Americans with Disabilities Act (ADA) improvements including special tubs/showers, access rams, special cabinets/counters

· Sidewalks/walkways providing access to the structure, which pose a health and/or safety hazard

· Any and all necessary site work required to complete the rehabilitation.

· Construction material/waste removal and disposal

· Abatement activities for materials containing lead

· Abatement activities for any materials containing asbestos

Additional Parameters Include:

· Cost-effective energy measures and improvements that meet local zoning and code.

· Decent Safe and Sanitary (DSS) standards or required Housing Quality Standards (HQS).

· Improvements that add enhanced resilience, such as elevation of major electrical components, roof strapping, and other measures.

· Lead-based paint testing, mitigation, or stabilization, as needed.

· Asbestos testing, mitigation, or encapsulation.

· Mold remediation, if necessary.

· Section 106 adverse mitigation activities as required by the Georgia Historic Preservation Division.

· Accessibility features for documented special needs. Repaired homes inhabited by special needs or elderly (age 62 or older) persons must be analyzed as to the special physical needs of such persons. Improvements such as widened doorways, ramps, level entry and doorways, and grab bars in bath areas must be installed, if appropriate. Hearing and sight-impaired adaptations should also be considered. All special needs requirements must be documented prior to approval.

· Ventilation and energy efficiency items such as ceiling fans, window screens, and screen doors if missing or not functional at the time of inspections.

· Elevation with the lowest finished floor two feet above the base flood elevation level for homes in the 100-year floodplain that are substantially damaged, substantially improved, reconstructed, or replaced. Elevation height requirements are governed by the applicable Federal Register Notice(s).

· All electrical components must be inspected including service, meter, wiring, and fixtures even if no electrical work is being specified. Unsafe components must be replaced. All exposed wiring, switches, and light bulbs in living areas must be encased.

· All homes must be equipped with smoke and carbon monoxide detectors installed in conformity with code requirements.

· Additional related costs such as green building and mitigation requirements, insurance, accessibility modifications, repair or replacement of water, or sewer and utility connection needs may be included.

QUALIFICATIONS

Dougherty County is seeking firms/individuals with substantial experience and success as General Contractors. The selected respondents must be able to adequately demonstrate their experience in Construction. Dougherty County desires that the respondent’s resources meet or exceed criteria listed within this RFPQ.

· Respondents that are corporations, partnerships, or any other legal entity, domestic or foreign, shall be properly registered or have applied for a license to do business in the County at the time of the submission of their response to this RFPQ. Such Respondents shall attach their license to do business or copy of their application for a license.

· Ability to meet all bonding and insurance coverage requirements.

· Entity responding to this RFPQ must provide a copy of its Georgia General Contractor’s License to perform all the work associated with residential construction/rehabilitation. The Georgia General Contractor’s License must be issued in the name of the Respondent or in the name of its qualifying agent. If a proposed Respondent is relying upon a qualifying agent’s Georgia General Contractor’s License, then the name of the proposed Respondent must be set forth on the license as an affiliated business organization/dependent licensee. All licenses must be current, valid, and issued in compliance with applicable law. Failure to provide this license with the Proposal may result in the Proposal being deemed non-responsive.

· Not on the State of Georgia Debarred, Suspended, or Ineligible Firms List; and

· Not been adjudged bankrupt either voluntary or involuntary within the past ten (10) years

· Neither Respondent nor any person or entity associated or partnering with Respondent has been the subject of any adverse findings that may prevent the County from selecting Respondent. Such adverse findings may include, but are not limited to, the following:

· A record of substantial building code violations or litigation against properties owned and/or managed by Respondent or by any entity or individual that comprises Respondent

· Conviction for fraud, bribery, or grand larceny

· Listing on the Federal or State excluded parties’ lists.

· Respondent has a satisfactory performance record.

· Respondent has a satisfactory record of integrity and business ethics.

