HomeMy WebLinkAboutContract 57504 CSC No. 57504
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement("Agreement")is entered into by and between Quadient Inc.
("Vendor") and the City of Fort Worth, ("City"), a Texas home rule municipality.
The Cooperative Purchase Agreement includes the following documents which shall be construed in the
order of precedence in which they are listed:
1. This Cooperative Purchase Agreement;
2. Exhibit A— Seller's Quote, Scope of Services or Purchase Order;
3. Exhibit B—Cooperative Agency Contract Sourcewell 041917-NPI; and
4. Exhibit C—Conflict of Interest Questionnaire
Exhibits A, B, and C,which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. Vendor agrees to provide City with the services and goods included in
Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all
exhibits thereto.
City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with
the provisions of this Agreement. Total payment made under this Agreement by City shall not exceed
Three Thousand Dollars ($3,000.00). Vendor shall not provide any additional items or services or bill
for expenses incurred for City not specified by this Agreement unless City requests and approves in
writing the additional costs for such services. City shall not be liable for any additional expenses of
Vendor not specified by this Agreement unless City first approves such expenses in writing.
The term of this Agreement is effective beginning on the date signed by the Assistant City
Manager below ("Effective Date") and expires on May 17, 2022.
Vendor agrees that City shall,until the expiration of three(3)years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books,documents,papers and records,
including, but not limited to, all electronic records, of Vendor involving transactions relating to this
Agreement at no additional cost to City. Vendor agrees that City shall have access during normal
working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work
space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor
reasonable advance notice of intended audits.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined
to have been delivered when (1) hand-delivered to the other party, its agents, employees, servants or
representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3)
received by the other party by United States Mail, registered, return receipt requested, addressed as
follows:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
To CITY: To VENDOR:
City of Fort Worth Quadient,Inc
Attn: Valerie Washington,Assistant City Manager John Tartaro,Deputy, CFO
200 Texas Street
Fort Worth,TX 76102-6314 Address:
Facsimile: (817) 392-8654 478 Wheelers Farms Road
Milford,CT 06461
With copy to Fort Worth City Attorney's Office at
same address Facsimile: 1-203-301-2600
The undersigned represents and warrants that he or she has the power and authority to execute this
Agreement and bind the respective Vendor.
CITY OF FORT WORTH:
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
By: Valerie Wash in gton(May 2,202212:17 CDT) responsible for the monitoring and administration
Name: Valerie Washington of this contract,including ensuring all performance
Title: Assistant City Manager and reporting requirements.
Date:
APPROVAL RECOMMENDED: By: Shelley Ho Ha rs(Apr 29,202211:40CDT)
Name: Shelley Hollars
Title: Administrative Services Manager
By: Wi Ilia mRi nuly a ,202209:20CDT) APPROVED AS TO FORM AND LEGALITY:
Name: William Rumuly
Title: Municipal Court Director
ATTEST: BY
Name: Taylor Paris
Title: Assistant City Attorney
By: J �Goo7m7y4-,-57
� any CONTRACT AUTHORIZATION:
ap FORtaad M&C: N/A
Name: Jannette Goodall 1�F°°°°°°°°°°o d
Title: City Secretary pro °o�.,do
ova o=o
o °° d
VENDOR: dad a�nF.o..o
Quadient,Inc� /
By:
Name: John Tartaro
Title: Deputy, CFO
OFFICIAL RECORD
Date: CITY SECRETARY
FT. WORTH, TX
N
O
U _
04
N
L L C
N Z N
T
T O
Q � �
++ d O U
_ T W
N
X L
W � r d
� T
N N
C O o 0
0 N a)
T � O
a) (1)
W m 7 9 a) al
O N
OQ a o in a
}' o
V/ 0 m U Y T
Cl) ru D
W 7 u
V O
a)
Uru E (Y
L Dw �
(Y ar a
0
a �� o
� = N w a
a U a) c
�"► U) � U a °
>
a o
a) u a
0) �
ar w
n u
r—n, O
w � a) a)
� a a
0) 7 O al 7 O Z• N
al O U a/ a 0 O > O
ate+ ut 0 0 V) 0 0 0 .--i
U 0 .-i t0 N 3 N E , O N 0
Ln
U N t,0 i0 0 a/ 1 0 C
'J� H w i 0 M N mm m i O 10 M O
a) N v (D 0 O J N a) o o x m
U � rn ma) a) U0N a rn c
ut i a3 z O 0 J i a3 z CO0 d
X — •• X
H a (Y LL LL a d LL 't � a ii u
��� ����m��������
..
