HomeMy WebLinkAboutContract 61280CSC No. 61280
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into between Kinetric Inc. dba
Poly Printer ("Vendor through Inter local Procurement Systems (TIPS) Contract #220 l 05), 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;
3.Exhibit B-Cooperative Agency Contract-TIPS Contract #220105; and
4.Exhibit C -Conflict oflnterest 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. If any provisions of
the attached Exhibits conflict with the terms herein, are prohibited by applicable law, conflict with any applicable
rule, regulation or ordinance of City, the terms in this Cooperative Purchase Agreement shall control.
City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with the
provisions of this Agreement. Total payment made under this Agreement for the first year by City shall not exceed
One Hundred Thousand Dollars and Zero Cents ($100,000.00). Vendor shall not provide any additional items
or services or bill for expenses incurred for City not specified by this Agreement unless City requests and approves
in writing the additional costs for such services. City shall not be liable for any additional expenses of Vendor not
specified by this Agreement unless City first approves such expenses in writing.
The term of this Agreement is effective beginning on the date signed by the Assistant City
Manager below ("Effective Date") and expires on May 31, 2025 in line with the cooperative contract. The City
shall be able to renew this agreement for two (2) one-year renewal options by written agreement of the parties.
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.
1.Scope of Services. Vendor enters into this purchase agreement to provide City with services procured under
the City's procurement process on an as-needed basis ("Services"). Exhibit "A," -Scope of Services more
specifically describes the Services to be provided hereunder.
2.Term. This Agreement shall begin on the date signed by the Assistant City Manager below ("Effective Date")
and shall expire on May 31, 2025 to align with TIPS Contract# 220105 ("Expiration Date"), unless terminated
earlier in accordance with this Agreement. The City shall be able to renew this agreement for two (2) one
year renewal options by written agreement of the parties.
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3. Compensation & Statement of Work.
3.1. General Provisions. No funding is allocated to this Agreement on an annual basis. All funding shall be
assigned through individual statements of work that are provided in response to emergency situations for
which the City has gone through the emergency procurement process required by City policy.
3.2. Addendum-Statement of Work. When Services are needed, City will provide Vendor with an applicable.
Each Statement of Work will list the requested Services, a projected timeframe detailing when
Services need to be completed, and the projected amounts for the Services based on Exhibit "A" of
this Agreement. Each Statement of Work must be signed by both parties. No additional services
beyond the scope of the Statement of Work will be provided by the Vendor unless the City requests
and approves in writing the additional costs for such services. City agrees to pay all invoices of
Vendor within thirty (30) days of receipt of such invoice.
33. Invoice. Each invoice shall reference the applicable Statement of Work by addendum number.
Vendor shall submit invoices to the individual identified as the requesting City department's point of
contact in the applicable Statement of Work.
4. Termination.
4.L Written Notice. City or Vendor may terminate this Agreement at any time and for any reason by
providing the other party with 30 days' written notice of termination.
4.2. Non-a�propriation of Funds. In the event no funds or insufficient funds are appropriated by City in any
fiscal period for any payments due hereunder, City will notify Vendor of such occurrence and this
Agreement shall terminate on the last day of the fiscal period for which appropriations were received
without penalty or expense to City of any kind whatsoever, except as to the portions of the payments
herein agreed upon for which funds have been appropriated.
4.3. Duties and Obli�ations of the Parties. In the event that this Agreement is terminated prior to the
Expiration Date, City shall pay Vendor for services actually rendered up to the effective date of
termination and Vendor shall continue to provide City with services requested by City and in accordance
with this Agreement up to the effective date of termination. Upon termination of this Agreement for any
reason, Vendor shall provide City with copies of all completed or partially completed documents
prepared under this Agreement. In the event Vendor has received access to City Information or data as a
requirement to perform services hereunder, Vendor shall return all City provided data to City in a
machine-readable format or other format deemed acceptable to City.
5. Disclosure of Conflicts and Contidential Information.
5.1. Disclosure of Conflicts. Vendor hereby warrants to City that Vendor has made full disclosure in writing
of any existing or potential conflicts of interest related to Vendor's services under this Agreement. In the
event that any conflicts of interest arise after the Effective Date of this Agreement, Vendor hereby agrees
immediately to make full disclosure to City in writing.
5.2. Confidential Information. Vendor, for itself and its officers, agents and employees, agrees that it shall
treat all information provided to it by City ("City Information") as confidential and shall not disclose any
such information to a third party without the prior written approval of City.
53. Public Information Act. City is a government entity under the laws of the State of Texas and all
documents held or maintained by City are subject to disclosure under the Texas Public Information Act.
In the event there is a request for information marked Confidential or Proprietary, City shall promptly
notify Vendor. It will be the responsibility of Vendor to submit reasons objecting to disclosure. A
determination on whether such reasons are sufficient will not be decided by City, but by the Office of the
Attorney General of the State of Texas or by a court of competent jurisdiction.
5.4. Unauthorized Access. Vendor shall store and maintain City Information in a secure manner and shall not
allow unauthorized users to access, modify, delete or otherwise corrupt City Information in any way.
Vendor shall notify City immediately if the security or integrity of any City Information has been
compromised or is believed to have been compromised, in which event, Vendor shall, in good faith, use
all commercially reasonable efforts to cooperate with City in identifying what information has been
accessed by unauthorized means and shall fully cooperate with City to protect such City Information
from further unauthorized disclosure.
6. Ri�ht to Audit. Vendor agrees that City shall, until the expiration of three (3) years after final payment under
this contract, 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.
7. Independent Contractor. It is expressly understood and agreed that Vendor shall operate as an independent
contractor as to all rights and privileges and work performed under this Agreement, and not as agent,
representative or employee of City. Subject to and in accordance with the conditions and provisions of this
Agreement, Vendor shall have the exclusive right to control the details of its operations and activities and
shall be solely responsible for the acts and omissions of its officers, agents, servants, employees, contractors
and subcontractors. Vendor acknowledges that the doctrine of respondeat superior shall not apply as between
City, its officers, agents, servants and employees, and Vendor, its officers, agents, employees, servants,
contractors and subcontractors. Vendor further agrees that nothing herein shall be construed as the
creation of a partnership or joint enterprise between City and Vendor. Vendor further understands
that City shall in no way be considered a Co-employer or a Joint employer of Vendor or any individual
Vendor places with the City, including Vendor's of�cers, agents, servants, employees or subcontractors.
Vendor also recognizes that it shall be responsible for the management of its officers, agents, servants,
employees and subcontractors for any violations of the Vendor's own policies and procedures, which Vendor
represents meet the requirements under the request for proposal for these services.
8. Liability and Indemnification.
8.1. LIABILITY - VENDOR SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND ALL
PROPERTYLOSS, PROPERTYDAMAGEAND/OR PERSONAL INJURY, INCLUDING DEATH,
TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR
ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S),
MALFEASANCE OR INTENTIONAL MISCONDUCT OF VENDOR, ITS OFFICERS, AGENTS,
SERVANTS OR EMPLOYEES.
8.2. GENERAL INDEMNIFICATION - VENDOR HEREBY COVENANTS AND AGREES TO
INDEMNIFY, HOLD HARMLESSAND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS
AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR LAWSUITS OF ANY
KIND OR CHARACTER, WHETHER REAL OR ASSERTED, FOR EITHER PROPERTY
DAMAGE OR LOSS (INCL UDING ALLEGED DAMAGE OR LOSS TO VENDOR'S BUSINESS
AND ANYRESULTING LOST PROFITS) AND/OR PERSONAL INJURY, INCLUDING DEATH,
TO ANY AND ALL PERSONS, ARISING O UT OF OR IN CONNECTION WITH THIS
AGREEMENT, TO THE EXTENT CAUSED BY THE INTENTIONAL AND NEGLIGENT ACTS
OR OMISSIONS OR MALFEASANCE OF VENDOR, ITS OFFICERS, AGENTS, SERVANTS OR
EMPLOYEES. FURTHER, IN THE EVENT CITY IS HELD LIABLE AS A JOINT-EMPLOYER
OR DETERMINED TO BE A JOINT-EMPLOYER BY A COURT OF LAW, ADMINISTRATIVE
BODY OR SIMILAR AUTHORITY, VENDOR COVENANTS AND AGREES TO INDEMNIFY
CITY FOR ANY JUDGMENTS, AWARDS, EXPENSES AND COSTS (INCLUDING BUT NOT
LIMITED TO ATTORNEYS FEES) ORDERED AGAINST THE CITY.
8.3. WAIVER OF CLAIMS AS JOINT-EMPLOYER — Vendor hereby disclaims and waives any and all
claims or causes of action against the City with regard to liability or responsibility for Vendor's
obligations as employer with respect to Vendor's err�ployees, including but not limited to obligations
such as payment of workers compensation claims or benefits; compliance with the Federal Fair Labor
Stnndards Act; payment or furnishing of health, retirement or other benefits; and responsibility for
payment of unemployment insurance or contributions.
8.4. INTELLECTUAL PROPERTY INDENINIFICATION — Vendor agrees to defend, settle, or pay,
at its own cost and expense, any claim or action against City for infringement of any patent,
copyright, trade mark, trade secret, or similar property right arising from City's use of the
software and/or documentation in accordance with this Agreement, it being understood that this
agreement to defend, settle or pay shall not apply if City modifies or misuses the software and/or
documentation. So long as Vendor bears the cost and expense of payment for claims or actions
against City pursuant to this section, Vendor shall have the right to conduct the defense of any
such claim or action and all negotiations for its settlement or compromise and to settle or
compromise any such claim; however, City shall have the right to fully participate in any and all
such settlement, negotiations, or lawsuit as necessary to protect City's interest, and City agrees to
cooperate with Vendor in doing so. In the event City, for whatever reason, assumes the
responsibility for payment of costs and expenses for any claim or action brought against City for
infringement arising under this Agreement, City shall have the sole right to conduct the defense of
any such claim or action and all negotiations for its settlement or compromise and to settle or
compromise any such claim; however, Vendor shall fully participate and cooperate with City in
defense of such claim or action. City agrees to give Vendor timely written notice of any such claim
or action, with copies of all papers City may receive relating thereto. Notwithstanding the
foregoing, City's assumption of payment of costs or expenses shall not eliminate Vendor's duty to
indemnify City under this Agreement. If the software and/or documentation or any part thereof is
held to infringe and the use thereof is enjoined or restrained or, if as a result of a settlement or
compromise, such use is materially adversely restricted, Vendor shall, at its own expense and as
City's sole remedy, either: (a) procure for City the right to continue to use the software and/or
documentation; or (b) modify the software and/or documentation to make it non-infringing,
provided that such modi�cation does not materially adversely affect City's authorized use of the
software and/or documentation; or (c) replace the software and/or documentation with equally
suitable, compatible, and functionally equivalent non-infringing software and/or documentation at
no additional charge to City; or (d) if none of the foregoing alternatives is reasonably available to
Vendor terminate this Agreement, and refund all amounts paid to Vendor by City, subsequent to
which termination City may seek any and all remedies available to City under law.
9. Assignment and Subcontracting.
9.1. Assi�nment. Vendor shall not assign or subcontract any of its duties, obligations or rights under this
Agreement without the prior written consent of City. If City grants consent to an assignment, the assignee
shall execute a written agreement with City and Vendor under which the assignee agrees to be bound by
the duties and obligations of Vendor under this Agreement. Vendor and Assignee shall be jointly liable
for all obligations of Vendor under this Agreement prior to the effective date of the assignment.
9.2. Subcontract. If City grants consent to a subcontract, sub Vendor shall execute a written agreement with
Vendor referencing this Agreement under which sub Vendor shall agree to be bound by the duties and
obligations of Vendor under this Agreement as such duties and obligations may apply. Vendor shall
provide City with a fully executed copy of any such subcontract.
10. Insurance. Vendor shall provide City with certificate(s) of insurance documenting policies of the following
types and minimum coverage limits that are to be in effect prior to commencement of any work pursuant to
this Agreement:
10.1. Covera�e and Limits
(a) Commercial General Liability:
$1,000,000 - Each Occurrence
$2,000,000 — Aggregate
(b) Automobile Liability:
$1,000,000 - Each occurrence on a combined single limit basis
Coverage shall be on any vehicle used by Vendor, its employees, agents, representatives in
the course of providing services under this Agreement. "Any vehicle" shall be any vehicle
owned, hired and non-owned.
(c) Worker's Compensation:
Statutory limits according to the Texas Workers' Compensation Act or any other state
workers' compensation laws where the work is being performed
Employers' liability
$100,000 - Bodily Injury by accident; each accident/occurrence
$100,000 - Bodily Injury by disease; each employee
$500,000 - Bodily Injury by disease; policy limit
(d) Professional Liability (Errors & Omissions):
$1,000,000 - Each Claim Limit
$1,000,000 - Aggregate Limit
Professional Liability coverage may be provided through an endorsement to the Commercial
General Liability (CGL) policy, or a separate policy specific to Professional E&O. Either is
acceptable if coverage meets all other requirements. Coverage shall be claims-made, and
maintained for the duration of the contractual agreement and for two (2) years following
completion of services provided. An annual certificate of insurance shall be submitted to City
to evidence coverage.
10.2. General Requirements
(a) The commercial general liability and automobile liability policies shall name City as an additional
insured thereon, as its interests may appear. The term City shall include its employees, officers,
officials, agents, and volunteers in respect to the contracted services.
(b) The workers' compensation policy shall include a Waiver of Subrogation (Right of Recovery) in
favor of City.
(c) A minimum of Thirty (30) days' notice of cancellation or reduction in limits of coverage shall be
provided to City. Ten (10) days' notice shall be acceptable in the event of non-payment of premium.
Notice shall be sent to the Risk Manager, City of Fort Worth, 200 Texas Street, Fort Worth, Texas
76102, with copies to the Fort Worth City Attorney at the same address.
(d) The insurers for all policies must be licensed and/or approved to do business in the State of Texas.
All insurers must have a minimum rating of A- VII in the current A.M. Best Key Rating Guide, or
have reasonably equivalent financial strength and solvency to the satisfaction of Risk Management.
If the rating is below that required, written approval of Risk Management is required.
(e) Any failure on the part of City to request required insurance documentation shall not constitute a
waiver of the insurance requirement.
(fl Certificates of Insurance evidencing that Vendor has obtained all required insurance shall be
delivered to the City prior to Vendor proceeding with any work pursuant to this Agreement.
1 l. Compliance with Laws, Ordinances, Rules and Re�ulations. Vendor agrees that in the performance of its
obligations hereunder, it shall comply with all applicable federal, state and local laws, ordinances, rules and
regulations and that any work it produces in connection with this Agreement will also comply with all
applicable federal, state and local laws, ordinances, rules and regulations. In particular, and without limiting
the generality of the foregoing statement, the Vendor acknowledges and agrees that it is responsible for
compliance with all applicable requirements of the Federal Fair Labor Standards Act, including but not limited
to restrictions regarding number of hours worked per week and payment of lawfully owed over time and
minimum wage. If City notifies Vendor of any violation of such laws, ordinances, rules or regulations, Vendor
shall immediately desist from and correct the violation.
12. Non-Discrimination Covenant. Vendor, for itself, its personal representatives, assigns, subvendors and
successors in interest, as part of the consideration herein, agrees that in the performance of Vendor's duties
and obligations hereunder, it shall not discriminate in the treatment or employment of any individual or group
of individuals on any basis prohibited by law. IF ANY CLAIM ARISES FROM AN ALLEGED
VIOLATION OF THIS NON-DISCRIMINATION COVENANT BY VENDOR, ITS PERSONAL
REPRESENTATIVES, ASSIGNS, SUBVENDORS OR SUCCESSORS IN INTEREST, VENDOR
AGREES TO ASSUME SUCH LIABILITY AND TO INDEMNIFY AND DEFEND CITY AND HOLD
CITY HARMLESS FROM SUCH CLAIM.
13. Notices. 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 ofthe transmission, or (3) received by
the other party by United States Mail, certified, return receipt requested, addressed as follows:
To CITY:
To VENDOR:
City of Fort Worth Kinetric Inc. dba PolyPrinter
Attn: 7esica McEachern, Assistant City Manager Attn.: Robin KofFeman
200 Texas Street 2750 W FM 875
Fort Worth, TX 76102-6314 Midlothian, TX 76065
Facsimile: (817) 392-8654
Phone: 469-844-1229
With copy to Fort Worth City Attorney's Office at Fax: NA
same address
14. Solicitation of Employees. Vendor shall not, during the term of this Agreement and additionally for a period
of one year after its termination, solicit for employment or employ, whether as employee or independent
contractor, any person who is or has been employed by the City during the term of this Agreement, without
the prior written consent of the City. Notwithstanding the foregoing, this provision shall not apply to an
employee of City who responds to a general solicitation of advertisement of employment by Vendor.
15. Governmental Powers. It is understood and agreed that by execution of this Agreement, City does not waive
or surrender any of its governmental powers or immunities.
16. No Waiver. The failure of City or Vendor to insist upon the performance of any term or provision of this
Agreement or to exercise any right granted herein shall not constitute a waiver of City's or Vendor's respective
right to insist upon appropriate performance or to assert any such right on any future occasion.
