5955-0 CC Check Processing Svc -Main RFP
/
Materials Management Department
901-B Texas Street
Denton, Texas 76209
REQUEST FOR PROPOSALS
RFP 5955
SUPPLY OF DEBIT/CREDIT CARD AND ELECTRONIC CHECK PROCESSING SERVICES FOR THE CITY OF DENTON
NIGP CLASS and ITEM
946
25
946
35
946
70
Issue Date: October 19th, 2015
Response due Date and Time (Central Time):
Thursday, November 17, 2015, 11:00 A.M.
Table of Contents
1. INTRODUCTION 3
2. COMMODITY OR SERVICE DESCRIPTION 3
3. MINIMUM QUALIFICATIONS 3
4. SCHEDULE OF EVENTS 6
5. PRE-SUBMITTAL CONFERENCE AND WALKTHROUGH 7
6. CONTRACT TERM 7
7. PRICING 7
8. ADDENDA 7
9. BUSINESS OVERVIEW 7
10. EXCEPTIONS 7
11. DISCLOSURES 8
12. ACKNOWLEDGEMENT 8
13. PRODUCT LITERATURE 8
14. EQUIPMENT SCHEDULE 8
15. SAMPLE MONTHLY STATEMENT 8
16. SUBMITTAL INSTRUCTIONS 8
a. Submission Format 9
b. Electronic Submission Requirements 9
17. EVALUATION PROCEDURES 9
18. CONTACT BETWEEN RESPONDENT AND THE CITY 11
SOLICITATION CHECKLIST 12
ATTACHMENT A-BUSINESS OVERVIEW QUESTIONNAIRE AND FORMS 12
ATTACHMENT B-SUBMISSION EXCEPTIONS 16
ATTACHMENT D-REFERENCES 17
ATTACHMENT E-CONFLICT OF INTEREST QUESTIONNAIRE 18
ATTACHMENT F-ACKNOWLEDGEMENT 19
Exhibit 1 Pricing Sheet
Exhibit 2 General Provisions, Standard Terms and Conditions and Appendices
Exhibit 3 Scope of Work or Technical Specifications
Exhibit 4 NOT APPLICABLE
Exhibit 5 NOT APPLICABLE
Exhibit 6 NOT APPLICABLE
INTRODUCTION
In accordance with the provisions of Texas Local Government Code, Chapter 252 and 271, the City of Denton (the City) is requesting submissions to contract with an individual or business
with considerable experience in providing goods or 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.
A firm may submit a solicitation response for one or more of the categories of product or services requested in this solicitation.
COMMODITY OR SERVICE DESCRIPTION
The City is seeking a term contract for the supply of Debit/Credit Card and Electronic Check Processing Services to be purchased as needed over the contract term.
The products and services shall be accomplished per all exhibits identified in the table of contents.
MINIMUM QUALIFICATIONS
PART 1: MINIMUM QUALIFICATIONS FOR DEBIT/CREDIT CARD PROCESSING
The following minimum qualifications for debit/credit card processing 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 qualifications for debit/credit card processing shall be immediately disqualified and rejected as non-responsive.
The Respondent must provide encryption, tokenization and Euro MasterCard Visa (EMV) capable equipment (contact and contactless) and software.
For Point of Purchase (POP) locations, provide specifications on EMV equipment being proposed.
The Respondent must provide thermal printer or other comparable printing equipment.
Respondent must serve as the gateway, acquirer and processor through a fully integrated solution by themselves or through a third party. In addition, Respondent must be able to fully
integrate into the City’s existing software via an Application Program Interface (API) set up by Paymentus (formerly, Teleworks) the City’s payment integrator.
The Respondent must be PCI DSS compliant.
The Respondent must provide the following payment avenues:
Point of Purchase (POP)
Mail Order/Telephone Order (MOTO)
Virtual Terminal
Internet with and without convenience fee
Smart Phones and Tablets
The Respondent must provide next day settlement via ACH into the City’s bank account. Settlement must be in Central Standard Time (CST) and each Merchant Identification Number (MID)
must have auto-close at midnight CST.
The total of the settled batch amounts shall be posted to the City’s bank account and not be reduced by the applicable discount fees (i.e. gross settlement).
The Respondent must provide mechanisms and systems for the City to accept Visa, MasterCard and Discover Debit/Credit Cards (PIN and signature based).
The Respondent must provide real time authorization including notification of decline and reason for decline. The Respondent must provide a toll-free number for verbal card authorizations,
as needed.
An authorization number must be generated after processing a transaction successfully.
Proper monitoring and notification processes must be in place if an authorization fails.
The Respondent must provide batch settlement per MID.
The Respondent must provide anti-fraud verification services as listed below:
Address Verification Service (street number, zip code).
Card Security Verification Service (Visa CVV2, MasterCard CVC2).
Any others as may be used in the future in the payment card industry.
The Respondent must provide the notifications for chargebacks, refunds/credits, and adjustments.
The City’s Finance Department must receive notification of any chargeback or adjustment.
Chargebacks and adjustments cannot be combined and must post individually to the City’s bank account.
The Respondent must provide a separate Merchant Identification Number (MID) for each location. The numbers must be grouped in hierarchy under a department structure. The numbers must
also have the City’s reference number imbedded in each MID which should be identified in the addenda information provided in the ACH funding process. This number is used for bank reconciliation
purposes.
The Respondent must provide the capability of systematically identifying and eliminating duplicate transactions.
