REQUEST FOR PROPOSAL STATEMENT OF REQUIREMENTS. August 13, 2015



Similar documents
NAME AND LOCATION OF BUSINESS ORGANIZATION (PLACE OF PERFORMANCE)

Supplier Representations and Certifications

REPRESENTATIONS AND CERTIFICATIONS SAVANNAH RIVER REMEDIATION LLC

ATTACHMENT A SUPPLIER CERTIFICATIONS PACKAGE

STATE OF MAINE REQUEST FOR PROPOSALS AMENDMENT

ADDENDUM NO. 1 TO THE BIDDING DOCUMENTS. HVAC SERVICE AND MAINTENANCE Saint Clair County MidAmerica Saint Louis Airport.

CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS AND DRUG-FREE WORKPLACE REQUIREMENTS

IOWA LOTTERY AUTHORITY BID Security Assessment Services

REPRESENTATIONS AND CERTIFICATIONS SAVANNAH RIVER NUCLEAR SOLUTIONS, LLC

REQUEST FOR QUOTATIONS (RFQ) Drainage / Cleaning of Septic Well for CCI Kabul office

BID BOND 9/7/12 BS - 1. KNOW ALL MEN BY THESE PRESENTS, that I/We. as Principal, hereinafter called Contractor, and

FLORIDA ATLANTIC UNIVERSITY COST-REIMBURSABLE SUBAWARD AGREEMENT #

Event Details. Please note that Specifications for Genetec Software Support can be located in the Bid Documents attachment.

Duluth Transit Authority

MIT LINCOLN LABORATORY REPRESENTATIONS AND CERTIFICATIONS-COMMERCIAL (JUNE 2014)

AGREEMENT FOR CONSULTING SERVICES (Sponsored Research) Consulting Agreement Number CA###-####-#### IIT PURCHASE ORDER NO. **

Request for Proposal (RFP) for Contract Management

SMART. This proposal must be returned by: December 22, :00pm

INSTRUCTIONS TO BIDDERS

DOCUMENT BID FORM TO THE SAN FRANCISCO PORT COMMISSION, CITY AND COUNTY OF SAN FRANCISCO

MINNESOTA DEPARTMENT OF HEALTH MASTER GRANT CONTRACT FOR COMMUNITY HEALTH BOARDS

SECTION I (Applies to all offers)

STATEMENT OF WORK FOR MAINTENANCE OF AIR CONDITIONERS

LAWRENCE-DOUGLAS COUNTY HOUSING AUTHORITY. REQUEST FOR QUALIFICATIONS For a PRIVATE DEVELOPMENT PARTNER

Request for Qualifications. For Mobile Technology to enable. Job Placement and Retention Services. Due April 20, 2015

CHAPTER 11 APPEALS AND DISPUTES

REQUEST FOR PROPOSAL FOR CISCO VOIP TECHNICAL SUPPORT

REQUEST FOR PROPOSALS. March 4, 2016, 17:00 pm Central European Time Closing Deadline:

Air Conditioning Maintenance Services

Webb County Purchasing Department Dr. Cecilia Moreno, Purchasing Agent

Northern New Mexico College HUMAN RESOURCES POLICY

HOUSTON COUNTY BOARD OF COMMISSIONERS PURCHASING DEPARTMENT

RICHARDSON INDEPENDENT SCHOOL DISTRICT 400 S. GREENVILLE AVENUE RICHARDSON, TEXAS 75081

Evaluate, Clean, and Tune Guidance

ATTACHMENT B FEDERAL CERTIFICATIONS FOOD SERVICE MANAGEMENT COMPANIES AND PUBLIC SCHOOLS

Boiler and Burner Cleaning and Servicing Specifications

CERTIFICATION OF COMPLIANCE WITH SMALL, DISADVANTAGED, MINORITY, WOMEN-OWNED, AND HISTORICALLY UNDERUTILIZED BUSINESS POLICY

Request for Quotation (RFQ) for Goods

Tender document Estate Maintenance Department Web : Phone :

