Web Based Emotional Health Telehealth Services RFP.pdf

SUNY Erie Community College

Request for Proposal for:

Web Based Emotional Health Telehealth Services

Release Date:

08/07/2024

RFP Response Deadline:

08/28/2024 RFP Response Deadline: Please note: All proposals should be submitted via time stamped email no later than 08/28/2024

Contact Person/Committee Chairperson:

Dan Frontera Director of Student Access & Veterans Services

4041 Southwestern Blvd Orchard Park, NY 14127

716-851-1832 vafrontera@ecc.edu

Table of Contents

Notice to Responders Page 3

General Information Page 4-5

Statement of Rights Page 6-8

Instruction Sheet Page 9

Contract Page 10-13

About SUNY Erie Community College Page 14

Project Scope/Work Page 15

Evaluation Criteria Page 16

Schedule “C” References Page 17

Schedule “D” Proposer Certification Page 18

Schedule “E” Insurance Page 19-21

Schedule “F” Non-Collusive Proposal Certification Page 22

Notice to Responders

SUNY Erie Community College, Buffalo New York hereby invites the submission of proposals for: Web Based Emotional Health Telehealth Services

All proposals shall be marked “Web Based Emotional Health Telehealth Services”.

1. Each proposal shall be prepared simply and economically avoiding the use of elaborate promotional materials beyond what is sufficient to provide a complete, accurate and reliable presentation.

2. Submission of the proposals shall be directed to:

Dan Frontera Director of Student Access & Veteran Services

All proposals must be delivered by email to the above email address on or before August 28, 2024 by 4:00 p.m. Proposals received after the above date and time will not be considered. SUNY Erie is under no obligation to return proposals.

Anticipated Schedule of Proposal

The following schedule is for informational purposes only. SUNY Erie reserves the right to amend this schedule at any time

08/07/24 -- Release of RFP 08/14/24 -- Call/question/clarification deadline 08/28/24 -- RFP submission deadline 09/05/24 -- Proposal evaluated 09/06/24 -- Finalist notified 09/13/24 -- Finalist presentation if required 10/30/24 -- Potential anticipated award following all necessary College approvals mailto:vafrontera@ecc.edu

General Information:

A. In determining the qualification of a respondent, SUNY Erie will consider the depth and/or experience in providing the specific services outlined in the RFP.

B. SUNY Erie seeks at least three (3) references as part of the review process to gauge the overall effectiveness of the services rendered, Schedule “C”. Respondents should feel free to list more than three (3) references, if they so choose.

C. SUNY Erie specifically and expressly reserves the right to reject the proposal from any respondent if the record discloses any unsatisfactory experience in the performance of similar contracted services.

D. SUNY Erie may perform an investigation, if necessary, to determine the ability of a respondent to perform the terms of the contract. Should the respondent furnish any untruthful or misleading information, this shall serve as a basis to disqualify the respondent form consideration. CONDITIONAL PROPOSALS WILL NOT BE

ACCEPTED.

E. No proposal will be accepted from nor any agreement awarded to any proposer that is in arrears upon any debt or in default of any obligation owed to SUNY Erie. Additionally, no agreement will be awarded to any proposer that has failed to satisfactorily perform pursuant to any prior agreement with SUNY Erie.

F. SUNY Erie reserves the right to enter into a contract with as many companies as it deems necessary to fulfill the Web Based Emotional Health Telehealth Services.

Furthermore, it reserves the right to waive irregularities and accept or reject any proposals, or any part of any proposal.

G. SUNY Erie is an equal opportunity employer. Women, members of minority groups, persons with disabilities, and Vietnam Era veterans are encouraged to respond to this

RFP.

a. Certified Minority Business Enterprise/Women's Business Enterprise (MBE/WBE) proposers should include the County certification letter with the proposal.

b. If proposer is a Veteran Owned Business, proposer should include a letter indicating the company is 51% or more Veteran-owned.

H. Further, SUNY Erie expects that successful vendors will also comply with all Federal and

New York State Equal Opportunity and anti-discrimination laws.

I. SUNY Erie is established under authority of the State of New York and is entitled to exemption from New York State, Federal, and Local taxes.

J. The contractor may not assign specific parts of the work to other partners, without a clear statement, in writing about the transfer of work and without the consent of SUNY Erie.