5 5 5 5 5 5 5 5
ixa/s/�/laxosriessomem inrt,-
5 5 m 5 5 5 5 5
Smv/mF Forum na 5 5 5 5 5 5 5 5 5
5
5 5 5 5 5 5 5 5 5
aw/a3o/aao/q Iw//am�irvs a��/�m/�sa,i 5 5 5 5 5 5 5 5
'HERE M
IT
ii w/oeamncune um�xxap��m e 5 5 5 5 5 5 5
5 5 5 5 5 5 5
5 5 m 5 5 5 5 5 5 5 5
usrs/ouueierrcmeomearomneV�i%°erva¢msm perpea:.ism �5 5 5 5 5 5 5 5 5
5 5 m 5 5 5 5 5 5 5 5
SP 20 NeoStats SP27 Neostats 3G/4G Cell
Meter Rate Identifier Commercial Price Sourcewell Discount Meter Rental Enhanced Consolidate SP30 E-Services Service SP3S(eRR) NeoShip PLUS NeoShip ADV
IJ15K $ 113.00 38% $ 70.00 $ $ $ $ $ $ $
IN360 $ 48.00 38% $ 30.00 $ 5.00 $ 10.00 $ 10.00 $ 10.00 $ 15.00 $ 3.00 $ 15.00
IS280 $ 30.00 33% $ 20.00 Included Included $ 10.00 N/A $ 15.00 $ 3.00 $ 15.00
IS330 $ 38.00 34% $ 25.00 $ 5.00 $ 10.00 $ 10.00 N/A $ 15.00 $ 3.00 $ 15.00
IS350 $ 48.00 48% $ 25.00 $ 5.00 $ 10.00 $ 10.00 N/A $ 15.00 $ 3.00 $ 15.00
IS420 $ 48.00 38% $ 30.00 $ 15.00 $ 15.00 $ 10.00 N/A $ 35.00 $ 3.00 $ 15.00
IS440 $ 66.00 47% $ 35.00 $ 15.00 $ 15.00 $ 10.00 N/A $ 35.00 $ 3.00 $ 15.00
IS460 $ 84.00 35% $ 55.00 $ 15.00 $ 15.00 $ 10.00 N/A $ 40.00 $ 3.00 $ 15.00
IS480 $ 93.00 41% $ 55.00 $ 20.00 $ 20.00 $ 15.00 N/A $ 40.00 $ 3.00 $ 15.00
IS490 $ 93.00 41% $ 55.00 $ 20.00 $ 20.00 $ 15.00 N/A $ 40.00 $ 3.00 $ 15.00
IS5000 $ 118.00 32% $ 80.00 $ 15.00 $ 30.00 $ 15.00 N/A $ 25.00 $ 3.00 $ 15.00
IS6000 $ 118.00 32% $ 80.00 $ 15.00 $ 30.00 $ 15.00 N/A $ 25.00 $ 3.00 $ 15.00
IX-3 $ 48.00 38% $ 30.00 $ 10.00 $ 10.00 N/A N/A $ 25.00 $ 3.00 $ 15.00
iX-5HF $ 68.00 34% $ 45.00 $ 15.00 $ 15.00 $ 10.00 $ 10.00 $ 35.00 $ 3.00 $ 15.00
iX-5AF $ 76.00 28% $ 55.00 $ 15.00 $ 15.00 $ 10.00 $ 10.00 $ 35.00 $ 3.00 $ 15.00
iX-7 $ 94.00 20% $ 75.00 $ 15.00 $ 15.00 $ 10.00 $ 10.00 $ 40.00 $ 3.00 $ 15.00
iX-7PRO $ 103.00 27% $ 75.00 $ 20.00 $ 20.00 $ 15.00 $ 10.00 $ 40.00 $ 3.00 $ 15.00
IX9 $ 118.00 32% $ 80.00 $ 30.00 $ 30.00 N/A N/A $ 40.00 $ 3.00 $ 5.00
DocuSign Envelope ID: DE19E12D-2293-44F0-ADDE-EC8818D7926D
Exhibit B
Letter of Agreement
To Extend the Contract
Between
Quadient, Inc.
478 Wheelers Farms Road
Milford, CT 06461
And
Sourcewell
202 12th Street NE
Staples, MN 56479
Phone: (218) 894-1930
The Vendor and Sourcewell have entered into an Agreement(Contract#041917-NPI) for the
procurement of Mailing and Postage Equipment with Related Software, Accessories, Services
and Supplies.This Agreement has an expiration date of May 17, 2021, but the parties may
extend the Agreement for one additional year by mutual consent.
The parties acknowledge that extending the Agreement for another year benefits the Vendor,
Sourcewell and Sourcewell's members.The Vendor and Sourcewell therefore agree to extend
the Agreement listed above for a fifth year.This existing Agreement will terminate on May 17,
2022. All other terms and conditions of the Agreement remain in force.
SOUrrawall
D�o/cyu�Siigned by,
I.'.1�
By' �COFD2A139DD6489... , Its: Director of Operations&
Procurement/CPO
Name printed or typed: Jeremy Schwartz
11/6/2020 1 10:09 AM CST
Date
Qua&anr Inr
DocuSigned by:
�`-'i"" Vice President, Marketing
By:— 7D5BE3D66ACC45E... , Its:
Kevin O'Connor
Name printed or typed:
11/6/2020 1 8:11 AM PST
Date
Form C
EXCEPTIONS TO PROPOSAL,TERMS, CONDITIONS, ,,,w=*:��
AND SOLUTIONS RE QUEST C���f'JPA�I
��+�;
Company Name; Neopost USA [nc. —_
Any exceptions to the terns,conditions, specifications,or proposal forms contained in this RFP must be voted in
writing and included with the Proposer's response. The Proposer acl<.nowledges that the exceptions listed may or nay
not be accepted by NJPA or included in the final contract. NJPA will make reasonable efforts to accommodate the
listed exceptions and may clarify the exceptions in the appropriate section below.
Term,Condition,or NJPA 3
Section/page Specification Exception ACCEPT'S
"XCU Coverage" is not applicable to our
industry and we do not have such coverage.
This insurance covers property damage which
Policy shall uuelude bodily occurs as a result of explosion or blasting, Accepted.
injury, property damage and which of course, would not occur in relation to
broad form contractual liability the products or services we offer.
6,23.1.1 and XCU coverage
Subcontractors: Vendors'
certificate(s) must include all
subcontractors as additional
insureds under its policies, or Neopost dealer agreements require, among
the Vendor must furnish to other things, that dealers maintain a minimnn
NJPA separate certificates for of $1,000,000 of coverage. Some authorized Acknowledged.
each subcontractor. All dealers have additional umbrella policies for
coverage for subcontractors are additional coverage.
be subject to the mmlmunl
6.26 re uirements identified above. _
We wou]d ask that software terms and
conditions be addressed on a case-by-case
basis between the ordering entity and Neopost
as, depending on the software solution, a
Software license agreement, statement of See below.
work, etc may need to be agree(] upon.
Software licenses and any related documents
Software will be provided to the NJPA member at the
General appropriate time.
Proposer's Signature: � Date:Aj I I� a'o I PI
l
NJPA's clarification on exceptions listed above:
Section 7.3 allows NJPA and NJPA Members and awarded vendors to add additional terms and
conditions on the purchase order level if such additional terms and conditions do not interfere with
the general purpose, intent, or currently established terms and conditions contain in this RFP
document.