How To Design An Affordable Housing Rehabilitation Project

Heating Ventilation and Air Conditioning Diagnostics for Single Family Homes

HACKENSACK UNIVERSITY MEDICAL CENTER Research Department Policies and Procedures Manual

Phone: (201) Phone: (212) Fax: (973)


The Embassy of the United States of America invites you to submit an offer for supply and install the following A/Cs:

Air Conditioning Systems Warranty Manual. Version 1.8

** Please your quote response to:

Request for Proposal (RFP) Reference No: AUAF-RFP Issue Date: April 10, Deadline: April 20, :00 AM. Project:

CITY OF LEMOORE REQUEST FOR PROPOSALS FOR CREDIT CARD PROCESSING SERVICE. City of Lemoore Finance Department 119 Fox St Lemoore, CA 93245

ATLANTA PUBLIC SCHOOLS

PLP - TERMS AND CONDITIONS

REQUEST FOR PROPOSALS

REFRIGERATION & AIR-CONDITIONING UNIT IIT KHARAGPUR

INVITATION TO BID. Web and Application Development Services. Monday, February 23, 2015 at 10:00 AM

CERTIFICATION OF COMPLIANCE WITH SMALL, DISADVANTAGED, MINORITY, WOMEN OWNED, AND HISTORICALLY UNDERUTILIZED BUSINESS POLICY

REQUEST FOR PROPOSAL FOR NONPROFIT FUND ACCOUNTING SOFTWARE RFQ# EW 06/23-16/17

Invitation to Bid (ITB) ITB

National Competency Based Skill Training Refrigeration and Air-conditioning Mechanic Logbook

TRUSTEES OF THE GOVERNOR WILLIAM STOUGHTON TRUST REQUEST FOR QUOTES FOR THE PROCUREMENT OF APPRAISAL SERVICES

SECTION HEATING, VENTILATION AND AIR CONDITIONING EQUIPMENT

SMITH PLUMBING & HEATING 2012 Home Care SERVICE PLAN AGREEMENT. A. Silver Plan

AIR CONDITIONING UNITS

QUESTIONS TO ASK WHEN REPLACING YOUR HVAC TOGETHERWESAVE.COM

WorkLink Workforce Investment Board (effective July 1, 2015 WorkLink Workforce Development Board)

Request for Quotation (RFQ) for Adjustable Sit to Stand Desk Reference No.: UNWHQRFQ31. [Insert Title of Goods]

AGREEMENT FOR ENGINEERING SERVICES (AHTD VERSION LUMP SUM) JOB NO. FEDERAL AID PROJECT ( FAP ) NO. JOB TITLE PREAMBLE

AC Proposal Texarkana Regional Airport Airport Operations Director 201 Airport Drive Texarkana, AR 71854

EXTENDED 10 YEAR LIMITED LIFETIME WARRANTY LIMITED LIFETIME WARRANTY

REQUEST FOR PROPOSAL FOR DORCHESTER COUNTY COUNCIL HVAC SERVICES DCG Due Date December 6, 2011

AUSTIN COMMUNITY COLLEGE DISTRICT (ACC) SMALL BUSINESS DEVELOPMENT PROGRAM SBDP FORM A - SLBE PARTICIPATION COMMITMENT. Name of Offeror/Proposer:

Multifamily Cost Estimator Contractor

610-6-MURPHY PRIORITY SERVICE AGREEMENTS PLUMBING HEATING COOLING DUCT CLEANING BATHS TILE Thank You. Richard G.

Provided and Administered by CornerStone United, Inc. Eastway Plaza 1899 Tate Boulevard SE, Suite 2110 Hickory, NC FAX

Contractor Services for the Direct Installation of Heat Pump Water Heater and Ductless Mini-Split Heat Pumps in Income-Eligible Vermont Households

HOUSTON COUNTY BOARD OF COMMISSIONERS PURCHASING DEPARTMENT

1. What percent of a commercial business s energy usage comes from their HVAC system? A. 13% B. 23% C. 33% D. 43% E. 53%

Requirements for Qualifications Package Submittals

Carmel Unified School District. Prequalification Application For Bleacher and Pressbox Replacement Project at Carmel High School

ENERGY STAR Program Requirements for Residential Air Source Heat Pump (ASHPs) and Central Air Conditioner Equipment. Partner Commitments.

