No preview available
6283C - Construction of Denton Regional Public Safety Training Facility, 0.Main Solicitation / Materials Management Department 901-B Texas Street Denton, Texas 76209 REQUEST FOR PROPOSALS RFP 6283 CONSTRUCTION OF DENTON REGIONAL SAFETY TRAINING FACILITY FOR THE CITY OF DENTON NIGP CLASS and ITEM 912 00  913 61  914 00   Issue Date: November 1, 2016 Response due Date and Time (Central Time): Thursday, December 1, 2016, 11:00 A.M. Table of Contents 1. INTRODUCTION 2. PROJECT DESCRIPTION 3. MINIMUM QUALIFICATIONS 4. SCHEDULE OF EVENTS 5. PRE-SUBMITTAL CONFERENCE AND WALKTHROUGH 6. CONTRACT TERM 7. PRICING 8. PRICE ADJUSTMENTS 9. QUANTITIES 10. ADDENDA 11. BUSINESS OVERVIEW 12. EXCEPTIONS 13. SAFETY RECORD 14. DISCLOSURES 15. ACKNOWLEDGEMENT 16. EQUIPMENT SCHEDULE 17. SUBMITTAL INSTRUCTIONS a. Submission Format b. Electronic Submission Requirements 18. EVALUATION PROCEDURES 19. CONTACT BETWEEN RESPONDENT AND THE CITY SOLICITATION CHECKLIST ATTACHMENT A-BUSINESS OVERVIEW QUESTIONNAIRE AND FORMS ATTACHMENT B-SUBMISSION EXCEPTIONS ATTACHMENT C-SAFETY RECORD QUESTIONNAIRE ATTACHMENT D-REFERENCES ATTACHMENT E-CONFLICT OF INTEREST QUESTIONNAIRE ATTACHMENT F-ACKNOWLEDGEMENT Exhibit 1 Pricing Sheet Exhibit 2 General Provisions, Standard Terms and Conditions and Appendices Exhibit 3 Scope of Work or Technical Specifications Exhibit 4 Plans and Drawings INTRODUCTION In accordance with the provisions of Texas Local Government Code, Chapter 252 and 271 or the Government Code 2269, The City of Denton (the City) is requesting submissions to contract with an individual or business with considerable experience in providing services of this solicitation. The responses and the cost solutions shall be submitted to the City of Denton in a sealed submission. The awarded individual or business shall possess a proven track record of using innovative approaches to providing goods and services that represent the best value to their clients. The awarded individual or business shall have the ability to accomplish all aspects of the requested services. The selected individual or firm should be able to provide innovative methods to deal with municipal challenges, and cost effective solutions. PROJECT DESCRIPTION The City of Denton is seeking qualified construction firms to provide building construction for the Denton Regional Public Safety Training Facility located at 4111 Vintage Boulevard, Denton, Texas 76205. This project will require new construction to existing real property. For more detailed description, please refer to the scope of work, project specifications and technical drawings. The construction services shall be accomplished per all exhibits indentified in the table of contents. MINIMUM QUALIFICATIONS The following minimum requirements must be demonstrated in order for the submission to be considered responsive to the City of Denton. Any submission received, which is determined to not meet these mandatory requirements shall be immediately disqualified and rejected as non-responsive. Three (3) years’ experience providing similar services. Three (3) references from governmental entities for the services requested. The City prefers references from municipalities of similar size. The responding individual or business must be registered in the State of Texas, or the County of Denton, to provide the products or services required in this solicitation, and the individual or business must have all licensure required by the State to provide any services required under this contact.  To learn how to obtain information about filing with the State of Texas, or obtaining copies or certificates from the Secretary of State visit Webpage: http://www.sos.state.tx.us/corp/copies.shtml; Phone 512-463-5578; or email corpcert@sos.state.tx.us. Submittal documents including a cover sheet, Solicitation Checklist, Attachments A -F and Exhibit 1, per the method described in SUBMITTAL INSTRUCTIONS. SCHEDULE OF EVENTS The City of Denton reserves the right to change the dates indicated below: Solicitation Schedule: Issue Solicitation: 11/01/2016 Pre-submittal conference and walkthrough 11/16/2016 at 1:30 PM CST Deadline for Submission of Questions: 11/22/2016 at 11:00 AM CST Deadline for Submission of Responses: 12/01/2016 at 11:00 AM CST Evaluate and rank initial results: 12/02/2016 Completion of Negotiations: 12/03/2016 Official Award: 12/13/2016 The City of Denton is using the solicitation ‘Issue Date’ as noted in the Schedule of Events above as the official 30 day notification requirement for an interview with a firm. PRE-SUBMITTAL CONFERENCE AND WALKTHROUGH A non-mandatory, pre-submission conference and walkthrough will be available to interested contractors. Attendance at the pre-submission conference and walkthrough is strongly encouraged prior to submission of a proposal. The conference walkthrough will be held on Wednesday, November 16, 2016 at 1:30 pm. The conference and walkthrough will consist of a meeting in the Facilities Management Conference Room, 869 South Woodrow Lane, Denton, Texas 76205; to present a project overview then will reconvene at the proposed site of the Denton Regional Public Safety Training Facility, located at 4111 Vintage Blvd, Denton, Texas 76205, immediately thereafter. Internet link to meeting location: https://www.google.com/#hl=en&tbo=d&sclient=psy-ab&q=869+S+Woodrow+Ln%2C+Denton%2C+TX&oq=869+S.Wood&gs_l=hp.1.0.38l4.1547.5594.0.8657.10.10.0.0.0.0.297.1655.0j9j1.10.0.les%3B..0.0...1c.1.2.hp.