UNITED INDEPENDENT SCHOOL DISTRICT PURCHASING DEPARTMENT PROPOSAL INVITATION
UNITED INDEPENDENT SCHOOL DISTRICT (“DISTRICT”) INVITES YOUR FIRM TO SUBMIT COMPETITIVE SEALED PROPOSALS FOR:
“Integrated Instructional Management System” RFP NUMBER:
008-2013
RFP MUST BE DELIVERED BY:
Wednesday, May 8, 2013 at 3:00 pm c.s.t.
RFP MUST BE DELIVERED TO:
UNITED INDEPENDENT SCHOOL DISTRICT SERVICE CENTER – PURCHASING DEPARTMENT 3501 E. SAUNDERS LAREDO, TEXAS 78041
Submit with your proposal all pages that require signatures and/or initials. Failure to do so may result in disqualification of your bid/proposal. ADDITIONAL REQUIREMENTS Please submit one original and 5 copies of Proposal ALL OR NONE PROPOSALS This may or may not be an all or none proposal F.O.B. DESTINATON Bids/proposals must be submitted on a F.O.B. Destination Freight prepaid basis. All additional cost must be quoted. Unit cost must include the cost of profit, freight, packaging, insurance overhead, etc. No additional changes will be accepted. Possessions of goods will not pass to the DISTRICT until received at the DISTRICT’S receiving dock. QUALIFICATION OF PROPOSER The DISTRICT may make such investigations as deemed necessary to determine the qualifications and / or ability of the bidder to perform in accordance with the bid terms and conditions specified herein. The bidder shall furnish to the DISTRICT all such information as the DISTRICT may request. The DISTRICT reserves the right to reject any bid if the bidder fails to satisfy the DISTRICT that such bidder is properly qualified to carry out the obligations of the contract.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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INSURANCE REQUIREMENTS (Unless otherwise directed by DISTRICT, the following insurance provisions will apply) Vendor shall furnish a certificate of insurance within 10 days after receipt of award notification on said proposal/proposal with United Independent School District included as an additional insured. The vendor should maintain the following type of coverage with the required minimum limits with an insurance carrier authorized to do business in the State of Texas by the State Board of Insurance. Said certificate shall include a clause obligating the Insurer to give ten days prior written notice of any material change in the insurance including cancellation. The following are the types of coverage and acceptable limits that shall be maintained: A. Worker’s Compensation Insurance - Statutory B. Comprehensive General Liability in the following amounts: General Aggregate $1,000,000.00 Products-Comp/Ops Aggregate $1,000,000.00 Personal & Advertising Injury $1,000,000.00 Each Occurrence $1,000,000.00 The Comprehensive General Liability Insurance must include liability coverage for Bodily injury, Personal Injury (including employment related suits), Independent Contractor, Blanket Contractual, Product, Fire, Medical Expense and Complete Operations. C. Comprehensive Automobile Liability Insurance in the following minimum amounts. Combined Single Limit $1, 000,000.00 In the event of loss of or damage beyond reasonable repair to DISTRICT’S property due to Contractor's (including Contractor's employees, agents or subcontractors) negligence or intentional act, Contractor will, at DISTRICT’S option, either: (1) promptly replace the property, or (2) promptly reimburse DISTRICT for the replacement costs of the property. If Contractor proposes to exercise the former option, Contractor must provide to DISTRICT detailed information about the replacement property and obtain DISTRICT’S consent before replacing the property. However, DISTRICT reserves the right to replace the property at any time (and seek reimbursement from Contractor) unless DISTRICT has consented to Contractor's replacement property. WARRANTY Bidder must submit warranty information and service agreement information together with the bid. Failure to provide such information may be cause for rejection of the bid. EXPRESS WARRANTIES Implies wear of merchantability and implied warranty of fitness for a particular purpose shall apply to all purchases initiated by this document. The bidder shall assume all liabilities incurred within the scope of consequential damages and incidental exposure as set faith in the uniform commercial code which result from either delivery or use of product which does not meet specifications within this document. The warranty conditions as stated herein shall approx. and shall not be nullified, voided or altered in any way by the inclusion of the bidder pre-printed forms with this document. TERM OF CONTRACT This solicitation will initially be for a 12-month contract, and it may be extended four times in one (1) year increments by mutual agreement of both parties for a maximum possible total of 60 months. There shall be no upward price changes for the first year. Upward price changes (not to exceed 3%) for subsequent option years may be negotiated, however upward price changes may be cause for the DISTRICT not to exercise an extension option. The District reserves the right to extend the contract on a month to month basis, and/or 6 month or 12 month periods by mutual agreement of both parties. DELIVERY DATE The DISTRICT must have delivery within 30 days after awarding of contract. Delivery date will be a factor to consider in determining bid award. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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IDENTICAL PROPOSALS In the event of tie bids, the DISTRICT, shall select by the casting of lots or coin toss. CONTINUATION OF SERVICES In the event, subsequent to the execution of a service contract with UISD, there is a change in the make up of the provider's ownership and/or the person(s) substantially performing and providing services to UISD, as determined by UISD, under the service contract is no longer a member or affiliated with the provider, UISD reserves the option to continue the service contract with the new provider ownership or with the person(s) who substantially performed and provided services to UISD, and in such case, the service contract will be modified accordingly. Other provisions herein on assignment or subcontracting remain effective to the extent they do not conflict with this Continuation of Services provision. ASSIGNMENT No right or interest or obligation in the contract shall be assigned or delegated without the written permission of the DISTRICT. Any attempted assignment or delegation by proposer shall be wholly void and totally ineffective. RIGHT OF AWARD The DISTRICT reserves the right to award as may be in its best interest. The District may accept or reject any and all options proposed. The DISTRICT may negotiate with the top proposers. CONTRACT The RFP specifications set out by the DISTRICT, the response to the RFP specifications by the awarded proposer(s), the purchase order, and the written award notification will result in a binding contract without further action by either party. If proposer requires that a specific contract be signed, that contract must be submitted as part of the response to the RFP. Please note that in the event that any terms in proposer’s contract conflict with the RFP terms, the RFP terms will supersede, and reference to RFP will be incorporated into the language of the executed contract. DETERMINING AWARDS In conformance with Texas Education Code Section 44.031, in determining to whom to award a contract, the DISTRICT shall consider: 1. 2. 3. 4. 5. 6. 7. 8.
9.
the purchase price; the reputation of the vendor and of the vendor’s goods or services; the quality of the vendor’s goods or services; the extent to which the goods or services meet the DISTRICT’s need; the vendor’s past relationship with the DISTRICT; the impact on the ability of the DISTRICT to comply with laws and rules relating to historically underutilized businesses; the total long-term cost to the DISTRICT to acquire the vendor’s goods or services; for a contract for goods and services, other than goods and services related to telecommunications and information services, building construction and maintenance, or instructional materials, whether the vendor’s ultimate parent company or majority owner: (A). has its principal place of business in this state; or (B). employs at least 500 persons in this state; and any other relevant factor specifically listed in these specifications.
RIGHT TO HOLD PROPOSALS The DISTRICT reserves the right to hold proposals for 90 days before awarding the contract.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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PURCHASE OF ADDITIONAL UNITS The bid is guaranteed to be firm for 90 days after award so those additional units may be purchased. If additional quantities are still needed, the DISTRICT reserves the right to extend bid for an additional 90 days. On catalog and price list discounts the bid/proposal is good for the contract period.
