Workforce Solutions Alamo 115 E Travis, Suite 220 San Antonio, Texas 78205 INVITATION FOR BID For FUEL MANAGEMENT SYSTEM (GASOLINE CARDS) ISSUE DATE: MARCH 2, 2016 RESPONSE DEADLINE: MARCH 28, 2016 (2:00 P.M.) Workforce Solutions is an Equal Opportunity Employer/Program. Minority, disadvantaged and women-owned businesses are encouraged to apply. Auxiliary aids and services are available upon request for individuals with disabilities.
TABLE OF CONTENTS Part 1 - GENERAL INFORMATION 1. A Introduction 1. B Purpose 1. C Procurement Standards 1. D Eligibility 1. E Information Requirements/Specifications 1. F Point of Contact and Address 1. G Availability 1. H Response Deadline 1. I Contract Period 1. J Schedule of Events 1. K Governing Provision and Limitations Part 2 - BID SUBMISSION GUIDELINES 2. A Method of Submission 2. B Address for IFB Submittal 2. C Number of Copies Required 2. D Submission Requirements Part 3 - REQUIRED INFORMATION 3. A Organizational Background 3. B Demonstrated Performance 3. C Cost Information Part 4 - EVALUATION AND SELECTION PROCEDURES 4. A General 4. B Evaluation Criteria 4. C Notification of Award ATTACHMENTS A B C D E F G H I J K L IFB Cover Sheet Organizational Background List of Board of Directors, Owners, Principals and Officers Demonstrated Performance Cost Information Certification of Bidder Certification Regarding Debarment Certification Conflict of Interest Certification Regarding Lobbying and Drug-Free Workplace Equal Employment Opportunities Assurances and Certification Texas Corporate Franchise Tax
PART 1 - GENERAL INFORMATION 1.A INTRODUCTION The Alamo Workforce Development Board d/b/a Workforce Solutions Alamo (WSA) manages the operations of workforce development programs. In the delivery of services, WSA provides transportation assistance to its eligible customers. These services are provided to customers who are engaged in job search and/or skills training activities. Depending on their mode of transportation, customers are given a choice to choose from several options for transportation assistance. The provision of fuel cards provides them the option to use their own personal vehicle or participate in car pools. WSA provides workforce development services to the Alamo Workforce Development Area (AWDA), which consists of the following 13 counties: Atascosa, Bandera, Bexar, Comal, Comal, Frio, Gillespie, Guadalupe, Karnes, Kendall, Kerr, Medina, and Wilson. 1.B PURPOSE The purpose of this Invitation for Bid (IFB) is to obtain bids from interested and qualified vendors to provide approximately $500,000 - $750,000 FUEL MANAGEMENT SYSTEM / GASOLINE CARDS services on an annual basis as specified in this document. 1.C PROCUREMENT STANDARDS Procurement of goods and services are performed in accordance with the procurement rules and regulations that provides for maximum free and open competition regardless of the dollar amount or procurement method used. Awards will be made to the vendor with the best price, proven ability to successfully perform the terms and conditions of the IFB, and subsequently the Contract terms & conditions. 1.D ELIGIBILITY TO RESPOND Vendors are eligible to respond to this IFB if they are able to meet the specifications for the FUEL MANAGEMENT SYSTEM / GASOLINE CARDS services required under this IFB; and are not debarred and/or suspended from conducting business with federal and/or state funded agencies. 1.E INFORMATION REQUIREMENTS / SPECIFICATIONS Vendors responding may bid either as a sole supplier or as a consortium/partnership to provide services to the entire AWDA. Vendors must be insured/bonded. Vendors must have financial capacity to provide services within 30 calendar days after notification of contract award. Vendors must be able to provide an inventory sheet of sequential card numbers and amounts when shipped, and provide WSA a reconciliation of cards used with all issued numerical sequenced cards, if requested. Purchases may be in the following denominations: prepaid gas cards in $10.00 increments prepaid gas cards in $15.00 increments prepaid gas cards in $25.00 increments
The actual frequency and quantity purchase will vary in accordance with actual customer flows and support service needs. The value of the card shall purchase that amount of fuel, e.g., a gas card valued at $25.00 shall be able to purchase $25.00 of fuel. The cards must be restricted to fuel purchases only. This means that the cards can NOT be used for purchasing other items other than fuel. 1.F POINT OF CONTACT AND ADDRESS WSA is the sole Point of Contact (POC) with regard to all procurement and contractual matters relating to the services described herein. Questions regarding the IFB must be received in writing no later than March 9, 2016 at 3:00 p.m. (CST). Questions received after this date and time will not be considered and will not be responded to. Answers to timely questions may be shared with all prospective vendors. All correspondence concerning this