-iYUhUx DU74&pbx=1&bav=on.2,or.r_gc.r_pw.r_qf.&bvm=bv.41867550,d.eWU&fp=cb6acebdfad8e699&biw=1016&bih=500 CONTRACT TERM It is the intention of the City of Denton to award a contract for construction of the project as described in the drawings and specifications. Materials and services undertaken pursuant to this solicitation will be required to commence within fourteen (14) days of delivery of a Notice to Proceed. The Contract shall commence upon the issuance of a Notice to Proceed by the City of Denton and shall automatically expire upon completion of the work and acceptance by the City of Denton. PRICING Only firm pricing with no escalation will be accepted for this project. Unit Pricing in Exhibit 1 shall include all fees and costs to provide the goods and services to the City.  PRICE ADJUSTMENTS Price adjustments will not be allowed for this project unless a change in scope is approved that increases or decreases the amount of work required. Requests for changes in scope must be submitted in writing with documentation that provides justification for the change and supporting evidence that describes the basis for the cost change. Upon receipt of such request, the City of Denton reserves the right to either: accept the proposed change as competitive with the original agreed upon proposed unit pricing at the time and issue appropriate authorizations or reject the increases after receipt of a properly submitted request. No work shall be undertaken on a proposed change until authorized by the City of Denton in the form of a Purchase Order change and/or other documentation appropriate to amending the contract. The request can be sent by e-mail to: purchasing@cityofdenton.com noting the solicitation number. The City of Denton reserves the right to accept, reject, or negotiate the proposed price changes. QUANTITIES The quantities indicated on the drawings, technical specifications, and pricing exhibit are believed to be accurate but shall be considered only as estimates. The project requires complete and functional construction in accordance with the Technical Specifications in Exhibit 3 and the plans in Exhibit 4. Differences between the quantities of material required and the estimated quantities will not be considered as basis for a change in the unit price for the project. In submitting a response, the respondent is stating that he has reviewed the project drawings and specifications and understands their intent and has checked the quantities and dimension and is asserting that the submissions is intended to account for all conditions and quantities to complete the project as described in the plans and specification. ADDENDA Respondents are required to acknowledge addenda with their submission.  Respondents will be responsible for monitoring the City of Denton Purchasing website at www.dentonpurchasing.com to ensure they have downloaded and signed all addenda required for submission with their submission. Respondents should acknowledge each individual addendum on Attachment F. BUSINESS OVERVIEW Respondent shall complete the Business Overview Questionnaire, Project Information Form & Schedule Compliance Form as applicable per Attachment A. EXCEPTIONS The Request for Proposal (RFP) process allows for negotiation of the terms and conditions of this proposal. The respondent shall note any exceptions to the solicitation document, on Attachment B. The exceptions will be reviewed to ensure they meet the minimum specifications and requirements and will be ranked in accordance with the evaluation criteria. The City reserves the right to accept, reject or negotiate the exceptions provided. Respondents shall itemize all exceptions on Attachment B. Additional pages may be added as necessary. Do not mark or change the text of the solicitation document, exceptions shall be noted only on Attachment B. If no exceptions are taken, the respondent shall sign and return Attachment B in the appropriate signature block. SAFETY RECORD The City of Denton desires to avail itself of the benefits of Section 252.0435 of the Local Government Code, and consider the safety records of potential contractors prior to awarding City contracts. Pursuant to Section 252.0435 of the Local Government Code, the City of Denton has adopted the written definition and criteria as shown in the Safety Record Questionnaire (Attachment C) for accurately determining the safety record of a respondent prior to awarding City contracts. DISCLOSURES The individual or business must disclose any business relationship that would have an effect, of a conflict of interest. A conflict of interest statement must be signed as part of the contract negotiated with the awardee(s). (Attachment E) ACKNOWLEDGEMENT Submit a signed acknowledgement by authorized agent of the responding firm (Attachment F). EQUIPMENT SCHEDULE The respondent shall provide an equipment schedule. The schedule shall include the year, make, model and description of the equipment. SUBMITTAL INSTRUCTIONS The City