RIGHT TO INCREASE OR DECREASE QUANTITIES The DISTRICT reserves the right to increase or decrease quantities subject to the availability of funds during the period the bid/proposal is guaranteed to be firm. RIGHT TO EXTEND RFP The DISTRICT in accordance with the vendor may extend proposal on a monthly basis if needed. AVAILABILITY OF FUNDS All awards are subject to approval upon availability of funds. In the event funds do not become available, the contract may be terminated with a written notice. SALES TAX EXEMPTION The DISTRICT qualifies for exemption of the Texas limited sales, exercise and use tax; sales tax will not be changed on these purchases. RIGHT TO REJECT PROPOSALS The DISTRICT reserves the right to accept or reject any or all proposals or any part thereof and to waive any and all minor informalities or technicalities in any part of the proposal not deemed to be in the best interest of the DISTRICT. REBATE If a rebate is offered by the manufacturer of a proposal item(s) after proposal is awarded, the successful proposers will advice the DISTRICT and deduct the rebate from the proposal price. INSPECTION OF BID ITEM(S) The bid item(s) will be inspected upon arrival. All defects will be repaired or replaced at the expense of the successful proposer. SUBSTITUTIONS Substitutions from the brand(s) proposed will not be accepted unless approved in writing by the Purchasing Director. Samples of possible substitution items may be requested at that time. TERMINATION FOR CAUSE The DISTRICT shall have the right to cancel or default all or part of the undelivered portion of the order if the contractor breaches any of the terms hereof, including warranties, if the contractor becomes insolvent or commits acts of bankruptcy. Other factors shall include service performance. TERMINATION WITHOUT CAUSE The DISTRICT in accordance with this provision may terminate the performance under this order in whole or in part. Termination hereunder shall be effected by the delivery to the contractor or a “Notice of Termination” specifying the extent to which performance of work under the order in terminated and the date upon which such termination becomes effective.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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CERTIFICATION OF PAYMENT Payment by the DISTRICT will be made within 30 days after the date on which the District receives the goods under the contract or the date on which the performance of services under the contract was completed, or the date on which the District received the invoice for the goods or services, whichever is later. This procedure is in accordance with the District’s policy CHF Legal “Purchasing and Acquisition – Payment Procedures”. The District's preferred method of payment is, Direct Deposit (ACH). Awarded vendors are urged to register with the Accounts Payable Department at 956-473-6201. FELONY CONVICTION NOTIFICATION A person or business entity that enters into a contract with the DISTRICT shall notify the DISTRICT if the person or an owner or operator of the business entity has been convicted of a felony. Such notice shall include a general description of the conduct resulting in the conviction. Failure to provide such information may result in termination of the contract. Vendors must complete and submit the “Felony Conviction Affidavit” included with the Bid/Proposal form. Furthermore, District Policy CH Local states that “The District shall not consider for contract approval a business whose owner or operator has a criminal record that includes a conviction, deferred adjudication, plea of guilt, or no lo contendere for any felony offense”. VENUE It is understood and agreed by both the successful bidder and the DISTRICT that venue for any litigation from this contract shall lie in Webb County, Texas. SUBMISSION OF RFP All bids/proposals, whether delivered by hand or mail, are due in sealed envelopes endorsed with RFP 008-2013 “Integrated Instructional Management System” no later than Wednesday, May 8, 2013 at 3:00 pm cst, at the DISTRICT’s Purchasing Office located in the Service Center on 3501 E. Saunders, Laredo, Texas 78041. Responses sent by overnight mail shall have Proposal number written on delivery ticket. FACSIMILIES / E-MAILS Proposals may not be faxed or e-mailed. OPENING OF BIDS/RFP Bids will be publicly opened at the Purchasing Department conference room, Service Center Building. Request for Proposals (RFP) will only identify proposers. PROPOSAL INTERPRETATION No interpretation to the meaning of the “Invitation to Bid” or other documents will be given orally. Every request will be in writing, addressed to the Purchasing Director, and must be received at least five days prior to the date fixed for the opening of the bids. Any and all such interpretations and supplemental instructions will be in the form of written addenda to the “Invitation to Bid”, which if issued, will be mailed to all known prospective of any bidder to receive any such addenda or interpretations shall not relieve such bidder from any obligation under his bid as submitted. All addenda so issued shall become part of the contract document. MODIFICATIONS OR WITHDRAWALS BEFORE PROPOSAL OPENING Modifications or withdrawals of bids/proposals will be accepted only when the same is received on or before the fixed time scheduled for opening. Such requests must be executed in writing, or withdrawn in person by the bidder, or his/her authorized representative, provided his/her identity is made known and he/she signs a receipt for the bid/proposal documents. MODIFICATIONS OR WITHDRAWAL BY SUCCESSFUL PROPOSER Modifications or withdrawal of a bid by the successful bidder will be accepted only if the change is the best interest of the DISTRICT, not prejudicial to other bidders and executed in writing.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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LATE PROPOSAL All bids delivered will be stamped with the time and date as proof they were received on or before the requested time and date. Bids received after the requested time and date will be considered late and returned unopened. If a return address is not provided, a late bid will be opened for identification and returned. PROPOSAL FORM All proposals must be submitted on the proposal form furnished to insure uniformity, If there is a substitute product that vendor would like to propose, in addition to the product referenced, please make a copy of the proposal form and submit it with your original bid. Please provide response on this bid even if you do not wish to participate, failure to send back proposal form may result in deleting that company’s name off our vendor list records. INDEMNIFICATION Vendor shall fully indemnify, save and hold harmless the District, its officers, employees, and agents (hereinafter “the Indemnities”) against any and all liability, damage, loss, claims, demands, and actions of any nature whatsoever on account of personal injuries (including, without limitation on the foregoing, worker’s compensation and death claims), or property loss or damage of any kind whatsoever, which arise out of or are in any manner connected with, the performance of the contract, unless such injury, loss or damage is caused by the sole negligence of indemnities. Vendor shall at its own expense investigate all such claims and demands, attend to their settlement or other disposition, defend all actions based thereon and pay all charges of attorneys and all other costs and expenses of any kind arising from any such liability, damage, loss, claims demands, and actions. CONTACTING BOARD MEMBERS Pursuant to United I.S.D. Board Policy CHE (LOCAL): Vendors or Board Members shall not contact (oral/written) each other individually for the purpose of soliciting a purchase or contract or discussing an outstanding bid or proposal that the vendor has submitted or will submit a bid or proposal between the time a request for proposal or a bid is formally released and a recommendation is made by the administration to the Board. If a vendor or Board member violates this prohibition during this time frame, consideration of the vendor for award shall be invalidated. Board members shall be notified of possible violations and actions taken. CRIMINAL HISTORY BACK GROUND th Senate Bill 9, passed during the 80 Legislative Session requires that all Texas public school districts receive certification from any entity with which it contracts to provide services that it has obtained a criminal history background check on all employees hired before January 1, 2008 who (1) have continuing duties related to contracted services; and (2) have direct contact with students. Therefore, all entities and individuals who contract with the District to perform services, must complete the attached UISD form “CERTIFICATION OF CRIMINAL HISTORY RECORD INFORMATION”, which includes an information sheet related to the services to be performed and the duties related to those services that employees will be performing and the type of contact that those employees might have with students CONFLICT OF INTEREST (CIQ) FORM According to Local Government Code, Chapter 176, a person or an agent of a person who contacts or seeks contracts for the sale or purchase of property, goods, or services with United Independent School District (the District) must file a complete Conflict of Interest Questionnaire with the Purchasing Department when submitting to the District a response to a request for proposals or bids, correspondence, or another writing related to a potential agreement with the District. This Conflict of Interest Questionnaire must be completed and returned with the response to a request for proposals or bids. Failure to do so may result in disqualification of the response.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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OTHER INFORMATION For additional information, contact Ms. Dolores Schandua, Procurement Officer, at (956) 473-7921. Proposal should be mailed or delivered to: United Independent School District C/O Ms. Cordelia Flores Jackson, Director of Purchasing 3501 E. Saunders Laredo, TX 78041
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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SPECIFICATIONS Integrated Instructional Management System
RFP 008-2013 1.0
INSTRUCTIONS This section provides necessary information for vendors to qualify as “responsive” to this Request for Proposals (“RFP”). This section should be studied carefully before attempting to respond so that proposals are not rejected on a minor technicality that could have been avoided. Proposals should be submitted in the manner prescribed herein and for the systems and services requested herein. All required forms and submissions requirements are provided herein or attached hereto.
1.1
Purpose: This RFP has been issued to solicit vendor proposals to deploy an Integrated Instructional Management System at United ISD. United ISD seeks a solution that will fully integrate with existing student data management and grade book applications and will allow for the creation, modification, and distribution of curriculum documents and electronic resources, and the creation, administration, and analysis of district benchmark and classroom assessments. The specific requirements of this system are described in Section 4 herein.
1.2
RFP Format and Included Documents This RFP has been organized to allow United ISD to collect the information required to make a determination as to which proposed solution, if any, meets United ISD’s needs and offers the best value. The RFP format closely mirrors the format required for vendor responses, which has been designed to obtain detailed proposals. The RFP consists of several sections and related response forms. The response forms are associated with a specific section of the RFP such that each collects the information required by the corresponding RFP section. These are described below: RFP Section General Bid Terms 1.0 Instructions
2.0 UISD Profile
3.0 Legal Specifications 4.0 Software and Service Requirements
Establishes requirement that vendors respond to UISD software license and service contract terms Provides a high level view of the applications software and related professional services sought by this RFP. Exhibit A
5.0 Platform Hardware and Software Requirement
Provides an overview of the platform technologies that will likely be required to support the proposed applications software
6.0 Implementation
Requires that vendors submit an implementation proposal providing vendor’s proposed schedule, key dates and resource requirements. Displays current UISD Network
Exhibit B – Network Diagram
1.3
Purpose Informs vendors of specific terms and conditions of RFP Provides vendors instructions and structure for vendor RFP response and collects vendor information and acknowledgements related to requirements. Provides an overview of UISD as a district, existing technology and existing infrastructure
Cost of Proposal Development United ISD disclaims any financial responsibility for, and vendors shall be solely responsible for, any costs incurred by vendors in responding to this RFP, whether or not any award is made as a result of this RFP. Such costs include, for illustrative and not limiting purposes: proposal development and authoring costs, travel costs, bonding costs, legal costs, delivery costs, marketing costs, and technical research costs.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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1.4
Questions Regarding this RFP Any questions concerning this RFP should be directed in written format, emailed to the Purchasing Department at
[email protected] no later than 3:00 pm, Tuesday, April 30, 2013. Only those inquiries District replies to by addendum shall be binding. All such addendum issued by United ISD prior to the time that statements are received shall be considered part of the RFP.
1.5
RFP Interpretation and Addenda Any changes, clarifications, or other interpretations regarding this RFP will be sent by UISD to each vendor who has requested to be on the RFP addenda distribution list. All such addenda will become part of the RFP and will be included by reference in any final agreement that may be negotiated between UISD and any successful vendor or vendors.
1.6
Partial or Joint Proposals UISD desires a single vendor solution. It is preferred that all software products, except those that are general in nature (server or workstation operating systems, Adobe products, etc.), be purchased through a single vendor. It is desired that all services be coordinated through a single vendor and that a single vendor assume responsibility for that, and any third party or cooperating vendors, performance.
1.7
Cooperating Vendors The submitting vendor may have a relationship with other vendors participating in this project which must be disclosed. There are three categories of vendors and the submitting vendor may use one or all three types to complete the project: a) Subcontractor A subcontracting vendor will be under the complete responsibility of the submitting vendor and must be covered by the same terms and conditions of the final agreement between UISD and the awarded vendor. b) Materials Vendor Any vendor supplying materials only under this project would not be subject to the terms of the final agreement except that the performance of the submitting vendor is dependent on the performance of the materials supplied. Payment is made through the submitting Vendor and not directly to the materials vendor. c). Third Party Vendor A third party vendor is a “pass through” vendor whose products are required as part of the proposed solution but requires a direct license between the third party and UISD. Initial payment will be subject to Acceptance as defined herein but on-going maintenance and support after any initial warranty period will be contracted for and paid directly to the third party by UISD. The vendor to which an award is made must maintain the relationship with the Third Party Vendor for the term of the agreement negotiated between the UISD or provide appropriate substitute products (at no additional cost to UISD) that ensure the continued performance of the proposed solution at UISD.
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Common Platform and Infrastructure Component Purchase Vendors may opt to include pricing for common hardware, infrastructure, or platform software (operating systems, utilities, etc.) in their proposals. Given the possibility that UISD will obtain better pricing through existing channels, vendors must provide, in lieu of pricing of such components, specifications of sufficient detail to allow UISD to purchase hardware and other common components separately and through separate channels. Vendors should note that UISD will require an endorsement from the awarded vendor(s) indicating that the hardware specified, and to be ordered by UISD, will allow the proposed solution to provide the functionality and performance indicated in the agreement executed between UISD and the awarded vendor(s). Should the specified hardware fail to deliver functionality and performance promised, UISD will require replacement, upgrade, or reconfiguration and no additional cost to UISD.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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1.9
Confidentiality The submitted proposals, including response forms, are public records subject to public disclosure pursuant to the provisions of the Texas Public Information Act (TX Govt. Code §552 et seq.). Vendors should consult with legal counsel and review both the code and various Texas Attorney General Open Records Decisions prior to submitting their proposals. Vendors should also note that UISD may request a financial information.
