7067 - LED LUminaires - Dealers Electrical Supply - Energy Saving Lighting - #527-17
January 25, 2017
Sent Via E‐mail: daryld@dealerselectrical.com
Daryl Donaldson Dealers Electrical Supply
2320 Columbus Avenue
Waco, TX 76701
Re: Notice of The Local Government Purchasing Cooperative Award
Proposal Name and Number: Energy Saving Lighting Products, Proposal No. 527-17
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard®
contract based on the above-referenced Proposal. The contract is effective 4/1/2017 through 3/31/2018, with two
possible one-year renewals. The contract documents are those identified in Section 3 of the General Terms and
Conditions of the specifications.
To view the items your company has been awarded, please review the proposal tabulation No. 527-17 on the following
web-site: www.buyboard.com/vendor. Only items marked as awarded to your company can be sold through the BuyBoard contract. In addition, on this website you will find the membership list which will provide you with the names of
all entities with membership in our purchasing cooperative.
Enclosed with this letter you will find the following documents:
Vendor Quick Reference Sheet
Electronic Catalog Format Instructions
Vendor Billing Procedures
You are advised that receipt of a purchase order directly from a Cooperative member is not within the
guidelines of the Cooperative. Accepting purchase orders directly from Cooperative members may result in a violation
of the State of Texas competitive bid statute and termination of this Cooperative BuyBoard contract. Therefore, all
purchase orders must be processed through the BuyBoard in order to comply. Please forward by fax (1-800-
211-5454) any order received directly from a Cooperative member. If you inadvertently process a purchase order sent
directly to you by a Cooperative member, please fax the order to the above number and note it as RECORD ONLY to prevent duplication.
Per proposal specifications, awarded vendors will have 30 days or sooner to submit their electronic catalog
including pricing. If the electronic data is not provided within 30 days or sooner of notice of award, we
reserve the right to inactivate any company’s award information from the BuyBoard until such time the
electronic data is received.
On behalf of the Texas Association of School Boards, we appreciate your interest in the Cooperative and we are looking forward to your participation in the program. If you have any questions, please contact BuyBoard Procurement Staff
at 800‐695‐2919.
Sincerely,
Arturo Salinas
BuyBoard Procurement Director v.12.15
January 25, 2017
Sent Via E-mail: daryld@dealerselectrical.com
Daryl Donaldson
Dealers Electrical Supply
2320 Columbus Avenue
Waco, TX 76701
Re: Notice of National Purchasing Cooperative Piggy-Back Award
Proposal Name and Number: Energy Saving Lighting Products, Proposal No. 527-17
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard®
contract based on the above-referenced Proposal. As provided for in the Proposal and your National Purchasing
Cooperative Vendor Award Agreement, you are authorized to sell the goods and services awarded under the Proposal to
National Cooperative members in states other than Texas through the BuyBoard. The contract is effective 4/1/2017
through 3/31/2018, with two possible one-year renewals.
The National Cooperative membership list is available at our website www.buyboard.com/vendor. The list identifies the
current members that may purchase awarded goods and services under your National Cooperative BuyBoard contract.
You are advised that receipt of a purchase order directly from a National Cooperative member is not within
BuyBoard guidelines. Accepting purchase orders directly from Cooperative members may result in a violation of
applicable competitive procurement law and termination of this National Cooperative BuyBoard contract. Therefore, all
purchase orders from National Cooperative members must be processed through the BuyBoard. Please
forward by fax (1-800-211-5454) any order received directly from a National Cooperative member. If you inadvertently process a purchase order sent directly to you by a National Cooperative member, please fax the order to the above
number and note it as RECORD ONLY to prevent duplication.
Per proposal specifications, awarded vendors will have 30 days or sooner to submit their electronic catalog
including pricing. If the electronic data is not provided within 30 days or sooner of notice of award, we
reserve the right to inactivate any company’s award information from the BuyBoard until such time the
electronic data is received.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any
questions, please contact BuyBoard Procurement Staff at 800-695-2919.
Sincerely,
BuyBoard Procurement Director
v.12.15
^BoartT
^Cooperative Purchasing I w
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •wvw.buyboard.com
Proposer's Agreement and Signature
Proposal Name;Energy Saving Lighting Products Proposal Opening Date and Time;
August 18,2016 at 2:00 PM
Proposal Number:527-17
ContractTime Period;April 1,2017 through
March 31, 2018 with two (2)possible one-year
renewals.
Location of Proposal Opening;
Texas Association of School Boards,Inc.
BuyBoard Department
12007 Research Blvd.
Austin,TX 78759
Anticipated Cooperative Board Meeting Date;
January 2017
Name of Proposing Company Date
?r<?0 .
Street Address
W KOo TLaToV
City,State,Zip
?<.4-75^--7£s\
teA -15^-0
Fax Number of Authorized Company Official
Signature of Authorized Compai^Official
Printed Name of Authorized Company Official
Telephone Number of Authorized Company Official Position or Title of Authorized Company Official
~7A ASTevto
Federal ID Number
The proposing company CVou"or "your")hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all Cooperative information and documentation associated with
this Proposal Invitation,including the Instructions,Genera!Terms and Conditions,Attachments/Forms,Item
Specifications,and Line Items (collectively "Requirements");
2. By your response C'Proposal")to this Proposal Invitation,you propose to supply the products or services
submitted at the prices quoted in your Proposal and in strict compliance with the Requirements,unless
specific deviations or exceptions are noted in the Proposal;
3. Any and all deviations and exceptions to the Requirements have been noted in your Proposal and no others
will be claimed;
lO-MFORMA-PAGE 1 COMM.V.U.18.15
^7Boanl'
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
4. If the Cooperative accepts any part of your Proposal and awards you a contract,you will furnish all awarded
products or services at the prices quoted and in strict compliance with the Requirements (unless specific
exceptions are noted in the Proposal),including without limitation the Requirements related to:
a.conducting business with Cooperative members,including offering pricing to members that is the
best you offer compared to similar customers;
b.payment of a service fee in the amount specified and as provided for in this Proposal Invitation;
c.the possible award of a piggy-back contract by another governmental entity,in which event you will
offer the awarded goods and services in accordance with the Requirements;and
d. submitting price sheets or catalogs in the proper format for posting on the BuyBoard as a
prerequisite to activation of your contract;
5. You have clearly identified any information in your Proposal that you believe to be confidential or proprietary
or that you do not consider to be public information subject to public disclosure under a Texas Public
Information Act request or similar public information law;
6. The individual signing this Agreement is duly authorized to enter into the contractual relationship
represented by this Proposal Invitation on your behalf and bind you to the Requirements,and such
individual (and any individual signing a Form) is authorized and has the requisite knowledge to provide the
information and make the representations and certifications required in the Requirements;
7. You have carefully reviewed your Proposal, and certify that all information provided is true,complete and
accurate,and you authorize the Cooperative to take such action as it deems appropriate to verify such
information;and
8. Any misstatement,falsification, or omission in your Proposal,whenever or however discovered,may
disqualify you from consideration for a contract award under this Proposal Invitation or result in termination
of an award or any other remedy or action provided for in the General Terms and Conditions or by law.
FORM A-PAGE 2 COMM.V.11.18.15
Aitanate E-mail Address:
Cat^eiBtlve Pumtmalag
12007 Research Boul»/ard •Austin,Texas 78759-2439
PH:800-695-2919•FAX;800-211-5454•www.buyboand.oom
Vendor Purchase Order,Request for Quotes,and Invoice Receipt Options
Comfany:DE/li.££S Genaal Contact Name:
purchase orders from Cooperative manberswlB be available through the Internet orbyfacsimile.
Qptton 1:Internet.Vendors need Intanet access and at least one e-mail address so that notification of new
orderscan be sent to the Intern^contact when a new purchase orda arrives.An Information guide will be
provided tovendors thatchoose this option toassist them with retrieving their orders.
Option 2: Fax.Vendors needa designated fax line available at ail times to receive purchase orders.
Please choose oniv one of the following options for receipt of purchase orders and provide the
requested Ir^miatlon:
[M I will usethe INTERNET to receive purchase orders.
E-mail Address:(jAlUdiJ Qrl6.AL£AS
Internet Contact:Phone;
Alternate Internet Contact:Phone:
• I will receive purchase ordersvia FAX.
Fax Number:—
FaxContact:Phone:
Request fq^r'RFO'^;Cooperative members will send RFQs toyou by e-mail.Please provide e-mail addresses
for the receipt of RFQs:
E-mail Address:,
Alternate E-mail Address:
Invoice:Your company will be billed monthly forthe service fee due under a contract awarded under this Proposal
Invitation.All Invoice are available on the BuyBoard websiteand e-mail notifications will be sent when
they are ready toberetrieved.Please provide the fbllowlng address,contact and e-mail Information for receipt of
service fee invoice and related communications:
Mailing address:P.O.^ox Department
City:U)A:CO State:Zip Code;^
Contact Name:Phone:^^
Fax:E-mail Address:
Ae-M £U<LrfZ/CAL.dtm
Alternative E-mail Address:
COMM.V.11.18.15
^Board'
^Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Felony Conviction Disclosure and Debarment Certification
Felony Conviction Disclosure
Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of
Contractor)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 has been convicted of a felony. The
notice must include a general description of the conduct resulting in the conviction of a felony."
Section 44.034 further states in Subsection (b): "Aschool 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."
Please check (^/')one of the following:
•My company isa publicly-held corporation.(Advance notice requirement does not apply to publicly-held corporation.)
[x]My company is notownedoroperated byanyonewhohas been convicted ofa felony.
•My company is owned/operated bythe following individual(s)whohas/have been convicted o a
felony:
Name of Felon(s):
Details of Conviction(s):
Bysignature below, I certify that the above information is true,complete and accurate and that I am
authorized by my company to make this certification.
Dealers Electrical SuppIv Co.
Company Name
Chris M.Lanham
Signatufe-efAuthoriz^Company Official Printed Name
*Dealers is an employee-owned company.To the best of my knowledge,no officer or director
of Dealers has ever been convicted of a feiony.
Debarment Certification
Neither my company nor an owner or principal of my company has been debarred,suspended or
otherwise made ineligible for participation in Federal Assistance programs under Executive Order 12549,
"Debarment and Suspension,"as described in the Federal Register and Rules and Regulations.
By signature below, I certify that the above is true,complete and accurate and that I am authorized by
my company to make this certification.
Dealers Electrical SuddIv Co.