17. Governing Law / Venue. This Agreement shall be construed in accordance with the laws of the State of
Texas. If any action, whether real or asserted, at law or in equity, is brought pursuant to this Agreement, venue
for such action shall lie in state courts located in Tarrant County, Texas or the United States District Court for
the Northern District of Texas, Fort Worth Division.
18. Severability. If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining provisions shall not in any way be affected or impaired.
19. Force Majeure. City and Vendor will exercise their best efforts to meet their respective duties and obligations
as set forth in this Agreement, but will not be held liable for any delay or omission in performance due to
force majeure or other causes beyond their reasonable control, including, but not limited to, compliance with
any government law, ordinance, or regulation; acts of God; acts of the public enemy; fires; strikes; lockouts;
natural disasters; wars; riots; epidemics or pandemics; government action or inaction; orders of government;
material or labor restrictions by any governmental authority; transportation problems; restraints or
prohibitions by any court, board, department, commission, or agency of the United States or of any States;
civil disturbances; other national or regional emergencies; or any other similar cause not enumerated herein
but which is beyond the reasonable control of the Party whose performance is affected (collectively, "Force
Majeure Event"). The perforinance of any such obligation is suspended during the period of, and only to the
extent of, such prevention or hindrance, provided the affected Party provides notice of the Force Majeure
Event, and an explanation as to how it prevents or hinders the Party's performance, as soon as reasonably
possible after the occurrence of the Force Majeure Event, with the reasonableness of such notice to be
determined by the City in its sole discretion. The notice required by this section must be addressed and
delivered in accordance with Section 13 of this Agreement.
20. Headin�s not Controllin�. Headings and titles used in this Agreement are for reference purposes only, shall
not be deemed a part of this Agreement, and are not intended to define or limit the scope of any provision of
this Agreement.
21. Review of CounseL The parties acknowledge that each party and its counsel have reviewed and revised this
Agreement and that the normal rules of construction to the effect that any ambiguities are to be resolved
against the drafting party shall not be employed in the interpretation of this Agreement or Exhibits A-C.
22. Amendments / Modifications / Extensions. No amendment, modification, or extension of this Agreement
shall be binding upon a party hereto unless set forth in a written instrument, which is executed by an authorized
representative of each party.
23. Entirety of A�reement. This Agreement, including Exhibits A-C, contains the entire understanding and
agreement between City and Vendor, their assigns and successors in interest, as to the matters contained
herein. Any prior or contemporaneous oral or written agreement is hereby declared null and void to the extent
in conflict with any provision of this Agreement.
24. Counteruarts. This Agreement may be executed in one or more counterparts and each counterpart shall, for
all purposes, be deemed an original, but all such counterparts shall together constitute one and the same
instrument.
25. Warrantv of Services. Vendor warrants that its services will be of a high quality and conform to generally
prevailing industry standards. City must give written notice of any breach of this warranty within thirty (30)
days from the date that the services are completed. In such event, at Vendor's option, Vendor shall either (a)
use commercially reasonable efforts to re-perform the services in a manner that conforms with the warranty,
or (b) refund the fees paid by City to Vendor for the nonconforming services.
26. Immi�ration Nationalitv Act. Vendor shall verify the identity and employment eligibility of its employees
who perform work under this Agreement, including completing the Employment Eligibility Verification Form
(I-9). Upon request by City, Vendor shall provide City with copies of all I-9 forms and supporting eligibility
documentation for each employee who performs work under this Agreement. Vendor shall adhere to all
Federal and State laws as well as establish appropriate procedures and controls so that no services will be
performed by any Vendor employee who is not legally eligible to perform such services. VENDOR SHALL
INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR
LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY VENDOR, VENDOR'S EMPLOYEES,
SUBVENDORS, AGENTS, OR LICENSEES. City, upon written notice to Vendor, shall have the right to
immediately terminate this Agreement for violations of this provision by Vendor.
27. Ownership of Work Product. City shall be the sole and exclusive owner of all reports, work papers,
procedures, guides, and documentation, created, published, displayed, and/or produced in conjunction with
the services provided under this Agreement (collectively, "Work Product"). Further, City shall be the sole
and exclusive owner of all copyright, patent, trademark, trade secret and other proprietary rights in and to the
Work Product. Ownership of the Work Product shall inure to the benefit of City from the date of conception,
creation or fixation of the Work Product in a tangible medium of expression (whichever occurs first). Each
copyrightable aspect of the Work Product shall be considered a"work-made-for-hire" within the meaning of
the Copyright Act of 1976, as amended. If and to the ea�tent such Work Product, or any part thereof, is not
considered a"work-made-for-hire" within the meaning of the Copyright Act of 1976, as amended, Vendor
hereby expressly assigns to City all exclusive right, title and interest in and to the Work Product, and all copies
thereof, and in and to the copyright, patent, trademark, trade secret, and all other proprietary rights therein,
that City may have or obtain, without further consideration, free from any claim, lien for balance due, or rights
of retention thereto on the part of City.
28. Signature Authority. The person signing this Agreement hereby warrants that he/she has the legal authority
to execute this Agreement on behalf of his or her respective party and that such binding authority has been
granted by proper order, resolution, ordinance or other authorization of the entity. This Agreement and any
amendment(s) or statement of works hereto may be executed accordingly. Each party is fully entitled to rely
on these warranties and representations in entering into this Agreement or any amendment or statement of
work hereto. Any signature delivered by a party by facsimile or other electronic transmission (including email
transmission of a portable document file (pd� or similar image shall be deemed to be an original signature
hereto.
29. Chan�e in Companv Name or Ownership. Vendor shall notify City's Purchasing Manager, in writing, of
a company name, ownership, or address change for the purpose of maintaining updated City records. The
president of Vendor or authorized official must sign the letter. A letter indicating changes in a company name
or ownership must be accompanied with supporting legal documentation such as an updated W-9, documents
filed with the state indicating such change, copy of the board of director's resolution approving the action, or
an executed merger or acquisition agreement. Failure to provide the specified documentation so may adversely
impact future invoice payments.
30. No Bovcott of IsraeL If Vendor has fewer than 10 employees or this Agreement is for less than $100,000,
this section does not apply. Vendor acknowledges that in accordance with Chapter 2270 of the Texas
Government Code, the City is prohibited from entering into a contract with a company for goods or services
unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and
(2) will not boycott Israel during the term of the contract. The terms "boycott Israel" and "company" shall
have the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing
this contract, Vendor certifies that Vendor's signature provides written verification to the City that
Vendor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract.
31. Prohibition on Bovcotting Ener�v Companies. Vendor acknowledges that in accordance with Chapter 2274
of the Texas Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2, the City is prohibited
from entering into a contract for goods or services that has a value of $100,000 or more that is to be paid
wholly or partly from public funds of the City with a company with 10 or more full-time employees unless
the contract contains a written verification from the company that it: (1) does not boycott energy companies;
and (2) will not boycott energy companies during the term of the contract. The terms "boycott energy
company" and "company" have the meaning ascribed to those terms by Chapter 2274 of the Texas
Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2. To the extent that Chapter 2274 of
the Government Code is applicable to this Agreement, by signing this Agreement, Vendor certifies that
Vendor's signature provides written verification to the City that Vendor: (1) does not boycott energy
companies; and (2) will not boycott energy companies during the term of this Agreement.
32. Prohibition on Discrimination A�ainst Firearm and Ammunition Industries. Vendor acknowledges that
except as otherwise provided by Chapter 2274 of the Texas Government Code, as added by Acts 2021, 87th
Leg., R.S., S.B. 19, § 1, the City is prohibited from entering into a contract for goods or services that has a
value of $100,000 or more that is to be paid wholly or partly from public funds of the City with a company
with 10 or more full-time employees unless the contract contains a written verification from the company that
it: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or
firearm trade association; and (2) will not discriminate during the term of the contract against a firearm entity
or firearm trade association. The terms "discriminate," "firearm entity" and "firearm trade association" have
the meaning ascribed to those terms by Chapter 2274 of the Texas Government Code, as added by Acts 2021,
87th Leg., R.S., S.B. 19, § 1. To the extent that Chapter 2274 of the Government Code is applicable to this
Agreement, by signing this Agreement, Vendor certifies that Vendor's signature provides written verification
to the City that Vendor: (1) does not have a practice, policy, guidance, or directive that discriminates against
a firearm entity or firearm trade association; and (2) will not discriminate against a firearm entity or firearm
trade association during the term of this Agreement.
33. Federal Comuliance: Vendor agrees to comply with all federal statutes relating to nondiscrimination, labor
standards, domestic preference and environmental compliance. Additionally, for work to be performed under
the 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 on the 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; (� 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) applicable provisions 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; (j) 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; (I) 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 E�ecutive Order 12-549, Debarment andSuspension, which prohibit participation of debarred or suspended or otherwise excluded from 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.
34.Electronic Signatures. This Agreement may be executed by electronic signature, which will be considered
as an original signature for all purposes and have the same force and effect as an original signature. For these
purposes, "electronic signature" means electronically scanned and transmitted versions (e.g. via pdf file or
facsimile transmission) of an original signature, or signatures electronically inserted via software such as
Adobe Sign
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: �
Name: Jesica McEachern Title: Assistant City Manager
Date: Apr 16, 2024
APPROVAL RECOMMENDED: J..£c By: Midori Clark (Apr 2, 2024 20:10 EDT) Name: Midori Clark Title: Library Director
ATTEST:
By: Name: Jannette S. Goodall Title: City Secretary
VENDOR:
Kinetric Inc. dba Poly Printer
By: ��
Name: Robin Koffeman
Title: VP
Date: 0p;J ;;2 1 ri D:J v/
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: Name: Paul Orr Title: Interim Administrative Services Manager
APPROVED AS TO FORM AND LEGALITY:
By: Name: Jeremy Anato-Mensah Title:' Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C:N/A
EXHIBIT A
PolyPrinter
2750 W FM 875
Midlothian, TX 76065-5917
QU Ot@
Date Estimate #
3/1/2024 1160
EXHIBIT B
TIPS VENDDR AGREEMENT
6etweer. p
nd
(Company Namej
THE lNTERLqCAL PURCHASlNG 5Y5TEM �TiPS�,
a Depar#ment af TexaS Edu�ati�on Servit� Cente�' Region 8 for
TIPS RFP 2�0105 iecFtnology 5okutions, Prvdutts and 5er�ices
Gener�f Infarrnatio�
The Vendar Agreement �"Agreement"} made and entered into by and between The �nterlocal Purthasing
5ystem (hereinafter "TlP5"j a government caaperatf�e purchasing program authorized �y the Region 8
Education 5e�vite Center, having its principaf place af business at 4845 US Hwy �71 Horth, Pittshurg, Texas
7558b and the TiPS vendor. This Agreement �onsists of the provis�ons set forth foeEow, ineiuding provisions
of ali attachments referenced herein. In the event of a conflict �etween the provisians set forth below and
thase contained in any atta�hment, the provisions set farth shall contral unless otherwise agreed by the
parties in writing and by signature an� dat� on tne attachmeni.
A Purchase Order ("PQ"}, Agreement or Cantract is the TiPS Mem�er's appraval pro�iding the authority ta
proceed with the negotiated deli�ery order under the Agreernent. 5pecia] terms and �anditions as agreed
between the Vendor and TIPS Member shvuld be added as addendum� to the Pur�hase �rder, Agreement
❑r Contract. ltems sueh as certificate of �nsurance, honding requirements, small ❑r disadvantaged �usiness
goals are some, but not all, of the p�ssi�ie addendums.
Terms and C�ndi�i�ns
Fr�2ight
A!! quotes to Mem�ers shall proaide a iine item far cost for freight vr shipping regardiess if there is a charge
or not. If no c�arge far freight or shipping, indicate hy stating "I�a Charge", "$0", "inckuded in pri�e" pr ather
similar €ndication. at�erwise, al€ shipping, fre�ght ❑r deiivery changes shall be passed thraugh to the TIPS
Member at cQst with no markup and said charges shal� be agreed by the TIPS Member unless alternative
shipping terms are agreed by TIPS as a result of th� prop�sal award.
Warranty Con�+tions
Ail new supplies equipment and ser�iees shall in[lu�e mcnu actu er's minimurrr standard worrent unless
otF�erwise agreed ta in writing. Vendor shal! be legalfy permftted ta sell all products offered for sale to TiPS
Mem�ers if the affering is i�cEuded in the Request for Proposal �"RFP"} category. All goads propase� and
sold shall be new uniess cleariy stated i[� writing.
Custamer 5upport
Tha Vendor 5ha11 pro�ide timely and a�curate customer support for orders ta TIPS Membets as agreed by
the Parties. Vendors shall respond to su�h requests within a eammereially reasanabke time after reteipt of
the request. lf support andjor training is a line item sold or packa�etl with a sale, support sha41 �e as agreed
with the TI�5 Member.
7IP5 Vendor Agreement Ofi022020_sr Page I
�..
Agreernents
Agreements fQr purchase will normally be put into effect �y means of a contract, agreernent, or purchase
Qrder�s} executed by authorixed agents of the TIPS Member participating gv�ernment entitias, hut vther
means of placing an arder may be used at the Member's discretion. Ver�dar acceqts and_undes-stands that
when a urchase order or similar urchase do�ument is sent fcom a customer thrau h Tf�S ta the Vendor
TIPS is recprdin the urchase and veri in whether the urchase is within the ararr�eters af the TIPS
Contract onl . Vendar a rees that TIPS is nat a ie al art to the urc�ase arder or similar urchase
dacument and 71PS is not responsihle far identifvinR fraud, mista_k_es. or misrepresentations for the specific
arder. Vendor a�rees that anv �urehase order or sirnilar qurchase_dacument issued from a customer to
Vendor even when rocessed throu h T�PS canstitutes a le al contract between the customer and vendor
❑n#v. A Vendar that accepts a purchase order flr similar qurchase dotumer�t and fui�lls an order,_even when.
rocessed throu h TIPS is re resentin t�at the �endor �nas earefulE re�iewed the urehase order ar simi�ar
purchase document for #e�aiity, authentiGitv, a_n_d accu�_
Tax exempt status
MastTIPS Members are tax exempt and the re�ated faws and�or regulatians of the contralling jurisdiction[s]
Qf the �lPS Memher s�all apply.
Assignments of Agreements
Na assignrr�ent of this Agreement may be made w€thout the prior notificatsan nf TIPS. Written appraval flf
TIPS shall nat be unreasonahly wsthheld. Payment for delivered goods and ser�ices tan only be rnade ta the
awarded Vendor, Vendar designated reseller or �er�dor assigned company.
piscio5ure5
Vendar and TIPS affirm that he/s�e, ar any autl�arized empEoyees ar agents, has nat given, offered ta
give, nor intends to give at any time hereafter any economic apportunity, future ernplayment, g'tft,
loan, gratuity, special di5count, trt�, favor or ser�ice ta a public ser�ant in cannection with this
Agreement.
■ Vendar shall aitach, �n writing, a complete des�ription af any and all relatianships that might be
considered a�onflitt af interest in daing business with the TIPS program. �
+ The Vendar affirms that, tp the best of his�her knowEedge, the offer has i�een arrived at
independently, and is suhmitted without collusion w"sth anyone to obtain informatian ar gain any
favoritism that wauld in aRy way lirnit tampetition or glve an unfair advantage a�er other �endors In
the award of this Agreernent.
ierm of Agreement arid Renewals
The Agreement with 7fPS is for appraximately five (5] years with an aption for renewal for an additiorsal one t1}
eanse�uti�e year. If TIPS pffers the renewal extension year, the Ver�dor wiil be r�otified by email tn ti�e primary
c4ntact of the awarded vendar and shall be �eemed accepted by the Vendor unless the awarded vendQr nvtifies
iIPS af its alajection to the additional term. TIAS may or rnay not exercise the a�ailable extension�s] pravided in
the ariginal soiiCitation heyond the hase five-year term. Wi�ether or nat to affer the extension is at the sfl�e
d'ss�retian of TlPS.
"5tart pate" far Term Calculation Purposes �nly: itegardless of actuai award�effecti�e date of Contract, far
Agreement "term" caicufation purpases onsy, the Agreement "start date" is the last day of the rr�anth that
�
,
*r
71P5 Vendor Agreement 06422DZfl_sr P�B� Z
Award Natifications are anti�ipated as published fn the 5olicitation.
Example: If the anticipated award date published in the 5oiicitation is May 22, 242f1 but extended negotiations
del�y award unti! lune �7, 202� the end date af the resulting fnitial "fiva-year" term Agreement, {whith is
subject tp an exter�si�on[s]) wii� stisi be May 31, 2025 in this examp[e.
`Termination 1]ate": The stheduled Agreement "termination date" shail he the last day of the manth of the
month af the ariginal 5olicitatian's Anti�ipated Award Date plus five years.
Example: lf the original term is approxirs3ately five years, and the solicitatinn pravides an anticipated award
date of May 2z, 2��0, the expiratiors date of the original five-year term shaEl be May 31, 2025 in this exarrzple.
Extensians: Any extensians of the ❑riginal term shall begin ❑n the next day after the day the original term
expires.
Exampie Following the Pre►+laus Example: If TIP5 affers a�ne-year �xtension, ti�e expiration af t�e extended
term shall be May 3i, 2D2fi in tt�is example.