1.10
FERPA Any vendors to which an award is made will be required to comply with all applicable provisions of the Family Educational Rights and Privacy Act (20 U.S.C. § 1232g; 34 CFR Part 99)(“FERPA”). Further, UISD will require that any vendor to which an award is made execute a FERPA agreement.
1.11
Included Documents The following documents, in addition to any others that may be required, will be included in, and part of, any agreement that may be executed between UISD and any vendor as a result of this RFP: a) Software License or Application Service Provider Agreement b) Scope of Work which shall include acceptance testing protocols c) Completed Functionality Inventory d) United Independent School District Request for Proposals for Integrated Instructional Management System and any addenda attached thereto
1.12
Delivery UISD may request delivery of computer software and documentation in an electronic format via secure download. All physical deliveries shall be freight prepaid F.O.B. destination and proposals shall include all freight and delivery charges to any location in UISD.
1.13
RFP Response Requirements Each vendor response must include the following: An Original RFP Response, labeled “ORIGINAL” which shall contain wet signatures, in blue ink, where required. Five (5) copies of the RFP response, each a complete copy of the original, labeled “COPY” All blank spaces on all response forms provided must have entries. Vendors should use entries such as “N/A,” “Included”, “Not Required,” or “0” as appropriate. All proposals must be submitted in three ring binders. The cover of each binder should include the name of the vendor submitting the response and the title “Response to UISD Integrated Instructional Management System RFP #008-2013.” As indicated above, the binder cover must also indicate “ORIGINAL” or “COPY” as appropriate. Proposals must be received in sealed envelopes or containers clearly showing the Vendor's company name, address and must also include the label “Response to UISD Integrated Instructional Management System RFP #008-2013.” Vendors shall use the forms provided in the RFP Packet and mirror the format described herein. The use of other forms in lieu of those provided may be cause for rejection of proposals. Every effort has been made to make the entry of this information as straightforward as possible. It is the intent of this RFP to ascertain full and complete disclosure of all costs related to the successful implementation of the products and services requested. If there are additional costs or requirements which are not covered in the forms and formats provided, it is the vendor’s responsibility to present that information as part of their response to this RFP and to clearly identify such additional costs. All proposals should be submitted in the following format to enable UISD to fairly evaluate and compare all proposals. Failure to follow this format may constitute disqualification from consideration. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Cover letter This should be no more than one page in length. Tab 1 – Executive Summary Vendors are asked to outline briefly the entire scope of the proposal and key elements to which readers should pay particular attention. Tab 2 – Vendor Profile Vendors should include the vendor profile in this section as well as any other relevant information about the vendor’s organization including the history of the vendor and the history of the products proposed. Include in this section sample of any contracts or information the company may require of the District; Reference letters from clients with similar contracts and comprehensive financial report. Tab 3 – Legal Specifications Vendors should include the any deviations. Vendors should note that categorical rejection of UISD legal terms in lieu of vendor standard contract language may result in elimination from further consideration. Tab 4 – Software/Service Proposal and Costs This tab should contain the vendor’s functionality and price proposal. Functionality Proposal Vendors should describe, in narrative fashion, their proposed solution for UISD, from a functionality standpoint. This should include the vendors’ understanding of UISD interface and integration requirements as well as an explanation of how the vendor proposes to best leverage existing UISD technology. Vendors should include the Functionality Form (Exhibit A) in this section of their RFP response. Vendors should note that this form will become part of any contract executed by UISD as a result of this RFP. Any falsification or material overstatement of software functionality will be considered a material breach of any agreement negotiated by UISD as a result of this RFP and may result in termination of any agreement. UISD will pursue any and all available remedies as a result of such breach. Vendors should include clarifying notes on appropriate responses to the Functionality Form if so required. In the functionality narrative, vendors should specifically address any included assessment item banks. Vendors should include a narrative describing the number of items in the assessment item bank, for each content area provided, the research basis for these items and metadata, and the degree to which vendor provided items have been psychometrically validated. Cost Proposal In addition to the service and functionality narrative, vendors should include their cost proposal form for applications software and related implementation services in this section of the RFP response. Vendor must use the Proposal Form included within to provide applications software and related services costs. This form has been designed to allow for fair comparison of all vendor proposals. Vendors should note that separate vendor pricing forms will not be considered during evaluation and will not be included in any subsequent agreement that UISD may execute as a result of this RFP. The Proposal Form must capture all costs. Tab 5 – Infrastructure Requirements and Specifications Vendors should include the Infrastructure Specifications/Cost in this section of their RFP response. Vendors should provide pricing for any platform, infrastructure, or specialty product that either must be purchased from the vendor or that the vendor believes they can provide for UISD at the lowest available cost. Vendors should note that platform and hardware costs, for those items that must be purchased from the vendor, will be included in the cost analysis for that vendor. Vendor pricing provided for other items will include in this analysis only if the vendor price is the best available pricing for UISD. UISD will include pricing for hardware and platform components from its independent sources if these sources provide the best available pricing. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Vendors should provide specifications for all hardware, platform software, and specialty products (if applicable) of sufficient detail to allow UISD to purchase these items from its own sources. Vendors should note that a vendor endorsement of all platform software and hardware purchases will be required prior to UISD purchasing such items. This endorsement will require that the vendor guarantee system performance (exclusive of internet or network latency beyond the control of the vendor) and functionality of the proposed solution when used on the purchased hardware and platform software. Should the system fail to function or perform as promised, vendor will be required to provide replacement, upgraded, or reconfigured hardware of platform software at no additional cost to UISD. Tab 6 – Implementation Vendors should include the Implementation Timeline in this section of the RFP response. Vendors should note that this is provided for illustrative purposes and specific dates and deliverables are subject to negotiation and will be included the Scope of Work document, which will be attached to, and part of, any agreement that may be executed between UISD and any vendor as a result of this RFP. In addition to this form, vendors should describe their approach to training and continuing support in a district the size of UISD. Vendors should also note that UISD may designate its own project manager during the implementation who will be charged with working, as a team, with any required vendor project manager. Tab 7 – General RFP Response Forms Vendors should include all response forms, which include the signed RFP invitation, Certification Sheet Form, Conflict of Interest Questionnaire, W-9 Form, Certification of Criminal History Record Information, Vendor Acknowledgement Form and original invitation with appropriate signatures required within the RFP invitation. Tab 8 – Marketing Materials Vendors may include marketing materials in this section of their RFP response. 1.14
Proposal Evaluation Evaluation will be conducted by a stakeholder representative committee (“Evaluation Committee”) and any sub-committees that may be required. Evaluation of vendor RFP responses will involve multiple phases. Each phase has been assigned a weight, as described below: Evaluation Criteria Responsiveness Pass / Fail Risk 50% Value 50%
Weight
Each phase of the evaluation process is further described below: (a) Responsive Evaluation The initial evaluation phase will determine if proposals are responsive to UISD’s RFP. Responsive proposals are those that are delivered as described herein and that provide all functionality classified by UISD as “Required.” Vendors may meet these requirements using existing system functionality or customizations. Additionally, to be considered responsive, the vendor must be substantially responsive to UISD legal requirements. While specific milestones and dollar amounts associated with performance based payments are subject to negotiation, acceptance of these general terms is not. (b) Risk Evaluation During this phase of the evaluation the Evaluation Committee will perform a risk evaluation that may include: i. a review of reference letters from Districts using system provided within, and /or review of references conducted independently by UISD; Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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ii. a review of vendor and product history; iii. a technical evaluation, by UISD’s technology team, to determine the likelihood that UISD could both implement and support the proposed solution, given UISD’s existing platforms; iv. on-site scripted demonstrations performed by vendors which will address functionality, ease of use, and user interface issues, as well as examine other potential risk factors; v. a financial review of vendor; vi. a review of the assessment item bank provided by the vendor which will include an assessment of the degree to which the items have been psychometrically validated, are research based, are aligned to TEKS, and the level and quality of metadata included with the items. (c) Value Analysis During this phase of the evaluation, the Evaluation Committee will examine the vendors Functionality Scores (derived as specified herein), Cost Per Unit of Functionality (“Value Score”), and first and five year Total Costs of Ownership. Vendors should note that this is a “best value” analysis, not a “lowest total cost” analysis.
1.15
(d) Final Analysis The committee will review the results of the Risk Evaluation and the Value Analysis and either: (i) select a solution that provides UISD with a solution that, in UISD’s sole judgment represents the most advantageous combination of risk and value, or; (ii) opt to cancel the RFP process. During this phase of the evaluation, vendors will be ranked based on their risk and value scores. Vendors should note that should contract discussion with the finalist vendor not be successful, UISD may discontinue discussions with that vendor and begin discussions with the next ranking vendor. Value Score Value represents the best combination of functionality and price. To make an objective determination of value, UISD will perform a Value Analysis, as described above. To effect this analysis, UISD has presented a number of specific functional requirements, on the Functionality Form, in this RFP. Each specific functional requirement has been defined as: “Required,” “Highly Desired,” “Desired," or “Optional.” Each of these categories is assigned a numerical value, as follows: 4 = Required 3 = Highly Desired 2 = Desired 1 = Optional As indicated on the instructions for the Functionality Form, vendors are required to provide their level of compliance, as of the date of the RFP response, to each of these requirements. Valid vendor responses are: “Fully Compliant,” “Partially Compliant,” “Customization Required,” “Procedural Workaround Proposed,” or “Not Compliant.” Each of these levels of compliance has been assigned a numerical value, as follows: 4 = Fully Compliant 3 = Partially Compliant 2 = Customization Required to make product fully compliant 1 = Procedural Workaround Proposed 0 = Not Compliant A compliance score is computed for each requirement listed on the Functionality Form. This score is computed as follows: Compliance Score = UISD Priority x Vendor Compliance Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Thus, if UISD has determined that a given functional requirement is “Required” and the vendor has determined that their degree of compliance is “Fully Compliant” the score for that item would be “16” (4 x 4). In the case a vendor has determined that their solution is partially compliant with a UISD requirement, the score would be “12” (3 x 4). Individual Compliance Scores will be summed to arrive at a Functionality Score for the proposal. In addition to the functionality scoring, a Total Cost of Ownership (“TCO”) will be determined for the first year and for five years. First year TCO includes all first year software, service, maintenance, hardware costs (using the lowest of the vendors’ proposed hardware/platform costs, or UISD’s independent costs), and other costs that will be incurred during the first twelve (12) months following contract execution. Five year TCO includes all costs the UISD will incur during the first five (5) years of ownership, or use, of the proposed solution. Once both Functionality Scores and TCOs have been derived, the Value Scores (Price Per Unit of Functionality), first year and five year, will be computed, as follows: First Year Value Score = First Year TCO / Functionality Score Five Year Value Score = Five Year TCO / Functionality Score Thus, if a vendor’s first year TCO is $100,000, five year TCO is $250,000 and functionality score is 1,000, the First Year Value Score is 100 = (100,000 / 1000) and the Five Year Value Score is 250= (250,000 / 1000). 1.16
On-site Scripted Demonstrations As part of the evaluation process, vendors may be required to provide an on-site scripted demonstration of their proposed solution. These demonstrations will be forty five minutes (45) in length and will be generally structured as follows: Vendor must be prepared to demonstrate proposed software to evaluation committee, if requested to do so, within a week of notification at a designated District site.
