HomeMy WebLinkAboutHD Supply Facilities Maintenance LP Informal Cooperative Purchase Agreement 2-9-24GSD-S Informal Cooperative Purchase Agreement (08-2023)
-1-
INFORMAL COOPERATIVE PURCHASE AGREEMENT
THIS AGREEMENT (Agreement) is made and entered into EFFECTIVE
____________________________. by and between CITY OF FRESNO, a California
municipal corporation (City), and HD Supply Facilities Maintenance, LP, a California
Limited Partnership (Vendor).
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing and of the covenants,
conditions, and promises hereinafter contained to be kept and performed by the
respective parties, it is mutually agreed as follows:
1. The Charter for the City allows for cooperative purchase agreements for
materials, supplies, and equipment. The City is allowed to piggyback an existing
government agency’s agreement, under Fresno City Charter 1208. The parties agree the
Vendor was the lowest responsive and responsible bidder for Invitation for Bid (IFB)
issued by Fresno Unified School District, contract number RFP 22-07. The IFB is attached
hereto as Exhibit A and is incorporated herein by reference. The Parties agree that the
Vendor has entered a Cooperative Purchase Contract with HD Supply Facilities
Maintenance, LP (Original Government Contract).
2. Vendor’s Obligation. Vendor shall provide those services and carry out that
work described in the Original Government Contract, which is attached hereto as Exhibit
B and is incorporated herein by reference, subject to all the terms and conditions
contained or incorporated herein.
3. City’s Obligation. City shall make to the Vendor those payments described
in Exhibits A and B, subject to all the terms and condition contained or incorporated
herein
4. Notwithstanding the requirements that the Original Government Contract is
fully binding on the Parties, the parties have agreed to modify certain non-material
provisions of the Original Government Contract as applied to this Agreement between the
Vendor and the City, as follows:
a) City’s Insurance and Indemnity provisions attached as Exhibit C.
b) Address change for the City: Notwithstanding the address and
contract information for the government entity as set out in Exhibit B, the Vendor agrees
that notices and invoices will be sent to:
City of Fresno
Attention: Melissa Perales
2101 G Street, Bldg A
Fresno, Ca 93706]
Phone: (559) 621-1332
FAX: (559) 457-1564
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
2/9/2024
GSD-S Informal Cooperative Purchase Agreement (08-2023)
-2-
c) Notwithstanding anything in Exhibits A and B to the contrary, this
Agreement shall be governed by, and construed and enforced in accordance with , the
laws of the State of California, excluding however, any conflict of laws rule which would
apply the law of another jurisdiction. Venue for purposes of the filing of any action
regarding the enforcement or interpretation of this Agreement and any rights and dut8ies
hereunder shall be Fresno County, California.
d) All other provisions in the Original Government Contract are fully
binding on the parties and will represent the agreement between the City and the Vendor.
[Signatures follow on the next page.]
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
GSD-S Informal Cooperative Purchase Agreement (08-2023)
-3-
IN WITNESS WHEREOF, the parties have executed this Agreement at Fresno,
California, the day and year first above written.
CITY OF FRESNO,
a California municipal corporation
By:
Melissa Perales
Purchasing Manager
General Services Department
No signature of City Attorney required.
Standard Document #GSD-S Informal
Cooperative Purchase Agreement
(08-2023) has been used without
modification, as certified by the
undersigned.
By:
Augustus Krider
Procurement Specialist
ATTEST:
TODD STERMER, CMC
City Clerk
By:
Date
Deputy
Addresses:
CITY
City of Fresno
Attention: Melissa Perales
2101 G Street, Bldg A
Fresno, Ca. 93706
Phone: (559) 621-1332
E-mail: Melissa.Perales@fresno.gov
HD Supply Facilities Maintenance, LP, a
a California Limited Partnership
By:
Name:
Title:
(If corporation or LLC., Board Chair,
Pres. or Vice Pres.)
By:
Name:
Title:
(If corporation or LLC., CFO, Treasurer,
Secretary or Assistant Secretary)
Vendor:
HD Supply Facilities Maintenance, LP
Attention: Brent Weigand
6881 District Blvd Suite F
Bakersfield, CA 93313
Phone: (559) 977-8831
E-mail: brent.weigand@hdsupply.com
Attachments:
Exhibit A - Invitation For Bids
Exhibit B - Original Government Contract
Exhibit C - City’s Insurance and Indemnity
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
VP Institutional HD Supply
Craig Hodges
2/2/2024
2/8/2024
Director of Compliance
Ran Garver
2/8/2024
2/8/2024
2/9/2024
EXHIBIT A
Invitation for Bids
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Cover Page
FRESNO UNIFIED SCHOOL DISTRICT
REQUEST FOR PROPOSAL
RFP No. 22-07
CLEANING SUPPLIES, EQUIPMENT AND
CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS
Fresno Unified School District
Purchasing Services
4498 N. Brawley
Fresno, California, 93722
559-457-3588
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Table of Contents
FRESNO UNIFIED SCHOOL DISTRICT
TABLE OF CONTENTS
SECTION TITLE PAGE NUMBER
NOTICE OF INVITATION ....................................................................................................... 1
I. RFP INSTRUCTIONS ........................................................................................................... 2
II. GENERAL TERMS AND CONDITIONS ........................................................................... 5
III. SPECIAL TERMS AND CONDITIONS ............................................................................ 8
IV. INTRODUCTION
............ A. DESIRED SERVICES ............................................................................................. 11
............ B. SCOPE OF WORK .................................................................................................. 11
V. RFP SUBMITTAL/RESPONSE FORMAT ......................................................................... 13
VI. EVALUATION AND AWARD .......................................................................................... 15
VII. EVALUATION CRITERIA ............................................................................................... 16
SUBMITTAL CHECKLIST ...................................................................................................... 17
APPENDIX 1- General Forms ...................................................................................................
a. Proposal Signature Page
b. Prime Point of Contact
c. Non-Collusion Declaration
d. No Prohibited Interest/Conflicts of Interest Declaration
e. Debarment, Suspension, and Other Responsibility Matters
f. Request for References
g. Certification Regarding Lobbying
i. Disclosure of Lobbying Activities
ii. Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities.
APPENDIX 2 – Proposal Forms
A. Attachment # 1- Requirements for National Cooperative Contract to be administered by OMNIA Partners
B. Attachment # 2- Sample Pricing for Evaluation
C. Attachment # 3- Pricing Schedule- discount from a manufacturer’s price list or catalog
END
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 1
FRESNO UNIFIED SCHOOL DISTRICT
RFP No. 22-07
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED
PRODUCTS, SERVICES AND SOLUTIONS
NOTICE OF INVITATION
Notice is hereby given that Fresno Unified School District (DISTRICT) will receive sealed proposals
for RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED
PRODUCTS, SERVICES AND SOLUTIONS to provide Custodial supplies and services for
DISTRICT schools and facilities. This solicitation will result in a three-year contract term.
A NON-MANDATORY Pre-proposal conference is scheduled for Wednesday, June 8, 2022 at 10:00
AM. The virtual Pre-Proposal conference will be hosted via SKYPE with options to join in online or
over the phone. Instructions are posted on Procureware.
Proposals will be received prior to 2:01 P.M. on Wednesday, June 29, 2022 , on Procureware, the
District’s online purchasing portal https://fresnousdpurchasing.procureware.com/home.
Proposals received later than the designated time and date will not be accepted. Facsimile (FAX) or e-
mailed copies of submittals will not be accepted. Proposals will not be read out loud since award is
based on “best value” criteria which could result in multiple vendor awards.
Fresno Unified School District reserves the right to accept or reject any or all proposals or any
combination thereof and to waive any informality or irregularity in the bidding process.
Copies of the bid documents may be downloaded from Procureware at:
https://fresnousdpurchasing.procureware.com/home Refer any questions to Marisa Thibodeaux at
(559) 457-3584.
Distributed: May 26, 2022
Published dates: May 26, 2022
June 2, 2022
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 2
I. RFP INSTRUCTIONS
RFP Submittal. The proposer’s RFP submittal shall include the information/documentation
addressing each of the minimum requirements outlined in Section VII, EVALUATION CRITERIA.
Proposals will be evaluated on based on Relevant Experience/Performance, Product
Options/Variety/Availability and Service Capability, Price, Response to the National Program
(including detailed response to Attachment #1, Requirements for National Cooperative Contract to be
Administered by OMNIA Partners, Public Sector).
A. Interested Vendors/Firms may attend the NON-MANDATORY Pre-proposal conference.
Information Request(s). All questions regarding this RFP are to be submitted in Procureware. Questions
must be submitted by 5:00 P.M. on June 15, 2022, to allow sufficient time for release of any final
addendum prior to the bid closing date and time. The DISTRICT will distribute to all Vendors/Firms the
questions and answers by addendum as deemed appropriate.
In order to control information disseminated and protect the integrity of the bid process of this RFP, Vendors
interested in submitting responses are directed not to make personal contact with members of the governing
Board, DISTRICT Administration, or staff.
B. Proposals. Proposal submittals must be received prior to the date and time identified in the
Notice of Invitation. Facsimile (FAX) copies or email copies of the RFP will not be accepted.
The DISTRICT reserves the right to request information for clarification of the information submitted
and request additional information from any firm in determining the most responsive, responsible
proposal that best meets the DISTRICT’s desired services or products.
The DISTRICT reserves the right to conduct discussions with any or all Vendors, but may, at its sole
discretion, elect to conduct interviews with highest ranking firm(s).
C. Accept or Reject Proposal. The DISTRICT reserves the right to accept or reject any or all
proposals or to negotiate with any or all responsible parties submitting a response to this RFP, and to
waive any informality in the RFP process. The cost for developing responses to this RFP are entirely
the responsibility of the firm and shall not be chargeable to DISTRICT.
D. Name and Nature of Proposer’s legal Entity. The proposer(s) shall specify in the proposal
and in the bond, if bond is required, the legal name and nature of its legal entity and any fictitious name
under which it does any business covered by the bond. The bid shall be signed under the correct firm
name by an authorized officer.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 3
E. Tentative Timeline.
RFP Schedule of Events Dates
RFP release date 5/26/2022
NON-MANDATORY Pre-Proposal conference 6/8/2022 at 10:00 AM
Deadline to receive final questions 6/15/2022
Proposal due date 6/29/2022, before 2:01 pm
Evaluation of Proposals 07/01/2022
Interviews (by invitation only) week of 07/11/2022
Anticipated Board Award Date August 24, 2022
F. Withdraw of Proposals. Proposals may be withdrawn by the respondents prior to the time
fixed for the opening of the proposals but may not be withdrawn for a period of ninety (90) days after
the opening of proposals. A successful Firm shall not be relieved of the proposal submitted without
the DISTRICT’s consent or Firm’s recourse to public Contract Code Sections 5100 et. seq.
G. Exceptions. All exceptions which are taken in response to this RFP must be stated clearly. The
failure to identify exceptions/deviations will constitute an acceptance by the Firm of the RFP as
proposed by the DISTRICT. The DISTRICT reserves the right to reject an RFP containing any
deviations, including but not limited to exceptions, additions, qualifiers, or conditions. The taking of
RFP exceptions or providing false, incomplete or unresponsive statements may result in the
disqualification of the proposal. Allowance of exceptions will be determined by the governing board
whose decisions shall be final. Any RFP exceptions or additional conditions requested after RFP
closure, which are not detailed within the RFP response, may result in disqualification of the proposal.
No oral or telegraphic modification of any proposal submitted will be considered and a confirmation
of the telegram duly signed by the Firm was placed in the mail prior to the opening of the RFPs.
H. Report Fraud, Waste, or Abuse. Call the Anti-Fraud Hotline, (559) 325-3200, or by completing
the fraud, waste, or abuse reporting form online at http://www.ppcpas.com/fresno-unified-fraud-alert. The
anti-fraud, waste, or abuse reporting hotline is available to report alleged fraud, waste, or abuse in the
DISTRICT. The responsibility for monitoring the hotline rests with the internal auditor for Fresno Unified
School District, Price, Page & Company. A report may be made anonymously.
I. Prohibited Interests/Conflict of Interest. Vendor/ Firm is responsible for understanding and
ensuring adherence to California Government Code section 1090 et seq., with respect to the
Project. Pursuant to Government Code section 1090, no DISTRICT officers or employees shall be
financially interested in any contract made by them in their official capacity, or by any body or board
of which they are members. Nor shall DISTRICT officers or employees be purchasers at any sale or
Vendors at any purchase made by them in their official capacity. No official or employee of DISTRICT
who is authorized in such capacity and on behalf of DISTRICT to negotiate, make, accept, or approve,
or to take part in negotiating, making, accepting or approving, any architectural, engineering,
inspection, construction or material supply contract or any subcontract in connection with construction
of the Project, shall become, directly or indirectly, financially interested in the Project or in any part
thereof. An officer shall not be deemed to be interested in a contract entered into by the Board if the
officer has only a “remote interest” in the contract (as "remote interest" is defined in Government Code
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 4
section 1091(b)) and if the fact of that interest is disclosed to the Board and noted in its official records,
and thereafter the Board authorizes, approves, or ratifies the contract in good faith by a vote of its
membership sufficient for the purpose without counting the officer’s vote with the remote interest per
Government Code 1091.
J. Anti-discrimination. Fresno Unified School DISTRICT prohibits discrimination,
harassment, intimidation, and bullying based on actual or perceived race, color, ethnicity, national
origin, immigration status, ancestry, age, creed, religion, political affiliation, gender, gender identity,
gender expression, genetic information, mental or physical disability, sex, sexual orientation, marital
status, pregnancy or parental status, medical information, military veteran status, or association with a
person or a group with one or more of these actual or perceived characteristics or any other basis
protected by law or regulation, in its educational program(s) or employment. If you believe you, or
your student, have been subjected to discrimination, harassment, intimidation, or bullying you should
contact your school site principal and/or the DISTRICT’s Chief Compliance and Title IX Officer Paul
Idsvoog, by phone at 559-457-3730, by email at Paul.Idsvoog@fresnounified.org, or in person at 2309
Tulare Street Fresno, CA 93721.
K. Public Records Act. The RFP may be regarded as public records and subject to public records
request in accordance to Government Code 6252 , with the exception of those elements in each
proposal which are defined by the Respondent as business or trade secrets and plainly marked as
“Confidential,” “Trade Secret,” or “Proprietary.” The DISTRICT shall not be liable or in any way
responsible for the disclosure of any such proposal or portions thereof, if they are not plainly marked
as “Confidential,” “Trade Secret,” or “Proprietary” or if disclosure is required under the Public
Records Act. Any proposal which contains language purporting to render all or significant portions
of the proposal “Confidential,” “Trade Secret,” or “Proprietary,” shall be regarded as non-responsive.
Although the California Public Records Act recognizes that certain confidential trade secret
information may be protected from disclosure, the DISTRICT may not be in a position to establish that
the information that a Respondent submits is a trade secret. If a request is made for information marked
“Confidential,” “Trade Secret,” or “Proprietary”, the DISTRICT will provide the Respondent who
submitted the information with reasonable notice to allow the Respondent to seek protection from
disclosure by a court of competent jurisdiction. All information, written, oral, electronic or otherwise
prepared or furnished to the DISTRICT by Respondent shall become the property of the DISTRICT
and may be used as it deems appropriate.
L. Restriction on Disclosure and use of Data. Any portion of the RFP that the Firm considers
confidential or proprietary information, or to contain trade secrets of Firm, must be marked
accordingly. This marking must be explicit as to the designated information. This designation may
not necessarily guarantee the non-release of the information under the Public Information Act or as
otherwise required by law, but does provide the DISTRICT with a means to review the issues
thoroughly and, if justified, request an opinion by the Attorney General's office prior to release of any
information requested under the Public Information Act.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 5
II. GENERAL TERMS AND CONDITIONS
PROPOSALS. To receive consideration, proposals shall be developed in accordance with the
following terms:
A. THE PROPOSAL – If applicable by inclusion of a proposal form, all items on the form
should be stated in figures, and signatures of all individuals must be in long hand. The completed form
should be without interlineations, alterations, or erasures. Unsigned bids will not be accepted.
B. DEFINITIONS – Responsible; a bidding party possessing the skill, judgment, integrity
and financial ability necessary to timely perform and complete the contract being solicited by proposal.
Responsive; a bid which meets all of the specifications set forth in the request for proposal.
C. ACCEPTANCE OR REJECTION OF PROPOSALS – The DISTRICT may
purchase an individual item or combination of items, whichever is in the best interest of the DISTRICT,
provided also that bidder(s) may specify that the DISTRICT’s acceptance of one item shall be
contingent upon the DISTRICT’s acceptance of one or more additional items submitted in the same
proposal. Proposals shall remain open and valid and subject to acceptance for ninety (90) calendar
days after the bid opening.
D. EXECUTION OF CONTRACT – Issuance of a Purchase Order(s) shall evidence the
contractual agreement between the bidder(s) and the DISTRICT and the bidder’s acceptance of these
Bid Instructions and Conditions.
E. DEFAULT BY CONTRACTOR – The DISTRICT shall hold the proposer(s)
responsible for any damage which may be sustained because of failure or neglect to comply with any
terms or conditions listed herein. It is specifically provided and agreed that time shall be of the essence
in meeting the contract delivery requirements. If the successful proposers(s) fails or neglects to furnish
or deliver any of the materials, supplies or services listed herein at the prices named and at the time and
place herein stated or otherwise fails or neglects to comply with the terms of the bid, the DISTRICT
may, upon written notice to the bidder, cancel the contract/purchase order in its entirety or cancel or
rescind any or all items affected by such default, and may, whether or not the contract is cancelled in
whole or in part, purchase the materials, supplies or services elsewhere without further notice to the
proposer. The prices paid by the DISTRICT at the time such purchases are made shall be considered
the prevailing market price. Any extra cost incurred by such default may be collected by the DISTRICT
from the proposer or deducted from any funds due the proposer.
F. COMPREHENSIVE GENERAL LIABILITY AND AUTOMOBILE
INSURANCE – The successful proposer(s) shall maintain insurance adequate to protect him from
claims under Workers’ Compensation Laws and from claims for damages for personal injury, including
death and damage to property, which may arise from bidder’s operations under the contract. The
proposer shall secure and maintain in force during the term of this agreement a comprehensive general
liability and automobile policy utilizing an occurrence policy form, with combined single limits of
One Million Dollars ($1,000,000.00 or ($1,000,000.00) per person, ($1,000,000.00) per accident with
no annual aggregate limit. Property damage limits shall be $500,000 per loss. FRESNO UNIFIED
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 6
SCHOOL DISTRICT, AND ITS EMPLOYEES AND AGENTS shall be named as an additional
insured on the policies by separate endorsement that shall be attached to the contract as proof of
insurance. Insurance Accord shall state “All operations resulting from informally or formally quoted
projects”. Failure to furnish such evidence and insurance, if required, may be considered default by
the bidder(s).
G. INVOICES AND PAYMENTS – Unless otherwise specified, the successful
proposer(s) shall render invoices in duplicate for materials delivered or services performed under the
contract, to the Accounting Department of the DISTRICT, 2309 Tulare Street, Fresno, California,
93721. Invoices shall be submitted under the same firm name as shown on the bid. The successful
Firm(s) shall list separately any taxes PAYABLE BY THE DISTRICT and shall certify on the invoices
that Federal Excise Tax is not included in the prices listed thereon. The DISTRICT shall make payment
for materials, supplies, or services furnished under the contract within a reasonable and proper time
after acceptance thereof and approval of the invoices by the authorized DISTRICT Representative.
H. MISCELLANEOUS PROVISIONS:
A. Assignment of Contracts – The successful Firm shall not assign or transfer by
operation of law or otherwise any or all of its rights, burdens, duties or obligations without the prior
written consent of the DISTRICT.
B. Binding Effect – This Agreement shall inure to the benefit of and shall be binding
upon the Contractor and DISTRICT and their respective successors and assigns.
C. Severability – If any provisions of this agreement shall be held invalid or
unenforceable by a court of competent jurisdiction, such holding shall not invalidate or render
unenforceable any other provisions hereof.
D. Amendments – The terms of this Agreement shall not be waived, altered, modified,
supplemented or amended in any manner whatsoever except by written agreement signed by the
parties.
E. Entire Agreement – This proposal and all attachments thereto constitutes the entire
agreement between the parties. There are no understandings, agreements, representations or
warranties, express or implied, not specified in the Agreement. Proposer, by the execution of his/her
signature on the Proposal Signature Page Form acknowledges that he/she has and read this
Agreement, understands it, and agrees to be bound by its terms and conditions stated in the RFP.
F. Non-Exclusive Contract. Any resultant contract will be awarded with the
understanding and agreement that it is for the sole convenience of the DISTRICT. The DISTRICT
reserves the right to obtain like goods or services from another source when necessary.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 7
G. Hold Harmless Clause – The successful proposer agrees to indemnify, defend and
save harmless Fresno Unified School DISTRICT, its governing board, related divisions and entities,
officers, agents, and employees from and against any and all claims, demands, losses, defense costs,
or liability of any kind or nature which the DISTRICT, it’s officers, agents, and employees may
sustain or injure or which may be imposed upon them for injury to or death of persons, or damage to
property as a result of, arising out of, or in any manner connected with the bidder or bidder’s agents,
employees or subcontractor’s performance under the terms of this contract, expecting only liability
arising out of the sole negligence of the DISTRICT.
H. Law – In the event of any conflict or ambiguity between these instructions and state
or federal law or regulations, the latter shall prevail. Additionally, all equipment to be supplied or
services to be performed under the proposal shall conform to all applicable requirements of local,
state and federal law.
I. Governing Law and Venue – In the event of litigation, the bid documents,
specifications and related matters shall be governed by and construed only in accordance with the
laws of the State of California. Venue shall only be with the appropriate state of federal court located
in Fresno County.
J. Permits and Licenses – The successful proposer(s) and all of his employees or
agents shall secure and maintain in force such licenses and permits as are required by law, in
connection with the furnishing of materials, articles or services herein listed. All operations and
materials shall be in accordance with law.
K. Independent Contractor – While engaged in carrying out and complying with
terms and conditions of the contract, the bidder agrees by his/her signature on the RFP that he/she is
an independent contractor and not an officer, employee or agent of the DISTRICT.
L. Termination without Cause –This Agreement may be terminated by the
DISTRICT upon giving sixty (60) calendar days advance written notice of an intention to terminate.
M. Student Safety (Fingerprinting) – Requirements for Contact with Students:
Vendor shall comply with Education Code section 45125.2 and this Article. DISTRICT Processing
to Department of Justice: If Vendor is required to receive verification for an employee, agent or
subcontractor from the Department of Justice pursuant to this Article or the Education Code, Vendor
will have individual(s) processing submitted through the DISTRICT to the Department of Justice
using the DISTRICT’s fingerprinting hardware and materials. The DISTRICT will charge for such
assistance at its standard rates charged to its own employees. Department of Justice clearance
processed through any other agency will not be accepted by the DISTRICT.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 8
III. SPECIAL TERMS AND CONDITIONS
1) TERM OF CONTRACT. The successful proposer shall be awarded a contract for a period of
three years. The total term of this contract will be September 1, 2022 through August 31, 2025. No extensions
are allowed.
2) PRICING CONDITIONS. For the first calendar year of the Contract, pricing will be fixed
at the proposal pricing. Ninety (90) calendar days prior to the expiration of the fixed pricing term,
the Firm may submit proposed pricing revisions for the following year, which will be subject to
negotiation by Fresno Unified School DISTRICT at the DISTRICTs discretion. The Firm must
provide adequate documentation to substantiate any request for price increase. In addition to
decreasing prices for the balance of the Contract term due to a change in market conditions,
Contractor may conduct sales promotions involving price reductions for a specified lesser period.
Contractor may offer Participating Agencies competitive pricing which is lower than the not-to-
exceed price set forth herein at any time during the Contract term and such lower pricing shall not
be applied as a global price reduction under the Contract.
3) MINIMUM WAGE CONDITION. In the event the Contractor is required by the Federal
Government to increase the minimum wage, then the minimum wage and salary rates paid to the
Contractor employees shall be subject to negotiation between the Contractor and the DISTRICT.
4) EXECUTION OF CONTRACT. A Board approved notification will be issued upon
Fresno USD Board award. Purchase Order(s) issued against the RFP shall be proof of the District
acceptance to Vendor’s/Firm’s offer to provide services to the District per the pricing, and subject
to the terms and conditions of the RFP. Only services listed in submitted fee schedules may be billed
against Purchase orders issued for this RFP.
5) SERVICE ORDERS. The Purchasing Department will issue Blanket Purchase orders on
an as needed basis for services to prequalified Vendors/Firms as requested. If discrepancy exists
between the District issued Purchase Order(s) and the quotation/invoice, the order of precedence
that shall govern all service work, responsibility, and compensation shall be: (1) terms, conditions,
& pricing of the RFP; (2) Purchase Order(s); then (3) the quotation/invoice. The District will not be
responsible for any services that exceed the amount of Purchase Order issued against this RFP
without prior approval from the Purchasing Department.
6) PAYMENT: The Firm must invoice Fresno Unified School District, Contract
Administrator, in order to initiate the payment process. All invoices shall indicate (a) the Bid No.
and (b) the purchase order number and should be emailed to Invoices@fresnounified.org.
The DISTRICT will not approve for payment any fee which is not documented on the Firm’s monthly
statement and there is no support documentation on file with the DISTRICT.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 9
7) CHANGES TO CONTRACT. The DISTRICT reserves the right to add or delete service
and/or sites during the term of the contract. The submitted prices in this RFP will be used to adjust
compensation during the contract period.
8) ALTERNATE PROVIDER OPTION. It is the intent of the DISTRICT to fully utilize the
selected Firm for services listed herein, however the DISTRICT reserves the right to engage
services elsewhere to perform specific services due to negligence in performance at any given site
or if Firm is unable to provide requested staff. Written notice will be provided to the Firm in an
event, which would require exercising this article.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 10
IV. INTRODUCTION
1. National Program
Fresno Unified School District, as the Principal Procurement Agency, defined in APPENDIX 2,
has partnered with OMNIA Partners, Public Sector (“OMNIA Partners”) to make the resultant
contract (also known as the “Master Agreement” in materials distributed by OMNIA Partners)
from this solicitation available to other public agencies nationally, including state and local
governmental entities, public and private primary, secondary and higher education entities,
non-profit entities, and agencies for the public benefit (“Public Agencies”), through OMNIA
Partners’ cooperative purchasing program. Fresno Unified School District is acting as the
contracting agency for any other Public Agency that elects to utilize the resulting Master
Agreement. Use of the Master Agreement by any Public Agency is preceded by their
registration with OMNIA Partners (a “Participating Public Agency”) and by using the Master
Agreement, any such Participating Public Agency agrees that it is registered with OMNIA
Partners, whether pursuant to the terms of a Master Intergovernmental Cooperative Purchasing
Agreement, a form of which is attached hereto on APPENDIX 2, or as otherwise agreed to.
APPENDIX 2 contains additional information about OMNIA Partners and the cooperative
purchasing program.
OMNIA Partners is the largest and most experienced purchasing organization for public and
private sector procurement. Through the economies of scale created by OMNIA Partners
public sector subsidiaries and affiliates, National IPA and U.S. Communities, our participants
now have access to more competitively solicited and publicly awarded cooperative agreements.
The lead agency contracting process continues to be the foundation on which we are founded.
OMNIA Partners is proud to offer more value and resources to state and local government,
higher education, K-12 education and non-profits.
OMNIA Partners provides shared services and supply chain optimization to government,
education and the private sector. With corporate, pricing and sales commitments from the
Supplier, OMNIA Partners provides marketing and administrative support for the Supplier that
directly promotes the Supplier’s products and services to Participating Public Agencies through
multiple channels, each designed to promote specific products and services to Public Agencies
on a national basis. Participating Public Agencies benefit from pricing based on aggregate
spend and the convenience of a contract that has already been advertised and publicly
competed. The Supplier benefits from a contract that generally allows Participating Public
Agencies to directly purchase goods and services without the Supplier’s need to respond to
additional competitive solicitations. As such, the Supplier must be able to accommodate a
nationwide demand for services and to fulfill obligations as a nationwide Supplier and respond
to the OMNIA Partners documents (APPENDIX 2).
Fresno Unified School District anticipates spending approximately $10 million over the full
potential Master Agreement term for Cleaning Supplies, Equipment and Custodial Related
Services and Solutions. While no minimum volume is guaranteed to the Supplier, the estimated
annual volume of Cleaning Supplies, Equipment and Custodial Related Services and Solutions
purchased under the Master Agreement through OMNIA Partners is approximately $250
Million. This projection is based on the current annual volumes among the Fresno Unified
School District, other Participating Public Agencies anticipated to utilize the resulting Master
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 11
Agreement to be made available to them through OMNIA Partners, and volume growth into
other Public Agencies through a coordinated marketing approach between the Supplier and
OMNIA Partners
2. Desired Services
Fresno Unified School District, CA (herein “Lead Public Agency”) on behalf of itself and all
states, local governments, school districts, and higher education institutions in the United
States of America, and other government agencies and nonprofit organizations (herein
“Participating Public Agencies”) is soliciting proposals from qualified suppliers to enter into a
Master Agreement for a complete line of Cleaning Supplies, Equipment and Custodial Related
Products, Services and Solutions. Pricing for complete product offering/balance of line items
will be determined by a percentage discount off the Supplier’s manufactures suggested retail
price list. The pricing percentage discount offered must be entered in a Complete Product
Offering/Balance of Line section in the Supplier’s response to the Pricing section of the
Proposal Evaluation Criteria Requirements.
Fresno Unified School District (District) is a K-12 public school system, including an Adult
Education program. There are approximately 100 different school sites plus an additional 30
administrative support facilities. It is the third largest school district in California, with a student
population of approximately 74,000 average daily attendance, and approximately 10,000
employees, located in Fresno, CA.
3. Scope of Work
This Solicitation is to establish a nationwide master agreement for the acquisition of the
following products listed below. The category descriptive examples below are not to be
considered restrictive, but rather, provide a general, non-inclusive, description of the category.
The intent is for each Supplier to submit their complete line of Cleaning Supplies, Equipment
and Custodial Related Products, Services and Solutions so that Participating Public Agencies
may order a wide array of products, services and solutions as appropriate for their needs. Refer
to and complete Attachment #2 Sample Pricing Document for Evaluation with the following
categories;
Cleaning Supplies
CHEMICALS
Air care and odor control, carpet care chemicals, chemical management systems,
disinfectants/pest control, floor care chemicals, general purpose chemicals, glass
cleaners, industrial and bench maintenance chemicals, institutional products,
polishes, restroom cleaners, specialty chemicals, and other miscellaneous cleaning
chemicals.
SKIN CARE
Liquid soap, paste soap, foam soap, hand sanitizer, antibacterial wash, general skin
and body cleanser, and dispensers.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 12
PAPER TOWELS/TISSUES/WIPERS/ DISPENSERS
Facial tissue, seat covers, toilet tissue, towels, wipers, and dispensers.
CLEANING TOOLS AND SUPPLIES
Brooms and dust pans, brushes, dispensing equipment, floor and hand pads,
material handling, mopping supplies, feminine hygiene, squeegee, gloves, dust
masks, shoe covers, disposable aprons, hair covers, safety treads, goggles, signs,
barriers and scrapers.
WASTE CONTAINMENT AND SUPPLIES
Can liners, hazardous materials containment bags, waste receptacles, recycling
containers, trash pickers and dollies.
MISCELLANEOUS CLEANING SUPPLIES
Air Quality Controls including air filters, HVAC, air purifiers and any additional
cleaning supplies offered by Vendor/ Firm.
Cleaning and Maintenance Equipment
A complete selection of outdoor cleaning equipment, walk-behind scrubbers, rider
scrubbers, scrubber-sweepers, rider sweepers, walk-behind sweepers and floor
machines, burnishers, carpet extractors, vacuums, and any other cleaning and
maintenance equipment offered by Supplier.
Complete Product Offering/Balance of Line
Each offeror awarded an item under this solicitation may offer their complete product and service
offering/a balance of line for cleaning supplies, equipment and custodial related products, services
and solutions. Pricing for complete product offering/balance of line items will be determined by a
percentage discount off the offeror’s retail price list. The pricing percentage discount offered must
be entered on the Price Schedule in the Complete Product Offering/Balance of Line section/in the
offeror’s response to the Price Proposal section of the Proposal Evaluation Requirements. The District
reserves the right to accept or reject any or all balance of line items offered.
The District makes no guarantee of annual spend with this RFP.
The contract term shall be for a 3-year term. Pricing will be fixed for the first 12-months with an
option to increase/decrease pricing annually. Written requests for price adjustments must be received
in Fresno Unified Purchasing Department prior to 90-calendar days of Board award anniversary
date. Requests for price adjustments must be supported by justification. The District reserves the
right to accept or reject price adjustments and remove a Firm from prequalified status for any reason
that are in the best interest of the District. Price adjustments must be approved by the Executive
Director of Purchasing.
In fulfilling its duties under the contract, the vendor and all its personnel will be required to comply
with all laws, policies, rules and regulations promulgated by all governmental authorities having
jurisdiction over vendor and its personnel, including but not limited to the Department of Consumer
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 13
Affairs of the State of California. It will be vendors obligation to determine which laws, policies,
rules and regulations apply to its conduct, and any failure to comply will be considered a material
breach of the contract and grounds for its termination at the District's option.
V. RFP SUBMITTAL FORMAT
Proposer’s RFP submittal shall include the information/documentation addressing each of
the minimum requirements outlined in Section VII, EVALUATION CRITERIA.
All proposals shall include the forms listed on the SUBMITTAL CHECK LIST. Failure to
submit the documents/forms may render the proposal non-responsive.
PROPOSAL CONTENTS
To assist in the evaluation of proposals resulting from this RFP, it is requested that each proposal
be written in a concise and forthright manner and the unnecessary marketing statements and
materials be avoided. The proposal shall consist of the sections outlined and organized in the
manner set forth below, separated, and appropriately titled. Responses for each proposal section
and requirement listed below must be clearly stated. Any additional relevant information may be
placed in appendices.
Cover Letter
The proposer shall provide a cover letter describing a brief history of the Proposer and its
organization. The letter will list the Principal or Officer of the organization who will be Fresno
Unified’s primary point of contact during clarifications or negotiations. This individual must have
the authority to clarify and/or negotiate all aspects on the scope of products and services on behalf
of the Proposer. An officer authorized to bind the Proposer to the terms and conditions of this RFP
must sign the cover letter.
Executive Summary
The Proposer shall provide an Executive Summary that presents in brief, concise terms a summary
level description of the contents of the proposal.
Company Background/Profile
Provide information on company background to include the following:
1. Legal name, address, phone and fax numbers, e-mail, Federal ID#, and website
address.
2. Date business was established under current name.
3. Size of company including the total number of employees
4. Type of ownership or legal structure of business
5. Has the company ever failed to complete work for which a contract was issued? If
yes, explain the circumstances.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 14
6. Are there any civil or criminal actions pending against the firm, or any key
personnel related in any way to contracting? If yes, explain in detail. Are there any
current unresolved disputes/allegations?
7. Has the firm ever been disqualified from working for any public entity? If yes,
explain the circumstances.
Experience
Include a list of the five (5) most relevant or comparable contracts completed by your firm during
the past five (5) years with a public entity. For each contract, provide the following information.
1. Scope of services/contract description.
2. Dollar value of contract.
3. Assigned project personnel.
4. The contracting entity’s contact person, current phone number, and current e-mail
address as reference information.
Product Information/Service Capability
1. Provide available ordering methods – online ordering, order tracking, search
options, order history, etc.
2. Provide available payment terms and payment methods – purchase order, credit
card (procurement card), etc. If credit cards are accepted, may credit card
payment(s) be made online?
3. In addition to new products, indicate if used, trade-ins, leasing/financing, or other
offerings are available, and provide pricing structure for each of these items.