Date
Contract Award
RFP 100419111
FORM D � =w= �
Formal Offering of Proposal
(To be completed only by the Proposer)
MAILING AND POSTAGE EQUIPMENT WITH RELATED SOFTWARE,ACCESSORIES,SERVICES,AND
SUPPLIES
In compliance with the Request for Proposal (RFP) for MAILING AND POSTAGE EQUIPMENT WITH RELATED
SOFTWARE, ACCESSORIES, SERVICES,AND SUPPLIES, the undersigned warrants that the Proposer has examined
this RFP and,being familiar with all of the instructions,terms and conditions,general and technical specifications,sales and
service expectations, and any special terms, agrees to furnish the defined products and related services in fill compliance
with all terms and conditions of this RFP, any applicable amendments of this RFP, and all Proposer's response
documentation. The Proposer further understands that it accepts the full responsibility as the sole source of solutions
proposed in this RFP response and that the Proposer accepts responsibility for any subcontractors used to fulfill this
proposal.
1
Company Name: Neopost USA Inc. Date: 4/3/2017
Company Address: 478 Wheelers Farms Rd.
City: Milford State: CT Zip: 06461
Contact Person: Kevin O'Connor Title: VP US Marketing
Authorized Signature:
(Name printed or typed)
i
37
FORM E Cs
CONTRACT ACCEPTANCE AND AWARD
Nallomal Una Powers Mince-
(Top portion of this form w111 be completed by NJPA if the vendor is awarded a contract.The vendor should
complete the vendor authorized signatures as part of the RFP response.)
NJPA Contract #:041917-NPI
Proposer's full legal name: Neopost USA Inc.
Based on NJPA's evaluation of your proposal,you have been awarded a contract. As an awarded vendor,you
agree to provide the products and services contained in your proposal and to meet all of the terms and
conditions set forth in this RFP,in any amendments to this RFP,and in any exceptions that are accepted by NJPA.
The effective date of the Contract will be May 17, 2017 and will expire on May 17,2021 (no later than the later of
four years from the expiration date of the currently awarded contract or fouryears from the date that the NJPA
Chief Procurement Officer awards the Contract). This Contract may be extended for a fifth year at NJPA's
discretion,
NJPA Authorized Signatures:
Jeremy Schwartz
NJPA 6riLro OF COO CTS (NAME PRINTED OR TYPED)
AND PROCURE SIGNATUR
Chad Coauette
NJPA EXECUTIVE DIRECTOR/CEO SIGNATURE (NAME PRINTED OR TYPED)
Awarded on May 17,2017 NJPA Contract # 041917-NPI
Vendor Authorized Signatures:
The Vendor hereby accepts this Contract award,including all accepted exceptions and amendments.
Vendor Name Neopost USA Inc.
Authorized Sig atory's rifle VP Marketing
Kevin O'Connor
VENDOR AUTHORIZED SIGNATURE (NAME PRINTED OR TYPED)
Executed on May 17,2017 NJPA Contract# 041917-NPI
Form F
PROPOSER ASSURANCE OF COMPLIANCEJpA
Proposal Affidavit Signature Page
PROPOSER'S AFFIDAVIT
The undersigned, authorized representative of the entity submitting the foregoing proposal (the"Proposer"),swears that
the following statements are true to the best of his or her knowledge.
1. The Proposer is submitting its proposal under its true and correct name,the Proposer has been properly originated
and legally exists in good standing in its state of residence, the Proposer possesses, or will possess before
delivering any products and related services,all applicable licenses necessary for such delivery to NJPA members
agencies.The undersigned affirms that he or she is authorized to act on behalf of,and to legally bind the Proposer
to the terms in this Contract.
2. The Proposer,or any person representing the Proposer,has not directly or indirectly entered into any agreement
or arrangement with any other vendor or supplier, any official or employee of NJPA, or any person, firm, or
corporation under contract with NJPA, in an effort to influence the pricing,tennis, or conditions relating to this
RFP in any way that adversely affects the free and open competition for a Contract award tinder this RFP.
3. The Proposer has examined and understands the terms, conditions, scope, contract opportunity, specifications
request, and other documents in this solicitation and affirms that any and all exceptions have been noted in
writing and have been included with the Proposer's RFP response.
4. The Proposer will, if awarded a Contract, provide to NJPA Members the/products and services in accordance
with the terms, conditions, and scope of this RFP, with the Proposer-offered specifications, and with the other
documents in this solicitation.
5. The Proposer agrees to deliver products and services through valid contracts,purchase orders, or means that air,
acceptable to NJPA Members.Unless otherwise agreed to,the Proposer must provide only new and first-quality
products and related services to NJPA Members under an awarded Contract.
6. The Proposer will comply with all applicable provisions of federal, state,and local laws, regulations,rules, and
orders.
7. The Proposer understands that NJPA will reject RFP proposals that are marked"confidential" (or"nonpublic,"
etc.), either substantially or in their entirety. Under Minnesota Statute §13.591, Subd. 4, all proposals are
considered nonpublic data until the evaluation is complete and a Contract is awarded. At that point, proposals
generally become public data. Minnesota Statute §13.37 permits only certain narrowly defined data to be
considered a"trade secret,"and thus nonpublic data under Minnesota's Data Practices Act.
S. The Proposer understands that it is the Proposer's duty to protect information that it considers nonpublic,
and it agrees to defend and indemnify NJPA for reasonable measures that NJPA takes to uphold such a
data designation.
[The rest of this page has been left intentionally blank. Signature page below]
39
By signing below, Proposer is acknowledging that lie or slip, has read, understands, and agrees to comply with the terms
and conditions specified above.
Company Nance: Neopost USA Inc.
Address: 478 Wheelers F rnis a Rd.
City/State/Zip: Milford CT 06461
Telephone Number: 203-301-3400
E-mail Address; overnment neo ost.corn
Authorized Signawre:—
Authorized Name(printed): Kevin O'Connor
Title: VP US Marketing
Date: 4/3/2017
Notar•rzed
i
Subscribed and sworn to before ine this 3rd day of April ,2017
Notary Public in and for the County of New Haven State of Connecticut
My commission expires:
Signature: �s� ��— NDTARYPUBLIC
40
Form PYJPA
PROPOSER QUESTIONNAIRE
Payment Terms,Warranty,Products and Services,Pricing and Delivery,and Industry-Specific Questions
Proposer Name: Neopost USA Inc.
Questionnaire completed by: David Nagel,Deborah Nesdale
Payment Terms and Financing Options
1) What are your payment terms(e.g.,net 10,net 30)?
