AEPA 024-A Part E Signature Forms - Natural & Synthetic Surfaces - final

Part E – Signature Forms
AEPA 024-A
NATURAL & SYNTHETIC SURFACES FOR SPORTS FIELDS, TRACKS, COURTS, PLAYGROUND & LANDSCAPING
APPLICATIONS


Instructions
Contained herein are forms that require a signature from an authorized person at your company. All items found
within this document are mandatory. Failure to sign the required areas, sections, or signature lines will allow
AEPA to consider your company’s proposal as non-responsive.

To submit the required signed forms, follow these steps:
    1. Read the documents in their entirety.
    2. Complete all forms and sign when required.
    3. Return the forms and pages in their correct order and scan one (1) single PDF format titled “Part E –
       Signature Forms – Name of Bidding Company” (i.e. one PDF document for all signature forms).
    4. Submit Part E, along with other required documents in Public Purchase.


*Note, a bid checklist has been provided to review with your submission.


The following sections will need to be completed prior to submission as one (1), single PDF titled “Part E –
Signature Forms – Name of Bidding Company”.

Uniform Guidance “EDGAR” Certification Form – *signature required
Bid Affidavit – *signature required
Acceptance of Bid & Contract Award – *signature required




AEPA 024-A Part E – Signature Forms             1                          Due Date: September 12, 2023 at 1:30 p.m. ET
 Uniform Guidance “EDGAR” Certification Form
 2 CFR Part 200
When a purchasing agency seeks to procure goods and services using funds under a federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state 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, referred to as the “Uniform Guidance” or new “EDGAR”. All Respondents submitting proposals
must complete this EDGAR Certification form regarding the Respondent’s willingness and ability to comply with certain
requirements, which may apply to specific agency purchases using federal grant funds.

For each of the items below, the Respondent will certify its agreement and ability to comply, where applicable, by having
the Respondent’s authorized representative check, initial the applicable boxes, and sign the acknowledgment at the end
of this form. If a Respondent fails to complete any item of this form, AEPA will consider and may list the response, as the
Respondents are unable to comply. A “No” response to any of the items below may influence the ability of a purchasing
agency to purchase from the Respondent using federal funds.

 1. Violation of Contract Terms and Conditions
 Provisions regarding Respondent default are included in AEPA’s terms and conditions. Any contract award will be
 subject to such terms and conditions, as well as any additional terms and conditions in any purchase order, ancillary
 agency contract, or construction contract agreed upon by the Respondent and the purchasing agency, which must be
 consistent with and protect the purchasing agency at least to the same extent as AEPA’s terms and conditions. The
 remedies under the contract are in addition to any other remedies that may be available under law or in equity.

 2. Termination for Cause of Convenience
 For a participating agency purchase or contract in excess of $10,000 made using federal funds, you agree that the
 following term and condition shall apply:

 The participating agency may terminate or cancel any purchase order under this contract at any time, with or without
 cause, by providing seven (7) business days in advance written notice to the Respondent. If this agreement is
 terminated in accordance with this paragraph, the participating agency shall only be required to pay Respondent for
 goods and services delivered to the participating agency prior to the termination and not otherwise returned in
 accordance with the Respondent’s return policy. If the participating agency has paid the Respondent for goods and
 services provided as the date of termination, Respondent shall immediately refund such payment(s).

 If an alternate provision for termination of a participating agency’s purchase for cause and convenience, including how
 it will be affected and the basis for settlement, is in the participating agency’s purchase order, ancillary agreement or
 construction contract agreed to by the Respondent, the participating agency’s provision shall control.

 3. Equal Employment Opportunity
 Except as otherwise provided under 41 CFR Part 60, all participating agency purchases or contract 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 under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment
 Opportunity” (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., 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. Respondent agrees
 that such provision applies to any participating agency purchase or contract that meets the definition of “federally
 assisted construction contract” in 41 CFR Part 60-1.3 and Respondent agrees that it shall comply with such provision.

