HomeMy WebLinkAboutContract 61238DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
FORT WORTH CSC No. 61238
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between B&H Foto and
Electronics Corporation, dba B&H ("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 — Omnia Partners No. R201202; 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 firstyear by City
shall not exceed Six Thousand Nine Hundred and Thirty -Five Dollars ($6,935.00). 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, 2025 in line with the COOP Agreement. City
shall be able to renew this agreement for up to one (1) one-year renewal option by written agreement of
the parties, so long as the underlying COOP is renewed.
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.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Federal Comnliance: Vendor agrees to comply with all federal statutes relating to
nondiscrimination, labor standards, domestic preference and environmental compliance. Additionally, for
work to be performed underthe Agreement or subcontract thereof, including procurement of materials or
leases of equipment, Vendor shall notify each potential subcontractor or supplier of the Vendor's federal
compliance obligations. These may include,but are not limited to: (a) Title VI of the Civil Rights Act of
1964 (P.L. 88-352) which prohibits discrimination onthe basis of race, color or national origin; (b) Title
IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and 1685-1686),
which prohibits discrimination on the basis of sex; (c) the Fair Labor Standards Act of 1938 (29 USC
676 et. seq.), (d) Section 504 of the Rehabilitation Act of 1973, as amended (29
U.S.C. § 794), which prohibits discrimination on the basis of handicaps and the Americans with
Disabilities Act of 1990; (e) the Age Discrimination in Employment Act of 1967 (29 USC 621 et. seq.)
and the Age Discrimination Act of 1974, as amended (42 U.S.C. §§ 6101-6107), which prohibits
discrimination on the basis of age; (f) any other nondiscrimination provisions in any specific statute(s)
applicable to any Federal funding for this Agreement; (g) the requirements of any other nondiscrimination
statute(s) which may apply to this Agreement; (h) applicableprovisions of the Davis -Bacon Act under 40
USC § 3141 — 3148, and the Contract Work Hours and Safety Standards Act under 40 USC § 3701 —
3708; (i) applicable provisions of the Rights to Invention Made Under Contract or Agreement Act under
37 CFR Part 401; 0) applicable provisions of the Clean Air Act under 42 USC § 7401— 7671, the Energy
Federal Water Pollution Control Act 33 USC § 1251 — 1387, and the Energy Policy Conservation Act
under 42 USC § 6201; (k) compliance with all Buy America requirements under 23 USC 313 and 23
CFR 635.410, which require a domestic manufacturing process for any steel or iron products; (1)
Compliance with Prohibition on Certain Telecommunications and Video Surveillance Services or
Equipment under 2 CFR §200.216 and §200.471; (m) compliance with federal assistance programs under
Executive Order 12549, Debarment and Suspension, which prohibit participation of debarred or
suspended or otherwise excludedfrom or ineligible vendor or its suppliers using federal funds; (n)
compliance with federal restriction on lobbying expenditures under 2 CFR 200 clauses: (o) consistent
with Domestic preferences for procurements under 2 CFR §200.322, which provide a preference for the
purchase, acquisition, or use of goods, products, or materials produced in the United States as appropriate
and to the greatest extent practicable.
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:
To CITY:
City of Fort Worth
Attn: Valerie Washington, Assistant City
Manager
200 Texas Street
Fort Worth, TX 76102-6314
Facsimile: (817) 392-8654
With copy to Fort Worth CityAttorney's Office
at same address
To VENDOR:
B&H Foto and Electronics Corporation
Israel Mamann, Manager B2B Contracts
420 Ninth Avenue
New York NY, 10001
Facsimile: 800 — 858 -5517
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
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-ValerieWashington rnri
Name: Valerie Washington
Title: Assistant City Manager
Date:
APPROVAL RECOMMENDED:
-4-
By.
Name: Roger Venables
Title: Director, Aviation
4,00vonp��
ATTEST:
pao .'o—%
o
Pvo o=d
p° °' d
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By:
Name: Jannette S. Goodall
Title: City Secretary
VENDOR:
B&H Foto and Electronics Corporation
BfDocuSigned by:
st6raU.
-saaa5aanr�
Name:Manny Steigman
Title: VP Marketing
Date: 4/2/2024
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.
By: Er&nl L . 2 �
Name: Erin Roden
Title: Senior Contract
Compliance Specialist
APPROVED AS TO FORM AND LEGALITY:
By.
Name: Jeremy Anato Mensah
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: N/A
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
L/%1 I I LIT A -Quote
REQUISITION FORM
Check One
MASTERCARD �✓ ANNUAL AGREEMENT
PSK #:
PURCHASE ORDER
0000000347
SID#:
One Time Purchase 03/13/2024
Date:
❑ End Fiscal Year Employee: Erin Roden
Recurring Facility: FWT -
Lowest Bidder
Vendor: B & H Photo & Electronics Corp
Contact: COOP Omnia Partners
Address:
Phone:
Qtv. ITEM # -Item Description
1 Matterport MC300 Pro 3 Camera Bundle 1 REG
Purpose:
See attached Camera to photograph and video airports
Unit Cost/Total
$6935.00 / $ 6935
$ /$0
$ /$0
$ /$0
$ /$0
$ /$0
$ /$0
$ /$0
Total: $ 6935
* Purchase Order should be issued BEFORE order placement
Approval Information:
Ricardo BarCeIO Digitally signed by Ricardo Barce16 DATE,
Supervisor Signature Date: 2024.02.12 17:04:28-06'00'
Print Name: Ricardo Barce16
Account/Center: 55001-0551000-5610601 (Information Tech Supplies)
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Government, Education, and Corporate Department
o For Pricing Requests, Purchase Orders, and Customer Service:
800-947-8003 ucation: emailbids@bhphoto.com Fed Gov: federalsales@bhphoto.com
�12-239-7503 Fr;00-858-5517
212-239-7759 FrEd,
rporate:corporatesales@bhphoto.com State and Local:biddept@bhphoto.com
The Professionals Source 420 Ninth Avenue, New York City, NY 10001 • www.bhphotovideo.com
Prices Are Valid Until: 02/17/24 Quote No.:903821026
Reference No.: R201202
Sold To: Erin Roden
City Of Fort Worth -Aviation
201 American Concourse
Attn: Erin Roden
FORT WORTH, TX 76106
Bill Phone: (817)392-5400
Date Customer Code Perms
01/18/24 B8796240 N/A
1 1 MATTERPORT MC300 PR03 CAMERA - BUNDLE 1/REG
Manufacturer's Rebate Free Item
In Stock - while supplies last.
Ship To:
Forth Worth Meecham Intl Aipor
201 American Concourse
FORT WORTH, TX 76106
(817)392-5408
Salesperson Ship Via
AFll I FDX GROUND
PLEASE NOTE:
**** Please reference your quote number on all PO's ****
**** ALL PRICES ARE LISTED IN USD ****
NO PAYMENT TYPE SELECTED
MAMC300BUND 6,935.00 6,935.00
(MC300_BUNDLE 1)
Sub -Total: 6,935.00
Shipping: Free STND
2
Total: 6,935.00
s
m Customer Copy Page 1 of 1
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
My Account / My Orders / Quote Details
420 Ninth Avenue
Eves-1
_ New York, NY 10001
Phone: 212.3.329.7509.7500
VNOTOVIDEOAU�IO www.bhphotovideo.com
QUOTE DETAILS Expires Feb 17, 2024
January 18, 2024
Quote #903821026
Need help with your order?
Call us: 800.606.6969
STOCK PRICE QTY SUBTOTAL
Matterport MC300 Pro3 3D Digital Camera In Stock $6,935.00 1 $6,935.00
Acceleration Bundle
BH# MAMC300BUND
SHIP TO
Forth Worth Meecham Intl Aipor
201 AMERICAN CONCOURSE
FORT WORTH, TX, 76106
817-392-5408
Subtotal: $6,935.00 Expires Feb 17, 2024
Shipping Free Modify/Cancel Quote
FedEx Ground Delivery
Sales Tax $0.00
Total $6,935.00
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Audio Visual Equipment, Accessories & Services
RFP # 20-12 Contract # R201202
Offeror Company Name: B&H
Item No. I Category I Manufacturer Name I Proposed Discount
1 B&H Full Catalog B&H Full Catalog 0.5-25%off retail pricing
1 B&H Full Catalog B&H Full Catalog Free Shipping (FOB destination) Items weighing more than 70 Ibs or requiring truck delivery due to their weight or size may be charged reasonable shipping.
1 B&H Full Catalog B&H Full Catalog Maufacturers unilateral priced products will be sold at the unilateral price
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY t000x
400 Cedar Lane
Florence, NJ 08518
s �
s EB28i
T H E P R 0 F E S S 1 0 N A L` S
IV. Evaluation Process and Criteria- Response
2.
a) Products/ Pricing
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
i. B&H is offering a range discount of 0.5-25% off retail pricing. Discounts vary by brand
and product but will remain within the discount range with an average discount of
12.5% off our retail pricing. Manufacturers unilateral priced items will remain at price
set forth by the manufacturer. Where a quote is over $5000, the B&H pricing team will
review the price to ensure the best discount is given.
H. An electronic copy of the retail catalog can be found at www.bhohoto.com. B&H will
provide a discounted portal where discounts will be verifiable. A catalog is also attached
on a flash drive labeled "catalog."
iii. The B & H catalog represents over 500,000 products. B&H is extending making pricing
available for all products and services in our catalog.
iv. B&H works with Hampton Ridge Financial for leasing programs. Contact
Leasing@bhphoto.com for more information.
httr)s://www.bhohotovideo.com/find/leasing.isp.
v. B&H will offer free shipping FOB destination for this contract. Items weighing mare
than 70 Ibs or requiring truck delivery due to their size or weight may be charged
reasonable shipping.
vi. B&H includes all standard manufactured warranties with our products. Please
reference the warranty section of our site.
httos://www,bhohotovideo.com/find/HeloCenter/Poilcies.isp#warranties. B&H also sells
additional protection plans that will be made available to the contract members.
vii. If you are dissatisfied with your purchase for any reason, you may return it to B&H
within 30 days of the purchase date, subject to the conditions and exclusions found
httos: //www. bh p hotovi deo. co m /find/H e l pCenter/Ret u rn Excha nee. iso?o rigSea rch=ret u r
ns
viii. On top of the significant savings this contract will generate, B&H's pricing team will
review any quote over $5000.00 to ensure the OMNIA member is getting the greatest
discount possible.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue B2bCor►tracts@Bhphoto.com
New York, NY mot ' 212-239-7500
�vww. Bhphoto. comb 2b
40o Cedar Lane NaAMWAE ;1 05
Florence, NCI 08518
T H E PROFESS IONA L` S S O U R C E
ix. A portal will be made available for the contract users to generate quotes, checkout
and verify contract pricing. All discounts will be displayed underneath the price.
Olympus Barrel Style Lens Case for
m.Zuiko Digital Lenses (Extra Small,
Black)
•. 7
3 Rev ekes
Key Features
+ Hea5se.'a;Extre5ma r-7j,k3
•=e�erCes�'a
jAdd to Compare Ha^a =ye ar7 aayn:r C�r;,rrc �-
Add .a wish List
In stock
Fie W ppl^g(IiSA)
F) p esy, Rore F dcup ;n 30 m ^s
Sae All Detaiis >
HvallaNe in ocher 5cyles. Configurations & Kits
x. As Iong as the contract is referenced, B&H's highly trained sales team will apply
contract pricing to the order. Within the B&H ordering system there are many
procedures in place to ensure the customer will obtain contract pricing. This system is
accessible in our one retail store. All payment methods are accepted including P-card,
NET terms and financing.
xi. The range discount will remain steady throughout the term of the contract. B&H adds
products to our catalog and updates pricing daily on various items across our catalog
(usually the pricing goes down due to the nature of the commodity).
xii. Future products will be automatically included into the catalog and will therefore be
offered on this contract at the discounted rate.
xiii. B&H has held this contract for the last S years saving public agencies millions of
dollars due to this pricing structure. B&H looks forward to offering our catalog to public
agencies with these incredible discounts for many years to come. B&H understands that
the contract is a "not to exceed contract" price model and where we are able to offer a
larger discount, we will.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
EXHIBIT B - Renewal Letter and Original Contract
region�f (PI)ctrt)
, t �
Israel Mamann
Manager — 13213 Contracts
B&H Foto and Electronics DBA B&H
420 Ninth Ave.
New York, NY 10001
Email: israelmC&bhphoto.com
Re: Renewal Award of Contract # R201202
Dear Mr. Mamann:
Per official action taken by the Board of Directors of Region 4 Education Service Center on
October 24, 2023, Region 4 ESC is pleased to announce that B&H Foto and Electronics DBA
B&H has been awarded an annual contract renewal for the following, based on the sealed proposal
submitted to Region 4 on December 15, 2020, and subsequent performance thereafter:
Contract
Audio Visual Equipment, Accessories & Services
The contract will expire on March 31, 2025, completing the fourth year of a five-year term
contract. The contract is available through OMNIA Partners, Public Sector. Your designated
OMNIA Partners, Public Sector contact is Deborah Bushnell, at (713) 554-7348 or
deborah.bushnella,,omniapartners.com .
The partnership between B&H Foto and Electronics DBA B&H, Region 4 and OMNIA Partners,
Public Sector can be of great help to participating agencies. Please provide copies of this letter to
your sales representative(s) to assist in their daily course of business.
Sincerely,
EDocuSigned by:
kll� lb aUJ,4_
RZeErtSLLingelmann
Chief Financial Officer, Finance and Operations Services
Region 4 Education Service Center • 7145 West Tidwell Road • Houston, Texas 77092-2096
Phone: 713.462.7708 • Fax: 713.744.6514 • www.esc4.net
Pam Wells, Ed. D., Executive Director
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
OMNI
S
eN. ATIONALI PA U P;ii "n aTT M
Audio Visual Equipment, Accessories, and Services
Executive Summary
Lead Agency: Region 4 ESC
RFP Issued: October 11, 2020
Response Due Date: December 15, 2020
RH
Awarded to: rov Euu cuRp
Solicitation: 20-12
Pre -Proposal Date: November 30, 2020
Proposals Received: 7
Contract # R201202
The Board of Directors of Region 4 Education Service Center (ESC) issued RFP 20-12 on October 11, 2020, to
establish a national cooperative contract for Audio Visual Equipment, Accessories, and Services
The solicitation included cooperative purchasing language in Section I. Scope of Work:
NATIONAL CONTRACT
Region 4 ESC, as the Principal Procurement Agency, defined in Appendix D, has partnered with OMNIA Partners to
make the resultant contract (also known as the "Master Agreement" in materials distributed by OMNIA Partners)
from this solicitation available to other public agencies nationally, including state and local governmental entities,
public and private primary, secondary and higher education entities, non-profit entities, and agencies for the public
benefit ("Public Agencies"), through OMNIA Partners' cooperative purchasing program. The Region 4 is acting as
the contracting agency for any other Public Agency that elects to utilize the resulting Master Agreement. Use of
the Master Agreement by any Public Agency is preceded by their registration with OMNIA Partners (a
"Participating Public Agency"). Appendix D contains additional information about OMNIA Partners and the
cooperative purchasing agreement.
Notice of the solicitation was sent to potential offerors, as well as advertised in the following:
• Region 4 ESC website
• OMNIA Partners, Public Sector website
• USA Today, nationwide
• Arizona Business Gazette, AZ
• San Bernardino Sun, CA
• Honolulu Star -Advertiser, HI
• The Advocate — New Orleans, LA
• New Jersey Herald, NJ
• Times Union, NY
• Daily Journal of Commerce, OR
• The State, SC
• Houston Community Newspapers, Cy Creek
Mirror, TX
• Deseret News, UT
• Richmond Times, VA
• Seattle Daily Journal of Commerce, WA
• Helena Independent Record, MT
Page 1 of 2
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
On December 15, 2020 proposals were received from the following offerors:
• Video Hi -Tech Corp. d/b/a Adwar Video
• Audio Visual Innovations, Inc.
• B&H Foto and Electronics DBA B&H
• Best Buy Stores, L.P.
• Clearwing Systems Integration, LLC
• Ford Audio -Visual Systems, LLC
• Iron Bow Technologies, LLC
The proposals were evaluated by an evaluation committee. Using the evaluation criteria established in the RFP,
the committee determined that B&H Foto and Electronics DBA B&H demonstrated the ability to provide the
products and services outlined in the solicitation while offering competitive pricing to members.
Region 4 ESC executed agreements with a contract effective date of April 1, 2021.
Contract Highlights:
B&H has been working with government agencies for over twenty (20) years and has a well-known
reputation based on product knowledge, customer service, large selection, standard discounted pricing,
in -stock availability, and extensive e-procurement capabilities featuring over 500,000 products.
Contract includes:
Term:
Full product catalogue offering
Initial three-year agreement from April 1, 2021 through March 31, 2024 with the option to renew for two
(2) additional one-year periods through March 31, 2026.
Pricing/Discount:
Provided discount from MSRP for all products and services with discount ranging from 0-3 — 25%.
Discounts vary by brand and product but will remain within the discount range with an average discount
of 12.5% off our retail pricing. Apple products available to State and Local government agencies only.
OMNIA Partners, Public Sector Web Landing Page:
https://public.omniapartners.com/suppliers/bh-photo-video-pro-audio/contract-documentation#c35730
Page 2 of 2
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
region4'
February 23, 2021
Israel Mamann
Manager — B2B Contracts
B&H Foto and Electronics DBA B&H
420 Ninth Ave.
New York, NY 10001
israelm@bhphoto.com
Re: Award of Contract #R201202
Dear Mr. Mamann:
Per official action taken by the Board of Directors of Region 4 Education Service Center on
February 23, 2021, we are pleased to announce that after successful negotiated terms and
conditions, B&H Foto and Electronics DBA B&H has been awarded an annual contract for the
following, based on the sealed proposal (RFP#20-12) submitted on December 15, 2020:
Commodity/Service Suuulier
Audio Visual Equipment, Accessories B&H Foto and Electronics DBA B&H
& Services
This contract is effective April 1, 2021 and will expire on March 31, 2024. As indicated above,
your contract # is R201202. This contract may be renewed annually for an additional two (2) years
if mutually agreed upon by Region 4 ESC/OMNIA Partners, Public Sector and B&H Foto and
Electronics DBA B&H.
Your participation in the proposal process is appreciated and we look forward to a successful
partnership. Please feel free to provide copies of this letter to your sales representative(s) to assist
in their daily course of business.
If you have any questions, please contact Deborah Bushnell, the Contract Manager assigned to
your contract, at 713-554-7348 or deborah.bushnell@omniapartners.com.
Sincerely,
DocuSigned by:
�bKft*AAA&w
30EE15BFEF1 C4C6...