of Denton will accept electronic or hard copy submittals until the date and time on the cover sheet of this solicitation. Any submission received after the date and/or hour set for solicitation opening will be returned unopened. Electronic submittals may be emailed to ebids@cityofdenton.com with the solicitation number and name in the subject line. Emails received by the City will remain unopened until after the due date and time. Only authorized Materials Management Staff will have access to the e-bid email inbox. Please do not email the buyer directly to ensure security of the proposal. Hard copy submissions may be hand delivered (by firm or express courier) to the address listed below: City of Denton Materials Management SOLICITATION NUMBER AND NAME 901B Texas Street Denton, TX 76209 The City of Denton reserves the right to accept or reject in part or in whole any submission, and to waive technicalities of the submission, in the best interest of obtaining best value for the City. Each respondent is responsible for taking the necessary steps to ensure their submission is received by the date and time noted herein. The City is not responsible for missing, lost or late mail or any mail or email delays, internal or external, that may result in the submission arriving after the set time. Submission Format Respondents shall provide detailed information to allow the City to properly evaluate the submission. The City requests the following format be used: Hard copy submissions shall be bound only utilizing a staple or binder clip. Do not submit responses in a binder or file folder. Submission shall be no more than 200 pages in length Utilize tabs to indentify exhibits and attachments The submission shall be in the following order: Coversheet – including Solicitation number and name, firm name, address, contact name, phone, fax, website and email address. Pricing Sheet – Exhibit 1 Completed Solicitation Checklist Attachment A- Business Questionnaire Attachment B- Exception Form Attachment C -Safety Record Attachment D -References Attachment E -Conflict of Interest Questionnaire Form Attachment F -Signed Acknowledgement form Appendices may be used for additional documentation or clarification at the respondent’s option. Hard Copy submittals shall include one (1) original signed by an officer authorized to bind the firm, and three (3) copies of the completed response. Submit response, before the published due date. Hard copy submittals must be in a sealed envelope with the solicitation number and name. Electronic Submission Requirements All respondents shall submit their pricing sheet (Exhibit 1) in Microsoft Excel format for quick tabulation of results. The electronic pricing sheet must be received regardless of the method chosen by the proposer to submit (hard copy or electronic). If a respondent is only submitting a hard copy, they shall provide a flash drive, containing a complete copy of the response to this solicitation, or submit electronically to ebids@cityofdenton.com. Emails to the City should include the solicitation number and name in the subject line. Please do not email the buyer directly to ensure security of the proposal. EVALUATION PROCEDURES Selection of a firm(s) to provide the aforementioned materials and services shall be in accordance with the City of Denton Purchasing Policies and procedures and the State of Texas Local Government Code 252.043 and Texas Government Code 2269. The City of Denton shall open all submissions and evaluate each respondent in accordance to the below criteria: Step 1: The City of Denton will evaluate the submission in accordance with the selection criteria and will rank the firms on the basis of the submittals. The City of Denton, reserves the right to consider information obtained in addition to the data submitted in the response. The selection criterion is listed below: Project Schedule (FACTOR: 10%). Ability to timely start and complete project. This includes the schedule to complete project and may include ability to meet required milestones of completion. Compliance with specifications, quality, reliability, characteristics to meet stated or implied needs (FACTOR 20%) Compliance with the stated specification(s) coupled with the quality and reliability of the goods and services such as fitness for use that meets or exceeds Owner’s expectations and the characteristics of the product or service that bear on its ability to meet the stated/implied needs. Indicators of Probable Performance under contract (FACTOR: 10%). Indicators of probable performance under the contract to include: past vendor performance, financial resources and ability to perform, experience or demonstrated capability and responsibility, references, and the vendor’s ability to provide reliable maintenance agreements and support. Price, Total Cost of Ownership (FACTOR: 60%). The price of the items, to include total cost of ownership, such as installation costs, life cycle costs, and warranty provisions. In addition to the above factors, others that can be utilized as stated within Local Government Code 252.043 are: (1) the extent to which the goods or services meet the City’s needs, (2)the impact on the ability of the City to comply with the laws and