IFB must be addressed, in writing to: Ms. Venessa Miller Director of Contracts and Procurements Workforce Solutions Alamo 115 E. Travis, Ste. 220 San Antonio, Texas 78205 or submit questions to: vmiller@wsalamo.org 210-272-3260 WSA is not responsible for the accuracy of information from sources other than the POC authorized for this procurement. Direct communication with other individuals regarding specifics of this IFB is prohibited. Failure to follow this provision may be grounds for disqualification of this IFB. 1.G AVAILABILITY IFB packets will be available beginning March 2, 2016 at the address indicated in paragraph 1.E above or at www.workforcesolutionsalamo.org. 1.H RESPONSE DEADLINE All IFB and any modifications must be received and recorded no later than 2:00 p.m. CST on March 28, 2016 at WSA at 115 E. Travis, Suite 220, San Antonio, TX 78205. Late IFB responses will not be accepted. There will be no exceptions. A receipt will be available at the time the IFB is submitted, if requested. No protests of untimely submission will be accepted without such document. 1.I CONTRACT PERIOD Funding will be for a contract period to commence as early as the date of execution of said Contract. The agreed upon contract period is for one (1) year with an option to extend for an additional three (3) one year terms based on need, performance, and availability of funds.
1.J SCHEDULE OF EVENTS WSA reserves the right to amend the schedule. All Vendors will be notified of any changes. Publication of IFB (Packets available for pick up) March 2, 2016 Deadline for written questions for IFB Packet March 9, 2016 DEADLINE FOR SUBMITTING BIDS: 2:00 p.m. CST March 28, 2016 Proposals will be publically opened on March 28, 2016 at 3:00 p.m. CST at the following location: Workforce Solutions Alamo Basement Conference Room 115. E. Travis, Ste. 220 San Antonio, TX 78205 1.K GOVERNING PROVISIONS AND LIMITATIONS a) The intent of this IFB is to identify various prospective contract alternatives and obtain estimates of cost for goods and/or services solicited. WSA is under no legal requirement to execute a contract on the basis of any bid received. Furthermore, this IFB does not commit WSA to pay for any costs incurred in submitting a bid. b) WSA reserves the right to accept or reject any and all bids received, cancel this IFB in part or in its entirety, or to reissue this IFB. c) WSA reserves the right to waive any defects in this procurement process or to make changes to this solicitation, as it deems necessary. WSA will provide notification of such changes to all Prospective Bidders recorded in the official record (Distribution Log/Receipts Log) as having received an IFB. d) WSA reserves the right to withdraw, reduce the amount of an award, or to cancel any contract(s) resulting from this procurement, as funding for this project is contingent upon receipt of funds from the State of Texas and/or the United States Government. e) WSA reserves the right to determine as reasonable, or unreasonable the terms of all or part of any contract (s) resulting from this IFB. WSA reserves the right to require specific modifications to responses accepted before agreeing to a contract(s), including but not limited to: 1) Increase or decrease in specific line items of cost, 2) Modifications to project information, 3) Other modifications, to bring the bid into compliance with the Act, the Regulation(s), requirements of this bid, and/or Board Policies and Procedures. f) WSA is not responsible for any costs incurred in services provided by a Bidder prior to the commencement date of a contract resulting from this IFB. g) No employee, officer or member of WSA participate in the selection, development of a response to this IFB, award or administration of a contract (s) supported by the IFB if a conflict of interest,
real or apparent, would be involved. preparation of a bid. No employee of WSA shall assist any Bidder in the h) Bidder shall not, under penalty of law, offer or provide any gratuities, favors or anything of monetary value to an officer, employee, or member of WSA or C2 Global Professional Services. Bidders who submit a bid may not have any contact outside of the formal review process with any employee or member of WSA. Contact includes correspondence, telephone calls, meetings, and personal contact. Bids that violate this provision will be rejected. i) All bids and any attachments, appendices, or other information submitted as a part of a response become the property of WSA upon submission and may be printed, published, or distributed in any manner WSA deems appropriate, in accordance with open records laws, and applicable State and Federal policies and procedures. j) Bidders shall not engage in any activity that restricts or eliminates competition. Violation of this provision will disqualify bid. This statement does not preclude joint ventures or subcontracts. k) WSA reserves the right to conduct a review of records, systems, procedures, etc., of