Company Name
Chris N.Lanham
SignatCufi^f AuthorL^d Company Official Printed Name
FORM C COMM.V.ll.18.15
^BoartT
^Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Resident/Nonresident Certification
Chapter 2252,Subchapter A, of the Texas Government Code establishes certain requirements applicable
to proposers who are not Texas residents. Under the statute,a "resident"proposer is a person whose
principal place of business is in Texas, including a person whose ultimate parent company or majority
owner has its principal place of business in Texas. A "nonresident"proposer is a person who is not a
Texas resident. Please indicate the status of your company as a "resident"proposer or a "nonresident"
proposer under these definitions. Please check N'\one of the followino.
[X]I certify that mycompany isa Resident Proposer.
• I certify that mycompany isa Nonresident Proposer.
If your company is a Nonresident Proposer,you must provide the following information for your resident
state (the state in which your company's principal place of business is located):
Company Name Address
City State Zip Code
A.Does your resident state require a proposer whose principal place of business is in Texas to
under-price proposers whose resident state is the same as yours by a prescribed amount or
percentage to receive a comparable contract?
• Yes •No
B.What is the prescribed amount or percentage?$.or %
Vendor Employment Certification
Section 44.031(b)of the Texas Education Code establishes certain criteria that a school district must
consider when determining to whom to award a contract.Among the criteria for certain contracts is
whether the vendor or the vendor's ultimate parent or majority owner (i) has its principal place of
business in Texas;or (ii)employs at least 500 people in Texas.
If neither your company nor the ultimate parent company or majority owner has its principal place of
business in Texas,does your company,ultimate parent company,or majority owner employ at least 500
people in Texas?Please check one of the followino.
• Yes •No
By signature below, I certify that the information in Sections 1 {Resident/Nonresident Certification) and 2
(Vendor Employment Certification)dboMQ is true,complete and accurate and that I am authorized by my
company to make this certification.
Dealers Electrical Supply Co.
Company Name
Chris N.Lanham
Signatu uthorizea Company Official Printed Name
FORM D COMM.V.11.18.15
O KJ Ci
WBoard
CooperativePurchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Historically Underutilized Business Certification
A proposer that has been certified as a Historically Underutilized Business (also known as a
Minority/Women Business Enterprise or ''MWBE"and all referred to in this form as a "HUB")is
encouraged to indicate its HUB certification status when responding to this Proposal Invitation. The
electronic catalogs will indicate HUB certifications for vendors that properly indicate and document their
HUB certification on this form.
Please check fV)all that aoolv
n I certify that mycompany has been certified as a HUB inthe following categories:
G Minority Owned Business
•Women Owned Business
•Service-Disabled Veteran Owned Business (veteran defined by 38 U.S.C.
§101(2),who has a service-connected disability as defined by U.S.C. §
101(16),and who has a disability rating of 20%or more as determined by the
U. S.Department of Veterans Affairs or Department of Defense)
Certification Number:
Name of Certifying Agency:
Ixl My company has NOT been certified as a HUB.
By signature below, I certify that the above is true,complete and accurate and that I am authorized by
my company to make this certification.
Dealers Electrical Suppiv Co.
Signature ofAuth^ized Company Official
Chris N,Lanham
Printed Name
FORM E C0MM.V.11.18.1S
dhr/r —i)u c.WBoard
Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 *FAX:800-211-5454 •www.buyboard.com
Affirmation Regarding Construction-Related Goods and Services
A contract awarded under this Proposal Invitation covers only the specific goods and services awarded by
the BuyBoard. As expiained in the BuyBoard Construction Related Goods and Services Advisory for Texas
Members ("Advisory"),Texas law prohibits the procurement of architecture or engineering
services through a purchasing cooperative.This BuyBoard contract does not include such
services.Architecture or engineering services must be procured by a Cooperative member
separately,in accordance with the Professional Services Procurement Act (Chapter 2254 of
the Texas Government Code)and other applicable law and local policy.
The Advisory,attached to this Form F,provides an overview of certain legal requirements that are
potentially relevant to a Cooperative member's procurement of construction or construction-related goods
and services,including those for projects that may involve or require architecture,engineering or
independent testing services.
By signature below,the undersigned affirms that Proposer has read and understands the Advisory
attached to this Form F and is authorized by Proposer to make this affirmation.If Proposer sells
construction-related goods or services to a Cooperative member under a BuyBoard contract awarded
under this Proposal Invitation, Proposer will comply with the Advisoryand applicable legal requirements,
make a good faith effort to make its Cooperative member customers or potential Cooperative member
customers aware of such requirements,and provide a Cooperative member with a copy of the Advisory
before executing a Member Construction Contract with the member or accepting the member's purchase
order for construction-related goods or services,whichever comes first.
Company Name
Signatur^of AutKorized Company Official Printed Name
Date
FORM F-PAGE 1 COMM.V.ll.18.15
^MBoartl'
^Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 'FAX:800-211-5454 •www.buyboard.com
BUYBOARD PROCUREMENT AND CONSTRUCTION-RELATED GOODS AND SERVICES
ADVISORY FOR TEXAS MEMBERS
Why make purchases using BuyBoard?Purchasing through a cooperative or ''interioca!contract"
satisfies the requirement of local governments to seek competitive procurement for the purchase of
goods or services.'Therefore,you may purchase goods and services from a vendor through BuyBoard
without having to conduct your own competitive procurement.If,however,you are procuring
construction-related services through a BuyBoard Job Order Contract (JOG)or contract for the installation
of equipment or materials (e.g.,athletic fields and surfaces,kitchen equipment,HVAC,playground
equipment,or modular buildings), you may, as explained in this Advisory,need to procure certain aspects
of these services using a separate procurement process outside of the BuyBoardand should consult your
procurement officer and/or legal advisor for specific advice.
What is BuyBoard's Procurement Process?The BuyBoard uses a competitive procurement process
to award contracts to vendors for goods and services that the BuyBoard determines,based on an
evaluation of multiple criteria,represents the best value for its members.
How does BuyBoard award a contract to a vendor?As a condition of being awarded a BuyBoard
contract,a vendor is bound by and must agree to comply with all the terms of the BuyBoard's proposal
Invitation (or specifications),the vendor's proposal response,and any additional contract terms
negotiated with the BuyBoard member.Among other things,the vendor must honor the pricing
submitted in the vendor's proposal.THE PRICE YOU PAY FORTHE GOODS AND SERVICES COVERED BY
THE BUYBOARD CONTRACT MAY BE LESS THAN THE AWARDED PRICING, BUT CANNOT BE MORE.
Additionally,the vendor must comply with the BuyBoard contract's general terms and conditions, and any
additional terms and conditions that apply to the specific BuyBoard contract,as set out in the proposal
invitation.
How does a BuyBoard member make purchases through the BuyBoard contract?You utilize
the awarded BuyBoard contract by Issuing a signed purchase order through the BuyBoard online
application to procure the selected goods or services.Although BuyBoard must receive a copy of the
signed purchase order,BuyBoard does not review or approve the purchase order or other supplemental
agreement that you obtain - this is a matter between you and the vendor.If construction-related
services are procured through the BuyBoard,additional contracts with professionals and the contractor
may be required,depending on the nature and scope of the services.As stated above,you should
consult your procurement officer and/or legal advisor for specific advice.
How do I know that my entity has made a purchase through the BuyBoard?
BuyBoard must have a copy of the purchase order in order for the purchase to be considered a BuyBoard
procurement.To ensure that your entity has satisfied state law requirements for competitive
procurement,make sure that the BuyBoard has your purchase order.Do not rely on the vendor to
submit the purchase order on your behalf; it Is your responsibility to make sure that the BuyBoard has
the signed purchase order.You may log in to www.buvboard.com using your member I.D.and password
to view the Purchase Order Status Report to confirm that the purchase order is in the BuyBoardsystem.
What should BuyBoard members consider when using BuyBoard for construction-related
purchases?While purchasing goods and services through BuyBoard satisfies your legal requirement to
competitively procure a good or service, as a general matter you must keep in mind other legal
requirements that may relate to the purchase,especially when using BuyBoard for construction-related
procurement.
F0RMF-PAGE2 COMM.V.11.18.15
^MBoard'
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
When making construction-related purchases through a BuyBoard contract,BuyBoard members must
consider the following:
>Best value determination.In compliance with Texas law and any local policy,your entity
must first determine that purchasing through an Interlocal contract or purchasing cooperative Is
the procurement method that will provide best value." This Isdone by the governing body (e.g.,
board of trustees,council,commissioners'court,etc.)or may be delegated by the governing
body to an individual or committee,with written notice.
>Products or services not covered by the BuyBoard contract.The BuyBoard contract
covers only the specific goods and services awarded by the BuyBoard. If you want to purchase
from a BuyBoard vendor goods or services from a BuyBoard vendor that are not covered by the
vendor's BuyBoard contract,such as architectural,design,or engineering services,you must
procure them separately In accordance with state law and local policy.
>Architectural or Engineering and Independent Testing services.If your procurement
Includes a construction component that requires architectural or engineering services,you must
procure those services separately.YOU MAY NOT PROCURE ARCHITECTURAL OR ENGINEERING
SERVICES THROUGH A BUYBOARD CONTRACT.Texas law requires architectural and engineering
services to be obtained in accordance with the Professional Services Procurement Act (Chapter
2254 of the Texas Government Code)and prohibits them from being procured through a
purchasing cooperative."'
o Architecture.A new building owned by a political subdivision having construction costs
exceeding $100,000 or an alteration or addition to an existing building having construction
costs exceeding $50,000 must have architectural plans and specifications prepared by an
architect.'"(An "alteration"or "addition"for purposes of this requirement requires the
removal,relocation,or addition of a wall or partition or the alteration or addition of an exit.)
o Engineering.If the goods or services procured through the BuyBoard will Involve
engineering In which the public health,welfare,or safety Is involved,the plans for structural,
mechanical,electrical,electronic,fire suppression,geotechnical systems,foundation design,
surface water drainage,plumbing and certain roof modifications and associated estimates
must be prepared by an engineer,and the engineering construction must be performed
under the direct supervision of an engineer." The Engineering Practice Act provides two
exceptions to this rule - no engineer Is required If (1)the project Involves mechanical or
electrical engineering and will cost $8,000 or less, or (2)the project does not require
mechanical or electrical engineering and will cost $20,000 or less."'
o Independent Testing.If acceptance of a facility by a public entity Involves
Independent testing of construction materials engineering and/or verification testing services,
the testing services should be procured under the Professional Services Procurement Act, and
may not be procured under a BuyBoard contract.
o Written Certification.Effective 09/01/2013,a local governmental entity purchasing
construction-related goods and services through a cooperative In an amount that exceeds
$50,000 must designate a person to certify In writing that the project does not require the
preparation of plans or specifications by an architect or engineer OR that an architect or
engineer has prepared the plans or specifications.""