rules related to contracting with historically underutilized businesses and non-profit organizations employing persons with disabilities, (3) the long term cost to the City to acquire the respondents’ goods and services, and (4) any relevant criteria specifically listed in the solicitation by the City. The total possible score of the submissions shall be scored and weighted as indicated above, Step 1 items a-d. Based on the outcome of the computations performed, each submission will be assigned a raw score. The assigned weight will then be applied to these scores to calculate an overall score for each submission for completion of the final scoring process. The submissions shall be evaluated utilizing standard tools, based upon the weighted factors above, and will be assigned a final score. The City of Denton will proceed to Step 2, with the firm(s) that are considered within the competitive range and present an overall best value to the City of Denton. Step 2: After the final ranking of the submissions and determination of Firm(s) that provide a best value to the City and are within the competitive range, provided the City of Denton elects to proceed without oral discussions, the City will immediately proceed to negotiate final pricing, terms and conditions with the highest ranked Firm or Firms. The City of Denton may elect to conduct oral discussions, request clarifications, and presentations concerning the project approach and ability to furnish the requirements, as part of the negotiation process. The City may elect to utilize a Best and Final negotiation phase to determine the Firm that provides the overall best value to the City. Step 3: Upon selection of the submission or Best and Final Offer that represents the “best value”, a written recommendation will be presented to the appropriate approving authority for the City of Denton (the City Manager, Public Utility Board, City Council) requesting authorization to proceed with contract execution for the proposed services. In accordance with Local Government Code 252.049, trade secrets and confidential information in competitive sealed proposals are not open for public inspection. All submissions shall be opened in a manner that avoids disclosure of the contents to competing respondents and keeps the responses secret during negotiations. A public opening will not be conducted with this process. After the contract has been awarded all submissions will be open for public inspection, and the unsuccessful respondent(s) may request a debriefing regarding their submittal. Please contact the City of Denton Materials Management staff to document the request for a debriefing. A meeting with the City of Denton Materials Management Staff and the using Division will be scheduled within a reasonable time. CONTACT BETWEEN RESPONDENT AND THE CITY Respondents shall direct all inquiries and communications concerning this solicitation to the Point of Contact(s) listed below: Elton D. Brock, MBA, CTPM, CTCM, C.P.M., CPSM Manager, Materials Management 901-B Texas Street Denton, TX 76209 (940) 349-7100 Fax: (940) 349-7302 elton.brock@cityofdenton.com *** Please do not email the buyer any portion of the final proposal unless requested after the due date and time published on the coversheet. A proposal should be emailed to ebids@cityofdenton.com, ONLY. SOLICITATION CHECKLIST Check when Completed Task to be Completed by Respondent   Exhibit 1 – Pricing sheet   Review Exhibit 2 – General Provisions and Terms and Conditions   Review Exhibit 3 – Scope of Work   Review Exhibit 4 – Plans         Cover sheet   Solicitation number   Solicitation name   Firm name   Firm address   Contact name   Contact phone   Contact fax   Website address   Contact email address   Solicitation Checklist   Attachment A- Business Overview Questionnaire   Document how firm meets Minimum Qualifications (Section 3)   Detail to support evaluation criteria   Attachment B – Exception Form   Attachment C – Safety Record Questionnaire   Attachment D – Reference Form   Attachment E – Conflict of Interest Questionnaire Form – with signature   Attachment F - Acknowledgment   Acknowledgment of Addenda   Submission signed by authorized officer, in the order specified below   Hard Copy Submission: If submitting a hard copy, the City requires one (1) original and three (3) copies, with the pricing sheet submitted electronically in excel or emailed in excel to Ebids@cityofdenton.com with the solicitation # and name in the subject line.   Electronic Submission: If submitting an electronic proposal only, email to Ebids@cityofdenton.com with the solicitation # and name in the subject line. The pricing sheet (Exhibit 1) must be in excel format.   