any entity selected to receive an award for a contract. This may occur prior to or subsequent to any contract award. Misrepresentation of the Bidder s ability to perform, as stated in the IFB may result in contract cancellation. l) WSA reserves the right to contact any individual, agencies or employers listed in a bid, to contact others who have experience and/or knowledge of the Bidder s relevant performance and/or qualifications, and request additional information. m) Solicitation and selection of bids must conform to Federal and State laws and regulations and local policies governing the procurement of goods and services. Successful Bidders will be responsible for all applicable laws and regulations. n) If selected for an award, the contents of a successful bid may become a contractual obligation. Failure of the Bidder to accept this obligation may result in contract cancellation. Bidder cannot plea for error or mistake as basis for release. o) If issues of contract compliance, or questioned costs/disallowed costs exist, a contract with the selected Bidder may be withheld and/or cancelled at the discretion of WSA until such issues are satisfactorily resolved.
PART 2 BID SUBMISSION GUIDELINES BACKGROUND: Workforce Solutions Alamo (WSA) serves the City of San Antonio (Bexar County) and the following 12 counties: Atascosa, Bandera, Comal, Comal, Frio, Gillespie, Guadalupe, Karnes, Kendall, Kerr, Medina, and Wilson. WSA is issuing an Invitation for Bids (IFB) to obtain prices/costs/fees of FUEL MANAGEMENT SYSTEM / GASOLINE CARDS. Funding is through the Alamo Workforce Development Board Area (AWDBA). 2.A Method of Submission Bids may be submitted or delivered by any acceptable delivery method, except by WSA facsimile (FAX). The Bidder s name must be clearly indicated externally and the IFB number must be included. 2.B Address for delivery of Responses Mail or hand-deliver bid to the address indicated in paragraph 1.E. 2.C Number of copies required Bidders must submit one (1) original and two (2) stapled copies of the complete bid. The original must be clearly marked ORIGINAL on the cover sheet and contain original signatures of the Contract Signatory Authority. 2.D Submittal requirements All responses must be typed on 8 ½ by 11-inch paper with all pages sequentially numbered and either stapled or bound together. Please do not use any font size smaller than 12 point. Please do not use any binders and do not submit any documents not specifically required in the IFB. Cover Sheet Complete the Cover Sheet at Attachment A. If the vendor is a Historically Underutilized Business (HUB), the HUB certification number must be included. Organizational Background Narrative - Use Attachment B to enter information. Demonstrated Performance - Use Attachment D to enter information. Cost Information - Use Attachment E to enter information. Certifications Sign and attach the certificates at Attachments F through L. The Contract Signatory Authority as indicated on the Cover Sheet at Attachment A must sign all certificates. Certificate of Good Standing Attach a copy of the Bidder s most recent Certificate of Good Standing or Certificate of Account Status from the Texas Comptroller of Public Accounts, OR Documentation indicating satisfactory/compliant State & Federal Tax Status.
SUMMARY AND CHECK LIST DOCUMENT COMPLETED ATTACHMENTS Cover Sheet A Organizational Background-Narrative SIGNED B List of Board of Directors Owner, Principals and Officers Demonstrated Performance Most recent three-year contracts Cost Information Reasonableness of Cost C D E All Certificates SIGNED F - L Bonding Information Current Certificate of Coverage Provide
PART 3 REQUIRED INFORMATION 3.A Organizational Background Narrative The following information must be entered and submitted under. Fiscal Capabilities Briefly describe the equipment or services to be used and/or provided in financial capacity perspectives. Organization/Vendor Information History / Background of Organization Type of Business Organizational Structure Description / Organizational Chart Additional Vendor / Organization Information Provide a list of Board of Directors, Owner, Principals and Officers 3.B Demonstrated Performance List each similar contract that the Bidder has successfully executed in the last 3 years beginning with the most recent. Address items below for each contract: Geographic area where services were provided (city, county, state) Contract Award Amount Contract Dates Description of the goods and services offered Any other indicator of successful contract performance. 3.C Cost Information Demonstrate reasonable justification of cost either through the submission of a line item budget or cost comparison for similar services. Provide financial incentives/savings that may be available obtained through available fuel management/gasoline card system. Provide payment schedules, which may allow for savings, or percentage discounts on volume purchases.