 4. Davis Bacon Act
 When required by Federal program legislation, Respondent agrees that, for all participating agency contracts for the
 construction, alteration, or repair (including painting and decorating) of public buildings or public works, in excess of
 $2,000, Respondent shall comply with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by
 Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering
 Federally Financed and Assisted Construction”). In accordance with the statute, Respondent is required to pay wages

AEPA 024-A Part E – Signature Forms                  2                          Due Date: September 12, 2023 at 1:30 p.m. ET
 to laborers and mechanics at a rate not less than the prevailing wages specific in a wage determinate made by the
 Secretary of Labor. Also, Respondent shall pay wages not less than once a week.

 Current prevailing wage determinations issued by the Department of Labor are available at www.wdol.gov.
 Respondent agrees that, for any purchase to which this requirement applies, the award of the purchase to the
 Respondent is conditioned upon Respondent’s acceptance of wage determination.

 Respondent further agrees that is shall also comply with the Copeland “Anti-Kickback” Act (40 U.S.C. 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
 construction completion, or repair of public work, to give up any part of the compensation to which he is otherwise
 entitled under his contract of employment, shall be defined under this titled or imprisoned not more than five (5) years,
 or both.

 5. Contract Work Hours and Safety Standards Act
 Where applicable, for all participating agency purchases in excess of $100,000 that involve the employment of
 mechanics or laborers, Respondent agrees to comply with 40 U.S.C. 3702 and 3704, as supplemented by Department of
 Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, Respondent is required to compute the wages of
 every mechanic and laborer based on a standard workweek of 40 hours. Work in excess of the standard workweek is
 permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay
 for all hours worked in excess of 40 hours in the workweek. The requirements of the 40 U.S.C. 3704 applies to
 construction work and provides that no laborer or mechanic must be required to work in surroundings or under
 working conditions that are unsanitary, hazardous, or dangerous. These requirements do not apply to the purchase of
 supplies, materials or articles ordinarily available on the open market, or contracts for transportation or transmission
 of intelligence.

 6. Right to Inventions Made Under a Contract or Agreement
 If the participating agency’s federal award meets the definition of “funding agreement” under 37 CFR 401.2(a) and the
 recipient or sub-recipient wishes to enter into a contract with a small business firm or nonprofit organization regarding
 the substitution of parties, assignment or performance or experiments, developmental or research work under the
 “funding agreement,” the recipient or sub-recipient must comply with the requirements of 37 CFR Part 401, “Rights to
 Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and
 Cooperative Agreements,” and any implementing regulations issued by the awarding agency.

 7. Clean Air Act and Federal Water Pollution Control Act
 Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 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
 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act, as amended (33 U.S.C. 1251-1387). Violations must
 be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
 When required, Respondent agrees to comply with all applicable standards, orders, or regulations issued pursuant to
 the Clean Air Act and the Federal Water Pollution Control Act.

 8. Debarment and Suspension
 Debarment and Suspension (Executive Orders 12549 and 12689), a contract award (see 2 CFR 180.222) must not be
 made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance
 with OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689
 (3 CFR Part 1989 Comp. p. 235), “Debarment and Suspension.” SAM exclusions contain 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. Respondent certifies that the Respondent is not currently listed and
 further agrees to immediately notify AEPA and all participating agencies with pending purchases or seeking to purchase
 from the Respondent if Respondent is later listed on the government-wide exclusions in SAM, or is debarred, suspended,
 or otherwise excluded by agencies or declared ineligible under state statutory or regulatory authority other than
 Executive Order 12549.

 9. Byrd Anti-Lobbying Amendment


AEPA 024-A Part E – Signature Forms                 3                          Due Date: September 12, 2023 at 1:30 p.m. ET
 Byrd Anti-Lobbying Amendment (31 U.S.C. 1352), Respondents 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 not and has not used Federal appropriated
 funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency,
 a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with
 obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any
 lobbying with non-Federal funds that take place in connection with obtaining any Federal award. Such disclosures are
 forwarded from tier to tier up to the non-Federal award.