TiPS may �fFer t� exten� Vendar Agreements to the fullest extent the ariginai Saiicitation permits.
TIPS reser�es ti�e right to soiicit proposals at any tirrEe it is in the best interest of TIPS and�or its memhers.
Autamat�e Renewal Clauses Incorporated in Awarded Vendnr Agreements w3th TIPS Merrr6ers Resuiting fram the
Salicitatian and with the Vendor Narr�ed in th9s Agreement.
No Agreement for goods ar serviees with a TIP5 Member by the awarded vendor named in this Agreement
that results from the sofic"station award named in this Agreement, may incarpprate an automatic renewal
clause that exceeds manth to manth terms with whith the TIPS Member must compiy. All renQwal terrris
incorporated in an Agreement by the vendor with the iIPS Member shaf€ only be valid and enforcea6le when
the vendar reteives written canfirmatiQn by purchase vrder, executed Agreement or ather writ�en
instruetian issued by the 3iPS Member far any renewal period. The purpose af this cla�se is to avaid a TIPS
Mem6er inadvertently renewing an Agreerr�ent during a periad in which the go�erning tsody of tt�e TIPS
Member has nAt praperly apprapriated and budgeted the funds to satisfiy the Agreement renewal. Thisterm
is nat negot'sable and any Agreement between a TIPS Merriber and a TfPS awarded �endor with an automatic
renewal clause that confli�ts with these terms is rendered va�d and unenfvrceable.
Si�ipments
7he vendor 5hall ship, deli�er or pravide ardered pradurts or ser�ices within a commerciafly reasona�le time
after the receipt of the �rder frpm the TiPS Member. ff a defay in said deli�er�r is anti�ipated, the Vendor
shail natify 71�5 Memher as to why deli�ery is delayed and shail prv�ide an estimated time far completian
of the order. TIPS ar the requesting entity may can�el the arder if estimated dei�very time is not aceeptab[e
ar not as agreed by the parties.
IiiVb1C8$
Ea�h in�oice ar pay request shall ir,clude the TIPS Membe�'s purchase order number ar other identifying
designation as pro�ided in the ❑rdar hy the TfPS Member. If app�icable, the shipment tracking numher or
pertinent infarmation for �erification of TIPS Member re�eipt shall be made a�ailable upon request.
Paymen#s
TIPS Vendor Agreement �6a2202Q_sr Page 3
7he 7iPS Member wi[I make payments directly to the Vendor, the Vendor Assign�d ❑ealer or as agreed by
the Vendor and the TIPS Member after recei�ing in�aice and is� �ompliance with appli�ahle payrnent
statute[s}, whiche�er is the greater time ar as atherwise prn�ided by an agreement af the parCies.
Pric9 ng
Pri�e intreases wil! be honared accarding ta the terms of the solicitatian. All pricing submitted to TIPS shall
include the partiupation fee, as pro�ided in the so�ieitation, to be remitted #p T1PS by the Vendor. Vendor
will not show adding the fee ta the invaice presented ta TlP5 Member customer.
Partic9pation Fees and Regoriir�g of 5ales to TIPS hy Ver�dar
The Participation Fee that was �uhlished as part of the 5oficitatian and the fee puhlished is t�e legally effective
fee, alor�g with any fee conditians stated in the 5olicitation, Collectifln of the fees hy TIPS is require� �n�er
Texas Ga�ernmer�# Cade §791.013 Et seq. Fees are due an all T'lP5 purthases reported by eit�er Vendor ar
Mernber. �ees are d�e tq TIPS upQn payment hy the Member to the Vendor, Reseller or Vendor Assigned
Dealer. Vendor, Reselker or Vendor Assigned Dealer agrees that the participation fee is due to TlPS for all
Agreement sales immediately upon reteipt of payment including partial payment, fram the Merrs�er Entity
and must be paid to TI�S at least on a monthly basis, specifica4iy within 31 ealendar days of receipt of payment,
if nat mare frequenily, or as otherwise agreed hyTIPS in writing and signed by an authoriied signatory af TIPS.
Thus, whe� an awarc4ed Vendar, Reseller ar Vendor Assigr�ed Oealer receives any arnount af payrY+ent, e�en
partial payment, for a TIPS safe� the legally effective fee for that amount is irrrrnediate{y due ta 7EPS fram the
Vendor and fees due to TIPS should 5e paid at keast on a manthfy basis. specifi�ally within 3I �alendar days of
receipt af payment, if nat mare frequently.
Reparting of Sales ta TIPS hy Vendor
Vendar is required ta repart a11 sates under the T1P5 contrart to TIPS. When a public erstity irsitiates a purthase
with a TIPS Awarded Vendor, if the Member inquires verbally or in writing whether the Vendor halds a TiPS
Car�#ract, it "ss the duty flf the Vendor to verify whether or not the Member is seeicing a TIPS pur�hase. Qnee
verified, the vendor must indude the TIPS Contract number on any communications and reiated sales
dacuments exchanged with the TIPS M�mber entity. To report sales, the Vendar must Iflgin tathe T1PS Vendor
Partal ❑nline at htt�s:llwww.tips-usa.�omlvendors form_.c#rn and click an the P�'s and Payments tab. Pages
3-7 0# the Vendor Por-tal Liser Guide wifl walk you thraugh the proeess af reparting sa�es tp TIPS. Rlease refer
to the TkPS Accauntin� FAQ's for more infarmatian about re�arting saEes and if yau ha�e iurther questions,
cantact the Accounting Team at accauntin�@tips-usa.cam. The Vendor ar �endar assigned dealers are
respansible for keeping record of all sales that go thrnugh the TIPS Agreement and submitting same to TIPS.
Failure to render the participation fee to iIPS shall �anstitute a breach a€ this agreement with vur parent
ga�ernmental entity, Texas Education Ser�ice Center Region 8, as established by theTexas legislature and sha!!
be graunds for terrninatian af this agreement and any other agseement held w"rth TI�5 and possihie legal
actian. Any overpayment af participation fees ta T3P5 by a Vendor will be refunded to the Vendor within ninety
{94j days of receipt of notificatian if TIPS re�ei�e$ written natificatiafl of the a�erpayment not Eater thart the
expiration of six (5J m�nths #rom the date af averpayment �nd T[PS determines that the amount was r�at
legaily due to 71P5 pursuani tr� this agreement and applicahle faw. It is the Vendor's respansibility to ide�tify
whith sales are TkPS Agreement sales ar�d pay th� �arrect participatian fee due forTIPS Agreemer�t sales. Any
notificativn of o�erpayment reeeived �y 7fPS after the expiratian of six �6} months frqrr� the date of
overpayment wili be non-refundable, Region 8�SC and TIPS reserve the right to extend t�e six (6) rnonth
deadline ta notify if appro�ed by the Region 8 ESC BQard vf �irectflrs. TIP5 reserves all rights under the law to
callect the fees due. PleaSe [onta�t TIPS at tips@tips-usa.com ❑r Call (86fiJ 839-8477 if yvu ha�e questians
about paying fees.
7lP5 Vendar Rgreement 05022020_sr Page 4
ln�emnity
7he Vendoragreesto indemnify and hald harmless and defen�TIPS�TiPS Member�s), a�cers and emplayees
from and against alf clai►ns an� suits by tF�ird parties for damages. injuries to persans (including death},
praperty darnages, lasses, and expenses in�luding cpurt cvsts and reasona�le attorney's fees, arising out of,
or resulting frnm, VEf1CiOr's performance under this Agreement, inciuding all such causes of aGtion hased
upon common, eonstitutionai, or statutary lauv, ar hased in whoke ar in �art, upon allegati�ns of negligent
or intentional a�ts on the part vf the Vandar, its officers, employees, agents, subcontractars, licensees, or
invitees. Parties faund liahfe shalf pay their proportionate share af darrsages as agreed hy the paRies ar as
ardered by a cvurt of campetent jurisdiction o�er the �ase. ND LIMl7Aif�N OF LIA6ILITY FOR OAMAG�S
FpR P�R50NAL If�JURY �R RROPERTY DAMAGE AR� PERMITfE� �R AGREEf] BY TIPS ESC REGION 8. Per
Texas �ducatian Cpde §44.C132�fJ, and pursuant to its requirernents only� reasonable Attorney's fees are
recoverable by t#�e prevailing party in any dis�ute resulting in litigation.
State of Texas Franchise Tax
6y signature herean, the Vendor hereby certifies that he�she is rsQt currently deiinquent in the payment of
any fra��hise taxes awed the 5tate of Texas under Chapter 171, Tax Code.
Mis�ellaneous
T�e Vendor atknow4edg�s and agrees that continued participatiQn in TIPS is suhject to TIPS sale dis�retEon
and that any Vendar may be rem��ed fram the par�icipation in ti�e Program at any time with ar wit�aut
tause. Nathing in the Agreement or in any ather communicatian between TIP5 and the Vendor may he
canstrued as a guarantee that T1P5 ar 7iP5 Memhers will sul�mit any orders at any time. TIPS reserves the
right to request adcfitional proposals for iterr►s or services already on Agreement at any tirrse.
Purchase �rder Pri�ing/Product D��iatian
!f a deviation of pricing��roduct an a Rurchase �rder or can#ract modificativn oc�urs between the Ver�dor
ar�d the TIP5 Member,'�IPS must be notifie� within fi�e �5) business days af receipt of change order.
7ermirsatian for Can�en4ence af TIPS Agreement On{y
TIPS reser�es the right to terrninate this agreement for taiase or no cause for convenience with a thirty �3Q}
days pri4r written notic�. iermination fnr can�enience is eonditionalVy required under Federal Regulations �
CFR �art �OQ if the custc�mer is using federal funds for t�� pr�curement. All purchase orders presented to
the Vendor, f�ut not €ulfilled by the Vendor, by a TIPS Member prior to the aRual termination Df this
agreement shall be hanored at the option of the 31P5 Member. The awarded Vendor may terminate the
agreement with ninety �90} day5 prior written notice to Tl?5 4845 U5 Hwy Narth, Pitts�urg, Texas 75686.
�he vendor wi�l he paid for gaads and services deli�ered priar ta the terrr�inatian provided that the goads
and services were deEi�ered in accardan�e with the terms and conditions of the terminated a�reement.
This termination clause does not affect the sales agreemen#s executeri 6y the Vendar and the T3P5 Memher
customer pursuant ta thi5 agreement. TIPS Memhers may negotiate a terminatio� for conveniente clause
that meets the needs af the transaztion �ased on applicable factars, such as funding sources ar other
needs.
TiPS Memher Purchasing Prflcedures
llsuaily, purchase orders vr their e�ual are issued �y partic's�a#ing TIPS Memk�er to the awarded vendor and
shauld indicate an the ❑rder that the purehase is per the applicable TIPS Agreement �kumber. ❑rders are
typicaily emailed ta ��PS at tipspo@tips-usa.eam.
- Awarded Vendar tleli�ers g�ods�services �irectly to the partitipating mem�er.
- Awarded Vendor invai�es tha participating TIP5 Member directly.
TIRS Vendor Agreement a6[}22D2�_sr Page 5
- Awarded Vendor recei�es payment directly from the participating memher.
• Fees are due to T€P5 upon payment f�y the Member ta the Vendor. Vendos agrees ta pay the
participatia� fee to 71PS far all Agreement saies upon r�teipt af payment in�luding partial payment, fram
the Memher Entity or as otherwise agreed by TlPS in writing and signed by an autharized s+gnatory of TlPS.
ticenses
Awarded Vendor shall maintain, in Curr@n# statu5, ail federal, state and lacal litenses, bonds and permits
required for the operation af the business �anducted hy awarded vendor. Awarded Vendor shall remain
reasonabfy fully informed of and in campliance wiit� all ardinances and regulations pertaining to the lawfu!
pro�isipn af gtiods or services under the Agreement.TIPS and TIPS Members reserves the rig�t #o stop work
and�ar tan�el an order arterrrsinate this vr any other sales Agreement of any awarded Vendor whase license�sj
required for per#ormance untler this AgreemeRt have expiied, lapsed, are suspanded or terminated sui�ject
ta a 30-day eure period uniess prohsbited hy ap�licable statue or regulation.
Na�ation
If awarded Vendor sells ar transfers all assets, rights pr the entire portion of the assets ar rights required to
perforrn this Agreement, a successar in interest rnust guarantee ta perform a!I obligatians under thi5
AgreemenC. A simple change af name agreement wiil not c�ange the Agreement ohligations of awarded
�endar. TIPS wili consider Contract Assignments an a case by case basis. TIP5 must be notified within fir►e
(5} business days of the transfer of assets or rights.
5ite Requirements (anly wher+ applicorble fu service ar jvbj
Cleanup: When perForming work on site at a 71P5 Merr►ber's properry, awarded Vendor shall tEean up and
remQ�e afl debris and ruh�ish resulting fram their work as required or directed by 1"IP5 Member or as
agreed by the parties. Upon completiQn of wark, tfie premises shall be left in good repair and an orderiy,
neat, �lean and unahstructed condition.
Rreparatian: Awarded Vendar shall not begin a praject fQr which �1P5 Member has not prepared ihe site,
unfess awarded Vendor does the {�reparation wvrk a# no Gost, or untif TIFS Mem�er ineludes the cost of
site preparation in a purchase arder. 5ite preparation inGludes, but is not limited to: mo�ing furr�iture,
installing wiringfor networks or pawer� and similar pre-installation requiremenis.
Registered sex afFender restrictians: For worfc to be performed at s�haols, awarded Vendar agrees that
na employee of a s�bcontractor who has been adjudieated to be a registered sex offender will perForm
work at any time when students are, ❑r reasonably expeeted io be, present unless otherwise agreed by
the �'IPS Member. Awarded Vendar agrees that a �ia3ation of this candition shall he eansidered a material
breach and may result in the cancellation of the purchase order at theTIPS Member's discretion. Awarded
Vendor must �dentify any additional �osts asso�iated witf� �ompiiance of this term. lf no casts are
spe�ified, compliance wi#h this term will be prQvided at no additional tharge. Safe#y measures: Awarded
Vendor shaii take all reasanable precautions for the safety vf emplvyees on the warksite, and 5hall erett
and properly maintain all necessary safeguards far protection of workers and the publi�. Awarde� Vendor
shall post warning signs against aIl haxards created by the vperation and wark in progress. Rroper
precautions shail �e taken pursuant tQ state iaw and standard prartices to protectwarkers, general �uhlic
and existir�g structuresfrom injury ar damage.
Safety Measures
Awarded Vendor shali take all reasanable precautions forthe safaty nf employees on tl�e worksite, and shall
erert and properly maintain all necessary safeguards for protection vf workers anck the pub�ic. Awarded
vendar shall post warning signs against ai1 haxards created by the operation and wark in progress. Proper
precautions shail he #aken pursuant ta state iaw and star�dard practices ta protett warkers, general public
TiPS Vendar Agreement 06422Dx0_sr Page 6
and existing structures from injury or damage.
5mnking
Persons working under Agreement shall adhere to the TIPS Member's or Eocal smoking statutes, codes or
policies.
Marketi ng
Awarded Vendor agrees to allaw TIPS to use #heir name and fogo within TIPS website, mariceting materiafs
and advertisement suhject to any reasana�le restrict�ons prouided ta TIPS in the Propasal to the
5olicitation. The Vendor may submit an acceptable use directi�e for Vendor's names and logos with whi�h
TIPS agrees to comply. Any use af TIPS name and laga or any form of pu�licity, int�usi�e of press re�ease,
regarding this Agreemen# by awarded vendor must have prior approva€ from TIPS which will nat be
unreasonably withheid. Request may be made by emai! ta TIPS@TIPS-L1SA.COM.
Supplemen#al Agreements
The 71�5 Member entity participating in the TIPS Agreernent and awarded Vendar may enter inta a separate
5upplemental Agreer�ent or contract ta further defir�e the le�ei of serviCe requirements over and above
the minirnum defined in this Agreemer�t such as l�ut not fimited ta, in��i�e requirements, ordering
requirernents, spe�ialized deli�ery, etc. Any 5uppiemental Agreement flr con#ract developed as � result of
this Agreement is exclusi�eiy between ihe 71PS Meminer entity eustomer and the Vendor. TiPS, its agents,
TkPS Members and empkayees not a party to the 5upplernental Agreement with the �IPS Member tustomer,
shall nat be made party to any claim for breach of such agreement unless named a�d agreed by the Party
in question in writing in the agreemerst. 1f a Vendor suhmitting a Proposal requires TIPS and/or TIPS
Memher to sign an additianal agreement, thase agreernents sha�i cQmply with the award made hy TIPS to
#he Vendor. 5uppiementa! Vendar's Agreement dacuments may not become part of TIPS' Agreement with
Vendar unless and until an authorized representati�e pf TIPS reviews ar�d approves it. iIPS review and
approval may be at any time during the iife of this Vendor Agreement. TIFS permiis TIP5 Member5 ta
negatiate additional terms and conditivns with the Vendor for t�e provision of goads ar ser�ices underthe
Vendar's TI�S Agreernent so long as they do not materially conflict with this Agreernent.
