RFQu 25_752_003 Attachments Package.pdf

DeKalb County School District RFQu No. 25-752-003 A/E Services for Bus Maintenance, Parking and Charging Facilities Project Nos. N/A October 10, 2024 Page 1 of 2

ATTACHMENT A: ARCHITECT/ENGINEER CHECKLIST AND CERTIFICATION

The undersigned, hereby acknowledges having received Request for Qualifications (RFQu) No. 25-752-003 for Project No. N/A Professional A/E Services for Bus Maintenance, Parking and Charging Facilities containing a full set of documents:

IMPORTANT NOTICE: The omission of any of the required items listed below shall cause the bid submission to be declared non-responsive and to be rejected.

Owner’s Standard Forms:

Include with

Proposal

Check Box to

Confirm Inclusion

Attachment A Architect/Engineer Checklist and Certification (2 pages) YES

Attachment B1 Corporate Certificate (1 page) B1 or B2 or

B3 as applicable

Attachment B2 Partnership Certificate (1 page)

Attachment B3 Entity Certificate (1 page)

Attachment C1 Design Fee Form – East Dekalb Campus (5 pages) YES

Attachment C2 Design Fee Form -- Former Hooper Alexander Elementary School Site (5 pages)

YES

Attachment D Offeror’s and Individuals’ Affidavit of Noncollusion (2 pages) YES

Attachment E Conflict of Interest Disclosure Affidavit (2 pages) YES

Attachment F Consent to Release Information (1 page) YES

Attachment G Immigration and Security Certification (2 pages) YES

Attachment H No Submittal Response Form (1 page) N/A

Other Requirements:

Include with

Proposal

Check Box to

Confirm Inclusion

Copy of Business License and Certificates YES

Certificate of Insurance YES

Indicate Addenda(s) Nos. _____________________________ received (none unless indicated here). The Architect/Engineer is responsible for reading and understanding all sections of this RFQu and affirms that the Architect/Engineer shall be bound by all of the terms and conditions contained in this RFQu.

Further, the undersigned, being duly sworn, states on oath that no disclosures of ownership have been withheld from the Board, that the information provided herein is current, and Architect/Engineer and its officers and employees have not entered into any agreement with any other Architect/Engineer or prospective Architect/Engineer or with any other person, firm or corporation relating to any prices or other terms named in this RFQu or any other RFQu, nor has it entered into any agreement or arrangement under which a person, firm or corporation is to refrain from responding to this RFQu.

A/E Services for Bus Maintenance, Parking and Charging Facilities Project Nos. N/A October 10, 2024 Page 2 of 2

Name of Architect/Engineer:

Signature: ____________________________ Printed Name: ____________________________

Title: ____________________________ Date: ____________________________

Sworn to and subscribed before me this ___ day of _______________, 2_____.

Notary Public: _____________________________ My commission expires: __/__/__.

(SEAL)

THE DEKALB COUNTY SCHOOL DISTRICT RESERVES THE RIGHT TO REJECT ANY AND ALL

PROPOSALS AND TO WAIVE INFORMALITIES.

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A October 10, 2024 Page 1 of 1

ATTACHMENT B1: CORPORATE CERTIFICATE

STATE OF _______________________

COUNTY OF _____________________

I, ________________________________, certify that I am the Secretary of the corporation named as offeror in the foregoing proposal; that ____________________________ who signed said proposal on behalf of the offeror was then _______________________ of said corporation; that said proposal was duly signed for and in behalf of said corporation by authority of its Board of Directors, and is within the scope of its corporate powers; and that said corporation is organized under the laws of the State of ____________________.

[signature]

[typed name]

Subscribed and sworn to before me this ___ day of _______________, 2_____.

Notary Public

My Commission Expires:

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT B2: PARTNERSHIP CERTIFICATE

STATE OF __________________________

COUNTY OF ________________________

On this day of , 20 , personally appeared , who executed the above proposal, and being first duly sworn, deposes and says that he or she is a general partner in the firm of and that said firm consists of himself or herself and and that he or she executed the foregoing proposal on behalf of said firm for the uses and purposes stated therein, and that no one except the above named members of the firm have any financial interest whatsoever in said proposed contract.

