Department of Public Safety and Correctional Services Division of Capital Construction and Facilities Maintenance 6776 REISTERSTOWN ROAD • SUITE 201 • BALTIMORE, MARYLAND 21215-2341 (410) 585-3020 • FAX (410) 764-4434 E-MAIL:
[email protected] • www.maryland.gov
STATE OF MARYLAND LARRY HOGAN GOVERNOR
July 9, 2015
BOYD K. RUTHERFORD LT. GOVERNOR STEPHEN T. MOYER SECRETARY
INVITATION FOR BID
DAVID N. BEZANSON ASSISTANT SECRETARY CAPITAL PROGRAMS
Solicitation Number: MDQ0031021692
KATHERINE Z. DIXON DIRECTOR, DCCFM
Contract No:
KK-001-160-C01
Approx. Cost:
Project Classification “B”
Sets Allowed:
As required.---All documents can be downloaded by prospective bidders from eMM
Cost:
Project Manual/Specifications Available after July 9, 2015 at No Cost
Project
Security Electronics Upgrade for CCTV System Upgrade at Chesapeake Detention Facility at 401 East Madison St. Baltimore, Maryland 21201
Location
Chesapeake Detention Facility at 401 East Madison St. Baltimore, Md. 21202
Summary of: Work
This contract is comprised of providing Vicon cameras, interface into the existing Vicon Head end, conduit and cable for the upgrade of the CCTV system at CDF Baltimore, Maryland FUNCTIONALITY: The intent of this work is to provide additional Vicon cameras integrated into the present Vicon CCTV network, that can monitor, and record/playback activity from the new cameras installed per construction documents. All camera activity shall record onto the required Digital Video Recorders (DVR’s). The Pre-Bid meeting is scheduled July 16, 2015 at 10:00a.m., and will be held at the Warden’s Conference Room at CDF 401 East Madison Street Baltimore, Maryland 21202. For directions call Donna Hansen, Security Chief, 410-332-0970 ext. 2526. Bid documents are available only online from eMaryland Marketplace (eMM). Those are the only official documents to be used by Bidders for this invitation for Bid (IFB). The Bidders shall print on their own stationary, the required documents for submitting their bid (Construction BID Form: Bid Proposal Affidavit, BID Bond, etc.) and submit to the Owner (DPSCS, Division of Capital Construction and Facilities Maintenance) in a sealed envelope which clearly indicates that the envelope contains a sealed bid for this project, the bid due date and the name and address of the Bidder. Bids are to be submitted no later than 2:00p.m. on August 6, 2015 to Division of Capital Construction and Facilities Maintenance at the following address: 6776 Reisterstown Rd., Suite 201, Baltimore, Maryland 21215, Attention: Crystal Price, Division of Capital Construction and Facilities Maintenance. No bid will be accepted after the due date and time. DPSCS/DCCFM ELECTRONIC DOCUMENTS AND FORMS OF THE “INVITATION FOR BID” PACKAGE ARE THE ONLY OFFICIAL DOCUMENTS AND THEREFORE, ONLY THESE MAY BE USED FOR BIDDING PURPOSES. CONTRACT AWARD SHALL BE BASED ON OFFICIAL DOCUMENTS ISSUED BY THE ISSUING OFFICE.
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Bids Due:
August 6, 2015 at 2:00 p.m. at Division of Capital Construction and Facilities Maintenance: 6776 Reisterstown Road, Suite 201, Baltimore, Maryland 21215
MBE Goal:
There is no MBE participation goal established for this solicitation.
VSBE Goal:
There is no goal set for VSBE subcontracting participation, however bidders are encouraged to strive to obtain VSBE subcontractors
Oral, telegraphic or telephonic bids will not be considered. Integrator’s Qualifications Document after its review and approval by DPSCS will be filed with the Department of Public Safety and Correctional Services, Division of Capital Construction & Facilities Maintenance prior to Bid Date. Bids shall be delivered to the Department of Public Safety and Correctional Services, Division of Capital Construction & Facilities Maintenance, 6776 Reisterstown Road, Suite 201, Baltimore, Maryland 21215 on or before the above mentioned due date at which time they will be publicly opened. The State reserves the right to reject any and all bids or to accept any bid in the interest of the people of the State of Maryland. Minority Business Enterprises are Encouraged To Respond To This Solicitation Notice. For further information please contact Crystal Price, Tel.: (410) 585-3021, email:
[email protected] Very truly yours,
Katherine Z. Dixon Director, Division of Capital Construction and Facilities Maintenance Enclosures: 1. 2. 3. 4. 5. 6. 7. 8. 9.
Project Manual Integrator’s Qualifications requirement with AIA305 Form Construction Bid Form Bid Bond Form Conflict of Interest Affidavit Form Bid/Proposal Affidavit Form Criminal History Security Background Check Form Secretary’s Department Directive Number 04-2007 Executive Directive OPS.110.0002
Distribution: via eMM
IFB KK-001-160-C01 -- 2/39
e AIA Document A305" - 1986 Contractor's Qualification Statement
The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not to be misleading.
SUBMITTED TO:
ADDRESS:
SUBMITTED BY:
NAME:
ADDRESS :
PRINCIPAL OFFICE:
Corporation Partnership Individual Joint Venture Other
NAME OF PROJECT (if applicable):
ADDITIONS AND DELETIONS: The author of this document has added information needed for its completion. The author may also have revised the text of the original AlA slandard form . An Additions and Deletions Report that notes added information as well as revisions to the standard form text is available from the aUlhor and should be reviewed . A vertical fine in the left margin of this documenl indicates where the author has added necessary information and where the author has added to or deleted from Ihe original AlA text. This document has important
legaf consequences.
Consultation with an attorney
is encouraged with respect to
its completion or modification .
This form is approved and recommended by the American Institute of Architects (AlA) and The Associated General Contractors of America (AGC) for use in evaluating the qualifications of contractors . No endorsement of the submitting party or verification of the information is made by AlA or AGC .
TYPE OF WORK (file separate form for each Classification of Work): General Construction
HVAC Electrical Plumbing Other (please specify) AlA Documen t A305™ -1 986. Copyrig ht © 1964 , 1969,1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AIA~ Document,s protected by U.S. Copyright law and Internationat Treaties Unauthorized reproduction or distribution of this AlA' Document, or any portion of It, may resutt III severe civil and criminal penalties, and will be prosecuted to the muimum extent possible under the law. This document was produced by AlA software at 13:28:18 on 03/22/2006 under Order No.1000201877_1 which expires on 10/11 /2006, and is not lor resale. User Notes: (2533789901)
IFB KK-001-160-C01 -- 3/39
§ 1. ORGANIZATION § 1.1 How many years has your organization been in bu si ness as a Co ntractor? § 1.2 How many years has your organization been in business under its present business name? § 1.2.1 Under what other or for mer names has your organization operated?
