HomeMy WebLinkAboutContract 59376CSC No. 59376
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Rexel USA
("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 Buyboard 690-23; 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 for the first year by City
shall not exceed One Hundred Thousand Dollars ($100,000.00). 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 March 31, 2024. The City shall be able to renew this
agreement for two (2) one-year renewal options by written agreement of the parties, contingent on
renewal of Buyboard cooperative purchasing agreement.
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:
City of Fort Worth
Attn: William Johnson, Assistant City Manager
200 Texas Street
Fort Worth, TX 76102-6314
Facsimile: (817) 392-8654
With copy to Fort Worth City Attorney's Office at
same address
To VENDOR:
Rexel USA
John Hauuy, Branch Manager at
Rexel Fort Worth
Address:
719 S. Greenville Suite 100 Allen,
TX 75002
Facsimile: NIA
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:
By: William Johnson (MEt 11, 202312:13 CDT)
Name: William Johnson
Title: Assistant City Manager
Date:
APPROVAL RECOMMENDED:
By:
Name: Mike Crum
Title: Director
ATTEST:
Name: Jannette Goodall
Title: City Secretary
VENDOR:
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Rexel USA
By: GW
Na a John Haury
Titl ' Branch Manager at Rexel Fort Worth
Date: 5 4-1023
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all performance
and reporting requirements.
K� K�-
By:
Name: Kevin Kemp
Title: Asst Pub Facilities/Events Dir
APPROVED AS TO FORM AND LEGALITY:
By:
Name: Jessika Williams
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: N/A
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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Ln Ln O m w w O I, O m r, r, r-I N N I- w O Ill M M w I- m w w m m m m m m w w
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. . . . . . . . . . . . . . . . . . . . . . . . . .
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w w O I, m m m m m m w w w w 00 Ln O O O O O OI�t N M M M M M Ln I- M M M
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N N c-I r-I c-I r-I c-I r-I r-I c-I r-I c-I r-I c-I r-I r-I N N N
i/} in in to -Ln to -Ln to -Ln to i/} i/i i/} i/i i/} -L4 -Ln -L4 -Ln -L4 i/). in in to i/} i/} i/} i/)- i/} i/)- i/} to i/)• to
N N = N N N N N N N N N N N N \ N = N N N
m m � m m m m m m m m m m m m
M�t M M Ln Ln Ln M M Ln \ � M
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0 0>> 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0-1 0 0 0 0 0 0 > 0 0 0
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J J Q LL J J J J J J M M M M M O J J J J J J O_ LL _J J J
LL LL J LL LL LL LL LL LL = LL LL LL LL LL LL Q J - - -
Q Q} w Q Q Q Q Q Q ac o' OC o' OC Q Q Q Q Q Q J OC O' OC O' OC > w Q Q Q
w w Lu Z w w w w w w 0 0 0 0 0 0 w w w w w w Q 0 0 0 0 0 0 Z w w w
Or- = Y Q ar- = ar- = ar- = W W W W W W J W W W W W W Q
Q Q 0_ Q Q Q Q Q Q J J J J J J Q Q Q Q Q
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I- r, -zt �t m O m m O m -zt M M rr) -zt O Ln Tl- Ln Tl- Ln Ln 00 -1 -zt Tl- -zt Tl- -zt Tl- 00 w l0 w
N N Ln ri N M N N M N Lll Ln Lll Lll Lll Lll N N N N N N M N Lll Ln Lll Ln Lll 00 00 N N N
Ln Ln Ln N Ln Ln Ln Ln Ln Ln r-I r-I r-I r-I r-I r-I Ln Ln Ln Ln Ln Ln Tt Tl- r-I r-I r-I r-I r-I O r-I Ln Ln Ln
c-I r-I c-I r-I c-I ri r-I r-I r-I r-I r-I r-I -- r-I ri r-I ri ri -- r-I r-1 r-I c-I ri c-I r-I c-I r-I r-1 r-I r-1 r-I -- r-I
c-I c-I c-I c-I c-I c-I r-I r-I r-I r-I r-I r-I r-I r-I r-I r-I r-I ri -- ri r-I c-I c-I c-I c-I c-I c-I r-I -- r-I -- r-I -- r-I
0>_
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I� r, r� 00 I� 00 00 00 00 m ri I, lD w W Ln � r-1 r-I r-I r-I M w w O 00 00 00 00 00 N
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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m m m rr) ri N N N N I- r- �t 00 00 00 r- r- w LD w LD �t 00 00 Ln Ln Ln Ln Ln Ln O lD LD lD
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p p p H dl Ol dl Ol 00 Ln � Owl 0)0)OMl 00 > 0) OMl OmLn l m � p p r, m Oml Oml m 00) �
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Z Z Z O D N> D D m> m D D D N z z> O N
D =) =) O O O O O z cI z O 0 0 z 0 0 0 0 0 cI Z O O O O O O Y m
O O O m O 0 0 0 p O p O 0 0 p Ln O O O O o 0 0 p O 0 0 0 0 Y Z
\ O O O O N lD O Ln Ln Ln N O O O O O lD O O Ln ri ri ri ri r-1 \ 00 p N
N N N a O N N N N m O Ln r-I ri r-I m\ Ln Ln Ln Ln O m m Ln ri r-I ri r-I ri a
N \\ \ m Ln N N N O\ O N N N O co N cn n \ Ln c\\ O N N N N N N
a a a\ a a a a\ a\ a a a\ Tt a a a a a a a\ a a a a a�
N N N ���t lzt a N a a Z N N rq a OC H H H
D' OC Q' OC ri Y OC = OC ri Y 0' OC cc OC Y p p � OC cc OC 0' lD lD lD lD
pLr) o0 00 00 0o J o_ 0 J a 00 00 00 00 0_ � LL p p p p
LL LL LLH H H H H H H a H H H H H H H H H
a a a ri w �� w J�� a a a ��
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a a J J J J J J D_ N (n J J J D_ 3: J J J J (n a a U J J J J J J J J J
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lD w lD O I- Ln Ln Ln Ln O 00 ri Ln Ln Ln dl -zt w lD w lD 00 00 00 O Ln -zt �t -zt Ln O dl Ol dl
N N N It w Ln Ln Ln Ln W M Ql Ln Ln Ln Ln N Ln Ln Ln Ln M N N Ln M Ln Ln Ln M -:I- m m m
Ln Ln Ln ri ri ri ri ri ri ri i rri ri N ri ri i i rri Ln Ln qt ri rri i rri i 1.r
c-I r-I c-I r-I c-I ri c-I ri c-I ri ri ri ri ri ri ri ri ri ri ri ri r-I c-I ri c-I r-I c-I ri ri ri ri ri ri ri
c-I c-I c-I c-I c-I c-I c-I ri c-I ri ri ri ri ri ri ri ri ri ri ri ri c-I c-I c-I c-I c-I c-I ri ri ri ri ri ri ri
lD m m I- N N n M I- N N N n l0 O m n w r-I r-I r-I r-I M I- I- I, Ln M O Ol r-I I- I- u1
Ln Ol lD 00 I- r- r- � lD N N N Ln M M � � Ql ri ri ri ri � n r" n lD 00 Tt Ol I� N � r,
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Exhibit B
M u
U.yA
i 1 1 1
February 7, 2023
Sent Via Email: paul.bigalke@rexelusa.com
Paul Bigalke
Rexel, Inc.
2965 Commodore Dr.
Carrollton, TX 75007
Welcome to BuyBoard!
P.O. Box 400, Austin, Texas 78767
800.695.2919 • info@buyboard.com • buyboard.com
Re: Notice of The Local Government Purchasing Cooperative ContractAward; Proposal Invitation No. 690-
23, Energy Saving Lighting Products
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company
a BuyBoard@ contract based on the above -referenced Proposal Invitation. The contract is effective for an
initial one-year term of April 1, 2023 through March 31, 2024, and may be subject to two possible one-
year renewals. Please refer to the Proposal Invitation for the contract documents, including the General
Terms and Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 690-23 at:
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract
award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply
with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and
Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded
that, in accordance with the General Terms and Conditions, all purchase orders must be
processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's
administrator, you are not authorized to process a purchase order received directly from a Cooperative
member that has not been processed through the BuyBoard or provided to the Cooperative. If you receive
a purchase order directly from a Cooperative member that you have reason to believe has not been received
by the Cooperative or processed through the BuyBoard, you must promptly forward a copy of the purchase
order by email to info@buyboard.com.
A list of Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations
staff will be contacting you to assist with the resources available and to provide any support you may need
as an awarded BuyBoard vendor.
On behalf of the Cooperative, we appreciate your interest in the Cooperative and we are looking forward
to your participation in the program. If you have any questions, feel free contact me at 800-695-2919.
Sincerely,
Leigh Clover, Bid Analyst
Texas Association of School Boards, Inc.,
Administrator for The Local Government Purchasing Cooperative
v.02.01.2021
Endorsed by A TASAV VT Aoi
A
Board®
National Pumhasing Cooperative
February 7, 2023
Sent Via Email: paul.bigalke@rexelusa.com
Paul Bigalke
Rexel, Inc.
2965 Commodore Dr.
Carrollton, TX 75007
Welcome to BuyBoard!
Re: Notice ofNational Purchasing Cooperative Award; Proposal Invitation No. 690-23, Energy Saving Lighting Products
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard®
contract based on the above -referenced Proposal Invitation. The contract is effective for an initial one-year term of April 1,
2023 through March 31, 2024, and may be subject to two possible one-year renewals. Please refer to the Proposal Invitation
for the contract documents, including the National Purchasing Cooperative Vendor Award Agreement and General Terms and
Conditions of the Contract.
To review the items your company has been awarded, please review Proposal Tabulation No. 690-23 at
www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and only
those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms and must
be at or below the awarded pricing as set forth in the General Terms and Conditions.
The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded that, in
accordance with the General Terms and Conditions, all purchase orders from National Cooperative members
must be processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative's administrator,
you are not authorized to process a purchase order received directly from a National Cooperative member that has not been
processed through the BuyBoard or provided to the Cooperative. If you receive a purchase order directly from a National
Cooperative member that you have reason to believe has not been received by the National Cooperative or processed through
the BuyBoard, you must promptly forward a copy of the purchase order by e-mail to info@buyboard.com
A list of National Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations staff will
be contacting you to assist with resources available and provide any support you may need as an awarded BuyBoard vendor.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any questions,
feel free to contact me at 800-695-2919.
Sincerely,
/ �] 0
Leigh Clover, Bid Analyst
Texas Association of School Boards, Inc.,
Procurement Administrator for the National Purchasing Cooperative
v.02.01.2021
■ti
P.O. Box 400, Austin, Texas 78767-0400
800.695.2919 • buyboard.com
Board -
PURCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
PROPOSER'S ACCEPTANCE AND AGREEMENT
Proposal Invitation Name: Energy Saving
Lighting Products
Proposal Invitation Number: 690-23
Contract Term: April 1, 2023, through March 31,
2024, with two possible one-year renewals.
Proposal Due Date/Opening Date and Time:
September 15, 2022, at 4:00 PM
Location of Proposal Opening:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Anticipated Cooperative Board Meeting Date:
February 2023
By signature below, the undersigned acknowledges and agrees that you are authorized to submit this
Proposal, including making all acknowledgements, consents, and certifications herein, on behalf of Proposer
and, to the best of your knowledge, the information provided is true, accurate, and complete.
