FLORIDA STATE FAIR AUTHORITY INVITATION TO BID CONTRACTUAL SERVICES

Transcription

1 SUBMIT BID TO: Florida State Fair Authority 4800 Hwy 301 North / P.O. Box Tampa, Fl Tampa, Fl (Orient Road Entrance) Attn: Phyllis J. Bridges Telephone Number: phyllis.bridges@freshfromflorida.com FLORIDA STATE FAIR AUTHORITY INVITATION TO BID CONTRACTUAL SERVICES Bidder Acknowledgment Page 1 of pages 13 BIDS WILL BE OPENED October 11, 2013, 3:00 P. M. (EDT) and may not be withdrawn within sixty (60) days after such dare and time. BID NO. ITB/FSF MAILING DATE: AUGUST 27 th, 2013 BID TITLE: ATM SERVICES POSTING OF BID: Bid tabulations with recommended awards will be posted for review by interested parties at the location where bid was opened and will remain posted for a period of 72 hours. Posting will be on or about October 22 nd, FEDERAL ID NUMBER REASON FOR - NO QUOTE VENDOR NAME VENDOR MAILING ADDRESS CITY - STATE ZIP VENDOR AREA CODE PHONE NUMBER TOLL FREE NUMBER I certify that this bid is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a Bid for the same materials, supplies, or equipment, and is in all respects fair and without collusion or fraud. I agree to abide by all conditions of this bid and certify that I am authorized to sign this bid that this bid is in compliance with all requirements of the Invitation to Bid including, but not limited to, certification requirements. Authorized Signature (Manual) Authorized Signature (Typed) Title 1

2 INVITATION TO BID FLORIDA STATE FAIR AUTHORITY SPECIAL TERMS, CONDITIONS AND SPECIFICATIONS PURPOSE: The Florida State Fair Authority ( Authority ), an instrumentality of the State of Florida, is seeking proposals from interested persons ( Bidder(s) ) to provide Automated Teller Machines ( ATMs or ATM Services ) to be utilized by the Florida State Fair Authority. The Florida State Fair Authority is located at 4800 Hwy 301 North, Tampa, Florida ( Fairgrounds ). SCOPE/INTENT: It is the intent of the Authority to seek bids from qualified bidders to establish an open end agreement for providing ATM Services, at the annual Florida State Fair ( Fair ), in the month of February and at non-fair events throughout the year In order to provide ATM services for the Fair and non-fair events, the Authority is seeking bid proposals that will meet our needs and be cost effective. Bidders must be able to provide both permanent and temporary ATM machines, to be installed at agreed upon locations on the Fairgrounds, as determined by the Authority. TERM OF THE CONTRACT: The initial term of the contract will be for three (3) years with two (2) one (1) year renewal options, based on performance, availability of funding and the best interest of the Authority. The Authority reserves the right to rebid, at its sole discretion. Note: Multi-year agreements are subject to approval of the Fair Authority Board. If approval is not available, a one-year agreement with four (4) one (1) year renewals may be done if agreed to by both parties. The Authority makes no guarantee of the actual volume or amount of usage the ATMs will receive. During the most recent contract year, the current provider reported 38,921 transactions (25,799 during the Fair) with over $2.7 million dispensed (over $1.6 million during the Fair). LAWS AND REQULATIONS: Bidders agree to abide by all applicable Federal, State, County, and local laws, rules, regulations, ordinance and codes. BASIS OF AWARD: The bids will be publicly opened in the presence of any Bidders that wish to be present and to those staff members of the Authority that will be tabulating and evaluating each proposal. Once the proposals have been opened and read, Bidders will be excused. Results of the awarded Bidder will be posted within 72 hours, in the lobby of the Authority s Administration Office. Award will be made to the lowest responsive, responsible Bidder. BID EVENTS TIMETABLE DATE: PROCESS: 8/27/2013 Invitation to Bid released 9/10/ :00 a.m. (EDT) On Site Visit (Participants use Orient Road Service Gate) 9/23/2013 Written Requests Due 9/27/2013 Written Responses Completed 10/11/2013 3:00 p.m. (EDT) Invitation Opening (Participants use Orient Road Service Gate) 10/22/2013 Posting of Award (Administration Lobby) 2

