RFQ 2025_004 Catering Services for Town Green.pdf

REQUEST FOR QUALIFICATIONS

FOR

CATERING SERVICES

THE CITY OF DOUGLASVILLE

TOWN GREEN

RFQ 2025-004

Issued on: April 21, 2025

Due Date: May 22, 2025

I. INTRODUCTION

1. Approved Caterers

The Douglasville Town Green, hereinafter referred to as the Town Green, is seeking to provide an approved list of independent licensed full-service caterers, hereinafter referred to as the Approved Caterers, to provide catered food service for receptions, corporate events, meetings, and other group functions at the Town Green, 6840 Church St., Douglasville, GA 30134.

The City of Douglasville is seeking to add three additional full-service caterers to the approved caterers list. Only caterers capable of providing a diverse menu that includes a wide range of cuisines and accommodates various dietary preferences will be considered for this Request for Qualifications.

The Approved Caterer will provide its own employees in the performance of these duties and will compensate such employees and provide all workers compensation and unemployment benefits and other employee benefits as required under Georgia law. The Approved Caterer will employ only competent employees who keep themselves neat and clean and provide courteous treatment and service to the public. All employees will be identified by a staff shirt and/or uniform when at the Town Green. The Approved Caterer will employ an adequate number of employees to successfully operate a catering event at the Town Green.

The City of Douglasville regards customer service as the main priority within its facilities; it is imperative that all Approved Caterers share this concern. The City of Douglasville reserves the right to terminate Approved Caterer status if said caterer is unable to provide quality service.

The Approved Caterer will provide their own tablecloths, linens, utensils, etc., as well as all beverages, including alcoholic beverages, if licensed.

2. Scope of Facility

The following spaces are available for rent: The Tower has an occupancy of 138 and contains the three following spaces: the Bridge, an enclosed space that has an occupancy of 50, the Patio, an open-air space that has an occupancy of 60, and the Rooftop, which has an occupancy of 28. The Tower is equipped with a full-service warming kitchen available for the exclusive use of the selected caterer.

The Town Green is designated as SMOKE FREE. The Approved Caterer’s employees are responsible for enforcing the no-smoking designation during the catered events and abiding by this policy.

3. Availability

The Town Green facilities will be available to the public for rental for receptions, corporate meetings, meetings, group functions, etc. year-round from the hours between 8 AM – 11 PM.

4. Utilities and Cleanup The utility costs for gas, electricity, water, sewer, recycling, and trash removal will be paid by the City of Douglasville. The Approved Caterer will be responsible for the cleanup of any area utilized by said caterer for an event (removal of trash from the facility, busing of tables, cleaning and removal of dishes and serving ware, etc.).

5. Indemnification Approved Caterer shall hold harmless the City of Douglasville, Georgia, its agents, officers, and employees from and against liability, claims, actions, costs, damages or losses of any kind, arising from, or in connection with, the performance of professional services by Approved Caterer or its agents, officers and employees under this Agreement including, but not limited to Approved Caterer’s negligence, reckless, or willful act of omission.

6. Permits The Approved Caterer shall obtain any of the necessary permits or licenses for the operation of a catered event.

7. Disclaimer The City of Douglasville is not responsible for equipment left in the facility overnight.

8. Non-Discrimination Policy The Approved Caterer shall operate its catering business without discrimination as to sex, race, age, creed, or national origin and will comply with the Americans with Disabilities Act.

9. Assignment The Approved Caterer agrees not to assign any contract entered into as a result of this Request for Qualifications in whole or part, or subcontract all or any part of such a contract, without prior written consent of the City of Douglasville.

10. Brochures The Caterer will provide the City of Douglasville with appropriate materials specific to the Approved Caterer’s operation, for distribution to the public.

11. Annual Review and Cancellation The Approved Caterer status will be reviewed on a 3-year basis. The Approved Caterer status may be revoked by the City of Douglasville upon written notice for reasons involving illegal, corrupt, or immoral practices of the Caterer, for quality control purposes, or the conduct of the Caterer is such as to bring discredit upon the City of Douglasville or to create a financial loss to the Town Green.