A proposal may be rejected if it is determined that a vendor’s ability to work with the existing SUNY Erie infrastructure will be too limited or difficult to manage.

K. SUNY Erie, SUNY Erie Community College Board of Trustees, Erie County and all employees thereof shall be indemnified and held harmless from all claims that may result from qualified firm activity.

L. The Office of the Student Access reserves the right to request a formal presentation as a method of final review of potential vendors. Respondents may prepare PowerPoint presentation, handouts or other aides in preparing for the presentation. Those proposers will be notified to arrange specific times.

Statement of Rights:

Please take notice, by submission of a proposal in response to this request for proposals, the proposer agrees to and understands:

A. SUNY Erie reserves the right to reject any or all Proposals and is not limited to the evaluation criteria listed in this RFP. Award of a contract is dependent on the signing of a mutually agreeable contract, and should the parties fail to agree upon such a contract, SUNY Erie in its sole discretion may cancel negotiations with the first selected proposer and negotiate with other proposer as necessary.

B. That any proposal, attachments, additional information, etc. submitted pursuant to this Request for Proposals constitute merely a suggestion to negotiate with SUNY Erie and is not a bid under Section 103 of the New York State General Municipal Law.

C. Submission of a proposal, attachments, and additional information shall not entitle the proposer to enter into an agreement with SUNY Erie for the required services.

D. By submitting a proposal, the proposer agrees and understands that SUNY Erie is not obligated to respond to the proposal, nor is it legally bound in any manner whatsoever by submission of same.

E. That any and all counter-proposals, negotiations or any communications received by a proposing entity, its officers, employees or agents , its elected officials, officers, employees or agents, shall not be binding against SUNY Erie, its elected officials, officers, employees or agents unless and until a formal written agreement for the services sought by this RFP is duly executed by both parties and approved by the Erie County Legislature (if necessary), and the President at Erie Community College.

F. The following documents listed below are required by the selected awarded vendor.

• Contract (Page 10)

• Proposal

• Schedule (C) References

• Schedule (D) Proposer Certification

• Schedule (E) Certificate of Insurance for Professional Services, Workers'

Compensation and NYS Disability

• Schedule (F) Non-Collusive Proposal Certification

• W-9

• Supplier Application

Schedule (C), (D), (E) and (F) are required to be submitted with your proposal.

Schedule (D) and (F) are located at the end of this RFP.

W-9 and Supplier Application will be required upon selection.

If the selected awarded vendor is unable to submit the required agreement and/or certificates of insurance, it may cause the award to be rescinded.

G. In addition to the foregoing, by submitting a proposal, the proposer also understands and agrees that SUNY Erie reserves the right, and may at its sole discretion exercise, the following rights and options with respect to this Request for Proposals:

a) To reject any or all proposals;

b) To issue amendments to this RFP;

c) To issue additional solicitations for proposals;

d) To waive any irregularities in proposals received after notification to proposers affected;

e) To select any proposal as the basis for negotiations of a contract, and to negotiate with one or more of the proposers for amendments or other modifications to their proposals;

f) To conduct investigations with respect to the qualifications of each proposer;

g) To exercise its discretion and apply its judgment with respect to any aspect of this RFP, the evaluation of proposals, and the negotiations and award of any contract;

h) To enter into an agreement for only portions (or not to enter into an agreement for any) of the services contemplated by the proposals with one or more of the proposers;

i) To select the proposal that best satisfies the interests of SUNY Erie and not necessarily on the basis of price or any other single factor;

j) To interview the proposer(s) and/or request demonstrations of their training offerings;

k) To request or obtain additional information SUNY Erie deems necessary to determine the ability of the proposer;

l) To modify dates;

m) All proposals prepared in response to this RFP are at the sole expense of the proposer, and with the express understanding that there will be no claim, whatsoever, for reimbursement from SUNY Erie for the expenses of preparation.