§ 1.3 If your organization is a corporat ion, answer the following: § 1.3.1 Date of incorporation: § 1.3.2 State of incorporatio n: § 1.3.3 President 's na me: § 1.3.4 Vice-president's na me(s)
§ 1.3.5 Secretary's na me: § 1.3.6 Treasurer's na me :
§ 1.4 If your orga ni zation is a paL1nership , an swer the fo ll owing: § 1.4.1 Date of organization: § 1.4.2 Type of partnership (if applicable):
§ 1.4.3 Name(s) of general partner(s)
§ 1.5 If your organizat io n is indi vidu ally owned, an swer the following: § 1.5.1 Date of o rga nization:
ALA Document A305 ™ -1986. Copyri ght © 1964. 1969.1979 and 1986 by The American Institute of Architects. All rig hts reserved. WARNING: This AlA Document is prolected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this ALA Document. or any portion of It. may result in severe civil and criminal penalties , and wIll be prosecuted to the maximum extent possible under the law. This document was prod uced by ALA software at 13:28: 18 on 03/22/2006 under Order No.100020 1877_1 which expires on 10/ 11 /2 006. and is not for resale . User Notes: (2533789901)
IFB KK-001-160-C01 -- 4/39
2
§ 1.5.2 Name of owner:
§ 1.6 If the form of your organization is other than those listed above, describe it and name the principals:
§ 2. LICENSING § 2.1 List jurisdictions and trade categories in whic h your organization is legally qualified to do business, and indicate registration or licen se numbers, if applicable .
§ 2.2 List jurisd ictions in which your organization ' s partnership or trade name is filed.
§ 3. EXPERIENCE
§ 3.1 List the categories of work that your organization normally performs wit h its own forces.
§ 3.2 Claims and Suits . (If the answer to any of the question s below is yes, please attac h details.) § 3.2.1 Has your organization ever failed to complete any work awarded to it?
§ 3.2.2 Are there any judgments, claims, arbi tration proceedings or suits pending or outstanding against your organization o r its officers?
AlA Document A305™ - 1986. Copyright © 1964 , 1969, 1979 and 1986 by The American Institute 01 Architects. All rights reserved . WARNING: ThiS AlA" Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution 01 thIS AlA Document, or any portion or it, may result in severe civil and criminal penalties . and will be prosecuted to the maximum extent possible under the law. This document was produced by AlA software at 13:28: 18 on 03/22/2006 under Order NO.100020 1877_1 which expires on 10/11/2006 , and is not for re sale. User Notes: (2533789901)
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3
§ 3.2.3 Has your organization filed any law suit s or requested arbitration with regard to construction contracts within the last five years?
§ 3.3 Within the last five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.)
§ 3.4 On a separate sheet, li st major construction projects your organization has in progress, giving the name of project, owner, architect, contract amou nt, percent complete and scheduled completion date.
§ 3.4.1 State total wonh of work in progress and under contract:
§ 3.5 On a separate sheet, li st the major projects your organization has completed in the past five years, givi ng the name of project. owner, architect, contract amount, date of completion and percentage of the cost of the work performed with your own forces.
§ 3.5.1 State average annual amount of construction work performed during the past five years:
§ 3.6 On a separate sheet, li st the construction experience and present commitments of the key individual s of your organization.
AlA Document A305™ - 1986. Copyright © 1964.1969,1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AlA Document is protected by U.S. Copyright Law and International Treaties Unauthorized reproduction or distribution 01 this AlA Document or any portion 01 It. may resullin severe civil and criminal penaltoes . and will be prosecuted to the maximum exlent possible under the law. This document was produced by AlA soHware at 13:28:18 on 03/22/2006 under Order NO .l000201877_1 which expires on 10/ 11 /2006, and is not for resale. (2533789901) User Notes:
IFB KK-001-160-C01 -- 6/39
4
§ 4. REFERENCES § 4.1 Trade References:
§ 4.2 Bank References:
§ 4.3 Surety: § 4.3.1 Name of bonding company:
§ 4.3.2 Name and address of agent:
§ 5. FINANCING § 5.1 Financial Statement. § 5.1.1 Attach a financial statement, preferably audited, including your organization's latest balance sheet and income statement showing the fOllowing items: Current Assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, material s inventory and prepaid expenses); Net Fixed Assets; Other Assets; Current Liabilities (e.g., accounts payable, notes payable, accrued expenses, provision for income taxes , advances, accrued salaries and accrued payroll taxes); Other Liabilities (e.g., capital, capital stock, authorized and outstanding shares par values, earned surplus and retained earnings).
§ 5.1.2 Name and address of firm preparing attached financial statement, and date thereof: AlA Document A305™ - 1986. Copyright © 1964, 1969. 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING: This AlA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction Or distribution of thIS AlA" Document, or any portion of it, may result in severe civil and criminal penalties . and wilt be prosecuted to the maximum extent possib le under the law. This document was produced by AlA software at 13 :28:18 on 03/22/2006 under Order No.1 000201877_ 1 which expires on 10/11/2006, and is not lor resale. User Notes: (2533789901)
IFB KK-001-160-C01 -- 7/39
5
§ 5.1.3 Is the attached financial statement for the identical organization named on page one?
§ 5.1.4lf not , expl ai n the relationship and fina ncial responsibility of the organization whose financial statement is provided (e.g., parent-subsidiary).
§ 5.2 Will the organizatio n whose financial statement is attached act as guarantor of the contract for construction?
§ 6. SIGNATURE
§ 6.1 Dated at this
day of
Name of Organization: By : Title:
§ 6.2
being duly sworn deposes and says that the information provided herein is true and sufficiently complete so as not to be mi sleading. Subscribed and sworn before me this
day of
20
Notary Public : My Commission Expires:
AlA Document A305™ - 1986. Copyright © 1964, 1969, 1979 and 1986 by The Americ an Institute 01 Architects. All rights reserved. WARNING: This AlA· Document is protected by U.S. COPYright Law and Internallonal Treaties. Unauthorized reproduction or distribulion of this AlA Document, or any portion 01 it, may result In severe civil and criminal penalties, and will be prosecuted \0 the maximum extent possible under the law. This document was produced by AlA software at 13 :28:18 on 03/22/2006 under Order No.1 000201877_1 which expires on 10/ 11 /2006, and is not for resale . User Notes: (2533789901)
IFB KK-001-160-C01 -- 8/39
6
Additions and Deletions Report for ®
TM
AlA Document A305 - 1986 This Additions and Deletions Report, as defined on page 1 of the associated document, reproduces below all text the author has added to the standard form AlA document in order to complete it, as well as any text the author may have added to or deleted from the original AlA text. Added text is shown underlined. Deleted text is indicated with a horizontal line through the original AlA text. Note: This Additions and Deletions Report is provided for information purposes onfy and is not incorporated into or constitute any part of the asso ciated AlA document. This Additions and Deletions Report and its associated document were generated simultaneously by AlA software at 13:28:18 on 03/22/2006 .