12. Facility Usage Fee The City of Douglasville will receive for the operation of a catering event a facility usage fee of a minimum of ten (10%) percent of the gross food and beverage sales, not including sales tax. Said proof of payment of catering services must be given to the City of Douglasville by the 20th day of the following month.

13. License and Experience The Approved Caterer must be licensed and have previous experience as a full-service caterer.

14. Locally owned, Minority owned and Female owned Firms Locally owned businesses and minority-owned businesses and female-owned businesses are encouraged to respond to this RFQ. Procurement of catering services by the City of Douglasville will be carried out in compliance with the City of Douglasville’s purchasing policy.

15. Alcoholic Beverages If the Caterer does not hold the appropriate alcohol license in the City of Douglasville, alcoholic beverages must be purchased through the business that holds the alcohol license for the concessions at the Town Green.

16. Other Related Issues All other issues and items not mentioned in the above specifications will be negotiable between the Approved Caterers and Town Green through its designee.

17. Pre-Proposal Meeting There will not be a pre-proposal meeting for this RFQ.

18. REQUESTS FOR INFORMATION

All requests for information and clarifications regarding this project shall reference the above invitation name and be submitted via Bidnet Direct at https://www.bidnetdirect.com no later than May 05, 2025 at 04:00 PM EDT.

Questions and answers will be issued in the form of an addendum to all interested parties and will be available on Bidnet Direct at https://www.bidnetdirect.com.

Please contact Alyssa Gordon, Senior Accounting Specialist at gordona@douglasvillega.gov if further assistance is needed. All firms are responsible for checking Bidnet Direct https://www.bidnetdirect.com on a regular basis for updates, clarifications, and announcements. The City of Douglasville reserves the right to communicate via electronic mail with the primary contact listed in the proposer’s response to the RFQ.

RFQ ESTIMATED TIMELINE

Owner issues public advertisement of RFQ. 04/21/ 2025 Deadline for written questions/requests for information

05/05/ 2025 04:00PM EDT

Deadline for submission for proposals 05/22/ 2025 04:00 PM EDT City Council will vote on selection of firm(s) TBD

II. SUBMISSION INSTRUCTIONS

A. Proposals must be received by 05/22/2025 and submitted to: Bidnet Direct at https://www.bidnetdirect.com.

B. Selection Criteria are outlined in the RFQ herein.

C. All Bidders submitting a proposal will receive written notice of the award decision.

D. All submittals and documentation received by the City of Douglasville shall become property of the City of Douglasville and will not be returned.

E. The City of Douglasville reserves the right to reject any and all submittals received in response to this RFQ. The City of Douglasville is under no obligation to award and/or enter into a contract for these services and the catering selection schedule may be revised at the City of Douglasville’s discretion.

F. All costs associated with the preparation and submission of the RFQ packet shall be borne solely at the expense of the Bidder. The City of Douglasville shall not be responsible for any costs or expense incurred by Bidder.

G. This RFQ and, if applicable, interview selection process shall in no way be deemed to create a binding contract or agreement of any kind between the City of Douglasville and Bidder.

H. The City of Douglasville reserves the right in its sole discretion to waive informalities in the RFQ or an RFQ Response, but it is not required to do so.

I. The RFQ Response should be responsive to each item in the specific range of issues elaborated in this RFQ. Submission of excessive “boilerplate” information is discouraged, and failure to address all required items or failure to submit all required documents will disqualify an RFQ Response from consideration.

J. It is the responsibility of each Bidder to examine the entire RFQ, seek clarification in writing, and review its proposal for accuracy before submitting the RFQ Response. Once the submission deadline has passed, all RFQ Responses will be final. The City of Douglasville will not request clarification from any Bidder relative to its RFQ Response.

III. RFQ RESPONSES

A. Submit to Bidnet Direct at https://www.bidnetdirect.com B. Business Identification Form C. Provide description of Bidder’s special capabilities, techniques or resources that can be contributed to this assignment. A minimum of three references from https://www.proposalnetdirect.com/gia/cityofdouglasville https://www.bidnetdirect.com/ projects of a similar scope and type shall be submitted with each RFQ Response.