SUNY Erie assumes no responsibility or liability of any kind for costs incurred in the preparation or submission of any proposal;

n) While this is a RFP and not a bid, SUNY Erie reserves the right to apply the case law under General Municipal Law § 103 regarding bidder responsibility in determining whether a proposer is a responsible vendor for the purpose of this RFP process;

o) SUNY Erie is not responsible for any internal or external delivery delays which may cause any proposal to arrive beyond the stated deadline. To be considered, proposals MUST arrive at the place specified herein and be time stamped prior to the deadline;

p) Piggybacking: Other New York government entities as authorized by NYS Finance Law and General Municipal Law, and other departments, agencies or instrumentalities of the United States government as well as any department, agency, office, political subdivision, or instrumentality of any state or state(s) who are permitted to do so by their procurement laws and regulations, may utilize the resultant contract upon securing all legally-required approvals. Private entities, cooperatives and consortia may also utilize the resultant contract with the express approval of SUNY Erie and the vendor. The sole responsibility with regard to performance of the contract, or any obligation, covenant, condition or term thereunder is between the successful vendor and the participating entities.

In the event of a failure or breach in performance of any such contract by a participating entity or the successful vendor, SUNY Erie Community College specifically and expressly disclaims any and all liability for such defective performance or breach, or failure of either party to perform in accordance with its obligation, covenants and the terms and conditions of the SUNY Erie Community College centralized contract.

Instruction Sheet to Responders:

Please read all documents contained in the proposal specification and in the General Information section.

1. Responders are responsible for submitting their proposal before the deadline indicated in this proposal. NO PROPOSALS WILL BE ACCEPTED AFTER THE DEADLINE.

2. Respondents are responsible for reporting, in writing, any errors discovered in the proposal specification to Dan Frontera, Director of Student Access & Veterans Services,

3. Questions or requests for clarifications can be emailed to Dan Frontera, vafrontera@ecc.edu.

Responses will be sent to all vendors who have requested the RFP.

NO COMMUNICATIONS OF ANY KIND WILL BE BINDING AGAINST THE

COLLEGE, EXCEPT FOR THE FORMAL WRITTEN RESPONSES TO ANY REQUEST

FOR CLARIFICATION.

4. The response to this proposal should contain:

• The Proposal

• Three (3) references (Schedule C)

• Proposer Certification (Schedule D)

• Certificate of Insurance for Professional Service, Workers’ Compensation and NYS

Disability (Schedule E)

• Non-Collusive Proposal Certification (Schedule F)

• If proposer is a Certified Minority Business Enterprise/Women's Business Enterprise

(MBE/WBE), proposer should include the County certification letter.

• If proposer is a Veteran Owned Business, proposer should include a letter indicating company is 51% or more Veteran-owned.

5. All Proposals must be typewritten. All information must be submitted electronically via email.

6. Should any errors or significant omission be discovered after release of the request for proposal, additional instructions will be forwarded to any persons or organizations who have requested a copy of the RFP. The college will not assume any responsibility for any oral instructions, or interpretations of the meaning of the specification or other contract documents to any vendor by any person or persons.

Contract After selection of the successful proposer, a formal written contract will be prepared by SUNY Erie and will not be binding until signed by both parties and, if necessary, approved by the Erie County Legislature and the Office of the Executive Vice President of Administration and Finance.

NO RIGHTS SHALL ACCRUE TO ANY PROPOSER BY THE FACT THAT A PROPOSAL

HAS BEEN SELECTED BY THE COLLEGE FOR SUBMISSION TO THE ERIE COUNTY

LEGISLATURE FOR APPROVAL. THE APPROVAL OF SAID LEGISLATURE AND/OR

AUTHORITY MAY BE NECESSARY BEFORE A VALID AND BINDING CONTRACT

MAY BE EXECUTED BY THE COLLEGE.

The proposer accepts and agrees that language in substantially the following form will be included in the contract between the proposer and SUNY Erie:

A. Executory Clause: This agreement shall be deemed executory only to the extent of the monies appropriated and available for the purpose of the Agreement and no liability on account thereof shall be incurred by Erie Community College or the County of Erie beyond the amount of such monies.

B. Jurisdiction Clause: This Agreement may be executed simultaneously in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. This Agreement shall be construed and enforced in accordance with the laws of the State of New York, without regard to conflict of laws. In addition, the parties hereby agree that jurisdiction and venue for any cause of action arising out of this Agreement shall be in the County of Erie either in New York State Supreme Court, Erie County or United States District Court, Western District of New York.