F0RMF-PA6E3 COMM.V.11.18.15
^7Boartl'
^Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 'FAX:800-211-5454 •www.buyboard.com
>Bonds.You must also consider whether the vendor Is required to provide a payment or
performance bond.A payment bond Is required for contracts that exceed $25,000 to protect
subcontractors who supply labor or materials for the project.A performance bond Is required for
a contract that exceeds $100,000,to protect the local government If a contractor falls to
complete the project.Without payment and performance bonds.If the contractor falls to pay
Its subcontractors or to complete the project,the public entity that entered the contract can be
held responsible for payment claims or costs to complete.
>Construction Contract.Even though the procurement of construction or construction-related
services may be through the BuyBoard, your construction contract Is between your entity and the
contractor.The BuyBoard contract's general terms and conditions,standing alone,are not
sufficient to document your entity's specific transaction.THEREFORE,YOU SHOULD USE AN
APPROPRIATE FORM OF CONSTRUCTION CONTRACT JUST AS YOU WOULD DO IF YOU
PROCURED CONSTRUCTION SERVICES INDEPENDENTLY,USING COMPETITIVE SEALED
PROPOSALS.The contract must contain provisions required by state law Including:performance
and payment bonds,requirements for payment of prevailing wages to all construction workers,
workers'compensation coverage for all workers and, on projects where contractor employees
may have direct contact with students,criminal history record checks.Other provisions which
should be considered In the construction contract are retalnage,contingency,liquidated damages
and dispute resolution, among others.By supplementing the BuyBoard contract with an
appropriate form of construction contract,you ensure that your entity's unique Interests are
addressed and that your entity can enforce the contract directly.
>Legal advice.Because of the variety of laws that relate to construction-related purchasing and
the potential risk of high exposure,you are well-advised to consult with your entity's legal
counsel before procuring construction-related goods and services under any procurement
method.Including a purchasing cooperative.
This Advisory is provided for educational purposes only to facilitate a general understanding
of the law.This Advisory is neither an exhaustive treatment on the subject nor is it intended
to substitute for the advice of an attorney.
For more Information about BuyBoard,contact us at 800-695-2919.
i. Tex.607*1 Code §791.025 and Tex. LocalGov't Code §271.102.
11.Tex. Ed.Code §44.031(a)(school districts); Tex.Local Gov't Code §252.043(a)(municipallties) and §262.022(5-a)and
§262.027(counties)
ill. Tex. Gov't Code §2254.004 and §791.011(h)
iv. Tex. Occ.Code §1051.703
v. Tex. Occ. Code §1001.0031(c)
vi. Tex. Occ. Code §1001.053
vii. Tex. Gov't Code §791.011(j),effective September 1, 2013
viii. Tex. Gov't Code §2253.021(a)
IssuedMarch 31,2014
F0RMF-PAGE4 COMM.V.ll.18.15
fslMi
O u c.WBoard
Cooperative Purchasing
12007 Research Boulevard 'Austin,Texas 78759-2439
PH:800-695-2919 *FAX:800-211-5454 *www.buyboard.com
Deviation and Compliance Signature Form
If your company intends to deviate from the General Terms and Conditions,Item Specifications or other
requirements associated with this Proposal Invitation,you must list all such deviations on this form,and
provide complete and detailed information regarding the deviations on this form,an attachment to this
form, or elsewhere in your Proposal.(If you do not provide the information on or as an attachment to
this form,the information must be clearly identified in your Proposal.)The Cooperative will consider any
deviations in its contract award decision,and reserves the right to accept or reject a proposal based upon
any submitted deviation.
In the absence of any deviation identified and described in accordance with the above,your company
must fully comply with the General Terms and Conditions,Item Specifications and all other requirements
associated with this Proposal Invitation if awarded a contract under this Proposal Invitation.
[~|Ho',Deviations
^Yes;Deviations
List and fully explain any deviations you are submitting:
PLEASE PROVIDE THE FOLLOWING INFORMATION;
i:izfcommon Carrier Q^nipany Truck 0^repaid and Add to Invoice Bother:1. Shipping Via:1%^Common Carrier Company Truck Prepaid and Add to Invoice
2.Payment Terms:0^t 30 days •1%in 10/Net 30 days •Other:
3.Number ofDays for Delivery:\0 ARO
4. Vendor Reference/Quote Number:.
5.State yopr return policy:.
^o<i.vc ae Plaefi»^o
tvve<^ifte££..\\ews.aeg.
6.Are electronic payments acceptable?QVes •No
7.Are credit card payments acceptable?B^s •No
Compan^'-*'^^*^—s.
Signature of Autfrorized Confpany Official Printed Name
FORM G COMM.V.ll.lS.lS
Stacy Finn
From:Daryl Donaldson <daryld@dealerselectrical.com>
Sent:Thursday,November 17,2016 11:10 AM
To:Arturo Salinas
Cc:Ava Benford-Clay;Stacy Finn
Subject:Re: Fwd:Deviations to BuyBoard Proposal No.527-17
Attachments:daryld.vcf
Follow Up Flag:Flag for follow up
Flag Status:Flagged
Mr.Salinas,
Referencing the notification regarding the multiple deviations listed separately under the pages listed
BuyBoard Proposal-Deviations to the Proposal and General Terms and Conditions that were included in
the Proposal No.527-17,dated Aug 2016:
Upon further review,dealers electrical supply co. wishes to remove all the deviations originally noted with our
submitted proposal,
in their entirety.Should we need to confirm this in writing hard copy, please advise and will send
any appropriate document required to confirm the removal.
With regards to future TASB-Buyboard proposals,any questions or concerns,
I will be the main point ofcontact:
Daryl Donaldson
2320 Columbus Avenue
Waco,Texas 76701
Vice President Sales and Marketing
darvld@dealerselectrical.com
254-756-7251 Ext.260
We greatly appreciate this opportunity to service TASB.
Thank you.
Forwarded Message
Subject:Deviations to BuyBoard Proposal No.527-17
Date:Wed,16Nov2016 16:26:33 +0000
From:Arturo Salinas <Arturo.Salinas@tasb.org>
To:pgriff@,dealerselectrical.com <pgriff@,dealerselectrical.com>
CC: Ava Benford-Clay <Ava.Benford-Clav@tasb.org>. Stacy Finn <Stacv.Finn@tasb.org>
Good Morning Mr. Griffith,
*Dealers Electrical Supply's*response to _BuyBoard Proposal No.527-17 for Energy Saving
Lighting Products_included multiple deviation(s)to the terms and conditions ofthe
proposal.Unfortunately,these deviation(s)are not acceptable or beneficial to the
Cooperative.
As noted on *Form G-Deviation and Compliance Signature Form*ofthis proposal,the
Cooperative reserves the right to accept or reject a proposal based upon any submitted deviation.
Therefore,unless your company considers the removal ofthese deviations the Cooperative may
recommend to not award your company the proposal.
Please respond no later than *_Wednesday,November 30, 2016,_* and feel free to contact me at
the BuyBoard should you need any further information regarding this matter.
**
*A**RTURO **S**ALINAS*
*Director ofCooperative Procurement*/
/Texas Association ofSchool Boards
P.O.Box 400 •Austin,Texas 78767-0400
12007 Research Blvd.•Austin,Texas 78759-2439
Phone:512.483.7101 •800.580.8272
Fax:800-211-5454
_arturo.salinas@tasb.org <mailto:arturo.salinas@tasb.org>
cid:image002.ipg@01D0E184.83870120
No virus found in this message.
Checked by AVG -www.avg.com
Version:2016.0.7859 /Virus Database:4664/13421 -Release Date:11/16/16
Arturo Salinas
From:Arturo Salinas
Sent:Wednesday,November 16,2016 10:27 AM
To:'pgriff@dealerselectrical.com'
Cc:Ava Benford-Clay; Stacy Finn
Subject:Deviations to BuyBoard Proposal No.527-17
Attachments:Dealer's Electrical Supply.pdf
Good Morning Mr.Griffith,
Dealers Electrical Supply's response to BuyBoard Proposal No.527-17 for Energy Saving Lighting Products
included multiple deviation(s)to the terms and conditions of the proposal.Unfortunately,these deviation(s)
are not acceptable or beneficial to the Cooperative.
As noted on Form G-Deviation and Compliance Signature Form of this proposal,the Cooperative
reserves the right to accept or reject a proposal based upon any submitted deviation.Therefore,unless your
company considers the removal of these deviations the Cooperative may recommend to not award your
company the proposal.
Please respond no later than Wednesday,November 30,2016,and feel free to contact me at the
BuyBoard should you need any further information regarding this matter.
ARTURO SALINAS
DIRECTOR OF COOPERATIVE PROCUREMENT
Texas Association of School Boards
P.O.Box 400 •Austin,Texas 78767-0400
12007 Research Blvd. •Austin,Texas 78759-2439
Phone:512.483.7101 •800.580.8272
Fax:800-211-5454
arturo.salinas@tasb.orQ
^Board'
O V/CcopvtUn
^7Board'
^Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 "FAX:800-211-5454 *www.buyboard.com
Dealership Listings
If you have more than one location that will service a contract awarded under this Proposal Invitation,
please list each location below.If additional sheets are required,please duplicate this form as necessary.