Robert Zingelmann
Chief Financial Officer, Finance and Operations Services
Region 4 Education Service Center • 7145 West Tidwell Road • Houston, Texas 77092-2096
Phone: 713.462.7708 • Fax: 713.744.6514 • www.esc4.net
Pam Wells, Ed. D., Executive Director
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Region 4 Education Service Center (ESC)
Contract # R201202
for
Audio Visual Equipment, Accessories and Services
with
Effective: April 1, 2021
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
The following documents comprise the executed contract between the
Region 4 Education Service Center and B&H, effective April 1, 2021:
I. Executed Purchasing Agreement
II. Supplier's Response to the RFP, incorporated by reference.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
APPENDIX A
CONTRACT
This Contract ("Contract') is made as of February 23„ 2021 by and between B&H foto and
Electronics DBA B&H ("Contractor") and Region 4 Education Service Center ("Region 4
ESC') for the purchase of Audio Visual Equipment, Accessories & Services ("the products and
services').
RECITALS
WHEREAS, Region 4 ESC issued Request for Proposal ("RFP") Number 20-14, to which
Contractor provided a response ("Proposal"); and
WHEREAS, Region 4 ESC selected Contractor's Proposal and wishes to engage Contractor in
providing the services/materials described in the RFP and Proposal;
WHEREAS, both parties agree and understand the following pages will constitute the Contract
between the Contractor and Region 4 ESC, having its principal place of business at 7145 West
Tidwell Road, Houston, TX 77092.
WHEREAS, Contractor included, in writing, any required exceptions or deviations from these
terms, conditions, and specifications; and it is further understood that, if agreed to by Region 4
ESC, said exceptions or deviations are incorporated into the Contract.
WHEREAS, this Contract consists of the provisions set forth below, including provisions of all
attachments referenced herein. In the event of a conflict between the provisions set forth below
and those contained in any attachment, the provisions set forth below shall control.
WHEREAS, the Contract will provide that any state and local governmental entities, public and
private primary, secondary and higher education entities, non-profit entities, and agencies for the
public benefit ("Public Agencies") may purchase products and services at prices indicated in the
Contract upon the Public Agency's registration with OMNIA Partners.
1) Term of agreement. The term of the Contract is for a period of three (3) years unless
terminated, canceled or extended as otherwise provided herein. Region 4 ESC shall have the
right to renew the Contract for two (2) additional one-year periods or portions thereof. Region
4 ESC shall review the Contract prior to the renewal date and notify the Contractor of Region
4 ESC's intent renew the Contract. Contractor may elect not to renew by providing three
hundred sixty-five days' (365) notice to Region 4 ESC. Notwithstanding the expiration of the
initial term or any subsequent term or all renewal options, Region 4 ESC and Contractor may
mutually agree to extend the term of this Agreement. Contractor acknowledges and
understands Region 4 ESC is under no obligation whatsoever to extend the term of this
Agreement.
2) Scope: Contractor shall perform all duties, responsibilities and obligations, set forth in this
agreement, and described in the RFP, incorporated herein by reference as though fully set
forth herein.
3) Form of Contract. The form of Contract shall be the RFP, the Offeror's proposal and Best and
Final Offer(s).
CONTRACT
1
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
4) Order of Precedence. In the event of a conflict in the provisions of the Contract as accepted
by Region 4 ESC, the following order of precedence shall prevail:
i. This Contract
ii. Offeror's Best and Final Offer
iii. Offeror's proposal
iv. RFP and any addenda
5) Commencement of Work. The Contractor is cautioned not to commence any billable work or
provide any material or service under this Contract until Contractor receives a purchase order
for such work or is otherwise directed to do so in writing by Region 4 ESC.
6) Entire Aqreement (Parol evidence). The Contract, as specified above, represents the final
written expression of agreement. All agreements are contained herein and no other
agreements or representations that materially alter it are acceptable.
7) Assignment of Contract. No assignment of Contract may be made without the prior written
approval of Region 4 ESC. Contractor is required to notify Region 4 ESC when any material
change in operations is made (i.e. bankruptcy, change of ownership, merger, etc.).
8) Novation. If Contractor sells or transfers all assets or the entire portion of the assets used to
perform this Contract, a successor in interest must guarantee to perform all obligations under
this Contract. Region 4 ESC reserves the right to accept or reject any new party. A change
of name agreement will not change the contractual obligations of Contractor.
9) Contract Alterations. No alterations to the terms of this Contract shall be valid or binding
unless authorized and signed by Region 4 ESC.
10) Add inq-Authorized Distributors/Dealers. Contractor is prohibited from authorizing additional
distributors or dealers, other than those identified at the time of submitting their proposal, to
sell under the Contract without notification and prior written approval from Region 4 ESC.
Contractor must notify Region 4 ESC each time it wishes to add an authorized distributor or
dealer. Purchase orders and payment can only be made to the Contractor unless otherwise
approved by Region 4 ESC. Pricing provided to members by added distributors or dealers
must also be less than or equal to the Contractor's pricing.
11) TERMINATION OF CONTRACT
a) Cancellation for Non -Performance or Contractor Deficiency. Region 4 ESC may terminate
the Contract if purchase volume is determined to be low volume in any 12-month period.
Region 4 ESC reserves the right to cancel the whole or any part of this Contract due to
failure by Contractor to carry out any obligation, term or condition of the contract. Region
4 ESC may issue a written deficiency notice to Contractor for acting or failing to act in any
of the following:
i. Providing material that does not meet the specifications of the Contract;
ii. Providing work or material was not awarded under the Contract;
iii. Failing to adequately perform the services set forth in the scope of work and
specifications;
iv. Failing to complete required work or furnish required materials within a reasonable
amount of time;
CONTRACT
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DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
v. Failing to make progress in performance of the Contract or giving Region 4 ESC
reason to believe Contractor will not or cannot perform the requirements of the
Contract; or
vi. Performing work or providing services under the Contract prior to receiving an
authorized purchase order.
Upon receipt of a written deficiency notice, Contractor shall have ten (10) days to provide
a satisfactory response to Region 4 ESC. Failure to adequately address all issues of
concern may result in Contract cancellation. Upon cancellation under this paragraph, all
goods, materials, work, documents, data and reports prepared by Contractor under the
Contract shall immediately become the property of Region 4 ESC.
b) Termination for Cause. If, for any reason, Contractor fails to fulfill its obligation in a timely
manner, or Contractor violates any of the covenants, agreements, or stipulations of this
Contract Region 4 ESC reserves the right to terminate the Contract immediately and
pursue all other applicable remedies afforded by law. Such termination shall be effective
by delivery of notice, to the Contractor, specifying the effective date of termination. In such
event, all documents, data, studies, surveys, drawings, maps, models and reports
prepared by Contractor will become the property of the Region 4 ESC. If such event does
occur, Contractor will be entitled to receive just and equitable compensation for the
satisfactory work completed on such documents.
c) DelivervlService Failures. Failure to deliver goods or services within the time specified, or
within a reasonable time period as interpreted by the purchasing agent or failure to make
replacements or corrections of rejected articles/services when so requested shall
constitute grounds for the Contract to be terminated. In the event Region 4 ESC must
purchase in an open market, Contractor agrees to reimburse Region 4 ESC, within a
reasonable time period, for all expenses incurred.
d) Force Ma(eure. If by reason of Force Majeure, either party hereto shall be rendered unable
wholly or in part to carry out its obligations under this Agreement then such party shall
give notice and full particulars of Force Majeure in writing to the other party within a
reasonable time after occurrence of the event or cause relied upon, and the obligation of
the party giving such notice, so far as it is affected by such Force Majeure, shall be
suspended during the continuance of the inability then claimed, except as hereinafter
provided, but for no longer period, and such parry shall endeavor to remove or overcome
such inability with all reasonable dispatch.
The term Force Majeure as employed herein, shall mean acts of God, strikes, lockouts, or
other industrial disturbances, act of public enemy, orders of any kind of government of the
United States or the State of Texas or any civil or military authority; insurrections; riots;
epidemics; landslides; lighting; earthquake; fires; hurricanes; storms; floods; washouts;
droughts; arrests; restraint of government and people; civil disturbances; explosions,
breakage or accidents to machinery, pipelines or canals, or other causes not reasonably
within the control of the party claiming such inability. It is understood and agreed that the
settlement of strikes and lockouts shall be entirely within the discretion of the party having
the difficulty, and that the above requirement that any Force Majeure shall be remedied
with all reasonable dispatch shall not require the settlement of strikes and lockouts by
acceding to the demands of the opposing party or parties when such settlement is
unfavorable in the judgment of the party having the difficulty.
e) Standard Cancellation. Region 4 ESC may cancel this Contract in whole or in part by
providing written notice. The cancellation will take effect 30 business days after the other
party receives the notice of cancellation. After the 30th business day all work will cease
following completion of final purchase order.
12) Licenses. Contractor shall maintain in current status all federal, state and local licenses, bonds
and permits required for the operation of the business conducted by Contractor. Contractor
CONTRACT
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DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
shall remain fully informed of and in compliance with all ordinances and regulations pertaining
to the lawful provision of services under the Contract. Region 4 ESC reserves the right to stop
work and/or cancel the Contract if Contractor's license(s) expire, lapse, are suspended or
terminated.
13) Survival Clause. All applicable software license agreements, warranties or service
agreements that are entered into between Contractor and Region 4 ESC under the terms and
conditions of the Contract shall survive the expiration or termination of the Contract. All
Purchase Orders issued and accepted by Contractor shall survive expiration or termination of
the Contract.
14),Deliverv. Conforming product shall be shipped within 7 days of receipt of Purchase Order. If
delivery is not or cannot be made within this time period, the Contractor must receive
authorization for the delayed delivery. The order may be canceled if the estimated shipping
time is not acceptable. All deliveries shall be freight prepaid, F.O.B. Destination and shall be
included in all pricing offered unless otherwise clearly stated in writing.
15) Insoection & Acceotance. If defective or incorrect material is delivered, Region 4 ESC may
make the determination to return the material to the Contractor at no cost to Region 4 ESC.
The Contractor agrees to pay all shipping costs for the return shipment. Contractor shall be
responsible for arranging the return of the defective or incorrect material.
16) Pavments. Payment shall be made after satisfactory performance, in accordance with all
provisions thereof, and upon receipt of a properly completed invoice.
17) Price Adiustments. Should it become necessary or proper during the term of this Contract to
make any change in design or any alterations that will increase price, Region 4 ESC must be
notified immediately. Price increases must be approved by Region 4 ESC and no payment for
additional materials or services, beyond the amount stipulated in the Contract shall be paid
without prior approval. All price increases must be supported by manufacturer documentation,
or a formal cost justification letter. Contractor must honor previous prices for thirty (30) days
after approval and written notification from Region 4 ESC. It is the Contractor's responsibility
to keep all pricing up to date and on file with Region 4 ESC. All price changes must be
provided to Region 4 ESC, using the same format as was provided and accepted in the
Contractor's proposal.
Price reductions may be offered at any time during Contract. Special, time -limited reductions
are permissible under the following conditions: 1) reduction is available to all users equally; 2)
reduction is for a specific period, normally not less than thirty (30) days; and 3) original price
is not exceeded after the time -limit. Contractor shall offer Region 4 ESC any published price
reduction during the Contract term.
18) Audit Riqhts. Contractor shall, at its sole expense, maintain appropriate due diligence of all
purchases made by Region 4 ESC and any entity that utilizes this Contract. Region 4 ESC
reserves the right to audit the accounting for a period of three (3) years from the time such
purchases are made. This audit right shall survive termination of this Agreement for a period
of one (1) year from the effective date of termination. Region 4 ESC shall have the authority
to conduct random audits of Contractor's pricing at Region 4 ESC's sole cost and expense.
Notwithstanding the foregoing, in the event that Region 4 ESC is made aware of any pricing
being offered that is materially inconsistent with the pricing under this agreement, Region 4
ESC shall have the ability to conduct an extensive audit of Contractor's pricing at Contractor's
CONTRACT
4
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
sole cost and expense. Region 4 ESC may conduct the audit internally or may engage a third -
party auditing firm. In the event of an audit, the requested materials shall be provided in the
format and at the location designated by Region 4 ESC.
19) Discontinued Products. If a product or model is discontinued by the manufacturer, Contractor
may substitute a new product or model if the replacement product meets or exceeds the
specifications and performance of the discontinued model and if the discount is the same or
greater than the discontinued model.
24} New Products/Services. New products and/or services that meet the scope of work may be
added to the Contract. Pricing shall be equivalent to the percentage discount for other
products. Contractor may replace or add product lines if the line is replacing or supplementing
products, is equal or superior to the original products, is discounted similarly or greater than
the original discount, and if the products meet the requirements of the Contract. No products
and/or services may be added to avoid competitive procurement requirements. Region 4 ESC
may require additions to be submitted with documentation from Members demonstrating an
interest in, or a potential requirement for, the new product or service. Region 4 ESC may reject
any additions without cause.
21 ] Options. Optional equipment for products under Contract may be added to the Contract at
the time they become available under the following conditions: 1) the option is priced at a
discount similar to other options; 2) the option is an enhancement to the unit that improves
performance or reliability.
22) Warranty Conditions. All supplies, equipment and services shall include manufacturer's
minimum standard warranty and one (1) year labor warranty unless otherwise agreed to in
writing.
23) Site Cleanup. Contractor shall clean up and remove all debris and rubbish resulting from their
work as required or directed. Upon completion of the work, the premises shall be left in good
repair and an orderly, neat, clean, safe and unobstructed condition.
24) Site Preparation. Contractor shall not begin a project for which the site has not been prepared,
unless Contractor does the preparation work at no cost, or until Region 4 ESC includes the
cost of site preparation in a purchase order. Site preparation includes, but is not limited to:
moving furniture, installing wiring for networks or power, and similar pre -installation
requirements.
25) Registered Sex Offender Restrictions. For work to be performed at schools, Contractor
agrees no employee or employee of a subcontractor who has been adjudicated to be a
registered sex offender will perform work at any time when students are or are reasonably
expected to be present. Contractor agrees a violation of this condition shall be considered a
material breach and may result in the cancellation of the purchase order at Region 4 ESC's
discretion. Contractor must identify any additional costs associated with compliance of this
term. If no costs are specified, compliance with this term will be provided at no additional
charge.
26) Safety measures. Contractor shall take all reasonable precautions for the safety of employees
on the worksite and shall erect and properly maintain all necessary safeguards for protection
of workers and the public. Contractor shall post warning signs against all hazards created by
its operation and work in progress_ Proper precautions shall be taken pursuant to state law
CONTRACT
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and standard practices to protect workers, general public and existing structures from injury
or damage.
27) Smokina. Persons working under the Contract shall adhere to local smoking policies.
Smoking will only be permitted in posted areas or off premises.
28) Stored materials. Upon prior written agreement between the Contractor and Region 4 ESC,
payment may be made for materials not incorporated in the work but delivered and suitably
stored at the site or some other location, for installation at a later date. An inventory of the
stored materials must be provided to Region 4 ESC prior to payment. Such materials must be
stored and protected in a secure location and be insured for their full value by the Contractor
against loss and damage. Contractor agrees to provide proof of coverage and additionally
insured upon request. Additionally, if stored offsite, the materials must also be clearly identified
as property of Region 4 ESC and be separated from other materials. Region 4 ESC must be
allowed reasonable opportunity to inspect and take inventory of stored materials, on or offsite,
as necessary. Until final acceptance by Region 4 ESC, it shall be the Contractor's
responsibility to protect all materials and equipment. Contractor warrants and guarantees that
title for all work, materials and equipment shall pass to Region 4 ESC upon final acceptance.
29) Fundina Out Clause. A Contract for the acquisition, including lease, of real or personal
property is a commitment of Region 4 ESC's current revenue only, Region 4 ESC retains the
right to terminate the Contract at the expiration of each budget period during the term of the
Contract and is conditioned on a best effort attempt by Region 4 ESC to obtain appropriate
funds for payment of the contract.
30) Indemnity. Contractor shall protect, indemnify, and hold harmless both Region 4 ESC and its
administrators, employees and agents against all claims, damages, losses and expenses
arising out of or resulting from the actions of the Contractor, Contractor employees or
subcontractors in the preparation of the solicitation and the later execution of the Contract.
Any litigation involving either Region 4 ESC, its administrators and employees and agents will
be in Harris County, Texas.
31) Marketina. Contractor agrees to allow Region 4 ESC to use their name and logo within
website, marketing materials and advertisement. Any use of Region 4 ESC name and logo
or any form of publicity, inclusive of press releases, regarding this Contract by Contractor must
have prior approval from Region 4 ESC.
32) Certificates of Insurance. Certificates of insurance shall be delivered to the Region 4 ESC
prior to commencement of work. The Contractor shall give Region 4 ESC a minimum of ten
(14) days' notice prior to any modifications or cancellation of policies. The Contractor shall
require all subcontractors performing any work to maintain coverage as specified.
33) Legal Obligations_ It is Contractor's responsibility to be aware of and comply with all local,
state, and federal laws governing the sale of productslservices and shall comply with all laws
while fulfilling the Contract. Applicable laws and regulation must be followed even if not
specifically identified herein.
CONTRACT
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DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
OFFER AND CONTRACT SIGNATURE FORM
The undersigned hereby offers and, if awarded, agrees to furnish goods and/or services in strict
compliance with the terms, specifications and conditions at the prices proposed within response
unless noted in writing.
Company Name B&H Foto and Electronics DBA B&H
Address 420 Ninth Ave
City/State/Zip New York, NY, 10001
Telephone No. 212-239.7500
Email Address israelm@bhphoto.com
Printed Name Israel Mamann
Title Manager- 13213 Contracts
Authorized signature
Accepted by Region 4 ESC:
Contract No. I2CV2
Initial Contract Term April 11,7W11 to
4Rei 4 E Authorize%Boar Member
Margaret S. Bass
Print Name
Region 4 ESC Authorized Board Member
Linda Tinnerman
Print Name
March Maryb2j1, 2024
2/23/2021
Date
2/23/2021
Date
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
AoDendix B
TERMS & CONDITIONS ACCEPTANCE FORK!
Signature on the Offer and Contract Signature form certifies complete acceptance of the terms
and conditions in this solicitation and draft Contract except as noted below with proposed
substitute language (additional pages may be attached, if necessary). The provisions of the
RFP cannot be modified without the express written approval of Region 4 ESC. If a proposal
is returned with modifications to the draft Contract provisions that are not expressly approved
in writing by Region 4 ESC, the Contract provisions contained in the RFP shall prevail.
Check one of the following responses:
Offeror takes no exceptions to the terms and conditions of the RFP and draft Contract.
(Note: if none are listed below, if is understood that no exceptions/deviations are taken.)
D Offeror takes the following exceptions to the RFP and draft Contract. All exceptions must
be clearly explained, reference the corresponding term to which Offeror is taking exception
and clearly state any proposed modified language, proposed additional terms to the RFP
and draft Contract must be included:
(Note: Unacceptable exceptions may remove Offeror's proposal from consideration for
award. Region 4 ESC shall be the sole judge on the acceptance of exceptions and
modifications and the decision shall be final.
If an offer is made with modifications to the contract provisions that are not expressly
approved in writing, the contract provisions contained in the RFP shall prevail.)