C. Termination Clause: Either party may terminate this agreement, for any reason, upon thirty (30) days written notice. In the event of termination for any reason other than the fault of vendor, or the non-availability of funds as provided in the above Executory Clause, the vendor shall be paid the amount due to date of termination.

D. Severability Clause: If any term or provision of this Agreement is held by a court of competent jurisdiction to be invalid or void or unenforceable, the remainder of the terms and provisions of this Agreement shall in no way be affected, impaired, or invalidated, and to the extent permitted by applicable law, any such term, or provision shall be restricted in applicability or reformed to the minimum extent required for such to be enforceable. This provision shall be interpreted and enforced to give effect to the original written intent of the parties prior to the determination of such invalidity or unenforceability.

E. Term Clause: The term of the contract shall be for a one-year period commencing

November 1, 2024 and terminating October 31, 2025. The College, in its sole discretion may extend the agreement beyond the initial term for up to four (4) additional one-year

(1) periods at the same prices and conditions.

F. Indemnification: In addition to, and not in limitation of the insurance requirements contained herein the Consultant agrees:

a. that except for the amount, if any, of damage contributed to, caused by or resulting from the negligence of the College, the vendor shall indemnify and hold harmless the College, the County of Erie, each entity’s officers, employees and agents from and against any and all liability, damage, claims, demands, costs, judgments, fees, attorneys' fees or loss arising directly or indirectly out of the acts or omissions hereunder by the vendor or third parties under the direction or control of the Consultant; and

b. to provide defense for and defend, at its sole expense, any and all claims, demands or causes of action directly or indirectly arising out of this Agreement and to bear all other costs and expenses related thereto.

G. Insurance: Insurance shall be procured and maintained without interruption for the duration of the Agreement, in the kinds, amounts and minimum coverage specified in Schedule “E”. In addition, as noted in the insurance specification, the County of Erie and Erie Community College shall be named as additional insureds on the policies and subrogation must be waived as indicated in the instructions and sample forms. Insurance coverage in amount and form shall not be deemed acceptable until approved by the College.

H. The Contractor expressly agrees that neither it nor any Contractor, sub-Contractor, employee, or any other person acting on its behalf shall discriminate against or intimidate any employee or other individual on the basis of race, creed, religion, color, gender, age, national origin, ethnicity, alienage or citizenship status, disability, marital status, sexual orientation, familial status, genetic predisposition or carrier status or any other status protected by New York State or Federal laws during the term of or in connection with this Agreement.

Non-Collusion The proposer, by signing the proposal, does hereby warrant and represent that any ensuing agreement has not been solicited, secured or prepared directly or indirectly, in a manner contrary to the laws of the State of New York and the County of Erie, and that said laws have not been violated and shall not be violated as they relate to the procurement or the performance of the agreement by any conduct, including the paying or the giving of any fee, commission, compensation, gift, gratuity or consideration of any kind, directly or indirectly, to any College employee, officer or official.

Conflict of Interest All proposers must disclose with their proposals the name of any officer, director or agent who is also an employee of the College. Further, all proposers must disclose the name of any College employee who owns, directly or indirectly, an interest of ten percent or more in the firm or any of its subsidiaries or affiliates.

There shall be no conflicts in existence during the term of any contract with the College. The existence of a conflict shall be grounds for termination of a contract.

Compliance with Laws:

By submitting a proposal, the proposer represents and warrants that it is familiar with all federal, state and local laws and regulations and will conform to said laws and regulations. The preparation of proposals, selection of proposers and the award of contracts are subject to provisions of all Federal, State and County laws, rules and regulations.

Contents of Proposal:

The New York State Freedom of Information Law as set forth in Public Officers Law, Article 6, Sections 84 et seq., mandates public access to government records. However, proposals submitted in response to this RFP may contain technical, financial background or other data, public disclosure of which could cause substantial injury to the proposer's competitive position or constitute a trade secret. Proposers who have a good faith belief that information submitted in their proposals is protected from disclosure under the New York Freedom of Information Law shall:

A. Insert the following notice in the front of its proposal:

“NOTICE

The data on pages ___ of this proposal identified by an asterisk (*) contains technical or financial information constituting trade secrets or information the disclosure of which would result in substantial injury to the proposer’s competitive position.