4. If an Offeror requires additional agreements, a copy of the proposed agreement
must be included with the proposal
Pricing
Suppliers shall fill out and return Attachment # 2 Sample Pricing Form for Evaluation
(located in documents on Procureware) which includes the catalog price and % discount on the top
items used by the district. Supplier shall fill in all the tabs, one for each category noted under
Scope of Work above. There is an area for an alternate product number and description. In
addition, suppliers shall provide pricing based on a discount from a manufacturer’s price list or
vendor catalog and title the pdf Exhibit 1 (see below items to be included). Prices listed will be
used to establish the extent of a manufacturer’s product lines, services, warranties, etc. that are
available from Supplier and the pricing per item. Multiple percentage discounts are acceptable, if
where different percentage discounts apply, different percentages are specified. Additional pricing
and/or discounts may be included. The discount proposed shall remain the same throughout the
term of the contract and at all renewal options. At a minimum, the Contractor must hold the
proposed price list firm for the first 12 months after the contract award. Include an electronic copy
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 15
of your price catalog from which discount is calculated. Title the pdf Exhibit 1. Electronic price
lists must contain the following: (if applicable)
1. Manufacturer part #
2. Supplier’s Part # (if different from manufacturer part #)
3. Description
4. Manufacturer’s Suggested List Price and Net Price
5. Net price to Fresno Unified, (net price shall include freight and any additional fees
that may be charged such as credit card processing, administrative fees, etc.)
6. Provide details of and propose additional discounts for volume orders, special
manufacturer’s offers, minimum order quantity, free goods programs, total annual
spend, etc. (if offered).
7. If leasing/financing is an option, provide applicable pricing and discounts.
Due to products and services potentially being used in response to an emergency or disaster
recovery situation in which federal funding may used, provide alternative pricing that does
not include cost plus a percentage of cost or pricing based on time and materials; if time and
materials is necessary, a ceiling price that the contract exceeds at its own risk will be needed.
Products and services provided in a situation where an agency is eligible for federal funding,
Offeror is subject to and must comply with all federal requirements applicable to the funding
including, but not limited to the FEMA Special Conditions section located in the Federal
Funds Certifications Exhibit.
National Contract
Include a detailed response to Appendix 2, Attachment 1, Exhibit A, OMNIA Partners
Response for National Cooperative Contract. Responses shall highlight experience, demonstrate a
strong national presence, describe how Supplier will educate its national sales force about the
contract, describe how products and services will be distributed nationwide, include a plan for
marketing the products and services nationwide, and describe how volume will be tracked and
report to OMNIA Partners.
The successful Supplier will be required to sign Attachment 1, Exhibit B, OMNIA Partners
Administration Agreement, Suppliers shall have any reviews required to sign the document prior
to submitting a response. Supplier’s response shall include any proposed exceptions to the OMNIA
Partners Administration Agreement.
VI. EVALUATION AND AWARD
The method used for evaluating and awarding this RFP will involve a two (2) step process:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS,
SERVICES AND SOLUTIONS Page 16
Step 1: The committee will evaluate submitted proposals. The proposal that is deemed to be
responsive, compliant, and capable of meeting the DISTRICT’s needs, and scores the highest points
based on the evaluation criteria stated in the proposal, will be approved to move forward to step
two.
i. The DISTRICT reserves the right to conduct interviews of proposers with the highest scores.
No firm will be by-passed for a firm with a lower score. If necessary, the interviews will be
held between 07/11/2022-07/15/2022
ii. If interviews are held, the Committee will select by consensus the most responsible,
responsive Proposer that best meets the needs of the DISTRICT.
Step 2: If necessary, negotiations will begin with the highest ranked Proposer. If a mutually
acceptable agreement cannot be reached, negotiations with that Proposer will be formally closed and
negotiations will be opened with the next most responsible, responsive Proposer, and so on until an
agreement can be reached.
VII. EVALUATION CRITERIA
Proposals will be evaluated based on information presented in the proposal package and on an
analysis of any other available information. Fresno Unified may conduct such investigations or
interviews as it deems necessary to assist in the evaluation of any proposal submitted and to
establish to the district’s satisfaction the qualifications of any Proposer.
Proposal will be evaluated based on the following criteria:
a. Relevant Experience/Performance including References. Experiences with Fresno
Unified that evaluation committee members represent may be taken into consideration when
evaluating qualifications and experience. (25 points available)
b. Product Information/Service Capability Options/Variety/Availability and Service
Capability (25 points available)
c. Pricing Appendix 3 Pricing Schedule. (25 points available)
d. Response to the National Program (including detailed response to Attachment #1,
Requirements for National Cooperative Contract to be Administered by OMNIA Partners, Public
Sector) (25 points available)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 17
SUBMITTAL CHECK LIST
The listed documents below are required to be provided as part of your submittal
APPENDIX 1- General Forms
a) Proposal Signature Page
b) Prime Point of Contact
c) Non-Collusion Declaration
d) No Prohibited Interest/Conflicts of Interest Declaration
e) Notification of Governor’s Executive Order N-6-22/ Russian Sanctions
f) Debarment, Suspension, and Other Responsibility Matters
g) Request for References
h) Iran Contracting Act Certification
i) Certification Regarding Lobbying
iii. Disclosure of Lobbying Activities
iv. Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities
APPENDIX 2 – Proposal Forms
Attachment #1 – Requirements for National Cooperative Contract to be administered by OMNIA Partners
Attachment #2 - Sample Pricing for Evaluation- Excel Spreadsheet located in documents on Procureware
Exhibit #1- Pricing Schedule– discount from a manufacturer’s price list or vendor catalog (electronic copy from catalog)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 18
APPENDIX 1
GENERAL FORMS
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 19
PROPOSAL SIGNATURE PAGE FORM
The undersigned, having carefully examined the RFP and all addenda, proposes and agrees to be bound
by all terms and conditions of the complete Contract Documents. I have thoroughly reviewed the
Pricing Sheet for RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL
RELATED PRODUCTS, SERVICES AND SOLUTIONS submitted herewith and agree to provide
products consistent with the terms of the RFP at the prices identified on the Pricing Sheet.
"I declare under penalty of perjury under the laws of the State of California that the foregoing is true
and correct."
To be signed by authorized company agent acknowledging submittal of RFP. Prices should be typed
and shown as instructed on the Proposal Pricing form for each type of service. Errors may be crossed
off and corrections made prior to RFP opening only and must be initialed in ink by the person signing
this form.
______________________________ ______________________________
Signature/Title Area Code / Telephone Number
______________________________ ______________________________
Type or Print Name Area Code / Fax Number
______________________________ ______________________________
Name of Company as Licensed E-Mail Address
______________________________ ______________________________
Address
_____________________________
City State Zip Code
The receipt of the following addenda to the specifications is acknowledged:
Addendum No.___ Date__________ Addendum No.____ Date__________
Addendum No.___ Date__________ Addendum No.____ Date__________
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 20
PRIME POINT OF CONTACT
RFP No. 22-07
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED
PRODUCTS, SERVICES AND SOLUTIONS
Name of Company Address
Signature City State Zip Code
Print Name Phone Number Fax Number
Title Email Address
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 21
NONCOLLUSION DECLARATION
I, , declare that I am the party making the foregoing proposal, that the proposal
is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association,
organization, or corporation; that the proposal is genuine and not collusive or sham; that the proponent
has not directly or indirectly induced or solicited any other proponent to put in a false or sham proposal
and has not directly or indirectly colluded, conspired, connived, or agreed with any proponent or anyone
else to put in a sham proposal, or that anyone shall refrain from responding; that the proponent has not
in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone
to fix any overhead, profit, or cost element of the proposal price, or of that of any other proponent, or to
secure any advantage against the public body awarding the Contract of anyone interested in proposed
Contract; that all statements contained in the proposal are true, and, further, that the proponent has not,
directly or indirectly, submitted his or her proposal price of any breakdown thereof, or the contents
thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any
corporation, partnership, company association, organization, bid depository, or to any member or agent
thereof to effectuate a collusive or sham bid.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and
correct.
___________________________________________
Date
___________________________________________
Name of Firm
___________________________________________
Printed name of Authorized Company Representative
___________________________________________
Signature of Authorized Company Representative
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 22
NO PROHIBITED INTEREST/CONFLICTS OF INTEREST DECLARATION
I hereby certify and declare that the undersigned Bidder has reviewed and understands the Information
to Bidders, Prohibited Interests/Conflicts of Interest clause, and that Bidder has no business relationship
with any member of the Board of Education (“BOE”) that gives any BOE member a financial interest in
any contract between Bidder and the DISTRICT, other than a financial interest that qualifies as a “remote
interest” or a “noninterest,” and that no Prohibited Interests/Conflicts of Interest exist which violate this
clause of the Information to Bidders and thereby preclude Bidder from contracting with the Fresno
Unified School DISTRICT. Bidder further understands that the provision of a bid/quote to Bidder over
5 years prior to a BOE member’s election or appointment, without the goods or services included in the
bid actually being furnished to Bidder, i.e., an unaccepted bid/quote, does not qualify to cause a financial
interest to be a “remote interest” as that term is defined in California Government Code section
1091(b)(8).
Consistent with the foregoing and with the clause of the Information to Bidders relating to Prohibited
Interests/Conflicts of Interest, Bidder understands that if Bidder is awarded the contract for this Project
and a Prohibited Interests/Conflict of Interest is thereafter discovered which violates the clause of the
Information to Bidders, Prohibited Interests/Conflicts of Interest, the contract between Bidder and Fresno
Unified School DISTRICT may be void, and in such event Bidder may be required to disgorge all monies
received pursuant to such void contract.
I declare under penalty of perjury under the laws of the State of California that 1) Bidder has reviewed
all necessary documents and exercised all due diligence in determining that no Prohibited
Interests/Conflicts of Interest exist as set forth above and as described in the clause of the Information to
Bidders relating to Prohibited Interests/Conflicts of Interest, with respect to the undersigned Bidder, 2)
I am authorized by Bidder to execute this form on Bidder’s behalf and to make the certifications contained
herein, and 3) the representations and certifications set forth herein are true and correct.
Dated:____________________, 2022 ________________________________________
[Company Name]
________________________________________________
[Name and Title of Bidder’s Representative]
________________________________________________
[Signature]
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 23
Notification of Governor's Executive Order N-6-22/ Russian Sanctions
RE: Contractor and Grantee Compliance with Economic Sanctions Imposed in Response
to Russia’s Actions in Ukraine
On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions in response
to Russian aggression in Ukraine. The EO is located at https:// www.gov.ca.gov/wp-
content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf.
The EO directs all agencies and departments that are subject to the Governor’s authority to take certain immediate
steps, including notifying all contractors and grantees of their obligations to comply with existing economic
sanctions imposed by the U.S. government in response to Russia's actions in Ukraine, as well as any sanctions
imposed under state law.
This correspondence serves as a notice under the EO that as a contractor or grantee, compliance with the economic
sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to,
the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury
website (https:// home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-
information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants,
as applicable.
For any agreements valued at $5 million or more, Contractor shall, within 45 days of receipt of Notice to Proceed,
report in writing to District on steps Contractor has taken to comply with California Executive Order N-6-22, signed
March 4, 2022, and with Federal Executive Order 14065, signed February 21, 2022, including but not limited to,
desisting from making new investments in, or engaging in financial transactions with, Russian entities.
Thank you for your prompt attention to the above matter. Please feel free to contact the District if you have any
questions.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 24
Debarment, Suspension, and Other Responsibility Matters
As required by Executive Order 12549, Debarment and Suspension, for participants or Vendors in primary covered
transactions:
5.The participant or Vendor certifies that it and its principals:
1.2 Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any federal department or agency;
1.2 Have not within a three-year period preceding this application 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 of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, or receiving stolen property;
1.2 Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(federal, state, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this
certification; and
1.2 Have not within a three-year period preceding this application had one or more public transactions
(federal, state, or local) terminated for cause or default.
6.Where the participant or Vendor is unable to certify to any of the statements in this certification, he or she
shall attach an explanation to this application.
________________________________________________________________
Participant or Vendor Company Name
________________________________________________________________
Award Number, Contract Number, or Project Name
________________________________________________________________
Name(s) and Title(s) of Authorized Representatives
________________________________________________________________ ______________________________
Signature(s) Date
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 25
REQUEST FOR REFERENCES
All Proposers shall submit with their proposal at least three (3) previous jobs of similar scope and size in
the last five years. They must include a contact name and phone number for verification purposes. Failure
to provide reference may result in your bid being determined non-responsive.
1. Name of Reference Contact Person
Address Phone
Contract Period: _____________________________
Scope of Work:
2. Name of Reference Contact Person
Address Phone
Contract Period:
Scope of Work:
3. Name of Reference Contact Person
Address Phone
Contract Period:
Scope of Work:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 26
IRAN CONTRACTING ACT CERTIFICATION
Public Contract Code Sections 2202-2208
Pursuant to Public Contract Code 2204. (a) A public entity shall require a person that submits a bid or proposal to, or otherwise
proposes to enter into or renew a contract with, a public entity with respect to a contract for goods or services of one million
dollars ($1,000,000) or more to certify, at the time the bid is submitted or the contract is renewed, that the person is not
identified on a list created pursuant to subdivision (b) of Section 2203 as a person engaging in investment activities in Iran
described in subdivision (a) of Section 2202.5, or as a person described in subdivision (b) of Section 2202.5, as applicable.
To comply with this requirement, please insert your company/entity and Federal ID Number (if available) and complete one
of the options below. Please note: California law establishes penalties for providing false certifications, including civil
penalties equal to the greater of $250,000 or twice the amount of the contract for which the false certification was made;
contract termination; and three-year ineligibility to bid on contracts in accordance with Public Contract Code section 2205.
OPTION 1 - CERTIFICATION
I, the official named below, certify I am duly authorized to execute this certification on behalf of the company/entity identified
below, and the company/entity identified below is not on the current list of persons engaged in investment activities in Iran
created by DGS and is not a financial institution extending twenty million dollars ($20,000,000) or more in credit to another
person or entity, for 45 days or more, if that other person or company/entity will use the credit to provide goods or services in
the energy sector in Iran and is identified on the current list of persons engaged in investment activities in Iran created by DGS
in accordance with subdivision (b) of Public Contract Code 2203.
Company Name/Financial Institution (Printed) Federal ID Number (or n/a)
By (Authorized Signature)
Printed Name and Title of Person Signing
Date Executed
Executed in the County of _____________________________
in the State of __________________________________
OPTION 2 – EXEMPTION
Pursuant to Public Contract Code sections 2203(c) and (d), a public entity may permit a Firm/financial institution engaged in
investment activities in Iran, on a case-by-case basis, to be eligible for, or to bid on, submit a proposal for, or enters into or
renews, a contract for goods and services.
If you have obtained an exemption from the certification requirement under the Iran Contracting Act, please fill out the
information below, and attach documentation demonstrating the exemption approval.
Firm Name/Financial Institution (Printed) Federal ID Number (or n/a)
By (Authorized Signature)
Printed Name and Title of Person Signing Date Executed
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 27
Certification Regarding Lobbying
The undersigned certifies, to the best of his or her knowledge and belief, 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 any agency, a Member of Congress, 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, an 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 of Lobbying Activities," in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award documents of 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. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, United States Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
Organization:
Street address: ________________________________________________________
City, State, Zip:
_______________________________________________________________________
CERTIFIED BY: (type or print)
TITLE:
(Signature) (Date)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 28
Approved by OMB 0348-0046
Disclosure of Lobbying Activities
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 (See reverse for public burden
disclosure)
f Federal Action:
1. contract
b. grant
cooperative agreement
loan
loan guarantee
loan insurance
Status of Federal Action:
bid/offer/application
b. initial award
c. post-award
Report Type:
initial filing
b. material change
For material change only:
Year______Quarter_____Date of last report
4. Name and Address of Reporting Entity:
Prime Subawardee
Tier , if Known:
Congressional District, if known:
If Reporting Entity in No. 4 is Subawardee, Enter Name and
Address of Prime:
Congressional District, if known:
6. Federal Department/Agency: 7. Federal Program Name/Description:
CFDA Number, if applicable:
8. Federal Action Number, if known: 9. Award Amount, if known:
$
10. a. Name and Address of Lobbying Registrant
(if individual, last name, first name, MI):
b. Individuals Performing Services (including address if
different from No. 10a)
(last name, first name, MI):
11. Information requested through this form is authorized
by title 31 U.S.C. section 1352. This disclosure of lobbying
activities is a material representation of fact upon which
reliance was placed by the tier above when this
transaction was made or entered into. This disclosure is
required pursuant to 31
U.S.C. 1352. This information will be reported to the
Congress semi-annually and will be available for public
inspection. Any person who fails to file the required
disclosure shall be subject to a civil penalty of not less
than $10,000 and not more than $100,000 for each such
failure.
Signature: Print
Name: Title:
Telephone No.: Date:
Federal Use Only
Authorized for Local Reproduction Standard Form - LLL
(Rev. 7-97)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 29
INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation
or receipt of a covered Federal action, or a material change to a previous filing, pursuant to Title 31, U.S.C. section 1352. The
filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting
to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with a covered Federal action. Complete all items that apply for both the initial filing
and material change report. Refer to the implementing guidance published by the Office of Management and Budget for
additional information.
1 Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered
Federal action.
2 Identify the status of the covered Federal action.
3 Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously
reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this
reporting entity for this covered Federal action.
4 Enter the full name, address, city, State and zip code of the reporting entity. Include Congressional District, if known. Check the
appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier
of the subawardee, e.g., the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts,
subgrants and contract awards under grants.
5 If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, State and zip code of the
prime Federal recipient. Include Congressional District, if known.
6 Enter the name of the federal agency making the award or loan commitment. Include at least one organizational level below agency
name, if known. For example, Department of Transportation, United States Coast Guard.
7 Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal
Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.
8 Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal
(RFP) number; Invitations for Bid (IFB) number; grant announcement number; the contract, grant, or loan award number; the
application/proposal control number assigned by the Federal agency). Included prefixes, e.g., “RFP-DE-90-001.”
9 For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of
the award/loan commitment for the prime entity identified in item 4 or 5.
10 (a) Enter the full name, address, city, State and zip code of the lobbying registrant under the Lobbying Disclosure Act of 1995
engaged by the reporting entity identified in item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services and include full address if different from 10(a). Enter Last Name, First
Name, and Middle Initial (MI).
11.The certifying official shall sign and date the form, print his/her name, title, and telephone number.
According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays
a valid OMB control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden
for this collection of information is estimated to average 10 minutes per response, including time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments
regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the
Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, DC 20503
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
RFP No. 22-07, CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS, SERVICES AND
SOLUTIONS Page 30
APPENDIX 2
PROPOSAL FORMS
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
ATTACHMENT #1
Requirements for National Cooperative Contract To Be Administered by OMNIA Partners
The following documents are used in evaluating and administering national cooperative contracts
and are included for Supplier’s review and response.
Exhibit A – Response for National Cooperative Contract
Exhibit B – Administration Agreement, Example
Exhibit C – Master Intergovernmental Cooperative Purchasing Agreement, Example
Exhibit D – Principal Procurement Agency Certificate, Example
Exhibit E – Contract Sales Reporting Template
Exhibit F – Federal Funds Certifications
Exhibit G – New Jersey Business Compliance
Exhibit H – Advertising Compliance Requirement
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Exhibit A
Response for National Cooperative Contract
1.0 Scope of National Cooperative Contract
Capitalized terms not otherwise defined herein shall have the meanings given to them in the
Master Agreement or in the Administration Agreement between Supplier and OMNIA
Partners.
1.1 Requirement
The Fresno Unified School District (hereinafter defined and referred to as “Principal
Procurement Agency”), on behalf of itself and the National Intergovernmental
Purchasing Alliance Company, a Delaware corporation d/b/a OMNIA Partners, Public
Sector (“OMNIA Partners”), is requesting proposals for Cleaning Supplies,
Equipment and Custodial Related Products, Services and Solutions. The intent of this
Request for Proposal is any contract between Principal Procurement Agency and
Supplier resulting from this Request for Proposal (“Master Agreement”) be made
available to other public agencies nationally, including state and local governmental
entities, public and private primary, secondary and higher education entities, non-
profit entities, and agencies for the public benefit (“Public Agencies”), through
OMNIA Partners’ cooperative purchasing program. The Principal Procurement
Agency has executed a Principal Procurement Agency Certificate with OMNIA
Partners, an example of which is included as Exhibit D, and has agreed to pursue the
Master Agreement. Use of the Master Agreement by any Public Agency is preceded
by their registration with OMNIA Partners as a Participating Public Agency in
OMNIA Partners’ cooperative purchasing program. Registration with OMNIA
Partners as a Participating Public Agency is accomplished by Public Agencies entering
into a Master Intergovernmental Cooperative Purchasing Agreement, an example of
which is attached as Exhibit C, and by using the Master Agreement, any such
Participating Public Agency agrees that it is registered with OMNIA Partners, whether
pursuant to the terms of the Master Intergovernmental Purchasing Cooperative
Agreement or as otherwise agreed to. The terms and pricing established in the
resulting Master Agreement between the Supplier and the Principal Procurement
Agency will be the same as that available to Participating Public Agencies through
OMNIA Partners.
All transactions, purchase orders, invoices, payments etc., will occur directly between
the Supplier and each Participating Public Agency individually, and neither OMNIA
Partners, any Principal Procurement Agency nor any Participating Public Agency,
including their respective agents, directors, employees or representatives, shall be
liable to Supplier for any acts, liabilities, damages, etc., incurred by any other
Participating Public Agency. Supplier is responsible for knowing the tax laws in each
state.
This Exhibit A defines the expectations for qualifying Suppliers based on OMNIA
Partners’ requirements to market the resulting Master Agreement nationally to Public
Agencies. Each section in this Exhibit A refers to the capabilities, requirements,
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
obligations, and prohibitions of competing Suppliers on a national level in order to
serve Participating Public Agencies through OMNIA Partners.
These requirements are incorporated into and are considered an integral part of this
RFP. OMNIA Partners reserves the right to determine whether to make the Master
Agreement awarded by the Principal Procurement Agency available to Participating
Public Agencies, in its sole and absolute discretion, and any party submitting a
response to this RFP acknowledges that any award by the Principal Procurement
Agency does not obligate OMNIA Partners to make the Master Agreement available
to Participating Procurement Agencies.
1.2 Marketing, Sales and Administrative Support
During the term of the Master Agreement OMNIA Partners intends to provide
marketing, sales, partnership development and administrative support for Supplier
pursuant to this section that directly promotes the Supplier’s products and services to
Participating Public Agencies through multiple channels, each designed to promote
specific products and services to Public Agencies on a national basis.
OMNIA Partners will assign the Supplier a Director of Partner Development who will
serve as the main point of contact for the Supplier and will be responsible for managing
the overall relationship between the Supplier and OMNIA Partners. The Director of
Partner Development will work with the Supplier to develop a comprehensive strategy
to promote the Master Agreement and will connect the Supplier with appropriate
stakeholders within OMNIA Partners including, Sales, Marketing, Contracting,
Training, and Operations & Support.
The OMNIA Partners marketing team will work in conjunction with Supplier to
promote the Master Agreement to both existing Participating Public Agencies and
prospective Public Agencies through channels that may include:
A. Marketing collateral (print, electronic, email, presentations)
B. Website
C. Trade shows/conferences/meetings
D. Advertising
E. Social Media
The OMNIA Partners sales teams will work in conjunction with Supplier to promote
the Master Agreement to both existing Participating Public Agencies and prospective
Public Agencies through initiatives that may include:
A. Individual sales calls
B. Joint sales calls
C. Communications/customer service
D. Training sessions for Public Agency teams
E. Training sessions for Supplier teams
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
The OMNIA Partners contracting teams will work in conjunction with Supplier to
promote the Master Agreement to both existing Participating Public Agencies and
prospective Public Agencies through:
A. Serving as the subject matter expert for questions regarding joint powers authority
and state statutes and regulations for cooperative purchasing
B. Training sessions for Public Agency teams
C. Training sessions for Supplier teams
D. Regular business reviews to monitor program success
E. General contract administration
Suppliers are required to pay an Administrative Fee of 3% of the greater of the
Contract Sales under the Master Agreement and Guaranteed Contract Sales under this
Request for Proposal. Supplier will be required to execute the OMNIA Partners
Administration Agreement (Exhibit B).
1.3 Estimated Volume
The dollar volume purchased under the Master Agreement is estimated to be
approximately $250 million annually. While no minimum volume is guaranteed to
Supplier, the estimated annual volume is projected based on the current annual
volumes among the Principal Procurement Agency, other Participating Public
Agencies that are anticipated to utilize the resulting Master Agreement to be made
available to them through OMNIA Partners, and volume growth into other Public
Agencies through a coordinated marketing approach between Supplier and OMNIA
Partners.
1.4 Award Basis
The basis of any contract award resulting from this RFP made by Principal
Procurement Agency will, at OMNIA Partners’ option, be the basis of award on a
national level through OMNIA Partners. If multiple Suppliers are awarded by
Principal Procurement Agency under the Master Agreement, those same Suppliers will
be required to extend the Master Agreement to Participating Public Agencies through
OMNIA Partners. Utilization of the Master Agreement by Participating Public
Agencies will be at the discretion of the individual Participating Public Agency.
Certain terms of the Master Agreement specifically applicable to the Principal
Procurement Agency (e.g., governing law) are subject to modification for each
Participating Public Agency as Supplier and such Participating Public Agency may
agree without being in conflict with the Master Agreement as a condition of the
Participating Agency’s purchase and not a modification of the Master Agreement
applicable to all Participating Agencies. Participating Agencies may request to enter
into a separate supplemental agreement to further define the level of service
requirements over and above the minimum defined in the Master Agreement (e.g.,
governing law, invoice requirements, order requirements, specialized delivery,
diversity requirements such as minority and woman owned businesses, historically
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
underutilized business, etc.) (“Supplemental Agreement”). It shall be the
responsibility of the Supplier to comply, when applicable, with the prevailing wage
legislation in effect in the jurisdiction of the Participating Agency. It shall further be
the responsibility of the Supplier to monitor the prevailing wage rates as established
by the appropriate department of labor for any increase in rates during the term of the
Master Agreement and adjust wage rates accordingly. In instances where
supplemental terms and conditions create additional risk and cost for Supplier,
Supplier and Participating Public Agency may negotiate additional pricing above and
beyond the stated contract not-to-exceed pricing so long as the added price is
commensurate with the additional cost incurred by the Supplier. Any supplemental
agreement developed as a result of the Master Agreement is exclusively between the
Participating Agency and the Supplier (Contract Sales are reported to OMNIA
Partners).
All signed Supplemental Agreements and purchase orders issued and accepted by the
Supplier may survive expiration or termination of the Master Agreement. Participating
Agencies’ purchase orders may exceed the term of the Master Agreement if the
purchase order is issued prior to the expiration of the Master Agreement. Supplier is
responsible for reporting all sales and paying the applicable Administrative Fee for
sales that use the Master Agreement as the basis for the purchase order, even though
Master Agreement may have expired.
1.5 Objectives of Cooperative Program
This RFP is intended to achieve the following objectives regarding availability through
OMNIA Partners’ cooperative program:
I. Provide a comprehensive competitively solicited and awarded national agreement
offering the Products covered by this solicitation to Participating Public Agencies;
J. Establish the Master Agreement as the Supplier’s primary go to market strategy to
Public Agencies nationwide;
K. Achieve cost savings for Supplier and Public Agencies through a single solicitation
process that will reduce the Supplier’s need to respond to multiple solicitations and
Public Agencies need to conduct their own solicitation process;
L. Combine the aggregate purchasing volumes of Participating Public Agencies to
achieve cost effective pricing.
2.0 REPRESENTATIONS AND COVENANTS
As a condition to Supplier entering into the Master Agreement, which would be available to
all Public Agencies, Supplier must make certain representations, warranties and covenants to
both the Principal Procurement Agency and OMNIA Partners designed to ensure the success
of the Master Agreement for all Participating Public Agencies as well as the Supplier.
2.1 Corporate Commitment
Supplier commits that (1) the Master Agreement has received all necessary corporate
authorizations and support of the Supplier’s executive management, (2) the Master
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Agreement is Supplier's primary “go to market” strategy for Public Agencies, (3) the
Master Agreement will be promoted to all Public Agencies, including any existing
customers, and Supplier will transition existing customers, upon their request, to the
Master Agreement, and (4) that the Supplier has read and agrees to the terms and
conditions of the Administration Agreement with OMNIA Partners and will execute
such agreement concurrent with and as a condition of its execution of the Master
Agreement with the Principal Procurement Agency. Supplier will identify an
executive corporate sponsor and a separate national account manager within the RFP
response that will be responsible for the overall management of the Master Agreement.
2.2 Pricing Commitment
Supplier commits the not-to-exceed pricing provided under the Master Agreement
pricing is its lowest available (net to buyer) to Public Agencies nationwide and further
commits that if a Participating Public Agency is eligible for lower pricing through a
national, state, regional or local or cooperative contract, the Supplier will match such
lower pricing to that Participating Public Agency under the Master Agreement.
2.3 Sales Commitment
Supplier commits to aggressively market the Master Agreement as its go to market
strategy in this defined sector and that its sales force will be trained, engaged and
committed to offering the Master Agreement to Public Agencies through OMNIA
Partners nationwide. Supplier commits that all Master Agreement sales will be
accurately and timely reported to OMNIA Partners in accordance with the OMNIA
Partners Administration Agreement. Supplier also commits its sales force will be
compensated, including sales incentives, for sales to Public Agencies under the Master
Agreement in a consistent or better manner compared to sales to Public Agencies if
the Supplier were not awarded the Master Agreement.
3.0 SUPPLIER RESPONSE
Supplier must supply the following information for the Principal Procurement Agency to
determine Supplier’s qualifications to extend the resulting Master Agreement to Participating
Public Agencies through OMNIA Partners.
3.1 Company
N. Brief history and description of Supplier to include experience providing similar
products and services.
O. Total number and location of salespersons employed by Supplier.
P. Number and location of support centers (if applicable) and location of corporate
office.
Q. Annual sales for the three previous fiscal years.
a. Submit FEIN and Dunn & Bradstreet report.
R. Describe any green or environmental initiatives or policies.
S. Describe any diversity programs or partners supplier does business with and how
Participating Agencies may use diverse partners through the Master Agreement.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Indicate how, if at all, pricing changes when using the diversity program. If there
are any diversity programs, provide a list of diversity alliances and a copy of their
certifications.
T. Indicate if supplier holds any of the below certifications in any classified areas and
include proof of such certification in the response:
a. Minority Women Business Enterprise
Yes No
If yes, list certifying agency: ___________________________________
b. Small Business Enterprise (SBE) or Disadvantaged Business Enterprise
(DBE)
Yes No
If yes, list certifying agency: ___________________________________
c. Historically Underutilized Business (HUB)
Yes No
If yes, list certifying agency: ___________________________________
d. Historically Underutilized Business Zone Enterprise (HUBZone)
Yes No
If yes, list certifying agency: ___________________________________
e. Other recognized diversity certificate holder
Yes No
If yes, list certifying agency: ____________________________________
U. List any relationships with subcontractors or affiliates intended to be used when
providing services and identify if subcontractors meet minority-owned standards.
If any, list which certifications subcontractors hold and certifying agency.
V. Describe how supplier differentiates itself from its competitors.
W. Describe any present or past litigation, bankruptcy or reorganization involving
supplier.
X. Felony Conviction Notice: Indicate if the supplier
a. is a publicly held corporation and this reporting requirement is not
applicable;
b. is not owned or operated by anyone who has been convicted of a felony; or
c. is owned or operated by and individual(s) who has been convicted of a
felony and provide the names and convictions.
Y. Describe any debarment or suspension actions taken against supplier
3.2 Distribution, Logistics
A. Each offeror awarded an item under this solicitation may offer their complete
product and service offering/a balance of line. Describe the full line of products
and services offered by supplier.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
B. Describe how supplier proposes to distribute the products/service nationwide.
Include any states where products and services will not be offered under the Master
Agreement, including U.S. Territories and Outlying Areas.
C. Describe how Participating Agencies are ensured they will receive the Master
Agreement pricing; include all distribution channels such as direct ordering,
retail or in-store locations, through distributors, etc. Describe how Participating
Agencies verify and audit pricing to ensure its compliance with the Master
Agreement.
D. Identify all other companies that will be involved in processing, handling or
shipping the products/service to the end user.
E. Provide the number, size and location of Supplier’s distribution facilities,
warehouses and retail network as applicable.
3.3 Marketing and Sales
A. Provide a detailed ninety-day plan beginning from award date of the Master
Agreement describing the strategy to immediately implement the Master
Agreement as supplier’s primary go to market strategy for Public Agencies to
supplier’s teams nationwide, to include, but not limited to:
i. Executive leadership endorsement and sponsorship of the award as the
public sector go-to-market strategy within first 10 days
ii. Training and education of Supplier’s national sales force with participation
from the Supplier’s executive leadership, along with the OMNIA Partners
team within first 90 days
B. Provide a detailed ninety-day plan beginning from award date of the Master
Agreement describing the strategy to market the Master Agreement to current
Participating Public Agencies, existing Public Agency customers of Supplier, as
well as to prospective Public Agencies nationwide immediately upon award, to
include, but not limited to:
i. Creation and distribution of a co-branded press release to trade publications
ii. Announcement, Master Agreement details and contact information
published on the Supplier’s website within first 90 days
iii. Design, publication and distribution of co-branded marketing materials
within first 90 days
iv. Commitment to attendance and participation with OMNIA Partners at
national (i.e. NIGP Annual Forum, NPI Conference, etc.), regional (i.e.
Regional NIGP Chapter Meetings, Regional Cooperative Summits, etc.)
and supplier-specific trade shows, conferences and meetings throughout
the term of the Master Agreement
v. Commitment to attend, exhibit and participate at the NIGP Annual Forum
in an area reserved by OMNIA Partners for partner suppliers. Booth space
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
will be purchased and staffed by Supplier. In addition, Supplier commits
to provide reasonable assistance to the overall promotion and marketing
efforts for the NIGP Annual Forum, as directed by OMNIA Partners.
vi. Design and publication of national and regional advertising in trade
publications throughout the term of the Master Agreement
vii. Ongoing marketing and promotion of the Master Agreement throughout its
term (case studies, collateral pieces, presentations, promotions, etc.)
viii. Dedicated OMNIA Partners internet web-based homepage on Supplier’s
website with:
• OMNIA Partners standard logo;
• Copy of original Request for Proposal;
• Copy of Master Agreement and amendments between Principal
Procurement Agency and Supplier;
• Summary of Products and pricing;
• Marketing Materials
• Electronic link to OMNIA Partners’ website including the online
registration page;
• A dedicated toll-free number and email address for OMNIA
Partners
C. Describe how Supplier will transition any existing Public Agency customers’
accounts to the Master Agreement available nationally through OMNIA Partners.
Include a list of current cooperative contracts (regional and national) Supplier
holds and describe how the Master Agreement will be positioned among the other
cooperative agreements.
D. Acknowledge Supplier agrees to provide its logo(s) to OMNIA Partners and agrees
to provide permission for reproduction of such logo in marketing communications
and promotions. Acknowledge that use of OMNIA Partners logo will require
permission for reproduction, as well.
E. Confirm Supplier will be proactive in direct sales of Supplier’s goods and services
to Public Agencies nationwide and the timely follow up to leads established by
OMNIA Partners. All sales materials are to use the OMNIA Partners logo. At a
minimum, the Supplier’s sales initiatives should communicate:
I. Master Agreement was competitively solicited and publicly awarded by a
Principal Procurement Agency
II. Best government pricing
III. No cost to participate
IV. Non-exclusive
F. Confirm Supplier will train its national sales force on the Master Agreement. At
a minimum, sales training should include:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
iii. Key features of Master Agreement
iv. Working knowledge of the solicitation process
v. Awareness of the range of Public Agencies that can utilize the Master
Agreement through OMNIA Partners
vi. Knowledge of benefits of the use of cooperative contracts
G. Provide the name, title, email and phone number for the person(s), who will be
responsible for:
i. Executive Support
ii. Marketing
iii. Sales
iv. Sales Support
v. Financial Reporting
vi. Accounts Payable
vii. Contracts
H. Describe in detail how Supplier’s national sales force is structured, including
contact information for the highest-level executive in charge of the sales team.
I. Explain in detail how the sales teams will work with the OMNIA Partners team to
implement, grow and service the national program.