Section/Page Term, Condition, or Exception/Proposed Modification Accepted
Specification (For Region 4
ESC's use)
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42❑ Ninth Avenue
New York, NY t000x
400 Cedar Lane
Florence, NJ 08518
s �
^ICJ r,p►, -.. �,�� ��
T H E P R 0 F E S S 1 4 N A L` S
IV. Evaluation Process and Criteria- Response
2.
a) Products/ Pricing
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
i. B&H is offering a range discount of 0.5-25% off retail pricing. Discounts vary by brand
and product but will remain within the discount range with an average discount of
125% off our retail pricing. Manufacturers unilateral priced items will remain at price
set forth by the manufacturer. Where a quote is over $5000, the B&H pricing team will
review the price to ensure the best discount is given.
ii. An electronic copy of the retail catalog can be found at www.bhohoto.ccm. B&H will
provide a discounted portal where discounts will be verifiable. A catalog is also attached
on a flash drive labeled "catalog."
iii. The B & H catalog represents over 500,000 products. B&H is extending making pricing
available for all products and services in our catalog.
iv. B&H works with Hampton Ridge Financial for leasing programs. Contact
Leasing@bhphoto.com for more information.
httt)s://www.bhohotovideo.com/find/leasing.isp
v. B&H will offer free shipping FOB destination for this contract. Items weighing mare
than 70 Ibs or requiring truck delivery due to their size or weight may be charged
reasonable shipping.
vi. B&H includes all standard manufactured warranties with our products. Please
reference the warranty section of our site.
htti)s://www.bhohotovideo.com/find/HeloCenter/Policies.isp#warranties. B&H also sells
additional protection plans that will be made available to the contract members.
vii. If you are dissatisfied with your purchase for any reason, you may return it to B&H
within 30 days of the purchase date, subject to the conditions and exclusions found
httos: //www. bh p hotovi deo. co m /find/H e I pCenter/Ret u rn Excha nRe. iso?o riF&Sea rch=ret u r
ns
viii. 0n top of the significant savings this contract will generate, B&H's pricing team will
review any quote over $5000.00 to ensure the OMNIA member is getting the greatest
discount possible.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue B2bCor►tracts@Bhphoto.com
New York, NY mot ' 212-239-7500
�vww. Bhphoto. comb 2b
40o Cedar Lane NaAMWAE ;1 05
Florence, NCI 08518
T H E PROFESS IONA L` S S O U R C E
ix. A portal will be made available for the contract users to generate quotes, checkout
and verify contract pricing. All discounts will be displayed underneath the price.
Olympus Barrel Style Lens Case for
m.Zuiko Digital Lenses (Extra Small,
Black)
•. 7
3 Rev ekes
Key Features
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jAdd to Compare Ha^a =ye ar7 aayn:r C�r;,rrc �-
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In stock
Fie W ppl^g(IiSA)
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Sae All Detaiis >
HvallaNe in ocher 5cyles. Configurations & Kits
x. As Iong as the contract is referenced, B&H's highly trained sales team will apply
contract pricing to the order. Within the B&H ordering system there are many
procedures in place to ensure the customer will obtain contract pricing. This system is
accessible in our one retail store. All payment methods are accepted including P-card,
NET terms and financing.
xi. The range discount will remain steady throughout the term of the contract. B&H adds
products to our catalog and updates pricing daily on various items across our catalog
(usually the pricing goes down due to the nature of the commodity).
xii. Future products will be automatically included into the catalog and will therefore be
offered on this contract at the discounted rate.
xiii. B&H has held this contract for the last S years saving public agencies millions of
dollars due to this pricing structure. B&H looks forward to offering our catalog to public
agencies with these incredible discounts for many years to come. B&H understands that
the contract is a "not to exceed contract" price model and where we are able to offer a
larger discount, we will.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY 10001
400 Cedar Lane
Florence, NJ o8518
T H E PRO F E S S I O N A L` S
b) Performance Capability
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
i. Please see detailed response "Appendix D Exhibit A OMNIA partners response".
ii. Please see signed acceptance form.
iii. Please see signed forms
iv. B&H takes pride in its award winning customer service. During the pandemic, all
emergency orders were placed on priority to ensure all public agencies received their
products in a timely manner. B&H hopes to never use these priority procedures again
but if required, we are prepared to offer top of the line emergency ordering again.
v. B&H aims to have a 100% fill rate as we continue to alert customers of in stock items
to ensure timely deliveries. Our current fill rate is above 95%.
vi. B&H is known for its in stock availability and timely deliveries. B&H takes on time
deliveries very seriously and customers are always provided with an accurate delivery
date at the time of order. If an item goes out of stock, B&H immediately alerts the
customer and offers an alternative so they can meet their project requirements on time.
vii. If you are dissatisfied with your purchase for any reason, you may return it to B&H
within 30 days of the purchase date, subject to the conditions and exclusions found
https://www.bhphotovideo.com/find/HeIpCenter/ReturnExchange.iso?origSearch=retur
ns
viii. B&H includes all standard manufactured warranties with our products. Please
reference the warranty section of our site.
httos://www.bhohotovideo.com/find/HeloCenter/Policies.isi)#warranties B&H also sells
additional protection plans that will be made available to the contract members. B&H
will help the customer access their warranty through the manufacturer.
ix. B&H organizational sales team consists of Inbound reps, outbound reps, business
development reps, contract managers, pricing reps, supervisors and managers. An order
starts with our inbound sales team and if there is an issue they escalate it to a
supervisor or business development representative who will ensure the issue is
resolved.
We are open weekdays from 9:00 AM to 6:00 PM EST and Fridays from 9:00 AM to 2:00
PM EST. Our warehouse is open Sunday as well.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY 10001
400 Cedar Lane
Florence, NJ 08518
■
T H E P R O F E S S 1 a N A L` S
The inside sales team can be reached at:
1800-947-8003
❑ m n is Cal bh D hoto. corn
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S❑ U R C E
x. B&H offers multiple invoicing options to fit our customers needs. From manual
invoicing to 7CML invoicing, B&H likely has an invoicing option that works for each
member individually. Standard payment terms are NET 30 and credit card is accepted at
the time of purchase. Credit card fees may apply at time of purchase.
xi. B & H currently holds the Region 4 ESC Audio Visual contract and has met all
requirements to implement this contract. We see this as a seamless transition to the
new contract with minimal training required to implement.
xii. As a multibillion -dollar corporation, B&H is in good financial standing. We have tens
of millions of dollars of untapped credit lines that can be used if needed and we have
weathered many financial crises. We are A plus rated with the Better Business Bureau
and have great relationships with our banking partners.
xiii. www.bhohoto.com/amnia
Our highly -rated website and apps offer shopping at your leisure. Our industry experts
prepare the comprehensive product information you will find on our site, and within a
minute of selecting Live Chat they will be available as personal guides. Your purchasing
and product inquiries can be made by email as well. We combine the personability of a
storefront with the convenience of a web retailer. Our site moves fast, our staff moves
even more quickly when responding to you, and our same -day shipping policies move
your order out the door with immediacy.
B&H offers customized E-quote, P❑ Punch -Out and Procurement Card Check -Out Portals
for Institutions and their faculty as well as EDI and cXML processing.
B&H is dedicated to being a leader in e-procurem ent and have an internal team that
manages the contract and e-procurement enablements. Our website offers tiered
wish Iist/favorites functionality, email/chat services for 1-on-1 technical help and a
plethora of information, reviews, and recommended accessories for each product.
xiv. B&H views employee safety with upmost importance and ensures employees are
always safe.
The B&H website is tested and certified daily to pass the HACKER SAFE Security Scan.
Our customers can be assured that the HACKER SAFE mark only appears on those sites
which meet the rigorous HACKER SAFE standards. Through the judicious use of HACKER
SAFE, B&H Photo -Video can prevent over 99% of hacker crime on our site.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
420 Ninth Avenue
New York, NY i000l
400 Cedar Lane
Florence, NJ 08518
■
�i Y1oe'-' Pere eu'' B211
T H E P R❑ F E S S 10 N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S❑ U R C E
xv. B&H looks forward to continuing our relationship with region 4 ESC for many years
to come.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
APPENDIX D
OMNIA®
P A R T N E R S
eINATr 10NAIIPA moo"annRr
REQUIREMENTS FOR NATIONAL COOPERATIVE CONTRACT
TO BE ADMINISTERED BY
OMNIA PARTNERS
The following documents are used in evaluating and administering national cooperative contracts
and are included for Supplier's review and response.
Exhibit A — RESPONSE FOR NATIONAL COOPERATIVE CONTRACT
Exhibit B — ADMINISTRATION AGREEMENT, EXAMPLE
Exhibit C — MASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING
AGREEMENT, EXAMPLE
Exhibit D — PRINCIPAL PROCUREMENT AGENCY CERTIFICATE, EXAMPLE
Exhibit E — CONTRACT SALES REPORTING TEMPLATE
Exhibit F — FEDERAL FUNDS CERTIFICATIONS
Exhibit G — NEW JERSEY BUSINESS COMPLIANCE
Exhibit H — ADVERTISING COMPLIANCE REQUIREMENT
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY i000t
400 Cedar Lane
Florence, NJ 08518
IZ28
D
T H E P R D F E S S 1 4 N A L` S
3.0 Supplier Response
3.1 Company
B2bContracts@Bhphoto.com
217-239-7500
www.Bhphoto.com/b2b
S O U R C E
A. Once a neighborhood mom-and-pop camera store in New York City, B&H has grown to be a
world -class source for creative technology products serving the Corporate, Government and
Education markets as weft as our high-tech consumer customers.
Starting as a two -person family owned business in 1973 serving the professional photographer,
B&H now employs aver 1800 people and is home to a two story, city block long Superstore and
600,000+ square foot of state-of-the-art warehouse in Florence, NJ.
B&H's well-known reputation is based on our product knowledge, customer service, large
selection, standard discounted pricing, in -stock availability and extensive e-procurement
capabilities.
B & H has a large selection of creative technology supplies and equipment, featuring over
500,000 products. Our business began in the photography industry selling cameras and film, but
as the digital age of photography and the convergence of technology became the standard, we
have expanded our line to include all products related to our core. We employ in-house experts,
up to engineer level, in all areas of technology. We pride ourselves on our ability to convey that
expertise to our customers, to ensure they are purchasing the best product for their needs.
The B2B division is now comprised of over 100 sales and customer service representatives
whose sole purpose is serving the education, government, and non-profit sectors, including
representatives in the field participating in tradeshows and visiting and training customers.
B. B&H has 1800 employees based in New York city and Florence New Jersey.
C. The B&H corporate office is located at:
440 Ninth Ave
New York, NY
10001
D. B&H is a multibillion -dollar corporation doing over $2.5 billion+ in each of the past 3 years.
a. Federal EIN: 132768071
D&B: 116012659
E. B&H is committed to supporting the US government Go Green initiatives and offering our
customers a wide variety of Green compliant products. We work with major certifications such
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
420 Ninth Avenue
New York, NY r000l
400 Cedar Lane
Florence, NJ 08518
■
+ knq viw Pk;j war
02ZBD
T H E P R O F E S S 1 0 N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
as Energy Star, EPEAT, RohS and others to allow customers to search for these products. We
have also created a Go Green products showcase on our website that can be found at:
htt P: //www. bh photovi d eo. com/c/browse/green-i) rod ucts/ci/29817/N /3708116854
B&H future Go- Green initiatives:
1. Energy Star Products to be increased to comprise more than 40% of our inventory
2. To use environmental packaging material that is recyclable.
3. Re -using manufacturer's packaging.
4. Instituting a complete recycling program on supplies and waste.
F. B&H supports the growth of historically underrepresented businesses. Our diversity supplier
program generates business opportunities that position diverse suppliers for economic
sustainabi€ity, yield competitive advantages for both diverse suppliers and deliver exceptional
technology experiences for our customers. We recognize that teaming up with certified diverse
partners who can deliver goods, support, and services creates significant competitive
advantages for our diverse partners and the customer. Diversity partners have access to our
entire catalog and special pricing, our customer service and our in -stock availability.
G. N/A
H. N/A
I. B&H stands out from its competitors with our award -winning customer service, in stock
availability, fast delivery, great pricing and the breadth of our catalog. B&H is there with the
customer every step of the way.
J. As in the case in any large corporation, B&H has been involved in various commercial litigation
matters in the past. Currently, we are involved in an action brought by the NYAG regarding the
collection of sales tax on items featuring instant savings. The results of this case will not affect
the financial standing of B&H in any way.
K. B&H is not owned or operated by anyone who has been convicted of a felony.
L. N/A
3.2 Distribution and Logistics
B&H carries aver 500,000 products in our catalog in technology equipment and accessories.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
420 Ninth Avenue
New York, NY 10001
400 Cedar Lane
Florence, NJ 08518
M
7
T H E P R Q F E S S 1 Q N A L` S
Categories include:
• Photography
■ Computers
• Pro Video
• Lighting
• Pro Audio
• Mobile
• Ns and Entertainment
■ Camcorders
■ Surveillance
• Optics
■ Audio Visual
■ Accessories
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b?b
S a U R C E
B. B&H currently ships and operates in all 50 states and will offer our entire catalog on the
OMNIA contact nationwide.
C. Ordering agencies will be able to request a savings report from B&H to verify their savings on
the OMNIA contract regardless of how they order. Internal audits are performed periodically to
ensure the contract pricing is correctly applied to the customers orders. An OMNIA purchasing
portal will immediately be available for contract users to generate quotes, checkout and verify
contract pricing. All discounts will be displayed right next to the price to contract price.
I_j Add to compare
D. N/A
Olympus Barrel Style Lens Case for
m.Zuiko Digital Lenses [Extra Small,
Black)
**** 'SRev evs
Key Features
He as Se'e : Ex_ a Srta m,_L Q A- lei
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See Alf Details )
Available irto.her Styles, Configurations & kits
$599 - _.---
Add -o wish Usi w
In Stock
Flee 5h pafng wSA;
Exp,ess Sm -e v ckup : n 30 m es
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY i000i
400 Cedar Lane
Florence, NJ o8518
■
B2bContracts@Bhphoto.com
212-239-7500
T H E P R❑ F E S S 1 0 N A L` S S Q U R C E
E. B & H has a 600,000 sq. foot warehouse located in Florence NJ. The warehouse address is:
404 Cedar Lane
Florence, NJ 08518
3.3 Marketing and Sales
A. Upon award, B&H wi€I train our sales representatives and customer service reps on the details
of the award, the key features of the master agreement and the benefits of using a cooperative
contract. We will train them how to apply the correct pricing, methods of ordering, the benefits of
this contract and how to market this contract correctly. B&H has the endorsement of its executives
to market this contract.
B. On the first day of the contract B&H will:
■ Provide a dedicated portal that will have access to contract pricing and B&H's B28 interface
■ Provide a dedicated account management team to help implement this contract effectively
• Update marketing peripherals accordingly to be used at relevant trade shows and events
• Provide an OMNIA landing page that will direct customers to the contract
B&H will position this contract as our preferred offering to public agencies nationwide and will
continue to work with ❑MNIA to communicate to customers about the OMNIA contract. B&H will
provide 0MNIA with its logo for use in its marketing materials or website. B&H already attends and
exhibits at the NIGP forum annually in the area reserved for ❑MNIA partners. B&H looks forward to
working with the 0MN€A marketing team for many years to come to ensure that this contract is
properly marketed and utilized.
C. B&H has already transitioned many of its existing public agency customers to our OMNIA contract
and will use the same strategy going forward. B & H holds numerous cooperative contracts across
public procurement and will continue to position the 0MN€A contract our preferred offering for
public agencies.
D. B&H agrees to provide logos to ❑MNIA partners so they can successfully use it in their marketing
material. We understand that the OMNIA partners logo will require permission for reproduction.
E. B&H understands and confirms this requirement.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY too o i
400 Cedar Lane
Florence, NTJ 08518
■ n
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B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
T H E P R 0 F E S S 1 0 N A L` S S O U R C E
F. B&H already has a highly trained salesforce in place that understands the key features of our
current OMNIA contract and will communicate and train staff on the new award as well.
G.
i. Barry Eisenberg - barrve[EDbhnhoto.com , Tiffani Barton- tiffanib(@bhohoto.com
ii. Jerry Zorek- Jerryz bhphoto.com , Jaclyn Mehl- iaclvnm(@bhnhoto.com
iii. Jerry Zorek- Lerryz@ bhnhoto.com , Jaclyn Mehl- jaclvnm(@bhphoto.com
iv. Jerry Zorek- ierrvzPbhohoto.com , Jaclyn Mehl- iaclvnmPbhr)hoto.com
v. Benjamin Steinmetz bens0)bhr)hoto.com
vi. Isaac Rosenberg isaacrPbhohoto.com
viii. Israel Mamann IsraelmPbhr)hoto.cam
H. Please see Org chart below:
❑irector of
B2B
Inside Contracts and Business
Sales eprocurement Development
Manager Manager
Gov�Ed Corp. Outbound
Supervisor Supervisor sales reps
Regional Industry Regional Industry
Vertical Edu and Vertical
Teams Teams Gov't Safes ]1 Sales
Key Personnel include:
Sarah Bialo- Inside Sales Manager
Jerry Zorek- Business Development Manager, Government and Education
Israel Mamann- 13213 Contracts
Barry Eisenberg- Manager, 8213 Contracts
Tiffani Barton- Assistant manager, B2B Contracts
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
Neiv York, NY t000l
400 Cedar Lane
Florence, NJ o8518
Es
T H E P R O F E S S 1 O N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/bzb
S O U R C E
Our government and education outbound sales reps are each assigned to a geographic location
and are highly trained on the nuances of the OMNIA contract. They attend many shows, work
with our manufacturers to stay up to date with the latest technology and ensure our customers
are always taken care of.
J. B&H currently does $75,000,000 a year annually with public agencies.
A list of some key accounts:
Agency Name
State
2020
sales
NYC DOE
NY
$
HOUSTON ISD
I TX
LAKEWOOD BOARD OF ED.
I NJ
$
TEXAS STATE UNIV SAN MARCOS
+ TX
$
PROSPER ISD
TX
$
LOS ANGELES USD
CA
$
CHICAGO PUBLIC SCHOOLS
I IL
' $
WASHINGTON CO PUBLIC SCHOOL
, MD
I $
K-121NDIANA
IN
$
SAN BERNARDINO CITY USD
CA
$
K. B&H offers customized E-quote, Punch -Out and Check -Out Portals for Institutions and their
faculty as well as EDI and cXML PO and invoicing.
B&H is dedicated to being a leader in e-procurement and have an internal team that manages the
contract and e-procurement enablements. Our website offers tiered wishlist/favorites functionality,
email/chat services for 1-on-1 technical help and a plethora of information, reviews, and
recommended accessories for each product.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42❑ Ninth Avenue
New York, NY moox
400 Cedar Lane
Florence, NJ o8518
■
B28
T H E P R 0 F E S S 1 4 N A L` S
B2bContracts@Bhphoto.com
212-239-75oo
www.Bhphoto.com/b2b
S O U R C E
M. B&H prefers to respond to solicitations with our OMNIA Partners contract, where applicable. Any
contract awarded with an OMNIA response will be reported to OMNIA as a contract safe.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
EXHIBIT F
FEDERAL FUNDS CERTIFICATIONS
FEDERAL CERTIFICATIONS
ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT
TO WHOM IT MAY CONCERN:
Participating Agencies may elect to use federal funds to purchase under the Master Agreement. This form should be
completed and returned.