The proposer requests that such information be used only for the evaluation of the proposal but understands that any disclosure will be limited to the extent that the College considers proper under the law.

If the College enters into an agreement with this proposer, the College shall have the right to use or disclose such information as provided in the agreement, unless otherwise obligated by law.”

And

B. clearly identify the pages of the proposals containing such information by typing in bold face on the top of each page " * THE PROPOSER BELIEVES THAT THIS

INFORMATION IS PROTECTED FROM DISCLOSURE UNDER THE STATE

FREEDOM OF INFORMATION LAW."

The College assumes no liability for disclosure of information so identified, provided that the College has made a good faith legal determination that the information is not protected from disclosure under applicable law or where disclosure is required to comply with an order or judgment of a court of competent jurisdiction.

The contents of the proposal, which is accepted by the College, except portions "Protected from Disclosure", may become part of any agreement resulting from this RFP.

Effective Period of Proposals:

All proposals must state the period for which the proposal shall remain in effect (i.e. how much time the College has to accept or reject the proposal under the terms proposed). Such period shall not be less than 180 days from the proposal date.

About SUNY Erie Community College

Since 1946, SUNY Erie Community College has met the needs of a diverse student body while contributing to the economic vitality of Western New York. A member of the State’s SUNY system, our work spans three campuses in Erie County, New York and engages key stakeholders from education, business, government, nonprofits, and local communities. It is our mission to provide flexible, affordable and accessible educational programs in an accommodating academic environment. To learn more about our programs and services, please visit: www.ecc.edu http://www.ecc.edu/

Project Scope/Work:

Student emotional health is a priority for The State University of New York (SUNY) and for SUNY Erie Community College. SUNY Erie recognizes that due to the unprecedented rise in student emotional health issues in recent years, colleges are struggling to provide the support and interventions that students need.

This Request for Proposal (RFP) seeks a company that can provide a web-based emotional health support telehealth option to allow students to connect with a Licensed Mental Health Clinician for support. The goal is to find a solution that supports students with their academic needs by improving their mental health and well-being.

The College is looking for a vendor who provides easy and personal access to clinical providers and that provides a variety of tools to support and improve students’ emotional health and well-being in virtual and online formats.

• Proposer shall have successfully provided services of a similar nature for a minimum of five (5) years.

• Proposals must outline the responsibilities of the college with regard to infrastructure and staff support, if any.

• The cost proposal shall detail the fee structure for the Proposal and shall identify all potential costs for which the college would be responsible for under the contract. Hourly rates, ancillary and reimbursable costs shall be clearly itemized, if not included in other components of the cost proposal.

• Services must include collaboration with the college to ensure students are aware of, and are able to access the services provided, and that staff is aware of available resources.

• The vendor should provide monthly reports for all the offered services that should include, but not limited to the count of Enrollees, Enrollee satisfaction, service duration, waiting time (to get a clinician), issues faced, and new enrollments (per month).

• The proposer must have a quality assessment and assurance program defined to co-ordinate implementation, handle issues and provide feedback, communication and document and track performance.

• Proposals must identify key professional staff members who will be involved with this engagement. Briefly describe the experience each possesses as it pertains to the proposed services or provide a resume for each.

• The platform must be easily accessible and should function on computers, tablets, and hand-held devices (phones) with Windows, Apple (MacOS and iOS) and Google (Chrome and Android) operating systems.

• Services should encompass support for students dealing with various issues.

• The web-based system should offer daily check-ins with mood and behavioral tracking and offer a variety of resources for support.

• The web-based system should offer multiple modes of connection for the student to include 24/7 text therapy, teletherapy appointments via secure video connection, web portal, online chat, or similar means, with referral to on campus and community resources as needed.

• Access to services must be on-demand, 24 hours per day, 365 days per year during the term of the agreement without additional cost.

• Once a consultation is requested provider must facilitate a Telehealth consultation within 24-hours.

• Services must use a secure virtual communication platform that is FERPA and HIPAA compliant.

• Vendor must maintain student confidentiality in accordance with FERPA and HIPAA laws.

• Telehealth services must be administered by a licensed mental health clinician.

• Enrollees must have access to a wide set of licensed clinicians with visibility into clinician’s availability with ability to choose preferred clinicians and appointment dates/time.