Mailing addresses, telephone/fax numbers, email addresses (if available) and the names of the contacts must be provided as part of the reference package.

Particular emphasis should be placed on demonstrating previous experience in catering services at medium-sized event facilities.

D. Submit Organization chart showing key team members’ names and roles/titles, responsibilities, and reporting relationships.

E. Submit menu of meal options with pricing and costs of service staff.

F. Bidder must provide proof of insurance.

G. Bidder must provide in declaration pages showing it carries the required levels and types of insurance. Further, as a mandatory term of any contract with the City of Douglasville, Bidder must agree to the indemnification requirements set forth in Attachment B, and Bidder must agree to list the City of Douglasville as an additional insured on its policies

H. A Table of Contents, which corresponds to items (B-G), must be included as well, to identify each section, in the same sequence requested in this document.

IV. SELECTION PROCESS

A. Scoring Values The decision for selecting a Bidder will be made by the “Evaluation Committee,” comprised of City of Douglasville staff who will use the criteria listed below:

Schedule of Scoring Criteria

(Maximum 100 Points)

No. Description of Item Points

A Evaluation of Bidder’s ability to follow instruction in preparing and submitting proposal

5 Pts.

B The experience of Bidder and key staff as it relates to work of a similar nature and scope

15 Pts.

C Evaluation of Bidder’s ability to serve diverse groups via pricing and menu options

15 Pts.

D Evaluation of the Bidder’s demonstrated strong knowledge of Food & Beverage and Catering Operations as well as processes and workflow

25 Pts.

E Evaluation of Bidder’s references 15 Pts.

F Evaluation of Fee Proposal 10 Pts.

G Evaluation of tasting option 15 Pts.

B. Selection Process

1. Each member of the Evaluation Committee will read, review, evaluate and score each RFQ Response based on items contained above.

2. The Evaluation Committee will be responsible for reviewing all RFQ

Responses. The five highest scoring Consultants (MAXIMUM 100 pts) will be requested to come in for an on-site interview with a tasting to select three Bidders for recommendation to the Mayor and City of Douglasville Council for approval. The Mayor and City Council have final approval authority.

3. Any RFQ Response shall remain a valid proposal for three months after the proposal date.

V. MISCELLANEOUS PROVISIONS

A. Satisfactory Work Any work found to be in any way defective or unsatisfactory shall be corrected by the Caterer at their own expense.

B. Fixed-Price to Remain in Place

1. All prices, costs, and conditions outlined in the RFQ Response shall remain fixed and valid for acceptance for ninety calendar days starting on the due date of the bid.

2. Prices will remain consistent for the duration of the Contract.

C. Equal Employment Opportunity Bidder shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, or disability. Bidder will take affirmative action to ensure applicants are employed, and that employees are treated fairly during employment without regard to their race, color, religion, sex, national origin, or disability.

Such action shall include, but not be limited to, (1) employment, (2) upgrading,

(3) demotion, (4) transfer, (5) recruitment or recruitment advertising, (6) layoff or termination, (7) pay rates or other forms of compensation and (8) selection for training, including apprenticeship. The City of Douglasville fully encourages the participation of qualified minority and female-owned businesses with respect to this RFQ.

D. Prohibited Interests No elected official, officer or employee or agent of the City of Douglasville will have a direct or an indirect interest in this Contract or the proceeds thereof. By submitting a response to this RFQ, you certify that this is a true statement.

E. Prohibited Contact

No Bidder, team member or consulting organization is to discuss any part of this RFQ with any member, official, or employee of the City of Douglasville outside of the evaluation meeting.

F. Rejection The City of Douglasville reserves the right to reject any and all submittals or parts thereof and to reissue this RFQ. In addition, the City of Douglasville does not guarantee that a contract will be awarded as a result of this RFQ.

Attachment A

Please answer all questions. Attach additional sheets as necessary.