DEFINITIONS
Contract means a legal instrument by which a non -Federal entity purchases property or services needed to carry out the project
or program under a Federal award. The term as used in this part does not include a legal instrument, even if the non -Federal entity
considers it a contract, when the substance of the transaction meets the definition of a Federal award or subaward
Contractor means an entity that receives a contract as defined in Contract.
Cooperative agreement means a legal instrument of financial assistance between a Federal awarding agency or pass -through
entity and a non -Federal entity that, consistent with 31 U.S.C, 6302- 6305:
(a) is used to enter into a relationship the principal purpose of which is to transfer anything of value from the Federal
awarding agency or pass -through entity to the non -Federal entity to carry out a public purpose authorized by a law of the
United States (see 31 U.S.C. 6101(3)); and not to acquire property or services for the Federal government or pass -through
entity's direct benefit or use;
(b) Is distinguished from a grant in that it provides for substantial involvement between the Federal awarding agency or
pass -through entity and the non -Federal entity in carrying out the activity contemplated by the Federal award,
(c) The term does not include;
(1) A cooperative research and development agreement as defined in 15 U.S.C. 371 Oa; or
(2) An agreement that provides only:
(1) Direct United States Government cash assistance to an individual;
(ii) A subsidy;
(lii) A loan;
(iv) A loan guarantee; or
(v) Insurance.
Federal awarding agency means the Federal agency that provides a Federal award directly to a non -Federal entity
Federal award has the meaning, depending on the context, in either paragraph (a) or (b) of this section:
(a)(1) The Federal financial assistance that a non -Federal entity receives directly from a Federal awarding agency or
indirectly from a pass -through entity, as described in § 200.101 Applicability; or
(2) The cost -reimbursement contract under the Federal Acquisition Regulations that a non -Federal entity
receives directly from a Federal awarding agency or indirectly from a pass -through entity, as described in §
200,101 Applicability.
(b) The instrument setting forth the terms and conditions. The instrument is the grant agreement, cooperative agreement,
other agreement for assistance covered in paragraph (b) of § 200.40 Federal financial assistance, or the cost -
reimbursement contract awarded under the Federal Acquisition Regulations.
(c) Federal award does not include other contracts that a Federal agency uses to buy goods or services from a contractor
or a contract to operate Federal government owned, contractor operated facilities (GOCas).
(d) See also definitions of Federal financial assistance, grant agreement, and cooperative agreement.
Non -Federal entity means a state, local government, Indian tribe, institution of higher education (1HE), or nonprofit organization
that carries out a Federal award as a recipient or subrecipient.
Nonprofit organization means any corporation, trust, association, cooperative, a other organization, not including IHEs, that:
(a) Is operated primarily for scientific, educational, service, charitable, or similar purposes in the public interest;
(b) Is not organized primarily for profit; and
Requirements for National Cooperative Contract
Page 23 of 68
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(c) Uses net proceeds to maintain, improve, or expand the operations of the organization
Obligations means, when used in connection with a non -Federal entity's utilization of funds under a Federal award, orders placed
for property and services, contracts and subawards made, and similar transactions during a given period that require payment by
the non -Federal entity during the same or a future period.
Pass -through entity means a non-Federai entity that provides a subaward to a subrecipient to carry out part of a Federal program.
Recipient means a non -Federal entity that receives a Federal award directly from a Federal awarding agency to carry out an
activity under a Federal program. The term recipient does not include subrecipients.
Simplified acquisition threshold means the dollar amount below which a non -Federal entity may purchase property or services
using small purchase methods. Non -Federal entities adopt small purchase procedures in order to expedite the purchase of items
costing less than the simplified acquisition threshold. The simplified acquisition threshold is set bythe Federal Acquisition Regulation
at 48 CFR Subpart 2.1 (Definitions) and in accordance with 41 U.S.C. 1908. As of the publication of this part, the simplified
acquisition threshold is $250,000, but this threshold is periodically adjusted for inflation. (Also see definition of § 200.67 Micro -
purchase.)
subaward means an award provided by a pass -through entity to a subrecipient for the subrecipient to carry out part of a Federal
award received by the pass -through entity. It does not include payments to a contractor or payments to an individual that is a
beneficiary of a Federal program. A subaward may be provided through any form of legal agreement, including an agreement that
the pass -through entity considers a contract.
subrecipient means a non -Federal entity that receives a subaward from a pass -through entity to carry out part of a Federal
program; but does not include an individual that is a beneficiary of such program. A subrecipient may also be a recipient of other
Federal awards directly from a Federal awarding agency.
Termination means the ending of a Federal award, in whole or in part at any time prior to the planned end of period of performance.
The following certifications and provisions may be required and apply when Participating Agency expends federal funds for any
purchase resulting from this procurement process. Pursuant to 2 C.F.R. § 200.326, all contracts, including small purchases, awarded
by the Participating Agency and the Participating Agency's subcontractors shall contain the procurement provisions of Appendix II to
Part 200, as applicable.
APPENDIX 11 TO 2 CFR PART 200
(A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted
amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils)
as authorized by 41 U.S.C. 1908, must address administrative, contractual, or legal remedies in instances where
contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
Pursuant to Federal Rule (A) above, when a Participating Agency expends federal funds, the Participating Agency reserves all rights
and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either
party.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(B) Termination for cause and for convenience by the grantee or subgrantee including the manner by which it will be
effected and the basis for settlement. (All contracts in excess of $10,000)
Pursuant to Federal Rule (B) above, when a Participating Agency expends federal funds, the Participating Agency reserves the right
to immediately terminate any agreement in excess of $10,000 resulting from this procurement process in the event of a breach or
default of the agreement by Offeror as detailed in the terms of the contract.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(C) Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the
definition of "federally assisted construction contract" in 41 CFR Part 60.1.3 must include the equal opportunity clause
provided under 41 CFR 60.1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 CFR
12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order
11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of tabor."
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Pursuant to Federal Rule (C) above, when a Participating Agency expends federal funds on any federally assisted construction
contract, the equal opportunity clause is incorporated by reference herein.
Does offeror agree to abide by the above? YES VEM initials of Authorized Representative of offeror
(D) Davis -Bacon Act, as amended (40 U.S.C. 3141-3148). When required by Federal program legislation, all prime
construction contracts in excess of $2,000 awarded by non -Federal entities must include a provision for compliance
with the Davis -Bacon Act (40 U.S.C. 3141-3144, and 3146.3148) as supplemented by Department of Labor regulations (29
CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted
Construction"). In accordance with the statute, contractors must be required to pay wages to laborers and mechanics at
a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In
addition, contractors must be required to pay wages not less than once a week. The non -Federal entity must place a copy
of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award
a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non- Federal entity
must report all suspected or reported violations to the Federal awarding agency. The contracts must also include a
provision for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. 3145), as supplemented by Department of
Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole
or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient must be
prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to
give up any part of the compensation to which he or she is otherwise entitled. The non -Federal entity must report all
suspected or reported violations to the Federal awarding agency.
Pursuant to Federal Rule (D) above, when a Participating Agency expends federal funds during the term of an award for all
contracts and subgrants for construction or repair, offeror will be in compliance with all applicable Davis -Bacon Act provisions.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(E) Contract Wort[ Hours and Safety Standards Act (40 U.S.C. 3701-3708). Where applicable, all contracts awarded by the
non -Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a provision
for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under
40 U.S.C. 3702 of the Act, each contractor must be required to compute the wages of every mechanic and laborer on the
basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the
worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess
of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are applicable to construction work and provide that no
laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous
or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on
the open market, or contracts for transportation or transmission of intelligence.
Pursuant to Federal Rule (E) above, when a Participating Agency expends federal funds, offeror certifies that offeror will be in
compliance with all applicable provisions of the Contract Work Hours and Safety Standards Act during the term of an award for all
contracts by Participating Agency resulting from this procurement process.
Does offeror agree? YES VENT Initials of Authorized Representative of offeror
(F) Rights to Inventions Made Under a Contract or Agreement. if the Federal award meets the definition of "funding
agreement" under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small
business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental,
developmental, or research work under that "funding agreement," the recipient or subrecipient must comply with the
requirements of 37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under
Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the awarding
agency.
Pursuant to Federal Rule (F) above, when federal funds are expended by Participating Agency, the offeror certifies that during the
term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror agrees to comply with
all applicable requirements as referenced in Federal Rule (F) above.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251.1387), as amended —
Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non - Federal award
to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-
7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251. 1387). Violations must be reported to the
Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA)
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Pursuant to Federal Rule (G) above, when federal funds are expended by Participating Agency, the offeror certifies that during the
term of an award for all contracts by Participating Agency member resulting from this procurement process, the offeror agrees
to comply with all applicable requirements as referenced in Federal Rule (G) above.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(H) Debarment and Suspension (Executive Orders 12549 and 12689)—A contract award (see 2 CFR 180.220) must not be
made to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance with
the Executive Office of the President Office of Management and Budget (OMB) guidelines at 2 CFR 180 that implement
Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and
Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as
well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.
Pursuant to Federal Rule (H) above, when federal funds are expended by Participating Agency, the offeror certifies that during tthhe
term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror certifies that neither
it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation by any federal department or agency. If at any time during the term of an award the offeror or its principals becomes
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal
department or agency, the offeror wi11 notify the Participating Agency.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
(1) Byrd Anti -Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000
must file the required certification. Each tier certifies to the tierabove that it will not and has not used Federal appropriated
funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a
member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with
obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any
lobbying with non -Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are
forwarded from tier to tier up to the non -Federal award.
Pursuant to Federal Rule (1) above, when federal funds are expended by Participating Agency, the offeror certifies that during the
term and after the awarded term of an award for all contracts by Participating Agency resulting from this procurement process, the
offeror certifies that it is in compliance with all applicable provisions of the Byrd Anti -Lobbying Amendment (31 U.S.C. 1352), The
undersigned further certifies that;
(1 ) No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, to any person for Influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of congress, or an
employee of a Member of Congress In connection with the awarding of a Federal contract, the making of a Federal grant, the making
of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification
of a Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an off cer or employee of congress, or an
employee of a Member of Congress in connection with this Federal grantor cooperative agreement, the undersigned shall complete
and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all covered sub -
awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly.
Does offeror agree? YES VEM Init! a€s of Authorized Representative of offeror
RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS
When federal funds are expended by Participating Agency for any contract resulting from this procurement process, offeror certifies
that it will comply with the record retention requirements detailed in 2 CFR § 200.333. The offeror further certifies that offeror will
retain all records as required by 2 CFR § 200.333 for a period of three years after grantees or subgrantees submit final
expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.
Does offeror agree? YES VEM initials of Authorized Representative of offeror
CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT
When Participating Agency expends federal funds for any contract resulting from this procurement process, offeror certifies that it
will comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy
conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18).
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Does offeror agree? YES VEM Initials of Authorized Representative of Offeror
-- CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS
To the extent purchases are made with Federal Highway Administration, Federal Railroad Administration, or Federal Transit
Administration funds, offeror certifies that its products comply with all applicable provisions of the Buy America Act and agrees to
provide such certification or applicable waiver with respect to specific products to any Participating Agency upon request.
Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling for free and
open competition.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
CERTIFICATION OF ACCESS TO RECORDS - 2 C.F.R. § 200.336
Offeror agrees that the Inspector General of the Agency or any of their duly authorized representatives shall have access to any
documents, papers, or other records of offeror that are pertinent to offeror's discharge of its obligations under the Contract for the
purpose of making audits, examinations, excerpts, and transcriptions. The right also includes timely and reasonable access to
offeror's personnel for the purpose of interview and discussion relating to such documents.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS
Offeror agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.
Does offeror agree? YES VEM Initials of Authorized Representative of offeror
Offeror agrees to comply with at federal, state, and local laws, rules, regulations and ordinances, as applicable. It is
further acknowledged that offeror certifies compliance with all provisions, laws, acts, regulations, etc. as specifically
noted above.
Offeror's Name: B&H Foto & Electronics Carp
Address, City, State, and Zip Code: 420 Ninth Avenue, New York, NY 10001
Phone Number: 212-239-7500 Fax Number: 212-239-7509
Printed Name and Title of Authorized Representative: V. Elizabeth Melia 1 Compliance Specialist
Email Address: Registrations@bhphoto.com
Signature of Authorized Representative: iV Date: 1217 020
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FEMA SPECIAL CONDITIONS
Awarded Supplier(s) may need to respond to events and losses where products and services are needed for
the immediate and initial response to emergency situations such as, but not limited to, water damage, fire
damage, vandalism cleanup, biohazard cleanup, sewage decontamination, deodorization, and/or wind
damage during a disaster or emergency situation. By submitting a proposal, the Supplier is accepted these
FEMA Special Conditions required by the Federal Emergency Management Agency (FEMA).
"Contract" in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as the
"Master Agreement'.
"Contractor in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as
"Supplier' or "Awarded Supplier".
Conflicts of Interest
No employee, officer, or agent may participate in the selection, award, or administration of a contract supported
by a FEMA award if he or she has a real or apparent conflict of interest. Such a conflict would arise when the
employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization
which employs or is about to employ any of these parties, has a financial or other interest in or a tangible
personal benefit from a firm considered for award, 2 C.F.R. § 200.318(c)(1); See also Standard Form 424D, 5
7; Standard Form 42413, ¶ 3. i. FEMA considers a "financial interest" to be the potential for gain or loss to the
employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization
which employs or is about to employ any of these parties as a result of the particular procurement. The
prohibited financial interest may arise from ownership of certain financial instruments or investments such as
stock, bonds, or real estate, or from a salary, indebtedness, job offer, or similar interest that might be affected
by the particular procurement. ii. FEMA considers an "apparent" conflict of interest to exist where an actual
conflict does not exist, but where a reasonable person with knowledge of the relevant facts would question the
impartiality of the employee, officer, or agent participating in the procurement. c. Gifts. The officers, employees,
and agents of the Participating Public Agency nor the Participating Public Agency ("NFE") must neither solicit
nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts.
However, NFE's may set standards for situations in which the financial interest is de minimus, not substantial,
- or the gift is an unsolicited item of nominal value. 2 C.F.R. § 200.318(c)(1). d. Violations. The NFE's written
standards of conduct must provide for disciplinary actions to be applied for violations of such standards by
officers, employees, or agents of the NFE, 2 C.F.R. § 200.318(c)(1). For example, the penalty for a NFE's
employee may be dismissal, and the penalty for a contractor might be the termination of the contract.
Contractor Integrity
A contractor must have a satisfactory record of integrity and business ethics. Contractors that are debarred or
suspended as described in Chapter III, % 6.d must be rejected and cannot receive contract awards at any level.
Public Policv
A contractor must comply with the public policies of the Federal Government and state, local government, or
tribal government. This includes, among other things, past and current compliance with the:
a. Equal opportunity and nondiscrimination laws
b. Five affirmative steps described at 2 C.F.R. § 200.321(b) for all subcontracting under contracts supported
by FEMA financial assistance; and FEMA Procurement Guidance June 21, 2016 Page IV- 7
c. Applicabie prevailing wage laws, regulations, and executive orders
Affirmative Steps
For any subcontracting opportunities, Contractor must take the following Affirmative steps,
1. Placing qualified small and minority businesses and women's business enterprises on solicitation lists;
2. Assuring that small and minority businesses, and women's business enterprises are solicited whenever
they are potential sources;
3. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit
maximum participation by small and minority businesses, and women's business enterprises;
4. Establishing delivery schedules, where the requirement permits, which encourage participation by small
and minority businesses, and women's business enterprises; and
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5. Using the services and assistance, as appropriate, of such organizations as the Small Business
Administration and the Minority Business Development Agency of the Department of Commerce.
Prevailing Waae Requirements
When applicable, the awarded Contractor (s) and any and all subcontractor(s) agree to comply with all laws
regarding prevailing wage rates including the Davis -Bacon Act, applicable to this solicitation and/or
Participating Public Agencies. The Participating Public Agency shall notify the Contractor of the applicable
pricinglprevailing wage rates and must apply any local wage rates requested. The Contractor and any
subcontractor(s) shall comply with the prevailing wage rates set by the Participating Public Agency.
Federal Requirements
If products and services are issued in response to an emergency or disaster recovery the items below, located
in this FEMA Special Conditions section of the Federal Funds Certifications, are activated and required when
federal funding may be utilized.
2 C.F.R. $ 200.326 and 2 C.F.R. Part 200. ADoendix il. Reauired Contract Clauses
Termination for Convenience
The right to terminate this Contract for the convenience of the Participating Public Agency is retained by the
Participating Public Agency. In the event of a termination for convenience by the Participating Public Agency,
the Participating Public Agency shall, at least ten (10) calendar days in advance, deliver written notice of the
termination for convenience to Contractor. Upon Contractor's receipt of such written notice, Contractor
immediately shall cease the performance of the Work and shall take reasonable and appropriate action to
secure and protect the Work then in place. Contractor shall then be paid by the Participating Public Agency, in
accordance with the terms and provisions of the Contract Documents, an amount not to exceed the actual
labor costs incurred, the actual cost of all materials installed and the actual cost of all materials stored at the
project site or away from the project site, as approved in writing by the Participating Public Agency but not yet
paid for and which cannot be returned, and actual, reasonable and documented demobilization costs, if any,
paid by Contractor and approved by the Participating Public Agency in connection with the Scope of Work in
place which is completed as of the date of termination by the Participating Public Agency and that is in
conformance with the Contract Documents, less all amounts previously paid for the Work. No amount ever
shall be owed or paid to Contractor for lost or anticipated profits on any part of the Scope of Work not performed
or for consequential damages of any kind.
2. Equal Emplovment ODDortunity:
The Participating Public Agency highly encourages Contractors to implement Affirmative Action practices in
their employment programs. This means Contractor should not discriminate against any employee or applicant
for employment because of race, color, religion, sex, pregnancy, sexual orientation, political belief or affiliation,
age, disability or genetic information.
During the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for employment because of race,
color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative
action to ensure that applicants are employed, and that employees are treated during employment, without
regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall
include, but not be limited to the following. Employment, upgrading, demotion, or transfer, recruitment or
recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for
training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees
and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of
this nondiscrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the
contractor, state that all qualified applicants will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, or national origin.
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(3) The contractor will not discharge or in any other manner discriminate against any employee or applicant
for employment because such employee or applicant has inquired about, discussed, or disclosed the
compensation of the employee or applicant or another employee or applicant. This provision shall not apply to
instances in which an employee who has access to the compensation information of other employees or
applicants as a part of such employee's essential job functions discloses the compensation of such other
employees or applicants to individuals who do not otherwise have access to such information, unless such
disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding,
hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's
legal duty to furnish information.