3 CONTRACT MANAGER: The Bidder will coordinate and schedule all work with the Fair Authority s Finance Director, John Prestianni, or his designee, with the following address and phone number: Florida State Fair Authority, 4800 U.S. Highway 301 North, Tampa, Florida 33610, telephone (813) , John.prestianni@freshfromflorida.com NON-RESPONSIVE PROPOSALS, NON-RESPONSIBLE RESPONDENTS : Proposals which do not meet all material requirements of this ITB or which fail to provide all required information, documents, or materials may be rejected as non-responsive. Material requirements of the ITB are those set forth as mandatory or without which an adequate analysis and comparison of proposals are impossible, or those which affect the competitiveness of proposals or the cost to the Authority. Bidders whose proposals, past performance or current status do not reflect the capability, integrity or reliability to fully and in good faith perform the requirements of the Contract may be rejected as non-responsible. The Authority reserves the right to determine which proposals meet the material requirements of the ITB, and which respondents are responsible. COSTS OF DEVELOPING AND SUBMITTING PROPOSAL; OWNERSHIP: The Authority shall not be liable for any of the costs incurred by the Bidder in preparing and submitting a proposal. All proposals become the property of the Authority upon receipt and will not be returned to the Bidder once opened. The Authority shall have the right to use any and all ideas or adaptations of ideas contained in any proposal received in response to this ITB. Selection or rejection of the proposal will not affect this right. REFERENCES: Failure to submit the required references or incomplete references shall result in rejection of the bid. Bidder shall provide with the bid a list of at least four (4) customers for whom they have provided product and service of similar size within the last 5 years. As a minimum, at least three (3) of the references must be comparable, be verified, and indicate satisfactory performance. If this minimum is not met, the bid shall be automatically disqualified. References must be current or former clients of the bidding firm. The Authority will not accept sub-bidder / proposed personnel or personal references of a member of the bidding firm as a substitute for bidder references. References must include company, contact name, address, phone number, address and be available to provide information and/or written questionnaire requested by the Authority within a 72 hour deadline. BENEFIT: The Contract is for the benefit of the Authority and the Bidder and not for the benefit of any third party.. CONTRACT DOCUMENTS: The construction, interpretation, and performance of this contract, and all transactions under it, shall be governed by the laws of the State of Florida. The contract documents shall include all terms and conditions of the bid specifications, any addenda, bid proposal, and the Florida State Fair Authority contract issued as a result of this bid. DELIVERY AND ACCEPTANCE: The delivery of this product shall be our Service Entrance on Orient Road. Delivery hours shall be made between 8:00 a. m., and 3:30 p. m. Monday through Friday, except that for holidays and at any other times not provided herein, by special arrangement with the Authority. Inspection shall be made at point of delivery, unless otherwise specified. If the Bidder fails at any time to meet the delivery requirements set forth herein, for whatever reason, the Purchasing Manager, at his/her discretion, may allow the Bidder additional time, obtain the supplies elsewhere, or, cancel the contract immediately, upon written notice. The Purchasing Manager, may withhold acceptance of or reject any goods which are found upon examination, not to meet the specification requirements. Upon written notification of rejection, goods shall be removed within five (5) business days by the Bidder at the Bidder s expense. 3