 10. Procurement of Recovered Materials
 For participating agency purchases utilizing Federal funds, Respondent 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 participating agency 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 CFR Part 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.

 11. Profit as a Separate Element of Price
 For purchases using federal funds in excess of $150,000, a participating agency may be required to negotiate profit as
 a separate element of the price. See 2 CFRR 200.323(b). When required by a participating agency, Respondent agrees
 to provide information and negotiate with the participating agency regarding profit as a separate element of the price
 for a particular purchase. However, Respondent agrees that the total price, including profit, charged by the Respondent
 to the participating agency shall not exceed the awarded pricing, including any applicable discount, under the
 Respondent’s contract with AEPA.

 12. General Compliance with Participating Agencies
 In addition to the foregoing specific requirements, Respondent agrees, in accepting any purchase order from a
 participating agency, it shall make a good faith effort to work with a participating agency to provide such information
 and to satisfy requirements as may apply to a particular purchase or purchases including, but not limited to, applicable
 record keeping and record retention requirements as noted in the Federal Acquisition Regulation, FAR 4.703(a).

 13. Governing Law; Forum Selection.
 Respondent acknowledges and agrees that any legal action or proceeding in which the Association of Educational
 Purchasing Agencies, Inc. (“AEPA”), is a party, that in any way relates to this solicitation, any contract award or the
 services provided thereunder, any other document executed in connection herewith, or for recognition and
 enforcement of any judgment in respect hereof brought by Respondent, a participating agency, or other party hereto,
 or its successors or assigns, will be governed by, construed and interpreted by the laws of the Commonwealth of
 Kentucky, and must be brought and determined in the state courts of the Commonwealth of Kentucky in Warren County,
 Kentucky, or the United States Western District of Kentucky (and may not be brought or determined in any other forum
 or jurisdiction), and each party hereto submits with regard to any action or proceeding for itself and in respect of its
 property, generally and unconditionally, to the sole and exclusive jurisdiction of the aforesaid courts and waives any
 further objection.

 Respondent further acknowledges and agrees that any legal action or proceeding in which a party includes a
 participating agency, but does not include AEPA as a party, that in any way relates to this solicitation, any contract
 award or the services provided thereunder, any other document executed in connection herewith, or for recognition
 and enforcement of any judgment in respect hereof brought by Respondent, a participating agency, or other party
 hereto, or its successors or assigns, will be governed by, construed and interpreted by the laws of the state in which the
 participating agency is domiciled, and must be brought and determined in the state in which the participating agency
 is domiciled (and may not be brought or determined in any other forum or jurisdiction), and each party hereto submits
 with regard to any action or proceeding for itself and in respect of its property, generally and unconditionally, to the
 sole and exclusive jurisdiction of the aforesaid courts and waives any further objection.




AEPA 024-A Part E – Signature Forms                   4                           Due Date: September 12, 2023 at 1:30 p.m. ET
 By initialing the table (1-13) and signing below, I certify that the information in this form is true,
 complete and accurate and I am authorized by my business to make this certification and all consents
 and agreements contained herein.
                Respondent Certification (By Item)                    Respondent Certification:       Initial
                                                                            YES, I agree or
                                                                          NO, I do NOT agree
 1. Violation of Contract Terms and Conditions