Opening/Overview/ Presentation – 30Minutes Closing Statements – 15 Minutes UISD will provide a script of items that the vendor will be required to demonstrate approximately one (1) week prior to the demonstration. The vendor demonstration team should include representatives capable of demonstrating the proposed solution and addressing questions related to its functionality as well as a technology expert who will answer questions from Technology Team if applicable. On-site scripted demonstrations should be conducted using a demonstration database that contains student records, with appropriate student schedules and other configurations required to demonstrate the items requested on the script. The use of PowerPoint slides in lieu of demonstrating actual software is unacceptable. Only proposed and currently available functionality should be demonstrated. Vendors may address coming enhancements and use PowerPoints as part of their opening or closing statements.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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1.17
Secondary Disclosure During the evaluation process, UISD may request additional information from vendors, based on refined requirements, questions, or other issues that arise during evaluation. Such a request for Secondary Disclosure may be made uniformly to all vendors under consideration at the time such a request is made.
1.18
Award As explained herein, any award is subject to successful contract negotiations between UISD and the finalist vendor(s). Selection as the finalist vendor is not an award. The RFP process will be concluded, and an award will be considered to have been made, with execution of a final agreement between UISD and a vendor, with approval of the UISD Board of Trustees.
1.19
Change Orders Once awarded, UISD may authorize changes in plans or specifications, or allow substitutions provided that such changes are in writing and approved by UISD prior to incurring any charges and becoming a contract modification. Specific Change Order terms will be provided in the Scope of Work negotiated between any vendor to which an award may be made and UISD.
1.20
Payment Payment will be issued to any vendor to which an award may be made as a result of this RFP based on specific acceptance criteria and milestones. While exact acceptance criteria, milestones and percentages of payment associated with each are subject to negotiation, a performance based payment schedule is not. For illustrative purposes, the following payment schedule is provided. This is representative of UISD requirements: (a) Software / Application Service Payment Schedule
E Event / Milestone Installation and configuration Delivery of Instructional Management System System Functionality Testing Complete System Performance / Production Testing Complete Implementation Effort Complete
% of License Fee 15% 15% 30% 30% 10%
ent/ It is likely that the system deployment will be “phased” in which case, milestones (and resultant payments) will be adjusted. (b) Data Conversion Payment Schedule Event / Milestone Execution of the Agreement Final conversion delivered to UISD
% of Fee 25% 75%
(c) Customization Payment Schedule Event / Milestone Execution of Agreement or Change Order requesting Customization Delivery of Customization and successful completion of Functionality Test
% of Fee 50% 50%
(d) Training, Project Management, Consulting, and Other Related Professional Services Payment Schedule Fees for these services will be paid as approved and invoiced, subject to the invoicing provisions contained herein.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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1.21
Invoicing All invoices should be submitted monthly and, for professional services, should include the number of hours worked, hourly rate, and reference to a project deliverable. An itemization of all expenses should also be provided. UISD may also request copies of all receipts. UISD will use its best efforts to pay any invoice, not subject to dispute, within thirty (30) days of receipt of such invoice.
1.22
Acceptance Acceptance shall only occur following successful completion of System Functionality Testing and System Performance and Production Testing.
1.23
System Functionality Testing The purpose of System Functionality Testing is to ensure that the software or application service provides the functionality promised in the vendor’s RFP response. The basis for making this determination is the completed Functionality Form. While the specific System Functionality Testing protocol is subject to mutual agreement and will be documented in the Functionality Test Plan of the Scope of Work, the following generalities are non-negotiable: System Functionality Testing will compare the functionality of the system, as installed and initially configured at UISD, with preliminary UISD data, or a mutually agreeable test database, loaded onto the system, with the Functionality Inventory Response Form. Lack of functionality, response errors, or similar defects will not be considered “passing” for any part of the System Functionality Test. System Functionality Testing will only occur after at least two (2) UISD resources are trained in the configuration, management, and use of the proposed solution. System Functionality Testing will take a minimum of fifteen (15) days. During System Functionality Testing, vendor(s) should make available to UISD, by toll free telephone number, or on-site, at least one qualified representative capable of addressing technology, functionality, and general use issues. During System Functionality Testing, UISD shall provide vendor(s) with reasonable access to UISD’s systems to troubleshoot and correct problems. If specific features or functionalities should fail to perform as indicated on the Functionality Inventory Response Form, UISD may, at its sole option, exercise one of the following options: (i) grant vendor additional time, which shall be subject to mutual agreement, to bring the software into compliance, withholding payment for any acceptance testing milestone until such time as system is brought into full compliance; or (ii) designate the defective or non-conforming functionalities as a development project, all of which to be delivered at a mutually agreeable date, and assign to these an aggregate value not to exceed 50% of the amount due upon completion of System Functionality Testing, and grant acceptance, and payment, on the balance of the system; or (iii) determine that the system is not acceptable and terminate any in effect agreements for cause and invoke the Performance Bond. System Functionality Testing is based on the Functionality Form and not additional, new, or modified requirements that have not been mutually agreed to prior to beginning System functionality Testing.
1.24
System Performance and Production Testing The purpose of System Performance and Production Testing is to ensure that the system functions and is stable in a production environment, and that the system provides a level of performance and system response times promised in the Scope of Work. While the exact testing protocol is subject to negotiation, and will be document in the System Performance Test Plan of the Statement of Work, the following generalities are not negotiable: Performance and Production Testing shall occur on UISD’s deployed system, in a live production environment. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Performance and Production Testing shall commence no later than thirty (30) days after System Functionality Testing is complete and shall last no longer than thirty (30) days. Performance and Production Testing shall occur following final conversion, by phase as appropriate, of UISD data. Vendor shall not be held responsible for internet latency, network latency, or other performance degradation issues that are outside of the control of the vendor and the vendor’s installed solution. If performance or stability problems occur which are attributable to the proposed solution or the vendor endorsed hardware platform, UISD may, at its sole option, exercise one of the following options: (i) grant vendor a mutually agreeable period of time to bring the system into compliance, withholding any payment related to Performance and Production Testing until such time as the system is brought into compliance; or (ii) require the vendor reconfigure, upgrade, or replace any software or equipment that is required to bring the system into compliance, at no additional cost to UISD; or (iii) negotiate a mutually agreeable solution with the vendor; or (iv) determine that the system is unacceptable and terminate any agreements with the vendor for cause and invoke the Performance Bond. During Performance and Production Testing vendor(s) should make available to UISD, by tollfree telephone number, or on-site, at least one qualified representative capable of addressing technology, functionality, and general use issues. During Performance and Production Testing UISD shall provide vendor(s) with reasonable access to UISD’s systems to trouble shoot and correct problems. Performance and Production Testing is based on a protocol that is mutually agreeable and included in the Scope of Work, it is not an opportunity to add or modify system requirements. 1.25
Anticipated Schedule The anticipated timeline, subject to change, for the RFP and evaluation process is as follows: Event Target Date(s) RFP release Tuesday, April 23, 2013 Last day to submit questions Tuesday, April 30th, 2013 at 3:00 pm RFP Due Wednesday, May 8, 2013 at 3:00 pm On-site Scripted demonstrations Monday, May 13, 2013 Final Evaluations Wednesday, May 13, 2013 Board of Trustees Approval Wednesday, May 15, 2013 Begin Implementation Monday, June 10, 2013
2.0 UNITED ISD PROFILE 2.1
Demographics United Independent School District (“UISD”) is the largest school district in Webb County. UISD serves approximately 42,921 students and has consistently experienced enrollment growth of approximately +500 students per year over the past three years.
2.2
Student Population Profile UISD serves students in within surrounding Laredo, TX city limits extending throughout Webb County. UISD consists of the following: Campus Type High Schools (5 locations) High Schools Magnet (each housed at a high school) Middle Schools (10 locations) Elementary Schools Special Education Schools (1 housed 9th grade campus & 1 stand alone)
Number 4 4 9 26
Enrollment
2
102
12,196 9,889 20,734
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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M pus Type Number High Schools J.B. Alexander J.B. Alexander Health & Science Magnet L.B. Johnson L.B. Johnson Career Academy United United Engineering & Technology Magnet United 9th grade campus United South United South Academy of Global Business & Advance Technology Magnet
Enrollment
Middle Schools Lamar Bruni Vergara Clark Salvador Garcia Gonzalez Los Obispos Trautmann Trautmann 6th United United South Washington
Enrollment 899 821 473 1,174 1,032 1,105 594 1,091 1,372 1,294
Elementary Arndt Col. Santos Benavides Borchers Centeno Clark Cuellar De Llano Fasken Finley B. Garcia Gutierrez Juarez Lincoln Juarez Lincoln Early Childhood Center at D.D. Hachar Kazen Kennedy Zapata Killam Malakoff Muller Newman Nye Perez Prada Roosevelt Ruiz Salinas Trautmann Zaffirini
Enrollment 991 911 812 863 554 637 609 915 546 1,011 656 516 210 609 492 844 928 841 641 808 1,057 792 767 980 821 834 1,089
2,754 2,512 2,942 1,081 2,907
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Spcial Program Facilituies Cherish Skilled Unit Center at United 9th grade campus Schooling Toward Exceptional Performance (S.T.E.P.)
Enrollment Included with 9th grade campus 120
As of 2011, approximately 74.5% of UISD’s students participated in free/reduced price lunch programs. Approximately 40.8% of UISD’s student population was classified as LEP and approximately 7.7% were classified as special education students. UISD maintains a student:teacher ratio of 16.8:1. 2.3
Employee / Staff Profile There are approximately 2,570 teachers and 139 school principals and assistant principals in UISD. UISD classroom teachers have an average of 11 years of experience. UISD hires approximately 130 new teachers per year.