4 EXCLUSIVE RIGHTS The right to provide the commodities and services which will be granted under the Contract shall be exclusive to the awarded Bidder. However, the Authority reserves the right to contract for and/or purchase related commodities and services from as many firms as it deems necessary, without infringing upon or terminating the Contract. INDEPENDENT CAPACITY OF BIDDER: The Bidder, its officers, agents and employees, in submitting the bid, shall act in the capacity of an independent Bidder and not as an officer, employee, or agent of the Authority. BIDDER RESPONSIBILITY: The Authority will consider the Bidder to be the sole point of contact with regard to contractual matters. The Bidder will assume sole responsibility for providing the commodities and services offered in its proposal whether or not the Bidder is the supplier of said commodities and services or any component. ASSIGNMENT OF THE CONTRACT: The contract resulting from the winning bid ( Agreement ) is not assignable, except with the prior written approval of the Authority. Monies which become due under the Agreement are not assignable, except with the prior written approval of the Authority. In the event of such approval, the terms and conditions hereof shall apply to and bind the party or parties to whom the Agreement is assigned, as fully and completely as the Bidder is bound and obligated. No assignment, if any, shall operate to release the Bidder from its liability for the prompt and effective performance of its obligations under the Agreement. COPYRIGHTS AND PATENT RIGHTS: Bidder warrants that there has been no violation of copyrights or patents rights in manufacturing, producing, and/or selling the item (s) ordered or shipped as a result of the bid; and successful Bidder agrees to indemnify and hold harmless the Authority, its representatives, and employees, against any and all liability, loss, or expense resulting from such violation. SERVICE REQUIREMENTS The Bidder warrants that it will provide necessary service and monitoring of its ATMs throughout the year. The bidder will be required to have adequate services and personnel on-site during the annual State Fair. The bidder will also have adequate service in place to replenish the ATMs on large weekend shows (including Sunday replenishments) throughout the year. COSTS BORNE BY THE BIDDER Responsibility and costs for maintenance, replenishments, communication services, weather protection, signage, setup/teardown costs and miscellaneous other costs will all be borne by the bidder. The only direct cost borne by the Authority will be for the electrical service. PRICE QUOTATIONS: Service fees shall be firm for the first year of the Agreement; thereafter all requests for adjustments must be made to coincide with the anniversary/renewal date of the Agreement. Adjustments to the service fees after the first year will only be considered with documentation to support the request. SIGNED BID CONSIDERED AN OFFER: This signed bid is considered an offer on the part of the Bidder, and shall be considered accepted upon approval By Authority and signing of the final contract document. DEFAULT: Failure of the Bidder to perform according to the Agreement shall be cause for the Bidder to be found in default. In the event of default, any and all re-procurement costs, and any other remedies provided in the ITB, Agreement and/or by rule or law, may be charged against the Bidder. 4

5 SPECIFICATIONS: The following points should be specifically addressed when proposing on ATM services for the Florida State Fair Authority: 1. Indicate the number of ATM machines you are proposing, (permanent and fair)? Our current provider presently supplies us with five (5) permanent ATMs and thirty-six (36) temporary ATMs during the Fair. 2. Indicate Electric and Communication requirements. 3. What are the Electric Costs per machine to the Authority? (Annual basis for permanent and weekly basis for temporary). 4. What is the estimated response time for ATM cash replenishment? 5. What is the estimated response time for ATM service issues? 6. Indicate Authority responsibility for ATM security? 7. Address contract termination? 8. Indicate any other contractual restrictions. REVENUE PROJECTIONS (BID SHEET): The following points should be specifically addressed when proposing on ATM services for the Florida State Fair Authority: 1. What will be the fixed fee (if any) payable to the Authority? 2. What will be the ATM surcharge amount (permanent and Fair)? 3. What will be the percentage (if any) of surcharge payable to the Authority? 4. What will be the expected ATM signage / sponsorship revenue? 5. What will be the percentage (if any) of signage / sponsorship revenue payable to the Authority? 6. What is the settlement and payment time with Authority? CERTIFIED MINORITY BUSINESS ENTERPRISE PARTICIPATION: The Authority wishes to encourage award of the Contract, or subcontracting of portions of the Contract to, or purchase of goods and services from, State of Florida Certified Minority Business Enterprises (CMBEs). Each Bidder must state whether or not they are a CMBE, and if not, what percentage of the total Contract price will be spent with CMBE firms who will be supplying them. NOTE: Not all minority business enterprises are presently certified by the State of Florida. However, only certified minority business enterprises (CMBEs) will be considered in evaluating this portion of a Bidder s proposal. Bidders may obtain information on CMBEs by contacting: Office of Supplier Diversity 4050 Esplanade Way, Suite 360 Tallahassee, Florida Telephone (850) DRUG-FREE WORKPLACE: Preference shall be given to bids certifying a drug-free workplace has been implemented in accordance with Section , Florida Statutes. Whenever two or more equal bids, which are received by the Florida State Fair Authority or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certified that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie bids will be followed if none of the tied Bidders have a drug-free workplace program. See DRUG-FREE WORKPLACE PROGRAM - BIDDER CERTIFICATION. If applicable, please sign and return with your bid response. 5