[Affiant’s Signature]

Partner Partner

Partner Partner

Subscribed and sworn to before me this ___ day of _______________, 2____.

(seal)

My Commission Expires:

NOTE: If only one partner signs, a Power of Attorney executed by all other partners authorizing him or her to act in the name of the partnership must be attached; otherwise, all partners must sign.

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT B3: ENTITY CERTIFICATE

STATE OF _______________________

COUNTY OF _____________________

I, ________________________________, certify that I am the Secretary of the entity named as offeror in the foregoing proposal; that _____________________________________ who signed said proposal in behalf of the offeror was then _______________________ of said entity; that said proposal was duly signed for and on behalf of said entity by due authority, and is within the scope of its legal powers; and that said entity is a ________________________ organized under the laws of the State of ____________________.

[typed name]

Subscribed and sworn to before me this ___ day of _______________, 2____.

ATTACHMENT C1: DESIGN FEE PROPOSAL FORM

Project Name A/E Services for Bus Maintenance, Parking and Charging Facilities RFQu No.: 25-752-003 Project No: N/A RFQu Due Date November 14, 2024

DeKalb County Board of Education Sam A. Moss Service Center 1780 Montreal Road Tucker, Georgia 30084

Board of Education:

In compliance with DCSD’s Request for Qualifications, the undersigned Architect, [legal name of Architect]

[address of Architect]

[telephone number of Architect]

[email address of Architect] having carefully examined the site of the Project and the Owner’s Criteria, and having carefully examined the proposed Standard Form of Contract for Architectural Services (State Capital Outlay Projects) between the DeKalb County Board of Education and the Architect; (Appendix I and the Owner’s standard forms and other documents included in the

Request for Qualifications and any Addenda thereto for an Electric Bus Charging Facility at East Dekalb Campus proposes and agrees, if this proposal is accepted, to enter into a contract with the Owner in the exact form provided in the Request for Qualifications and to perform the Design Services and Work in conformance with the Contract Documents, in the time stated therein, for the Contract Price set forth below, and submits the following proposed compensations and fees and other matters set forth below:

a. DCSD has determined that the maximum stipulated fee the Architect will receive for this project scope will be $227,500.00. This fee is all inclusive and incorporates all reimbursable expenses for this project.

b. The Proposed Design Fee will NOT be considered for the Selection Criteria.

c. Below provide your proposed breakdown of the stated fee per the requirements of the Agreement and the Design Review- Minimal Submittal Requirements (Appendix B) with the milestones provided for Bus

Maintenance, Parking and Charging Facilities

Project Name: A/E Services for Bus Maintenance, Parking and Charging Facilities RFQu No. 25-752-003 DeKalb County Board of Education Project No. N/A

Page 2 of 5 RFQu Due Date: November 14, 2024

A. Preliminary Consultation/Examination Report $___________________

B. Schematic Design Phase $___________________

• Provide three (3) potential schemes

• Provide schematic design drawings per Appendix B

• Provide project specifications per Appendix B

• Provide cost estimate per Appendix B

• Space and functional program Appendix B

• Life cycle analysis

• Other items identified in Appendix B

C. Design Development Phase $

• Provide design development drawings per Appendix B

• Provide project specifications per Appendix B

• Provide detailed cost estimate per Appendix B

• Geotechnical & surveys per Appendix B

• Final life cycle analysis

• Submittal to GaDOE

D. Construction Document Phase:

30% Complete CD phase $___________________

• 30% complete drawings

• Detailed project manual

• Detailed cost estimate

80% Complete CD Phase $___________________

• Construction documents per Appendix B

• Detailed project manual

• Detailed cost estimate

• Fire Marshal review

• Submittal to GaDOE

100% Complete CD Phase $

• Construction documents per Appendix B

• Detailed project manual

• Submittal for permitting

• Fire Marshal review

E. Sub-Consultants $ Included in Fee

F. FF&E Services $ N/A

G. Reimbursable Expenses $ Included in Fee

H. Construction Administration Fee $____________________ (Minimum of 15% of Fee Required)

TOTAL LUMP SUM $ 227,500.00

Page 3 of 5 RFQu Due Date: November 14, 2024

d. The hourly rates as required in Section 11.2. of the Agreement (Appendix I) in the following manner are indicated below. (These hourly rates will be added to the contract for this project):