5urvival Clause
All appficabie sales, leases, 5upplemental Agreements, contratts, software license agreements, warranties or
service agreements that were entered into between Vendor and TIPS ar the TfPS Member Customer under
the terms and conditions of this Agreementshafl survive the expiration or termination of this Agreement. All
�rders, Purchase �rders issued or contracts executed by TIP5 or a TIPS Memh�r and aecepted �y the Vendor
prior ta the exp�ration or termination of this agreement, shall survive expirati�n ar termination of the
Agreement, sub�ect to previously agreed terrrss and canditions agreed by the parties or as atherwise
spe�ified herein relating to termination of this agreement.
Legal ohligatians
It is the responding Vendar's responsibiiity ta he aware of and camply with all IQcal, state and federa! laws
gQ�erning the sale of products/ser�ites identified ir� the applicahie 5o�icitation that resulted in this Vendor
Agreement and any awarded Agreementti�erea€. Applicable laws and r�gulations must be follawed e�en if
not specifically identified herein.
Aud1t rig�ts
Due to transparency statutes and public ac�aunta�ility requirements of TIP5 and 7lPS Members', the
awarded Vendor shali, at their sole expense, maintain apprapriate due diligen�e of all purchases made hy
T1P5 Vendor Agreemeni �6a22020_sr Page 7
TIPS Member that utilizes this Agreement. TIPS and Regian 8 E5C each reserve the right to audit t�e
acrounting af TIPS related purchases for a period of three {3y years fram the time such purchases are macie.
7h"ss a�s�it right shail survi�e termination of this Agreement far a period af one �1y year from the effective
date o# termination. In order tv ensure and canfirm compiian�e witfi this agreerrient, TIPS shall ha�e
autharity to conduct audits af Awarded Vendor's pricing ar TIFS transactian d�eumentatian w+th TIPS
Members with 3� days' rsatice unless the audit is ardered by a Caurt Order ar hy a Go�ernment Agenry with
auth�rity to do so without natice. Notwithstanding the faregaing, in the e�ent that TIPS is made aware af
any pri�ing �eing of�ered to eligible er�titEes that i5 materia�Iy inconsistent with the pricing under this
agreement, T1PS shafl ha�e ihe abiiity to tonduct the audit internaEly ar may engage a third- party auditing
firrn to invest�gate any passihle non- compliant �andu�t ar may terminate the Agreement according ta the
terms of this Agreement. In the event of an audit, the requested materials shall be reasanahly pravided in
the time� farmat and at the locatton accepta6le ta Region $ E5C ar TIPS. TIPS agrees nat to perfarm a randpm
au�"st the TIPS transaction documentation more t�an once per calendar year, but reser�es the right ta audit
�ar just tause or a5 required by any governmental agen�y or caurt witf� regulatary autharity over TIPS or the
TIFS Mem�er.
Force Majeure
If hy reasan Qf Force Maje�re, either party hereta shall t�e rendered unable whally ar in part ta carry aut 3ts
abligations under this Agreemen# #hen Suth party shall gi�e notiee ar�d f�fi �articulars of Force Maj�ure in
writing ta the ather party within a reasona�le time after ocwrrence af the e�ent ar cause relied upon, �nd
the obligatian of the party giving such �oti�e, so far as it is afferted by suc� Force Majeure, sk�all be
suspended during t�e �antinuance of the inability then claimed, except as hereina�ter pro�id�d, but far no
�onger periad, and such party sha{I endea�or ta remave or o�ereome such inability with all reasonable
dispatc�.
Chaice of I,aw
The Agreement b�tween the Vendor and 73PS�E5C Region 8 anck any addenda ar other additior�s resulting
from this pracurement pracess, hawever descrihed, shall be go�erned by, construed and enfarced in
a�cordance with the laws of the 5tate of 7exas, regardiess of any confiitt of laws principles.
Venue, lurisdict�on and 5ervi�e of Process
Any Proceeding arising out of or reEatir�g to this procurernent protess ar any contra�t issued by TI P5 resulting
#rom ar any contemplated transactian s(�all be brought in a court flf tampetentjurisdiction in Camp Caunty,
Texas and eaeh of the parties irrevoeahly suhmits tp t�e exclusi�e jurisdictian af said caurt in any such
prflceeding, waives any abjectian it may now or hereafter have ta �enue or to eanuenience vf forum, agrees
that al! claims in respect ef the Proceeding shall be heard and determined only ir� any such court, and agrees
nat to bring any pcoceeding arising out of ar relating ta this pracurement process ar any �or�tract resuiting
fr�m or any contempiated transaction in ar�y ather court. The parties agree that either or 6oth of ihem may
�iie a copy af this paragraph with any court as written evidencs of the knowing, �oluntary and freely
bargained fQr agreement hetw�en the �arties irre�ocabfy to wai�e any ab}e�tians ta �enue ar to
canvenience af forum. Pracess in any Praceeding referred ta in the first sentenee of this Settiqn may be
served on any party ar�ywhere in the war�d. Venue fqr any dispute resolution ptocess, ather than litigation,
between TIPS and the Vendor shaif be loeated in Camp pr Titus County, 7exas.
Pr�ject Deli�ery arder Pracedures
The i"tPS Member ha�ing approved and signed an interlaca! agreemer�t, or vtt�er TfPS Membership
dacument, may make a request of the awarded Vendor under this Agreement when the TIPS Member desires
goads vr services awarded to the Vendor. Natification may accur via phone, the web, cou�ier� email, fax� ar
TIPS Vendar Agreement 060�2D�a_sr
Page 8
. t
in person. Upon natificatioR of a pending request, the awarded Vendar shall aeknowiedge the TIPS
Mem�er'S request as soan as passible, �ut must make contact with the 71RS Member within twa warkirsg
days.
Status of iIPS Members as �te�ated ta This Agreement
TIPS Members stand in the place af TIPS as related to this agreement and have the same access ta the
praposal inf�rmation and all related da�uments. TIFS Memhers have aEl the same rights under the awarded
Agreement as TIPS.
Vendar's Resellers as Related ta This Agreement
Vendor's ivamed Resellers �"Resellers"j under this Agreement shall comply with all terms and candit"sa�s of
Eh�s agreement and all addenda ❑r inc�rparated documents. A1€ aeti�ns related to safes !�y Authariied
Vendar's Resellers under ti�is Agreemer�t are the respansihilfty of the awarded Vendor. kf Reseiiers fail ta
report sales to TIPS under your Agreement, the awarded Vendor'ss respansihle for their cantractual failures
and shall be billed for the fees. "fhe awarded Vendor rnay then re�a►+er the fees fram their rramed reseiler.
Support Requirements
lf there is a dispute �aetween the awarded Vendor and T1P5 Member, 71p5 ar its representatives may, at TIP5
sole discretion, a55ist in conflict resolutipn if requested by either party. TIPS, or its repre5enta#ives, reserves
the right to inspe�t any project and audit the awarded Vendor`s TlPS project files, dacumentation and
�arrespondence related to the requestingTlP5 Members arder. If there are canfidentiality requirements hy
either party, 71P5 shall comply to the extent permitte� by law.
Inr,arporatian af Solicitation
7he TIPS Solieitatian which resulted in this Vendor Agreement, whether a Requestfvr Proposais� the Request
for Campetiti�e 5ealed Propasals or Request far quafifitations soli�itativn, or other, the Vendar's respanse
ta same and all as5ociated dacuments and farms rnade part of the salicitation process, incfuding any
addenda, are hereby incorporated by reference inta this Agreerrserst as if copied verbatim.
SECTIQH HEADEFtS OR TIZLES
TME S�CT[7N HEA�ERS ❑R TITLES WIT#�I1� TH15 DaCUMEEVT ARE MERELY GU10E5 F�R C�NVEEVIENC� AN�
AftE NOT ��R CLASSkFICATION OR LIMITING OF TF�E RESPONSIBiLI7E5 Qf 7HE �ARTIESTn THIS D�CEIMENT.
5TA7LiTQRY REQUIREMENT5
3exas governmental ent'sties are prahibited from doing business with companies that fail to ceriiiy ta this
�onditi�n as required �y Texas Government Code Sec. 227fl.
$y executing this agreement, you certify that yau are aut�orixed to bind the undersigned vendar and that
your tompa�y [1J does no# boycott Israel; and �2j will not baycatt lsrael during tt�e term af the Agreement.
You tertifythat yaur �ompany is not iisted on and daes not and will nat dp bLsiness with eompanies that are
vn the �exas Comptralker af Public Accovnts iist af Designated Fareign Terrarists �rganixativns per Texas
Go�'t Cade 227�.d153 found at htt s: com troller.texas. ❑� ur�t�asin dots forei n-terrorist. df
Yau certi#y that if the certified sta�ements aho�e �ecame untrue at any time during the life af this Agreernent
that the Vendarwiil notifyTlPS within three �3j husiness day af the change by a letter on Vendor's letterhead
from and signed hy an autharixed representative af the vendor stating the non-corr3pliance �e�i5ion and the
TIPS Vendar Agreement C15DZi42�_sr P�ge g
TIPS Agreement number and des�ri�tian at:
Attentipn: General Caunsel
E5C Regian S�The lnterloeai Furchasing 5ystem (TIPS}
4845 iiighway 27I North
Pittsburg, T7(,75585
And �y an email sent ta bids@tips-usa.cam
Insurance Requirement5
The undersigned Ven�or agrees t� maintain th�e below minimum insurance requirement5 far T1P5 Cantract
Ftolders:
General Lialoil�ty
Automo6ile Liability
Warkers' Campensation
llmbrella Liability
$1,QQa,QaO each O�currencel Aggregate
$3�]D,000 Includes owned, hired & nvn-nwned
Statutory fimits far the jurisdictian in whicF�
the Vendor performs under this Agreement.
$1,OOD,DD�
When the Ver�dor or its suhcantractars are liable for any damages or claims, the Vendor's policy, when the
Vendar is res�onsible for the claim, must he primary o�er any other vaiid and collettible ir�surance tarried
by th2 Member. Any immunity availabie t� TlPS ar TIPS Memhers shall not he used as a de#ense �y the
cantra�tor's insurance policy. The ca�erages and limits are ta be �onsidered minimum requirements and in
no way limit the fiahility of the Vendor{s]. Insurance shall be written �y a carrier with an A-; V11 ar better
raCing in actprdanee with Current A.M. Best Key Rating Guide. Orily deducti�les appficable to prnperty
damage are acceptahle, unless praof of retenttan fundsta coversaid deductihles is pra+rided. "ClairrEs made"
polities will not be accepted. Vendor's required minimum �average sf�all not he sus��nded� voided,
cancelled, non-renewed or redueed in coverage or in fimits unless replaced by a pa�iry that pro�ides the
minirnum required eo�erage except after thirty (3fl] days prior writter� notice by certified mail, return receipt
requested has �een given ta TIPS ar the TIP5 Member if a pro�ect or pendirsg deiivery af an arder is ongaing.
tJpon request, c@rtified eopies af all i�surance policies shali he furn'sshed to the TIPS or the TlPS Member.
Special Terms and �ondit�ans
■ Qrc{ers: AI[ Vendor �rders received fror� TiPS Mem�ers must be emailed to TlPS at tipspa@tips-
usa.cam. 5hould a TIPS Memhersend an order directlyto the Vendor, it isthe Vendor's responsibility
to forward a eopy of the arder to TIP5 at the email above within 3 business days and confirrn its
reCeipt with TfP5.
■ Vendar Encouraging Members ta bypass TiPS agreemeRt: Eneouraging T1P5 Members ta purchase
directly from t�e Vendor orthrough anather agreement, when the Member has requested using the
TIPS cooperati�e Agreement or price, and thereby bypassingthe TIPS Agreement is a vialation of the
terrns and conditions �f this Agreement and will result in removal af the Vendar fcom the TIPS
Program.
*❑rder Confirmation: All TIPS Member Agreement arders are appro�e� daily hy TIPS and sent tQ the
Vendor. The Vendor shouid confirm re�eipt of orders ta the �1PS Member �customerj within 3
�usiness days.
• Vendar custvrn wekssite for TtPS: f# Vendvr is hasting a custom'fiPS website, updated pricing when
TlPS Vendar Agreement a6�Z2Q20_sr Pa�� ��
etFecti�e. T1PS shall be notified when prices change in accordance with the award.
■ 8ack �rdered Products: If product is not expected to ship within the time pra�ided to the TIPS
Member by the Vendor� the Member is tQ be not�fied within 3 husiness days and appropriate activn
taken based an cust4mer request.
The TIPS Vendvr Agreement Signature Page is inserted here.
T1P5 Vendar Agreement 06Q220Zq_sr pa8� ��
TIPS Vendor Agr�ement Signature Farm
R�P �2b105 Te�hnology 5ofutions, Prad��ts and Ser�ices
Company Name PolyPrint�r
Address 275Q VIJ FM875
c��yM�dlathian st�te TX 2ip 76�65
Phone g72 77� 13�3
Fax
Email af Autharized R�presentati�e robin @ polyprinter.eom
Name of Autharized Repr�sentati�e Robin Koffeman
��t,� Vice President
Signature of Authoriied Represer�tative `�Gp.�.�. �C�a�.4�.c,�
Date Z1412022
1"IPS Authariaed Repr�sentati�e I�ame _�a��irl Fittc
zitle Executive Director
iIPS Authocized R�presentative Signatu�e �a�o(.,Y�+����
Approved hy E5C Region 8
Date 5-24-2022
NOTICE TO MEMBERS REGARDING ATTRIBUTE RESPONSES
TIPS VENDORS RESPOND TO ATTRIBUTE QUESTIONS AS PART OF TIPS COMPETITIVE
SOLICITATION PROCESS. THE VENDOR'S RESPONSES TO ATTRIBUTE QUESTIONS
ARE INCLUDED HEREIN AS "SUPPLIER RESPONSE." PLEASE BE ADVISED THAT
DEVIATIONS, IF ANY, IN VENDOR'S RESPONSE TO ATTRIBUTE QUESTIONS MAY NOT
REFLECT VENDOR'S FINAL ATTRIBUTE RESPONSE, WHICH IS SUBJECT TO
NEGOTIATIONS PRIOR TO AWARD. PLEASE CONTACT THE TIPS OFFICE AT 866-839-
8477 WITH QUESTIONS OR CONCERNS REGARDING VENDOR ATTRIBUTE RESPONSE
DEVIATIONS. PLEASE KEEP IN MIND THAT TIPS DOES NOT PROVIDE LEGAL
COUNSEL TO MEMBERS. TIPS RECOMMENDS THAT YOU CONSULT YOUR LEGAL
COUNSEL WHEN EXECUTING CONTRACTS WITH OR MAKING PURCHASES FROM
TIPS VENDORS.
�
� �
220105 Addendum 1
PolyPrinter
Kinetric Inc. DBA PolyPrinter
Supplier Response
Event Information
Number: 220105 Addendum 1
Title: Technology Solutions, Products and Services
Type: Request for Proposal
Issue Date: 1 /6/2022
Deadline: 2/25/2022 03:00 PM (CT)
Notes: IF YOU ALREADY HOLD TIPS CONTRACT 200105
TECHNOLOGY SOLUTIONS, PRODUCTS AND SERVICES
("200105") OR 210101 TECHNOLOGY SOLUTIONS, PRODUCTS
AND SERVICES ("210101"), YOU DO NOT NEED TO RESPOND
TO THIS SOLICITATION UNLESS YOU WISH TO REPLACE
200105 OR 210101 AT THIS TIME. IF YOU HOLD 200105 OR
210101, CHOOSE TO RESPOND HEREIN, AND ARE AWARDED
ON THIS CONTRACT, YOUR 200105 OR 2101101 WILL BE
TERMINATED AND REPLACED BY THIS CONTRACT.
IF YOU HOLD ANY OF THE FOLLOWING TIPS CONTRACTS
AND YOU DO NOT HOLD 200105 OR 2101101, PER TIPS PRIOR
NOTIFICATION, YOU MUST RESPOND TO THIS SOLICITATION
BECAUSE YOUR SPECIFIC CONTRACT IS BEING
CONSOLIDATED INTO OR REPLACED BY THIS CONTRACT.
Page 1 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
TIPS 190103 Web and Cloud Computing Services
TIPS 181203 Management Software and Services
TIPS 181204 Notification Systems
TIPS RESERVES THE RIGHT TO ISSUE, REBID, OR CANCEL
ANY PLANNED SOLICITATIONS AT ANY TIME AS NECESSARY
FOR THE NEEDS OF TIPS, TIPS VENDORS, AND TIPS
MEMBERS.
Contact Information
Address: Region 8 Education Service Center
4845 US Highway 271 North
Pittsburg, TX 75686
Phone: +1 (866) 839-8477
Email: bids@tips-usa.com
Page 2 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
PolyPrinter Information
Address: 2750 W. Fm 875
Midlothian, TX 76065
Phone: (469) 844-1229
By submitting your response, you certify that you are authorized to represent and bind your company.
Robin Koffeman robin@polyprinter.com
Signature Email
Submitted at 2/17/2022 8:12:02 PM
uested Attachments
Agreement Signature Form
Vendor Agreement Signature Form.pdf
If you have not taken exception or deviation to the agreement language in the solicitation attributes, download the
AGREEMENT SIGNATURE FORM from the "ATTACHMENTS" tab. This PDF document is a fillable form. Download the
document to your computer, fill in the requested company information, print the file, SIGN the form, SCAN the
completed and signed AGREEMENT SIGNATURE FORM, and upload here.