2.4
Key Administrative Technology Systems Function Student Data Management Data Warehouse / Reporting Financials, HR, Payroll Gradebook Scanning / Scoring
2.5
Application Tyler Systems Version 10.4 DMac Sungard Public Sector Finance Plus Version 4.1 Tyler Systems Version 10.4 DMac
Existing Technology Infrastructure (a) Overview The UISD data center houses approximately 125 HP file servers and one IBM P550 server. The district uses Windows Server and Novell (Version 6.5) platforms, except for the IBM server, which uses the IBM AIX platform (Version 5.2). There are no servers at campuses or other remote locations. The SunGard Public Sector Systems (student and financial) are located on the IBM server. All campuses are connected to the data center via fiber cable. UISD has studied current bandwidth usage and determined that at least 50% of the possible bandwidth is available. UISD has sufficient bandwidth to accommodate all foreseen additional applications or possible solutions. Internet connectivity to the district is provided by AT & T. Including laptops issued to students, there are over 20,000 workstations on the UISD network. (b) WAN A WAN diagram for the district is provided in Exhibit B to this RFP. (c) Campus Based Technology Each classroom is equipped with at least one Windows workstation, minimally equipped with Windows XP (SP2), 1 GB RAM, 80 GB storage, and a 3.2 MHz processor. Additionally, all schools have technology labs, laptop carts, or other facilities for students to access technology.
2.6
Interfaces The need for interfaces is largely driven by the need to preserve investment in existing tools. UISD uses a SQL data warehouse system and views this as a strategic tool for the district. Given this, UISD requires that SQL be utilized to the greatest extent possible by any new system. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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While specific interfaces are somewhat system dependent, the diagram on the follow page describes what UISD anticipates will be required interfaces for the management solution. 2.7
Data Conversion (a) Assessment UISD desires to use its existing SQL data warehouse as the authoritative source for all assessment result data. Given this, it is envisioned that UISD will not require any data conversion, but rather will require extensive interface capabilities to the SQL data warehouse. (b) Curriculum Curriculum documents are presently in a variety of formats, primarily Microsoft Word. These documents are not indexed, but are stored and named such that all grade level and content area documents can be easily identified.
2.8
Existing Assessment Management Process and Technology The existing system for generating and scoring district benchmark assessments utilizes a combination of technology tools and manual processes. UISD uses its DMAC and Scantron assessment scanning and scoring system, which uses its own software for scoring, to print, scan and score student assessments. Assessment items, metadata associated with those items (local or TAKS objective), and answer key data are manually entered into the DMAC System using the DMAC TEK Score Module. Student Rosters from the Tyler Student System are imported into DMAC and once an assessment is scheduled , Pre-slugged response forms are generated from the DMAC rosters. Scanning is performed at the site level. The Scantron scanners scan the images and transmit the scanned images back to the DMAC System. Once the images are received, the DMAC System scores the assessments and results are available to teachers thru the DMAC Website. Teachers and administrators may view results using the Internet Explorer browser and the DMAC System.
2.9
Existing Curriculum Management Process UISD’s curriculum is continuously developed and updated. UISD takes a “team approach” to curriculum development. There are approximately 20 curriculum developers within UISD, each with defined content area of grade level expertise. These individuals write and update curriculum documents for the district. These developers meet regularly with campus based staff to receive input and feedback on curriculum documents. Campus based staff has considerable input into development of model lessons, identification of resources, etc. At the campus level, team planning is institutionalized. Teachers develop lessons with other grade-level or content area teachers within a campus.
2.10
Technology Department Staffing The department is divided into 2 Units: Student Systems and Applications, Network Engineering and Support. Key positions are shown below: Position Number of Personnel Network Administrator 1 Student Systems Developer / Analyst 1 PEIMS Supervisor 1 Student Systems Analyst 1 District Office PC Support 1 Computer Supervisor North Schools 1 Computer Supervisor South Schools 1 Help Desk Support 1 Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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osition F 2.11 Training and Deployment Capabilities UISD has a technology deployment and training infrastructure that will be well equipped to support this project. Staff resources are described below: Instructional Technology Specialists Campus Technology Liaison District Administrative Technology Subject Matter Experts Resource FTE Primary 3.0 LEGAL REQUIREMENTS 3.1
General UISD desires a single source solution for all items proposed. If multiple providers are involved, they must be identified and cross-referenced either as Subcontractors or Third Party vendors, as defined in Section 1.7 herein. Subcontractors and Third Party vendors must be identified and the role of each party must be articulated in the narrative response to this RFP. In all cases, one vendor must assume responsibility for the implementation effort (“Primary Vendor”) and take full responsibility for all aspects of the proposed solution and vendor obligations during implementation. Submittal of any contracts or information the company may require of the District needs to be include in Tab 2. Please note that in the event that any terms in proposer’s contract conflict with the RFP terms, the RFP terms will supersede, and reference to RFP will be incorporated into the language of the executed contract. These specifications are not designed to be all-inclusive or be used as the final agreement(s) but are included to proactively present terms that UISD will seek to have included in any agreements between any vendor and UISD. Vendors should note that, while some terms are subject to negotiation, a performance based payment plan, tied to System Functionality and System Performance and Production Testing, as defined herein, are negotiable only with respect to payment milestones, amounts, or percentages. As part of a RFP response, vendors must indicate that the vendor accepts the term or condition (as written). Any deviations of the terms/conditions and /or specifications must be submitted in your company letterhead. While it is likely that not all terms will be agreeable to any given vendor, vendors should note that the degree of acceptance of UISD’s legal specifications is part of the evaluation criteria.
4.0
SOFTWARE SPECIFICATIONS UISD has determined that all applications software listed in this section of the RFP is required. It is anticipated that UISD will initially award most, if not all, of the required components if an acceptable solution is identified through this process. This section of the RFP defines in general terms the intended use or function of the various modules or system components needed by UISD. Detailed functionality requirements are present in Functionality Inventory (Exhibit A), which is included. Should a vendor offer both a UISD hosted solution and a vendor hosted solution, vendors should make a copy of the Proposal Form and submit two copies: a UISD hosted version (including all implementation services required for this type of solution) and a vendor hosted version (including all implementation services required for this type of solution) and submit under Tab 4.
4.1
Required Services and Software The modules defined in this section represent those of most important near-term to UISD. The systems specified in this phase are mandatory requirements. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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Vendors specifying development or modification projects to fulfill any functionality requirements for any of the required software applications or modules will be considered, but will be rated as only partially compliant because they cannot be evaluated prior to award. Therefore, functionally requiring development or customization will be rated lower on the price-per-point scoring (as described in Section 1.15 of this RFP). The applications listed in this section represent the core applications of the Integrated Instructional Management System. Both modules listed as required must fully integrate with each other in their native state and require no customized interface to achieve seamless integration. When third-party applications are proposed, there should be a contractual relationship between the submitting vendor and the third party vendor so that the integration (or interfaces) are coordinated as part of the vendor’s on-going support of the product. 4.1.1 Required – Implementation Support Services This section identifies specific minimum professional services that UISD will require as part of the implementation effort. (a) Project Planning / Consulting UISD will require that the successful vendor(s) collaborate with UISD’s project team to develop a deployment schedule for the project. Vendors should include time in this section of their response to become very familiar with UISD’s infrastructure, systems, existing curriculum documents and storage formats, assessment data, SQL data warehouse and any other technical or work process information reasonably necessary to work cooperatively with UISD to develop of an implementation plan for this project. (b) Business Process Review Any successful vendor(s) should include time in this section to allow for at least two (2) days of review of UISD work processes with UISD’s implementation team after bid has been awarded. (c) Installation and Configuration Vendor should propose sufficient time, travel and related expenses to provide onsite installation and initial configuration of the Integrated Instructional Management System. (d) System Administration Training UISD will require that up to five (5) UISD employees be trained on the installation, configuration, and on-going maintenance of the vendor’s system. This training must be on-site at UISD. (e) Project Management UISD requires that the successful vendor assign a project manager to this project and that this person and other members of the vendor’s implementation team, as appropriate, participate in weekly project management meetings or conference calls with UISD’s implementation team. At least one meeting per month shall be onsite at UISD. Project Management meetings will occur weekly until Acceptance (as defined in Section 1.22) by UISD. (f) Go-live / Key Process Support UISD requires that vendor provide at least three (3) training or support resource, on-site, during “go-live” for each module and during the first execution of any key processes (district-wide assessment administration, as an example) using the new system. The exact number of days may vary depending on deployment model, however, vendors should propose no less than eight (8) days and two (2) trips for on-site go-live and key process support. (g) System Administration Refresher Training Approximately one (1) year after Acceptance of the vendor’s system, UISD will require that the vendor return to UISD to provide UISD’s system administrators with at least two (2) days of refresher training. UISD will work cooperatively with the vendor to identify areas that need to be addressed during this training. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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(h) Interface Development UISD will require that the successful vendor’s system interface to existing UISD Tyler student information, DMAC, and grade book systems and fully leverage the existing SQL system. Vendors should include time to develop these interfaces from initial planning through acceptance by UISD. (i) Data Conversion Vendor should proposed system time, resources, travel, and other discovery costs to convert UISD’s existing curriculum documents into the vendor’s proposed system. (j) Other Vendor should propose time and related expenses to perform any other professional services that would reasonably be expected to be required to successfully implement the Integrated Instructional Management System. 4.1.2
Required – Training Services This section of the RFP identifies required vendor provided training services. UISD has a core team of twenty (20) curriculum and technology leaders who will act as primary end-user trainers during the deployment of the vendor’s Instructional Management System. For both curriculum and assessment modules, these individuals should be trained to the same level of expertise as the vendor’s training staff. Webinar trainings will not be available for both the curriculum and assessment modules during the first year of implementation. (a) Curriculum Management 1. Initial Training (Core Team) This is the “train-the-trainer” training that UISD core team of approximately 30 to 40 experts will receive. This training may be conducted over the course of the deployment and must result in the trainers have an equivalent level of expertise as the vendor’s training staff. Vendors should propose the most effective combination of classroom, walk-in support lab, or small group training to achieve the required outcome. 2. Training Support (End-User) It is anticipated that during the initial roll-out, UISD may require additional vendor training support. Vendors should propose sufficient time to allow vendor training staff to participate in at least eight (8) days of classroom and walk-in lab training in support of the core training team. 3. Refresher Training (Core Training Team) Approximately eight (8) to twelve (12) months after the deployment is complete, the core training team will require refresher training. The purpose of this training is to refresh the training staff on system functionality that may not have been widely used during the initial rollout. It is anticipated that UISD will work with the successful vendor to identify areas that the core training team needs additional or refresher training on. Vendors should note that this training will take place after the implementation is complete and must guarantee their daily rates for no less than twelve (12) months following Acceptance of the Curriculum Management System. (b) Assessment Management 1. Initial Training (Core Team) This is the “train-the-trainer” training that the UISD core team of approximately 30 to 40 experts will receive. This training may be conducted over the course of the deployment and must result in the trainers have an equivalent level of expertise as the vendor’s training staff. Vendors should propose the most effective combination of classroom, walk-in support lab, or small group training to achieve the requited outcome.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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2. Training Support (End-User) It is anticipated that during the initial roll-out, the UISD may require additional vendor training support. Vendors should propose sufficient time to allow vendor training staff to participate in at least eight (8) days of classroom and walk-in lab training. 3. Refresher Training (Core Team) Approximately eight (8) to twelve (12) months after the deployment is complete, the core training team will require refresher training. The purpose of this training is to refresh the training staff on system functionality that may not have been widely used during the initial rollout. It is anticipated that UISD will work with the successful vendor to identify areas that the core training team needs additional or refresher training on. Vendors should note that this training will take place after the implementation is complete and must guarantee their daily rates for no less than twelve (12) months following Acceptance of the Integrated Instructional Management System. (c) Other Because training requirements are somewhat system dependant, vendors must propose any additional training that they believe would be required for UISD to successfully implement their proposed solution, such as uploading additional student information. 4.1.3