I. Explain in detail how Supplier will manage the overall national program
throughout the term of the Master Agreement, including ongoing coordination of
marketing and sales efforts, timely new Participating Public Agency account set-
up, timely contract administration, etc.
J. State the amount of Supplier’s Public Agency sales for the previous fiscal year.
Provide a list of Supplier’s top 10 Public Agency customers, the total purchases
for each for the previous fiscal year along with a key contact for each.
K. Describe Supplier’s information systems capabilities and limitations regarding
order management through receipt of payment, including description of multiple
platforms that may be used for any of these functions.
L. Provide the Contract Sales (as defined in Section 12 of the OMNIA Partners
Administration Agreement) that Supplier will guarantee each year under the
Master Agreement for the initial three years of the Master Agreement
(“Guaranteed Contract Sales”).
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
$_______.00 in year one
$_______.00 in year two
$_______.00 in year three
To the extent Supplier guarantees minimum Contract Sales, the Administrative
Fee shall be calculated based on the greater of the actual Contract Sales and
the Guaranteed Contract Sales.
M. Even though it is anticipated many Public Agencies will be able to utilize the
Master Agreement without further formal solicitation, there may be circumstances
where Public Agencies will issue their own solicitations. The following options
are available when responding to a solicitation for Products covered under the
Master Agreement.
VIII. Respond with Master Agreement pricing (Contract Sales reported to
OMNIA Partners).
IX. If competitive conditions require pricing lower than the standard
Master Agreement not-to-exceed pricing, Supplier may respond with
lower pricing through the Master Agreement. If Supplier is awarded
the contract, the sales are reported as Contract Sales to OMNIA
Partners under the Master Agreement.
X. Respond with pricing higher than Master Agreement only in the
unlikely event that the Public Agency refuses to utilize Master
Agreement (Contract Sales are not reported to OMNIA Partners).
XI. If alternative or multiple proposals are permitted, respond with
pricing higher than Master Agreement, and include Master
Agreement as the alternate or additional proposal.
Detail Supplier’s strategies under these options when responding to a solicitation.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Exhibit B
Administration Agreement, Example
ADMINISTRATION AGREEMENT
THIS ADMINISTRATION AGREEMENT (this “Agreement”) is made this ___ day of
______ 20__, between National Intergovernmental Purchasing Alliance Company, a Delaware
corporation d/b/a OMNIA Partners, Public Sector (“OMNIA Partners”), and ________________
(“Supplier”).
RECITALS
WHEREAS, the ___________________ (the “Principal Procurement Agency”) has
entered into a Master Agreement effective _________________, Agreement No_______, by and
between the Principal Procurement Agency and Supplier, (as may be amended from time to time in
accordance with the terms thereof, the “Master Agreement”), as attached hereto as Exhibit A and
incorporated herein by reference as though fully set forth herein, for the purchase of
____________________________ (the “Product”);
WHEREAS, said Master Agreement provides that any or all public agencies, including state
and local governmental entities, public and private primary, secondary and higher education entities,
non-profit entities, and agencies for the public benefit (collectively, “Public Agencies”), that register
(either via registration on the OMNIA Partners website or execution of a Master Intergovernmental
Cooperative Purchasing Agreement, attached hereto as Exhibit B) (each, hereinafter referred to as a
“Participating Public Agency”) may purchase Product at prices stated in the Master Agreement;
WHEREAS, Participating Public Agencies may access the Master Agreement which is
offered through OMNIA Partners to Public Agencies;
WHEREAS, OMNIA Partners serves as the cooperative contract administrator of the Master
Agreement on behalf of Principal Procurement Agency;
WHEREAS, Principal Procurement Agency desires OMNIA Partners to proceed with
administration of the Master Agreement; and
WHEREAS, OMNIA Partners and Supplier desire to enter into this Agreement to make
available the Master Agreement to Participating Public Agencies and to set forth certain terms and
conditions governing the relationship between OMNIA Partners and Supplier.
NOW, THEREFORE, in consideration of the payments to be made hereunder and the mutual
covenants contained in this Agreement, OMNIA Partners and Supplier hereby agree as follows:
DEFINITIONS
1. Capitalized terms used in this Agreement and not otherwise defined herein shall have
the meanings given to them in the Master Agreement.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
TERMS AND CONDITIONS
2. The Master Agreement and the terms and conditions contained therein shall apply to
this Agreement except as expressly changed or modified by this Agreement. Supplier acknowledges
and agrees that the covenants and agreements of Supplier set forth in the solicitation and Supplier’s
response thereto resulting in the Master Agreement are incorporated herein and are an integral part
hereof.
3. OMNIA Partners shall be afforded all of the rights, privileges and indemnifications
afforded to Principal Procurement Agency by or from Supplier under the Master Agreement, and such
rights, privileges and indemnifications shall accrue and apply with equal effect to OMNIA Partners,
its agents, employees, directors, and representatives under this Agreement including, but not limited
to, Supplier’s obligation to obtain appropriate insurance.
4. OMNIA Partners shall perform all of its duties, responsibilities and obligations as the
cooperative contract administrator of the Master Agreement on behalf of Principal Procurement
Agency as set forth herein, and Supplier hereby acknowledges and agrees that all duties,
responsibilities and obligations will be undertaken by OMNIA Partners solely in its capacity as the
cooperative contract administrator under the Master Agreement.
5. With respect to any purchases by Principal Procurement Agency or any Participating
Public Agency pursuant to the Master Agreement, OMNIA Partners shall not be: (i) construed as a
dealer, re-marketer, representative, partner or agent of any type of the Supplier, Principal Procurement
Agency or any Participating Public Agency; (ii) obligated, liable or responsible for any order for
Product made by Principal Procurement Agency or any Participating Public Agency or any employee
thereof under the Master Agreement or for any payment required to be made with respect to such
order for Product; and (iii) obligated, liable or responsible for any failure by Principal Procurement
Agency or any Participating Public Agency to comply with procedures or requirements of applicable
law or the Master Agreement or to obtain the due authorization and approval necessary to purchase
under the Master Agreement. OMNIA Partners makes no representation or guaranty with respect to
any minimum purchases by Principal Procurement Agency or any Participating Public Agency or any
employee thereof under this Agreement or the Master Agreement.
6. OMNIA Partners shall not be responsible for Supplier’s performance under the Master
Agreement, and Supplier shall hold OMNIA Partners harmless from any liability that may arise from
the acts or omissions of Supplier in connection with the Master Agreement.
7. Supplier acknowledges that, in connection with its access to OMNIA Partners
confidential information and/or supply of data to OMNIA Partners, it has complied with and shall
continue to comply with all laws, regulations and standards that may apply to Supplier, including,
without limitation: (a) United States federal and state information security and privacy statutes,
regulations and/or best practices, including, without limitation, the Gramm-Leach-Bliley Act, the
Massachusetts Data Security Regulations (201 C.M.R. 17.00 et. seq.), the Nevada encryption statute
(N.R.S. § 603A), the California data security law (Cal. Civil Code § 1798.80 et. seq.) and California
Consumer Privacy Act (Cal. Civil Code § 1798.100 et. seq.); and (b) applicable industry and
regulatory standards and best practices (collectively, “Data Regulations”).
With regard to Personal Information that Supplier collects, receives, or otherwise processes
under the Agreement or otherwise in connection with performance of the Agreement, Supplier agrees
that it will not: (i) sell, rent, release, disclose, disseminate, make available, transfer, or otherwise
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
communicate orally, in writing, or by electronic or other means, such Personal Information to another
business or third party for monetary or other valuable consideration; or (ii) retain, use, or disclose
such Personal Information outside of the direct business relationship between Supplier and OMNIA
Partners or for any purpose other than for the specific purpose of performance of the Agreement,
including retaining, using, or disclosing such Personal Information for a commercial purpose other
than for performance of the Agreement. By entering into the Agreement, Supplier certifies that it
understands the specific restrictions contained in this Section 7 and will comply with them. For
purposes hereof, “Personal Information” means information that identifies, relates to, describes, is
reasonably capable of being associated with, or could reasonably be linked, directly or indirectly, with
a particular consumer or household, and includes the specific elements of “personal information” as
defined under Data Regulations, as defined herein. Supplier will reasonably assist OMNIA Partners
in timely responding to any third party “request to know” or “request to delete” (as defined pursuant
to Data Regulations) and will promptly provide OMNIA Partners with information reasonably
necessary for OMNIA Partners to respond to such requests. Where Supplier collects Personal
Information directly from Public Agencies or others on OMNIA Partners’ behalf, Supplier will
maintain records and the means necessary to enable OMNIA Partners to respond to such requests to
know and requests to delete.
8. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, OMNIA
PARTNERS EXPRESSLY DISCLAIMS ALL EXPRESS OR IMPLIED REPRESENTATIONS
AND WARRANTIES REGARDING OMNIA PARTNERS’ PERFORMANCE AS A CONTRACT
ADMINISTRATOR OF THE MASTER AGREEMENT. OMNIA PARTNERS SHALL NOT BE
LIABLE IN ANY WAY FOR ANY SPECIAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL,
EXEMPLARY, PUNITIVE, OR RELIANCE DAMAGES, EVEN IF OMNIA PARTNERS IS
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
TERM OF AGREEMENT; TERMINATION
9. This Agreement shall be in effect so long as the Master Agreement remains in effect,
provided, however, that the provisions of Sections 3 – 8 and 11 – 22, hereof and the indemnifications
afforded by the Supplier to OMNIA Partners in the Master Agreement, to the extent such provisions
survive any expiration or termination of the Master Agreement, shall survive the expiration or
termination of this Agreement.
NATIONAL PROMOTION
10. OMNIA Partners and Supplier shall publicize and promote the availability of the
Master Agreement’s products and services to Public Agencies and such agencies’ employees.
Supplier shall require each Public Agency to register its participation in the OMNIA Partners program
by either registering on the OMNIA Partners website (www.omniapartners.com/publicsector) or
executing a Master Intergovernmental Cooperative Purchasing Agreement prior to processing the
Participating Public Agency’s first sales order. Upon request, Supplier shall make available to
interested Public Agencies a copy of the Master Agreement and such price lists or quotes as may be
necessary for such Public Agencies to evaluate potential purchases.
11. Supplier shall provide such marketing and administrative support as set forth in the
solicitation resulting in the Master Agreement, including assisting in development of marketing
materials as reasonably requested by Principal Procurement Agency and OMNIA Partners. Supplier
shall be responsible for obtaining permission or license of use and payment of any license fees for all
content and images Supplier provides to OMNIA Partners or posts on the OMNIA Partners website.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Supplier shall indemnify, defend and hold harmless OMNIA Partners for use of all such content and
images including copyright infringement claims. Supplier and OMNIA Partners each hereby grant to
the other party a limited, revocable, non-transferable, non-sublicensable right to use such party’s logo
(each, the “Logo”) solely for use in marketing the Master Agreement. Each party shall provide the
other party with the standard terms of use of such party’s Logo, and such party shall comply with
such terms in all material respects. Both parties shall obtain approval from the other party prior to
use of such party’s Logo. Notwithstanding the foregoing, the parties understand and agree that except
as provided herein neither party shall have any right, title or interest in the other party’s Logo. Upon
termination of this Agreement, each party shall immediately cease use of the other party’s Logo.
ADMINISTRATIVE FEE, REPORTING & PAYMENT
12. An “Administrative Fee” shall be defined and due to OMNIA Partners from Supplier
in the amount of three percent (3%) (“Administrative Fee Percentage”) multiplied by the total
purchase amount paid to Supplier, less refunds, credits on returns, rebates and discounts, for the sale
of products and/or services to Principal Procurement Agency and Participating Public Agencies
pursuant to the Master Agreement (as amended from time to time and including any renewal thereof)
(“Contract Sales”). From time to time the parties may mutually agree in writing to a lower
Administrative Fee Percentage for a specifically identified Participating Public Agency’s Contract
Sales.
13. Supplier shall provide OMNIA Partners with an electronic accounting report monthly,
in the format prescribed by OMNIA Partners, summarizing all Contract Sales for each calendar
month. The Contract Sales reporting format is provided as Exhibit C (“Contract Sales Report”),
attached hereto and incorporated herein by reference. Contract Sales Reports for each calendar month
shall be provided by Supplier to OMNIA Partners by the 10th day of the following month. Failure to
provide a Contract Sales Report within the time and manner specified herein shall constitute a material
breach of this Agreement and if not cured within thirty (30) days of written notice to Supplier shall
be deemed a cause for termination of the Master Agreement, at Principal Procurement Agency’s sole
discretion, and/or this Agreement, at OMNIA Partners’ sole discretion.
14. Administrative Fee payments are to be paid by Supplier to OMNIA Partners at the
frequency and on the due date stated in Section 13, above, for Supplier’s submission of corresponding
Contract Sales Reports. Administrative Fee payments are to be made via Automated Clearing House
(ACH) to the OMNIA Partners designated financial institution identified in Exhibit D. Failure to
provide a payment of the Administrative Fee within the time and manner specified herein shall
constitute a material breach of this Agreement and if not cured within thirty (30) days of written notice
to Supplier shall be deemed a cause for termination of the Master Agreement, at Principal
Procurement Agency’s sole discretion, and/or this Agreement, at OMNIA Partners’ sole discretion.
All Administrative Fees not paid when due shall bear interest at a rate equal to the lesser of one and
one-half percent (1 1/2%) per month or the maximum rate permitted by law until paid in full.
15. Supplier shall maintain an accounting of all purchases made by Participating Public
Agencies under the Master Agreement. OMNIA Partners, or its designee, in OMNIA Partners’ sole
discretion, reserves the right to compare Participating Public Agency records with Contract Sales
Reports submitted by Supplier for a period of four (4) years from the date OMNIA Partners receives
such report. In addition, OMNIA Partners may engage a third party to conduct an independent audit
of Supplier’s monthly reports. In the event of such an audit, Supplier shall provide all materials
reasonably requested relating to such audit by OMNIA Partners at the location designated by OMNIA
Partners. In the event an underreporting of Contract Sales and a resulting underpayment of
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Administrative Fees is revealed, OMNIA Partners will notify the Supplier in writing. Supplier will
have thirty (30) days from the date of such notice to resolve the discrepancy to OMNIA Partners’
reasonable satisfaction, including payment of any Administrative Fees due and owing, together with
interest thereon in accordance with Section 13, and reimbursement of OMNIA Partners’ costs and
expenses related to such audit.
GENERAL PROVISIONS
16. This Agreement, the Master Agreement and the exhibits referenced herein supersede
any and all other agreements, either oral or in writing, between the parties hereto with respect to the
subject matter hereto and no other agreement, statement, or promise relating to the subject matter of
this Agreement which is not contained or incorporated herein shall be valid or binding. In the event
of any conflict between the provisions of this Agreement and the Master Agreement, as between
OMNIA Partners and Supplier, the provisions of this Agreement shall prevail.
17. If any action at law or in equity is brought to enforce or interpret the provisions of this
Agreement or to recover any Administrative Fee and accrued interest, the prevailing party shall be
entitled to reasonable attorney’s fees and costs in addition to any other relief to which it may be
entitled.
18. This Agreement and OMNIA Partners’ rights and obligations hereunder may be
assigned at OMNIA Partners’ sole discretion to an affiliate of OMNIA Partners, any purchaser of any
or all or substantially all of the assets of OMNIA Partners, or the successor entity as a result of a
merger, reorganization, consolidation, conversion or change of control, whether by operation of law
or otherwise. Supplier may not assign its obligations hereunder without the prior written consent of
OMNIA Partners.
19. All written communications given hereunder shall be delivered by first-class mail,
postage prepaid, or overnight delivery on receipt to the addresses as set forth below.
M. OMNIA Partners:
OMNIA Partners
Attn: President
840 Crescent Centre Drive
Suite 600
Franklin, TN 37067
N. Supplier:
____________________
____________________
____________________
____________________
• 20. If any provision of this Agreement shall be deemed to be, or shall in
fact be, illegal, inoperative or unenforceable, the same shall not affect any other provision or
provisions herein contained or render the same invalid, inoperative or unenforceable to any
extent whatever, and this Agreement will be construed by limiting or invalidating such
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
provision to the minimum extent necessary to make such provision valid, legal and
enforceable.
• 21. This Agreement may not be amended, changed, modified, or altered
without the prior written consent of the parties hereto, and no provision of this Agreement
may be discharged or waived, except by a writing signed by the parties. A waiver of any
particular provision will not be deemed a waiver of any other provision, nor will a waiver
given on one occasion be deemed to apply to any other occasion.
22. This Agreement shall inure to the benefit of and shall be binding upon OMNIA
Partners, the Supplier and any respective successor and assign thereto; subject, however, to the
limitations contained herein.
23. This Agreement will be construed under and governed by the laws of the State of
Delaware, excluding its conflicts of law provisions and any action arising out of or related to this
Agreement shall be commenced solely and exclusively in the state or federal courts in Williamson
County Tennessee.
24. This Agreement may be executed in counterparts, each of which is an original but all
of which, together, shall constitute but one and the same instrument. The exchange of copies of this
Agreement and of signature pages by facsimile, or by .pdf or similar electronic transmission, will
constitute effective execution and delivery of this Agreement as to the parties and may be used in lieu of
the original Agreement for all purposes. Signatures of the parties transmitted by facsimile, or by .pdf or
similar electronic transmission, will be deemed to be their original signatures for any purpose whatsoever.
[INSERT SUPPLIER ENTITY NAME] NATIONAL
INTERGOVERNMENTAL
PURCHASING ALLIANCE
COMPANY, A DELAWARE
CORPORATION D/B/A OMNIA
PARTNERS, PUBLIC SECTOR
Signature Signature
Name Name
Sr. Vice President, Public Sector Contracti
Title Title
Date Date
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Exhibit C
Master Intergovernmental Cooperative Purchasing Agreement, Example
MASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENT
This Master Intergovernmental Cooperative Purchasing Agreement (this “Agreement”) is entered
into by and between those certain government agencies that execute a Principal Procurement Agency
Certificate (“Principal Procurement Agencies”) with National Intergovernmental Purchasing
Alliance Company, a Delaware corporation d/b/a OMNIA Partners, Public Sector and/or
Communities Program Management, LLC, a California limited liability company d/b/a U.S.
Communities (collectively, “OMNIA Partners”), in its capacity as the cooperative administrator, to
be appended and made a part hereof and such other public agencies (“Participating Public
Agencies”) who register to participate in the cooperative purchasing programs administered by
OMNIA Partners and its affiliates and subsidiaries (collectively, the “OMNIA Partners Parties”)
by either registering on the OMNIA Partners website (www.omniapartners.com/publicsector or any
successor website), or by executing a copy of this Agreement.
RECITALS
WHEREAS, after a competitive solicitation and selection process by Principal Procurement
Agencies, in compliance with their own policies, procedures, rules and regulations, a number of
suppliers have entered into “Master Agreements” (herein so called) to provide a variety of goods,
products and services (“Products”) to the applicable Principal Procurement Agency and the
Participating Public Agencies;
WHEREAS, Master Agreements are made available by Principal Procurement Agencies through
the OMNIA Partners Parties and provide that Participating Public Agencies may purchase Products
on the same terms, conditions and pricing as the Principal Procurement Agency, subject to any
applicable federal and/or local purchasing ordinances and the laws of the State of purchase; and
WHEREAS, in addition to Master Agreements, the OMNIA Partners Parties may from time to time
offer Participating Public Agencies the opportunity to acquire Products through other group
purchasing agreements.
NOW, THEREFORE, in consideration of the mutual promises contained in this Agreement, and of
the mutual benefits to result, the parties hereby agree as follows:
4. Each party will facilitate the cooperative procurement of Products.
5. The Participating Public Agencies shall procure Products in accordance with and
subject to the relevant federal, state and local statutes, ordinances, rules and regulations that govern
Participating Public Agency’s procurement practices. The Participating Public Agencies hereby
acknowledge and agree that it is the intent of the parties that all provisions of this Agreement and that
Principal Procurement Agencies’ participation in the program described herein comply with all
applicable laws, including but not limited to the requirements of 42 C.F.R. § 1001.952(j), as may be
amended from time to time. The Participating Public Agencies further acknowledge and agree that
they are solely responsible for their compliance with all applicable “safe harbor” regulations,
including but not limited to any and all obligations to fully and accurately report discounts and
incentives.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
6. The Participating Public Agency represents and warrants that the Participating Public
Agency is not a hospital or other healthcare provider and is not purchasing Products on behalf of a
hospital or healthcare provider; provided that the foregoing shall not prohibit Participating Public
Agency from furnishing health care services so long as the furnishing of healthcare services is not in
furtherance of a primary purpose of the Participating Public Agency.
7. The cooperative use of Master Agreements shall be in accordance with the terms and
conditions of the Master Agreements, except as modification of those terms and conditions is
otherwise required by applicable federal, state or local law, policies or procedures.
8. The Principal Procurement Agencies will make available, upon reasonable request,
Master Agreement information which may assist in improving the procurement of Products by the
Participating Public Agencies.
9. The Participating Public Agency agrees the OMNIA Partners Parties may provide
access to group purchasing organization (“GPO”) agreements directly or indirectly by enrolling the
Participating Public Agency in another GPO’s purchasing program, provided that the purchase of
Products through the OMNIA Partners Parties or any other GPO shall be at the Participating Public
Agency’s sole discretion.
10. The Participating Public Agencies (each a “Procuring Party”) that procure Products
through any Master Agreement or GPO Product supply agreement (each a “GPO Contract”) will
make timely payments to the distributor, manufacturer or other vendor (collectively, “Supplier”) for
Products received in accordance with the terms and conditions of the Master Agreement or GPO
Contract, as applicable. Payment for Products and inspections and acceptance of Products ordered by
the Procuring Party shall be the exclusive obligation of such Procuring Party. Disputes between
Procuring Party and any Supplier shall be resolved in accordance with the law and venue rules of the
State of purchase unless otherwise agreed to by the Procuring Party and Supplier.
11. The Procuring Party shall not use this Agreement as a method for obtaining additional
concessions or reduced prices for purchase of similar products or services outside of the Master
Agreement. Master Agreements may be structured with not-to-exceed pricing, in which cases the
Supplier may offer the Procuring Party and the Procuring Party may accept lower pricing or additional
concessions for purchase of Products through a Master Agreement.
12. The Procuring Party shall be responsible for the ordering of Products under this
Agreement. A non-procuring party shall not be liable in any fashion for any violation by a Procuring
Party, and, to the extent permitted by applicable law, the Procuring Party shall hold non-procuring
party harmless from any liability that may arise from the acts or omissions of the Procuring Party.
13. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE OMNIA
PARTNERS PARTIES EXPRESSLY DISCLAIM ALL EXPRESS OR IMPLIED
REPRESENTATIONS AND WARRANTIES REGARDING ANY PRODUCT, MASTER
AGREEMENT AND GPO CONTRACT. THE OMNIA PARTNERS PARTIES SHALL NOT BE
LIABLE IN ANY WAY FOR ANY SPECIAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL,
EXEMPLARY, PUNITIVE, OR RELIANCE DAMAGES, EVEN IF THE OMNIA PARTNERS
PARTIES ARE ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE
PROCURING PARTY ACKNOWLEDGES AND AGREES THAT THE OMNIA PARTNERS
PARTIES SHALL HAVE NO LIABILITY FOR ANY ACT OR OMISSION BY A SUPPLIER OR
OTHER PARTY UNDER A MASTER AGREEMENT OR GPO CONTRACT.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
14. This Agreement shall remain in effect until termination by either party giving thirty
(30) days’ written notice to the other party. The provisions of Paragraphs 6 - 10 hereof shall survive
any such termination.
15. This Agreement shall take effect upon (i) execution of the Principal Procurement
Agency Certificate, or (ii) registration on the OMNIA Partners website or the execution of this
Agreement by a Participating Public Agency, as applicable.
Participating Public Agency:
OMNIA Partners, as the cooperative
administrator on behalf of Principal
Procurement Agencies:
NATIONAL INTERGOVERNMENTAL
PURCHASING ALLIANCE COMPANY
COMMUNITIES PROGRAM
MANAGEMENT, LLC
Authorized Signature Signature
Sarah E. Vavra
Name Name
Sr. Vice President, Public Sector Contracting
Title and Agency Name Title
Date Date
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Exhibit D
Principal Procurement Agency Certificate, Example
PRINCIPAL PROCUREMENT AGENCY CERTIFICATE
In its capacity as a Principal Procurement Agency (as defined below) for National
Intergovernmental Purchasing Alliance Company, a Delaware corporation d/b/a OMNIA Partners,
Public Sector (“OMNIA Partners”), [PPA Name] agrees to pursue Master Agreements for
Products as specified in the attached Exhibits to this Principal Procurement Agency Certificate.
I hereby acknowledge, in my capacity as _____________ of and on behalf of [PPA Name]
(“Principal Procurement Agency”), that I have read and hereby agree to the general terms and
conditions set forth in the attached Master Intergovernmental Cooperative Purchasing Agreement
regulating the use of the Master Agreements and purchase of Products that from time to time are
made available by Principal Procurement Agencies to Participating Public Agencies nationwide
through OMNIA Partners.
I understand that the purchase of one or more Products under the provisions of the Master
Intergovernmental Cooperative Purchasing Agreement is at the sole and complete discretion of the
Participating Public Agency.
Authorized Signature, [PPA Name]________
Signature
Name
Title
Date
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Exhibit E
Contract Sales Reporting Template
Contract Sales Report submitted electronically in Microsoft Excel:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Exhibit F
Federal Funds Certifications
FEDERAL CERTIFICATIONS ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT
TO WHOM IT MAY CONCERN:
Participating Agencies may elect to use federal funds to purchase under the Master Agreement. This form should be
completed and returned.
DEFINITIONS
Contract means a legal instrument by which a non–Federal entity purchases property or services needed to carry out the project
or program under a Federal award. The term as used in this part does not include a legal instrument, even if the non–Federal
entity considers it a contract, when the substance of the transaction meets the definition of a Federal award or subaward
Contractor means an entity that receives a contract as defined in Contract.
Cooperative agreement means a legal instrument of financial assistance between a Federal awarding agency or pass-through
entity and a non–Federal entity that, consistent with 31 U.S.C. 6302–6305:
(a) Is used to enter into a relationship the principal purpose of which is to transfer anything of value from the Federal
awarding agency or pass-through entity to the non–Federal entity to carry out a public purpose authorized by a law of
the United States (see 31 U.S.C. 6101(3)); and not to acquire property or services for the Federal government or
pass-through entity's direct benefit or use;
(b) Is distinguished from a grant in that it provides for substantial involvement between the Federal awarding agency
or pass-through entity and the non–Federal entity in carrying out the activity contemplated by the Federal award.
(c) The term does not include:
(1) A cooperative research and development agreement as defined in 15 U.S.C. 3710a; or
(2) An agreement that provides only:
(i) Direct United States Government cash assistance to an individual;
(ii) A subsidy;
(iii) A loan;
(iv) A loan guarantee; or
(v) Insurance.
Federal awarding agency means the Federal agency that provides a Federal award directly to a non–Federal entity
Federal award has the meaning, depending on the context, in either paragraph (a) or (b) of this section:
(a)(1) The Federal financial assistance that a non–Federal entity receives directly from a Federal awarding agency or
indirectly from a pass-through entity, as described in § 200.101 Applicability; or
(2) The cost-reimbursement contract under the Federal Acquisition Regulations that a non–Federal entity
receives directly from a Federal awarding agency or indirectly from a pass-through entity, as described in §
200.101 Applicability.
(b) The instrument setting forth the terms and conditions. The instrument is the grant agreement, cooperative
agreement, other agreement for assistance covered in paragraph (b) of § 200.40 Federal financial assistance, or the
cost-reimbursement contract awarded under the Federal Acquisition Regulations.
(c) Federal award does not include other contracts that a Federal agency uses to buy goods or services from a
contractor or a contract to operate Federal government owned, contractor operated facilities (GOCOs).
(d) See also definitions of Federal financial assistance, grant agreement, and cooperative agreement.
Non–Federal entity means a state, local government, Indian tribe, institution of higher education (IHE), or nonprofit organization
that carries out a Federal award as a recipient or subrecipient.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Nonprofit organization means any corporation, trust, association, cooperative, or other organization, not including IHEs, that:
(a) Is operated primarily for scientific, educational, service, charitable, or similar purposes in the public interest;
(b) Is not organized primarily for profit; and
(c) Uses net proceeds to maintain, improve, or expand the operations of the organization.
Obligations means, when used in connection with a non–Federal entity's utilization of funds under a Federal award, orders
placed for property and services, contracts and subawards made, and similar transactions during a given period that require
payment by the non–Federal entity during the same or a future period.
Pass-through entity means a non–Federal entity that provides a subaward to a subrecipient to carry out part of a Federal
program.
Recipient means a non–Federal entity that receives a Federal award directly from a Federal awarding agency to carry out an
activity under a Federal program. The term recipient does not include subrecipients.
Simplified acquisition threshold means the dollar amount below which a non–Federal entity may purchase property or
services using small purchase methods. Non–Federal entities adopt small purchase procedures in order to expedite the
purchase of items costing less than the simplified acquisition threshold. The simplified acquisition threshold is set by the Federal
Acquisition Regulation at 48 CFR Subpart 2.1 (Definitions) and in accordance with 41 U.S.C. 1908. As of the publication of this
part, the simplified acquisition threshold is $250,000, but this threshold is periodically adjusted for inflation. (Also see definition
of § 200.67 Micro-purchase.)
Subaward means an award provided by a pass-through entity to a subrecipient for the subrecipient to carry out part of a Federal
award received by the pass-through entity. It does not include payments to a contractor or payments to an individual that is a
beneficiary of a Federal program. A subaward may be provided through any form of legal agreement, including an agreement
that the pass-through entity considers a contract.
Subrecipient means a non–Federal entity that receives a subaward from a pass-through entity to carry out part of a Federal
program; but does not include an individual that is a beneficiary of such program. A subrecipient may also be a recipient of other
Federal awards directly from a Federal awarding agency.
Termination means the ending of a Federal award, in whole or in part at any time prior to the planned end of period of
performance.
The following provisions may be required and apply when Participating Agency expends federal funds for any purchase resulting
from this procurement process. Per FAR 52.204-24 and FAR 52.204-25, solicitations and resultant contracts shall contain the
following provisions.
52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct
2020)
The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does
not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in
the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26,
Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3,
Offeror Representations and Certifications-Commercial Items. The Offeror shall not complete the representation in paragraph
(d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or
any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the
provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.
(a) Definitions. As used in this provision—
Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements,
reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25,
Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
(b) Prohibition.
(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a
contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as
a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall
be construed to—
(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the
facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or
(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into
any user data or packets that such equipment transmits or otherwise handles.
(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-
232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing
a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to
the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a
Federal contract. Nothing in the prohibition shall be construed to—
(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the
facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or
(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into
any user data or packets that such equipment transmits or otherwise handles.
(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM)
(https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".
(d) Representation. The Offeror represents that—
(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance
of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional
disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section;
and
(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—
It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service
that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information
required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.
(e) Disclosures.
(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation
in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer.
(i) For covered equipment—
(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity
identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);
(B) A description of all covered telecommunications equipment offered (include brand; model number, such as
OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and
(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to
determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and
explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would
be permissible under the prohibition in paragraph (b)(1) of this provision.
(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the
representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:
(i) For covered equipment—
(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity
identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);
(B) A description of all covered telecommunications equipment offered (include brand; model number, such as
OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to
determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed
use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the
prohibition in paragraph (b)(2) of this provision.
52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment (Aug 2020).
(a) Definitions. As used in this clause—
Backhaul means intermediate links between the core network, or backbone network, and the small subnetworks at the edge
of the network (e.g., connecting cell phones/towers to the core telephone network). Backhaul can be wireless (e.g., microwave) or
wired (e.g., fiber optic, coaxial cable, Ethernet).
Covered foreign country means The People’s Republic of China.
Covered telecommunications equipment or services means–
(1) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary
or affiliate of such entities);
(2) For the purpose of public safety, security of Government facilities, physical security surveillance of critical
infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera
Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any
subsidiary or affiliate of such entities);
(3) Telecommunications or video surveillance services provided by such entities or using such equipment; or
(4) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary
of Defense, in consultation with the Director of National Intelligence or the Director of the Federal Bureau of Investigation,
reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country.
Critical technology means–
(1) Defense articles or defense services included on the United States Munitions List set forth in the International Traffic
in Arms Regulations under subchapter M of chapter I of title 22, Code of Federal Regulations;
(2) Items included on the Commerce Control List set forth in Supplement No. 1 to part 774 of the Export Administration
Regulations under subchapter C of chapter VII of title 15, Code of Federal Regulations, and controlled-
(i) Pursuant to multilateral regimes, including for reasons relating to national security, chemical and biological
weapons proliferation, nuclear nonproliferation, or missile technology; or
(ii) For reasons relating to regional stability or surreptitious listening;
(3) Specially designed and prepared nuclear equipment, parts and components, materials, software, and technology
covered by part 810 of title 10, Code of Federal Regulations (relating to assistance to foreign atomic energy activities);
(4) Nuclear facilities, equipment, and material covered by part 110 of title 10, Code of Federal Regulations (relating to
export and import of nuclear equipment and material);
(5) Select agents and toxins covered by part 331 of title 7, Code of Federal Regulations, part 121 of title 9 of such Code,
or part 73 of title 42 of such Code; or
(6) Emerging and foundational technologies controlled pursuant to section 1758 of the Export Control Reform Act of
2018 (50 U.S.C. 4817).
Interconnection arrangements means arrangements governing the physical connection of two or more networks to allow
the use of another's network to hand off traffic where it is ultimately delivered (e.g., connection of a customer of telephone provider
A to a customer of telephone company B) or sharing data and other information resources.
Reasonable inquiry means an inquiry designed to uncover any information in the entity's possession about the identity of
the producer or provider of covered telecommunications equipment or services used by the entity that excludes the need to include
an internal or third-party audit.
Roaming means cellular communications services (e.g., voice, video, data) received from a visited network when unable to
connect to the facilities of the home network either because signal coverage is too weak or because traffic is too high.
Substantial or essential component means any component necessary for the proper function or performance of a piece of
equipment, system, or service.
(b) Prohibition.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a
contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as
a substantial or essential component of any system, or as critical technology as part of any system. The Contractor is prohibited
from providing to the Government any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system, unless an exception at
paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described
in FAR 4.2104.
(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-
232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract, or extending or renewing
a contract, with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system, unless an exception at
paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described
in FAR 4.2104. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether
that use is in performance of work under a Federal contract.
(c) Exceptions. This clause does not prohibit contractors from providing—
(1) A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;
or
(2) Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or
packets that such equipment transmits or otherwise handles.
(d) Reporting requirement.
(1) In the event the Contractor identifies covered telecommunications equipment or services used as a substantial or essential
component of any system, or as critical technology as part of any system, during contract performance, or the Contractor is notified
of such by a subcontractor at any tier or by any other source, the Contractor shall report the information in paragraph (d)(2) of this
clause to the Contracting Officer, unless elsewhere in this contract are established procedures for reporting the information; in the
case of the Department of Defense, the Contractor shall report to the website at https://dibnet.dod.mil. For indefinite delivery
contracts, the Contractor shall report to the Contracting Officer for the indefinite delivery contract and the Contracting Officer(s) for
any affected order or, in the case of the Department of Defense, identify both the indefinite delivery contract and any affected
orders in the report provided at https://dibnet.dod.mil.
(2) The Contractor shall report the following information pursuant to paragraph (d)(1) of this clause
(i) Within one business day from the date of such identification or notification: the contract number; the order
number(s), if applicable; supplier name; supplier unique entity identifier (if known); supplier Commercial and Government Entity
(CAGE) code (if known); brand; model number (original equipment manufacturer number, manufacturer part number, or wholesaler
number); item description; and any readily available information about mitigation actions undertaken or recommended.
(ii) Within 10 business days of submitting the information in paragraph (d)(2)(i) of this clause: any further available
information about mitigation actions undertaken or recommended. In addition, the Contractor shall describe the efforts it undertook
to prevent use or submission of covered telecommunications equipment or services, and any additional efforts that will be
incorporated to prevent future use or submission of covered telecommunications equipment or services.