If you have taken exception to any of the agreement language and noted the exception in the deviations section of the
attributes for the agreement, complete the AGREEMENT SIGNATURE FORM, but DO NOT SIGN until those deviations
have been negotiated and resolved with TIPS management. Upload the unsigned form here, because this is a
required document.
All Other Certificates
No response
All Other Certificates (if applicable) must be scanned and uploaded. If vendor has more than one other certification
scan into one document. (PDF Format ONLY)
DO NOT UPLOAD encrypted or password protected files.
Pricing Form 2
220105 Pricing Form 2.xlsx
The vendor must download the PRICING SPREADSHEET SHEET from the attachment tab, fill in the requested
information and upload the completed spreadsheet.
DO NOT UPLOAD encrypted or password protected files.
Reference Form
220105 Reference_Form.xls
The vendor must download the References spreadsheet from the attachment tab, fill in the requested information and
upload the completed spreadsheet. DO NOT UPLOAD encrypted or password protected files.
Conflict of Interest Form CIQ- ONLY REQUIRED IF A CONFLICT EXISTS PER THE No response
INSTRUCTIONS
ONLY REQUIRED IF A CONFLICT EXISTS PER THE INSTRUCTIONS
Conflict of Interest Form for Vendors that are required to submit the form. The Conflict of Interest Form is included in
the Base documents or can be found at https://www.tips-usa.com/assets/documents/docs/CIQ.pdf.
Proposed Goods and Services
TIPS_Proposed_Goods_and_Services.pdf
Please upload one or more documents or sheets describing your offerings, line cards, catalogs, links to offerings OR
list links to your offerings that illustrate the catalog of proposed lines of goods and or services you carry and offer
under this proposal. It does not have to be exhaustive but should, at a minimum tell us what you are offering. It could
be as simple as a sheet with your link to your online catalog of goods and services.
D/M/WBE Certification OPTIONAL
No response
D/M/WBE Certification documentation may be scanned and uploaded if you desire to claim your status as one of the
identified enterprises. (Disadvantaged Business Enterprise, Minority Business Enterprise and/or Woman Business
Enterprise) If vendor has more than one certification scan into one document. (PDF Format ONLY)
DO NOT UPLOAD encrypted or password protected files.
Page 3 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
Warranty
PolyPrinter Warranty Policy.pdf
Warranty information (if applicable) must be scanned and uploaded. (PDF Format ONLY)
DO NOT UPLOAD encrypted or password protected files.
Vendor Agreement
Vendor Agreement.pdf
The vendor must download the Vendor Agreement from the attachment tab, fill in the requested information and
upload the completed agreement.
DO NOT UPLOAD encrypted or password protected files.
Pricing Form 1
220105 Pricing Form 1.xlsx
The vendor must download the PRICING SPREADSHEET SHEET from the attachment tab, fill in the requested
information and upload the completed spreadsheet.
DO NOT UPLOAD encrypted or password protected files.
Supplementary
PolyPrinter 229 InfoSheet New.pdf
Supplementary information may be scanned and uploaded. (Company information, brochures, catalogs, etc.) (PDF
Format ONLY)
DO NOT UPLOAD encrypted or password protected files.
Logo and Other Company Marks
PolyLogo.png
If you desire, please upload your company logo to be added to your individual profile page on the TIPS website. If any
particular specifications are required for use of your company logo, please upload that information under the
Supplementary section or another non-required section under the "Response Attachment" tab. Preferred Logo
Format: 300 x 225 px -.png, .eps, .jpeg preferred
Certification of Corporate Offerer Form- COMPLETE ONLY IF Certification By Corporate Offerer.pdf
OFFERER IS A CORPORATION
COMPLETE AND UPLOAD FORM IN ATTACHMENTS SECTION ONLY IF OFFERER IS A CORPORATION
Disclosure of Lobbying Activities Standard Form LLL
No response
ONLY IF you answered "I HAVE Lobbied per above" to attribute #66, please download and complete and upload the
Standard Form-LLL, "disclosure Form to Report Lobbying," in the Response attachments section.
Confidentiality Claim Form
Confidential Info Status Form.pdf
REQUIRED CONFIDENTIALITY FORM. Complete the form according to your company requirements, make any
desired attachments and upload to the appropriate section under "Response Attachments" THIS FORM DETERMINES
HOW ESC8/TIPS RESPONDS TO LEGAL PUBLIC INFORMATION REQUESTS.
Current W-9 Tax Form
W9.pdf
You are required by TIPS to upload a current W-9 Internal Revenue Service (IRS) Tax Form for your entity. This form
will be utilized by TIPS to properly identify your entity.
Bid Attributes
11Yes-No
Disadvantaged/Minority/Women Business Enterprise - D/M/WBE/Federal HUBZone (Required by some participating
governmental entities). Vendor certifies that their firm is a D/M/WBE or HUBZone? Vendor must upload proof of
certification to the "Response Attachments" D/M/WBE CERTIFICATES section.
NO
21Yes-No
Historically Underutilized Business - HUB (Required by some participating governmental entities) Vendor certifies
that their firm is a HUB as defined by the State of Texas at https://comptroller.texas.gov/purchasing/vendor/hub/.
Proof may be submitted. Vendor must upload proof of certification to the "Response Attachments" HUB
CERTIFICATES section.
No
Page 4 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
31Yes-No
The Vendor can provide services and/or products to all 50 US States?
No
4 I States Served:
If answer is NO to question #3, please list which states can be served. (Example: AR, OK, TX)
TX
5 � Company and/or Product Description:
This information will appear on the TIPS website in the company profile section, if awarded a TIPS contract. (Limit
750 characters.)
PolyPrinter manufactures 3D printers and offers 3D printer related service, tools and supplies. Our printers include
classroom friendly features like a full enclosure and internal air filtration system. They are fast, quiet, user friendly,
and require little maintenance overall and practically no maintenance or fiddling in between prints. We also supply
all of the items 3D printers use along with the tools required to use and maintain them. In addition, we offer Onsite
repair services and staff training.
6 � Primary Contact Name
Primary Contact Name
Robin Koffeman
7 � Primary Contact Title
Primary Contact Title
Vice President
8 � Primary Contact Email
Primary Contact Email
robin@polyprinter.com
9 � Primary Contact Phone
Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
4698441229
1 Primary Contact Fax
� Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
No response
Primary Contact Mobile
Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
No response
1 Secondary Contact Name
2 Secondary Contact Name
Ed Koffeman
Page 5 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
1 Secondary Contact Title
3 Secondary Contact Title
President
1 Secondary Contact Email
4 Secondary Contact Email
ed@polyprinter.com
1 Secondary Contact Phone
5 Enter 10 digit phone number. (No dashes or extensions)
Example� 8668398477
4698441229
1 Secondary Contact Fax
6 Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
No response
1 Secondary Contact Mobile
7 Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
No response
1 Admin Fee Contact Name
$ Admin Fee Contact Name. This person is responsible for paying the admin fee to TIPS.
Robin Koffeman
1 I Admin Fee Contact Email
9 Admin Fee Contact Email
robin@polyprinter.com
2 Admin Fee Contact Phone
� Enter 10 digit phone number. (No dashes or extensions)
Example: 8668398477
9727751363
2 Purchase Order Contact Name
� Purchase Order Contact Name. This person is responsible for receiving Purchase Orders from TIPS.
Robin Koffeman
2 I Purchase Order Contact Email
2 Purchase Order Contact Email
robin@polyprinter.com
2 Purchase Order Contact Phone
3 Enter 10 digit phone number. (No dashes or extensions)
Example� 8668398477
9727751363
Page 6 of 28 pages Vendor: PolyPrinter
220105 Addendum 1
2 Company Website
4 Company Website (Format - www.company.com)
www.polyprinter.com
2 Entity D/B/A's and Assumed Names
5 Please identify all of your entity's assumed names and D/B/A's. Please note that you will be identified publicly by
the legal name under which you responded to this solicitation unless you organize otherwise with TIPS after award.
Kinetric Inc. DBA PolyPrinter
2 Primary Address
6 Primary Address
2750 W FM 875
2 Primary Address City
7 Primary Address City
Midlothian
2 Primary Address State
$ Primary Address State (2 Digit Abbreviation)
Texas
2 Primary Address Zip
9 Primary Address Zip
76065
3 Search Words:
� Please list search words to be posted in the TIPS database about your company that TIPS website users might
search. Words may be product names, manufacturers, or other words associated with the category of award. YOU
MAY NOT LIST NON-CATEGORY ITEMS. (Limit 500 words) (Format: product, paper, construction, manufacturer
name, etc.)
3d printer printers filament supplies PolyPrinter service printing training FDM FFF fabrication repair parts training
support polyprinter reliable onsite
3 Do you want TIPS Members to be able to spend Federal grant funds with you if awarded? Is it your
� intent to be able to sell to our members regardless of the fund source, whether it be local, state or
federal?
Most of our members receive Federal Government grants or other funding and they make up a significant portion of
their budgets. The Members need to know if your company is willing to sell to them when they spend federal budget
funds on their purchase. There are attributes that follow that include provisions from the federal regulations in 2
CFR part 200, etc. Your answers will determine if your award will be designated as eligible for TIPS Members to
utilize federal funds with your company.
Do you want TIPS Members to be able to spend Federal funds, at the Member's discretion, with you?
Yes
Page 7 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
3 Yes - No
2 Certification of Residency (Required by the State of Texas) The vendor's ultimate parent company or majority
owner:
(A) has its principal place of business in Texas;
•�
(B) employs at least 500 persons in Texas?
This question is required as a data gathering function for information to our members making purchases with
awarded vendors. It does not affect scoring with TIPS.
Yes
3 Company Residence (City)
3 Vendor's principal place of business is in the city of?
Midlothian
3 Company Residence (State)
4 Vendor's principal place of business is in the state of?
TX
3 Discount Offered - CAUTION READ CAREFULLY BECAUSE VENDORS FREQUENTLY MAKE MISTAKES
5 ON THIS ATTRIBUTE QUESTION
Remember this is a MINIMUM discount percentage. So, be sure that the discount percentage inserted here can be
applied to ANY OFFERING OF GOODS OR SERVICES THROUGHOUT THE LIFE OF THE CONTRACT.
CAUTION: BE CERTAIN YOU CAN HONOR THIS MIN/MUM DISCOUNT PERCENTAGE ON ANY OFFERED SERVICE
OR GOOD NOW OR DURING THE LIFE OF THE CONTRACT.
What is the MINIMUM percentage discount off of any item or service you offer to TIPS Members that is in your
regular catalog (as defined in the solicitation specifications document), website, store or shelf pricing or when
adding new goods or services to your offerings during the life of the contract? The resulting price of any goods or
services Catalog list prices after this discount is applied is a ceiling on your pricing and not a floor because, in order
to be more competitive in the individual circumstance, you may offer a larger discount depending on the items or
services purchased and the quantity at time of sale. Please note that any specific greater discount offered for a
particular product, brand, or service listed in Vendor's proposal will control and Vendor will be required to honor that
greater specific discount, in excess of the minimum discount, for that particular product, brand, or service for the life
of the contract.
Must answer with a number between 0% and 100%.
0%
Page 8 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
3 MINIMUM Discount Term
6 Does the vendor agree to at least offer, for the life of the Agreement, the Minimum Discount Percentage off list or
catalog proposed by Vendor in response to the Attribute entitled "Discount Offered - CAUTION READ CAREFULLY
BECAUSE VENDORS FREQUENTLY MAKE MISTAKES ON THIS ATTRIBUTE QUESTION"? TIPS will utilize this
response to satisfy the Long Term Cost scoring evaluation criteria. A"YES" answer will be awarded the maximum
10 points for this criterion out of the 100 total points and a"NO" answer is awarded 0 points.
YES
3 Yes - No
7 If awarded on this TIPS Contract, for the duration of the Contract, Vendor agrees to provide, upon request, their
then current catalog pricing, as defined in the solicitation and below, to TIPS upon request for any goods and
services offered on Vendor's TIPS Contract.
"Catalog" means the available list of tangible personal property or services, in the most current listing, regardless of
date, during the life of the contract, that takes the form of a catalog, price list, schedule, shelf price or other form
that:
A. is regularly maintained by the manufacturer or Vendor of an item; and
B. is either published or otherwise available for inspection by a customerduring the purchase process;
C. to which the minimum discount proposed by the proposing Vendor may be applied.
YES
3 TIPS Administration Fee
$ By submitting a proposal, I agree that all pricing submitted to TIPS shall include the Administration Fee, as
designated in the solicitation or as otherwise agreed in writing which shall be remitted to TIPS by the Vendor, or the
vendor's named resellers, and as agreed to in the Vendor Agreement. I agree that the fee shall not and will not be
added by the Vendor as a separate line item on a TIPS member invoice, quote, proposal or any other written
communications with the TIPS member.
3 Yes - No
9 Vendor agrees to remit to TIPS the required administration fee or, if resellers are named, Vendor agrees to
guarantee the fee remittance by or for the reseller named by the vendor?
TIPS/ESC Region 8 is required by Texas Government Code § 791 to be compensated for its work and thus, failure
to agree shall render your response void and it will not be considered.
Agreed
4 TIPS Administration Fee Paid by Vendor - Not Charged to Customer
� Vendor understands and agrees that it owes TIPS a TIPS Administration Fee (published in the RFP/RCSP
document) on every TIPS sale made under an awarded TIPS Contract. Vendor further understands and agrees
that Vendor shall submit pricing with this proposal which includes and accounts for the TIPS Administration Fee and
shall never separately charge the TIPS Member Customer the TIPS fee or add the TIPS Administration Fee line
item to an invoice or similar purchase document. Submission of this proposal is Vendor's certification that Vendor
agrees to this mandatory term.
4 Additional Discounts?
� Do you offer additional discounts to TIPS members for large order quantities or large scope of work?
Yes
4 I Years in Business as Proposing Company
2 Years in business as proposing company?
Page 9 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
4 Resellers:
3 Does the vendor have resellers that it will name under this contract? Resellers are defined as other companies that
sell your products under an agreement with you, the awarded vendor of TIPS.
EXAMPLE: BlGmart is a reseller of ACME brand televisions. If ACME were a TIPS awarded vendor, then ACME
would list BlGmart as a reseller.
(If applicable, Vendor should add all Authorized Resellers within the TIPS Vendor Portal upon award).
No
4 Right of Refusal
4 The proposing vendor has the right not to sell under the awarded agreement with a TIPS member at vendor's
discretion unless required by law.
4 I NON-COLLUSIVE BIDDING CERTIFICATE
5 By submission of this bid or proposal, the Bidder certifies that:
1) This bid or proposal has been independently arrived at without collusion with any other Bidder or with any
Competitor;
2) This bid or proposal has not been knowingly disclosed and will not be knowingly disclosed, prior to the opening of
bids, or proposals for this project, to any other Bidder, Competitor or potential competitor:
3) No attempt has been or will be made to induce any other person, partnership or corporation to submit or not to
submit a bid or proposal;
4) The person signing this bid or proposal certifies that he has fully informed himself regarding the accuracy of the
statements contained in this certification, and under the penalties being applicable to the Bidder as well as to the
person signing in its behalf.
Not a negotiable term. Failure to agree will render your proposal non-responsive and it will not be considered.
4 CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ - Do you have any CONFLICT OF INTEREST
6 TO REPORT OR DISCLOSE under this statutory requirement?
Do you have any CONFLICT OF INTEREST TO REPORT OR DISCLOSE under this statutory requirement? YES or
NO
If you have a conflict of interest as described in this form or the Local Government Code Chapter 176, cited therein-
you are required to complete and file with TIPS.
The Form CIQ is one of the attachments to this solicitation.
There is an optional upload for this form provided if you have a conflict and must file the form
No
4 Filing of Form CIQ
7 If yes (above), have you filed a form CIQ by uploading the form to this RFP as directed above?
No response
Page 10 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
4 Regulatory Standing
$ I certify to TIPS for the proposal attached that my company is in good standing with all governmental agencies
Federal or state that regulate any part of our business operations. If not, please explain in the next attribute
question.
Yes
4 Regulatory Standing
9 Regulatory Standing explanation of no answer on previous question.
No response
5 I Antitrust Certification Statements (Tex. Government Code § 2155.005)
� By submission of this bid or proposal, the Bidder certifies that:
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 bid, 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 bid, neither I nor any representative of the Company has violated any federal antitrust
law;
(4) Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of
this bid 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.
Page 11 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
5 I Suspension or Debarment Instructions
� Instructions for Certification:
1. By answering yes to the next Attribute question below, the vendor and prospective lower tier participant is
providing the certification set out herein in accordance with these instructions.
2. The certification in this clause is a material representation of fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered
an erroneous certification in addition to other remedies available to the federal government, the department or
agency with which this transaction originated may pursue available remedies, including suspension and / or
debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal
is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"participants," "person," "primary covered transaction," "principal," "proposal" and "voluntarily excluded," as used in
this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive
Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of
those regulations.