Company Name
Address
City State Zip
Phone Number Fax Number
Contact Person
Company Name
Address
City State Zip
Phone Number Fax Number
Contact Person
FORM H COMM.V.ll.18.15
*dealers
electrical
supply
j ""ALBUQIJERQUE^^W^^^g
RO. Box 92947 87199-2947
4220-A2ncJSl.NW 87107-2245
(5051880-1344 FAX (505)880-0090
RO.Box 2787
1010 W.SlhAve.
(806)376-5567
RO.Box 14624
6714 N.Lamor
(512)459-5423
RO.Box 150293
4700 Sunset Trail
(512)892-5910
RO.Box 42
213 Gunther Lone
(504)684-8747
RO.Box 1326
214 N.Cedar St.
(806)274-4420
RO.Box 1088
2000 E.Tom Green St
(979)251-9600
RO.Box 3009
419 Dellwood St.
(979)775-6500
RO.Box 4489
101 Koenig St.
(979)775-1697
RO.Box 811
1120 E.Henderson
(817)641-3621
RO.Box 4747
1833 N.Padre Island Dr.
(361)299-2222
RO.Box 623
400 N.Main
(903)872-1211
RO.Box 540695
2580 Mahona
(214)358-5222
79105-2787
79101-1110
FAX (806)376-9473
78761-4624
78752-3504
FAX (512)459-0635
78715-0293
78745-1313
FAX (512)892-1481
70037-0042
70037-3157
FAX (504)684-8748
79008-1326
79007-4026
FAX (806)274-4422
77834-1088
77833-5127
FAX (979)251-9680
77805-3009
77801-2544
FAX (979)779-0236
77805-4489
77801-2128
FAX (979)775-4158
76033-0811
76031-5233
FAX (817)556-0232
78469-4747
78408-2331
FAX (361)299-5555
75151-0623
75110-4628
FAX(903)872-9753
75354-0695
75220-1206
FAX (214)358-1087
RO,Box2066 76202-2066
716 E. Hickory 76205-4302
(940)566-3515 FAX (940)566-5645
RO.Box 381059 75138-1059
1107 S.Cedar Ridge Dr.75137-3070
(972)709-0025 FAX (972)709-4654
RO.Box 26279
1050 Kostrin St.
(915)775-9700
79926-6279
79907-1705
FAX (915)772-4711
Corporate Office -Credit -Purchasing
P.O.Box 2676 76702-2676
2320 Columbus Ave.76701-1041
(254) 756-7251 FAX(254)756-0133
Visit and Place your Orders on our Website at:
www.dealerselectrical.com
RO.Box 1487
100Madison Ooks Ave.
(512)763-8000
RO.Box 530131
2000 S.Great Southwest Pkwy
(972)206-0725
RO.Box 1458
2629 Traders Rd.
(903)454-3073
RO.Box 1750
402 North T. St.
(956)425-8690
RO.Box 16160
4433 Airline Dr.
(713)691-6521
RO.Box 12669
5220 Old Galveston Rd
(713)944-3098
RO.Box 153586
3831 Conflans Rd
(972)790-7000
RO.Box 290627
428 Schrelner St.
(830)896-0555
78627-1487
78626-7835
FAX(512)763-8600
75053-0131
75051-3507
FAX(972)206-0717
75403-1458
75401
FAX(903)454-3743
78551-1750
78550-8011
FAX(956)425-8798
77222-6160
77022-2927
FAX (713)694-4535
77217-2669
77017-6146
FAX (713)944-4387
75015-3586
75061-3914
FAX(972)986-2107
78029-0627
78028-4470
FAX (830)896-7137
RO.Box 788 76540-0788
405 Commerce Dr.76543-4037
(254)628-9002 FAX (254)628-0468
:ft|ASiCRUCESi^NM'*m
RO.Box 1120 88004-1120
1844-A West Amador Ave.88005-4009
(575)526-4010 FAX (575)526-4149
RO.Box 1072
349 W.Cotton
(903)758-3317
RO.Box 1783
401 Atkinson Dr.
(936)634-5591
RO.Box 425
2709 Commerce St.
(830)693-9191
RO.Box 687
506 W.Houston
(903)935-7865
RO.Box 1549
1400 N.Main St.
(918)683-5000
75606-1072
75606-6223
FAX (903)236-3154
75901-1783
75901-3155
FAX (936)639-3867
78654-0425
78654-3924
FAX (830)798-1000
75670-0687
75670-3933
FAX(903)935-9873
74402-1549
74401-4445
FAX (918)683-3035
RO.Box 272368
8500W.RenoAve.
(405)782-0400
RO.Box 1489
2230W.Reogon St.
(903)729-3205
RO.Box 6310
3430 Pine Mill Rd.
(903)784-0011
P.O. Box 940169
911 J.Place
(972)422-2720
73137-2368
73127-2952
FAX (405)782-0404
STINEI
75802-1489
75801-2247
FAX (903)723-3691
75461-6310
75460-4939
FAX (903)784-6619
75094-0169
75074-8536
FAX (972)422-0472
IVERTON;;W¥|
RO.Box 506 82501
928 N.Federal Blvd.82501
(307)856-1741 FAX (307)856-9185
AM^ANfONfO;
RO.Box 17000
2400 FreedomSt.
(210)828-9995
RO.Box 680967
8786 Timber Path
(210)520-3397
RO.Box845
616 Texas Ave.
(512)396-5454
RO.Box23178
2815 Industriol Rd.
(505)471-2131
RO.Box 1205
1616 Baker Rd.
(903)893-1177
NTOISI
RO.Box 1100
12730Sugar Ridge Blvd.
(281)933-0797
RO.Box 494
555South Hillcrest Dr.
(903)438-2222
RO.Box 923
4013 Bell Dr.
(254)773-5271
RO.Drawer 38
1804Woterall
(903)794-3596
78217-7000
78217-4423
FAX (210)828-0701
78268-0967
78250-4314
FAX (210)520-3950
78667-0845
78666-5200
FAX (512)396-5457
87502-3178
87507-3119
FAX (505)471-2192
75091-1205
75090-2143
FAX (903)893-7536
77477-1100
77477-3118
FAX (281)933-9529
75483-0494
75482-3601
FAX (903)438-4845
76503-0923
76502-4841
FAX (254)770-0380
75504-0038
75501-3639
FAX (903)792-4820
^UJtSASOKai
RO.Box 580190
6920 E.13th St.
(918)835-7672
74158-0190
74112-5616
FAX (918)835-0583
RO.Box 1110
316 S.Palace Ave.
(903)593-7357
75710-1110
75702-7049
FAX (903)593-9701
RO. Box 1130 76703-1130
1418 Franklin Ave.76701-1793
(254)756-3716 FAX (254)756-0316
^Board'
^Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Texas Regional Service Designation
Unless you designate otherwise on this form,you agree to service members of
The Local Government Purchasing Cooperative statewide!
n
The Cooperative (referred to as "Texas Cooperative"in this form and in the State Service Designation form) offers
vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service
all Texas Cooperative members statewide,you must indicate the specific regions you will service on this form.
Additionally,if you do not plan to service Texas Cooperative members (i.e.,ifyou willservice only states other
than Texas), you must so indicate on this form.
Regional Education Service Centers I will service Texas
Cooperative members
statewide.
I will not service Texas
Cooperative members
statewide.I will only
service members in the
regions checked below:
Region Headouarters
1 Edinburg
2 Corpus Christi
3 Victoria
4 Houston
5 Beaumont
6 Huntsvllle
7 Kilgore
8 Mount Pleasant
9 Wichita Falls
10 Richardson
11 Fort Worth
12 Waco
13 Austin
14 Abilene
15 San Angelo
16 Amarillo
17 Lubbock
18 Midland
19 El Paso
20 San Antonio
Company N^F^e ^
•
n
•
n
•
•
n
n
n
•
n
n
•
n
n
n
•
n
n
n
Sigpafepe^Autho^fzed Com[^y Official
Printed Name
FORM I
n I will not service members
of the Texas Cooperative.
COMM.V.ll.18.15
<s>^7Board
^Cooperative Purchasing
12007 Research Boulevard *Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
State Service Designation
The Cooperative offers vendors the opportunity to service other governmental entities in the United States,
including intergovernmental purchasing cooperatives such as the National Purchasing Cooperative BuyBoard. You
must complete this form if you plan to service the entire United States,or will service only the specific states
indicated.{Note:If you plan to service Texas Cooperative members,be sure that you complete the Texas
RegionalService Designation form.)
•I^ll service all states in the United States.
I will not service all states in the United States.I will service only the states checked below:
•Alabama
•Alaska
D Arizona
• Arkansas
•California (Public Contract Code 20118 &20652)
0"^Colorado
•Connecticut
• Delaware
• Districtof Columbia
•Florida
•Georgia
•Hawaii
D^daho
0"^Illinois
• Indiana
• Iowa
• Kansas
•C^ntucky
0^Louisiana
• Maine
•Maryland
• Massachusetts
•Michigan
• Minnesota
•Mississippi
•Missouri
• Montana
• Nebraska
• Nevada
•New Hampshire
•^w Jersey
0New Mexico
• New York
•Werth Carolina
0^orth Dakota
•Oh'o
0oklahoma
•Oregon
•Pennsylvania
• Rhode Island
• South Carolina
Q South Dakota
•j^nessee
0iexas
• Utah
•Vermont
Q Virginia
•Washington
Q West Virginia
•Wisconsin
B^yoming
This form will be used to ensure that you can service other governmental entities throughout the United States as
indicated. Your signature below confirms that you understand your service commitments during the term of a
contract awarded under this proposal.
Company Name
Printed NameSignatunmpanyOlficial
FORM J COMM.V.11.18.15
O O (?i
WBoard
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 'FAX:800-211-5454 •www.buyboard.com
National Purchasing CooperativeVendor Award Agreement
In accordance with the Terms and Conditions associated with this Proposal Invitation,a contract awarded
under this Proposal Invitation may be "piggy-backed"by another governmental entity. The National
Purchasing Cooperative is an intergovernmental purchasing cooperative formed by certain school districts
outside of Texas to serve its members throughout the United States.If you agree to be considered for a
piggy-back award by the National Purchasing Cooperative,you agree to the following terms and agree to
serve National Purchasing Cooperative members in the states you have indicated on the State Service
Designation form,in your Proposal.
By signing this form,Proposer (referred to in this Agreement as "Vendor")agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative CTexas Cooperative")
awards Vendor a contract under this Proposal Invitation C'Underlying Award"),the National Purchasing
Cooperative C'National Cooperative") may - but is not required to - "piggy-back" on or re-award all or a
portion of that Underlying Award C'Piggy-Back Award"). By signing this National Cooperative Vendor
Award Agreement C'Agreement"),Vendor accepts and agrees to be bound by any such Piggy-Back Award
as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy-Back Award,the National Cooperative
Administrator O'BuyBoard Administrator")wiii notify Vendor in writing of such Piggy-Back Award, which
award shall commence on the effective date stated in the Notice and end on the expiration date of the
Underlying Award,subject to annual renewals as authorized in writing by the BuyBoard Administrator.
Vendor agrees that no further signature or other action is required of Vendor in order for the Piggy-Back
Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or
changes to this Agreement by Vendor will be binding on National Cooperative,unless such changes are
agreed to by its BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same
unit pricing and same general terms and conditions,subject to applicable state laws in the state of
purchase,as required by the Underlying Award. However, nothing in this Agreement prevents Vendor
from offering National Cooperative members better (i.e., lower)competitive pricing and more favorable
terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State
Service Designation Form of this Proposal Invitation. Any changes to the states designated on the State
Service Designation Form must be approved in writing by the BuyBoard Administrator.