Neopost Response:Neopost payment terms are net 30 days.
2) Do you provide leasing or financing options, especially those options that schools and governmental entities may
need to use in order to make certain acquisitions?.
Neopost Response: Yes,as mentioned on Form A,Neopost offers various leasing and financing options thru
MailFinance Inc., an affiliate of Neopost USA Inc. NJPA members can submit a signed purchase order
referencing the NJPA contract number and their NJPA member number in lieu of signing lease documents.
This streamlines the ordering process and makes it easier for NJPA members.
MailFinance is able to provide both a Fair Market Value (FMV) and Lease to Own Purchase (LTOP) lease
programs with the ability to combine hardware,software,software support,maintenance services and meter
rental into one simple payment.
As a leasing company 100% dedicated to the mailing,shipping and document handling industry,we offer the
flexibility to take advantage of the most advanced equipment and systems available. Additionally,we ensure
you have the ability to stay in complete compliance with USPS regulations.
For complete information on the Neopost Leasing program refer to item 21 below.
3) Briefly describe your proposed order process.Please include enough detail to support your ability to report quarterly
sales to NJPA. For example, indicate whether your dealer network is included in your response and whether each
dealer(or some other entity)will process the NJPA Members' purchase orders.
Neopost Response: Signed purchase orders can be sent directly to the Neopost local office or authorized
Neopost dealer who, in turn, completes the necessary paperwork and submits all orders to Neopost for
processing. All orders go thru a quality assurance process to make sure that the NJPA contract number is
provided,that the pricing is correct and that the purchase order is from an NJPA member entity.
Being that all purchase orders and billing for NJPA transactions are centralized and processed by Neopost
(and/or MailFinance Inc.) this will ensure that all transactions are recorded and available for NJPA
quarterly reporting.
For a more detailed explanation of the order entry process,please see below:
• Order paperwork is prepared by district and dealer field admin
• Order sent by field admin to efax(a)neopost.com
• Order shell is set up by the Customer Information Management team using the NJPA price list in Oracle
ERP
• The order is released to the credit department for review
o When the credit check passes,the order is released to the Order Entry department
• Order Entry
o Ensures the papetivork contains the NJPA member number, NJPA contract number and NJPA
pricing
• The order is released from our warehouse in Memphis and the equipment ships directly to the customer
or to the Neopost channel partner
4) Do you accept the P-card procurement and payment process? If so, is there any additional cost to NJPA Members
for using this process?
Neopost Response: Neopost accepts P-card procurement for payment without additional costs to NJPA
Members. However, please note, P-cards are not accepted for postage payments. For recurring peard
payments the customer rills out a form and is setup in our system. When the invoice drops the payment
is pulled from the card.
For a one-off payment (monthly, quarterly), the client contacts our customer service department. They
will assist them with making the payment over the phone.If they are not able to assist at the first point of
contact,a case and form is submitted to our Cash Apps department for processing.
Warranty
S) Describe in detail your manufacturer warranty program, including conditions and requirements to qualify, claims
procedure, and overall structure. You may include in your response a copy of your warranties, but at a minimum
please also answer the following questions.
Neopost Response: The Neopost warranty program is offered from the date of installation of the equipment
for a period of 90 days. This warranty covers all defective parts and all labor associated with the required
warranty repair. Additionally any parts fitted outside the warranty period on equipment covered by a
maintenance contract are also covered for a period of 90 days after replacement. Warranty claims are not
required by end users as our fully automated systems ensure correct allocation of costs when any item is
replaced or fails during this period. No charges would be raised automatically if the work is carried out
within the defined warranty period.
• Do your warranties cover all products,parts,and labor?
Neopost Response: As previously stated, the Neopost warranty program is offered from the date of
installation of the equipment for a period of 90 days. This warranty covers all defective parts and all
labor associated with the required warranty repair. Additionally,any parts fitted outside the warranty
period on equipment covered by a maintenance contract are also covered for a period of 90 days after
replacement. We unconditionally guarantee that our equipment will perform to specification. If for any
reason a product does not perform at published specification levels and we cannot repair it, we will
replace it with a comparable product.
• Do your warranties impose usage restrictions or other limitations that adversely affect coverage?
Neopost Response: Neopost products covered under warranty will be repaired or replaced if found not
working in accordance with their manufacturer specifications. Therefore, usage outside of
manufacturers specifications will not be covered. Consumable supplies and wearable parts are not
included.
• Do your warranties cover the expense of technicians'travel time and mileage to perform warranty repairs?
Neopost Response: Yes
• Are there any geographic regions of the United States for which you cannot provide a certified technician to
perform warranty repairs? How will NJPA Members in these regions be provided service for warranty repair?
Neopost Response: There are over two hundred Neopost offices that will provide warranty
repairs throughout the country. Neopost account representatives in local communities are easily
accessible by phone, email or in person. Our decentralized, closer-to-the-customer business
philosophy empowers local management to make quick decisions when responding to customer
concerns. Certain warrantied products are serviced via the Neopost Depot repair program referenced
in number 19,Form A.
• Will you cover warranty service for items made by other manufacturers that are part of your proposal, or are
these warranties issues typically passed on to the original equipment manufacturer?
Neopost Response: We do both,this depends on the product and the manufacturer.
• What are your proposed exchange and return programs and policies?
Neopost Response: Neopost products that are covered under warranty are repaired or replaced if found
not working in accordance with the manufacturers specifications. The replacement unit is provided at no
charge to the customer.
6) Describe any service contract options for the items included in your proposal.
Neopost Response: Neopost and its partners offer maintenance service and software support for the
equipment and solutions we market,which is second to none in the industry. Neopost agreements provide
the parts and labor associated with ordinary maintenance of the products due to normal wear and tear.
For more detailed information on Neopost service/maintenance programs please reference Form A,item 19.
Prior to dispatching a Neopost authorized technician, the local office contacts the customer and trouble
shoots the issue via the phone. In most cases the issue can be resolved, and if not, the local office will then
dispatch a technician.