· Respondent has established prior experience in successfully performing the scope of services requested.

· Respondent and its employees hold and maintain any and all territorial, federal, state, and local licenses or certifications as required to perform the services requested.

· Respondent is otherwise qualified and eligible to receive an award under applicable laws and regulations.

A Respondent’s response to the RFPQ may be rejected at any time during the evaluation process and thereafter if there are any adverse findings that would prevent the County from selecting the firm or any person or entity associated or partnering with the firm. Such adverse findings include, but are not limited to:

· A record of substantial building code violations or litigation against properties owned and/or managed by the Respondent or by any entity or individual that comprises the Respondent.

· Conviction for fraud, bribery or grand larceny by any principal of the Respondent

PRE-QUALIFIED CONTRACTOR ORIENTATION

Dougherty County will conduct an orientation with eligible contractors prior to bidding projects. The purpose of this orientation is to:

· Provide information on the HRRP, process, and requirements

· Provide information on the bidding process

· Provide information on the inspection process

· Provide information on the pay request process

· Familiarize the contractors with the contract documents and forms that will be used

· Familiarize the contractors with the client eligibility standards

· Familiarize the contractors with the Subrecipient’s property standards required by the HRRP

LICENSING AND CERTIFICATION REQUIREMENTS FOR CONSTRUCTION AND TRADES IN THE STATE OF GEORGIA Subrecipients administering the HRRP program should be well-informed of the construction and trade industry licensing and certification requirements required by the State of Georgia. Residential and General Contractors must be licensed with the State Licensing Board. For more information regarding licensing, please see the Georgia Secretary of State website at https://sos.ga.gov/index.php/licensing.

Anyone engaged in the practice of Lead Hazard Reduction or Abatement must be certified by the State of Georgia Department of Natural Resources, Environmental Protection Division.

BONDING REQUIREMENTS

In the State of Georgia, general contractors performing work over $2,500 and all residential contractors need to obtain a license at the state level. The contractors are required to obtain a contractor license bond when they apply for the license. Similar to most surety bonds, this bond is required as a form of protection to both the public and the state. Contractor license bonds are underwritten by bonding companies who back an agreement between them, the contractor, and the state. Should the contractor fail to abide by the terms of the license and a third party suffers losses, said party can ask for compensation from the bonding company. Keep in mind, however, that it’s ultimately the responsibility of the contractor to cover all costs incurred. Annual bond costs are based on credit scores.

For rehabilitation activities, no performance or payment bond is required. For reconstruction projects, a performance and payment bond in the total amount of the contract is required. All contractors must secure and provide proof of performance and payment bonds within 10 business days of award. Failure to do so may result in termination of award.

USE OF SUBCONTRACTORS

The County shall select multiple General Contractors, and those General Contractors shall be responsible for all deliverables specified in the RFPQ and proposal. This general requirement notwithstanding, it is anticipated that Respondents will enter into subcontractor arrangements; however, bidders shall acknowledge in their proposals that they will have total responsibility for the entire contract. Additionally, the subcontractors shall not subcontract for any portion of work they are expected to complete.

NUMBER OF AWARDS

The Respondent recognizes that, at the sole discretion of the County and based upon the breadth and experience of respondents to this RFPQ, the County intends on creating a pool of general contractors to support the requirements outlined in this RFPQ. The County then intends on conducting mini-bid solicitations for specific work. Nothing in this paragraph shall be construed in derogation of the County’s right, in its sole discretion, to cancel this RFPQ.

GENERAL FEDERAL GRANT REQUIREMENTS

Because the contract is being funded with federal funds, the contract shall be governed by certain federal terms and conditions for federal grants, such as the Office of Management and Budget’s (“OMB”) applicable circulars.

HUD GENERAL PROVISIONS

Because the contract is being funded with HUD funds, the contract shall be governed by certain general HUD terms and conditions as attached.