Title/Position Hourly Rate Principal: $ per hour Director: $ per hour Project Architect: $ per hour Project Manager: $ per hour Project Coordinator: $ per hour Interior Designer: $ per hour Project Captain: $ per hour Technical Staff: $ per hour Contract Administrator: $ per hour Clerical: $ per hour Estimator: $ per hour Scheduler: $ per hour Designer: $ per hour CADD: $ per hour Civil Engineer $ per hour Junior Civil Engineer $ per hour Structural Engineer $ per hour Junior Structural Engineer $ per hour Mechanical Engineer $ per hour Junior Mechanical Engineer $ per hour Electrical Engineer $ per hour Junior Electrical Engineer $ per hour Fire Protection Engineer $ per hour Junior Fire Protection Engineer $ per hour FF&E Coordinator $ per hour Others as appropriate $ per hour

e. The undersigned Architect hereby acknowledges receipt of the following Addenda:

[insert the number and date of each Addendum; if none, insert "None"]

f. The Architect understands that the Owner reserves the right to reject any or all Proposals, and to waive any technicalities or informalities.

g. The Architect agrees that this Proposal may not be withdrawn for a period of one hundred and twenty

(120) calendar days after the date and time fixed for receiving said Proposals.

h. The undersigned Architect agrees that if it is notified in writing by mail, telegraph, facsimile or hand-delivery of the acceptance of this Proposal, via Notice of Award or otherwise, within one hundred and twenty (120) calendar days after the date and time fixed for receiving said Proposals, the undersigned Architect will execute, within three (3) business days of the date of the notice, a contract for the Design Services and the Work in accordance with the Request for Qualifications in the exact form provided therein for the Contract Price as agreed upon by the Owner and Architect.

i. The undersigned Architect agrees to commence the Design Services under the Owner’s form of contract after its receipt of a written Notice to Proceed from the Owner.

Page 4 of 5 RFQu Due Date: November 14, 2024

By submission of the Proposal, Architect represents and warrants that:

(1) Architect has read and understands the Proposal Documents and the Proposal is made in accordance therewith;

(2) Architect has read and understands the bidding or proposal documents or contract documents for other portions of the Project, if any, being bid or offered concurrently or presently under construction, to the extent that such documentation relates to the Design Services or the Work for which the Proposal is submitted;

(3) Architect has visited, examined and inspected the site of the Project, obtained first-hand knowledge of existing conditions, the conformation of the ground, the character, quality and quantity of the products needed preliminary to and during the prosecution of the Work, the general and local conditions and all other matters which can in any way affect the Work to be done under the Contract, and become thoroughly familiar with all conditions under which the Work is to be performed and has correlated all the Architect’s personal observations and any other facts or conditions that are known to or reasonably knowable by the Architect with the requirements of the Proposal Documents, including without limitation the proposed Contract Documents;

(4) the Proposal is based upon furnishing all of the Design Services and the Work, and other things required by the Proposal Documents; and

(5) all facts stated in the Proposal are true and correct.

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

Respectfully submitted, [typed name of Architect]

By: __________________________________[seal]

[typed name and title]

[business telephone number]

[date of execution]

[If the Architect is a joint venture, utilize the following page of this proposal form for signatures.]

Page 5 of 5 RFQu Due Date: November 14, 2024

(For Joint Venture Proposals)

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

Respectfully submitted ________________________________________________________, [typed name of Joint Venture]

By: _________________________________ [typed name of Joint Venture partner]

[address of Joint Venture partner]

By: __________________________________

ATTACHMENT C2: DESIGN FEE PROPOSAL FORM

Project Name A/E Services for Bus Maintenance, Parking and Charging Facilities RFQu No.: 25-752-003 Project No: N/A RFQu Due Date November 14, 2024

DeKalb County Board of Education Sam A. Moss Service Center 1780 Montreal Road Tucker, Georgia 30084

Board of Education:

In compliance with DCSD’s Request for Qualifications, the undersigned Architect, [legal name of Architect]