5. The prospective lower tier participant agrees by submitting this form that, should the proposed covered
transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, declared ineligible or voluntarily excluded from participation in this covered transaction,
unless authorized by the department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this form that it will include this clause titled
"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered
Transaction" without modification in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier
covered transaction that it is not debarred, suspended, ineligible or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency
by which it determines the eligibility of its principals. Each participant may, but is not required to, check the
Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to
render in good faith the certification required by this clause. The knowledge and information of a participant is not
required to exceed that which is normally possessed by a prudent person in the ordinary course of business
dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible or voluntarily excluded from participation in this transaction, in addition to other remedies available to the
federal government, the department or agency with which this transaction originated may pursue available
remedies, including suspension and / or debarment.
5 Suspension or Debarment Certification
2 By answering yes, you certify that no federal suspension or debarment is in place, which would preclude receiving a
federally funded contract as described above.
Yes
Page 12 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
5 Non-Discrimination Statement and Certification
3 In accordance with Federal civil rights law, all U.S. Departments, including the U.S. Department of Agriculture
(USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions
participating in or administering USDA programs are prohibited from discriminating based on race, color, national
origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status,
family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for
prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all
programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille,
large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET
Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027,
found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed
to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint
form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of
Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C.
20250-9410; (2) fax: (202) 690-7442; or (3)
email: program.intake@usda.gov.
(Title VI of the Education Amendments of 1972; Section 504 of the Rehabilitation Act of 1973; the Age
Discrimination Act of 1975; Title 7 CFR Parts 15, 15a, and 15b; the Americans with Disabilities Act; and FNS
Instruction 113-1, Civil Rights Compliance and Enforcement — Nutrition Programs and Activities)
All U.S. Departments, including the USDA are equal opportunity provider, employer, and lender.
Not a negotiable term. Failure to agree by answering YES will render your proposal non-responsive and it will not be
considered. I certify that in the performance of a contract with TIPS or its members, that our company will conform to
the foregoing anti-discrimination statement and comply with the cited and all other applicable laws and regulations.
�❑ Yes, I certify (Yes)
5 2 CFR PART 200 Contract Provisions Explanation
4 Required Federal contract provisions of Federal Regulations for Contracts for contracts with ESC Region 8 and
TIPS Members:
The following provisions are required to be in place and agreed if the procurement is funded in any part with federal
funds.
The ESC Region 8 and TIPS Members are the subgrantee or Subrecipient by definition. Most of the provisions are
located in 2 CFR PART 200 - Appendix II to Part 200—Contract Provisions for Non-Federal Entity Contracts Under
Federal Awards at 2 CFR PART 200. Others are included within 2 CFR part 200 et al.
In addition to other provisions required by the Federal agency or non-Federal entity, all contracts made by the non-
Federal entity under the Federal award must contain provisions covering the following, as applicable.
Page 13 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
5 2 CFR PART 200 Contracts
5 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.
Notice: Pursuant to the above, when federal funds are expended by ESC Region 8 and TIPS Members, ESC Region
8 and TIPS Members 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 vendor agree?
Yes
5 2 CFR PART 200 Termination
6 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 the above, when federal funds are expended by ESC Region 8 and TIPS Members, ESC Region 8 and
TIPS Members reserves the right to terminate any agreement in excess
of $10,000 resulting from this procurement process for cause after giving the vendor an appropriate opportunity
and up to 30 days, to cure the causal breach of terms and conditions. ESC Region 8 and
TIPS Members reserves the right to terminate any agreement in excess of $10,000 resulting from this procurement
process for convenience with 30 days notice in writing to the awarded vendor. The vendor
would be compensated for work performed and goods procured as of the termination date if for convenience of the
ESC Region 8 and TIPS Members. Any award under this procurement process is not exclusive and the ESC Region
8 and TIPS reserves the right to purchase goods and services from other vendors when it is in the best interest of
the ESC Region 8 and TIPS.
Does vendor agree?
Yes
5 2 CFR PART 200 Clean Air Act
7 Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as
amended—Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the
non-Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the
Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251-
1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental
Protection Agency (EPA).
Pursuant to the Clean Air Act, et al above, when federal funds are expended by ESC Region 8 and TIPS Members,
ESC Region 8 and TIPS Members requires that the proposer certify that during the term of
an award by the ESC Region 8 and TIPS Members resulting from this procurement process the vendor agrees to
comply with all of the above regulations, including all of the terms listed and referenced therein.
Does vendor agree?
Yes
Page 14 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
5 2 CFR PART 200 Byrd Anti-Lobbying Amendment
$ Byrd Anti-Lobbying Amendment (31 U.S.C. 1352)—Contractors that apply or bid for an award exceeding $100,000
must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal
appropriated funds to pay any person or organization for influencing or attempting to influence an officer or
employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of
Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352.
Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any
Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award.
Pursuant to the above, when federal funds are expended by ESC Region 8 and TIPS Members, ESC Region 8 and
TIPS Members requires the proposer certify that during the term and during the life of any contract with ESC Region
8 and TIPS Members resulting from this procurement process the vendor certifies to the terms included or
referenced herein.
Does vendor agree?
Yes
5 2 CFR PART 200 Federal Rule
9 Compliance with all applicable standards, orders, or requirements issued under section 306 of the Clean Air Act (42
U.S.C. 1857(h)), section 508 of the Clean Water Act (33 U.S.C. 1368), Executive Order 11738, and Environmental
Protection Agency regulations (40 CFR part 15). (Contracts, subcontracts, and subgrants of amounts in excess of
$250,000)
Pursuant to the above, when federal funds are expended by ESC Region 8 and TIPS Members, ESC Region 8 and
TIPS Members requires the proposer certify that in performance of the contracts, subcontracts, and subgrants of
amounts in excess of $250,000, the vendor will be in compliance with all applicable standards, orders, or
requirements issued under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508 of the Clean Water Act
(33 U.S.C. 1368), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR part 15).
Does vendor certify that it is in compliance with the Clean Air Act?
Yes
6 2 CFR PART 200 Procurement of Recovered Materials
� A non-Federal entity that is a state agency or agency of a political subdivision of a state and its contractors must
comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and
Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the
Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered
materials practicable, consistent with
maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value
of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management
services in a manner that maximizes energy and resource recovery; and establishing an affirmative procurement
program for procurement of recovered materials identified in the EPA guidelines.
Does vendor certify that it is in compliance with the Solid Waste Disposal Act as described above?
Yes
Page 15 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
6 2 CFR PART 200 Rights to Inventions
� 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 the above, when the foregoing applies to ESC Region 8 and TIPS Members, Vendor certifies that
during the term of an award resulting from this procurement process, Vendor agrees to comply with all applicable
requirements as referenced in the Federal rule above.
Does vendor agree?
Yes
6 2 CFR PART 200 Domestic Preferences for Procurements
2 As appropriate and to the extent consistent with law, the non-Federal entity should, to the greatest extent
practicable under a Federal award, provide a preference for the purchase, acquisition, or use of goods, products,
or materials produced in the United States (including but not limited to iron, aluminum, steel, cement, and other
manufactured products). The requirements of this section must be included in all subawards including all contracts
and purchase orders for work or products under this award. For purposes of 2 CFR Part 200.322, "Produced in the
United States" means, for iron and steel products, that all manufacturing processes, from the initial melting stag
through the application of coatings, occurred in the United States. Moreover, for purposes of 2 CFR Part 200.322,
"Manufactured products" means items and construction materials composed in whole or in part of non-ferrous
metals such as aluminum, plastics and polymer-based products such as polyvinyl chloride pipe, aggregates such as
concrete, glass, including optical fiber, and lumber.
Pursuant to the above, when federal funds are expended by ESC Region 8 and TIPS Members, Vendor certifies
that to the greatest extent practicable Vendor will provide a preference for the purchase, acquisition, or use of
goods, products, or materials produced in the United States (including but not limited to iron, aluminum, steel,
cement, and other manufactured products).
Does vendor agree?
Yes
6 2 CFR PART 200 Ban on Foreign Telecommunications
3 Federal grant funds may not be used to purchase equipment, services, or systems that use "covered
telecommunications" equipment or services as a substantial or essential component of any system, or as critical
technology as part of any system. "Covered telecommunications" means purchases from Huawei Technologies
Company or ZTE Corporation (or any subsidiary or affiliate of such entities), and video surveillance and
telecommunications equipment produced by Hytera Communications Corporation, Hangzhou Hikvision Digital
Technology Company, or Dahua Technology Company (or any subsidiary or affiliate of such entities).
Pursuant to the above, when federal funds are expended by ESC Region 8 and TIPS Members, Vendor certifies
that Vendor will not purchase equipment, services, or systems that use "covered telecommunications", as defined
by 2 CFR §200.216 equipment or services as a substantial or essential component of any system, or as critical
technology as part of any system.
Does vendor agree?
Yes
Page 16 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
6 2 CFR PART 200 Contract Cost & Price
4 For contracts more than the simplified acquisition threshold currently set at $250,000, a TIPS Member may, in very
rare circumstances, be required to negotiate profit as a separate element of the price pursuant to 2 C.F.R.
200.324(b). Under those circumstances, Vendor agrees to provide information and negotiate with the TIPS Member
regarding profit as a separate element of the price. However, Vendor certifies that the total price charged by the
Vendor shall not exceed the Vendor's TIPS pricing and pricing terms proposed.
Does Vendor Agree?
Yes
6 FEMA Fund Certifications
5 Submission of this proposal is Vendor's certification that Vendor agrees to this term. Vendor certifies that IF and
when Vendor accepts a TIPS purchase paid for in full or part with FEMA funds, Vendor certifies that:
(1) Vendor agrees to provide the TIPS Member, the FEMA Administrator, the Comptroller General of the United
States, or any of their authorized representatives access to and rights to reproduce 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. The Vendor agrees to provide the FEMA Administrator or an authorized
representatives access to construction or other work sites pertaining to the work being completed under the
contract. Vendor acknowledges and agrees that no language in this contract or the contract with the TIPS Member
is intended to prohibit audits or internal reviews by the FEMA Administrator or the Comptroller General of the United
States.
(2) The Vendor shall not use the Department of Homeland Security's seal(s), logos, crests, or reproductions of flags
or likenesses of DHS agency officials without specific FEMA pre-approval.
(3) The Vendor will comply with all applicable Federal law, regulations, executive orders, FEMA policies, procedures,
and directives.
(4) 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.
(5) The Vendor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements)
applies to the Vendor's actions pertaining to this contract.
6 Certification of Compliance with the Energy Policy and Conservation Act
6 When appropriate and to the extent consistent with the law, Vendor certifies that it will comply with the Energy Policy
and Conservation Act (42 U.S.C. 6321 et seq; 49 C.F.R. Part 18) and any mandatory standards and policies
relating to energy efficiency which are contained in applicable state energy conservation plans issued in compliance
with the Act.
Does Vendor agree?
Yes
Page 17 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
6 Certification Regarding Lobbying
7 Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts Exceeding $100,000 in Federal Funds
Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by
section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was
placed when this transaction was made or entered into. 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 undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person
for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
employee of congress, or an employee of a Member of Congress in connection with the awarding of a Federal
contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement,
and the extension, continuation, renewal, amendment, or modification of a Federal contract, grant, loan, or
cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing
or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "disclosure Form to Report Lobbying,"
in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for all
covered subawards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall
certify and disclose accordingly.
I HAVE NOT Lobbied per above
6 If you answered "I HAVE lobbied" to the above Attribute Question
$ If you answered "I HAVE lobbied" to the above Attribute question, you must download the Lobbying Report
"Standard From LLL, disclosure Form to Report Lobbying" which includes instruction on completing the form,
complete and submit it in the Response Attachments section as a report of the lobbying activities you performed or
paid others to perform.
6 I Subcontracting with Small and Minority Businesses, Women's Business Enterprises, and Labor Surplus
9 Area Firms.
Do you ever anticipate the possibility of subcontracting any of your work under this award if you are successful?
IF NO, DO NOT ANSWER THE NEXT ATTRIBUTE QUESTION. . IF YES, and ONLY IF YES, you must answer the
next question YES if you want a TIPS Member to be authorized to spend Federal Grant Funds for Procurement.
NO
Page 18 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
7 ONLY IF YES TO THE PREVIOUS QUESTION OR if you ever do subcontract any part of your
� performance under the TIPS Agreement, do you agree to comply with the following federal
requirements?
ONLY IF YES TO THE PREVIOUS QUESTION OR if you ever do subcontract any part of your performance under
the TIPS Agreement,
do you agree to comply with the following federal requirements?
Federal Regulation 2 CFR §200.321 Contracting with small and minority businesses, women's business enterprises,
and labor surplus area firms. (a)The non-Federal entity must take all necessary affirmative steps to assure that
minority businesses, women's business enterprises, and labor surplus area firms are used when possible.
(b) Affirmative steps must include:
(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;
(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 ; and
(6) Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs(1)
through (5) of this section.
No response
7 Indemnification
� The ESC Region 8 and TIPS is a Texas Political Subdivision and a local governmental entity; therefore, is prohibited
fro m
indemnifying third parties pursuant to the Texas Constitution (Article 3, Section 52) except as specifically provided
by law or as
ordered by a court of competent jurisdiction. A provision in a contract to indemnify or hold a party harmless is a
promise to pay for
any expenses the indemnified party incurs, if a specified event occurs, such as breaching the terms of the contract
or negligently
performing duties under the contract. Article III, Section 49 of the Texas Constitution states that "no debt shall be
created by or on
behalf of the State ... " The Attorney General has counseled that a contractually imposed obligation of indemnity
creates a "debt" in
the constitutional sense. Tex. Att'y Gen. Op. No. MW 475 (1982). Contract clauses which require the System or
institutions to
indemnify must be deleted or qualified with "to the extent permitted by the Constitution and Laws of the State of
Texas." Liquidated
damages, attorney's fees, waiver of vendor's liability, and waiver of statutes of limitations clauses should also be
deleted or qualified
with "to the extent permitted by the Constitution and laws of State of Texas."
Not a negotiable term.
you agree
to these terms?
�❑ Yes, I Agree (Yes)
Failure to agree will render your proposal non-responsive and it will not be considered. Do
Page 19 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
7 Remedies
2 The parties shall be entitled to exercise any right or remedy available to it either at law or in equity, subject to the
choice of law, venue
and service of process clauses limitations agreed herein. Nothing in this agreement shall commit the TIPS to an
arbitration resolution
of any disagreement under any circumstances. Any Claim arising out of or related to the Contract, except for those
specifically waived
under the terms of the Contract, may, after denial of the Board of Directors, be subject to mediation at the request
of either party. Any
issues not resolved hereunder MAY be referred to non-binding mediation to be conducted by a mutually agreed
upon mediator as a
prerequisite to the filing of any lawsuit over such issue(s). The parties shall share the mediator's fee and any
associated filing fee
equally. Mediation shall be held in Camp or Titus County, Texas. Agreements reached in mediation shall be reduced
to writing, and
will be subject to the approval by the District's Board of Directors, signed by the Parties if approved by the Board of
Directors, and, if
signed, shall thereafter be enforceable as provided by the laws of the State of Texas.
Do you agree to these terms?
Yes, I Agree
7 Remedies Explanation of No Answer
3
No response
7 Choice of Law
4 The agreement between the Vendor and TIPS/ESC Region 8 and any addenda or other additions resulting from this
procurement process, however described, shall be governed by, construed and enforced in accordance with the
laws of the State of Texas, regardless of any conflict of laws principles.
THIS DOES NOT APPLY to a vendor's agreement entered into with a TIPS Member, as the Member may be located
outside Texas.
Do you agree to these terms?
Agreed
7 Venue, Jurisdiction and Service of Process
5 An roceedin
y p g, involving Region 8 ESC or TIPS, arising out of or relating to this procurement process or any
contract issued by TIPS resulting from or any contemplated transaction shall be brought in a court of competent
jurisdiction in Camp County, Texas and each of the parties irrevocably submits to the exclusive jurisdiction of said
court in any such proceeding, waives any objection it may now or hereafter have to venue or to convenience of
forum, agrees that all claims in respect of the Proceeding shall be heard and determined only in any such court,
and agrees not to bring any proceeding arising out of or relating to this procurement process or any contract
resulting from or any contemplated transaction in any other court. The parties agree that either or both of them may
file a copy of this paragraph with any court as written evidence of the knowing, voluntary and freely bargained for
agreement between the parties irrevocably to waive any objections to venue or to convenience of forum. Process in
any Proceeding referred to in the first sentence of this Section may be served on any party anywhere in the world.
Any dispute resolution process other than litigation shall have venue in Camp County or Titus County Texas.
Do you agree to these terms?
Agreed
Page 20 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
7 Infringement(s)
6 The successful vendor will be expected to indemnify and hold harmless the TIPS and its employees, officers,
agents, representatives, contractors, assignees and designees from any and all third party claims and judgments
involving infringement of patent, copyright, trade secrets, trade or service marks, and any other intellectual or
intangible property rights attributed to or claims based on the Vendor's proposal or Vendor's performance of
contracts awarded and approved.
Do you agree to these terms?
Yes, I Agree
7 Infringement(s) Explanation of No Answer
7
No response
7 Contract Governance
$ Any contract made or entered into by the TIPS is subject to and is to be governed by Section 271.151 et seq, Tex
Loc Gov't Code. Otherwise, TIPS does not waive its governmental immunities from suit or liability except to the
extent expressly waived by other applicable laws in clear and unambiguous language.