(4) The contractor will send to each labor union or representative of workers with which it has a collective
bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting
officer, advising the labor union or workers' representative of the contractor's commitments under section 202
of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places
available to employees and applicants for employment.
(5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the
rules, regulations, and relevant orders of the Secretary of Labor.
(6) The contractor will furnish all information and reports required by Executive Order 11246 of September 24,
1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit
access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes
of investigation to ascertain compliance with such rules, regulations, and orders.
(7) In the event of the contractor's non-compliance with the nondiscrimination clauses of this contract or with
any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or
in part and the contractor may be declared ineligible for further Government contracts in accordance with
procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be
imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule,
regulation, or order of the Secretary of Labor, or as otherwise provided by law.
(8) The contractor will include the provisions of paragraphs (1) through (8) in every subcontract or purchase
order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section
204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each
subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order
as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for
noncompliance: Provided, however, that in the event the contractor becomes involved in, or is threatened with,
litigation with a subcontractor or vendor as a result of such direction, the contractor may request the United
States to enter into such litigation to protect the interests of the United States.
3. "Durina the performance of this contract. the contractor aorees as follows:
(1) The contractor will not discriminate against any employee or applicant for
employment because of race, color, religion, sex, or national origin. The contractor
will take affirmative action to ensure that applicants are employed, and that
employees are treated during employment without regard to their race, color,
religion, sex, or national origin. Such action shall include, but not be limited to the
following: Employment, upgrading, demotion, or transfer; recruitment or recruitment
advertising; layoff or termination; rates of pay or other forms of compensation; and
selection for training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for employment, notices
to be provided setting forth the provisions of this nondiscrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive
considerations for employment without regard to race, color, religion, sex, or national
origin.
{3) The contractor will send to each labor union or representative of workers with which
he has a collective bargaining agreement or other contractor understanding, a notice
to be provided advising the said labor union or workers' representatives of the
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contractor's commitments under this section, and shall post copies of the notice in
conspicuous places available to employees and applicants for employment.
(4) The contractor will comply with all provisions of Executive Order 11246 of September
24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor.
(5) The contractor will furnish all information and reports required by Executive Order
11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary
of Labor, or pursuant thereto, and will permit access to his books, records, and
accounts by the administering agency and the Secretary of Labor for purposes of
investigation to ascertain compliance with such rules, regulations, and orders.
(6) In the event of the contractor's noncompliance with the nondiscrimination clauses of
this contract or with any of the said rules, regulations, or orders, this contract may be
canceled, terminated, or suspended in whole or in part and the contractor may be
declared ineligible for further Government contracts or federally assisted construction
contracts in accordance with procedures authorized in Executive Order 11246 of
September 24, 1965, and such other sanctions as may be imposed and remedies
invoked as provided in Executive Order 11246 of September 24, 1965, or by rule,
regulation, or order of the Secretary of Labor, or as otherwise provided bylaw.
(7) The contractor will include the portion of the sentence immediately preceding
paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract
or purchase order unless exempted by rules, regulations, or orders of the Secretary
of Labor issued pursuant to section 204 of Executive Order 11246 of September 24,
1965, so that such provisions will be binding upon each subcontractor or vendor. The
contractor will take such action with respect to any subcontract or purchase order as
the administering agency may direct as a means of enforcing such provisions,
including sanctions for noncompliance: Provided, however, That in the event a
contractor becomes involved in, or is threatened with, litigation with a subcontractor
or vendor as a result of such direction by the administering agency the contractor
may request the United States to enter into such litigation to protect the interests of
the United States."
4. Davis Bacon Act and Cooeland Anti-KickbackAct.
a. Applicability of Davis -Bacon Act. The Davis -Bacon Act only applies to the emergency
Management Preparedness Grant Program, Homeland Security Grant Program, Nonprofit
Security Grant Program, Tribal Homeland Security Grant Program, Port Security Grant
Program, and Transit Security Grant Program. It does not angv to other FEMA gran
and coonerativg agreementagreeMent programs, including the Public ;assistance Program.
b. All prime construction contracts in excess of $2,000 awarded by non -Federal entities must
include a provision for compliance with the Davis -Bacon Act (40 U.S.C. §§ 3141-3144 and
3146-3148) as supplemented by Department of Labor regulations at 29 C.F.R. Part 5
(Labor Standards Provisions Applicable to Contracts Covering Federally Financed and
Assisted Construction)). See 2 C.F.R. Part 200, Appendix Il, ff D.
c. In accordance with the statute, contractors must be required to pay wages to laborers and
rnechanlcs at a rate not less than the prevailing wages specified in a wage determination
made by the Secretary of Labor. In addition, contractors must be required to pay wages
not less than once aweek.
d. The non -Federal entity must place a copy of the current prevailing wage determination
issued by the Department of Labor in each solicitation. The decision to award a contract
or subcontract must be conditioned upon the acceptance of the wage determination. The
non -Federal entity must report all suspected or reported violations to the Federal awarding
agency.
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e. In contracts subject to the Davis -Bacon Act, the contracts must also include a provision
for compliance with the Copeland "Anti -Kickback" Act (40 U.S.C. § 3145), as
supplemented by Department of Labor regulations at 29 C.F.R. Part 3 (Contractors and
Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans
or Grants from the United States). The Copeland Anti- Kickback Act provides that each
contractor or subrecipient must be prohibited from inducing, by any means, any person
employed in the construction, completion, or repair of public work, to give up any part of
the compensation to which he or she is otherwise entitled. The non -Federal entity must
report all suspected or reported violations to FEMA.
f. The regulation at 29 C.F.R. § 5.5(a) does provide the required contract clause that applies
to compliance with both the Davis -Bacon and Copeland Acts. However, as discussed in the
previous subsection, the Davis -Bacon Act does not apply to Public Assistance recipients and
subrecipients. ins wharf t -
Go -Deland "Anfl-Kockback Act-' " However, for purposes of grant oroarams where both
clauses do aooiv. FEMA reouires the following contract clause:
"Compliance with the Copeland "Anti -Kickback" Act.
(I} Contractor. The contractor shall comply with 18 U.S.C. § 874, 40U.S.C. § 3145, and
the requirements of 29 C.F.R. pt. 3 as may be applicable, which are incorporated by
reference into this contract.
(2) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the
clause above and such other clauses as the FEMA may by appropriate instructions
require, and also a clause requiring the subcontractors to include these clauses in
any lower tier subcontracts. The prime contractor shall be responsible for the
compliance by any subcontractor or lower tier subcontractor with all of these contract
clauses
(3) Breach. A breach of the contract clauses above may be grounds for termination of
the contract, and for debarment as a contractor and subcontractor as provided in 29
C.F.R. §5.12."
5. Contract Work Hours and Safetv Standards Act.
a. Applicability: This requirement applies to all FEMA grant and cooperative
agreement programs.
b. Where applicable (see 40 U.S.C. § 3701), all contracts awarded by the non -Federal entity in
excess of $100,000 that involve the employment of mechanics or laborers must include a
provision for compliance with 40 U.S.C. §§ 3702 and 3704, as supplemented by Department
of Labor regulations at 29 C.F.R. Part 5. See 2 C.F.R. Part 200, Appendix II, ¶ E.
c. Under 40 U.S.C. § 3702, each contractor must be required to compute the wages of every
mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of
the standard work week is permissible provided that the worker is compensated at a rate of
not less than one and a half times the basic rate of pay for all hours worked in excess of 40
hours in the workweek.
d. The requirements of 40 U.S.C. § 3704 are applicable to construction work and provide
that no laborer or mechanic must be required to work in surroundings or under working
conditions which are unsanitary, hazardous or dangerous. These requirements do not
apply to the purchases of supplies or materials or articles ordinarily available on the open
market, or contracts for transportation or transmission of intelligence.
e. The regulation at 29 C.F.R. § 5.5(b) provides the required contract clause concerning
compliance with the Contract Work Hours and Safety Standards Act:
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"Compliance with the Contract Work Hours and Safetv Standards Act.
(1) Overtime requirements. No contractor or subcontractor contracting for any part of
the contract work which may require or involve the employment of laborers or
mechanics shall require or permit any such laborer or mechanic in any workweek
in which he or she is employed on such work to work in excess of forty hours in
such workweek unless such laborer or mechanic receives compensation at a rate
not less than one and one-half times the basic rate of pay for all hours worked in
excess of forty hours in such workweek.
(2) Violation: liabilitv for unpaid wages; liquidated damages. In the event of any
violation of the clause set forth in paragraph (1) of this section the contractor and
any subcontractor responsible therefor shall be liable for the unpaid wages. In
addition, such contractor and subcontractor shall be liable to the United States (in
the case of work done under contract for the District of Columbia or a territory, to
such District or to such territory), for liquidated damages. Such liquidated damages
shall be computed with respect to each individual laborer or mechanic, including
watchmen and guards, employed in violation of the clause set forth in paragraph
(1) of this section, in the sum of $10 for each calendar day on which such individual
was required or permitted to work in excess of the standard workweek of forty
hours without payment of the overtime wages required by the clause set forth in
paragraph (1) of this section.
(3) Withholding for unpaid wages and liauidated damages. The (write in the name of
the Federal agency or the loan or grant recipient) shall upon its own action or upon
written request of an authorized representative of the Department of Labor withhold
or cause to be withheld, from any moneys payable on account of work performed
by the contractor or subcontractor under any such contract or any other Federal
contract with the same prime contractor, or any other federally -assisted contract
subject to the Contract Work Hours and Safety Standards Act, which is held by the
same prime contractor, such sums as may be determined to be necessary to
satisfy any liabilities of such contractor or subcontractor for unpaid wages and
liquidated damages as provided in the clause set forth in paragraph (2) of this
section.
(4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the
clauses set forth in paragraph (1) through (4) of this section and also a clause
requiring the subcontractors to include these clauses in any lower tier
subcontracts. The prime contractor shall be responsible for compliance by any
subcontractor or lower tier subcontractor with the clauses set forth in paragraphs
(1) through (4) of this section."
6. Rights to Inventions Made Under a Contract or Agreement.
a. Stafford Act Disaster Grants. This requirement does not; angly to the Public_ Assistance,
Hazard Mitigation Grant Program, Fire Management Assistance Grant Program, Crisis
Counseling Assistance and Training Grant Program, Disaster Case Management Grant
Program, and Federal Assistance to Individuals and Households — Other Needs Assistance
Grant Program, as
FEMA awards under these programs do not meet the definition of "funding agreement."
b. If the FEMA award meets the definition of "funding agreement' under 37 C.F.R.§ 401.2(a) and
the non -Federal entity wishes to enter into a contract with a small business firm or nonprofit
organization regarding the substitution of parties, assignment or performance of experimental,
developmental, or research work under that "funding agreement," the non -Federal entity must
comply with the requirements of 37 C.F.R. Part 401 (Rights to inventions Made by Nonprofit
Organizations and Small Business Firms Under Government Grants. Contracts and
Cooperative Agreements), and any implementing regulations issued by FEMA. See 2 C.F.R.
Part 200, Appendix II, ¶ F.
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c. The regulation at 37 C.F.R. § 401.2(a) currently defines "funding agreement" as any contract,
grant, or cooperative agreement entered into between any Federal agency, other than the
Tennessee Valley Authority, and any contractor for the performance of experimental,
developmental, or research work funded in whole or in part by the Federal government. This
term also includes any assignment, substitution of parties, or subcontract of any type entered
into for the performance of experimental, developmental, or research work under a funding
agreement as defined in the first sentence of this paragraph.
7. Clean Air Act and the Federal Water Pollution Control Act.. Contracts of amounts in excess of $150,000
must contain a provision that requires the contractor to agree to comply with all applicable standards,
orders, or regulations issued pursuant to the Clean Air Act (42 U.S.C.§§ 7401-7671q) and the Federal
Water Pollution Control Act as amended (33 U.S.C. §§ 1251-1387). Violations must be reported to FEMA
and the Regional Office of the Environmental Protection Agency. See 2 C.F.R. Part 200, Appendix 11, If
G.
a. The followina provides a sample contract clause concerning como{iance for contracts of
amounts in excess of$150,000:
"Clean Air Act
(1) The contractor agrees to comply with all applicable standards, orders or regulations
issued pursuant to the Clean Air Act, as amended, 42 US. C.§ 7401 et seq.
(2) The contractor agrees to report each violation to the (name of the state agency or local
or Indian tribal government) and understands and agrees that the (name of the state
agency or local or Indian tribal government) will, in turn, report each violation as required
to assure notification to the (name of recipient), Federal Emergency Management
Agency, and the appropriate Environmental Protection Agency Regional Office.
(3) The contractor agrees to include these requirements in each subcontract exceeding
$150,000 financed in whole or in part with Federal assistance provided by FEMA.
Federal Water Pollution Control Act
(1) The contractor agrees to comply with all applicable standards, orders or regulations
issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S.C.
1251 et seq.
(2) The contractor agrees to report each violation to the (name of the state agency or local
or Indian tribal government) and understands and agrees that the (name of the state
agency or local or Indian tribal government) will, in turn, report each violation as
required to assure notification to the (name of recipient), Federal Emergency
Management Agency, and the appropriate Environmental Protection Agency Regional
Office.
(3) The contractor agrees to include these requirements in each subcontract exceeding
$150,000 financed in whole or in partwith Federal assistance provided by FEMA."
8. Debarment and Suspension.
a. Aoolicabilitv: This requirement applies to all FEMA grant and cooperative agreement
programs.
b. Non-federal entities and contractors are subject to the debarment and suspension regulations
implementing Executive Order 12549, Debarment and Suspension (1986) and Executive
Order 12689, Debarment and Suspension (1989) at 2 C.F.R. Part 180 and the Department of
Homeland Security's regulations at 2 C.F.R. Part 3000 (Non procurement Debarment and
Suspension).
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c. These regulations restrict awards, subawards, and contracts with certain parties that are
debarred, suspended, or otherwise excluded from or ineligible for participation in Federal
assistance programs and activities. See 2 C.F.R. Part200, Appendix II, ¶ H; and Procurement
Guidance for Recipients and Subrecipients Under 2 C.F.R. Part 200 (Uniform Rules);
Supplement to the Public Assistance Procurement Disaster Assistance Team (PDA T) Field
Manual Chapter IV, 16.d, and Appendix C, q 2 [hereinafter PRAT Supplement], A contract
award must not be made to parties listed in the SAM Exclusions. SAM Exclusions is the list
maintained by the General Services Administration that contains the names of parties
debarred, suspended, or otherwise excluded by agencies, as well as parties declared
ineligible under statutory or regulatory authority other than Executive Order 12549. SAM
exclusions can be accessed at www.sam.00v. See 2 C.F.R. § 180.530; PDAT Supplement,
Chapter IV, ¶ 6.d and Appendix C, T 2.
d. In general, an "excluded" party cannot receive a Federal grant award or a contract within the
meaning of a "covered transaction," to include subawards and subcontracts. This includes
parties that receive Federal funding indirectly, such as contractors to recipients and
subrecipients. The key to the exclusion is whether there is a "covered transaction," which is
any non -procurement transaction (unless excepted) at either a "primary" or "secondary" tier.
Although "covered transactions" do not include contracts awarded by the Federal
Government for purposes of the non -procurement common rule and DHS's implementing
regulations, it does include some contracts awarded by recipients and subrecipient.
e. Specifically, a covered transaction includes the following contracts for goods or services:
(1) The contract is awarded by a recipient or subrecipient in the amount of at feast $25,000.
(2) The contract requires the approval of FEMA, regardless of amount.
(3) The contract is for federally required audit services.
(4) A subcontract is also a covered transaction if it is awarded by the contractor of a
recipient or subrecipient and requires either the approval of FEMA or is in excess of
$25,000.
d. The following provides a debarment and suspension clause. It incorporates an optional
method of verifvina that contractors are not excluded or disaualified:
"Suspension and Debarment
(1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt.
3000. As such the contractor is required to verify that none of the contractor, its
principals (defined at 2 G.F.R. § 180.995), or its affiliates (defined at2 C.F.R. § 180,905)
are excluded (defined at 2 C.F.R.§ 180.940) or disqualified (defined at 2 C.F.R. §
180,935).
(2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000,
subpart C and must include a requirement to comply with these regulations in any lower
tier covered transaction it enters into.
(3) This certification is a material representation of fact relied upon by (insert name of
subrecipient). If it is later determined that the contractor did not comply with 2 C.F.R.
pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available
to (name of state agency serving as recipient and name of subrecipient), the Federal
Government may pursue available remedies, including but not limited to suspension
and/or debarment.
(4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt. 180,
subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the
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Period of any contract that may arise from this offer. The bidder or proposer further
agrees to include a provision requiring such compliance in its lower tier covered
transactions.'
9. Bvrd Anti-Lobbvina Amendment.
a. ADDlicability: This requirement applies to all FEMA grant and cooperative agreement
programs.
b. Contractors that apply or bid for an award of $100,000 or more must file the required
certification. See 2 C.F.R. Part 200, Appendix €I, 4 I; 44 C.F.R. Part 18; PDAT Supplement,
Chapter IV, 6.c; Appendix C,14.
c. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds
to pay any person or organization for influencing or attempting to influence an officer or
employee of any agency, a member of Congress, officer or employee of Congress, or an
employee of a member of Congress in connection with obtaining any Federal contract, grant
or any other award covered by 31 U.S.C. § 1352. Each tier must also disclose any lobbying
with non -Federal funds that takes place in connection with obtaining any Federal award.
Such disclosures are forwarded from tier to tier up to the non -Federal award. See PDAT
Supplement, Chapter IV, 16.c and Appendix C, ¶ 4.
d. The followinq provides a Bvrd Anti-Lobbvina contract clause:
"Bvrd Anti-Lobbvina Amendment. 31 U.S.C. � 1352 (as amended)
Contractors who apply or bid for an award of $100,000 or more shall fife the required certification.
Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay
any person or organization for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, officer or employee of Congress, or an employee of a member of
Congress in connection with obtaining any Federal contract, grant, or any other award covered by 31
U.S.C. § 1352. Each tier shall also disclose any lobbying with non -Federal funds that takes place in
connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to
the recipient."
APPENDIX A. 44 C.F.R. PART 18 — CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements (To be submitted with
each bid or offer exceeding $100,000)
The undersigned [Contractor] certifies, to the best of his or her knowledge, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or employee of
an agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form- LLL, "Disclosure Form to Report
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Lobbying," in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants , and contracts under
grants, loans, and cooperative agreements) and that all subrecipients shall certifyand disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person
who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not
more than $100,000 for each such failure.
The Contractor. B&H iroto & Electronics Corp , certifies or affirms the truthfulness and
accuracyof each statement of its certification and disclosure, if any. In addition, the Contractor
understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification
and disclosure, if any,
Signature of Contractor s Authorized Official
V. Elizabeth Mejia I Compliance Specialist
Name and Title of Contractor's Authorized Official
121712020
Date"
10. Procurement of Recovered Materials.
a. Applicability: This requirement applies to all FEMA grant and cooperative agreement
programs.
b. A non -Federal entity that is a state agency or agency of a political subdivision of a state and
its contractors must comply with Section 6002 of the Solid Waste Disposal Act, Pub. L. No.