6 EMPLOYMENT OF UNAUTHORIZED ALIENS: Pursuant to Federal law, the employment of unauthorized aliens is a violation of Section 274A of the Immigration and Nationality Act. If Bidder knowingly employs illegal aliens, such violation shall be cause for unilateral cancellation of the Agreement contract. BIDDING INSTRUCTIONS: In addition to the instructions on the Invitation to Bid cover sheet, Bidder Acknowledgment, the required Statement of Qualifications and the completed Reference Sheet, each Bidder must complete the Bid Price Sheet, as indicated below. By affixing a manual signature on the Bid Price Sheet, the Bidder states that he/she has read all the provisions of the bid package and agrees to the terms, conditions and specifications contained therein. BID RESPONSES BY FAX, WILL NOT BE ACCEPTED BY THE AUTHORITY. ONE (1) ORIGINAL, TWO (2) DUPLICATE COPIES AND AN ELECTRONIC COPY OF THE BID DOCUMENTS MUST BE SUBMITTED IN A SEALED PACKAGE TO THE PURCHASING MANAGER AT THE ADDRESS LISTED ON THE INVITATION TO BID CONTRACTUAL SERVICES BIDDER ACKNOWLEDGMENT FORM AND AS SPECIFIED HEREIN. THE OUTSIDE OF THE PACKAGE MUST BE MARKED WITH THE BID NUMBER AND DATE OF BID OPENING. The original must contain an original signature of an official of the Bidder who is authorized to bind the Bidder to the bid. In addition to the address, the face of the envelope shall be marked with the date and time of the bid opening, and the bid number. BID PACKAGE REQUIREMENTS: The interpretation and performance of the contract resulting from this Bid Proposal, and all transactions under it, shall include all terms and conditions of the bid specifications, any addenda, and Authority contract issued as a result of this bid. The purpose of the evaluation is to establish which Bidder with their qualification will meet the needs of the Authority. Therefore each Bidder must submit a Statement of Qualifications to include at a minimum: a. Acknowledgement & Bid Pricing Form b. Conflict of Interest Statement c. Drug Free Workplace Certification d. References: A list of four (4) previous or currant clients, comparable to the Authority; that the Bidder has served within the last five (5) years. e. Insurance Certificate & Indemnification f. Letter of Interest which indicates the firm s qualifications, related experience, abilities to perform work, and any other pertinent data. Any additional information the respondent determines to be essential or valuable may be included for the Evaluation Committee s analysis. The omission of any part of these requirements may result in the rejection and non-consideration for analysis of your entire package by the Authority. DISQUALIFICATION OF BIDDERS: Any or all bids will be rejected if there is reason to believe that collusion exists among the bidders and no participants in such collusion will be considered in future bids for the same work. Falsifications of any entry made on the bidder's offer will be deemed a material irregularity and will be grounds for rejection. REJECTION OF BIDS: The Authority reserves the right to reject any and all bids when such rejection is in the interest of the Authority, and to reject the bid of a Bidder who the Authority determines is not in a position to perform the Contract. BID WITHDRAWAL: Bidders certifies that prices, terms, and conditions in the bid will be irrevocable for a period of ninety (90) days from the date of bid opening unless otherwise required in the bid. Bids may not be withdrawn before the expiration of ninety (90) days. Bids may be withdrawn after the ninety (90) days, upon written notification to the Authority Purchasing Office. 6