(e) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (e) and excluding
paragraph (b)(2), in all subcontracts and other contractual instruments, including subcontracts for the acquisition of commercial
items.
The following certifications and provisions may be required and apply when Participating Agency expends federal funds for any
purchase resulting from this procurement process. Pursuant to 2 C.F.R. § 200.326, all contracts, including small purchases,
awarded by the Participating Agency and the Participating Agency’s subcontractors shall contain the procurement provisions of
Appendix II to Part 200, as applicable.
APPENDIX II TO 2 CFR PART 200
(A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council
(Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances
where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Pursuant to Federal Rule (A) above, when a Participating Agency expends federal funds, the Participating Agency reserves all
rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract
by either party.
Does offeror agree? YES Initials of Authorized Representative of
offeror (B) Termination for cause and for convenience by the grantee or subgrantee including the manner by which it will be effected and the basis for settlement. (All contracts in excess of $10,000)
Pursuant to Federal Rule (B) above, when a Participating Agency expends federal funds, the Participating Agency reserves the
right to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a
breach or default of the agreement by Offeror as detailed in the terms of the contract.
Does offeror agree? YES Initials of Authorized Representative of
offeror
(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60 -1.3 must include the equal opportunity cla use
provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 C FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive
Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR part 60, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.”
Pursuant to Federal Rule (C) abo ve, when a Participating Agency expends federal funds on any federally assisted construction
contract, the equal opportunity clause is incorporated by reference herein.
Does offeror agree to abide by the above? YES Initials of Authorized Representative of offeror (D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime
construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance
with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations
(29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted
Construction”). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In
addition, contractors must be required to pay wages not less than once a week. The non -Federal entity must place a
copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision
to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non - Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a provision for compliance with the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by
Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontra ctors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or
subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non -Federal entity must report all suspected or reported violations to the Federal awarding agency.
Pursuant to Federal Rule (D) above, when a Participating Agency expends federal funds during the term of an award for all
contracts and subgrants for construction or repair, offeror will be in compliance with all applicable Davis-Bacon Act provisions.
Does offeror agree? YES Initials of Authorized Representative of offeror
(E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701 -3708). Where applicable, all contracts awarded by the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a
provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR
Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible
provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all
hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requiremen ts do not apply to the purchases of supplies or
materials or articles ordinarily available on the open market, or contracts for transportation or transmission of
intelligence.
Pursuant to Federal Rule (E) above, when a Participating Agency expends federal funds, offeror certifies that offeror will be in
compliance with all applicable provisions of the Contract Work Hours an d Safety Standards Act during the term of an award for
all contracts by Participating Agency resulting from this procurement process.
Does offeror agree? YES Initials of Authorized Representative of offeror
(F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of “funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of
experimental, developmental, or research work under that “funding agreement,” the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any implementing regulations
issued by the awarding agency.
Pursuant to Federal Rule (F) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror agrees to
comply with all applicable requirements as referenced in Federal Rule (F) above.
Does offeror agree? YES Initials of Authorized Representative of offeror
(G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251 -1387), as
amended—Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non - Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air
Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251 - 1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency
(EPA)
Pursuant to Federal Rule (G) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency member resulting from this procurement process, the offeror
agrees to comply with all applicable requirements as referenced in Federal Rule (G) above .
Does offeror agree? YES Initials of Authorized Representative of offeror
(H) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be
made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance
with the Executive Office of the President Office of Management and Budget (OMB) guidelines at 2 CFR 180 that
implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235),
“Debarment and Suspension.” SAM Exclusions contain s the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive
Order 12549.
Pursuant to Federal Rule (H) above, when federal funds are expe nded by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror certifies that
neither it nor its principals is presently debarred, suspended, proposed for debarment, declare d ineligible, or voluntarily excluded
from participation by any federal department or agency. If at any time during the term of an award the offeror or its principals
becomes debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any
federal department or agency, the offeror will notify the Participating Agency.
Does offeror agree? YES Initials of Authorized Representative of offeror
(I) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal
appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must
also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award.
Such disclosures are forwarded from tier to tier up to the non -Federal award.
Pursuant to Federal Rule (I) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term and after the awarded term of an award for all contracts by Participating Agency resulting from this procurement
process, the offeror certifies that it is in compliance with all applicable provisions of the Byrd Anti-Lobbying Amendment (31
U.S.C. 1352). The undersigned further certifies that:
(1) No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, to any person for influencing
or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress,
or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant,
the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment,
or modification of a 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, an officer or employee of congress,
or an employee of a Member of Congress in connection with this Federal grant 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 be included in the award documents for all covered
sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose
accordingly.
Does offeror agree? YES Initials of Authorized Representative of offeror
RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS
When federal funds are expended by Participating Agency for any contract resulting from this procurement process, offeror
certifies that it will comply with the record retention requirements detailed in 2 CFR § 200.333. The offeror further certifies that
offeror will retain all records as required by 2 CFR § 200.333 for a period of three years after grantees or subgrantees
submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT
When Participating Agency expends federal funds for any contract resulting from this procurement process, offeror certifies that
it will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy
conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18).
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS
To the extent purchases are made with Federal Highway Administration, Federal Railroad Administration, or Federal Transit
Administration funds, offeror certifies that its products comply with all applicable provisions of the Buy America Act and
agrees to provide such certification or applicable waiver with respect to specific products to any Participating Agency upon
request. Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling
for free and open competition.
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. § 200.336
Offeror agrees that the Inspector General of the Agency or any of their duly authorized representatives shall have access to any
documents, papers, or other records of offeror that are pertinent to offeror’s discharge of its obligations under the Contract for
the purpose of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access
to offeror’s personnel for the purpose of interview and discussion relating to such documents.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS
Offeror agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.
Does offeror agree? YES Initials of Authorized Representative of offeror
Offeror agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that offeror certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above.
Offeror’s Name:
____________________________________________________________________________________________
Address, City, State, and Zip Code:
_____________________________________________________________________________
Phone Number: __________________________________ Fax Number:
______________________________________
Printed Name and Title of Authorized Representative:
_____________________________________________________________________
Email Address:
____________________________________________________________________________________________
Signature of Authorized Representative: ____________________________________Date: _____________________________
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
FEMA SPECIAL CONDITIONS
Awarded Supplier(s) may need to respond to events and losses where products and services are needed
for the immediate and initial response to emergency situations such as, but not limited to, water damage,
fire damage, vandalism cleanup, biohazard cleanup, sewage decontamination, deodorization, and/or wind
damage during a disaster or emergency situation. By submitting a proposal, the Supplier is accepted these
FEMA Special Conditions required by the Federal Emergency Management Agency (FEMA).
“Contract” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as the
“Master Agreement”.
“Contractor” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as
“Supplier” or “Awarded Supplier”.
Conflicts of Interest
No employee, officer, or agent may participate in the selection, award, or administration of a contract
supported by a FEMA award if he or she has a real or apparent conflict of interest. Such a conflict would
arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner,
or an organization which employs or is about to employ any of these parties, has a financial or other interest
in or a tangible personal benefit from a firm considered for award. 2 C.F.R. § 200.318(c)(1); See also
Standard Form 424D, ¶ 7; Standard Form 424B, ¶ 3. i. FEMA considers a “financial interest” to be the
potential for gain or loss to the employee, officer, or agent, any member of his or her immediate family, his
or her partner, or an organization which employs or is about to employ any of these parties as a result of
the particular procurement. The prohibited financial interest may arise from ownership of certain financial
instruments or investments such as stock, bonds, or real estate, or from a salary, indebtedness, job offer,
or similar interest that might be affected by the particular procurement. ii. FEMA considers an “apparent”
conflict of interest to exist where an actual conflict does not exist, but where a reasonable person with
knowledge of the relevant facts would question the impartiality of the employee, officer, or agent
participating in the procurement. c. Gifts. The officers, employees, and agents of the Participating Public
Agency nor the Participating Public Agency (“NFE”) must neither solicit nor accept gratuities, favors, or
anything of monetary value from contractors or parties to subcontracts. However, NFE’s may set standards
for situations in which the financial interest is de minimus, not substantial, or the gift is an unsolicited item
of nominal value. 2 C.F.R. § 200.318(c)(1). d. Violations. The NFE’s written standards of conduct must
provide for disciplinary actions to be applied for violations of such standards by officers, employees, or
agents of the NFE. 2 C.F.R. § 200.318(c)(1). For example, the penalty for a NFE’s employee may be
dismissal, and the penalty for a contractor might be the termination of the contract.
Contractor Integrity
A contractor must have a satisfactory record of integrity and business ethics. Contractors that are debarred
or suspended, as described in and subject to the debarment and suspension regulations implementing
Executive Order 12549, Debarment and Suspension (1986) and Executive Order 12689, Debarment and
Suspension (1989) at 2 C.F.R. Part 180 and the Department of Homeland Security’s regulations at 2 C.F.R.
Part 3000 (Non-procurement Debarment and Suspension), must be rejected and cannot receive contract
awards at any level.
Public Policy
A contractor must comply with the public policies of the Federal Government and state, local government,
or tribal government. This includes, among other things, past and current compliance with the:
a. Equal opportunity and nondiscrimination laws
b. Five affirmative steps described at 2 C.F.R. § 200.321(b) for all subcontracting under contracts supported
by FEMA financial assistance; and FEMA Procurement Guidance June 21, 2016 Page IV- 7
c. Applicable prevailing wage laws, regulations, and executive orders
Affirmative Steps
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
For any subcontracting opportunities, Contractor must take the following Affirmative steps:
1. Placing qualified small and minority businesses and women's business enterprises on solicitation
lists;
2. Assuring that small and minority businesses, and women's business enterprises are solicited
whenever they are potential sources;
3. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit
maximum participation by small and minority businesses, and women's business enterprises;
4. Establishing delivery schedules, where the requirement permits, which encourage participation by
small and minority businesses, and women's business enterprises; and
5. Using the services and assistance, as appropriate, of such organizations as the Small Business
Administration and the Minority Business Development Agency of the Department of Commerce.
Prevailing Wage Requirements
When applicable, the awarded Contractor (s) and any and all subcontractor(s) agree to comply with all laws
regarding prevailing wage rates including the Davis-Bacon Act, applicable to this solicitation and/or
Participating Public Agencies. The Participating Public Agency shall notify the Contractor of the applicable
pricing/prevailing wage rates and must apply any local wage rates requested. The Contractor and any
subcontractor(s) shall comply with the prevailing wage rates set by the Participating Public Agency.
Federal Requirements
If products and services are issued in response to an emergency or disaster recovery the items below,
located in this FEMA Special Conditions section of the Federal Funds Certifications, are activated and
required when federal funding may be utilized.
2 C.F.R. § 200.326 and 2 C.F.R. Part 200, Appendix II, Required Contract Clauses
1. REMEDIES
a. Standard. Contracts for more than the simplified acquisition threshold, currently set at
$250,000, must address administrative, contractual, or legal remedies in instances where
contractors violate or breach contract terms, and provide for such sanctions and penalties
as appropriate. See 2 C.F.R. Part 200, Appendix II(A).
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
2. TERMINATION FOR CAUSE AND CONVENIENCE
a. Standard. All contracts in excess of $10,000 must address termination for cause and for
convenience by the non-Federal entity, including the manner by which it will be effected
and the basis for settlement. See 2 C.F.R. Part 200, Appendix II(B).
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
3. EQUAL EMPLOYMENT OPPORTUNITY
When applicable:
a. Standard. Except as otherwise provided under 41 C.F.R. Part 60, all contracts that meet
the definition of “federally assisted construction contract” in 41 C.F.R.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
§ 60-1.3 must include the equal opportunity clause provided under 41 C.F.R. § 60- 1.4(b),
in accordance with Executive Order 11246, Equal Employment Opportunity (30 Fed. Reg.
12319, 12935, 3 C.F.R. Part, 1964-1965 Comp., p.
339), as amended by Executive Order 11375, Amending Executive Order 11246 Relating
to Equal Employment Opportunity, and implementing regulations at 41
C.F.R. Part 60 (Office of Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor). See 2 C.F.R. Part 200, Appendix II(C).
b. Key Definitions.
i. Federally Assisted Construction Contract. The regulation at 41 C.F.R. § 60-
1.3 defines a “federally assisted construction contract” as any agreement or
modification thereof between any applicant and a person for construction work which
is paid for in whole or in part with funds obtained from the Government or borrowed
on the credit of the Government pursuant to any Federal program involving a grant,
contract, loan, insurance, or guarantee, or undertaken pursuant to any Federal
program involving such grant, contract, loan, insurance, or guarantee, or any
application or modification thereof approved by the Government for a grant, contract,
loan, insurance, or guarantee under which the applicant itself participates in the
construction work.
ii. Construction Work. The regulation at 41 C.F.R. § 60-1.3 defines “construction work”
as the construction, rehabilitation, alteration, conversion, extension, demolition or
repair of buildings, highways, or other changes or improvements to real property,
including facilities providing utility services. The term also includes the supervision,
inspection, and other onsite functions incidental to the actual construction.
c. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
d. Required Language. The regulation at 41 C.F.R. Part 60-1.4(b) requires the insertion of
the following contract clause.
During the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, sexual orientation, gender identity, or
national origin. The contractor will take affirmative action to ensure that applicants are
employed, and that employees are treated during employment without regard to their
race, color, religion, sex, sexual orientation, gender identity, or national origin. Such
action shall include, but not be limited to the following:
Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising;
layoff or termination; rates of pay or other forms of compensation; and selection for
training, including apprenticeship. The contractor agrees to post in conspicuous places,
available to employees and applicants for employment, notices to be provided setting
forth the provisions of this nondiscrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex, sexual orientation, gender
identity, or national origin.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
(3) The contractor will not discharge or in any other manner discriminate against any
employee or applicant for employment because such employee or applicant has inquired
about, discussed, or disclosed the compensation of the employee or applicant or another
employee or applicant. This provision shall not apply to instances in which an employee
who has access to the compensation information of other employees or applicants as a
part of such employee's essential job functions discloses the compensation of such other
employees or applicants to individuals who do not otherwise have access to such
information, unless such disclosure is in response to a formal complaint or charge, in
furtherance of an investigation, proceeding, hearing, or action, including an investigation
conducted by the employer, or is consistent with the contractor's legal duty to furnish
information.
(4) The contractor will send to each labor union or representative of workers with which
he has a collective bargaining agreement or other contract or understanding, a notice to
be provided advising the said labor union or workers' representatives of the contractor's
commitments under this section and shall post copies of the notice in conspicuous
places available to employees and applicants for employment.
(5) The contractor will comply with all provisions of Executive Order 11246 of September
24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
(6) The contractor will furnish all information and reports required by Executive Order
11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of
Labor, or pursuant thereto, and will permit access to his books, records, and accounts by
the administering agency and the Secretary of Labor for purposes of investigation to
ascertain compliance with such rules, regulations, and orders.
(7) In the event of the contractor's noncompliance with the nondiscrimination clauses of
this contract or with any of the said rules, regulations, or orders, this contract may be
canceled, terminated, or suspended in whole or in part and the contractor may be
declared ineligible for further Government contracts or federally assisted construction
contracts in accordance with procedures authorized in Executive Order 11246 of
September 24, 1965, and such other sanctions may be imposed and remedies invoked
as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or
order of the Secretary of Labor, or as otherwise provided by law.
(8) The contractor will include the portion of the sentence immediately preceding
paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or
purchase order unless exempted by rules, regulations, or orders of the Secretary of
Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965,
so that such provisions will be binding upon each subcontractor or vendor. The
contractor will take such action with respect to any subcontract or purchase order as the
administering agency may direct as a means of enforcing such provisions, including
sanctions for noncompliance:
Provided, however, that in the event a contractor becomes involved in, or is threatened
with, litigation with a subcontractor or vendor as a result of such direction by the
administering agency, the contractor may request the United States to enter into such
litigation to protect the interests of the United States.
The applicant further agrees that it will be bound by the above equal opportunity clause
with respect to its own employment practices when it participates in federally assisted
construction work: Provided, That if the applicant so participating is a State or local
government, the above equal opportunity clause is not applicable to any agency,
instrumentality or subdivision of such government which does not participate in work on
or under the contract.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
The applicant agrees that it will assist and cooperate actively with the administering
agency and the Secretary of Labor in obtaining the compliance of contractors and
subcontractors with the equal opportunity clause and the rules, regulations, and relevant
orders of the Secretary of Labor, that it will furnish the administering agency and the
Secretary of Labor such information as they may require for the supervision of such
compliance, and that it will otherwise assist the administering agency in the discharge of
the agency's primary responsibility for securing compliance.
The applicant further agrees that it will refrain from entering into any contract or contract
modification subject to Executive Order 11246 of September 24, 1965, with a contractor
debarred from, or who has not demonstrated eligibility for, Government contracts and
federally assisted construction contracts pursuant to the Executive Order and will carry
out such sanctions and penalties for violation of the equal opportunity clause as may be
imposed upon contractors and subcontractors by the administering agency or the
Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition, the
applicant agrees that if it fails or refuses to comply with these undertakings, the
administering agency may take any or all of the following actions: Cancel, terminate, or
suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from
extending any further assistance to the applicant under the program with respect to
which the failure or refund occurred until satisfactory assurance of future compliance has
been received from such applicant; and refer the case to the Department of Justice for
appropriate legal proceedings.
4. DAVIS-BACON ACT
a. Standard. All prime construction contracts in excess of $2,000 awarded by non- Federal
entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. §§ 3141-
3144 and 3146-3148) as supplemented by Department of Labor regulations at 29 C.F.R. Part
5 (Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction). See 2 C.F.R. Part 200, Appendix II(D). In accordance with the statute,
contractors must be required to pay wages to laborers and mechanics at a rate not less than
the prevailing wages specified in a wage determination made by the Secretary of Labor. In
addition, contractors must be required to pay wages not less than once a week.
b. Applicability. The Davis-Bacon Act applies to the Emergency Management Preparedness
Grant Program, Homeland Security Grant Program, Nonprofit Security Grant Program, Tribal
Homeland Security Grant Program, Port Security Grant Program, and Transit Security Grant
Program.
c. Requirements. If applicable, the non-federal entity must do the following:
i. The non-Federal entity must place a copy of the current prevailing wage
determination issued by the Department of Labor in each solicitation. The decision
to award a contract or subcontract must be conditioned upon the acceptance of
the wage determination. The non-Federal entity must report all suspected or
reported violations to the Federal awarding agency.
ii. Additionally, pursuant 2 C.F.R. Part 200, Appendix II(D), contracts subject to the
Davis-Bacon Act, must also include a provision for compliance with the Copeland
“Anti-Kickback” Act (40 U.S.C. § 3145), as supplemented by Department of Labor
regulations at 29 C.F.R. Part 3 (Contractors and Subcontractors on Public
Building or Public Work Financed in Whole or in Part by Loans or Grants from the
United States). The Copeland Anti- Kickback Act provides that each contractor or
subrecipient must be prohibited from inducing, by any means, any person
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
employed in the construction, completion, or repair of public work, to give up any
part of the compensation to which he or she is otherwise entitled. The non-
Federal entity must report all suspected or reported violations to FEMA.
iii. Include a provision for compliance with the Davis-Bacon Act (40 U.S.C. 3141-
3144, and 3146-3148) as supplemented by Department of Labor regulations (29
CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering
Federally Financed and Assisted Construction”).
Suggested Language. The following provides a sample contract clause:
Compliance with the Davis-Bacon Act.
a. All transactions regarding this contract shall be done in
compliance with the Davis-Bacon Act (40 U.S.C. 3141- 3144, and
3146-3148) and the requirements of 29 C.F.R. pt. 5 as may be
applicable. The contractor shall comply with 40 U.S.C. 3141-
3144, and 3146-3148 and the requirements of 29 C.F.R. pt. 5 as
applicable.
b. Contractors are required to pay wages to laborers and mechanics
at a rate not less than the prevailing wages specified in a wage
determination made by the Secretary of Labor.
c. Additionally, contractors are required to pay wages not less than
once a week.
5. COPELAND ANTI-KICKBACK ACT
a. Standard. Recipient and subrecipient contracts must include a provision for compliance with
the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by Department of Labor
regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public
Work Financed in Whole or in Part by Loans or Grants from the United States”).
b. Applicability. This requirement applies to all contracts for construction or repair work above
$2,000 in situations where the Davis-Bacon Act also applies. It DOES NOT apply to the FEMA
Public Assistance Program.
c. Requirements. If applicable, the non-federal entity must include a provision for compliance
with the Copeland “Anti-Kickback” Act (40 U.S.C. § 3145), as supplemented by Department
of Labor regulations at 29 C.F.R. Part 3 (Contractors and Subcontractors on Public Building
or Public Work Financed in Whole or in Part by Loans or Grants from the United States). Each
contractor or subrecipient must be prohibited from inducing, by any means, any person
employed in the construction, completion, or repair of public work, to give up any part of the
compensation to which he or she is otherwise entitled. The non-Federal entity must report all
suspected or reported violations to FEMA. Additionally, in accordance with the regulation,
each contractor and subcontractor must furnish each week a statement with respect to the
wages paid each of its employees engaged in work covered by the Copeland Anti-Kickback
Act and the Davis Bacon Act during the preceding weekly payroll period. The report shall be
delivered by the contractor or subcontractor, within seven days after the regular payment
date of the payroll period, to a representative of a Federal or State agency in charge at the
site of the building or work.
Sample Language. The following provides a sample contract clause:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Compliance with the Copeland “Anti-Kickback” Act.
a. Contractor. The contractor shall comply with 18 U.S.C. § 874, 40 U.S.C.
§ 3145, and the requirements of 29 C.F.R. pt. 3 as may be applicable,
which are incorporated by reference into this contract.
b. Subcontracts. The contractor or subcontractor shall insert in any
subcontracts the clause above and such other clauses as FEMA may
by appropriate instructions require, and also a clause requiring the
subcontractors to include these clauses in any lower tier subcontracts.
The prime contractor shall be responsible for the compliance by any
subcontractor or lower tier subcontractor with all of these contract
clauses.
c. Breach. A breach of the contract clauses above may be grounds for
termination of the contract, and for debarment as a contractor and
subcontractor as provided in 29 C.F.R. §5.12.”
6. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT
a. Standard. Where applicable (see 40 U.S.C. §§ 3701-3708), all contracts awarded by the
non-Federal entity in excess of $100,000 that involve the employment of mechanics or
laborers must include a provision for compliance with 40 U.S.C. §§ 3702 and 3704, as
supplemented by Department of Labor regulations at 29 C.F.R. Part 5. See 2 C.F.R. Part
200, Appendix II(E). Under 40 U.S.C. § 3702, each contractor must be required to
compute the wages of every mechanic and laborer on the basis of a standard work week
of 40 hours. Work in excess of the standard work week is permissible provided that the
worker is compensated at a rate of not less than one and a half times the basic rate of
pay for all hours worked in excess of 40 hours in the work week. Further, no laborer or
mechanic must be required to work in surroundings or under working conditions which
are unsanitary, hazardous, or dangerous.
b. Applicability. This requirement applies to all FEMA contracts awarded by the non- federal
entity in excess of $100,000 under grant and cooperative agreement programs that involve
the employment of mechanics or laborers. It is applicable to construction work. These
requirements do not apply to the purchase of supplies or materials or articles ordinarily
available on the open market, or contracts for transportation or transmission of
intelligence.
c. Suggested Language. The regulation at 29 C.F.R. § 5.5(b) provides contract clause
language concerning compliance with the Contract Work Hours and Safety Standards
Act. FEMA suggests including the following contract clause:
Compliance with the Contract Work Hours and Safety Standards Act.
(1) Overtime requirements. No contractor or subcontractor contracting for any part of
the contract work which may require or involve the employment of laborers or mechanics
shall require or permit any such laborer or mechanic in any workweek in which he or she
is employed on such work to work in excess of forty hours in such workweek unless such
laborer or mechanic receives compensation at a rate not less than one and one-half
times the basic rate of pay for all hours worked in excess of forty hours in such workweek.
(2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
of the clause set forth in paragraph (b)(1) of this section the contractor and any
subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such
contractor and subcontractor shall be liable to the United States (in the case of work
done under contract for the District of Columbia or a territory, to such District or to such
territory), for liquidated damages. Such liquidated damages shall be computed with
respect to each individual laborer or mechanic, including watchmen and guards,
employed in violation of the clause set forth in paragraph (b)(1) of this section, in the sum
of
$27 for each calendar day on which such individual was required or permitted to work in
excess of the standard workweek of forty hours without payment of the overtime wages
required by the clause set forth in paragraph (b)(1) of this section.
(3) Withholding for unpaid wages and liquidated damages. The Federal agency or
loan/grant recipient shall upon its own action or upon written request of an authorized
representative of the Department of Labor withhold or cause to be withheld, from any
moneys payable on account of work performed by the contractor or subcontractor under
any such contract or any other Federal contract with the same prime contractor, or any
other federally-assisted contract subject to the Contract Work Hours and Safety
Standards Act, which is held by the same prime contractor, such sums as may be
determined to be necessary to satisfy any liabilities of such contractor or subcontractor
for unpaid wages and liquidated damages as provided in the clause set forth in
paragraph (b)(2) of this section.
(4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the
clauses set forth in paragraph (b)(1) through (4) of this section and also a clause requiring
the subcontractors to include these clauses in any lower tier subcontracts. The prime
contractor shall be responsible for compliance by any subcontractor or lower tier
subcontractor with the clauses set forth in paragraphs (b)(1) through (4) of this section.
7. RIGHTS TO INVENTIONS MADE UNDER A CONTRACT OR AGREEMENT
a. Standard. If the FEMA award meets the definition of “funding agreement” under 37C.F.R.
§ 401.2(a) and the non-Federal entity wishes to enter into a contract with a small business
firm or nonprofit organization regarding the substitution of parties, assignment or
performance of experimental, developmental, or research work under that “funding
agreement,” the non- Federal entity must comply with the requirements of 37 C.F.R. Part
401 (Rights to Inventions Made by Nonprofit Organizations and Small Business Firms
Under Government Grants, Contracts and Cooperative Agreements), and any
implementing regulations issued by FEMA. See 2 C.F.R. Part 200, Appendix II(F).
b. Applicability. This requirement applies to “funding agreements,” but it DOES NOT apply
to the Public Assistance, Hazard Mitigation Grant Program, Fire Management Assistance
Grant Program, Crisis Counseling Assistance and Training Grant Program, Disaster Case
Management Grant Program, and Federal Assistance to Individuals and Households –
Other Needs Assistance Grant Program, as FEMA awards under these programs do not
meet the definition of “funding agreement.”
c. Funding Agreements Definition. The regulation at 37 C.F.R. § 401.2(a) defines “funding
agreement” as any contract, grant, or cooperative agreement entered into between any
Federal agency, other than the Tennessee Valley Authority, and any contractor for the
performance of experimental, developmental, or research work funded in whole or in part
by the Federal government. This term also includes any assignment, substitution of
parties, or subcontract of any type entered into for the performance of experimental,
developmental, or research work under a funding agreement as defined in the first
sentence of this paragraph.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
8. CLEAN AIR ACT AND THE FEDERAL WATER POLLUTION CONTROL ACT
a. Standard. If applicable, contracts must contain a provision that requires the contractor to
agree to comply with all applicable standards, orders, or regulations issued pursuant to
the Clean Air Act (42 U.S.C. §§ 7401-7671q.) and the Federal Water Pollution Control Act
as amended (33 U.S.C. §§ 1251-1387). Violations must be reported to FEMA and the
Regional Office of the Environmental Protection Agency. See 2 C.F.R. Part 200,
Appendix II(G).
b. Applicability. This requirement applies to contracts awarded by a non-federal entity of
amounts in excess of $150,000 under a federal grant.
c. Suggested Language. The following provides a sample contract clause.
Clean Air Act
1. The contractor agrees to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C.
§ 7401 et seq.
2. The contractor agrees to report each violation to the Participating Public
Agency and understands and agrees that the Participating Public Agency
will, in turn, report each violation as required to assure notification to the
Federal Emergency Management Agency, and the appropriate
Environmental Protection Agency Regional Office.
3. The contractor agrees to include these requirements in each subcontract
exceeding $150,000 financed in whole or in part with Federal assistance
provided by FEMA.
Federal Water Pollution Control Act
1. The contractor agrees to comply with all applicable standards, orders, or
regulations issued pursuant to the Federal Water Pollution Control Act, as
amended, 33 U.S.C. 1251 et seq.
2. The contractor agrees to report each violation to the Participating Public
Agency and understands and agrees that the Participating Public Agency
will, in turn, report each violation as required to assure notification to the
Federal Emergency Management Agency, and the appropriate
Environmental Protection Agency Regional Office.
3. The contractor agrees to include these requirements in each subcontract
exceeding $150,000 financed in whole or in part with Federal assistance
provided by FEMA.
9. DEBARMENT AND SUSPENSION
a. Standard. Non-Federal entities and contractors are subject to the debarment and
suspension regulations implementing Executive Order 12549, Debarment and
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Suspension (1986) and Executive Order 12689, Debarment and Suspension (1989) at 2
C.F.R. Part 180 and the Department of Homeland Security’s regulations at 2 C.F.R. Part
3000 (Non-procurement Debarment and Suspension).
b. Applicability. This requirement applies to all FEMA grant and cooperative
agreement programs.
c. Requirements.
i. These regulations restrict awards, subawards, and contracts with certain parties
that are debarred, suspended, or otherwise excluded from or ineligible for
participation in Federal assistance programs and activities. See 2 C.F.R. Part 200,
Appendix II(H); and 2 C.F.R. § 200.213. A contract award must not be made to
parties listed in the SAM Exclusions. SAM Exclusions is the list maintained by the
General Services Administration that contains the names of parties debarred,
suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549.
SAM exclusions can be accessed at www.sam.gov. See 2 C.F.R. § 180.530.
ii. In general, an “excluded” party cannot receive a Federal grant award or a contract
within the meaning of a “covered transaction,” to include subawards and
subcontracts. This includes parties that receive Federal funding indirectly, such
as contractors to recipients and subrecipients. The key to the exclusion is whether
there is a “covered transaction,” which is any non-procurement transaction
(unless excepted) at either a “primary” or “secondary” tier. Although “covered
transactions” do not include contracts awarded by the Federal Government for
purposes of the non-procurement common rule and DHS’s implementing
regulations, it does include some contracts awarded by recipients and
subrecipients.
iii. Specifically, a covered transaction includes the following contracts for goods or
services:
1. The contract is awarded by a recipient or subrecipient in the amount of at
least $25,000.
2. The contract requires the approval of FEMA, regardless of amount.
3. The contract is for federally-required audit services.
4. A subcontract is also a covered transaction if it is awarded by the
contractor of a recipient or subrecipient and requires either the approval of
FEMA or is in excess of $25,000.
d. Suggested Language. The following provides a debarment and suspension clause. It
incorporates an optional method of verifying that contractors are not excluded or
disqualified.
Suspension and Debarment
(1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R.
pt. 3000. As such, the contractor is required to verify that none of the contractor’s
principals (defined at 2 C.F.R. § 180.995) or its affiliates (defined at 2 C.F.R. §
180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
C.F.R. § 180.935).
(2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and2 C.F.R. pt. 3000,
subpart C, and must include a requirement to comply with these regulations in any
lower tier covered transaction it enters into.
(3) This certification is a material representation of fact relied upon by the Participating
Public Agency. If it is later determined that the contractor did not comply with 2
C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies
available to the Participating Public Agency, the Federal Government may pursue
available remedies, including but not limited to suspension and/or debarment.
(4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt.
180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and
throughout the period of any contract that may arise from this offer. The bidder or
proposer further agrees to include a provision requiring such compliance in its
lower tier covered transactions.
10. BYRD ANTI-LOBBYING AMENDMENT
a. Standard. Each tier certifies to the tier above that it will not and has not used Federal
appropriated funds to pay any person or organization for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, officer or
employee of Congress, or an employee of a Member of Congress in connection with
obtaining any Federal contract, grant or any other award covered by 31 U.S.C. § 1352.
FEMA’s regulation at 44 C.F.R. Part 18 implements the requirements of 31 U.S.C. § 1352
and provides, in Appendix A to Part 18, a copy of the certification that is required to be
completed by each entity as described in 31 U.S.C. § 1352. Each tier must also disclose
any lobbying with non-Federal funds that takes place in connection with obtaining any
Federal award. Such disclosures are forwarded from tier to tier up to the Federal
awarding agency.
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs. Contractors that apply or bid for a contract of $100,000 or more under a federal
grant must file the required certification. See 2 C.F.R. Part 200, Appendix II(I); 31 U.S.C.
§ 1352; and 44 C.F.R. Part 18.
c. Suggested Language.
Byrd Anti-Lobbying Amendment, 31 U.S.C. § 1352 (as amended)
Contractors who apply or bid for an award of $100,000 or more shall file the required
certification. Each tier certifies to the tier above that it will not and has not used Federal
appropriated funds to pay any person or organization for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, officer or
employee of Congress, or an employee of a Member of Congress in connection with
obtaining any Federal contract, grant, or any other award covered by 31 U.S.C. § 1352.
Each tier shall also disclose any lobbying with non-Federal funds that takes place in
connection with obtaining any Federal award. Such disclosures are forwarded from tier
to tier up to the recipient who in turn will forward the certification(s) to the awarding
agency.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
d. Required Certification. If applicable, contractors must sign and submit to the non-federal
entity the following certification.
APPENDIX A, 44 C.F.R. PART 18 – CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, 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 an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making 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, an 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 be included in
the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans, and cooperative agreements) and that
all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, title
31, U.S. Code. Any person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor, , certifies or affirms the truthfulness and
accuracy of each statement of its certification and disclosure, if any. In addition, the
Contractor understands and agrees that the provisions of 31 U.S.C. Chap. 38,
Administrative Remedies for False Claims and Statements, apply to this certification and
disclosure, if any.
Signature of Contractor’s Authorized Official
Name and Title of Contractor’s Authorized Official
Date
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
11. PROCUREMENT OF RECOVERED MATERIALS
a. Standard. A non-Federal entity that is a state agency or agency of a political subdivision
of a state and its contractors must comply with Section 6002 of the Solid Waste Disposal
Act, as amended by the Resource Conservation and Recovery Act. See 2 C.F.R. Part
200, Appendix II(J); and 2 C.F.R. § 200.322.
b. Applicability. This requirement applies to all contracts awarded by a non- federal entity
under FEMA grant and cooperative agreement programs.
c. Requirements. The requirements of Section 6002 include procuring only items
designated in guidelines of the EPA at 40 C.F.R. Part 247 that contain the highest
percentage of recovered materials practicable, consistent with maintaining a satisfactory
level of competition, where the purchase price of the item exceeds
$10,000 or the value of the quantity acquired by the preceding fiscal year exceeded
$10,000; procuring solid waste management services in a manner that maximizes energy
and resource recovery; and establishing an affirmative procurement program for
procurement of recovered materials identified in the EPA guidelines.
d. Suggested Language.
i. In the performance of this contract, the Contractor shall make maximum use of
products containing recovered materials that are EPA-designated items unless
the product cannot be acquired—
1. Competitively within a timeframe providing for compliance with the contract performance
schedule;
2. Meeting contract performance requirements; or
3. At a reasonable price.
ii. Information about this requirement, along with the list of EPA- designated items,
is available at EPA’s Comprehensive Procurement Guidelines web site,
https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program.
iii. The Contractor also agrees to comply with all other applicable requirements of
Section 6002 of the Solid Waste Disposal Act.”
12. ACCESS TO RECORDS
a. Standard. All recipients, subrecipients, successors, transferees, and assignees must
acknowledge and agree to comply with applicable provisions governing DHS access to
records, accounts, documents, information, facilities, and staff. Recipients must give
DHS/FEMA access to, and the right to examine and copy, records, accounts, and other
documents and sources of information related to the federal financial assistance award
and permit access to facilities, personnel, and other individuals and information as may be
necessary, as required by DHS regulations and other applicable laws or program
guidance. See DHS Standard Terms and Conditions: Version 8.1 (2018). Additionally,
Section 1225 of the Disaster Recovery Reform Act of 2018 prohibits FEMA from providing
reimbursement to any state, local, tribal, or territorial government, or private non-profit for
activities made pursuant to a contract that purports to prohibit audits or internal reviews
by the FEMA administrator or Comptroller General.