PAGE 6 M-being duly sworn deposes and says that the informati on provided herein is true and sufficie ntly complete so as not to be mi sleading. Subscribed and sworn before me this
day of
Additions and Deletions Report for AlA Document A305™ -1986, Copyright © 1964, 1969, 1979 and 1986 by The American Institute of Architects. All
rights reserved. WARNING : Th is AlA- Document Is protected by U.S. Copyright Law and Intemationat Treaties Unauthorized reproduction or
distribution of th is AtA' Document, or any portion of it, may result In severe civil and crimlnat penalties , and will be prosecuted to the maxim um
extent possibte under the law. This document was produced by AlA sollware at 13:28:18 on 03/22/2006 under Order. No.1000201877_1 which expires on
10/1 1/2006, and is not for resale .
User Notes: (2533789901)
IFB KK-001-160-C01 -- 9/39
1
Certification of Document's Authenticity AIA® Document D401™ - 2003 I, Charles v. Bucci, hereby certify, to the best of my knowledge, information and belief, that I created the attached final document simultaneously with its associated Additions and Deletions Report and this certification at 13 :28: 18 on 03/22/2006 under Order No.1 000201877 _I from AlA Contract Documents software and that in preparing the attached final document I made no changes to the original text of AlA ® Document A305™ - 1986 - Contractor's Qualification Statement, as published by the AlA in its software, other than those additions and deletions shown in the associated Additions and Deletions Report.
(Signed)
(Title)
(Dated)
AlA Document 0401™ - 2003. Copyright © 1992 and 2003 by The American Institute of Architects. All rights re served. WARNING: This AlA Document
is protected by U.S. Copyright law and International Treaties. Unauthorized reproduction or distribution 01 this AlA Document, or any portion of it.
may result In severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced
by AlA software at 13:28: 18 on 03/2212006 under Order No. 1000201877_1 which expires on 10/ 11 /2006 , and is not lor resale.
(2533 78990 I )
User Notes:
IFB KK-001-160-C01 -- 10/39
1
CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
STATE OF MARYLAND Department of Public Safety and Correctional Services Division of Capital Construction and Facilities Maintenance Katherine Z. Dixon - Director 6776 Reisterstown Road Suite 201, Plaza Office Center Baltimore, Maryland 21215-2341 DPSCS CONTRACT NO: KK-001-160-C01
DATE SUBMITTED: ____________
Gentlemen: We hereby submit our bid for the construction of the Contract described as: Chesapeake Detention Facility 401 East Madison Street Baltimore, Maryland CCTV INSTALLATION TO INCLUDE IP AND ANALOG CAMERAS THROUGHOUT THE THREE (3) FLOORS OF THE INSTITUTION, TIED INTO THE EXISTING CCTV NETWORK. 1. We have received, read, and fully understand: The drawings and the Project Manual for the project, dated July 9, 2015, as prepared by DPSCS, including the "Instructions to Bidders" and the "General Conditions" contained therein. Addenda to above numbered and dated: (Insert all addendum numbers and respective issue dates) ____________________________________________________________________________ (Insert all addendum numbers and respective issue dates)
(Insert all addendum numbers and respective issue dates) The undersigned, having received clarification from the State on any and all issues and questions, proposes to furnish all materials, labor, equipment, supervision, managerial, and professional services necessary for the contract in accordance with the contract documents. 2.
We have examined the site, existing structures, existing utilities, equipment, fencing and all existing conditions which affect the construction bid.
3.
We are able to provide all the materials, products, labor, equipment, supervision, managerial and professional services necessary for the contract, and are able to construct the project as intended by the contract documents.
4.
We are able to complete this project within the stipulated calendar days and/or critical completion dates specified in the contract documents.
5.
We clearly understand that this Construction Bid Form must be completed and submitted in its entirety to be considered a responsive bid by the bidder. Failure to completely fill in all blanks, including Unit Price Schedule, may be cause for rejection of this bid.
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-1
IFB KK-001-160-C01 -- 11/39
CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
6.
We understand that seeking Veteran Small Businesses Enterprise (VSBE) participation is encouraged, though no VSBE goal has been set. If we succeed in acquiring VSBE Participation for this solicitation, forms Veteran-Owned Small Business Enterprise Utilization Affidavit (form DPSCS OS 11 MBE) and Participation Schedule (form DPSCS OS 13 MBE) shall be completed and submitted as authorized by Code of Maryland Regulations (COMAR) 21.11.13. and the State of Maryland DPSCS “General Conditions” Section 11.
7.
We provide our e-Maryland Marketplace Vendor ID on page 5 of this Construction Bid Form. Having carefully examined the "Instructions to Bidders," the "General Conditions", technical specifications, drawings and addenda, and having received clarification on all items of conflict or upon which any doubt arose, the undersigned proposes to furnish all materials, labor, equipment, supervision, managerial, and professional services necessary for the contract in accordance with the contract documents.
A. AWARD OF CONTRACT: The Contract will be awarded to the responsible Bidder submitting the lowest responsive Bid. The State reserves the right to reject any or all bids, at its sole discretion, in the interest of the State of Maryland.
BASE BID: The LUMP SUM PRICE for construction of the Project is as described in Section 01010 – Summary of Work and specification section 28100, within the limits defined in the Contract Documents, inclusive of structures, temporary facilities, and all other Work as written and/or indicated. The BASE BID Work cost is the following Lump Sum Price and INCLUDES all the work required by the Contract Documents, Unit Price Schedule-A. The Lump Sum Price includes all work in place as described in the Contract Documents. This Lump Sum Price includes all materials and labor, overhead, profit, escalation, applicable taxes and fees, inclusive of sales tax, to provide a complete and fully operational CCTV system inclusive of any other associated work such as electrical system and finishes; Work shall be performed within the time identified in Section 01010 - Summary of Work. Lump Sum Price for Base Bid (includes Unit Price Schedule – A) Dollars Written ($) Figures Provide a separate bid price wherein the price shall include all materials and labor, overhead, profit, escalation, applicable taxes and fees, inclusive of sales tax, to provide a `associated work such as structural system, mechanical system and finishes. B. QUALIFIED CCTV PROVIDER/INSTALLER (ESC ) TEAM: The Bidder shall name its qualified subcontractor who, on the Bidder’s behalf, will provide the work described in the Contract Documents and who is one of the Approved and qualified ESC’s complying with the requirements in Sections 01010 , 16000 and 28100 of the specifications and the Contract General Requirements.