89-272 (1965) (codified as amended by the Resource Conservation and Recovery Act at
42 U.S.C. § 6962). See 2 C.F.R. Part 200, Appendix II, ¶ J; 2 C.F.R. § 200.322; POAT
Supplement, Chapter V,'f7.
c. The requirements of Section 6002 include procuring only items designated in guidelines of
the EPA at 40 C.F.R. Part 247 that contain the highest percentage of recovered materials
practicable, consistent with maintaining a satisfactory level of competition, where the
purchase price of the item exceeds $10,000 or the value of the quantity acquired by the
preceding fiscal year exceeded $10,000; procuring solid waste management services in a
manner that maximizes energy and resource recovery; and establishing an affirmative
procurement program for procurement of recovered materials identified in the EPA
guidelines.
d. The following provides the clause that a state aaencv or aaencv of a political,
subdivision of a state and its contractors can include in contracts meetinq the above,
contract thresholds:
"(1 ) In the performance of this contract, the Contractor shall make maximum use of products
containing recovered materials that are EPA- designated items unless the product cannot
be acquired—
(i) Competitively within a timeframe providing forcompliance with the
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contract performance schedule;
(ii) Meetingcontract performance requirements; or
(iii) At a reasonable price.
(2) Information about this requirement, along with the list of EPA- designate items, is
available at EPA's Comprehensive Procurement Guidelines web site,
https:llwww.eoa.aovlsmmlcomprehensive- procurement-guideline-coo-Drooram."
11. Additional FEMA Requirements.
a. The Uniform Rules authorize FEMA to require additional provisions for non- Federal
entity contracts. FEMA, pursuant to this authority, requires or recommends the
following:
b. Changes.
To be eligible for FEMA assistance under the non -Federal entity's FEMA grant or
cooperative agreement, the cost of the change, modification, change order, or constructive
change must be allowable, allocable, within the scope of its grant or cooperative agreement,
and reasonable for the completion of project scope. FEMA recommends, therefore, that a
non -Federal entity include a changes clause in its contract that describes how, if at all,
changes can be made by either party to alter the method, price, or schedule of the work
without breaching the contract- The language of the clause may differ depending on the
nature of the contract and the end -item procured,
C. Access to Records.
All non -Federal entities must place into their contracts a provision that all contractors and
their successors, transferees, assignees, and subcontractors acknowledge and agree to
comply with applicable provisions governing Department and FEMA access to records,
accounts, documents, information, facilities, and staff. See ❑HS Standard Terms and
Ccnditions, v 3A, T XXVI (2013).
d. The following provides a contract clause regarding access to records:
"Access to Records. The following access to records requirements aDDIv to this contract:
(1) The contractor agrees to provide (insert name of state agency or local or Indian
tribal government), (insert name of recipient), the FEMA Administrator, the Comptroller
General of the United States, or any of their authorized representatives access to any
books, documents, papers, and records of the Contractor which are directly pertinent
to this contract for the purposes of making audits, examinations, excerpts, and
transcriptions.
(2) The Contractor agrees to permit any of the foregoing parties to reproduce by any
means whatsoever or to copy excerpts and transcriptions as reasonably needed.
(3) The contractor agrees to provide the FEMA Administrator or his authorized
representatives access to construction or other work sites pertaining to the work being
completed under thecontract."
12. ❑HS Seal, Logo, and Flags.
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a. All non -Federal entities must place in their contracts a provision that a contractor shall not
use the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency
officials without specific FEMA pre -approval. See DHS Standard Terms and Conditions, v
3.0, 1 XXV (2013).
b. The following provides a contract clause reaardina DHS Seal. Loao, and Flags: "The
contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or likenesses
of DHS agency officials without specific FEMA pre- approval."
13. Compliance with Federal Law, Regulations, and Executive Orders.
a. All non -Federal entities must place into their contracts an acknowledgement that FEMA
financial assistance will be used to fund the contract along with the requirement that the
contractor will comply with all applicable federal law, regulations, executive orders, and
FEMA policies, procedures, and directives.
b. The following provides a contract clause reaardina Compliance with Federal Law,
Regulations. and Executive Orders: "This is an acknowledgement that FEMA financial
assistance will be used to fund the contract only. The contractor will comply will all applicable
federal law, regulations, executive orders, FEMA policies, procedures, and directives."
14. No Obligation by Federal Government.
a. The non -Federal entity must include a provision in its contract that states that the Federal
Government is not a party to the contract and is not subject to any obligations or liabilities
to the non -Federal entity, contractor, or any other party pertaining to any matter resulting
from the contract.
b. The following provides a contract clause regarding no obligation by the Federal
Government: "The Federal Government is not a party to this contract and is not subject to
any obligations or liabilities to the non -Federal entity, contractor, or any other party pertaining
to any matter resulting from the contract."
15. Program Fraud and False or Fraudulent Statements or Related Acts.
a. The non -Federal entity must include a provision in its contract that the contractor
acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and
Statements) applies to its actions pertaining to the contract.
b. The following orovides a contract clause reaardina Fraud and False or Fraudulent or
Related Acts: "The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative
Remedies for False Claims and Statements) applies to the contractor's actions pertaining
to thiscontract."
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Additional contract clauses per 2 C.F.R. & 200,325
For applicable constructionlreconstruction!renovation and related services: A navment and performance
bond are both required for 100 percent of the contract price. A "performance bond" is one executed in
connection with a contract to secure fulfitiment of all the contractor's obligations under such contract. A
"pavment bond" is one executed in connection with a contract to assure navment as required by law of all
Persons supplvinp labor and material in the execution of the work provided in the contract.
Offeror agrees to comply with ali terms and conditions outlined in the FEMA Special Conditions
section of this solicitation.
Offeror's Name:
B&H Foto and Electronics
Address, City, State, and Zip Code:
420 Ninth Ave, New York NY 10001
Phone Number: 212-239-7500
Fax Number: 212-239-7509
Printed Name and Title of Authorized
Representative: Israel Mamann- B213 Contracts
Email Address:
israelm{a bhphoto. com
Signature of Authorized Representative:
Date: *a� . � �W ZP 4.
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EXHIBIT G
NEW JERSEY BUSINESS COMPLIANCE
NEW JERSEY BUSINESS COMPLIANCE
Suppliers intending to do business in the State of New Jersey must comply with policies and
procedures required under New Jersey statues. All offerors submitting proposals must complete the
following forms specific to the State of New Jersey. Completed forms should be submitted with the
offeror's response to the RFP. Failure to complete the New Jersey packet will impact OMNIA
Partners' ability to promote the Master Agreement in the State of New Jersey.
DOC # 1
Statement of Ownership Disclosure
DOC #2
Non -Collusion Affidavit
DOC #3
Affirmative Action Affidavit
DOC 44
Political Contribution Disclosure Form
DOC 45
Stockholder Disclosure Certification
DOC 46
Certification of Non -Involvement in Prohibited Activities in Iran
DOC 47
New Jersey Business Registration Certificate
DOC 48
EEOAA Evidence
DOC #9
McBride -Principles
New Jersey suppliers are required to comply with the following New Jersey statutes when
applicable:
• all anti -discrimination laws, including those contained in N.J.S.A. 10.2-1 through N.J.S.A.
10:2-14, N.J.S.A. 10:5-1, and N.J.S.A. 10:5-31 through 10:5-38;
• Prevailing Wage Act, N.J.S.A. 34:11-56.26, for all contracts within the contemplation of the
Act;
• Public Works Contractor Registration Act, N.J.S.A. 34:11-56.26; and
Bid and Performance Security, as required by the applicable municipal or state statutes.
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DOC #1
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)
This statement shall be completed, certified to, and included with all bid and proposal submissions.
Failure to submit the required information is cause for automatic rejection of the bid or proposal.
Name of Organization: B&H Foto & Electronics Corp
Organization Address: 420 Ninth Avenue, New York, NY 10001
Part I Check the box that represents the type of business organization:
Sale Proprietorship (skip Parts 11 and III, execute certification in Part IV)
0 Non -Profit Corporation (skip Parts II and III, execute certification in Part IV)
® For -Profit Corporation (any type) Limited Liability Company (LLC)
0 Partnership 0 Limited Partnership Mimited Liability Partnership (LLP)
❑ Other (be specific):
Part II
® The list below contains the names and addresses of all stockholders in the
corporation who own 10 percent or more of its stock, of any class, or of all individual
partners in the partnership who own a 10 percent or greater interest therein, or of a[I
members in the limited liability company who own a 10 percent or greater interest
therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION)
OR
0 No one stockholder in the corporation owns 10 percent or more of its stock, of any
class, or no individual partner in the partnership owns a 10 percent or greater
interest therein, or no member in the limited liability company owns a 10 percent or
greater interest therein, as the case may be. (SKIP TO PART IV)
(Please attach additional sheets if more space is needed):
Name of Individual or Business Entity
Herman Schreiber
Sam Goldstein
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Home Address (for Individuals) or Business Address
420 Ninth Avenue, New York, NY 10001
420 Ninth Avenue, New York, NY 10001
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Part III DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS,
PARTNERS OR LLC MEMBERS LISTED IN PART If
If a bidder has a direct or indirect parent entity which is publicly traded, and any person
holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of
the fast annual federal Security and Exchange Commission (SEC) or foreign equivalent
filing, ownership disclosure can be met by providing links to the website(s) containing the last
annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent)
that contain the name and address of each person holding a 10% or greater beneficial interest
in the publicly traded parent entity, along with the relevant page numbers of the filing($) that
contain the information on each such person. Attach additional sheets if more space is
needed.
Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #'s
Please list the names and addresses of each stockholder, partner or member owning a 10
percent or greater interest in any corresponding corporation, partnership and/or limited liability
company (LLC) listed in Part II other than for any publicly traded parent entities
referenced above. The disclosure shall be continued until names and addresses of every
noncorporate stockholder, and individual partner, and member exceeding the 10 percent
ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach
additional sheets if more space is needed.
Stockholder/Partner/Member and Corresponding
Entity Listed in Part II
Part IV Certification
Home Address (for Individuals) or Business Address
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto
to the best of my knowledge are true and complete. 1 acknowledge: that I am authorized to execute this
certification on behalf of the bidder/proposer; that the <name of contracting unity is relying on the information
contained herein and that I am under a continuing obligation from the date of this certification through the
completion of any contracts with <type of contracting unit> to notify the atype of contracting unity in writing
of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false
statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the
law and that it will constitute a material breach of my agreement(s) with the, permitting the atype of
contracting unity to declare any contract(s) resulting from this certification void and unenforceable.
Full Name (Print): V. Elizabeth Mejia Title. Compliance Specialist
Signature: ,7, f f, Date: 12/7/2020
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DOC #2
NON -COLLUSION AFFIDAVIT
STANDARD BID DOCUMENT REFERENCE
Reference: VH-H
Name of Form:
NON -COLLUSION AFFIDAVIT
Statutory Reference:
No specific statutory reference
State Statutory Reference N.J.S.A. 52:34-15
Instructions Reference:
Statutory and Other Requirements VII-H
The Owner's use of this form is optional. It is used to ensure that
Description:
the bidder has not participated in any collusion with any other
bidder or Owner representative or otherwise taken any action in
restraint of free and competitive bidding,
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State orgy- New York
County or New York
NON-1COLLUSION AFFIDAVIT
ss:
I. V. Elizabeth Meiia - residing in New York
Inaine of aftiamI Jmrnc ormuniapnlitr 1
in the County of New York and State or New York �T of fill l
age, being duty sworn according to taw on my oath depose and say that:
1 am Compliance Specialist of the firm of B&H Foto & Electronics Corp
Otle or position) (name of fi)m)
the bidder making this Proposal for the bid
entitled 20-12Audw Visual EqLiipmemt Serv*n , and that 1 executed the said proposal with
(Lilk ofbid proposal )
full authority to do so that said bidder has not, directly or indirectly entered into.any agreement.
}participated in any collusion, or otherwise taken any action in restraint of free, competitive bidding in
connection with the above named project; and that all statements contained in said proposal and in this
affidavit are true and correct, and made with full knowledge that the:
_relies upon the truth of the statements contained in said Proposal
(name aropnehaing Unit)
and in the statements contained in this affidavit in awarding the contract for the said project.
1 further warrant that no person or selling agency has been employed or retained to solicit or secure such
contract upon an agreement or understanding for a commission, percentage, brokerage, or contingent
fee, except bona Fide employees or bona fide established commercirl or selling; agencies maintained by
B&H Foto & Electronics Corp
Subscribed and sworn to
before me this day
December 7 , 2020
4 public of
My Commission expires.
(Sea]) /ouj
f C tAmS 600,U , /V 9�
Version Sepu'mber N.2020
Signature
V. Elizabeth Mejia
(Type or print name Jaff"iant under sipature)
11
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DOC #3
AFFIRMATIVE ACTION AFFIDAVIT
(P.L. 1975, C.127)
Company Name: B&H Foto & Electronics Corp
Street: 420 Ninth Avenue
City, State, Zip Code: New York, NY 10001
Pronosal Certification:
Indicate below company's compliance with New Jersey Affirmative Action regulations. Company's
proposal will be accepted even if company is not in compliance at this time. No contract and/or
purchase order may be issued, however, until all Affirmative Action requirements are met.
Reauired Affirmative Action Evidence:
Procurement, Professional & Service Contracts {Exhibit A}
Vendors must submit with uronosal:
1. A photo copy of their Federal Letter of Affirmative Action Plan Anoroval
W:
2. A photo copy of their Certificate of Emniovee Information Report
OR
3. A complete Affirmative Action Emnlovee Information Reoort (AA302)
Public Work — Over $50.000 Total Proiect Cost:
A. No approved Federal or New Jersey Affirmative Action Plan. We will complete Report Form
AA201-A upon receipt from the
B. Approved Federal or New Jersey Plan — certificate enclosed
7further certify that the statements and information contained herein, are complete and correct to
the Kest of my knowledge and belief.
12/7'/2020
Date
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Authorized Signature and Title
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DOC #3, continued
P.L. 1995, c. 127 (N.J.A.C. 17:27)
MANDATORY AFFIRMATIVE ACTION LANGUAGE
PROCUREMENT. PROFESSIONAL AND SERVICE
CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for
employment because of age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual
orientation. The contractor will take affirmative action to ensure that such applicants are recruited and employed, and
that employees are treated during employment, without regard to their age, race. creed, color, national origin, ancestry,
marital status, sex, affectional or sexual orientation. Such action shall include, but not be limited to the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay
or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in
conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency
Compliance Officer setting forth provisions of this non-discrimination clause.
The contractor or subcontractor, where applicable will, in all solicitations or advertisement for employees placed by or
on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to
age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation.
The contractor or subcontractor, where applicable, will send to each labor union or representative of workers with which
it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency
contracting officer advising the Iabor union or workers' representative of the contractor's commitments under this act and
shall post copies of the notice in conspicuous places available to employees and applicants for employment.
The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer
pursuant to P.L. 1975, c. 127, as amended and supplemented from time to time and the Americans with Disabilities Act.
The contractor or subcontractor agrees to attempt in good faith to employ minority and female workers trade consistent
with the applicable county employment goal prescribed by N.J.A.C. 17:27-5.2 promulgated by the Treasurer pursuant to
P.L. 1975, C.127, as amended and supplemented from time to time or in accordance with a binding determination of the
applicable county employment goals determined by the Affirmative Action Office pursuant to N.J.A.C. 17:27-5.2
promulgated by the Treasurer pursuant to P.L. 1975, C.127, as amended and supplemented from time to time.
The contractor or subcontractor agrees to inform in writing appropriate recruitment agencies in the area, including
employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis
of age, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation, and that it will
discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.
The contractor or subcontractor agrees to revise any of it testing procedures, if necessary, to assure that all personnel
testing conforms with the principles of job -related testing. as established by the statutes and court decisions of the state
of New Jersey and as established by applicable Federal law and applicable Federal court decisions.
The contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and lay-off
to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, sex,
affectional or sexual orientation, and conform with the applicable emptoy merit goal s, consistent with the statutes and court
decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions.
The contractor and its subcontractors shall furnish such reports or other documents to the Affirmative Action Office as
may be requested by the office from time to time in order to carry out the purposes of these regulations, and public
agencies shall furnish such information as may be requested by the Affirmative Action Office for conducting a compliance
investigation pursuant to Subchavter 10 of the Administrative Code (NJAC 17:27).
Signature of Procurement Agent
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DOC #4
- C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Public Agency Instructions
This page provides guidance to public agencies entering into contracts with business entities that are required to file
Political Contribution Disclosure forms with the agency. It is not intended to be provided to contractors. What follows
are instructions on the use of form local units can provide to contractors that are required to disclose political contributions
pursuant to N.].S.A. 19:44A-20.26 (P.L. 2005, c. 271, s.2), Additional information on the process is available in Local
Finance Notice 2006-1ihttn://www.ni.trov/dea/divisions/dies/resources/lfns 2006.htmi}. Please refer back to these
instructions for the appropriate links, as the Local Finance Notices include links that are no longer operational.
I. The disclosure is required for ail contracts in excess of $17,500 that are not awarded pursuant to a "fair and open,"
process N.].S.A. 19:44A-20.7).
2. Due to the potential length of some contractor submissions, the public agency should consider allowing data to be
submitted in electronic form (i.e., spreadsheet, pdf file, etc.). Submissions must be kept with the contract documents
or in an appropriate computer file and be available for public access. The form is worded to accept this alternate
submission. The text should be amended if electronic submission will not be allowed.
3. The submission must be received from the contractor and on file at least 10 days prior to award of the contract.
Resolutions of award should reflect that the disclosure has been received and is on file.
4. The contractor must disclose contributions made to candidate and party committees covering a wide range of public
agencies, including all public agencies that have elected officials in the county of the public agency, state legislative
positions, and various state entities, The Division of Local Government Services recommends that contractors be
provided a list of the affected agencies. This will assist contractors in determining the campaign and political
committees of the officials and candidates affected by the disclosure.
a. The Division has prepared model disclosure forms for each county. They can be downloaded from the "County
PCD Forms" link on the Pay -to -Play web site at httn://www.ni.p-ov/dca/divisions/dlgs/Drogratns/lncl.html#12.
They will be updated from time -to -time as necessary.
b. A public agency using these forms should edit them to properly reflect the correct legislative district(s). As
the forms are county -based, they list all legislative districts in each county. Districts that do not represent
the public agency should be removed from the lists.
c. Some contractors may find it easier to provide a single list that covers all contributions, regardless afthe county.
These submissions are appropriate and should be accepted.
d. The form may be used "as -is", subject to edits as described herein.
e. The "Contractor Instructions" sheet is intended to be provided with the form. It is recommended that the
Instructions and the form be printed on the same piece of paper. The form notes that the Instructions are printed
on the back of the form; where that is not the case, the text should be edited accordingly.
f. The form is a Word document and can be edited to meet local needs, and posted for download on web sites, used
as an e-mail attachment, or provided as a printed document.