Rexe I USA
Name of Proposing Company
719 S. Greenville Suite 100
Street Address
Allen, TEXAS 75002
City, State, Zip
469-247-6403
Telephone Number of Authorized Company Official
Fax Number of Authorized Company Official
9/ 15/2022
Date
1)42Zd 5
4
Z�a�
Signature of Authorized Com any Official
Paul Biaalke
Printed Name of Authorized Company Official
Director of Energy
Position or Title of Authorized Company Official
20-5021845
Federal ID Number
Page 10 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
PROPOSAL FORMS PART 1: COMPLIANCE FORMS
INSTRUCTIONS:
Proposer must review and complete all forms in this Proposal Forms Part 1:
■ Proposal Acknowledgements
■ Felony Conviction Disclosure
■ Resident/Nonresident Certification
■ Debarment Certification
■ Vendor Employment Certification
■ No Boycott Verification
■ No Excluded Nation or Foreign Terrorist Organization Certification
■ Historically Underutilized Business Certification
■ Acknowledgement of BuyBoard Technical Requirements
■ Construction -Related Goods and Services Affirmation
■ Deviation and Compliance
■ Vendor Consent for Name Brand Use
■ Confidential/Proprietary Information
■ EDGAR Vendor Certification
■ Compliance Forms Signature Page
An authorized representative of Proposer must initial in the bottom right corner of each page where indicated
and complete and sign the Compliance Forms Signature Page. Proposer's failure to fully complete, initial, and
sign forms as required may result in your Proposal being rejected as non -responsive.
PROPOSAL ACKNOWLEDGEMENTS
The proposing company ("you" or "your' hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all information and documentation associated with this Proposal Invitation,
including the Instructions to Proposers, General Information, General Terms and Conditions, attachments/forms,
appendices, item specifications, and line items (collectively "Requirements');
2. By your response ("Proposal') to this Proposal Invitation, you propose to supply the products or services submitted at
the pricing quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or
exceptions are noted in the Proposal;
3. By your Proposal, you acknowledge and certify all items set forth in the General Terms and Conditions, Section B.12
(Certifications), including all non -collusion certifications and certifications regarding legal, ethical, and other matters set
forth therein.
4. Any and all deviations and exceptions to the Requirements have been noted in your Proposal on the required form and
no others will be claimed;
Initial:
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
5. If the Cooperative accepts any part of your Proposal and awards you a Contract, you will furnish all awarded products or
services at the pricing quoted and in strict compliance with the Requirements (unless specific deviations or exceptions
are noted on the required form and accepted by the Cooperative), including without limitation the Requirements related
to:
a. conducting business with Cooperative members, including offering pricing to members that is the best you offer
compared to similarly situated customers in similar circumstances;
b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation;
c. the possible award of a piggy -back contract by the National Purchasing Cooperative or nonprofit entity, in which
event you will offer the awarded products and services in accordance with the Requirements; and
d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to activation
of your Contract;
6. You have clearly identified on the included form any information in your Proposal that you believe to be confidential or
proprietary or that you do not consider to be public information subject to public disclosure under the Texas Public
Information Act or similar public information law;
7. The individual submitting this Proposal is duly authorized to enter into the contractual relationship represented by this
Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any individual signing a
form or Proposal document) is authorized and has the requisite knowledge to provide the information and make the
representations and certifications required in the Requirements;
8. You have carefully reviewed your Proposal, and certify that all information provided is true, complete, and accurate to
the best of your knowledge, and you authorize the Cooperative to take such action as it deems appropriate to verify such
information; and
9. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, will be grounds for
disqualifying you from consideration for a contract award under this Proposal Invitation, termination of a contract award,
or any other remedy or action provided for in the General Terms and Conditions or by law.
FELONY CONVICTION DISCLOSURE
Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor)
states: "A person or business entity that enters into a contract with a school district must give advance notice to the district
if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the
conduct resulting in the conviction of a felony."
Section 44.034 further states in Subsection (b): "A school district may terminate a contract with a person or business
entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or
misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for
services performed before the termination of the contract."
Please check (,/) one of the following:
❑■ My company Is a publicly -held corporation. (Advance notice requirement does not apply to publicly -held corporation.)
❑ My company is not owned or operated by anyone who has been convicted of a felony.
❑ My company is owned/operated by the following individual(s) who has/have been convicted of a felony:
Name of Felon(s):
Details of Conviction(s):
Initial: Pll�_F
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W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
RESIDENT/ NONRESIDENT CERTIFICATION
Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who
are not Texas residents. Under the statute, a "resident" proposer is a person whose principal place of business is in Texas,
including a contractor whose ultimate parent company or majority owner has its principal place of business in Texas. A
"nonresident" proposer is a person who is not a Texas resident. Please indicate the status of your company as a "resident"
proposer or a "nonresident" proposer under these definitions.
Please check (,/) one of the following:
❑■ I certify that my company is a Resident Proposer.
❑ I certify that my company is a Nonresident Proposer.
If your company is a Nonresident Proposer, you must provide the following information for your resident state (the state in
which your company's principal place of business is located):
Company Name Address
City
State Zip Code
A. Does your resident state require a proposer whose principal place of business is in Texas to under -price proposers
whose resident state is the same as yours by a prescribed amount or percentage to receive a comparable contract?
❑ Yes ❑ No
B. What is the prescribed amount or percentage? $ or
DEBARMENT CERTIFICATION
By signature on the Compliance Forms Signature Page, I certify that neither my company nor an owner or principal of my
company has been debarred, suspended or otherwise made ineligible for participation in Federal Assistance programs under
Executive Order 12549, "Debarment and Suspension," as described in the Federal Register and Rules and Regulations.
Neither my company nor an owner or principal of my company is currently listed on the government -wide exclusions in SAM,
debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory or regulatory authority.
My company agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or seeking
to purchase from my company if my company or an owner or principal is later listed on the government -wide exclusions in
SAM, or is debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory or regulatory
authority.
VENDOR EMPLOYMENT CERTIFICATION
Section 44.031(b) of the Texas Education Code establishes certain criteria that a school district must consider when
determining to whom to award a contract. Among the criteria for certain contracts is whether the vendor or the vendor's
ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii) employs at least 500 people in Texas.
If neither your company nor the ultimate parent company or majority owner has its principal place of business in Texas, does
your company, ultimate parent company, or majority owner employ at least 500 people in Texas?
Please check (,/) one of the following_ ��
❑ Yes ❑ No Initial:/C%�/
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
NO BOYCOTT VERIFICATION
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or
partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees for goods
or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel and will
not boycott Israel during the term of the contract (TEx. Gov'T CODE Ch. 2271), (2) does not boycott energy companies and
will not boycott energy companies during the term of the contract (TEx. Gov't CODE Ch. 2274 effective September 1, 2021),
and (3) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade
association and will not discriminate during the term of the contract against a firearm entity or firearm trade association (TEx.
Gov'T CODE Ch. 2274 effective September 1, 2021). Accordingly, this certification form is included to the extent required by
law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is
intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity
doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business
purposes. TEx. Gov'T CODE §808.001(1).
"Boycott energy company" means, without an ordinary business purpose, refusing to deal with, terminating business activities
with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations with
a company because the company: (A) engages in the exploration, production, utilization, transportation, sale, or
manufacturing of fossil fuel -based energy and does not commit or pledge to meet environmental standards beyond applicable
federal and state law; or (B) does business with a company described by Paragraph (A). TEx. Gov'T CODE §809.001(1)
(effective September 1, 2021).
"Discriminate against a firearm entity or firearm trade association" means, (A) with respect to the entity or association, to:
(i) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a firearm
entity or firearm trade association; (ii) refrain from continuing an existing business relationship with the entity or association
based solely on its status as a firearm entity or firearm trade association; or (iii) terminate an existing business relationship
with the entity or association based solely on its status as a firearm entity or firearm trade association; and (B) does not
include: (i) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or selling of
ammunition, firearms, or firearm accessories; and (ii) a company's refusal to engage in the trade of any goods or services,
decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship:
(aa) to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency; or (bb) for any
traditional business reason that is specific to the customer or potential customer and not based solely on an entity's or
association's status as a firearm entity or firearm trade association. TEx. Gov'T CODE §2274.001(3) (effective September 1,
2021).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor does not
boycott Israel, boycott energy companies, or discriminate against a firearm entity or firearm trade association and will not
do so during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and
accurate, and that I am authorized by my company to make this certification.
Initial: A�
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANIZATION CERTIFICATION
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with
a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization — specifically, any
company identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051,
807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be excluded from its federal sanctions
regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign terrorist organization is not subject to
the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas Comptroller's list
identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make this
certification.
HISTORICALLY UNDERUTILIZED BUSINESS CERTIFICATION
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women Business
Enterprise or "MWBE" and all referred to in this form as a "HUB' is encouraged to indicate its HUB certification status when
responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications for awarded Vendors that
properly indicate and document their HUB certification on this form. Please check ( /) all that apply:
❑ I certify that my company has been certified as a HUB in the following categories:
❑ Minority Owned Business ❑ women Owned Business
❑ Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a
service -connected disability as defined by 38 U.S.C. § 101(16), and who has a disability rating
of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of
Defense)
Certification Number:
Name of Certifying Agency:
0 My company has NOT been certified as a HUB.
ACKNOWLEDGEMENT OF BUYBOARD TECHNICAL REQUIREMENTS
Vendor shall review the BuyBoard Technical Requirements included in this Proposal Invitation. By signature on the Compliance
Forms Signature Page, the undersigned affirms that Proposer has obtained a copy of the BuyBoard Technical Requirements,
has read and understands the requirements, and certifies that Vendor is able to meet and will comply with those requirements
except as follows: [List and explain BuyBoard Technical Requirements, if any, to which your company cannot or will not
comply.]
Note: In accordance with the General Terms and Conditions of the Contract, to the extent Vendor is awarded a Contract
under this Proposal Invitation but is unable or unwilling to meet the applicable BuyBoard Technical Requirements, the
information available on the BuyBoard for Vendor's awarded products or services may be limited, potentially placing Vendor
at a disadvantage and impacting the ability of Cooperative members to search, find, review, and purchase Vendor's awarded
products and services on the BuyBoard website. Further, to the extent Vendor has acknowledged ability to meet and comply
with the BuyBoard Technical Requirements, any subsequent failure or refusal by Vendor to promptly provide information
upon request to the Cooperative administrator in accordance with those technical requirements may be deemed an e
default under the Contract. Initial:
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
CONSTRUCTION -RELATED GOODS AND SERVICES AFFIRMATION
The Cooperative issued the BuyBoard Procurement and Construction -Related Goods and Services Advisory for Texas Members
("Advisory'), which provides information specifically relevant to the procurement of construction -related goods and services
by Texas Cooperative members. The Advisory, available at buyboard.com/Vendor/Resources.aspx, provides an overview of
certain legal requirements that are potentially relevant to a Cooperative member's procurement of construction or
construction -related goods and services, including those for projects that may involve or require architecture, engineering or
independent testing services. A copy of the Advisory can also be provided upon request. Because many BuyBoard contracts
include goods or installation services that might be considered construction -related, Proposer must make this Construction
Related -Goods and Services Affirmation regardless of type of goods or services associated with this Proposal Invitation.
A contract awarded under this Proposal Invitation covers only the specific goods and/or services awarded by the Cooperative.
As explained in the Advisory ("Advisory', Texas law prohibits the procurement of architecture or engineering
services through a purchasing cooperative. This Proposal Invitation and any Contract awarded thereunder
does not include such services. Architecture or engineering services must be procured by a Cooperative
member separately, in accordance with the Professional Services Procurement Act (Chapter 2254 of the Texas
Government Code) and other applicable law and local policy.
By signature on the Compliance Forms Signature Page, Proposer affirms that Proposer has obtained a copy of the Advisory,
has read and understands the Advisory, and is authorized by Proposer to make this affirmation. If Proposer sells construction -
related goods or services to a Cooperative member under a Contract awarded under this Proposal Invitation, Proposer will
comply with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative member
customers or potential Cooperative member customers aware of such requirements, and provide a Cooperative member with
a copy of the Advisory before accepting the member's Purchase Order or other agreement for construction -related goods or
services.
Initial: A�
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
DEVIATION AND COMPLIANCE
If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements
associated with this Proposal Invitation, you MUST list all such deviations on this form, and provide complete and detailed
information regarding the deviations on this form or an attachment to this form. Prior to completing this form, Vendor
shall review the General Terms and Conditions section B.4 (Deviations from Item Specifications and General
Terms and Conditions). Please note that, as provided in section B.4, certain provisions of the General Terms
and Conditions are NOT subject to deviation, and certain deviations will be deemed rejected without further
action by the Cooperative. Any attempted deviation, whether directly or indirectly, to provisions identified in
this Proposal Invitation as not subject to deviation shall be deemed rejected by the Cooperative and, unless
otherwise withdrawn by Vendor, may result in Vendor's Proposal being rejected in its entirety.
