Purchasing
730 Wisconsin Avenue
Racine WI 53403
262-636-3700
Duane.McKinney@racinecounty.com
June 15, 2022
Dear Prospective Bidder:
You are invited to submit a bid to provide HVAC Products, Installation, Labor Based Solutions,
and Related Products and Services for Racine County and other municipal governments and
local public agencies. A copy of this solicitation is available for download at:
https://www.racinecounty.com/departments/finance/purchasing-rfps-and-bids. Submitted bids
are due on or before 1:00 p.m. CST on Thursday July 21, 2022, you must submit electronically
online using the DemandStar application at www.DemandStar.com. Late bids will not be
accepted.
Bids must be submitted electronically online using the DemandStar application at
www.DemandStar.com. The terms ‘Firms’, ‘Suppliers’, ‘Contractors’, ‘Offeror’, ‘Vendor’,
‘Respondent’, and/or ‘Bidder’ may be used interchangeably.
General questions regarding this solicitation should be directed to Duane McKinney at (262)
636-3700 or via email at Duane.McKinney@racinecounty.com.
Technical questions should be submitted via email to Duane McKinney, Purchasing Manager, at
Duane.McKinney@racinecounty.com.
No other Racine County employee or representative is authorized to provide information or
interpret any portion of this solicitation. No contact from a vendor to any Racine County
employee or elected official should be made during this process unless authorized by Racine
County Finance Department.-Purchasing Division.
If your firm chooses not to submit a response for this procurement, please complete Attachment
E – No Bid Form.
RACINE COUNTY RESERVES THE RIGHT TO ACCEPT OR REJECT ANY OR ALL BIDS; TO
WAIVE ANY TECHNICALITY OR ERROR IN ANY BID OR PART THEREIN, AND TO ACCEPT
THE SAME OR COMBINATIONS, IN WHOLE OR IN PART, WHICHEVER IS DEEMED TO BE
IN THE BEST INTEREST OF RACINE COUNTY IN ITS SOLE AND EXCLUSIVE
DISCRETION.
Sincerely,
Duane McKinney
Racine County Purchasing Manager
Encl: Bid Package
INVITATION FOR BID
IFB # RC2022-1001
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND
RELATED PRODUCTS AND SERVICES
I. PROJECT OVERVIEW
Racine County is accepting bids for HVAC Products, Installation, Labor Based Solutions,
and Related Products and Services. The Master Agreement will allow government agencies
to purchase the products and services defined herein, in indefinite quantities on an as-
needed basis. Participating Public Agencies may have different requirements and they may
choose to sign supplemental agreements with the Awarded Bidder(s) to conform to their
purchasing and contracting requirements.
A. STEP-ONE
For the first step of the bidding process, Bidders will submit their sealed bid with all
requested information, to include Certification of Vendor, and Attachment C – Bid Form
by the due date and time outlined in this IFB. After the due date and time, all Bids will be
reviewed to determine if they are responsive, responsible, and meet the minimum
requirements. Each Bidder determined to be responsive, responsible, and qualified shall
be deemed to be a “Responsible Bidder”.
B. STEP-TWO
For the second step of the bidding process, Racine County will distribute to each
Responsible Bidder the Sample Project Forms, which have already been prepared and
are actual (hypothetical) projects. When completing the Sample Project Form,
Responsible Bidders are required to USE THE SAME LINE ITEM PRICING from
Attachment C – Bid Form and apply them to the Sample Projects Forms to be supplied
upon identification of a Responsible Bidder(s) in the first step; a reduction in price for the
sample projects outlined in a Responsible Bidder’s Sample Project Form will not be
allowable. The final basis for award to the lowest responsible Bidder(s) will result from
the lowest total dollar amount of the combined sample projects.
II. INSTRUCTION TO BIDDERS
A. SCHEDULE
Issuance of Bid: Wednesday June 15, 2022
Virtual Only Non-Mandatory
Pre-Bid Meeting: Wednesday June 29 at 10am (CST), 2022
Deadline for Bidder Questions: Wednesday June 29, 2022 by 5pm (CST)
Addendum/Questions Answered
for Solicitation: Wednesday July 6, 2022
Bid Due Date: Thursday July 21, 2022 by 1pm (CST)
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B. BIDDER’S QUESTIONS
Bidders are reminded to carefully examine the bid packet and specifications upon
receipt. If the Bidder does not fully understand the Invitation for Bid (IFB) or is in doubt
as to the County’s ideas or intentions concerning any portion of the IFB, any/all
questions shall be submitted in writing to Duane McKinney, Purchasing Manager by 5:00
p.m. on Wednesday June 29, 2022, either by fax or e-mail for interpretation or correction
of any printed material:
Fax: 262-636-3763
E-mail: Duane.McKinney@racinecounty.com
No verbal explanation or instructions will be given in regard to the meaning of the
specifications during the response period. If necessary, in Racine County’s sole
discretion, answers to questions will be provided to all specification holders in the form of
an addendum. Any addendum will include a list of each question received and Racine
County’s response as of the date of the addendum.
C. ADDENDA
Any changes made to the Invitation to Bid after posting will be issued via addenda to all
prospective bidders and if necessary, an extension will be made to the Bid Due Date.
The original Invitation to Bid and any addenda will be posted to the Racine County
Website https://www.racinecounty.com/departments/finance/purchasing-rfps-and-bids.
Bidders are responsible for checking this website for any future addenda prior to the
opening date. All addenda must be signed and returned with your submitted bid as
specified in the addenda. Bidders who do not return the addenda may have their bids
rejected.
If a vendor receives a bid packet from any source or entity other than the Racine County
Purchasing Department, the Bidder is responsible for contacting the Racine County
Purchasing Department and requesting the firm’s name be put on the response list for
the project. Failure to do so in no way obligates the County to send out addendum or
other information concerning this request to the firm.
D. VIRTUAL ONLY NON-MANDATORY PRE-BID MEETING
A non-mandatory (virtual only) pre-bid meeting will be held on Wednesday June 29,
2022 at 10am local time held by phone. Due to COVID, Bidders should register for the
meeting by Tuesday June 28, 2022 with Duane via above email or (262) 636-3700, to
obtain the dial in information.
While non-mandatory, it is strongly encouraged for Bidders to attend the pre-bid
meeting. Oral statements or discussions during the pre-bid meeting will not be binding.
Any questions should be submitted in writing per item B. of this Section. Changes, if any,
will only be made in writing via Addenda as described in item C. Addenda.
The purpose of this meeting will be to clarify the contents of this IFB in order to prevent
any misunderstandings of the IFB. Any doubt as to the requirements of this IFB or any
apparent omission or discrepancy should be presented to Racine County at this
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conference. Racine County will then determine the appropriate action necessary, if any,
and may issue a written addendum to the IFB. Oral statements or instructions will not
constitute an addendum to this IFB. No other Racine County employee or representative
is authorized to provide information or interpret any portion of this solicitation. Contact to
any Racine County employee or elected official regarding this IFB during this process is
prohibited unless authorized by the Racine County Purchasing Manager.
E. METHOD OF BID
Bidders must submit their bids using the Bid Form documents attached to this IFB and
incorporated herein as Attachment C and shall submit all other information and materials
required by this IFB. Bids written in pencil or in a format other than the attached forms will
be rejected. Erasures or corrections of mistakes on forms submitted shall be initialed or
signed by Bidder. Failure to meet any requirements listed in this solicitation document
may be cause for disqualification of the bid.
Any information considered to be proprietary by a Bidder must be plainly marked as such
and may not include pricing. Racine County makes no warranty or representation as to
the application of the Wisconsin Public Records Law (Wis. Stat. § 19.31, et seq.)(the
“WPRL”) to any documents and information submitted in response to this IFB. Each copy
of the response shall include the Certification of Vendor page and acknowledgement of
addendum(s) if any. A legally authorized representative of the Bidder will sign the
Certification of Vendor page.
F. INCURRING COSTS
Racine County shall not be liable for any costs incurred in replying to this IFB.
G. ADDITIONAL DATA WITH BID
Bidders may include any additional information deemed advantageous to Racine County.
Consideration of additional data and information is to be held optional to Racine County
however if an award is made, it will be awarded as outlined in Section D Award under
Part V. Award Information.
H. DUE DATE
You must submit electronically online using the DemandStar application at
www.DemandStar.com of your bid is to be received by 1:00 p.m. (CST) Thursday July
21, 2022, in the offices of the Racine County Purchasing Division. Bids received after
1:00 p.m. central time as dictated by www.time.gov shall be considered late and will not
be accepted. Late bids will not be accepted. Faxes will not be accepted.
Any Bid received by the County after this date and time will not be accepted. Bidders are
responsible for ensuring that the above office receives its Bid before the deadline. All
Bids will be reviewed and evaluated as described in Part V. Award Information
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I. WITHDRAWAL OF BIDS
Bids may be withdrawn on written or electronic request received from Bidder prior to
time and date fixed for bid opening if the bid contains a mistake, omission, or error.
Subject to Wis. Stat. § 66.0901(5), negligence on the part of the Bidder in preparing their
bid confers no right for withdrawal of the bid after it has been opened. Bids that are
withdrawn prior to the time and date set for bid opening with be returned unopened and
the Bidder may not re-submit a bid to this solicitation unless no contract is awarded
under this IFB and the IFB is re-advertised.
J. AMENDMENTS TO BIDS
Subject and pursuant to Wis. Stat. § 66.0901(5), each Bidder will be allowed a period of
forty-eight (48) hours after the time and date set for receipt of responses to notify the
County in writing of a material mistake in the bid. However, no changes to the line item
prices in Bid Form, included as part of this bid, are permitted after sealed bids are
accepted by the due date and time outlined in this IFB. Failure of Bidder to notify the
County in the manner and within the time limit specified above will constitute a waiver by
the Bidder of all rights and remedies relative to a material mistake.
Formal bid amendments thereto or requests for withdrawal of bid received by Racine
County after time specified for opening will not be considered.
K. BIDS BINDING 90 DAYS
Unless otherwise specified, all formal responses submitted shall be binding for ninety
(90) calendar days following the bid opening date.
II. TERMS AND CONDITIONS
A. GENERAL TERMS AND CONDITIONS
The successful Bidder(s) (the “Contractor”) agrees to all of Racine County’s General
Terms and Conditions located at
https://racinecounty.com/home/showdocument?id=11726 and incorporated by reference
herein.
B. INSURANCE
1. Requirement
Contractor shall procure and maintain in full force and effect for the duration of this
Agreement, insurance protecting against claims for injuries to persons or damages to
property which may arise from or in connection with performance of the work hereunder
by the Contractor, his agents, representatives, employees, or subcontractors.
2. Minimum Limits of Insurance
Each vendor shall obtain insurance at the following minimum limits:
• General Liability
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o $1,000,000 each occurrence
o $1,000,000 personal and advertising injury
o $2,000,000 general aggregate
o $2,000,000 products and completed operations aggregate
• Umbrella Liability Insurance on a following form basis
o $4,000,000 each occurrence
o $4,000,000 aggregate
o Any combination of underlying coverage and umbrella equaling $5,000,000
shall be acceptable.
• Workers Compensation Statutory Limits plus:
o $100,000 E.L. Each Accident
o $100,000 E.L. Disease Each Employee
o $500,000 E.L. Disease Policy Limit
The following applies to all policies:
• The county is named as an additional insured on the general liability, automobile,
and umbrella policies.
• All insurance must be placed with an insurance company with a minimum AM
Best Rating of A- VII
• The insurers shall agree under each required policy of insurance to waive all
rights of subrogation against the insured parties for losses arising from work
performed by the Contractor for Racine County.
The making of progress payments to the Contractor shall not be construed as relieving
the Contractor or its subcontractors or insurance carriers providing the coverage
described herein for responsibility for loss or direct physical loss, damage or destruction
occurring prior to final acceptance of the Work.
3. Deductibles and Self-Insured Retention
Any deductibles or self-insurance retentions must be declared to and approved by
Racine County so that the County may ensure the financial solvency of the Contractor.
At the option of the County, either the insurer shall reduce or eliminate such deductibles
or self-insured retentions as respects the County, its officers, officials, and employees; or
the Contractor shall procure a bond guaranteeing payment of losses and related
investigations, claim administration and defense expenses. Contractor shall pay all
deductibles and be liable for all claims, losses and damages for which it self-insures.
4. Other Insurance Provisions
The policies are to contain, or be endorsed to contain, the following provisions:
1. General Liability, Automobile Liability, and Umbrella/Excess Insurance
a. Additional Insured Requirement. Racine County, its elected and appointed
officials, officers, boards, commissions, officers, employees, representatives,
servants, volunteers and agents (hereinafter referred to as “Insured Party” or
“Insured Parties”) are to be covered as additional insureds as respects: liability
arising out of activities performed by or on behalf of the Contractor; products and
completed operations of the Contractor, premises owned, leased, or used by the
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Contractor; and automobiles owned, leased, hired, or borrowed by the
Contractor. The coverage shall contain no special limitations on the scope of
protection afforded to the Insured Parties. Nothing contained in this section shall
be construed to require the Contractor to provide liability insurance coverage to
the any Insured Party for claims asserted against such Insured Party for its sole
negligence.
b. Primary Insurance Requirement. The Contractor's insurance coverage shall be
primary and noncontributing insurance as respects to any other insurance or self-
insurance available to the Insured Parties. Any insurance or self-insurance
maintained by the Insured Parties shall be in excess of the Contractor's
insurance and shall not contribute with it.
c. Reporting Requirement. Any failure to comply with reporting provisions of the
policies shall not affect coverage provided to the Insured Parties.
d. Separate Coverage. Coverage shall state that the Contractor's insurance shall
apply separately to each Insured Party against whom claim is made or suit is
brought.
e. Defense Costs/Cross Liability. Coverage shall be provided on a “pay on behalf”
basis, with defense costs payable in addition to policy limits. There shall be no
cross liability exclusion.
5. Workers’ Compensation and Employers Liability Coverage
The Contractor shall have and maintain in full force and effect for the duration of
this Agreement, insurance protecting against claims for injuries to persons or
damages to property which may arise from or in connection with the performance
of the Work by the Contractor, its agents, representatives, employees or
subcontractors. The insurer shall agree to waive all rights of subrogation against
Racine County, and its officers, officials, employees and volunteers for losses
arising from the work performed by the Contractor for Racine County.
6. Waiver of Subrogation
The insurers shall agree under each policy of insurance required by this Contract
to waive all rights of subrogation against the Insured Parties for losses arising
from work performed by the Contractor for Racine County.
7. All Coverages
1. Notice Requirement.
Each insurance policy required by this Contract shall be endorsed to state that
coverage shall not be suspended, voided, canceled, reduced in coverage or in
limits except after thirty (30) days' prior written notice by certified mail, return
receipt requested, has been given to Racine County Courthouse, Purchasing
Department, 730 Wisconsin Avenue, Racine WI 53403. The County reserves the
right to accept alternate notice terms and provisions provided they meet the
minimum requirements under Wisconsin law.
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2. Acceptability.
The insurance to be maintained by Contractor must be issued by a company
licensed or approved to transact business in the State of Wisconsin. Such
insurance shall be placed with insurers with a Best's Policyholder’s Rating of “A”
or better and with a financial rating of Class VII or greater, or be otherwise
acceptable to Racine County. All policies shall be subject to approval by the
Racine County Corporation Counsel as to form and content.
3. Failure of Insurers.
The Contractor shall be responsible for any delay resulting from the failure of any
insurer to furnish proof of coverage in the prescribed form.
8. Verification of Coverage
Prior to execution of the contract, Contractor shall furnish Racine County with
certificates of insurance and endorsements to the policies evidencing all
coverages required by this Contract. Additionally, the declarations page for each
insurance policy listed on the certificate of insurance shall be submitted to the
County. The certificates and endorsements for each insurance policy are to be
signed by a person authorized by that insurer to bind coverage on its behalf. The
certificates shall reference the contract and provide for thirty (30) days advance
notice of cancellation or non-renewal during the term of the contract. Racine
County reserves the right to require complete, certified copies of all required
insurance policies at any time. The contractor shall provide proof that any
expiring coverage has been renewed or replaced prior to the expiration of the
coverage.
9. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or shall
furnish separate certificates and endorsements for each subcontractor. All
coverage for subcontractors shall be subject to all of the requirements stated in
this Agreement, including, but not limited to, naming the Insured Parties as
additional insureds. The Contractor shall not allow any subcontractor to
commence work until the aforementioned requirements are met.
C. USE OF PREMISES
The Successful Bidder(s), also referred to as Contractor, shall confine their equipment,
the storage of materials and the operations of their work persons to the limits of the work
area or in accordance with the directions of the County, laws, ordinances and permits,
and shall not unreasonably encumber the premises with their materials. All construction
materials, shelter, vehicle parking and storage shall be confined to site. Locations of
such storage shall be approved in advance by the County.
The Contractor is responsible for any damage done to the building structure, existing
hallways, doors etc., that is not part of the scope of work and was damaged during the
construction period by the Contractor.
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The County shall have the right to use or occupy the premises and use the whole or any
part of the work area as is possible without interference with the work prior to its final
acceptance. Such use is not to be taken as an acceptance by the County of the whole
or any part of the work performed under this contract.
The Contractor is responsible for obtaining any necessary licenses and permits, and for
complying with any applicable Federal, State, and municipal laws, codes, and
regulations in connection with the prosecution of the work without additional expense.
The Contractor is similarly responsible for all damages to persons or property that
occurs because of their fault or negligence. The Contractor shall take proper safety and
health precautions to protect the work, the workers, the public, and the property of
others. The Contractor is also responsible for all materials delivered and work performed
until completion and acceptance of the entire construction work, except for any
completed unit of construction previously accepted.
D. LIEN WAIVERS
If Contractor requires multiple payments, all requests will be only for work completed at
date of application. Lien Waivers will be provided.
All necessary lien waivers are required with each request for payment. Lien waivers for
first pay request total may be submitted at time of second pay request only if approved
by Owner. Accurate sequencing henceforth will be followed. Final lien waivers will be
processed and ready for distribution to Owner prior to final payment being processed.
All Lien waivers will contain the following language, clearly typed:
“Except for retainage, if applicable, there are no outstanding Claims made against
the Owner and/or its lenders and guarantors, or the Project, in connection with the
work performed in the construction of the Project through the Period Date, except as
set forth in Exhibit A attached hereto, if any, and no such claims set forth on Exhibit
A have been included in the Application for Payment dated as of the Application
Date.”
E. BONDS
1. PERFORMANCE & PAYMENT BONDS
When required by the Participating Public Agency, the Contractor shall furnish a
Performance Bond and Labor and Materials Payment Bond covering the faithful
performance of the contract and the payment of all obligations arising there under
and complying with the requirements of Wisconsin’s law or the applicable state of the
Participating Public Agency. Both bonds shall be in the amount of one hundred
percent (100%) of the contract amount and shall name the Participating Public
Agency as an oblige. Companies issuing bonds must be licensed to write bonds in
the state of the Participating Public Agency. The Contractor shall pay premiums for
required bonds. Obtaining of bonds by the Contractor shall be a condition precedent
to effectuation of the Master Agreement between the Participating Public Agency and
Contractor. If additional work is authorized, the amount of the bonds shall be
increased to cover the value of the increased contract sum.
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F. PERMITS, CODES AND ORDINANCES
Contractor shall, at his own expense, obtain all necessary permits and licenses and
comply with municipal and State laws, ordinances, and regulations.
Should any change in the plan and scope of work be required to conform to law and /or
ordinances, Contractor shall notify the County before submitting his quote. After
entering a contract, the Contractor shall be held to complete all work necessary to
meet the above local requirements without extra expense to the County.
G. STANDARDS AND JOB SITE SAFETY
Contractor shall perform all work in accordance with the best present-day practices and
conform and test in accordance with the applicable sections of the latest revisions of the
codes and standards listed in the scope of work. In the event of a conflict between the
referenced codes, standards, scope of work and plans, the one establishing the most
stringent requirement will be followed.
Contractor shall be totally responsible for initiating, instituting, enforcing, maintaining,
and supervising all safety precautions and job site safety programs in connection with
the work. The Contractor shall take all reasonable precautions for the safety of all its
employees and all other persons who may be on the job site. In that regard, Contractor
shall comply with all applicable Federal, State, and local laws, ordinances, rules and
regulations and order of any public authority having jurisdiction for the safety of persons
or property or to protect them from damage, injury, or loss. Contractor shall erect and
maintain as required by existing conditions and the progress of the work, all reasonable
safeguards for safety and protection, including posting of danger signs and other
warnings against hazard, promulgating safety regulations and notifying owners and
users of adjacent utilities. County does require that Contractor comply, at a minimum,
with the safety regulations of County as set out in the scope of work for this contract, to
protect County’s employees who may be on the job site.
Enactment of safety precautions and regulations; placement and provision of safety
material, barricades, etc.; and use or provision of all required safety equipment shall be
the sole responsibility of the Contractor whose employees or subcontractors are
exposed to the applicable hazard or whose work endangers surrounding persons,
property, equipment, contractors, etc.
H. INSPECTION/CLOSE OUT PROCEDURES
All materials used and all work completed by the Contractor shall be always subject to
the examination, observation, and approval of the County.
At their discretion, the County shall have the authority to suspend work that does not
comply with plans and scope of work and reject non-complying work and materials
provided, however, that the failure of such inspector to reject non-complying work and
material shall not constitute a waiver by the County of any rights of the County.
For final acceptance, the County shall inspect the work included in the contract as soon
as practical after notification by the Contractor that such work has, in their opinion, been
completed and final cleanup has been performed. Should the inspection disclose any
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work, in whole or in part, as being unsatisfactory, the County will give the Contractor the
necessary instructions for correction of the same, and the Contractor shall immediately
comply with and execute such instructions. Upon correction of the work, another
inspection will be made which shall constitute the final inspection provided the work has
been satisfactorily completed.
I. BIDDER SUPPLIED DOCUMENTATION AND MATERIALS; CONFIDENTIALITY
All Bidder-supplied materials, including the Bidder’s Bid, become the property of Racine
County.
Bidder acknowledges that Racine County is an “authority” for the purposes of the WPRL.
Any information obtained by Racine County is considered public records and will be
subject to disclosure under the WPRL, except for information falling within one of the
exemptions therefrom. Racine County is required to and shall comply with the WPRL in
relation to any records, documents and information related to its dealings and
relationship with the Bidder. Nothing in the Master Agreement shall be deemed or
construed as a limitation on Racine County’s discretion relating to compliance with the
WPRL or other applicable law.
Notwithstanding the foregoing, if any of the material a Bidder provides is confidential or
is a proprietary trade secret, Bidder may mark that material with a “Confidential” stamp.
While Racine County will attempt to keep such information confidential, as an authority,
it cannot guaranty that it will remain confidential. Racine County will endeavor to inform
Bidders of a public records request to view or obtain such information. Any Bidder may
contest such a request at its sole expense. Racine County assumes no responsibility for
any liability whatsoever in relation to its compliance with the WPRL.
J. AFFIRMATIVE ACTION; NON-DISCRIMINATION
Racine County is committed to fulfilling its role as an Affirmative Action/Equal
Opportunity Employer. We request your vigorous support of our Affirmative Action
efforts. Our relationship with your agency is based upon your willingness to accept and
comply with Executive Order 11246, as amended, and other federal laws requiring equal
employment opportunity without regard to race, religion, color, national origin, sex,
disability or veteran status. By signing the Certification of Vendor, you indicate your
acceptance and compliance.
In connection with the performance of work awarded under this IFB, the Contractor
agrees not to discriminate against any employee or applicant for employment because of
age, race, religion, color, handicap, sex, physical condition, developmental disability as
defined in Wis. Stat. § 51.01(5)(a), sexual orientation as provided in Wis. Stat. § 111.36,
national origin, or military service as provided in Wis. Stat. § 111.355(1). This provision
shall include, but not be limited to the following: employment, upgrading, demotion, or
transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or
other forms of compensation; and selection for training, including apprenticeship. The
Contractor further agrees to take affirmative action to ensure equal employment
opportunities. The Contractor agrees to post in conspicuous places, available for
employees and applicants for employment, notices to be provided by the contracting
officer setting forth the provisions of the non-discrimination clause (Wis. Stat. § 16.765
(2)).
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K. NATIONAL CONTRACT
Subject to its fiduciary and statutory obligations, Racine County, as the Principal
Procurement Agency, defined in Attachment D – National Cooperative Contract to be
Administered by OMNIA Partners, has partnered with OMNIA Partners, Public Sector
(“OMNIA Partners”) to make the resultant contract (also known as the “Master
Agreement” in materials distributed by OMNIA Partners) from this solicitation available to
other public agencies nationally, including state and local governmental entities, public
and private primary, secondary and higher education entities, non-profit entities, and
agencies for the public benefit (“Public Agencies”), through OMNIA Partners’ cooperative
purchasing program. Racine County is acting as the contracting agency for any other
Public Agency that elects to utilize the resulting Master Agreement. Use of the Master
Agreement by any Public Agency is preceded by their registration with OMNIA Partners
(a “Participating Public Agency”) and by using the Master Agreement, any such
Participating Pubic Agency agrees that it is registered with OMNIA Partners, whether
pursuant to the terms of a Master Intergovernmental Cooperative Purchasing
Agreement, a form of which is attached hereto on Attachment D – National Cooperative
Contract, or as otherwise agreed to. Attachment D – National Cooperative Contract
contains additional information about OMNIA Partners and the cooperative purchasing
agreement.
OMNIA Partners is the largest and most experienced purchasing organization for public
and private sector procurement. Through the economies of scale created by OMNIA
Partners public sector subsidiaries and affiliates, National IPA and U.S. Communities,
our participants now have access to more competitively solicited and publicly awarded
cooperative agreements. The lead agency contracting process continues to be the
foundation on which we are founded. OMNIA Partners is proud to offer more value and
resources to state and local government, higher education, K-12 education and non-
profits.
OMNIA Partners provides shared services and supply chain optimization to government,
education, and the private sector. With corporate, pricing and sales commitments from
the Vendor, OMNIA Partners provides marketing and administrative support for the
Contractor that directly promotes the Contractor’s products and services to Participating
Public Agencies though multiple channels, each designed to promote specific products
and services to Public Agencies on a national basis. Participating Public Agencies
benefit from pricing based on aggregate spend and the convenience of a contract that
has already been advertised and publicly competed. The Contractor benefits from a
contract that generally allows Participating Public Agencies to directly purchase goods
and services without the Contractor’s need to respond to additional competitive
solicitations. As such, the Contractor must be able to accommodate a nationwide
demand for services and to fulfill obligations as a nationwide Contractor and respond to
the OMNIA Partners documents (Attachment D).
While no minimum volume is guaranteed to the awarded Contractor(s), the estimated
annual volume of HVAC Products, Installation, Labor Based Solutions, and Related
Products and Services purchased under the Master Agreement through OMNIA Partners
is approximately $500M. This projection is based on the current annual volumes among
the Racine County and other Participating Public Agencies anticipated to utilize the
resulting Master Agreement to be made available to them through OMNIA Partners, and
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volume growth into other Public Agencies through a coordinated marketing approach
between the awarded Bidder(s) and OMNIA Partners.
The successful Bidder(s) will be required to sign Attachment D – National Cooperative
Contract to be Administered by OMNIA Partners, Exhibit B – Administration Agreement.
Contractors should have any reviews required to sign the document prior to submitting a
response.
Notwithstanding the foregoing, Racine County makes no representation or warranty
concerning the use of the Master Agreement by any other Participating Public Agency.
III. HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED
PRODUCTS AND SERVICES
The requirements identified in this section represent the products and services currently
being used and are the basis for the resulting contract. The following specifications are
minimum acceptable requirements. Bid specifications may not be revised without an official
written addendum issued by the Purchasing Coordinator.
A. DESCRIPTION OF WORK
The expected outcome of this IFB is to enter into a contractual relationship with a business
partner(s) who will provide a comprehensive selection of HVAC products and solutions,
including complete turn-key services. Vendors are to provide a broad selection of HVAC
EQUIPMENT, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS
AND SERVICES. The intent of this IFB is to provide Participating Public Agencies with
products, services and turn-key solutions to meet their various needs. Therefore, the
Vendors should have demonstrated experience in providing similar Products and Services
as defined in this solicitation, including but not limited to:
1. HVAC Equipment and Products: This includes, but is not limited to, all commercial
equipment such as chillers: air-cooled chillers, water-cooled chillers, compressor chillers,
ancillary chiller water plant equipment and absorption liquid chillers; unitary systems that
combine heating, cooling and fan sections: rooftop systems, split systems, self-contained
systems and water source heat pumps; air handling systems: performance air handlers, blower
coil air handlers, make-up air gas heating systems, air handler options and air cleaning options;
terminal devices: unit heaters, unit ventilators, fan coil units, ventilation fans and variable air
volume; ductless variable refrigerant volume units; dedicated outdoor air systems; replacement
coils; automation equipment; parts and aftermarket products and any other HVAC products
offered by Bidder.
2. Installation and Services: This includes, but is not limited to, any installation of new
equipment, maintenance of existing systems, upgrading of existing infrastructure, turn-key
services and any other installation and services offered by Bidder.
3. Related Products, Solutions, and Other Services: This includes, but is not limited to,
new, and/or retrofitting older products and solutions, HVAC equipment controls, ancillary
services, thermostats, sensors, energy programs, design and analysis tools, commissioning,
building management and/or certifications, enterprise management, rental and lease services,
financial services, training and/or educational services, municipal services, and any other
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related products and services offered by Bidder.
B. TERM
The term of the Master Agreement will be for five (5) years following the contract award date
with the option to review for one (1) additional five (5) year period. The anticipated full term
of the contract is ten (10) years. The awarded Bidder(s) shall have the right to enter local
“service” agreements with Participating Public Agencies accessing the contract through
OMNIA Partners, so long as the effective date of such agreement is prior to the expiration of
the Contract. All local agreements may have a full potential term (any combination of initial
and renewal periods) subject to the discretion of the Participating Public Agency. Any job
orders, project agreements, or maintenance agreements executed against the Master
Agreement during the effective term may survive beyond the expiration of the Master
Agreement as established and agreed to by both parties.
Racine County may terminate the Master Agreement without penalty due to the non-
appropriation of funds, or for cause or convenience in accordance with the procedures set
forth in the Master Agreement.
Participating Agencies commonly require a modification to a term of the Contract (e.g.,
governing law). The awarded Bidder and Participating Agencies may agree to modify terms
on any specific purchase by a Participating Agency without being in conflict with the
Contract.
C. PRICING
Labor rates should be based on regional and national rates. The Awarded Bidder may
submit requests for labor rate increases on an annual basis, sixty (60) days prior to the
anniversary contract date. Price increase requests are not automatic and must be approved
by Racine County. The request for a change in the rate outside of the anniversary contract
date shall include: (1) the cause for the adjustment and (2) the amount of the change
requested with documentation to support the requested adjustment (i.e.: appropriate Bureau
of Labor Statistics index).
The pricing structure, or percent discount for product pricing should remain fixed for the term
of the contract.
The Awarded Bidder agrees to offer all future product and service introductions at similar
pricing as that offered through this solicitation and contract.
D. ALTERNATIVE COSTING METHOD
If a project requires products and services that are not covered on the Bid Form or if a
product or service is required that is more appropriate to be custom designed and
manufactured to meet an individual project site’s conditions and/or provided for a unique
application or project, the Contractor may use the alternative costing method as follows:
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The Contractor will be required to:
Obtain three (3) written cost proposals from local providers:
• Use the most advantageous cost proposals;
• Apply the discount as submitted on the Response Form; and
• All products and services falling under this category must be submitted in
advance and approved by the Participating Public Agency prior to being included in any
quote or proposal from the Contractor.
E. PRICE LIST FOR ADDITIONAL PRODUCTS
The intent is to enter into a Master Agreement for a complete line of HVAC products,
installation, labor based solutions, and related products and services. Therefore, in addition
to specific line items listed on the pricing schedules, Bidders are encouraged to provide
Manufacturer’s Price Lists for additional related products including green products as well as
current catalogs and price lists. Bidders shall attach to the Bid Form one (1) copy of one (1)
price list or retail price sheet, clearly marking the column to which the discount is applied for
each item listed. Manufacturer’s Price Lists shall be the currently published National
Standard Manufacturer’s Price Lists. The Bidder’s Retail Price Sheets shall be the current
Price Sheet at the time of bid submission. Bidders shall quote the percentage of discount
from the Manufacturer’s Price List or Retail Price Sheet cited above and shall furnish a copy
of same with the bid submission. Discounts must be stated as a single percentage.
FAILURE TO PROVIDE THE MANUFACTURER’S PRICE LIST OR RETAIL PRICE SHEET
MAY BE CAUSE FOR REJECTION OF THE BID. When award is made, current catalogs
and price lists provided by the Bidder shall become a part of the contract. The Bidder’s
name and address shall appear on all catalogs and price lists. Where the price list shows
more than one (1) column of prices, Bidder shall clearly mark the column which represents
its bid. If a fee or charge is to be made, it should be indicated on the Bid Form.
F. SPECIAL OFFERS AND PROMOTIONS
In addition to decreasing prices for the balance of the Contract term due to a change in
market conditions, Contractor may conduct sales promotions involving price reductions for a
specified lesser period. Contractor may offer Participating Agencies competitive pricing
which is lower than the not-to-exceed price set forth herein at any time during the Contract
term and such lower pricing shall not be applied as a global price reduction under the
Contract.
IV. BID SUBMITTAL INSTRUCTIONS
To adequately review bids uniformly and objectively, all bids should be submitted according
to the format detailed below. The bid should be prepared simply and economically,
providing straightforward and concise information as requested. Use of existing materials,
brochures and other standard preprinted materials containing information responsive to the
requests in the solicitation, if available, are encouraged as a method to reduce your
response time. However, unnecessary elaborate brochures or other presentations beyond
that required to present a complete and effective bid are not desired. Racine County
reserves the right to reject any bid not properly formatted.
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A. CERTIFICATION OF VENDOR PAGE
Place this page on top of the original and each copy of your complete bid. See page 23.
B. TABLE OF CONTENTS
Include clear identification of the material to be used.
C. EXECUTIVE SUMMARY
Limit to one or two pages. Briefly state the Bidder’s understanding of the service to be
provided and a positive commitment to perform the services as defined in the IFB.
D. RESPONSIBLE BIDDER
Failure of Bidder to provide the required information, may result in a determination that
Bidder is a non-responsive bidder. If Bidder does not adequately demonstrate the
minimum qualifications, as outlined throughout this section, Bidder may be deemed not
qualified and responsible. Bidders must demonstrate that they have the resources and
capability to provide the materials and services described herein. The following minimum
criteria shall be met to be eligible for this contract:
• Bidders shall demonstrate that they are financially stable;
• Bidder shall have been in business providing similar service for at least the last
three (3) years;
• Bidders should have the capability of providing a combination of products,
services, consulting, or other labor-based solutions to accommodate the range of
products and services utilized by Participating Public Agencies; and
• Bidders shall be properly licensed and incorporated to do business in the State of
Wisconsin.