It is recommended that the contractor also complete a "Stockholder Disclosure Certification." This will assist the
local unit in its obligation to ensure that contractor did not make any prohibited contributions to the committees listed
on the Business Entity Disclosure Certification in the 12 months prior to the contract (See Local Finance Notice
2006-7 for additional information on this obligation at
htto://www.ni.gpv/dca/divisions/digslresourecOfns_200fj.html}, A sample Certification form is part of this package
and the instruction to complete it is included in the Contractor Instructions. NOTE: This section is not applicable to
Boards of Education.
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DOC #4, continued
- C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a "fair and
open" process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 27I, s.2 (N.J.S.A. 19:44A-
20.26). This Iaw provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions
to:
• any State, county, or municipal committee of a political party
• any legislative leadership committee'
• any continuing political committee (a.k.a., political action committee)
• any candidate committee of a candidate for, or holder of, an elective office:
a of the public entity awarding the contract
0 of that county in which that public entity is located
a of another public entity within that county
0 or of a legislative district in which that public entity is located or, when the public entity is a county, of
any legislative district which includes all or part of the county
The disclosure must list reportable contributions to any of the committees that exceed $300 per election cycle that were
made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on
reportable contributions.
N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a
natural person. This includes the following:
r individuals with an "interest" ownership or control of more than 10% of the profits or assets of a business entity
or 10% of the stock in the case of a business entity that is a corporation for profit
• ail principals, partners, officers, or directors of the business entity or their spouses
• any subsidiaries directly or indirectly controlled by the business entity
• IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity
and filing as continuing political committees, (PACs).
When the business entity is a natural person, "a contribution by that person's spouse or child, residing therewith, shall be
deemed to be a contribution by the business entity." N� J.S.A. 19:44A-20.26(b)] The contributor must be listed on the
disclosure.
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an
amount to be determined by the Commission which may be based upon the amount that the business entity failed to report.
The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official
and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor's responsibility to
identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed
information may exceed the minimum requirement.
The enclosed form, a content -consistent facsimile, or an electronic data file containing the required details (along with a
signed cover sheet) may be used as the contractor's submission and is disclosable to the public under the Open Public
Records Act.
The contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in
meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts.
' N.J.S.A. 19:44A-3(s): "The term "legislative leadership committee" means a committee established, authorized io be
established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the General
Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.LA993, c.65 (C.19:44A-10.1) for
the purpose of receiving contributions and making expenditures."
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #4, continued
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant to N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the local unit
no later than 14 days prior to the sward of the contract.
Part 1 — Vendor Information
I Vendor Name: I B&H Foto & Electronics Coro
Address: 1420 Ninth Avenue
I city: I New York —I State: NY FZip: 10001 I
The undersigned being authorized to certify, hereby certifies that the submission provided herein represents
compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions
accompanying this form.
el 64-11'a V. Elizabeth Mejia Compliance Specialist
Signature Printed Name Vitle
Part II — Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable
political contributions (more than $300 per election cycle) over the 12 months prior to submission to
the committees of the government entities listed on the form provided by the local unit.
❑ Check here if disclosure is provided in electronic form
�+• I Contributor Name Recipient Name Date Dollar Amount
None $ I
I
I
1 l
I
I I
I 1
f
Check here if the information is continued on subsequent page(s)
Version September29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #4, continued
List of Agencies with Elected Officials Required for Political Contribution Disclosure
N.J.S.A. 19:44A-24.26
County Name:
State: Governor, and Legislative Leadership Committees
Legislative District #s:
State Senator and two members of the General Assembly per district.
County:
Freeholders County Clerk Sheriff
County Executive} Surrogate
Municipalities (Mayor and members of governing body, regardless of title):
USERS SHOULD CREATE THEIR OWN FORM, DR DOWNLOAD
FROM THE PAY TO PLAY SECTION OF THE DLGS WEBSITE A
COUNTY -BASED, CUSTOMIZABLE FORM.
version September 29, 2020
■
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #S
STOCKHOLDER DISCLOSURE CERTIFICATION
Name of Businexs.
® I certify that the list below contains the names and home addresses of all stockholders
Balding 10% or more of the issued and outstanding stuck of the undersigned.
OR
0 I certify that no one stockholder owns 10% or more of, tile issued and outstanding stock of
the undersigned.
Check the box that represents the type of business Organization:
❑Partnership ❑Corpora.tion 13Sole Proprietorship
OLimited Partnership Mimited Liability Corporation Limited Liability Partnership
0 Subchapter S Corporation
Sign and notarize the form below, and, if necessary, complete the stockholder list below.
Stockholders:
Name: Herman Schreiber
Home Address: 1418 54th Street
i
Brooklyn, NY 11219
I
Name:
Home Address:
Flame:
Home Address:
subscribed and s om before me this 7- day o�
2 = 'L 1 --
(Notary "'r-I
rA v Ia4, 1?G evs
My Commission expires: WV'7 • j'z j Qo,k
ICZ',r��5 Coo Vt Y, X/ y
VCFS1011 Scplcnihcr 29.2020
Name: Sam Goldstein
Home Address: 6 Vincent Dr
Spring Valle,
Name:
Home Address:
Name:
Home Address:
sari
V. Elizabeth Mejia
(Print name & Lille of'al7iant)
(Comwate su-al) -
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
STATE OF NEW JERSEY -- DIVISION OF PURCHASE AND PROPERTY
DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
Quote Number: 20-12
sidder/Offeror: B&H Foto and Electronics Corp.
FART 1: CERTIFICATION
BIDDERS MUST COMPLETE. PART 1 BY CHECKING EITHER BOX.
FAILURE TO CHECK ONE OF THE BOXES WILL RENDER THE PROPOSAL NON -RESPONSIVE.
Pursuant to Public Law 2012, c. 25, any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a
contract must complete the certification beiow to attest, under penalty of perjury, that neither the person or entity, nor any of its parents,
subsidiaries, or affiliates, is identified on the Department of Treasury's Chapter 25 list as a person or entity engaging in investment activities
in Iran. The Chapter 25 list is found on the Division's website at htt :1lwu,+v state.ni usAreasurvl ur ase,�dflCba�tpr SLis pdf, Bidders
must review this list prior to completing the below certification. Failure to complete the certification will render a bidder's proposal
non -responsive. If the Director finds a person or entity to be in violation of law, s/he shall take action as may be appropriate and provided
by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in
default and seeking debarment or suspension of the party
P SE CHECK THE APPROPRIATr:_B_0X-
I certify, pursuant to Public Law 2012, c. 25, that neither the bidder listed above nor any of the bidder's parents,
❑subsidiaries, or affiliates is listed on the N.J. Department of the Treasury"s list of entities determined to be engaged in prohibited
activities in Iran pursuant to P,L. 2012, c. 25 ('Chapter 25 List"). I further certify that I am the person listed above, or I am an officer
or representative of the entity listed above and am authorized to make this certification on its behalf. I will skip Fart 2 and sign and
complete the Certification below.
❑l am unable to certify as above because the bidder andlor one or more of its parents, subsidiaries, or affiliates is listed on
the Department's Chapter 25 list. I will provide a detailed, accurate and precise description of the activities in Part 2 below
and sign and complete the Certification below. Failure to provide such will result in the oropos@L being rendered as non-
responsive and appropriate penalties, fines andlor sanctions will be assessed as provided by law.
PAR : PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN IRAN
You must provide a detailed, accurate and precise description of the activities of the bidding person/entity, or one of its parents,
subsidiaries or affiliates, engaging in the investment activities in Iran outlined above by completing the boxes below.
EACH BOX WILL PROMPT YOU TO PROVIDE INFORMATION RELATIVE TO THE ABOVE QUESTIONS. PLEASE PROVIDE
THOROUGH ANSWERS TO EACH QUESTION, IF YOU NEED TO MAKE AODITIONAL ENTRIES, CLICK THE "ADD AN ADDITIONAL
ACTIVITIES ENTRY" BUTTON.
Name
Description of Activities
Duration of Engagement
Bidder/Offeror Contact Name
ADD AN ADDITIONAL ACfIVIDES ENTRY
Relationship to Bidder/Offeror
Anticipated Cessation Date
Contact Phone Number
Certification: 1, being duly sworn upon my oath, hereby represent and stela that the foregoing information and any attachments thereto to the bast of
my knowledge are true and complete. I attest that t am authorized to execute this certification on behalf of the above -referenced person or entity. I
acknowledge that the State of New Jersey is relying on the information contained herein and thereby acknowledge that I am under a continuing
obligation from the date of this certification through the completion of any contracts with the State to notify the State in writing of any changes to the
answers of information contained herein. t acknowledge that 1 am aware that it is a criminal offense to make a false statement or misrepresentation in
this certification, and if I do so, I recognize that I am subject to criminal prosecution under the law and that it will also constitute a material breach of
my agreement(s) with the State of New Jersey and that the State at Its option may declare any contrac"sl resulting from this certification void and
unenforceable. Full �r
Full Name (Print): Israel Mamann signature:
Title: B213 Contracts Date_ 12/08/2020
DPP Standard Forms Packet 11/2013
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #7
NEW JERSEY BUSINESS REGISTRATION CERTIFICATE
(N.J.S.A. 52:32-44)
Offerors wishing to do business in New Jersey must submit their State Division of Revenue issued
Business Registration Certificate with their proposal here. Failure to do so will disqualify the
Offeror from offering products or services in New Jersey through any resulting contract.
httDs://www.niportal-com/])ORiBLISinessRe,gistration/
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
CERT-1
02102M 7
Taxpayer ldenlificalion* 132.768-0711000
Dear Business Representative
Congratulations! You are now registered with the New Jersey Division of Revenue
Use the Taxpayer Identification Number, listed above on all correspondence with the Dwisions
of Revenue and Taxation. as well as with the Department of Labor (if the business is subject
la unemployment withholaingsj. Your tax returns and payments will be filed under this number,
and you will be able to access information about your account by referencing it.
Additionally- please note that State law requires all contractors and subconlractors. with Public
agencies to provide proof of their registration with the Division of Revenue. The law also amended
Section 92 of the Casino Control Act, which deals with The casino service industry.
We have attached a Proof of Registration Certificate for your use- To comply with the law, if you are
currently under contract or entering rnto a contract with a State agi?ni:y you must provide a copy
of the certificate to the contracting agency
If you have arty questions or require more information, feat free to call our Registration Hotline at
(609)292-9292
T wish you continued success in your business endeavors.
Sincerely.
James J. fruscione
Director
New Jersey Division of Revenue
€ t
STATE OF NEW JERSEY
F •3 BUSINESS REGISTRATION CERTIFICATE ; DEPARTMENT OF TREASURVI
�. DiviS'ON OF H EWNUE
Po Box yS2
�n�-! -r.R '+l-� r�' [.`rn^ `R` s.!Ak-swq.M!•.�:�'�k�'{!tw `h r••!3nnryn'q•y RENTON. N . OW6,0151
TAXPAYER NAME. TRADE NAME:
F B b H FOTO & ELECTRONICS CORP
ADDRESS SEQUFNCE NUMBER:
420 9TH AVENUE '
2108463
NEW YORK NY 10001
• EFFECTIVE DATE: ISSUANCE DATE:
02/02/17 02/02/17
Z.
Di a[tor
.ti New .lnty D,Wk ClP_ of Rel*rLe
-+�,^:.--..-.,�.wc.�.+,,d`.e...:••.r......yyth'y•nv�s�vei•,•�['$P:1F}I�it�s�vw�,�r,a�A • --
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #8
EEOAA EVIDENCE
Equal Employment Opportunity/Affirmative Action
Goods, Professional Services & General Service Projects
EEO/AA Evidence
Vendors are required to submit evidence of compliance with N.J.S.A. 10:5-31 et seq. and
N.J.A.C. 17:27 in order to be considered a responsible vendor.
One of the following must be included with submission:
Copy of Letter of Federal Approval
• Certificate of Employee Information Report
■ Fully Executed Form AA302
• Fully Executed EEO- I Report
See the guidelines at: htty://www.state.n_i.us/treasury/contract_ compliance/ndf/n_ a.ndf
for further information.
I certify that my bid package includes the required evidence per the above list and
State website.
Name: V. Elizabeth Meiia Title. Compliance Specialist
Signature: fi Date: 12/7/2020
Requirements for National Cooperative Contract
Page 55 of 68
CO= DV. h
,- HC98538
SECTION B - COMPANY IDENTIFICATION
' B & H FOTO & ELECTRONICS CORP.
420 9TH AVENUE
NEW YORK, NY 10011
SECTION D - EMPLOYMENT DATA
HISPANIC OR
LATINO
jOB CATEGORIES
MALE F1;MALE
EQUAL EMPLOYME. JPPORTUNITY
2018 EMPLOYER INFORMATION REPORT
INDIVIDUAL ESTABLISHMENT REPORT -TYPE 4
SECTION C - TEST FOR FILING REQUIREMENT
Z.a. FLORENCE WAREHOUSE 1-Y 2-N 3-Y DUNS NO.:116012659 EIN :132768071
400 CEDAR LANE
FLORENCE, NJ 08518
BURLINGTON COUNTY
C. Y
SECTION E - ESTABLISHMENT INFORMATION
NAICS: 443142 Electronics Stores
NOT -HISPANIC OR LATINO
wwwwwwxwxxxx TSALExxwwxxxxxxxx
w***xxwwwxw
FEMALEwwwxxxxxxxx --
OVERALI
NATIVES
BLACK OR IIAWA11AN
AMERICAN
TWO
BLACK OR NATIVE
AMERICAN
7lNO TOTALS
WHITE. ,AFRICAN OR
INI]IAN OR
AS[AN AI.ASKAN
OR
MORE WHITE
AFR[CAN HA WAAIIAN
;NI]IAN OR
ASIAN
OR
AMERICAN PACIFIC
NATIVE
RACES
AMERICAN PACIFIC
ALASKAN
MORE
ISLAISLANDER15LANI)ER
N.A"f'14'l
RACES
EXECUTIVE/SR OFFICIALS & MGRS
0
0
1
0
0
0 0
FIRST/Mill OFFICIALS & MGRS
10
2
26
6
0
21 0
PROFFU&SIONALS
8
1
24
14
0
0 � 0
' EC'HNICIANS
0
0
4
0
0
01 0
SALES WORKERS
0
0 I
0
0
0
01 0
ADMINISTRA'11VESUPPORI
2
4 I
21
14 I
0
1 I 0
CRAI-r WORKERS
2
0
3
0
0
1 0
OPERATIVES
18
6
7I
28 I
0
01 1
LABORERS& HELPERS
18
20 I
7 I
53 I
0
51 0
SERVICEWORKERS
0
0
0 I
0 I
0
01 0
TOTAL
58
33
93I
115
0
9
1
PREVIOUS REPORT TOTAL.
11
1
23
16
0
1
0
SECTION F - REMARKS
0
0
0
0
0
1
3
0
0
7
6
1
0
0
01
0
0
0
01
0
01
5
6
0
01
0
01
0
01
21
211
0
01
31
13I
0
01
01
01
0
01
181
49'
1
01 41 4I 0
01
0 I
0I
1
01
0 1
0 1
50
01
0 I
0'
6 1
01
0 1
01
4
01
0 1
01
0
1 1
0
0 1
54
0I
0
0 1
61
4
0 I
0 I
87 1
81
0
0 I
1271
0
0'
0
J
13 !
a I
a i
51 0 I 0 I 65]
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
DOC #9
MCBRIDE-PRINCIPLES
STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY
A.DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
MACBRIDE PRINCIPALS FORM
BID SOLICITATION #: 882889366 VENDORIBIDDER: B&H Foto & Electronics Corp
VENDOR'S/BIDDER'S REQUIREMENT
TO PROVIDE A CERTIFICATION IN COMPLIANCE WITH THE MACBRIDE PRINCIPALS
AND NORTHERN IRELAND ACT OF 1989
Pursuant to Public Law 1995, c. 134, a responsible Vendor/Bidder selected, after public bidding, by the Director
of the Division of Purchase and Property, pursuant to N.J.S.A. 52:34-12, must complete the certification below by
checking one of the two options listed below and signing where indicated. If Vendor/Bidder that would otherwise
be awarded a purchase, contract or agreement does not complete the certification, then the Director may determine,
in accordance with applicable law and rules, that it is in the best interest of the State to award the purchase, contract
or agreement to another Vendor/Bidder that has completed the certification and has submitted a bid within five (5)
percent of the most advantageous bid. If the Director finds contractors to be in violation of the principals that are
the subject of this law, he/she shall take such action as may be appropriate and provided by law, rule or contract,
including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in
default and seeking debarment or suspension of theparty.
—` I, the undersigned, on behalf the Vendor/Bidder, certify pursuant to N.J.S.A. 52:34-12.2 that:
7 The Vendor/Bidder has no business operations in Northern Ireland; or
OR
The Vendor/Bidder will take lawful steps in good faith to conduct any business operations it has in Northern Ireland
in accordance with the MacSride principals of nondiscrimination in employment as set forth in section 2 of P.L. 1987,
c. 177 (N.J.S.A. 52:18A-89.5) and in conformance with the United Kingdom's Fair Employment (Northern Ireland)
Act of 1989, and permit independent monitoring of its compliance with those principals.
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor/Bidder, that the foregoing
information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State
of New Jersey is relying on the information contained herein, and that the Vendor/Bidder is under a continuing oblip-ation
from the date of this certification through the completion of any contract(s) with the State to notify the State in writing of
any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or
misrepresentation in this certification. If I do so, I will be subject to criminal prosecution under the law, and it will constitute
a material breach of my agreement(s) with the State, permitting the State to declare any contract(s) resulting from this
certification to be void and unenforceable.
12/7/2020
Signature Date
V. Elizabeth Mejia I Compliance Specialist
Print Name and Title
Version September 29, 2020
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
Nev`zYork, NY i000i
400 Cedar Lane
Florence, NJ 08518
T H E P R 0 F E S S 1 0 N A L` S
c) Qualifications and Experience
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S v U R C E
i. once a neighborhood mom-and-pop camera stare in New York City, B&H has grown to
be a world -class source for creative technology products serving the Corporate,
Government and Education markets as well as our high-tech consumer customers.
Starting as a two -person family awned business in 1973 serving the professional photographer,
B & H now employs aver 1800 people and is home to a two story, city block long Superstore and
600,000+ square foot of state-of-the-art warehouse in Florence, NJ.
B&H's well-known reputation is based on our product knowledge, customer service, large
selection, standard discounted pricing, in -stock availability and extensive e-procurement
capabilities.
B&H has a large selection of creative technology supplies and equipment, featuring over
500,000 products. our business began in the photography industry selling cameras and film, but
as the digital age of photography and the convergence of technology became the standard, we
have expanded our line to include all products related to our core. We employ in-house experts,
up to engineer level, in all areas of technology. We pride ourselves on our ability to convey that
expertise to our customers, to ensure they are purchasing the best product far their needs.