[telephone number of Architect]

[email address of Architect] having carefully examined the site of the Project and the Owner’s Criteria, and having carefully examined the proposed Standard Form of Contract for Architectural Services (State Capital Outlay Projects) between the DeKalb County Board of Education and the Architect; (Appendix I and the Owner’s standard forms and other documents included in the

Request for Qualifications and any Addenda thereto for a Bus Parking and Charging Facility at the Former Hooper Alexander Elementary School proposes and agrees, if this proposal is accepted, to enter into a contract with the Owner in the exact form provided in the Request for Qualifications and to perform the Design Services and Work in conformance with the Contract Documents, in the time stated therein, for the Contract Price set forth below, and submits the following proposed compensations and fees and other matters set forth below:

a. DCSD has determined that the maximum stipulated fee the Architect will receive for this project scope will be $428,000.00. This fee is all inclusive and incorporates all reimbursable expenses for this project.

b. The Proposed Design Fee will NOT be considered for the Selection Criteria.

c. Below provide your proposed breakdown of the stated fee per the requirements of the

Agreement and the Design Review- Minimal Submittal Requirements (Appendix B) with the milestones provided for Bus Maintenance, Parking and Charging Facilities

Page 2 of 5 RFQu Due Date: November 14, 2024

A. Preliminary Consultation/Examination Report $___________________

B. Schematic Design Phase $___________________

• Provide three (3) potential schemes

• Provide schematic design drawings per Appendix B

• Provide project specifications per Appendix B

• Provide cost estimate per Appendix B

• Space and functional program Appendix B

• Life cycle analysis

C. Design Development Phase $

• Provide design development drawings per Appendix B

• Provide project specifications per Appendix B

• Provide detailed cost estimate per Appendix B

• Geotechnical & surveys per Appendix B

• Final life cycle analysis

D. Construction Document Phase:

30% Complete CD phase $___________________

• 30% complete drawings

• Detailed project manual

• Detailed cost estimate

80% Complete CD Phase $___________________

• Construction documents per Appendix B

• Detailed project manual

• Detailed cost estimate

• Fire Marshal review

• Submittal to GaDOE

100% Complete CD Phase $

• Construction documents per Appendix B

• Detailed project manual

• Submittal for permitting

• Fire Marshal review

E. Sub-Consultants $ Included in Fee

F. FF&E Services $ N/A

G. Reimbursable Expenses $ Included in Fee

H. Construction Administration Fee $____________________ (Minimum of 15% of Fee Required)

TOTAL LUMP SUM $ 428,000.00

Page 3 of 5 RFQu Due Date: November 14, 2024

d. The hourly rates as required in Section 11.2. of the Agreement (Appendix I) in the following manner are indicated below. (These hourly rates will be added to the contract for this project):

Title/Position Hourly Rate Principal: $ per hour Director: $ per hour Project Architect: $ per hour Project Manager: $ per hour Project Coordinator: $ per hour Interior Designer: $ per hour Project Captain: $ per hour Technical Staff: $ per hour Contract Administrator: $ per hour Clerical: $ per hour Estimator: $ per hour Scheduler: $ per hour Designer: $ per hour CADD: $ per hour Civil Engineer $ per hour Junior Civil Engineer $ per hour Structural Engineer $ per hour Junior Structural Engineer $ per hour Mechanical Engineer $ per hour Junior Mechanical Engineer $ per hour Electrical Engineer $ per hour Junior Electrical Engineer $ per hour Fire Protection Engineer $ per hour Junior Fire Protection Engineer $ per hour FF&E Coordinator $ per hour Others as appropriate $ per hour

e. The undersigned Architect hereby acknowledges receipt of the following Addenda:

[insert the number and date of each Addendum; if none, insert "None"]

f. The Architect understands that the Owner reserves the right to reject any or all Proposals, and to waive any technicalities or informalities.

g. The Architect agrees that this Proposal may not be withdrawn for a period of one hundred and twenty

(120) calendar days after the date and time fixed for receiving said Proposals.

h. The undersigned Architect agrees that if it is notified in writing by mail, telegraph, facsimile or hand-delivery of the acceptance of this Proposal, via Notice of Award or otherwise, within one hundred and twenty (120) calendar days after the date and time fixed for receiving said Proposals, the undersigned Architect will execute, within three (3) business days of the date of the notice, a contract for the Design Services and the Work in accordance with the Request for Qualifications in the exact form provided therein for the Contract Price as agreed upon by the Owner and Architect.

i. The undersigned Architect agrees to commence the Design Services under the Owner’s form of contract after its receipt of a written Notice to Proceed from the Owner.