The Cooperative will consider any deviations in its contract award decision and reserves the right to accept or reject a proposal
based upon any submitted deviation.
In the absence of any deviation identified and described in accordance with the above, your company must fully comply with
the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal Invitation
if awarded a Contract under this Proposal Invitation. A deviation will not be effective unless accepted by the Cooperative.
The Cooperative, by and through the Cooperative administrator, may, in its sole discretion, seek clarification from and/or
communicate with Proposer(s) regarding any submitted deviation, consistent with general procurement principles of fair
competition. The Cooperative reserves the right to accept or reject a Proposal based upon any submitted deviation.
Please check (i) one of the following_
❑■ NO; Deviations
❑ Yes; Deviations
List and fully explain any deviations you are submitting:
Initial: Algt
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
VENDOR CONSENT FOR NAME BRAND USE
BuyBoard members seeking to make purchases using a Contract awarded under this Proposal Invitation may view information
regarding awarded Vendors, including but not limited to product catalogs, pricelists, pricing, and Proposals, through the
BuyBoard website. To improve and enhance the experience of BuyBoard members seeking to procure goods and services
under the Contract utilizing the BuyBoard website, any Vendor logo, product images, and similar brand and trademark
information provided by Vendor for purposes of the Contract ("Vendor Information's may be posted on the BuyBoard website.
You acknowledge that, by submitting your Proposal, unless you specifically opt out below, you consent to use
of your company's Vendor Information on the BuyBoard website if awarded a Contract. You further acknowledge
that whether, where, and when to include the Vendor Information on the BuyBoard website shall be at the sole discretion of
the BuyBoard Administrator. Vendor retains, however, the right of general quality control over the BuyBoard Administrator's
authorized display of proprietary Vendor Information. Neither the BuyBoard nor its administrator will be responsible for the
use or distribution of Vendor Information by BuyBoard members or any other third party using the BuyBoard website. This
Vendor Consent shall be effective for the full term of the Contract, including renewals, unless Vendor provides a signed,
written notice revoking consent to contractadmin@buyboard.com. BuyBoard shall have up to thirty days from the date of
receipt of a termination or revocation of a Vendor Consent to remove Vendor information from the BuyBoard website.
This Vendor Consent is subject to the Terms and Conditions of the Contract, including, but not limited to, those terms
pertaining to Disclaimer of Warranty and Limitation of Liability, Indemnification, and Intellectual Property Infringement.
Vendor logo files must be submitted in one of the formats set forth in the BuyBoard Technical Requirements. Proposers are
requested to submit this information with Vendor's Proposal. (This consent shall not authorize use of your company's Vendor
Information by BuyBoard if your company is not awarded a Contract.)
OPT OUT:
If your company wishes to opt out of the Vendor Consent for Name Brand Use, you must check the opt out box below. DO
NOTselect this box unless your company is opting out of this Vendor Consent for Name Brand Use.
❑ By checking this box, Vendor hereby declines to provide consent for use of Vendor Information (as defined herein) on
the BuyBoard website. By opting out, Vendor acknowledges and agrees that, if Vendor is awarded a Contract
under this Proposal Invitation, information available on the BuyBoard for Vendor's awarded products or
services may be limited, potentially placing Vendor at a disadvantage and impacting the ability of
Cooperative members to search, find, review, and purchase Vendor's awarded products and services on the
BuyBoard website.
Initial://e5
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
CONFIDENTIAL/ PROPRIETARY INFORMATION
A. Public Disclosure Laws
All Proposals, forms, documentation, catalogs, pricelists, or other materials submitted by Vendor to the Cooperative in
response to this Proposal Invitation, may be subject to the disclosure requirements of the Texas Public Information Act (Texas
Government Code chapter 552.001, et, seq.) or similar disclosure law. Proposer must clearly identify on this form any
information in its Proposal (including forms, documentation, or other materials submitted with the Proposal) that Proposer
considers proprietary or confidential. If Proposer fails to properly identify the information, the Cooperative shall have no
obligation to notify Vendor or seek protection of such information from public disclosure should a member of the public or
other third party request access to the information under the Texas Public Information Act or similar disclosure law. When
required by the Texas Public Information Act or other disclosure law, Proposer may be notified of any third -party request for
information in a Proposal that Proposer has identified in this form as proprietary or confidential.
Does your Proposal (including forms, documentation, catalogs, pricelists, or other materials submitted with the Proposal)
contain information which Vendor considers proprietary or confidential?
Please check W) one of the following:
MNO, I certify that none of the information included with this Proposal is considered confidential or proprietary.
❑ YES, I certify that this Proposal contains information considered confidential or proprietary and all such information is
specifically identified on this form.
If you responded "YES", you must clearly identify below the specific information you consider confidential or proprietary. List
each page number, form number, or other information sufficient to make the information readily identifiable. The Cooperative
and Cooperative administrator shall not be responsible for a Proposer's failure to clearly identify information considered
confidential or proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and Cooperative
administrator will disclose information when required by law, even if such information has been identified herein as
information Vendor considers confidential or proprietary.
Confidential / Proprietary Information:
(Attach additional sheets if needed.)
Initial:
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
B. Copyright Information
Does your Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal)
contain copyright information?
Please check C) one of the following:
NO, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does not
contain copyright information.
❑ YES, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does
contain copyright information.
If you responded "YES", clearly identify below the specific documents or pages containing copyright information.
Copyright Information:
(Attach additional sheets if needed.)
C. Consent to Release Confidential/Proprietary/Copyright Information to BuyBoard Members
BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard may wish to
view information included in the Proposals of awarded Vendors. If you identified information on this form as confidential,
proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract
award constitutes your consent to the disclosure of such information to BuyBoard members, including posting of such
information on the secure BuyBoard website for members. Note: Neither the Cooperative nor Cooperative administrator will
be responsible for the use or distribution of information by BuyBoard members or any other party.
D. Consent to Release Proposal Tabulation
Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal, Vendor
consents and agrees that, upon Contract award, the Cooperative may publicly release, including posting on the public
BuyBoard website, a copy of the proposal tabulation and award information for the Contract including Vendor name; proposed
catalog/pricelist name(s); proposed percentage discount(s), hourly labor rate(s), or other specified pricing; and Vendor award
or non -award information.
Initial:
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URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
EDGAR VENDOR CERTIFICATION
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, 2 CFR 200 (sometimes referred to as the "Uniform Guidance" or new "EDGAR'�. All Vendors submitting a
Proposal must complete this EDGAR Certification Form regarding Vendor's willingness and ability to comply with certain
requirements which may be applicable to specific Cooperative member purchases using federal grant funds. Completed
forms will be made available to Cooperative members for their use while considering their purchasing options when using
federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in addition to the
terms and conditions of the BuyBoard contract, to address the member's specific contractual needs, including contract
requirements for a procurement using federal grants or contracts.
For each of the items below, Vendor should certify Vendor's agreement and ability to comply, where
applicable, by having Vendor's authorized representative check the applicable boxes, initial each page, and
sign the Compliance Forms Signature Page. If you fail to complete any item in this form, the Cooperative will
consider and may list the Vendor's response on the BuyBoard as "NO,"the Vendor is unable or unwilling to
comply. A "NO" response to any of the items may, if applicable, impact the ability of a Cooperative member to purchase
from the Vendor using federal funds.
1. Vendor Violation or Breach of Contract Terms:
Contracts for more than the simplified acquisition threshold, which is the inflation adjusted amount determined by the Civilian
Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 USC 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.
Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms and
Conditions, as well as any additional terms and conditions in any Purchase Order or Cooperative member ancillary contract
agreed upon by Vendor and the Cooperative member which must be consistent with and protect the Cooperative member at
least to the same extent as the BuyBoard Terms and Conditions. The remedies under the Contract are in addition to any
other remedies that may be available under law or in equity. By submitting a Proposal, you agree to these Vendor violation
and breach of contract terms.
F YES, I agree. ❑ NO, I do not agree.
2. Termination for Cause or Convenience:
For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the following
term and condition shall apply:
The Cooperative member may terminate or cancel any Purchase Order under this Contract at any time, with or without cause,
by providing seven (7) business days advance written notice to the Vendor. If this Agreement is terminated in accordance
with this Paragraph, the Cooperative member shall only be required to pay Vendor for goods or services delivered to the
Cooperative member prior to the termination and not otherwise returned in accordance with Vendors return policy. If the
Cooperative member has paid Vendor for goods or services not yet provided as of the date of termination, Vendor shall
immediately refund such payment(s).
If an alternate provision for termination of a Cooperative member purchase for cause and convenience, including the manner
by which it will be effected and the basis for settlement, is included in the Cooperative member's Purchase Order or ancillary
agreement agreed to by the Vendor, the Cooperative member's provision shall control.
11 YES, I agree. ❑ NO, I do not agree. Initial:AeF
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12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
3. Equal Employment Opportunity:
Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the definition
of "federally assisted construction contract" in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause
provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246
Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR Part 60, "Office of Federal Contract
Compliance Programs, Equal Employment Opportunity, Department of Labor."
The equal opportunity clause provided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees that such
provision applies to any Cooperative member purchase or contract that meets the definition of "federally assisted construction
contract" in 41 CFR Part 60-1.3 and Vendor agrees that it shall comply with such provision.
F YES, I agree. ❑ NO, I do not agree.
4. Davis -Bacon Act:
When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction
contracts/purchases in excess of $2,000, Vendor shall comply with the Davis -Bacon Act (40 USC 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, Vendor is required to pay wages to
laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by the Secretary
of Labor. In addition, Vendor shall pay wages not less than once a week.
Current prevailing wage determinations issued by the Department of Labor are available at beta.sam.gov. Vendor agrees
that, for any purchase to which this requirement applies, the award of the purchase to the Vendor is conditioned upon
Vendor's acceptance of the wage determination.
Vendor further agrees that it shall also comply with the Copeland "Anti -Kickback" Act (40 USC 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.
F YES, I agree. ❑ NO, I do not agree.
S. Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment of
mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is 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 USC 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.
F YES, I agree. ❑ NO, I do not agree.
Initial:16 C
Page 22 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
6. Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member's 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 or 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.
Vendor agrees to comply with the above requirements when applicable.
11 YES, I agree. ❑ NO, I do not agree.
7. Clean Air Act and Federal Water Pollution Control Act:
Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 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 USC 7401-7671q.) and
the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the Federal
awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act and the Federal Water Pollution Control Act.
e YES, I agree. ❑ NO, I do not agree.
S. Debarment and Suspension:
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
OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR
Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions 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.
Vendor certifies that Vendor is not currently listed on the government -wide exclusions in SAM, is not debarred, suspended,
or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order
12549. Vendor further agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or
seeking to purchase from Vendor if Vendor is later listed on the government -wide exclusions in SAM, or is debarred,
suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
e YES, I agree. ❑ NO, I do not agree.
9. Byrd Anti -Lobbying Amendment:
Byrd Anti -Lobbying Amendment (31 USC 1352) - Vendors 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 USC 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. As applicable, Vendor agrees to file all certifications and disclosures required by, and otherwise comply
with, the Byrd Anti -Lobbying Amendment (31 USC 1352).
F YES, I agree. ❑ NO, I do not agree.
Initial'A491F/
Page 23 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
10. Procurement of Recovered Materials:
For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste
Disposal Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such information
and certifications as a Cooperative member may require to confirm estimates and otherwise comply. The requirements of
Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR
Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory
level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the
preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and
resource recovery, and establishing an affirmative procurement program for procurement of recovered materials identified in
the EPA guidelines.
F YES, I agree. ❑ NO, I do not agree.
11. Domestic Preferences for Procurements:
Where appropriate and consistent with law, 2 CFR §200.322 contains certain considerations for domestic preferences for
procurements which may be applicable to Cooperative members using federal funds. When required by a Cooperative
member, Vendor agrees to provide such information or certification as may reasonably be requested by the Cooperative
member regarding Vendor's products, including whether goods, products, or materials are produced in the United States.