 2. Termination for Cause of Convenience

 3. Equal Employment Opportunity

 4. Davis-Bacon Act

 5. Contract Work Hours and Safety Standards Act

 6. Right to Inventions Made Under a Contract or Agreement

 7. Clean Air Act and Federal Water Pollution Control Act

 8. Debarment and Suspension

 9. Byrd Anti-Lobbying Amendment

 10. Procurement of Recovered Materials

 11. Profit as a Separate Element of Price

 12. General Compliance with Participating Agencies

 13. Governing Law; Forum Selection.




Name of Business




Signature of Authorized Representative



Printed Name



Date




AEPA 024-A Part E – Signature Forms             5                        Due Date: September 12, 2023 at 1:30 p.m. ET
 Solicitation Affidavit
Instructions: This form must be signed by the business’s authorized representative and notarized below. If awarded, the
Respondent is required to produce a copy of this document for each Member Agency with which it contracts.
1. The undersigned, is duly authorized to represent the persons, business and corporations joining and participating in
   the submission of the foregoing bid (such persons, business and corporations hereinafter being referred to as the
   Respondent), being duly sworn, on his/her oath, states that to the best of his/her belief and knowledge no person,
   business or corporation, nor any person duly representing the same joining and participating in the submission of the
   foregoing bid, has directly or indirectly entered into any agreement or arrangement with any other Respondents, or
   with any official of the Member Agency, or any employee thereof, or any person, business or corporation under
   contract with the Member Agency whereby the Respondent, in order to induce the acceptance of the foregoing bid by
   the Member Agency, has paid, or is to pay to any other Respondent, or to any of the aforementioned persons, anything
   of value whatever, and that the Respondent has not, directly nor indirectly entered into any arrangement, or
   agreement, with any other Respondent or Respondents which tends to or does lessen or destroy free competition in
   the letting of the contract sought for by the foregoing bid.
2. This is to certify that the Respondent, or any person on his/her behalf, has not agreed, connived, or colluded to produce
   a deceptive show of competition in the manner of the bidding, or award of the referenced contract.
3. This is to certify that neither I, nor to the best of my knowledge, information and belief, the Respondent, nor any officer,
   director, partner, member or associate of the Respondent, nor any of its employees directly involved in obtaining
   contracts with the Member Agency, or any subdivision of the state has been convicted of false pretenses, attempted
   false pretenses, or conspiracy to commit false pretenses, bribery, attempted bribery or conspiracy to bribe under the
   laws of any state or federal government for acts or omissions after January 1, 1985.
4. This is to certify that the Respondent or any person on his behalf has examined and understands the terms, conditions,
   the scope of work and specifications, and other documents of this solicitation and that any and all exceptions have
   been noted in writing and have been included with the bid submittal.
5. This is to certify that if awarded a contract, the Respondent will provide the equipment, commodities, and/or services
   to members and affiliate members of the Agency in accordance with the terms, conditions, the scope of work and
   specifications and other documents of this solicitation in the following pages of this bid.
6. This is to certify that the Respondent is authorized by the manufacturer(s) to sell all proposed products on a national
   basis.
7. This is to certify that we have completed, reviewed, approved, and have included all information that is required of
   these bid forms.




 Authorized Representative (Please print or type)               Mailing Address




 Title (Please print or type)                                   City, State, Zip




 Signature of Authorized Representative                         Date




AEPA 024-A Part E – Signature Forms                   6                            Due Date: September 12, 2023 at 1:30 p.m. ET
  Acceptance of Solicitation & Contract
  Award PART I of this form is to be completed by the Respondent and signed by its Authorized Representative. PART II will be
Instructions:
completed by the AEPA Member Agency only upon the occasion of the bid award. If approved by AEPA, the Respondent is required to produce
a copy of the document for each of the AEPA Member Agency with which it contracts.

PART I: RESPONDENT
In compliance with the Published Solicitation (IFB OR RFP), the undersigned warrants that I/we have examined all
Instructions to Respondents, associated documents, and being familiar with all of the conditions of the solicitation, hereby
offer and agree to furnish all labor, materials, supplies, and equipment incurred in compliance with all terms, conditions,
specifications, and amendments associated with this IFB OR RFP and any written exceptions to the bid. The signature also
certifies understanding and compliance with the certification requirements of the AEPA Member Agency’s Terms and
Conditions and/or Special Terms and Conditions. The undersigned understands that their competence, ability, capacity
and obligations to offer and provide the proposed tangible personal property, professional services, construction services,
and other services on behalf of the Vendor Partner as well as other factors of interest to the AEPA Member Agency as
stated in the evaluation section, will be a consideration in making the award.