Page 4 of 5 RFQu Due Date: November 14, 2024

By submission of the Proposal, Architect represents and warrants that:

(1) Architect has read and understands the Proposal Documents and the Proposal is made in accordance therewith;

(2) Architect has read and understands the bidding or proposal documents or contract documents for other portions of the Project, if any, being bid or offered concurrently or presently under construction, to the extent that such documentation relates to the Design Services or the Work for which the Proposal is submitted;

(3) Architect has visited, examined and inspected the site of the Project, obtained first-hand knowledge of existing conditions, the conformation of the ground, the character, quality and quantity of the products needed preliminary to and during the prosecution of the Work, the general and local conditions and all other matters which can in any way affect the Work to be done under the Contract, and become thoroughly familiar with all conditions under which the Work is to be performed and has correlated all the Architect’s personal observations and any other facts or conditions that are known to or reasonably knowable by the Architect with the requirements of the Proposal Documents, including without limitation the proposed Contract Documents;

(4) the Proposal is based upon furnishing all of the Design Services and the Work, and other things required by the Proposal Documents; and

(5) all facts stated in the Proposal are true and correct.

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

Respectfully submitted, [typed name of Architect]

[If the Architect is a joint venture, utilize the following page of this proposal form for signatures.]

Page 5 of 5 RFQu Due Date: November 14, 2024

(For Joint Venture Proposals)

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

Respectfully submitted ________________________________________________________, [typed name of Joint Venture]

By: _________________________________

By: __________________________________

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT D: OFFEROR’S and INDIVIDUALS’ AFFIDAVIT OF NONCOLLUSION (This affidavit to be executed in accordance with O.C.G.A. § 36-91-21(e))

STATE OF ______________________

COUNTY OF ____________________

COMES NOW, ________________________________________________________ (“Offeror”), [Name of Offeror] appearing by and through __________________________________, its _________________________ [insert name of individual with [title] authority to bind Offeror]

(averring both individually and in his or her representative capacity on behalf of Offeror) (the “Individual and Representative Affiant”), and [in these blanks insert the names of all those required to give the oath under O.C.G.A. § 36-91-21(e)]

(collectively, the “Individual Affiants”), and each of the Individual And Representative Affiant and the Individual Affiants, after first being duly sworn, deposes and says that:

1. He, she or it, as applicable, has not directly or indirectly violated subsection (d) of the Official

Code of Georgia Annotated Section 36-91-21, which subsection provides as follows:

(d) Whenever a public works construction contract for any governmental entity subject to the requirements of this chapter is to be let out by competitive sealed bid or proposal, no person, by himself or herself or otherwise, shall prevent or attempt to prevent competition in such bidding or proposals by any means whatever. No person who desires to procure such work for himself or herself or for another shall prevent or endeavor to prevent anyone from making a bid or proposal therefor by any means whatever, nor shall such person so desiring the work cause or induce another to withdraw a bid or proposal for the work.

2. If the Offeror is a partnership, then the Individual and Representative Affiant, together with the

Individual Affiants, constitute all of the partners and any officer, agent or other person who may have represented or acted for them in bidding or proposing for or procuring the contract for the DeKalb County

Board of Education A/E Services for Bus Maintenance, Parking, and Charging Facilities (the “Project”).

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

3. If the Offeror is a corporation or other entity, then the Individual And Representative Affiant, together with the Individual Affiants, constitute all officers, agents, or other persons who may have acted for or represented the corporation or other entity in bidding for or procuring the contract for the Project.

Further, the Individual And Representative Affiant and the Individual Affiants sayeth not.