F YES, I agree. ❑ NO, I do not agree.
12. Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
2 CFR §200.216 prohibits expending federal loan or grant funds to procure or obtain certain telecommunications and video
surveillance services or equipment. To the extent applicable and when required by a Cooperative member, Vendor agrees to
provide such information or certification as may reasonably be requested by the Cooperative member to confirm whether
any telecommunications or video surveillance services or equipment provided by Vendor is covered equipment or covered
services under 2 CFR §200.216.
F YES, I agree. ❑ NO, I do not agree.
13. Profit as a Separate Element of Price:
For purchases using federal funds in excess of the Simplified Acquisition Threshold, a Cooperative member may be required
to negotiate profit as a separate element of the price. See, 2 CFR 200.324(b). When required by a Cooperative member,
Vendor agrees to provide information and negotiate with the Cooperative member regarding profit as a separate element of
the price for a particular purchase. However, Vendor agrees that the total price, including profit, charged by Vendor to the
Cooperative member shall not exceed the awarded pricing, including any applicable discount, under Vendor's Cooperative
Contract.
F YES, I agree. ❑ NO, I do not agree.
14. General Compliance and Cooperation with Cooperative Members:
In addition to the foregoing specific requirements, Vendor agrees, in accepting any Purchase Order from a Cooperative
member, it shall make a good faith effort to work with Cooperative members to provide such information and to satisfy such
requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to, applicable
recordkeeping and record retention requirements.
e YES, I agree. ❑ NO, I do not agree.
Initial: A/�
Page 24 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
COMPLIANCE FORMS SIGNATURE PAGE
By initialing pages and by signature below, I certify that I have reviewed the following forms; that the information provided
therein is true, complete, and accurate; and that I am authorized by my company to make all certifications, consents,
acknowledgements, and agreements contained herein:
■ Proposal Acknowledgements
■ Felony Conviction Disclosure
■ Debarment Certification
■ Resident/Nonresident Certification
■ Vendor Employment Certification
■ No Boycott Verification
■ No Excluded Nation or Foreign Terrorist Organization Certification
■ Historically Underutilized Business Certification
■ Construction -Related Goods and Services Affirmation
■ Acknowledgement of BuyBoard Technical Requirements
■ Deviation and Compliance
■ Vendor Consent for Name Brand Use
■ Confidential/Proprietary Information
■ EDGAR Vendor Certification
Rexel USA
Company Nameud
#�Y'
Signature of Authorize Company Official
Paul Bigalke / Director of Energy
Printed Name and Title
9-15-2022
Date
Page 25 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
INSTRUCTIONS:
Proposer must completely and accurately provide all information requested in the following Vendor Information Forms or
your Proposal may be rejected as non -responsive:
■ Vendor Business Name
■ Vendor Contact Information
■ Federal and State/Purchasing Cooperative
Experience
■ Governmental References
■ Company Profile
■ Texas Regional Service Designation
■ State Service Designation
■ National Purchasing Cooperative Vendor Award
Agreement (vendors serving outside Texas only)
■ Local/Authorized Seller Listings
■ Manufacturer Dealer Designation
■ Proposal Invitation Questionnaire
■ Vendor Request to Self -Report BuyBoard
Purchases (optional)
To the extent any information requested is not applicable to your company, you must so indicate on the form.
VENDOR BUSINESS NAME
By submitting a Proposal, Vendor is seeking to enter into a legal contract with the Cooperative. As such, Vendor must be an
individual or legal business entity capable of entering into a binding contract.
Name of Pr000sina Comoanv: Rexel USA
(List the legal name of the company seeking to contract with the Cooperative. Do NOT list an assumed name, dba, aka, etc. here. Such information may
be provided below. If you are submitting a joint proposal with another entity to provide the same proposed goods or services, each submitting entity should
complete a separate vendor information form. Separately operating legal business entities, even if affiliated entitles, which propose to provide goods or
services separately must submit their own Proposals.)
Please check W) one of the following:
Type of Business: ❑ Individual/Sole Proprietor Pq Corporation ❑ Limited Liability Company ❑ Partnership
❑ Other (Specify: )
State of Incorporation (if applicable):
Texas
Federal Employer Identification Number: 20-5021845
(Vendor must include a completed IRS W- form with their Proposal)
Name by which Vendor, if awarded, wishes to be identified on the BuyBoard: (Note: Ifdiberentthan the Name of Proposing
Company listed above, only valid trade names (dba, aka, etc.) of the Proposing Company may be used and a copy of your Assumed Name Certificate(s), if
applicable, must be attached)
Page 26 of 72
Proposal Forms COMM/SVCS v.08.11.2021
_
Request for Taxpayer
Give Form to the
Form
Identification Number and Certification
requester. Do not
(Rev. October2018)
Department of the Treasury
send to the IRS.
Internal
Revenue Service
► Go to wwwJrs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
Rexel USA, Inc.
2 Business name/disregarded entity name, if different from above
Rexel Commerical & Industrial
M
m
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
following seven boxes.
certain entities, not individuals; see
Q
instructions on page 3):
o
❑ Individual/sole proprietor or ❑✓ C Corporation ElS Corporation ElPartnership ElTrust/estate
di c
single -member LLC
Exempt payee code (if any)
� 2
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) Do-
0 ._�.
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
W
c
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
code (if an
( y)
a
w
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
d
❑ Other (see instructions) ►
(Applies to accounts maintained outside the U.S.)
to
5 Address (number, street, and apt. or suite no.) See instructions.
Requester's name and address (optional)
in
5429 Lyndon B Johnson Fwy, Suite 600
6 City, state, and ZIP code
Dallas, TX 75240
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
Social security number
backup withholding. For individuals, this is generally your social security number . However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I,, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M2O - 5 0 2 1 8 4 5
Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Signature of
Here U.S. person ► 4::1,�— Date ► 1/3/22
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov1F6rmW9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returns include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual
funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
VENDOR CONTACT INFORMATION
Vendor shall pro vide the requested Vendor Contact Information in the electronic proposal submission system
including contract, purchase order, RFQ, and invoice contacts (or, if submitting a hard copy Proposal, timely
request and complete the Vendor Contact Information form in accordance with the Instructions to Proposers).
FEDERAL AND STATE/ PURCHASING COOPERATIVE EXPERIENCE
The Cooperative strives to provide Cooperative members with the best services and products at the best prices available from
Vendors with the technical resources and ability to serve Cooperative members. Please respond to the following questions.
Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or market
price during the previous 12-month period or the last fiscal year: $ $100,000 . (The period of the 12-month
period is 4-2021 / 4-2022 ). In the event that a dollar value is not an appropriate measure of the sales, provide
and describe your own measure of the sales of the item(s).
By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the
Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items under
equivalent circumstances.
Provide the information requested below for other purchasing cooperatives for which Proposer currently serves, or in
the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing cooperatives
as required.
PURCHASING
GROUPCURRENT
1. Federal General Services Administration
VENDOR?
FORMER VENDOR (Y/N)? —
IF YES, LIST YEARS
D••
AWARDED
COMMODITY
••
2. T-PASS (State of Texas)
3. OMNIA Partners
4. Sourcewell (NIPA)
5. E&I Cooperative
6. Houston -Galveston Area Council (HGAC)
7. Choice Partners
8. The Interlocal Purchasing System (TIPS)
Y
MRO / Lighting
9. Other
❑ MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYBOARD VENDORS
If you are a current BuyBoard vendor in the same contract category as proposed in this Proposal Invitation, indicate the
discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between your
current and proposed discounts.
Current Discount (%): 70%
Proposed Discount (%): 16.67% - 70% - 80%
Explanation: We will be submitting with three manufactures with three discounts for each individual manufacture
Page 27 of 72
Proposal Forms COMM/SVCS v.08.11.2021
W:Board
URCHASING COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 . buyboard.com
GOVERNMENTAL REFERENCES
For your Proposal to be considered, you must supply a minimum of five (5) individual governmental entity references. The
Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the information requested
below, including the existing pricing/discounts you offer each customer. The Cooperative may determine whether
pricing/discounts are fair and reasonable by comparing pricing/discounts stated in your Proposal with the pricing/discounts
you offer other governmental customers. Attach additional pages if necessary.
Quantity/
Entity Name Contact Phone# Email Address Discount Volume
1 Amtrak JT Thomspon 215.349.1058 john.thompson@amtrak.com- $250-500K Annually
Z Arnold Air Force Base Adam Foret 931.454.4448 adam.foret.1 @us.af.mil - $50OK- 1 M Annually
3 City of Allen Bill Little 214.509.4100 blittle@cityofallen.org 50K Annually
4 Houston First Len Masengale 281.520.8891 len.masengale@tdindustries.com- 1 OOK Annually
,.Veterans Administration Joseph Cesar joseph.cesar@va.gov 713. 794. 7591
Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give
better discounts (lower pricing) than indicated? YES ❑ NO ❑■ If YES, please explain:
COMPANY PROFILE
Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard website. If your
company is awarded a Contract under this Proposal Invitation, please provide a brief company description that you would
like to have included with your company profile on the BuyBoard website. Submit your company profile in a separate
file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any content provided for inclusion on
the BuyBoard website. The Cooperative reserves the right to exclude or remove any content in its sole discretion, with or
without prior notice, including but not limited to any content deemed by the Cooperative to be inappropriate, irrelevant to
the Contract, inaccurate, or misleading.)
Page 28 of 72
Proposal Forms COMM/SVCS v.08.11.2021
About Rexel USA, Inc
Our Focus on Smarter Solutions Made Us America's Premier
Distributor
Millions of US electrical customers trust the expertise, resources and relationships
of Rexel USA, Inc. As the US presence of Rexel Group, one of the world's largest
electrical distributors, we apply our know-how, productivity tools and hands-on
business -building initiatives to help our customers thrive. Not satisfied with
simply delivering products, nearly half of our employees are dedicated to
improving how we connect customers with the supplies, solutions, and services
they need. We've developed supply chain models that reduce inventory, raise
productivity, and cut installation costs. We also help our customers uncover new
opportunities. Our energy teams can slash the cost and raise the performance
across a facility — from lighting upgrades to complete energy management
solutions.
D:VBoard-
PURCHASWO COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' buyboard.com
TEXAS REGIONAL SERVICE DESIGNATION
This form must be completed in the electronic proposal submission system (or, if submitting a hard copy
Proposal, timely request and complete the form in accordance with the Instructions to Pr000sers).
The Cooperative (referred to as "Texas Cooperative" in this form and in the State Service Designation form) offers vendors
the opportunity to service its members throughout the entire State of Texas. In the electronic proposal submission system,
you must indicate if you will service Texas Cooperative members statewide or, if you do not plan to service all Texas
Cooperative members statewide, you must indicate the specific regions you will service. If you propose to serve different
regions for different products or services included in your Proposal, you must complete and submit a separate Texas Regional
Service Designation form for each group of products and clearly indicate the products or services to which the designation
applies. (Additional forms can be obtained by contacting bids@buyboard.com at least five (5) business days prior to
the Proposal Due Date.) By designating a region or regions, you are certifying that you are authorized and willing
to provide the proposed products and services in those regions. Designating regions in which you are either
unable or unwilling to provide the specified products and services shall be grounds for either rejection of your
Proposal or, if awarded, termination of your Contract. Additionally, if you do not plan to service Texas Cooperative
members (i.e., if you will service only states other than Texas), you must so indicate on the form in the electronic proposal
submission system.
Regional Education Service Centers
Region and Headquarters
1 Edinburg
2 Corpus Christi
3 Victoria
4 Houston
5 Beaumont
6 Huntsville
7 Kilgore
8 Mount Pleasant
9 Wichita Falls
10
Richardson
11
Fort Worth
12
Waco
13
Austin
14
Abilene
15
San Angelo
16
Amarillo
17
Lubbock
18
Midland
19
ElPaso
20
San Antonio
Page 29 of 72
Proposal Forms COMM/SVCS v.08.11.2021
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
STATE SERVICE DESIGNATION
This form must be completed in the electronic proposal submission system (or, if submitting a hard copy
Proposal, timely request and complete the in accordance with the Instructions to Proposers).