QUALIFICATION PACKAGE FORMAT & PROPOSAL CONTENT

To be considered for award, the qualification package shall meet the following requirements. The qualification package should include five (5) properly labeled, sealed envelopes. One envelope labeled original and containing an original hardcopy of all the materials and the other four containing copies of the original. Failure to meet the requirements as outlined will disqualify the respondent.

A. Proposal Application Each proposal must have a completed proposal application listing the following:

1. GC’s information including name of business (include any dba names); headquarters and parent company locations; and brief history of the business.

2. GC’s mailing address, contact person, telephone number for primary contact person, and email address.

3. A principal or officer of the business authorized to execute contracts or other similar documents on the business’ behalf.

4. Existing staffing levels to include name, position, and years of experience

B. General Contractor Experience and Capacity Provide information on the GC’s qualifications. Respondents shall include information to establish their Team’s Experience and Capacity.

Respondents shall provide the below information in this section of the proposal:

1. History of the construction business/company including year of inception

2. Overview of qualifications and experience constructing residential, rehabilitation projects to include the number of years, types of projects, and number of projects.

3. Litigation and default history over the past five (5) years to include agreements, financing arrangement with any bank, financial institution, or other entity and if yes, specify date(s), details, circumstances, and prospects for resolution.

4. Organizational chart for the business

C. Reference Form The Responder shall provide three (3) references within the past five (5) years on the business/company on completed projects similar to residential projects mentioned within this RFPQ. For each reference, the GC shall provide the following information:

1. Company name

2. Contact name

3. Address

4. Email address

5. Telephone numbers

D. Documents The Responder shall complete and submit the following documents:

1. Conflict of Interest Disclosure

2. Certificate and Acknowledgement

3. Certificate of Non-Collusion

4. Governing Law and Venue

5. Drugfree Workplace Certification

6. Debarred Bidders/Integrity Certification

7. Indemnity Agreement

8. Affidavit to comply with O.C.G.A

E. Attachments The Responder shall attach the following documents:

1. Business License or Business License application.

2. State Contractor’s License

3. Lead Based Paint Right to Renovate Certificate

4. Proof of Insurance – County Insurance Requirements

Failure to provide the required documents within the stated time period may result in the proposals deemed non-responsive and may be immediately disqualified with no further consideration given for potential awarding of the contract.

Approval/Selection Process Following the deadline for receipt, Responders may be interviewed before a final recommendation is made.

The contract for construction/rehabilitation services will be conveyed to the most advantageous proposer, as determined by the County after a final review with the Dougherty County Board of Commissioners. The selection process will be made in three (3) phases:

1. Each proposal will be reviewed for completeness to determine whether all Minimum Requirements have been met, and any proposal not meeting those requirements will be eliminated from consideration.

2. The remaining proposals will be evaluated in accordance with the RFPQ Requirements, Selection Committee Criteria, and ratings of evaluators.

3. The evaluations will be reviewed in conjunction with the submittals of the proposal, the results of any interviews and any additional information requested by the County on which basis the most advantageous proposer will be identified.

During the Selection Process, the County reserves the right for any reason deemed appropriate by the County: to waive portions of the RFPQ; to waive any minor informality in the proposal; to reject any and all Proposals; to terminate the RFPQ; and to issue a new RFPQ.

Proposal Review All proposals will be reviewed by an Evaluation Committee. Members of the Committee shall include members from the County, and individuals with professional expertise in the fields of construction, housing, public administration, and legal. Proposals that meet the minimum requirements will be reviewed for responsiveness to the comparative evaluation criteria below.

Selection Scoring Criteria The selection of contractors resulting from this part of the RFPQ shall be determined by analysis of, but not necessarily limited to, the factors shown below. Points will be designated for each factor with a maximum score of 100 points.

A. Completeness of Submission of Requested Information Specified.

Proposals should be organized and demonstrate completeness, cohesiveness, conciseness, clarity, and comprehensiveness with respect to compliance and relevant to RFPQ submittal requirements.