Racine County reserves the right to make such additional investigations as it deems
necessary to verify a Bidder submitting a bid is qualified and responsible to include
investigating Bidder’s past work with Racine County and Racine County employees.
In addition to the pricing and certification information indicated under item D. Award
under V. Award Information, Bidders will submit the following items with their bid:
1. Include a detailed response to Attachment D, Exhibit A, OMNIA Partners
Response for National Cooperative contract, to show proof of organizational
capacity, equipment, and technical competency.
a. Racine County makes no representation or warranty concerning the
use of the Master Agreement by any other Participating Public Agency.
b. The lowest responsible Bidder(s) will be required to sign Attachment D,
Exhibit B, OMNIA Partners Administration Agreement.
c. If applicable, provide a sample of additional agreements that
Participating Public Agencies may be asked to sign.
2. Provide proof of a positive balance sheet and profitable business operations for
two (2) of the last three (3) years.
3. Provide business license and applicable information that Bidder can do business
in the State of Wisconsin. List the states where other business or contractor
licenses are held.
4. Proof of insurance.
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5. Describe Bidder’s bonding capacity and capability of securing high dollar
Performance Bonds.
6. A completed and signed W-9 Request for Taxpayer Identification Number and
Certification form.
7. Furnish background of Bidder, including such information as size of the firm,
legal status (corporation or partnership, etc.) lines of business, management and
technical expertise, financial position, and years in business. Include any unique
approaches or techniques developed and used by the firm.
8. Provide a minimum of three (3) comparable references of current work being
performed. Information shall include name, phone number, fax number and email
address of a person that may be contacted. Ideally, at least two (2) references
will be with a government facility of similar size. Also include a brief description
of the projects. Bidder’s may use the Reference sheets enclosed in this IFB.
9. To further demonstrate similar experience and provide proof of performance:
a. Include a detailed description of the Services Bidder can perform,
including training, start-up and commissioning services, installation,
maintenance, turn-key services, project approach to Indoor
Environmental Quality (IEQ), repair services, rentals, leases,
equipment upgrades, and any other services provided by the Bidder.
• Identify the manufacturer products/brands the Bidder can service
and support.
• Stipulate the minimum work crew that will be made available at all
times, ensuring timely and effective project completion. A project
foreman, fluent in English, must be onsite during all construction
activities and have authority to act on behalf of the Bidder. Each
site work crew must have at least one journeyman assigned.
• Describe how Bidder selects sub-contractors for service and/or
installation and how Bidder ensures customer satisfaction related
to the sub-contractors.
• Describe Bidder’s company’s process for submitting a test and
balance report for each piece of equipment installed, including
items that will be covered in the test and balance report.
• Describe Bidder’s company’s process for delivering a
comprehensive commission plan at least two (2) weeks prior to
start-up, including details of what will be covered in the plan.
• Describe Bidder’s company’s scope of work for preventative
maintenance work.
• Describe and define all scenarios in which additional charges
would apply outside of routine preventive maintenance.
• Describe Bidder’s methodologies for assisting Participating Public
Agencies with recommendations on repairs and upgrades from
defining the repair/upgrade through the completion of work.
• Describe Bidder’s firm’s process for notifying a Participating Public
Agency when personnel are going to be in a facility, arrival and
departure time and the work performed. How does Bidder handle
requirements for sign-off of work prior to leaving a facility?
b. Describe Bidder’s ability to provide temporary cooling/chiller units.
c. Describe in detail the depth of product and services Bidder provides and
any related products or services being offered. Include:
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• A description of the Products, including all related components
and parts to be provided by the major product category.
• A catalog or brochure type information as applicable.
• A matrix breaking out product information on all products, options,
accessories such as product type, capacity range, standard
warranty information, extended warranty information, estimated
lead time/delivery time, etc.
• All necessary technical information relating to operation of
equipment and systems, along with list of spare parts
recommended by manufacturers with part numbers needed to
maintain and efficiently run the systems and equipment.
d. Describe Bidder’s record keeping and processing system for work
performed. Include:
• Bidder’s ability to provide online access to records.
• State any options for expediting delivery of product.
• State backorder policy. Does Bidder fill or kill order and require
Participating Public Agency to reorder if item is backordered?
• State restocking procedures for returning products, if applicable.
• Describe any special programs offered that will improve
customers’ ability to access Products and Services, on-time
delivery, or other innovative strategies.
• Describe the capacity of Bidder to broaden the scope of the
contract and keep the product and service offerings current and
ensure the latest products, standards and technology for HVAC
Products, Installation, Labor Based Solutions, and Related
Products and Services.
• Describe your Bidder’s safety policy and/or program, including
how the policy is communicated to employees, whether the
employees are evaluated on safety, and if any employees are
dedicated to safety.
• Describe Bidder’s quality control processes.
• Describe Bidder’s problem escalation process.
• Describe how customer complaints are measured and
categorized. What processes are in place to know that a problem
has been resolved?
• Describe Bidder’s post-installation support and warranty specifics.
Include both product and installation warranty information.
• Describe the process for replacement or repair of defective
products and warranty related issues.
• Describe how Bidder evaluates and determines unit repair versus
unit replacement.
• Identify all other companies that may be involved in processing,
handling, shipping, products and/or services.
• Provide the number, size and location of Bidder’s distribution
facilities, warehouses, and retail network as applicable.
• Provide order information to include available ordering methods
and available payment terms.
• Provide the number and location of support centers (if applicable).
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• Describe Bidder’s customer service department staffing levels,
hours of operation and other relevant details.
• Describe the process for ordering when supply of a unit and
installation is involved, specifically addressing whether one
purchase order is required for the entire project, or if separate
purchase orders are required for ordering the product and
securing installation services.
• Describe Bidder’s internal management system for processing
orders from point of customer contact through delivery and billing.
Please state if Bidder uses single system or platform for all
phases of ordering, processing, delivery, and billing.
• Describe the capacity of Bidder to provide management reports,
i.e., commodity histories, procurement card histories, green
spend, etc. for each Participating Public Agency.
E. BID FORM CRITERIA
All pricing submitted using the Bid Form (Attachment C) or a document using the same
requested information in the same format. The Bid form shall be inclusive of all fees and
service/shipping charges. All prices are FOB destination. Additional pages and pricing
information may be included.
Bidder shall also be responsible for compliance with any federal, state, or local prevailing
wage laws.
Price/Discounts should remain firm and will include all charges that may be incurred in
fulfilling requirements.
Invoices may be audited on a random basis along with the necessary supporting
documentation. Billing errors will be promptly adjusted.
As part of the bid, Bidders shall provide the following:
• Details of any proposed additional discounts for volume orders, special offers,
minimum order quantity, free goods program, total annual spend.
• Comprehensive Product Offering
Bidder(s) awarded under this IFB may offer their complete product and service
offering/balance of line. Pricing for complete product offering/balance of line
items will be determined by a percentage discount from a price list or catalog, or
fixed price, or a combination of both with indefinite quantities. Prices listed will
be used to establish the extent of a Bidder’s product lines, services, warranties,
etc. that are available from Bidder and the pricing per item. Multiple percentage
discounts are acceptable if, where different percentage discounts apply, the
different percentages are specified. Additional pricing and/or discounts may be
included. Products and services proposed are to be priced separately with all
ineligible items identified. Bidders may elect to limit their bids to any category or
categories. Where the price list shows more than one column of prices, Bidder
shall clearly mark the column which represents the discounted pricing to
Participating Public Agencies.
• Federal Funding Pricing
Due to products and services potentially being used in bid to an emergency or
disaster recovery situation in which federal funding may used, if not already
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incorporated as part of the bid, provide alternative pricing that does not include
cost plus a percentage of cost or pricing based on time and materials; if time and
materials is necessary, a ceiling price that the contract exceeds at its own risk
will be needed. Products and services provided in a situation where an agency is
eligible for federal funding, Bidder is subject to and must comply with all federal
requirements applicable to the funding including, but not limited to the FEMA
Special Conditions section located in the Federal Funds Certifications Exhibit.
V. AWARD INFORMATION
A. COMPLIANCE WITH IFB
Bids submitted must be in strict compliance with the terms of the solicitation. Failure to
comply with all provisions of the IFB may result in disqualification.
B. CONDITIONS OF AWARD
All Bidders, by submission of their respective bids, agree to abide by the rules,
regulations, procedures, and decisions of Racine County.
C. QUALIFYING BIDDERS
Failure of Bidder to provide the required information, may result in a determination that
Bidder is a non-responsive Bidder. If Bidder does not adequately demonstrate the
necessary qualifications, as outlined throughout Section IV. Bid Submittal Instructions,
and submit the information indicated under item D. Responsible Bidder, Bidder may be
deemed not qualified and/or responsible. Racine County reserves the right to make such
additional investigations as it deems necessary to verify a Bidder may be deemed not
qualified and/or responsible. Racine County reserves the right to make such additional
investigations as it deems necessary to verify a Bidder submitting a bid is qualified and
responsible to include investigating Bidder’s past work with Racine County and Racine
County employees.
D. AWARD
Utilizing the two-step process set forth herein, it is the intent of the County to award the
Contract to the lowest responsive responsible Bidder provided the bid has been
submitted in accordance with the requirements of the Contract Documents, the Bidder is
adequately qualified, and the bid does not exceed the funds available. Racine County
reserves the right to make an award as deemed in its best interest, which may include
awarding to a single bidder or multiple bidders; or to award the whole bid, only part of
the bid, or none of the bid to single or multiple bidders, based on its sole discretion of its
best interest, together with compliance with applicable law. Intent to award will not be
made and a contract will not be executed until Racine County, at its sole discretion,
accepts a bid.
RACINE COUNTY RESERVES THE RIGHT TO REJECT ANY OR ALL BIDS AND TO
WAIVE ANY TECHNICALITY OR ERROR IN ANY BID OR PART THEREIN, AND TO
ACCEPT THE SAME OR COMBINATIONS, IN WHOLE OR IN PART, WHICHEVER IS
DEEMED TO BE IN THE BEST INTEREST OF RACINE COUNTY IN ITS SOLE AND
EXCLUSIVE DISCRETION. While not all inclusive, the following items may be used
when determining if a Bidder is considered responsive and responsible: work schedule,
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technical competency, ability to render satisfactory service, past performance, reputation
for providing a quality product, timely delivery of products and/or services, financial
ability, bonding, experience in performance of similar work, references, equipment, and
capacity.
For the first step of the bidding process, Bidders will submit their sealed bids with all
requested information, to include Certification of Vendor and Attachment C – Bid Form,
by the due date and time outlined in this IFB. After the due date and time, all Bidders will
be evaluated to determine if they are responsive, responsible, and qualified. Each Bidder
determined to be responsive, responsible, and qualified shall be determined to be a
“Responsible Bidder.”
As part of the first step of the bidding process, Racine County may seek additional
information or clarification from one or more of the Bidders.
If Bidder does not adequately demonstrate the necessary minimum qualifications, Bidder
may be deemed not qualified and/or responsible. Racine County reserves the right to make
such additional investigations as it deems necessary to verify a Bidder submitting a bid is
qualified and responsible to include investigating Bidder’s past work with Racine County
and Racine County employees.
Award may be made without discussion with Bidder, therefore, Bidders are
cautioned that Bidders should be submitted initially on the most favorable terms.
For the second step of the bidding process, Racine County will distribute to each
Responsible Bidder a Sample Project Form to determine which Responsible Bidder(s)
constitute the lowest responsible bidder(s) when the bid responses are applied to actual
(hypothetical) projects. As indicated in Section I. Project Overview, when responding to
the Sample Project Form, Responsible Bidders are required to USE THE SAME LINE
ITEM PRICING from Attachment C – Bid Form and apply them to the Sample Projects
Form (to be supplied to Responsible Bidders as part of Step-One); a reduction in price
for the sample projects outlined in a Responsible Bidder’s Sample Project Form will not
be allowable. The final basis for award and lowest responsible Bidder(s) will result from
the lowest total dollar amount of the combined sample projects.
E. TIE BIDS
If two (2) or more Bidders submit identical bids, the decision of the County to make
award to one or more of such Bidders shall be final.
F. NOTICE OF ACCEPTANCE
Racine County will notify the lowest responsible and responsive Bidder(s) as soon as
practical of the selection. Written notice of award to Bidder(s) in the form of a letter,
contract or otherwise, mailed or delivered to the address shown on the Certification of
Vendor page will be considered sufficient notice of acceptance of bid.
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REFERENCES
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND
RELATED PRODUCTS AND SERVICES
List three (3) references for construction services to that requested in this IFB.
1. Company: ________________________________________________
Address: _________________________________________________
Contact Person: ________________________________ Phone: ______________
Email address: ___________________________________
Description of project: ____________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
2. Company: ________________________________________________
Address: _________________________________________________
Contact Person: ________________________________ Phone: ______________
Email address: ___________________________________
Description of project: ____________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
3. Company: ________________________________________________
Address: _________________________________________________
Contact Person: ________________________________ Phone: ______________
Email address: ___________________________________
Description of project: ____________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
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CERTIFICATION OF VENDOR
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND
RELATED PRODUCTS AND SERVICES
The undersigned, submitting this Bid, hereby agrees with all the terms, conditions, and
specifications required by the County in this IFB and declares that the attached Bid is in
conformity therewith.
The undersigned attests to the following:
• I have reviewed in detail the IFB and all related attachments and information provided by
Racine County before submitting this Bid.
• I have full authority to make such statements and to submit this Bid as the duly recognized
representative of the Bidder.
SIGNATURE: ______________________________________________________
PRINT NAME: _____________________________________________________
TITLE: ___________________________________________________________
COMPANY: _______________________________________________________
ADDRESS: _______________________________________________________
CITY, STATE, ZIP: _________________________________________________
TELEPHONE: ________________________ FAX: _______________________
E-MAIL: __________________________________________________________
DATE: ___________________________________________________________
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Attachment A
Community Development Block Grant Addendum
Purchases made under this contract may be partially or fully funded with federal grant funds. Funding for
this work may include Federal Funding sources, including Community Development Block Grant (CDBG)
funds from the U.S. Department of Housing and Urban Development. When such funding is provided,
Contractor shall comply with all terms, conditions and requirements enumerated by the grant funding
source, as well as requirements of the State statutes for which the contract is utilized, whichever is the
more restrictive requirement. When using Federal Funding, Contractor shall comply with all wage and
latest reporting provisions of the Federal Davis-Bacon Act. HUD-4010 Labor Provisions also applies to
this contract.
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Attachment B
Federal Grant Funding Addendum
For more information on Federal Grant Funding for ESSER and GEER, please click on the following link:
https://www.hcps.org/departments/docs/BusinessServices/Purchasing/FAQs_ESSER_GEER.pdf for
Frequently Asked Questions on Elementary and Secondary School Emergency Relief (ESSER) Programs
Governor’s Emergency Education Relief (GEER) Programs (U.S. Department of Education Washington,
D.C. 20202, May 2021).
For more information on Federal Grant Funding for HEERF, please click on the following link:
https://www2.ed.gov/about/offices/list/ope/arpfaq.pdf for Higher Education Emergency Relief (HEERF)
Fund III Frequently Asked Questions (American Rescue Plan Act of 2021 Published May 11, 2021,
updated May 24, 2021).
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Attachment C
Bid Form
(To be submitted in a sealed envelope or box as indicated)
Bid Form documents are provided. A discount percentage or structure must be clearly delineated. The
Bid form shall be inclusive of all fees and service/shipping charges. All prices are FOB destination.
Additional pages and pricing information may be included.
1. Definitions
Labor Wage Classification Definitions - definitions as used herein for establishing labor rates.
Participating Public Agencies may choose to establish alternative definitions.
LABOR WAGE CLASSIFICATION DEFINITIONS
Architect Professional licensed designer providing Architectural drawings.
Asbestos Worker Worker who removes and disposes of asbestos materials.
Worker who assembles boilers, tanks, vats and pressure vessels. The
duties of the boilermaker include welding, acetylene burning, riveting,
Boilermaker
caulking, rigging, fitting up, grounding, reaming and impact machine
operating.
Worker who builds wood structures or structures of any material which
Carpenter has replaced wood. Includes rough and finish carpentry, hardware and
trim.
Carpet/Floor Installer Worker who installs carpet and/or floor coverings and vinyl tile.
Agent who ensures proper installation and operation of technical building
Commissioning Agent
systems.
Concrete Finisher Worker who floats, trowels, and finishes concrete.
Data Communications / Worker who installs data/telephone and television cable and associated
Telecommunications Installer equipment and accessories.
Worker who can deliver materials to other HVAC personnel as well as
Delivery Personnel
work as a second man on jobs if necessary.
Worker who provides detail engineering drawings utilizing CADD type
Drafting
documents.
Worker who installs metal framed walls and ceilings, drywall coverings,
Drywall/Ceiling Installer
ceiling grids and ceilings.
Worker who cleans air conveyance systems using compressed air tools
Duct Cleaner and mechanical agitation devices to dislodge dirt and other contaminants
from the ductwork and other HVAC components.
Skilled craftsperson who installs or repairs electrical wiring and devices.
Electrician
Includes fire alarm systems and HVAC electrical controls.
LABOR WAGE CLASSIFICATION DEFINITIONS (continued)
INVITATION FOR BID - IFB # RC2002-1001
Page 25 of 119
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
Elevator Mechanic Craftsperson skilled in the installation and maintenance of elevators.
Professional licensed engineer. An Engineering Designer is not a
requirement of this solicitation but may be beneficial for Participating
Engineering Designer Public Agencies to utilize should they choose. In such case, an
Engineering Design may lay out HVAC, plumbing, electrical, structural, or
civil systems.
Fire Proofing Installer Worker who sprays or applies fire proofing materials.
Worker who lays coiled pipe and tests and connects to HVAC equipment
Geothermal Well Field Labor
in earthen trench.
Glazier Worker who installs glass, glazing and glass framing.
Equipment operator that operates the following, including but not limited
to, all Cat tractors, all derrick-powered, all power operated cranes, back-
Heavy Equipment Operator
hoe, back filler, power operated shovel, winch truck, all trenching
machines.
HVAC Building Automation Worker who can work on low temperature refrigeration equipment as well
Technician as small commercial equipment under 60 tons.
HVAC Commercial A/C
Worker who can work on large commercial up to 3000 tons.
Technician
HVAC Light Commercial Worker who can work on small commercial up to 25 tons.
HVAC Duct Installer Worker who installs ductwork. Assists with some equipment installation.
Worker who monitors quality as well as provide technical support to all
HVAC Field Supervisor
other HVAC technician skill levels.
Worker who changes filters in all types of HVAC equipment as well as
HVAC Filter Technician minor maintenance on light commercial equipment such as changing
worn belts.
Worker who can assist a commercial or refrigeration technician as well as
HVAC Helper
perform minor analysis and repairs on equipment under 30 tons.
HVAC Refrigeration Worker who can work on low temperature refrigeration equipment as well
Technician as small commercial equipment under 60 tons.
Insulator Worker who applies, sprays or installs insulation.
Skilled craftsperson who erects structural steel framing and installs
Iron Worker
structural concrete rebar.
Worker qualified for only unskilled or semi-skilled work, including but not
Laborer/Helper
limited to, lifting, carrying materials and tools, hauling, digging, clean-up.
Worker who installs metal framing and lath. Worker who applies plaster to
Lather/Plasterer
lathing & installs associated accessories
Includes, but is not limited to, operation of air compressors, truck crane
Light Equipment Operator driver, flex plane, building elevator, form grader, concrete mixer (less than
14cf), conveyer.
Craftsperson who works with masonry products, stone, brick, block, or
Mason, Bricklayer
any material substituting for those materials and accessories.
LABOR WAGE CLASSIFICATION DEFINITIONS (continued)
INVITATION FOR BID - IFB # RC2002-1001
Page 26 of 119
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
Metal Building Assembler Worker who assembles pre-made metal buildings.
Mechanic specializing in the installation of heavy machinery, conveyance,
Millwright
wrenches, dock levelers, hydraulic lifts and align pumps.
Painter/Wall Covering Worker who prepares wall surfaces & applies paint and/or wall covering,
Installer tape and bedding.
Trained worker who installs piping systems, chilled water piping and hot
Pipefitter water (boiler) piping, pneumatic tubing controls, chillers, boilers and
associated mechanical equipment.
Skilled craftsperson who installs domestic hot & cold-water piping, waste
Plumber piping, storm system piping, water closets, sinks, urinals, and related
work.
A Project Engineer is not a requirement but may be beneficial for
Participating Public Agencies to utilize should they choose. In such case,
a Project Engineer may monitor engineering documents as well as
Project Engineer
provide technical support regarding the engineering plans and
specifications as designed by the Professional Engineer. Worker may be
responsible for maintaining project status and reports.
Worker who monitors quality as well as provide technical support to all
Project Manager other HVAC technician skill levels and is responsible for maintaining
project status and reports.
Worker who provides administrative support to all technician skill levels
and is responsible for all administrative functions of the project such as
Project Administrator
billings, contracts, work orders, legal requirements, purchase orders,
sales tax certificates as well as proper record keeping.
Worker who installs roofing materials, Bitumen (asphalt and coal tar) felts,
Roofer
flashings, all types roofing membranes & associated products.
Worker who installs sheet metal products. Roof metal, flashings and
Sheet Metal Worker
curbs, ductwork, mechanical equipment and associated metals.
Sprinkler Fitter Worker who installs fire sprinkler systems and fire protection equipment.
Terrazzo Worker Craftsperson who places and finishes Terrazzo.
Worker who prepares wall and/or floor surfaces & applies ceramic tiles to
Tile Setter
these surfaces.
Worker who applies water proofing material to buildings. Products include
Water Proofer/Caulker sealant, caulk, sheet membrane, liquid membranes, sprayed, rolled, or
brushed.
Certified technician per AABC or NEBB standards trained to perform
Test and Balance Technician water and air balance. Also provides sound and vibration testing and
preparing of certified reports.
Worker who utilizes infrared photography to determine location of thermal
Infrared Technician
heat losses.
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
LABOR WAGE CLASSIFICATION DEFINITIONS (continued)
Certified technician who is trained to evaluate analytical test results on
boiler system water, condenser water, and chill water samples and to
Water Treatment Technician
make appropriate recommendations regarding residual levels, cycles,
and feed rates.
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM
SECTION A
Product Pricing
Bidder shall include all product pricing using this format as pricing utilized on this form should be
consistent with the individual pricing scenarios that are to be distributed to responsive, responsible, and
qualified Bidders. Use additional space as necessary.
MFG Part % Discount off
Product Name Product Description List Price Net Price
No. List Price
INVITATION FOR BID - IFB # RC2002-1001
Page 29 of 119
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM (CONT'D)
SECTION B
Labor Rates
Normal business hours are defined as: ____________________________
Overtime hours are defined as: ____________________________
Holiday hours are defined as: ____________________________
For all applicable Labor Classifications, using the below format, Bidder shall provide labor rates by geographic
areas, regions, zones or other means for pricing nationally as sample projects included in Step-Two will be
diverse project types including projects from different states and regions outside of Racine County and
Wisconsin. Participating Public Agencies may have differing needs and requirements depending on the scope of
their project(s); Participating Public Agencies may determine the appropriate Labor Classifications at their
discretion. If Bidder is unable to provide one or more of the Labor Classifications below (either as part of their
primary staff or as a subcontractor), Bidder should notate that in their response. Pricing utilized on this form will
need to be consistent with the individual pricing scenarios provided to responsible, responsive, and qualified
Bidders.
Hourly Rate
Normal
Item Labor Classification Business Overtime Holiday
Hours
1 Architect
2 Asbestos worker
3 Boilermaker
4 Concrete finishers
5 Delivery personnel
6 Drafting
7 Drywall and ceiling installers
8 Electricians
9 Engineering design
10 Geothermal well field labor
11 Heavy equipment operators
12 HVAC commercial A/C technician
13 HVAC light commercial
14 HVAC helper
15 HVAC field supervisor
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM (CONT'D)
SECTION B
Labor Rates (Cont'd)
Hourly Rate
Normal
Item Labor Classification Overtime Holiday
Business Hours
16 HVAC refrigeration technician
17 HVAC duct installer
18 HVAC filter technician
19 HVAC building automation technician
20 Infrared technician
21 Insulators
22 Laborers
23 Light equipment operators
24 Metal building assembler
25 Millwrights
26 Operating engineer
27 Painters, wall covering installers
28 Pipefitters
29 Plasterers
30 Plumbers
31 Project manager
32 Project administrator
33 Project engineering
34 Roofers
35 Sheet metal workers
36 Test and balance technician
37 Tile setters
38 Water Proofers, caulkers
39 Water treatment technician
Use additional space as necessary to add any additional
labor categories.
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM (CONT'D)
SECTION C
Additional Costs
INSTRUCTIONS:
Bidder shall utilize net product prices and labor rates listed in Sections A and B of this Bid Form to determine
cost for installation of new equipment, maintenance of existing systems, upgrading of existing infrastructures,
turn-key services and any other installation and services offered. If there are other elements that should also be
taken into consideration, Bidder shall list these elements below and any associated pricing. Pricing utilized on this
form will need to be consistent with the individual pricing scenarios provided to responsible, responsive, and
qualified Bidders.
Any Additional Pricing Elements for Installation, Maintenance, Cost
Upgrades and Turn-Key Services
List any other elements to be taken into consideration for
installation, maintenance, upgrades and turn-key services
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM (CONT'D)
SECTION D
Additional Costs
Use the below space to provide pricing for any related products and services your company wishes to be
considered. Pricing utilized on this form will need to be consistent with the individual pricing scenarios provided
to responsible, responsive, and qualified Bidders.
Product or Service Cost
Use additional space as necessary
INVITATION FOR BID - IFB # RC2002-1001
Page 33 of 119
HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
BID FORM (CONT'D)
SECTION E
Additional Discounts
Insert additional lines as necessary. Pricing utilized on this form will need to be consistent with the individual
pricing scenarios provided to responsible, responsive, and qualified Bidders.
ADDITIONAL DISCOUNTS/INCENTIVES COST
Additional Discounts for volume (i.e., price breaks for multiple
products/services, etc.)
$
$
$
$
Any additional pricing incentives, discounts, or rebates such as for large
volume purchases and services, total spend, etc.
$
$
$
$
Any additional pricing discounts for the purchase of products and services for
groups of Participating Public Agencies in a local geographic area that desire
to combine requirements, i.e., local city, county, school district, housing
authority, transit authority, etc.
$
$
$
$
INVITATION FOR BID - IFB # RC2002-1001
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HVAC PRODUCTS, INSTALLATION, LABOR BASED SOLUTIONS, AND RELATED PRODUCTS AND SERVICES-
ATTACHMENT D
Requirements for National Cooperative Contract To Be Administered by OMNIA Partners
The following documents are used in reviewing and administering national cooperative contracts
and are included for Supplier’s review and bid.
Exhibit A – Response for National Cooperative Contract
Exhibit B – Administration Agreement, Example
Exhibit C – Master Intergovernmental Cooperative Purchasing Agreement, Example
Exhibit D – Principal Procurement Agency Certificate, Example
Exhibit E – Contract Sales Reporting Template
Exhibit F – Federal Funds Certifications
Exhibit G – New Jersey Business Compliance
Exhibit H – Advertising Compliance Requirement
Version April 12, 2022
Exhibit A
Response for National Cooperative Contract
1.0 Scope of National Cooperative Contract
Capitalized terms not otherwise defined herein shall have the meanings given to them in the
Master Agreement or in the Administration Agreement between Vendor (sometimes referred
to as ‘Supplier’) and OMNIA Partners.
1.1 Requirement
Racine County, Wisconsin (hereinafter defined and referred to as “Principal
Procurement Agency”), on behalf of itself and the National Intergovernmental
Purchasing Alliance Company, a Delaware corporation d/b/a OMNIA Partners, Public
Sector (“OMNIA Partners”), is requesting bids for HVAC Products, Installation,
Labor Based Solutions, and Related Products and Services. The intent of this Invitation
for Bid is any contract between Principal Procurement Agency and Vendor resulting
from this Invitation for Bid (“Master Agreement”) be made available to other public
agencies nationally, including state and local governmental entities, public and private
primary, secondary and higher education entities, non-profit entities, and agencies for
the public benefit (“Public Agencies”), through OMNIA Partners’ cooperative
purchasing program. The Principal Procurement Agency has executed a Principal
Procurement Agency Certificate with OMNIA Partners, an example of which is
included as Exhibit D, and has agreed to pursue the Master Agreement. Use of the
Master Agreement by any Public Agency is preceded by their registration with
OMNIA Partners as a Participating Public Agency in OMNIA Partners’ cooperative
purchasing program. Registration with OMNIA Partners as a Participating Public
Agency is accomplished by Public Agencies entering into a Master Intergovernmental
Cooperative Purchasing Agreement, an example of which is attached as Exhibit C, and
by using the Master Agreement, any such Participating Public Agency agrees that it is
registered with OMNIA Partners, whether pursuant to the terms of the Master
Intergovernmental Purchasing Cooperative Agreement or as otherwise agreed to. The
terms and pricing established in the resulting Master Agreement between the Vendor
and the Principal Procurement Agency will be the same as that available to
Participating Public Agencies through OMNIA Partners.
All transactions, purchase orders, invoices, payments etc., will occur directly between
the Vendor and each Participating Public Agency individually, and neither OMNIA
Partners, any Principal Procurement Agency nor any Participating Public Agency,
including their respective agents, directors, employees or representatives, shall be
liable to Vendor for any acts, liabilities, damages, etc., incurred by any other
Participating Public Agency. Vendor is responsible for knowing the tax laws in each
state.
This Exhibit A defines the expectations for qualifying Vendors based on OMNIA
Partners’ requirements to market the resulting Master Agreement nationally to Public
Agencies. Each section in this Exhibit A refers to the capabilities, requirements,
obligations, and prohibitions of competing Vendors on a national level in order to
serve Participating Public Agencies through OMNIA Partners.
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These requirements are incorporated into and are considered an integral part of this
IFB. OMNIA Partners reserves the right to determine whether to make the Master
Agreement awarded by the Principal Procurement Agency available to Participating
Public Agencies, in its sole and absolute discretion, and any party submitting a
response to this IFB acknowledges that any award by the Principal Procurement
Agency does not obligate OMNIA Partners to make the Master Agreement available
to Participating Procurement Agencies.
1.2 Marketing, Sales and Administrative Support
During the term of the Master Agreement OMNIA Partners intends to provide
marketing, sales, partnership development and administrative support for Vendor
pursuant to this section that directly promotes the Vendor’s products and services to
Participating Public Agencies through multiple channels, each designed to promote
specific products and services to Public Agencies on a national basis.
OMNIA Partners will assign the Vendor a Director of Partner Development who will
serve as the main point of contact for the Vendor and will be responsible for managing
the overall relationship between the Vendor and OMNIA Partners. The Director of
Partner Development will work with the Vendor to develop a comprehensive strategy
to promote the Master Agreement and will connect the Vendor with appropriate
stakeholders within OMNIA Partners including, Sales, Marketing, Contracting,
Training, and Operations & Support.
The OMNIA Partners marketing team will work in conjunction with Vendor to
promote the Master Agreement to both existing Participating Public Agencies and
prospective Public Agencies through channels that may include:
A. Marketing collateral (print, electronic, email, presentations)
B. Website
C. Trade shows/conferences/meetings
D. Advertising
E. Social Media
The OMNIA Partners sales teams will work in conjunction with Vendor to promote
the Master Agreement to both existing Participating Public Agencies and prospective
Public Agencies through initiatives that may include:
A. Individual sales calls
B. Joint sales calls
C. Communications/customer service
D. Training sessions for Public Agency teams
E. Training sessions for Vendor teams
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The OMNIA Partners contracting teams will work in conjunction with Vendor to
promote the Master Agreement to both existing Participating Public Agencies and
prospective Public Agencies through:
A. Serving as the subject matter expert for questions regarding joint powers authority
and state statutes and regulations for cooperative purchasing
B. Training sessions for Public Agency teams
C. Training sessions for Vendor teams
D. Regular business reviews to monitor program success
E. General contract administration
Vendors are required to pay an Administrative Fee of 3% of the greater of the Contract
Sales under the Master Agreement and Guaranteed Contract Sales under this Invitation
for Bid. Vendor will be required to execute the OMNIA Partners Administration
Agreement (Exhibit B).
1.3 Estimated Volume
The dollar volume purchased under the Master Agreement is estimated to be
approximately $500M annually. While no minimum volume is guaranteed to Vendor,
the estimated annual volume is projected based on the current annual volumes among
the Principal Procurement Agency, other Participating Public Agencies that are
anticipated to utilize the resulting Master Agreement to be made available to them
through OMNIA Partners, and volume growth into other Public Agencies through a
coordinated marketing approach between Vendor and OMNIA Partners.
1.4 Award Basis
The basis of any contract award resulting from this IFB made by Principal
Procurement Agency will, at OMNIA Partners’ option, be the basis of award on a
national level through OMNIA Partners. If multiple Vendors are awarded by Principal
Procurement Agency under the Master Agreement, those same Vendors will be
required to extend the Master Agreement to Participating Public Agencies through
OMNIA Partners. Utilization of the Master Agreement by Participating Public
Agencies will be at the discretion of the individual Participating Public Agency.
Certain terms of the Master Agreement specifically applicable to the Principal
Procurement Agency (e.g., governing law) are subject to modification for each
Participating Public Agency as Vendor and such Participating Public Agency may
agree without being in conflict with the Master Agreement as a condition of the
Participating Agency’s purchase and not a modification of the Master Agreement
applicable to all Participating Agencies. Participating Agencies may request to enter
into a separate supplemental agreement to further define the level of service
requirements over and above the minimum defined in the Master Agreement (e.g.,
governing law, invoice requirements, order requirements, specialized delivery,
diversity requirements such as minority and woman owned businesses, historically
underutilized business, etc.) (“Supplemental Agreement”). It shall be the
responsibility of the Vendor to comply, when applicable, with the prevailing wage
Version April 12, 2022
legislation in effect in the jurisdiction of the Participating Agency. It shall further be
the responsibility of the Vendor to monitor the prevailing wage rates as established by
the appropriate department of labor for any increase in rates during the term of the
Master Agreement and adjust wage rates accordingly. In instances where
supplemental terms and conditions create additional risk and cost for Vendor, Vendor
and Participating Public Agency may negotiate additional pricing above and beyond
the stated contract not-to-exceed pricing so long as the added price is commensurate
with the additional cost incurred by the Vendor. Any supplemental agreement
developed as a result of the Master Agreement is exclusively between the Participating
Agency and the Vendor (Contract Sales are reported to OMNIA Partners).
All signed Supplemental Agreements and purchase orders issued and accepted by the
Vendor may survive expiration or termination of the Master Agreement. Participating
Agencies’ purchase orders may exceed the term of the Master Agreement if the
purchase order is issued prior to the expiration of the Master Agreement. Vendor is
responsible for reporting all sales and paying the applicable Administrative Fee for
sales that use the Master Agreement as the basis for the purchase order, even though
Master Agreement may have expired.