• The expertise of the clinician should be made available to the enrollee. The expertise could be classified into multiple parameters, including but not limited to topic knowledge (anxiety, diversity, family, etc.) and demographics (Hispanic, Latin, Asian, etc.)

Evaluation Criteria:

Criteria Weight Ability to meet the needs of the Department 10% Experience 20% Professional qualifications 20% Approach & Methodology 15% References 10% Work Samples 10% Cost 15% Total 100%

SCHEDULE “C”

References

Please provide three required references here:

SCHEDULE “D”

PROPOSER CERTIFICATION

The undersigned agrees and understands that this proposal and all attachments, additional information, etc. submitted herewith constitute merely an offer to negotiate with Erie Community College and is NOT A BID. Submission of this proposal, attachments, and additional information shall not obligate or entitle the proposing entity to enter into a service agreement with the College for the required services.

The undersigned agrees and understands that the College is not obligated to respond to this proposal nor is it legally bound in any manner whatsoever by the submission of same. Further, the undersigned agrees and understands that any and all proposals and negotiations shall not be binding or valid against the College, its directors, officers, employees or agents unless an agreement is signed by a duly authorized officer of the College and, if necessary, approved by the Erie County Legislature and Erie County Fiscal Stability Authority and the Erie County Attorney’s Office.

It is understood and agreed that the College reserves the right to reject consideration of any and all proposals including, but not limited to, proposals which are conditional or incomplete. It is further understood and agreed that the College reserves all rights specified in the Request for Proposals.

It is represented and warranted by those submitting this proposal that except as disclosed in the proposal, no officer or employee of the College is directly or indirectly a party to or in any other manner interested in this proposal or any subsequent service agreement that may be entered into.

Proposer Name

By:

Name and Title

SCHEDULE “E” CERTIFICATE OF INSURANCE

INSTRUCTIONS FOR COUNTY OF ERIE, ERIE COMMUNITY COLLEGE STANDARD INSURANCE CERTIFICATE

I. Insurance shall be procured and certificates delivered before commencement of work or delivery of merchandise or equipment.

II. CERTIFICATES OF INSURANCE

A. Shall be made to the "County of Erie and Erie Community College, 4041 Southwestern Blvd. Orchard Park, NY 14127" B. Coverage must comply with all specifications of the contract.

C. Must be executed by an insurance company, agency or broker, which is licensed by the NYS Department of Financial Services. If executed by a broker, notarized copy of authorization to bind or certify coverage must be attached.

III. Forward the completed certificate to: Erie Community College, (Department or Division) responsible for entering into the agreement for construction, purchase, lease or service.

IV. Minimum coverage with limits are as follows:

Vendor Classification

A Construction and Maintenance

B Purchase or Lease of Merchandise or

Equipment

C Professional

Services

D Property Leased To Others Or Use

Of Facilities Or Grounds

E Concessionaires

Services

F Livery

Services

G All Purposes

Public Entity Contracts

H Athletic Fields and

Gyms

I Use of Pools

Commercial Gen. Liab. $1,000,000 per occ.

$1,000,000 CSL $1,000,000 CSL $1,000,000 $1,000,000 CSL $1,000,000 $1,000,000 CSL $1,000,000 $1,000,000

General Aggregate $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 Products Completed Operations Liability $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 Blanket Broad Form Contractual Liability INCLUDE

Contractual Liability INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE Broad Form P.D. INCLUDE X.C.U. (explosion, collapse, Underground)

INCLUDE

Athletic Participant Liability INCLUDE INCLUDE

Abuse and Molestation INCLUDE (where applicable *) INCLUDE (where applicable *) INCLUDE (where applicable *) Auto Liab. $1,000,000

CSL

$1,000,000 CSL $1,000,000 CSL $1,000,000 CSL $1,000,000 CSL $1,000,000 CSL $1,000,000 CSL $1,000,000 CSL

Owned INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE Hired INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE Non-Owned INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE INCLUDE Excess/Umbrella Liab. $5,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $5,000,000 $1,000,000 $1,000,000 $2,000,000 Worker's Compensation STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY & Employer's Liability Disability Benefits STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY STATUTORY Professional Liability $5,000,000 Cyber Liability $1,000,000 N/A 3,000,000 N/A $1,000,000 N/A N/A N/A N/A Erie County, Erie Community College To Be Named Add'l Insd.