Access to Records. The following access to records requirements apply to this contract:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
i.The Contractor agrees to provide Participating Public Agency, the FEMA
Administrator, the Comptroller General of the United States, or any of their
authorized representatives access to any books, documents, papers, and records
of the Contractor which are directly pertinent to this contract for the purposes of
making audits, examinations, excerpts, and transcriptions.
ii.The Contractor agrees to permit any of the foregoing parties to reproduce by any
means whatsoever or to copy excerpts and transcriptions as reasonably needed.
iii. The Contractor agrees to provide the FEMA Administrator or his authorized
representatives access to construction or other work sites pertaining to the work
being completed under the contract.
iv.In compliance with the Disaster Recovery Act of 2018, the Participating Public
Agency and the Contractor acknowledge and agree that no language in this
contract is intended to prohibit audits or internal reviews by the FEMA Administrator
or the Comptroller General of the United States.
13. CHANGES
a. Standard. To be eligible for FEMA assistance under the non-Federal entity’s FEMA grant
or cooperative agreement, the cost of the change, modification, change order, or
constructive change must be allowable, allocable, within the scope of its grant or
cooperative agreement, and reasonable for the completion of project scope.
b. Applicability. FEMA recommends, therefore, that a non-Federal entity include a changes
clause in its contract that describes how, if at all, changes can be made by either party to
alter the method, price, or schedule of the work without breaching the contract. The
language of the clause may differ depending on the nature of the contract and the end-item
procured.
14. DHS SEAL, LOGO, AND FLAGS
a. Standard. Recipients must obtain permission prior to using the DHS seal(s), logos, crests,
or reproductions of flags or likenesses of DHS agency officials. See DHS Standard Terms
and Conditions: Version 8.1 (2018).
b. Applicability. FEMA recommends that all non-Federal entities place in their contracts a
provision that a contractor shall not use the DHS seal(s), logos, crests, or reproductions of
flags or likenesses of DHS agency officials without specific FEMA pre-approval.
c. “The contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or
likenesses of DHS agency officials without specific FEMA pre-approval.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
15. COMPLIANCE WITH FEDERAL LAW, REGULATIONS, AND EXECUTIVE ORDERS
a. Standard. The recipient and its contractors are required to comply with all Federal laws,
regulations, and executive orders.
b. Applicability. FEMA recommends that all non-Federal entities place into their contracts an
acknowledgement that FEMA financial assistance will be used to fund the contract along with
the requirement that the contractor will comply with all applicable Federal law, regulations,
executive orders, and FEMA policies, procedures, and directives.
c. “This is an acknowledgement that FEMA financial assistance will be used to fund all or a
portion of the contract. The contractor will comply with all applicable Federal law, regulations,
executive orders, FEMA policies, procedures, and directives.”
16. NO OBLIGATION BY FEDERAL GOVERNMENT
a. Standard. FEMA is not a party to any transaction between the recipient and its contractor.
FEMA is not subject to any obligations or liable to any party for any matter relating to the
contract.
b. Applicability. FEMA recommends that the non-Federal entity include a provision in its contract
that states that the Federal Government is not a party to the contract and is not subject to any
obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to
any matter resulting from the contract.
c. “The Federal Government is not a party to this contract and is not subject to any obligations or
liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter
resulting from the contract.”
17. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS OR RELATED ACTS
a. Standard. Recipients must comply with the requirements of The False Claims Act (31 U.S.C.
§§ 3729-3733) which prohibits the submission of false or
fraudulent claims for payment to the federal government. See DHS Standard Terms and
Conditions: Version 8.1 (2018); and 31 U.S.C. §§ 3801-3812, which details the
administrative remedies for false claims and statements made. The non-Federal entity must
include a provision in its contract that the contractor acknowledges that 31 U.S.C. Chap. 38
(Administrative Remedies for False Claims and Statements) applies to its actions pertaining
to the contract.
b. Applicability. FEMA recommends that the non-Federal entity include a provision in its contract
that the contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False
Claims and Statements) applies to its actions pertaining to the contract.
c. “The Contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False
Claims and Statements) applies to the Contractor’s actions pertaining to this contract.”
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Offeror agrees to comply with all terms and conditions outlined in the FEMA Special Conditions
section of this solicitation.
Offeror’s Name: ______________________________________________
Address, City, State, and Zip Code:
_____________________________________________________________________________
Phone Number: ________________________ Fax Number: ______________________________
Printed Name and Title of Authorized Representative:
____________________________________________________________
Email Address: _____________________________________________
Signature of Authorized Representative: ____________________________________
Date: ________________________________
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Exhibit G
New Jersey Business Compliance
NEW JERSEY BUSINESS COMPLIANCE
Suppliers intending to do business in the State of New Jersey must comply with policies and
procedures required under New Jersey statues. All offerors submitting proposals must complete the
following forms specific to the State of New Jersey. Completed forms should be submitted with the
offeror’s response to the RFP. Failure to complete the New Jersey packet will impact OMNIA
Partners’ ability to promote the Master Agreement in the State of New Jersey.
DOC #1 Ownership Disclosure Form
DOC #2 Non-Collusion Affidavit
DOC #3 Affirmative Action Affidavit
DOC #4 Political Contribution Disclosure Form
DOC #5 Stockholder Disclosure Certification
DOC #6 Certification of Non-Involvement in Prohibited Activities in Iran
DOC #7 New Jersey Business Registration Certificate
DOC #8 EEOAA Evidence
DOC #9 MacBride Principals Form
New Jersey suppliers are required to comply with the following New Jersey statutes when
applicable:
• all anti-discrimination laws, including those contained in N.J.S.A. 10:2-1 through N.J.S.A.
10:2-14, N.J.S.A. 10:5-1, and N.J.S.A. 10:5-31 through 10:5-38;
• Prevailing Wage Act, N.J.S.A. 34:11-56.26, for all contracts within the contemplation of the
Act;
• Public Works Contractor Registration Act, N.J.S.A. 34:11-56.26; and
• Bid and Performance Security, as required by the applicable municipal or state statutes.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #1
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)
This statement shall be completed, certified to, and included with all bid and proposal submissions.
Failure to submit the required information is cause for automatic rejection of the bid or proposal.
Name of Organization:_____________________________________________________
Organization Address:_____________________________________________________
Part I Check the box that represents the type of business organization:
Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
For-Profit Corporation (any type) Limited Liability Company (LLC)
Partnership Limited Partnership Limited Liability Partnership (LLP)
Other (be specific): ______________________________________________
Part II
The list below contains the names and addresses of all stockholders in the
corporation who own 10 percent or more of its stock, of any class, or of all individual
partners in the partnership who own a 10 percent or greater interest therein, or of all
members in the limited liability company who own a 10 percent or greater interest
therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION)
OR
No one stockholder in the corporation owns 10 percent or more of its stock, of any
class, or no individual partner in the partnership owns a 10 percent or greater
interest therein, or no member in the limited liability company owns a 10 percent or
greater interest therein, as the case may be. (SKIP TO PART IV)
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity Home Address (for Individuals) or Business Address
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS,
PARTNERS OR LLC MEMBERS LISTED IN PART II
If a bidder has a direct or indirect parent entity which is publicly traded, and any person
holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of
the last annual federal Security and Exchange Commission (SEC) or foreign equivalent
filing, ownership disclosure can be met by providing links to the website(s) containing the last
annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent)
that contain the name and address of each person holding a 10% or greater beneficial interest
in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that
contain the information on each such person. Attach additional sheets if more space is
needed.
Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s
Please list the names and addresses of each stockholder, partner or member owning a 10
percent or greater interest in any corresponding corporation, partnership and/or limited liability
company (LLC) listed in Part II other than for any publicly traded parent entities
referenced above. The disclosure shall be continued until names and addresses of every
noncorporate stockholder, and individual partner, and member exceeding the 10 percent
ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach
additional sheets if more space is needed.
Stockholder/Partner/Member and Corresponding
Entity Listed in Part II
Home Address (for Individuals) or Business Address
Part IV Certification
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto
to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this
certification on behalf of the bidder/proposer; that the <name of contracting unit> is relying on the information
contained herein and that I am under a continuing obligation from the date of this certification through the
completion of any contracts with <type of contracting unit> to notify the <type of contracting unit> in writing
of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false
statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the
law and that it will constitute a material breach of my agreement(s) with the, permitting the <type of
contracting unit> to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #2
NON-COLLUSION AFFIDAVIT
STANDARD BID DOCUMENT REFERENCE
Reference: VII-H
Name of Form: NON-COLLUSION AFFIDAVIT
Statutory Reference: No specific statutory reference
State Statutory Reference N.J.S.A. 52:34-15
Instructions Reference: Statutory and Other Requirements VII-H
Description:
The Owner’s use of this form is optional. It is used to ensure that
the bidder has not participated in any collusion with any other
bidder or Owner representative or otherwise taken any action in
restraint of free and competitive bidding.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
NON-COLLUSION AFFIDAVIT
State of New Jersey
County of _________________ ss:
I, ________________________________ residing in ___________________________________
(name of affiant) (name of municipality)
in the County of _______________________________ and State of _____________________of full
age, being duly sworn according to law on my oath depose and say that:
I am _____________________________________ of the firm of _________________________
(title or position) (name of firm)
_____________________________________ the bidder making this Proposal for the bid
entitled ______________________________, and that I executed the said proposal with (title of bid proposal) full authority to do so that said bidder has not, directly or indirectly entered into any agreement,
participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in
connection with the above named project; and that all statements contained in said proposal and in this
affidavit are true and correct, and made with full knowledge that the ______________
_________________________relies upon the truth of the statements contained in said Proposal (name of contracting unit) and in the statements contained in this affidavit in awarding the contract for the said project.
I further warrant that no person or selling agency has been employed or retained to solicit or secure such
contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent
fee, except bona fide employees or bona fide established commercial or selling agencies maintained by
_________________________________________________.
Subscribed and sworn to
before me this day _____________________________
Signature
________________, 2____ ___________________________________
(Type or print name of affiant under signature)
_____________________________
Notary public of
My Commission expires _______________
(Seal)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #3
AFFIRMATIVE ACTION AFFIDAVIT
(P.L. 1975, C.127)
Company Name:
Street:
City, State, Zip Code:
Proposal Certification:
Indicate below company’s compliance with New Jersey Affirmative Action regulations. Company’s
proposal will be accepted even if company is not in compliance at this time. No contract and/or
purchase order may be issued, however, until all Affirmative Action requirements are met.
Required Affirmative Action Evidence:
Procurement, Professional & Service Contracts (Exhibit A)
Vendors must submit with proposal:
1. A photocopy of a valid letter that the contractor is operating under an existing Federally
approved or sanctioned affirmative action program (good for one year from the date of the
letter);
OR
2. A photocopy of a Certificate of Employee Information Report approval, issued in
accordance with N.J.A.C. 17:27-4;
OR
3. A photocopy of an Employee Information Report (Form AA302) provided by the Division
of Contract Compliance and Equal Employment Opportunity in Public Contracts and
distributed to the public agency to be completed by the contractor in accordance with
N.J.A.C. 17:27-4.
Public Work – Over $50,000 Total Project Cost:
D. No approved Federal or New Jersey Affirmative Action Plan. We will complete Report Form
AA201. A project contract ID number will be assigned to your firm upon receipt of the
completed Initial Project Workforce Report (AA201) for this contract.
E. Approved Federal or New Jersey Plan – certificate enclosed
I further certify that the statements and information contained herein, are complete and correct to
the best of my knowledge and belief.
_______________________ _________________________________
Date Authorized Signature and Title
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #3, continued
P.L. 1995, c. 127 (N.J.A.C. 17:27)
MANDATORY AFFIRMATIVE ACTION LANGUAGE
PROCUREMENT, PROFESSIONAL AND SERVICE
CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for
employment because of age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual
orientation. The contractor will take affirmative action to ensure that such applicants are recruited and employed, and
that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry,
marital status, sex, affectional or sexual orientation. Such action shall include, but not be limited to the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay
or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency
Compliance Officer setting forth provisions of this non-discrimination clause.
The contractor or subcontractor, where applicable will, in all solicitations or advertisement for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to
age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation.
The contractor or subcontractor, where applicable, will send to each labor union or representative of workers with which
it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency
contracting officer advising the labor union or workers' representative of the contractor's commitments under this act and
shall post copies of the notice in conspicuous places available to employees and applicants for employment.
The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer
pursuant to P.L. 1975, c. 127, as amended and supplemented from time to time and the Americans with Disabilities Act.
The contractor or subcontractor agrees to attempt in good faith to employ minority and female workers trade consistent
with the applicable county employment goal prescribed by N.J.A.C. 17:27-5.2 promulgated by the Treasurer pursuant to
P.L. 1975, C.127, as amended and supplemented from time to time or in accordance with a binding determination of the
applicable county employment goals determined by the Affirmative Action Office pursuant to N.J.A.C. 17:27-5.2
promulgated by the Treasurer pursuant to P.L. 1975, C.127, as amended and supplemented from time to time.
The contractor or subcontractor agrees to inform in writing appropriate recruitment agencies in the area, including
employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis
of age, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation, and that it will
discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.
The contractor or subcontractor agrees to revise any of it testing procedures, if necessary, to assure that all personnel
testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the state
of New Jersey and as established by applicable Federal law and applicable Federal court decisions.
The contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and lay-off
to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, sex,
affectional or sexual orientation, and conform with the applicable employment goals, consistent with the statutes and court
decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions.
The contractor and its subcontractors shall furnish such reports or other documents to the Affirmative Action Office as
may be requested by the office from time to time in order to carry out the purposes of these regulations, and public
agencies shall furnish such information as may be requested by the Affirmative Action Office for conducting a compliance
investigation pursuant to Subchapter 10 of the Administrative Code (NJAC 17:27).
________________________________________________
Signature of Procurement Agent
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #4
F. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Public Agency Instructions
This page provides guidance to public agencies entering into contracts with business entities that are
required to file Political Contribution Disclosure forms with the agency. It is not intended to be provided to
contractors. What follows are instructions on the use of form local units can provide to contractors that are required to
disclose political contributions pursuant to N.J.S.A. 19:44A-20.26 (P.L. 2005, c. 271, s.2). Additional information on the
process is available in Local Finance Notice 2006-1 (http://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html).
Please refer back to these instructions for the appropriate links, as the Local Finance Notices include links that are no
longer operational.
4. The disclosure is required for all contracts in excess of $17,500 that are not awarded pursuant to a “fair and open”
process (N.J.S.A. 19:44A-20.7).
5. Due to the potential length of some contractor submissions, the public agency should consider allowing data to be
submitted in electronic form (i.e., spreadsheet, pdf file, etc.). Submissions must be kept with the contract documents
or in an appropriate computer file and be available for public access. The form is worded to accept this alternate
submission. The text should be amended if electronic submission will not be allowed.
6. The submission must be received from the contractor and on file at least 10 days prior to award of the contract.
Resolutions of award should reflect that the disclosure has been received and is on file.
7. The contractor must disclose contributions made to candidate and party committees covering a wide range of public
agencies, including all public agencies that have elected officials in the county of the public agency, state legislative
positions, and various state entities. The Division of Local Government Services recommends that contractors be
provided a list of the affected agencies. This will assist contractors in determining the campaign and political
committees of the officials and candidates affected by the disclosure.
a. The Division has prepared model disclosure forms for each county. They can be downloaded from the “County
PCD Forms” link on the Pay-to-Play web site at http://www.nj.gov/dca/divisions/dlgs/programs/lpcl.html#12.
They will be updated from time-to-time as necessary.
b. A public agency using these forms should edit them to properly reflect the correct legislative district(s). As
the forms are county-based, they list all legislative districts in each county. Districts that do not represent
the public agency should be removed from the lists.
c. Some contractors may find it easier to provide a single list that covers all contributions, regardless of the county.
These submissions are appropriate and should be accepted.
d. The form may be used “as-is”, subject to edits as described herein.
e. The “Contractor Instructions” sheet is intended to be provided with the form. It is recommended that the
Instructions and the form be printed on the same piece of paper. The form notes that the Instructions are printed
on the back of the form; where that is not the case, the text should be edited accordingly.
f. The form is a Word document and can be edited to meet local needs, and posted for download on web sites, used
as an e-mail attachment, or provided as a printed document.
8. It is recommended that the contractor also complete a “Stockholder Disclosure Certification.” This will assist the
local unit in its obligation to ensure that contractor did not make any prohibited contributions to the committees listed
on the Business Entity Disclosure Certification in the 12 months prior to the contract (See Local Finance Notice
2006-7 for additional information on this obligation at
http://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html). A sample Certification form is part of this package
and the instruction to complete it is included in the Contractor Instructions. NOTE: This section is not applicable to
Boards of Education.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #4, continued
O. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair and
open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (N.J.S.A. 19:44A-
20.26). This law provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions
to:
• any State, county, or municipal committee of a political party
• any legislative leadership committee*
• any continuing political committee (a.k.a., political action committee)
• any candidate committee of a candidate for, or holder of, an elective office:
o of the public entity awarding the contract
o of that county in which that public entity is located
o of another public entity within that county
o or of a legislative district in which that public entity is located or, when the public entity is a county, of
any legislative district which includes all or part of the county
The disclosure must list reportable contributions to any of the committees that exceed $300 per election cycle that were
made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on
reportable contributions.
N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a
natural person. This includes the following:
• individuals with an “interest” ownership or control of more than 10% of the profits or assets of a business entity
or 10% of the stock in the case of a business entity that is a corporation for profit
• all principals, partners, officers, or directors of the business entity or their spouses
• any subsidiaries directly or indirectly controlled by the business entity
• IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity
and filing as continuing political committees, (PACs).
When the business entity is a natural person, “a contribution by that person’s spouse or child, residing therewith, shall be
deemed to be a contribution by the business entity.” [N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the
disclosure.
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an
amount to be determined by the Commission which may be based upon the amount that the business entity failed to report.
The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official
and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor’s responsibility to
identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed
information may exceed the minimum requirement.
The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a
signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the Open Public
Records Act.
The contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in
meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts.
* N.J.S.A. 19:44A-3(s): “The term "legislative leadership committee" means a committee established, authorized to be
established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the General
Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65 (C.19:44A-10.1) for
the purpose of receiving contributions and making expenditures.”
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #4, continued
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant to N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the local unit
no later than 10 days prior to the award of the contract.
• Part I – Vendor Information
Vendor Name:
Address:
City: State: Zip:
The undersigned being authorized to certify, hereby certifies that the submission provided herein represents
compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions
accompanying this form.
_______________________ _______________________ ________________________
Signature Printed Name Title
• Part II – Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable
political contributions (more than $300 per election cycle) over the 12 months prior to submission to
the committees of the government entities listed on the form provided by the local unit.
Check here if disclosure is provided in electronic form
Contributor Name Recipient Name Date Dollar Amount
$
Check here if the information is continued on subsequent page(s)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #4, continued
List of Agencies with Elected Officials Required for Political Contribution Disclosure
N.J.S.A. 19:44A-20.26
County Name:
State: Governor, and Legislative Leadership Committees
Legislative District #s:
State Senator and two members of the General Assembly per district.
County:
Freeholders County Clerk Sheriff
{County Executive} Surrogate
Municipalities (Mayor and members of governing body, regardless of title):
USERS SHOULD CREATE THEIR OWN FORM, OR DOWNLOAD
FROM THE PAY TO PLAY SECTION OF THE DLGS WEBSITE A
COUNTY-BASED, CUSTOMIZABLE FORM.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #5
STOCKHOLDER DISCLOSURE CERTIFICATION
Name of Business:
I certify that the list below contains the names and home addresses of all stockholders
holding 10% or more of the issued and outstanding stock of the undersigned.
OR
I certify that no one stockholder owns 10% or more of the issued and outstanding stock of
the undersigned.
Check the box that represents the type of business organization:
Partnership Corporation Sole Proprietorship
Limited Partnership Limited Liability Corporation Limited Liability Partnership
Subchapter S Corporation
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
Stockholders:
Name: Name:
Home Address:
Home Address:
Name: Name:
Home Address: Home Address:
Name:
Name:
Home Address:
Home Address:
Subscribed and sworn before me this ___ day of ___________,
2__.
(Notary Public)
My Commission expires:
_________________________________
(Affiant)
________________________________
(Print name & title of affiant)
(Corporate Seal)
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #6
Certification of Non-Involvement in Prohibited Activities in Iran
Pursuant to N.J.S.A. 52:32-58, Offerors must certify that neither the Offeror, nor any of its parents,
subsidiaries, and/or affiliates (as defined in N.J.S.A. 52:32 – 56(e) (3)), is listed on the Department
of the Treasury’s List of Persons or Entities Engaging in Prohibited Investment Activities in Iran
and that neither is involved in any of the investment activities set forth in N.J.S.A. 52:32 – 56(f).
Offerors wishing to do business in New Jersey through this contract must fill out the Certification of
Non-Involvement in Prohibited Activities in Iran here:
http://www.state.nj.us/humanservices/dfd/info/standard/fdc/disclosure_investmentact.pdf.
Offerors should submit the above form completed with their proposal.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
DOC #7
NEW JERSEY BUSINESS REGISTRATION CERTIFICATE
(N.J.S.A. 52:32-44)
Offerors wishing to do business in New Jersey must submit their State Division of Revenue issued
Business Registration Certificate with their proposal here. Failure to do so will disqualify the
Offeror from offering products or services in New Jersey through any resulting contract.
https://www.njportal.com/DOR/BusinessRegistration/
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DOC #8
EEOAA EVIDENCE
Equal Employment Opportunity/Affirmative Action
Goods, Professional Services & General Service Projects
EEO/AA Evidence
Vendors are required to submit evidence of compliance with N.J.S.A. 10:5-31 et seq. and
N.J.A.C. 17:27 in order to be considered a responsible vendor.
One of the following must be included with submission:
• Copy of Letter of Federal Approval
• Certificate of Employee Information Report
• Fully Executed Form AA302
• Fully Executed EEO-1 Report
See the guidelines at:
https://www.state.nj.us/treasury/contract_compliance/documents/pdf/guidelines/pa.pdf
for further information.
I certify that my bid package includes the required evidence per the above list and
State website.
Name: ______________________________ Title: _____________________
Signature: ___________________________ Date: _____________________
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor/Bidder, that the foregoing
information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State
of New Jersey is relying on the information contained herein, and that the Vendor/Bidder is under a continuing obligation
from the date of this certification through the completion of any contract(s) with the State to notify the State in writing of
any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or
misrepresentation in this certification. If I do so, I will be subject to criminal prosecution under the law, and it will constitute
a material breach of my agreement(s) with the State, permitting the State to declare any contract(s) resulting from this
certification to be void and unenforceable.
DOC #9
MACBRIDE-PRINCIPLES
MACBRIDE PRINCIPALS FORM
• _____________________
VENDOR’S/BIDDER’S REQUIREMENT
TO PROVIDE A CERTIFICATION IN COMPLIANCE WITH THE MACBRIDE PRINCIPALS
AND NORTHERN IRELAND ACT OF 1989
Pursuant to Public Law 1995, c. 134, a responsible Vendor/Bidder selected, after public bidding, by the Director
of the Division of Purchase and Property, pursuant to N.J.S.A. 52:34-12, must complete the certification below by
checking one of the two options listed below and signing where indicated. If a Vendor/Bidder that would otherwise
be awarded a purchase, contract or agreement does not complete the certification, then the Director may determine,
in accordance with applicable law and rules, that it is in the best interest of the State to award the purchase, contract
or agreement to another Vendor/Bidder that has completed the certification and has submitted a bid within five (5)
percent of the most advantageous bid. If the Director finds contractors to be in violation of the principals that are
the subject of this law, he/she shall take such action as may be appropriate and provided by law, rule or contract,
including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in
default and seeking debarment or suspension of the party.
I, the undersigned, on behalf the Vendor/Bidder, certify pursuant to N.J.S.A. 52:34-12.2 that:
CHECK THE APPROPRIATE BOX
The Vendor/Bidder has no business operations in Northern Ireland; or
OR
The Vendor/Bidder will take lawful steps in good faith to conduct any business operations it has in Northern Ireland
in accordance with the MacBride principals of nondiscrimination in employment as set forth in section 2 of P.L. 1987,
c. 177 (N.J.S.A. 52:18A-89.5) and in conformance with the United Kingdom’s Fair Employment (Northern Ireland)
Act of 1989, and permit independent monitoring of its compliance with those principals.
Signature Date
Print Name and Title
STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
BID SOLICITATION #: VENDOR/BIDDER:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version April 12, 2022
Exhibit H
Advertising Compliance Requirement
Pursuant to certain state notice provisions, including but not limited to Oregon Revised Statutes Chapter 279A.210, Chapter
279A.220, and other related provisions, the following public agencies and political subdivisions of the referenced public agencies are
eligible to register with OMNIA Partners and access the Master Agreement contract award made pursuant to this solicitation, and are
hereby given notice of the foregoing request for proposals for purposes of complying with the procedural requirements of said
statutes:
Nationwide:
State of Alabama State of Hawaii Commonwealth of
Massachusetts
State of New Mexico State of South
Dakota
State of Alaska State of Idaho State of Michigan State of New York State of Tennessee
State of Arizona State of Illinois State of Minnesota State of North Carolina State of Texas
State of Arkansas State of Indiana State of Mississippi State of North Dakota State of Utah
State of California State of Iowa State of Missouri State of Ohio State of Vermont
State of Colorado State of Kansas State of Montana State of Oklahoma Commonwealth of
Virginia
State of Connecticut Commonwealth of
Kentucky
State of Nebraska State of Oregon State of Washington
State of Delaware State of Louisiana State of Nevada Commonwealth of
Pennsylvania
State of West
Virginia
State of Florida State of Maine State of New Hampshire State of Rhode Island State of Wisconsin
State of Georgia State of Maryland State of New Jersey State of South Carolina State of Wyoming
District of Columbia
Lists of political subdivisions and local governments in the above referenced states / districts may be found at
http://www.usa.gov/Agencies/State_and_Territories.shtml and https://www.usa.gov/local-governments.