1. GENERAL INFORMATION Firm Name: Address: City: State/Province: ZIP:

REQUEST FOR QUOTES (RFQ) FOR HVAC MAINTENANCE AND REPAIR SERVICES. RFQ Release Date: August 3, Quote Due Date: August 21, 2015 at 5:00 p.m.

Request for Proposal for Permit Tracking Software

BID DOCUMENTS FOR LAUNDERING, PRESSING & DRY CLEANING SERVICES FOR THREE-YEAR TERM

Department of Purchasing & Contract Compliance

REQUEST FOR PROPOSALS: Internet Access Service. For: Peach County School District (BEN: )

Bidding Documents. Procurement of Cloud-based Mobile CRM with Back-Office Services Education E-Governance PMU. Education & Literacy Department

123 street Salt Lake City, Utah 84092

Department of Purchasing & Contract Compliance

COUNTY OF MARIN PROFESSIONAL SERVICES CONTRACT Edition 1

Transcription:

REQUEST FOR PROPOSAL STATEMENT OF REQUIREMENTS August 13, 2015 RFQ # 306 Tetra Tech (AESP) Spilt Air Conditioners On-Call Preventative Maintenance Services Reference: USAID/Tetra Tech Contract No. EDH-I-00-08-00027-00, Task Order No. 1 Office of Economic, Growth & Infrastructure (OEGI), Kabul, Afghanistan. Date this request for quotation issued RFQ available for Distribution to Vendors until RFQ must be returned to AESP no later than RFQ opening and Review Date August 13,, 2015 time 2:00PM August 21 2015 time 04:30PM August 22, 2015 time 04:30PM August 23, 2015 1.0 Introduction Tetra Tech AESP a USAID implementing partner is inviting quotations from eligible suppliers/service providers to supply of on call preventative maintenance services of air conditioner units described in Appendix B of this Request for Quotation (RFQ). These service are to be delivered to Tetra Tech Offices located in Kabul, Afghanistan. 2.0 Source Selection and Specifications Tetra Tech is sending this Request for Quotation (RFQ) to eligible firms. The service provider shall provide all labor, supervision, materials, supplies, tools, transportation and equipment to perform Spilt air conditioners preventative maintenance service at Tetra Tech-AESP facilities. PREVENTATIVE MAINTENANCE TASKS for AC units shall be serviced by the Contractor every three months per the manufacturer s specifications, but not less than twice quarterly to AESP project funded by the U.S. Agency for International Development (USAID) under Contract No. EDH-I-08-00027-00, Task Order No. 1) Project, in the Central Region of Afghanistan. 3.0 Details Required in the Proposal Tetra Tech is issuing this RFQ for: 1) Supplying genuine parts for HVAC when needed and Tetra Tech will pay for the parts as according to the market rate 2) Provide on Call and Preventative air conditioner maintenance service as noted in Appendix B Specifically to provide the following services: Genuine HVAC Supplies The Offeror shall provide genuine parts for AC units: 1. Offerror is expected to have the supplies readily available in sufficient quantities to support Tetra Tech office located in Kabul until November 8, 2015.