As set forth in the Proposal Invitation, it is the Cooperative's intent that other governmental entities in the United States have
the opportunity to purchase goods or services awarded under the Contract, subject to applicable state law, through a piggy-
back award or similar agreement through the National Purchasing Cooperative BuyBoard. If you plan to service the entire
United States or only specific states, you must complete the State Service Designation information in the electronic proposal
submission system. (Note: If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional
Service Designation form.) In addition to this form, to be considered for a piggy -back award by the National
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this page.
If you serve different states for different products or services included in your Proposal, you must complete and submit a
separate State Service Designation form for each group of products and clearly indicate the products or services to which the
designation applies. (Additional forms can be obtained by contacting bids@buyboard.com at least five U business
days prior to the Proposal Due Date.) By designating a state or states, you are certifying that you are authorized
and willing to provide the proposed products and services in those states. Designating states in which you are
either unable or unwilling to provide the specified products and services shall be grounds for either rejection
of your Proposal or, if awarded, termination of your Contract.
■ I will service all states in the United States.
• I will not service all states in the United States.
Alabama
Alaska
Nebraska
Arizona
Nevada
Arkansas
New Hampshire
California (Public Contract Code 20118 & 20652)
New Jersey
Colorado
New Mexico
Connecticut
New York
Delaware
North Carolina
District of Columbia
North Dakota
Florida
Ohio
Georgia
Oklahoma
Hawaii
Oregon
Idaho
Pennsylvania
Illinois
Rhode Island
Indiana
South Carolina
Iowa
South Dakota
Kansas
Tennessee
Kentucky
Texas
Louisiana
Utah
Maine
Vermont
Maryland
Virginia
Massachusetts
Washington
Michigan
West Virginia
Minnesota
Wisconsin
Mississippi
Wyoming
Missouri
Montana
Proposal Forms COMM/SVCS v.08.11.2021
Page 30 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT
In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal
Invitation may be "piggy -backed" by another governmental entity. The National Purchasing Cooperative is an
intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members throughout
the United States. If you agree to be considered for a piggy -back award by the National Purchasing Cooperative, you agree
to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the
State Service Designation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as "Vendor") agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative ("Texas Cooperative") awards Vendor a
contract under this Proposal Invitation ("Underlying Award', the National Purchasing Cooperative ("National Cooperative")
may - but is not required to - "piggy -back" on or re -award all or a portion of that Underlying Award ("Piggy -Back Award").
By signing this National Cooperative Vendor Award Agreement ("Agreement"), Vendor accepts and agrees to be bound by
any such Piggy -Back Award as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy -Back Award, the National Cooperative Administrator ("BuyBoard
Administrator") will notify Vendor in writing of such Piggy -Back Award, which award shall commence on the effective date
stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as authorized in
writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of Vendor in order
for the Piggy -Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or
changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are agreed to by its
BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same unit pricing and
same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying
Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e., lower)
competitive pricing and more favorable terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form
of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be approved
in writing by the BuyBoard Administrator.
5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of
purchases generated from National Cooperative members through the Piggy -Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon request,
Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members,
vendor invoices, and/or such other documentation regarding those purchase orders as the Cooperative's administrators may
require in their reasonable discretion for purposes of reviewing and verifying purchase activity. Vendor further agrees that
National Cooperative shall have the right, upon reasonable written notice, to review Vendor's records pertaining to purchases
made by National Cooperative members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and responsibilities
that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to National Cooperative;
and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying Award shall inure to
Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this
Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the
event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control,
and then only to the extent necessary to reconcile the conflict.
Proposal Forms COMM/SVCS v.08.11.2021
Page 31 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
7. This Agreement shall be governed and construed in accordance with the laws of the State of Rhode Island and venue for
any dispute shall lie in the federal district court of Alexandria, Virginia.
8. Vendor acknowledges and agrees that the award of a Piggy -Back Award is within the sole discretion of National
Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy -Back
Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy -Back Award as provided for herein.
WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this
Agreement.
Rexel USA
Name of Vendor
Signature of Authorized Company Official
690-23
Proposal Invitation Number
Paul Bigalke
Printed Name of Authorized Company Official
9-15-2022
Date
Proposal Forms COMM/SVCS v.08.11.2021
Page 32 of 72
Board°
PIIRCHASM COOPERATIVE
12007 Research Boulevard ' Austin, Texas 78759-2439 - PH: 800-695-2919 ' buyboard.com
LOCATION/AUTHORIZED SELLER LISTINGS
If you have more than one location/authorized seller that will service a Contract awarded under this Proposal Invitation,
please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary.
NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders,
and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the Contract.
If you are a product manufacturer and wish to designate Designated Dealers as defined in the General Terms
and Conditions to receive Cooperative member Purchase Orders on your behalf, you must complete the
Manufacturer Designated Dealer form,
Location /Authorized
Contact Information
Seller Name
Contact Person
(Mailing Address,Phone,
Martin Bausch
716 S. Greenville Suite #100 Allen
Rexel
TX 75002 469-512-8910 469-2088
Rexel
Martin Bausch
2965 Commodore Dr Carrollton,
TX 75007 469-512-8910
Rexel Amarillo
Randy Wooledge
1808 SW 6th Ave Amarillo TX
79106 P 806-373-3377 f: 806-373-
3399
Rexel Austin
John Darimen
2013 Centimeter Dr Austin TX
78758 p: 512-462-0300 f: 512-462-
1209
Rexel Beaumont
Jared Bulter
3025 Milam Beaumont TX 77701
p: 409-273-1059 F 409-832-2531
Rexel Fort Worth
John Haury
2600 NE Loop 820 Suite 110 Fort
Worth TX 76137 p: 817-831-2271
f: 682-647-1326
Rexel Grand Prairie
Martin Bausch
3100 N State Hwy 161 Suite 600
Grand Praire TX 75050 p: 469-
805-6640
Rexel Houston
Grace Prather
3443 N San Houston PKWY West
Suite 500 Houston TX 77086 P:
713-316-1700
Rexel Longview
Martin Bausch
807 West Cotton St Longview TX
75604 p: 903-757-6021 F: 903-
757-4824
Rexel Midland
Justin Smith
2900 South County RD 1250
Midland TXC 79706 P: 432-561-
9671
Proposal Forms COMM/SVCS v.08.11.2021
Page 33 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
MANUFACTURER DEALER DESIGNATION
If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple dealers
("Designated Dealers') to receive Cooperative member Purchase Orders on Vendor's behalf, you must complete this form for
each dealer you wish to designate.
Regardless of any Designated Dealers submitted by Vendor, Vendor specifically agrees and acknowledges that any such
designations are for Vendor's convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any
obligations under the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor or
any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall remain responsible
and liable for all of its obligations under the Contract and the performance of both Vendor and any of Vendor's Designated
Dealers under and in accordance with the Contract and remain subject to all remedies for default thereunder, including, but
not limited to suspension and termination of Vendor's Contract for nonpayment of service fees.
If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard
system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor with
Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process such
Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to a
Designated Dealer for processing.
The Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated Dealer,
and Vendor agrees to immediately require such Designated Dealer to cease accepting Purchase Orders or otherwise acting
on Vendor's behalf under the Contract. Further, the Cooperative administrator shall be authorized to remove or suspend any
or all Designated Dealers from the BuyBoard at any time in its sole discretion.
If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated
Dealer below. If you wish to designate multiple dealers, please duplicate this form as necessary.
N/A
Designated Dealer Name Designated Dealer Contact Person
Designated Dealer Address
City
Phone Number
Email address
State Zip
Fax Number
Designated Dealer Tax ID Number* (*attach W-9)
Proposal Forms COMM/SVCS v.08.11.2021
Page 34 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
PROPOSAL INVITATION QUESTIONNAIRE
The Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial
resources to provide the goods and perform the services ("Work' under the BuyBoard contract contemplated by this Proposal
Invitation ("Contract"). Proposers must fully answer each question, numbering your responses to correspond to the
questions/numbers below. Proposers must complete below or attach your responses to this questionnaire and submit in one
document with your Proposal. You must submit the questionnaire and responses with your Proposal or the
Proposal will not be considered.
1. List the number of years Proposer has been in business and former business names (if applicable). Note whether your
company is currently for sale or involved in any transaction that would significantly alter its business or result in acquisition
by another entity.
Rexel USA was incorporated in December of 2004. Rexel has been doing
business for over 15 years; Rexel Commercial and Industrial.We are publicly traded and
are not for sale or involved in any transaction that would alter it's business
2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this
Contract. State the number and summarize the experience of company personnel who may be utilized for the Work,
including those who will be available to Cooperative members for assistance with project development, technical issues,
and product selection for Work associated with this Contract.
As one of the largest electrical distributors in the world we have trained
professionals on staff that have the capabilities to assist all cooperative
members with development, product selection and any technical issues
We have product specialists across the country willing to share their expertise
3. Marketing Strategy: For your Proposal to be considered, you must submit the Marketing Strategy you will use if the
Cooperative accepts all or part of your Proposal. (Example: Explain how your company will initially inform Cooperative
members of your BuyBoard Contract, and how you will continue to support the BuyBoard for the duration of the Contract
term.) Attach additional pages if necessary.
Rexel has a very strong marketing team in the region for Texas and across the United States. If the Cooperative accepts all or part of our proposal we would
begin our marketing strategy by sending targeted mailers to all members introducing our brand and products that we represent. We would also purchase
space if possible from buyboard to advertise on the top banner so that all members who were searching for a certain product would see our brand. After gaining
brand recognition we would filter by members, list priorities; with our footprint that covers the country we would make face to face contact with individuals.
Proposal Forms COMM/SVCS v.08.11.2021
Page 35 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
4. Describe Proposer's financial capability to perform the Contract. State or describe the firm's financial strength and rating,
bonding capacity, and insurance coverage limits. State whether the firm, or any of the firm's past or present owners,
principal shareholders or stockholders, or officers, have been a debtor party to a bankruptcy, receivership, or insolvency
proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position with your firm.
Upon award of contract; Rexel would be pleased to provide financial statements upoA request. Our
annual revenue exceeds 535 Million and we are financially capable of performing the contract.
We are providing a material only proposal; bonding and insurance requirements would be be applicable.
Rexel; past nor present has shareholders that have been a debtor party to a bankruptcy or any other insolvency proceeding in the last 7 years.
5. Does your company have any outstanding financial judgments and/or is it currently in default on any loan or financing
agreement? If so, provide detailed information on the nature of such items and prospects for resolution.
N/A
6. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or
that have been terminated for any reason. For each such contract, provide the project name, scope, value and date and
the name of the procuring entity. Fully explain the circumstances of the default, failure to complete or deliver the work,
or termination.
N/A
7. List all litigation or other legal proceedings (including arbitration proceedings), if any, in the last 10 years brought against
your firm, or any of the firm's past or present owners, principal shareholders or stockholders, officers, agents or
employees, that relate to or arise from a contract similar to this Contract or the Work contemplated under this Contract.
Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), nature of the claim,
and resolution or current status.
N/A
Proposal Forms COMM/SVCS v.08.11.2021
Page 36 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
VENDOR REQUEST TO SELF -REPORT BUYBOARD PURCHASES
The General Terms and Conditions require that all Purchase Orders generated by or under any Contract awarded under this
Proposal Invitation be processed through the BuyBoard and, except as expressly authorized in writing by the Cooperative
administrator, Vendors are not authorized to process Purchase Orders received directly from Cooperative members that have
not been processed through the BuyBoard or provided to the Cooperative. In accordance with this provision, Vendor may
request authorization of the Cooperative administrator to self -report Cooperative member purchases if awarded a Contract
under this Proposal Invitation. By making such a request, Vendor acknowledges and agrees that self -reporting is specifically
subject to and conditioned upon (1) Vendor's agreement to the Additional Terms and Conditions for BuyBoard Self -Reporting
which are included in this Proposal Invitation and incorporated herein for all purposes and (2) approval of this request in
writing by the Cooperative administrator.
Note: This form is NOT required as part of your proposal. You should sign and return this form ONLY if you
wish to request authorization to self -report BuyBoard purchases. Any request to self -report will not be effective,
and Vendor shall not be authorized to self -report BuyBoard member purchases, unless and until (1) Vendor is awarded a
Contract under this Proposal Invitation, and (2) the request has been approved in writing by the Cooperative administrator.
By my signature below, I hereby request authorization from the Cooperative administrator to self -report
BuyBoard purchases if my company is awarded a Contract. I certify that I am authorized by the above -named
Vendor to approve this form, and I have received and read the Additional Terms and Conditions for BuyBoard
Self -Reporting included in this Proposal Invitation and do hereby approve and agree to such terms and
conditions on behalf of Vendor.
NAME OF VENDOR: Rexe I USA
t�oQzd "_54�
Signature of Vendor Authorized Representative
Printed Name: Paul B i g a l ke
Title: Director of Energy
Date: 9 15-2022
(For Cooperative Administrator Use Only)
Approved by BuyBoard Administrator:
Effective/Start Date for Self -Reporting:
Proposal Forms COMM/SVCS v.08.11.2021
Page 37 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
REQUIRED FORMS CHECKLIST
(Please check (-V) the following)
0 Reviewed/Completed: Proposer's Acceptance and Agreement
PROPOSAL FORMS PART 1: COMPLIANCE FORMS
Reviewed/Completed:
Proposal Acknowledgements
Reviewed/Completed:
Felony Conviction Disclosure
Reviewed/Completed:
Resident/Nonresident Certification
Reviewed/Completed:
Debarment Certification
Reviewed/Completed:
Vendor Employment Certification
Reviewed/Completed:
No Boycott Verification
Reviewed/Completed: No Excluded Nation or Foreign Terrorist Organization Certification
Reviewed/Completed: Historically Underutilized Business Certification
Reviewed/Completed: Acknowledgement of BuyBoard Technical Requirements
Reviewed/Completed: Construction -Related Goods and Services Affirmation
Reviewed/Completed:
Deviation and Compliance
Reviewed/Completed:
Vendor Consent for Name Brand Use
Reviewed/Completed:
Confidential/Proprietary Information
Reviewed/Completed:
EDGAR Vendor Certification
Reviewed/Completed:
Compliance Forms Signature Page
PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS
Reviewed/Completed: Vendor Business Name
Reviewed/Completed: Vendor Contact Information (complete ine%tronicproposalsubmission system)
Reviewed/Completed: Federal and State/Purchasing Cooperative Experience
Reviewed/Completed: Governmental References
Reviewed/Completed: Company Profile
Reviewed/Completed: Texas Regional Service Designation (complete in electronic proposal submission system)
Reviewed/Completed: State Service Designation(complete inelectronic proposal submission system)
Reviewed/Completed: National Purchasing Cooperative Vendor Award Agreement (vendors serving outside Texas only)
Reviewed/Completed: Local/Authorized Seller Listings
Reviewed/Completed: Manufacturer Dealer Designation
Reviewed/Completed: Proposal Invitation Questionnaire
Reviewed/Completed: Vendor Request to Self -Report BuyBoard Purchases (optional)
0 Reviewed/Completed: Proposal Specifications Discount (%) off Catalog/Pricelist and/or other required pricing
information including Catalogs/Pricelists (or no bid response) must be submitted with the Proposal or the Proposal will not
be considered.
Proposal Forms COMM/SVCS v.08.11.2021
Page 40 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
PROPOSAL SPECIFICATION SUMMARY
The categories and items specified for this Proposal Invitation are summarized below. For full Proposal
Specifications, you must review and complete the Proposal Specification information in the electronic proposal
submission system in accordance with the Instructions to Proposers (or, if submitting a hard copy Proposal, timely
request and complete the Proposal Specification Form in accordance with the Instructions to Proposers).
PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the Proposal will not be
considered. Vendors shall submit catalog (s)/pricel ist(s) with the Proposal in a readily available and readable electronic format,
with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted.
Section I: Equipment, Products, and Supplies
1. Discount (%) off catalog/pricelist for All Types of Energy Saving Electronic Ballasts (high efficiency, low wattage,
and other related items).
2. Discount (%) off catalog/pricelist for All Types of Energy Saving Fluorescent Lamps and Fixtures (high efficiency,
low wattage, and other related items).
3. Discount (%) off catalog/pricelist for All Types of Ceiling and Wall Box Motion Sensors.
4. Discount (%) off catalog/pricelist for All Types of Electronic HID Ballasts, Lamps, and Fixtures.
5. Discount (%) off catalog/pricelist for All Types of Electronic HPS Ballasts, Lamps, and Fixtures.
6. Discount (%) off catalog/pricelist for All Types of Exit Polycarbonate Products (3W LED and other related items).
7. Discount (%) off catalog/pricelist for All Types of LED Tube Lighting Products.
8. Discount (%) off catalog/pricelist for All Types of Solar Lighting Products.
9. Discount (%) off catalog/pricelist for All Types of Watt Stopper Sensors.
10. Discount (%) off catalog/pricelist for Recycle Services of Lamps, Batteries, Ballasts, and Fixtures.
11. Discount (%) off catalog/pricelist for All Other Energy Saving Lighting Products.
PROPOSAL NOTE 2: The intent of this Proposal Invitation is to establish a contract for Cooperative members to procure
equipment, supplies, and installation or repair of energy saving lighting products only. "Energy Audit Programs" as used
in this Proposal Invitation refers only to general reviews of existing Cooperative member lighting to determine potential
lighting needs as it may relate directly to the purchase, installation and servicing of energy saving lighting products to be
procured within the scope and intent of this Proposal Invitation. "Energy Audit Programs" does not include, and no vendor
shall propose or, if awarded, offer to provide under this Proposal Invitation any services that are required to be procured in
the manner prescribed by the Professional Services Procurement Act (Chapter 2254 of the Texas Government Code), including
without limitation architectural services, professional engineering services, or energy savings performance contract services
where required under Texas law to be let according to the procedures established for professional services under Texas
Government Code Chapter 2254.004.
Section II: Energy Audit Programs
12. Energy Audit Programs - State the Not to Exceed per square foot price for Energy Audit Programs and related
services as defined in this proposal invitation.
Section III: Installation and Repair Service
13. Hourly Labor Rate for Installation/Repair Service of Energy Saving Electronic Ballasts, Fluorescent Lamps,
Fixtures, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and
Products.
14. Hourly Labor Rate for Installation/Repair Service of Ceiling and Wall Box Motion Sensors, Equipment and
Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
15. Hourly Labor Rate for Installation/Repair Service of Electronic HID and HPS Ballasts, Lamps, Fixtures,
and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
Proposal Forms COMM/SVCS v.08.11.2021
Page 38 of 72
Board°
PURCHASING COOPERATIVE
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • buyboard.com
16. Hourly Labor Rate for Installation/Repair Service of Exit Polycarbonate, LED Tube Lighting, Watt Stopper
Sensor Products and Related Items -.Not to Exceed hourly labor rate for Installation/Repair Service of Equipment
and Products.
17. Hourly Labor Rate for Installation/Repair Service of Solar Lighting Products and Related Items —
Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
18. Hourly Labor Rate for Installation/Repair Service of All Other Energy Saving Lighting, Equipment,
Products, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and
Products.
Proposal Forms COMM/SVCS v.08.11.2021
Page 39 of 72
Rexel, Inc. Information
Address: 14951 Dallas Parkway
Dallas, TX 75254
Phone: (972) 389-5615
By submitting your response, you certify that you are authorized to represent and bind your company.
Paul Bigalke paul.bigalke@rexelusa.com
Signature Email
Submitted at 911512022 02:45:03 PM (CT)
Requested Attachments
BuyBoard Proposal Invitation No. 690-23 Energy Saving Lighting Products Proposal-No-690-23 Final.pdf
REQUIRED -In PDF format, upload all proposal invitation documents available for download at vendor.buyboard.com
including any additional pages, as necessary. NOTICE: DO NOT complete proposal forms in internet browser. No data
will be stored. Download file to computer and complete proposal forms prior to submitting. (Please DO NOT password
protect uploaded files.)
Catalog/Pricelist
All Items LedVance Keystone LED.xlsx
REQUIRED -In Excel or PDF format, upload catalog(s)/pricelist(s) in accordance with proposal invitation instructions.
Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or Proposal will not be considered. No paper
catalogs or manufacturer/vendor websites will be accepted. File size must not exceed 250MB. (Please DO NOT
password protect uploaded files.)
Exceptions and/or Detailed Information Related to Discount % and/or Hourly Labor Rate No response
Proposed
In PDF format and if necessary, vendor shall attach detailed information regarding exceptions to pricing and/or
discount percentage and define the services that are proposed to be provided. NOTE: IF DETAILED INFORMATION IS
NOT SUBMITTED, PROPOSAL MAY NOT BE CONSIDERED. (Please DO NOT password protect uploaded files.)
Company Profile
About US.docx
REQUIRED -Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard
website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company
description that you would like to have included with your company profile on the BuyBoard website. Submit your
company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any
content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any
content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the
Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.)
IRS Form W-9 Request for Taxpayer 2022 Rexel USA, Inc. W-9 dba Rexel Commercial & Industrial.pdf
Identification Number and Certification
REQUIRED -In PDF format, upload W-9 form. (Please DO NOT password protect uploaded files.)
Bid Attributes
1
Federal Identification Number
Federal Identification Number
20-5021845
2
HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification
Page 3 of 30 pages Vendor: Rexel, Inc. 690-23
3
No Israel Boycott Certification
A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly
or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees
for goods or services unless the contract contains a written verification from the company that it: (1) does not
boycott Israel; and (2) will not boycott Israel during the term of the contract. (TEX. GOV'T CODE Ch. 2270).
Accordingly, this certification form is included to the extent required by law.
"Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that
is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a
person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for
ordinary business purposes. TEX. GOV'T CODE §808.001(1).
By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor
does not boycott Israel and will not boycott Israel during the term of any contract awarded under this Proposal
Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this
certification.
Yes
4
No Excluded Nation or Foreign Terrorist Organization Certification
Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a
contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization
— specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas
Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares
to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to
a foreign terrorist organization is not subject to the contract prohibition.)
By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas
Comptroller's list identified above; that this certification is true, complete and accurate; and that I am authorized by
my company to make this certification.
Yes
5
MWBE/HUB Status Certification
A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women
Business Enterprise or "MWBE" and all referred to in this form as a "HUB") is encouraged to indicate its HUB
certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications
for awarded Vendors that properly indicate and document their HUB certification on this form.
certify that my company has been certified as a MWBE/HUB in the following categories: (Please check all that
apply)
6
Minority Owned Business
Minority Owned Business
❑ Minority Owned Business (Yes)
7
Women Owned Business
Women Owned Business
❑ Women Owned Business (Yes)
8
Service -Disabled Veteran Owned Business
Service -Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a service -connected
disability as defined by 38 U.S.C. § 101(16), and who has a disability rating of 20% or more as determined by the U.
S. Department of Veterans Affairs or Department of Defense)
❑ Service -Disabled Veteran Owned Business (Yes)
Page 4 of 30 pages Vendor: Rexel, Inc. 690-23
9
Certification Number
Certification Number
No response
1
U
Name of Certifying Agency
Certifying Agency
No response
1
1
Non-MWBE/HUB
My company has NOT been certified as a MWBE/HUB
❑ Non -HUB (Yes)
1
2
Vendor General Contact Information
Proposal/Contract General Contact Information
1
3
Vendor Proposal/Contract Contact Name
Vendor Proposal/Contract Contact Name
Paul Bigalke
1
4
Vendor Proposal/Contract Contact E-mail Address
Vendor Proposal/Contract Contact E-mail Address
paul.bigalke@rexelusa.com
1
5
Vendor Proposal/Contract Mailing Address
Vendor Proposal/Contract Mailing Address
2965 Commodore Dr
1
6
Vendor Proposal/Contact Mailing Address - City
Vendor Proposal/Contact Mailing Address - City
Carrollton
1
7
Vendor Proposal/Contact Mailing Address - State
Vendor Proposal/Contact Mailing Address - State (Abbreviate State Name)
TX
1
8
Vendor Proposal/Contact Mailing Address - Zip Code
Vendor Proposal/Contact Mailing Address - Zip Code
75007
1
9
Vendor Proposal/Contact Phone Number
Vendor Proposal/Contact Phone Number (xxx-xxx-)xxx)
469-247-6403
2
U
Vendor Proposal/Contact Extension Number
Vendor Proposal/Contact Extension Number
No response
Page 5 of 30 pages Vendor: Rexel, Inc. 690-23
2
Company Website
Company Website (www.xxxxx.com)
www.rexelusa.com
2
2
Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• I will use the internet to receive Purchase Orders at the following address
Yes
2
3
Purchase Order E-mail Address
Purchase Order E-mail Address
buyboard@rexelusa.com
2
4
Purchase Order Contact Name
Purchase Order Contact Name
Martin Bausch
2
5
Purchase Order Contact Phone Number
Purchase Order Contact Phone Number (xxx-xxx-)o=)
469-512-8910
2
6
Purchase Order Contact Extension Number
Purchase Order Contact Extension Number
LRC@rexelusa.com
2
7
Alternate Purchase Order E-mail Address
Alternate Purchase Order E-mail Address
No response
2
8
Alternate Purchase Order Contact Name
Alternate Purchase Order Contact Name
No response
2
9
Alternate Purchase Order Contact Phone Number
Alternate Purchase Order Contact Phone Number (xxx-xxx-xxxx)
No response
3
U
Alternate Purchase Order Contact Extension Number
Alternate Purchase Order Contact Extension Number
No response
Page 6 of 30 pages Vendor: Rexel, Inc. 690-23
3
Purchase Orders Contact Information
All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet
access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a
new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their
orders.
Please select options below for receipt of Purchase Orders and provide the requested information:
• Purchase Orders may be received by the Designated Dealer(s) identified on my company's Dealer
Designation form as provided to the Cooperative administrator. I understand that my company shall remain
responsible for the Contract and the performance of all Designated Dealers under and in accordance with
the Contract.
Yes
3
2
Request for Quotes (5EceRFQ5E)
Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs:
3
3
Request for Quote (RFQ) E-mail Address
Request for Quote (RFQ) E-mail Address
buyboard@rexelusa.com
3
4
Request for Quote (RFQ) Contact Name
Request for Quote (RFQ) Contact Name
Martin Bausch
3
5
Request for Quote (RFQ) Contact Phone Number
Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
469-512-8910
3
6
Request for Quote (RFQ) Contact Extension Number
Request for Quote (RFQ) Contact Extension Number
No response
3
7
Alternate Request for Quote (RFQ) E-mail Address
Alternate Request for Quote (RFQ) E-mail Address
LRC@rexelusa.com
3
8
Alternate Request for Quote (RFQ) Contact Name
Alternate Request for Quote (RFQ) Contact Name
No response
3
9
Alternate Request for Quote (RFQ) Contact Phone Number
Alternate Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx)
No response
4
U
Alternate Request for Quote (RFQ) Contact Extension Number
Alternate Request for Quote (RFQ) Contact Extension Number
No response
Page 7 of 30 pages Vendor: Rexel, Inc. 690-23
4
Invoices
Your company will be billed monthly for the service fee due under a Contract awarded under this Proposal
Invitation. All invoices are available on the BuyBoard website and e-mail notifications will be sent when
they are ready to be retrieved.
4
Invoices
2
Please choose only one (1) of the following options for receipt of invoices and provide the requested
information:
(a) Service fee invoices and related communications should be provided directly to my company at:
or
(b) In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following
billing agent:
If Vendor authorizes a billing agent to receive and process service fee invoices, in accordance with the General Terms and Conditions of the Contract,
Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the
Contract including, but not limited to, payment of all service fees under any Contract awarded Vendor.
Service fee invoices and notices direct to company
4
Invoice Company Name
3
Invoice Company Name
Rexel USA
4
Invoice Company Department Name
4
Invoice Company Department Name
Accounts Payable
4
Invoice Contact Name
5
Invoice Contact Name
Martin Bausch
4
Invoice Mailing Address
6
Invoice Mailing Address (P.O. Box or Street Address)
2965 Commodore Dr
4
Invoice Mailing Address - City
7
Invoice Mailing Address - City
Carrollton
4
Invoice Mailing Address - State
8
Invoice Mailing Address - State (Abbreviate State Name)
TX
4
Invoice Mailing Address - Zip Code
9
Invoice Mailing Address (Zip Code)
75007
Page 8 of 30 pages Vendor: Rexel, Inc. 690-23
5
U
Invoice Contact Phone Number
Invoice Contact Phone Number (xxx-xxx-xxxx)
469-512-8910
5
1
Invoice Contact Extension Number
Invoice Contact Extension Number
No response
5
2
Invoice Contact Fax Number
Invoice Contact Fax Number (xxx-xxx-xxxx)
No response
5
3
Invoice Contact E-mail Address
Invoice Contact E-mail
buyboard@rexelusa.com
5
4
Invoice Contact Alternate E-mail Address
Invoice Contact Alternate E-mail Address
LRC@rexelusa.com
5
5
Billing Agent Company Name
Billing Agent Company Name
No response
5
6
Billing Agent Department Name
Billing Agent Department Name
No response
5
7
Billing Agent Contact Name
Billing Agent Contact Name
No response
5
8
Billing Agent Mailing Address
Billing Agent Mailing Address (P.O. Box or Street Address)
No response
5
9
Billing Agent Mailing Address - City
Billing Agent Mailing Address - City
No response
6
U
Billing Agent Mailing Address - State
Billing Agent Mailing Address - State (Abbreviate State Name)
No response
6
Billing Agent Mailing Address - Zip Code
Billing Agent Mailing Address - Zip Code
No response
Page 9 of 30 pages Vendor: Rexel, Inc. 690-23
6
2
Billing Agent Contact Phone Number
Billing Agent Contact Phone Number (xxx-xxx-xxxx)
No response
6
3
Billing Agent Contact Extension Number
Billing Agent Contact Extension Number
No response
6
4
Billing Agent Fax Number
Billing Agent Fax Number
No response
6
5
Billing Agent Contact E-mail Address
Billing Agent Contact E-mail Address
No response
6
6
Billing Agent Alternative E-mail Address
Billing Agent Alternative E-mail Address
No response
6
7
Shipping Via
Common Carrier, Company Truck, Prepaid and Add to Invoice, or Other
Company Truck
6
8
Payment Terms
Note: Vendor payment terms must comply with the BuyBoard General Terms and Conditions and the Texas Prompt
Payment Act (Texas Government Code Ch. 2251).
Net 30
6
9
Vendor's Internal/Assigned Reference/Quote Number
Vendor's Internal/Assigned Reference/Quote Number
No response
7
U
State or Attach Return Policy
Note: Only return requirements and processes will be deemed part of Vendor's return policy. Any unrelated contract
terms, terms of sale, or other information not specifically related to return requirements and processes included in
Vendor's return policy shall not apply to any awarded Contract unless specifically included as a deviation in the
Deviation and Compliance Form and accepted by the Cooperative.
No response
7
1
Electronic Payments
Are electronic payments acceptable to your company?
No
7
2
Credit Card Payments
Are credit card payments acceptable to your company?
No
Page 10 of 30 pages Vendor: Rexel, Inc. 690-23
7
Texas Regional Service Designation
3
Texas Regional Service Designation - Refer to Form in Proposal Invitation
The Cooperative (referred to as "Texas Cooperative" in this form and in the State Service Designation form) offers
vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all
Texas Cooperative members statewide, you must indicate the specific regions you will service on this form. If you
propose to serve different regions for different products or services included in your Proposal, you must complete
and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the
products or services to which the designation applies. By designating a region or regions, you are certifying that
you are authorized and willing to provide the proposed products and services in those regions. Designating
regions in which you are either unable or unwilling to provide the specified products and services shall be
grounds for either rejection of your Proposal or, if awarded, termination of your Contract. Additionally, if you
do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), you must
so indicate on this form.
7
Company Name
4
Company Name
Rexel USA
7
Texas Regional Service Designation
5
Select only one of the following options. If you select "I will NOT serve all Regions of Texas", you must then
check the individual Regions you wish to serve.
All Regions
7
Region 1
6
Region 1 - Edinburg
❑ Region 1 (1)
7
Region 2
7
Region 2 - Corpus Christi
❑ Region 2 (2)
7
Region 3
8
Region 3 - Victoria
❑ Region 3 (3)
7
Region 4
9
Region 4 - Houston
❑ Region 4 (4)
8
Region 5
U
Region 5 - Beaumont
❑ Region 5 (5)
8
Region 6
1
Region 6 - Huntsville
❑ Region 6 (6)
8
Region 7
2
Region 7 - Kilgore
❑ Region 7 (7)
Page 11 of 30 pages Vendor: Rexel, Inc. 690-23
8
Region 8
3
Region 8 - Mount Pleasant
❑ Region 8 (8)
8
Region 9
4
Region 9 - Wichita Falls
❑ Region 9 (9)
8
Region 10
5
Region 10 - Richardson
❑ Region 10 (10)
8
Region 11
6
Region 11 - Fort Worth
❑ Region 11 (11)
8
Region 12
7
Region 12 - Waco
❑ Region 12 (12)
8
Region 13
8
Region 13 - Austin
❑ Region 13 (13)
8
Region 14
9
Region 14 - Abilene
❑ Region 14 (14)
9
Region 15
0
Region 15 - San Angelo
❑ Region 15 (15)
9
Region 16
1
Region 16 - Amarillo
❑ Region 16 (16)
9
Region 17
2
Region 17 - Lubbock
❑ Region 17 (17)
9
Region 18
3
Region 18 - Midland
❑ Region 18 (18)
9
Region 19
4
Region 19 - El Paso
❑ Region 19 (19)
Page 12 of 30 pages Vendor: Rexel, Inc. 690-23
9
Region 20
5
Region 20 - San Antonio
❑ Region 20 (20)
9
State Service Designation
6
State Service Designation - Refer to Form in Proposal Invitation.
As set forth in the Proposal Invitation, it is the Cooperative's intent that other governmental entities in the United
States have the opportunity to purchase goods or services awarded under the Contract, subject to applicable state
law, through a piggy -back award or similar agreement through the National Purchasing Cooperative BuyBoard. If
you plan to service the entire United States or only specific states, you must complete this form accordingly. (Note:
If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service
Designation form.) In addition to this form, to be considered for a piggy -back award by the National
Purchasing Cooperative, you must have an authorized representative sign the National Purchasing
Cooperative Vendor Award Agreement that follows this form.
If you serve different states for different products or services included in your Proposal, you must complete and
submit a separate State Service Designation form for each group of products and clearly indicate the products or
services to which the designation applies. By designating a state or states, you are certifying that you are
authorized and willing to provide the proposed products and services in those states. Designating states in which
you are either unable or unwilling to provide the specified products and services shall be grounds for either
rejection of your Proposal or, if awarded, termination of your Contract.
9
Company Name
7
Company Name
Rexel USA
9
State Service Designation
8
Select only one of the following options. If you select "I will NOT serve all States", you must then check
the individual States you wish to serve.
All States
9
Alabama
9
Alabama
❑ Alabama (AL)
1
Alaska
6
0
Alaska
❑ Alaska (AK)
1
Arizona
Arizona
❑ Arizona (AZ)
1
Arkansas
2
Arkansas
❑ Arkansas (AR)
1
California
0
3
California (Public Contract Code 20118 & 20652)
❑ California (CA)
Page 13 of 30 pages Vendor: Rexel, Inc. 690-23
I
Colorado
U
4
Colorado
❑ Colorado (CO)
1
Connecticut
5
Connecticut
❑ Connecticut (CT)
1
Delaware
6
Delaware
❑ Delaware (DE)
1
District of Columbia
U
7
District of Columbia
❑ District of Columbia (DC)
1
Florida
U
8
Florida
❑ Florida (FL)
1
Georgia
9
Georgia
❑ Georgia (GA)
1
Hawaii
dHawaii
❑ Hawaii (HI)
1
Idaho
1
1
Idaho
❑ Idaho (ID)
1
Illinois
1
2
Illinois
❑ Illinois (IL)
1
Indiana
1
Indiana
❑ Indiana (IN)
1
Iowa
4
Iowa
❑ Iowa (IA)
1
Kansas
5
Kansas
❑ Kansas (KS)
Page 14 of 30 pages Vendor: Rexel, Inc. 690-23
1
Kentucky
1
6
Kentucky
❑ Kentucky (KY)
1
Louisiana
1
Louisiana
❑ Louisiana (LA)
1
Maine
8
Maine
❑ Maine (ME)
1
Maryland
1
9
Maryland
❑ Maryland (MD)
1
Massachusetts
2
0
Massachusetts
❑ Massachusetts (MA)
1
Michigan
2
1
Michigan
❑ Michigan (MI)
1
Minnesota
2
Minnesota
❑ Minnesota (MN)
1
Mississippi
2
3
Mississippi
❑ Mississippi (MS)
1
Missouri
2
Missouri
❑ Missouri (MO)
1
Montana
22
Montana
❑ Montana (MT)
1
Nebraska
2
6
Nebraska
❑ Nebraska (NE)
1
Nevada
2
Nevada
❑ Nevada (NV)
Page 15 of 30 pages Vendor: Rexel, Inc. 690-23
1
New Hampshire
2
8
New Hampshire
❑ New Hampshire (NH)
1
New Jersey
2
9
New Jersey
❑ New Jersey (NJ)
1
New Mexico
UNew
Mexico
❑ New Mexico (NM)
1
New York
3
1
New York
❑ New York (NY)
1
North Carolina
3
2
North Carolina
❑ North Carolina (NC)
1
North Dakota
3
3
North Dakota
❑ North Dakota (ND)
1
Ohio
3
Ohio
❑ Ohio (OH)
1
Oklahoma
3
5
Oklahoma
❑ Oklahoma (OK)
1
Oregon
33
Oregon
❑ Oregon (OR)
1
Pennsylvania
3
7
Pennsylvania
❑ Pennsylvania (PA)
1
Rhode Island
3
8
Rhode Island
❑ Rhode Island (RI)
1
South Carolina
3
9
South Carolina
❑ South Carolina (SC)
Page 16 of 30 pages Vendor: Rexel, Inc. 690-23
1
South Dakota
4
0
South Dakota
❑ South Dakota (SD)
1
Tennessee
Tennessee
❑ Tennessee (TN)
1
Texas
4
Texas
❑ Texas (TX)
1
Utah
4
3
Utah
❑ Utah (UT)
1
Vermont
4
Vermont
❑ Vermont (VT)
1
Virginia
4
Virginia
❑ Virginia (VA)
1
Washington
4
6
Washington
❑ Washington (WA)
1
West Virginia
4
7
West Virginia
❑ West Virginia (WV)
1
Wisconsin
4
Wisconsin
❑ Wisconsin (WI)
1
Wyoming
4
9
Wyoming
❑ Wyoming (WY)
Bid Lines
Page 17 of 30 pages Vendor: Rexel, Inc. 690-23
1
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Energy Saving Electronic Ballasts (high efficiency, low
wattage, and other related items). Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 1 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Alternate 1
Section I: Equipment, Products. and Supplies
Discount (%) off catalog/pricelist for All Types of Energy Saving Electronic Ballasts (high efficiency, low wattage,
and other related items). Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 1 70%
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Keystone Technologies
Alternate 2
Section I: Equipment, Products. and Supplies
Discount (%) off catalog/pricelist for All Types of Energy Saving Electronic Ballasts (high efficiency, low wattage,
and other related items). Catalog/Pricelist MUST be included or proposal will not be considered.
Total:
1 16.6%
Page 18 of 30 pages Vendor: Rexel, Inc. 690-23
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NO E: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". T
Light Efficient Design
2
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Energy Saving Fluorescent Lamps and Fixtures (high
efficiency, low wattage, and other related items). Catalog/Pricelist MUST be included or proposal will not be
considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NO E: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". T
LedVance Sylvania
Page 19 of 30 pages Vendor: Rexel, Inc. 690-23
3
Section I: Equipment, Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Ceiling and Wall Box Motion Sensors. Catalog/Pricelist
MUST be included or proposal will not be considered.
No Bid
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Page 20 of 30 pages Vendor: Rexel, Inc. 690-23
4
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Electronic HID Ballasts, Lamps, and Fixtures.
Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Page 21 of 30 pages Vendor: Rexel, Inc. 690-23
5
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Electronic HPS Ballasts, Lamps, and Fixtures.
Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Page 22 of 30 pages Vendor: Rexel, Inc. 690-23
6
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Exit Polycarbonate Products (3W LED and other related
items). Catalog/Pricelist MUST be included or proposal will not be considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Page 23 of 30 pages Vendor: Rexel, Inc. 690-23
7
Section I: Equipment. Products, and Supplies
Discount (%) off catalog/pricelist for All Types of LED Tube Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Alternate 1
Section I: Equipment, Products, and Supplies
Discount (%) off catalog/pricelist for All Types of LED Tube Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 70%
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Keystone Technologies
Alternate 2
Section I: Equipment, Products. and Supplies
Discount (%) off catalog/pricelist for All Types of LED Tube Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 1 16.6%
Page 24 of 30 pages Vendor: Rexel, Inc. 690-23
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NO E: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". T
Light Efficient Design
8
Section I: Equipment, Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Solar Lighting Products. Catalog/Pricelist MUST be included
or proposal will not be considered.
Total:
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NO E: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". T
Light Efficient Design
Page 25 of 30 pages Vendor: Rexel, Inc. 690-23
9
Section I: Equipment, Products, and Supplies
Discount (%) off catalog/pricelist for All Types of Watt Stopper Sensors. Catalog/Pricelist MUST be included or
proposal will not be considered.
No Bid
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Page 26 of 30 pages Vendor: Rexel, Inc. 690-23
1
Section I: Equipment, Products, and Supplies
0
Discount (%) off catalog/pricelist for Recycle Services of Lamps, Batteries, Ballasts, and Fixtures.
Catalog/Pricelist MUST be included or proposal will not be considered.
No Bid
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
No response
Page 27 of 30 pages Vendor: Rexel, Inc. 690-23
1
Section I: Equipment. Products, and Supplies
1
Discount (%) off catalog/pricelist for All Other Energy Saving Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 80%
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit
the information as follows or proposal may not be considered:
• Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist
proposed
• Vendor's must list one specific percentage discount for each manufacturer and/or
catalog/pricelist listed
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
LedVance Sylvania
Alternate 1
Section I: Equipment, Products, and Supplies
Discount (%) off catalog/pricelist for All Other Energy Saving Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 1 70%
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed".
Keystone Technologies
Alternate 2
Section I: Equipment, Products. and Supplies
Discount (%) off catalog/pricelist for All Other Energy Saving Lighting Products. Catalog/Pricelist MUST be
included or proposal will not be considered.
Total: 1 16.6%
Page 28 of 30 pages Vendor: Rexel, Inc. 690-23
Item Attributes
1. State Name of Catalog/Pricelist Proposed with Discount Percentage
NO E: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". T
Light Efficient Design
1 Section II: Energy Audit Programs
2
Energy Audit Programs - State the Not to Exceed per square foot price for Energy Audit Programs and related
services as defined in this proposal invitation.
Quantity: 1 UOM: Per Square Foot Price: F $0.03 1 Total: I$0.03
Item Notes: PROPOSAL NOTE 1: Vendors shall submit catalog (s)/pricelist(s) with their Proposal response or the
Proposal will not be considered. Vendors shall submit catalog (s)/pricelist(s) with the Proposal in a
readily available and readable electronic format, with Excel or searchable PDF preferred. No paper
catalogs or manufacturer/vendor websites will be accepted.
PROPOSAL NOTE 2: The intent of this Proposal Invitation is to establish a contract for Cooperative
members to procure equipment, supplies, and installation or repair of energy saving lighting products
only. "Energy Audit Programs" as used in this Proposal Invitation refers only to general reviews of
existing Cooperative member lighting to determine potential lighting needs as it may relate directly to
the purchase, installation and servicing of energy saving lighting products to be procured within the
scope and intent of this Proposal Invitation. "Energy Audit Programs" does not include, and no
vendor shall propose or, if awarded, offer to provide under this Proposal Invitation any services that are
required to be procured in the manner prescribed by the Professional Services Procurement Act
(Chapter 2254 of the Texas Government Code), including without limitation architectural services,
professional engineering services, or energy savings performance contract services where required
under Texas law to be let according to the procedures established for professional services under Texas
Government Code Chapter 2254.004.
1 Section III: Installation and Repair Service
3
Hourly Labor Rate for Installation/Repair Service of Energy Saving Electronic Ballasts, Fluorescent
Lamps, Fixtures, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of
Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section III: Installation and Repair Service
4
Hourly Labor Rate for Installation/Repair Service of Ceiling and Wall Box Motion Sensors, Equipment
and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section III: Installation and Repair Service
5
Hourly Labor Rate for Installation/Repair Service of Electronic HID and HPS Ballasts, Lamps, Fixtures,
and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
Page 29 of 30 pages Vendor: Rexel, Inc. 690-23
1 Section III: Installation and Repair Service
6
Hourly Labor Rate for Installation/Repair Service of Exit Polycarbonate, LED Tube Lighting, Watt
Stopper Sensor Products and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service
of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section III: Installation and Repair Service
7
Hourly Labor Rate for Installation/Repair Service of Solar Lighting Products and Related Items - Not to
Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.
Quantity: 1 UOM: Hourly Labor Rate No Bid
1 Section III: Installation and Repair Service
8
Hourly Labor Rate for Installation/Repair Service of All Other Energy Saving Lighting, Equipment,
Products, and Related Items - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and
Products.
Quantity: 1 UOM: Hourly Labor Rate
Response Total: $0.03
Page 30 of 30 pages Vendor: Rexel, Inc. 690-23
Exhibit C
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
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.
-IJ Name of vendor who has a business relationship with local governmental entity.
R. ,eGe I K5�r -�h(C ,
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.)
a Name of local government officer about whom the information is being disclosed.
Name of Officer
41 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 13 for each employment or business relationship described. Attach additional pages to this Form
CIO as necessary. —
f�oUt2
i
A. Is the local government officer or a family membeof-tfie officer receiving or likely to receive taxable income,
other than investment income, from the vend�cr?-
Yes �No
B. Is the vend ceiving or likely to receive taxable income, other than investment income, from or at the direction
of the Io overnment officer or a family member of the officer AND the taxable income is not received from the
loc overnmental entity?
Yes E:1 No
-sj 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 am-
6
Cheek-thris-box if#ievendor has given the Ioeal-govemment offiew of a fare* m ember of the -off ieer one -or -more -gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
7
Signature of vendor doing business with the governmental entity Date
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 111l2021
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.legis.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) Avendor 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 focal 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 emplaymew-or-othter business-reW4ns40-m4th.a local gavertarneat-office ora,
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
Named insureds include:
Rexel of America, LLC
SKRLA,LLC
SPT Holdings, Inc.
Beacon Electric Supply
Rexel USA, Inc. (dba Gexpro)
Rexel USA, Inc. DBA: Platt Electric Supply
Rexel USA, Inc. DBA Rexel Energy Solutions
Rexel USA, Inc. DBA Capitol Light
Rexel USA, Inc. dba Brohl and Appell
Rexel USA, Inc. dba New Haven Supply
Rexel USA, Inc. dba Rexel Commercial & Industrial
Rexel USA, Inc. dba Parts Super Center
Rexel USA, Inc. Rexel Automation Solutions
Rexel USA, Inc. d/b/a Utility Supply Group
Rexel USA, Inc. dba Electrical Parts
Rexel USA, Inc. d/b/a Mayer Electric Supply
Rexel USA, Inc. d/b/aThe Hite Company
Rexel USA, Inc. d/b/a/ Horizon Solutions LLC