Order for Submission Document  1 Cover Sheet  2 Bid Bond (if required in Section 3- Minimum Qualifications)  3 Pricing Sheet – Exhibit 1  4 Solicitation Checklist  5 Attachment A- Business Overview Questionnaire  6 Attachment B – Exception Form  7 Attachment C – Safety Record Questionnaire  8 Attachment D – Reference Form  9 Attachment E – Conflict of Questionnaire Form  10 Attachment F - Acknowledgment  Submit response, with tabs marking each section, in the following order: ATTACHMENT A-BUSINESS OVERVIEW QUESTIONNAIRE AND FORMS Contractor legal name and address (for contracting purposes): Subsidiary of: Organization Class (circle): Partnership Corporation Individual Association Tax Payer ID#: Date Established: Historically Underutilized Business: Yes or No Does your company have an established physical presence in the State of Texas, or the City of Denton? Yes or No, in which? Please provide a detailed listing of all products and/or services that your company provides. Has your company filed or been named in any litigation involving your company and the Owner on a contract within the last five years under your current company name or any other company name? If so provide details of the issues and resolution if available. Include lawsuits where Owner was involved. Have you ever defaulted on or failed to complete a contract under your current company name or any other company name? If so, where and why? Give name and telephone number of Owner. Have you ever had a contract terminated by the Owner? If so, where and why? Give name and telephone number (s) of Owner (s). Has your company implemented an Employee Health and Safety Program compliant with 29 CFR 1910 “General Industry Standards” and/or 29 CFR 1926 “General Construction Standards” as they apply to your Company’s customary activities? http://www.osha.gov/pls/oshaweb/owasrch.search_form?p_doc_type=STANDARDS&p_toc_level=1&p_keyvalue=1926 Resident/Non-Resident Bidder Determination: Texas Government Code Section 2252.002: Non-resident bidders. Texas law prohibits cities and other governmental units from awarding contracts to a non-resident firm unless the amount of such a bid is lower than the lowest bid by a Texas resident by the amount the Texas resident would be required to underbid in the non-resident bidders’ state. In order to make this determination, please provide the name, address and phone number of: Responding firms principle place of business: Company’s majority owner principle place of business: Ultimate Parent Company’s principle place of business: Provide details to support the evaluation criteria, including experience and delivery. Provide details on how firm meets the minimum qualifications stated in this Main document Section 3. The details must be completed on this form, and shall not point to another document in the respondent’s proposal. Sign below and return form with final submission. I certify that our firm meets the minimum qualifications as stated in this Main document, Section 3. _______________________ _____________________ _____________________ Signature Company Date ATTACHMENT B-SUBMISSION EXCEPTIONS Any exceptions taken to this solicitation (including terms and conditions in Exhibit 2, the General Provisions and Terms and Conditions) must be itemized on the lines below. Additional pages may be added as needed. If there are no exceptions, please sign where indicated at the bottom of the page. Item # Description The above exceptions (and any additional pages identified) are the ONLY exceptions to the specifications, General Provisions and Terms and Conditions in Exhibit 2, and sample contract to this solicitation. I understand that the City may not accept additional exceptions produced after final submission of this proposal. _______________________ _____________________ _____________________ Signature Company Date No Exceptions are taken to this solicitation or the General Provisions and Terms and Conditions in Exhibit 2. _______________________ _____________________ _____________________ Signature Company Date ATTACHMENT C-SAFETY RECORD QUESTIONNAIRE The City of Denton desires to avail itself of the benefits of Section 252.0435 of the Local Government Code, and consider the safety records of potential contractors prior to award of City contracts. Pursuant to Section 252.0435 of the Local Government Code, the City of Denton has adopted the following written definition and criteria for accurately determining the safety record of a respondent prior to awarding City contracts. The definition and criteria for determining the safety record of a respondent for this consideration shall be: The City of Denton shall consider the safety record of the respondent in determining the responsibility thereof. The City may consider any incidence involving worker safety or safety of the citizens of the City of Denton, be it related or caused by environmental, mechanical, operational, supervision or any other cause or factor. Specifically, the City may consider, among other things: a. Complaints to, or final orders entered by, the Occupational Safety and Health Review Commission (OSHRC), against the respondent for violations of OSHA regulations within the past three (3) years. b. Citations (as defined below) from an Environmental Protection Agency (as defined below) for violations within the past five (5) years. Environmental Protection Agencies include, but are not necessarily limited to, the U.S. Army Corps of Engineers (USACOE), the U.S. Fish and Wildlife Service (USFWS), the Environmental Protection Agency (EPA), the Texas Commission on Environmental Quality (TCEQ), the Texas Natural Resource Conservation Commission (TNRCC) (predecessor to the TCEQ), the Texas Department of Health (TDH), the Texas Parks and Wildlife