2. Offerror shall provide genuine air conditioner supplies with at least a 30 days warranty or manufacturer s warranty, whichever is longer (see APPENDIX B) 100 percent of the time. On-Call air conditioner Maintenance Service The Offeror shall provide on-site, on-call assistance, identify technical problems, secure and install genuine replacement parts, performing maintenance measures and test spilt air conditioners once the repairs have been made. Provide bi-three month s preventative service for spilt air conditioners listed in Appendix B. Preventative maintenance shall include the following items: In every three months the service provider will service of approximately 47 split AC units in accordance with Appendix B The service provider shall perform all deliveries and services in a safe and professional manner to prevent accidents or endangering Tetra Tech personnel or property. While cleaning, adding Freon, inspection, development of parts' list, etc. and service provider needs to provide the inspection and reporting of required parts replacement Components & Parts Components and parts used for replacement and maintenance services for spilt air conditioners are to be genuine factory authorized supplies and replacement parts. The service provider shall supply genuine spare parts that are new, free from rust, oil, dirt and any other contamination prior to installation. Any parts not listed in the Bill of Quantities are to be provided by the Offeror at a reasonable price as needed. Warranties The Offeror warrants the material furnished to be genuine factory authorized supplies, complying with the specifications and free from all defects. The Offeror shall provide in writing their company warranties and guarantees. The Offeror shall not provide expired oil (gas) Tetra Tech shall not work with awarded Offeror to resolve any defective, returns, exchanges required with manufacturer. Operation Hours The Offeror shall be available to perform the maintenance services from Saturday through Thursday (6 days per week), 8:00 am to 4:00 pm. 4.0 Quotation Format In order to qualify for this procurement, all service providers are requested to provide the following information, and format their bids as follows: 1. Basic information on the Service providers, 2. Copy of work license or Legal operation documents 3. Support documents to confirm the company has worked with International NGOs. 4. Cost Proposal - a detailed fixed cost proposal in USD should be submitted using the form in Attachment B.

5. Exceptions to the RFQ In accordance with FAR 52.211, variations in the quantity or specified type of any item called for in this RFQ and described in your proposal will not be accepted unless the variation has been caused by conditions of loading, shipping, or packing. Allowances in manufacturing processes must be approved in writing by TetraTech, Operations Manager. Any exceptions to the RFQ should be noted by the Service providers here. 6. Delivery Schedule a brief confirmation of vendors, statement on last page of attachment B indicating their ability to deliver to Tetra tech Villa. 7. Tetra Tech requests all service providers to confirm that they can meet proposed delivery schedules or otherwise service providers may propose a delivery schedule in which they can deliver the items in Appendices A and B of this RFQ. 8. Completed Representations & Certifications as requested in Appendix E and confirmation of your willingness to comply with Tetra Tech s standard Terms and Conditions from USAID (available upon request). 5.0 Submission Requirements 5.1 Submission of Proposals All responses must be in English, in PDF or word format and sent via e-mail (document needing signature/stamp should be scanned) indicating the RFQ number and closing date and sent to: aesp.procurement@tetratech.com. Proposal can also be submitted in hard copy format to the Tetra Tech Contracts and Procurement Office. Please call mobile: 0796 300 774. If delivery of proposal is preferred, proposal should be in a sealed envelope clearly labeled with the subject RFQ number 306, if submitted in hardcopy with the name of the Contracts & Procurement Department. The Service providers shall submit its best price offer/proposal as per the following requirements: 1. Proposal Cover Letter signed by a person authorized to sign on behalf of the Service providers. Use the template in Appendix A. 2. All Prices shall be quoted in United States (US) Dollars Only 3. Service provider shall submit quotes in prescribed Format of Appendix B. Please follow the same product listing/order provided in the Scope of work when making your submissions. 4. In case of price discrepancy between unit price and Subtotal price, the unit price shall prevail. 5. The rates quoted shall be for complete service inclusive of all taxes all charges for service contingent to the work. 6. Tetra Tech is Exempt from Import Duties into Afghanistan. 7. The award will be a fixed price celling amount Blanket Purchase Agreement (BPA), with ordering arrangements. 8. The period for completion of project is approximately four (4) months or up to November 8, 2015 from the time of signing the subcontract with the possibility of one year extension. 9. Tetra Tech reserves the right to increase or decrease the services/goods mentioned in this RFQ. 10. Bid validity: Net 30 days from date of submission. 11. The service providers to complete and submit all appendices cited in article 10.0 List of Appendices to Be Completed 6. Submission of Questions Should the Service providers be interested in bidding, (Attachment B: Proposal/Bill of Quantities), additional information can be requested by emailing to aesp.procurement@tetratech.com.