PART 4 EVALUATION AND SELECTION PROCEDURES 4.A General A Committee will be assigned to evaluate all bids received. Upon completion of the evaluation, each bid will be ranked by responsiveness and by the lowest costs submitted. Only those bids received by the submission deadline will be considered. 4.B Evaluation Criteria The appointed committee to open/review each qualified bid will use the following criteria: Responsiveness All required information and attachments signed and submitted? YES NO Organizational Background Is the responding entity financially stable per the documents submitted? YES NO Demonstrated effectiveness Did the Bidder demonstrate the ability to provide requested goods based on past experience and performance? YES NO Can the Bidder provide services in all service areas? YES NO Cost Information Is the cost of the services clearly stated? YES NO Reasonable justification of cost: How does the cost compare to the cost of other responses received? YES NO Does vendor provide discount possibilities, upon volume purchases? YES NO HUB Certified Did Bidder provide the HUB certification number, if applicable? YES NO LOWEST BID Was the Vendor s bid the lowest (Minimal Dollar Amount)? YES NO Are additional fees waived? YES NO 4.C Notification of results: All Bidders will be notified of WSA s contracting recommendations. The Successful Bidder, approved for funding by WSA will receive a Letter of Intent to contract for the requested services, pending finalization of a Contract Award by WSA.
COVER SHEET - ATTACHMENT A Due: 2:00 p.m. CST Date: March 28, 2016 Date and Time Submitted: (Obtain receipt from Workforce Solutions Alamo (WSA) Procurement Section if response is hand delivered; if response is mailed, certified mail is recommended) Submitted by: Vendor / Agency: Address: STREET CITY STATE ZIP Contact Person: Contract Signatory Authority: TITLE CONTACT PHONE NO. CONTACT PHONE NO. TAX / LEGAL STATUS State OR Local Government Agency Community College/Higher Education Institution Union Non-profit Private for-profit Other Federal Employer Identification Number: Texas State Comptroller ID: HUB Status: HUB Certification Number, if applicable:
ATTACHMENT B ORGANIZATIONAL BACKGROUND NARRATIVE LAST NAME FIRST MI SIGNATURE - DATE Describe Organization
ATTACHMENT C LIST OF BOARD OF DIRECTORS, OWNERS, PRINCIPALS, AND OFFICERS (or Attach Certificate(s) of incorporation or registered Company Format) Name Position/Title Business Address/Phone Number 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
ATTACHMENT D DEMOSTRATED PERFORMANCE (Letters of Recommendation may be attached)
ATTACHMENT E COST INFORMATION Additional pricing information may be attached in support of cost analysis, or proposing justification. Fuel Management System Costs can be described/proposed in the section(s) relevant to the Vendors capacities/abilities to serve the required specified guidelines. 1. System/Software/Equipment Costs/Supplies/Cards A. B. C. D. E. F. G. H. I. J. 2. Cost per card without programmed/loaded dollar value: 1,000 Cards: 5,000 Cards: 10,000 Cards: 20,000 Cards: 3. Cost per card with programmed dollar amount value range: $5.00 - $10.00 = $ $10.00 $15.00 = $ $15.00 - $20.00 = $ $20.00 - $25.00 = $ $30.00 - $35.00 = $ $35.00 - $40.00 = $ $40.00 - $45.00 = $ $45.00 - $50.00 = $ Describe Proposed Cost Per Card: 4. Volume discount on monthly gasoline purchases described below (as applicable) A. $5,000.00: B. $10,000.00: C. $15,000.00 D. $20,000.00: E. $25,000.00: F: $30,000.00
VENDOR NAME: Phone/Fax No: Address: Contact Person: Please indicate if your firm is a Historically Underutilized Business (HUB) as defined by the State of Texas. No Yes If yes, provide Certification No. Vendor Representative: Signature / Date:
ATTACHMENT F CERTIFICATION OF BIDDER I hereby certify that the information contained in the bid and any attachments is true and correct and may be viewed as an accurate representation of proposed goods and/or services to be provided by the organization. I certify that no employee of Workforce Solutions Alamo (WSA) has assisted in the preparation of this response. I acknowledge that I have read and understand the requirements and provisions of the IFB and that the organization will comply with applicable regulations and other applicable Federal, State and local rules and regulations and directives in the implementation of this program. I also certify that I have read and understand the Governing Provisions and Limitations stated on Section 1.J of this IFB and will comply with the terms; and furthermore that I,, certify that I am the of the corporation, (Typed name) Partnership, or sole proprietorship, or other eligible entity named as Bidder and Bidder herein and that I am legally authorized to sign this Bid and submit it to WSA on behalf of said organization by authority of its governing body. Authorized Representative Signature Authorized Representative Name Date Title