Name of the Company under which you do business:

Permanent main office address:

City, State and Zip Code:

Business Phone Number:

E-Mail Address:

Type of organization: (Check all applicable)

___ Individually-Owned

___ Partnership ___ Corporation/LLC

___ Joint Venture ___ Non-profit ___ Private

___ Public ___ Minority Owned ___ Female-Owned

If a corporation/LLC, enter the date of incorporation/organization and the state in which incorporated/organized: Date: ___________ State: ___________

Identify number of employees: ______________

Enter the number of years you have been in business under the present catering name: _____________

Enter any other names your company has done business under:

Indicate the dates, locations and number of years for each:

Identify the name, title and telephone number of the person(s) in your organization authorized to negotiate and bind the Bidder to a contract:

Name Title Phone #

Name Title Phone #

Name Title Phone #

Name Title Phone #

Attachment B

INDEMNIFICATION AND INSURANCE REQUIREMENTS

I. INDEMNIFICATION

A. Bidder will defend, at Bidder’s sole expense, indemnify and hold harmless the City of Douglasville, their officials, employees, agents, servants, representatives and assignees from and against any and all liability damages, losses, expenses, claims, demands, suits, actions, judgments, bodily injuries or sicknesses to any person, or damage, destruction or loss of use of any property arising out of or related to the services provided by Bidder and/or caused by Bidder's negligence or willful misconduct.

B. This indemnification obligation includes paying City of Douglasville attorney’s fees and costs in defending or responding to any such claim, demand, suit, action, judgment, etc.

II. INSURANCE REQUIREMENTS

A. Types and Amount of Required Insurance: Bidder shall at all times maintain in full force and effect Automobile, and Commercial General Liability. All insurance shall be by Insurers, or a self-insurance plan, acceptable to the City of Douglasville before commencement of work hereunder. For the purpose of the RFQ Response, Bidder shall carry the following types of insurance in at least the limits specified below:

Coverages Limits of Liability

Commercial General Liability $500,000/$1 million Automobile Insurance $100,000/$300,000

B. All certificates of insurance shall provide the City of Douglasville within thirty days written notice of cancellation of any of the coverage areas named in said certificate.

C. The City of Douglasville will be named as additional insured under these insurance policies.

Attachment C

Please include a copy of your business license, food service permit, and your most recent health inspection.

Attachment D

SCOPE OF SERVICES

The scope of services includes catering services for the City of Douglasville and its rental clients.

Rentals include:

• Room for designated time.

• Setup of tables and chairs.

Caterer is responsible for:

• Contacting the Operations Coordinator as soon as you have booked clients for an event.

• Providing food and setup.

• Must have ample catering staff on site before, during, and after the event.

• Providing plates, cups, napkins, eating utensils, and service utensils, to include cleaning cloths, and dishwashing products.

• Cleaning of any area utilized by the Caterer including removal of trash from the facility, cleaning of food preparation stations, busing of tables, etc.

• Linens and skirts for food and guest tables.

• Scheduling a tasting with booked clients (Town Green) by submitting a Tasting

Request form prior to scheduling a client to ensure room, date and time are allocated for successful tasting. (Please note: Caterer must provide their own linens for tastings; Town Green will only provide the tables and a maximum of 4 chairs).

City of Douglasville- owned equipment for use by Caterer:

• Tables and chairs

• Warming Kitchen

Commission

• Caterer shall pay a minimum facility usage fee of ten percent of the gross food sales, not including sales tax to the City of Douglasville.

• The Caterer must provide the City of Douglasville with a copy of the invoice for food and beverage sales within 10 days of the scheduled event.

• Payments are to be made to the City of Douglasville by the 20th day of the following month.

BIDDER hereby submits this Bid as set forth above:

Bidder:

(typed or printed name of organization)

By:

(individual’s signature) Name:

(typed or printed) Title:

(typed or printed)

Date:

(typed or printed)

If Bidder is a corporation, a partnership, or a joint venture, attach evidence of authority to sign.