Insert in subject line: RFQ # 306 Tetra Tech (OEGI- AESP) Supply of Spilt Air Conditioners on-call Preventative Maintenance Services Tetra tech will disseminate to all potential service providers the questions received and related responses to all potential service providers Proposal Deadline Offer/bid must be sent no later than Saturday August 22, 2015 (4:30 pm Kabul, local time). Offers received after the closing date will not be considered and will be counted non-responsive. 7. Payment Successful service providers will work under the following payment arrangements. Payment will be made within 30 days of receipt of an acceptable invoice. Payment shall be either by cheque or Electronic Fund Transfer (EFT) directly into the bank account of the Vendor s company. 8. Evaluation Criteria All Proposals received in response to this solicitation will be evaluated and scored by evaluation factors noted below. The BPA shall be awarded on a best value basis. The following sub factors shall be used to evaluate offers: a. Cost (up to 50 points) b. Technical Acceptability and Qualification including providing all Appendices (up to 30 points) c. Past Performance (up to 20 points) 9. RFQ Cancellation Reservation Tetra Tech reserves the right to cancel, amend or modify the RFQ requirements prior to award if the project goals cannot be achieved through the RFP process. Tetra Tech shall notify all Service providers, in writing of any cancellation. Tetra Tech is not obligated to make an award and is not responsible for proposal costs. 10. List of Appendices To Be Completed Appendix A: Cover Letter Appendix B: Detailed Cost Breakdown/Bill of Quantities Form Appendix C: Summary of Relevant Capability, Experience and Past Performance Appendix D: Copy of Business License/Certificate Appendix E: Certifications and Representations

APPENDIX A PROPOSAL COVER LETTER [On Letterhead] < > TO: TETRATECH Contracts & Procurement Manager Kabul, Afghanistan Ladies and Gentlemen: We, the undersigned, offer to provide a Quote to TETRATECH for the Supply of Genuine air conditioners Supplies and for the provision of On-Call Preventative air conditioners maintenance services, in accordance with your Request for Proposal no 306 dated and our Proposal (Technical and Financial). Our attached Proposal is for the sum of <Sum in Words ($0.00 Sum in Figures) >. Our Proposal shall be binding upon us subject to the modifications resulting from contract negotiations, up to expiration of the validity period of the Proposal, i.e., < >. The supply contract that we will enter into with Tetra Tech will be for a period of Nine months from the date of signing the Blanket Purchase Agreement ( BPA). We understand you are not bound to accept any Proposal you receive. We remain, Yours sincerely, Authorized Signature: Name and Title of Signatory: Name of Firm: E-mail: Phone No: Address:

APPENDIX B PROPOSAL /BILL OF QUANTITIES Air Conditioning Units The Service provider is to perform regular periodic maintenance of all HVAC split mechanical units, both interior and exterior, of Tetra Tech compound every three months, with additional service repair calls as requested. The provider should take the following action during regular periodic maintenance but not limited to the following. Exterior HVAC UNITS 11. Inspect unit for proper refrigerant level and add or release refrigerant if necessary. 12. The Service provider is to use the HVAC unit manufacturer s recommended refrigerant. 13. Clean dirt, leaves and debris from the inside of the exterior units 14. Wash the outdoor coils. 15. Be sure the outdoor unit is bolted to the wall or bolted to the floor; an outdoor unit shall not be sitting on the floor without being bolted down. Bolt the exterior unit to the floor or the wall if not already bolted. 16. Inspect base pan for restricted drain openings remove obstructions as necessary 17. Inspect coil and cabinet clean as needed 18. Inspect fan motor and fan blades for wear and damage on older models lubricate as needed 19. Inspect control box, associated controls/accessories, wiring and connections. Controls may include contactors, relays, circuit boards, capacitors, sump heater, terminal blocks, and other accessories. All control box and electrical parts should be checked for wear, burning, excessive heating, or damage. 20. Re-install the cover to the termination box if the cover is loose or missing. 21. Inspect compressor and associated tubing for damage or leaks. Repair the leak (for example, replace the tubing, or re-make (re-flair) the fitting and re-install the fitting). 22. Fill the type of refrigerant appropriate for the unit. 23. Check for air leaks where the refrigerant and electric lines exit the room to the outside. Fill any holes with sealing foam or spun glass fiber insulation. 24. Service provider shall provide rate for service repair calls per pieces, with four hours onsite being the minimum per agreed service repair visit. 25. Service provider shall provide the cost for each quarterly service of all the HVAC units at the Tetra Tech compound. Interior HVAC UNITS 26. Inspect and clean blower assembly (includes blower housing, blower wheel and motor) filters 27. On older models, lubricate motor and inspect and replace fan belt if needed 28. Check blower housing for lint, dirt or debris and clean as necessary 29. Inspect evaporator coil, drain pan and condensate drain lines. Clean as needed, including cleaning the P-trap in the unit. 30. Clean the evaporator coil; vacuum as necessary, rinse with water as necessary. 31. Pour water into the drain pain and confirm whether the water drains to the outside. Adjust and clear the drain line as needed to be sure it drains properly.