Department (TPWD), the Structural Pest Control Board (SPCB), agencies of local governments responsible for enforcing environmental protection or worker safety related laws or regulations, and similar regulatory agencies of other states of the United States. Citations include notices of violation, notices of enforcement, suspension/revocations of state or federal licenses or registrations, fines assessed, pending criminal complaints, indictments, or convictions, administrative orders, draft orders, final orders, and judicial final judgments. c. Convictions of a criminal offense within the past ten (10) years, which resulted in bodily harm or death. d. Any other safety related matter deemed by the City Council to be material in determining the responsibility of the respondent and his or her ability to perform the services or goods required by the solicitation documents in a safe environment, both for the workers and other employees of respondent and the citizens of the City of Denton. In order to obtain proper information from respondents so that City of Denton may consider the safety records of potential contractors prior to awarding bids on City contracts, City of Denton requires that respondents answer the following three (3) questions and submit them with their submissions: QUESTION ONE Has the respondent, or the firm, corporation, partnership, or institution represented by the respondent, or anyone acting for such firm, corporation, partnership or institution, received citations for violations of OSHA within the past three (3) years? YES NO If the respondent has indicated YES for question number one above, the respondent must provide to City of Denton, with its submission, the following information with respect to each such citation: Date of offense, location of establishment inspected, category of offense, final disposition of offense, if any, and penalty assessed. QUESTION TWO Has the respondent, or the firm, corporation, partnership, or institution represented by the respondent, or anyone acting for such firm, corporation, partnership or institution, received citations for violations of environmental protection laws or regulations, of any kind or type, within the past five years? Citations include notice of violation, notice of enforcement, suspension/revocations of state or federal licenses, or registrations, fines assessed, pending criminal complaints, indictments, or convictions, administrative orders, draft orders, final orders, and judicial final judgments. YES NO If the respondent has indicated YES for question number two above, the respondent must provide to City of Denton, with its submission, the following information with respect to each such conviction: Date of offense or occurrence, location where offense occurred, type of offense, final disposition of offense, if any, and penalty assessed. QUESTION THREE Has the respondent, or the firm, corporation, partnership, or institution represented by respondent, or anyone acting for such firm, corporation, partnership, or institution, ever been convicted, within the past ten (10) years, of a criminal offense which resulted in serious bodily injury or death? YES NO If the respondent has indicated YES for question number three above, the respondent must provide to City of Denton, with its submission, the following information with respect to each such conviction: Date of offense, location where offense occurred, type of offense, final disposition of offense, if any, and penalty assessed. ATTACHMENT D-REFERENCES Please list three (3) Government references, other than the City of Denton, who can verify the quality of service your company provides. The City prefers customers of similar size and scope of work to this solicitation. REFERENCE ONE   GOVERNMENT/COMPANY NAME: LOCATION: CONTACT PERSON AND TITLE: TELEPHONE NUMBER: SCOPE OF WORK: CONTRACT PERIOD: REFERENCE TWO   GOVERNMENT/COMPANY NAME: LOCATION: CONTACT PERSON AND TITLE: TELEPHONE NUMBER: SCOPE OF WORK: CONTRACT PERIOD: REFERENCE THREE   GOVERNMENT/COMPANY NAME: LOCATION: CONTACT PERSON AND TITLE: TELEPHONE NUMBER: SCOPE OF WORK: CONTRACT PERIOD: PROJECT INFORMATION FORM Please detail three (3) of the most recent projects your firm has completed: Project #1 Name of Project: Project Owner Name, Address and Phone Number: Original Contract Amount: Final Contract Amount: Contract Time Allotted (Calendar Days): Start Date for Project: Final Completion Date for Project: Number of Days to complete (calendar days): Please detail the project, including size, length, and materials used. Also describe any known contractual issues, successes, or potential problems and solutions encountered. _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ PROJECT INFORMATION FORM Project #2 Name of Project: Project Owner Name, Address and Phone Number: Original Contract Amount: Final Contract Amount: Contract Time Allotted (Calendar Days): Start Date for Project: Final Completion Date for Project: Number of Days to complete (calendar days): Please detail the project, including size, length, and materials used. Also describe any known contractual issues, successes, or potential problems and solutions encountered. _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ PROJECT