1.5 Objectives of Cooperative Program
This IFB is intended to achieve the following objectives regarding availability through
OMNIA Partners’ cooperative program:
A. Provide a comprehensive competitively solicited and awarded national agreement
offering the Products covered by this solicitation to Participating Public Agencies;
B. Establish the Master Agreement as the Vendor’s primary go to market strategy to
Public Agencies nationwide;
C. Achieve cost savings for Vendor and Public Agencies through a single solicitation
process that will reduce the Vendor’s need to respond to multiple solicitations and
Public Agencies need to conduct their own solicitation process;
D. Combine the aggregate purchasing volumes of Participating Public Agencies to
achieve cost effective pricing.
2.0 REPRESENTATIONS AND COVENANTS
As a condition to Vendor entering into the Master Agreement, which would be available to
all Public Agencies, Vendor must make certain representations, warranties and covenants to
both the Principal Procurement Agency and OMNIA Partners designed to ensure the success
of the Master Agreement for all Participating Public Agencies as well as the Vendor.
2.1 Corporate Commitment
Vendor commits that (1) the Master Agreement has received all necessary corporate
authorizations and support of the Vendor’s executive management, (2) the Master
Agreement is Vendor's primary “go to market” strategy for Public Agencies, (3) the
Master Agreement will be promoted to all Public Agencies, including any existing
customers, and Vendor will transition existing customers, upon their request, to the
Master Agreement, and (4) that the Vendor has read and agrees to the terms and
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conditions of the Administration Agreement with OMNIA Partners and will execute
such agreement concurrent with and as a condition of its execution of the Master
Agreement with the Principal Procurement Agency. Vendor will identify an executive
corporate sponsor and a separate national account manager within the IFB response
that will be responsible for the overall management of the Master Agreement.
2.2 Pricing Commitment
Vendor commits the not-to-exceed pricing provided under the Master Agreement
pricing is its lowest available (net to buyer) to Public Agencies nationwide and further
commits that if a Participating Public Agency is eligible for lower pricing through a
national, state, regional or local or cooperative contract, the Vendor will match such
lower pricing to that Participating Public Agency under the Master Agreement.
2.3 Sales Commitment
Vendor commits to aggressively market the Master Agreement as its go to market
strategy in this defined sector and that its sales force will be trained, engaged and
committed to offering the Master Agreement to Public Agencies through OMNIA
Partners nationwide. Vendor commits that all Master Agreement sales will be
accurately and timely reported to OMNIA Partners in accordance with the OMNIA
Partners Administration Agreement. Vendor also commits its sales force will be
compensated, including sales incentives, for sales to Public Agencies under the Master
Agreement in a consistent or better manner compared to sales to Public Agencies if
the Vendor were not awarded the Master Agreement.
3.0 VENDOR BID
Vendor must supply the following information for the Principal Procurement Agency to
determine if Vendor is qualified and responsible to extend the resulting Master Agreement
to Participating Public Agencies through OMNIA Partners.
3.1 Company
A. Brief history and description of Vendor to include experience providing similar
products and services.
B. Total number and location of salespersons and/or project managers employed by
Vendor to help support Participating Public Agencies.
C. Number and location of support centers (if applicable) and location of corporate
office.
D. Annual sales for the three previous fiscal years.
a. Submit FEIN and Dunn & Bradstreet report.
E. Describe any green or environmental initiatives or policies.
F. Describe any diversity programs or partners Vendor does business with and how
Participating Agencies may use diverse partners through the Master Agreement.
Indicate how, if at all, pricing changes when using the diversity program. If there
are any diversity programs, provide a list of diversity alliances and a copy of their
certifications.
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G. Indicate if Vendor holds any of the below certifications in any classified areas and
include proof of such certification in the response:
a. Minority Women Business Enterprise
Yes No
If yes, list certifying agency: ___________________________________
b. Small Business Enterprise (SBE) or Disadvantaged Business Enterprise
(DBE)
Yes No
If yes, list certifying agency: ___________________________________
c. Historically Underutilized Business (HUB)
Yes No
If yes, list certifying agency: ___________________________________
d. Historically Underutilized Business Zone Enterprise (HUBZone)
Yes No
If yes, list certifying agency: ___________________________________
e. Other recognized diversity certificate holder
Yes No
If yes, list certifying agency: ____________________________________
H. List any relationships with subcontractors or affiliates intended to be used when
providing services and identify if subcontractors meet minority-owned standards.
If any, list which certifications subcontractors hold and certifying agency.
I. Describe how Vendor differentiates itself from its competitors.
J. Describe any present or past litigation, bankruptcy or reorganization involving
Vendor.
K. Felony Conviction Notice: Indicate if the Vendor
a. is a publicly held corporation and this reporting requirement is not
applicable;
b. is not owned or operated by anyone who has been convicted of a felony; or
c. is owned or operated by and individual(s) who has been convicted of a
felony and provide the names and convictions.
L. Describe any debarment or suspension actions taken against Vendor
3.2 Distribution, Logistics
A. Each offeror awarded under this IFB may offer their complete product and service
offering/a balance of line. Describe the full line of products and services offered
by Vendor.
B. Describe how Vendor proposes to distribute the products/service nationwide.
Include any states where products and services will not be offered under the Master
Agreement, including U.S. Territories and Outlying Areas.
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C. Describe how Participating Agencies are ensured they will receive the Master
Agreement pricing; include all distribution channels such as direct ordering,
retail or in-store locations, through distributors, etc. Describe how Participating
Agencies verify and audit pricing to ensure its compliance with the Master
Agreement.
D. Identify all other companies that will be involved in processing, handling or
shipping the products/service to the end user.
E. Provide the number, size and location of Vendor’s distribution or other operations
facilities, warehouses, and/or retail network as applicable.
3.3 Marketing and Sales
A. Provide a detailed ninety-day plan beginning from award date of the Master
Agreement describing the strategy to immediately implement the Master
Agreement as Vendor’s primary go to market strategy for Public Agencies to
Vendor’s teams nationwide, to include, but not limited to:
i. Executive leadership endorsement and sponsorship of the award as the
public sector go-to-market strategy within first 10 days
ii. Training and education of Vendor’s national sales force with participation
from the Vendor’s executive leadership, along with the OMNIA Partners
team within first 90 days
B. Provide a detailed ninety-day plan beginning from award date of the Master
Agreement describing the strategy to market the Master Agreement to current
Participating Public Agencies, existing Public Agency customers of Vendor, as
well as to prospective Public Agencies nationwide immediately upon award, to
include, but not limited to:
i. Creation and distribution of a co-branded press release to trade publications
ii. Announcement, Master Agreement details and contact information
published on the Vendor’s website within first 90 days
iii. Design, publication and distribution of co-branded marketing materials
within first 90 days
iv. Commitment to attendance and participation with OMNIA Partners at
national (i.e. NIGP Annual Forum, NPI Conference, etc.), regional (i.e.
Regional NIGP Chapter Meetings, Regional Cooperative Summits, etc.)
and supplier-specific trade shows, conferences and meetings throughout
the term of the Master Agreement
v. Commitment to attend, exhibit and participate at the NIGP Annual Forum
in an area reserved by OMNIA Partners for partner Vendors. Booth space
will be purchased and staffed by Vendor. In addition, Vendor commits to
provide reasonable assistance to the overall promotion and marketing
efforts for the NIGP Annual Forum, as directed by OMNIA Partners.
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vi. Design and publication of national and regional advertising in trade
publications throughout the term of the Master Agreement
vii. Ongoing marketing and promotion of the Master Agreement throughout its
term (case studies, collateral pieces, presentations, promotions, etc.)
viii. Dedicated OMNIA Partners internet web-based homepage on Vendor’s
website with:
• OMNIA Partners standard logo;
• Copy of original Invitation to Bid;
• Copy of Master Agreement and amendments between Principal
Procurement Agency and Vendor;
• Summary of Products and pricing;
• Marketing Materials
• Electronic link to OMNIA Partners’ website including the online
registration page;
• A dedicated toll-free number and email address for OMNIA
Partners
C. Describe how Vendor will transition any existing Public Agency customers’
accounts to the Master Agreement available nationally through OMNIA Partners.
Include a list of current cooperative contracts (regional and national) Vendor holds
and describe how the Master Agreement will be positioned among the other
cooperative agreements.
D. Acknowledge Vendor agrees to provide its logo(s) to OMNIA Partners and agrees
to provide permission for reproduction of such logo in marketing communications
and promotions. Acknowledge that use of OMNIA Partners logo will require
permission for reproduction, as well.
E. Confirm Vendor will be proactive in direct sales of Vendor’s goods and services
to Public Agencies nationwide and the timely follow up to leads established by
OMNIA Partners. All sales materials are to use the OMNIA Partners logo. At a
minimum, the Vendor’s sales initiatives should communicate:
i. Master Agreement was competitively solicited and publicly awarded by a
Principal Procurement Agency
ii. Best government pricing
iii. No cost to participate
iv. Non-exclusive
F. Confirm Vendor will train its national sales force on the Master Agreement. At a
minimum, sales training should include:
i. Key features of Master Agreement
ii. Working knowledge of the solicitation process
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iii. Awareness of the range of Public Agencies that can utilize the Master
Agreement through OMNIA Partners
iv. Knowledge of benefits of the use of cooperative contracts
G. Provide the name, title, email and phone number for the person(s), who will be
responsible for:
i. Executive Support
ii. Marketing
iii. Sales
iv. Sales Support
v. Financial Reporting
vi. Accounts Payable
vii. Contracts
H. Describe in detail how Vendor’s national sales force personnel and/or project
managers are structured, including contact information for the highest-level
executive in charge of the sales and/or project management team.
I. Explain in detail how the sales or project management teams will work with the
OMNIA Partners team to implement, grow and service the national program.
I. Explain in detail how Vendor will manage the overall national program throughout
the term of the Master Agreement, including ongoing coordination of marketing
and sales efforts, timely new Participating Public Agency account set-up, timely
contract administration, etc.
J. State the amount of Vendor’s Public Agency sales for the previous fiscal year.
Provide a list of Vendor’s top 3 Public Agency customers, the total purchases for
each for the previous fiscal year along with a key contact for each.
K. Describe Vendor’s information systems capabilities and limitations regarding
order management through receipt of payment, including description of multiple
platforms that may be used for any of these functions.
L. Provide the Contract Sales (as defined in Section 12 of the OMNIA Partners
Administration Agreement) that Vendor will guarantee each year under the Master
Agreement for the initial three years of the Master Agreement (“Guaranteed
Contract Sales”).
Version April 12, 2022
$_______.00 in year one
$_______.00 in year two
$_______.00 in year three
To the extent Vendor guarantees minimum Contract Sales, the Administrative
Fee shall be calculated based on the greater of the actual Contract Sales and
the Guaranteed Contract Sales.
M. Even though it is anticipated many Public Agencies will be able to utilize the
Master Agreement without further formal solicitation, there may be circumstances
where Public Agencies will issue their own solicitations. The following options
are available when responding to a solicitation for Products covered under the
Master Agreement.
i. Respond with Master Agreement pricing (Contract Sales reported to
OMNIA Partners).
ii. If competitive conditions require pricing lower than the standard
Master Agreement not-to-exceed pricing, Vendor may respond with
lower pricing through the Master Agreement. If Vendor is awarded
the contract, the sales are reported as Contract Sales to OMNIA
Partners under the Master Agreement.
iii. Respond with pricing higher than Master Agreement only in the
unlikely event that the Public Agency refuses to utilize Master
Agreement (Contract Sales are not reported to OMNIA Partners).
iv. If alternative or multiple bid and/or proposals are permitted, respond
with pricing higher than Master Agreement, and include Master
Agreement as the alternate or additional bid/proposal.
Detail Vendor’s strategies under these options when responding to a solicitation.
Version April 12, 2022
Exhibit B
Administration Agreement, Example
ADMINISTRATION AGREEMENT
THIS ADMINISTRATION AGREEMENT (this “Agreement”) is made this ___ day of
______ 20__, between National Intergovernmental Purchasing Alliance Company, a Delaware
corporation d/b/a OMNIA Partners, Public Sector (“OMNIA Partners”), and ________________
(“Supplier”).
RECITALS
WHEREAS, the ___________________ (the “Principal Procurement Agency”) has
entered into a Master Agreement effective _________________, Agreement No_______, by and
between the Principal Procurement Agency and Supplier, (as may be amended from time to time in
accordance with the terms thereof, the “Master Agreement”), as attached hereto as Exhibit A and
incorporated herein by reference as though fully set forth herein, for the purchase of
____________________________ (the “Product”);
WHEREAS, said Master Agreement provides that any or all public agencies, including state
and local governmental entities, public and private primary, secondary and higher education entities,
non-profit entities, and agencies for the public benefit (collectively, “Public Agencies”), that register
(either via registration on the OMNIA Partners website or execution of a Master Intergovernmental
Cooperative Purchasing Agreement, attached hereto as Exhibit B) (each, hereinafter referred to as a
“Participating Public Agency”) may purchase Product at prices stated in the Master Agreement;
WHEREAS, Participating Public Agencies may access the Master Agreement which is
offered through OMNIA Partners to Public Agencies;
WHEREAS, OMNIA Partners serves as the cooperative contract administrator of the Master
Agreement on behalf of Principal Procurement Agency;
WHEREAS, Principal Procurement Agency desires OMNIA Partners to proceed with
administration of the Master Agreement; and
WHEREAS, OMNIA Partners and Supplier desire to enter into this Agreement to make
available the Master Agreement to Participating Public Agencies and to set forth certain terms and
conditions governing the relationship between OMNIA Partners and Supplier.
NOW, THEREFORE, in consideration of the payments to be made hereunder and the mutual
covenants contained in this Agreement, OMNIA Partners and Supplier hereby agree as follows:
DEFINITIONS
1. Capitalized terms used in this Agreement and not otherwise defined herein shall have
the meanings given to them in the Master Agreement.
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TERMS AND CONDITIONS
2. The Master Agreement and the terms and conditions contained therein shall apply to
this Agreement except as expressly changed or modified by this Agreement. Supplier acknowledges
and agrees that the covenants and agreements of Supplier set forth in the solicitation and Supplier’s
response thereto resulting in the Master Agreement are incorporated herein and are an integral part
hereof.
3. OMNIA Partners shall be afforded all of the rights, privileges and indemnifications
afforded to Principal Procurement Agency by or from Supplier under the Master Agreement, and such
rights, privileges and indemnifications shall accrue and apply with equal effect to OMNIA Partners,
its agents, employees, directors, and representatives under this Agreement including, but not limited
to, Supplier’s obligation to obtain appropriate insurance.
4. OMNIA Partners shall perform all of its duties, responsibilities and obligations as the
cooperative contract administrator of the Master Agreement on behalf of Principal Procurement
Agency as set forth herein, and Supplier hereby acknowledges and agrees that all duties,
responsibilities and obligations will be undertaken by OMNIA Partners solely in its capacity as the
cooperative contract administrator under the Master Agreement.
5. With respect to any purchases by Principal Procurement Agency or any Participating
Public Agency pursuant to the Master Agreement, OMNIA Partners shall not be: (i) construed as a
dealer, re-marketer, representative, partner or agent of any type of the Supplier, Principal Procurement
Agency or any Participating Public Agency; (ii) obligated, liable or responsible for any order for
Product made by Principal Procurement Agency or any Participating Public Agency or any employee
thereof under the Master Agreement or for any payment required to be made with respect to such
order for Product; and (iii) obligated, liable or responsible for any failure by Principal Procurement
Agency or any Participating Public Agency to comply with procedures or requirements of applicable
law or the Master Agreement or to obtain the due authorization and approval necessary to purchase
under the Master Agreement. OMNIA Partners makes no representation or guaranty with respect to
any minimum purchases by Principal Procurement Agency or any Participating Public Agency or any
employee thereof under this Agreement or the Master Agreement.
6. OMNIA Partners shall not be responsible for Supplier’s performance under the Master
Agreement, and Supplier shall hold OMNIA Partners harmless from any liability that may arise from
the acts or omissions of Supplier in connection with the Master Agreement.
7. Supplier acknowledges that, in connection with its access to OMNIA Partners
confidential information and/or supply of data to OMNIA Partners, it has complied with and shall
continue to comply with all laws, regulations and standards that may apply to Supplier, including,
without limitation: (a) United States federal and state information security and privacy statutes,
regulations and/or best practices, including, without limitation, the Gramm-Leach-Bliley Act, the
Massachusetts Data Security Regulations (201 C.M.R. 17.00 et. seq.), the Nevada encryption statute
(N.R.S. § 603A), the California data security law (Cal. Civil Code § 1798.80 et. seq.) and California
Consumer Privacy Act (Cal. Civil Code § 1798.100 et. seq.); and (b) applicable industry and
regulatory standards and best practices (collectively, “Data Regulations”).
With regard to Personal Information that Supplier collects, receives, or otherwise processes
under the Agreement or otherwise in connection with performance of the Agreement, Supplier agrees
that it will not: (i) sell, rent, release, disclose, disseminate, make available, transfer, or otherwise
Version April 12, 2022
communicate orally, in writing, or by electronic or other means, such Personal Information to another
business or third party for monetary or other valuable consideration; or (ii) retain, use, or disclose
such Personal Information outside of the direct business relationship between Supplier and OMNIA
Partners or for any purpose other than for the specific purpose of performance of the Agreement,
including retaining, using, or disclosing such Personal Information for a commercial purpose other
than for performance of the Agreement. By entering into the Agreement, Supplier certifies that it
understands the specific restrictions contained in this Section 7 and will comply with them. For
purposes hereof, “Personal Information” means information that identifies, relates to, describes, is
reasonably capable of being associated with, or could reasonably be linked, directly or indirectly, with
a particular consumer or household, and includes the specific elements of “personal information” as
defined under Data Regulations, as defined herein. Supplier will reasonably assist OMNIA Partners
in timely responding to any third party “request to know” or “request to delete” (as defined pursuant
to Data Regulations) and will promptly provide OMNIA Partners with information reasonably
necessary for OMNIA Partners to respond to such requests. Where Supplier collects Personal
Information directly from Public Agencies or others on OMNIA Partners’ behalf, Supplier will
maintain records and the means necessary to enable OMNIA Partners to respond to such requests to
know and requests to delete.
8. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, OMNIA
PARTNERS EXPRESSLY DISCLAIMS ALL EXPRESS OR IMPLIED REPRESENTATIONS
AND WARRANTIES REGARDING OMNIA PARTNERS’ PERFORMANCE AS A CONTRACT
ADMINISTRATOR OF THE MASTER AGREEMENT. OMNIA PARTNERS SHALL NOT BE
LIABLE IN ANY WAY FOR ANY SPECIAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL,
EXEMPLARY, PUNITIVE, OR RELIANCE DAMAGES, EVEN IF OMNIA PARTNERS IS
ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.
TERM OF AGREEMENT; TERMINATION
9. This Agreement shall be in effect so long as the Master Agreement remains in effect,
provided, however, that the provisions of Sections 3 – 8 and 11 – 22, hereof and the indemnifications
afforded by the Supplier to OMNIA Partners in the Master Agreement, to the extent such provisions
survive any expiration or termination of the Master Agreement, shall survive the expiration or
termination of this Agreement.
NATIONAL PROMOTION
10. OMNIA Partners and Supplier shall publicize and promote the availability of the
Master Agreement’s products and services to Public Agencies and such agencies’ employees.
Supplier shall require each Public Agency to register its participation in the OMNIA Partners program
by either registering on the OMNIA Partners website (www.omniapartners.com/publicsector) or
executing a Master Intergovernmental Cooperative Purchasing Agreement prior to processing the
Participating Public Agency’s first sales order. Upon request, Supplier shall make available to
interested Public Agencies a copy of the Master Agreement and such price lists or quotes as may be
necessary for such Public Agencies to evaluate potential purchases.
11. Supplier shall provide such marketing and administrative support as set forth in the
solicitation resulting in the Master Agreement, including assisting in development of marketing
materials as reasonably requested by Principal Procurement Agency and OMNIA Partners. Supplier
shall be responsible for obtaining permission or license of use and payment of any license fees for all
content and images Supplier provides to OMNIA Partners or posts on the OMNIA Partners website.
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Supplier shall indemnify, defend and hold harmless OMNIA Partners for use of all such content and
images including copyright infringement claims. Supplier and OMNIA Partners each hereby grant to
the other party a limited, revocable, non-transferable, non-sublicensable right to use such party’s logo
(each, the “Logo”) solely for use in marketing the Master Agreement. Each party shall provide the
other party with the standard terms of use of such party’s Logo, and such party shall comply with
such terms in all material respects. Both parties shall obtain approval from the other party prior to
use of such party’s Logo. Notwithstanding the foregoing, the parties understand and agree that except
as provided herein neither party shall have any right, title or interest in the other party’s Logo. Upon
termination of this Agreement, each party shall immediately cease use of the other party’s Logo.
ADMINISTRATIVE FEE, REPORTING & PAYMENT
12. An “Administrative Fee” shall be defined and due to OMNIA Partners from Supplier
in the amount of __ percent (__%) (“Administrative Fee Percentage”) multiplied by the total
purchase amount paid to Supplier, less refunds, credits on returns, rebates and discounts, for the sale
of products and/or services to Principal Procurement Agency and Participating Public Agencies
pursuant to the Master Agreement (as amended from time to time and including any renewal thereof)
(“Contract Sales”). From time to time the parties may mutually agree in writing to a lower
Administrative Fee Percentage for a specifically identified Participating Public Agency’s Contract
Sales.
13. Supplier shall provide OMNIA Partners with an electronic accounting report monthly,
in the format prescribed by OMNIA Partners, summarizing all Contract Sales for each calendar
month. The Contract Sales reporting format is provided as Exhibit C (“Contract Sales Report”),
attached hereto and incorporated herein by reference. Contract Sales Reports for each calendar month
shall be provided by Supplier to OMNIA Partners by the 10th day of the following month. Failure to
provide a Contract Sales Report within the time and manner specified herein shall constitute a material
breach of this Agreement and if not cured within thirty (30) days of written notice to Supplier shall
be deemed a cause for termination of the Master Agreement, at Principal Procurement Agency’s sole
discretion, and/or this Agreement, at OMNIA Partners’ sole discretion.
14. Administrative Fee payments are to be paid by Supplier to OMNIA Partners at the
frequency and on the due date stated in Section 13, above, for Supplier’s submission of corresponding
Contract Sales Reports. Administrative Fee payments are to be made via Automated Clearing House
(ACH) to the OMNIA Partners designated financial institution identified in Exhibit D. Failure to
provide a payment of the Administrative Fee within the time and manner specified herein shall
constitute a material breach of this Agreement and if not cured within thirty (30) days of written notice
to Supplier shall be deemed a cause for termination of the Master Agreement, at Principal
Procurement Agency’s sole discretion, and/or this Agreement, at OMNIA Partners’ sole discretion.
All Administrative Fees not paid when due shall bear interest at a rate equal to the lesser of one and
one-half percent (1 1/2%) per month or the maximum rate permitted by law until paid in full.
15. Supplier shall maintain an accounting of all purchases made by Participating Public
Agencies under the Master Agreement. OMNIA Partners, or its designee, in OMNIA Partners’ sole
discretion, reserves the right to compare Participating Public Agency records with Contract Sales
Reports submitted by Supplier for a period of four (4) years from the date OMNIA Partners receives
such report. In addition, OMNIA Partners may engage a third party to conduct an independent audit
of Supplier’s monthly reports. In the event of such an audit, Supplier shall provide all materials
reasonably requested relating to such audit by OMNIA Partners at the location designated by OMNIA
Partners. In the event an underreporting of Contract Sales and a resulting underpayment of
Version April 12, 2022
Administrative Fees is revealed, OMNIA Partners will notify the Supplier in writing. Supplier will
have thirty (30) days from the date of such notice to resolve the discrepancy to OMNIA Partners’
reasonable satisfaction, including payment of any Administrative Fees due and owing, together with
interest thereon in accordance with Section 13, and reimbursement of OMNIA Partners’ costs and
expenses related to such audit.
GENERAL PROVISIONS
16. This Agreement, the Master Agreement and the exhibits referenced herein supersede
any and all other agreements, either oral or in writing, between the parties hereto with respect to the
subject matter hereto and no other agreement, statement, or promise relating to the subject matter of
this Agreement which is not contained or incorporated herein shall be valid or binding. In the event
of any conflict between the provisions of this Agreement and the Master Agreement, as between
OMNIA Partners and Supplier, the provisions of this Agreement shall prevail.
17. If any action at law or in equity is brought to enforce or interpret the provisions of this
Agreement or to recover any Administrative Fee and accrued interest, the prevailing party shall be
entitled to reasonable attorney’s fees and costs in addition to any other relief to which it may be
entitled.
18. This Agreement and OMNIA Partners’ rights and obligations hereunder may be
assigned at OMNIA Partners’ sole discretion to an affiliate of OMNIA Partners, any purchaser of any
or all or substantially all of the assets of OMNIA Partners, or the successor entity as a result of a
merger, reorganization, consolidation, conversion or change of control, whether by operation of law
or otherwise. Supplier may not assign its obligations hereunder without the prior written consent of
OMNIA Partners.
19. All written communications given hereunder shall be delivered by first-class mail,
postage prepaid, or overnight delivery on receipt to the addresses as set forth below.
A. OMNIA Partners:
OMNIA Partners
Attn: President
840 Crescent Centre Drive
Suite 600
Franklin, TN 37067
B. Supplier:
____________________
____________________
____________________
____________________
20. If any provision of this Agreement shall be deemed to be, or shall in fact be, illegal,
inoperative or unenforceable, the same shall not affect any other provision or provisions herein
contained or render the same invalid, inoperative or unenforceable to any extent whatever, and this
Agreement will be construed by limiting or invalidating such provision to the minimum extent
necessary to make such provision valid, legal and enforceable.
Version April 12, 2022
21. This Agreement may not be amended, changed, modified, or altered without the prior
written consent of the parties hereto, and no provision of this Agreement may be discharged or
waived, except by a writing signed by the parties. A waiver of any particular provision will not be
deemed a waiver of any other provision, nor will a waiver given on one occasion be deemed to apply
to any other occasion.
22. This Agreement shall inure to the benefit of and shall be binding upon OMNIA
Partners, the Supplier and any respective successor and assign thereto; subject, however, to the
limitations contained herein.
23. This Agreement will be construed under and governed by the laws of the State of
Delaware, excluding its conflicts of law provisions and any action arising out of or related to this
Agreement shall be commenced solely and exclusively in the state or federal courts in Williamson
County Tennessee.
24. This Agreement may be executed in counterparts, each of which is an original but all
of which, together, shall constitute but one and the same instrument. The exchange of copies of this
Agreement and of signature pages by facsimile, or by .pdf or similar electronic transmission, will
constitute effective execution and delivery of this Agreement as to the parties and may be used in lieu of
the original Agreement for all purposes. Signatures of the parties transmitted by facsimile, or by .pdf or
similar electronic transmission, will be deemed to be their original signatures for any purpose whatsoever.
[INSERT SUPPLIER ENTITY NAME] NATIONAL
INTERGOVERNMENTAL
PURCHASING ALLIANCE
COMPANY, A DELAWARE
CORPORATION D/B/A OMNIA
PARTNERS, PUBLIC SECTOR
Signature Signature
Sarah Vavra
Name Name
Sr. Vice President, Public Sector
Contracting
Title Title
Date Date
Version April 12, 2022
Exhibit C
Master Intergovernmental Cooperative Purchasing Agreement, Example
MASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENT
This Master Intergovernmental Cooperative Purchasing Agreement (this “Agreement”) is entered
into by and between those certain government agencies that execute a Principal Procurement Agency
Certificate (“Principal Procurement Agencies”) with National Intergovernmental Purchasing
Alliance Company, a Delaware corporation d/b/a OMNIA Partners, Public Sector and/or
Communities Program Management, LLC, a California limited liability company d/b/a U.S.
Communities (collectively, “OMNIA Partners”), in its capacity as the cooperative administrator, to
be appended and made a part hereof and such other public agencies (“Participating Public
Agencies”) who register to participate in the cooperative purchasing programs administered by
OMNIA Partners and its affiliates and subsidiaries (collectively, the “OMNIA Partners Parties”)
by either registering on the OMNIA Partners website (www.omniapartners.com/publicsector or any
successor website), or by executing a copy of this Agreement.
RECITALS
WHEREAS, after a competitive solicitation and selection process by Principal Procurement
Agencies, in compliance with their own policies, procedures, rules and regulations, a number of
suppliers have entered into “Master Agreements” (herein so called) to provide a variety of goods,
products and services (“Products”) to the applicable Principal Procurement Agency and the
Participating Public Agencies;
WHEREAS, Master Agreements are made available by Principal Procurement Agencies through
the OMNIA Partners Parties and provide that Participating Public Agencies may purchase Products
on the same terms, conditions and pricing as the Principal Procurement Agency, subject to any
applicable federal and/or local purchasing ordinances and the laws of the State of purchase; and
WHEREAS, in addition to Master Agreements, the OMNIA Partners Parties may from time to time
offer Participating Public Agencies the opportunity to acquire Products through other group
purchasing agreements.
NOW, THEREFORE, in consideration of the mutual promises contained in this Agreement, and of
the mutual benefits to result, the parties hereby agree as follows:
1. Each party will facilitate the cooperative procurement of Products.
2. The Participating Public Agencies shall procure Products in accordance with and
subject to the relevant federal, state and local statutes, ordinances, rules and regulations that govern
Participating Public Agency’s procurement practices. The Participating Public Agencies hereby
acknowledge and agree that it is the intent of the parties that all provisions of this Agreement and that
Principal Procurement Agencies’ participation in the program described herein comply with all
applicable laws, including but not limited to the requirements of 42 C.F.R. § 1001.952(j), as may be
amended from time to time. The Participating Public Agencies further acknowledge and agree that
they are solely responsible for their compliance with all applicable “safe harbor” regulations,
including but not limited to any and all obligations to fully and accurately report discounts and
incentives.
3. The Participating Public Agency represents and warrants that the Participating Public
Agency is not a hospital or other healthcare provider and is not purchasing Products on behalf of a
hospital or healthcare provider; provided that the foregoing shall not prohibit Participating Public
Agency from furnishing health care services so long as the furnishing of healthcare services is not in
furtherance of a primary purpose of the Participating Public Agency.
4. The cooperative use of Master Agreements shall be in accordance with the terms and
conditions of the Master Agreements, except as modification of those terms and conditions is
otherwise required by applicable federal, state or local law, policies or procedures.
5. The Principal Procurement Agencies will make available, upon reasonable request,
Master Agreement information which may assist in improving the procurement of Products by the
Participating Public Agencies.
6. The Participating Public Agency agrees the OMNIA Partners Parties may provide
access to group purchasing organization (“GPO”) agreements directly or indirectly by enrolling the
Participating Public Agency in another GPO’s purchasing program, provided that the purchase of
Products through the OMNIA Partners Parties or any other GPO shall be at the Participating Public
Agency’s sole discretion.
7. The Participating Public Agencies (each a “Procuring Party”) that procure Products
through any Master Agreement or GPO Product supply agreement (each a “GPO Contract”) will
make timely payments to the distributor, manufacturer or other vendor (collectively, “Supplier”) for
Products received in accordance with the terms and conditions of the Master Agreement or GPO
Contract, as applicable. Payment for Products and inspections and acceptance of Products ordered by
the Procuring Party shall be the exclusive obligation of such Procuring Party. Disputes between
Procuring Party and any Supplier shall be resolved in accordance with the law and venue rules of the
State of purchase unless otherwise agreed to by the Procuring Party and Supplier.
8. The Procuring Party shall not use this Agreement as a method for obtaining additional
concessions or reduced prices for purchase of similar products or services outside of the Master
Agreement. Master Agreements may be structured with not-to-exceed pricing, in which cases the
Supplier may offer the Procuring Party and the Procuring Party may accept lower pricing or additional
concessions for purchase of Products through a Master Agreement.
9. The Procuring Party shall be responsible for the ordering of Products under this
Agreement. A non-procuring party shall not be liable in any fashion for any violation by a Procuring
Party, and, to the extent permitted by applicable law, the Procuring Party shall hold non-procuring
party harmless from any liability that may arise from the acts or omissions of the Procuring Party.
10. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE OMNIA
PARTNERS PARTIES EXPRESSLY DISCLAIM ALL EXPRESS OR IMPLIED
REPRESENTATIONS AND WARRANTIES REGARDING ANY PRODUCT, MASTER
AGREEMENT AND GPO CONTRACT. THE OMNIA PARTNERS PARTIES SHALL NOT BE
LIABLE IN ANY WAY FOR ANY SPECIAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL,
EXEMPLARY, PUNITIVE, OR RELIANCE DAMAGES, EVEN IF THE OMNIA PARTNERS
PARTIES ARE ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE
PROCURING PARTY ACKNOWLEDGES AND AGREES THAT THE OMNIA PARTNERS
PARTIES SHALL HAVE NO LIABILITY FOR ANY ACT OR OMISSION BY A SUPPLIER OR
OTHER PARTY UNDER A MASTER AGREEMENT OR GPO CONTRACT.
Version April 12, 2022
11. This Agreement shall remain in effect until termination by either party giving thirty
(30) days’ written notice to the other party. The provisions of Paragraphs 6 - 10 hereof shall survive
any such termination.
12. This Agreement shall take effect upon (i) execution of the Principal Procurement
Agency Certificate, or (ii) registration on the OMNIA Partners website or the execution of this
Agreement by a Participating Public Agency, as applicable.
Participating Public Agency: OMNIA Partners, as the cooperative
administrator on behalf of Principal
Procurement Agencies:
NATIONAL INTERGOVERNMENTAL
PURCHASING ALLIANCE COMPANY
COMMUNITIES PROGRAM
MANAGEMENT, LLC
Authorized Signature Signature
Sarah E. Vavra
Name Name
Sr. Vice President, Public Sector Contracting
Title and Agency Name Title
Date Date
Version April 12, 2022
Exhibit D
Principal Procurement Agency Certificate, Example
PRINCIPAL PROCUREMENT AGENCY CERTIFICATE
In its capacity as a Principal Procurement Agency (as defined below) for National
Intergovernmental Purchasing Alliance Company, a Delaware corporation d/b/a OMNIA Partners,
Public Sector (“OMNIA Partners”), [PPA Name] agrees to pursue Master Agreements for
Products as specified in the attached Exhibits to this Principal Procurement Agency Certificate.
I hereby acknowledge, in my capacity as _____________ of and on behalf of [PPA Name]
(“Principal Procurement Agency”), that I have read and hereby agree to the general terms and
conditions set forth in the attached Master Intergovernmental Cooperative Purchasing Agreement
regulating the use of the Master Agreements and purchase of Products that from time to time are
made available by Principal Procurement Agencies to Participating Public Agencies nationwide
through OMNIA Partners.
I understand that the purchase of one or more Products under the provisions of the Master
Intergovernmental Cooperative Purchasing Agreement is at the sole and complete discretion of the
Participating Public Agency.