Attest:

(individual’s signature)

Name:

(typed or printed)

Title:

(typed or printed)

Date:

(typed or printed)

Address for giving notices:

Bidder’s Contact:

Name:

(typed or printed)

Title:

(typed or printed)

Phone:

Email:

Address:

BIDDERS’ DISCLOSURE STATEMENT

All bidders should be aware that the Project is a public project, and the City is a public agency.

Pursuant to the laws, rules and Executive Orders of the State of Georgia, the City of Douglasville shall make every effort to avoid even the appearance of a conflict of interest or any impropriety in both the selection process for this project and the negotiation and performance of any resulting contract. As part of any submittal you intend to make for this project, you must include a Disclosure Statement with your submittal which answers the following specific questions:

1. Describe any business transactions occurring within the prior two years between your firm and the City of Douglasville. <Insert Response Here>

2. Describe any gift, hospitality, or benefit of any sort that your firm has provided to the City of Douglasville within the prior one-year period.

<Insert Response Here>

3. A conflict of interest or potential conflict of interest is defined as any action, decision, or recommendation by a person acting in a capacity as a public official, the effect of which is or could be to the private monetary or financial benefit or detriment of the person, the person’s relative, or any business with which the person or a relative of the person is associated. The potential conflict of interest is viewed from the perspective of a reasonable person who has knowledge of the relevant facts. Based upon this definition, describe any conflict of interest or potential conflict of interest that your firm has with the City of Douglasville. <Insert Response Here>

This Disclosure Statement should be dated and signed by an authorized signer for the bidder and submitted with the Bidder’s submittal.

Name of Firm

Authorized Signature Date

Printed Name and Title of Authorized Agent

Georgia Security and Immigration Compliance.

Compliance with the requirements of O.C.G.A. 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02 are conditions of this contract. Contractor certifies that it has the following number of employees (check one appropriate box):

500 or more employees, or

100 or more employees, or fewer than 100 employees, as identified in O.C.G.A. 13-10-91. In the event the Contractor employs or contracts with any subcontractor(s) in connection with this contract, the Contractor will secure from the subcontractor(s) such subcontractor(s’) indication of the employee-number category applicable to the subcontractor. The contractor’s compliance with the requirements of O.C.G.A. 13-10-91 and Rule 300-10-1-.02 is attested by the execution of the contractor affidavit as shown in Rule 300-10-1-.07, or a substantially similar contractor affidavit, which document is attached to this Contract, and is a part of this Contract.

In the event the Contractor employs or contracts with any subcontractor(s) in connection with this contract, the Contractor will secure from such subcontractor(s) attestation of the subcontractor’s compliance with O.C.G.A. 13- 10-91 and Rule 300-10-1-.02 by the subcontractor’s execution of the subcontractor affidavit shown in Rule 300-10- 1-.08 or a substantially similar subcontractor affidavit, and maintain records of such attestation for inspection by the City at any time. Such subcontractor affidavit shall become a part of any contractor/subcontractor agreement.

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

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify the public employer in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;

e) The Contractor will contract for the 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(a), (b), and (c);

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) Contractor acknowledges its responsibility to submit copies of any affidavits, drivers’ licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the public employer within five business days of receipt.

Federal Work Authorization User Identification Number (This is a 4 ,5, 6, or 7-digit number, referred to as the E-Verify company ID number. It is NOT the Tax ID or SS Number.) Enroll at https://www.e-verify.gov/employers/enrolling-in-e-verify. The site guides you through the process, lists requirements, and provides a Federal Work Authorization User ID Number and Date of Authorization.

Date of Authorization

Name of Contractor

Name of Project

Name of Public Employer

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

Executed on , , 20 in (city), (state).

Signature of Authorized Officer

Printed Name and Title of Authorized Officer

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF , 20 .

Affix notary seal or stamp here:

Signature of Notary Public Date Commission Expires

*Document MUST be signed by an individual identified on, and authorized by, Corporate Resolution (for Non-Profit) or Authorization (for a Public Entity).