INFORMATION FORM Project #3 Name of Project: Project Owner Name, Address and Phone Number: Original Contract Amount: Final Contract Amount: Contract Time Allotted (Calendar Days): Start Date for Project: Final Completion Date for Project: Number of Days to complete (calendar days): Please detail the project, including size, length, and materials used. Also describe any known contractual issues, successes, or potential problems and solutions encountered. _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________ ATTACHMENT E-CONFLICT OF INTEREST QUESTIONNAIRE CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ For vendor or other person doing business with local governmental entity  This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person who has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the person meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code. A person commits an offense if the person knowingly violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor.  1 Name of person who has a business relationship with local governmental entity.     2  Check this box if you are filing an update to a previously filed questionnaire.   (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.)  3 Name of local government officer with whom filer has an employment or business relationship.       Name of Officer    This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? Yes No Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? Yes No Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each affiliation or business relationship.  4  I have no Conflict of Interest to disclose.     5                Signature of person doing business with the governmental entity  Date    ATTACHMENT F-ACKNOWLEDGEMENT The undersigned agrees this submission becomes the property of the City of Denton after the official opening. The undersigned affirms he has familiarized himself with the specification, drawings, exhibits and other documents; the local conditions under which the work is to be performed; satisfied himself of the conditions of delivery, handling and storage of materials and equipment; and all other matters that will be required for the work before submitting a response. In submitting a response the undersigned further understands that the work required is to provide construction of the project that functions as described in the specification. The undersigned understands that all requirements of the construction may not be described in every detail and agrees to provide labor, tools, material and equipment necessary to complete all construction to make the project functional as described in the specification and drawings before submitting a response. The undersigned agrees, if this submission is accepted, to furnish any and all items/services upon which prices are offered, at the price(s) and upon the terms and conditions contained in the specification. The period for acceptance of this submission will be 120 calendar days unless a different period is noted. The undersigned affirms that they are duly authorized to execute this contract, that this submission has not been prepared in collusion with any other respondent, nor any employee of the City of Denton, and that the contents of this submission have not been communicated to any other respondent or to any employee of the City of Denton prior to the acceptance of this submission. Respondent hereby assigns to the City any and all claims for overcharges associated with this contract which arise under the antitrust laws of the United States, 15 USCA Section 1 et seq., and which arise under the antitrust laws of the State of Texas, Tex. Bus. & Com. Code, Section 15.01, et seq. The undersigned affirms that they have read and do understand the specifications, all exhibits and attachments contained in this solicitation package. The undersigned agrees that the solicitation package posted on the website are the official specifications and shall not alter the electronic copy of the specifications and/or pricing sheet (Exhibit 1), without clearly identifying changes. The undersigned understands they will be responsible for monitoring the City of Denton Purchasing Website at: http://www.cityofdenton.com/index.aspx?page=397 to ensure they have downloaded and signed all addendum(s) required for submission with their response. I certify that I have made no willful misrepresentations in this submission, nor have I withheld information in my statements and answers to questions. I am aware that the information given by me in this submission will be investigated, with my full permission, and that any misrepresentations or omissions may cause my submission to be rejected. Acknowledge receipt of following addenda to the solicitation: Addendum No 1 Dated _______________________ Received _________________ Addendum No 2 Dated _______________________ Received _________________ Addendum No 3 Dated _______________________ Received _________________ NAME AND ADDRESS OF COMPANY: AUTHORIZED REPRESENTATIVE: ___________________________________ Signature ___________________________________ Date ___________________________________ Name ___________________________________ Title Tel. No. ____________________________ Fax No. Email.