Authorized Signature, [PPA Name]________
Signature
Name
Title
Date
Exhibit E
Contract Sales Reporting Template
Contract Sales Report submitted electronically in Microsoft Excel:
Exhibit F
Federal Funds Certifications
FEDERAL CERTIFICATIONS
ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT
TO WHOM IT MAY CONCERN:
Participating Agencies may elect to use federal funds to purchase under the Master Agreement. This form should be
completed and returned.
DEFINITIONS
Contract means a legal instrument by which a non–Federal entity purchases property or services needed to carry out the project
or program under a Federal award. The term as used in this part does not include a legal instrument, even if the non–Federal
entity considers it a contract, when the substance of the transaction meets the definition of a Federal award or subaward
Contractor means an entity that receives a contract as defined in Contract.
Cooperative agreement means a legal instrument of financial assistance between a Federal awarding agency or pass-through
entity and a non–Federal entity that, consistent with 31 U.S.C. 6302–6305:
(a) Is used to enter into a relationship the principal purpose of which is to transfer anything of value from the Federal
awarding agency or pass-through entity to the non–Federal entity to carry out a public purpose authorized by a law of
the United States (see 31 U.S.C. 6101(3)); and not to acquire property or services for the Federal government or
pass-through entity's direct benefit or use;
(b) Is distinguished from a grant in that it provides for substantial involvement between the Federal awarding agency
or pass-through entity and the non–Federal entity in carrying out the activity contemplated by the Federal award.
(c) The term does not include:
(1) A cooperative research and development agreement as defined in 15 U.S.C. 3710a; or
(2) An agreement that provides only:
(i) Direct United States Government cash assistance to an individual;
(ii) A subsidy;
(iii) A loan;
(iv) A loan guarantee; or
(v) Insurance.
Federal awarding agency means the Federal agency that provides a Federal award directly to a non–Federal entity
Federal award has the meaning, depending on the context, in either paragraph (a) or (b) of this section:
(a)(1) The Federal financial assistance that a non–Federal entity receives directly from a Federal awarding agency or
indirectly from a pass-through entity, as described in § 200.101 Applicability; or
(2) The cost-reimbursement contract under the Federal Acquisition Regulations that a non–Federal entity
receives directly from a Federal awarding agency or indirectly from a pass-through entity, as described in §
200.101 Applicability.
(b) The instrument setting forth the terms and conditions. The instrument is the grant agreement, cooperative
agreement, other agreement for assistance covered in paragraph (b) of § 200.40 Federal financial assistance, or the
cost-reimbursement contract awarded under the Federal Acquisition Regulations.
(c) Federal award does not include other contracts that a Federal agency uses to buy goods or services from a
contractor or a contract to operate Federal government owned, contractor operated facilities (GOCOs).
(d) See also definitions of Federal financial assistance, grant agreement, and cooperative agreement.
Non–Federal entity means a state, local government, Indian tribe, institution of higher education (IHE), or nonprofit organization
that carries out a Federal award as a recipient or subrecipient.
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Nonprofit organization means any corporation, trust, association, cooperative, or other organization, not including IHEs, that:
(a) Is operated primarily for scientific, educational, service, charitable, or similar purposes in the public interest;
(b) Is not organized primarily for profit; and
(c) Uses net proceeds to maintain, improve, or expand the operations of the organization.
Obligations means, when used in connection with a non–Federal entity's utilization of funds under a Federal award, orders
placed for property and services, contracts and subawards made, and similar transactions during a given period that require
payment by the non–Federal entity during the same or a future period.
Pass-through entity means a non–Federal entity that provides a subaward to a subrecipient to carry out part of a Federal
program.
Recipient means a non–Federal entity that receives a Federal award directly from a Federal awarding agency to carry out an
activity under a Federal program. The term recipient does not include subrecipients.
Simplified acquisition threshold means the dollar amount below which a non–Federal entity may purchase property or
services using small purchase methods. Non–Federal entities adopt small purchase procedures in order to expedite the
purchase of items costing less than the simplified acquisition threshold. The simplified acquisition threshold is set by the Federal
Acquisition Regulation at 48 CFR Subpart 2.1 (Definitions) and in accordance with 41 U.S.C. 1908. As of the publication of this
part, the simplified acquisition threshold is $250,000, but this threshold is periodically adjusted for inflation. (Also see definition
of § 200.67 Micro-purchase.)
Subaward means an award provided by a pass-through entity to a subrecipient for the subrecipient to carry out part of a Federal
award received by the pass-through entity. It does not include payments to a contractor or payments to an individual that is a
beneficiary of a Federal program. A subaward may be provided through any form of legal agreement, including an agreement
that the pass-through entity considers a contract.
Subrecipient means a non–Federal entity that receives a subaward from a pass-through entity to carry out part of a Federal
program; but does not include an individual that is a beneficiary of such program. A subrecipient may also be a recipient of other
Federal awards directly from a Federal awarding agency.
Termination means the ending of a Federal award, in whole or in part at any time prior to the planned end of period of
performance.
The following provisions may be required and apply when Participating Agency expends federal funds for any purchase resulting
from this procurement process. Per FAR 52.204-24 and FAR 52.204-25, solicitations and resultant contracts shall contain the
following provisions.
52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance Services or Equipment (Oct
2020)
The Offeror shall not complete the representation at paragraph (d)(1) of this provision if the Offeror has represented that it "does
not provide covered telecommunications equipment or services as a part of its offered products or services to the Government in
the performance of any contract, subcontract, or other contractual instrument" in paragraph (c)(1) in the provision at 52.204-26,
Covered Telecommunications Equipment or Services—Representation, or in paragraph (v)(2)(i) of the provision at 52.212-3,
Offeror Representations and Certifications-Commercial Items. The Offeror shall not complete the representation in paragraph
(d)(2) of this provision if the Offeror has represented that it "does not use covered telecommunications equipment or services, or
any equipment, system, or service that uses covered telecommunications equipment or services" in paragraph (c)(2) of the
provision at 52.204-26, or in paragraph (v)(2)(ii) of the provision at 52.212-3.
(a) Definitions. As used in this provision—
Backhaul, covered telecommunications equipment or services, critical technology, interconnection arrangements,
reasonable inquiry, roaming, and substantial or essential component have the meanings provided in the clause 52.204-25,
Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment.
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(b) Prohibition.
(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a
contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as
a substantial or essential component of any system, or as critical technology as part of any system. Nothing in the prohibition shall
be construed to—
(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the
facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or
(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into
any user data or packets that such equipment transmits or otherwise handles.
(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-
232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract or extending or renewing
a contract with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system. This prohibition applies to
the use of covered telecommunications equipment or services, regardless of whether that use is in performance of work under a
Federal contract. Nothing in the prohibition shall be construed to—
(i) Prohibit the head of an executive agency from procuring with an entity to provide a service that connects to the
facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or
(ii) Cover telecommunications equipment that cannot route or redirect user data traffic or cannot permit visibility into
any user data or packets that such equipment transmits or otherwise handles.
(c) Procedures. The Offeror shall review the list of excluded parties in the System for Award Management (SAM)
(https://www.sam.gov) for entities excluded from receiving federal awards for "covered telecommunications equipment or services".
(d) Representation. The Offeror represents that—
(1) It □ will, □ will not provide covered telecommunications equipment or services to the Government in the performance
of any contract, subcontract or other contractual instrument resulting from this solicitation. The Offeror shall provide the additional
disclosure information required at paragraph (e)(1) of this section if the Offeror responds "will" in paragraph (d)(1) of this section;
and
(2) After conducting a reasonable inquiry, for purposes of this representation, the Offeror represents that—
It □ does, □ does not use covered telecommunications equipment or services, or use any equipment, system, or service
that uses covered telecommunications equipment or services. The Offeror shall provide the additional disclosure information
required at paragraph (e)(2) of this section if the Offeror responds "does" in paragraph (d)(2) of this section.
(e) Disclosures.
(1) Disclosure for the representation in paragraph (d)(1) of this provision. If the Offeror has responded "will" in the representation
in paragraph (d)(1) of this provision, the Offeror shall provide the following information as part of the offer.
(i) For covered equipment—
(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity
identifier, CAGE code, and whether the entity was the original equipment manufacturer (OEM) or a distributor, if known);
(B) A description of all covered telecommunications equipment offered (include brand; model number, such as
OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and
(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to
determining if such use would be permissible under the prohibition in paragraph (b)(1) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the Product Service Code (PSC) of the service being provided; and
explanation of the proposed use of covered telecommunications services and any factors relevant to determining if such use would
be permissible under the prohibition in paragraph (b)(1) of this provision.
(2) Disclosure for the representation in paragraph (d)(2) of this provision. If the Offeror has responded "does" in the
representation in paragraph (d)(2) of this provision, the Offeror shall provide the following information as part of the offer:
(i) For covered equipment—
(A) The entity that produced the covered telecommunications equipment (include entity name, unique entity
identifier, CAGE code, and whether the entity was the OEM or a distributor, if known);
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(B) A description of all covered telecommunications equipment offered (include brand; model number, such as
OEM number, manufacturer part number, or wholesaler number; and item description, as applicable); and
(C) Explanation of the proposed use of covered telecommunications equipment and any factors relevant to
determining if such use would be permissible under the prohibition in paragraph (b)(2) of this provision.
(ii) For covered services—
(A) If the service is related to item maintenance: A description of all covered telecommunications services offered
(include on the item being maintained: Brand; model number, such as OEM number, manufacturer part number, or wholesaler
number; and item description, as applicable); or
(B) If not associated with maintenance, the PSC of the service being provided; and explanation of the proposed
use of covered telecommunications services and any factors relevant to determining if such use would be permissible under the
prohibition in paragraph (b)(2) of this provision.
52.204-25 Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment
(Aug 2020).
(a) Definitions. As used in this clause—
Backhaul means intermediate links between the core network, or backbone network, and the small subnetworks at the edge
of the network (e.g., connecting cell phones/towers to the core telephone network). Backhaul can be wireless (e.g., microwave) or
wired (e.g., fiber optic, coaxial cable, Ethernet).
Covered foreign country means The People’s Republic of China.
Covered telecommunications equipment or services means–
(1) Telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary
or affiliate of such entities);
(2) For the purpose of public safety, security of Government facilities, physical security surveillance of critical
infrastructure, and other national security purposes, video surveillance and telecommunications equipment produced by Hytera
Communications Corporation, Hangzhou Hikvision Digital Technology Company, or Dahua Technology Company (or any
subsidiary or affiliate of such entities);
(3) Telecommunications or video surveillance services provided by such entities or using such equipment; or
(4) Telecommunications or video surveillance equipment or services produced or provided by an entity that the Secretary
of Defense, in consultation with the Director of National Intelligence or the Director of the Federal Bureau of Investigation,
reasonably believes to be an entity owned or controlled by, or otherwise connected to, the government of a covered foreign country.
Critical technology means–
(1) Defense articles or defense services included on the United States Munitions List set forth in the International Traffic
in Arms Regulations under subchapter M of chapter I of title 22, Code of Federal Regulations;
(2) Items included on the Commerce Control List set forth in Supplement No. 1 to part 774 of the Export Administration
Regulations under subchapter C of chapter VII of title 15, Code of Federal Regulations, and controlled-
(i) Pursuant to multilateral regimes, including for reasons relating to national security, chemical and biological
weapons proliferation, nuclear nonproliferation, or missile technology; or
(ii) For reasons relating to regional stability or surreptitious listening;
(3) Specially designed and prepared nuclear equipment, parts and components, materials, software, and technology
covered by part 810 of title 10, Code of Federal Regulations (relating to assistance to foreign atomic energy activities);
(4) Nuclear facilities, equipment, and material covered by part 110 of title 10, Code of Federal Regulations (relating to
export and import of nuclear equipment and material);
(5) Select agents and toxins covered by part 331 of title 7, Code of Federal Regulations, part 121 of title 9 of such Code,
or part 73 of title 42 of such Code; or
(6) Emerging and foundational technologies controlled pursuant to section 1758 of the Export Control Reform Act of
2018 (50 U.S.C. 4817).
Interconnection arrangements means arrangements governing the physical connection of two or more networks to allow
the use of another's network to hand off traffic where it is ultimately delivered (e.g., connection of a customer of telephone provider
A to a customer of telephone company B) or sharing data and other information resources.
Reasonable inquiry means an inquiry designed to uncover any information in the entity's possession about the identity of
the producer or provider of covered telecommunications equipment or services used by the entity that excludes the need to include
an internal or third-party audit.
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Roaming means cellular communications services (e.g., voice, video, data) received from a visited network when unable to
connect to the facilities of the home network either because signal coverage is too weak or because traffic is too high.
Substantial or essential component means any component necessary for the proper function or performance of a piece of
equipment, system, or service.
(b) Prohibition.
(1) Section 889(a)(1)(A) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-232)
prohibits the head of an executive agency on or after August 13, 2019, from procuring or obtaining, or extending or renewing a
contract to procure or obtain, any equipment, system, or service that uses covered telecommunications equipment or services as
a substantial or essential component of any system, or as critical technology as part of any system. The Contractor is prohibited
from providing to the Government any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system, unless an exception at
paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described
in FAR 4.2104.
(2) Section 889(a)(1)(B) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Pub. L. 115-
232) prohibits the head of an executive agency on or after August 13, 2020, from entering into a contract, or extending or renewing
a contract, with an entity that uses any equipment, system, or service that uses covered telecommunications equipment or services
as a substantial or essential component of any system, or as critical technology as part of any system, unless an exception at
paragraph (c) of this clause applies or the covered telecommunication equipment or services are covered by a waiver described
in FAR 4.2104. This prohibition applies to the use of covered telecommunications equipment or services, regardless of whether
that use is in performance of work under a Federal contract.
(c) Exceptions. This clause does not prohibit contractors from providing—
(1) A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements;
or
(2) Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or
packets that such equipment transmits or otherwise handles.
(d) Reporting requirement.
(1) In the event the Contractor identifies covered telecommunications equipment or services used as a substantial or essential
component of any system, or as critical technology as part of any system, during contract performance, or the Contractor is notified
of such by a subcontractor at any tier or by any other source, the Contractor shall report the information in paragraph (d)(2) of this
clause to the Contracting Officer, unless elsewhere in this contract are established procedures for reporting the information; in the
case of the Department of Defense, the Contractor shall report to the website at https://dibnet.dod.mil. For indefinite delivery
contracts, the Contractor shall report to the Contracting Officer for the indefinite delivery contract and the Contracting Officer(s) for
any affected order or, in the case of the Department of Defense, identify both the indefinite delivery contract and any affected
orders in the report provided at https://dibnet.dod.mil.
(2) The Contractor shall report the following information pursuant to paragraph (d)(1) of this clause
(i) Within one business day from the date of such identification or notification: the contract number; the order
number(s), if applicable; supplier name; supplier unique entity identifier (if known); supplier Commercial and Government Entity
(CAGE) code (if known); brand; model number (original equipment manufacturer number, manufacturer part number, or wholesaler
number); item description; and any readily available information about mitigation actions undertaken or recommended.
(ii) Within 10 business days of submitting the information in paragraph (d)(2)(i) of this clause: any further available
information about mitigation actions undertaken or recommended. In addition, the Contractor shall describe the efforts it undertook
to prevent use or submission of covered telecommunications equipment or services, and any additional efforts that will be
incorporated to prevent future use or submission of covered telecommunications equipment or services.
(e) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (e) and excluding
paragraph (b)(2), in all subcontracts and other contractual instruments, including subcontracts for the acquisition of commercial
items.
The following certifications and provisions may be required and apply when Participating Agency expends federal funds for any
purchase resulting from this procurement process. Pursuant to 2 C.F.R. § 200.326, all contracts, including small purchases,
awarded by the Participating Agency and the Participating Agency’s subcontractors shall contain the procurement provisions of
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Appendix II to Part 200, as applicable.
APPENDIX II TO 2 CFR PART 200
(A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted
amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council
(Councils) as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances
where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
Pursuant to Federal Rule (A) above, when a Participating Agency expends federal funds, the Participating Agency reserves all
rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract
by either party.
Does offeror agree? YES Initials of Authorized Representative of
offeror
(B) Termination for cause and for convenience by the grantee or subgrantee including the manner by which it will be
effected and the basis for settlement. (All contracts in excess of $10,000)
Pursuant to Federal Rule (B) above, when a Participating Agency expends federal funds, the Participating Agency reserves the
right to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a
breach or default of the agreement by Offeror as detailed in the terms of the contract.
Does offeror agree? YES Initials of Authorized Representative of
offeror
(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the
definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 must include the equal opportunity clause
provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30
CFR 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.”
Pursuant to Federal Rule (C) above, when a Participating Agency expends federal funds on any federally assisted construction
contract, the equal opportunity clause is incorporated by reference herein.
Does offeror agree to abide by the above? YES Initials of Authorized Representative of offeror
(D) Davis-Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime
construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance
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, contractors must be required to pay wages to laborers and mechanics
at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In
addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a
copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision
to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non
- Federal entity must report all suspected or reported violations to the Federal awarding agency. The contracts must
also include a provision for compliance 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 contractor or
subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or
repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non -Federal
entity must report all suspected or reported violations to the Federal awarding agency.
Pursuant to Federal Rule (D) above, when a Participating Agency expends federal funds during the term of an award for all
contracts and subgrants for construction or repair, offeror will be in compliance with all applicable Davis-Bacon Act provisions.
Does offeror agree? YES Initials of Authorized Representative of offeror
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(E) Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by
the non-Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a
provision for compliance 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, each contractor must be required to compute the wages of every mechanic and
laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible
provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all
hours worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction
work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions
which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or
materials or articles ordinarily available on the open market, or contracts for transportation or transmission of
intelligence.
Pursuant to Federal Rule (E) above, when a Participating Agency expends federal funds, offeror certifies that offeror will be in
compliance with all applicable provisions of the Contract Work Hours and Safety Standards Act during the term of an award for
all contracts by Participating Agency resulting from this procurement process.
Does offeror agree? YES Initials of Authorized Representative of offeror
(F) Rights to Inventions Made Under a Contract or Agreement. If the Federal award meets the definition of “funding
agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small
business firm or nonprofit organization regarding the substitution of parties, assignment or performance of
experimental, developmental, or research work under that “funding agreement,” the recipient or subrecipient 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.
Pursuant to Federal Rule (F) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror agrees to
comply with all applicable requirements as referenced in Federal Rule (F) above.
Does offeror agree? YES Initials of Authorized Representative of offeror
(G) 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)
Pursuant to Federal Rule (G) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency member resulting from this procurement process, the offeror
agrees to comply with all applicable requirements as referenced in Federal Rule (G) above.
Does offeror agree? YES Initials of Authorized Representative of offeror
(H) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be
made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance
with the Executive Office of the President Office of Management and Budget (OMB) guidelines at 2 CFR 180 that
implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235),
“Debarment and Suspension.” SAM Exclusions contains 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.
Pursuant to Federal Rule (H) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror certifies that
neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded
from participation by any federal department or agency. If at any time during the term of an award the offeror or its principals
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becomes debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any
federal department or agency, the offeror will notify the Participating Agency.
Does offeror agree? YES Initials of Authorized Representative of offeror
(I) Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors 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 takes place in connection with obtaining any Federal award.
Such disclosures are forwarded from tier to tier up to the non-Federal award.
Pursuant to Federal Rule (I) above, when federal funds are expended by Participating Agency, the offeror certifies that during
the term and after the awarded term of an award for all contracts by Participating Agency resulting from this procurement
process, the offeror certifies that it is in compliance with all applicable provisions of the Byrd Anti-Lobbying Amendment (31
U.S.C. 1352). The undersigned further certifies that:
(1) No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, to any person for influencing
or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress,
or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant,
the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment,
or modification of a Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress,
or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall
complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying”, in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all covered
sub-awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose
accordingly.
Does offeror agree? YES Initials of Authorized Representative of offeror
RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS
When federal funds are expended by Participating Agency for any contract resulting from this procurement process, offeror
certifies that it will comply with the record retention requirements detailed in 2 CFR § 200.333. The offeror further certifies that
offeror will retain all records as required by 2 CFR § 200.333 for a period of three years after grantees or subgrantees
submit final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT
When Participating Agency expends federal funds for any contract resulting from this procurement process, offeror certifies that
it will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy
conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18).
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS
To the extent purchases are made with Federal Highway Administration, Federal Railroad Administration, or Federal Transit
Administration funds, offeror certifies that its products comply with all applicable provisions of the Buy America Act and
agrees to provide such certification or applicable waiver with respect to specific products to any Participating Agency upon
request. Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling
for free and open competition.
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Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. § 200.336
Offeror agrees that the Inspector General of the Agency or any of their duly authorized representatives shall have access to any
documents, papers, or other records of offeror that are pertinent to offeror’s discharge of its obligations under the Contract for
the purpose of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access
to offeror’s personnel for the purpose of interview and discussion relating to such documents.
Does offeror agree? YES Initials of Authorized Representative of offeror
CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS
Offeror agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.
Does offeror agree? YES Initials of Authorized Representative of offeror
Offeror agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is
further acknowledged that offeror certifies compliance with all provisions, laws, acts, regulations, etc. as
specifically noted above.
Offeror’s Name:
____________________________________________________________________________________________
Address, City, State, and Zip Code:
_____________________________________________________________________________
Phone Number: __________________________________ Fax Number:
______________________________________
Printed Name and Title of Authorized Representative:
_____________________________________________________________________
Email Address:
____________________________________________________________________________________________
Signature of Authorized Representative: ____________________________________Date: _____________________________
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FEMA SPECIAL CONDITIONS
Awarded Supplier(s) may need to respond to events and losses where products and services are needed
for the immediate and initial response to emergency situations such as, but not limited to, water damage,
fire damage, vandalism cleanup, biohazard cleanup, sewage decontamination, deodorization, and/or wind
damage during a disaster or emergency situation. By submitting a bid, the Supplier is accepted these FEMA
Special Conditions required by the Federal Emergency Management Agency (FEMA).
“Contract” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as the
“Master Agreement”.
“Contractor” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as
“Supplier” or “Awarded Supplier”.
Conflicts of Interest
No employee, officer, or agent may participate in the selection, award, or administration of a contract
supported by a FEMA award if he or she has a real or apparent conflict of interest. Such a conflict would
arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner,
or an organization which employs or is about to employ any of these parties, has a financial or other interest
in or a tangible personal benefit from a firm considered for award. 2 C.F.R. § 200.318(c)(1); See also
Standard Form 424D, ¶ 7; Standard Form 424B, ¶ 3. i. FEMA considers a “financial interest” to be the
potential for gain or loss to the employee, officer, or agent, any member of his or her immediate family, his
or her partner, or an organization which employs or is about to employ any of these parties as a result of
the particular procurement. The prohibited financial interest may arise from ownership of certain financial
instruments or investments such as stock, bonds, or real estate, or from a salary, indebtedness, job offer,
or similar interest that might be affected by the particular procurement. ii. FEMA considers an “apparent”
conflict of interest to exist where an actual conflict does not exist, but where a reasonable person with
knowledge of the relevant facts would question the impartiality of the employee, officer, or agent
participating in the procurement. c. Gifts. The officers, employees, and agents of the Participating Public
Agency nor the Participating Public Agency (“NFE”) must neither solicit nor accept gratuities, favors, or
anything of monetary value from contractors or parties to subcontracts. However, NFE’s may set standards
for situations in which the financial interest is de minimus, not substantial, or the gift is an unsolicited item
of nominal value. 2 C.F.R. § 200.318(c)(1). d. Violations. The NFE’s written standards of conduct must
provide for disciplinary actions to be applied for violations of such standards by officers, employees, or
agents of the NFE. 2 C.F.R. § 200.318(c)(1). For example, the penalty for a NFE’s employee may be
dismissal, and the penalty for a contractor might be the termination of the contract.
Contractor Integrity
A contractor must have a satisfactory record of integrity and business ethics. Contractors that are debarred
or suspended, as described in and subject to the debarment and suspension regulations implementing
Executive Order 12549, Debarment and Suspension (1986) and Executive Order 12689, Debarment and
Suspension (1989) at 2 C.F.R. Part 180 and the Department of Homeland Security’s regulations at 2 C.F.R.
Part 3000 (Non-procurement Debarment and Suspension), must be rejected and cannot receive contract
awards at any level.
Public Policy
A contractor must comply with the public policies of the Federal Government and state, local government,
or tribal government. This includes, among other things, past and current compliance with the:
a. Equal opportunity and nondiscrimination laws
b. Five affirmative steps described at 2 C.F.R. § 200.321(b) for all subcontracting under contracts supported
by FEMA financial assistance; and FEMA Procurement Guidance June 21, 2016 Page IV- 7
c. Applicable prevailing wage laws, regulations, and executive orders
Affirmative Steps
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For any subcontracting opportunities, Contractor must take the following Affirmative steps:
1. Placing qualified small and minority businesses and women's business enterprises on solicitation
lists;
2. Assuring that small and minority businesses, and women's business enterprises are solicited
whenever they are potential sources;
3. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit
maximum participation by small and minority businesses, and women's business enterprises;
4. Establishing delivery schedules, where the requirement permits, which encourage participation by
small and minority businesses, and women's business enterprises; and
5. Using the services and assistance, as appropriate, of such organizations as the Small Business
Administration and the Minority Business Development Agency of the Department of Commerce.
Prevailing Wage Requirements
When applicable, the awarded Contractor (s) and any and all subcontractor(s) agree to comply with all laws
regarding prevailing wage rates including the Davis-Bacon Act, applicable to this solicitation and/or
Participating Public Agencies. The Participating Public Agency shall notify the Contractor of the applicable
pricing/prevailing wage rates and must apply any local wage rates requested. The Contractor and any
subcontractor(s) shall comply with the prevailing wage rates set by the Participating Public Agency.
Federal Requirements
If products and services are issued in response to an emergency or disaster recovery the items below,
located in this FEMA Special Conditions section of the Federal Funds Certifications, are activated and
required when federal funding may be utilized.
2 C.F.R. § 200.326 and 2 C.F.R. Part 200, Appendix II, Required Contract Clauses
1. REMEDIES
a. Standard. Contracts for more than the simplified acquisition threshold, currently set at
$250,000, must address administrative, contractual, or legal remedies in instances where
contractors violate or breach contract terms, and provide for such sanctions and penalties
as appropriate. See 2 C.F.R. Part 200, Appendix II(A).
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
2. TERMINATION FOR CAUSE AND CONVENIENCE
a. Standard. All contracts in excess of $10,000 must address termination for cause and for
convenience by the non-Federal entity, including the manner by which it will be effected
and the basis for settlement. See 2 C.F.R. Part 200, Appendix II(B).
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
3. EQUAL EMPLOYMENT OPPORTUNITY
When applicable:
a. Standard. Except as otherwise provided under 41 C.F.R. Part 60, all contracts that meet
the definition of “federally assisted construction contract” in 41 C.F.R.
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§ 60-1.3 must include the equal opportunity clause provided under 41 C.F.R. § 60- 1.4(b),
in accordance with Executive Order 11246, Equal Employment Opportunity (30 Fed. Reg.
12319, 12935, 3 C.F.R. 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
C.F.R. Part 60 (Office of Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor). See 2 C.F.R. Part 200, Appendix II(C).
b. Key Definitions.
i. Federally Assisted Construction Contract. The regulation at 41 C.F.R. § 60-
1.3 defines a “federally assisted construction contract” as any agreement or
modification thereof between any applicant and a person for construction work which
is paid for in whole or in part with funds obtained from the Government or borrowed
on the credit of the Government pursuant to any Federal program involving a grant,
contract, loan, insurance, or guarantee, or undertaken pursuant to any Federal
program involving such grant, contract, loan, insurance, or guarantee, or any
application or modification thereof approved by the Government for a grant, contract,
loan, insurance, or guarantee under which the applicant itself participates in the
construction work.
ii. Construction Work. The regulation at 41 C.F.R. § 60-1.3 defines “construction work”
as the construction, rehabilitation, alteration, conversion, extension, demolition or
repair of buildings, highways, or other changes or improvements to real property,
including facilities providing utility services. The term also includes the supervision,
inspection, and other onsite functions incidental to the actual construction.
c. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs.
d. Required Language. The regulation at 41 C.F.R. Part 60-1.4(b) requires the insertion of
the following contract clause.
During the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, sexual orientation, gender identity, or
national origin. The contractor will take affirmative action to ensure that applicants are
employed, and that employees are treated during employment without regard to their
race, color, religion, sex, sexual orientation, gender identity, or national origin. Such
action shall include, but not be limited to the following:
Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising;
layoff or termination; rates of pay or other forms of compensation; and selection for
training, including apprenticeship. The contractor agrees to post in conspicuous places,
available to employees and applicants for employment, notices to be provided setting
forth the provisions of this nondiscrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex, sexual orientation, gender
identity, or national origin.
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(3) The contractor will not discharge or in any other manner discriminate against any
employee or applicant for employment because such employee or applicant has inquired
about, discussed, or disclosed the compensation of the employee or applicant or another
employee or applicant. This provision shall not apply to instances in which an employee
who has access to the compensation information of other employees or applicants as a
part of such employee's essential job functions discloses the compensation of such other
employees or applicants to individuals who do not otherwise have access to such
information, unless such disclosure is in response to a formal complaint or charge, in
furtherance of an investigation, proceeding, hearing, or action, including an investigation
conducted by the employer, or is consistent with the contractor's legal duty to furnish
information.
(4) The contractor will send to each labor union or representative of workers with which
he has a collective bargaining agreement or other contract or understanding, a notice to
be provided advising the said labor union or workers' representatives of the contractor's
commitments under this section and shall post copies of the notice in conspicuous
places available to employees and applicants for employment.
(5) The contractor will comply with all provisions of Executive Order 11246 of September
24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
(6) The contractor will furnish all information and reports required by Executive Order
11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of
Labor, or pursuant thereto, and will permit access to his books, records, and accounts by
the administering agency and the Secretary of Labor for purposes of investigation to
ascertain compliance with such rules, regulations, and orders.
(7) In the event of the contractor's noncompliance with the nondiscrimination clauses of
this contract or with any of the said rules, regulations, or orders, this contract may be
canceled, terminated, or suspended in whole or in part and the contractor may be
declared ineligible for further Government contracts or federally assisted construction
contracts in accordance with procedures authorized in Executive Order 11246 of
September 24, 1965, and such other sanctions may be imposed and remedies invoked
as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or
order of the Secretary of Labor, or as otherwise provided by law.
(8) The contractor will include the portion of the sentence immediately preceding
paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or
purchase order unless exempted by rules, regulations, or orders of the Secretary of
Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965,
so that such provisions will be binding upon each subcontractor or vendor. The
contractor will take such action with respect to any subcontract or purchase order as the
administering agency may direct as a means of enforcing such provisions, including
sanctions for noncompliance:
Provided, however, that in the event a contractor becomes involved in, or is threatened
with, litigation with a subcontractor or vendor as a result of such direction by the
administering agency, the contractor may request the United States to enter into such
litigation to protect the interests of the United States.
The applicant further agrees that it will be bound by the above equal opportunity clause
with respect to its own employment practices when it participates in federally assisted
construction work: Provided, That if the applicant so participating is a State or local
government, the above equal opportunity clause is not applicable to any agency,
instrumentality or subdivision of such government which does not participate in work on
or under the contract.
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The applicant agrees that it will assist and cooperate actively with the administering
agency and the Secretary of Labor in obtaining the compliance of contractors and
subcontractors with the equal opportunity clause and the rules, regulations, and relevant
orders of the Secretary of Labor, that it will furnish the administering agency and the
Secretary of Labor such information as they may require for the supervision of such
compliance, and that it will otherwise assist the administering agency in the discharge of
the agency's primary responsibility for securing compliance.
The applicant further agrees that it will refrain from entering into any contract or contract
modification subject to Executive Order 11246 of September 24, 1965, with a contractor
debarred from, or who has not demonstrated eligibility for, Government contracts and
federally assisted construction contracts pursuant to the Executive Order and will carry
out such sanctions and penalties for violation of the equal opportunity clause as may be
imposed upon contractors and subcontractors by the administering agency or the
Secretary of Labor pursuant to Part II, Subpart D of the Executive Order. In addition, the
applicant agrees that if it fails or refuses to comply with these undertakings, the
administering agency may take any or all of the following actions: Cancel, terminate, or
suspend in whole or in part this grant (contract, loan, insurance, guarantee); refrain from
extending any further assistance to the applicant under the program with respect to
which the failure or refund occurred until satisfactory assurance of future compliance has
been received from such applicant; and refer the case to the Department of Justice for
appropriate legal proceedings.
4. DAVIS-BACON ACT
a. Standard. All prime construction contracts in excess of $2,000 awarded by non- Federal
entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. §§ 3141-
3144 and 3146-3148) as supplemented by Department of Labor regulations at 29 C.F.R. Part
5 (Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction). See 2 C.F.R. Part 200, Appendix II(D). In accordance with the statute,
contractors must be required to pay wages to laborers and mechanics at a rate not less than
the prevailing wages specified in a wage determination made by the Secretary of Labor. In
addition, contractors must be required to pay wages not less than once a week.
b. Applicability. The Davis-Bacon Act applies to the Emergency Management Preparedness
Grant Program, Homeland Security Grant Program, Nonprofit Security Grant Program, Tribal
Homeland Security Grant Program, Port Security Grant Program, and Transit Security Grant
Program.
c. Requirements. If applicable, the non-federal entity must do the following:
i. The non-Federal entity must place a copy of the current prevailing wage
determination issued by the Department of Labor in each solicitation. The decision
to award a contract or subcontract must be conditioned upon the acceptance of
the wage determination. The non-Federal entity must report all suspected or
reported violations to the Federal awarding agency.
ii. Additionally, pursuant 2 C.F.R. Part 200, Appendix II(D), contracts subject to the
Davis-Bacon Act, must also include a provision for compliance with the Copeland
“Anti-Kickback” Act (40 U.S.C. § 3145), as supplemented by Department of Labor
regulations at 29 C.F.R. 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 Copeland Anti- Kickback Act provides that each contractor or
subrecipient must be prohibited from inducing, by any means, any person
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employed in the construction, completion, or repair of public work, to give up any
part of the compensation to which he or she is otherwise entitled. The non-
Federal entity must report all suspected or reported violations to FEMA.
iii. Include a provision for compliance 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”).
Suggested Language. The following provides a sample contract clause:
Compliance with the Davis-Bacon Act.
a. All transactions regarding this contract shall be done in
compliance with the Davis-Bacon Act (40 U.S.C. 3141- 3144, and
3146-3148) and the requirements of 29 C.F.R. pt. 5 as may be
applicable. The contractor shall comply with 40 U.S.C. 3141-
3144, and 3146-3148 and the requirements of 29 C.F.R. pt. 5 as
applicable.
b. Contractors are required to pay wages to laborers and mechanics
at a rate not less than the prevailing wages specified in a wage
determination made by the Secretary of Labor.
c. Additionally, contractors are required to pay wages not less than
once a week.