• Standard Onsite Maintenance: S hour onsite response time by a Neopost authorized technician
o Zone maintenance pricing based on distance from Authorized Neopost Service Location
• Premier Maintenance: This plan provides a more comprehensive service offering,with a four hour onsite
response time by a Neopost authorized technician. Premier maintenance is provided in some
geographical areas as an option
• Remote Support: Provided during normal working hours and provides software technical support
• Depot Repair: specific products
• Preventative Care: Preventative care is provided with all Neopost maintenance programs
• Software Care: provides software support and software updates
Pricing,Delivery,Audits,and Administrative Fee
7) Provide a general narrative description of the equipment/products and related services you are offering in your
proposal.
Neopost Response: Neopost is providing to the NJPA members all of the Neopost brand products and
solutions. Neopost delivers mailing equipment and software, business communications management
solutions,shipping and tracking hardware and software solutions, postal lockers,and various other products
and solutions that complement the mailing industry, as well as a full range of consultancy, maintenance,
software support and financing services. We help our customers send, receive and connect in the most
efficient manner possible via physical mail, digital communications and parcels. Our equipment systems are
supported by a combination of Neopost direct sales and a network of authorized Neopost independent
dealers providing sales,supplies and service to their customers in all 50 states.
i
8) Describe your pricing model (e.g., line-item discounts or product-category discounts).Provide detailed pricing data
(including standard or list pricing and the NJPA discounted price) on all of the items that you want NJPA to
consider as part of your RFP response. Provide a SKU for each item in your proposal. (Keep in mind that
reasonable price and product adjustments can be made during the term of an awarded Contract. See the body of the
RFP and the Price and Product Change Request Form for more detail.)
Neopost Response: Neopost has submitted pricing based on a "Percentage Discount from Commercial
Suggested List" concept. This percentage discount from list is applied to the various product categories as
defined in number nine below. This discount percentage will apply to all items within that specific category.
Subscription services which do not have suggested list prices are also provided in the catalog. When Neopost
launches new products, the new products will he priced based an the specific discount from list for that
particular product category awarded to Neopost.
Attached is the Neopost price list for all Neopost products. There are two tabs, one tab labeled `NJPA Price
Boole' including hardware and software. There is a second tab labeled `meter rates'. This is the United
States Postal Service meter rental rates and services. Neopost reserves the right to substitute Hasler branded
products in specific markets. Hasler branded products are exactly the same as Neopost branded products,
the only difference being the name on the unit.
The following information is included per line item on the spreadsheet tab `NJPA Price Book':
• Commercial Product Number: This is Neopost SKU number for ordering
• Manufacturer: Neopost brand
• Product Description: This provides a descihption of the product
• Equipment Category: This is the product category that the individual product is part of
• Commercial Price: Neopost Suggested Retail List Price
• NJPA Discount Level: NJPA percent discount from list price
• NJPA Contract Price: This is the NJPA member's pricing after the discount is applied
• NJPA Annual Maintenance: Maintenance items including onsite and remote support are annual
maintenance charges which can be billed upon request monthly or quarterly.
• NJPA Annual Software Updates: For products that require software care
• NJPA Annual Software Subscription: Subscription Services
• NJPA Annual Depot Repair: Depot repair program and services
Additionally, for NJPA members who choose to procure via a purchase, we have included the "Neopost
NJPA Product Purchase Agreement".
9) Please quantify the discount range presented in this response.For example, indicate that the pricing in your response
represents is a 50%percent discount from the MSRP or your published list.
Neopost Response: Please see the various product categories and their respective discount levels below.
Core product categories and applicable discount levels:
NJPA Discount Percentage from
Commercial Price(Suggested
Equipment Category Retail List
Professional Services o%
Shipping&Tracking{Parcel Lockers) 0%
Supplies 0%
Data Quality 5%
Output Mana ement 5%
Shipping&Tracking(ESS,Proship,WTS,WTS-P,
WTS Lite) 5%
Document Systems Furniture 6%
Document Systems Letter Openers and Folders) 10%
Addressing and Printing 20%
Document Systems Production, AIMS 22%
Document Systems Low,Mid,Hi h 30%
Shipping&Tracking ARM,EMS,G2) 30%
Nailing Systems and Accessories 35%
LISPS Mailing Meter Rentals and Services 23-55%
10)The pricing offered in this proposal is
a.the same as the Proposer typically offers to an individual municipality,university,or school
district.
-X-b. the same as the Proposer typically offers to GPOs, cooperative procurement
organizations,or state purchasing departments.
X c.better than the Proposer typically offers to GPOs,cooperative procurement organizations,
or state purchasing departments.
X d.other than what the Proposer typically offers(please describe).
Note: Neopost pricing being offered has been customized specifically for NJPA members.
Depending on the product category, the Neopost pricing can be the same as offered to other
cooperative procurement organizations and better than state purchasing departments that do not
have a contract thru a cooperative organization.
11)Describe any quantity or volume discounts or rebate programs that you offer.
Neopost Response: Neopost will offer additional discounts from the established NJPA contract pricing based
on the following:
1. Neopost Product Promotions: When Neopost has a promotional pricing program that is lower than the
published Neopost NJPA Pricing Agreement, Neopost will extend that promotion to ALL NJPA
members. Being that most of these types of promotions are very short term (one to three months), it
would he extremely difficult to re-publish the NJPA pricing catalog. Neopost will make this a pricing
policy that will be included in the NJPA Playbook that is available to all Neopost Authorized Dealers and
Direct Sales Operations.
2. Neopost Package Pricing: When Neopost offers package pricing (equipment and applicable accessories),
and the package pricing is lower than the established NJPA contract pricing based on individual items,
Neopost will make these package pricing items available to all NJPA members. Neopost will make this a
pricing policy that will be included in the NJPA Playbook that is available to all Neopost Authorized
Dealers and Direct Sales Operations.
3. Spot Pricing Reductions: Neopost will provide spot pricing reductions for NJPA members. This pricing
reduction will be based on; competition, specific NJPA member's volume, volume commitment, specific
needs,or special requirements that would justify a price discount.
The advantage to the NJPA members is that they CAN still use the NJPA contract number even if Neopost
provides them with a Product Promotion,Package Pricing or Spot Pricing Reduction.