U Yes, I Agree (Yes)
7 Payment Terms and Funding Out Clause
9 Payment Terms:
TIPS or TIPS Members shall not be liable for interest or late payment fees on past-due balances at a rate higher
than permitted by the laws or regulations of the jurisdiction of the TIPS Member.
Funding Out Clause:
Vendor agrees to abide by the laws and regulations, including Texas Local Government Code § 271.903, or any
statutory or regulatory limitations of the jurisdiction of any TIPS Member which governs contracts entered into by the
Vendor and TIPS or a TIPS Member that requires all contracts approved by TIPS or a TIPS Member are subject to
the budgeting and appropriation of currently available funds by the entity or its governing body.
See statute(s) for specifics or consult your legal counsel.
Not a negotiable term. Failure to agree will render your proposal non-responsive and it will not be considered.
Do you agree to these terms?
�❑ Yes, I Agree (Yes)
Page 21 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
8 I Insurance and Fingerprint Requirements Information
� Insurance
If applicable and your staff will be on TIPS member premises for delivery, training or installation etc. and/or with an
automobile, you must carry automobile insurance as required by law. You may be asked to
provide proof of insurance.
Finaerprint
It is possible that a vendor may be subject to Chapter 22 of the Texas Education Code. The Texas Education Code,
Chapter 22, Section 22.0834 & 22.08341. Statutory language may be found at: http://www.statutes.legis.state.tx.us/
If the vendor has staff that meet both of these criterion:
(1) will have continuing duties related to the contracted services; and
(2) has or will have direct contact with students
Then you have "covered" employees for purposes of completing the attached form.
TIPS recommends all vendors consult their legal counsel for guidance in compliance with this law. If you have
questions on how to comply, see below. If you have questions on compliance with this code section, contact the
Texas Department of Public Safety Non-Criminal Justice Unit, Access and Dissemination Bureau, FAST-FACT at
NCJU@txdps.state.tx.us and you should send an email identifying you as a contractor to a Texas Independent
School District or ESC Region 8 and TIPS. Texas DPS phone number is (512) 424-2474.
See form in the next attribute to complete entitled:
Texas Education Code Chapter 22 Contractor Certification for Contractor Employees
Page 22 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
8 Texas Education Code Chapter 22 Contractor Certification for Contractor Employees
� Introduction: Texas Education Code Chapter 22 requires entities that contract with school districts to provide
services to obtain criminal history record information regarding covered employees. Contractors must certify to the
district that they have complied. Covered employees with disqualifying criminal histories are prohibited from serving
at a school district.
Definitions: Covered employees: Employees of a contractor or subcontractor who have or will have continuing
duties related to the service to be performed at the District and have or will have direct contact with students. The
District will be the final arbiter of what constitutes direct contact with students. Disqualifying criminal history: Any
conviction or other criminal history information designated by the District, or one of the following offenses, if at the
time of the offense, the victim was under 18 or enrolled in a public school:
(a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required to register as
a sex offender under Chapter 62, Texas Code of Criminal Procedure; or (c) an equivalent offense under federal law
or the laws of another state.
I certify that:
NONE (Section A) of the employees of Contractor and any subcontractors are covered employees, as defined
above. If this box is checked, I further certify that Contractor has taken precautions or imposed conditions to ensure
that the employees of Contractor and any subcontractor will not become covered employees. Contractor will
maintain these precautions or conditions throughout the time the contracted services are provided.
OR
SOME (Section B) or all of the employees of Contractor and any subcontractor are covered employees. If this box
is checked, I further certify that:
(1) Contractor has obtained all required criminal history record information regarding its covered employees. None
of the covered employees has a disqualifying criminal history.
(2) If Contractor receives information that a covered employee subsequently has a reported criminal history,
Contractor will immediately remove the covered employee from contract duties and notify the District in writing within
3 business days.
(3) Upon request, Contractor will provide the District with the name and any other requested information of covered
employees so that the District may obtain criminal history record information on the covered employees.
(4) If the District objects to the assignment of a covered employee on the basis of the covered employee's criminal
history record information, Contractor agrees to discontinue using that covered employee to provide services at the
District.
Noncompliance or misrepresentation regarding this certification may be grounds for contract termination.
Some
Page 23 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
8 Texas Business and Commerce Code § 272 Requirements as of 9-1-2017
2 SB 807 prohibits construction contracts to have provisions requiring the contract to be subject to the laws of
another state, to be required to litigate the contract in another state, or to require arbitration in another state. A
contract with such provisions is voidable. Under this new statute, a"construction contract" includes contracts,
subcontracts, or agreements with (among others) architects, engineers, contractors, construction managers,
equipment lessors, or materials suppliers. "Construction contracts" are for the design, construction, alteration,
renovation, remodeling, or repair of any building or improvement to real property, or for furnishing materials or
equipment for the project. The term also includes moving, demolition, or excavation. BY RESPONDING TO THIS
SOLICITATION, AND WHEN APPLICABLE, THE PROPOSER AGREES TO COMPLY WITH THE TEXAS BUSINESS
AND COMMERCE CODE § 272 WHEN EXECUTING CONTRACTS WITH TIPS MEMBERS THAT ARE TEXAS
GOVERNMENT ENTITIES.
8 I Texas Government Code 2270 & 2271 Verification Form
3 Texas Government Code 2270 & 2271 Verification Form
If (a) Vendor is not a sole proprietorship; (b) Vendor has ten (10) or more full-time employees; and (c) this
Agreement has a value of $100,000 or more, the following certification shall apply; otherwise, this certification is not
required. Pursuant to Chapter 2271 of the Texas Government Code, the Vendor hereby certifies and verifies that
neither the Vendor, nor any affiliate, subsidiary, or parent company of the Vendor, if any (the "Vendor Companies"),
boycotts Israel, and the Vendor agrees that the Vendor and Vendor Companies will not boycott Israel during the
term of this Agreement. For purposes of this Agreement, the term "boycott" shall mean and include refusing to deal
with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic
harm on, or limit commercial relations with Israel, or with a person or entity doing business in Israel or in an Israeli-
controlled territory, but does not include an action made for ordinary business purposes.
Our entity further certifies that it is is not listed on and we do not do business with companies prohibited by Texas
Government Code 2270 or that are on the Texas Comptroller of Public Accounts list of Designated Foreign
Terrorists Organizations per Texas Gov't Code 2270.01 53 found at
https://comptroller.texas.gov/purchasing/docs/foreign-terrorist.pdf
I swear and affirm that the above is true and correct.
YES
8 Logos and other company marks
4 Please u load our com an lo o to be added to our individual rofile a e on the TIPS website. If an articular
P Y P Y 9 Y P P J YP
specifications are required for use of your company logo, please upload that information under the "Logo and Other
Company Marks" section under the "Response Attachment" tab. Preferred Logo Format: 300 x 225 px -.png, .eps,
.jpeg preferred
Potential uses of company logo:
* Your Vendor Profile Page of TIPS website
* Potentially on TIPS website scroll bar for Top Performing Vendors
* TIPS Quarterly eNewsletter sent to TIPS Members
* Co-branding Flyers and or email blasts to our TIPS Members (Permission and approval will be obtained before
publishing)
Page 24 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
8 Solicitation Deviation/Compliance
5 Does the vendor agree with the General Conditions Standard Terms and
Conditions or Item Specifications listed in this proposal invitation?
Yes
8 Solicitation Exceptions/Deviations Explanation
6 If the bidder intends to deviate from the General Conditions Standard Terms and Conditions or Item Specifications
listed in this proposal invitation, all such deviations must be listed on this attribute, with complete and detailed
conditions and information included or attached.
TIPS will consider any deviations in its proposal award decisions, and TIPS reserves the right to accept or reject any
bid based upon any deviations indicated below or in any attachments or inclusions.
In the absence of any deviation entry on this attribute, the proposer assures TIPS of their full compliance with the
Standard Terms and Conditions, Item Specifications, and all other information contained in this Solicitation.
No response
8 Agreement Deviation/Compliance
7 Does the vendor agree with the language in the Vendor Agreement?
Yes
8 Agreement Exceptions/Deviations Explanation
$ If the proposing Vendor desires to deviate form the Vendor Agreement language, all such deviations must be listed
on this attribute, with complete and detailed conditions and information included. TIPS will consider any deviations in
its proposal award decisions, and TIPS reserves the right to accept or reject any proposal based upon any
deviations indicated below. In the absence of any deviation entry on this attribute, the proposer assures TIPS of
their full compliance with the Vendor Agreement.
No response
8 Felony Conviction Notice
9 Texas Education Code, Section 44.034, Notification of Criminal History, Subsection (a), states "a person or business
entity that enters into a contract with a school district must give advance notice to the district if the person or an
owner or operator of the business entity has been convicted of a felony. The notice must include a general
description of the conduct resulting in the conviction of a felony." Subsection (b) states "a school district may
terminate a contract with a person or business entity if the district determines that the person or business entity
failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The
district must compensate the person or business entity for services performed before the termination of the
contract." (c) This section does not apply to a publicly held corporation. The person completing this proposal
certifies that they are authorized to provide the answer to this question.
Select A., B. or C.
A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable.
OR B.My firm is not owned nor operated by anyone who has been convicted of a felony, OR
C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony. (if you
answer C below, you are required to provide information in the next attribute.
B. Firm not owned nor operated by felon; per above
Page 25 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
9 If you answered C. My Firm is owned or operated by a felon to the previous question, you are
0 REQUIRED TO ANSWER THE FOLLOWING QUESTIONS.
If you answered C. My Firm is owned or operated by a felon to the previous question, you must provide the following
information.
1. Name of Felon(s)
2. The named person's role in the firm, and
3. Details of Conviction(s).
No response
9 Required Confidentiality Claim Form
� Required Confidentiality Claim Form
This completed form is required by TIPS. By submitting a response to this solicitation you agree to download from
the "Attachments" section, complete according to the instructions on the form, then upload the completed form, with
any confidential attachments, if applicable, to the "Response Attachments" section titled "Confidentiality Form" in
order to provide to TIPS the completed form titled, "CONFIDENTIALITY CLAIM FORM". THIS REQUIRED PROCESS
IS THE ONLY WAY TO DEEM PROPOSAL DOCUMENTATION CONFIDENTIAL ANY OTHER CONFIDENTIAL
DESIGNATION WILL BE DISREGARDED UNLESS THE DOCUMENT IS IDENTIFIED BY AND ATTACHED TO THE
REQUIRED FORM. By completing this process, you provide us with the information we require to comply with the
open record laws of the State of Texas as they may apply to your proposal submission. If you do not provide the
form with your proposal, an award will not be made if your proposal is qualified for an award, until TIPS has an
accurate, completed form from you.
Read the form carefully before completing and if you have any questions, email bids@tips-usa.com.
9 Member Access to Vendor Proposal
2 Notwithstanding any other information provided in this solicitation or Vendor designation of certain documentation
as confidential or proprietary, Vendor's acceptance of this TIPS Contract constitutes Vendor's consent to the
disclosure of Vendor's comprehensive proposal, including any information deemed confidential or proprietary, to
TIPS Members. The proposing Vendor agrees that TIPS shall not be responsible or liable for any use or
distribution of information or documentation by TIPS Members or any other party. By submitting this proposal,
Vendor certifies the foregoing.
9 Choice of Law clauses with TIPS Members
3 If the vendor is awarded a contract with TIPS under this solicitation, the vendor agrees to make any Choice of Law
clauses in any contract or agreement entered into between the awarded vendor and with a TIPS member entity to
read as follows: "Choice of law shall be the laws of the state where the customer resides" or words to that effect.
Agreed
9 Venue of dispute resolution with a TIPS Member
4 In the event of litigation or use of any dispute resolution model when resolving disputes with a TIPS member entity
as a result of a transaction between the vendor and TIPS or the TIPS member entity, the Venue for any litigation or
other agreed upon model shall be in the state and county where the customer resides unless otherwise agreed by
the parties at the time the dispute resolution model is decided by the parties.
Agreed
9 Automatic renewal of contracts or agreements with TIPS or a TIPS member entity
5 This clause DOES NOT prohibit multiyear contracts or agreements with TIPS member entities.
Because TIPS and TIPS members are governmental entities subject to laws that control appropriations of funds
during their fiscal years for contracts and agreements to provide goods and services, does the Vendor agree to limit
any automatic renewal clauses of a contract or agreement executed as a result of this TIPS solicitation award to not
longer than "month to month" and at the TIPS contracted rate.
Agreed
Page 26 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
9 Indemnity Limitation with TIPS Members
6 Texas and other states restrict by law or state Constitution the ability of a governmental entity to indemnify others.
TIPS requires that any contract entered into between a vendor and TIPS or a TIPS Member as a result of an award
under this Solicitation limit the requirement that the Customer indemnify the Vendor by either eliminating any such
indemnity requirement clauses in any agreements, contracts or other binding documents OR by prefacing all
indemnity clauses required of TIPS or the TIPS Member entity with the following: "To the extent permitted by the laws
or the Constitution of the state where the customer resides, ".
Aqreement is a required condition to award of a contract resulting from this Solicitation.
Agreed
9 Arbitration Clauses
7 Except for certain circumstances, TIPS forbids a mandatory arbitration clause in any contract or agreement entered
into between the awarded vendor with TIPS or a TIPS member entity. Does the vendor agree to exclude any
arbitration requirement in any contracts or agreement entered into between TIPS or a TIPS member entity through
an awarded contract with TIPS?
Agreed
9 Required Vendor Sales Reporting
$ By responding to this Solicitation, you agree to report to TIPS all sales made under any awarded Agreement with
TIPS. Vendor is required to report all sales under the TIPS contract to TIPS. If the TIPS Member entity requesting a
price from the awarded Vendor requests the TIPS contract, Vendor must include the TIPS Contract number on any
communications with the TIPS Member entity. If awarded, you will be provided access to the Vendor Portal. To
report sales, login to the TIPS Vendor Portal and click on the PO's and Payments tab. Pages 3-7 of the Vendor
Portal User Guide will walk you through the process of reporting sales to TIPS. Please refer to the TIPS Accountinq
FAQ's for more information about reporting sales and if you have further questions, contact the Accounting Team
at accountinq�tips-usa.com. The Vendor or vendor assigned dealers are responsible for keeping record of all
sales that go through the TIPS Agreement and submitting same to TIPS.
9 Upload of Current W-9 Required
9 Please note that you are required by TIPS to upload a current W-9 Internal Revenue Service (IRS) Tax Form for
your entity. This form will be utilized by TIPS to properly identify your entity.
1 CERTIFICATION REGARDING BOYCOTTING CERTAIN ENERGY COMPANIES (Texas law as of
� September 1, 2021)
0
By submitting a proposal to this Solicitation, you certify that you agree, when it is applicable, to the
following required by Texas law as of September 1, 2021:
If (a) company is not a sole proprietorship; (b) company has ten (10) or more full-time employees; and (c) this
contract has a value of $100,000 or more that is to be paid wholly or partly from public funds, the following
certification shall apply; otherwise, this certification is not required. Pursuant to Tex. Gov't Code Ch. 2274 of SB 13
�87th session), the company hereby certifies and verifies that the company, or any wholly owned subsidiary,
majority-owned subsidiary, parent company, or affiliate of these entities or business associations, if any, does not
boycott energy companies and will not boycott energy companies during the term of the contract. For purposes of
this contract, the term "company" shall mean an organization, association, corporation, partnership, joint venture,
limited partnership, limited liability partnership, or limited liability company, that exists to make a profit. The term
"boycott energy company" shall mean "without an ordinary business purpose, refusing to deal with, terminating
business activities with, or otherwise taking any action intended to penalize, inflict economic harm on, or limit
commercial relations with a company because the company (a) engages in the exploration, production, utilization,
transportation, sale, or manufacturing of fossil fuel-based energy and does not commit or pledge to meet
environmental standards beyond applicable federal and state law, or (b) does business with a company described
by paragraph (a)." See Tex. Gov't Code § 809.001(1).
Page 27 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
1 CERTIFICATION PROHIBITING DISCRIMINATION AGAINST FIREARM AND AMMUNITION INDUSTRIES
0(Texas law as of September 1, 2021)
1
By submitting a proposal to this Solicitation, you certify that you agree, when it is applicable, to the
following required by Texas law as of September 1, 2021:
If (a) company is not a sole proprietorship; (b) company has at least ten (10) full-time employees; (c) this contract
has a value of at least $100,000 that is paid wholly or partly from public funds; (d) the contract is not excepted
under Tex. Gov't Code § 2274.003 of SB 19 (87th leg.); and (e) governmental entity has determined that company
is not a sole-source provider or governmental entity has not received any bids from a company that is able to
provide this written verification, the following certification shall apply; otherwise, this certification is not required.