Required – Core Curriculum and Assessment Applications This section of the RFP identifies the required software functionality, in general terms, which UISD desires to implement as a result of this process. (a) Curriculum Management This component, and all of the modules required will be used to manage curriculum, curriculum development, curriculum access and distribution throughout UISD. This module allows UISD’s curriculum development team to design and distribute curriculum documents to teachers, principals, and others who participate in the instructional and instructional development and evaluation process. This component allows educators to view the curriculum horizontally and vertically and to design classroom lesson plans in the system based on UISD designed curriculum scope and sequence, which are maintained and distributed by the system. This system empowers district level educators to develop and distribute an effective curriculum and empowers classroom teachers with model lessons linked to instructional and support resources. Additionally, this system allows site and District administrators to track a student or teacher’s progress through the curriculum. (b) Assessment Management The Assessment Management components provide a single inquiry source for student performance data on State tests, District assessments, and /or classroom assessments that are created by classroom teachers using this system. This system includes a robust and psychometrically validated item bank and an open ability to accept items from multiple publishers, the State of Texas, or UISD. This system allows for the creation of Site, District, and Grade-wide assessments that are maintained confidentially until published for testing as well as teacher designed assessments. This system is designed to support, and be based on, the District’s curriculum such that it provides feedback on growth, learning, and the effectiveness of the curriculum. Additionally, the system includes robust analysis and reporting capabilities to allow UISD to monitor student growth and performance longitudinally. (c) Uploading Student Documentation The system will allow end users to upload pertinent student information in order to make sound instructional decisions, ensuring compliance with FERPA laws. (d) Exporting Capabilities The system allows the end users to export information from student and/or teacher files to compile data for customized reports. Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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5.0
PLATFORM SPECIFICATIONS This section of the RFP describes various hardware, software, and related configuration, setup, and training services that may be required to implement the vendor’s proposed solution for UISD. If the vendor is proposing a vendor hosted solution, only the hardware and software components necessary to implement this type of solution at UISD should be identified. However, in the vendor’s narrative response, a detailed description of vendor’s hosting infrastructure should be provided. Because UISD can likely obtain better pricing for common hardware, which may include servers, workstations, operating systems, database engines, and other platform technologies, vendors are required to provide sufficiently detailed specifications to allow UISD to purchase these items independently. Vendors should note that for such common hardware, UISD will require vendor to provide an endorsement stating that the hardware and platform components to be purchased will provide UISD with the system functionality and performance specified by the vendor. In some cases, proprietary hardware or other platform technologies may be available only through the vendor. In these cases, vendors are required to provide pricing for these items, inclusive of all taxes, delivery charges (to UISD), etc. Other than the client workstations, new hardware will be required for central server functions. Pricing if the vendor is providing hardware for any and all necessary platform elements to support the proposed application software must be submitted. In developing platform specifications, consideration must be given to UISD’s network infrastructure, number of users, etc. These details are provided in Sections 2 and 4 of this RFP. 5.1.1
Required Platform Components The sections below generally describe the various platform technologies and servers that may be included in UISD’s new system. If additional technologies are required, vendors must document these in the narrative portion of their response. Implementation Services These services are those that are provided by the vendor and required to install, configure, setup, and manage the new platform technologies. (a) Server Installation and Initial Configuration Vendors should provide pricing for server setup, installation, and configuration for all servers specified in this section of the RFP. (b) System Administration Training Vendors should provide pricing to provide no more than five (5) UISD staff members with system administration training, if required, for all new platform components. (c) Campus Hardware Installation and Configuration If any campus based hardware or platform software is required, including upgrades to existing hardware, vendor should provide pricing to install and configure these components.
5.1.2
Platform Components - Software This section is provided to designate site licenses, system software licenses, and any other relevant system-wide or UISD-wide license fees that apply. (a) Server Operating System and Utilities Vendors should provide specifications, and pricing if required, for server operating systems, utilities, and related third party products. These specifications, and prices if applicable, should be inclusive of all licenses required to allow UISD to productively use the proposed Applications Software. (b) Server Database Engine/System Vendors should provide specifications, and pricing if applicable, for server database systems. These specifications should include the core database system and any required database utilities.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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(c) Backup/Restoration Vendors should provide specifications, and pricing if applicable, for system backup and data restoration tools. (d) Other Vendors should provide specifications, and pricing if applicable, for any additional platform software that is required to implement the proposed solution. 5.1.3
Platform Components - Hardware Vendors should provide detailed specifications for required hardware components in this section of the RFP and related response forms. (a) Application Servers Vendors should provide detailed specifications and pricing for all application servers required to implement the vendor’s proposed solution. In developing these specifications, vendors should consider existing infrastructure and standards, as documented in Section 2 of this RFP. (b) Database Servers Considering UISD’s existing standards and environment, vendors should provide detailed specifications for any required database servers. (c) Web Servers If web servers are required, vendors should provide detailed specifications and pricing for these. (d) Other Servers Vendors should provide detailed specifications and pricing for any other required servers in this section of the narrative response and on the RFP Proposal Form. (e) Scanners If additional or replacement scanning devices are required, vendors should provide detailed specifications and pricing, and specifically note in the narrative portion of the response if these scanners are replacement or additional devices. (f) Centralized Printers If additional printers are required at the district office, vendors should provide detailed specifications and pricing for these. (g) Site Printers If additional printers are required at UISD campuses, vendors should provide detailed specifications and pricing for these. (h) Classroom Handheld Devices Some vendor solutions may involve the use of classroom devices such as handheld scoring devices that are used by students. If these devices are required or recommended by the vendor, detailed specifications, specifically including the number of devices required, should be provided. If these are vendor devices, or if the vendor is typically the most cost effective entity to obtain these devices from, pricing should be provided. (i) Workstations and Workstation Enhancements If upgrades, additional client side software (such as Adobe Reader) is required on UISD workstations, or if any workstation hardware enhancements are required to existing UISD workstations, the required components should be specified, and priced if applicable. (j) Other If additional hardware components are required, these should be specified, and priced if applicable, by the vendor.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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6.0
SYSTEM IMPLEMENTATION This project requires a complete implementation, not just installation. This not only means the coordination of the installation, configuration, and setup of all of the application modules proposed, but establishing a logical and practical sequence of tasks. The vendor should design an implementation plan that accounts for UISD’s existing environment, resources. This plan should include provisions for technical training, system installation and configuration, end-user training, and the required Acceptance and Performance tests. Vendors need to identify tasks involved in the implementation, the resources required, and the approximate time commitment required of UISD functional and IT staff. Vendors should provide a narrative of their implementation plan as part of the narrative response to this RFP. Vendors should use June 10, 2013 as the target start date for implementation.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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PROPOSAL FORM Integrated Instructional Management System
RFP 008-2013 In conformance with the terms and conditions of this invitation to propose, the undersigned proposer submits the following:
1st Year
2nd Year
3rd Year
4th Year
5th Year
Set Up and Installation Cost Software Cost Service Cost Maintenance Cost Technical Training Cost Other Costs Total Costs
Please list any other cost associated with this proposal. All costs must be disclosed on this proposal. By submitting proposal vendor is attesting compliance with specifications. No other costs will be paid to vendor unless included in proposal and accepted by Purchasing Department at United ISD. Any deviations of the terms/conditions and /or specifications must be submitted in your company letterhead and included in Tab 4 of your proposal. By submitting the “Proposal Form”, I fully understand the terms and conditions and proposal specifications and will fully execute them if I am awarded this proposal.
_____________________________ COMPANY
___________________________________ AUTHORIZED REPRESENTATIVE SIGNATURE
_____________________________ ADDRESS
__________________________________ AUTHORIZED REPESENTATIVE PRINT
_____________________________ CITY, STATE, ZIP CODE
___________________________________ TITLE
_____________________________ AREA CODE / TELEPHONE
___________________________________ E-MAIL ADDRESS
_____________________________ AREA CODE / FAX
___________________________________ COMPANY WEBSITE
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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ALL BIDS MUST BE F.O.B. DESTINATION. DELIVERY INFORMATION Bid item(s) will be delivered within ___________ days after the purchase order is issued. WARRANTY INFORMATION Length of Warranty on parts ________________ Length of Warranty on Labor ________________ COMPANY INFORMATION Company has been in business _______________years Companies tax identification # ______________ _ Number of Employees ______________ _ REFERENCE INFORMATION Please provide at least five (5) references for similar services/equipment provided. Please print information clearly. Incomplete references will not be considered and may affect your proposal status. Contact Name:
Contact Name:
Organization or Company:
Organization or Company:
Phone:
Phone:
Email:
Email:
Description of Service Provided:
Description of Service Provided:
Contact Name:
Contact Name:
Organization or Company:
Organization or Company:
Phone:
Phone:
Email:
Email:
Description of Service Provided:
Description of Service Provided:
Contact Name:
Contact Name:
Organization or Company:
Organization or Company:
Phone:
Phone:
Email:
Email:
Description of Service Provided:
Description of Service Provided:
ACKNOWLEDGMENT OF RECEIPT OF ADDENDUM (If applicable) Addendum no.: ___________________ Date: ___________________ Addendum no.: ___________________ Date: ___________________ Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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PROPOSER’S CHECKLIST 1.