5. Vendor agrees to pay National Cooperative the service fee provided for in the UnderlyingAward based
on the amount of purchases generated from National Cooperative members through the Piggy-Back
Award. Vendor shall remit payment to National Cooperative on such schedule as it specifies (which shall
not be more often than monthly). Further, upon request.Vendorshall provide National Cooperative with
copies of all purchase orders generated from National Cooperative members for purposes of reviewing
and verifying purchase activity.Vendor further agrees that National Cooperative shall have the right,
upon reasonable written notice, to review Vendor's records pertaining to purchases made by National
Cooperative members in order to verify the accuracy of service fees.
FORM K-PAGE 1 COMM.V.11.18.15
^Board'
^Cooperative Purchasing
12007 Research Boulevard *Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
6.Vendor agrees that the Underlying Award,including its General Terms and Conditions,are adopted by
reference to the fullest extent such provisions can reasonably apply to the post-proposal/contract award
phase.The rights and responsibilities that would ordinarily inure to the Texas Cooperative pursuant to
the Underlying Award shall inure to National Cooperative;and,conversely,the rights and responsibilities
that would ordinarily inure to Vendor in the Underlying Award shall inure to Vendor in this Agreement.
Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this
Agreement,and that nothing in this Agreement has application to other third parties,including the Texas
Cooperative.In the event of conflict between this Agreement and the terms of the Underlying Award,
the terms of this Agreement shall control,and then only to the extent necessary to reconcile the conflict.
7. This Agreement shall be governed and construed in accordance with the laws of the State of Rhode
•Islond and venue for any dispute shall lie in the federal district court of Aicxondna,Virginio.
8. Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole discretion of
National Cooperative,and that this Agreement does not take effect unless and until National Cooperative
awards Vendor a Piggy-Back Award and the BuyBoard Administrator notifies Vendor in writing of such
Piggy-Back Award as provided for herein.
WHEREFORE,by Signing below Vendor agrees to the foregoing and warrants that it has the authority to
enter into this Agreement.
Name of Vendor Proposal Invitation Number
SignaturerjfAuthorized Comfany Official Printed Name of Authorized Company Official
Date
FORM K-PAGE 2 COMM.V.11.18.15
^Board'
^Cooperative Purchasing
12007 Research Boulevard 'Austin,Texas 78759-2439
PH;800-695-2919 •FAX:800-211-5454 •www.buyboard.com
FederalAND State/Purchasing Cooperative DiscountComparison Form
Ttie Cooperative strives to provide its members with the best services and products at the best prices available. The
Cooperative determines whether prices/discounts are fair and reasonable by comparing prices/discounts stated in
your Proposal with prices/discounts you offer federal and state entities and other intetiocal purchasing cooperatives
(collectively referred to as "purchasing cooperative"in this form).Please respond to the following questions.
1.
2.
3.
Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or
market price during the previous 12-month period or the last fiscal year:$— . — (The
period of the 12 month period is -—/—). In the event that a dollar value is not an appropriate
measure of the sales,provide and describe your own measure of the sales of the item(s).
Based on your written discounting policies are the discounts you offer the Cooperative equal to or better than
the best price you offer other purchasing cooperatives acquiring the same items regardless of quantity or terms
and conditions?
yesD no
Based on your written discounting policies,provide the information requested below for other purchasing
cooperatives, either in the chart belowor in an equivalent format.Rows should be added to accommodate as
many purchasing cooperatives as required.
PURCHASING GROUP DISCOUNT (°/o)QUANTITY/VOLUME FOB TERM
1.Federal General Services Adm.
2.T-PASS
3. U.S.Communities Purchasing Alliance
4. The Cooperative Purchasing Network
5.Houston-Galveston Area Council
6.Other
•MY COMPANY DOES NOTCURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYBOARD VENDORS
If you are a current BuyBoard vendor,indicate the discount for your current BuyBoard contract and the proposed
discount in this Proposal.Explain any difference between your current and proposed discounts.
Current Discount (%):Proposed Discount (%):O
Explanation:
By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company
to make this certification.
SignatUFeofAuthorized
FORM L
pany Official
Company Name
Printed Name
COMM.V.U.18.15
^Board'
Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 *FAX:800-211-5454 •www.buyboard.com
Governmental References and Price/Discount Information
For your Proposal to be considered,you must supply a minimum of five (5)Individual governmental entity
references.Provide the information requested below, including the existing price/discounts you offer each customer.
The Cooperative determines whether prices/discounts are fair and reasonable by comparing prices/discounts stated
in your Proposal with the prices/discounts you offer other governmental customers.Attach additional pages if
necessary.
Quantity/
Entity Name Contact Phone#Discount Volume FOB Term
1.o\-
2.
3.CLNT.-J V4pi.cc71^
4.
5.\S>0
Doyou ever modifyyour written policies or standard governmental sales practices as identified in the above chart to
give better discounts (lower prices)th^n indicated?YES •NOD If YES,please explain:.
By signature below, I certify that the above Is true and correct and that I am authorized by my company to make
this certification.
Company N/mTT&
Signatuxe-bf^uthori^d Compaf^Official
Printed Name
FORM M COMM.V.ll.18.15
JprnsoardKJCooperativePurchasing12007ResearchBoulevard • Austin,Texas78759-2439PH:800-695-2919*FAX:800-211-5454•www.buyboard.comMarketingStrategyForyourProposalto be considered, you must submit theMarketingStrategy youwilluse iftheCooperativeacceptsallor part of yourProposal.(Example:HowyourcompanywillinitiallyinformCooperativemembersof yourBuyBoardcontract,and howyouwiiicontinuetosupport theBuyBoardforthedurationofthe contractperiod.)Attachadditionalpagesifnecessary.\K\xsi.Ooo-TycrCompanyNameSignatureofOfficialPrintedNameFORMNCOMM.V.ll.18.15
^Board'
^Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 'FAX:800-211-5454 'www.buyboard.com
Confidential/Proprietary Information Form
A.Public Disclosure Laws
All Proposals, forms,documentation,or other materials submitted by Vendor to the Cooperative in response
to this Proposal Invitation may be subject to the disclosure requirements of the Texas Public Information Act
(Texas Government Code chapter 552.001,et seq.) or similardisclosure law. Proposer must clearly identify
on this form any information in its Proposal (including forms, documentation, or other materials submitted
with the Proposal)that Proposer considers proprietary or confidential.If Proposer fails to properly identify
the information,the Cooperative shall have no obligation to seek protection of such information from public
disclosure should a member of the public or other third party request access to the information under the
Texas Public Information Actor similardisclosure law. Proposer will be notifiedof any third party request for
information ina Proposal that Proposerhas identified inthis form as proprietary or confidential.
Does your Proposal (including forms, documentation, or other materialssubmitted with the Proposal)contain
information which Vendor considers proprietary or confidential?
fV)one of the followinQiPleasech
NO,I certify that noneofthe information included with this Proposal isconsidered confidential or proprietary.
•YES,Icertify that this Proposal contains information considered confidential or proprietary and all suchinformationisspecificallyidentified on this form.
If you responded "YES",you must identify below the specific information you consider confidential or
proprietary.List each page number, form number, or other information sufficient to make the information
readily identifiable.The Cooperative and its Administrator will not be responsible for a Proposer's failure to
clearly identify information considered confidential or proprietary.Further, by submitting a Proposal,
Proposer acknowledges that the Cooperative and its Administratorwill disclose information when required by
law, even if such information has been identified herein as information the vendor considers confidential or
proprietary.
Confidential /Proprietary Information:
(Attach additionalsheetsifneeded.)
FORM 0-PAGE 1 COMM.V.ll.18.15
^Board'
Kj KmJ Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 *FAX:800-211-5454 •www.buyboard.com
B.Copyright Information
Does your Proposal (Including forms, documentation, or other materials submitted with the Proposal) contain
copyright information?
Please checl/fV)oneofthe foliowina:
NO,Proposal (including forms,documentation,orothermaterials submitted with the Proposal)doesnot
contain copyright information.
•YES,Proposal (including forms,documentation,or other materials submitted with the Proposal)does
contain copyright information.
Ifyou responded "YES",identify below the specific documents or pages containing copyrightinformation.
Copyright Information:
(Attach additionalsheetsifneeded.)
C.Consent to Release Confidential/ProDrietarv/CoDvriaht Information to BuvBoard Members
BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard
may wish to view information included in the Proposals of awarded Vendors. If you Identified informationon
this form as confidential,proprietary,or subject to copyright, and you are awarded a BuyBoard contract,your
acceptance of the BuyBoard contract award constitutes your consent to the disclosure of such informationto
BuyBoard members,including posting of such Information on the secure BuyBoard website for members.
Note: Neither the Cooperative nor its Administrator will be responsible for the use or distribution of
information by BuyBoard members or any other party.
By signature below, I certify that the information in this form is true, complete, and accurate and that I am
authorized by my company to make this certification and all consents and agreements contained herein.
CompanyTvlame
itore of Authorized cempany Official
aV4^P Qe
Printed Name
e\v\\fep
Date
FORM 0-PAGE 2 COMM.V.ll.18.15
^Board'
^Cooperative Purchasing
12007 Research Boulevard *Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Vendor Business Name Form
By submitting a Proposal, Proposer is seeking to enter into a iegai contract with the Cooperative. Assuch, a
Proposer must be an individuai or legal business entity capable of entering into a binding contract.
Proposers,must completely and accurately provide the information requested belowor your Proposal may be
deemed non-responsive.
Name of Proposing Company:V>i
{List the legal name of the companyseeking to contract with the Cooperative.Do NOT list an assumed name, dba, aka, etc. here.
Sued)information maybe providedbeiow.Ifyouare submitting aJointproposalwith another entitytoprovidethe same proposedgoods
or services, each submitting entity should complete a separate vendor information form. Separateiy operating legal business entities,
even ifaffiliatedentities,which propose to providegoods or servicesseparately must submit theirownProposals.)
Please check N)one of the followino:
Type of Business:
Individual/Soie Proprietor ^
Corporation
Limited Liability Company
Partnership
Other If other,identify
State of Incorporation (ifapplicable):_
Federal Employer Identification Number:
(Vendor must include a completedIRS W-9form with theirproposal)
Listthe Name(s) by which Vendor, if awarded,wishes to be identified on the BuyBoard:(Note:ifdifferent than
the Name ofProposing Company listed above, only valid trade names (dba, aka,etc.)of the Proposing Company may be used and a
copyofyourAssumedName Certificate(s),ifapplicable,mustbeattached.)
FORM P COMM.V.11.18.15
Form
(Rev.Oecombcr2011)
Oepaitmcntolthe Treasury
Itfternal RevenueService
W-9 Request for Taxpayer
Identification Number and Certification
Give Form to the
requester.Do not
send to the IRS.