The B2B division is now comprised of over 100 sales and customer service representatives
whose sole purpose is serving the education, government, and non-profit sectors, including
representatives in the field participating in tradeshows and visiting and training customers.
We have preferred vendor status and contracts with nearly 1000 Universities, Colleges, School
Districts, and Fortune 500 companies as well as federal, state, local governments. Our success is
based on a simple philosophy of service, knowledge, honesty and an unsurpassed level of in
stock items.
B&H is located at:
420 Ninth Ave
New York NY
10001
I B&H has an extremely loyal customer base in the United States with more than 500,000
customers. B&H has an extensive list of accounts where our relationship has been developed
over years into long-standing clients. B&H is the leader in this industry when it comes to
customer service, in stock availability, vast product offering and on time shipments.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
E&H
42o Ninth Avenue
New York, NY r000x
400 Cedar Lane
Florence, NJ o85i8
T H E P R a F E S S 1 0 N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
ill. B&H is known as one of the largest suppliers of creative technology, equipment, and
accessories in the U.S. We carry over 500,000 items from more than 5,SOO brands in a wide
range of technology products, including Computer Hardware and Software, IT networking
equipment and accessories, Printers, Mobile technology, TV's, Peripherals, Projectors and more.
Most of our products are in stock in our New Jersey warehouse and ready to ship, allowing for
quick delivery.
Our slogan, "The Professional's Source," did not only come out of our vast stock and shipping
capabilities, it cause from knowing our product and our customer, and the ability to match the
two. We design our website, sales, customer service and marketing all towards developing the
customer's experience to perfection.
iv. Please see Org chart below:
:MeProcui
tra
Director of
B2B
Business
Development
Manager
Outbound
sales reps
Regional fndui
Edu and Vert'
Gov't Sales Sall
Key Personnel include:
Sarah Bialo- Inside Sales Manager
Jaclyn Mehl- Business Development Manager, Government and Education
Israel Mamann- Manager, 132B Contracts
Barry Eisenberg- Customer Relationship Manager
Tiffani Barton- Customer Success Manager
Jerry Zorek- Business Intelligence Manager
Our government and education outbound sales reps are each assigned to a geographic location
and are highly trained on the nuances of the Region 4 contract. They attend many shows, work
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY i000>i
400 Cedar Lane
Florence, NJ o8$1S
M��
T H E P R O F E S S f O N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
with our manufactures to stay up to date with the latest technology and ensure our customers
are always taken care of.
v. B&H has been working with government clients for over 20 years and understands the
technicalities that come with a public sector customer. We make sure our staff understands the
importance of government procurement requirements and train staff to understand the
requirements in their assigned geographic location. We work with our public sector customers
to make sure all their needs are met.
vi. As in the case in any large corporation, B&H has been involved in various commercial
Iitigation matters in the past. Currently, we are involved in an action brought by the NYAG
regarding the collection of sales tax on items featuring instant savings. The results of this case
will not affect the financial standing of B&H in any way.
vii. Please see attached sheet titled "References"
viii. B&H is highly qualified to service a contract of this size and hopes to do so with Region 4 ESC
and OMNIA for many years to come.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
420 Ninth Avenue
New York, NY i000l
4O0 Cedar Lane
Florence, NJ o8518
T H E P R 0 F E S S 1 0 N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.Bhphoto.com/b2b
S O U R C E
d) value Add
i. B&H adds tremendous value to an Audio -Visual contract. Because of the size of our
corporation, we buy hundreds of millions of dollars in stock from our manufacturers. This in turn
allows us to get the greatest discounts possible from our manufacturers which B&H passes on to
our customers,
Further, because B&H has held this contract for the past 5 years, we understand the nuances of
this contract and already have the platform in place to make this contract highly successful. The
B&H OMNIA website is already built, and a few quick changes will allow for the contract to be
utilized on day one.
Aside from the extremely competitive discount we offered in this solicitation, B&H has a price
review system, that is offered y no other reseller. With a quick click in the web portal, a public
agency customer can have their quote reviewed to make sure they are receiving the best
discount.
B&H has A vast base of information on our website with technical specifications, customer
reviews and recommended accessories on all products. B&H also has the quickest delivery in the
industry with average delivery time being three business days across the United States. Orders
placed before 4.00 PM EST are shipped out the same day.
B&H has earned multiple awards for our excellence in customer service, 24/7 online order
tracking and pre and post sales support. Our sales staff is trained in all categories to ensure our
customers get the correct product.
B&H is world renowned and prides itself on having the most knowledgeable staff. Many of our
employees are accomplished experts having worked in their professions for years before joining
us. We have recruited photography, pro audio and pro video specialists, many of whom
continue their involvement in industry groups through B&H and on their own. We place them at
your disposal to offer advice based on years of working in their specific fields.
The B&H catalog hosts over 500,000 products from 5000 different brands with the highest in
- stock availability in the industry. Our warehouse is over 600,O00 square feet and carries the
latest warehouse technology to ensure orders are shipped out in an efficient manner.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
B&H
42o Ninth Avenue
New York, NY wool
400 Cedar Lane
Florence, NJ 08518
■
BB
T H E P R 0 F E S S 1 Q N A L` S
B2bContracts@Bhphoto.com
212-239-7500
www.BhphOtO.COM/b2b
S O U R C E
B&H is committed to supporting the US government Go Green initiatives and offering our
customers a wide variety of Green compliant products. We work with major certifications such
as Energy Star, EPEAT, RohS and others to allow customers to search for these products. We
have also created a Go Green products showcase on our website that can be found at:
http://www.bhohotovideo.com/c/browse/preen-products/ci/29817/N/3708116854
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Annendix C
ADDITIONAL REQUIRED DOCUMENTS
DOC #1 Acknowledgment and Acceptance of Region 4 ESC's Open Records Policy
❑OC #2 Antitrust Certification Statements (Tex. Government Code § 2155,005)
DOC #3 Implementation of House Bill 1295 Certificate of Interested Parties (Form 1295)
HOC #4 Texas Government Code 2270 Verification Form
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Appendix C, Doc #1
ACKNOWLEDGMENT AND ACCEPTANCE
OF REGION 4 ESC's OPEN RECORDS POLICY
OPEN RECORDS POLICY
All proposals, information and documents submitted are subject to the Public Information Act
requirements governed by the State of Texas once a Contract(s) is executed. If an Offeror
believes its response, or parts of its response, may be exempted from disclosure, the Offeror
must specify page -by -page and line -by-line the parts of the response, which it believes, are
exempt and include detailed reasons to substantiate the exemption. Price is not confidential and
will not be withheld. Any unmarked information will be considered public information and released,
if requested under the Public Information Act.
The determination of whether information is confidential and not subject to disclosure is the duty
of the Office of Attorney General (OAG). Region 4 ESC must provide the OAG sufficient
information to render an opinion and therefore, vague and general claims to confidentiality by the
Offeror are not acceptable. Region 4 ESC must comply with the opinions of the OAG. Region 4
ESC assumes no responsibility for asserting legal arguments on behalf of any Offeror. Offeror is
advised to consult with their legal counsel concerning disclosure issues resulting from this
procurement process and to take precautions to safeguard trade secrets and other proprietary
information.
Signature below certifies complete acceptance of Region 4 ESC's Open Records Policy,
except as noted below (additional pages may be attached, if necessary).
Check one of the following responses to the Acknowledgment and Acceptance of Region 4
ESC's Open Records Policy below:
We acknowledge Region 4 ESC's Open Records Policy and declare that no information
submitted with this proposal, or any part of our proposal, is exempt from disclosure under
the Public Information Act.
We declare the following information to be a trade secret or proprietary and exempt from
disclosure under the Public Information Act.
(Note: Offeror must specify page -by -page and line -by-line the parts of the response, which it
believes, are exempt. In addition, Offeror must include detailed reasons to substantiate the
exemption(s). Price is not confident and will not be withheld. All information believed to be a trade
secret or proprietary must be listed. It is further understood that failure to identify such information,
in strict accordance with the instructions, will result in that information being considered public
information and released, if requested under the Public Information Act.)
B&H is requesting our "references" sheet be kept confidential.
�)P, g�k Ac t
Date Authorized Signature & Title
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Appendix C, Doc #2
ANTITRUST CERTIFICATION STATEMENTS
(Tex. Government Code § 2155.005)
Attorney General Form
I affirm under penalty of perjury of the laws of the State of Texas that:
1. I am duly authorized to execute this Contract on my own behalf or on behalf of the company,
corporation, firm, partnership or individual (Company) listed below;
2. In connection with this proposal, neither I nor any representative of the Company has violated
any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm, Code Chapter
15;
3. In connection with this proposal, neither I nor any representative of the Company has violated
any federal antitrust law; and
4. Neither I nor any representative of the Company has directly or indirectly communicated any
of the contents of this proposal to a competitor of the Company or any other company,
corporation, firm, partnership or individual engaged in the same line of business as the
Company.
Company
Address
B&H Foto & Electronics Corp
420 Ninth Avenue
New York, NY 10001
Phone 212-239-7500
Fax 212-239-7509
Contact
Official
Authorizing
Proposal
el
Signature
V. Elizabeth Mejia
Printed Name
Compliance Specialist
Position with Company
+ a ure
�5r-V � Il a�rr
Printed Name
9ZA Ca'i 4'&J)
Position with Company
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Appendix C, DOC # 3
Implementation of House Bill 1295
Certificate of Interested Parties (Form 1295):
In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the
Government Code. The law states that a governmental entity or state agency may not enter
into certain contracts with a business entity unless the business entity submits a disclosure of
interested parties to the governmental entity or state agency at the time the business entity
submits the signed contract to the governmental entity or state agency. The law applies only
to a contract of a governmental entity or state agency that either (1 ) requires an action or vote
by the governing body of the entity or agency before the contract may be signed or (2) has a
value of at least $1 million. The disclosure requirement applies to a contract entered into on or
after January 1, 2016.
The Texas Ethics Commission was required to adopt rules necessary to implement that law,
prescribe the disclosure of interested parties form, and post a copy of the form on the
commission's website. The commission adopted the Certificate of Interested Parties form
{Form 1295) on October 5, 2015. The commission also adopted new rules (Chapter 46) on
November 30, 2015, to implement the law. The commission does not have any additional
authority to enforce or interpret House Bill 1295.
Filing Process:
Staring on January 1, 2016, the commission made available on its website a new filing
application that must be used to file Form 1295. A business entity must use the application to
enter the required information on Form 1295 and print a copy of the completed form, which will
include a certification of filing that will contain a unique certification number. An authorized
agent of the business entity must sign the printed copy of the form. The completed Form 1295
with the certification of filing must be filed with the governmental body or state agency with
which the business entity is entering into the contract.
The governmental entity or state agency must notify the commission, using the commission's
filing application, of the receipt of the fled Form 1295 with the certification of filing not later
than the 30th day after the date the contract binds all parties to the contract. This process is
known as acknowledging the certificate. The commission will post the acknowledged Form
1295 to its website within seven business days after receiving notice from the governmental
entity or state agency. The posted acknowledged form does not contain the declaration of
signature information provided by the business.
A certificate will stay in the pending state until it is acknowledged by the governmental agency.
Only acknowledged certificates are posted to the commission's website.
Electronic Filing Application:
httDs:l/www.ethics.state.tx.us/whatsnew/elf info form1295.htm
Frequently Asked Questions:
httDs://www.ethics.state.tx.uslresources/FAQs/FAQ Forml295.DhD
Changes to Form 1295: httr)s:llwww.ethics.state.tx.us/data/filinginfo/1295Chanaes,Ddf
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
CERTIFICATE OF INTERESTED PARTIES `
Complete Nos. 1 - 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties,
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
B&H Foto & Electronics Corp
New York, NY United States
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Region One Education Service Center
FORM 1295
1 of 1
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2020-696169
Date Filed:
1210712020
Date Acknowledged-
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goads, or other property to be provided under the contract.
20-12
Audio Visual Equipment, Accessories & Services
4 Nature of interest
Name of Interested Party City, State, Country (place of business) (check applicable)
Controlling Intermediary
5 check only if there is NO Interested Party.
6 UNSWORN DECLARATION
My name is V. Elizabeth Mejia
❑X
, and my date of birth is
My address is 420 Ninth Avenue New York N . 10001 us
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in New York County, State of NY on the 7 day of Dec 20 Zd
(month) (year)
Signature of authorized agent of contracting business entity
(Detlarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.cd34673b
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
Appendix C, DOC # 4
Texas Government Code 2270 Verification Form
House Bill 89 (85R Legislative Session), which adds Chapter 2270 to the Texas Government
Code, provides that a governmental entity may not enter into a contract with a company without
verification that the contracting vendor does not and will not boycott Israel during the term of the
contract.
Furthermore, Senate Bill 252 (85R Legislative Session), which amends Chapter 2252 of the
Texas Government Code to add Subchapter F, prohibits contracting with a company engaged in
business with Iran, Sudan or a foreign terrorist organization identified on a list prepared by the
Texas Comptroller.
I, V. Elizabeth Mejia as an authorized
representative of
B&H Foto & Electronics Corp a contractor
engaged by
Insert Name of Company
Region 4 Education Service Center. 7145 West Tidwell Road. Houston. TX 77092., verify by this
writing that the above -named company affirms that it (1 ) does not boycott Israel; and (2) will not
boycott Israel during the term of this contract, or any contract with the above -named Texas
governmental entity in the future.
Also, our company is not listed on and we do not d❑ business with companies that are on the
Texas Comptroller of Public Accounts list of Designated Foreign Terrorists Organizations found
at httr)s://comptroller.texas.aov/Durchasinaldocs/foreign-terrorist.odf.
I further affirm that if our company's position on this issue is reversed and this affirmation is no
longer valid, that the above -named Texas governmental entity will be notified in writing within one
(1) business day and we understand that our company's failure to affirm and comply with the
requirements of Texas Government Code 2270 et seq. shall be grounds for immediate contract
termination without penalty to the above -named Texas governmental entity.
I swear and affirm that the above is true and correct.
Signature of Named Authorized Company Representative
12/7/2020
Date
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
EXHIBIT C
CONFLICT OF INTEREST DISCLOSURE REQUIREMENT
Pursuant to Chapter 176 of the Local Government Code, any person or agent of a person who contracts or
seeks to contract for the sale or purchase of property, goods, or services with a local governmental entity
(i.e. The City of Fort Worth) must disclose in the Questionnaire Forms CIQ ("Questionnaire") the person's
affiliation or business relationship that might cause a conflict of interest with the local governmental entity.
By law, the Questionnaire must be filed with the Fort Worth City Secretary no later than seven days after
the date the person begins contract discussions or negotiations with the City, or submits an application or
response to a request for proposals or bids, correspondence, or another writing related to potential
agreement with the City. Updated Questionnaires must be filed in conformance with Chapter 176.
A copy of the Questionnaires Form CIQ is enclosed with submittal documents. The form is also available at
http://www.ethics.state.tx.us/forms/CIQ.pdf.
If you have any questions about compliance, please consult your own legal counsel. Compliance is the
individual responsibility of each person or agent of a person who is subject to the filing requirement. An
offense under Chapter 176 is a Class C misdemeanor.
NOTE: If you are not aware of a Conflict of Interest in any business relationship that you might have
with the City, state Contractor name in the # 1, use N/A in each of the areas on the form. However, a
signature is required in the #7 box in all cases.
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the Law by fLB. 23, 134rh Leg., Regular Session- OFfICIELISEONLY
This questionnaire is being tiled in accordance with Ct aptar 176, Local Govemment Code, by a vendor who Date Received
has a business relationship as defined by Section 176-001(1-4 with a local governmental entity and the
vendor meets requirements under Section 176.006(a)-
By law this questionnaire must be lled with the records administrator of the local govemmenlal entity not later
than the 7th business day after the dale the vendor becomes aware of fads that require the statement to be
filed. Sae Section 175-006(a-1), Local Gowemment Code.
A vendor commits an offense if the vendor knowingly violates Section 176.0%, Loral Government Cade- An
offense under this sedion is a misdemeanor.
J Name of vendor who has a business relationship with local governmental entity.
N/A
J ❑ Check this box ifytw are filing an update to proviousyfilad questionnaire. (The law requires that you file an updated
c, mpleted questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
ym beca-noaware that the originally filed questionnaire was incomplats OF inaccurate.)
J Name of local government officer about whom the information is being disclosed.
N/A
Name of Officer
J Describe each employment or other business relationship with the local government officer. or a famiy member of the
officer, as described by Section 176.443(a)(2)(A). Also describe any family relationship with the local govemrrtent officer.
Complete subparts A and B loreach employment or business relationship described. Attach additional pages to this Form
GIG as necessary.
A- Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
Yes =No
B- Is the vendor receiving or likely to receive taxablo income, other than investment income. from or at the direction
of the local gay emmont officer OF a family member of the officer AND the taxable income is not received from the
local governmental entity?
Yes =No
139scribeeach employment or business relationship that thevendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
N/A
J
ElCheck this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.009(a-1).
7 1 [ I L,�
a'j SfuqmaA- 4/2/2024
15irUW0I5W9MWing business with the governmental errw ja:a
Form provided by Texas Ethics Commission wwrvv.ethics.state_tx_us Revised 111=1
DocuSign Envelope ID: F2E28DB2-EE1C-4C66-B5DA-697E3CD074A8
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local 0overnment Code may be found at http:;,'s+wwws[ar.uies_legis_state.tx_us!
Docs; LG,'htrw LCL 176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code & 17&001f1-a): "Business relationship" means a connection between two or more parties
based on con-n--- rciail activity of one of the parties. The term does not include a connection based on:
(A) a Iran saction that is s ubject 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 Gave m me nt Cade 41 76.11103(a)(2)(A) and (B):
(a) A local government officer shall file a conflicts disclosure statement with respect to avendor if:
(2) thevendor:
(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 irrrestment income, that exceeds $2.500 during the 12-month period
preceding the date that the officer becomes aware that
(i) acontract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
(B) has given to the local government officer orafamily memberofthe off icer one ormore gifts
that have an aggregate value of more than $100 in the 12-month period preceding the date the
off icerbecomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(i i) the local gave rnmental entity is considering entering into a contract with the vendor_
Local Government Code 4176.006fa1 and fa-1]
(a) Avendor shall fide a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an emp loyment or other busi ness relationship with a I ocal government officer of th at local
governmental entity, or a fam ily member of the off ioer, descri bed by Section 176.003(a)(2) (A)'
(2) has given a local government officer of that focal governmental entity, or a family member of the
officer. one or more giftswith the aggregate value specified by Section 17-6.003(a)(2)(B), excluding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a Ioeal government officer of that local governmental entity-
(a- I ) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity' or
(B) submits to the local governmental entity an application, response to arequest for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B) that the ven dor has g iven one or more g ifts described by Subsection (a)' or
(C) of a family relationship with a local government officer_
Form provided by Texas Ethics Commission www.ethics.state.Ix.us Revered 1110021