Certain Public Agencies and Political Subdivisions:
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
CITIES, TOWNS, VILLAGES AND BOROUGHS INCLUDING BUT NOT LIMITED TO:
BAKER CITY GOLF COURSE, OR
CITY OF ADAIR VILLAGE, OR
CITY OF ASHLAND, OR
CITY OF AUMSVILLE, OR
CITY OF AURORA, OR
CITY OF BAKER, OR
CITY OF BATON ROUGE, LA
CITY OF BEAVERTON, OR
CITY OF BEND, OR
CITY OF BOARDMAN, OR
CITY OF BONANAZA, OR
CITY OF BOSSIER CITY, LA
CITY OF BROOKINGS, OR
CITY OF BURNS, OR
CITY OF CANBY, OR
CITY OF CANYONVILLE, OR
CITY OF CLATSKANIE, OR
CITY OF COBURG, OR
CITY OF CONDON, OR
CITY OF COQUILLE, OR
CITY OF CORVALLI, OR
CITY OF CORVALLIS PARKS AND RECREATION
DEPARTMENT, OR
CITY OF COTTAGE GROVE, OR
CITY OF DONALD, OR
CITY OF EUGENE, OR
CITY OF FOREST GROVE, OR
CITY OF GOLD HILL, OR
CITY OF GRANTS PASS, OR
CITY OF GRESHAM, OR
CITY OF HILLSBORO, OR
CITY OF INDEPENDENCE, OR
CITY AND COUNTY OF HONOLULU, HI
CITY OF KENNER, LA
CITY OF LA GRANDE, OR
CITY OF LAFAYETTE, LA
CITY OF LAKE CHARLES, OR
CITY OF LEBANON, OR
CITY OF MCMINNVILLE, OR
CITY OF MEDFORD, OR
CITY OF METAIRIE, LA
CITY OF MILL CITY, OR
CITY OF MILWAUKIE, OR
CITY OF MONROE, LA
CITY OF MOSIER, OR
CITY OF NEW ORLEANS, LA
CITY OF NORTH PLAINS, OR
CITY OF OREGON CITY, OR
CITY OF PILOT ROCK, OR
CITY OF PORTLAND, OR
CITY OF POWERS, OR
CITY OF PRINEVILLE, OR
CITY OF REDMOND, OR
CITY OF REEDSPORT, OR
CITY OF RIDDLE, OR
CITY OF ROGUE RIVER, OR
CITY OF ROSEBURG, OR
CITY OF SALEM, OR
CITY OF SANDY, OR
CITY OF SCAPPOOSE, OR
CITY OF SHADY COVE, OR
CITY OF SHERWOOD, OR
CITY OF SHREVEPORT, LA
CITY OF SILVERTON, OR
CITY OF SPRINGFIELD, OR
CITY OF ST. HELENS, OR
CITY OF ST. PAUL, OR
CITY OF SULPHUR, LA
CITY OF TIGARD, OR
CITY OF TROUTDALE, OR
CITY OF TUALATIN, OR
CITY OF WALKER, LA
CITY OF WARRENTON, OR
CITY OF WEST LINN, OR
CITY OF WILSONVILLE, OR
CITY OF WINSTON, OR
CITY OF WOODBURN, OR
LEAGUE OF OREGON CITES
THE CITY OF HAPPY VALLEY OREGON
ALPINE, UT
ALTA, UT
ALTAMONT, UT
ALTON, UT
AMALGA, UT
AMERICAN FORK CITY, UT
ANNABELLA, UT
ANTIMONY, UT
APPLE VALLEY, UT
AURORA, UT
BALLARD, UT
BEAR RIVER CITY, UT
BEAVER, UT
BICKNELL, UT
BIG WATER, UT
BLANDING, UT
BLUFFDALE, UT
BOULDER, UT
CITY OF BOUNTIFUL, UT
BRIAN HEAD, UT
BRIGHAM CITY CORPORATION, UT
BRYCE CANYON CITY, UT
CANNONVILLE, UT
CASTLE DALE, UT
CASTLE VALLEY, UT
CITY OF CEDAR CITY, UT
CEDAR FORT, UT
CITY OF CEDAR HILLS, UT
CENTERFIELD, UT
CENTERVILLE CITY CORPORATION, UT
CENTRAL VALLEY, UT
CHARLESTON, UT
CIRCLEVILLE, UT
CLARKSTON, UT
CLAWSON, UT
CLEARFIELD, UT
CLEVELAND, UT
CLINTON CITY CORPORATION, UT
COALVILLE, UT
CORINNE, UT
CORNISH, UT
COTTONWOOD HEIGHTS, UT
DANIEL, UT
DELTA, UT
DEWEYVILLE, UT
DRAPER CITY, UT
DUCHESNE, UT
EAGLE MOUNTAIN, UT
EAST CARBON, UT
ELK RIDGE, UT
ELMO, UT
ELSINORE, UT
ELWOOD, UT
EMERY, UT
ENOCH, UT
ENTERPRISE, UT
EPHRAIM, UT
ESCALANTE, UT
EUREKA, UT
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
FAIRFIELD, UT
FAIRVIEW, UT
FARMINGTON, UT
FARR WEST, UT
FAYETTE, UT
FERRON, UT
FIELDING, UT
FILLMORE, UT
FOUNTAIN GREEN, UT
FRANCIS, UT
FRUIT HEIGHTS, UT
GARDEN CITY, UT
GARLAND, UT
GENOLA, UT
GLENDALE, UT
GLENWOOD, UT
GOSHEN, UT
GRANTSVILLE, UT
GREEN RIVER, UT
GUNNISON, UT
HANKSVILLE, UT
HARRISVILLE, UT
HATCH, UT
HEBER CITY CORPORATION, UT
HELPER, UT
HENEFER, UT
HENRIEVILLE, UT
HERRIMAN, UT
HIDEOUT, UT
HIGHLAND, UT
HILDALE, UT
HINCKLEY, UT
HOLDEN, UT
HOLLADAY, UT
HONEYVILLE, UT
HOOPER, UT
HOWELL, UT
HUNTINGTON, UT
HUNTSVILLE, UT
CITY OF HURRICANE, UT
HYDE PARK, UT
HYRUM, UT
INDEPENDENCE, UT
IVINS, UT
JOSEPH, UT
JUNCTION, UT
KAMAS, UT
KANAB, UT
KANARRAVILLE, UT
KANOSH, UT
KAYSVILLE, UT
KINGSTON, UT
KOOSHAREM, UT
LAKETOWN, UT
LA VERKIN, UT
LAYTON, UT
LEAMINGTON, UT
LEEDS, UT
LEHI CITY CORPORATION, UT
LEVAN, UT
LEWISTON, UT
LINDON, UT
LOA, UT
LOGAN CITY, UT
LYMAN, UT
LYNNDYL, UT
MANILA, UT
MANTI, UT
MANTUA, UT
MAPLETON, UT
MARRIOTT-SLATERVILLE, UT
MARYSVALE, UT
MAYFIELD, UT
MEADOW, UT
MENDON, UT
MIDVALE CITY INC., UT
MIDWAY, UT
MILFORD, UT
MILLVILLE, UT
MINERSVILLE, UT
MOAB, UT
MONA, UT
MONROE, UT
CITY OF MONTICELLO, UT
MORGAN, UT
MORONI, UT
MOUNT PLEASANT, UT
MURRAY CITY CORPORATION, UT
MYTON, UT
NAPLES, UT
NEPHI, UT
NEW HARMONY, UT
NEWTON, UT
NIBLEY, UT
NORTH LOGAN, UT
NORTH OGDEN, UT
NORTH SALT LAKE CITY, UT
OAK CITY, UT
OAKLEY, UT
OGDEN CITY CORPORATION, UT
OPHIR, UT
ORANGEVILLE, UT
ORDERVILLE, UT
OREM, UT
PANGUITCH, UT
PARADISE, UT
PARAGONAH, UT
PARK CITY, UT
PAROWAN, UT
PAYSON, UT
PERRY, UT
PLAIN CITY, UT
PLEASANT GROVE CITY, UT
PLEASANT VIEW, UT
PLYMOUTH, UT
PORTAGE, UT
PRICE, UT
PROVIDENCE, UT
PROVO, UT
RANDOLPH, UT
REDMOND, UT
RICHFIELD, UT
RICHMOND, UT
RIVERDALE, UT
RIVER HEIGHTS, UT
RIVERTON CITY, UT
ROCKVILLE, UT
ROCKY RIDGE, UT
ROOSEVELT CITY CORPORATION, UT
ROY, UT
RUSH VALLEY, UT
CITY OF ST. GEORGE, UT
SALEM, UT
SALINA, UT
SALT LAKE CITY CORPORATION, UT
SANDY, UT
SANTA CLARA, UT
SANTAQUIN, UT
SARATOGA SPRINGS, UT
SCIPIO, UT
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
SCOFIELD, UT
SIGURD, UT
SMITHFIELD, UT
SNOWVILLE, UT
CITY OF SOUTH JORDAN, UT
SOUTH OGDEN, UT
CITY OF SOUTH SALT LAKE, UT
SOUTH WEBER, UT
SPANISH FORK, UT
SPRING CITY, UT
SPRINGDALE, UT
SPRINGVILLE, UT
STERLING, UT
STOCKTON, UT
SUNNYSIDE, UT
SUNSET CITY CORP, UT
SYRACUSE, UT
TABIONA, UT
CITY OF TAYLORSVILLE, UT
TOOELE CITY CORPORATION, UT
TOQUERVILLE, UT
TORREY, UT
TREMONTON CITY, UT
TRENTON, UT
TROPIC, UT
UINTAH, UT
VERNAL CITY, UT
VERNON, UT
VINEYARD, UT
VIRGIN, UT
WALES, UT
WALLSBURG, UT
WASHINGTON CITY, UT
WASHINGTON TERRACE, UT
WELLINGTON, UT
WELLSVILLE, UT
WENDOVER, UT
WEST BOUNTIFUL, UT
WEST HAVEN, UT
WEST JORDAN, UT
WEST POINT, UT
WEST VALLEY CITY, UT
WILLARD, UT
WOODLAND HILLS, UT
WOODRUFF, UT
WOODS CROSS, UT
COUNTIES AND PARISHES INCLUDING BUT NOT
LIMITED TO:
ASCENSION PARISH, LA
ASCENSION PARISH, LA, CLEAR OF COURT
CADDO PARISH, LA
CALCASIEU PARISH, LA
CALCASIEU PARISH SHERIFF’S OFFICE, LA
CITY AND COUNTY OF HONOLULU, HI
CLACKAMAS COUNTY, OR
CLACKAMAS COUNTY DEPT OF TRANSPORTATION, OR
CLATSOP COUNTY, OR
COLUMBIA COUNTY, OR
COOS COUNTY, OR
COOS COUNTY HIGHWAY DEPARTMENT, OR
COUNTY OF HAWAII, OR
CROOK COUNTY, OR
CROOK COUNTY ROAD DEPARTMENT, OR
CURRY COUNTY, OR
DESCHUTES COUNTY, OR
DOUGLAS COUNTY, OR
EAST BATON ROUGE PARISH, LA
GILLIAM COUNTY, OR
GRANT COUNTY, OR
HARNEY COUNTY, OR
HARNEY COUNTY SHERIFFS OFFICE, OR
HAWAII COUNTY, HI
HOOD RIVER COUNTY, OR
JACKSON COUNTY, OR
JEFFERSON COUNTY, OR
JEFFERSON PARISH, LA
JOSEPHINE COUNTY GOVERNMENT, OR
LAFAYETTE CONSOLIDATED GOVERNMENT, LA
LAFAYETTE PARISH, LA
LAFAYETTE PARISH CONVENTION & VISITORS
COMMISSION
LAFOURCHE PARISH, LA
KAUAI COUNTY, HI
KLAMATH COUNTY, OR
LAKE COUNTY, OR
LANE COUNTY, OR
LINCOLN COUNTY, OR
LINN COUNTY, OR
LIVINGSTON PARISH, LA
MALHEUR COUNTY, OR
MAUI COUNTY, HI
MARION COUNTY, SALEM, OR
MORROW COUNTY, OR
MULTNOMAH COUNTY, OR
MULTNOMAH COUNTY BUSINESS AND COMMUNITY
SERVICES, OR
MULTNOMAH COUNTY SHERIFFS OFFICE, OR
MULTNOMAH LAW LIBRARY, OR
ORLEANS PARISH, LA
PLAQUEMINES PARISH, LA
POLK COUNTY, OR
RAPIDES PARISH, LA
SAINT CHARLES PARISH, LA
SAINT CHARLES PARISH PUBLIC SCHOOLS, LA
SAINT LANDRY PARISH, LA
SAINT TAMMANY PARISH, LA
SHERMAN COUNTY, OR
TERREBONNE PARISH, LA
TILLAMOOK COUNTY, OR
TILLAMOOK COUNTY SHERIFF'S OFFICE, OR
TILLAMOOK COUNTY GENERAL HOSPITAL, OR
UMATILLA COUNTY, OR
UNION COUNTY, OR
WALLOWA COUNTY, OR
WASCO COUNTY, OR
WASHINGTON COUNTY, OR
WEST BATON ROUGE PARISH, LA
WHEELER COUNTY, OR
YAMHILL COUNTY, OR
COUNTY OF BOX ELDER, UT
COUNTY OF CACHE, UT
COUNTY OF RICH, UT
COUNTY OF WEBER, UT
COUNTY OF MORGAN, UT
COUNTY OF DAVIS, UT
COUNTY OF SUMMIT, UT
COUNTY OF DAGGETT, UT
COUNTY OF SALT LAKE, UT
COUNTY OF TOOELE, UT
COUNTY OF UTAH, UT
COUNTY OF WASATCH, UT
COUNTY OF DUCHESNE, UT
COUNTY OF UINTAH, UT
COUNTY OF CARBON, UT
COUNTY OF SANPETE, UT
COUNTY OF JUAB, UT
COUNTY OF MILLARD, UT
COUNTY OF SEVIER, UT
COUNTY OF EMERY, UT
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
COUNTY OF GRAND, UT
COUNTY OF BEVER, UT
COUNTY OF PIUTE, UT
COUNTY OF WAYNE, UT
COUNTY OF SAN JUAN, UT
COUNTY OF GARFIELD, UT
COUNTY OF KANE, UT
COUNTY OF IRON, UT
COUNTY OF WASHINGTON, UT
OTHER AGENCIES INCLUDING ASSOCIATIONS, BOARDS,
DISTRICTS, COMMISSIONS, COUNCILS, PUBLIC
CORPORATIONS, PUBLIC DEVELOPMENT
AUTHORITIES, RESERVATIONS AND UTILITIES
INCLUDING BUT NOT LIMITED TO:
ADAIR R.F.P.D., OR
ADEL WATER IMPROVEMENT DISTRICT, OR
ADRIAN R.F.P.D., OR
AGNESS COMMUNITY LIBRARY, OR
AGNESS-ILLAHE R.F.P.D., OR
AGRICULTURE EDUCATION SERVICE EXTENSION
DISTRICT, OR
ALDER CREEK-BARLOW WATER DISTRICT NO. 29, OR
ALFALFA FIRE DISTRICT, OR
ALSEA R.F.P.D., OR
ALSEA RIVIERA WATER IMPROVEMENT DISTRICT, OR
AMITY FIRE DISTRICT, OR
ANTELOPE MEADOWS SPECIAL ROAD DISTRICT, OR
APPLE ROGUE DISTRICT IMPROVEMENT COMPANY, OR
APPLEGATE VALLEY R.F.P.D. #9, OR
ARCH CAPE DOMESTIC WATER SUPPLY DISTRICT, OR
ARCH CAPE SANITARY DISTRICT, OR
ARNOLD IRRIGATION DISTRICT, OR
ASH CREEK WATER CONTROL DISTRICT, OR
ATHENA CEMETERY MAINTENANCE DISTRICT, OR
AUMSVILLE R.F.P.D., OR
AURORA R.F.P.D., OR
AZALEA R.F.P.D., OR
BADGER IMPROVEMENT DISTRICT, OR
BAILEY-SPENCER R.F.P.D., OR
BAKER COUNTY LIBRARY DISTRICT, OR
BAKER R.F.P.D., OR
BAKER RIVERTON ROAD DISTRICT, OR
BAKER VALLEY IRRIGATION DISTRICT, OR
BAKER VALLEY S.W.C.D., OR
BAKER VALLEY VECTOR CONTROL DISTRICT, OR
BANDON CRANBERRY WATER CONTROL DISTRICT, OR
BANDON R.F.P.D., OR
BANKS FIRE DISTRICT, OR
BANKS FIRE DISTRICT #13, OR
BAR L RANCH ROAD DISTRICT, OR
BARLOW WATER IMPROVEMENT DISTRICT, OR
BASIN AMBULANCE SERVICE DISTRICT, OR
BASIN TRANSIT SERVICE TRANSPORTATION DISTRICT, OR
BATON ROUGE WATER COMPANY
BAY AREA HEALTH DISTRICT, OR
BAYSHORE SPECIAL ROAD DISTRICT, OR
BEAR VALLEY SPECIAL ROAD DISTRICT, OR
BEAVER CREEK WATER CONTROL DISTRICT, OR
BEAVER DRAINAGE IMPROVEMENT COMPANY, INC., OR
BEAVER SLOUGH DRAINAGE DISTRICT, OR
BEAVER SPECIAL ROAD DISTRICT, OR
BEAVER WATER DISTRICT, OR
BELLE MER S.I.G.L. TRACTS SPECIAL ROAD DISTRICT, OR
BEND METRO PARK AND RECREATION DISTRICT
BENTON S.W.C.D., OR
BERNDT SUBDIVISION WATER IMPROVEMENT DISTRICT,
OR
BEVERLY BEACH WATER DISTRICT, OR
BIENVILLE PARISH FIRE PROTECTION DISTRICT 6, LA
BIG BEND IRRIGATION DISTRICT, OR
BIGGS SERVICE DISTRICT, OR
BLACK BUTTE RANCH DEPARTMENT OF POLICE
SERVICES, OR
BLACK BUTTE RANCH R.F.P.D., OR
BLACK MOUNTAIN WATER DISTRICT, OR
BLODGETT-SUMMIT R.F.P.D., OR
BLUE MOUNTAIN HOSPITAL DISTRICT, OR
BLUE MOUNTAIN TRANSLATOR DISTRICT, OR
BLUE RIVER PARK & RECREATION DISTRICT, OR
BLUE RIVER WATER DISTRICT, OR
BLY R.F.P.D., OR
BLY VECTOR CONTROL DISTRICT, OR
BLY WATER AND SANITARY DISTRICT, OR
BOARDMAN CEMETERY MAINTENANCE DISTRICT, OR
BOARDMAN PARK AND RECREATION DISTRICT
BOARDMAN R.F.P.D., OR
BONANZA BIG SPRINGS PARK & RECREATION DISTRICT,
OR
BONANZA MEMORIAL PARK CEMETERY DISTRICT, OR
BONANZA R.F.P.D., OR
BONANZA-LANGELL VALLEY VECTOR CONTROL
DISTRICT, OR
BORING WATER DISTRICT #24, OR
BOULDER CREEK RETREAT SPECIAL ROAD DISTRICT, OR
BRIDGE R.F.P.D., OR
BROOKS COMMUNITY SERVICE DISTRICT, OR
BROWNSVILLE R.F.P.D., OR
BUELL-RED PRAIRIE WATER DISTRICT, OR
BUNKER HILL R.F.P.D. #1, OR
BUNKER HILL SANITARY DISTRICT, OR
BURLINGTON WATER DISTRICT, OR
BURNT RIVER IRRIGATION DISTRICT, OR
BURNT RIVER S.W.C.D., OR
CALAPOOIA R.F.P.D., OR
CAMAS VALLEY R.F.P.D., OR
CAMELLIA PARK SANITARY DISTRICT, OR
CAMMANN ROAD DISTRICT, OR
CAMP SHERMAN ROAD DISTRICT, OR
CANBY AREA TRANSIT, OR
CANBY R.F.P.D. #62, OR
CANBY UTILITY BOARD, OR
CANNON BEACH R.F.P.D., OR
CANYONVILLE SOUTH UMPQUA FIRE DISTRICT, OR
CAPE FERRELO R.F.P.D., OR
CAPE FOULWEATHER SANITARY DISTRICT, OR
CARLSON PRIMROSE SPECIAL ROAD DISTRICT, OR
CARMEL BEACH WATER DISTRICT, OR
CASCADE VIEW ESTATES TRACT 2, OR
CEDAR CREST SPECIAL ROAD DISTRICT, OR
CEDAR TRAILS SPECIAL ROAD DISTRICT, OR
CEDAR VALLEY - NORTH BANK R.F.P.D., OR
CENTRAL CASCADES FIRE AND EMS, OR
CENTRAL CITY ECONOMIC OPPORTUNITY CORP, LA
CENTRAL LINCOLN P.U.D., OR
CENTRAL OREGON COAST FIRE & RESCUE DISTRICT, OR
CENTRAL OREGON INTERGOVERNMENTAL COUNCIL
CENTRAL OREGON IRRIGATION DISTRICT, OR
CHAPARRAL WATER CONTROL DISTRICT, OR
CHARLESTON FIRE DISTRICT, OR
CHARLESTON SANITARY DISTRICT, OR
CHARLOTTE ANN WATER DISTRICT, OR
CHEHALEM PARK & RECREATION DISTRICT, OR
CHEHALEM PARK AND RECREATION DISTRICT
CHEMULT R.F.P.D., OR
CHENOWITH WATER P.U.D., OR
CHERRIOTS, OR
CHETCO COMMUNITY PUBLIC LIBRARY DISTRICT, OR
CHILOQUIN VECTOR CONTROL DISTRICT, OR
CHILOQUIN-AGENCY LAKE R.F.P.D., OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
CHINOOK DRIVE SPECIAL ROAD DISTRICT, OR
CHR DISTRICT IMPROVEMENT COMPANY, OR
CHRISTMAS VALLEY DOMESTIC WATER DISTRICT, OR
CHRISTMAS VALLEY PARK & RECREATION DISTRICT, OR
CHRISTMAS VALLEY R.F.P.D., OR
CITY OF BOGALUSA SCHOOL BOARD, LA
CLACKAMAS COUNTY FIRE DISTRICT #1, OR
CLACKAMAS COUNTY SERVICE DISTRICT #1, OR
CLACKAMAS COUNTY VECTOR CONTROL DISTRICT, OR
CLACKAMAS RIVER WATER
CLACKAMAS RIVER WATER, OR
CLACKAMAS S.W.C.D., OR
CLATSKANIE DRAINAGE IMPROVEMENT COMPANY, OR
CLATSKANIE LIBRARY DISTRICT, OR
CLATSKANIE P.U.D., OR
CLATSKANIE PARK & RECREATION DISTRICT, OR
CLATSKANIE PEOPLE'S UTILITY DISTRICT
CLATSKANIE R.F.P.D., OR
CLATSOP CARE CENTER HEALTH DISTRICT, OR
CLATSOP COUNTY S.W.C.D., OR
CLATSOP DRAINAGE IMPROVEMENT COMPANY #15, INC.,
OR
CLEAN WATER SERVICES
CLEAN WATER SERVICES, OR
CLOVERDALE R.F.P.D., OR
CLOVERDALE SANITARY DISTRICT, OR
CLOVERDALE WATER DISTRICT, OR
COALEDO DRAINAGE DISTRICT, OR
COBURG FIRE DISTRICT, OR
COLESTIN RURAL FIRE DISTRICT, OR
COLTON R.F.P.D., OR
COLTON WATER DISTRICT #11, OR
COLUMBIA 911 COMMUNICATIONS DISTRICT, OR
COLUMBIA COUNTY 4-H & EXTENSION SERVICE DISTRICT,
OR
COLUMBIA DRAINAGE VECTOR CONTROL, OR
COLUMBIA IMPROVEMENT DISTRICT, OR
COLUMBIA R.F.P.D., OR
COLUMBIA RIVER FIRE & RESCUE, OR
COLUMBIA RIVER PUD, OR
COLUMBIA S.W.C.D., OR
COLUMBIA S.W.C.D., OR
CONFEDERATED TRIBES OF THE UMATILLA INDIAN
RESERVATION
COOS COUNTY AIRPORT DISTRICT, OR
COOS COUNTY AIRPORT DISTRICT, OR
COOS COUNTY AREA TRANSIT SERVICE DISTRICT, OR
COOS COUNTY AREA TRANSIT SERVICE DISTRICT, OR
COOS FOREST PROTECTIVE ASSOCIATION
COOS S.W.C.D., OR
COQUILLE R.F.P.D., OR
COQUILLE VALLEY HOSPITAL DISTRICT, OR
CORBETT WATER DISTRICT, OR
CORNELIUS R.F.P.D., OR
CORP RANCH ROAD WATER IMPROVEMENT, OR
CORVALLIS R.F.P.D., OR
COUNTRY CLUB ESTATES SPECIAL WATER DISTRICT, OR
COUNTRY CLUB WATER DISTRICT, OR
COUNTRY ESTATES ROAD DISTRICT, OR
COVE CEMETERY MAINTENANCE DISTRICT, OR
COVE ORCHARD SEWER SERVICE DISTRICT, OR
COVE R.F.P.D., OR
CRESCENT R.F.P.D., OR
CRESCENT SANITARY DISTRICT, OR
CRESCENT WATER SUPPLY AND IMPROVEMENT DISTRICT,
OR
CROOK COUNTY AGRICULTURE EXTENSION SERVICE
DISTRICT, OR
CROOK COUNTY CEMETERY DISTRICT, OR
CROOK COUNTY FIRE AND RESCUE, OR
CROOK COUNTY PARKS & RECREATION DISTRICT, OR
CROOK COUNTY S.W.C.D., OR
CROOK COUNTY VECTOR CONTROL DISTRICT, OR
CROOKED RIVER RANCH R.F.P.D., OR
CROOKED RIVER RANCH SPECIAL ROAD DISTRICT, OR
CRYSTAL SPRINGS WATER DISTRICT, OR
CURRY COUNTY 4-H & EXTENSION SERVICE DISTRICT, OR
CURRY COUNTY PUBLIC TRANSIT SERVICE DISTRICT, OR
CURRY COUNTY S.W.C.D., OR
CURRY HEALTH DISTRICT, OR
CURRY PUBLIC LIBRARY DISTRICT, OR
DALLAS CEMETERY DISTRICT #4, OR
DARLEY DRIVE SPECIAL ROAD DISTRICT, OR
DAVID CROCKETT STEAM FIRE COMPANY #1, LA
DAYS CREEK R.F.P.D., OR
DAYTON FIRE DISTRICT, OR
DEAN MINARD WATER DISTRICT, OR
DEE IRRIGATION DISTRICT, OR
DEER ISLAND DRAINAGE IMPROVEMENT COMPANY, OR
DELL BROGAN CEMETERY MAINTENANCE DISTRICT, OR
DEPOE BAY R.F.P.D., OR
DESCHUTES COUNTY 911 SERVICE DISTRICT, OR
DESCHUTES COUNTY R.F.P.D. #2, OR
DESCHUTES PUBLIC LIBRARY DISTRICT, OR
DESCHUTES S.W.C.D., OR
DESCHUTES VALLEY WATER DISTRICT, OR
DEVILS LAKE WATER IMPROVEMENT DISTRICT, OR
DEXTER R.F.P.D., OR
DEXTER SANITARY DISTRICT, OR
DORA-SITKUM R.F.P.D., OR
DOUGLAS COUNTY FIRE DISTRICT #2, OR
DOUGLAS S.W.C.D., OR
DRAKES CROSSING R.F.P.D., OR
DRRH SPECIAL ROAD DISTRICT #6, OR
DRY GULCH DITCH DISTRICT IMPROVEMENT COMPANY,
OR
DUFUR RECREATION DISTRICT, OR
DUMBECK LANE DOMESTIC WATER SUPPLY, OR
DUNDEE R.F.P.D., OR
DURKEE COMMUNITY BUILDING PRESERVATION
DISTRICT, OR
EAGLE POINT IRRIGATION DISTRICT, OR
EAGLE VALLEY CEMETERY MAINTENANCE DISTRICT, OR
EAGLE VALLEY R.F.P.D., OR
EAGLE VALLEY S.W.C.D., OR
EAST FORK IRRIGATION DISTRICT, OR
EAST MULTNOMAH S.W.C.D., OR
EAST SALEM SERVICE DISTRICT, OR
EAST UMATILLA CHEMICAL CONTROL DISTRICT, OR
EAST UMATILLA COUNTY AMBULANCE AREA HEALTH
DISTRICT, OR
EAST UMATILLA COUNTY R.F.P.D., OR
EAST VALLEY WATER DISTRICT, OR
ELGIN COMMUNITY PARKS & RECREATION DISTRICT, OR
ELGIN HEALTH DISTRICT, OR
ELGIN R.F.P.D., OR
ELKTON ESTATES PHASE II SPECIAL ROAD DISTRICT, OR
ELKTON R.F.P.D., OR
EMERALD P.U.D., OR
ENTERPRISE IRRIGATION DISTRICT, OR
ESTACADA CEMETERY MAINTENANCE DISTRICT, OR
ESTACADA R.F.P.D. #69, OR
EUGENE R.F.P.D. # 1, OR
EUGENE WATER AND ELECTRIC BOARD
EVANS VALLEY FIRE DISTRICT #6, OR
FAIR OAKS R.F.P.D., OR
FAIRVIEW R.F.P.D., OR
FAIRVIEW WATER DISTRICT, OR
FALCON HEIGHTS WATER AND SEWER, OR
FALCON-COVE BEACH WATER DISTRICT, OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
FALL RIVER ESTATES SPECIAL ROAD DISTRICT, OR
FARGO INTERCHANGE SERVICE DISTRICT, OR
FARMERS IRRIGATION DISTRICT, OR
FAT ELK DRAINAGE DISTRICT, OR
FERN RIDGE PUBLIC LIBRARY DISTRICT, OR
FERN VALLEY ESTATES IMPROVEMENT DISTRICT, OR
FOR FAR ROAD DISTRICT, OR
FOREST GROVE R.F.P.D., OR
FOREST VIEW SPECIAL ROAD DISTRICT, OR
FORT ROCK-SILVER LAKE S.W.C.D., OR
FOUR RIVERS VECTOR CONTROL DISTRICT, OR
FOX CEMETERY MAINTENANCE DISTRICT, OR
GARDINER R.F.P.D., OR
GARDINER SANITARY DISTRICT, OR
GARIBALDI R.F.P.D., OR
GASTON R.F.P.D., OR
GATES R.F.P.D., OR
GEARHART R.F.P.D., OR
GILLIAM S.W.C.D., OR
GLENDALE AMBULANCE DISTRICT, OR
GLENDALE R.F.P.D., OR
GLENEDEN BEACH SPECIAL ROAD DISTRICT, OR
GLENEDEN SANITARY DISTRICT, OR
GLENWOOD WATER DISTRICT, OR
GLIDE - IDLEYLD SANITARY DISTRICT, OR
GLIDE R.F.P.D., OR
GOLD BEACH - WEDDERBURN R.F.P.D., OR
GOLD HILL IRRIGATION DISTRICT, OR
GOLDFINCH ROAD DISTRICT, OR
GOSHEN R.F.P.D., OR
GOVERNMENT CAMP ROAD DISTRICT, OR
GOVERNMENT CAMP SANITARY DISTRICT, OR
GRAND PRAIRIE WATER CONTROL DISTRICT, OR
GRAND RONDE SANITARY DISTRICT, OR
GRANT COUNTY TRANSPORTATION DISTRICT, OR
GRANT S.W.C.D., OR
GRANTS PASS IRRIGATION DISTRICT, OR
GREATER BOWEN VALLEY R.F.P.D., OR
GREATER ST. HELENS PARK & RECREATION DISTRICT, OR
GREATER TOLEDO POOL RECREATION DISTRICT, OR
GREEN KNOLLS SPECIAL ROAD DISTRICT, OR
GREEN SANITARY DISTRICT, OR
GREENACRES R.F.P.D., OR
GREENBERRY IRRIGATION DISTRICT, OR
GREENSPRINGS RURAL FIRE DISTRICT, OR
HAHLEN ROAD SPECIAL DISTRICT, OR
HAINES CEMETERY MAINTENANCE DISTRICT, OR
HAINES FIRE PROTECTION DISTRICT, OR
HALSEY-SHEDD R.F.P.D., OR
HAMLET R.F.P.D., OR
HARBOR R.F.P.D., OR
HARBOR SANITARY DISTRICT, OR
HARBOR WATER P.U.D., OR
HARNEY COUNTY HEALTH DISTRICT, OR
HARNEY S.W.C.D., OR
HARPER SOUTH SIDE IRRIGATION DISTRICT, OR
HARRISBURG FIRE AND RESCUE, OR
HAUSER R.F.P.D., OR
HAZELDELL RURAL FIRE DISTRICT, OR
HEBO JOINT WATER-SANITARY AUTHORITY, OR
HECETA WATER P.U.D., OR
HELIX CEMETERY MAINTENANCE DISTRICT #4, OR
HELIX PARK & RECREATION DISTRICT, OR
HELIX R.F.P.D. #7-411, OR
HEPPNER CEMETERY MAINTENANCE DISTRICT, OR
HEPPNER R.F.P.D., OR
HEPPNER WATER CONTROL DISTRICT, OR
HEREFORD COMMUNITY HALL RECREATION DISTRICT, OR
HERMISTON CEMETERY DISTRICT, OR
HERMISTON IRRIGATION DISTRICT, OR
HIDDEN VALLEY MOBILE ESTATES IMPROVEMENT
DISTRICT, OR
HIGH DESERT PARK & RECREATION DISTRICT, OR
HIGHLAND SUBDIVISION WATER DISTRICT, OR
HONOLULU INTERNATIONAL AIRPORT
HOOD RIVER COUNTY LIBRARY DISTRICT, OR
HOOD RIVER COUNTY TRANSPORTATION DISTRICT, OR
HOOD RIVER S.W.C.D., OR
HOOD RIVER VALLEY PARKS & RECREATION DISTRICT,
OR
HOODLAND FIRE DISTRICT #74
HOODLAND FIRE DISTRICT #74, OR
HORSEFLY IRRIGATION DISTRICT, OR
HOSKINS-KINGS VALLEY R.F.P.D., OR
HOUSING AUTHORITY OF PORTLAND
HUBBARD R.F.P.D., OR
HUDSON BAY DISTRICT IMPROVEMENT COMPANY, OR
I N (KAY) YOUNG DITCH DISTRICT IMPROVEMENT
COMPANY, OR
ICE FOUNTAIN WATER DISTRICT, OR
IDAHO POINT SPECIAL ROAD DISTRICT, OR
IDANHA-DETROIT RURAL FIRE PROTECTION DISTRICT, OR
ILLINOIS VALLEY FIRE DISTRICT
ILLINOIS VALLEY R.F.P.D., OR
ILLINOIS VALLEY S.W.C.D., OR
IMBLER R.F.P.D., OR
INTERLACHEN WATER P.U.D., OR
IONE LIBRARY DISTRICT, OR
IONE R.F.P.D. #6-604, OR
IRONSIDE CEMETERY MAINTENANCE DISTRICT, OR
IRONSIDE RURAL ROAD DISTRICT #5, OR
IRRIGON PARK & RECREATION DISTRICT, OR
IRRIGON R.F.P.D., OR
ISLAND CITY AREA SANITATION DISTRICT, OR
ISLAND CITY CEMETERY MAINTENANCE DISTRICT, OR
JACK PINE VILLAGE SPECIAL ROAD DISTRICT, OR
JACKSON COUNTY FIRE DISTRICT #3, OR
JACKSON COUNTY FIRE DISTRICT #4, OR
JACKSON COUNTY FIRE DISTRICT #5, OR
JACKSON COUNTY LIBRARY DISTRICT, OR
JACKSON COUNTY VECTOR CONTROL DISTRICT, OR
JACKSON S.W.C.D., OR
JASPER KNOLLS WATER DISTRICT, OR
JEFFERSON COUNTY EMERGENCY MEDICAL SERVICE
DISTRICT, OR
JEFFERSON COUNTY FIRE DISTRICT #1, OR
JEFFERSON COUNTY LIBRARY DISTRICT, OR
JEFFERSON COUNTY S.W.C.D., OR
JEFFERSON PARK & RECREATION DISTRICT, OR
JEFFERSON R.F.P.D., OR
JOB'S DRAINAGE DISTRICT, OR
JOHN DAY WATER DISTRICT, OR
JOHN DAY-CANYON CITY PARKS & RECREATION
DISTRICT, OR
JOHN DAY-FERNHILL R.F.P.D. #5-108, OR
JORDAN VALLEY CEMETERY DISTRICT, OR
JORDAN VALLEY IRRIGATION DISTRICT, OR
JOSEPHINE COMMUNITY LIBRARY DISTRICT, OR
JOSEPHINE COUNTY 4-H & EXTENSION SERVICE DISTRICT,
OR
JOSEPHINE COUNTY 911 AGENCY, OR
JUNCTION CITY R.F.P.D., OR
JUNCTION CITY WATER CONTROL DISTRICT, OR
JUNIPER BUTTE ROAD DISTRICT, OR
JUNIPER CANYON WATER CONTROL DISTRICT, OR
JUNIPER FLAT DISTRICT IMPROVEMENT COMPANY, OR
JUNIPER FLAT R.F.P.D., OR
JUNO NONPROFIT WATER IMPROVEMENT DISTRICT, OR
KEATING R.F.P.D., OR
KEATING S.W.C.D., OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
KEIZER R.F.P.D., OR
KELLOGG RURAL FIRE DISTRICT, OR
KENO IRRIGATION DISTRICT, OR
KENO PINES ROAD DISTRICT, OR
KENO R.F.P.D., OR
KENT WATER DISTRICT, OR
KERBY WATER DISTRICT, OR
K-GB-LB WATER DISTRICT, OR
KILCHIS WATER DISTRICT, OR
KLAMATH 9-1-1 COMMUNICATIONS DISTRICT, OR
KLAMATH BASIN IMPROVEMENT DISTRICT, OR
KLAMATH COUNTY DRAINAGE SERVICE DISTRICT, OR
KLAMATH COUNTY EXTENSION SERVICE DISTRICT, OR
KLAMATH COUNTY FIRE DISTRICT #1, OR
KLAMATH COUNTY FIRE DISTRICT #3, OR
KLAMATH COUNTY FIRE DISTRICT #4, OR
KLAMATH COUNTY FIRE DISTRICT #5, OR
KLAMATH COUNTY LIBRARY SERVICE DISTRICT, OR
KLAMATH COUNTY PREDATORY ANIMAL CONTROL
DISTRICT, OR
KLAMATH DRAINAGE DISTRICT, OR
KLAMATH FALLS FOREST ESTATES SPECIAL ROAD
DISTRICT UNIT #2, OR
KLAMATH INTEROPERABILITY RADIO GROUP, OR
KLAMATH IRRIGATION DISTRICT, OR
KLAMATH RIVER ACRES SPECIAL ROAD DISTRICT, OR
KLAMATH S.W.C.D., OR
KLAMATH VECTOR CONTROL DISTRICT, OR
KNAPPA-SVENSEN-BURNSIDE R.F.P.D., OR
LA GRANDE CEMETERY MAINTENANCE DISTRICT, OR
LA GRANDE R.F.P.D., OR
LA PINE PARK & RECREATION DISTRICT, OR
LA PINE R.F.P.D., OR
LABISH VILLAGE SEWAGE & DRAINAGE, OR
LACOMB IRRIGATION DISTRICT, OR
LAFAYETTE AIRPORT COMMISSION, LA
LAFOURCHE PARISH HEALTH UNIT – DHH-OPH REGION 3
LAIDLAW WATER DISTRICT, OR
LAKE CHINOOK FIRE & RESCUE, OR
LAKE COUNTY 4-H & EXTENSION SERVICE DISTRICT, OR
LAKE COUNTY LIBRARY DISTRICT, OR
LAKE CREEK R.F.P.D. - JACKSON, OR
LAKE CREEK R.F.P.D. - LANE COUNTY, OR
LAKE DISTRICT HOSPITAL, OR
LAKE GROVE R.F.P.D. NO. 57, OR
LAKE GROVE WATER DISTRICT, OR
LAKE LABISH WATER CONTROL DISTRICT, OR
LAKE POINT SPECIAL ROAD DISTRICT, OR
LAKESIDE R.F.P.D. #4, OR
LAKESIDE WATER DISTRICT, OR
LAKEVIEW R.F.P.D., OR
LAKEVIEW S.W.C.D., OR
LAMONTAI IMPROVEMENT DISTRICT, OR
LANE FIRE AUTHORITY, OR
LANE LIBRARY DISTRICT, OR
LANE TRANSIT DISTRICT, OR
LANGELL VALLEY IRRIGATION DISTRICT, OR
LANGLOIS PUBLIC LIBRARY, OR
LANGLOIS R.F.P.D., OR
LANGLOIS WATER DISTRICT, OR
LAZY RIVER SPECIAL ROAD DISTRICT, OR
LEBANON AQUATIC DISTRICT, OR
LEBANON R.F.P.D., OR
LEWIS & CLARK R.F.P.D., OR
LINCOLN COUNTY LIBRARY DISTRICT, OR
LINCOLN S.W.C.D., OR
LINN COUNTY EMERGENCY TELEPHONE AGENCY, OR
LINN S.W.C.D., OR
LITTLE MUDDY CREEK WATER CONTROL, OR
LITTLE NESTUCCA DRAINAGE DISTRICT, OR
LITTLE SWITZERLAND SPECIAL ROAD DISTRICT, OR
LONE PINE IRRIGATION DISTRICT, OR
LONG PRAIRIE WATER DISTRICT, OR
LOOKINGGLASS OLALLA WATER CONTROL DISTRICT, OR
LOOKINGGLASS RURAL FIRE DISTRICT, OR
LORANE R.F.P.D., OR
LOST & BOULDER DITCH IMPROVEMENT DISTRICT, OR
LOST CREEK PARK SPECIAL ROAD DISTRICT, OR
LOUISIANA PUBLIC SERVICE COMMISSION, LA
LOUISIANA WATER WORKS
LOWELL R.F.P.D., OR
LOWER MCKAY CREEK R.F.P.D., OR
LOWER MCKAY CREEK WATER CONTROL DISTRICT, OR
LOWER POWDER RIVER IRRIGATION DISTRICT, OR
LOWER SILETZ WATER DISTRICT, OR
LOWER UMPQUA HOSPITAL DISTRICT, OR
LOWER UMPQUA PARK & RECREATION DISTRICT, OR
LOWER VALLEY WATER IMPROVEMENT DISTRICT, OR
LUCE LONG DITCH DISTRICT IMPROVEMENT CO., OR
LUSTED WATER DISTRICT, OR
LYONS R.F.P.D., OR
LYONS-MEHAMA WATER DISTRICT, OR
MADRAS AQUATIC CENTER DISTRICT, OR
MAKAI SPECIAL ROAD DISTRICT, OR
MALHEUR COUNTY S.W.C.D., OR
MALHEUR COUNTY VECTOR CONTROL DISTRICT, OR
MALHEUR DISTRICT IMPROVEMENT COMPANY, OR
MALHEUR DRAINAGE DISTRICT, OR
MALHEUR MEMORIAL HEALTH DISTRICT, OR
MALIN COMMUNITY CEMETERY MAINTENANCE
DISTRICT, OR
MALIN COMMUNITY PARK & RECREATION DISTRICT, OR
MALIN IRRIGATION DISTRICT, OR
MALIN R.F.P.D., OR
MAPLETON FIRE DEPARTMENT, OR
MAPLETON WATER DISTRICT, OR
MARCOLA WATER DISTRICT, OR
MARION COUNTY EXTENSION & 4H SERVICE DISTRICT, OR
MARION COUNTY FIRE DISTRICT #1, OR
MARION JACK IMPROVEMENT DISTRICT, OR
MARION S.W.C.D., OR
MARY'S RIVER ESTATES ROAD DISTRICT, OR
MCDONALD FOREST ESTATES SPECIAL ROAD DISTRICT,
OR
MCKAY ACRES IMPROVEMENT DISTRICT, OR
MCKAY DAM R.F.P.D. # 7-410, OR
MCKENZIE FIRE & RESCUE, OR
MCKENZIE PALISADES WATER SUPPLY CORPORATION, OR
MCMINNVILLE R.F.P.D., OR
MCNULTY WATER P.U.D., OR
MEADOWS DRAINAGE DISTRICT, OR
MEDFORD IRRIGATION DISTRICT, OR
MEDFORD R.F.P.D. #2, OR
MEDFORD WATER COMMISSION
MEDICAL SPRINGS R.F.P.D., OR
MELHEUR COUNTY JAIL, OR
MERLIN COMMUNITY PARK DISTRICT, OR
MERRILL CEMETERY MAINTENANCE DISTRICT, OR
MERRILL PARK DISTRICT, OR
MERRILL R.F.P.D., OR
METRO REGIONAL GOVERNMENT
METRO REGIONAL PARKS
METROPOLITAN EXPOSITION RECREATION COMMISSION
METROPOLITAN SERVICE DISTRICT (METRO)
MID COUNTY CEMETERY MAINTENANCE DISTRICT, OR
MID-COLUMBIA FIRE AND RESCUE, OR