Name(as shown on yourIncome tax rclum)
Deaiers Electrical Supply Co.
Business rtame/disregardedentity name,ifdifferent from at>ove
Q.^
t O
Check appropriate box for federal tax classification:
•Individual/solo proprietor E]CCorporation 0 SCorporation Q Partnership Q Trust/estate
•c £OL o
c
o
a<0
4>
n Umited ilabllity company.Enterthelaxclassification (C=C corporation,S=Scorporation,P=partnership)^
n Other (see instructions)•
0 Exempt payee
CO
Address(number,street,andapt.orsuiteno.)
P.O.Box 2676
City,state,andZIP code
Waco,TX.76702
List accountnu)nber(s)here (optional)
Taxpayer Identification Number (TIN)
Requester's nameand address(optional)
Enter your TINin the appropriate box. The TINprovided must match the namegiven on the"Name"line
to avoid backupwithholding. 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. Forother
entities, itis your employer identification number (EIN).Ifyou do not have a number,seeHow to get a
TINon page3.
Note.Ifthe accountIs In more than one name,see the charton page 4 for guidelineson whose
numberto enter.
Socialsecurity number
EmployerIdentification number
7 4 -1 9 7 2 1 2 0
Part II Certification
Under penalties of perjury, Icertify that:
1.The number shown on this form is mycorrect taxpayer [dentificalionnumber (orIam waitingfora number to be issued to me), and
2. Iam not subject to backup withholding because:(a) Iam exemptfrom backup withholding, or (b)Ihavenot been notified by the Internal Revenue
Service (IRS)that Iam subject to backup withholding as a result ofa failureto report allinterest or dividends, or (c)the IRShas notified me that Iam
no longersubjectto backup withholding,and
3. Iam a U.S. citizen or otherU.S.person (defined below).
Certificationinstructions.Youmustcross out item2 above ifyouhavebeen notified bythe IRSthat youare currentlysubject to backup withhofding
because youhavefailedto report allinterest and dividendson yourtax return. Forrealestate transactions, item2 does not apply. For mortgage
interestpaid,acquisition orabandonment ofsecured property,cancellation ofdebt,contributions toan individual retirement arrangement(IRA),and
generally,payments other than interest and dividends, you are not required to sign the certification,but you must provideyourcorrect TIN.See the
instructions on page 4.
Sign
Here
Signature of'
U.S.person•
General Instructions
Section references are tothe InternalRevenue Codeunless otherwise
noted.
Purpose of Form
A person who is required to filean information return with the IRS must
obtainyourcorrect taxpayer identification number (TIN)to report,for
example,incomepaidto you, real estatetransactions, mortgage interest
you paid,acquisilionor abandonment of secured property, cancellation
ofdebt, or contributions you made to an IRA.
UseForm W-9onlyifyouare a U.S.person(including a resident
alien),to provideyourcorrect TIN to the person requesting it(the
requester)and, when applicable,to:
1.Certify that theTIN youare giving is correct (oryouare waiting fora
numberto beissued),
2.Certify thatyouarenotsubject to backup withholding,or
3.Claim exemption from backup withholding ifyouare a U.S.exempt
payee.Ifapplicable,youare also certifying thatas a U.S.person,your
ailocable shareof any partnership income from a U.S.tradeor business
isnotsubjectto the withholding taxonforeign partners' share of
effectivelyconnected income.
Dato^
Note. Ifa requestergivesyoua forrfi other^an FormW-9to request
yourTIN.youmustuse the requester's formif|l issubstantially similar
to this Form W-9.
Definition of a U.S.person.For federal tax purposes,you are
considered a U.S.person ifyou are:
• An individual who is a U.S.citizen or U.S.resident alien,
• Apartnership,corporation,company,or association createdor
organized In the United Statesor underthe lawsof the United States,
• An estate (other than a foreign estate),or
• Adomestic trust (as defined in Reguiationssection 301.7701-7). •
Special rules forpartnerships.Partnershipsthatconduct a tradeor
business Inthe United States are generallyrequiredto pay a withholding
tax on any foreign partners'shareof Income from suchbusiness.
Further, in certain caseswhere a Form W-9 has not been received,a
partnership is required to presumethat a partner is a foreign person,
and pay the withholdingtax. Therefore, ifyou are a U.S.person that is a
partner in a partnership conducting a trade or business in the United
States, provideFormW-9to the partnership to establish yourU.S.
statusand avoid withholdingon your shareof partnership income.
Cat.No.10231X Form W-9 (Rev.12-2011)
^Board'
CooperativePurchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
EDGAR Vendor Certification Form
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goodsand services using funds undera federal grant or
contract,specific federal laws,regulations,and requirements may apply in addition to those understate
law. This includes, but is not limited to, the procurement standards of the Uniform Administrative
Requirements,Cost Principles and Audit Requirements for Federal Awards,2 CFR 200 (sometimes referred
to as the "Uniform Guidance" or new "EDGAR").All Vendors submitting proposals must complete this
EDGAR Certification Form regarding Vendor's willingness and ability to complywith certain requirements
which may be applicable to specific Cooperative member purchases using federal grant funds.This
completed form will be made available to Cooperative members for their use while considering their
purchasing options when using federal grant funds.Cooperative members may also require Vendors to
enter into ancillary agreements, in addition to the BuyBoard contract's general terms and conditions,to
address the member's specific contractual needs,including contract requirementsfora procurementusing
federal grants or contracts.
For each ofthe items beiow.Vendorshouldcertify Vendorls agreementandability to comply,
where applicable,by having Vendor's authorized representative check and initial the
applicable boxes and sign the acknowledgment at the end of this form.If you faii to
complete any item in this form,the Cooperative wiii consider and may list the Vendor's
response on the BuyBoard as "NO,"the Vendoris unabie or unwiiiing to comply. A "NO"
response to any of the items may,ifapplicable,impact the ability ofa Cooperative member to purchase
from the Vendor using federal funds.
1.VendorViolation or Breach of ContractTerms:
Contracts for more than the simplified acquisition threshold currently set at $150,000, which is the
inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense
Acquisition Regulations Council (Councils)as authorized by 41 USC 1908, must address administrative,
contractual,or legalremedies in instanceswhere contractorsviolateor breach contract terms, and provide
for such sanctions and penalties as appropriate.
Provisions regarding Vendordefault are includedinthe BuyBoard GeneralTerms and Conditions,including
Section E.18, Remedies for Default and Termination of Contract.Any Contract award will be subject to
such BuyBoard General Terms and Conditions, as well as any additional terms and conditions in any
Purchase Order, Cooperative member ancillarycontract,or Member Construction Contract agreed upon by
Vendor and the Cooperative member which must be consistent with and protect the Cooperative member
at least to the same extent as the BuyBoard Terms and Conditions.
The remedies under the Contract are in addition to any other remedies that may be available under law or
in equity.
By submitting a Proposal,you agree to these Vendor violation and breach of contract terms.
Vendor Certification,Item 1 (Vendor Violation or Breach ofContractTerms)
lU YES,I agree to the above.(Initial:^
• NO,I do NOTagree to the above.(Initial:)
FORM Q-PAGE 1 COMM.V.11.18.15
^^Board'
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
2.Termination for Cause or Convenience:
Forany Cooperative member purchase or contract In excess of $10,000 made using federal funds, you
agree that the following term and conditionshallapply:
The Cooperative member may terminate or cancel any purchase order under this Contract at any time,
withor withoutcause, byprovidingseven (7) business daysadvance writtennotice to the Vendor.Ifthis
Agreement is terminated in accordance with this Paragraph,the Cooperative membershall only be
requiredtopay Vendor forgoods orservicesdelivered to the Cooperative memberpriorto the terminarion
and not otherwise returned in accordance with Vendor's return policy.Ifthe Cooperative member has
paid Vendor forgoodsorservices notyet provided as ofthedateoftermination.Vendor shallimmediately
refundsuch payment(s).
If an alternate provision for termination of a Cooperative member purchase for cause and convenience,
including the manner by which it will be effected and the basis for settlement,is included in the
Cooperative member's purchase order,ancillary agreement,or Member Construction Contract agreed to
bythe Vendor,the Cooperative member's provision shallcontrol.
Vendor Certification,Item 2 (Termination for Cause or Convenience):
B YES, I agree to the above.(Initial:)
• NO, I do NOT agree to the above.(Initial: )
3.Equal Employment Opportunity:
Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that
meet the definition of ''federally assisted construction contract"in 41 CFR Part 60-1.3 shall be deemed to
include the equal opportunity clause provided under41 CFR 60-1.4(b),inaccordancewith Executive Order
11246,"Equal Employment Opportunity"(30 FR 12319,12935, 3 CFR Part, 1964-1965Comp., p. 339), as
amended by Executive Order 11375,"Amending Executive Order 11246 Relating to Equal Employment
Opportunity,"and implementing regulations at 41 CFR Part 60,"Office of Federal Contract Compliance
Programs, Equal Employment Opportunity,Department of Labor."
The equal opportunity clause provided under 41 CFR 60-1.4(b)is hereby incorporated by reference.
Vendoragrees that such provision applies to any Cooperativemember purchase or contract that meets the
definition of"federallyassisted construction contract" in41 CFR Part 60-1.3 and Vendoragrees that it shall
comply with such provision.
Vendor Certification,Item 3 (Equal Employment Opportunity):
H YES,I agree to the above.(Initial:)
• NO,I do NOTagree to the above.(Initial:)
FORM Q-PAGE 2 COMM.V.11.18.15
4.Davis-Bacon Act:
^JBoard'
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 • wv7W.buyboard.com
When required by Federal program legislation,Vendor agrees that, for all Cooperative member prime
construction contracts/purchases in excessof $2,000,Vendor shall comply with the Davis-Bacon Act (40
use 3141-3144,and 3146-3148)as supplemented by Departmentof Labor regulations (29 CFR Part 5,
''Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted
Construction").In accordance with the statute.Vendor is required to pay wages to laborers and
mechanics at a rate not less than the prevailing wages specified in a wage determinate made by the
Secretary of Labor.In addition.Vendor shall paywages notlessthan oncea week.
Current prevailing wage determinations issued by the Department ofLabor are available at www.wdol.aov.
Vendor agrees that,for any purchase to which tiiis requirement applies,the award ofthe purchase to the
Vendor is conditioned upon Vendor's acceptance of the wage determination.
Vendor further agreesthat it shall also comply with the Copeland "Anti-Kickback"Act (40 USC 3145),as
supplemented by Department of Labor regulations (29 CFR Part 3,"Contractors and Subcontractors on
Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States").