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-2
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CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
Name of CCTV System Contractor (integrator) for this project Corporate/Company Name
Address
( ) Telephone
-
( ) Telephone
-
Name of CCTV provider/installer to be used in this project Corporate/Company Name
Address
C. UNIT PRICE SCHEDULE - A: (to be included in Lump Sum Price For Base Bid) The Unit Prices in Unit Price Schedule-A are for contractual purposes as indicated and shall be included in the Lump Sum Price For Base Bid. The Schedule-A Unit Prices shall remain in effect for the duration of the Contract. The Unit Prices are for work beyond the limits of work indicated in the contract documents and will be used to increase or decrease the Contract Sum. Unit Prices shall include all material, labor, excavation, backfill, incidentals, other direct and indirect costs, overhead, taxes, insurance, and profits. The Contractor is responsible to determine measurement of material and quantities per the Contractor’s Quality Control Program. The State reserves the right to verify materials and quantities. Payment for any Unit Price items will be made on the basis of the quantities as actually measured in place where applicable. Unit Price Schedule-A is provided in the Contract Documents as an Allowance for use by the Owner. All items of work required for Unit Price Schedule-A shall be completed in compliance with the contract documents for this contract. All items of work may or may not be utilized during the Contract Period. All remaining unused portion of this Allowance shall be credited to the Owner. The Contractor may not file a claim against the State should the Unit Price Schedule-A be eliminated entirely or in part UNIT PRICE SCHEDULE-A
Item No.
Description/Task
Qty.
UP-1
Furnish and install Analog camera V920-N311 …single lot 100’ RG59, 18/2 cable and Rigid conduit Furnish and install IP camera V922D-39D CAT 6 cable, rigid conduit …single lot 100’. (2MP) Furnish and install IP camera V-Cell-HD…single lot 100’ CAT 6 cable and rigid conduit.
1 each
$
$
1 each
$
$
1 each
$
$
UP-2 UP-3
Unit Cost
Total Item Cost
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-3
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CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
Item No.
UP-4A
UP-4B
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
Description/Task
Qty.
Analyze, furnish and install a new power supply for the PTZ camera to return the camera back to operation. Analyze, remove and package for shipping the faulty PTZ camera, and re-install back to operation.
Unit Cost
Total Item Cost
1 each
$
$
1 each
$
$
TOTAL
$
Failure to properly and completely fill in all blanks, including Unit Price Schedules may be cause for rejection of this Bid. The Bidder shall include the TOTAL Unit Price Schedule-A cost in the Bid Price.
Unit Price Schedule-A shall be included in the Lump Sum Price For Bid and in accordance with the Contract Documents. Dollars Written ($) Figures E. CLARIFICATIONS DURING BIDDING: All questions related to this solicitation are to be submitted by Email concurrently in type-written format to DPSCS and to the Engineer no later than noon, TEN (10) calendar days prior to the Bid Opening Date. All questions received after this date and time will not be answered. Verbal questions will not be answered during the Bid period, no exception. A response to all valid questions will be by written Addendum only. Transmit questions to the following individuals as follows: 1.
DPSCS: Crystal Price, Division of Capital Construction and Facility Maintenance: Telephone: 410-585-3021 Facsimile: 410-764-4434 Email:
[email protected]
F. CONSTRUCTION START DATE: "Start Date" is the date stipulated in the "Notice to Proceed" (NTP) for the Contractor to begin as defined in Article 7.01 of the State of Maryland DPSCS General Conditions. G. CONTRACT TIME AND COMPLETION DATE:
In accordance with the State of Maryland DPSCS General Conditions the Substantial Completion for the bid shall not exceed one hundred fifty (150) calendar days with 30 days, Final Completion, thereafter. H. LIQUIDATED DAMAGES: In accordance with the State of Maryland DPSCS “ General Conditions of the Contract Between Owner and Contractor”, Article 7.07 Termination for Default, Damages for Delays & Time Extensions, Liquidated Damages of two hundred dollars ($200.00) per calendar day basis will be assessed on a per
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-4
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CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
calendar day basis commencing on the day following the date established for Substantial Completion. Liquidated damages will accrue until the Work is accepted and approved for use under the requirements established in the State of Maryland General Conditions Article 7.12, Substantial Completion and Final Inspection. I. PRELIMINARY PROGRESS SCHEDULE:
As required by Article 7.06.B of the "State of Maryland General Conditions," the Contractor shall submit, within fourteen (14) calendar days of the execution of the Contract, a Preliminary Progress Schedule in Gantt Bar Chart Format, showing the intended start date (NTP), complete milestone dates, project Substantial Completion Date and project Final Completion date. The fully cost loaded Project CPM schedule shall be submitted to the State as stated in Specification Section 01310 of the Project Manual. J. BID BONDS: Submitted with this bid shall be a fully executed Bid Bond in the amount of 5% of the Bid. Bid Bonds, except those of the three low bidders, will be returned after the bid opening. Other bid bonds will be returned after the related contract has been executed. If no bid has been accepted within ninety (90) calendar days after the bid opening, then any bond may be returned upon demand of the bidder. K. BID PRICE SHALL BE HELD FIRM:
It is understood that the Bid Price shall be firm for a time period of ninety (90) calendar days from the bid opening date. If the undersigned is notified of acceptance of this bid within this time period, the undersigned shall execute a contract for the above stated compensation(s) and shall complete the work. The Contract Work must be accepted and approved for use and/or the work must be substantially completed as specified in the “General Conditions” Section 7.12, Substantial Completion and Final Inspection. e-Maryland Marketplace Vendor I.D.
(Federal Employer Identification No. or Social Security No. if no F.E. I. N.)
(Construction License No.)**
(Date Issued)
(Place of issuance)
THIS CONSTRUCTION LICENSE IS NOT A BUSINESS LICENSE. ** Construction licenses are issued by the Clerks of the Circuit Court and are required for DPSCS Construction Projects. Contact the State License Bureau (http://www.maryland taxes. com at 410-260-6240
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-5
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CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
INDIVIDUAL PRINCIPAL In Presence of:
FIRM NAME:
Witness:
SIGNED: ADDRESS:
TELEPHONE NUMBER:
(
)
TELEPHONE NUMBER: (
)
CO-PARTNERSHIP PRINCIPAL In Presence of:
FIRM NAME:
Witness:
SIGNED:
as to
By:
as to
By:
as to
By:
(Partner)
(Partner) ADDRESS:
THIS SPACE INTENTIONALLY LEFT BLANK
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-6
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CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
CORPORATE PRINCIPAL Attest: (Corporate Secretary)
(Name of Corporation) By: (Corporate Principal)
(Affix Corporate Seal)
By: (Print name and title) ADDRESS:
Sworn to and Subscribed before me this _______ day of __________ 20 ______ ________________________________ Notary Public My Commission expires: ___________
TELEPHONE NUMBER: (
)
JOINT VENTURE PRINCIPAL
(Name of Joint Venture) (Secretary)
(Principal) (Firm Name) as to
By:
(Secretary)
(Principal) (Firm Name)
ADDRESS:
TELEPHONE NUMBER: (
)
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-7
IFB KK-001-160-C01 -- 17/39
CONSTRUCTION BID FORM SECURITY ELECTRONICS UPGRADE CHESAPEAKE DETENTION FACILITY
CONTRACT NO: KK-001-160-C01 BALTIMORE, MARYLAND
The Bidder represents, and it is a condition precedent to acceptance of this bid, that the Bidder has not been a party to any agreement to bid a fixed or uniform price. WITNESS: (SEAL) (Signature of Witness)
(Signature of Officer and Title)
SUBSCRIBED AND SWORN TO before me, a Notary Public of the State of , County or City of on this
day of
, 20.