Pursuant to Tex. Gov't Code Ch. 2274 of SB 19 (87th session), the company hereby certifies and verifies that the
company, or association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or
limited liability company, including a wholly owned subsidiary, majority-owned subsidiary parent company, or affiliate
of these entities or associations, that exists to make a profit, does not have a practice, policy, guidance, or directive
that discriminates against a firearm entity or firearm trade association and will not discriminate during the term of
this contract against a firearm entity or firearm trade association. For purposes of this contract, "discriminate
against a firearm entity or firearm trade association" shall mean, with respect to the entity or association, to: "(1)
refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a
firearm entity or firearm trade association; (2) refrain from continuing an existing business relationship with the
entity or association based solely on its status as a firearm entity or firearm trade association; or (3) terminate an
existing business relationship with the entity or association based solely on its status as a firearm entity or firearm
trade association. See Tex. Gov't Code § 2274.001(3) of SB 19. "Discrimination against a firearm entity or firearm
trade association" does not include: "(1) the established policies of a merchant, retail seller, or platform that restrict
or prohibit the listing or selling of ammunition, firearms, or firearm accessories; and (2) a company's refusal to
engage in the trade of any goods or services, decision to refrain from continuing an existing business relationship,
or decision to terminate an existing business relationship to comply with federal, state, or local law, policy, or
regulations or a directive by a regulatory agency, or for any traditional business reason that is specific to the
customer or potential customer and not based solely on an entity's or association's status as a firearm entity or
firearm trade association." See Tex. Gov't Code § 2274.001(3) of SB 19.
1 CERTIFICATION REGARDING CERTAIN FOREIGN-OWNED COMPANIES IN CONNECTION WITH
� CRITICAL INFRASTRUCTURE (Texas law as of September 1, 2021)
2
By submitting a proposal to this Solicitation, you certify that you agree to the following required by
Texas law as of September 1, 2021:
Proposing Company is prohibited from entering into a contract or other agreement relating to critical infrastructure
that would grant to the company direct or remote access to or control of critical infrastructure in this state, excluding
access specifically allowed by the Proposing Company for product warranty and support purposes. Company,
certifies that neither it nor its parent company nor any affiliate of company or its parent company, is (1) owned by or
the majority of stock or other ownership interest of the company is held or controlled by individuals who are citizens
of China, Iran, North Korea, Russia, or a designated country; (2) a company or other entity, including governmental
entity, that is owned or controlled by citizens of or is directly controlled by the government of China, Iran, North
Korea, Russia, or a designated country; or (3) headquartered in China, Iran, North Korea, Russia, or a designated
country. For purposes of this contract, "critical infrastructure" means "a communication infrastructure system,
cybersecurity system, electric grid, hazardous waste treatment system, or water treatment facility." See Tex. Gov't
Code § 2274.0101(2) of SB 1226 (87th leg.). The company verifies and certifies that company will not grant direct
or remote access to or control of critical infrastructure, except for product warranty and support purposes, to
prohibited individuals, companies, or entities, including governmental entities, owned, controlled, or headquartered
in China, Iran, North Korea, Russia, or a designated country, as determined by the Governor.
1 Acknowledgement
� By submitting this proposal, Vendor certifies that it has read, examined, and understands all portions of this
3
solicitation including but not limited to all attribute questions, attachments, solicitation documents, bid notes, and the
Vendor Agreement(s). Vendor certifies that, if found to be necessary by the proposing vendor, vendor has sought
the advice of counsel in understanding all portions of the solicitation.
Page 28 of 28 pages Vendor: PolyPrinter 220105 Addendum 1
ADDENDUM NO. 1 TIPS 220105 TECHNOLOGY SOLUTIONS, PRODUCTS AND SERVICES
This Addendum #1 does not require action from responding Vendors and does not require resubmission
for Vendors who have already submitted. It is only to correct a misstatement originally included in Page
7 of the solicitation attachment entitled "220105 RFP Specifications." The original Page 7 of the
solicitation attachment entitled "220105 RFP Specifications" mistakenly stated at the top of the page that,
"This solicitation is seeking providers for: Safety Equipment, Supplies and Services." This Addendum No.
1 corrects it to properly state, "This solicitation is seeking providers for: Technology Solutions, Products
and Services."
TIPS RFP 220105 Technology Solutions, Products and
Services
REFERENCES
Please provide three (3) references from three different entities, preferably from school districts or other governmental entil
the last three years. Additional references may be required. DO NOT INCLUDE TIPS EMPLOYEES AS A REFERENCE.
Verifv vour references emails are
deliverable and that thev a�ree to provide
a reference. Failure to do this mav delav
the evaluation process.
You may provide more than three (3) references.
CERTIFICATIDN BY C�RPURATE aFFERER
C�:�iYLETE (3�iL�' IF CIFFk:iZFl� iS A CDRPi]R�,Tin�,
THE Fa[.LUWLNG CERTIFICATE SHDULD BE E�ECUTED AND INCLL`DED AS PART UF
PRQPDSAL FORMIPAUPOSAL FDRM.
UFFERER: R 1 L t- � �7 ti << n �r'
(Name of Cflrporation}
����n ��em•�.Y., certify #hat I am the 5ecretary of t�e Corporatiaa
�, ( ame a ❑r�orate 5e�reta� �
named as UFFERER herei�n a�or�e; that
�o�,�s��� a�F m '
{i�iame af person who eompleted prapasa! dacumen#]
who signed the foregoi�g �rapas$1 on be�alf of the �orparatioa afferer is the authorixed person that is
aeting as
l �'e. � � r� �x�� - - , .
("I'ittelPasitian uf person signing propasallnffer document within the corporation}
of the said Cor�uratioQ; t�at said proposailoffer was d�Ey signed far a�d in behalf at'said cvrparation by
a�sthority-:�f-tts go�r�i�g hody, and is wi#�in the s�ope of its curporate powers.
'J .
• � • -� •
1 �
- .� � `\ - - -
_ � ` •' -
C�Ft?''+�R�.:L.�S��AL if a�ailable
i
SIGNATURE
�./ r �1-�-�.-�.
1]ATE
�
TIPS RFP # 22�� D5
Reauired Confidential lnfarmati�n 5tatus Form
PolyPrinter
Name af evmpany
Robin Koffeman, Vice Presiden�
Printed Name and 7itle af Authorixed Campany nffcer declaring helow the �onfidential status pf material
275� W FM875 Midl�thian T� 76055 g���'�3
Address City 5tate Z!P Phone
ALL VENO�RS MUST COMPLETE THE ASOVE SECTION
C�NFIDEMTIALlNF�RMATI�NSU6MiTTEDIN RESF'dN5ET0 CDMPETITIVf PRaC[JREMENTREQUE5T5aF EDfJG4TlON SERVICECENTER REGION 8 ANDTIPS
{E5C8) 15 GaVERNEp BY TE](AS GDVERNMENT CQDE, CHAPTER 552
If you consider any poRion of your proposal to he cflnfidential �nd not subject to publit disclosure pursuant to Cha�ter 552 Texas Ga�t Code ar other kaw(s],
ycu must attach a copy of all claimed eonfldential materia[s tn this C�NIP�ETEO farm, name the tamhined PDF documents "LDNFIbEIVTIAL", and upfuad
the cam6ined, [onfidential documents with your propflsal submissivn. If a document is nnt attarhed, it will not pe r.onsidered confidential. 7he copy uplaaded
will k�e the sole indi�ator of which materiai in yaur propasal, i# any, yflu deem �onfdential in the event 71P5/E5C 8 receives a Puhlic lnfarmation Request. If E5C
8 receives a request, any responsive documentation not deemed c4nfidential hy y�u in this manner will 6e automatically released. For documents deemed
�onfideniial }ay you in this man�er, E5C8 and TlPS will follow pro�edures of evntrqlling statute[sj regarding any claim af con£dent9aiity and shaH not Ge IiabEe
for any release af informatian required �y law, including Attorney General determinatian. Nqtw9thstanding any pther information pro�ided in this soli�itation
or Vendor [fesignation af �ert8in documentation aS Corsfidential or prapriet8ry, Vendor's acceptan�e of this TIpS Vendor Agreement �anstitutes Vendor's
consent ta the dis�fosure of Vendor's �omprahensive propvsal, including any infiarmation deemed �vnfidential ar proprietary, to TiPS Members. The prapasing
Vendor agrees that TiPS shall not he responsibfe or iiable for any use ar distribution of infarmatian ar do�umentation 6y TiPS Members or any pther party.
ALL VEND�FtS MUST C�MPLEiE QNE DF TFEE TINd f�PTi�NS B��DW
OPTI�N 1�
l 0 LAkM parts of rrty praposai to be �onfidential and ADlV07 desire ta expressly wai�e a c�aim of [onfidentiafity af
aEl infarmatian contained within our response to the sol{cEtation. The attached contains material from our proposal that I
classify and deem canfdential under Texas Gov't Code Sec. 55� or other Eaw�s} and I in�oke my statutary rights to
canfidentialtreatment of the enrlosed materials.
kF CLAI��ING PARTS �F YQUR PRDP05AL C�NFIDElV�IAL, YO�I MUS�' ATTACH TH� SHEETS TC3 THi5 FORM ANp L1577HE
NUM6ER OT TE7TAL PAGES �'HATARE C�NFIQEIVTIAL.
ATTRCH� A�tE COPIES OF PAGES 4]F CLAIMED C�NFIQENTIAL MATERIAL FFt�M ❑UR PRaP�SAL TFiAT
WE DEEM T� BE NOT PUBLIC INFaRMATI�N ANp WILL DEFEND THAi CLAIM TQ THE 7E7(A5 ATT�RlVEY GENERAL IF REQ,UESTEL]
WHEN A PUBLIC lNFORMATIDf� REQUEST 15 MADE FQR �UR PR�P�SAL.
Signature aate
---------------�-_____-------------------._..._.----------- oR- -----------------__...._.----------------_-_-----
OP71QN Z:
i❑p N�T CLAiM any af my praposal ta be �onfidentiai, tornplete the settian below.
Exnress wai�er: I desire to expressly waive any claim af confidentiality as to any and al[ information contained within our
response to the competitive pra�urement proeess (e.g. RFP, CSP, eid, RFC2, �tc.) by corr�pfeting the foilowing and submitting
this sheet with aur response to Edu�atian 5ervice Cent�r Region 8 and TIPS.
'�e.k, � y j 2.v�
Canfidentiality Claim Form Re� 10292�215R
PolyPrinter
PolyPrinter 229, 508, 465dx, 325dx Warranty
We (PolyPrinter) want all PolyPrinter customers to be happy with their purchase. We feel a
reasonable duration parts warranty can help. We want to be responsible for providing a machine
that operates as it was intended and designed to. As a result PolyPrinter reserves the right to
offer, at its own discretion, additional value other than this warranty provides, but such action
shall not be construed as a new warranty provision.
For a period of 12 months after a customer has received their new PolyPrinter, PolyPrinter will
send replacement parts free of charge, if the original part is found to be defective. Polyprinter
will choose the shipping method and pay for shipping both ways for such parts.
Standard warranty is offered with the understanding that the customer must be prepared to
install parts or transport the printer to a PolyPrinter Service Facility, without expectation of
reimbursement from PolyPrinter. We will gladly assist with advice or instruction in replacing the
parts, free of charge. The entire PolyPrinter can be disassembled and reassembled with hand
tools. It does, however, require dextrous manipulations and a"feel" for mechanical things.
If you prefer to have PolyPrinter perform the labor, you may bring or send your machine to us at
your expense (both ways) and we will do the repair, with no labor charge. Otherwise, you may
purchase an Onsite Service Plan which is an annual service travel plan whereby PolyPrinter
travels to your location to perform Warranty work.
Continuous Improvement vs New Models and Versions
We intend for the PolyPrinter to continually evolve. We intend to keep improving it in minor and
major ways for a long time. Each PolyPrinter represents the "state of the art" at the time it was
manufactured. The existence of newer PolyPrinters with improvements does not by itself imply
that your PolyPrinter has a defect covered by the warranty. The warranty only covers
components that were not manufactured correctly or could not fulfill their intended function to
the degree they were specified to at the time.
New PolyPrinters come with a 12 Month "carry-in" warranty.
The warranty begins the first day the printer is in customer's possession.
Warranty is renewable for an annual fee, which is subject to price adjustment by PolyPrinter at
each renewal. When warranty expires it is up to PolyPrinter's discretion to allow for a warranty
extension.
PolyPrinter
PolyPrinter 229, 508, 465dx, 325dx Warranty
The warranty covers:
• Failures due to defects in manufacturing
. Design problems impeding functional printer operation
• Two-way shipping of replacement parts
• Labor at a designated PolyPrinter service facility
• Email and live telephone support for diagnosis and repair
• Breakage or wearing-out of vital things that are not nominally wear items:
o Extruder
o Bearings
o Rods
o Belts
o Heaters
o Motherboard
The Warranty does not cover:
• Obsolescence
. Mistreatment
• Consumables or wear items.
o Nozzles
o Filament
o Bed Tape
o Air Filters
• Shipping the entire printer
. Cosmetic Damage
. Onsite labor
o Power Supply
o Cables
o Motors
o Printed components
o Wiring harness
o Fans
Warranty does not cover general printer maintenance:
• Replacing Nozzles
. Replacing Bed Tape
. Replacing Air Filters
• Re-calibrating the Z-height
�
PolyPrinter
PolyPrinter 229, 508, 465dx, 325dx Warranty
Obtaining Service:
a. Customers may contact PolyPrinter Support through email at su�portCcr�_polyprinter.com or call
us at 469-844-1229, or by transporting printer to a PolyPrinter service facility listed below.
b. Customers will need to provide a description of the problem and their printer serial number
(found inside printer right-hand sliding panel).
c. PolyPrinter Support may ask customer to perform basic diagnostic tests on the printer to help
determine the issue. Support will then determine steps customer can take to fix the issue. If
necessary, Support will promptly ship replacement parts to customer and provide instructions for
installing the new parts. The defective parts may need to be returned to PolyPrinter. PolyPrinter
will choose the method, and pay for shipping both ways.
Rev. 2022/02/17
3
PolyPrinter is a 3D printer manufacturer based in Midlothian, Tx. We design and manufacture
our 3D printers in Texas. Many of the parts are manufactured in-house and those that aren't we
are able to modify. This ability results in high quality and reliable 3D printers.
We also offer services like printer delivery, onsite service visits, and staff training in order to help
our customers start and maintain a productive 3D printing program.
In addition, we offer all of the supplies and tools 3D printers need in order to operate effectively
and properly be maintained.
All products and services can be found at www.polyprinter.com.
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 Form 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 a potential Agreement with the City. Updated Questionnaires must be filed in conformance with
Chapter 176.
A copy of the Questionnaire Form CIQ is enclosed with the 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 Vendor name in the # 1, use N/A in each of the areas on the form.
However, a signature is required in the #4 box in all cases.
Revised 6.2518cg
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This qusstlonnaire ratlects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFRCEUSEONIY
This questionnaire is being filed in accordance with Chapter 7 7B, Local Govemment Code, by a vendor who Date Received
has a businass relationship as defined by Section 176.001(1•a) with a local governmentat entity and the
vendor meets requirements under $ection 176.006(a).
By law this questionnaire must be �led with the records administaror of the IoCzl governmental entlry not later
tl�an the 7th business day aker fhe date the vendor beComes aware of facts that require the statement to be
filed. See Section 176.096(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Sec6on 176.006, Local Government Code. An
offense under this seaion is a misdemeanor.
� Name of vendor who has s(wsines� relationship with local governmernal entity.
T b ��Qf t n�-�c.r
2
� Check this box if you arefiling an update to a previously filed questionnaire. (The law requires that you file an updated
compieted questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.j
3 Mame of local government officer about whom the information ig being disdosed.
� 1�
Name of Officer
4 Describe eech employment or other lwsiness relationship with the local governmeirt offlcer, or a famity member of the
officer, as described by Section 176.003(a)(2){A). Also describe any family relationship with the local governmeM officer.
Complete subparts A and B for each employment or business relatlonship described. Attach additional p�ges to this Form
CIQ as ne�ssary.
N�p
A. Is the IoGal government officer or a family member of the officer ret�
other than investment income, from the vendqr?
� Yes � No
8. Is the vendor receiving or likely to reCeive taxable income, other than ir
of the local government officer or a family member of the officer AND th�
local governmental entity?
� Yes � No
5 Describe each employment or business relationship Uiat the vendor named in Se
other business eirtity wiih respect to which the local government officer serve
ownership interest of one percent or more.
6
�Check this box if the vendor has given the local government officer or afamity
as described in Section 176.003(a)(2)(B), excluding gifts described in Sec
7
� �
ignature of ven or d' g iness with ihe govemmental entity -
F4rm provided by Texas Ethics Commission www.ethics.state.tx.us
CONFLICT OF INTEREST GIUESTIONNAIRE
For vendor doing business with local governmental entity
Acomplete copy of Ghapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/
Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code § 176.001(1-a�: "Business relationship" means a connection between two or more parties
based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code § 176.003(a)(2)(A) and (B):
(a) A local government officer shall file a conflicts disdosure statement with respect to a vendor if:
(2) the vendor:
(A} has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
vendor;
(B) has given to the local government officeror a family member of the officer one or more gifts
that have an aggregate value of more than $100 in the 12-month period preceding the date the
officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
{ii) the local governmental entity is considering entering into a contract with the vendor.
Local Go�ernment Code � 176.006(a) and (a-1)
(a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity, or a family member of the officer, described by Section 176.003{a){2){A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer, one or more giftswith the aggregate value specified by Section 176.003(a){2){B), exduding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A} begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application, response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
{2) the date the vendor becomes aware:
(A} of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B} that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
Revised 7.1118cg