MIDDLE FORK IRRIGATION DISTRICT, OR
MIDLAND COMMUNITY PARK, OR
MIDLAND DRAINAGE IMPROVEMENT DISTRICT, OR
MILES CROSSING SANITARY SEWER DISTRICT, OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
MILL CITY R.F.P.D. #2-303, OR
MILL FOUR DRAINAGE DISTRICT, OR
MILLICOMA RIVER PARK & RECREATION DISTRICT, OR
MILLINGTON R.F.P.D. #5, OR
MILO VOLUNTEER FIRE DEPARTMENT, OR
MILTON-FREEWATER AMBULANCE SERVICE AREA
HEALTH DISTRICT, OR
MILTON-FREEWATER WATER CONTROL DISTRICT, OR
MIROCO SPECIAL ROAD DISTRICT, OR
MIST-BIRKENFELD R.F.P.D., OR
MODOC POINT IRRIGATION DISTRICT, OR
MODOC POINT SANITARY DISTRICT, OR
MOHAWK VALLEY R.F.P.D., OR
MOLALLA AQUATIC DISTRICT, OR
MOLALLA R.F.P.D. #73, OR
MONITOR R.F.P.D., OR
MONROE R.F.P.D., OR
MONUMENT CEMETERY MAINTENANCE DISTRICT, OR
MONUMENT S.W.C.D., OR
MOOREA DRIVE SPECIAL ROAD DISTRICT, OR
MORO R.F.P.D., OR
MORROW COUNTY HEALTH DISTRICT, OR
MORROW COUNTY UNIFIED RECREATION DISTRICT, OR
MORROW S.W.C.D., OR
MOSIER FIRE DISTRICT, OR
MOUNTAIN DRIVE SPECIAL ROAD DISTRICT, OR
MT. ANGEL R.F.P.D., OR
MT. HOOD IRRIGATION DISTRICT, OR
MT. LAKI CEMETERY DISTRICT, OR
MT. VERNON R.F.P.D., OR
MULINO WATER DISTRICT #1, OR
MULTNOMAH COUNTY DRAINAGE DISTRICT #1, OR
MULTNOMAH COUNTY R.F.P.D. #10, OR
MULTNOMAH COUNTY R.F.P.D. #14, OR
MULTNOMAH EDUCATION SERVICE DISTRICT
MYRTLE CREEK R.F.P.D., OR
NEAH-KAH-NIE WATER DISTRICT, OR
NEDONNA R.F.P.D., OR
NEHALEM BAY FIRE AND RESCUE, OR
NEHALEM BAY HEALTH DISTRICT, OR
NEHALEM BAY WASTEWATER AGENCY, OR
NESIKA BEACH-OPHIR WATER DISTRICT, OR
NESKOWIN REGIONAL SANITARY AUTHORITY, OR
NESKOWIN REGIONAL WATER DISTRICT, OR
NESTUCCA R.F.P.D., OR
NETARTS WATER DISTRICT, OR
NETARTS-OCEANSIDE R.F.P.D., OR
NETARTS-OCEANSIDE SANITARY DISTRICT, OR
NEW BRIDGE WATER SUPPLY DISTRICT, OR
NEW CARLTON FIRE DISTRICT, OR
NEW ORLEANS REDEVELOPMENT AUTHORITY, LA
NEW PINE CREEK R.F.P.D., OR
NEWBERG R.F.P.D., OR
NEWBERRY ESTATES SPECIAL ROAD DISTRICT, OR
NEWPORT R.F.P.D., OR
NEWT YOUNG DITCH DISTRICT IMPROVEMENT COMPANY,
OR
NORTH ALBANY R.F.P.D., OR
NORTH BAY R.F.P.D. #9, OR
NORTH CLACKAMAS PARKS & RECREATION DISTRICT, OR
NORTH COUNTY RECREATION DISTRICT, OR
NORTH DOUGLAS COUNTY FIRE & EMS, OR
NORTH DOUGLAS PARK & RECREATION DISTRICT, OR
NORTH GILLIAM COUNTY HEALTH DISTRICT, OR
NORTH GILLIAM COUNTY R.F.P.D., OR
NORTH LAKE HEALTH DISTRICT, OR
NORTH LEBANON WATER CONTROL DISTRICT, OR
NORTH LINCOLN FIRE & RESCUE DISTRICT #1, OR
NORTH LINCOLN HEALTH DISTRICT, OR
NORTH MORROW VECTOR CONTROL DISTRICT, OR
NORTH SHERMAN COUNTY R.F.P.D, OR
NORTH UNIT IRRIGATION DISTRICT, OR
NORTHEAST OREGON HOUSING AUTHORITY, OR
NORTHEAST WHEELER COUNTY HEALTH DISTRICT, OR
NORTHERN WASCO COUNTY P.U.D., OR
NORTHERN WASCO COUNTY PARK & RECREATION
DISTRICT, OR
NYE DITCH USERS DISTRICT IMPROVEMENT, OR
NYSSA ROAD ASSESSMENT DISTRICT #2, OR
NYSSA RURAL FIRE DISTRICT, OR
NYSSA-ARCADIA DRAINAGE DISTRICT, OR
OAK LODGE WATER SERVICES, OR
OAKLAND R.F.P.D., OR
OAKVILLE COMMUNITY CENTER, OR
OCEANSIDE WATER DISTRICT, OR
OCHOCO IRRIGATION DISTRICT, OR
OCHOCO WEST WATER AND SANITARY AUTHORITY, OR
ODELL SANITARY DISTRICT, OR
OLD OWYHEE DITCH IMPROVEMENT DISTRICT, OR
OLNEY-WALLUSKI FIRE & RESCUE DISTRICT, OR
ONTARIO LIBRARY DISTRICT, OR
ONTARIO R.F.P.D., OR
OPHIR R.F.P.D., OR
OREGON COAST COMMUNITY ACTION
OREGON HOUSING AND COMMUNITY SERVICES
OREGON INTERNATIONAL PORT OF COOS BAY, OR
OREGON LEGISLATIVE ADMINISTRATION
OREGON OUTBACK R.F.P.D., OR
OREGON POINT, OR
OREGON TRAIL LIBRARY DISTRICT, OR
OTTER ROCK WATER DISTRICT, OR
OWW UNIT #2 SANITARY DISTRICT, OR
OWYHEE CEMETERY MAINTENANCE DISTRICT, OR
OWYHEE IRRIGATION DISTRICT, OR
PACIFIC CITY JOINT WATER-SANITARY AUTHORITY, OR
PACIFIC COMMUNITIES HEALTH DISTRICT, OR
PACIFIC RIVIERA #3 SPECIAL ROAD DISTRICT, OR
PALATINE HILL WATER DISTRICT, OR
PALMER CREEK WATER DISTRICT IMPROVEMENT
COMPANY, OR
PANORAMIC ACCESS SPECIAL ROAD DISTRICT, OR
PANTHER CREEK ROAD DISTRICT, OR
PANTHER CREEK WATER DISTRICT, OR
PARKDALE R.F.P.D., OR
PARKDALE SANITARY DISTRICT, OR
PENINSULA DRAINAGE DISTRICT #1, OR
PENINSULA DRAINAGE DISTRICT #2, OR
PHILOMATH FIRE AND RESCUE, OR
PILOT ROCK CEMETERY MAINTENANCE DISTRICT #5, OR
PILOT ROCK PARK & RECREATION DISTRICT, OR
PILOT ROCK R.F.P.D., OR
PINE EAGLE HEALTH DISTRICT, OR
PINE FLAT DISTRICT IMPROVEMENT COMPANY, OR
PINE GROVE IRRIGATION DISTRICT, OR
PINE GROVE WATER DISTRICT-KLAMATH FALLS, OR
PINE GROVE WATER DISTRICT-MAUPIN, OR
PINE VALLEY CEMETERY DISTRICT, OR
PINE VALLEY R.F.P.D., OR
PINEWOOD COUNTRY ESTATES SPECIAL ROAD DISTRICT,
OR
PIONEER DISTRICT IMPROVEMENT COMPANY, OR
PISTOL RIVER CEMETERY MAINTENANCE DISTRICT, OR
PISTOL RIVER FIRE DISTRICT, OR
PLEASANT HILL R.F.P.D., OR
PLEASANT HOME WATER DISTRICT, OR
POCAHONTAS MINING AND IRRIGATION DISTRICT, OR
POE VALLEY IMPROVEMENT DISTRICT, OR
POE VALLEY PARK & RECREATION DISTRICT, OR
POE VALLEY VECTOR CONTROL DISTRICT, OR
POLK COUNTY FIRE DISTRICT #1, OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
POLK S.W.C.D., OR
POMPADOUR WATER IMPROVEMENT DISTRICT, OR
PONDEROSA PINES EAST SPECIAL ROAD DISTRICT, OR
PORT OF ALSEA, OR
PORT OF ARLINGTON, OR
PORT OF ASTORIA, OR
PORT OF BANDON, OR
PORT OF BRANDON, OR
PORT OF BROOKINGS HARBOR, OR
PORT OF CASCADE LOCKS, OR
PORT OF COQUILLE RIVER, OR
PORT OF GARIBALDI, OR
PORT OF GOLD BEACH, OR
PORT OF HOOD RIVER, OR
PORT OF MORGAN CITY, LA
PORT OF MORROW, OR
PORT OF NEHALEM, OR
PORT OF NEWPORT, OR
PORT OF PORT ORFORD, OR
PORT OF PORTLAND, OR
PORT OF SIUSLAW, OR
PORT OF ST. HELENS, OR
PORT OF THE DALLES, OR
PORT OF TILLAMOOK BAY, OR
PORT OF TOLEDO, OR
PORT OF UMATILLA, OR
PORT OF UMPQUA, OR
PORT ORFORD CEMETERY MAINTENANCE DISTRICT, OR
PORT ORFORD PUBLIC LIBRARY DISTRICT, OR
PORT ORFORD R.F.P.D., OR
PORTLAND DEVELOPMENT COMMISSION, OR
PORTLAND FIRE AND RESCUE
PORTLAND HOUSING CENTER, OR
POWDER R.F.P.D., OR
POWDER RIVER R.F.P.D., OR
POWDER VALLEY WATER CONTROL DISTRICT, OR
POWERS HEALTH DISTRICT, OR
PRAIRIE CEMETERY MAINTENANCE DISTRICT, OR
PRINEVILLE LAKE ACRES SPECIAL ROAD DISTRICT #1, OR
PROSPECT R.F.P.D., OR
QUAIL VALLEY PARK IMPROVEMENT DISTRICT, OR
QUEENER IRRIGATION IMPROVEMENT DISTRICT, OR
RAINBOW WATER DISTRICT, OR
RAINIER CEMETERY DISTRICT, OR
RAINIER DRAINAGE IMPROVEMENT COMPANY, OR
RALEIGH WATER DISTRICT, OR
REDMOND AREA PARK & RECREATION DISTRICT, OR
REDMOND FIRE AND RESCUE, OR
RIDDLE FIRE PROTECTION DISTRICT, OR
RIDGEWOOD DISTRICT IMPROVEMENT COMPANY, OR
RIDGEWOOD ROAD DISTRICT, OR
RIETH SANITARY DISTRICT, OR
RIETH WATER DISTRICT, OR
RIMROCK WEST IMPROVEMENT DISTRICT, OR
RINK CREEK WATER DISTRICT, OR
RIVER BEND ESTATES SPECIAL ROAD DISTRICT, OR
RIVER FOREST ACRES SPECIAL ROAD DISTRICT, OR
RIVER MEADOWS IMPROVEMENT DISTRICT, OR
RIVER PINES ESTATES SPECIAL ROAD DISTRICT, OR
RIVER ROAD PARK & RECREATION DISTRICT, OR
RIVER ROAD WATER DISTRICT, OR
RIVERBEND RIVERBANK WATER IMPROVEMENT
DISTRICT, OR
RIVERDALE R.F.P.D. 11-JT, OR
RIVERGROVE WATER DISTRICT, OR
RIVERSIDE MISSION WATER CONTROL DISTRICT, OR
RIVERSIDE R.F.P.D. #7-406, OR
RIVERSIDE WATER DISTRICT, OR
ROBERTS CREEK WATER DISTRICT, OR
ROCK CREEK DISTRICT IMPROVEMENT, OR
ROCK CREEK WATER DISTRICT, OR
ROCKWOOD WATER P.U.D., OR
ROCKY POINT FIRE & EMS, OR
ROGUE RIVER R.F.P.D., OR
ROGUE RIVER VALLEY IRRIGATION DISTRICT, OR
ROGUE VALLEY SEWER SERVICES, OR
ROGUE VALLEY SEWER, OR
ROGUE VALLEY TRANSPORTATION DISTRICT, OR
ROSEBURG URBAN SANITARY AUTHORITY, OR
ROSEWOOD ESTATES ROAD DISTRICT, OR
ROW RIVER VALLEY WATER DISTRICT, OR
RURAL ROAD ASSESSMENT DISTRICT #3, OR
RURAL ROAD ASSESSMENT DISTRICT #4, OR
SAINT LANDRY PARISH TOURIST COMMISSION
SAINT MARY PARISH REC DISTRICT 2
SAINT MARY PARISH REC DISTRICT 3
SAINT TAMMANY FIRE DISTRICT 4, LA
SALEM AREA MASS TRANSIT DISTRICT, OR
SALEM MASS TRANSIT DISTRICT
SALEM SUBURBAN R.F.P.D., OR
SALISHAN SANITARY DISTRICT, OR
SALMON RIVER PARK SPECIAL ROAD DISTRICT, OR
SALMON RIVER PARK WATER IMPROVEMENT DISTRICT,
OR
SALMONBERRY TRAIL INTERGOVERNMENTAL AGENCY,
OR
SANDPIPER VILLAGE SPECIAL ROAD DISTRICT, OR
SANDY DRAINAGE IMPROVEMENT COMPANY, OR
SANDY R.F.P.D. #72, OR
SANTA CLARA R.F.P.D., OR
SANTA CLARA WATER DISTRICT, OR
SANTIAM WATER CONTROL DISTRICT, OR
SAUVIE ISLAND DRAINAGE IMPROVEMENT COMPANY, OR
SAUVIE ISLAND VOLUNTEER FIRE DISTRICT #30J, OR
SCAPPOOSE DRAINAGE IMPROVEMENT COMPANY, OR
SCAPPOOSE PUBLIC LIBRARY DISTRICT, OR
SCAPPOOSE R.F.P.D., OR
SCIO R.F.P.D., OR
SCOTTSBURG R.F.P.D., OR
SEAL ROCK R.F.P.D., OR
SEAL ROCK WATER DISTRICT, OR
SEWERAGE AND WATER BOARD OF NEW ORLEANS, LA
SHANGRI-LA WATER DISTRICT, OR
SHASTA VIEW IRRIGATION DISTRICT, OR
SHELLEY ROAD CREST ACRES WATER DISTRICT, OR
SHERIDAN FIRE DISTRICT, OR
SHERMAN COUNTY HEALTH DISTRICT, OR
SHERMAN COUNTY S.W.C.D., OR
SHORELINE SANITARY DISTRICT, OR
SILETZ KEYS SANITARY DISTRICT, OR
SILETZ R.F.P.D., OR
SILVER FALLS LIBRARY DISTRICT, OR
SILVER LAKE IRRIGATION DISTRICT, OR
SILVER LAKE R.F.P.D., OR
SILVER SANDS SPECIAL ROAD DISTRICT, OR
SILVERTON R.F.P.D. NO. 2, OR
SISTERS PARKS & RECREATION DISTRICT, OR
SISTERS-CAMP SHERMAN R.F.P.D., OR
SIUSLAW PUBLIC LIBRARY DISTRICT, OR
SIUSLAW S.W.C.D., OR
SIUSLAW VALLEY FIRE AND RESCUE, OR
SIXES R.F.P.D., OR
SKIPANON WATER CONTROL DISTRICT, OR
SKYLINE VIEW DISTRICT IMPROVEMENT COMPANY, OR
SLEEPY HOLLOW WATER DISTRICT, OR
SMITH DITCH DISTRICT IMPROVEMENT COMPANY, OR
SOUTH CLACKAMAS TRANSPORTATION DISTRICT, OR
SOUTH COUNTY HEALTH DISTRICT, OR
SOUTH FORK WATER BOARD, OR
SOUTH GILLIAM COUNTY CEMETERY DISTRICT, OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
SOUTH GILLIAM COUNTY HEALTH DISTRICT, OR
SOUTH GILLIAM COUNTY R.F.P.D. VI-301, OR
SOUTH LAFOURCHE LEVEE DISTRICT, LA
SOUTH LANE COUNTY FIRE & RESCUE, OR
SOUTH SANTIAM RIVER WATER CONTROL DISTRICT, OR
SOUTH SHERMAN FIRE DISTRICT, OR
SOUTH SUBURBAN SANITARY DISTRICT, OR
SOUTH WASCO PARK & RECREATION DISTRICT, OR
SOUTHERN COOS HEALTH DISTRICT, OR
SOUTHERN CURRY CEMETERY MAINTENANCE DISTRICT,
OR
SOUTHVIEW IMPROVEMENT DISTRICT, OR
SOUTHWEST LINCOLN COUNTY WATER DISTRICT, OR
SOUTHWESTERN POLK COUNTY R.F.P.D., OR
SOUTHWOOD PARK WATER DISTRICT, OR
SPECIAL ROAD DISTRICT #1, OR
SPECIAL ROAD DISTRICT #8, OR
SPRING RIVER SPECIAL ROAD DISTRICT, OR
SPRINGFIELD UTILITY BOARD, OR
ST. PAUL R.F.P.D., OR
STANFIELD CEMETERY DISTRICT #6, OR
STANFIELD IRRIGATION DISTRICT, OR
STARR CREEK ROAD DISTRICT, OR
STARWOOD SANITARY DISTRICT, OR
STAYTON FIRE DISTRICT, OR
SUBLIMITY FIRE DISTRICT, OR
SUBURBAN EAST SALEM WATER DISTRICT, OR
SUBURBAN LIGHTING DISTRICT, OR
SUCCOR CREEK DISTRICT IMPROVEMENT COMPANY, OR
SUMMER LAKE IRRIGATION DISTRICT, OR
SUMMERVILLE CEMETERY MAINTENANCE DISTRICT, OR
SUMNER R.F.P.D., OR
SUN MOUNTAIN SPECIAL ROAD DISTRICT, OR
SUNDOWN SANITATION DISTRICT, OR
SUNFOREST ESTATES SPECIAL ROAD DISTRICT, OR
SUNNYSIDE IRRIGATION DISTRICT, OR
SUNRISE WATER AUTHORITY, OR
SUNRIVER SERVICE DISTRICT, OR
SUNSET EMPIRE PARK & RECREATION DISTRICT, OR
SUNSET EMPIRE TRANSPORTATION DISTRICT, OR
SURFLAND ROAD DISTRICT, OR
SUTHERLIN VALLEY RECREATION DISTRICT, OR
SUTHERLIN WATER CONTROL DISTRICT, OR
SWALLEY IRRIGATION DISTRICT, OR
SWEET HOME CEMETERY MAINTENANCE DISTRICT, OR
SWEET HOME FIRE & AMBULANCE DISTRICT, OR
SWISSHOME-DEADWOOD R.F.P.D., OR
TABLE ROCK DISTRICT IMPROVEMENT COMPANY, OR
TALENT IRRIGATION DISTRICT, OR
TANGENT R.F.P.D., OR
TENMILE R.F.P.D., OR
TERREBONNE DOMESTIC WATER DISTRICT, OR
THE DALLES IRRIGATION DISTRICT, OR
THOMAS CREEK-WESTSIDE R.F.P.D., OR
THREE RIVERS RANCH ROAD DISTRICT, OR
THREE SISTERS IRRIGATION DISTRICT, OR
TIGARD TUALATIN AQUATIC DISTRICT, OR
TIGARD WATER DISTRICT, OR
TILLAMOOK BAY FLOOD IMPROVEMENT DISTRICT, OR
TILLAMOOK COUNTY EMERGENCY COMMUNICATIONS
DISTRICT, OR
TILLAMOOK COUNTY S.W.C.D., OR
TILLAMOOK COUNTY TRANSPORTATION DISTRICT, OR
TILLAMOOK FIRE DISTRICT, OR
TILLAMOOK P.U.D., OR
TILLER R.F.P.D., OR
TOBIN DITCH DISTRICT IMPROVEMENT COMPANY, OR
TOLEDO R.F.P.D., OR
TONE WATER DISTRICT, OR
TOOLEY WATER DISTRICT, OR
TRASK DRAINAGE DISTRICT, OR
TRI CITY R.F.P.D. #4, OR
TRI-CITY WATER & SANITARY AUTHORITY, OR
TRI-COUNTY METROPOLITAN TRANSPORTATION
DISTRICT OF OREGON
TRIMET, OR
TUALATIN HILLS PARK & RECREATION DISTRICT
TUALATIN HILLS PARK & RECREATION DISTRICT, OR
TUALATIN S.W.C.D., OR
TUALATIN VALLEY FIRE & RESCUE
TUALATIN VALLEY FIRE & RESCUE, OR
TUALATIN VALLEY IRRIGATION DISTRICT, OR
TUALATIN VALLEY WATER DISTRICT
TUALATIN VALLEY WATER DISTRICT, OR
TUMALO IRRIGATION DISTRICT, OR
TURNER FIRE DISTRICT, OR
TWIN ROCKS SANITARY DISTRICT, OR
TWO RIVERS NORTH SPECIAL ROAD DISTRICT, OR
TWO RIVERS S.W.C.D., OR
TWO RIVERS SPECIAL ROAD DISTRICT, OR
TYGH VALLEY R.F.P.D., OR
TYGH VALLEY WATER DISTRICT, OR
UMATILLA COUNTY FIRE DISTRICT #1, OR
UMATILLA COUNTY S.W.C.D., OR
UMATILLA COUNTY SPECIAL LIBRARY DISTRICT, OR
UMATILLA HOSPITAL DISTRICT, OR
UMATILLA R.F.P.D. #7-405, OR
UMATILLA-MORROW RADIO AND DATA DISTRICT, OR
UMPQUA S.W.C.D., OR
UNION CEMETERY MAINTENANCE DISTRICT, OR
UNION COUNTY SOLID WASTE DISPOSAL DISTRICT, OR
UNION COUNTY VECTOR CONTROL DISTRICT, OR
UNION GAP SANITARY DISTRICT, OR
UNION GAP WATER DISTRICT, OR
UNION HEALTH DISTRICT, OR
UNION R.F.P.D., OR
UNION S.W.C.D., OR
UNITY COMMUNITY PARK & RECREATION DISTRICT, OR
UPPER CLEVELAND RAPIDS ROAD DISTRICT, OR
UPPER MCKENZIE R.F.P.D., OR
UPPER WILLAMETTE S.W.C.D., OR
VALE OREGON IRRIGATION DISTRICT, OR
VALE RURAL FIRE PROTECTION DISTRICT, OR
VALLEY ACRES SPECIAL ROAD DISTRICT, OR
VALLEY VIEW CEMETERY MAINTENANCE DISTRICT, OR
VALLEY VIEW WATER DISTRICT, OR
VANDEVERT ACRES SPECIAL ROAD DISTRICT, OR
VERNONIA R.F.P.D., OR
VINEYARD MOUNTAIN PARK & RECREATION DISTRICT,
OR
VINEYARD MOUNTAIN SPECIAL ROAD DISTRICT, OR
WALLA WALLA RIVER IRRIGATION DISTRICT, OR
WALLOWA COUNTY HEALTH CARE DISTRICT, OR
WALLOWA LAKE COUNTY SERVICE DISTRICT, OR
WALLOWA LAKE IRRIGATION DISTRICT, OR
WALLOWA LAKE R.F.P.D., OR
WALLOWA S.W.C.D., OR
WALLOWA VALLEY IMPROVEMENT DISTRICT #1, OR
WAMIC R.F.P.D., OR
WAMIC WATER & SANITARY AUTHORITY, OR
WARMSPRINGS IRRIGATION DISTRICT, OR
WASCO COUNTY S.W.C.D., OR
WATER ENVIRONMENT SERVICES, OR
WATER WONDERLAND IMPROVEMENT DISTRICT, OR
WATERBURY & ALLEN DITCH IMPROVEMENT DISTRICT,
OR
WATSECO-BARVIEW WATER DISTRICT, OR
WAUNA WATER DISTRICT, OR
WEDDERBURN SANITARY DISTRICT, OR
WEST EAGLE VALLEY WATER CONTROL DISTRICT, OR
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
WEST EXTENSION IRRIGATION DISTRICT, OR
WEST LABISH DRAINAGE & WATER CONTROL
IMPROVEMENT DISTRICT, OR
WEST MULTNOMAH S.W.C.D., OR
WEST SIDE R.F.P.D., OR
WEST SLOPE WATER DISTRICT, OR
WEST UMATILLA MOSQUITO CONTROL DISTRICT, OR
WEST VALLEY FIRE DISTRICT, OR
WESTERN HEIGHTS SPECIAL ROAD DISTRICT, OR
WESTERN LANE AMBULANCE DISTRICT, OR
WESTLAND IRRIGATION DISTRICT, OR
WESTON ATHENA MEMORIAL HALL PARK & RECREATION
DISTRICT, OR
WESTON CEMETERY DISTRICT #2, OR
WESTPORT FIRE AND RESCUE, OR
WESTRIDGE WATER SUPPLY CORPORATION, OR
WESTWOOD HILLS ROAD DISTRICT, OR
WESTWOOD VILLAGE ROAD DISTRICT, OR
WHEELER S.W.C.D., OR
WHITE RIVER HEALTH DISTRICT, OR
WIARD MEMORIAL PARK DISTRICT, OR
WICKIUP WATER DISTRICT, OR
WILLAKENZIE R.F.P.D., OR
WILLAMALANE PARK & RECREATION DISTRICT, OR
WILLAMALANE PARK AND RECREATION DISTRICT
WILLAMETTE HUMANE SOCIETY
WILLAMETTE RIVER WATER COALITION, OR
WILLIAMS R.F.P.D., OR
WILLOW CREEK PARK DISTRICT, OR
WILLOW DALE WATER DISTRICT, OR
WILSON RIVER WATER DISTRICT, OR
WINCHESTER BAY R.F.P.D., OR
WINCHESTER BAY SANITARY DISTRICT, OR
WINCHUCK R.F.P.D., OR
WINSTON-DILLARD R.F.P.D., OR
WINSTON-DILLARD WATER DISTRICT, OR
WOLF CREEK R.F.P.D., OR
WOOD RIVER DISTRICT IMPROVEMENT COMPANY, OR
WOODBURN R.F.P.D. NO. 6, OR
WOODLAND PARK SPECIAL ROAD DISTRICT, OR
WOODS ROAD DISTRICT, OR
WRIGHT CREEK ROAD WATER IMPROVEMENT DISTRICT,
OR
WY'EAST FIRE DISTRICT, OR
YACHATS R.F.P.D., OR
YAMHILL COUNTY TRANSIT AREA, OR
YAMHILL FIRE PROTECTION DISTRICT, OR
YAMHILL SWCD, OR
YONCALLA PARK & RECREATION DISTRICT, OR
YOUNGS RIVER-LEWIS & CLARK WATER DISTRICT, OR
ZUMWALT R.F.P.D., OR
K-12 INCLUDING BUT NOT LIMITED TO:
ACADIA PARISH SCHOOL BOARD
BEAVERTON SCHOOL DISTRICT
BEND-LA PINE SCHOOL DISTRICT
BOGALUSA HIGH SCHOOL, LA
BOSSIER PARISH SCHOOL BOARD
BROOKING HARBOR SCHOOL DISTRICT
CADDO PARISH SCHOOL DISTRICT
CALCASIEU PARISH SCHOOL DISTRICT
CANBY SCHOOL DISTRICT
CANYONVILLE CHRISTIAN ACADEMY
CASCADE SCHOOL DISTRICT
CASCADES ACADEMY OF CENTRAL OREGON
CENTENNIAL SCHOOL DISTRICT
CENTRAL CATHOLIC HIGH SCHOOL
CENTRAL POINT SCHOOL DISTRICT NO.6
CENTRAL SCHOOL DISTRICT 13J
COOS BAY SCHOOL DISTRICT NO.9
CORVALLIS SCHOOL DISTRICT 509J
COUNTY OF YAMHILL SCHOOL DISTRICT 29
CULVER SCHOOL DISTRICT
DALLAS SCHOOL DISTRICT NO.2
DAVID DOUGLAS SCHOOL DISTRICT
DAYTON SCHOOL DISTRICT NO.8
DE LA SALLE N CATHOLIC HS
DESCHUTES COUNTY SCHOOL DISTRICT NO.6
DOUGLAS EDUCATIONAL DISTRICT SERVICE
DUFUR SCHOOL DISTRICT NO.29
EAST BATON ROUGE PARISH SCHOOL DISTRICT
ESTACADA SCHOOL DISTRICT NO.10B
FOREST GROVE SCHOOL DISTRICT
GEORGE MIDDLE SCHOOL
GLADSTONE SCHOOL DISTRICT
GRANTS PASS SCHOOL DISTRICT 7
GREATER ALBANY PUBLIC SCHOOL DISTRICT
GRESHAM BARLOW JOINT SCHOOL DISTRICT
HEAD START OF LANE COUNTY
HIGH DESERT EDUCATION SERVICE DISTRICT
HILLSBORO SCHOOL DISTRICT
HOOD RIVER COUNTY SCHOOL DISTRICT
JACKSON CO SCHOOL DIST NO.9
JEFFERSON COUNTY SCHOOL DISTRICT 509-J
JEFFERSON PARISH SCHOOL DISTRICT
JEFFERSON SCHOOL DISTRICT
JUNCTION CITY SCHOOLS, OR
KLAMATH COUNTY SCHOOL DISTRICT
KLAMATH FALLS CITY SCHOOLS
LAFAYETTE PARISH SCHOOL DISTRICT
LAKE OSWEGO SCHOOL DISTRICT 7J
LANE COUNTY SCHOOL DISTRICT 4J
LINCOLN COUNTY SCHOOL DISTRICT
LINN CO. SCHOOL DIST. 95C
LIVINGSTON PARISH SCHOOL DISTRICT
LOST RIVER JR/SR HIGH SCHOOL
LOWELL SCHOOL DISTRICT NO.71
SALEM-KEIZER PUBLIC SCHOOLS 24J
MARION COUNTY SCHOOL DISTRICT 103
MARIST HIGH SCHOOL, OR
MCMINNVILLE SCHOOL DISTRICT NOAO
MEDFORD SCHOOL DISTRICT 549C
MITCH CHARTER SCHOOL
MONROE SCHOOL DISTRICT NO.1J
MORROW COUNTY SCHOOL DIST, OR
MULTNOMAH EDUCATION SERVICE DISTRICT
MULTISENSORY LEARNING ACADEMY
MYRTLE PINT SCHOOL DISTRICT 41
NEAH-KAH-NIE DISTRICT NO.56
NEWBERG PUBLIC SCHOOLS
NESTUCCA VALLEY SCHOOL DISTRICT NO.101
NOBEL LEARNING COMMUNITIES
NORTH BEND SCHOOL DISTRICT 13
NORTH CLACKAMAS SCHOOL DISTRICT
NORTH DOUGLAS SCHOOL DISTRICT
NORTH WASCO CITY SCHOOL DISTRICT 21
NORTHWEST REGIONAL EDUCATION SERVICE DISTRICT
ONTARIO MIDDLE SCHOOL
OREGON TRAIL SCHOOL DISTRICT NOA6
ORLEANS PARISH SCHOOL DISTRICT
PHOENIX-TALENT SCHOOL DISTRICT NOA
PLEASANT HILL SCHOOL DISTRICT
PORTLAND JEWISH ACADEMY
PORTLAND PUBLIC SCHOOLS
RAPIDES PARISH SCHOOL DISTRICT
REDMOND SCHOOL DISTRICT
REYNOLDS SCHOOL DISTRICT
ROGUE RIVER SCHOOL DISTRICT
ROSEBURG PUBLIC SCHOOLS
SCAPPOOSE SCHOOL DISTRICT 1J
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
SAINT TAMMANY PARISH SCHOOL BOARD, LA
SEASIDE SCHOOL DISTRICT 10
SHERWOOD SCHOOL DISTRICT 88J
SILVER FALLS SCHOOL DISTRICT 4J
SOUTH LANE SCHOOL DISTRICT 45J3
SOUTHERN OREGON EDUCATION SERVICE DISTRICT
SPRINGFIELD PUBLIC SCHOOLS
SUTHERLIN SCHOOL DISTRICT
SWEET HOME SCHOOL DISTRICT NO.55
TERREBONNE PARISH SCHOOL DISTRICT
THE CATLIN GABEL SCHOOL
TIGARD-TUALATIN SCHOOL DISTRICT
UMATILLA MORROW ESD
WEST LINN WILSONVILLE SCHOOL DISTRICT
WILLAMETTE EDUCATION SERVICE DISTRICT
WOODBURN SCHOOL DISTRICT
YONCALLA SCHOOL DISTRICT
ACADEMY FOR MATH ENGINEERING & SCIENCE (AMES),
UT
ALIANZA ACADEMY, UT
ALPINE DISTRICT, UT
AMERICAN LEADERSHIP ACADEMY, UT
AMERICAN PREPARATORY ACADEMY, UT
BAER CANYON HIGH SCHOOL FOR SPORTS & MEDICAL
SCIENCES, UT
BEAR RIVER CHARTER SCHOOL, UT
BEAVER SCHOOL DISTRICT, UT
BEEHIVE SCIENCE & TECHNOLOGY ACADEMY (BSTA) , UT
BOX ELDER SCHOOL DISTRICT, UT
CBA CENTER, UT
CACHE SCHOOL DISTRICT, UT
CANYON RIM ACADEMY, UT
CANYONS DISTRICT, UT
CARBON SCHOOL DISTRICT, UT
CHANNING HALL, UT
CHARTER SCHOOL LEWIS ACADEMY, UT
CITY ACADEMY, UT
DAGGETT SCHOOL DISTRICT, UT
DAVINCI ACADEMY, UT
DAVIS DISTRICT, UT
DUAL IMMERSION ACADEMY, UT
DUCHESNE SCHOOL DISTRICT, UT
EARLY LIGHT ACADEMY AT DAYBREAK, UT
EAST HOLLYWOOD HIGH, UT
EDITH BOWEN LABORATORY SCHOOL, UT
EMERSON ALCOTT ACADEMY, UT
EMERY SCHOOL DISTRICT, UT
ENTHEOS ACADEMY, UT
EXCELSIOR ACADEMY, UT
FAST FORWARD HIGH, UT
FREEDOM ACADEMY, UT
GARFIELD SCHOOL DISTRICT, UT
GATEWAY PREPARATORY ACADEMY, UT
GEORGE WASHINGTON ACADEMY, UT
GOOD FOUNDATION ACADEMY, UT
GRAND SCHOOL DISTRICT, UT
GRANITE DISTRICT, UT
GUADALUPE SCHOOL, UT
HAWTHORN ACADEMY, UT
INTECH COLLEGIATE HIGH SCHOOL, UT
IRON SCHOOL DISTRICT, UT
ITINERIS EARLY COLLEGE HIGH, UT
JOHN HANCOCK CHARTER SCHOOL, UT
JORDAN DISTRICT, UT
JUAB SCHOOL DISTRICT, UT
KANE SCHOOL DISTRICT, UT
KARL G MAESER PREPARATORY ACADEMY, UT
LAKEVIEW ACADEMY, UT
LEGACY PREPARATORY ACADEMY, UT
LIBERTY ACADEMY, UT
LINCOLN ACADEMY, UT
LOGAN SCHOOL DISTRICT, UT
MARIA MONTESSORI ACADEMY, UT
MERIT COLLEGE PREPARATORY ACADEMY, UT
MILLARD SCHOOL DISTRICT, UT
MOAB CHARTER SCHOOL, UT
MONTICELLO ACADEMY, UT
MORGAN SCHOOL DISTRICT, UT
MOUNTAINVILLE ACADEMY, UT
MURRAY SCHOOL DISTRICT, UT
NAVIGATOR POINTE ACADEMY, UT
NEBO SCHOOL DISTRICT, UT
NO UT ACAD FOR MATH ENGINEERING & SCIENCE
(NUAMES), UT
NOAH WEBSTER ACADEMY, UT
NORTH DAVIS PREPARATORY ACADEMY, UT
NORTH SANPETE SCHOOL DISTRICT, UT
NORTH STAR ACADEMY, UT
NORTH SUMMIT SCHOOL DISTRICT, UT
ODYSSEY CHARTER SCHOOL, UT
OGDEN PREPARATORY ACADEMY, UT
OGDEN SCHOOL DISTRICT, UT
OPEN CLASSROOM, UT
OPEN HIGH SCHOOL OF UTAH, UT
OQUIRRH MOUNTAIN CHARTER SCHOOL, UT
PARADIGM HIGH SCHOOL, UT
PARK CITY SCHOOL DISTRICT, UT
PINNACLE CANYON ACADEMY, UT
PIUTE SCHOOL DISTRICT, UT
PROVIDENCE HALL, UT
PROVO SCHOOL DISTRICT, UT
QUAIL RUN PRIMARY SCHOOL, UT
QUEST ACADEMY, UT
RANCHES ACADEMY, UT
REAGAN ACADEMY, UT
RENAISSANCE ACADEMY, UT
RICH SCHOOL DISTRICT, UT
ROCKWELL CHARTER HIGH SCHOOL, UT
SALT LAKE ARTS ACADEMY, UT
SALT LAKE CENTER FOR SCIENCE EDUCATION, UT
SALT LAKE SCHOOL DISTRICT, UT
SALT LAKE SCHOOL FOR THE PERFORMING ARTS, UT
SAN JUAN SCHOOL DISTRICT, UT
SEVIER SCHOOL DISTRICT, UT
SOLDIER HOLLOW CHARTER SCHOOL, UT
SOUTH SANPETE SCHOOL DISTRICT, UT
SOUTH SUMMIT SCHOOL DISTRICT, UT
SPECTRUM ACADEMY, UT
SUCCESS ACADEMY, UT
SUCCESS SCHOOL, UT
SUMMIT ACADEMY, UT
SUMMIT ACADEMY HIGH SCHOOL, UT
SYRACUSE ARTS ACADEMY, UT
THOMAS EDISON - NORTH, UT
TIMPANOGOS ACADEMY, UT
TINTIC SCHOOL DISTRICT, UT
TOOELE SCHOOL DISTRICT, UT
TUACAHN HIGH SCHOOL FOR THE PERFORMING ARTS, UT
UINTAH RIVER HIGH, UT
UINTAH SCHOOL DISTRICT, UT
UTAH CONNECTIONS ACADEMY, UT
UTAH COUNTY ACADEMY OF SCIENCE, UT
UTAH ELECTRONIC HIGH SCHOOL, UT
UTAH SCHOOLS FOR DEAF & BLIND, UT
UTAH STATE OFFICE OF EDUCATION, UT
UTAH VIRTUAL ACADEMY, UT
VENTURE ACADEMY, UT
VISTA AT ENTRADA SCHOOL OF PERFORMING ARTS AND
TECHNOLOGY, UT
WALDEN SCHOOL OF LIBERAL ARTS, UT
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
WASATCH PEAK ACADEMY, UT
WASATCH SCHOOL DISTRICT, UT
WASHINGTON SCHOOL DISTRICT, UT
WAYNE SCHOOL DISTRICT, UT
WEBER SCHOOL DISTRICT, UT
WEILENMANN SCHOOL OF DISCOVERY, UT
HIGHER EDUCATION
ARGOSY UNIVERSITY
BATON ROUGE COMMUNITY COLLEGE, LA
BIRTHINGWAY COLLEGE OF MIDWIFERY
BLUE MOUNTAIN COMMUNITY COLLEGE
BRIGHAM YOUNG UNIVERSITY - HAWAII
CENTRAL OREGON COMMUNITY COLLEGE
CENTENARY COLLEGE OF LOUISIANA
CHEMEKETA COMMUNITY COLLEGE
CLACKAMAS COMMUNITY COLLEGE
COLLEGE OF THE MARSHALL ISLANDS
COLUMBIA GORGE COMMUNITY COLLEGE
CONCORDIA UNIVERSITY
GEORGE FOX UNIVERSITY
KLAMATH COMMUNITY COLLEGE DISTRICT
LANE COMMUNITY COLLEGE
LEWIS AND CLARK COLLEGE
LINFIELD COLLEGE
LINN-BENTON COMMUNITY COLLEGE
LOUISIANA COLLEGE, LA
LOUISIANA STATE UNIVERSITY
LOUISIANA STATE UNIVERSITY HEALTH SERVICES
MARYLHURST UNIVERSITY
MT. HOOD COMMUNITY COLLEGE
MULTNOMAH BIBLE COLLEGE
NATIONAL COLLEGE OF NATURAL MEDICINE
NORTHWEST CHRISTIAN COLLEGE
OREGON HEALTH AND SCIENCE UNIVERSITY
OREGON INSTITUTE OF TECHNOLOGY
OREGON STATE UNIVERSITY
OREGON UNIVERSITY SYSTEM
PACIFIC UNIVERSITY
PIONEER PACIFIC COLLEGE
PORTLAND COMMUNITY COLLEGE
PORTLAND STATE UNIVERSITY
REED COLLEGE
RESEARCH CORPORATION OF THE UNIVERSITY OF
HAWAII
ROGUE COMMUNITY COLLEGE
SOUTHEASTERN LOUISIANA UNIVERSITY
SOUTHERN OREGON UNIVERSITY (OREGON UNIVERSITY
SYSTEM)
SOUTHWESTERN OREGON COMMUNITY COLLEGE
TULANE UNIVERSITY
TILLAMOOK BAY COMMUNITY COLLEGE
UMPQUA COMMUNITY COLLEGE
UNIVERSITY OF HAWAII BOARD OF REGENTS
UNIVERSITY OF HAWAII-HONOLULU COMMUNITY
COLLEGE
UNIVERSITY OF OREGON-GRADUATE SCHOOL
UNIVERSITY OF PORTLAND
UNIVERSITY OF NEW ORLEANS
WESTERN OREGON UNIVERSITY
WESTERN STATES CHIROPRACTIC COLLEGE
WILLAMETTE UNIVERSITY
XAVIER UNIVERSITY
UTAH SYSTEM OF HIGHER EDUCATION, UT
UNIVERSITY OF UTAH, UT
UTAH STATE UNIVERSITY, UT
WEBER STATE UNIVERSITY, UT
SOUTHERN UTAH UNIVERSITY, UT
SNOW COLLEGE, UT
DIXIE STATE COLLEGE, UT
COLLEGE OF EASTERN UTAH, UT
UTAH VALLEY UNIVERSITY, UT
SALT LAKE COMMUNITY COLLEGE, UT
UTAH COLLEGE OF APPLIED TECHNOLOGY, UT
STATE AGENCIES
ADMIN. SERVICES OFFICE
BOARD OF MEDICAL EXAMINERS
HAWAII CHILD SUPPORT ENFORCEMENT AGENCY
HAWAII DEPARTMENT OF TRANSPORTATION
HAWAII HEALTH SYSTEMS CORPORATION
OFFICE OF MEDICAL ASSISTANCE PROGRAMS
OFFICE OF THE STATE TREASURER
OREGON BOARD OF ARCHITECTS
OREGON CHILD DEVELOPMENT COALITION
OREGON DEPARTMENT OF EDUCATION
OREGON DEPARTMENT OF FORESTRY
OREGON DEPT OF TRANSPORTATION
OREGON DEPT. OF EDUCATION
OREGON LOTTERY
OREGON OFFICE OF ENERGY
OREGON STATE BOARD OF NURSING
OREGON STATE DEPT OF CORRECTIONS
OREGON STATE POLICE
OREGON TOURISM COMMISSION
OREGON TRAVEL INFORMATION COUNCIL
SANTIAM CANYON COMMUNICATION CENTER
SEIU LOCAL 503, OPEU
SOH- JUDICIARY CONTRACTS AND PURCH
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Version May 17, 2021
PRICING SCHEDULE
ATTACHMENT 2- SAMPLE PRICING FORM FOR EVALUATION – EXCEL FORMAT UNDER
DOCUMENTS ON PROCUREWARE
EXHIBIT 1- PRICING SCHEDULE-COMPLETE PRODUCT OFFERING/ BALANCE OF LINE
Include an electronic copy of your catalog from which the discount is calculated. Title the pdf
Exhibit 1. Electronic price lists must contain the following: (if applicable)
a. Manufacturer part #
b. Supplier’s Part # (if different from manufacturer part #)
c. Description
d. Manufacturer’s Suggested List Price and Net Price
e. Net price to Fresno Unified, (net price shall include freight and any additional fees that may
be charged such as credit card processing, administrative fees, etc.)