Has one (1) original and five (5) copies of the proposal been submitted with your response? YES ___ NO ___
2.
Have all specification been reviewed and deviations listed on company letterhead? (If applicable) YES ___ NO ___
3.
Is all the pricing information filled out? YES ___ NO ___
4.
Are the performance and payment bonds included with proposal? (If applicable) YES ___ NO ___ N/A___
5.
Are two copies of catalog/price list enclosed? (If applicable) YES ___ NO ___
6.
Has the certificate of non-collusion been signed? YES ___ NO ___
7.
Has the Felony Conviction Notification been filled out and signed? YES ___ NO ___
8.
Has the Conflict of Interest Questionnaire (CIQ –Form) been filled out and signed? YES ___ NO ___
9.
Has the W-9 form been filled out and signed? YES ___ NO ___
10.
Has the Residency Certification form been filled out and signed? YES ___ NO ___
11.
Has the Certification of Criminal History Record Information form been filled out and signed? YES ___ NO ___
12.
Has the Vendor Acknowledgement form been filled out and signed? YES ___ NO ___
13.
Is a self-addressed, stamped envelope enclosed for the bid results? (Optional) YES ___ NO ___
14.
Have all envelopes, packages or boxes labeled with the RFP #? YES ___ NO ___
THIS SHEET DOES NOT HAVE TO BE RETURNED WITH THIS PROPOSAL. IT SERVES AS A CHECKLIST FOR YOU.
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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NON-COLLUSION STATEMENT & SIGNATURE The undersigned affirms that he/she is duly authorized to execute this contract, that this company, corporation, firm, partnership or individual has not prepared this proposal in collusion with any other Proposer, and that the contents of this proposal as to prices, terms or conditions of said proposal have not been communicated by the undersigned nor by any employee or agent to any other person engaged in this type of business prior to the official opening of this proposal. I also affirm that have not given, offered to give, do not intend to give at any time. Hereinafter any economic opportunity, future employment, gift, loan, gratuity, specified discount, trip, favor, or service to a private service in connection with this contract. Further, I affirm that after the opening of this proposal, I (or any representative of my company) will not discuss the contents of this proposal with any person affiliated with UNITED ISD, other than the Purchasing Director of his Designee, prior to the awarding of this bid/proposal. I understand that failure to observe this procedure will cause my proposal to be rejected. I fully understand the terms and conditions and will fully execute them if I am awarded this proposal. I have represented the truth concerning the felony conviction notification. I fully understand the proposal specifications. COMPANY _____________________________________________ ADDRESS ______________________________________________ CITY, STATE, ZIP CODE ___________________________________ AREA CODE / TELEPHONE ________________________________ AREA CODE / FAX_______________________________________ E-MAIL ADDRESS________________________________________ COMPANY WEBSITE _____________________________________ ______________________________________________________ COMPANY OFFICIAL ___________________________________________________________ __________________________ SIGNATURE TITLE DATE
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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UNITED INDEPENDENT SCHOOL DISTRICT FELONY CONVICTION NOTIFICATION To Be Submitted With Bid / Proposal / Statement / Quote Texas Education Agency Code, Section 44.034, Notification of Criminal History, Subsection (a), states "a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony." Subsection (b) states "a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract." THIS NOTICE IS NOT REQUIRED OF A PUBLICLY-HELD CORPORATION District Policy CH Local states that “The District shall not consider for contract approval a business whose owner or operator has a criminal record that includes a conviction, deferred adjudication, plea of guilt, or nolo contendere for any felony offense”.
Please check off one box and sign the form in the appropriate space(s): I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the information furnished is true to the best of my knowledge. VENDOR'S NAME: ______________________________________________________________________________ AUTHORIZED COMPANY OFFICIAL'S NAME (PRINTED): ________________________________________________ A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. Signature of Company Official: ______________________________________________________________ B. My firm is not owned nor operated by anyone who has been convicted of a felony. Signature of Company Official: ______________________________________________________________ C. My firm is owned and operated by the following individual(s) who has/have been convicted of a felony:
Name of Felon(s): ________________________________________________________________________ Details of Conviction(s): _______________________________________________________________________________________ _______________________________________________________________________________________ Signature of Company Official: ______________________________________________________________
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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NO RESPONSE FORM UNITED INDEPENDENT SCHOOL DISTRICT PLEASE COMPLETE AND RETURN IF APPLICABLE The United Independent School DISTRICT (UISD) is interested in the reasons why you did not respond to our invitation to propose. Please fill out the information requested and return this form to the UISD Purchasing Department at the address below: United I.S.D. Purchasing Department Integrated Instructional Management System RFP 008-2013 3501 E. Saunders Laredo, Texas 78041 Reasons for No Response (please mark all those that apply to your circumstance) ___Could not meet specification requirements ___Do not supply this material or service ___Could not meet delivery requirements ___Did not have time to prepare a bid ___Cannot take additional jobs due to present workload ___Could not be price-competitive ___Other-please explain: _____________________________________________________________ ___I want to remain on the mailing list for this item or service. ___I do not want to remain on the mailing list for this item or service. ___Could not bid due to illness ___Could not set price with manufacturer ___Could not meet insurance requirements ___Could not meet bonding requirements ___Job is too big
Company Name:______________________________________ I have Read and agree to all terms on this page (initials):______
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CERTIFICATION SHEET In order for a proposal to be considered, the following information must be provided. FAILURE TO COMPLETE MAY RESULT IN DISQUALIFICATION Company Name _________________________________________________________________________________ Mailing address__________________________________________________________________________________ City _______________________________State____________________ Zip Code____________________________ Telephone_____________________________________ Fax _____________________________________________ Email address ___________________________________________________________________________________ In business under present name
___________ years and ___________ months COMPLETE THE APPROPRIATE SECTION BELOW:
I. RESIDENT BIDDER "Resident bidder" refers to a person whose principal place of business is in this state, including a contractor whose ultimate parent company or majority owner has its principal place of business in this state. I CERTIFY THAT MY COMPANY IS A "RESIDENT BIDDER": MR. MRS. MS. ___________________________________________________________________________________________ (Circle One) NAME (PLEASE PRINT) POSITION ________________________________________________________________________________________________ SIGNATURE ______________________________________________DATE ___________________________________________
OR
II. NONRESIDENT BIDDER "Nonresident bidder" refers to a person who is not a resident. IF YOU QUALIFY AS A "nonresident bidder", you must furnish the following information: What is your resident state? (The state your principal place of business is located.) ____________________________________
Does your "residence state" require bidders whose principal place of business is in Texas to under bid vendors whose residence state is the same as yours by a prescribed amount or percentage to receive a comparable contract? "Residence state" means the state in which the principal place of business is located. YES _______
NO _______ If “YES”, What is that amount or percentage?
_____________ %
I CERTIFY THAT MY COMPANY IS A “NONRESIDENT BIDDER” AND THE ABOVE INFORMATION IS TRUE AND CORRECT: MR. MRS. MS. ___________________________________________________________________________________________ (Circle One) NAME (PLEASE PRINT) POSITION ________________________________________________________________________________________________ SIGNATURE ___________________________________________________ DATE ___________________________________
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FORM
CONFLICT OF INTEREST QUESTIONNAIRE
CIQ
For vendor or other person doing business with local governmental entity OFFICE USE ONLY
This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person meets requirements under Section 176.006(a).
Date Received
By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person knowingly violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1
Name of person who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3
Name of local government officer with whom filer has employment or business relationship.
Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? Yes
No
B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? Yes
No
C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes
No
D. Describe each employment or business relationship with the local government officer named in this section.
4
Signature of person doing business with the governmental entity 35 of 42 4/23/2013
Date Adopted 06/29/2007
W-9
Request for Taxpayer Identification Number and Certification
Form (Rev. January 2011) Department of the Treasury Internal Revenue Service
Give Form to the requester. Do not send to the IRS.
Print or type See Specific Instructions on page 2.
Name (as shown on your income tax return) Business name/disregarded entity name, if different from above Check appropriate box for federal tax classification (required):
Individual/sole proprietor
C Corporation
S Corporation
Partnership
Trust/estate Exempt payee
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶ Other (see instructions) ▶ Address (number, street, and apt. or suite no.)
Requester’s name and address (optional)
City, state, and ZIP code List account number(s) here (optional)
Part I
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.
Social security number
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter.
Employer identification number
Part II
–
–
–
Certification
Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 4.
Sign Here
Signature of U.S. person ▶
Date ▶
General Instructions Section references are to the Internal Revenue Code unless otherwise noted.
Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income.
Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income.
36No. of 10231X 42 Cat. 4/23/2013
Form W-9 (Rev. 1-2011)
Page 2
Form W-9 (Rev. 1-2011)
The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: • The U.S. owner of a disregarded entity and not the entity, • The U.S. grantor or other owner of a grantor trust and not the trust, and • The U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person, do not use Form W-9. Instead, use the appropriate Form W-8 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a “saving clause.” Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity not subject to backup withholding, give the requester the appropriate completed Form W-8. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return.
Certain payees and payments are exempt from backup withholding. See the instructions below and the separate Instructions for the Requester of Form W-9. Also see Special rules for partnerships on page 1.
Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account, for example, if the grantor of a grantor trust dies.
Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account is in joint names, list first, and then circle, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor. Enter your individual name as shown on your income tax return on the “Name” line. You may enter your business, trade, or “doing business as (DBA)” name on the “Business name/disregarded entity name” line. Partnership, C Corporation, or S Corporation. Enter the entity's name on the “Name” line and any business, trade, or “doing business as (DBA) name” on the “Business name/disregarded entity name” line. Disregarded entity. Enter the owner's name on the “Name” line. The name of the entity entered on the “Name” line should never be a disregarded entity. The name on the “Name” line must be the name shown on the income tax return on which the income will be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a domestic owner, the domestic owner's name is required to be provided on the “Name” line. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on the “Business name/disregarded entity name” line. If the owner of the disregarded entity is a foreign person, you must complete an appropriate Form W-8. Note. Check the appropriate box for the federal tax classification of the person whose name is entered on the “Name” line (Individual/sole proprietor, Partnership, C Corporation, S Corporation, Trust/estate).