Gen. Liab., Auto Liab., &

Excess

Broad Form Vendors May Be Required

Gen. Liab., Auto

Liab., & Excess

Gen. Liab., Auto Liab., & Excess

Gen. Liab., Auto Liab., & Excess

Gen. Liab., Auto

Liab., & Excess

Gen. Liab., Auto Liab., & Excess

Gen. Liab., Auto Liab., & Excess

Gen. Liab., Auto Liab., & Excess

Construction contracts require excess Umbrella Liability limits of $5,000,000.

V. Coverage must be provided on a primary-non-contributory bases.

VI. Designated Construction Project General Aggregate Limit Per Project Endorsement CG 25 03 is required.

VII. In the event the concessionaire is required to have a N.Y.S. license to dispense alcoholic beverages an endorsement for liquor liability is required

VIII. Waiver of Subrogation: Required on all lines unless noted

IX. Abuse and Molestation included for activities involving children - $2,000,000 Limit (i.e.. Daysports, Camps, etc.)

X. Transportation of people in buses, vans or station wagons requires $5,000,000 excess liability.

XI. Workers Compensation: State Workers' Compensation / Disability Benefits Law

Use Applicable Certificates Below:

CE-200 Exemption CE-200 Exemption C105.2 Commercial Insurer DB-120.1 Insurers SI-12 Self Insurer DB-155 Self Insured GSI-105.2 Group Self Insured U-26.3 New York State Insurance Fund

XII. Cyber Liability coverage must be provided in instances where vendors/contractors have access to the County's IT network and/or any personal and confidential information

XIII. Pollution/Environmental Liability coverage required for projects involving the remediation, handling, transporting and/or disposal of hazardous waste, including but not limited to asbestos, lead and any other substance determined to be a Pollutant or Contaminant by the (DEC)

XIV. The "ACORD" form certificate may be used in place of the County of Erie Standard Insurance Certificate, provided that all of the above referenced requirements are incorporated into the "ACORD" form certificate.

XV. Endorsement CG2038 (Additional Insured) or equivalent should be used in construction contracts where there is no direct contract between the Contractor performing services and ECC/Erie County

Schedule “F”

NON-COLLUSIVE PROPOSAL CERTIFICATION

By submission of this proposal, each proposer and each person signing on behalf of any proposer certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of his knowledge and belief:

1) the prices in this proposal have been arrived at independently without collusion, consultation, communication or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other proposal or any competitor;

2) unless otherwise required by law, the prices which have been quoted in this proposal have not been knowingly disclosed by the proposer and will not knowingly be disclosed by the proposer prior to opening, directly or indirectly, to any other proposer or to any competitor; and

3) no attempt has been made or will be made by the proposer to induce any other person, partnership or corporation to submit or not to submit a proposal for the purpose of restricting competition.

NOTICE

(Penal Law, Section 210.45)

IT IS A CRIME, PUNISHABLE AS A CLASS A MISDEMEANOR UNDER THE LAWS OF

THE STATE OF NEW YORK, FOR A PERSON, IN AND BY A WRITTEN INSTRUMENT,

TO KNOWINGLY MAKE A FALSE STATEMENT, OR TO MAKE A FALSE STATEMENT,

OR TO MAKE A STATEMENT WHICH SUCH PERSON DOES NOT BELIEVE TO BE TRUE.

REQUEST FOR PROPOSAL NOT ACCEPTABLE WITHOUT FOLLOWING

CERTIFICATION

AFFIRMED UNDER PENALTY OF PERJURY THIS ________ DAY OF ________, 20 _____

TERMS ________________ DELIVERY DATE AT DESTINATION _____________________

FIRM NAME __________________________________________________________________

ADDRESS ____________________________________________________________________

CITY _______________STATE_______________ ZIP___________

Federal ID #________________ _________MBE___________________ WBE__________ Will you require a 1099 MISC Form? Yes___ No___

Authorized Signature ____________________________________________________________

Print Name of Authorized Signature and Title_________________________________________

Telephone #___________Email Address ______________________________Fax #_________