ATTACHMENT G CERTIFICATION REGARDING DEBARMENT, SUSPENSION, OTHER RESPONSIBILITY MATTERS Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.150, Participants' responsibilities. The regulations were published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211). (1) The prospective recipient of Federal assistance funds certifies, by submission of this Bid, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Have not within a three-year period preceding this offer 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) transaction or contract under a public transaction, violation of Federal or State antitrust statutes or commission under a public transaction, violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction or records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity with commission of any of the offenses enumerated in Paragraph (2) of this certification; and (4) Have not within a three-year period preceding this offer had one or more public transactions terminated for cause or default. Where the prospective recipient of Federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid. Name and Title of Authorized Representative Signature Date
ATTACHMENT H CERTIFICATION OF CONFLICT OF INTEREST It is the fiscal policy Alamo Workforce Development Board Area (AWDBA) that all persons or firms seeking to do business with Workforce Solutions Alamo as the contractor for the Board to provide the following information. Every question must be answered. If the question is not applicable, answer with "NA". VENDOR: FEDERAL ID# STREET: CITY: STATE: ZIP: ENTITY: Corporation ( ) Partnership ( ) Sole Owner ( ) Association ( ) Other ( ) 1. State the name of each "non-managerial employee" or managerial employee of the Board having an "ownership interest" constituting 5% or more of the ownership in the above named "firm". Name Job Title 2. State the names of each "board member" of the Board having an "ownership interest" constituting 5% or more of the ownership in the above named "firm". Name Board, Commission, or Committee 3. State the names of each employee or officer of a "consultant" for the Board who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 5% or more ownership in the above named "firm". Name Consultant 4. OTHER Name Job Title
CERTIFICATION OF CONFLICT OF INTEREST I certify that all information provided is true and correct as of the date of this statement, that I have not knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to WSA for the AWDBA. Name Title: Witness Name: Title: (Type or Print) (Type or Print) (Type or Print) (Type or Print) Signature: Date: Signature: Date: ATTACHMENT I
CERTIFICATION REGARDING LOBBYING AND DRUG-FREE WORKPLACE Lobbying: This certification is required by the Federal Regulations, implementing Section 1352 of the Program Fraud and Civil Remedies Act, Title 31 U.S. Code, for the Department of Agriculture (7 CFR Part 3018), Department of Labor (29 CFR Part 93), Department of Education (34 CFR Part 82), Department of Health and Human Services (45 CFR Part 93). The undersigned certifies that: (1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan or cooperative agreement. (2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, and officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, Disclosure Form to Report Lobbying in accordance with its instructions. (3) The undersigned shall require that the language of this certification by included in the award documents for all sub-awards at all tiers (including subcontracts, sub grants, and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly. Drug-Free Workplace: This certification is required by the Federal Regulations, implementing Sections 5151-5160 of the Drug-Free Workplace Act, 41 U.S.C. 701; for the Department of Agriculture (7 CFR Part 3017), Department of Labor (29 CFR Part 98), Department of Education (34 CFR Parts 85, 668, and 682), and Department of Health and Human Services (45 CFR Part 76). The undersigned Representative certifies that it shall provide a drug-free workplace by: (1) Publishing a policy statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the consequences of any such action by an employee; (2) Establishing an ongoing drug-free awareness program to inform employees of the dangers of drug abuse in the workplace, the policy of maintaining a drug-free workplace, the availability of counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed on employees for drug abuse violations in the workplace; (3) Providing each employee with a copy of the policy statement; (4) Notifying the employees in the policy statements that as a condition of employment under a contractual agreement, employees shall abide by the terms of the policy statement and notifying the employer in writing within five days after any conviction for a violation by the employee of a criminal drug statute in the workplace; (5) Notifying Workforce Solutions Capital Area within 10 (ten) days of receipt of a notice of a conviction of an employee; and