32. Inspect for refrigerant gas leaks in gas fittings. Repair the leak (for example, replace the tubing, or re-make (re-flair) the fitting and re-install the fitting). 33. The Service provider is to use the HVAC unit manufacturer s recommended refrigerant. 34. Clean or replace the removable air filters; wash the removable filters. 35. Inspect conditioned airflow system (ductwork) check for leaks 36. Monitor system starting characteristics and capabilities 37. Listen for, diagnose and correct abnormal noises (for example, unbalanced fans and blowers, excessively vibrating vanes, loose bolting to wall or floor). 38. Monitor air conditioning and heat pump systems for correct refrigerant charge 39. Measure outdoor dry bulb temperature 40. Measure indoor dry and wet bulb temperature 41. Measure high and low side system pressures 42. Monitor the electrical system for correct line voltage and load amps 43. Check the electrical cord, the plug and the receptacle. Repair or replace as necessary with a good three-prong plug and receptacle. All indoor units shall have proper three-wire power cord (hot, neutral and ground). 44. Monitor system operation per manufacturer's specifications 45. Provide system operation report and recommend repairs or replacement as necessary 46. Clean the remote control units. Replace remote control units that have failed. Check the batteries and install fresh batteries as needed. Provide remote control units where they are missing. NOTE: All maintenance and service work must be performed by a professional air conditioning and heating dealer that holds the appropriate credentials and certificate to install and service air conditioning and heating equipment. Table: Spilt Air Conditioners Maintenance Services and filling gas when necessary No. Description QTY Unit 1 2 3 Maintenance service charges for AC 24000 BTU Maintenance service charges for AC 18000/20000 BTU Maintenance service charges for AC 9000 BTU Unit Cost ($) for maintenance service provided every three months* We agree to provide the above stated items, in accordance with the specifications at a total fixed cost price of (Amount in figures) USD, (US dollars written in words). 14 20 13 EA EA EA Bid Total Cost $ No. Description QTY Unit Gas cost ($) per unit Total cost $ 4 Gas for AC 24000 BTU 14 EA 5 Gas for AC 18000/20000 BTU 20 EA 5 Gas for AC 9000 BTU 13 EA Total $

Appendix C SUMMARY OF RELEVANT CAPABILITY, EXPERIENCE AND PAST PERFORMANCE Include projects that best illustrate your experience relevant to this (RFQ) or similar activities, sorted by decreasing order of completion date. Projects should have been undertaken in the past three years (i.e. 2012, 2013 and 2014) Projects undertaken in the past Three years may be taken into consideration at the discretion of the evaluation panel. 1 # Project Title and Description of Activities Client Name/Tel # E-mail Cost in USD Start and End Date Completed on Schedule (Yes/No) 2 3 Tetra Tech, Inc. 1 Grant Street, Framingham, MA USA 01701 Tel 508.903.2000 Fax 508.903.2001 www.tetratech.com

Appendix D COPY OF BUSINESS LICENSE / CERTIFICATE 9

Appendix E Service providers Representations and Certifications Organizational Conflict of Interest Representation The Service providers represents, to the best of its knowledge and belief, that this award: Will [ ] or will not [ ] involve an organizational conflict of interest. 1. Source, Origin, and Componentry of Goods and Commodities (i) (ii) This is to certify that the Service providers is: an individual who is a citizen or legal resident of. a corporation of partnership organized under the laws of. a controlled foreign corporation of which more than 50% of the total combined voting power of all classes of stock is owned by United States shareholders; or a joint venture or incorporated association consisting entirely of individuals, partnerships or corporations. If so, please describe separately the citizenship or legal status of the individuals, the legal status of the partnership or corporations, and the percentage (%) of voting power of the corporations. This is to certify that the Source (the country from which a commodity is to be shipped from) of the Equipment to be supplied under this Order is: name of country or countries (iii) This is also to certify that the Origin (the country where goods are mined, grown, or produced through manufacturing, processing or substantial and major assembling of components) of the Equipment to be supplied under this Order is: 10

Name of country or countries (iv) This further certifies that the Equipment to be provided by Vendor under this Order does not contain any Components originating in any of the U.S. State Department s list of Non-Free World countries (Cuba, Iran, Iraq, Laos, Libya, North Korea, and Syria). The Componentry of the Equipment to be supplied under this Order will originate in: Name of country or countries 3. Certification Regarding Debarment, Suspension, Proposed Debarment and Other Responsibility Matters (FAR 52.209-5) The Vendor certifies, to the best of their knowledge and belief, that: The Vendor and/or any of its Principals: are are not have have not presently debarred, suspended, proposed for debarment, or declared ineligible for the award of contracts by any US Federal Government agency; within the three-year period preceding this certification, been convicted of or had a civil judgment rendered against them for: commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, state, or local) contract or subcontract; violation of Federal or state antitrust statutes relating to the submission of offers; or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, or receiving stolen property; and are are not presently indicted for, or otherwise criminally or civilly charged by a governmental entity with commission of any of the offenses enumerated in subdivision (a)(1)(i)(b) of this provision. (A) The Vendor has has not within the past three years, relative to tax, labor and employment, environmental, antitrust, or consumer protection laws: been convicted of a Federal or state felony (or has any Federal or state felony indictments currently pending against them); or had a Federal court judgment in a civil case brought by the United States rendered against them; or had an adverse decision by a Federal administrative law judge, board, or commission indicating a willful violation of the law. If the Vendor has responded affirmatively, the Vendor shall provide additional information if requested by the Contracting Officer; and 11

The Vendor has has not, within a three-year period preceding this certification, had one or more contracts terminated for default by any U.S. Federal Government agency. (a) "Principals," for the purposes of this certification, means officers; directors; owners; partners; and, persons having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a subsidiary, division, or business segment, and similar positions). This Certification Concerns a Matter Within the Jurisdiction of an Agency of the United States and the Making of a False, Fictitious, or Fraudulent Certification May Render the Maker Subject to Prosecution Under Section 1001, Title 18, United States Code. (b) The Vendor shall provide immediate written notice to the Contracting Officer if, at any time prior to contract award, the Vendor learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. (c) A certification that any of the items in paragraph (a) of this provision exists will not necessarily result in withholding of an award under this solicitation. However, the certification will be considered in connection with a determination of the Vendor s responsibility. Failure of the Vendor to furnish a certification or provide such additional information as requested by the Contracting Officer, or PA, may render the Vendor non-responsible. (d) Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the certification required by paragraph (a) of this provision. The knowledge and information of a Vendor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. (e) The certification in paragraph (a) of this provision is a material representation of fact upon which reliance was placed when making award. If it is later determined that the Vendor knowingly rendered an erroneous certification, in addition to other remedies available to the Government, the Contracting Officer may require PA to terminate the contract resulting from this solicitation for default. By signing below, the Service providers certifies that the representations and certifications made, and information provided herein, are accurate, current and complete. Signed by Name of authorized Dealer Date / Signature Stamp 12