_____________ Up to 25 points

B. General Contractor Experience (to include Team Experience) Proposers shall demonstrate evidence and qualifications of prior and existing experience, capacity, and ability to provide services in compliance with contract terms and any relevant federal, state, and local requirements.

_____________ Up to 25 points

C. Capacity Proposers shall demonstrate staffing capacity by providing a listing of key personnel and an organization chart to include any use of sub-contractors.

_____________ Up to 25 points

D. References. Proposers shall provide three (3) references within the past five (5) years on the business/company.

_____________ Up to 25 points

Award of Contract The Procurement Division will open the Proposals and prepare a register of those Respondents submitting proposals. All proposals shall remain firm for sixty (60) calendar days after the submittal date for receipt of Proposals.

Before selection of contractors, the County may request additional information from Respondents. The County reserves the right to reject any and all Proposals if it determines that the criteria set forth has not been met or for any other reason in its sole discretion.

Selection of contractors will not necessarily be dependent on the Proposal that receives the highest rankings. The County will develop a pool of contractors taking into consideration the evaluation criteria, responsiveness of the proposal to the RFPQ Requirements, program goals and objectives, benefits to the community, and overall advantage to the County.

Proposal Rejections The County reserves the right to accept or reject any and all responses and to waive technicalities as deemed to be in the best interest of the County. Proposals will be rejected from any party (as an individual or as part of a partnership or entity) who:

· Is delinquent in the payment of property taxes with Dougherty County.

· Is delinquent in the payment of a loan(s) with the County.

· Has had property acquired through foreclosure or a judgment within the past ten (10) years.

· Has outstanding judgments or debts owed to the County.

· Has been convicted of a felony that affects property or neighborhood stability, health, safety or welfare.

Public records and tax and court records will also be checked prior to award of contract.

Disclaimer/Reservation of Rights The County does not make representations or warranties, express or implied, as to the accuracy and/or completeness of the information provided in this RFPQ.

The County reserves the right to extend the deadline for submission of Proposals, to request supplementary information, to conduct interviews with any or all of the Responders submitting proposals, to waive minor informalities, and to reject any or all proposals, in whole or in part, if in its sole judgment the best interests of the County would be served in doing so. The County will reject any and all proposals when required to do so by applicable law.

COST OF OFFEROR PREPARATION

Dougherty County shall not be liable for any costs incurred by respondents prior to issuance of or entering into a contract. Costs associated with developing the proposal, preparing for oral presentations, and any other expenses incurred by the Respondent in responding to this RFPQ shall be entirely the responsibility of the Respondent and shall not be reimbursed in any manner by Dougherty County.

Due Diligence The Respondent shall be responsible for conducting due diligence in responding to this RFPQ. If, after the RFPQ is issued but prior to the receipt of Proposals, the RFPQ must be amended or clarified, the purchasing agent may issue an Addendum.

Should you have any questions, contact Christina (Tina) Strassenberg, Buyer, at (229) 431-3211 or cstrassenberg@albanyga.gov cc: jswilliams@albanyga.gov.

Proposal Checklist It is the Proposer’s responsibility to read the RFPQ fully to determine all necessary information/documents are submitted for the Proposal to be considered complete. You may use the checklist below as a guide to assist with providing the requested information.

PROPOSAL APPLICATION

This form must be completed by Responders to this RFPQ. Attach additional information as needed or as required. If you attach confidential material, clearly identify if the attachments are proprietary.

Company Name

Company Address

Company Phone Email

The Construction Management/General Contractor (that will be responsible for management of the contract associated with this RFPQ) is a Legal Entity:

If not a Georgia corporation/partnership, state where organized:

(Attach current corporation documentation.)