5. COPELAND ANTI-KICKBACK ACT
a. Standard. Recipient and subrecipient contracts must include a provision for compliance 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”).
b. Applicability. This requirement applies to all contracts for construction or repair work above
$2,000 in situations where the Davis-Bacon Act also applies. It DOES NOT apply to the FEMA
Public Assistance Program.
c. Requirements. If applicable, the non-federal entity must include a provision for compliance
with the Copeland “Anti-Kickback” Act (40 U.S.C. § 3145), as supplemented by Department
of Labor regulations at 29 C.F.R. 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). Each
contractor or subrecipient must be prohibited from inducing, by any means, any person
employed in the construction, completion, or repair of public work, to give up any part of the
compensation to which he or she is otherwise entitled. The non-Federal entity must report all
suspected or reported violations to FEMA. Additionally, in accordance with the regulation,
each contractor and subcontractor must furnish each week a statement with respect to the
wages paid each of its employees engaged in work covered by the Copeland Anti-Kickback
Act and the Davis Bacon Act during the preceding weekly payroll period. The report shall be
delivered by the contractor or subcontractor, within seven days after the regular payment
date of the payroll period, to a representative of a Federal or State agency in charge at the
site of the building or work.
Sample Language. The following provides a sample contract clause:
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Compliance with the Copeland “Anti-Kickback” Act.
a. Contractor. The contractor shall comply with 18 U.S.C. § 874, 40 U.S.C.
§ 3145, and the requirements of 29 C.F.R. pt. 3 as may be applicable,
which are incorporated by reference into this contract.
b. Subcontracts. The contractor or subcontractor shall insert in any
subcontracts the clause above and such other clauses as FEMA may
by appropriate instructions require, and also a clause requiring the
subcontractors to include these clauses in any lower tier subcontracts.
The prime contractor shall be responsible for the compliance by any
subcontractor or lower tier subcontractor with all of these contract
clauses.
c. Breach. A breach of the contract clauses above may be grounds for
termination of the contract, and for debarment as a contractor and
subcontractor as provided in 29 C.F.R. §5.12.”
6. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT
a. Standard. Where applicable (see 40 U.S.C. §§ 3701-3708), all contracts awarded by the
non-Federal entity in excess of $100,000 that involve the employment of mechanics or
laborers must include a provision for compliance with 40 U.S.C. §§ 3702 and 3704, as
supplemented by Department of Labor regulations at 29 C.F.R. Part 5. See 2 C.F.R. Part
200, Appendix II(E). Under 40 U.S.C. § 3702, each contractor must be required to
compute the wages of every mechanic and laborer on the basis of a standard work week
of 40 hours. Work in excess of the standard work week is permissible provided that the
worker is compensated at a rate of not less than one and a half times the basic rate of
pay for all hours worked in excess of 40 hours in the work week. Further, no laborer or
mechanic must be required to work in surroundings or under working conditions which
are unsanitary, hazardous, or dangerous.
b. Applicability. This requirement applies to all FEMA contracts awarded by the non- federal
entity in excess of $100,000 under grant and cooperative agreement programs that involve
the employment of mechanics or laborers. It is applicable to construction work. These
requirements do not apply to the purchase of supplies or materials or articles ordinarily
available on the open market, or contracts for transportation or transmission of
intelligence.
c. Suggested Language. The regulation at 29 C.F.R. § 5.5(b) provides contract clause
language concerning compliance with the Contract Work Hours and Safety Standards
Act. FEMA suggests including the following contract clause:
Compliance with the Contract Work Hours and Safety Standards Act.
(1) Overtime requirements. No contractor or subcontractor contracting for any part of
the contract work which may require or involve the employment of laborers or mechanics
shall require or permit any such laborer or mechanic in any workweek in which he or she
is employed on such work to work in excess of forty hours in such workweek unless such
laborer or mechanic receives compensation at a rate not less than one and one-half
times the basic rate of pay for all hours worked in excess of forty hours in such workweek.
(2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation
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of the clause set forth in paragraph (b)(1) of this section the contractor and any
subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such
contractor and subcontractor shall be liable to the United States (in the case of work
done under contract for the District of Columbia or a territory, to such District or to such
territory), for liquidated damages. Such liquidated damages shall be computed with
respect to each individual laborer or mechanic, including watchmen and guards,
employed in violation of the clause set forth in paragraph (b)(1) of this section, in the sum
of
$27 for each calendar day on which such individual was required or permitted to work in
excess of the standard workweek of forty hours without payment of the overtime wages
required by the clause set forth in paragraph (b)(1) of this section.
(3) Withholding for unpaid wages and liquidated damages. The Federal agency or
loan/grant recipient shall upon its own action or upon written request of an authorized
representative of the Department of Labor withhold or cause to be withheld, from any
moneys payable on account of work performed by the contractor or subcontractor under
any such contract or any other Federal contract with the same prime contractor, or any
other federally-assisted contract subject to the Contract Work Hours and Safety
Standards Act, which is held by the same prime contractor, such sums as may be
determined to be necessary to satisfy any liabilities of such contractor or subcontractor
for unpaid wages and liquidated damages as provided in the clause set forth in
paragraph (b)(2) of this section.
(4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the
clauses set forth in paragraph (b)(1) through (4) of this section and also a clause requiring
the subcontractors to include these clauses in any lower tier subcontracts. The prime
contractor shall be responsible for compliance by any subcontractor or lower tier
subcontractor with the clauses set forth in paragraphs (b)(1) through (4) of this section.
7. RIGHTS TO INVENTIONS MADE UNDER A CONTRACT OR AGREEMENT
a. Standard. If the FEMA award meets the definition of “funding agreement” under 37C.F.R.
§ 401.2(a) and the non-Federal entity wishes to enter into a contract with a small business
firm or nonprofit organization regarding the substitution of parties, assignment or
performance of experimental, developmental, or research work under that “funding
agreement,” the non- Federal entity must comply with the requirements of 37 C.F.R. 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 FEMA. See 2 C.F.R. Part 200, Appendix II(F).
b. Applicability. This requirement applies to “funding agreements,” but it DOES NOT apply
to the Public Assistance, Hazard Mitigation Grant Program, Fire Management Assistance
Grant Program, Crisis Counseling Assistance and Training Grant Program, Disaster Case
Management Grant Program, and Federal Assistance to Individuals and Households –
Other Needs Assistance Grant Program, as FEMA awards under these programs do not
meet the definition of “funding agreement.”
c. Funding Agreements Definition. The regulation at 37 C.F.R. § 401.2(a) defines “funding
agreement” as any contract, grant, or cooperative agreement entered into between any
Federal agency, other than the Tennessee Valley Authority, and any contractor for the
performance of experimental, developmental, or research work funded in whole or in part
by the Federal government. This term also includes any assignment, substitution of
parties, or subcontract of any type entered into for the performance of experimental,
developmental, or research work under a funding agreement as defined in the first
sentence of this paragraph.
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8. CLEAN AIR ACT AND THE FEDERAL WATER POLLUTION CONTROL ACT
a. Standard. If applicable, contracts must contain a provision that requires the contractor 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 FEMA and the
Regional Office of the Environmental Protection Agency. See 2 C.F.R. Part 200,
Appendix II(G).
b. Applicability. This requirement applies to contracts awarded by a non-federal entity of
amounts in excess of $150,000 under a federal grant.
c. Suggested Language. The following provides a sample contract clause.
Clean Air Act
1. The contractor agrees to comply with all applicable standards, orders or
regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C.
§ 7401 et seq.
2. The contractor agrees to report each violation to the Participating Public
Agency and understands and agrees that the Participating Public Agency
will, in turn, report each violation as required to assure notification to the
Federal Emergency Management Agency, and the appropriate
Environmental Protection Agency Regional Office.
3. The contractor agrees to include these requirements in each subcontract
exceeding $150,000 financed in whole or in part with Federal assistance
provided by FEMA.
Federal Water Pollution Control Act
1. The contractor agrees to comply with all applicable standards, orders, or
regulations issued pursuant to the Federal Water Pollution Control Act, as
amended, 33 U.S.C. 1251 et seq.
2. The contractor agrees to report each violation to the Participating Public
Agency and understands and agrees that the Participating Public Agency
will, in turn, report each violation as required to assure notification to the
Federal Emergency Management Agency, and the appropriate
Environmental Protection Agency Regional Office.
3. The contractor agrees to include these requirements in each subcontract
exceeding $150,000 financed in whole or in part with Federal assistance
provided by FEMA.
9. DEBARMENT AND SUSPENSION
a. Standard. Non-Federal entities and contractors are subject to the debarment and
suspension regulations implementing Executive Order 12549, Debarment and
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Suspension (1986) and Executive Order 12689, Debarment and Suspension (1989) at 2
C.F.R. Part 180 and the Department of Homeland Security’s regulations at 2 C.F.R. Part
3000 (Non-procurement Debarment and Suspension).
b. Applicability. This requirement applies to all FEMA grant and cooperative
agreement programs.
c. Requirements.
i. These regulations restrict awards, subawards, and contracts with certain parties
that are debarred, suspended, or otherwise excluded from or ineligible for
participation in Federal assistance programs and activities. See 2 C.F.R. Part 200,
Appendix II(H); and 2 C.F.R. § 200.213. A contract award must not be made to
parties listed in the SAM Exclusions. SAM Exclusions is the list maintained by the
General Services Administration that contains 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.
SAM exclusions can be accessed at www.sam.gov. See 2 C.F.R. § 180.530.
ii. In general, an “excluded” party cannot receive a Federal grant award or a contract
within the meaning of a “covered transaction,” to include subawards and
subcontracts. This includes parties that receive Federal funding indirectly, such
as contractors to recipients and subrecipients. The key to the exclusion is whether
there is a “covered transaction,” which is any non-procurement transaction
(unless excepted) at either a “primary” or “secondary” tier. Although “covered
transactions” do not include contracts awarded by the Federal Government for
purposes of the non-procurement common rule and DHS’s implementing
regulations, it does include some contracts awarded by recipients and
subrecipients.
iii. Specifically, a covered transaction includes the following contracts for goods or
services:
1. The contract is awarded by a recipient or subrecipient in the amount of at
least $25,000.
2. The contract requires the approval of FEMA, regardless of amount.
3. The contract is for federally-required audit services.
4. A subcontract is also a covered transaction if it is awarded by the
contractor of a recipient or subrecipient and requires either the approval of
FEMA or is in excess of $25,000.
d. Suggested Language. The following provides a debarment and suspension clause. It
incorporates an optional method of verifying that contractors are not excluded or
disqualified.
Suspension and Debarment
(1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R.
pt. 3000. As such, the contractor is required to verify that none of the contractor’s
principals (defined at 2 C.F.R. § 180.995) or its affiliates (defined at 2 C.F.R. §
180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2
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C.F.R. § 180.935).
(2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and2 C.F.R. pt. 3000,
subpart C, and must include a requirement to comply with these regulations in any
lower tier covered transaction it enters into.
(3) This certification is a material representation of fact relied upon by the Participating
Public Agency. If it is later determined that the contractor did not comply with 2
C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies
available to the Participating Public Agency, the Federal Government may pursue
available remedies, including but not limited to suspension and/or debarment.
(4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt.
180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and
throughout the period of any contract that may arise from this offer. The bidder or
proposer further agrees to include a provision requiring such compliance in its
lower tier covered transactions.
10. BYRD ANTI-LOBBYING AMENDMENT
a. Standard. 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.
FEMA’s regulation at 44 C.F.R. Part 18 implements the requirements of 31 U.S.C. § 1352
and provides, in Appendix A to Part 18, a copy of the certification that is required to be
completed by each entity as described in 31 U.S.C. § 1352. Each tier must also disclose
any lobbying with non-Federal funds that takes place in connection with obtaining any
Federal award. Such disclosures are forwarded from tier to tier up to the Federal
awarding agency.
b. Applicability. This requirement applies to all FEMA grant and cooperative agreement
programs. Contractors that apply or bid for a contract of $100,000 or more under a federal
grant must file the required certification. See 2 C.F.R. Part 200, Appendix II(I); 31 U.S.C.
§ 1352; and 44 C.F.R. Part 18.
c. Suggested Language.
Byrd Anti-Lobbying Amendment, 31 U.S.C. § 1352 (as amended)
Contractors who apply or bid for an award of $100,000 or more shall 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 shall also disclose any lobbying with non-Federal funds that takes place in
connection with obtaining any Federal award. Such disclosures are forwarded from tier
to tier up to the recipient who in turn will forward the certification(s) to the awarding
agency.
Version April 12, 2022
d. Required Certification. If applicable, contractors must sign and submit to the non-federal
entity the following certification.
APPENDIX A, 44 C.F.R. PART 18 – CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in
the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans, and cooperative agreements) and that
all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, title
31, U.S. Code. Any person who fails to file the required certification shall be subject to a
civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
The Contractor, , certifies or affirms the truthfulness and
accuracy of each statement of its certification and disclosure, if any. In addition, the
Contractor understands and agrees that the provisions of 31 U.S.C. Chap. 38,
Administrative Remedies for False Claims and Statements, apply to this certification and
disclosure, if any.
Signature of Contractor’s Authorized Official
Name and Title of Contractor’s Authorized Official
Date
Version April 12, 2022
11. PROCUREMENT OF RECOVERED MATERIALS
a. Standard. A non-Federal entity that is a state agency or agency of a political subdivision
of a state and its contractors must comply with Section 6002 of the Solid Waste Disposal
Act, as amended by the Resource Conservation and Recovery Act. See 2 C.F.R. Part
200, Appendix II(J); and 2 C.F.R. § 200.322.
b. Applicability. This requirement applies to all contracts awarded by a non- federal entity
under FEMA grant and cooperative agreement programs.
c. Requirements. The requirements of Section 6002 include procuring only items
designated in guidelines of the EPA at 40 C.F.R. 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 by 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.
d. Suggested Language.
i.
In the performance of this contract, the Contractor shall make maximum use of
products containing recovered materials that are EPA-designated items unless
the product cannot be acquired—
1. Competitively within a timeframe providing for compliance with the contract performance
schedule;
2. Meeting contract performance requirements; or
3. At a reasonable price.
ii. Information about this requirement, along with the list of EPA- designated items,
is available at EPA’s Comprehensive Procurement Guidelines web site,
https://www.epa.gov/smm/comprehensive-procurement-guideline-cpg-program.
iii. The Contractor also agrees to comply with all other applicable requirements of
Section 6002 of the Solid Waste Disposal Act.”
12. ACCESS TO RECORDS
a. Standard. All recipients, subrecipients, successors, transferees, and assignees must
acknowledge and agree to comply with applicable provisions governing DHS access to
records, accounts, documents, information, facilities, and staff. Recipients must give
DHS/FEMA access to, and the right to examine and copy, records, accounts, and other
documents and sources of information related to the federal financial assistance award
and permit access to facilities, personnel, and other individuals and information as may be
necessary, as required by DHS regulations and other applicable laws or program
guidance. See DHS Standard Terms and Conditions: Version 8.1 (2018). Additionally,
Section 1225 of the Disaster Recovery Reform Act of 2018 prohibits FEMA from providing
reimbursement to any state, local, tribal, or territorial government, or private non-profit for
activities made pursuant to a contract that purports to prohibit audits or internal reviews
by the FEMA administrator or Comptroller General.
Access to Records. The following access to records requirements apply to this contract:
Version April 12, 2022
i.The Contractor agrees to provide Participating Public Agency, the FEMA
Administrator, the Comptroller General of the United States, or any of their
authorized representatives access to any books, documents, papers, and records
of the Contractor which are directly pertinent to this contract for the purposes of
making audits, examinations, excerpts, and transcriptions.
ii.The Contractor agrees to permit any of the foregoing parties to reproduce by any
means whatsoever or to copy excerpts and transcriptions as reasonably needed.
iii. The Contractor agrees to provide the FEMA Administrator or his authorized
representatives access to construction or other work sites pertaining to the work
being completed under the contract.
iv.In compliance with the Disaster Recovery Act of 2018, the Participating Public
Agency and the Contractor acknowledge and agree that no language in this
contract is intended to prohibit audits or internal reviews by the FEMA Administrator
or the Comptroller General of the United States.
13. CHANGES
a. Standard. To be eligible for FEMA assistance under the non-Federal entity’s FEMA grant
or cooperative agreement, the cost of the change, modification, change order, or
constructive change must be allowable, allocable, within the scope of its grant or
cooperative agreement, and reasonable for the completion of project scope.
b. Applicability. FEMA recommends, therefore, that a non-Federal entity include a changes
clause in its contract that describes how, if at all, changes can be made by either party to
alter the method, price, or schedule of the work without breaching the contract. The
language of the clause may differ depending on the nature of the contract and the end-item
procured.
14. DHS SEAL, LOGO, AND FLAGS
a. Standard. Recipients must obtain permission prior to using the DHS seal(s), logos, crests,
or reproductions of flags or likenesses of DHS agency officials. See DHS Standard Terms
and Conditions: Version 8.1 (2018).
b. Applicability. FEMA recommends that all non-Federal entities place in their contracts a
provision that a contractor shall not use the DHS seal(s), logos, crests, or reproductions of
flags or likenesses of DHS agency officials without specific FEMA pre-approval.
c. “The contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or
likenesses of DHS agency officials without specific FEMA pre-approval.
Version April 12, 2022
15. COMPLIANCE WITH FEDERAL LAW, REGULATIONS, AND EXECUTIVE ORDERS
a. Standard. The recipient and its contractors are required to comply with all Federal laws,
regulations, and executive orders.
b. Applicability. FEMA recommends that all non-Federal entities place into their contracts an
acknowledgement that FEMA financial assistance will be used to fund the contract along with
the requirement that the contractor will comply with all applicable Federal law, regulations,
executive orders, and FEMA policies, procedures, and directives.
c. “This is an acknowledgement that FEMA financial assistance will be used to fund all or a
portion of the contract. The contractor will comply with all applicable Federal law, regulations,
executive orders, FEMA policies, procedures, and directives.”
16. NO OBLIGATION BY FEDERAL GOVERNMENT
a. Standard. FEMA is not a party to any transaction between the recipient and its contractor.
FEMA is not subject to any obligations or liable to any party for any matter relating to the
contract.
b. Applicability. FEMA recommends that the non-Federal entity include a provision in its contract
that states that the Federal Government is not a party to the contract and is not subject to any
obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to
any matter resulting from the contract.
c. “The Federal Government is not a party to this contract and is not subject to any obligations or
liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter
resulting from the contract.”
17. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS OR RELATED ACTS
a. Standard. Recipients must comply with the requirements of The False Claims Act (31 U.S.C.
§§ 3729-3733) which prohibits the submission of false or
fraudulent claims for payment to the federal government. See DHS Standard Terms and
Conditions: Version 8.1 (2018); and 31 U.S.C. §§ 3801-3812, which details the
administrative remedies for false claims and statements made. The non-Federal entity must
include a provision in its contract that the contractor acknowledges that 31 U.S.C. Chap. 38
(Administrative Remedies for False Claims and Statements) applies to its actions pertaining
to the contract.
b. Applicability. FEMA recommends that the non-Federal entity include a provision in its contract
that the contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False
Claims and Statements) applies to its actions pertaining to the contract.
c. “The Contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False
Claims and Statements) applies to the Contractor’s actions pertaining to this contract.”
Offeror agrees to comply with all terms and conditions outlined in the FEMA Special Conditions
section of this solicitation.
Offeror’s Name: ______________________________________________
Address, City, State, and Zip Code:
_____________________________________________________________________________
Phone Number: ________________________ Fax Number: ______________________________
Printed Name and Title of Authorized Representative:
____________________________________________________________
Email Address: _____________________________________________
Signature of Authorized Representative: ____________________________________
Date: ________________________________
Version April 12, 2022
Exhibit G
New Jersey Business Compliance
NEW JERSEY BUSINESS COMPLIANCE
Suppliers intending to do business in the State of New Jersey must comply with policies and
procedures required under New Jersey statues. All offerors submitting proposals must complete the
following forms specific to the State of New Jersey. Completed forms should be submitted with the
offeror’s response to the IFB. Failure to complete the New Jersey packet will impact OMNIA
Partners’ ability to promote the Master Agreement in the State of New Jersey.
DOC #1 Ownership Disclosure Form
DOC #2 Non-Collusion Affidavit
DOC #3 Affirmative Action Affidavit
DOC #4 Political Contribution Disclosure Form
DOC #5 Stockholder Disclosure Certification
DOC #6 Certification of Non-Involvement in Prohibited Activities in Iran
DOC #7 New Jersey Business Registration Certificate
DOC #8 EEOAA Evidence
DOC #9 MacBride Principals Form
New Jersey suppliers are required to comply with the following New Jersey statutes when
applicable:
• all anti-discrimination laws, including those contained in N.J.S.A. 10:2-1 through N.J.S.A.
10:2-14, N.J.S.A. 10:5-1, and N.J.S.A. 10:5-31 through 10:5-38;
• Prevailing Wage Act, N.J.S.A. 34:11-56.26, for all contracts within the contemplation of the
Act;
• Public Works Contractor Registration Act, N.J.S.A. 34:11-56.26; and
• Bid and Performance Security, as required by the applicable municipal or state statutes.
Version April 12, 2022
DOC #1
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)
This statement shall be completed, certified to, and included with all bid and proposal submissions.
Failure to submit the required information is cause for automatic rejection of the bid or proposal.
Name of Organization:_____________________________________________________
Organization Address:_____________________________________________________
Part I Check the box that represents the type of business organization:
Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
For-Profit Corporation (any type) Limited Liability Company (LLC)
Partnership Limited Partnership Limited Liability Partnership (LLP)
Other (be specific): ______________________________________________
Part II
The list below contains the names and addresses of all stockholders in the
corporation who own 10 percent or more of its stock, of any class, or of all individual
partners in the partnership who own a 10 percent or greater interest therein, or of all
members in the limited liability company who own a 10 percent or greater interest
therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION)
OR
No one stockholder in the corporation owns 10 percent or more of its stock, of any
class, or no individual partner in the partnership owns a 10 percent or greater
interest therein, or no member in the limited liability company owns a 10 percent or
greater interest therein, as the case may be. (SKIP TO PART IV)
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity Home Address (for Individuals) or Business Address
Version April 12, 2022
Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS,
PARTNERS OR LLC MEMBERS LISTED IN PART II
If a bidder has a direct or indirect parent entity which is publicly traded, and any person
holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of
the last annual federal Security and Exchange Commission (SEC) or foreign equivalent
filing, ownership disclosure can be met by providing links to the website(s) containing the last
annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent)
that contain the name and address of each person holding a 10% or greater beneficial interest
in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that
contain the information on each such person. Attach additional sheets if more space is
needed.
Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s
Please list the names and addresses of each stockholder, partner or member owning a 10
percent or greater interest in any corresponding corporation, partnership and/or limited liability
company (LLC) listed in Part II other than for any publicly traded parent entities
referenced above. The disclosure shall be continued until names and addresses of every
noncorporate stockholder, and individual partner, and member exceeding the 10 percent
ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach
additional sheets if more space is needed.
Stockholder/Partner/Member and Corresponding Home Address (for Individuals) or Business Address
Entity Listed in Part II
Part IV Certification
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto
to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this
certification on behalf of the bidder/proposer; that the <name of contracting unit> is relying on the information
contained herein and that I am under a continuing obligation from the date of this certification through the
completion of any contracts with <type of contracting unit> to notify the <type of contracting unit> in writing
of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false
statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the
law and that it will constitute a material breach of my agreement(s) with the, permitting the <type of
contracting unit> to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): Title:
Signature: Date:
Version April 12, 2022
DOC #2
NON-COLLUSION AFFIDAVIT
STANDARD BID DOCUMENT REFERENCE
Reference: VII-H
Name of Form: NON-COLLUSION AFFIDAVIT
No specific statutory reference
Statutory Reference:
State Statutory Reference N.J.S.A. 52:34-15
Instructions Reference: Statutory and Other Requirements VII-H
The Owner’s use of this form is optional. It is used to ensure that
the bidder has not participated in any collusion with any other
Description:
bidder or Owner representative or otherwise taken any action in
restraint of free and competitive bidding.
Version April 12, 2022
NON-COLLUSION AFFIDAVIT
State of New Jersey
County of _________________ ss:
I, ________________________________ residing in ___________________________________
(name of affiant) (name of municipality)
in the County of _______________________________ and State of _____________________of full
age, being duly sworn according to law on my oath depose and say that:
I am _____________________________________ of the firm of _________________________
(title or position) (name of firm)
_____________________________________ the bidder making this Proposal for the bid
entitled ______________________________, and that I executed the said proposal with
(title of bid proposal)
full authority to do so that said bidder has not, directly or indirectly entered into any agreement,
participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in
connection with the above named project; and that all statements contained in said proposal and in this
affidavit are true and correct, and made with full knowledge that the ______________
_________________________relies upon the truth of the statements contained in said Proposal
(name of contracting unit)
and in the statements contained in this affidavit in awarding the contract for the said project.
I further warrant that no person or selling agency has been employed or retained to solicit or secure such
contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent
fee, except bona fide employees or bona fide established commercial or selling agencies maintained by
_________________________________________________.
Subscribed and sworn to
before me this day _____________________________
Signature
________________, 2____ ___________________________________
(Type or print name of affiant under signature)
_____________________________
Notary public of
My Commission expires _______________
(Seal)
Version April 12, 2022
DOC #3
AFFIRMATIVE ACTION AFFIDAVIT
(P.L. 1975, C.127)
Company Name:
Street:
City, State, Zip Code:
Proposal Certification:
Indicate below company’s compliance with New Jersey Affirmative Action regulations. Company’s
proposal will be accepted even if company is not in compliance at this time. No contract and/or
purchase order may be issued, however, until all Affirmative Action requirements are met.
Required Affirmative Action Evidence:
Procurement, Professional & Service Contracts (Exhibit A)
Vendors must submit with proposal:
1. A photocopy of a valid letter that the contractor is operating under an existing Federally
approved or sanctioned affirmative action program (good for one year from the date of the
letter);
OR
2. A photocopy of a Certificate of Employee Information Report approval, issued in
accordance with N.J.A.C. 17:27-4;
OR
3. A photocopy of an Employee Information Report (Form AA302) provided by the Division
of Contract Compliance and Equal Employment Opportunity in Public Contracts and
distributed to the public agency to be completed by the contractor in accordance with
N.J.A.C. 17:27-4.
Public Work – Over $50,000 Total Project Cost:
A. No approved Federal or New Jersey Affirmative Action Plan. We will complete Report Form
AA201. A project contract ID number will be assigned to your firm upon receipt of the
completed Initial Project Workforce Report (AA201) for this contract.
B. Approved Federal or New Jersey Plan – certificate enclosed
I further certify that the statements and information contained herein, are complete and correct to
the best of my knowledge and belief.
_______________________ _________________________________
Date Authorized Signature and Title
Version April 12, 2022
DOC #3, continued
P.L. 1995, c. 127 (N.J.A.C. 17:27)
MANDATORY AFFIRMATIVE ACTION LANGUAGE
PROCUREMENT, PROFESSIONAL AND SERVICE
CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for
employment because of age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual
orientation. The contractor will take affirmative action to ensure that such applicants are recruited and employed, and
that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry,
marital status, sex, affectional or sexual orientation. Such action shall include, but not be limited to the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay
or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency
Compliance Officer setting forth provisions of this non-discrimination clause.
The contractor or subcontractor, where applicable will, in all solicitations or advertisement for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to
age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation.
The contractor or subcontractor, where applicable, will send to each labor union or representative of workers with which
it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency
contracting officer advising the labor union or workers' representative of the contractor's commitments under this act and
shall post copies of the notice in conspicuous places available to employees and applicants for employment.
The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer
pursuant to P.L. 1975, c. 127, as amended and supplemented from time to time and the Americans with Disabilities Act.
The contractor or subcontractor agrees to attempt in good faith to employ minority and female workers trade consistent
with the applicable county employment goal prescribed by N.J.A.C. 17:27-5.2 promulgated by the Treasurer pursuant to
P.L. 1975, C.127, as amended and supplemented from time to time or in accordance with a binding determination of the
applicable county employment goals determined by the Affirmative Action Office pursuant to N.J.A.C. 17:27-5.2
promulgated by the Treasurer pursuant to P.L. 1975, C.127, as amended and supplemented from time to time.
The contractor or subcontractor agrees to inform in writing appropriate recruitment agencies in the area, including
employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis
of age, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation, and that it will
discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.
The contractor or subcontractor agrees to revise any of it testing procedures, if necessary, to assure that all personnel
testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the state
of New Jersey and as established by applicable Federal law and applicable Federal court decisions.
The contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and lay-off
to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, sex,
affectional or sexual orientation, and conform with the applicable employment goals, consistent with the statutes and court
decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions.
The contractor and its subcontractors shall furnish such reports or other documents to the Affirmative Action Office as
may be requested by the office from time to time in order to carry out the purposes of these regulations, and public
agencies shall furnish such information as may be requested by the Affirmative Action Office for conducting a compliance
investigation pursuant to Subchapter 10 of the Administrative Code (NJAC 17:27).
________________________________________________
Signature of Procurement Agent
Version April 12, 2022
DOC #4
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Public Agency Instructions
This page provides guidance to public agencies entering into contracts with business entities that are required to file
Political Contribution Disclosure forms with the agency. It is not intended to be provided to contractors. What follows
are instructions on the use of form local units can provide to contractors that are required to disclose political contributions
pursuant to N.J.S.A. 19:44A-20.26 (P.L. 2005, c. 271, s.2). Additional information on the process is available in Local
Finance Notice 2006-1 (http://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html). Please refer back to these
instructions for the appropriate links, as the Local Finance Notices include links that are no longer operational.
1. The disclosure is required for all contracts in excess of $17,500 that are not awarded pursuant to a “fair and open”
process (N.J.S.A. 19:44A-20.7).
2. Due to the potential length of some contractor submissions, the public agency should consider allowing data to be
submitted in electronic form (i.e., spreadsheet, pdf file, etc.). Submissions must be kept with the contract documents
or in an appropriate computer file and be available for public access. The form is worded to accept this alternate
submission. The text should be amended if electronic submission will not be allowed.
3. The submission must be received from the contractor and on file at least 10 days prior to award of the contract.
Resolutions of award should reflect that the disclosure has been received and is on file.
4. The contractor must disclose contributions made to candidate and party committees covering a wide range of public
agencies, including all public agencies that have elected officials in the county of the public agency, state legislative
positions, and various state entities. The Division of Local Government Services recommends that contractors be
provided a list of the affected agencies. This will assist contractors in determining the campaign and political
committees of the officials and candidates affected by the disclosure.
a. The Division has prepared model disclosure forms for each county. They can be downloaded from the “County
PCD Forms” link on the Pay-to-Play web site at http://www.nj.gov/dca/divisions/dlgs/programs/lpcl.html#12.
They will be updated from time-to-time as necessary.
b. A public agency using these forms should edit them to properly reflect the correct legislative district(s). As
the forms are county-based, they list all legislative districts in each county. Districts that do not represent
the public agency should be removed from the lists.
c. Some contractors may find it easier to provide a single list that covers all contributions, regardless of the county.
These submissions are appropriate and should be accepted.
d. The form may be used “as-is”, subject to edits as described herein.
e. The “Contractor Instructions” sheet is intended to be provided with the form. It is recommended that the
Instructions and the form be printed on the same piece of paper. The form notes that the Instructions are printed
on the back of the form; where that is not the case, the text should be edited accordingly.
f. The form is a Word document and can be edited to meet local needs, and posted for download on web sites, used
as an e-mail attachment, or provided as a printed document.
5. It is recommended that the contractor also complete a “Stockholder Disclosure Certification.” This will assist the
local unit in its obligation to ensure that contractor did not make any prohibited contributions to the committees listed
on the Business Entity Disclosure Certification in the 12 months prior to the contract (See Local Finance Notice
2006-7 for additional information on this obligation at
http://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html). A sample Certification form is part of this package
and the instruction to complete it is included in the Contractor Instructions. NOTE: This section is not applicable to
Boards of Education.
Version April 12, 2022
DOC #4, continued
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair and
open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (N.J.S.A. 19:44A-
20.26). This law provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions
to:
• any State, county, or municipal committee of a political party
• any legislative leadership committee*
• any continuing political committee (a.k.a., political action committee)
• any candidate committee of a candidate for, or holder of, an elective office:
o of the public entity awarding the contract
o of that county in which that public entity is located
o of another public entity within that county
o or of a legislative district in which that public entity is located or, when the public entity is a county, of
any legislative district which includes all or part of the county
The disclosure must list reportable contributions to any of the committees that exceed $300 per election cycle that were
made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on
reportable contributions.
N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a
natural person. This includes the following:
• individuals with an “interest” ownership or control of more than 10% of the profits or assets of a business entity
or 10% of the stock in the case of a business entity that is a corporation for profit
• all principals, partners, officers, or directors of the business entity or their spouses
• any subsidiaries directly or indirectly controlled by the business entity
• IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity
and filing as continuing political committees, (PACs).
When the business entity is a natural person, “a contribution by that person’s spouse or child, residing therewith, shall be
deemed to be a contribution by the business entity.” [N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the
disclosure.
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an
amount to be determined by the Commission which may be based upon the amount that the business entity failed to report.
The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official
and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor’s responsibility to
identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed
information may exceed the minimum requirement.
The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a
signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the Open Public
Records Act.
The contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in
meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts.
*
N.J.S.A. 19:44A-3(s): “The term "legislative leadership committee" means a committee established, authorized to be
established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the General
Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65 (C.19:44A-10.1) for
the purpose of receiving contributions and making expenditures.”
Version April 12, 2022
DOC #4, continued
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant to N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the local unit
no later than 10 days prior to the award of the contract.
Part I – Vendor Information
Vendor Name:
Address:
City: State: Zip:
The undersigned being authorized to certify, hereby certifies that the submission provided herein represents
compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions
accompanying this form.
_______________________ _______________________ ________________________
Signature Printed Name Title
Part II – Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable
political contributions (more than $300 per election cycle) over the 12 months prior to submission to
the committees of the government entities listed on the form provided by the local unit.
Check here if disclosure is provided in electronic form
Contributor Name Recipient Name Date Dollar Amount
$
Check here if the information is continued on subsequent page(s)
Version April 12, 2022
DOC #4, continued
List of Agencies with Elected Officials Required for Political Contribution Disclosure
N.J.S.A. 19:44A-20.26
County Name:
State: Governor, and Legislative Leadership Committees
Legislative District #s:
State Senator and two members of the General Assembly per district.
County:
Freeholders County Clerk Sheriff
{County Executive} Surrogate
Municipalities (Mayor and members of governing body, regardless of title):
USERS SHOULD CREATE THEIR OWN FORM, OR DOWNLOAD
FROM THE PAY TO PLAY SECTION OF THE DLGS WEBSITE A
COUNTY-BASED, CUSTOMIZABLE FORM.