 Business Name                                                          Date

 Address                                                                City, State Zip

 Contact Person                                                         Title


 Authorized Signature                                                   Title

 Email                                                                  Phone

PART II: AWARDING MEMBER AGENCY
Your bid response for the above-identified bid is hereby accepted. As a Vendor Partner, you are now bound to offer and
provide the products and services identified within this solicitation, your response, and approved by AEPA, including all
terms, conditions, specifications, exceptions, and amendments. As a Vendor Partner, you are hereby not to commence any
billable work or provide any products or services under this contract until an executed purchase order is received from
the AEPA Member Agency or Participating Entities. This contract intends to constitute the final and complete agreement
between the AEPA Member Agency and Vendor Partner, and no other agreements, oral or otherwise, regarding the subject
matter of this contract, shall bind any of the parties hereto. No change or modification of this contract shall be valid unless
in writing and signed by both parties to this contract. If any provision of this contract is deemed invalid or illegal by any
appropriate court of law, the remainder of this contract shall not be affected thereby. The initial term of this contract shall
be for up to fifteen (15) months and will commence on the date indicated below and continue until February 28,
2025unless terminated, canceled, or extended. By mutual written agreement the contract may be extended for three (3)
additional 12-month periods after this initial contract term. In the event the AEPA Board does not recommend renewal of
the contract, or the contract expires, it may be extended for up to six (6) months by an AEPA state.

 Awarding Agency


 Authorized Representative

 Awarded this                             day of                                          Contract Number
 Contract to commence
 (Member Agency to select)                                3/1/2024                                Or


AEPA 024-A Part E – Signature Forms                      7                                Due Date: September 12, 2023 at 1:30 p.m. ET
 Solicitation Checklist
 Instructions: Utilize the checklist below, reviewing to confirm that all the required documents have been
 uploaded to Public Purchase, in their specified/required format, by the due date and time listed for this
 solicitation. Submissions not following the specified/required format may result in being marked non-
 responsive and may not be considered for evaluation. Respondents are reminded that failure to follow, comply
 with, and adhere to the enclosed instructions of this solicitation may result in their response being deemed non-
 responsive. AEPA, its Member Agencies, affiliate agencies, and authorized representatives are not responsible for
 bid proposals that are incomplete, unreadable, or received after the solicitation deadline submission date.
 “x” Document Title, Uploaded to Public Purchase                  Format of Uploaded          Notes
        (Respondent must submit documents in the required         Document
       title/format)
       Bid Bond – if Required, see Part B if applicable.        Upload PDF copy of the       The original bid
                                                                bid security.                security must be
                                                                                             received by Lakes
                                                                                             Country Service
                                                                                             Cooperative by due
                                                                                             date and time.
       Part C – State-Specific Forms – Name of Responding       Single, Scanned PDF          New Jersey Only
       Company                                                                               Requirement.
                                                                                             Signatures Required.
       Part D - Questionnaire – Name of Responding              Single, Scanned PDF          Required.
       Company
       Includes:
           • Company Information
           • Service Questionnaire
           • Exceptions
           • Deviations
       Part E – Signature Forms – Name of Responding            Single, Scanned PDF          Required.
       Company                                                                               Signatures required.
       Includes:
           • Uniform Guidance “EDGAR” Certification
           • Bid Affidavit
           • Acceptance of Bid & Contract Award
       Part F – Pricing Schedule – Name of Responding           Excel Workbook               Required.
       Company
       Price List and/or Catalog – Name of Responding           Upload PDF                   Required.
       Company
       Exhibit A – Marketing Plan – Name of Responding          Scanned PDF                  Optional. Form not
       Company                                                                               provided by AEPA,
                                                                                             Respondent Created




AEPA 024-A Part E – Signature Forms              8                        Due Date: September 12, 2023 at 1:30 p.m. ET