Limited Liability Company (LLC). If the person identified on the “Name” line is an LLC, check the “Limited liability company” box only and enter the appropriate code for the tax classification in the space 1. You do not furnish your TIN to the requester, provided. If you are an LLC that is treated as a partnership for federal 2. You do not certify your TIN when required (see the Part II tax purposes, enter “P” for partnership. If you are an LLC that has filed a instructions on page 3 for details), Form 8832 or a Form 2553 to be taxed as a corporation, enter “C” for C corporation or “S” for S corporation. If you are an LLC that is 3. The IRS tells the requester that you furnished an incorrect TIN, disregarded as an entity separate from its owner under Regulation 4. The IRS tells you that you are subject to backup withholding section 301.7701-3 (except for employment and excise tax), do not because you did not report all your interest and dividends on your tax check the LLC box unless the owner of the LLC (required to be return (for reportable interest and dividends only), or identified on the “Name” line) is another LLC that is not disregarded for 5. You do not certify to the requester that you are not subject to federal tax purposes. If the LLC is disregarded as an entity separate backup withholding under 4 above (for reportable interest and dividend from its owner, enter the appropriate tax classification of the owner accounts opened after 1983 only). 37 of 42identified on the “Name” line.
Payments you receive will be subject to backup withholding if:
4/23/2013
Page 3
Form W-9 (Rev. 1-2011)
Other entities. Enter your business name as shown on required federal tax documents on the “Name” line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the “Business name/ disregarded entity name” line.
Exempt Payee If you are exempt from backup withholding, enter your name as described above and check the appropriate box for your status, then check the “Exempt payee” box in the line following the “Business name/ disregarded entity name,” sign and date the form. Generally, individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Note. If you are exempt from backup withholding, you should still complete this form to avoid possible erroneous backup withholding. The following payees are exempt from backup withholding: 1. An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2), 2. The United States or any of its agencies or instrumentalities, 3. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalities, 4. A foreign government or any of its political subdivisions, agencies, or instrumentalities, or 5. An international organization or any of its agencies or instrumentalities. Other payees that may be exempt from backup withholding include: 6. A corporation, 7. A foreign central bank of issue, 8. A dealer in securities or commodities required to register in the United States, the District of Columbia, or a possession of the United States, 9. A futures commission merchant registered with the Commodity Futures Trading Commission, 10. A real estate investment trust, 11. An entity registered at all times during the tax year under the Investment Company Act of 1940, 12. A common trust fund operated by a bank under section 584(a), 13. A financial institution, 14. A middleman known in the investment community as a nominee or custodian, or 15. A trust exempt from tax under section 664 or described in section 4947. The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 15. IF the payment is for . . .
THEN the payment is exempt for . . .
Interest and dividend payments
All exempt payees except for 9
Broker transactions
Exempt payees 1 through 5 and 7 through 13. Also, C corporations.
Barter exchange transactions and patronage dividends
Exempt payees 1 through 5
Payments over $600 required to be Generally, exempt payees reported and direct sales over 1 through 7 2 1 $5,000 1 2
Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. However, the IRS prefers that you use your SSN. If you are a single-member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on page 2), enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/businesses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676). If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded domestic entity that has a foreign owner must use the appropriate Form W-8.
Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, below, and items 4 and 5 on page 4 indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on the “Name” line must sign. Exempt payees, see Exempt Payee on page 3. Signature requirements. Complete the certification as indicated in items 1 through 3, below, and items 4 and 5 on page 4. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification.
See Form 1099-MISC, Miscellaneous Income, and its instructions. However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney, and payments for services paid by a federal executive agency.
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Page 4
Form W-9 (Rev. 1-2011)
4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester For this type of account:
Give name and SSN of:
1. Individual 2. Two or more individuals (joint account)
The individual The actual owner of the account or, if combined funds, the first 1 individual on the account
3. Custodian account of a minor (Uniform Gift to Minors Act)
The minor
4. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law 5. Sole proprietorship or disregarded entity owned by an individual 6. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulation section 1.671-4(b)(2)(i)(A)) For this type of account:
The grantor-trustee
7. Disregarded entity not owned by an individual 8. A valid trust, estate, or pension trust
The owner
2
The actual owner The owner
The grantor*
Give name and EIN of:
Legal entity
4
The corporation
13. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 14. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section 1.671-4(b)(2)(i)(B))
The public entity
2 3
1
3
9. Corporation or LLC electing corporate status on Form 8832 or Form 2553 10. Association, club, religious, charitable, educational, or other tax-exempt organization 11. Partnership or multi-member LLC 12. A broker or registered nominee
1
1
The organization
The partnership The broker or nominee
Note. If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to
[email protected]. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at:
[email protected] or contact them at www.ftc.gov/idtheft or 1-877-IDTHEFT (1-877-438-4338). Visit IRS.gov to learn more about identity theft and how to reduce your risk.
The trust
List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished. Circle the minor’s name and furnish the minor’s SSN. You must show your individual name and you may also enter your business or “DBA” name on the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN.
4
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships on page 1. *Note. Grantor also must provide a Form W-9 to trustee of trust.
Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.
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United Independent School District Certification of Criminal History Record Information SB 9, passed during the 80th Legislative Session, requires that all Texas public school districts receive certification from any entity with which it contracts to provide services that it has obtained a criminal history background check on all employees hired before January 1, 2008 who (1) have continuing duties related to contracted services; and (2) have direct contact with students. The required criminal history record information can be obtained from either of the following: A law enforcement or criminal justice agency A private entity that is a consumer reporting agency governed by the Fair Credit Reporting Act (15 U.S.C. Section 1681 et seq.) Although state law provides guidance as to which employees must have a criminal background check, there is no specific definition or description as to what equals an employee who (1) has continuing duties related to contracted services; and (2) has direct contact with students.* The law states that the Commissioner of Education may adopt rules necessary to implement this requirement; however, at this time none have been adopted. Therefore, all entities and individuals who contract with the District to perform services, must complete the attached UISD Form “Certification of Criminal History Record Information, that includes an information sheet related to the services to be performed and the duties related to those services that employees will be performing and the type of contact that those employees might have with students. •
Employees who are hired by an entity that contracts with a school district after January 1, 2008 must submit to a national criminal history record information review which may include fingerprints and photographs before serving in the capacity described. The school district may not allow any employee of the entity or an individual to serve at the district if information is obtained through this review that the employee has been convicted of one of the following: (1) A Title 5 felony offense (2) An offense requiring the individual to register as a sex offender (3) An offense under the laws of another state or federal law that is equivalent to a Title 5 felony in the state of Texas or that would require registration in the Texas sex offender databank. At any time, a school district administrator, including a campus principal or designee, may request copies of the actual criminal background check or national criminal history record information review which may include fingerprints and photographs from the entity or individual who has contracted with the school district or may obtain from any law enforcement or criminal justice agency all criminal history record information that relates to an individual described above.
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UNITED INDEPENDENT SCHOOL DISTRICT CERTIFICATION OF CRIMINAL HISTORY RECORD INFORMATON
Please complete this form and attach it to your proposal packet response
Vendor: ________________________________________________________ Name
________________________________________________________ Address / City / State / Zip Code
RFP/CSP/RFCQ/BID Number: ___________________________________________________________
Answer Y for Yes or N for No:
Section 1
□
Will employees, including yourself, have continuing duties related to the proposal named above?
Until it receives further guidance, the District considers “continuing duties” to mean repetitive work duties rather than a one time appearance or engagement.
□
Will those employees, including yourself, have direct contact with students?
Until it receives further guidance, the District considers “direct contact” to mean services that may be performed independently from school district staff involvement. Direct contact can include chance contact such as performing routine inspections or maintenance; contact with groups of students during organized activities; or more obvious examples such as tutoring or therapy.
Section 3
Section 2
If either question is answered "no", vendor should complete section 2 of this form. IF answer to both questions is "yes", vendor should complete section 3 of this form.
I agree and understand employees of the company or individuals, including myself, who have not received the required criminal background check because the above description does not apply to them/myself will be considered visitors when on school campus and must follow school district and campus policies related to visitors on school campuses. _________________________ Signature of Vendor
_________________________ Date
I, _______________________________________________, certify that all employees, including myself, of the company that I own, operate, or manage, or myself as an independent contractor who have continuing duties related to the service to be performed on a United Independent School District Campus and who also have direct contact with students have undergone the required criminal history background check or national criminal history record information review which may include fingerprints and photographs and that no prohibited contact as described herein was revealed. _________________________
_________________________
Signature of Vendor
Date
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UNITED INDEPENDENT SCHOOL DISTRICT TO BE SUBMITTED WITH PROPOSAL/STATEMENT/QUOTE VENDOR ACKNOWLEDGEMENT FORM
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION -LOWER TIER COVERED TRANSACTIONS This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7CFR Part 3017, Section 3017.510, Participant’s responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. (Before completing certification, read attached instructions.) 1.
2.
The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals Is presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from participation in this transaction by any Federal Department or agency. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.
Initial: ______
APPLICABLE TO GRANTS, SUBGRANTS, COOPERATIVE AGREEMENT, AND CONTRACTS EXCEEDING $100,000 IN FEDERAL FUNDS. Certification Regarding Lobbying: Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to civil penalty of not less than $10,000 and not more than $100,000 for each such failure. When Federal Money is being used, the undersigned certifies, to the best of his/her knowledge and belief, that: 1.
2.
3.
No federal appropriated funds have been paid or will be paid 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, or an employee of a Member of Congress in connection with the awarding of a Federal contact, 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. 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 employed 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. 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 sub recipients shall certify and disclose accordingly.
Initial: ______
COMPLIANCE CERTIFICATION TO EPA REGULATIONS APPLICABLE TO GRANTS, SUBGRANTS, COOPERATIVE AGREEMENTS, AND CONTRACTS EXCEEDING $100,000 IN FEDERAL FUNDS. I, the vendor, am in compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970 as amended (42 U.S.C. 1857 (h) ), Section 508 of the Clean Water Act, as amended (33 U.S.C. 1368), executive Order 117389 and Environmental Protection Agency Regulation, 40 CFR part 15 as required under OMB Circular A-102, Attachment O, Paragraph 14 (1) regarding reporting violations to the grantor agency and to the United States Environment Protection Agency Assistant Administrator for the Enforcement. Initial: ______
ORGANIZATION NAME ADDRESS PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE SIGNATURE
DATE
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