This _______ day of _______________, 2____

[insert name of Offeror] and

[insert name of Individual And Representative Affiant]

By: ___________________________________, both individually and on behalf of Offeror as its

[insert title]

Individual Affiants’ signatures and names:

x_____________________________________ x____________________________________ Name: Name:

x_____________________________________ x____________________________________ Name: Name:

x_____________________________________ x____________________________________ Name: Name:

x_____________________________________ x____________________________________ Name: Name:

x_____________________________________ x____________________________________ Name: Name:

x_____________________________________ x____________________________________ Name: Name:

Sworn to and subscribed before me this ___ day of _______________, 2____.

Notary Public: _____________________ My commission expires: __/__/__.

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT E: CONFLICT OF INTEREST DISCLOSURE AFFIDAVIT

I HEREBY CERTIFY, UNDER OATH, that

1. I (Printed Name), ______________________________________ am the (Title)

_________________________________________________ and I am the duly authorized representative of the firm of (Firm Name) ______________________________________

_____________________________________________ (the “Firm”) for purposes of this

Affidavit, whose address is (Firm Address) _________________________

________________________, and I possess the legal authority to make this Affidavit on behalf of myself and the Firm, as follows:

2. The following employee(s), officer(s) or agent(s) of the Firm (collectively, “Firm

Representative”) is/are related, by blood or marriage, to an employee, agent or Board

Member of the DeKalb County Board of Education (collectively, “Owner

Representative”), as indicated below:

Firm Representative Owner Representative Relation

3. Except as listed below under “EXCEPTIONS”, neither the Firm nor any Firm

Representative have any conflicts of interest, whether real or potential, due to kinship, ownership, other clients, other contracts, interests, or otherwise concerning the DeKalb

County Board of Education, the Project, or any Owner Representative:

EXCEPTIONS (fully disclose and completely explain)

[Continued on Next Page]

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

4. This disclosure is made without prior understanding, agreement, or connection with any corporation, firm or person submitting a bid, proposal or qualification statement for the same contract or project and is in all respects without collusion or fraud.

Wherefore, the foregoing disclosure is fully complete and true, and may be relied upon by the

DeKalb County Board of Education:

Signature: ____________________________________________

Printed Name: ____________________________________________

Firm Name: ____________________________________________

Date: ____________________________________________

Sworn to and described before me this ________ day of _______________________

Personally known: ____________________________________________

OR Produced Identification: ____________________________________________

Type of Identification: ____________________________________________

Notary Public – State of ____________________________________________

My Commission Expires ____________________________________________

Affix Notary Seal Here:

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT F: CONSENT TO RELEASE INFORMATION

The undersigned, having submitted a competitive sealed Proposal to the DeKalb County Board of Education in respect of a local government entity public works construction project (or being a partner in a joint venture that has submitted such proposal), hereby authorizes any person or entity having in its possession, custody or control any information regarding the undersigned to fully disclose and make available such information to the DeKalb County Board of Education, its agents, attorneys and other representatives.

This ___ day of _______________, 2_____.

[Printed name of person or entity consenting to release of information]

By: ___________________________________

Printed name: ___________________________

Printed Title: ____________________________

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A

ATTACHMENT G: IMMIGRATION AND SECURITY CERTIFICATION

If you are providing service, performing work, or delivering goods to the DeKalb County Board of Education/DeKalb County School District including, but not limited to schools, warehouses and central offices, the applicable Georgia Security and Immigration Compliance documents found here must be completed, signed, notarized, and submitted with your bid/proposal. Failure to provide this document with your bid/proposal will result in the disqualification of the bid/proposal.

1) Offeror/Bidder shall at all times comply with the Georgia Security and Immigration Compliance Act, as amended, O.C.G.A. § 13-10-90 et. seq.

2) In order to insure compliance with the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99-603 and the Georgia Security and Immigration Compliance Act, as amended by the Illegal Immigration Reform Act of 2011, O.C.G.A. § 13-10-90 et. seq. (collectively the “Act”), the Offeror MUST INITIAL the statement applicable to Offeror below:

(a) (Initial here): Offeror declares under penalties of perjury that, Offeror has registered at https://e-verify.uscis.gov/enroll/ to verify information of all new employees in order to comply with the Act; is authorized to use and uses the federal authorization program under the federal work authorization user identification number issued on the date of authorization below; will continue to use the authorization program throughout the contract period; Offeror further warrants and agrees Offeror shall execute and return any and all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10-1-.01 et. seq. [Offerors who initial (a) must attach and return a signed, notarized Contractor Affidavit and Agreement with the Contract if awarded];

or

(b) ________ (Initial here): Offeror/Bidder warrants that he/she does not employ any other persons, and he/she does not intend to hire any employees or to perform the Contract. [Offerors/Bidders who initial (b) must attach and return a signed, notarized Affidavit of Exception with the Contract if awarded];

or

(c) _______ (Initial here) Offeror/Bidder is an individual who is licensed pursuant to Title 26 or Title 43 or by the State Bar of Georgia and is in good standing when such contract is for services to be rendered by such individual and thus does not have to provide an affidavit.

_ 3) _____ (Initial here) Offeror/Bidder will not employ or contract with any subcontractor in connection with a covered contract unless the subcontractor is registered, authorized to use, and uses the federal work authorization program; and provides Offeror/Bidder with all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10-1-.01 et. seq.

4) _____(Initial here) Offeror/Bidder agrees that, if Offeror/Bidder employs or contracts with any https://e-verify.uscis.gov/enroll/

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A sub-contractor in connection with the covered contract under the Act and DOL Rules 300-10-1-.01, et seq that Offeror/Bidder will secure from each sub-contractor at the time of the contract the sub-contractor’s name and address, the employee-number applicable to the sub-contractor, the date the authorization to use the federal work authorization program was granted to sub-contractor; the subcontractor’s attestation of the subcontractor’s compliance with the Act and Georgia Department of Labor Rule 300-10-1-.01, et seq.; and the subcontractor’s agreement not to contract with sub-subcontractors unless the sub-subcontractor is registered, authorized to use, and uses the federal work authorization program; and provides subcontractor with all affidavits required by the Act and the rules and regulations issued by the Georgia Department of Labor as set forth at Rule 300-10-1- .01 et. seq.

5) ______(Initial here) Offeror/Bidder agrees to provide the DeKalb County School District with all affidavits of compliance as required by O.C.G.A. § 13-10-90 et seq. and Georgia Department of Labor Rules 300-10-1-.01, et seq within five (5) business days of receipt.

Signature Date

EEV/Basic Pilot Program Date of Authorization User Identification Number

Firm Name: __________________________________________________________

Street/Mailing Address: ________________________________________________

City, State, Zip Code: __________________________________________________

Telephone Number: ___________________________________________________

Email Address: _______________________________________________________

SUBSCRIBED AND SWORN

BEFORE ME ON THIS THE

______ DAY OF_____________________, 20____

A/E Services for Bus Maintenance, Parking and Charging Facilities Project No. N/A October 10, 2024 Page 1 of 1

ATTACHMENT H: NO SUBMITTAL RESPONSE FORM

RFQu Number: 25-752-003 DCSD Project No.: N/A Title: Professional A/E Services for Bus Maintenance, Parking and Charging Facilities

If your company will not be submitting a proposal in response to this Request for Qualifications, please complete this form and return or email, prior to the RFQu due date established within to:

DeKalb County Board of Education (the “Board”) Attention: Procurement Manager

Email: angela_arlene-myrick@dekalbschoolsga.org

This information will assist Procurement Services in the preparation of future RFQu’s.

Company Name:

Contact:

Address:

Telephone: _________________________________ Fax:

Email:

Please check reason for a “no submittal.”

_____ Specifications ‘too tight,” geared toward one brand or manufacturer (explain below)

_____ Insufficient time to respond

_____ Specifications unclear (explain below)

_____ We do not offer this service or an equivalent

_____ Our schedule does not permit us to perform

_____ Unable to meet specifications

_____ Unable to meet bond requirements

_____ Unable to hold prices respondent throughout the term of the contract period

_____ Unable to meet insurance requirements

_____ Other

Explanation:

If submitting this form, only this form needs to be returned.

mailto:angela_arlene-myrick@dekalbschoolsga.org