The Respondent must provide customer technical support for all services 24 hours per day, seven days a week, 365 days a year.
The Respondent must provide a dedicated account representative to serve as the primary contact with the City’s Finance Department.
The Respondent must provide pricing based on “Interchange Plus.”
The Respondent must provide at least three (3) references from governmental entities for the products or services requested. The City prefers references from municipalities of similar
or larger size.
The Respondent must be registered in the State of Texas, or the County of Denton, to provide the products or services required in the 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.
PART 2: MINIMUM QUALIFICATIONS FOR OPTIONAL ELECTRONIC CHECK PROCESSING
The following minimum qualifications for electronic check processing 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 qualifications for electronic check processing shall be immediately disqualified and rejected as non-responsive.
The Respondent must provide electronic check conversion services with verification and guarantee. This will apply to both Point of Purchase (POP) and Mail Order/Telephone Order (MOTO)
environments.
The Respondent must provide industry standard hardware utilizing horseshoe bend-style check processor with COM or USB (preferred) connectivity to interface with current Microsoft Windows-based
desktop computer. Processor must perform MICR capture, two-
sided check imaging, and endorsement of the item in one pass and/or electronically franked “presented.”
The Respondent must provide daily batch settlement in Central Standard Time (CST).
The Respondent must be in compliance with NACHA and Check 21 regulations.
The Respondent must provide return check notifications and only two (2) check presentments.
The Respondent must provide real time authorization including notification of decline and reason for decline. The Respondent must provide a toll-free number for customer service support
for check declines.
The Respondent must provide next day settlement via ACH into the City’s bank account. Settlement must be in Central Standard Time (CST) and each Merchant Identification Number (MID)
must have auto-close at midnight CST.
The Respondent must provide a separate Merchant Identification Number (MID) for each location. The numbers must be grouped in hierarchy under a department structure. The numbers must
also have the City’s reference number imbedded in each MID which should be identified in the addenda information provided in the ACH funding process. This number is used for bank reconciliation
purposes.
The total of the settled batch amounts shall be posted to the City’s bank account and not be reduced by the applicable discount fees (i.e. gross settlement).
SCHEDULE OF EVENTS
The City of Denton reserves the right to change the dates indicated below:
Solicitation Schedule:
Issue Solicitation: 10/19/2015
Deadline for Submission of Questions: 11/6/2015 at 11:00 AM CST
Deadline for Submission of Responses: 11/17/2015 at 11:00 AM CST
Interview(s) with top ranked firms: 12/3/2015
Evaluate and rank initial results: 11/20/2015
Completion of Negotiations: 12/11/2015
Official Award: 1/5/2015
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
There will be no pre-submittal conference for this solicitation.
CONTRACT TERM
It is the intention of the City of Denton to award a contract for a five (5) year period. The Contract shall commence on June 1, 2016. At the sole option of the City of Denton, the
Contract may be extended as needed, not to exceed a total of four (4) months.
PRICING
Unit Pricing in Exhibit 1 shall include all fees and costs to provide the goods and services to the City. Unit pricing for goods shall include delivery costs, F.O.B. Destination
Only firm pricing with no escalation will be accepted for these goods or services.
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 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.
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).
PRODUCT LITERATURE
Complete descriptive literature for each proposed item to include outline drawings, nameplate data and verification of other ratings.
EQUIPMENT SCHEDULE
The respondent shall provide an equipment schedule for the proposed solution.
SAMPLE MONTHLY STATEMENT
The respondent shall provide a sample monthly statement with the proposal for review.
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. Please consolidate attachments as much as possible, and do not
exceed 35MB total for attachments. 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 or 35 MB is file size
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 (if applicable form will be attached)
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 RFP number and name in the subject line, consolidate attachments
as much as possible, and not exceed 35MB total. 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. 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:
Compliance with specifications, quality, reliability, characteristics to meet stated or implied needs (FACTOR 30%)
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: 20%).
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: 50%).
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-c. 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.
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:
Karen E. Smith
Assistant Purchasing Manager
901-B Texas Street
Denton, TX 76209
(940) 349-7100
Fax: (940) 349-7302
Karen.smith@cityofdenton.com
*** Please do not email the buyer the final proposal unless requested after the due date and time published on the coversheet. A proposal should be emailed to ebids@cityofdenton.com
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/Technical Specifications
Cover sheet
Solicitation number
Solicitation name
Firm name
Firm address
Contact name
Contact phone
Contact fax
Website address
Contact email address
Solicitation Checklist
Equipment Schedule ( Section 14 of Main RFP)
Submission of Sample Monthly Statement (Section 15 of Main RFP)
Attachment A- Business Overview Questionnaire
Document how firm meets minimum qualifications (Section 3)
Detail to support evaluation criteria
Attachment B – Exception Form
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
Pricing Sheet – Exhibit 1
3
Solicitation Checklist
4
Attachment A- Business Overview Questionnaire
5
Attachment B – Exception Form
6
Attachment C – Safety Record Questionnaire (if applicable)
7
Attachment D – Reference Form
8
Attachment E – Conflict of Questionnaire Form
9
Attachment F - Acknowledgment
Submit response, with tabs marking each section, in the following order:
ATTACHMENT A-BUSINESS OVERVIEW QUESTIONNAIRE AND FORMS
Contract Information (for formal contracting purposes):
The following information will be used to write a contract, should your firm be selected for award.
Firm’s Legal Name:
Address:
Agent Authorized to sign contract (Name):
Agent’s email address:
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 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:
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.
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.