Version April 12, 2022
DOC #5
STOCKHOLDER DISCLOSURE CERTIFICATION
Name of Business:
I certify that the list below contains the names and home addresses of all stockholders
holding 10% or more of the issued and outstanding stock of the undersigned.
OR
I certify that no one stockholder owns 10% or more of the issued and outstanding stock of
the undersigned.
Check the box that represents the type of business organization:
Partnership Corporation Sole Proprietorship
Limited Partnership Limited Liability Corporation Limited Liability Partnership
Subchapter S Corporation
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
Stockholders:
Name: Name:
Home Address: Home Address:
Name: Name:
Home Address: Home Address:
Name: Name:
Home Address: Home Address:
Subscribed and sworn before me this ___ day of ___________, _________________________________
2__. (Affiant)
(Notary Public) ________________________________
(Print name & title of affiant)
My Commission expires:
(Corporate Seal)
Version April 12, 2022
DOC #6
Certification of Non-Involvement in Prohibited Activities in Iran
Pursuant to N.J.S.A. 52:32-58, Offerors must certify that neither the Offeror, nor any of its parents,
subsidiaries, and/or affiliates (as defined in N.J.S.A. 52:32 – 56(e) (3)), is listed on the Department
of the Treasury’s List of Persons or Entities Engaging in Prohibited Investment Activities in Iran
and that neither is involved in any of the investment activities set forth in N.J.S.A. 52:32 – 56(f).
Offerors wishing to do business in New Jersey through this contract must fill out the Certification of
Non-Involvement in Prohibited Activities in Iran here:
http://www.state.nj.us/humanservices/dfd/info/standard/fdc/disclosure_investmentact.pdf.
Offerors should submit the above form completed with their proposal.
Version April 12, 2022
DOC #7
NEW JERSEY BUSINESS REGISTRATION CERTIFICATE
(N.J.S.A. 52:32-44)
Offerors wishing to do business in New Jersey must submit their State Division of Revenue issued
Business Registration Certificate with their proposal here. Failure to do so will disqualify the
Offeror from offering products or services in New Jersey through any resulting contract.
https://www.njportal.com/DOR/BusinessRegistration/
Version April 12, 2022
DOC #8
EEOAA EVIDENCE
Equal Employment Opportunity/Affirmative Action
Goods, Professional Services & General Service Projects
EEO/AA Evidence
Vendors are required to submit evidence of compliance with N.J.S.A. 10:5-31 et seq. and
N.J.A.C. 17:27 in order to be considered a responsible vendor.
One of the following must be included with submission:
• Copy of Letter of Federal Approval
• Certificate of Employee Information Report
• Fully Executed Form AA302
• Fully Executed EEO-1 Report
See the guidelines at:
https://www.state.nj.us/treasury/contract_compliance/documents/pdf/guidelines/pa.pdf
for further information.
I certify that my bid package includes the required evidence per the above list and
State website.
Name: ______________________________ Title: _____________________
Signature: ___________________________ Date: _____________________
DOC #9
MACBRIDE-PRINCIPLES
STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
MACBRIDE PRINCIPALS FORM
BID SOLICITATION #: VENDOR/BIDDER: _____________________
VENDOR’S/BIDDER’S REQUIREMENT
TO PROVIDE A CERTIFICATION IN COMPLIANCE WITH THE MACBRIDE PRINCIPALS
AND NORTHERN IRELAND ACT OF 1989
Pursuant to Public Law 1995, c. 134, a responsible Vendor/Bidder selected, after public bidding, by the Director
of the Division of Purchase and Property, pursuant to N.J.S.A. 52:34-12, must complete the certification below by
checking one of the two options listed below and signing where indicated. If a Vendor/Bidder that would otherwise
be awarded a purchase, contract or agreement does not complete the certification, then the Director may determine,
in accordance with applicable law and rules, that it is in the best interest of the State to award the purchase, contract
or agreement to another Vendor/Bidder that has completed the certification and has submitted a bid within five (5)
percent of the most advantageous bid. If the Director finds contractors to be in violation of the principals that are
the subject of this law, he/she shall take such action as may be appropriate and provided by law, rule or contract,
including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in
default and seeking debarment or suspension of the party.
I, the undersigned, on behalf the Vendor/Bidder, certify pursuant to N.J.S.A. 52:34-12.2 that:
CHECK THE APPROPRIATE BOX
The Vendor/Bidder has no business operations in Northern Ireland; or
OR
The Vendor/Bidder will take lawful steps in good faith to conduct any business operations it has in Northern Ireland
in accordance with the MacBride principals of nondiscrimination in employment as set forth in section 2 of P.L. 1987,
c. 177 (N.J.S.A. 52:18A-89.5) and in conformance with the United Kingdom’s Fair Employment (Northern Ireland)
Act of 1989, and permit independent monitoring of its compliance with those principals.
CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor/Bidder, that the foregoing
information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State
of New Jersey is relying on the information contained herein, and that the Vendor/Bidder is under a continuing obligation
from the date of this certification through the completion of any contract(s) with the State to notify the State in writing of
any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or
misrepresentation in this certification. If I do so, I will be subject to criminal prosecution under the law, and it will constitute
a material breach of my agreement(s) with the State, permitting the State to declare any contract(s) resulting from this
certification to be void and unenforceable.
Signature Date
Print Name and Title
Version April 12, 2022
Exhibit H
Advertising Compliance Requirement
Pursuant to certain state notice provisions, including but not limited to Oregon Revised Statutes Chapter 279A.210, Chapter
279A.220, and other related provisions, the following public agencies and political subdivisions of the referenced public agencies are
eligible to register with OMNIA Partners and access the Master Agreement contract award made pursuant to this solicitation, and are
hereby given notice of the foregoing request for bids for purposes of complying with the procedural requirements of said statutes:
Nationwide:
State of Alabama State of Hawaii Commonwealth of State of New Mexico State of South
Massachusetts Dakota
State of Alaska State of Idaho State of Michigan State of New York State of Tennessee
State of Arizona State of Illinois State of Minnesota State of North Carolina State of Texas
State of Arkansas State of Indiana State of Mississippi State of North Dakota State of Utah
State of California State of Iowa State of Missouri State of Ohio State of Vermont
State of Colorado State of Kansas State of Montana State of Oklahoma Commonwealth of
Virginia
State of Connecticut Commonwealth of State of Nebraska State of Oregon State of Washington
Kentucky
State of Delaware State of Louisiana State of Nevada Commonwealth of State of West
Pennsylvania Virginia
State of Florida State of Maine State of New Hampshire State of Rhode Island State of Wisconsin
State of Georgia State of Maryland State of New Jersey State of South Carolina State of Wyoming
District of Columbia
Lists of political subdivisions and local governments in the above referenced states / districts may be found at
http://www.usa.gov/Agencies/State_and_Territories.shtml and https://www.usa.gov/local-governments.
Certain Public Agencies and Political Subdivisions:
CITIES, TOWNS, VILLAGES AND BOROUGHS CITY AND COUNTY OF HONOLULU, HI
INCLUDING BUT NOT LIMITED TO: CITY OF KENNER, LA
BAKER CITY GOLF COURSE, OR CITY OF LA GRANDE, OR
CITY OF ADAIR VILLAGE, OR CITY OF LAFAYETTE, LA
CITY OF ASHLAND, OR CITY OF LAKE CHARLES, OR
CITY OF AUMSVILLE, OR CITY OF LEBANON, OR
CITY OF AURORA, OR CITY OF MCMINNVILLE, OR
CITY OF BAKER, OR CITY OF MEDFORD, OR
CITY OF BATON ROUGE, LA CITY OF METAIRIE, LA
CITY OF BEAVERTON, OR CITY OF MILL CITY, OR
CITY OF BEND, OR CITY OF MILWAUKIE, OR
CITY OF BOARDMAN, OR CITY OF MONROE, LA
CITY OF BONANAZA, OR CITY OF MOSIER, OR
CITY OF BOSSIER CITY, LA CITY OF NEW ORLEANS, LA
CITY OF BROOKINGS, OR CITY OF NORTH PLAINS, OR
CITY OF BURNS, OR CITY OF OREGON CITY, OR
CITY OF CANBY, OR CITY OF PILOT ROCK, OR
CITY OF CANYONVILLE, OR CITY OF PORTLAND, OR
CITY OF CLATSKANIE, OR CITY OF POWERS, OR
CITY OF COBURG, OR CITY OF PRINEVILLE, OR
CITY OF CONDON, OR CITY OF REDMOND, OR
CITY OF COQUILLE, OR CITY OF REEDSPORT, OR
CITY OF CORVALLI, OR CITY OF RIDDLE, OR
CITY OF CORVALLIS PARKS AND RECREATION CITY OF ROGUE RIVER, OR
DEPARTMENT, OR CITY OF ROSEBURG, OR
CITY OF COTTAGE GROVE, OR CITY OF SALEM, OR
CITY OF DONALD, OR CITY OF SANDY, OR
CITY OF EUGENE, OR CITY OF SCAPPOOSE, OR
CITY OF FOREST GROVE, OR CITY OF SHADY COVE, OR
CITY OF GOLD HILL, OR CITY OF SHERWOOD, OR
CITY OF GRANTS PASS, OR CITY OF SHREVEPORT, LA
CITY OF GRESHAM, OR CITY OF SILVERTON, OR
CITY OF HILLSBORO, OR CITY OF SPRINGFIELD, OR
CITY OF INDEPENDENCE, OR CITY OF ST. HELENS, OR
Version April 12, 2022
CITY OF ST. PAUL, OR ENTERPRISE, UT
CITY OF SULPHUR, LA EPHRAIM, UT
CITY OF TIGARD, OR ESCALANTE, UT
CITY OF TROUTDALE, OR EUREKA, UT
CITY OF TUALATIN, OR FAIRFIELD, UT
CITY OF WALKER, LA FAIRVIEW, UT
CITY OF WARRENTON, OR FARMINGTON, UT
CITY OF WEST LINN, OR FARR WEST, UT
CITY OF WILSONVILLE, OR FAYETTE, UT
CITY OF WINSTON, OR FERRON, UT
CITY OF WOODBURN, OR FIELDING, UT
LEAGUE OF OREGON CITES FILLMORE, UT
THE CITY OF HAPPY VALLEY OREGON FOUNTAIN GREEN, UT
ALPINE, UT FRANCIS, UT
ALTA, UT FRUIT HEIGHTS, UT
ALTAMONT, UT GARDEN CITY, UT
ALTON, UT GARLAND, UT
AMALGA, UT GENOLA, UT
AMERICAN FORK CITY, UT GLENDALE, UT
ANNABELLA, UT GLENWOOD, UT
ANTIMONY, UT GOSHEN, UT
APPLE VALLEY, UT GRANTSVILLE, UT
AURORA, UT GREEN RIVER, UT
BALLARD, UT GUNNISON, UT
BEAR RIVER CITY, UT HANKSVILLE, UT
BEAVER, UT HARRISVILLE, UT
BICKNELL, UT HATCH, UT
BIG WATER, UT HEBER CITY CORPORATION, UT
BLANDING, UT HELPER, UT
BLUFFDALE, UT HENEFER, UT
BOULDER, UT HENRIEVILLE, UT
CITY OF BOUNTIFUL, UT HERRIMAN, UT
BRIAN HEAD, UT HIDEOUT, UT
BRIGHAM CITY CORPORATION, UT HIGHLAND, UT
BRYCE CANYON CITY, UT HILDALE, UT
CANNONVILLE, UT HINCKLEY, UT
CASTLE DALE, UT HOLDEN, UT
CASTLE VALLEY, UT HOLLADAY, UT
CITY OF CEDAR CITY, UT HONEYVILLE, UT
CEDAR FORT, UT HOOPER, UT
CITY OF CEDAR HILLS, UT HOWELL, UT
CENTERFIELD, UT HUNTINGTON, UT
CENTERVILLE CITY CORPORATION, UT HUNTSVILLE, UT
CENTRAL VALLEY, UT CITY OF HURRICANE, UT
CHARLESTON, UT HYDE PARK, UT
CIRCLEVILLE, UT HYRUM, UT
CLARKSTON, UT INDEPENDENCE, UT
CLAWSON, UT IVINS, UT
CLEARFIELD, UT JOSEPH, UT
CLEVELAND, UT JUNCTION, UT
CLINTON CITY CORPORATION, UT KAMAS, UT
COALVILLE, UT KANAB, UT
CORINNE, UT KANARRAVILLE, UT
CORNISH, UT KANOSH, UT
COTTONWOOD HEIGHTS, UT KAYSVILLE, UT
DANIEL, UT KINGSTON, UT
DELTA, UT KOOSHAREM, UT
DEWEYVILLE, UT LAKETOWN, UT
DRAPER CITY, UT LA VERKIN, UT
DUCHESNE, UT LAYTON, UT
EAGLE MOUNTAIN, UT LEAMINGTON, UT
EAST CARBON, UT LEEDS, UT
ELK RIDGE, UT LEHI CITY CORPORATION, UT
ELMO, UT LEVAN, UT
ELSINORE, UT LEWISTON, UT
ELWOOD, UT LINDON, UT
EMERY, UT LOA, UT
ENOCH, UT LOGAN CITY, UT
Version April 12, 2022
LYMAN, UT SALEM, UT
LYNNDYL, UT SALINA, UT
MANILA, UT SALT LAKE CITY CORPORATION, UT
MANTI, UT SANDY, UT
MANTUA, UT SANTA CLARA, UT
MAPLETON, UT SANTAQUIN, UT
MARRIOTT-SLATERVILLE, UT SARATOGA SPRINGS, UT
MARYSVALE, UT SCIPIO, UT
MAYFIELD, UT SCOFIELD, UT
MEADOW, UT SIGURD, UT
MENDON, UT SMITHFIELD, UT
MIDVALE CITY INC., UT SNOWVILLE, UT
MIDWAY, UT CITY OF SOUTH JORDAN, UT
MILFORD, UT SOUTH OGDEN, UT
MILLVILLE, UT CITY OF SOUTH SALT LAKE, UT
MINERSVILLE, UT SOUTH WEBER, UT
MOAB, UT SPANISH FORK, UT
MONA, UT SPRING CITY, UT
MONROE, UT SPRINGDALE, UT
CITY OF MONTICELLO, UT SPRINGVILLE, UT
MORGAN, UT STERLING, UT
MORONI, UT STOCKTON, UT
MOUNT PLEASANT, UT SUNNYSIDE, UT
MURRAY CITY CORPORATION, UT SUNSET CITY CORP, UT
MYTON, UT SYRACUSE, UT
NAPLES, UT TABIONA, UT
NEPHI, UT CITY OF TAYLORSVILLE, UT
NEW HARMONY, UT TOOELE CITY CORPORATION, UT
NEWTON, UT TOQUERVILLE, UT
NIBLEY, UT TORREY, UT
NORTH LOGAN, UT TREMONTON CITY, UT
NORTH OGDEN, UT TRENTON, UT
NORTH SALT LAKE CITY, UT TROPIC, UT
OAK CITY, UT UINTAH, UT
OAKLEY, UT VERNAL CITY, UT
OGDEN CITY CORPORATION, UT VERNON, UT
OPHIR, UT VINEYARD, UT
ORANGEVILLE, UT VIRGIN, UT
ORDERVILLE, UT WALES, UT
OREM, UT WALLSBURG, UT
PANGUITCH, UT WASHINGTON CITY, UT
PARADISE, UT WASHINGTON TERRACE, UT
PARAGONAH, UT WELLINGTON, UT
PARK CITY, UT WELLSVILLE, UT
PAROWAN, UT WENDOVER, UT
PAYSON, UT WEST BOUNTIFUL, UT
PERRY, UT WEST HAVEN, UT
PLAIN CITY, UT WEST JORDAN, UT
PLEASANT GROVE CITY, UT WEST POINT, UT
PLEASANT VIEW, UT WEST VALLEY CITY, UT
PLYMOUTH, UT WILLARD, UT
PORTAGE, UT WOODLAND HILLS, UT
PRICE, UT WOODRUFF, UT
PROVIDENCE, UT WOODS CROSS, UT
PROVO, UT
RANDOLPH, UT COUNTIES AND PARISHES INCLUDING BUT NOT
REDMOND, UT LIMITED TO:
RICHFIELD, UT ASCENSION PARISH, LA
RICHMOND, UT ASCENSION PARISH, LA, CLEAR OF COURT
RIVERDALE, UT CADDO PARISH, LA
RIVER HEIGHTS, UT CALCASIEU PARISH, LA
RIVERTON CITY, UT CALCASIEU PARISH SHERIFF’S OFFICE, LA
ROCKVILLE, UT CITY AND COUNTY OF HONOLULU, HI
ROCKY RIDGE, UT CLACKAMAS COUNTY, OR
ROOSEVELT CITY CORPORATION, UT CLACKAMAS COUNTY DEPT OF TRANSPORTATION,
ROY, UT OR
RUSH VALLEY, UT CLATSOP COUNTY, OR
CITY OF ST. GEORGE, UT COLUMBIA COUNTY, OR
Version April 12, 2022
COOS COUNTY, OR COUNTY OF DAGGETT, UT
COOS COUNTY HIGHWAY DEPARTMENT, OR COUNTY OF SALT LAKE, UT
COUNTY OF HAWAII, OR COUNTY OF TOOELE, UT
CROOK COUNTY, OR COUNTY OF UTAH, UT
CROOK COUNTY ROAD DEPARTMENT, OR COUNTY OF WASATCH, UT
CURRY COUNTY, OR COUNTY OF DUCHESNE, UT
DESCHUTES COUNTY, OR COUNTY OF UINTAH, UT
DOUGLAS COUNTY, OR COUNTY OF CARBON, UT
EAST BATON ROUGE PARISH, LA COUNTY OF SANPETE, UT
GILLIAM COUNTY, OR COUNTY OF JUAB, UT
GRANT COUNTY, OR COUNTY OF MILLARD, UT
HARNEY COUNTY, OR COUNTY OF SEVIER, UT
HARNEY COUNTY SHERIFFS OFFICE, OR COUNTY OF EMERY, UT
HAWAII COUNTY, HI COUNTY OF GRAND, UT
HOOD RIVER COUNTY, OR COUNTY OF BEVER, UT
JACKSON COUNTY, OR COUNTY OF PIUTE, UT
JEFFERSON COUNTY, OR COUNTY OF WAYNE, UT
JEFFERSON PARISH, LA COUNTY OF SAN JUAN, UT
JOSEPHINE COUNTY GOVERNMENT, OR COUNTY OF GARFIELD, UT
LAFAYETTE CONSOLIDATED GOVERNMENT, LA COUNTY OF KANE, UT
LAFAYETTE PARISH, LA COUNTY OF IRON, UT
LAFAYETTE PARISH CONVENTION & VISITORS COUNTY OF WASHINGTON, UT
COMMISSION
LAFOURCHE PARISH, LA OTHER AGENCIES INCLUDING ASSOCIATIONS,
KAUAI COUNTY, HI BOARDS, DISTRICTS, COMMISSIONS, COUNCILS,
KLAMATH COUNTY, OR PUBLIC CORPORATIONS, PUBLIC DEVELOPMENT
LAKE COUNTY, OR AUTHORITIES, RESERVATIONS AND UTILITIES
LANE COUNTY, OR INCLUDING BUT NOT LIMITED TO:
LINCOLN COUNTY, OR ADAIR R.F.P.D., OR
LINN COUNTY, OR ADEL WATER IMPROVEMENT DISTRICT, OR
LIVINGSTON PARISH, LA ADRIAN R.F.P.D., OR
MALHEUR COUNTY, OR AGNESS COMMUNITY LIBRARY, OR
MAUI COUNTY, HI AGNESS-ILLAHE R.F.P.D., OR
MARION COUNTY, SALEM, OR AGRICULTURE EDUCATION SERVICE EXTENSION
MORROW COUNTY, OR DISTRICT, OR
MULTNOMAH COUNTY, OR ALDER CREEK-BARLOW WATER DISTRICT NO. 29,
MULTNOMAH COUNTY BUSINESS AND OR
COMMUNITY SERVICES, OR ALFALFA FIRE DISTRICT, OR
MULTNOMAH COUNTY SHERIFFS OFFICE, OR ALSEA R.F.P.D., OR
MULTNOMAH LAW LIBRARY, OR ALSEA RIVIERA WATER IMPROVEMENT DISTRICT,
ORLEANS PARISH, LA OR
PLAQUEMINES PARISH, LA AMITY FIRE DISTRICT, OR
POLK COUNTY, OR ANTELOPE MEADOWS SPECIAL ROAD DISTRICT, OR
RAPIDES PARISH, LA APPLE ROGUE DISTRICT IMPROVEMENT COMPANY,
SAINT CHARLES PARISH, LA OR
SAINT CHARLES PARISH PUBLIC SCHOOLS, LA APPLEGATE VALLEY R.F.P.D. #9, OR
SAINT LANDRY PARISH, LA ARCH CAPE DOMESTIC WATER SUPPLY DISTRICT,
SAINT TAMMANY PARISH, LA OR
SHERMAN COUNTY, OR ARCH CAPE SANITARY DISTRICT, OR
TERREBONNE PARISH, LA ARNOLD IRRIGATION DISTRICT, OR
TILLAMOOK COUNTY, OR ASH CREEK WATER CONTROL DISTRICT, OR
TILLAMOOK COUNTY SHERIFF'S OFFICE, OR ATHENA CEMETERY MAINTENANCE DISTRICT, OR
TILLAMOOK COUNTY GENERAL HOSPITAL, OR AUMSVILLE R.F.P.D., OR
UMATILLA COUNTY, OR AURORA R.F.P.D., OR
UNION COUNTY, OR AZALEA R.F.P.D., OR
WALLOWA COUNTY, OR BADGER IMPROVEMENT DISTRICT, OR
WASCO COUNTY, OR BAILEY-SPENCER R.F.P.D., OR
WASHINGTON COUNTY, OR BAKER COUNTY LIBRARY DISTRICT, OR
WEST BATON ROUGE PARISH, LA BAKER R.F.P.D., OR
WHEELER COUNTY, OR BAKER RIVERTON ROAD DISTRICT, OR
YAMHILL COUNTY, OR BAKER VALLEY IRRIGATION DISTRICT, OR
COUNTY OF BOX ELDER, UT BAKER VALLEY S.W.C.D., OR
COUNTY OF CACHE, UT BAKER VALLEY VECTOR CONTROL DISTRICT, OR
COUNTY OF RICH, UT BANDON CRANBERRY WATER CONTROL DISTRICT,
COUNTY OF WEBER, UT OR
COUNTY OF MORGAN, UT BANDON R.F.P.D., OR
COUNTY OF DAVIS, UT BANKS FIRE DISTRICT, OR
COUNTY OF SUMMIT, UT BANKS FIRE DISTRICT #13, OR
Version April 12, 2022
BAR L RANCH ROAD DISTRICT, OR CANBY UTILITY BOARD, OR
BARLOW WATER IMPROVEMENT DISTRICT, OR CANNON BEACH R.F.P.D., OR
BASIN AMBULANCE SERVICE DISTRICT, OR CANYONVILLE SOUTH UMPQUA FIRE DISTRICT, OR
BASIN TRANSIT SERVICE TRANSPORTATION CAPE FERRELO R.F.P.D., OR
DISTRICT, OR CAPE FOULWEATHER SANITARY DISTRICT, OR
BATON ROUGE WATER COMPANY CARLSON PRIMROSE SPECIAL ROAD DISTRICT, OR
BAY AREA HEALTH DISTRICT, OR CARMEL BEACH WATER DISTRICT, OR
BAYSHORE SPECIAL ROAD DISTRICT, OR CASCADE VIEW ESTATES TRACT 2, OR
BEAR VALLEY SPECIAL ROAD DISTRICT, OR CEDAR CREST SPECIAL ROAD DISTRICT, OR
BEAVER CREEK WATER CONTROL DISTRICT, OR CEDAR TRAILS SPECIAL ROAD DISTRICT, OR
BEAVER DRAINAGE IMPROVEMENT COMPANY, CEDAR VALLEY - NORTH BANK R.F.P.D., OR
INC., OR CENTRAL CASCADES FIRE AND EMS, OR
BEAVER SLOUGH DRAINAGE DISTRICT, OR CENTRAL CITY ECONOMIC OPPORTUNITY CORP, LA
BEAVER SPECIAL ROAD DISTRICT, OR CENTRAL LINCOLN P.U.D., OR
BEAVER WATER DISTRICT, OR CENTRAL OREGON COAST FIRE & RESCUE
BELLE MER S.I.G.L. TRACTS SPECIAL ROAD DISTRICT, OR
DISTRICT, OR CENTRAL OREGON INTERGOVERNMENTAL
BEND METRO PARK AND RECREATION DISTRICT COUNCIL
BENTON S.W.C.D., OR CENTRAL OREGON IRRIGATION DISTRICT, OR
BERNDT SUBDIVISION WATER IMPROVEMENT CHAPARRAL WATER CONTROL DISTRICT, OR
DISTRICT, OR CHARLESTON FIRE DISTRICT, OR
BEVERLY BEACH WATER DISTRICT, OR CHARLESTON SANITARY DISTRICT, OR
BIENVILLE PARISH FIRE PROTECTION DISTRICT 6, CHARLOTTE ANN WATER DISTRICT, OR
LA CHEHALEM PARK & RECREATION DISTRICT, OR
BIG BEND IRRIGATION DISTRICT, OR CHEHALEM PARK AND RECREATION DISTRICT
BIGGS SERVICE DISTRICT, OR CHEMULT R.F.P.D., OR
BLACK BUTTE RANCH DEPARTMENT OF POLICE CHENOWITH WATER P.U.D., OR
SERVICES, OR CHERRIOTS, OR
BLACK BUTTE RANCH R.F.P.D., OR CHETCO COMMUNITY PUBLIC LIBRARY DISTRICT,
BLACK MOUNTAIN WATER DISTRICT, OR OR
BLODGETT-SUMMIT R.F.P.D., OR CHILOQUIN VECTOR CONTROL DISTRICT, OR
BLUE MOUNTAIN HOSPITAL DISTRICT, OR CHILOQUIN-AGENCY LAKE R.F.P.D., OR
BLUE MOUNTAIN TRANSLATOR DISTRICT, OR CHINOOK DRIVE SPECIAL ROAD DISTRICT, OR
BLUE RIVER PARK & RECREATION DISTRICT, OR CHR DISTRICT IMPROVEMENT COMPANY, OR
BLUE RIVER WATER DISTRICT, OR CHRISTMAS VALLEY DOMESTIC WATER DISTRICT,
BLY R.F.P.D., OR OR
BLY VECTOR CONTROL DISTRICT, OR CHRISTMAS VALLEY PARK & RECREATION
BLY WATER AND SANITARY DISTRICT, OR DISTRICT, OR
BOARDMAN CEMETERY MAINTENANCE DISTRICT, CHRISTMAS VALLEY R.F.P.D., OR
OR CITY OF BOGALUSA SCHOOL BOARD, LA
BOARDMAN PARK AND RECREATION DISTRICT CLACKAMAS COUNTY FIRE DISTRICT #1, OR
BOARDMAN R.F.P.D., OR CLACKAMAS COUNTY SERVICE DISTRICT #1, OR
BONANZA BIG SPRINGS PARK & RECREATION CLACKAMAS COUNTY VECTOR CONTROL
DISTRICT, OR DISTRICT, OR
BONANZA MEMORIAL PARK CEMETERY DISTRICT, CLACKAMAS RIVER WATER
OR CLACKAMAS RIVER WATER, OR
BONANZA R.F.P.D., OR CLACKAMAS S.W.C.D., OR
BONANZA-LANGELL VALLEY VECTOR CONTROL CLATSKANIE DRAINAGE IMPROVEMENT
DISTRICT, OR COMPANY, OR
BORING WATER DISTRICT #24, OR CLATSKANIE LIBRARY DISTRICT, OR
BOULDER CREEK RETREAT SPECIAL ROAD CLATSKANIE P.U.D., OR
DISTRICT, OR CLATSKANIE PARK & RECREATION DISTRICT, OR
BRIDGE R.F.P.D., OR CLATSKANIE PEOPLE'S UTILITY DISTRICT
BROOKS COMMUNITY SERVICE DISTRICT, OR CLATSKANIE R.F.P.D., OR
BROWNSVILLE R.F.P.D., OR CLATSOP CARE CENTER HEALTH DISTRICT, OR
BUELL-RED PRAIRIE WATER DISTRICT, OR CLATSOP COUNTY S.W.C.D., OR
BUNKER HILL R.F.P.D. #1, OR CLATSOP DRAINAGE IMPROVEMENT COMPANY #15,
BUNKER HILL SANITARY DISTRICT, OR INC., OR
BURLINGTON WATER DISTRICT, OR CLEAN WATER SERVICES
BURNT RIVER IRRIGATION DISTRICT, OR CLEAN WATER SERVICES, OR
BURNT RIVER S.W.C.D., OR CLOVERDALE R.F.P.D., OR
CALAPOOIA R.F.P.D., OR CLOVERDALE SANITARY DISTRICT, OR
CAMAS VALLEY R.F.P.D., OR CLOVERDALE WATER DISTRICT, OR
CAMELLIA PARK SANITARY DISTRICT, OR COALEDO DRAINAGE DISTRICT, OR
CAMMANN ROAD DISTRICT, OR COBURG FIRE DISTRICT, OR
CAMP SHERMAN ROAD DISTRICT, OR COLESTIN RURAL FIRE DISTRICT, OR
CANBY AREA TRANSIT, OR COLTON R.F.P.D., OR
CANBY R.F.P.D. #62, OR COLTON WATER DISTRICT #11, OR
Version April 12, 2022
COLUMBIA 911 COMMUNICATIONS DISTRICT, OR DESCHUTES COUNTY 911 SERVICE DISTRICT, OR
COLUMBIA COUNTY 4-H & EXTENSION SERVICE DESCHUTES COUNTY R.F.P.D. #2, OR
DISTRICT, OR DESCHUTES PUBLIC LIBRARY DISTRICT, OR
COLUMBIA DRAINAGE VECTOR CONTROL, OR DESCHUTES S.W.C.D., OR
COLUMBIA IMPROVEMENT DISTRICT, OR DESCHUTES VALLEY WATER DISTRICT, OR
COLUMBIA R.F.P.D., OR DEVILS LAKE WATER IMPROVEMENT DISTRICT, OR
COLUMBIA RIVER FIRE & RESCUE, OR DEXTER R.F.P.D., OR
COLUMBIA RIVER PUD, OR DEXTER SANITARY DISTRICT, OR
COLUMBIA S.W.C.D., OR DORA-SITKUM R.F.P.D., OR
COLUMBIA S.W.C.D., OR DOUGLAS COUNTY FIRE DISTRICT #2, OR
CONFEDERATED TRIBES OF THE UMATILLA INDIAN DOUGLAS S.W.C.D., OR
RESERVATION DRAKES CROSSING R.F.P.D., OR
COOS COUNTY AIRPORT DISTRICT, OR DRRH SPECIAL ROAD DISTRICT #6, OR
COOS COUNTY AIRPORT DISTRICT, OR DRY GULCH DITCH DISTRICT IMPROVEMENT
COOS COUNTY AREA TRANSIT SERVICE DISTRICT, COMPANY, OR
OR DUFUR RECREATION DISTRICT, OR
COOS COUNTY AREA TRANSIT SERVICE DISTRICT, DUMBECK LANE DOMESTIC WATER SUPPLY, OR
OR DUNDEE R.F.P.D., OR
COOS FOREST PROTECTIVE ASSOCIATION DURKEE COMMUNITY BUILDING PRESERVATION
COOS S.W.C.D., OR DISTRICT, OR
COQUILLE R.F.P.D., OR EAGLE POINT IRRIGATION DISTRICT, OR
COQUILLE VALLEY HOSPITAL DISTRICT, OR EAGLE VALLEY CEMETERY MAINTENANCE
CORBETT WATER DISTRICT, OR DISTRICT, OR
CORNELIUS R.F.P.D., OR EAGLE VALLEY R.F.P.D., OR
CORP RANCH ROAD WATER IMPROVEMENT, OR EAGLE VALLEY S.W.C.D., OR
CORVALLIS R.F.P.D., OR EAST FORK IRRIGATION DISTRICT, OR
COUNTRY CLUB ESTATES SPECIAL WATER EAST MULTNOMAH S.W.C.D., OR
DISTRICT, OR EAST SALEM SERVICE DISTRICT, OR
COUNTRY CLUB WATER DISTRICT, OR EAST UMATILLA CHEMICAL CONTROL DISTRICT,
COUNTRY ESTATES ROAD DISTRICT, OR OR
COVE CEMETERY MAINTENANCE DISTRICT, OR EAST UMATILLA COUNTY AMBULANCE AREA
COVE ORCHARD SEWER SERVICE DISTRICT, OR HEALTH DISTRICT, OR