12)Propose a method of facilitating"sourced"products or related services,which may be referred to as"open market"
items or"nonstandard options".For example,you may supply such items"at cost"or"at cost plus a percentage,"or
you may supply a quote for each such request.
Neopost Response. Neopost can provide sourced products as an open market item. All sourced products
must be identified on the purchase order as "Open Market" A quote of these items will be presented upon
request by Neopost Direct or Authorized Dealer to the NJPA member.
13)Identify any total cost of acquisition costs that are NOT included in the pricing submitted with your response. This
cost includes all additional charges that are not directly identified as freight or shipping charges. For example, list
costs for items like installation, set up, mandatory training, or initial inspection. Identify any parties that impose
such costs and their relationship to the Proposer.
Neopost Response: Neopost/MailFinance has a $100 document fee for leases only. This fee is included in the
lease payment and has been identified in item number 21.
14) If delivery or shipping is an additional cost to the NJPA Member, describe in detail the complete shipping and
delivery program.
Neopost Response: Shipping, delivery and installation are at no additional cost to a NJPA member. If the
NJPA member requests expedited shipping(i.e.next day air),Neopost will provide a quote at time of order.
15) Specifically describe those shipping and delivery programs for Alaska,Hawaii,Canada,or any offshore delivery.
Neopost Response: We ship via major carriers and freight companies. Shipping and delivery to Canadian
NJPA customers would be negotiated directly with Neopost Canada. Offshore delivery is available and
would he addressed on a case-by-case basis.
16)Describe any unique distribution and/or delivery methods or options offered in your proposal.
Neopost Response: Following are some of the delivery methods available.
• Special handling: next day shipment,air shipment
• Delivery of software via email or internet download
• Ability to deliver and distribute via Neopost website
17) Please specifically describe any self-audit process or program that you plan to employ to verify compliance with
your proposed Contract with NJPA. This process includes ensuring that NJPA Members obtain the proper pricing,
that the Vendor reports all sales under the Contract each quarter, and that the Vendor remits the proper
administrative fee to NJPA.
Neopost Response: Being that all purchase orders and billing for NJPA transactions are centralized and
processed by Neopost (and/or MailFinance Inc.), this will ensure that all transactions are recorded and
available for NJPA quarterly reporting. As it relates to ensuring that NJPA members obtain the proper
pricing,please refer to the Neopost response to number three above.
The self-audit process is as follows:
• Neopost Government Operations team receives a monthly sales file the first week of every new month.
• The Government Operations Reporting Specialist will review the monthly sales report and identify all
sales utilizing the NJPA price list.
• The Government Operations Reporting Specialist prepares the NJPA sales report and submits to
Neopost Accounts Payable Team for the three month period of reporting.
• The Government Operations Reporting Specialist submits the reporting to NJPA and the check is
physically mailed.
18) Identify a proposed administrative fee that you will pay to NJPA for facilitating, managing, and promoting the
NJPA Contract in the event that you are awarded a Contract. This fee is typically calculated as a percentage of
Vendor's sales under the Contract or as a per-unit fee; it is not a line-item addition to the Member's cost of goods.
(See RFP Section 6.29 and following for details.)
Neopost Response: Neopost will provide a 2% administrative fee for all Neopost products and solutions,for
purchase and lease. Administrative fee is not applicable for the following items: United States postal meter
rental, maintenance, software care and software support. This is the current policy on the existing
Neopost(NJPA contract,Neopost GSA federal contract and other Neopost cooperative contracts.
Industry-Specific Ouestions
19)Describe your integration capabilities, if any,with other mailroom-related technologies.
Neopost Response: While Neopost is best known for our physical mail expertise, we are a major player in
digital communications and shipping automation. In addition to offering an extensive range of mail center
equipment, our software solutions help businesses with initiatives such as maintaining high-quality customer
contact data,deploying electronic document delivery and applying cost-savings and enterprise-wide shipping
controls.
Neopost has a team of service anti software engineers that will work with your members on all connectivity
and configuration requirements to get the equipment and solution performing to customer requirements.
20)Demonstrate your ability to customize your solution(s)to unique customer needs.
Neopost Response: During the sales and marketing process, Neopost conducts a survey/assessment of the
prospect's current processes and system. Some of the items that are discovered during the
survey/assessment include:
• Current equipment
• Current processes
• Pain points,areas for improvement
• Layout of installation facility
• Future plans and processes that they would like to implement
Upon completion of the survey/assessment and in conjunction with the prospect,a Statement of Work(SOW)
and or an Application Package (AP) is developed and agreed upon that outlines all of the current and
proposed new processes and solutions that the prospect would like to incorporate into the new Neopost
solution. This SOW and/or AP is the roadmap that identifies all of the customization of the solution that will
be provided by Neopost engineers. Neopost has the manpower, operations, technology and processes to
ensure a smooth delivery,installation and on-going support process.
21)If applicable to your proposal,provide your lease/rental pricing schedule.
Neopost Response:
Rental: Rental pricing has been provided for United States Postal System (LISPS) mail meters. These items
can only be rented as per USPS regulations. For LISPS rental pricing please refer to the pricing provided on
the Neopost NJPA pricing catalog
Lease: Neopost can provide to NJPA members various types of leasing vehicles thru the Neopost leasing
group called "Mailfinance". Neopost has submitted two programs for NJPA Members:
• State and Local Government Entities: This program provides both a Fair Market Value (FMV) lease
and a Lease To Own Purchase (LTOP) lease which has all of the terms and conditions that most
government entities require. For example this leasing programs includes; termination for convenience
clause, non-appropriation clause, along with incorporating the funding of property tax for those entities
that are required to pay property tax.
• All Other NJPA Members (as listed below): This program provides a Fair Market Value (FMV) lease
without all of the terms and conditions that are provided to the government entities. This, in-turn,
enables Neopost to provide a lower lease factor for these types of leases.
Neopost does NOT require any lease documents to be signed, as long as the NJPA contract number is listed
on the enti 's PO to Neo ost/MailPinance. This provides a tremendous advantage to all NJPA members as,
in most cases, that entity will not be required to have their legal department review extensive lease
agreements. Besides the two programs listed below, Neopost is also able to provide any type of creative or
different leasing program to meet the customer needs and requirements.