Authorized Representative Signature(s) Title(s)

REFERENCE FORM

Proposer’s Name:

The Proposer must list a minimum of three (3) separate and verifiable client references for which work similar in nature to that described in this solicitation has been performed for a period of at least one (1) year. Any information not submitted on this attachment shall not be considered. The same reference may not be listed twice. Confidential client references shall not be included. Please provide at least two (2) Contact Names for each client.

Reference 1

Company Name:

Address:

Contact Name:

Alternate Contact Name:

Phone:

Email:

Service Dates:

Reference 2

Company Name:

Address:

Contact Name:

Alternate Contact Name:

Phone:

Email:

Service Dates:

Reference 3

Company Name:

Address:

Contact Name:

Alternate Contact Name:

Phone:

Email:

Service Dates:

STATEMENT OF EXERIENCE AND CAPACITY

1. Please provide a history of the construction business/company including year of inception.

2. Please provide evidence of relevant project experience. Describe 5 projects in the last three years that demonstrate the capability to perform required services. For each project include the following:

Project 1

Project Name:

Location:

Contract Dates:

Description of Project:

Services Performed:

Project 2

Project Name:

Location:

Contract Dates:

Description of Project:

Services Performed:

Project 3

Project Name:

Location:

Contract Dates:

Description of Project:

Services Performed:

CLAIMS/LIENS/LITIGATION HISTORY

1. Within the past 7 years, has your organization filed suit or a formal claim against an owner or entity, or been sued by or had a formal claim filed by an owner, subcontractor or supplier resulting from a contract dispute? Yes No If yes, please attach additional sheet(s) to detail the issue, litigation amount, name of attorney’s representing all parties, amount actually recovered (if any), and names of project owner(s) or manager(s) to include address and phone number.

2. List all pending litigation and or arbitration.

3. List and explain all litigation and arbitration within the past seven (7) years - pending, resolved, dismissed, etc.

4. Within the past 7 years, please list all Liens, including Federal, State and Local, which have been filed against your Company. List in detail the type of Lien, date, amount and current status of each Lien.

5. Have you ever abandoned a contract, been terminated for cause? Yes No If yes, please explain in detail:

6. For all claims filed against your company within the past five-(5) years, have all been resolved satisfactorily with final judgment in favor of your company within 90 days of the date the judgment became final? Yes No If no, please explain why:

7. List the status of all pending claims currently filed against your company:

Financial Consequences

1. Has an owner or entity ever withheld payment, assessed fees or penalties, or made a claim against any Performance and Payment Bonds? Yes No If yes, please explain in detail:

(Use additional or supplemental pages as needed)

ORGANIZATIONAL CHART

General Contractor TEAM

List of Sub-Contractors

CONFLICT OF INTEREST DISCLOSURE

I certify that I/We have no personal or financial interests and no present employment or activity which would be incompatible with this organization’s participation in any activity related to the RFPQ or execution of the awarded Community Block Development Grant Disaster recovery (CDBG-DR) contract. For the duration of this contract, this organization agrees not accept any gift, benefit, gratuity or consideration, or begin a personal or financial interest in a party who is bidding and/or proposing or associated with a bidder and/or a proposer on the Community Block Development Grant Disaster Recovery (CDBG-DR) contract.

This statement must be fully completed and signed by an authorized representative.

Company Name:

Authorized Representative/Title:

Phone Number:

Email Address:

Signature:

Date:

This information is subject to verification. If misrepresentation is found, the bid may be automatically disqualified from the procurement process or the contract may be canceled.

CERTIFICATE AND ACKNOWLEDGEMENT

Yes __ No __ Applicant certifies that it as individual or member of a corporation or partnership is not now and will not be at contract execution in violation of the following policies:

actively abated.

Yes __ No __ Been convicted of a felony crime that affects property or neighborhood stability or safety.

voluntary or involuntary within the past five (5) years; and Yes __ No __ Been adjudged bankrupt either voluntary or involuntary within the past ten (10) years.

I/We acknowledge understanding of the above policies and certify that none of the individuals or members of a corporation or partnership are in violation. I certify that this information is true and correct.

I/We further certifies that the information and exhibits comprising this Proposal are true and correct. Unsigned/undated submissions will not be considered.

CERTIFICATION OF AUTHORIZED REPRESENTATIVE:

I as Authorized Representative for , hereby certify that all information and materials submitted in response to this RFPQ are true and accurate to the best of my knowledge and belief. I understand that any attempt to falsify information in this application shall result in disqualification. Further, I hereby consent to requests that the City may make of third parties for information to substantiate information provided in this RFPQ, and I authorize third parties to release such information to the City.

Authorized Signature of Respondent Date

Print or type name

Authorized Signature of Respondent Date

Print or type name

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT

Contractor’s Name:

Address:

CONTRACTOR AFFIDAVIT

I understand that Dougherty County may not enter into a contract with (Name of Corporation) unless it has registered and does participate in the Federal Work Authorization Program defined in O.C.G.A. § 13-10-90(2), to-wit” (2) “Federal work authorization program” means any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99-603.

By executing this affidavit, the undersigned Contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, entity or corporation which is engaged in the physical performance of services on behalf of Dougherty County 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 sub-Contractors 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 Date of Authorization Identification Number) (EEV/E-Verify Company Identification Number

Name of Contractor

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

Printed Name (of Authorized Officer or Agent of Contractor) Title (of Authorized Officer or Agent Contractor)

Signature (of Authorized Officer or Agent) Date Signed

SUBSCRIBED AND SWORN BEFORE ME ON [NOTARY SEAL]

Notary Public My Commission Expires: Approved 10/23/2020

*COMPLETE AND SUBMIT*

CERTIFICATION OF NON-COLLUSION

The bidder being sworn, disposes and says, _____________________________________________ The Consultant submitting this certification and its agents, officers or employees have not directly or indirectly entered into any agreements, participated in any collusion or otherwise taken any action in restraint of free competitive bidding in connection with this bid.

DATE: _____________________

COMPANY NAME: __________________________________________

AUTHORIZED REPRESENTATIVE NAME: ________________________________________

TITLE: ________________________________________

SIGNATURE: ___________________________________

*COMPLETE AND SUBMIT*

GOVERNING LAW AND VENUE

Consultant agrees that as to any actions or proceedings arising out of or related to this agreement, any such proceedings shall be governed and determined by Georgia Law.

Consultant further agrees that as to any actions or proceedings arising out of or related to this agreement, any such action or proceeding shall be resolved only in an appropriate court located in Dougherty County, Georgia.

DATE: _____________________

COMPANY NAME: __________________________________________

AUTHORIZED REPRESENTATIVE NAME: ________________________________________

TITLE: ________________________________________

SIGNATURE: ___________________________________

*COMPLETE AND SUBMIT*

Drug Free Workplace Certification

DRUG FREE WORKPLACE REQUIREMENTS: The Contractor will provide the following certification that a Drug Free Workplace will be provided on the Project.

The undersigned certifies that the provisions of Code Sections 50-24-1 through 50-24-6 of the Official Code of Georgia Annotated, relating the "Drug Free Workplace Act", have been complied with in full. The undersigned further certifies that:

1. A drug free workplace will be provided for the Contractor’s employees during the performance of the Contract; and

2. Each Contractor who hires a Subcontractor to work in a drug free workplace shall secure from that Subcontractor the following written certification:

DATE: _____________________

COMPANY NAME: __________________________________________

AUTHORIZED REPRESENTATIVE NAME: ________________________________________

TITLE: ________________________________________

SIGNATURE: ___________________________________

*COMPLETE AND SUBMIT*

DEBARRED BIDDERS/INTEGRITY CERTIFICATION

Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion (49 CFR, Part 29):

The Contractor must certify that neither it nor its principals are presently debarred, suspended, proposed…