f. Provide details of and propose additional discounts for volume orders, special manufacturer’s
offers, minimum order quantity, free goods programs, total annual spend, etc. (if offered).
g. If leasing/financing is an option, provide applicable pricing and discounts.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product Number Product Description Mfg.
Name Mfg. Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each Price
% Discount
from Catalog
Price
Unit Cost
With
Discount
Applied
Total Cost
SPA7116-12 NABC BATHROOM CLNR/DISINFECT RTU NABC QT 92000 -$ -$
JWP4277285 OXIVIR TB DISINFECTANT RTU 12QT/CS DIVERSEY QT 87000 -$ -$
SPA6075 STERIPHENE II SPRING BREZE DISINFEC SPARTAN EA 75000 -$ -$
310650028 BIOESQUE 1 GAL DISINFECTANT SOLUTION BIOESQUE EA 59000 -$ -$
310650027 BIOESQUE QUART DISINFECTANT(W/TRIGGER)BIOESQUE EA 38000 -$ -$
JWP04578 CREW CLINGING TOILET BOWL CLNR QT DIVERSEY QT 33600 -$ -$
REN05014-AM RENOWN FOAM DISINFECTANT CLEANER AEROSOL RENOWN EA 30000 -$ -$
SPA3195-12 SANI-TYZE FOOD CONTACT RTU QT SPARTAN QT 29000 -$ -$
CLO00031 CLOROX 24OZ TOILET BOWL CLEANER 12/CS CLOROX EA 28000 -$ -$
308569754 MICROBAN 24 HR 15OZ AERO SPRAY MICROBAN EA 25000 -$ -$
SPA1021-12 TB-CIDE QUAT DISINFEC/DEOD RTU QT SPARTAN QT 24000 -$ -$
REN02825-MS RENOWN MINT 9 ACID BOWL CLEANER 12QT/CS RENOWN QT 23000 -$ -$
REN05002-AM RENOWN HEAVY DUTY GLASS CLEANER AEROSOL RENOWN EA 23000 -$ -$
CLO38504 CLOROX DISINFECT SPRAY FRESH CLOROX EA 22000 -$ -$
CLO35417 CLEAN-UP CLNR W/BLEACH 32OZ CLOROX QT 22000 -$ -$
JWP04743 VIREX TB RTU DISINFECTANT CLEANER QT CLE DIVERSEY QT 21300 -$ -$
310650025 BIOESQUE 5 GALLON DISINFECTANT BIOESQUE EA 18200 -$ -$
PGC45112 DAWN ORIG POT/PAN DETERGENT 38 OZ DAWN EA 17300 -$ -$
PGC32987 COMET DEOD CLNSR 21OZ COMET EA 16400 -$ -$
CLO31650 CLOROX TOTAL 360 DISINFEC GL CLOROX GA 16000 -$ -$
SCW104826 GREEN SCAPES ICE MELT 50# BG SCOTWOOD EA 14000 -$ -$
SPA4820 CLEAN ON THE GO CLEAN BY PEROXY SPARTAN EA 13000 -$ -$
PGC73163 COMET DEOD CLNSR 32OZ.COMET EA 10000 -$ -$
700304 CLOTHESLINE FRESH LAUNDRY DETERGENT SPARTAN EA 250 -$ -$
311792136 DIVERSEY VIREX 11 2.5 LITER DIVERSEY EA 2000 -$ -$
WT762055008 BONA SUPERCOURT HD BONA EA 500 -$ -$
-$ TOTAL PRICE
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
CHEMICALS
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed specifications of each proposed alternate product.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product
Number
Product
Descriptio
n
Mfg.
Name
Mfg.
Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each price % Discount from
Catalog Price
Unit Cost
With
Discount
Applied
Total Cost
GOJ3659-12 PURELL INSTANT HAND SANITIZER PUMP PURELL EA 31000 -$ -$
GOJ2156-08 PURELL HAND SANITIZER NXT CLEAR 1000 ML PURELL EA 28000 -$ -$
GOJ8811-03 ADX-12 HANDWASH CLR/MILD 1250ML GOJO EA 24000 -$ -$
GOJ1905-02 PURELL HAND SANTZR FOAM LTX 1200ML PURELL EA 19500 -$ -$
GOJ9625-04 PURELL HAND SANITIZER PUMP BOTTLE 2 LT PURELL EA 17000 -$ -$
GOJ9128-12 PINK & KLEAN SKIN CLEANSER 800ML GOJO EA 17000 -$ -$
DIA84014 7.5OZ LIQUID DIAL GOLD SOAP DIAL EA 13000 -$ -$
9342-06 PURELL PROFESSIONAL SURFACE DISINFECTING WIPES 110 CANISTER PURELL EA 10000 -$ -$
313830854 SAFETY FIRST HAND SANITIZER 1 GALLON
SAFETY
WERCS EA 7000 -$ -$
5212-02 PURELL HEALTHY SOAP 2000 ML PURELL EA 9500 -$ -$
-$ TOTAL PRICE
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
SKIN CARE
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed
specifications of each proposed alternate product.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product
Number
Product
Descriptio
n
Mfg.
Name Mfg. Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each price % Discount from
Catalog Price
Unit Cost
With
Discount
Applied
Total Cost
REN06109-SP TT JRT 3.4"x1000' 2PLY WHITE (12 CASE)RENOWN CA 49000 -$ -$
REN06125-WB RENOWN SINGLE ROLL BATH TISSUE 2PLY (865 SHEETS PER ROLL 36 ROLLS PER CASE)RENOWN CA 42000 -$ -$
REN06004-WB RENOWN GS HARD ROLL TOWEL NATURAL 8 (800 FEET PER ROLL, 6 ROLLS PER CASE)RENOWN CA 35000 -$ -$
REN06131-WB RENOWN TWL CONTROL HARD ROLL WHT (800 FEET PER ROLL, 6 ROLLS PER CASE)RENOWN CA 30000 -$ -$
REN06003-WB RENOWN GS MULTI-FOLD TOWEL NATURAL 9-1/8 (250 SHTS PACK, 16 PACKS PER CASE)RENOWN CA 22000 -$ -$
GPT89460 ENMOTION WHITE ROLL TOWEL 10X800 6RL/CS ENMOTION CA 19000 -$ -$
REN06001-WB RENOWN KITCHEN ROLL TOWELS WHITE 2 PLY (84 SHEETS PER ROLL, 30 ROLLS PER CASE)RENOWN CA 14000 -$ -$
APP12507-WB APPEAL FLAT BOX 2 PLY FACIAL TISSUE 100 COUNT APPEAL CA 12000 -$ -$
310413436 RENOWN WHITE MULTIFOLD TOWELS (250 PER PACK 16 PACKS CS)RENOWN CA 12000 -$ -$
309330283 1/2 FOLD TOILET SEAT COVERS (250 PER PACK, 20 PACKS PER CASE) RENOWN CA 6000 -$ -$
KCC05701 WYPALL DISPOSABLE CLEANING DRYING TOWELS (18 PACKS/ CASE 56 SHEETS PACK)
KIMBERLY
CLARK CA 700 -$ -$
KCC48749 KIMBERLEY CLARK HUGGIES SIMPLY CLEAN FRAG FREE BABY WIPES (9 PACK 576 SHEETS)HUGGIES CA 800 -$ -$
-$
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
PAPER TOWELS, TISSUES, WIPERS
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed
specifications of each proposed alternate product.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product
Number
Product
Description
Mfg.
Name Mfg. Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each price
%
Discount
from
Catalog
Price
Unit Cost
With
Discount
Applied
Total Cost
314499114 LYSOL FLAT PACK WIPES 80/PK LYSOL EA 243000 -$ -$
REN02114 RENOWN PAD SCOURING 96 MEDIUM DUTY RENOWN EA 89000 -$ -$
PGC16449 MR CLEAN MAGIC ERASER X-POWR MR CLEAN EA 85000 -$ -$
JWP4599516 OXIVIR TB WIPE 6.1X6.8 160CT DIVERSEY EA 61000 -$ -$
BUN15949 CLOROX WET WIPES FRESH 75CT CLOROX EA 54000 -$ -$
REN05121 PLSTC BTL W/GRADUATION 32OZ RENOWN EA 45000 -$ -$
REN05113 32 GP TRIGGER SPRAYER 9 7/8in TUBE RENOWN EA 37000 -$ -$
RCP1820577 CLOTH MICROFIBER 12X12 PINK RUBBERMAID EA 36500 -$ -$
MMM20688 SCOTCH-BRITE 74 M-DUTY SCRUB SPONGE SCOTCH-BRITE EA 33000 -$ -$
REN05143 RENOWN STAIN AND MARK ERASER RENOWN EA 26000 -$ -$
559004 PUMICE SCOURING STICK PUMIE EA 22000 -$ -$
CLO30825 CLOROX HEALTHCARE WIPE 155CT CLOROX EA 19000 -$ -$
REN02115 RENOWN 98 LIGHT DUTY WHITE SCOURING PAD RENOWN EA 17000 -$ -$
RCP1820582 CLOTH MICROFIBER 16X16 GREEN RUBBERMAID EA 15000 -$ -$
311535522 TOILET MOPS - 6/PK RENOWN PK 13000 -$ -$
94 MOP HANDLE 64" WITH MOLDED HEAD
IMPACT
PRODUCTS EA 3500 -$ -$
120580 CLEANSOURCE MOP DUST WEDGE LAUNDERABLE WHITE CLEANSOURCE EA 4500 -$ -$
APP18030 APPEAL BLENDED FINISH MOP, BLUE/WHITE, 24 OZ., 1 IN. HEAD BAND APPEAL EA 4700 -$ -$
CON184GY JANITOR CART CONTINENTAL EA 900 -$ -$
RCP264200YL RUBBERMAID BRUTE TRASH CAN CADDY BAG RUBBERMAID EA 200 -$ -$
RCP611200YL MULTILINGUAL 2 SIDED CAUTION WET FLOOR SIGN RUBBERMAID EA 200 -$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
CLEANING TOOLS SUPPLIES
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed
specifications of each proposed alternate product.
TOTAL PRICE
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product
Number
Product
Description
Mfg.
Name Mfg. Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each price
%
Discount
from
Catalog
Price
Unit Cost
With
Discount
Applied
Total Cost
RCP295600BK MED WASTEBASKET 28.125QT BLK RUBBERMAID EA 500 -$ -$
RCP295673BL DESKSIDE RECYCLE 28QT BLUE CONT MED RUBBERMAID EA 1200 -$ -$
RCP264000BK BRUTE DOLLY BLK FOR 2620 2632 2643 RUBBERMAID EA 1400 -$ -$
RCP295700BK LG WASTEBASKET 41.25QT BLK RUBBERMAID EA 1200 -$ -$
RCP263200GY BRUTE CONTAINER W/O LID 32GL GRY RUBBERMAID EA 1000 -$ -$
REN03894 RENOWN NIFTY 36" PICK UP TOOL RENOWN EA 800 -$ -$
RCP264360GY BRUTE 44GL VENTED UTILITY CONT GRY RUBBERMAID EA 1200 -$ -$
RCP265500GY BRUTE CONTAINER W/O LID 55GL GRY RUBBERMAID EA 800 -$ -$
RCP295773BL DESKSIDE 41QT LG CONT RECYCLE BLU RUBBERMAID EA 2000 -$ -$
UNGNT080 NIFTY NABBER GRIP 32IN UNGER EA 300 -$ -$
RCP354060GY SLIM JIM CONT W/VENTING CHNLS 23 GL RUBBERMAID EA 700 -$ -$
CON2818-1 WASTEBASKET RECYCLING 28 1/8 QT BLU CONTINENTAL EA 3000 -$ -$
RCP262000GY BRUTE CONTAINER W/O LID 20GL GRY RUBBERMAID EA 700 -$ -$
RCP263100GY BRUTE CONTAINER LID GRY FOR 2632 RUBBERMAID EA 500 -$ -$
REN14540-CA RENOWN 40 X 48 CAN LINER 16 MICRON CLEAR RENOWN EA 8000 -$ -$
REN13312-CA RENOWN 33 X 40 CAN LINER 12 MICRON CLEAR RENOWN EA 2000 -$ -$
REN11510-CA RENOWN 24 X 33 CAN LINER 8 MICRON CLEAR RENOWN EA 6000 -$ -$
RCP9T1800BK RUBBERMAID TILT TRUCK ONE CUBIC YARD RUBBERMAID EA 500 -$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$ -$
-$
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
WASTE CONTAINMENT AND DISPOSAL
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed
specifications of each proposed alternate product.
TOTAL PRICE
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product
Number
Product
Description
Mfg.
Name Mfg. Number UOM Quantity
Catalog
Price or
Mfg. List
Price
Each price
%
Discount
from
Catalog
Price
Unit Cost
With
Discount
Applied
Total Cost
2488489 20x25x2 PLT MERV 8 12/CS Rochester -$ -$
2485778 FILTER 18X24X2 ANTIMICRO Rochester -$ -$
2488480 16x20x2 PLT MERV 8 12/CS Rochester -$ -$
2488487 20x20x2 PLT MERV 8 12/CS Rochester -$ -$
2488482 16x25x2 PLT MERV 8 12/CS Rochester -$ -$
2485431 FILTER 16X25X2 ANTIMICRO Rochester -$ -$
2488550 20x20x1 PLT MERV 8 12/CS Rochester -$ -$
2484139 10x20x1 PLT MERV 8 Rochester -$ -$
2484186 FLTR 18X24X1 STDCAP PLT 12CS Rochester -$ -$
2485949 FILTER 20X20X2 ANTIMICRO Rochester -$ -$
3560048 REPLACEMENT FILTER H, 1 BOX Winix -$ -$
2485713 FILTER 16X20X2 PLEAT HP Flanders -$ -$
2485420 FILTER 16X20X2 ANTIMICRO Rochester -$ -$
2484643 FILTER 24X24X1 POLY PRECUT Rochester -$ -$
314570828 PORT PLUG IN AIR PURIFIER SYSTM Restorair -$ -$
315963577 WINIX D480 3 STAGE AIR PURIFIER Winix -$ -$
315963579 D480 REPLACE FILTER Winix -$ -$
314570843 RAPID ROOM RECOVERY AIR PURIFIER Restorair -$ -$
317317630 WINIX XQ AIR PURIFIER 4 STAGE Winix -$ -$
305583917 GREEN TECH ENVIRONMENTAL HOME AIR PURIFIER Green Tech -$ -$
317368651 FILTER X REPLACEMENT FOR XQ Winix -$ -$
305583949 GREEN TECH ROOM AIR PURIFIER Green Tech -$ -$
3560041 WINIX 5500-2 AIR CLEANER Winix -$ -$
315963585 WINIX D360 3 STAGE AIR PURIFIER Winix -$ -$
315963590 D360 REPLACE FILTER Winix -$ -$
3560040 WINIX 5300-2 AIR CLEANER Winix -$ -$
AOC5PPI REPLACEMENT CELL FOR AOCPPI-16 PLUG IN Restorair -$ -$
-$ -$
-$ -$
-$ -$
-$
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
MISCELLANEOUS- AIR QULAITY CONTROLS
SAMPLE PRICING FOR EVALUATION
Alternate Product
If submitting an alternate product, provide detailed
specifications of each proposed alternate product.
TOTAL PRICE
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
NOTE: This Sample Pricing is for evaluation purposes only.
Product Number Product Description Mfg. Name Product Number Product Description Mfg. Name Mfg.
Number UOM Quantity Catalog Price or
Mfg. List Price Each Price % Discount from
Catalog Price
Unit Cost With
Discount Applied Total Cost
314154445 RYOBI ELECTROSTATIC SPRAYER 1 GAL RYOBI EA 3500 -$ -$
PTE107252 PROFORCE 1500XP HEPA VAC UPRIGHT PROTEAM EA 600 -$ -$
REN08012-VP RENOWN WET/DRY VACUUM 18GAL TANK RENOWN EA 400 -$ -$
REN08002-VP LOW SPEED FLOOR MACHINE 20IN 1.5 HP RENOWN EA 350 -$ -$
WINSRS12 SENSOR 12IN VACUUM CLEANER KARCHER EA 300 -$ -$
PTE107310 SUPER COACH PRO 6 VAC W/107100 PROTEAM EA 300 -$ -$
REN08008-VP RENOWN 3-SPEED MOVER RENOWN EA 250 -$ -$
ES400 ADVANCE CARPET EXTRACTOR WITH 18" PATH ADVANCE EA 21000 -$ -$
KV1250 KAIVAC 1250 NO TOUCH CLEANING SYSTEM KAIVAC EA 200 -$ -$
MMM29592 20IN SURFACE STRIP PREP PAD 3M EA 15000 -$ -$
REN02048 RENOWN RED BUFFING PAD 20IN 5/CS RENOWN EA 14000 -$ -$
REN02068 RENOWN WHITE POLISHING PAD 20IN RENOWN EA 11000 -$ -$
MMM08382 3M 7200 BLACK STRIPPER PAD 20IN 5/CS 3M EA 9200 -$ -$
MMM08278 3M 7300 HI PRO STRIPPING PAD 20IN 5/CS 3M EA 9000 -$ -$
REN02023 RENOWN SCRUBBING PAD 20IN GREEN RENOWN EA 6500 -$ -$
MMM02590 SPP14X20 SURFACE PREP PAD 10EA/CS 3M EA 6100 -$ -$
REN02009 RENOWN HI PRO STRIP PAD 20IN RENOWN EA 5700 -$ -$
PTE107314 INTERCEPT MICRO FILTERS FOR PRO 6 PROTEAM PK 4200 -$ -$
REN08050 RENOWN VAC BAG/WINDSOR SENSOR RENOWN PK 4100 -$ -$
REN02100 REN HOG HAIR FLR PAD TAN 20"RENOWN EA 4000 -$ -$
TT1120 TWINTEC 20" ELECTRIC AUTO SCRUBBER TWINTEC EA 3700 -$ -$
PTE100331 INTERCEPT MICRO FILTER-SUPERCOACH PROTEAM PK 3400 -$ -$
MMM08484 3M 4100 WHITE SUPER POLISH PAD 20IN 3M EA 3300 -$ -$
REN02015 RENOWN BLACK STRIPPING PAD 17IN 5/CS RENOWN EA 3002 -$ -$
-$
Alternate Product
If submitting an alternate product, provide detailed specifications of each proposed
alternate product.
CLEANING SUPPLIES, EQUIPMENT AND CUSTODIAL RELATED PRODUCTS
RFP # 22-07
ATTACHMENT 2
CLEANING AND MAINTENANCE EQUIPMENT AND ACCESSORIES
SAMPLE PRICING FOR EVALUATION
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
EXHIBIT B
Original Government Contract
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
EXHIBIT C
City’s Insurance and Indemnity
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
Exhibit C
Insurance and Indemnity
INDEMNIFICATION
To the furthest extent allowed by law, VENDOR shall indemnify, hold harmless and
defend CITY and each of its officers, officials, employees, agents and volunteers from
any and all loss, liability, fines, penalties, forfeitures, costs and damages (whether in
contract, tort or strict liability, including but not limited to personal injury, death at any
time and property damage) incurred by CITY, VENDOR or any other person, and from
any and all claims, demands and actions in law or equity (including reasonable
attorney's fees, litigation expenses and cost to enforce this agreement), arising or
alleged to have arisen directly or indirectly out of performance of this Contract.
VENDOR'S obligations under the preceding sentence shall apply regardless of whether
CITY or any of its officers, officials, employees, agents or volunteers are passively
negligent, but shall not apply to any loss, liability, fines, penalties, forfeitures, costs or
damages caused by the active or sole negligence, or the willful misconduct, of CITY or
any of its officers, officials, employees, agents or volunteers.
If VENDOR should subcontract all or any portion of the work to be performed
under this Contract, VENDOR shall require each subcontractor to indemnify, hold
harmless and defend CITY and each of its officers, officials, employees, agents and
volunteers in accordance with the terms of the preceding paragraph.
This section shall survive termination or expiration of this Contract.
INSURANCE REQUIREMENTS
(a) Throughout the life of this Agreement, VENDOR shall pay for and maintain in full
force and effect all insurance as required herein with an insurance company(ies) either
(i) admitted by the California Insurance Commissioner to do business in the State of
California and rated no less than “A-VII” in the Best’s Insurance Rating Guide, or (ii) as
may be authorized in writing by CITY'S Risk Manager or his/her designee at any time
and in his/her sole discretion. The required policies of insurance as stated herein shall
maintain limits of liability of not less than those amounts stated therein. However, the
insurance limits available to CITY, its officers, officials, employees, agents and
volunteers as additional insureds, shall be the greater of the minimum limits specified
therein or the full limit of any insurance proceeds to the named insured.
(b) If at any time during the life of the Agreement or any extension, VENDOR or any
of its subcontractors fail to maintain any required insurance in full force and effect, all
services and work under this Agreement shall be discontinued immediately, and all
payments due or that become due to VENDOR shall be withheld until notice is received
by CITY that the required insurance has been restored to full force and effect and that
the premiums therefore have been paid for a period satisfactory to CITY. Any failure to
maintain the required insurance shall be sufficient cause for CITY to terminate this
Agreement. No action taken by CITY pursuant to this section shall in any way relieve
VENDOR of its responsibilities under this Agreement. The phrase “fail to maintain any
required insurance” shall include, without limitation, notification received by CITY that an
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
insurer has commenced proceedings, or has had proceedings commenced against it,
indicating that the insurer is insolvent.
(c) The fact that insurance is obtained by VENDOR shall not be deemed to
release or diminish the liability of VENDOR, including, without limitation, liability under
the indemnity provisions of this Agreement. The duty to indemnify CITY shall apply to all
claims and liability regardless of whether any insurance policies are applicable. The
policy limits do not act as a limitation upon the amount of indemnification to be provided
by VENDOR. Approval or purchase of any insurance contracts or policies shall in no
way relieve from liability nor limit the liability of VENDOR, vendors, suppliers, invitees,
contractors, sub-contractors, subcontractors, or anyone employed directly or indirectly
by any of them.
1. PRODUCTS LIABILITY INSURANCE: VENDOR shall maintain, and provide the
City of Fresno with verification of, manufacturer's products liability insurance policy in
excess of $1,000,000 by providing a certificate of insurance on said Bid Item(s)
equipment. Certificates shall be issued by an insurance company meeting the
requirements to conduct business in the state of California. City of Fresno is required to
be an additional insured with primary and non- contributory coverage in favor of the City
on this General Liability Policy.
If the scope of work includes delivery and/or installation, the requirements below
apply in addition to the above requirements.
Coverage shall be at least as broad as:
1. The most current version of Insurance Services Office (ISO) Commercial General
Liability Coverage Form CG 00 01, providing liability coverage arising out of your
business operations. The Commercial General Liability policy shall be written on an
occurrence form and shall provide coverage for “bodily injury,” “property damage” and
“personal and advertising injury” with coverage for premises and operations (including
the use of owned and non-owned equipment), products and completed operations, and
contractual liability (including, without limitation, indemnity obligations under the
Agreement) with limits of liability not less than those set forth under “Minimum Limits of
Insurance.”
2. The most current version of ISO *Commercial Auto Coverage Form CA 00 01,
providing liability coverage arising out of the ownership, maintenance or use of
automobiles in the course of your business operations. The Automobile Policy shall be
written on an occurrence form and shall provide coverage for all owned, hired, and non-
owned automobiles or other licensed vehicles (Code 1- Any Auto).
3. Workers’ Compensation insurance as required by the State of California and
Employer’s Liability Insurance.
MINIMUM LIMITS OF INSURANCE
VENDOR shall procure and maintain for the duration of the contract, and for 5 years
thereafter, insurance with limits of liability not less than those set forth below. However,
insurance limits available to CITY, its officers, officials, employees, agents and
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
volunteers as additional insureds, shall be the greater of the minimum limits specified
herein or the full limit of any insurance proceeds available to the named insured:
1. COMMERCIAL GENERAL LIABILITY
(i) $1,000,000 per occurrence for bodily injury and property damage;
(ii) $1,000,000 per occurrence for personal and advertising injury;
(iii) $2,000,000 aggregate for products and completed operations; and,
(iv) $2,000,000 general aggregate applying separately to the work performed under
the Agreement.
2. COMMERCIAL AUTOMOBILE LIABILITY
$1,000,000 per accident for bodily injury and property damage.
3. Workers’ Compensation Insurance as required by the State of California with
statutory limits and EMPLOYER’S LIABILITY with limits of liability not less than:
(i) $1,000,000 each accident for bodily injury;
(ii) $1,000,000 disease each employee; and,
(iii) $1,000,000 disease policy limit.
UMBRELLA OR EXCESS INSURANCE
In the event VENDOR purchases an Umbrella or Excess insurance policy(ies) to meet
the “Minimum Limits of Insurance,” this insurance policy(ies) shall “follow form” and
afford no less coverage than the primary insurance policy(ies). In addition, such
Umbrella or Excess insurance policy(ies) shall also apply on a primary and non-
contributory basis for the benefit of the CITY, its officers, officials, employees, agents
and volunteers.
DEDUCTIBLES AND SELF-INSURED RETENTIONS
VENDOR shall be responsible for payment of any deductibles contained in any
insurance policy(ies) required herein and VENDOR shall also be responsible for
payment of any self-insured retentions.
OTHER INSURANCE PROVISIONS/ENDORSEMENTS
(i) All policies of insurance required herein shall be endorsed to provide that the
coverage shall not be cancelled, non-renewed, reduced in coverage or in limits except
after thirty (30) calendar days written notice has been given to CITY, except ten (10)
days for nonpayment of premium. VENDOR is also responsible for providing written
notice to the CITY under the same terms and conditions. Upon issuance by the insurer,
broker, or agent of a notice of cancellation, non-renewal, or reduction in coverage or in
limits, VENDOR shall furnish CITY with a new certificate and applicable endorsements
for such policy(ies). In the event any policy is due to expire during the work to be
performed for CITY, VENDOR shall provide a new certificate, and applicable
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793
endorsements, evidencing renewal of such policy not less than fifteen (15) calendar
days prior to the expiration date of the expiring policy.
(ii) The Commercial General and Automobile Liability insurance policies shall be
written on an occurrence form.
(iii) The Commercial General and Automobile Liability insurance policies shall be
endorsed to name City, its officers, officials, agents, employees and volunteers as an
additional insured all ongoing and completed operations. Additional Insured
endorsements under the General Liability policy must be as broad as that contained in
ISO Forms: GC 20 10 11 85 or both CG 20 10 & CG 20 37.
(iv) The Commercial General and Automobile Liability insurance shall contain, or be
endorsed to contain, that VENDOR’S insurance shall be primary to and require no
contribution from the City. Primary and Non Contributory language under the General
Liability policy must be as broad as that contained in ISO Form CG 20 01 04 13. These
coverages shall contain no special limitations on the scope of protection afforded to
City, its officers, officials, employees, agents and volunteers.
(v) Should any of these policies provide that the defense costs are paid within the
Limits of Liability, thereby reducing the available limits by defense costs, then the
requirement for the Limits of Liability of these polices will be twice the above stated
limits.
(vi) All insurance policies required herein shall contain, or be endorsed to contain, a
waiver of subrogation as to CITY, its officers, officials, agents, employees and
volunteers.
PROVIDING OF DOCUMENTS
VENDOR shall furnish CITY with all certificate(s) and applicable endorsements effecting
coverage required herein. All certificates and applicable endorsements are to be
received and approved by the CITY’S Risk Manager or his/her designee prior to CITY’S
execution of the Agreement and before work commences. All non-ISO endorsements
amending policy coverage shall be executed by a licensed and authorized agent or
broker. Upon request of CITY, VENDOR shall immediately furnish CITY with a
complete copy of any insurance policy required under this Agreement, including all
endorsements, with said copy certified by the underwriter to be a true and correct copy
of the original policy. This requirement shall survive expiration or termination of this
Agreement. All subcontractors working under the direction of VENDOR shall also be
required to provide all documents noted herein.
SUBCONTRACTORS
If VENDOR subcontracts any or all of the services to be performed under this
Agreement, VENDOR shall require, at the discretion of the CITY Risk Manager or
designee, subcontractor(s) to enter into a separate Side Agreement with the City to
provide required indemnification and insurance protection. Any required Side
Agreement(s) and associated insurance documents for the subcontractor must be
reviewed and preapproved by CITY Risk Manager or designee. If no Side Agreement is
required, VENDOR will be solely responsible for ensuring that it’s subcontractors
maintain insurance coverage at levels no less than those required by applicable law and
is customary in the relevant industry.
DocuSign Envelope ID: 5E328085-6B69-4401-B61E-6B4FB4AF5793