7 LATE BIDS: Bids received by the Authority after the bid opening time and date will be rejected as untimely and will not be opened. A late bid notice will be sent to the Bidder upon the posting of Award Notice with instructions for its return. Unclaimed late bids will be destroyed after 45 days. Offers from Bidders listed on the Authority s posted Award Notice are the only offers received timely in accordance with the Authority s bid opening time and date. BID TABULATIONS: The Authority will calculate the bid based 1. Total estimate of income to the Authority 2. Grading of experience of the bidder in performing the required tasks under the agreement 3. Ability to maintain, and service the ATMs in a timely manner The criteria or mix to evaluate the bid is at the sole discretion of the Authority to get the most favorable overall income and service to our patrons. AWARD OF IDENTICAL (TIE) BIDS: In the event that identical bids are received, preference shall be given to the bid certifying a drug-free workplace has been implemented in accordance with Section , Florida Statutes. Award shall be determined by using the number of valid Bidder complaints on file or by lot; except that the bid/proposal which relates to commodities manufactured within this State shall be given preference and the bid of any foreign manufacturer with factory in the state employing over 200 employees working in the State shall have preference over the bid of any foreign manufacturer. POSTING OF BID TABULATIONS: Bid tabulations with recommended award(s) will be posted on or about the date specified on the Invitation to Bid cover sheet, for review by interested parties at the location where bids were opened and will remain posted for a period of seventy-two (72) hours. Failure to file a protest within the time prescribed in Section (3), Florida Statutes, shall constitute a waiver of proceedings under Chapter 120, Florida Statutes. Failure to file the proper bond at the time of filing the formal protest will result in denial of the protest. QUESTIONS: All questions shall be sent to: Ms. Phyllis Bridges, Purchasing Manager Florida State Fair Authority 4800 U.S. Hwy 301 North Tampa, Florida Telephone: (813) phyllis.bridges@freshfromflorida.com Only communications from Bidders, which, are signed and in writing will be recognized by the Authority as duly authorized expressions on behalf of the bidder. Written or ed inquires must be received in the Authority s Purchasing Office no later than September 23, No negotiations, decisions, or actions shall be initiated or executed by the bidder as a result of any discussions with any purchaser or Authority employee. Only those communications, which are in writing from the Authority s Purchasing Office may be considered as a duly authorized expression on behalf of the Authority. The Authority s response to these written questions will be provided to Bidders no later than September 27, Any questions, correspondence or contact with the Authority initiated by the Bidder after the bid opening date and prior to posting of intended award must be directed to the Purchasing Office, attention Purchasing Manager. Authority personnel will not discuss bids or proposed contract activities with bidders during the bid evaluation period. The Authority will not accept any revisions or additions to any bid after the bid opening date. 7

8 INSURANCE REQUIRED INSURANCE COVERAGES: The Bidder agrees to purchase insurance and have the authorized agent state on the insurance certificate that the Bidder has purchased the following types of insurance coverage with the following minimum required coverage limits: Workers' Compensation Insurance. The Bidder agrees to provide at a minimum, Workers' Compensation coverage in accordance with the statutory limits as established by the State of Florida. Employers' Liability Insurance. The Bidder shall also maintain Employer's Liability Insurance Coverage with limits of at least: (i) Bodily Injury by Accident - $1,000,000 each accident; and (ii) Bodily Injury by Disease - $1,000,000 each employee. Commercial General Liability Insurance. The Bidder shall provide Commercial General Liability Insurance (2001 ISO Occurrence Form or equivalent) that shall include, but need not be limited to, coverage for bodily injury and property damage arising from premises and operations liability, products and completed operations liability, blasting and explosion, collapse of structures, underground damage, personal injury liability and contractual liability. The CGL policy must include separate aggregate limits per Project and shall provide at a minimum the following limits: Coverage Limit 1. Premises and Operations $ 2,000, per Occurrence 2. Products and Completed Operations $ 2,000, per Occurrence 3. Personal Injury $ 2,000, per Occurrence 4. Contractual $ 2,000, per Occurrence INSURANCE, LOSS DEDUCTIBLE CLAUSE: The Authority shall be exempt from, and in no way liable for, any sums of money which may represent a deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the Bidder providing such insurance. INSURANCE, PUBLIC LIABILITY AND PROPERTY DAMAGE: The Bidder shall require each of his Authorized Dealers, Partners, Support Specialists or similar Consultants or Trainers working on this project to secure and maintain during the life of this contract, insurance of the type specified above or insure the activities of these individuals or entities in his policy, as specified above. INSURANCE, LOSS DEDUCTIBLE CLAUSE: The Florida State Fair Authority shall be exempt from, and in no way liable for, any sums of money which may represent a deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the Bidder providing such insurance. 8

9 BID PRICING FORM & ACKNOWLEDGEMENT BIDDER ACKNOWLEDGEMENT: Bidder by virtue of submitting this bid acknowledges that they have read, understand, accept and will comply with all the terms, conditions and specifications of the Bid and any addenda issued. Bidders shall thoroughly examine and be familiar with these specifications. The failure or omission of any Bidder to review this document shall in no way relieve any Bidder of obligations with respect to this Bid. The submission of a bid and signature below shall be taken as evidence of acceptance of the terms and conditions of this Bid. The undersigned Bidder does declare that no other persons other than the Bidder herein named has any interest in this bid or in the contract to be taken, and that it is made without any connection with any other person or persons making bid for the same article, and is in all respects fair and without collusion or fraud. The undersigned further declares that the specifications have been carefully examined and the Bidder is thoroughly familiar with its provisions and with the quality, type and grade of required materials. The undersigned further declares and proposes to furnish the article called for within the specified time in the bid for the following price and guarantees that parts and services for the articles listed below are available within the State of Florida, to wit: Furthermore, I certify that I am duly authorized to sign this bid for bidder. Legal Name of Company Manual Signature of Company Officer Date Print Information Below: Name of Company Officer Title of Company Officer Please check one: Original Copy **Please submit One (1) Original, Two (2) copies and one electronic copy of all bid documents** 9

10 BID SHEET MINIMUM ATMS TO BE PROVIDED Product Description Number 1. Permanent ATMs 2. Temporary ATMs for the Fair BIDDER REVENUE INFORMATION Description 1. ATM surcharge amount Fair Bidder Revenue 2. ATM surcharge amount remainder of year 3. Total expected surcharge income 4. Estimated ATM signage / sponsorship revenue Please note who will be responsible for obtaining signage/sponsorship revenue (Bidder, Authority or Both)? AUTHORITY REVENUE INFORMATION Description 1. Fixed fee payable to the Authority Authority Revenue 2. Percentage of surcharge payable to the Authority 3. Percentage of signage / sponsorship revenue payable to the Authority 4. Estimated Annual Electricity costs to the Authority Please note the settlement and payment time frame with the Authority **Please submit One (1) Original, Two (2) copies and one electronic copy of all bid documents** 10

11 CONFLICT OF INTEREST I, as authorized representative of Certify that no member of this firm or any person having interest in this firm has been awarded a contract by The Florida State Fair AUTHORITY on a non-competitive basis to: (1) Develop this Invitation to Bid (ITB) (2 ) Perform a feasibility study concerning the scope of work contained in this ITB (3) Develop a program similar to what is contained in this ITB Authorized Representative Date Bid Number **Please submit One (1) Original, Two (2) copies and one electronic copy of all bid documents** 11

12 DRUG FREE WORK PLACE FLORIDA STATE FAIR AUTHORITY DRUG - FREE WORKPLACE PROGRAM - BIDDER CERTIFICATION IDENTICAL TIE BIDS - Preference shall be given to businesses with drug - free workplace programs. Whenever two or more bids, which are equal with respect to price, quality, and service are received by the State or by any political subdivision for the procurement of commodities or contractual services, a bid received from a business that certifies that it has implemented a drug - free workplace program shall be given preference in the award process. Established procedures for processing tie bids will be followed if none of the tied vendors have a drug - free workplace program. In order to have a drug - free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business s policy of maintaining a drug - free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893, Florida Statutes, or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee s community, by any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug - free workplace through implementation of this section. 7. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. BIDDER S SIGNATURE **Please submit One (1) Original, Two (2) copies and one electronic copy of all bid documents** 12

13 REFERENCES As per the requirements of bid special conditions BIDDER QUALIFICATIONS, each Bidder is required to submit the names, addresses, telephone numbers and comparable information for the required four references. References shall be listed below. In order for your bid to be considered responsive this form must be completed in its entirety and included in your bid package. COMPANY NAME: CONTACT: MAILING ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NUMBER: (Area code) ADDRESS: COMPANY NAME: CONTACT: MAILING ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NUMBER: (Area code) ADDRESS: COMPANY NAME: CONTACT: MAILING ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NUMBER: (Area code) ADDRESS: COMPANY NAME: CONTACT: MAILING ADDRESS: CITY: STATE: ZIP CODE: TELEPHONE NUMBER: (Area code) ADDRESS: 13

14 INSURANCE - INDEMNIFICATION By affixing an authorized signature to this document, Bidder acknowledges reading and agrees to accept all terms, provisions, and conditions contained in this Invitation to Bid pertaining to the required Insurance Coverage and Indemnification and shall provide certification of both if awarded the bid within 10 days after signing the contract. All such terms will be included in the final contract with the selected Bidder. BIDDER NAME: SIGNATURE (MANUAL): SIGNATURE (PRINTED): **Please submit One (1) Original, Two (2) copies and one electronic copy of all bid documents** 14