(6) Taking appropriate personnel action against an employee convicted of violating a criminal drug statute or requires such employee to participate in a drug abuse assistance or rehabilitation program. These certifications are a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission certification is a prerequisite for making or entering into this transaction. Name and Title of Authorized Representative Signature Date ATTACHMENT J 23
EQUAL OPPORTUNITY AND NON-DISCRIMINATION STATEMENT The Institution agrees to comply fully with Title VI and Title VII of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, as amended, Title IX of the Education Amendments of 1972, as amended, and with all requirements imposed by or pursuant to the implementing regulation in 29 CFR Part 31and 32. The Institution further assures that no person shall, on the grounds of race, color, religion, sex, national origin, age, physical handicap, mental disability, temporary medical condition, political affiliation or belief, be excluded from participation in, be denied employment in the administration of or in connection with any program or activity funded in whole or in part with funds made available under the Job Training Partnership Act. As subcontracts and supplier contracts become necessary to carry out the requirements of this contract, Vendor covenants to make a good faith effort to contract with historically underutilized (disadvantaged) businesses certified by the State of Texas, as that term is defined by state law, to wit, Texas Government Code, section 481.101. Vendor shall make a good faith effort to let at least ten (10) percent of the total value of all subcontracts and supplier contracts for the performance of the activities required by this agreement to historically underutilized (disadvantaged) businesses. Name and Title Date Signature ATTACHMENT K
ASSURANCES AND CERTIFICATIONS The Organizations or individual submitting a bid in response to a Workforce Solutions Alamo (WSA) Invitation for BID (IFB), warrants and assures the following: 1) The information contained in this bid is true and correct; 2) The cost described in the bid budget accurately reflects the Bidder s cost of providing services or goods; 3) The organization or individual possesses the legal authority to offer this bid; 4) Each organization with respect to operation of WSA funded program(s) or activities and all agreements or arrangements to carry out WSA funded programs or activities, will comply with the nondiscrimination and equal opportunity provisions, as they may apply to the specific program or activities. BY SIGNING I ACKNOLWEDGE THAT I HAVE READ THESE ASSURANCES AND CERTIFICATIONS AND THAT I AM AUTHORIZED TO BIND THE ORGANIZATION I REPRESENT TO THESE REQUIREMENTS SHOULD THIS BID BE ACCEPTED FOR FUNDING BY WSA. Organization s Name Signature of Authorized Representative Date Authorized Representative s Name Title ATTACHMENT L
TEXAS CORPORATE FRANCHISE TAX CERTIFICATION Pursuant to Article 2.45, Texas Business Corporation Act, state agencies may not contract with for-profit corporations that are delinquent in making state franchise tax payments. The following certification that the corporation entering into this offer is current in its franchise taxes must be signed by the individual authorized on Form 2031, Corporate Board of Directors Resolution, to sign the contract for the corporation. The undersigned authorized representative of the corporation making the offer herein certifies that the following indicated statement is true and correct and that the undersigned understands making a false statement is a material breach of contract and is grounds for contract cancellation. Indicate the certification that applies to your corporation: The Corporation is a for-profit corporation and certifies that it is not delinquent in its franchise tax payments to the State of Texas. (Attach Back up Documents) The Corporation is a non-profit corporation or is otherwise not subject to payment of franchise taxes to the State of Texas. Name and Title of Authorized Representative Signature Date