Please refer to the attached lease terms and conditions entitled:
• "NJPA—State and Local Government Lease Terms"
• "NJPA—Non Profit and Private School and University Lease Terms"
Neopost Leasing information detail:
Segment State&Local Government Entities All Other Nik Members
Government Entity State Agencies,Cities, Private Schools and
Counties,Towns, Public Offices Universities, Private Non-
and Agencies Profit Hospitals,Non-Profit
Organizations(Tax exempt
organizations), and
Associations
Terms/Conditions N]PA--State and Local Government NJPA- Non Profit&Private
(refer to attached documents) Lease Terms School/Unlversity Lease Terms
Lease Contract Purchase Order Purchase Order
Lease Types Fair Market Value(FMV or LTOP) Fair Market Value(FMV)
Lease Terms 12,24,36,48, 60,63 mo 12,24,36,48, 60,63 mo
Lease Rates 12 months=0.0907 12 months =0.0888
24 months =0.0490 24 months=0.0471
36 months =0.0352 36 months = 0.0332
48 months =0.0283 48 months= 0.0263
60 months =0.0243 60 months=0.0222
63 months=0.0236 63 months=0.0215
Document Fee $100,00 $100.00
Property Taxes Included in rate as long as Exempt Billed and paid by customer
Certificate Is provided with order
22)If you provide product training services, is this included in the product purchase price? Is additional
training available for a fee?If so,describe how such training is priced.
Neopost Response: As referenced in Form A number 27, Neopost has various training programs to ensure
that the customer is knowledgeable on the Neopost product/solution. At time of installation, Neopost
provides training to all applicable individuals related to the operation and use of the product along with
ongoing training as needed. Training is provided at no charge for the period of time that the customer has
either a Neopost Lease, maintenance agreement or software care support program. Neopost also provides
additional training and support programs via the Neopost website at no charge,which include:
• FAQ's: Find answers about billing,postage,customer service and more
• Knowledge Base: Find answers to your technical questions, user guides, machine specifications and
more
• Training videos on both the Neopost website and on YouTube
In addition to our standard onsite training for new equipment installations, Neopost offers a unique set of
opportunities for NJPA member customers as it relates to new and advanced solutions training.The industry
is changing rapidly. Neopost continues to invest in the most comprehensive set of solutions keeping us in the
forefront of R&D. As such, those customers embracing change and becoming early adopters have the
exciting opportunity to take advantage of various "Power User & Complex Solution Implementers" training
within several of our advanced "Competency Centers". Depending on the solution type, these centers are
located in Milford,Ct,Atlanta.,GA,Indianapolis IN and Dallas TX.
Neopost also provides Advanced Technical training (Train the Trainer) program for various high-end
products and solutions. These training programs are available at the Neopost "Competency Centers" and
usually there is a cost associated with this type of advanced training programs.
Self Installation Program: Specific low end products are self installed by the customer. To support this type
of installation the Neopost Call Center team in Dallas works diligently to help customers with their inquiries
and assisting them to get their product operational. Many customers are surprised by how easy it is to do
without actually calling us.
• If the customer requires any assistance or encounters a problem during the self installation process,
we do have support information available 24n which is much more accessible and immediate.
— The operation instructions provided indicate how quick and easy the product is to install
without any help.
— Then there is our customer-oriented knowledge base,the web materials are very clear in how
to unpack install and set up. There is even a section on troubleshooting if issues are
encountered.
23)If you provide complete product installation, is this included in the equipment purchase price? if not
included, detail what installation is required, who does it(e.g.,the proposer or a subcontractor), and how
much it costs. If NJPA members must pay for installation, how are they charged (e.g., by the hour; flat
fee)?
Neopost Response:Neopost provides complete product and solution installation and in most cases is included
in the equipment or solution purebase/lease price. For specific high-end products and solutions there is an
installation charge that has been provided in the Neopost price catalog. This installation charge is a flat fee
or hourly charge indicated in the Neopost Price catalog where applicable. Refer to self-installation program
in Form A question 27 and above in question 22. All installations are provided by Neopost or authorized
dealers.
Neopost's installation management process includes site preparation, equipment delivery, installation,
training and follow-up.
Signature: Date: 4/14/17
- i
DocuSign Envelope ID: 12EF14AC-5C68-481D-9A14-2E2BD09FA561
AMENDMENT#1
TO
SOURCEWELL CONTRACT#041917-NPI
This Amendment is by and between Sourcewell (Sourcewell) and Neopost USA Inc. (Vendor).
Vendor was awarded a Sourcewell Contract for Mailing and Postage Equipment with Related
Software, Accessories, Services, and Supplies effective May 17, 2017, until May 17, 2021,
relating to the provision of services by Vendor and to Sourcewell and its Members.
The parties agree that certain terms within the Agreement shall be updated and amended and
only to the extent as hereunder provided.
In consideration of the mutual covenants and agreements described in this Amendment, the
parties agree as follows:
1. This Amendment is effective upon the date of the last signature below.
2. Effective June 6, 2018, NJPA changed its name to Sourcewell. All references in these
documents to NJPA should be read as being replaced with "Sourcewell".
3. Form A, Company Information & Financial Strength, Question 1 in the Vendor's
Response to the above-mentioned Request for Proposal, the following portion of the
response shall be amended as follows to reflect the change in the company's name:
1) Provide the full legal name, mailing and email addresses, tax identification
number, and telephone number for your business.
RESPONSE: Quadient, Inc.
478 Wheelers Farms Road
Milford, CT 06461
us.government@quadient.com
Tax ID: 94-2388882
203-301-3400
4. Any reference to "Neopost USA, Inc." in their Request for Proposal Response and in
Contract#041917-NPI, shall be stricken and replaced with "Quadient, Inc."
DocuSign Envelope ID: 12EF14AC-5C68-481D-9A14-2E2BD09FA561
5. The Agreement and any previous amendments are incorporated into this Amendment
by reference.
Except as amended by this Amendment, the Agreement remains in full force and effect.
Sourcewell Quadient, Inc.
EDocuSigned by: DocuSigned by::
3
Autho,.-- FD2A139D06489... AUthc.,_ 18E09967628D49A..
Jeremy Schwartz Kevin O'Connor
Name— Printed Name— Printed
Title: Director of Operations & Procurement/CPO Title: VP Marketing
Date:
2/20/2020 1 12:27 PM CST Date: 2/20/2020 1 7:47 AM CST
Sourcewell—APPROVED:
DocuSigned by:
B :
.. ✓pA1. �F817A64CCAutho,..--Chad Coauette
Name— Printed
Title: Executive Director/CEO
Date: 2/20/2020 1 1:08 PM CST
DocuSign Envelope ID:A3B655CB-1 D46-4EB5-8145-97875CA2B83B
AMENDMENT#2
TO
SOURCEWELL CONTRACT#041917-NPI
This Amendment is by and between Sourcewell and Quadient, Inc. (Vendor).
Vendor was awarded a Sourcewell Contract#041917-NPI for Mailing and Postage Equipment
with Related Software, Accessories, Services, and Supplies effective May 17, 2017, until May 17,
2021 (Original Contract), relating to the provision of services by Vendor and to Sourcewell and
its Members.
The parties agree that certain terms within the Original Contract will be updated and amended
and only to the extent as hereunder provided.
In consideration of the mutual covenants and agreements described in this Amendment, the
parties agree as follows:
1. This Amendment is effective upon the date of the last signature below.
2. In the Original Contract, all references to either "MailFinance Inc." should now be read
as "Quadient Leasing USA, Inc."
Remainder of page intentionally left blank.
DocuSign Envelope ID:A313655C13-1 D46-4EB5-8145-97875CA2B83B
3. In the Original Contract, all reference to "Mailroom Finance Inc." should now be read as
"Quadient Finance USA, Inc."
Except as amended by this Amendment, the Original Contract remains in full force and effect.
Sourcewell Quadient, Inc.
DocuSigned by: DocuSigned by:
�B yrvm� S"of/� By: "w tV(hwar
5
AUthc.,_COFD2 139D06480..... AUtho 705BE3D66ACC45E...
o. .�......
Jeremy Schwartz Kevin O'Connor
Name — Printed Name — Printed
Title: Director of Operations& Procurement/CPO Title: VP of Marketing
Date: 3/18/2020 1 6:48 AM CDT Date: 3/18/2020 1 4:47 AM PDT
Sourcewell—APPROVED:
DocuSigned aa ep"�by:
By.
l. D� IAL
Authc--_7E42BSF817A64CC...
Chad Coauette
Name— Printed
Title: Executive Director/CEO
Date: 3/18/2020 1 6:59 AM CDT
DocuSign Envelope ID: BF300572-70AC-4DE5-9FB5-28852058E7D1
AMENDMENT #3
TO
SOURCEWELL CONTRACT #041917-NPI
THIS AMENDMENT is by and between Sourcewell and Quadient, Inc./Neopost USA Inc.
(Vendor).
Vendor was awarded Sourcewell Contract#041917-NPI for Mailing and Postage Equipment
with Related Software, Accessories, Services, and Supplies effective May 17, 2017, until May 17,
2021 (Original Contract), relating to the provision of services by Vendor and to Sourcewell and
its Members.
Earlier this year Vendor's name changed from Neopost USA Inc., to Quadient, Inc., and due to
delays caused by the global pandemic of COVID-19, the United States Internal Revenue Service
has been delayed in processing this name change. As a result, certain Sourcewell members are
having difficulty placing orders under the new vendor name.
IN CONSIDERATION of the mutual covenants and agreements described in this Amendment, the
parties agree as follows:
1. This Amendment is effective upon the date of the last signature below.
2. On February 20, 2020, the parties executed an amendment to change the vendor's
name from Neopost USA Inc., to Quadient, Inc.
3. Due to delays caused by the global pandemic of COVID-19, the United States Internal
Revenue Service has been delayed in processing this name change.
Remainder of page intentionally left blank.
DocuSign Envelope ID: BF300572-70AC-4DE5-9FB5-28852058E7D1
4. In order to assist Sourcewell Members place orders with Vendor, Sourcewell recognizes
that sales under the Original Contract may be placed under either Neopost USA Inc., or
Quadient, Inc.
Except as amended by this Amendment, the Original Contract remains in full force and effect.
Sourcewell Quadient, Inc.
DocuSigned by--'.I DocuSigned by:
By: y �U �j B O'Goz
Autho.„`CMFD2A139D06489... Autho.._ 705BE3D66ACC45E...
Jeremy Schwartz Kevin O'Connor
Name — Printed Name— Printed
Title: Director of Operations & Procurement/CPO Title: VP of Marketing
Date:
8/31/2020 1 6:18 AM CDT Date: 8/29/2020 1 6:58 AM PDT
Sourcewell—APPROVED:
Doc u Saig need by:
By.
IAL
Autho 7E42BSF817A64CC...
Chad Coauette
Name— Printed
Title: Executive Director/CEO
Date: 8/31/2020 1 6:29 AM CDT
2
Exhibit C
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code.An
offense under this section is a misdemeanor.
jJ Name of vendor who has a business relationship with local governmental entity.
Quadient, Ilnc.
2
Check this box if you are filing an update to a previously filed questionnaire.(The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information is being disclosed.
N/A
Name of Officer
4J Describe each employment or other business relationship with the local government officer, or a family member of the
officer,as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form
CIO as necessary.
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
Yes [::] No
B. Is the vendor receiving or likely to receive taxable income,other than investment income,from or at the direction
of the local government officer or a family member of the officer AND the taxable income is not received from the
local governmental entity?
Yes No
5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
N/A
6
❑ Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
71 9ell-q-
4/28/2022
Signat re of vendor doing business with the governmental entity Date
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.Iegis.state.tx.us/
Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code§176.001(1-a):"Business relationship"means a connection between two or more parties
based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code§176.003(a)(2)(A)and(B):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts
that have an aggregate value of more than$100 in the 12-month period preceding the date the
officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code§ 176.006(a)and (a-1)
(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity,or a family member of the officer,described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer,one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B),excluding any
gift described by Section 176.003(a-1);or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application,response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity;or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer,described by Subsection(a);
(B) that the vendor has given one or more gifts described by Subsection (a);or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021