(Notary Public) My Commission Expires: Please submit this form, pages 1 through 8 complete, with original signatures.
END OF CONSTRUCTION BID FORM
_______________________________________
__________________________________
(SIGN FOR IDENTIFICATION)
FIRM NAME (Please PRINT or Type) 00125-8
IFB KK-001-160-C01 -- 18/39
BID BOND Bond No.
We, ______________________________as Principal hereinafter called the Principal, and_____________________________________________ ________________________, a corporation duly organized under the laws of the State of ___________________________, or an individual surety qualified in accordance with State Finance and Procurement Article, § 13-207 or § 17-104, Annotated Code of Maryland, as Surety, hereinafter called the Surety, are held and firmly bound unto the State of Maryland, hereinafter called “State,” for sum of ______________________________ for the payment of which sum, the Principal and the Surety bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHERAS, the Principal has submitted a bid for (Identify project by number and brief description): NOW, THEREFORE, if the Principal, upon acceptance by the State of its bid identified above, within the period specified therein for acceptance (ninety (90) days, if no period is specified), shall execute such further contractual documents, if any, and give such bond(s) as may be required by the terms of the bid as accepted within the time specified (ten (10) days if no period is specified) after receipt of the forms, or in the event of failure so to execute such further contractual documents and give such bonds, if the Principal shall pay the State the difference not to exceed the penalty hereof between the amount specified in Principal’s bid and such larger amount for which the State may in good faith contract with another party to perform the work covered by said bid, then the above obligation shall be void and of no effect. The Surety executing this instrument hereby agrees that its obligation shall not be impaired by any extension(s) of the time for acceptance of the bid that the Principal may grant to the State, notice of which extension(s) to the Surety being waived; provided that such waiver of notice shall apply only with respect to extensions aggregating not more than ninety (90) calendar days in addition to the period originally allowed for acceptance of the bid.
In Presence of: Witness
Individual Principal (Name) as to
(SEAL)
In Presence of: Witness
Partnership Principal
(Name) as to
By:
(SEAL) Partner
as to
By:
(SEAL) Partner
as to
By:
Attest:
(SEAL) Corporate Principal
(Name of Corporation) By: Secretary
President
AFFIX CORPORATE SEAL
Attest: Surety By: Attorney-in-fact
AFFIX CORPORATE SEAL
Bonding Agent’s Name Agent’s Address Approved as to form and legal sufficiency this day of , 20
Assistant Attorney General Rev. May, 2014
IFB KK-001-160-C01 -- 19/39
CONFLICT OF INTEREST AFFIDAVIT A. ''Conflict of interest" means that because of other activities or relationships with other persons, a person is unable or potentially unable to render impartial assistance or advice to the State, or the person's objectivity in performing the contract work is or might be otherwise impaired, or a person has an unfair competitive advantage. B. "Person" has the meaning stated in COMAR 21 01.02.01B(64) and includes a bidder, offeror, contractor, consultant, or subcontractor or sub-consultant at any tier. and also includes an employee or agent of any of them if the employee or agent has or will have the authority to control or supervise all or a portion of the work for which a bid or offer is made. C. The bidder or offeror warrants that, except as disclosed in §D, below, there are no relevant facts or circumstance now divine rise or which could, in the future, give rise to a conflict of interest. D. The following facts or circumstances give rise or could in the future give rise to a conflict of interest (explain in detail—attach additional sheets if necessary): E. The bidder or offeror agrees that if an actual or potential conflict of interest arises after the date of this affidavit, the bidder or offeror shall immediately make a full disclosure in writing to the procurement officer of all relevant facts and circumstances. This disclosure shall include a description of actions which the bidder or offeror has taken and proposes to take to avoid, mitigate, or neutralize the actual or potential conflict of interest. If the contract has been awarded and performance of the contract has begun, the contractor shall continue performance until notified by the procurement officer of any contrary action to be taken. I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE, CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF.
By Date
Signature
Print Name: Authorized Representative and Affiant
Rev. 08/27/2014 IFB KK-001-160-C01 -- 20/39
BID/PROPOSAL AFFIDAVIT COMAR (21.05.08.07) A. AUTHORITY I HEREBY AFFIRM THAT: I (print name)_____________________ possess the legal authority to make this Affidavit. B. CERTIFICATION REGARDING COMMERCIAL NONDISCRIMINATION The undersigned bidder hereby certifies and agrees that the following information is correct: In preparing its bid on this project, the bidder has considered all proposals submitted from qualified, potential subcontractors and suppliers, and has not engaged in "discrimination" as defined in §19103 of the State Finance and Procurement Article of the Annotated Code of Maryland. "Discrimination" means any disadvantage, difference, distinction, or preference in the solicitation, selection, hiring, or commercial treatment of a vendor, subcontractor, or commercial customer on the basis of race, color, religion, ancestry, or national origin, sex, age, marital status, sexual orientation, or on the basis of disability or any otherwise unlawful use of characteristics regarding the vendor's, supplier's, or commercial customer's employees or owners. "Discrimination" also includes retaliating against any person or other entity for reporting any incident of "discrimination". Without limiting any other provision of the solicitation on this project, it is understood that, if the certification is false, such false certification constitutes grounds for the State to reject the bid submitted by the bidder on this project, and terminate any contract awarded based on the bid. As part of its bid or proposal, the bidder herewith submits a list of all instances within the past 4 years where there has been a final adjudicated determination in a legal or administrative proceeding in the State of Maryland that the bidder discriminated against subcontractors, vendors, suppliers, or commercial customers, and a description of the status or resolution of that determination, including any remedial action taken. Bidder agrees to comply in all respects with the State's Commercial Nondiscrimination Policy as described under Title 19 of the State Finance and Procurement Article of the Annotated Code of Maryland. B-1.
Certification Regarding Minority Business Enterprises.
The undersigned bidder hereby certifies and agrees that it has fully complied with the State Minority Business Enterprise Law, State Finance and Procurement Article, §14-308(a)(2), Annotated Code of Maryland, which provides that, except as otherwise provided by law, a contractor may not identify a certified minority business enterprise in a bid or proposal and: (1) Fail to request, receive, or otherwise obtain authorization from the certified minority business enterprise to identify the certified minority proposal; (2) Fail to notify the certified minority business enterprise before execution of the contract of its inclusion in the bid or proposal; (3) Fail to use the certified minority business enterprise in the performance of the contract; or (4) Pay the certified minority business enterprise solely for the use of its name in the bid or proposal. 1 | P a g e IFB KK-001-160-C01 -- 21/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
Without limiting any other provision of the solicitation on this project, it is understood that if the certification is false, such false certification constitutes grounds for the State to reject the bid submitted by the bidder on this project, and terminate any contract awarded based on the bid. B-2.
Certification Regarding Veteran-Owned Small Business Enterprises.
The undersigned bidder hereby certifies and agrees that it has fully complied with the State veteran-owned small business enterprise law, State Finance and Procurement Article, §14-605, Annotated Code of Maryland, which provides that a person may not: (1) Knowingly and with intent to defraud, fraudulently obtain, attempt to obtain, or aid another person in fraudulently obtaining or attempting to obtain public money, procurement contracts, or funds expended under a procurement contract to which the person is not entitled under this title; (2) Knowingly and with intent to defraud, fraudulently represent participation of a veteran– owned small business enterprise in order to obtain or retain a bid preference or a procurement contract; (3) Willfully and knowingly make or subscribe to any statement, declaration, or other document that is fraudulent or false as to any material matter, whether or not that falsity or fraud is committed with the knowledge or consent of the person authorized or required to present the declaration, statement, or document; (4) Willfully and knowingly aid, assist in, procure, counsel, or advise the preparation or presentation of a declaration, statement, or other document that is fraudulent or false as to any material matter, regardless of whether that falsity or fraud is committed with the knowledge or consent of the person authorized or required to present the declaration, statement, or document; (5) Willfully and knowingly fail to file any declaration or notice with the unit that is required by COMAR 21.11.12; or (6) Establish, knowingly aid in the establishment of, or exercise control over a business found to have violated a provision of §B-2(1)—(5) of this regulation. C. AFFIRMATION REGARDING BRIBERY CONVICTIONS I FURTHER AFFIRM THAT: Neither I, nor to the best of my knowledge, information, and belief, the above business (as is defined in Section 16-101(b) of the State Finance and Procurement Article of the Annotated Code of Maryland), or any of its officers, directors, partners, controlling stockholders, or any of its employees directly involved in the business's contracting activities including obtaining or performing contracts with public bodies has been convicted of, or has had probation before judgment imposed pursuant to Criminal Procedure Article, §6-220, Annotated Code of Maryland, or has pleaded nolo contendere to a charge of, bribery, attempted bribery, or conspiracy to bribe in violation of Maryland law, or of the law of any other state or federal law, except as follows 2 | P a g e IFB KK-001-160-C01 -- 22/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
(indicate the reasons why the affirmation cannot be given and list any conviction, plea, or imposition of probation before judgment with the date, court, official or administrative body, the sentence or disposition, the name(s) of person(s) involved, and their current positions and responsibilities with the business): ________________________________________________ ________________________________________________ ________________________________________________. D. AFFIRMATION REGARDING OTHER CONVICTIONS I FURTHER AFFIRM THAT: Neither I, nor to the best of my knowledge, information, and belief, the above business, or any of its officers, directors, partners, controlling stockholders, or any of its employees directly involved in the business's contracting activities including obtaining or performing contracts with public bodies, has: (1) Been convicted under state or federal statute of: (a) A criminal offense incident to obtaining, attempting to obtain, or performing a public or private contract; or (b) Fraud, embezzlement, theft, forgery, falsification or destruction of records or receiving stolen property; (2) Been convicted of any criminal violation of a state or federal antitrust statute; (3) Been convicted under the provisions of Title 18 of the United States Code for violation of the Racketeer Influenced and Corrupt Organization Act, 18 U.S.C. §1961 et seq., or the Mail Fraud Act, 18 U.S.C. §1341 et seq., for acts in connection with the submission of bids or proposals for a public or private contract; (4) Been convicted of a violation of the State Minority Business Enterprise Law, §14-308 of the State Finance and Procurement Article of the Annotated Code of Maryland; (5) Been convicted of a violation of §11-205.1 of the State Finance and Procurement Article of the Annotated Code of Maryland; (6) Been convicted of conspiracy to commit any act or omission that would constitute grounds for conviction or liability under any law or statute described in subsections (1)— (5) above; (7) Been found civilly liable under a state or federal antitrust statute for acts or omissions in connection with the submission of bids or proposals for a public or private contract; 3 | P a g e IFB KK-001-160-C01 -- 23/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
(8) Been found in a final adjudicated decision to have violated the Commercial Nondiscrimination Policy under Title 19 of the State Finance and Procurement Article of the Annotated Code of Maryland with regard to a public or private contract; (9) Been convicted of a violation of one or more of the following provisions of the Internal Revenue Code: (a) §7201, Attempt to Evade or Defeat Tax; (b) §7203, Willful Failure to File Return, Supply Information, or Pay Tax, (c) §7205, Fraudulent Withholding Exemption Certificate or Failure to Supply Information, (d) §7206, Fraud and False Statements, or (e) §7207 Fraudulent Returns, Statements, or Other Documents; (10) Been convicted of a violation of 18 U.S.C. §286 Conspiracy to Defraud the Government with Respect to Claims, 18 U.S.C. §287, False, Fictitious, or Fraudulent Claims, or 18 U.S.C. §371, Conspiracy to Defraud the United States; (11) Been convicted of a violation of the Tax-General Article, Title 13, Subtitle 7 or Subtitle 10, Annotated Code of Maryland; (12) Been found to have willfully or knowingly violated State Prevailing Wage Laws as provided in the State Finance and Procurement Article, Title 17, Subtitle 2, Annotated Code of Maryland, if: (a) A court: (i) Made the finding; and (ii) Decision became final; or (b) The finding was: (i) Made in a contested case under the Maryland Administrative Procedure Act; and (ii) Not overturned on judicial review; (13) Been found to have willfully or knowingly violated State Living Wage Laws as provided in the State Finance and Procurement Article, Title 18, Annotated Code of Maryland, if: (a) A court: (i) Made the finding; and 4 | P a g e IFB KK-001-160-C01 -- 24/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