The Act provides that each contractor or subrecipient must be prohibited from inducing,by any means,
any person employed in the construction,completion,or repair of public work,to give upanypartofthe
compensationto whichhe or she isotherwise entitled.
Vendor Certification,Item 4 (Davis-Bacon Act):
m YES.I agree totheabove.(Initial:'Davis-Bacon Act -Not applicable to Dealers.
• NO, I do NOTagree to the above.(Initial: )
5.Contract Work Hours and Safety Standards Act:
Where applicable,for all Cooperative membercontracts or purchases in excess of $100,000that involve
the employment of mechanics or laborers.Vendor agrees to comply with 40 USC 3702 and 3704, as
supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 USC 3702 of the Act,
Vendoris required to compute the wages of every mechanicand laborer on the basis of a standard work
week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is
compensated at a rate of not less than one and a halftimes the basic rate of pay for all hours worked in
excess of 40 hours in the work week. The requirements of 40 USC 3704 are applicable to construction
workand provide that no laborer or mechanic must be required to work insurroundings or under working
conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the
purchases of supplies or materials or articles ordinarily available on the open market, or contracts for
transportation or transmission of intelligence.
Vendor Certification,Item 5 (Contract Work Hours and Safety Standards Act):
H YES. I agree to the above.(Initial:
• NO,I do NOTagree to the above.(Initial:)
FORM Q-PAGE 3 COMM.V.11.18.15
^7Boanr
Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
6.Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member's Federal award meets the definition of "funding agreement"under 37 CFR
401.2(a)and the recipient or subrecipient wishes to enter into a contract with a small business firm or
nonprofit organization regarding the substitution of parties,assignment or performance or experimental,
developmental,or research work under that "funding agreement," the recipient or subrecipient must
comply with the requirements of 37 CFR Part401,"Rights to Inventions Made by Nonprofit Organizations
and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any
implementingregulations issued by the awarding agency.
Vendor agrees to comply withthe above requirements when applicable.
Vendor Certification,Item 6 (Right to Inventions Made Under a Contract or Agreement):
S YES,I agree to the above.(Initial:)HIA
• NO,I do NOTagree to the above.(Initial:)
7.Clean Air Act and Federal Water Pollution Control Act:
Clean Air Act (42 USC 7401-7671q.)andthe Federal Water Pollution Control Act (33 USC 1251-1387),as
amended -Contracts and subgrants of amounts in excess of $150,000 must contain a provision that
requires the non-Federal award to agree to comply with all applicable standards,orders,or regulations
issued pursuant to the Clean Air Act (42 USC 7401-7671q.)and the Federal Water Pollution Control Act,as
amended (33 USC 1251-1387).Violations must be reported to the Federal awarding agency and the
Regional Office ofthe Environmental Protection Agency (EPA).
When required.Vendor agrees to comply with all applicable standards,orders, or regulations issued
pursuantto the Clean Air Act and the Federal Water Pollution Control Act.
Vendor Certification,Item 7 (Clean Air Act and Federal Water Pollution Control Act):
Ix]YES. I agree to the above.(Initial:
• NO, I do NOT agree to the above.(Initial: )
8.Debarment and Suspension:
Debarment and Suspension (ExecutiveOrders 12549 and 12689) - Acontract award (see 2 CFR 180.220)
must not be made to parties listed on the government-wide exclusions in the System for Award
Management (SAM),in accordance with the 0MBguidelines at 2 CFR 180 that implement ExecutiveOrders
12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR Part 1989 Comp. p. 235),"Debarment and
Suspension."SAM Exclusionscontains the names of parties debarred,suspended,or otherwise excluded
by agencies,as well as parties declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
FORM Q-PAGE 4 COMM.V.ll.18.15
WBoard
Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
Vendor certifies that Vendor is not currently listed on the government-wide exclusions in SAM,is not
debarred, suspended, or otherwise excluded by agencies or declared ineligible under statutory or
regulatory authority other than Executive Order 12549.Vendor further agrees to immediately notify the
Cooperative and all Cooperative members with pending purchases or seeking to purchase from Vendor if
Vendor is later listed on the government-wide exclusions in SAM,or is debarred, suspended, or othenwise
excluded by agencies or declared ineligible under statutory or regulatory authorityother than Executive
Order 12549.
Vendor Certification,Item 8 (Debarment and Suspension):
[x]YES,I agree /certify to the above.(Initial:-)
•NO,I do NOT agree /certify to the above.(Initial:)
9.Byrd Anti-Lobbying Amendment:
Byrd Anti-Lobbying Amendment (31 USC 1352)-Vendors that apply or bid for an award exceeding
$100,000 must file the required certification.Each tier certifies to the tier above that it will notand has
not used Federal appropriated funds to pay any person or organization for influencing or attempting to
influence an officer or employeeof any agency, a memberof Congress,officer or employeeof Congress,
or an employee ofa member of Congress in connection with obtaining any Federal contract,grantor any
other award covered by31 USC 1352.Each tier mustalso disclose any lobbying with non-Federal funds
that takes place in connection with obtaining any Federal award.Such disclosures are forwarded from tier
to tier up to the non-Federal award.
As applicable.Vendor agrees to file all certifications and disclosures required by,and otherwise comply
with, the Byrd Anti-Lobbying Amendment (31 USC 1352).
Vendor Certification,Item 9 (Byrd Anti-Lobbying Amendment):
0 YES. I agree to the above.(Initial: )
• NO, I do NOT agree to the above.(Initial: )
10.Procurement of Recovered Materials:
For Cooperative member purchases utilizing Federal funds.Vendor agrees to comply with Section 6002 of
the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act where
applicable and provide such information and certifications as a Cooperative member may require to
confirm estimates and otherwise comply. The requirements of Section 6002 include procuring only items
designated in guidelines of the Environmental Protection Agency (EPA)at 40 CFRPart 247 that contain the
highest percentage of recovered materials practicable,consistent with maintaining a satisfactory level of
competition,where the purchase price of the item exceeds $10,000 or the value of the quantity acquired
during the preceding fiscal year exceeded $10,000;procuring solid waste management services in a
manner that maximizes energy and resource recovery, and establishing an affirmative procurement
program for procurement of recovered materials identified in the EPA guidelines.
FORM Q-PAGE 5 COMM.V.11.18.15
^BoartT
Cooperative Purchasing
12007 Research Boulevard • Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.buyboard.com
VendorCertification,Item 10 (Procurement of Recovered Materials):
Ix]YES.I aoree to the above.(Initial:i^j/a
• NO, I do NOTagree to the above.(Initial: )
11.Profit as a Separate Elementof Price **Not Applicable **
For purchases using federal funds in excess of $150,000,a Cooperative member may be required to
negotiate profit as a separate element of the price.See,2 CFR 200.323(b).When required by a
Cooperative member.Vendor agrees to provide information and negotiate with the Cooperative member
regarding profit as a separate element of the price for a particular purchase.However,Vendor agrees
that the total price,including profit,charged by Vendor to the Cooperative member shall not exceed the
awardedpricing,including any applicable discount,under Vendor's Cooperative Contract.
Vendor Certification,Item 11 (Profit as Separate Element of Price):
• YES,I agree to the above.(Initial: )
• NO,I do NOTagree to the above.(Initial:)
12.General Compliance and Cooperation with Cooperative Members
In addition to the foregoing specific requirements.Vendor agrees, in accepting any PurchaseOrderfrom a
Cooperative member,it shall make a good faith effort to work with Cooperative members to provide such
information and to satisfysuch requirementsas may applyto a particular Cooperative member purchase
or purchasesincluding,but not limited to,applicable recordkeeping and record retention requirements.
Vendor Certification,Item 12 (General Compliance and Cooperation with Cooperative
Members):
0 YES, I agree to the above.(Initial: )
• NO, I do NOTagree to the above.(Initial: )
By signature below, I certify that the information in this form is true, complete, and accurate and that I
am authorized by my company to make this certification and all consents and agreements contained
herein.
Dealers Electrical SudpIv Co.
CompanyMame
yv.,
Signature of Authorized Company Official
Chris N.Lanham
Printed Name
FORM Q-PAGE 6 COMM.V.11.18.15
O kJ c,
WBoard
Cooperative Purchasing
12007 Research Boulevard •Austin,Texas 78759-2439
PH:800-695-2919 'FAX:800-211-5454 •wvw/.buyboard.com
Required Forms Checklist
{Please check (V)the following)
Completed:Proposer's Agreement and Signature (Form A)
Completed:Vendor Purchase Order,Request for Quotes,and Invoice Receipt Options (Form B)
Completed:Felony Conviction Disclosure and Debarment Certification (Form C)
Completed:Resident/Nonresident Certification (Form D)
Completed:Historically Underutilized Business (HUB)Certification (Form E)
Completed:Affirmation Regarding Construction Related Goods and Services (Form F)
Completed:Deviation/Compliance Signature Form (Form G)
Completed:Dealership Listings (Form H)
Completed:Texas Regional Service Designation (Form I)
Completed:State Service Designation (Form J)
Completed:National Purchasing Cooperative Vendor Award Agreement (Form K)
Q Completed:Federal and State/Purchasing Cooperative Discount Comparison Form (Form L)
Completed:Governmental References and Price/Discount Information (Form M)
Completed:Marketing Strategy (Form N)
Completed:Confidential/Proprietary Information Form (Form O)
Completed:Vendor Business Name Form with IRS Form W-9 (Form P)
Completed:EDGAR Vendor Certification Form (Form Q)
Completed:Forms Checklist (Form R)
Completed:Proposal Specification Form with Catalogs/Pricelists (Form S)
*Catalogs/Pricelistsmustbesubmittedwithpropose!response orresponse willnotbeconsidered.
form R COMM.V,11.18.15
Proposal Invitation No.527-17-Energy Saving Lighting Products
(Catalogs/Pricelists must be submitted withProposal or Proposalwill not be considered^)
NOTE:Vendorsproposing various manufacturer product lines per lineitem on the ProposalSpecification Form(FormS) must submit the informationas
follows or proposal may not be considered:
'Manufacturers shall be listed In alphabetical order
•Vendor'smust list one specific percentage discountfor each Manufacturerlisted.
If a vendor's response to ProposalSpecificationForm(FormS)states "please see attachmentsheet,"all manufacturers listed on the attachmentsheet
must indicate per manufacturerthe lineitem thatcorrelates to ProposalSpecification Form (FormS)or Vendor'sproposalmaynot be considered.
Item
No.ShortDescription Full Description
State Percent (%)of
Discount off
Catalog/Pricelist^
state Name of
Catalog/Pricelist^
Exceptions to
Discount
1
>n I:Enuioment.Products,and SuDOlies
Discount (%)Off
Catalog/Pricelist for
Electronic Ballasts
Please state the discount (%)off catalog/pricelist for
Electronic Ballasts (T5/T8/T12,high efficiency
25/28/32 watt,and other related items.)Catalog/Pricelist
MUSTbe Included or proposal will notbeconsidered.
"O 0/n
PSNOO
omeo -i\\v
2
Discount {%)Off
Catalog/Pricelist for
Fluorescent Lamps
and Fixtures
Please state the discount (%)off cataiog/pricellst for
Fluorescent Lamps and Fixtures (T5/T8/T12,high
efficiency 25/28/32 watt^andother related items.)
Catalog/Pricelist MUST be Included or proposalwill not be
considered.
<0 %
~ll\\
le uvwtrr
3
Discount (%)Off
Catalog/Pricelist for
Exit Polycarbonate
Products
Please state the discount (%)off catalog/pricelist for Exit
Polycarbonate Products (Exit Polycarbonate 3W LED,
and other related items.)Cataiog/Priceiist must be included
orproposal will not be considered.
Ci %e.H.
uv
3z:?-n
T U^Hrr
4
Discount (%)Off
Catalog/Pricelistfor
Ceiling and Wall Box
Motion Sensors
Please state the discount (%)off cataiog/pricellst for Celling
and Wall Box Motion Sensors.Cataiog/Priceiistmustbe
includedor proposal will not beconsidered.
0
o-P v9"1
5
Discount (%)Off
Catalog/Pricelist for
Electronic HID
Ballasts,Lamps,and
Fixtures
Please state the discount (%)off catalog/pricelist for
Electronic HID Ballasts,Lamps,and Fixtures.
Catalog/pricelist MUST beincluded orproposal will not be
considered.
0 .
CT-Vl
PROPOSAL NOTE
1.Catalogs/Pricelists are required to be submitted with Proposal Page 1of 4
PROPOSALSPECIFICATION FORM
FORMS
Proposal Invitation No.527-17-Energy Saving Lighting Products
(Catalogs/Pricelists mustbe submitted with Proposal or Proposal will not be considered^.)
Item
No.ShortDescription Full Description
State Percent ("/o)of
Discountoff
Catalog/Pricellst^
State Name of
Catalog/pricelist^
Exceptionsto
Discount
6
Discount (%)Off
Catalog/Prlcelist for
Electronic HPS
Ballasts, Lamps, and
Fixtures
Please state the discount (%)off catalog/pricelist for
Electronic HPS Ballasts,Lamps,and Fixtures.
Catalog/PricellstMUSTbeIncludedor proposal will not be
considered.
^%
s-zn-vi
7
Discount (%)Off
Catalog/Pricellst for
LEDTube Lighting
Products
Please state the discount (%)off catalog/pricelist for LED
Tube Lighting Products.Catalog/Prlcellst mustbe included or
proposalwill notbeconsidered.
O o/o
S-Zl'Sl
8
Discount {%) Off
Catalog/Prlcelist for
Solar Lighting
Products
Please state the discount (%)off catalog/pricelist for Solar
Lighting Products,catalog/Pricellstmustbe includedor
proposal will notbeconsidered.
o %
S-CT-VI
9
Disccunt (%)Off
Catalog/Pricellst for
WattStopper Sensors
Please state the discount (%)off catalog/pricelist for Watt
StopperSensors.Catalog/Pncellst MUST be Includedor proposal
will notbeconsidered.
O o/o
S-en-n
10
Discount (%)Off
Catalog/Pricellst for
Recycle of Lamps,
Batteries,Ballasts,
and Fixtures
Please state the discount (%) offcatalog/pricelist for Recycle
of Lamps,Batteries,Ballasts,and Fixtures.
Catalog/Pricelist MUSTbe included or proposalwill not be
considered.
%
11
Discount (%)Off
Catalog/Prlcelist for
AllOther Energy
Saving Lighting
Products
Please state the discount (%) off catalog/pricelist for AllOther
Energy Saving Lighting Products.Cataiog/Priceiist mustbe
Includedor proposal will not be considered.
%
PROPOSALNOTE
1. Catalogs/Pricelistsare required to be submitted with Proposal Page 2 of 4
PROPOSALSPEaFICATION FORM
FORM S
Proposal Invitation No.527-17-EnergySaving Lighting Products
(Catalogs/Pricelists must be submittedwith Proposal or Proposal will not be considered^.)
Notto Exceed Hour^
LaborRate ^SecHon'n;''^lh^llati6h'ahd'RepairService
betafledjinformation
on Hourly Labor Rate
Exceptionsto
Hourly Labor Rate
12
13
14
15
Not to Exceed Hourly
Labor Rate for
Installation/Repair
Service of Electronic
Ballasts,Ruorescent
Lamps, Fixtures,
Equipment and
Products
Not to Exceed Hourly
Labor Ratefor
Installation/Repair
ServiceofExit
Polycarbonate
Equipment and
Products
Not to Exceed Hourly
Labor Rate for
Installation/Repair
Service of Ceilingand
Wall Box Motion
Sensors Equipment
and Products
Not to Exceed Hourly
Labor Rate for
Installation/Repair
Service ofElectronic
HID and HPS Ballasts,
Fixtures,Equipment
and Products
Hourly Labor Rate for Installation/Repair of Electronic
Ballasts,FluorescentLamps,Fixtures,Equipmentand
Products -State the Notto Exceed hourly labor rate for
Installation/Repair Service of Equipment and Products.
Hourly Labor Rate for Installation/Repairof Exit
Polycarbonate Equipmentand Products - State the Not
to Exceed hourlylabor rate for Installation/RepairServiceof
Equipment and Products.
Hourly Labor Rate for Installation/Repair of Celling and
Wall Box Motion Sensors Equipmentand Products -
State the Notto Exceed hourly labor rate for
Installation/Repair Service of Equipment and Products.
Hourly Labor Rate for Installation/Repairof Electronic
HID and HPS Baliasts,Lamps,Fixtures,Equipmentand
Products -State the Not to Exceed hourly labor rate for
Installation/Repair Service of Equipmentand Products.
PROPOSAL NOTE
1.Catalogs/Pricelists are requiredto be submitted with Proposal
Page 3 of 4
_/Hour
/Hour
JHour
./Hour
PROPOSALSPEanCATICN FORM
FORMS
^Board'
Proposal Invitation No.527-17-Energy Saving Lighting Products
(Catalogs/Pricelists must be submitted with Proposalor Proposalwill not be considered
'sMicmiir
Notto jExcmd Hourly
LaborRate
Detai^ilni^ihati^
on Houfiy Labor Rate
Exceptionsto
HourlyLabor Rate
16
Not to Exceed Hourly
Labor Rate for
Installation/Repair
Service of Solar
LightingEquipment
and Products
Hourly Labor Ratefor Installation/RepairofSolar
Lighting Equipment and Products - State the Not to
Exceed hourly labor rate for Installation/Repair Service of
Equipment and Products.
4 /Hour
17
Not to Exceed Hourly
Labor Ratefor
Installation/Repair
AllOther Energy
Saving Lighting
Equipment and
Products
Hourly LaborRate for Installation/RepairofAilOther
Energy Saving Lighting Equipmentand Products - State
the Notto Exceed hourlv labor rate for Installation/Reoair
Service of Equipment and Products.
4 /Hour
Sectiiiir'ini:Erierav^AudltPi^
NotTo Exceed
Square FootPrice Aiidi^betaiis
•
Exceptions
18
Square Foot Pricefor
Energy Audit
Programs
PleaseState the Notto Exceed Souare Foot Pricefor Enerav
Audit Programs 4 /Hour
PROPOSALNOTE
1.Catalogs/Pricelists are required to be submitted with Proposal
Page 4 of 4
PROPOSALSPEOHCATION FORM
FORMS
^BoartT
^Cooperative Purchasing
12007 Research Boulevard ' Austin,Texas 78759-2439
PH:800-695-2919 •FAX:800-211-5454 •www.vendor.buyboard.com
THE LOCAL GOVERNMENT PURCHASING COOPERATIVE
ADDENDUM NO.1
Proposal InyitationNo.527-17-Energy Saving Lighting Products
The following Information becomes a permanent part of the Proposal Invitation document.
Section III:Energy Audit Programs of the proposal specifications for the above referenced
proposal Invitation requests that vendors provide a not to exceed square foot price for Energy
Audit Programs.
"Energy Audit Programs" as used in the Proposal Invitation refers to basic reviews of existing
member lighting and potential lighting needs.Vendors proposing under this section will be
limited to Energy Audit Programs as they may relate to the purchase,installation and servicing
of energy saving lighting products to be purchased within the scope and intent of this Proposal
Invitation.
Any awarded contract will only Include those specific goods and services awarded by the
BuyBoard.As provided in the Proposal Invitation, the scope of services in this Proposal
Invitation and any resulting contract award do not include services that are required to be
procured under the Professional Services Procurement Act (Chapter 2254 of the Texas
Government Code), Including without limitation architecture and professional engineering
services.
Please sign and return one copy of the addendum with proposal as verification of receipt and
compliance with addendum information.
Company Name:
Address:.
Telephone Number:97'2-Z98-Z\\\_Date:_
12007 Research Boulevard · Austin, Texas 78759-2439 · PH: 800-695-2919 · FAX: 800-211-5454 · www.buyboard.com
NO ISRAEL BOYCOTT CERTIFICATION
Effective September 1, 2017, a Texas governmental entity may not enter into a contract with a company for goods or
services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2)
will not boycott Israel during the term of the contract. (TEX. GOV’T CODE Ch. 2270)
“Boycott Israel” means refusing to deal with, terminating business activities with, or otherwise taking any action that is
intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or
entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business
purposes. TEX. GOV’T CODE §808.001(1).
By signature below, I certify and verify that Vendor does not boycott Israel and will not boycott Israel during the term of
any contract awarded under this Proposal Invitation, that this certification is true, complete and accurate, and that I am
authorized by my company to make this certification.
Company Name
_
Signature of Authorized Company Official Printed Name
NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANIZATION CERTIFICATION
Effective September 1, 2017, Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may
not enter into a contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist
organization – specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas
Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be
excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign
terrorist organization is not subject to the contract prohibition.)
By signature below, I certify and verify that Vendor is not on the Texas Comptroller’s list identified above; that this
certification is true, complete and accurate; and that I am authorized by my company to make this certification.
Company Name
_
Signature of Authorized Company Official Printed Name