** Record name and title of officer or name and title of individual as it appears on Authorization (for Public Entity).

https://www.e-verify.gov/employers/enrolling-in-e-verify

Subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(3)

By executing this affidavit, the undersigned subcontractor 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 under a contract with (name of contractor) on behalf of City of Douglasville 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 subcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. § 13-10-91(b). Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the contractor within five business days of receipt. If the undersigned subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted sub-subcontractor, the undersigned subcontractor must forward, within five business days of receipt, a copy of the notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number (This is a 4 ,5, 6, or 7-digit number, referred to as the E-Verify company ID number. It is NOT the Tax ID or SS Number.) Enroll at https://www.e-verify.gov/employers/enrolling-in-e-verify. The site guides you through the process, lists requirements, and provides a Federal Work Authorization User ID Number and Date of Authorization.

Date of Authorization

Name of Subcontractor

Name of Project

Name of Public Employer

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

Executed on , , 20 in (city), (state).

Signature of Authorized Officer or Agent (Subcontractor Name)

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF

, 20 https://www.e-verify.gov/employers/enrolling-in-e-verify

Affix notary seal or stamp here:

Signature of Notary Public Date Commission Expires

*Document MUST be signed by an individual identified on, and authorized by, Corporate Resolution (for Non-Profit) or Authorization (for a Public Entity).

** Record name and title of officer or name and title of individual as it appears on Authorization (for Public Entity).

CERTIFICATION FORM

I, , being duly sworn, state that I am (title) of (firm) and hereby duly certify that I have read and understand the information presented in the attached bid and any enclosure and exhibits thereto.

I further certify that to the best of my knowledge the information given in response to the request for bids is full, complete and truthful.

I further certify that the bidder and any principal employee of the bidder have not, in the immediately preceding five years, been convicted of any crime of moral turpitude or any felony offense, nor has had their professional license suspended, revoked or been subjected to disciplinary proceedings.

I further certify that the bidder has not, in the immediately preceding five years, been suspended or debarred from contracting with any federal, state or local government agency, and further, that the bidder is not now under consideration for suspension or debarment from any such agency.

I further certify that the bidder has not in the immediately preceding five years been defaulted in any federal, state or local government agency contract, and further, that the bidder is not now under any notice of intent to default on any such contract.

I acknowledge, agree and authorize, and certify that the bidder acknowledges, agrees and authorizes, that the City of Douglasville may, by means that the City of Douglasville deems appropriate, determine the accuracy and truth of the information provided by the bidder and that the City of Douglasville or their agents may contact any individual or entity named in the RFB for the purpose of verifying the information supplied therein.

I acknowledge and agree that all the information contained in the RFB is submitted for the express purpose of inducing the City to award a contract.

A materially false statement or omission made in conjunction with this bid is sufficient cause for suspension or debarment from further contracts, or denial of rescission of any contract entered into based upon this bid thereby precluding the firm from doing business with, or performing work for, the State of Georgia. In addition, such false statement or omission may subject the person and entity making the bid to criminal prosecution under the laws of the State of Georgia of the United States, including but not limited to O.C.G.A. §16-10-20, 18 U.S.C. §§1001 or 1341.

Signature

SWORN AND SUBSCRIBED BEFORE ME

This (day) of (month), 20 (year)

NOTARY PUBLIC SIGNATURE

My Commission Expires:

NOTARY SEAL

List of Similar Projects:

1. Project Name: _________________________________________________ Project Location: __________________________________________________ Project Owner: ___________________________________________________ Owner Contact (Name and Phone): ___________________________________ Project Contract Amount: ___________________________________________ Description of Project: ______________________________________________

2. Project Name: _________________________________________________

Project Owner: ___________________________________________________ Owner Contact (Name and Phone): ___________________________________ Project Contract Amount: ___________________________________________ Description of Project: ______________________________________________

3. Project Name: _________________________________________________

Project Owner: ___________________________________________________ Owner Contact (Name and Phone): ___________________________________ Project Contract Amount: ___________________________________________ Description of Project: ______________________________________________