(ii) Decision became final; or (b) The finding was: (i) Made in a contested case under the Maryland Administrative Procedure Act; and (ii) Not overturned on judicial review; (14) Been found to have willfully or knowingly violated the Labor and Employment Article, Title 3, Subtitles 3, 4, or 5, or Title 5, Annotated Code of Maryland, if: (a) A court: (i) Made the finding; and (ii) Decision became final; or (b) The finding was: (i) Made in a contested case under the Maryland Administrative Procedure Act; and (ii) Not overturned on judicial review; or (15) Admitted in writing or under oath, during the course of an official investigation or other proceedings, acts or omissions that would constitute grounds for conviction or liability under any law or statute described in §§B and C and subsections D(1)—(14) of this regulation, except as follows (indicate reasons why the affirmations cannot be given, and list any conviction, plea, or imposition of probation before judgment with the date, court, official or administrative body, the sentence or disposition, the name(s) of the person(s) involved and their current positions and responsibilities with the business, and the status of any debarment): ____________________________________________________________ ____________________________________________________________ __________________________________________________________ _. E. AFFIRMATION REGARDING DEBARMENT I FURTHER AFFIRM THAT: Neither I, nor to the best of my knowledge, information, and belief, the above business, or any of its officers, directors, partners, controlling stockholders, or any of its employees directly involved in the business's contracting activities, including obtaining or performing contracts with public bodies, has ever been suspended or debarred (including being issued a limited denial of participation) by any public entity, except as follows (list each debarment or suspension providing 5 | P a g e IFB KK-001-160-C01 -- 25/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
the dates of the suspension or debarment, the name of the public entity and the status of the proceedings, the name(s) of the person(s) involved and their current positions and responsibilities with the business, the grounds of the debarment or suspension, and the details of each person's involvement in any activity that formed the grounds of the debarment or suspension). ____________________________________________________________ ____________________________________________________________ __________________________________________________________ _. F. AFFIRMATION REGARDING DEBARMENT OF RELATED ENTITIES I FURTHER AFFIRM THAT: (1) The business was not established and it does not operate in a manner designed to evade the application of or defeat the purpose of debarment pursuant to Sections 16-101, et seq., of the State Finance and Procurement Article of the Annotated Code of Maryland; and (2) The business is not a successor, assignee, subsidiary, or affiliate of a suspended or debarred business, except as follows (you must indicate the reasons why the affirmations cannot be given without qualification): ____________________________________________________________ ____________________________________________________________ _________________________________________________________ __. G. SUB-CONTRACT AFFIRMATION I FURTHER AFFIRM THAT: Neither I, nor to the best of my knowledge, information, and belief, the above business, has knowingly entered into a contract with a public body under which a person debarred or suspended under Title 16 of the State Finance and Procurement Article of the Annotated Code of Maryland will provide, directly or indirectly, supplies, services, architectural services, construction related services, leases of real property, or construction. H. AFFIRMATION REGARDING COLLUSION I FURTHER AFFIRM THAT: Neither I, nor to the best of my knowledge, information, and belief, the above business has: (1) Agreed, conspired, connived, or colluded to produce a deceptive show of competition in the compilation of the accompanying bid or offer that is being submitted; 6 | P a g e IFB KK-001-160-C01 -- 26/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
(2) In any manner, directly or indirectly, entered into any agreement of any kind to fix the bid price or price proposal of the bidder or offeror or of any competitor, or otherwise taken any action in restraint of free competitive bidding in connection with the contract for which the accompanying bid or offer is submitted. I. CERTIFICATION OF TAX PAYMENT I FURTHER AFFIRM THAT: Except as validly contested, the business has paid, or has arranged for payment of, all taxes due the State of Maryland and has filed all required returns and reports with the Comptroller of the Treasury, the State Department of Assessments and Taxation, and the Department of Labor, Licensing, and Regulation, as applicable, and will have paid all withholding taxes due the State of Maryland prior to final settlement. J. CONTINGENT FEES I FURTHER AFFIRM THAT: The business has not employed or retained any person, partnership, corporation, or other entity, other than a bona fide employee, bona fide agent, bona fide salesperson, or commercial selling agency working for the business, to solicit or secure the Contract, and that the business has not paid or agreed to pay any person, partnership, corporation, or other entity, other than a bona fide employee, bona fide agent, bona fide salesperson, or commercial selling agency, any fee or any other consideration contingent on the making of the Contract. K. CERTIFICATION REGARDING INVESTMENTS IN IRAN (1) The undersigned certifies that, in accordance with State Finance and Procurement Article, §17-705, Annotated Code of Maryland: (a) It is not identified on the list created by the Board of Public Works as a person engaging in investment activities in Iran as described in State Finance and Procurement Article, §17-702, Annotated Code of Maryland; and (b) It is not engaging in investment activities in Iran as described in State Finance and Procurement Article, §17-702, Annotated Code of Maryland. (2) The undersigned is unable to make the above certification regarding its investment activities in Iran due to the following activities: ________________________________________________________ L. CONFLICT MINERALS ORIGINATED IN THE DEMOCRATIC REPUBLIC OF CONGO (FOR SUPPLIES AND SERVICES CONTRACTS) I FURTHER AFFIRM THAT: The business has complied with the provisions of State Finance and Procurement Article, §14413, Annotated Code of Maryland governing proper disclosure of certain information regarding 7 | P a g e IFB KK-001-160-C01 -- 27/39
BID/PROPOSAL AFFIDAVIT (COMAR 21.05.08.07)
conflict minerals originating in the Democratic Republic of Congo or its neighboring countries as required by federal law. M. I FURTHER AFFIRM THAT: Any claims of environmental attributes made relating to a product or service included in the bid or proposal are consistent with the Federal Trade Commission’s Guides for the Use of Environmental Marketing Claims as provided in 16 CFR §260, that apply to claims about the environmental attributes of a product, package, or service in connection with the marketing, offering for sale, or sale of such item or service. N. ACKNOWLEDGEMENT I ACKNOWLEDGE THAT this Affidavit is to be furnished to the Procurement Officer and may be distributed to units of: (1) the State of Maryland; (2) counties or other subdivisions of the State of Maryland; (3) other states; and (4) the federal government. I further acknowledge that this Affidavit is subject to applicable laws of the United States and the State of Maryland, both criminal and civil, and that nothing in this Affidavit or any contract resulting from the submission of this bid or proposal shall be construed to supersede, amend, modify or waive, on behalf of the State of Maryland, or any unit of the State of Maryland having jurisdiction, the exercise of any statutory right or remedy conferred by the Constitution and the laws of Maryland with respect to any misrepresentation made or any violation of the obligations, terms and covenants undertaken by the above business with respect to (1) this Affidavit, (2) the contract, and (3) other Affidavits comprising part of the contract. I DO SOLEMNLY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT THE CONTENTS OF THIS AFFIDAVIT ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF. Date: ______________ By:
(print name of Authorized Representative and Affiant) (signature of Authorized Representative and Affiant)
Revised 04/09/2015
8 | P a g e IFB KK-001-160-C01 -- 28/39
Department of Public Safety & Correctional Services
Criminal History Security Background Check Attach Background Investigation Material Western Correctional Institution ( WCI ) & Division of Capital Construction & Facilities Maintenance
Date:
E-Mail To:
[email protected]
A security background check will be conducted on all persons entering an institution to provide services. This background check consists of a criminal history check using usual and customary automated criminal history data systems including but not necessarily limited to MDCJIS, NCIC, MVA, FBI, etc. This requirement pertains to persons providing services on a daily basis for an extended period of time such as medical contractors, volunteers, and long-term construction employees. It does not apply to persons entering and leaving on a one-day basis such as copier repair technicians. This security-check will be completed prior to the issuance of a picture I.D. and a security orientation.
Please provide the following information: Full Name: First
Middle
Last
Address: Street
City
Date of Birth:
State
Zip Code
Social Security Number:
Phone Number:
□ Male
Race:
Driver's License No:
□ Female
State:
Purpose of Clearance:
□
Volunteer
For: Department
□
Intern
From:
For: College/Agency
□
Department
Other State Agency: Agency Name
□
Contractual Services:
□
Construction:
Type (engineering, medical, etc.) Firm
Phone #
Sub-Contractor
Phone #
Contract #
Insert Scanned Photo ID Here:
Contract Completion Date
Design Engineer Contract #
Requested by: Name
Recommended:
Title
Facility
□
Approved
□
Disapproved
□
Approved
□
Disapproved
Name
Approval: Signature of Warden or Designee
IFB KK-001-160-C01 -- 29/39
IFB KK-001-160-C01 -- 30/39
IFB KK-001-160-C01 -- 31/39
IFB KK-001-160-C01 -- 32/39
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IFB KK-001-160-C01 -- 34/39
IFB KK-001-160-C01 -- 35/39
Executive Directive
Title: Custody and Security Construction Projects
Executive Directive Number: Correctional Facility
Related MD Statute/Regulations: Correction al Servi ces Article, §§2-103 , Annotated Code of Maryland ; Related ACA Standards: 2-CO-3A-01, 2-CO-3B-02; 4-4172,4-4196
OPS.1l0.0002 Su persedes: Secretary's Department Directive DPSCS , 110,0002, (fonnerly SDD 03 1995), dated 03 /2 !/95 Responsible Authority:
,-~~9::-r, \ ,~~
Related MCCS Standards: N/A
- -----.... .;;;.;;..1 ..;,;,. /
,f
.......
~
,. '
-
Director, Securi!)' Operat ions Effective Date: April 4, 2014 Number of Pages: 4
.~. ,~___ ' '
Gregg L. Hershberger Secretary .01
.
Carroll Parrish Deputy Secretary for Operations
Purpose. This directive updates existing policy and designates responsibilities for security and control during capital construction projects at a Department of Public Safety and Correctional Services (Department) correctional facility,
.02 Scope. This directive applies to units of the Department responsible for security and control at a Department correctional facil ity,
.03 Policy. A, The Department shall establish safeguards during a capital construction project at a correctional facility to maximize security for and control of individuals at the affected Department correctional facility. B. The Department shall establish safeguards during a capital construction project at a correctional facility that minimize the operational impact on the correctional facility caused by a capital construction project and the individuals responsible for completing the capital construction project.
.04 Definitions. A. In this directive, the following terms have the meanings indicated. B. Terms Defined. (1) Capital Construction Project. (a) "Capital construction project (project)" means developing, executing, and completing a plan intended to build, modify, renovate, improve, dismantle, or maintain a Department correctional facility.
(b) "Capital construction project (project)" includes a capital maintenance project. IFB KK-001-160-C01 -- 36/39
Executive Directive Number: OPS.IlO.0002 (2)
document" means a written communication, picture, drawing, or other text or graphic communication related to a construction
(3)
person to the Department to
to completing a
means an individual for a contractor or a sub-contractor to the contractor's obligations to the Department for a capital construction
(4) "Contractor's performing tasks project.
.05 Responsi bility IProced u reo of
has operational
with the
A. A managing security during a
B. The Division of Capital Construction and
lities Maintenance (DCCFM) by the as manager a project at a correctional shall liaison between the contractor to official and Director Security Operations, or a
Director ensure that: (I)
and control measures are included in the planning
the project;
Department approved security and control measures are included in the construction initiation to the contractor at measures are establ ished to ensure continuolls during capital constrllction and
(4)
at
correctional
contractor:
I be working at the correctional facility is aware of the (a) And each contractor's employee who ished the contractor's employee a copy
the security requirements established for
(ii)
by
(iii) Forwarding the
copy
the security guidelines to the managing official;
(b) And the contractor's employees are aware that provided by the managing official, or a Is aware of the conseq uences for The following are facil
um
d are required to comply related to security the project; and measures established for the
for security and control during a project at a correctional
2
IFB KK-001-160-C01 -- 37/39
the contractor and
Executive Directive Number: OPS.110.0002 (1) To the extent possible, the inmate population shall be isolated from the project work area to minimize security staffing requirements related to the project;
(2) The use of overtime for a Department employee shall be minimized and if overtime becomes necessary, overtime shall be authorized according to established overtime procedures; (3) Identification for a contractor's employee entering, working at, and leaving the correctional facility; (4) Searching a contractor's employee and equipment; (5) Security for tools and equipment at the project location; (6) Searching and parking contractor's employee's vehicles at the correctional facility ; (7) Ensuring that the capital construction project work area is "smoke free" according to the State's no smoking policy; (8) Hours of work; (9) Approving alternative hours of work; (10) Conducting a criminal history records check for each contractor's employee required to enter the secure perimeter at a correctional facility that includes, at a minimum, a records check through: (a) The National Crime Information Computer (NCTC) ; and (b) The Criminal Justice Information System - Central Repository (CJIS - CR). D. Contractor. (1) A contractor is required to agree to comply with security requirements established for the project at the correctional facility before work begins on the project. (2) A contractor is required to agree to have each contractor's employee working on a project at the correctional facility acknowledge, in writing, receipt of the security requirements for the project. .06 Attachment(s).
There are no attachments to this directive . .07 History.
A. This directive rescinds DPSCS . lI0.0002 - Custody and Security of Major Construction Projects
(formerly SDD 03-1995), dated 03 /21 /95 by updating style and format and changes based on re
organization.
B. This directive supersedes provisions of any other prior existing Department communication with which it may be in conflict.
3
IFB KK-001-160-C01 -- 38/39
Executive Directive Number: OPS.ll0.0002 .08
Operations Distribution. A
S-
Security Chief
4
IFB KK-001-160-C01 -- 39/39