COVE R.F.P.D., OR EAST UMATILLA COUNTY R.F.P.D., OR
CRESCENT R.F.P.D., OR EAST VALLEY WATER DISTRICT, OR
CRESCENT SANITARY DISTRICT, OR ELGIN COMMUNITY PARKS & RECREATION
CRESCENT WATER SUPPLY AND IMPROVEMENT DISTRICT, OR
DISTRICT, OR ELGIN HEALTH DISTRICT, OR
CROOK COUNTY AGRICULTURE EXTENSION ELGIN R.F.P.D., OR
SERVICE DISTRICT, OR ELKTON ESTATES PHASE II SPECIAL ROAD
CROOK COUNTY CEMETERY DISTRICT, OR DISTRICT, OR
CROOK COUNTY FIRE AND RESCUE, OR ELKTON R.F.P.D., OR
CROOK COUNTY PARKS & RECREATION DISTRICT, EMERALD P.U.D., OR
OR ENTERPRISE IRRIGATION DISTRICT, OR
CROOK COUNTY S.W.C.D., OR ESTACADA CEMETERY MAINTENANCE DISTRICT,
CROOK COUNTY VECTOR CONTROL DISTRICT, OR OR
CROOKED RIVER RANCH R.F.P.D., OR ESTACADA R.F.P.D. #69, OR
CROOKED RIVER RANCH SPECIAL ROAD DISTRICT, EUGENE R.F.P.D. # 1, OR
OR EUGENE WATER AND ELECTRIC BOARD
CRYSTAL SPRINGS WATER DISTRICT, OR EVANS VALLEY FIRE DISTRICT #6, OR
CURRY COUNTY 4-H & EXTENSION SERVICE FAIR OAKS R.F.P.D., OR
DISTRICT, OR FAIRVIEW R.F.P.D., OR
CURRY COUNTY PUBLIC TRANSIT SERVICE FAIRVIEW WATER DISTRICT, OR
DISTRICT, OR FALCON HEIGHTS WATER AND SEWER, OR
CURRY COUNTY S.W.C.D., OR FALCON-COVE BEACH WATER DISTRICT, OR
CURRY HEALTH DISTRICT, OR FALL RIVER ESTATES SPECIAL ROAD DISTRICT, OR
CURRY PUBLIC LIBRARY DISTRICT, OR FARGO INTERCHANGE SERVICE DISTRICT, OR
DALLAS CEMETERY DISTRICT #4, OR FARMERS IRRIGATION DISTRICT, OR
DARLEY DRIVE SPECIAL ROAD DISTRICT, OR FAT ELK DRAINAGE DISTRICT, OR
DAVID CROCKETT STEAM FIRE COMPANY #1, LA FERN RIDGE PUBLIC LIBRARY DISTRICT, OR
DAYS CREEK R.F.P.D., OR FERN VALLEY ESTATES IMPROVEMENT DISTRICT,
DAYTON FIRE DISTRICT, OR OR
DEAN MINARD WATER DISTRICT, OR FOR FAR ROAD DISTRICT, OR
DEE IRRIGATION DISTRICT, OR FOREST GROVE R.F.P.D., OR
DEER ISLAND DRAINAGE IMPROVEMENT FOREST VIEW SPECIAL ROAD DISTRICT, OR
COMPANY, OR FORT ROCK-SILVER LAKE S.W.C.D., OR
DELL BROGAN CEMETERY MAINTENANCE FOUR RIVERS VECTOR CONTROL DISTRICT, OR
DISTRICT, OR FOX CEMETERY MAINTENANCE DISTRICT, OR
DEPOE BAY R.F.P.D., OR GARDINER R.F.P.D., OR
Version April 12, 2022
GARDINER SANITARY DISTRICT, OR HOOD RIVER S.W.C.D., OR
GARIBALDI R.F.P.D., OR HOOD RIVER VALLEY PARKS & RECREATION
GASTON R.F.P.D., OR DISTRICT, OR
GATES R.F.P.D., OR HOODLAND FIRE DISTRICT #74
GEARHART R.F.P.D., OR HOODLAND FIRE DISTRICT #74, OR
GILLIAM S.W.C.D., OR HORSEFLY IRRIGATION DISTRICT, OR
GLENDALE AMBULANCE DISTRICT, OR HOSKINS-KINGS VALLEY R.F.P.D., OR
GLENDALE R.F.P.D., OR HOUSING AUTHORITY OF PORTLAND
GLENEDEN BEACH SPECIAL ROAD DISTRICT, OR HUBBARD R.F.P.D., OR
GLENEDEN SANITARY DISTRICT, OR HUDSON BAY DISTRICT IMPROVEMENT COMPANY,
GLENWOOD WATER DISTRICT, OR OR
GLIDE - IDLEYLD SANITARY DISTRICT, OR I N (KAY) YOUNG DITCH DISTRICT IMPROVEMENT
GLIDE R.F.P.D., OR COMPANY, OR
GOLD BEACH - WEDDERBURN R.F.P.D., OR ICE FOUNTAIN WATER DISTRICT, OR
GOLD HILL IRRIGATION DISTRICT, OR IDAHO POINT SPECIAL ROAD DISTRICT, OR
GOLDFINCH ROAD DISTRICT, OR IDANHA-DETROIT RURAL FIRE PROTECTION
GOSHEN R.F.P.D., OR DISTRICT, OR
GOVERNMENT CAMP ROAD DISTRICT, OR ILLINOIS VALLEY FIRE DISTRICT
GOVERNMENT CAMP SANITARY DISTRICT, OR ILLINOIS VALLEY R.F.P.D., OR
GRAND PRAIRIE WATER CONTROL DISTRICT, OR ILLINOIS VALLEY S.W.C.D., OR
GRAND RONDE SANITARY DISTRICT, OR IMBLER R.F.P.D., OR
GRANT COUNTY TRANSPORTATION DISTRICT, OR INTERLACHEN WATER P.U.D., OR
GRANT S.W.C.D., OR IONE LIBRARY DISTRICT, OR
GRANTS PASS IRRIGATION DISTRICT, OR IONE R.F.P.D. #6-604, OR
GREATER BOWEN VALLEY R.F.P.D., OR IRONSIDE CEMETERY MAINTENANCE DISTRICT, OR
GREATER ST. HELENS PARK & RECREATION IRONSIDE RURAL ROAD DISTRICT #5, OR
DISTRICT, OR IRRIGON PARK & RECREATION DISTRICT, OR
GREATER TOLEDO POOL RECREATION DISTRICT, IRRIGON R.F.P.D., OR
OR ISLAND CITY AREA SANITATION DISTRICT, OR
GREEN KNOLLS SPECIAL ROAD DISTRICT, OR ISLAND CITY CEMETERY MAINTENANCE DISTRICT,
GREEN SANITARY DISTRICT, OR OR
GREENACRES R.F.P.D., OR JACK PINE VILLAGE SPECIAL ROAD DISTRICT, OR
GREENBERRY IRRIGATION DISTRICT, OR JACKSON COUNTY FIRE DISTRICT #3, OR
GREENSPRINGS RURAL FIRE DISTRICT, OR JACKSON COUNTY FIRE DISTRICT #4, OR
HAHLEN ROAD SPECIAL DISTRICT, OR JACKSON COUNTY FIRE DISTRICT #5, OR
HAINES CEMETERY MAINTENANCE DISTRICT, OR JACKSON COUNTY LIBRARY DISTRICT, OR
HAINES FIRE PROTECTION DISTRICT, OR JACKSON COUNTY VECTOR CONTROL DISTRICT, OR
HALSEY-SHEDD R.F.P.D., OR JACKSON S.W.C.D., OR
HAMLET R.F.P.D., OR JASPER KNOLLS WATER DISTRICT, OR
HARBOR R.F.P.D., OR JEFFERSON COUNTY EMERGENCY MEDICAL
HARBOR SANITARY DISTRICT, OR SERVICE DISTRICT, OR
HARBOR WATER P.U.D., OR JEFFERSON COUNTY FIRE DISTRICT #1, OR
HARNEY COUNTY HEALTH DISTRICT, OR JEFFERSON COUNTY LIBRARY DISTRICT, OR
HARNEY S.W.C.D., OR JEFFERSON COUNTY S.W.C.D., OR
HARPER SOUTH SIDE IRRIGATION DISTRICT, OR JEFFERSON PARK & RECREATION DISTRICT, OR
HARRISBURG FIRE AND RESCUE, OR JEFFERSON R.F.P.D., OR
HAUSER R.F.P.D., OR JOB'S DRAINAGE DISTRICT, OR
HAZELDELL RURAL FIRE DISTRICT, OR JOHN DAY WATER DISTRICT, OR
HEBO JOINT WATER-SANITARY AUTHORITY, OR JOHN DAY-CANYON CITY PARKS & RECREATION
HECETA WATER P.U.D., OR DISTRICT, OR
HELIX CEMETERY MAINTENANCE DISTRICT #4, OR JOHN DAY-FERNHILL R.F.P.D. #5-108, OR
HELIX PARK & RECREATION DISTRICT, OR JORDAN VALLEY CEMETERY DISTRICT, OR
HELIX R.F.P.D. #7-411, OR JORDAN VALLEY IRRIGATION DISTRICT, OR
HEPPNER CEMETERY MAINTENANCE DISTRICT, OR JOSEPHINE COMMUNITY LIBRARY DISTRICT, OR
HEPPNER R.F.P.D., OR JOSEPHINE COUNTY 4-H & EXTENSION SERVICE
HEPPNER WATER CONTROL DISTRICT, OR DISTRICT, OR
HEREFORD COMMUNITY HALL RECREATION JOSEPHINE COUNTY 911 AGENCY, OR
DISTRICT, OR JUNCTION CITY R.F.P.D., OR
HERMISTON CEMETERY DISTRICT, OR JUNCTION CITY WATER CONTROL DISTRICT, OR
HERMISTON IRRIGATION DISTRICT, OR JUNIPER BUTTE ROAD DISTRICT, OR
HIDDEN VALLEY MOBILE ESTATES IMPROVEMENT JUNIPER CANYON WATER CONTROL DISTRICT, OR
DISTRICT, OR JUNIPER FLAT DISTRICT IMPROVEMENT COMPANY,
HIGH DESERT PARK & RECREATION DISTRICT, OR OR
HIGHLAND SUBDIVISION WATER DISTRICT, OR JUNIPER FLAT R.F.P.D., OR
HONOLULU INTERNATIONAL AIRPORT JUNO NONPROFIT WATER IMPROVEMENT
HOOD RIVER COUNTY LIBRARY DISTRICT, OR DISTRICT, OR
HOOD RIVER COUNTY TRANSPORTATION DISTRICT, KEATING R.F.P.D., OR
OR KEATING S.W.C.D., OR
Version April 12, 2022
KEIZER R.F.P.D., OR LEBANON AQUATIC DISTRICT, OR
KELLOGG RURAL FIRE DISTRICT, OR LEBANON R.F.P.D., OR
KENO IRRIGATION DISTRICT, OR LEWIS & CLARK R.F.P.D., OR
KENO PINES ROAD DISTRICT, OR LINCOLN COUNTY LIBRARY DISTRICT, OR
KENO R.F.P.D., OR LINCOLN S.W.C.D., OR
KENT WATER DISTRICT, OR LINN COUNTY EMERGENCY TELEPHONE AGENCY,
KERBY WATER DISTRICT, OR OR
K-GB-LB WATER DISTRICT, OR LINN S.W.C.D., OR
KILCHIS WATER DISTRICT, OR LITTLE MUDDY CREEK WATER CONTROL, OR
KLAMATH 9-1-1 COMMUNICATIONS DISTRICT, OR LITTLE NESTUCCA DRAINAGE DISTRICT, OR
KLAMATH BASIN IMPROVEMENT DISTRICT, OR LITTLE SWITZERLAND SPECIAL ROAD DISTRICT, OR
KLAMATH COUNTY DRAINAGE SERVICE DISTRICT, LONE PINE IRRIGATION DISTRICT, OR
OR LONG PRAIRIE WATER DISTRICT, OR
KLAMATH COUNTY EXTENSION SERVICE DISTRICT, LOOKINGGLASS OLALLA WATER CONTROL
OR DISTRICT, OR
KLAMATH COUNTY FIRE DISTRICT #1, OR LOOKINGGLASS RURAL FIRE DISTRICT, OR
KLAMATH COUNTY FIRE DISTRICT #3, OR LORANE R.F.P.D., OR
KLAMATH COUNTY FIRE DISTRICT #4, OR LOST & BOULDER DITCH IMPROVEMENT DISTRICT,
KLAMATH COUNTY FIRE DISTRICT #5, OR OR
KLAMATH COUNTY LIBRARY SERVICE DISTRICT, LOST CREEK PARK SPECIAL ROAD DISTRICT, OR
OR LOUISIANA PUBLIC SERVICE COMMISSION, LA
KLAMATH COUNTY PREDATORY ANIMAL LOUISIANA WATER WORKS
CONTROL DISTRICT, OR LOWELL R.F.P.D., OR
KLAMATH DRAINAGE DISTRICT, OR LOWER MCKAY CREEK R.F.P.D., OR
KLAMATH FALLS FOREST ESTATES SPECIAL ROAD LOWER MCKAY CREEK WATER CONTROL
DISTRICT UNIT #2, OR DISTRICT, OR
KLAMATH INTEROPERABILITY RADIO GROUP, OR LOWER POWDER RIVER IRRIGATION DISTRICT, OR
KLAMATH IRRIGATION DISTRICT, OR LOWER SILETZ WATER DISTRICT, OR
KLAMATH RIVER ACRES SPECIAL ROAD DISTRICT, LOWER UMPQUA HOSPITAL DISTRICT, OR
OR LOWER UMPQUA PARK & RECREATION DISTRICT,
KLAMATH S.W.C.D., OR OR
KLAMATH VECTOR CONTROL DISTRICT, OR LOWER VALLEY WATER IMPROVEMENT DISTRICT,
KNAPPA-SVENSEN-BURNSIDE R.F.P.D., OR OR
LA GRANDE CEMETERY MAINTENANCE DISTRICT, LUCE LONG DITCH DISTRICT IMPROVEMENT CO.,
OR OR
LA GRANDE R.F.P.D., OR LUSTED WATER DISTRICT, OR
LA PINE PARK & RECREATION DISTRICT, OR LYONS R.F.P.D., OR
LA PINE R.F.P.D., OR LYONS-MEHAMA WATER DISTRICT, OR
LABISH VILLAGE SEWAGE & DRAINAGE, OR MADRAS AQUATIC CENTER DISTRICT, OR
LACOMB IRRIGATION DISTRICT, OR MAKAI SPECIAL ROAD DISTRICT, OR
LAFAYETTE AIRPORT COMMISSION, LA MALHEUR COUNTY S.W.C.D., OR
LAFOURCHE PARISH HEALTH UNIT – DHH-OPH MALHEUR COUNTY VECTOR CONTROL DISTRICT,
REGION 3 OR
LAIDLAW WATER DISTRICT, OR MALHEUR DISTRICT IMPROVEMENT COMPANY, OR
LAKE CHINOOK FIRE & RESCUE, OR MALHEUR DRAINAGE DISTRICT, OR
LAKE COUNTY 4-H & EXTENSION SERVICE MALHEUR MEMORIAL HEALTH DISTRICT, OR
DISTRICT, OR MALIN COMMUNITY CEMETERY MAINTENANCE
LAKE COUNTY LIBRARY DISTRICT, OR DISTRICT, OR
LAKE CREEK R.F.P.D. - JACKSON, OR MALIN COMMUNITY PARK & RECREATION
LAKE CREEK R.F.P.D. - LANE COUNTY, OR DISTRICT, OR
LAKE DISTRICT HOSPITAL, OR MALIN IRRIGATION DISTRICT, OR
LAKE GROVE R.F.P.D. NO. 57, OR MALIN R.F.P.D., OR
LAKE GROVE WATER DISTRICT, OR MAPLETON FIRE DEPARTMENT, OR
LAKE LABISH WATER CONTROL DISTRICT, OR MAPLETON WATER DISTRICT, OR
LAKE POINT SPECIAL ROAD DISTRICT, OR MARCOLA WATER DISTRICT, OR
LAKESIDE R.F.P.D. #4, OR MARION COUNTY EXTENSION & 4H SERVICE
LAKESIDE WATER DISTRICT, OR DISTRICT, OR
LAKEVIEW R.F.P.D., OR MARION COUNTY FIRE DISTRICT #1, OR
LAKEVIEW S.W.C.D., OR MARION JACK IMPROVEMENT DISTRICT, OR
LAMONTAI IMPROVEMENT DISTRICT, OR MARION S.W.C.D., OR
LANE FIRE AUTHORITY, OR MARY'S RIVER ESTATES ROAD DISTRICT, OR
LANE LIBRARY DISTRICT, OR MCDONALD FOREST ESTATES SPECIAL ROAD
LANE TRANSIT DISTRICT, OR DISTRICT, OR
LANGELL VALLEY IRRIGATION DISTRICT, OR MCKAY ACRES IMPROVEMENT DISTRICT, OR
LANGLOIS PUBLIC LIBRARY, OR MCKAY DAM R.F.P.D. # 7-410, OR
LANGLOIS R.F.P.D., OR MCKENZIE FIRE & RESCUE, OR
LANGLOIS WATER DISTRICT, OR MCKENZIE PALISADES WATER SUPPLY
LAZY RIVER SPECIAL ROAD DISTRICT, OR CORPORATION, OR
Version April 12, 2022
MCMINNVILLE R.F.P.D., OR NEHALEM BAY WASTEWATER AGENCY, OR
MCNULTY WATER P.U.D., OR NESIKA BEACH-OPHIR WATER DISTRICT, OR
MEADOWS DRAINAGE DISTRICT, OR NESKOWIN REGIONAL SANITARY AUTHORITY, OR
MEDFORD IRRIGATION DISTRICT, OR NESKOWIN REGIONAL WATER DISTRICT, OR
MEDFORD R.F.P.D. #2, OR NESTUCCA R.F.P.D., OR
MEDFORD WATER COMMISSION NETARTS WATER DISTRICT, OR
MEDICAL SPRINGS R.F.P.D., OR NETARTS-OCEANSIDE R.F.P.D., OR
MELHEUR COUNTY JAIL, OR NETARTS-OCEANSIDE SANITARY DISTRICT, OR
MERLIN COMMUNITY PARK DISTRICT, OR NEW BRIDGE WATER SUPPLY DISTRICT, OR
MERRILL CEMETERY MAINTENANCE DISTRICT, OR NEW CARLTON FIRE DISTRICT, OR
MERRILL PARK DISTRICT, OR NEW ORLEANS REDEVELOPMENT AUTHORITY, LA
MERRILL R.F.P.D., OR NEW PINE CREEK R.F.P.D., OR
METRO REGIONAL GOVERNMENT NEWBERG R.F.P.D., OR
METRO REGIONAL PARKS NEWBERRY ESTATES SPECIAL ROAD DISTRICT, OR
METROPOLITAN EXPOSITION RECREATION NEWPORT R.F.P.D., OR
COMMISSION NEWT YOUNG DITCH DISTRICT IMPROVEMENT
METROPOLITAN SERVICE DISTRICT (METRO) COMPANY, OR
MID COUNTY CEMETERY MAINTENANCE DISTRICT, NORTH ALBANY R.F.P.D., OR
OR NORTH BAY R.F.P.D. #9, OR
MID-COLUMBIA FIRE AND RESCUE, OR NORTH CLACKAMAS PARKS & RECREATION
MIDDLE FORK IRRIGATION DISTRICT, OR DISTRICT, OR
MIDLAND COMMUNITY PARK, OR NORTH COUNTY RECREATION DISTRICT, OR
MIDLAND DRAINAGE IMPROVEMENT DISTRICT, OR NORTH DOUGLAS COUNTY FIRE & EMS, OR
MILES CROSSING SANITARY SEWER DISTRICT, OR NORTH DOUGLAS PARK & RECREATION DISTRICT,
MILL CITY R.F.P.D. #2-303, OR OR
MILL FOUR DRAINAGE DISTRICT, OR NORTH GILLIAM COUNTY HEALTH DISTRICT, OR
MILLICOMA RIVER PARK & RECREATION DISTRICT, NORTH GILLIAM COUNTY R.F.P.D., OR
OR NORTH LAKE HEALTH DISTRICT, OR
MILLINGTON R.F.P.D. #5, OR NORTH LEBANON WATER CONTROL DISTRICT, OR
MILO VOLUNTEER FIRE DEPARTMENT, OR NORTH LINCOLN FIRE & RESCUE DISTRICT #1, OR
MILTON-FREEWATER AMBULANCE SERVICE AREA NORTH LINCOLN HEALTH DISTRICT, OR
HEALTH DISTRICT, OR NORTH MORROW VECTOR CONTROL DISTRICT, OR
MILTON-FREEWATER WATER CONTROL DISTRICT, NORTH SHERMAN COUNTY R.F.P.D, OR
OR NORTH UNIT IRRIGATION DISTRICT, OR
MIROCO SPECIAL ROAD DISTRICT, OR NORTHEAST OREGON HOUSING AUTHORITY, OR
MIST-BIRKENFELD R.F.P.D., OR NORTHEAST WHEELER COUNTY HEALTH DISTRICT,
MODOC POINT IRRIGATION DISTRICT, OR OR
MODOC POINT SANITARY DISTRICT, OR NORTHERN WASCO COUNTY P.U.D., OR
MOHAWK VALLEY R.F.P.D., OR NORTHERN WASCO COUNTY PARK & RECREATION
MOLALLA AQUATIC DISTRICT, OR DISTRICT, OR
MOLALLA R.F.P.D. #73, OR NYE DITCH USERS DISTRICT IMPROVEMENT, OR
MONITOR R.F.P.D., OR NYSSA ROAD ASSESSMENT DISTRICT #2, OR
MONROE R.F.P.D., OR NYSSA RURAL FIRE DISTRICT, OR
MONUMENT CEMETERY MAINTENANCE DISTRICT, NYSSA-ARCADIA DRAINAGE DISTRICT, OR
OR OAK LODGE WATER SERVICES, OR
MONUMENT S.W.C.D., OR OAKLAND R.F.P.D., OR
MOOREA DRIVE SPECIAL ROAD DISTRICT, OR OAKVILLE COMMUNITY CENTER, OR
MORO R.F.P.D., OR OCEANSIDE WATER DISTRICT, OR
MORROW COUNTY HEALTH DISTRICT, OR OCHOCO IRRIGATION DISTRICT, OR
MORROW COUNTY UNIFIED RECREATION OCHOCO WEST WATER AND SANITARY
DISTRICT, OR AUTHORITY, OR
MORROW S.W.C.D., OR ODELL SANITARY DISTRICT, OR
MOSIER FIRE DISTRICT, OR OLD OWYHEE DITCH IMPROVEMENT DISTRICT, OR
MOUNTAIN DRIVE SPECIAL ROAD DISTRICT, OR OLNEY-WALLUSKI FIRE & RESCUE DISTRICT, OR
MT. ANGEL R.F.P.D., OR ONTARIO LIBRARY DISTRICT, OR
MT. HOOD IRRIGATION DISTRICT, OR ONTARIO R.F.P.D., OR
MT. LAKI CEMETERY DISTRICT, OR OPHIR R.F.P.D., OR
MT. VERNON R.F.P.D., OR OREGON COAST COMMUNITY ACTION
MULINO WATER DISTRICT #1, OR OREGON HOUSING AND COMMUNITY SERVICES
MULTNOMAH COUNTY DRAINAGE DISTRICT #1, OR OREGON INTERNATIONAL PORT OF COOS BAY, OR
MULTNOMAH COUNTY R.F.P.D. #10, OR OREGON LEGISLATIVE ADMINISTRATION
MULTNOMAH COUNTY R.F.P.D. #14, OR OREGON OUTBACK R.F.P.D., OR
MULTNOMAH EDUCATION SERVICE DISTRICT OREGON POINT, OR
MYRTLE CREEK R.F.P.D., OR OREGON TRAIL LIBRARY DISTRICT, OR
NEAH-KAH-NIE WATER DISTRICT, OR OTTER ROCK WATER DISTRICT, OR
NEDONNA R.F.P.D., OR OWW UNIT #2 SANITARY DISTRICT, OR
NEHALEM BAY FIRE AND RESCUE, OR OWYHEE CEMETERY MAINTENANCE DISTRICT, OR
NEHALEM BAY HEALTH DISTRICT, OR OWYHEE IRRIGATION DISTRICT, OR
Version April 12, 2022
PACIFIC CITY JOINT WATER-SANITARY PORT OF UMPQUA, OR
AUTHORITY, OR PORT ORFORD CEMETERY MAINTENANCE
PACIFIC COMMUNITIES HEALTH DISTRICT, OR DISTRICT, OR
PACIFIC RIVIERA #3 SPECIAL ROAD DISTRICT, OR PORT ORFORD PUBLIC LIBRARY DISTRICT, OR
PALATINE HILL WATER DISTRICT, OR PORT ORFORD R.F.P.D., OR
PALMER CREEK WATER DISTRICT IMPROVEMENT PORTLAND DEVELOPMENT COMMISSION, OR
COMPANY, OR PORTLAND FIRE AND RESCUE
PANORAMIC ACCESS SPECIAL ROAD DISTRICT, OR PORTLAND HOUSING CENTER, OR
PANTHER CREEK ROAD DISTRICT, OR POWDER R.F.P.D., OR
PANTHER CREEK WATER DISTRICT, OR POWDER RIVER R.F.P.D., OR
PARKDALE R.F.P.D., OR POWDER VALLEY WATER CONTROL DISTRICT, OR
PARKDALE SANITARY DISTRICT, OR POWERS HEALTH DISTRICT, OR
PENINSULA DRAINAGE DISTRICT #1, OR PRAIRIE CEMETERY MAINTENANCE DISTRICT, OR
PENINSULA DRAINAGE DISTRICT #2, OR PRINEVILLE LAKE ACRES SPECIAL ROAD DISTRICT
PHILOMATH FIRE AND RESCUE, OR #1, OR
PILOT ROCK CEMETERY MAINTENANCE DISTRICT PROSPECT R.F.P.D., OR
#5, OR QUAIL VALLEY PARK IMPROVEMENT DISTRICT, OR
PILOT ROCK PARK & RECREATION DISTRICT, OR QUEENER IRRIGATION IMPROVEMENT DISTRICT,
PILOT ROCK R.F.P.D., OR OR
PINE EAGLE HEALTH DISTRICT, OR RAINBOW WATER DISTRICT, OR
PINE FLAT DISTRICT IMPROVEMENT COMPANY, OR RAINIER CEMETERY DISTRICT, OR
PINE GROVE IRRIGATION DISTRICT, OR RAINIER DRAINAGE IMPROVEMENT COMPANY, OR
PINE GROVE WATER DISTRICT-KLAMATH FALLS, RALEIGH WATER DISTRICT, OR
OR REDMOND AREA PARK & RECREATION DISTRICT,
PINE GROVE WATER DISTRICT-MAUPIN, OR OR
PINE VALLEY CEMETERY DISTRICT, OR REDMOND FIRE AND RESCUE, OR
PINE VALLEY R.F.P.D., OR RIDDLE FIRE PROTECTION DISTRICT, OR
PINEWOOD COUNTRY ESTATES SPECIAL ROAD RIDGEWOOD DISTRICT IMPROVEMENT COMPANY,
DISTRICT, OR OR
PIONEER DISTRICT IMPROVEMENT COMPANY, OR RIDGEWOOD ROAD DISTRICT, OR
PISTOL RIVER CEMETERY MAINTENANCE RIETH SANITARY DISTRICT, OR
DISTRICT, OR RIETH WATER DISTRICT, OR
PISTOL RIVER FIRE DISTRICT, OR RIMROCK WEST IMPROVEMENT DISTRICT, OR
PLEASANT HILL R.F.P.D., OR RINK CREEK WATER DISTRICT, OR
PLEASANT HOME WATER DISTRICT, OR RIVER BEND ESTATES SPECIAL ROAD DISTRICT, OR
POCAHONTAS MINING AND IRRIGATION DISTRICT, RIVER FOREST ACRES SPECIAL ROAD DISTRICT, OR
OR RIVER MEADOWS IMPROVEMENT DISTRICT, OR
POE VALLEY IMPROVEMENT DISTRICT, OR RIVER PINES ESTATES SPECIAL ROAD DISTRICT, OR
POE VALLEY PARK & RECREATION DISTRICT, OR RIVER ROAD PARK & RECREATION DISTRICT, OR
POE VALLEY VECTOR CONTROL DISTRICT, OR RIVER ROAD WATER DISTRICT, OR
POLK COUNTY FIRE DISTRICT #1, OR RIVERBEND RIVERBANK WATER IMPROVEMENT
POLK S.W.C.D., OR DISTRICT, OR
POMPADOUR WATER IMPROVEMENT DISTRICT, OR RIVERDALE R.F.P.D. 11-JT, OR
PONDEROSA PINES EAST SPECIAL ROAD DISTRICT, RIVERGROVE WATER DISTRICT, OR
OR RIVERSIDE MISSION WATER CONTROL DISTRICT,
PORT OF ALSEA, OR OR
PORT OF ARLINGTON, OR RIVERSIDE R.F.P.D. #7-406, OR
PORT OF ASTORIA, OR RIVERSIDE WATER DISTRICT, OR
PORT OF BANDON, OR ROBERTS CREEK WATER DISTRICT, OR
PORT OF BRANDON, OR ROCK CREEK DISTRICT IMPROVEMENT, OR
PORT OF BROOKINGS HARBOR, OR ROCK CREEK WATER DISTRICT, OR
PORT OF CASCADE LOCKS, OR ROCKWOOD WATER P.U.D., OR
PORT OF COQUILLE RIVER, OR ROCKY POINT FIRE & EMS, OR
PORT OF GARIBALDI, OR ROGUE RIVER R.F.P.D., OR
PORT OF GOLD BEACH, OR ROGUE RIVER VALLEY IRRIGATION DISTRICT, OR
PORT OF HOOD RIVER, OR ROGUE VALLEY SEWER SERVICES, OR
PORT OF MORGAN CITY, LA ROGUE VALLEY SEWER, OR
PORT OF MORROW, OR ROGUE VALLEY TRANSPORTATION DISTRICT, OR
PORT OF NEHALEM, OR ROSEBURG URBAN SANITARY AUTHORITY, OR
PORT OF NEWPORT, OR ROSEWOOD ESTATES ROAD DISTRICT, OR
PORT OF PORT ORFORD, OR ROW RIVER VALLEY WATER DISTRICT, OR
PORT OF PORTLAND, OR RURAL ROAD ASSESSMENT DISTRICT #3, OR
PORT OF SIUSLAW, OR RURAL ROAD ASSESSMENT DISTRICT #4, OR
PORT OF ST. HELENS, OR SAINT LANDRY PARISH TOURIST COMMISSION
PORT OF THE DALLES, OR SAINT MARY PARISH REC DISTRICT 2
PORT OF TILLAMOOK BAY, OR SAINT MARY PARISH REC DISTRICT 3
PORT OF TOLEDO, OR SAINT TAMMANY FIRE DISTRICT 4, LA
PORT OF UMATILLA, OR SALEM AREA MASS TRANSIT DISTRICT, OR
Version April 12, 2022
SALEM MASS TRANSIT DISTRICT SOUTH WASCO PARK & RECREATION DISTRICT, OR
SALEM SUBURBAN R.F.P.D., OR SOUTHERN COOS HEALTH DISTRICT, OR
SALISHAN SANITARY DISTRICT, OR SOUTHERN CURRY CEMETERY MAINTENANCE
SALMON RIVER PARK SPECIAL ROAD DISTRICT, OR DISTRICT, OR
SALMON RIVER PARK WATER IMPROVEMENT SOUTHVIEW IMPROVEMENT DISTRICT, OR
DISTRICT, OR SOUTHWEST LINCOLN COUNTY WATER DISTRICT,
SALMONBERRY TRAIL INTERGOVERNMENTAL OR
AGENCY, OR SOUTHWESTERN POLK COUNTY R.F.P.D., OR
SANDPIPER VILLAGE SPECIAL ROAD DISTRICT, OR SOUTHWOOD PARK WATER DISTRICT, OR
SANDY DRAINAGE IMPROVEMENT COMPANY, OR SPECIAL ROAD DISTRICT #1, OR
SANDY R.F.P.D. #72, OR SPECIAL ROAD DISTRICT #8, OR
SANTA CLARA R.F.P.D., OR SPRING RIVER SPECIAL ROAD DISTRICT, OR
SANTA CLARA WATER DISTRICT, OR SPRINGFIELD UTILITY BOARD, OR
SANTIAM WATER CONTROL DISTRICT, OR ST. PAUL R.F.P.D., OR
SAUVIE ISLAND DRAINAGE IMPROVEMENT STANFIELD CEMETERY DISTRICT #6, OR
COMPANY, OR STANFIELD IRRIGATION DISTRICT, OR
SAUVIE ISLAND VOLUNTEER FIRE DISTRICT #30J, STARR CREEK ROAD DISTRICT, OR
OR STARWOOD SANITARY DISTRICT, OR
SCAPPOOSE DRAINAGE IMPROVEMENT COMPANY, STAYTON FIRE DISTRICT, OR
OR SUBLIMITY FIRE DISTRICT, OR
SCAPPOOSE PUBLIC LIBRARY DISTRICT, OR SUBURBAN EAST SALEM WATER DISTRICT, OR
SCAPPOOSE R.F.P.D., OR SUBURBAN LIGHTING DISTRICT, OR
SCIO R.F.P.D., OR SUCCOR CREEK DISTRICT IMPROVEMENT
SCOTTSBURG R.F.P.D., OR COMPANY, OR
SEAL ROCK R.F.P.D., OR SUMMER LAKE IRRIGATION DISTRICT, OR
SEAL ROCK WATER DISTRICT, OR SUMMERVILLE CEMETERY MAINTENANCE
SEWERAGE AND WATER BOARD OF NEW ORLEANS, DISTRICT, OR
LA SUMNER R.F.P.D., OR
SHANGRI-LA WATER DISTRICT, OR SUN MOUNTAIN SPECIAL ROAD DISTRICT, OR
SHASTA VIEW IRRIGATION DISTRICT, OR SUNDOWN SANITATION DISTRICT, OR
SHELLEY ROAD CREST ACRES WATER DISTRICT, SUNFOREST ESTATES SPECIAL ROAD DISTRICT, OR
OR SUNNYSIDE IRRIGATION DISTRICT, OR
SHERIDAN FIRE DISTRICT, OR SUNRISE WATER AUTHORITY, OR
SHERMAN COUNTY HEALTH DISTRICT, OR SUNRIVER SERVICE DISTRICT, OR
SHERMAN COUNTY S.W.C.D., OR SUNSET EMPIRE PARK & RECREATION DISTRICT,
SHORELINE SANITARY DISTRICT, OR OR
SILETZ KEYS SANITARY DISTRICT, OR SUNSET EMPIRE TRANSPORTATION DISTRICT, OR
SILETZ R.F.P.D., OR SURFLAND ROAD DISTRICT, OR
SILVER FALLS LIBRARY DISTRICT, OR SUTHERLIN VALLEY RECREATION DISTRICT, OR
SILVER LAKE IRRIGATION DISTRICT, OR SUTHERLIN WATER CONTROL DISTRICT, OR
SILVER LAKE R.F.P.D., OR SWALLEY IRRIGATION DISTRICT, OR
SILVER SANDS SPECIAL ROAD DISTRICT, OR SWEET HOME CEMETERY MAINTENANCE DISTRICT,
SILVERTON R.F.P.D. NO. 2, OR OR
SISTERS PARKS & RECREATION DISTRICT, OR SWEET HOME FIRE & AMBULANCE DISTRICT, OR
SISTERS-CAMP SHERMAN R.F.P.D., OR SWISSHOME-DEADWOOD R.F.P.D., OR
SIUSLAW PUBLIC LIBRARY DISTRICT, OR TABLE ROCK DISTRICT IMPROVEMENT COMPANY,
SIUSLAW S.W.C.D., OR OR
SIUSLAW VALLEY FIRE AND RESCUE, OR TALENT IRRIGATION DISTRICT, OR
SIXES R.F.P.D., OR TANGENT R.F.P.D., OR
SKIPANON WATER CONTROL DISTRICT, OR TENMILE R.F.P.D., OR
SKYLINE VIEW DISTRICT IMPROVEMENT TERREBONNE DOMESTIC WATER DISTRICT, OR
COMPANY, OR THE DALLES IRRIGATION DISTRICT, OR
SLEEPY HOLLOW WATER DISTRICT, OR THOMAS CREEK-WESTSIDE R.F.P.D., OR
SMITH DITCH DISTRICT IMPROVEMENT COMPANY, THREE RIVERS RANCH ROAD DISTRICT, OR
OR THREE SISTERS IRRIGATION DISTRICT, OR
SOUTH CLACKAMAS TRANSPORTATION DISTRICT, TIGARD TUALATIN AQUATIC DISTRICT, OR
OR TIGARD WATER DISTRICT, OR
SOUTH COUNTY HEALTH DISTRICT, OR TILLAMOOK BAY FLOOD IMPROVEMENT DISTRICT,
SOUTH FORK WATER BOARD, OR OR
SOUTH GILLIAM COUNTY CEMETERY DISTRICT, OR TILLAMOOK COUNTY EMERGENCY
SOUTH GILLIAM COUNTY HEALTH DISTRICT, OR COMMUNICATIONS DISTRICT, OR
SOUTH GILLIAM COUNTY R.F.P.D. VI-301, OR TILLAMOOK COUNTY S.W.C.D., OR
SOUTH LAFOURCHE LEVEE DISTRICT, LA TILLAMOOK COUNTY TRANSPORTATION DISTRICT,
SOUTH LANE COUNTY FIRE & RESCUE, OR OR
SOUTH SANTIAM RIVER WATER CONTROL TILLAMOOK FIRE DISTRICT, OR
DISTRICT, OR TILLAMOOK P.U.D., OR
SOUTH SHERMAN FIRE DISTRICT, OR TILLER R.F.P.D., OR
SOUTH SUBURBAN SANITARY DISTRICT, OR
Version April 12, 2022
TOBIN DITCH DISTRICT IMPROVEMENT COMPANY, WALLOWA S.W.C.D., OR
OR WALLOWA VALLEY IMPROVEMENT DISTRICT #1,
TOLEDO R.F.P.D., OR OR
TONE WATER DISTRICT, OR WAMIC R.F.P.D., OR
TOOLEY WATER DISTRICT, OR WAMIC WATER & SANITARY AUTHORITY, OR
TRASK DRAINAGE DISTRICT, OR WARMSPRINGS IRRIGATION DISTRICT, OR
TRI CITY R.F.P.D. #4, OR WASCO COUNTY S.W.C.D., OR
TRI-CITY WATER & SANITARY AUTHORITY, OR WATER ENVIRONMENT SERVICES, OR
TRI-COUNTY METROPOLITAN TRANSPORTATION WATER WONDERLAND IMPROVEMENT DISTRICT,
DISTRICT OF OREGON OR
TRIMET, OR WATERBURY & ALLEN DITCH IMPROVEMENT
TUALATIN HILLS PARK & RECREATION DISTRICT DISTRICT, OR
TUALATIN HILLS PARK & RECREATION DISTRICT, WATSECO-BARVIEW WATER DISTRICT, OR
OR WAUNA WATER DISTRICT, OR
TUALATIN S.W.C.D., OR WEDDERBURN SANITARY DISTRICT, OR
TUALATIN VALLEY FIRE & RESCUE WEST EAGLE VALLEY WATER CONTROL DISTRICT,
TUALATIN VALLEY FIRE & RESCUE, OR OR
TUALATIN VALLEY IRRIGATION DISTRICT, OR WEST EXTENSION IRRIGATION DISTRICT, OR
TUALATIN VALLEY WATER DISTRICT WEST LABISH DRAINAGE & WATER CONTROL
TUALATIN VALLEY WATER DISTRICT, OR IMPROVEMENT DISTRICT, OR
TUMALO IRRIGATION DISTRICT, OR WEST MULTNOMAH S.W.C.D., OR
TURNER FIRE DISTRICT, OR WEST SIDE R.F.P.D., OR
TWIN ROCKS SANITARY DISTRICT, OR WEST SLOPE WATER DISTRICT, OR
TWO RIVERS NORTH SPECIAL ROAD DISTRICT, OR WEST UMATILLA MOSQUITO CONTROL DISTRICT,
TWO RIVERS S.W.C.D., OR OR
TWO RIVERS SPECIAL ROAD DISTRICT, OR WEST VALLEY FIRE DISTRICT, OR
TYGH VALLEY R.F.P.D., OR WESTERN HEIGHTS SPECIAL ROAD DISTRICT, OR
TYGH VALLEY WATER DISTRICT, OR WESTERN LANE AMBULANCE DISTRICT, OR
UMATILLA COUNTY FIRE DISTRICT #1, OR WESTLAND IRRIGATION DISTRICT, OR
UMATILLA COUNTY S.W.C.D., OR WESTON ATHENA MEMORIAL HALL PARK &
UMATILLA COUNTY SPECIAL LIBRARY DISTRICT, RECREATION DISTRICT, OR
OR WESTON CEMETERY DISTRICT #2, OR
UMATILLA HOSPITAL DISTRICT, OR WESTPORT FIRE AND RESCUE, OR
UMATILLA R.F.P.D. #7-405, OR WESTRIDGE WATER SUPPLY CORPORATION, OR
UMATILLA-MORROW RADIO AND DATA DISTRICT, WESTWOOD HILLS ROAD DISTRICT, OR
OR WESTWOOD VILLAGE ROAD DISTRICT, OR
UMPQUA S.W.C.D., OR WHEELER S.W.C.D., OR
UNION CEMETERY MAINTENANCE DISTRICT, OR WHITE RIVER HEALTH DISTRICT, OR
UNION COUNTY SOLID WASTE DISPOSAL DISTRICT, WIARD MEMORIAL PARK DISTRICT, OR
OR WICKIUP WATER DISTRICT, OR
UNION COUNTY VECTOR CONTROL DISTRICT, OR WILLAKENZIE R.F.P.D., OR
UNION GAP SANITARY DISTRICT, OR WILLAMALANE PARK & RECREATION DISTRICT, OR
UNION GAP WATER DISTRICT, OR WILLAMALANE PARK AND RECREATION DISTRICT
UNION HEALTH DISTRICT, OR WILLAMETTE HUMANE SOCIETY
UNION R.F.P.D., OR WILLAMETTE RIVER WATER COALITION, OR
UNION S.W.C.D., OR WILLIAMS R.F.P.D., OR
UNITY COMMUNITY PARK & RECREATION WILLOW CREEK PARK DISTRICT, OR
DISTRICT, OR WILLOW DALE WATER DISTRICT, OR
UPPER CLEVELAND RAPIDS ROAD DISTRICT, OR WILSON RIVER WATER DISTRICT, OR
UPPER MCKENZIE R.F.P.D., OR WINCHESTER BAY R.F.P.D., OR
UPPER WILLAMETTE S.W.C.D., OR WINCHESTER BAY SANITARY DISTRICT, OR
VALE OREGON IRRIGATION DISTRICT, OR WINCHUCK R.F.P.D., OR
VALE RURAL FIRE PROTECTION DISTRICT, OR WINSTON-DILLARD R.F.P.D., OR
VALLEY ACRES SPECIAL ROAD DISTRICT, OR WINSTON-DILLARD WATER DISTRICT, OR
VALLEY VIEW CEMETERY MAINTENANCE WOLF CREEK R.F.P.D., OR
DISTRICT, OR WOOD RIVER DISTRICT IMPROVEMENT COMPANY,
VALLEY VIEW WATER DISTRICT, OR OR
VANDEVERT ACRES SPECIAL ROAD DISTRICT, OR WOODBURN R.F.P.D. NO. 6, OR
VERNONIA R.F.P.D., OR WOODLAND PARK SPECIAL ROAD DISTRICT, OR
VINEYARD MOUNTAIN PARK & RECREATION WOODS ROAD DISTRICT, OR
DISTRICT, OR WRIGHT CREEK ROAD WATER IMPROVEMENT
VINEYARD MOUNTAIN SPECIAL ROAD DISTRICT, DISTRICT, OR
OR WY'EAST FIRE DISTRICT, OR
WALLA WALLA RIVER IRRIGATION DISTRICT, OR YACHATS R.F.P.D., OR
WALLOWA COUNTY HEALTH CARE DISTRICT, OR YAMHILL COUNTY TRANSIT AREA, OR
WALLOWA LAKE COUNTY SERVICE DISTRICT, OR YAMHILL FIRE PROTECTION DISTRICT, OR
WALLOWA LAKE IRRIGATION DISTRICT, OR YAMHILL SWCD, OR
WALLOWA LAKE R.F.P.D., OR YONCALLA PARK & RECREATION DISTRICT, OR
Version April 12, 2022
YOUNGS RIVER-LEWIS & CLARK WATER DISTRICT, MULTISENSORY LEARNING ACADEMY
OR MYRTLE PINT SCHOOL DISTRICT 41
ZUMWALT R.F.P.D., OR NEAH-KAH-NIE DISTRICT NO.56
NEWBERG PUBLIC SCHOOLS
K-12 INCLUDING BUT NOT LIMITED TO: NESTUCCA VALLEY SCHOOL DISTRICT NO.101
ACADIA PARISH SCHOOL BOARD NOBEL LEARNING COMMUNITIES
BEAVERTON SCHOOL DISTRICT NORTH BEND SCHOOL DISTRICT 13
BEND-LA PINE SCHOOL DISTRICT NORTH CLACKAMAS SCHOOL DISTRICT
BOGALUSA HIGH SCHOOL, LA NORTH DOUGLAS SCHOOL DISTRICT
BOSSIER PARISH SCHOOL BOARD NORTH WASCO CITY SCHOOL DISTRICT 21
BROOKING HARBOR SCHOOL DISTRICT NORTHWEST REGIONAL EDUCATION SERVICE
CADDO PARISH SCHOOL DISTRICT DISTRICT
CALCASIEU PARISH SCHOOL DISTRICT ONTARIO MIDDLE SCHOOL
CANBY SCHOOL DISTRICT OREGON TRAIL SCHOOL DISTRICT NOA6
CANYONVILLE CHRISTIAN ACADEMY ORLEANS PARISH SCHOOL DISTRICT
CASCADE SCHOOL DISTRICT PHOENIX-TALENT SCHOOL DISTRICT NOA
CASCADES ACADEMY OF CENTRAL OREGON PLEASANT HILL SCHOOL DISTRICT
CENTENNIAL SCHOOL DISTRICT PORTLAND JEWISH ACADEMY
CENTRAL CATHOLIC HIGH SCHOOL PORTLAND PUBLIC SCHOOLS
CENTRAL POINT SCHOOL DISTRICT NO.6 RAPIDES PARISH SCHOOL DISTRICT
CENTRAL SCHOOL DISTRICT 13J REDMOND SCHOOL DISTRICT
COOS BAY SCHOOL DISTRICT NO.9 REYNOLDS SCHOOL DISTRICT
CORVALLIS SCHOOL DISTRICT 509J ROGUE RIVER SCHOOL DISTRICT
COUNTY OF YAMHILL SCHOOL DISTRICT 29 ROSEBURG PUBLIC SCHOOLS
CULVER SCHOOL DISTRICT SCAPPOOSE SCHOOL DISTRICT 1J
DALLAS SCHOOL DISTRICT NO.2 SAINT TAMMANY PARISH SCHOOL BOARD, LA
DAVID DOUGLAS SCHOOL DISTRICT SEASIDE SCHOOL DISTRICT 10
DAYTON SCHOOL DISTRICT NO.8 SHERWOOD SCHOOL DISTRICT 88J
DE LA SALLE N CATHOLIC HS SILVER FALLS SCHOOL DISTRICT 4J
DESCHUTES COUNTY SCHOOL DISTRICT NO.6 SOUTH LANE SCHOOL DISTRICT 45J3
DOUGLAS EDUCATIONAL DISTRICT SERVICE SOUTHERN OREGON EDUCATION SERVICE
DUFUR SCHOOL DISTRICT NO.29 DISTRICT
EAST BATON ROUGE PARISH SCHOOL DISTRICT SPRINGFIELD PUBLIC SCHOOLS
ESTACADA SCHOOL DISTRICT NO.10B SUTHERLIN SCHOOL DISTRICT
FOREST GROVE SCHOOL DISTRICT SWEET HOME SCHOOL DISTRICT NO.55
GEORGE MIDDLE SCHOOL TERREBONNE PARISH SCHOOL DISTRICT
GLADSTONE SCHOOL DISTRICT THE CATLIN GABEL SCHOOL
GRANTS PASS SCHOOL DISTRICT 7 TIGARD-TUALATIN SCHOOL DISTRICT
GREATER ALBANY PUBLIC SCHOOL DISTRICT UMATILLA MORROW ESD
GRESHAM BARLOW JOINT SCHOOL DISTRICT WEST LINN WILSONVILLE SCHOOL DISTRICT
HEAD START OF LANE COUNTY WILLAMETTE EDUCATION SERVICE DISTRICT
HIGH DESERT EDUCATION SERVICE DISTRICT WOODBURN SCHOOL DISTRICT
HILLSBORO SCHOOL DISTRICT YONCALLA SCHOOL DISTRICT
HOOD RIVER COUNTY SCHOOL DISTRICT ACADEMY FOR MATH ENGINEERING & SCIENCE
JACKSON CO SCHOOL DIST NO.9 (AMES), UT
JEFFERSON COUNTY SCHOOL DISTRICT 509-J ALIANZA ACADEMY, UT
JEFFERSON PARISH SCHOOL DISTRICT ALPINE DISTRICT, UT
JEFFERSON SCHOOL DISTRICT AMERICAN LEADERSHIP ACADEMY, UT
JUNCTION CITY SCHOOLS, OR AMERICAN PREPARATORY ACADEMY, UT
KLAMATH COUNTY SCHOOL DISTRICT BAER CANYON HIGH SCHOOL FOR SPORTS &
KLAMATH FALLS CITY SCHOOLS MEDICAL SCIENCES, UT
LAFAYETTE PARISH SCHOOL DISTRICT BEAR RIVER CHARTER SCHOOL, UT
LAKE OSWEGO SCHOOL DISTRICT 7J BEAVER SCHOOL DISTRICT, UT
LANE COUNTY SCHOOL DISTRICT 4J BEEHIVE SCIENCE & TECHNOLOGY ACADEMY
LINCOLN COUNTY SCHOOL DISTRICT (BSTA) , UT
LINN CO. SCHOOL DIST. 95C BOX ELDER SCHOOL DISTRICT, UT
LIVINGSTON PARISH SCHOOL DISTRICT CBA CENTER, UT
LOST RIVER JR/SR HIGH SCHOOL CACHE SCHOOL DISTRICT, UT
LOWELL SCHOOL DISTRICT NO.71 CANYON RIM ACADEMY, UT
SALEM-KEIZER PUBLIC SCHOOLS 24J CANYONS DISTRICT, UT
MARION COUNTY SCHOOL DISTRICT 103 CARBON SCHOOL DISTRICT, UT
MARIST HIGH SCHOOL, OR CHANNING HALL, UT
MCMINNVILLE SCHOOL DISTRICT NOAO CHARTER SCHOOL LEWIS ACADEMY, UT
MEDFORD SCHOOL DISTRICT 549C CITY ACADEMY, UT
MITCH CHARTER SCHOOL DAGGETT SCHOOL DISTRICT, UT
MONROE SCHOOL DISTRICT NO.1J DAVINCI ACADEMY, UT
MORROW COUNTY SCHOOL DIST, OR DAVIS DISTRICT, UT
MULTNOMAH EDUCATION SERVICE DISTRICT DUAL IMMERSION ACADEMY, UT
Version April 12, 2022
DUCHESNE SCHOOL DISTRICT, UT SALT LAKE CENTER FOR SCIENCE EDUCATION, UT
EARLY LIGHT ACADEMY AT DAYBREAK, UT SALT LAKE SCHOOL DISTRICT, UT
EAST HOLLYWOOD HIGH, UT SALT LAKE SCHOOL FOR THE PERFORMING ARTS,
EDITH BOWEN LABORATORY SCHOOL, UT UT
EMERSON ALCOTT ACADEMY, UT SAN JUAN SCHOOL DISTRICT, UT
EMERY SCHOOL DISTRICT, UT SEVIER SCHOOL DISTRICT, UT
ENTHEOS ACADEMY, UT SOLDIER HOLLOW CHARTER SCHOOL, UT
EXCELSIOR ACADEMY, UT SOUTH SANPETE SCHOOL DISTRICT, UT
FAST FORWARD HIGH, UT SOUTH SUMMIT SCHOOL DISTRICT, UT
FREEDOM ACADEMY, UT SPECTRUM ACADEMY, UT
GARFIELD SCHOOL DISTRICT, UT SUCCESS ACADEMY, UT
GATEWAY PREPARATORY ACADEMY, UT SUCCESS SCHOOL, UT
GEORGE WASHINGTON ACADEMY, UT SUMMIT ACADEMY, UT
GOOD FOUNDATION ACADEMY, UT SUMMIT ACADEMY HIGH SCHOOL, UT
GRAND SCHOOL DISTRICT, UT SYRACUSE ARTS ACADEMY, UT
GRANITE DISTRICT, UT THOMAS EDISON - NORTH, UT
GUADALUPE SCHOOL, UT TIMPANOGOS ACADEMY, UT
HAWTHORN ACADEMY, UT TINTIC SCHOOL DISTRICT, UT
INTECH COLLEGIATE HIGH SCHOOL, UT TOOELE SCHOOL DISTRICT, UT
IRON SCHOOL DISTRICT, UT TUACAHN HIGH SCHOOL FOR THE PERFORMING
ITINERIS EARLY COLLEGE HIGH, UT ARTS, UT
JOHN HANCOCK CHARTER SCHOOL, UT UINTAH RIVER HIGH, UT
JORDAN DISTRICT, UT UINTAH SCHOOL DISTRICT, UT
JUAB SCHOOL DISTRICT, UT UTAH CONNECTIONS ACADEMY, UT
KANE SCHOOL DISTRICT, UT UTAH COUNTY ACADEMY OF SCIENCE, UT
KARL G MAESER PREPARATORY ACADEMY, UT UTAH ELECTRONIC HIGH SCHOOL, UT
LAKEVIEW ACADEMY, UT UTAH SCHOOLS FOR DEAF & BLIND, UT
LEGACY PREPARATORY ACADEMY, UT UTAH STATE OFFICE OF EDUCATION, UT
LIBERTY ACADEMY, UT UTAH VIRTUAL ACADEMY, UT
LINCOLN ACADEMY, UT VENTURE ACADEMY, UT
LOGAN SCHOOL DISTRICT, UT VISTA AT ENTRADA SCHOOL OF PERFORMING
MARIA MONTESSORI ACADEMY, UT ARTS AND TECHNOLOGY, UT
MERIT COLLEGE PREPARATORY ACADEMY, UT WALDEN SCHOOL OF LIBERAL ARTS, UT
MILLARD SCHOOL DISTRICT, UT WASATCH PEAK ACADEMY, UT
MOAB CHARTER SCHOOL, UT WASATCH SCHOOL DISTRICT, UT
MONTICELLO ACADEMY, UT WASHINGTON SCHOOL DISTRICT, UT
MORGAN SCHOOL DISTRICT, UT WAYNE SCHOOL DISTRICT, UT
MOUNTAINVILLE ACADEMY, UT WEBER SCHOOL DISTRICT, UT
MURRAY SCHOOL DISTRICT, UT WEILENMANN SCHOOL OF DISCOVERY, UT
NAVIGATOR POINTE ACADEMY, UT
NEBO SCHOOL DISTRICT, UT HIGHER EDUCATION
NO UT ACAD FOR MATH ENGINEERING & SCIENCE ARGOSY UNIVERSITY
(NUAMES), UT BATON ROUGE COMMUNITY COLLEGE, LA
NOAH WEBSTER ACADEMY, UT BIRTHINGWAY COLLEGE OF MIDWIFERY
NORTH DAVIS PREPARATORY ACADEMY, UT BLUE MOUNTAIN COMMUNITY COLLEGE
NORTH SANPETE SCHOOL DISTRICT, UT BRIGHAM YOUNG UNIVERSITY - HAWAII
NORTH STAR ACADEMY, UT CENTRAL OREGON COMMUNITY COLLEGE
NORTH SUMMIT SCHOOL DISTRICT, UT CENTENARY COLLEGE OF LOUISIANA
ODYSSEY CHARTER SCHOOL, UT CHEMEKETA COMMUNITY COLLEGE
OGDEN PREPARATORY ACADEMY, UT CLACKAMAS COMMUNITY COLLEGE
OGDEN SCHOOL DISTRICT, UT COLLEGE OF THE MARSHALL ISLANDS
OPEN CLASSROOM, UT COLUMBIA GORGE COMMUNITY COLLEGE
OPEN HIGH SCHOOL OF UTAH, UT CONCORDIA UNIVERSITY
OQUIRRH MOUNTAIN CHARTER SCHOOL, UT GEORGE FOX UNIVERSITY
PARADIGM HIGH SCHOOL, UT KLAMATH COMMUNITY COLLEGE DISTRICT
PARK CITY SCHOOL DISTRICT, UT LANE COMMUNITY COLLEGE
PINNACLE CANYON ACADEMY, UT LEWIS AND CLARK COLLEGE
PIUTE SCHOOL DISTRICT, UT LINFIELD COLLEGE
PROVIDENCE HALL, UT LINN-BENTON COMMUNITY COLLEGE
PROVO SCHOOL DISTRICT, UT LOUISIANA COLLEGE, LA
QUAIL RUN PRIMARY SCHOOL, UT LOUISIANA STATE UNIVERSITY
QUEST ACADEMY, UT LOUISIANA STATE UNIVERSITY HEALTH SERVICES
RANCHES ACADEMY, UT MARYLHURST UNIVERSITY
REAGAN ACADEMY, UT MT. HOOD COMMUNITY COLLEGE
RENAISSANCE ACADEMY, UT MULTNOMAH BIBLE COLLEGE
RICH SCHOOL DISTRICT, UT NATIONAL COLLEGE OF NATURAL MEDICINE
ROCKWELL CHARTER HIGH SCHOOL, UT NORTHWEST CHRISTIAN COLLEGE
SALT LAKE ARTS ACADEMY, UT OREGON HEALTH AND SCIENCE UNIVERSITY
Version April 12, 2022
OREGON INSTITUTE OF TECHNOLOGY STATE OF LOUISIANA
OREGON STATE UNIVERSITY STATE OF LOUISIANA DEPT. OF EDUCATION
OREGON UNIVERSITY SYSTEM STATE OF LOUISIANA, 26TH JUDICIAL DISTRICT
PACIFIC UNIVERSITY ATTORNEY
PIONEER PACIFIC COLLEGE STATE OF UTAH
PORTLAND COMMUNITY COLLEGE
PORTLAND STATE UNIVERSITY HEART OF APPALACHIA REGION (VIRGINIA) to
REED COLLEGE include:
RESEARCH CORPORATION OF THE UNIVERSITY OF
HAWAII CITIES & TOWNS
ROGUE COMMUNITY COLLEGE Bluefield, VA
SOUTHEASTERN LOUISIANA UNIVERSITY
SOUTHERN OREGON UNIVERSITY (OREGON Grundy, VA
UNIVERSITY SYSTEM) Norton, VA
SOUTHWESTERN OREGON COMMUNITY COLLEGE Town of Tazewell, VA
TULANE UNIVERSITY
TILLAMOOK BAY COMMUNITY COLLEGE Big Stone Gap, VA
UMPQUA COMMUNITY COLLEGE Clintwood, VA
UNIVERSITY OF HAWAII BOARD OF REGENTS
UNIVERSITY OF HAWAII-HONOLULU COMMUNITY St. Paul, VA
COLLEGE
UNIVERSITY OF OREGON-GRADUATE SCHOOL COUNTIES
UNIVERSITY OF PORTLAND Buchanan County, VA
UNIVERSITY OF NEW ORLEANS Dickenson County, VA
WESTERN OREGON UNIVERSITY
WESTERN STATES CHIROPRACTIC COLLEGE Lee County, VA
WILLAMETTE UNIVERSITY Russell County, VA
XAVIER UNIVERSITY
Scott County, VA
UTAH SYSTEM OF HIGHER EDUCATION, UT
UNIVERSITY OF UTAH, UT Tazewell County, VA
UTAH STATE UNIVERSITY, UT Wise County, VA
WEBER STATE UNIVERSITY, UT
SOUTHERN UTAH UNIVERSITY, UT
SNOW COLLEGE, UT BLUE RIDGE HIGHLANDS REGION (VIRGINA) to include:
DIXIE STATE COLLEGE, UT
COLLEGE OF EASTERN UTAH, UT
CITIES & TOWNS
UTAH VALLEY UNIVERSITY, UT
SALT LAKE COMMUNITY COLLEGE, UT Abingdon, VA
UTAH COLLEGE OF APPLIED TECHNOLOGY, UT Blacksburg, VA
STATE AGENCIES Bristol, VA
ADMIN. SERVICES OFFICE Christiansburg, VA
BOARD OF MEDICAL EXAMINERS
Damascus, VA
HAWAII CHILD SUPPORT ENFORCEMENT AGENCY
HAWAII DEPARTMENT OF TRANSPORTATION Galax, VA
HAWAII HEALTH SYSTEMS CORPORATION Marion, VA
OFFICE OF MEDICAL ASSISTANCE PROGRAMS
OFFICE OF THE STATE TREASURER Pulaski, VA
OREGON BOARD OF ARCHITECTS Radford, VA
OREGON CHILD DEVELOPMENT COALITION
Wytheville, VA
OREGON DEPARTMENT OF EDUCATION
OREGON DEPARTMENT OF FORESTRY COUNTIES
OREGON DEPT OF TRANSPORTATION Bland County, VA
OREGON DEPT. OF EDUCATION
OREGON LOTTERY Carroll County, VA
OREGON OFFICE OF ENERGY Floyd County, VA
OREGON STATE BOARD OF NURSING Giles County, VA
OREGON STATE DEPT OF CORRECTIONS
OREGON STATE POLICE Grayson County, VA
OREGON TOURISM COMMISSION Montgomery County, VA
OREGON TRAVEL INFORMATION COUNCIL
SANTIAM CANYON COMMUNICATION CENTER Patrick County, VA
SEIU LOCAL 503, OPEU Pulaski County, VA
SOH- JUDICIARY CONTRACTS AND PURCH Smyth County, VA
STATE DEPARTMENT OF DEFENSE, STATE OF
HAWAII Washington County, VA
STATE OF HAWAII Wythe County, VA
STATE OF HAWAII, DEPT. OF EDUCATION
Version April 12, 2022
CENTRAL VIRGINIA REGION (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Appomattox, VA Albemarie County, VA
Ashland, VA Amelia County, VA
Blackstone, VA Amherst County, VA
Charlottesville, VA Appomattox County, VA
Colonial Heights, VA Buckingham County, VA
Chester, VA Campbell County, VA
Farmville, VA Chesterfield County, VA
Hopewell, VA Cumberland County, VA
Lynchburg, VA Dinwiddie County, VA
Petersburg, VA Fluvanna County, VA
Richmond, VA Goochland County, VA
Scottsville, VA Greene County, VA
Wintergreen, VA Hanover County, VA
Henrico County, VA
Louisa County, VA
Madison County, VA
Nelson County, VA
Nottoway County, VA
Orange County, VA
Powhatan County, VA
Prince Edward County, VA
Prince George County, VA
Sussex County, VA
TIDEWATER REGION (WHICH ALSO INCLUDES THE CHESAPEAKE BAY REGION)
(VIRGINA) to include:
CITIES & TOWNS COUNTIES
Kilmarnock, VA Middlesex County, VA
Warsaw, VA Lancaster County, VA
Urbanna, VA Northumberland County, VA
West Point, VA Richmond County, VA
Colonial Beach, VA King William County, VA
Tappahannock, VA King & Queen County, VA
Gloucester, VA Mathews County, VA
Irvington, VA Westmoreland County, VA
Essex County, VA
Gloucester County, VA
King George County, VA
COASTAL VIRGINIA - EASTERN SHORE REGION (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Accomac, VA Northampton County, VA
Cape Charles, VA Accomack County, VA
Chincoteague Island, VA
Exmore, VA
Onanock, VA
Tangier Island, VA
Wachapreague, VA
Tidewater COASTAL VIRGINIA - HAMPTON ROADS REGION (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Charles City, VA Charles City County, VA
Chesapeake, VA Isle of Wight County, VA
Franklin, VA James City County, VA
Hampton, VA New Kent County, VA
Newport News, VA Southampton County, VA
Norfolk, VA Surry County, VA
Poquoson, VA York County, VA
Portsmouth, VA
Smithfield, VA
Suffolk, VA
Virginia Beach, VA
Williamsburg, VA
Yorktown, VA
NORTHERN VIRGNIA REGION (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Alexandria, VA Rappanhannock County, VA
Arlington, VA Fauquier County, VA
Centreville, VA Stafford County, VA
Chantilly, VA Spotsylvania County, VA
Clifton, VA Caroline County, VA
Culpeper, VA Prince William County, VA
Dulles, VA Fairfax County, VA
Falls Church, VA Loudoun County, VA
Fairfax, VA Culpeper County, VA
Fredericksburg, VA
Herndon, VA
Leesburg, VA
Lorton, VA
Manassas Park, VA
Manassas, VA
Marshall, VA
McLean, VA
Middleburg, VA
Occoquan, VA
Purcellville, VA
Reston, VA
Spotsylvania, VA
Springfield, VA
Triangle, VA
Vienna, VA
Warrenton, VA
Woodbridge, VA
Washington, VA
SHENANDOAH VALLEY REGION (VIRGINA) to include:
CITIES & TOWNS
Berryville, VA Shenandoah, VA
Buena Vista, VA Staunton, VA
Front Royal, VA Waynesboro, VA
Harrisonburg, VA Winchester, VA
Lexington, VA
Luray, VA
Natural Bridge VA
COUNTIES
Augusta County, VA
Clarke County, VA
Frederick County, VA
Page County, VA
Rockbridge County, VA
Rockingham County, VA
Shenandoah County, VA
Warren County, VA
SOUTHERN VIRGINIA (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Danville, VA Brunswick County, VA
Emporia, VA Charlotte County, VA
Martinsville, VA Greensville County, VA
South Boston, VA Henry County, VA
South Hill, VA Halifax County, VA
Clarksville, VA Lunenburg County, VA
Mecklenburg County, VA
Pittsylvania County, VA
VIRGINIA MOUNTAINS REGION (VIRGINA) to include:
CITIES & TOWNS COUNTIES
Bedford, VA Alleghany County, VA
Buchanan, VA Bath County, VA
Clifton Forge, VA Bedford County, VA
Covington, VA Botetourt County, VA
Fincastle, VA Craig County, VA
Hot Springs, VA Franklin County, VA
New Castle, VA Highland County, VA
Roanoke, VA Roanoke County, VA
Rocky Mount, VA
Salem, VA
Troutville, VA
Vinton, VA
Warm Springs, VA
SCHOOL DISTRICTS (VIRGINA) to include:
Accomack County Public Schools, VA Lunenburg County Public Schools, VA
Albemarle County Public Schools, VA Lynchburg City Public Schools, VA
Alexandria City Public Schools, VA Madison County Public Schools, VA
Alleghany County Public Schools, VA Manassas City Public Schools, VA
Amelia County Public Schools, VA Manassas Park City Public Schools, VA
Amherst County Public Schools, VA Martinsville City Public Schools, VA
Appomattox County Public Schools, VA Mathews County Public Schools, VA
Arlington Public Schools, VA Mecklenburg County Public Schools, VA
Augusta County Public Schools, VA Middlesex County Public Schools, VA
Bath County Public Schools, VA Montgomery County Public Schools, VA
Bedford City Public Schools, VA Nelson County Public Schools, VA
Bedford County Public Schools, VA New Kent County Public Schools, VA
Bland County Public Schools, VA Newport News Public Schools, VA
Botetourt County Public Schools, VA Norfolk Public Schools, VA
Bristol Public Schools, VA Northampton County Public Schools, VA
Brunswick County Public Schools, VA Northumberland County Public Schools, VA
Buchanan County Public Schools, VA Norton City Schools, VA
Buckingham County Public Schools, VA Nottoway County Public Schools, VA
Buena Vista City Public Schools, VA Orange County Public Schools, VA
Campbell County Public Schools, VA Page County Public Schools, VA
Caroline County Public Schools, VA Patrick County Public Schools, VA
Carroll County Public Schools, VA Petersburg City Public Schools, VA
Charles City County Public Schools, VA Pittsylvania County Public Schools, VA
Charlotte County Public Schools, VA Poquoson City Public Schools, VA
Charlottesville City Schools, VA Portsmouth Public Schools, VA
Chesapeake Public Schools, VA Powhatan County Public Schools, VA
Chesterfield County Public Schools, VA Prince Edward County Public Schools, VA
Clarke County Public Schools, VA Prince George County Public Schools, VA
Colonial Beach Public Schools, VA Prince William County Public Schools, VA
Colonial Heights Public Schools, VA Pulaski County Public Schools, VA
Covington City Public Schools, VA Radford City Schools, VA
Craig County Public Schools, VA Rappahannock County Public Schools, VA
Culpeper County Public Schools, VA Richmond County Public Schools, VA
Cumberland County Public Schools, VA Richmond Public Schools, VA
Danville Public Schools, VA Roanoke City Public Schools, VA
Dickenson County Public Schools, VA Roanoke County Public Schools, VA
Dinwiddie County Public Schools, VA Rockbridge County Public Schools, VA
Essex County Public Schools, VA Rockingham County Public Schools, VA
Fairfax County Public Schools, VA Russell County Public Schools, VA
Falls Church City Public Schools, VA Salem City Schools, VA
Fauquier County Public Schools, VA Scott County Public Schools, VA
Floyd County Public Schools, VA Shenandoah County Public Schools, VA
Fluvanna County Public Schools, VA Smyth County Public Schools, VA
Franklin City Public Schools, VA Southampton County Public Schools, VA
Franklin County Public Schools, VA Spotsylvania County Public Schools, VA
Frederick County Public Schools, VA Stafford County Public Schools, VA
Fredericksburg City Schools, VA Staunton City Public Schools, VA
Galax City Public Schools, VA Suffolk Public Schools, VA
Giles County Public Schools, VA Surry County Public Schools, VA
Gloucester County Public Schools, VA Sussex County Public Schools, VA
Goochland County Public Schools, VA Tazewell County Public Schools, VA
Grayson County Public Schools, VA Virginia Beach City Public Schools, VA
Greene County Public Schools, VA Warren County Public Schools, VA
Greensville County Public Schools, VA Winchester Public Schools, VA
Halifax County Public Schools, VA Wise County Public Schools, VA
Hampton City Schools, VA Wythe County Public Schools, VA
Hanover County Public Schools, VA York County School Division, VA
Harrisonburg City Public Schools, VA
Henrico County Public Schools, VA
Henry County Public Schools, VA
Highland County Public Schools, VA
Hopewell City Public Schools, VA
Isle of Wight County Public Schools, VA
King and Queen County Public Schools, VA
King George County Public Schools, VA
King William County Public Schools, VA
Lancaster County Public Schools, VA
Lee County Public Schools, VA
Lexington City Schools, VA
Loudoun County Public Schools, VA
Louisa County Public Schools, VA
Washington County Public Schools, VA
Waynesboro Public Schools, VA
Westmoreland County Public Schools, VA
West Point Public Schools, VA
Williamsburg-James City County Public Schools, VA
Attachment E – No Bid Form
Contractors who do no wish to bid do not need to return the entire bid package. Simply
return this form to Racine County through Duane McKinney, Purchasing Manager at:
Duane.McKinney@racinecounty.com
STATEMENT OF NO BID
SEALED BID NUMBER X
HVAC Products, Installation, Labor Based Solutions, and Related
Products and Services
I do not wish to submit a bid on this solicitation.
_______________________________ _______________________________
Contractor Representative
Please indicate the reason(s) for your decision not to bid: