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HomeMy WebLinkAboutContract 61629CITY OF FORT WORTH COOPERATIVE PURCHASE AGREEMENT This Cooperative Purchase Agreement (“Agreement”) is entered into by and between Rainbow Water Purification (“Vendor”) and the City of Fort Worth, (“City”), a Texas home rule municipality. The Cooperative Purchase Agreement includes the following documents which shall be construed in the order of precedence in which they are listed: 1. This Cooperative Purchase Agreement; 2. Exhibit A – Seller’s Price List 3. Exhibit B – Cooperative Agency Contract Buy Board 691-23 4. Exhibit C – Conflict of Interest Questionnaire Exhibits A, B, and C, which are attached hereto and incorporated herein, are made a part of this Agreement for all purposes. Vendor agrees to provide City with the services and goods included in Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto. 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 ($100,000). Vendor shall not provide any additional items or services or bill for expenses incurred for City not specified by this Agreement unless City requests and approves in writing the additional costs for such services. City shall not be liable for any additional expenses of Vendor not specified by this Agreement unless City first approves such expenses in writing. The term of this Agreement is effective beginning on the date signed by the Assistant City Manager below ("Effective Date") and expires on March 31, 2025. The City shall be able to renew this agreement for an additional one-year renewal option or as allowed by the Buyboard Cooperative. Vendor agrees that City shall, until the expiration of three (3) years after final payment under this Agreement, or the final conclusion of any audit commenced during the said three years, have access to and the right to examine at reasonable times any directly pertinent books, documents, papers and records, including, but not limited to, all electronic records, of Vendor involving transactions relating to this Agreement at no additional cost to City. Vendor agrees that City shall have access during normal working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor reasonable advance notice of intended audits. Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have been delivered when (1) hand-delivered to the other party, its agents, employees, servants or representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3) received by the other party by United States Mail, registered, return receipt requested, addressed as follows: To CITY: City of Fort Worth Attn: Fernando Costa, Assistant City Manager To VENDOR: Rainbow Water Purification Giovanni Varela Sr. Owner Address: 200 Texas Street Fort Worth, TX 76102-6314 Facsimile: (817) 392-8654 With copy to Fort Worth City Attorney’s Office at same address 12431 Cutten Road Houston, Tx 77066 Facsimile: NA The Agreement and the rights and obligations of the parties hereto shall be governed by, and construed in accordance with the laws of the United States and state of Texas, exclusive of the conflict of laws provision. Venue for any suit brought under the Agreement shall be in a court of competent jurisdiction in Tarrant County, Texas. To the extent the Agreement is required to be governed by any state law other than Texas or venue in Tarrant County, City objects to such terms and any such terms are hereby deleted from the Agreement and shall have no force or effect. 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: Fernando Costa Title: Assistant City Manager Date: APPROVAL RECOMMENDED: By: ______________________________ Name: Christopher Harder, PE Title: Director, Water Department ATTEST: By: ______________________________ Name: Jannette Goodall Title: City Secretary 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: Shatabya Bergland Title: Contract Compliance Specialist APPROVED AS TO FORM AND LEGALITY: By: ______________________________ Name: Jeremy Anato-Mensah Title: Assistant City Attorney CONTRACT AUTHORIZATION: M&C: N/A VENDOR: Rainbow W'atcr Purification By: _;1��. L/-� Nan�c: Giovanni Varc�a 5r. 1'itic: Ov��ner 12.5-15% SODIUM HYPOCHLORITE 55 gallon drum $453.00 12.5-15% SODIUM HYPOCHLORITE 330 gallon ibc tote $2,676.00 Sodium Chloride Salt Bags 40lbs 63 bags per pallet $13.77 Sodium Chloride Salt Bags 50lbs 49 bags per pallet $14.95 Sodium Chloride Brine Solution 5000 gallons tanker $.65 / $3,250.00 10% High Chlorine Resistant Exchange Calcium Removal Resins 1 bag $250.00 10% High Chlorine Resistant Exchange Calcium Removal Resins 42 bags full pallet $6,825.00 COMMERCIAL WATER SOFTENER PREVENTIVE MAINTENANCE SERVICES Monthly Service Charge $250.00 RAINBOW WATER PURIFICATION 12002 CASSANDRA LANE HOUSTON, TEXAS 77064 R R CE L ST 202 U OARD 6 1 2 pe Hot & Cold Systems 5 gallon $/Lb weight total 15 gallon $/Lb weight total 55 gallon $/Lb weight total 05 - RWP 10 RWP 10M RWP 12 RWP d Water Closed Loop $ 3.80 43 $ 163.40 $ 3.75 130 487.50 $ 3.50 475 $ 1,662.50 $ 3.65 45 $ 164.25 $ 3.50 135 $ 472.50 $ 3.40 500 $ 1,700.00 $ 3.90 45 $ 175.50 $ 3.85 135 $ 519.75 $ 3.60 500 $ 1,800.00 $ 3.85 47 $ 180.95 $ 3.80 142 $ 539.60 $ 3.70 520 $ 1,924.00 $/Lb weight total $/Lb weight total $/Lb weight total C-440 RWP C-470 RWP Hot Water Closed Loop $ 2.95 43 $ 126.85 $ 2.90 129 $ 374.10 $ 2.80 467 $ 1,307.60 $ 3.25 45 $ 146.25 $ 3.20 135 $ 432.00 $ 3.30 500 $ 1,650.00 $/Lb weight total $/Lb weight total $/Lb weight total C-501 RWP C-530 RWP Cooling Tower Chemicals $ 1.20 46 $ 55.20 $ 1.15 140 $ 161.00 $ 1.05 510 $ 535.50 $ 1.15 54 $ 62.10 $ 1.10 162 $ 178.20 $ 1.00 600 $ 600.00 $/Lb weight total $/Lb weight total $/Lb weight total B-307 RWP B-3110 RWP B-394 RWP Other HVAC Chemicals $ 4.52 52 $ 235.04 $ 4.47 156 $ 697.32 $ 4.37 425 $ 1,857.25 $ 4.25 40 $ 170.00 $ 4.20 125 $ 525.00 $ 4.10 425 $ 1,742.50 $ 4.00 50 $ 200.00 $/Lb weight total $/Lb weight total $/Lb weight total C-750 RWP C-722 RWP Other HVAC Chemicals $ 3.35 43 $ 144.05 $ 3.30 129 $ 425.70 $ 3.20 475 $ 1,520.00 $ 3.05 42 $ 128.10 $ 3.00 126 $ 378.00 $ 2.95 470 $ 1,386.50 $/Lb weight total $/Lb weight total $/Lb weight total C-440 RWP C-700 RWP C-757 RWP C-2000 RWP Other HVAC Chemicals $ 3.45 42 $ 144.90 $ 3.30 126 $ 415.80 $ 3.20 465 $ 1,488.00 $ 3.25 50 $ 162.50 $ 3.40 54 $ 183.60 $ 3.35 162 $ 542.70 $ 3.25 600 $ 1,950.00 $ 3.75 50 $ 187.50 $ 3.70 150 $ 555.00 $ 3.60 550 $ 1,980.00 $/Lb weight total $/Lb weight total $/Lb weight total C-401: RWP $ 2.85 57 $ 162.45 $ 2.60 171 $ 444.60 $ 2.50 627 $ 1,567.50 Two Pi C- C- C- C- Chill RAINBOW WATER PURIFICATION 2023 PRICE LIST WATER TREATMENT CHEMICALS BUY BOARD CONTRACT # 691-23 MUNICIPAL WATER TREATMENT CHEMICALS 330 IBC & 55 GALLON DRUM – LIQUID CHLORINE, COMMERCIAL GRADE 12.5-15% SODIUM HYPOCHLORITE | NSF 50/60 CERTIFIED Commercial-grade sodium hypochlorite liquid chlorine NSF-grade. This 12.5-15% strength sodium hypochlorite is available in 55-gallon drums. Easy- to-use, fast, and effective – no mixing required. MUNICIPAL WATER TREATMENT EQUIPMENT LMI DIGITAL CHEMICAL DOSING INJECTION PUMPS HVAC Cooling Water Treatment C-405 is a blend of corrosion and scale inhibitors with dispersants systems that is designed to work in hard, alkaline water. This product works well without the use of acid for pH control. Using C-405, cooling water total hardness may be concentrated up to 1000 ppm in normal operations. HVAC Cooling Water Treatment C-410 is a single solution synergistic blend of stable and effective copper corrosion inhibitors, carbon steel corrosion inhibitors, and scale inhibitor-dispersants. An industrial/heavy commercial cooling water treatment for systems with hard make-up water. C- 410 is compatible with chlorine, bromine, chlorine dioxide and most common biocides. C-410 does not add alkalinity to the water. Cooling Water Treatment – C-410 with molybdate HVAC Cooling Water Treatment A cooling water treatment formulated for higher cycles of concentration. C-412 eliminates the need for pH control with acid. C-412 is compatible with chlorine, bromine, chlorine dioxide and most common biocides. C-412 reduces the alkalinity of the water. HVAC Chilled and Hot Loop Treatment An azole free, organic formulation, corrosion inhibitor package including scale inhibitors. This product is considered non-polluting, is effective for most dirty, scaled or fouled water systems, and does not contain nutrients that promote bacteria growth. The C-440 series products do not contain Tolytrialzole, Nitrites or Molybdate HVAC Nitrite/borate based Chilled and Hot Loop Treatment – Molybdate tracer is available A traditional formula where older product specification are still used. This product is effective in both hot or cold water systems to prevent corrosion. It is considered a non-polluting water treatment product Complete Treatment A single solution of dispersants, scale inhibitors, sulfite oxygen scavengers, and amines. This product will slowly remove old deposits, while acting as an iron transport agent and dispersant. C-501 is a boiler water conditioner for control scale, iron and to improve heat transfer. C-501 has the combined features of polyacrylates and phosphonates without the problems of hydrolytic and thermal instability. Oxygen Scavenger Catalyzed sulfide oxygen scavenger for boiler water make-up. Oxidizing BioCide Utilizes the nonoxidizing property of bromine, is less corrosive than chlorine products, is safer for multimetal systems, is more stable and a better penetrant than other products Non-Oxidizing BioCide A long-lasting, low foaming biocide with surface active properties. This algicide is very effective against microbiological slime. An additional biodispersant is not required to loosen the biomass. Bromine Tablets BioTabs can be regenerated with a small amount of chlorine or ozone to produce a low-cost biocide. This product is an organic- bromine compound used for disinfection of industrial water systems Organic-bromine is used to control microbiological growth, especially foulants and corrosive bacteria. Cooling water dispersant for mud and biomass, compatible with chlorine and bromine Cooling water dispersant for mud and biomass Chilled and Hot Loop, New Construction Pretreatment/Cleaner/Passivator, Piping Cleaner An enhanced C-440 solution with dispersants and surfactants added. This product is used to clean and passivate both old and new piping systems. C-440S is highly effective for cleaning most dirty, scaled or fouled water systems, is considered non-polluting and can be flushed to the drain. Organic Acid Crystals, Sulfamic acid Sulfuric Acid Replacement, Safer for Cooling Towers System Cleaner Based on fruit vinegar, this product has good oil and grease tolerance. It is a safer acidic water system cleaner This product is a linear chain phosphate forms a thin protective film on metal pipes. The film prevents corrosion and stops lead from leaching into the water. C-401 is a food grade, scale and corrosion inhibitor used to enhance the quality of potable waters. C-401 has a long half-life and is effective for large water distribution systems. WATER SOFTENER SALTS SODIUM CHLORIDES & LIQUID BRINE SOLUTION 26% Sodium Chloride Salt Bags 40lbs - 63 bags per order Sodium Chloride Salt Bags 50lbs - 49 bags per order Sodium Chloride Brine Solution - 5,000 gallons per order WATER SOFTENER CAT-ION STYRENE RESINS DOMESTIC 10% High Chlorine Resistant Exchange Calcium Removal Resins - 1 cuft bags 10% High Chlorine Resistant Exchange Calcium Removal Resins - 42 bags per MODEL Number and List Price Single MGT-600-3 $23,960.00 Single MGT-300-2 $19,089.00 Single MGT-210-2 $16, 800.00 Single MGT-300-3 $20,569.00 Single MGT-450-3 $21,151.00 Twin MGT-450-3 $32,249.00 v.02.01.2021 February 7, 2023 Sent Via Email: g@rwptx.com Giovanni Varela Sr. Rainbow Water Purification 12002 Cassandra Lane Houston, TX 77064 Welcome to BuyBoard! Re: Proposal Invitation No. 691- 23, Water Treatment Chemicals and Pipe Bursting Equipment Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard® contract based on the above-referenced Proposal Invitation. The contract is effective for an initial one-year term of April 1, 2023 through March 31, 2024, and may be subject to two possible one- year renewals. Please refer to the Proposal Invitation for the contract documents, including the General Terms and Conditions of the Contract. To review the items your company has been awarded, please review Proposal Tabulation No. 691-23 at: www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and Conditions. The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded that, in accordance with the General Terms and Conditions, all purchase orders must be processed through the BuyBoard. Except as expressly authorized in writing by the Cooperative’s administrator, you are not authorized to process a purchase order received directly from a Cooperative member that has not been processed through the BuyBoard or provided to the Cooperative. If you receive a purchase order directly from a Cooperative member that you have reason to believe has not been received by the Cooperative or processed through the BuyBoard, you must promptly forward a copy of the purchase order by email to info@buyboard.com. A list of Cooperative members is available on the buyboard.com website. The BuyBoard vendor relations staff will be contacting you to assist with the resources available and to provide any support you may need as an awarded BuyBoard vendor. On behalf of the Cooperative, we appreciate your interest in the Cooperative and we are looking forward to your participation in the program. If you have any questions, feel free contact me at 800 -695-2919. Sincerely, Stacy Finn, Bid Analyst Texas Association of School Boards, Inc., Administrator for The Local Government Purchasing Cooperative � Boar�� Pf1RG1iA5lRG CQOPERATIVE 12�07 Research Baulevard • A�stin, Texas 78759-2439 • PH: 800-695-2919 • buybaard.cosn PROPOSER'S ACCEPTANCE AND AGREEMENT Proposal In�itation Name: Water Treatment Chemic�ls �nd Pipe Bursting �quipment Proposal Invitation Number: 69�-23 Contract Term: April 1, 2DZ3, Chro�gh March 31, 2024, with two passible one-year renewal5. Pro osal Due Date 0 enin Date and Time: September 22, 2�22, at 4:00 PM Location of PropoSal Opening: Texas Assaciation oF 5chool Boards, Inc. BuyBoard Department 12007 Research Bl�d. AuStin, TX 78759 Antici ated Cao rati�e 8oard Meetiro Date: February 2023 By signature 6elow, the undersigned acknow/edges and agrees that you are authorized to su6mit this Proposal, rncluding making all acknowledgements, consents, and certifications herein, on behalf of Proposer and, ta the best of your knowledge, the information pro vided is true, accurate, and camp/ete. RAINBQW WATER PURi�ICATION Name of Proposi�g Company 12002 Cassandra Lane 5treet Address Hauston, Texas 77064 City, State, Zip �2H 1 } 874-9736 Telephone Number of Authorized Company bfficial �28 � } 874-970fi Fax iVurnber of Authorized Company Official 09/21/2022 Qate .� Signature of Authorized Company Official Giovanni Varela Sr. Printed Name of Authorized Company Officiaf Qwne� Pasition or Title of Authorized Company OfFicial 20-3168580 Federal ID Number Page 10 of 71 Proposai Fqrrns COMM�SVC5 v.OB.11.2�21 � BaardG PURCNASING COOPERA TIVE 12007 Research Baulevard • Austin, 'Fexas 78759-2439 � PH: Sfl0-695-2919 •�boarcl,com PROPOSAL FORMS PART 1: C�MPLIANCE FORMS INSTRUCTIONS: Praposer must review and camplete all forms in this Proposal Forms Part 1: ■ Proposal Acknowledg�ments • Felony Con�iction Disclasure • Resider�t/Nonresident Certification ■ Debarment Certification • Vendar Employment Certification • Na Boycott Verification ■ Na Excluded Nation or Foreign Terrorist Organization Cefification • Histarically Underutilized Business CertiFcation � Acknowledgement of BuyBaard Technical Requirements • Constructian-Related Goads and S�rvices AfFirmation • De�iatian and Compliance • Vendor Canse�t for �Vame Srand Use • Confidential/Praprietary Information • EDGAR Vendor Certification • Complianc� Forms Signature Page An authorized representative of Praposer must initial in the bottom right curner ofi each page where indicated and complete anc! sign the Compliance Forms Signature Page. Proposer's failure to fully complete, initial, and sign farms as required may result in your Praposal heing rejected as non-responsi►+e. PROPOSAL ACKNOWLEDGEMENTS The proposing company ("you" or "your") hereby acknowledges and agrees as follows: 1. You have carefully examined and understand a�l irsformatian and documentation associated with this Propasal Invitation, including Ehe Instructians to Propasers, General Information, General Terms and Conditions, attachments/forms, appencEices, item specifications, and line items (collectively "Requirements"}, Z. By yaur response ("Proposal"} io this Proposal in�itation, you propose t� supply the products ar servfces submitted at the pricing quoted in your Propasal and in strict compliarsce with the Requirements, Unless specific de�iations or exceptions are nated in the Proposal; 3. By yo�r Proposal, you acknowledge and certify all items set forth in the General Terms and Conditions, Sectifln 8.12 {Certificatians}, Entluding all non-collusion certifications and tertifications regarding legal, ethical, and oti�er matters set fortfi� therein. 4. Any and all de�iations and exceptions to the Requirernents have been nated in your Proposal an the req�Fred form and no others wil! be clairrted; Initial: � Page i l of 71 Proposal Forms L4MMl�1C5 v.06.11.2021 ' Boar� �� . PURCHASfNG COOPERA T1YE 12007 Research Boulevard ' Auskin, Texas 78759-2439 • PH: 804-595-2919 • buyboard.com If fihe Cooperative accepts any pari of your Proposa! and awards you a Contract, you will furni5h all awarded products or se�ices at the pricing quoted and in strict compliance with the Requirements (unless specific deviations or exceptions are noted on the required form and accepted by the Cooperati�e}, including withaut limitation the REquirements related to: a. co�ducting business with Cooperative members, including af�ering pricing to m�mbers that is the besf you offe� compared to similariy situated customers in similar circumstances; b. paymer�t of a service fee in the arnount specified and as provided for in this Proposal In�itation; c. the passibfe award of a piggy-back contracC by the Natianal Purcha5ing Cooperative or nonprofit entity, in which e�ent you will offer the awarded products and services in accordance with the Requirements; and d. submitCing price sheets or catalogs in the proper farmat as required by the Cooperative as a prerequisite to activatian of your Contract; 6. You ha�e dearly identified an the included form any infarmation in your Proposal that you believe to be confidential or praprietary or that you do not cansider to be public infarmatfon subject to pub�ic disclosure under the Texas Public Inforr�ation Act or similar public information (aw; 7. The indi�idual submftting thfs PrapoSal is duly authorized to enter into the contractuai relationship represented by this Proposal Invitation on your behalf and bind you to the Re4uirements, and such indiv9dual (and any individual signing a farm or Praposal do�umeRt} is autharized and has the requisite knowledge to provide the information and make the representations and certifications required in the Requirements; 8. You have carefully reviewed your Proposal, and certify that all information pravfded is true, camplete, and accurate ta the best of your knowfedge, and you authorize the Cooperative to take such action as it deems appropriate to verify such information; anri 9. Ar�y misstatement, falsification, or omission in yflur Prflpasal, w�enever or however discovered, will be grounds for disqualifying you from consideration for a contract award under this Proposa! In�itation, termination of a contract award, ar any other remedy or actian provided for in �he General Terms and Conditions or by I�w. FELONY CONVICTION DISCLOSURE 5ubsectian (a) of Section 44.034 nf the Texas Education Cade (Notification of Criminal Flistory of Contractor) states: "A person or l�usiness entity thak enters inta a contract with a schoal district must give ad�ance �otice to the district if the person or an awner or aperator has been co�victed of a feiany. The notice must include a general description of the Cor�dlECt r�SUltin� in the canvictian of a felony." Section 44.Q34 further states in 5ubsection (b): "A 5chool distrit�t may terminate a contract with a person or busin�ss entity if the district deterrr�ines that the person or business entity failed to give notice as required by 5ubsection (a) or misrepresented the canduct resulting in the ton�ickiors. The district must compensate the person or business entity for services perfarmed before the termination of the contract." Please check (,/) one of the followin�; ❑ My COmpdny IS d pUbllCly-hflld CO��O�dt10il, (Advance no6ce requirerrsent does not apply to publicly-held corporation.} �■ My campany is not owned ar operated by anyone who has been convicted of a felony. ❑ My campany is awned/operated 5y the fo!lowing in�ividual{s) whfl has�have been eonvicEed of a Felony: Name of Felon(s}: D�tails of Con�iction(s}: Initial: � Page 12 of 71 Prpppsal FormS COMMf5VC5 v.U8.11.2U2J. s Board� Puxt►�asiHc Canvicear�vF 120D7 Research Boulevard • Austin, Texas 78759-2439 ' PH; 800-695-2919 ' buvboard,com RESiDENT/ NONRESiDENT CERTIFICATION Chapter 225Z, Svbchapter A, of the Texas Government Code establishes tertain requirements applicabie to proposers who are not TexaS residents. Under the statute, a"resident" proposer is a person whose principal place of busine5s is in Texas, including a contractor whose ultimate parent Company or majority awner has its principal place af business in Texas. A "nonresident" proposer is a person who is not a Texas resident. Please incficate the status of yaur company as a"resident" proposer or a"nonresident" proposer u�der these definitians. Please check (d) one of the followir�a: ❑■ I certify that my company is a ReSident Propvser. ❑ I certify that my compa�y is a Nonresident Proposer. If your company is a Nonresident Proposer, you must pravide the following information for your resident state (the state in which your company`s principal plac� of business is located): Company Name City Address State Zip Code A. Does your resident state require a prop�ser whose principal place of business is in 7exas to under-price proposer5 whase resident statE is the same as yours by a prescribed amount or percentage to recei�e a�omparable contract? ❑ Yes ❑ No What is the prescribed amount or percentage? � or % DEBARMENT CERTI�ICATIQN By signature on the Compliance Forms 5ignature Page, I certify that Refther my campany nor an owner or principal of my company has been debarred, suspended or otherwise made ineligible for participation in Federal Assistance programs under Executive Order 12549, "Debarment and Suspension," as described in the Federal Register and Rules and Regulations. Neith�r my corrEpany nar an owner or principal of my company is currently listed on the government-wide exclusions in SAM, debarred, suspended, or otherwise excluded by agencies or declared ineligib�e under any s[atutory ar regulatory authority. N�y com�any agrees to immediatefy notify the Cooperative and all Cooperative merrtber5 with pending purchases ar seeking to purchase from my campany if my company or an owr�er or principal is later �isted on the government-wide exclusions in SAM, or is debarred, suspended, or otherwise exckuded by agencies or declared ineligible under any stat�,tory or regulatory authority. VENDQR EMPLOYMENT CERTIFICATION 5ection 44.Q31(b} of the Texas Education Code establishes �ertain criteria that a school district must cansider when determinEng to whom to award a contract. Arr�ong the criteria for certain cantracts is whether the vendor or the �endor'S ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii} employs at ieast 5QQ peop�e in Texas. If neither your eompany nor the ultimate �arent company ar majority owner has its principal place of business in Texas, does yaur company, ultirr�ate parent company, ar majority ow�er employ at lea5t 500 peopEe in Texas? Piease check [d) one of the followinq: ❑ Yes � �ko Initial: � Page 13 of 71 �roposal Forms COMM/S11C5 v.08.i1.2621 � Boar�� PURCHASfNC C40PER4TIYE 12D07 Ftesearch Boulevard � Austin, "�exas 78759-2439 ' PH: 800-695-2419 • buybaard.com NO BOYCOTT VERI�ICATION A TexaS governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or partiy frorn public funds with a company (excluding a sole proprietorship) that has �0 ar more full-time empioyees for goods ar 5ervices unless the contract contains a written verification from the tornpany that it: (1} does not boycott Israel and will nat bayco�t Israel during the term of the contract (TEx. �ov�T CQDf C�1. 2271), (Z� t�0e5 flOt I}pyCD1t 2ll�C'�y COfT1PaF1125 dfld wilf not boycott energy campanFes �uring the term of the cantract (TEx. Gov`T CoaE Ch. 2274 effective 5eptember 1, 20Z1), and (3) daes not have a practice, palicy, guidance, or directive that discriminates against a�rearm entity or frearm trade associatian and will nat discriminate during the term of the contract against a firearm entity or firearm trade association (T�x. Gov'T Ca�E Ch. 227�+ effettiye 5eptember 1, 2021). Accordingly, this certification forrr� is included ta the extent required by Iaw. "Boycotk Israel" means refusing to deal with, terminating business acti�ities with, or otherwise taking any action that is intended to penalize, irtflict economit harm on, or fimit commertial reGations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ardinary business purp�ses. TEx. Gov'r CooE §808.00f(1). "Boycott energy company" means, without an ordinary busi�ess purpose, refusing to deal with, terminating business activities with, or otherwise taking any action that is intended ta penalize, inflic� economic harm on, or limit commercial relations with a company because the torr��any: (A) engages in th� exploration, production, utilization, tr�nsparta#ion, sale, or manufacturing of fo5sil fuef-based energy and does not cornmit or pledge to meet en�ironmental standards beyond applicable federa! and state Eaw; or (S) does business with a company described by Paragraph {A). T�x. Go�'T Co�E §809.001{1) {effettive September 1, Z021), "Qiscriminate against a firearm entity or firearm trade associati�n" means, (A} with respect to the entiry or association, to: (i) refuse to engage in the trade of ar�y goods or 5ervices with the entity or associakion based solely an its statt�s as a firearm entity or �ir'earm trade association; (ii} refrain fram continuing an existing business relatianship with the entity or association basecf solely an its status as a flrearm entity ar firearm trade association; or (iif) terminate an existing business relationship with the entity or assaciatiar� based soiely on its status as a firearm entity ar firearm trade association; and (B) does �ot include: (i) the established palicies of a merchant, retai! seller, ar platFarm that restrict ar prohibit the listing or selling of a�munition, firearms, ar firearm a�cessorie5; and (ii) a company's refusal to e�gage in the trade of any good� or services, decision to refrain from cnntinui�g an existing business relationship, or decision tq terminate art existing business relationship: (aa) io comply with federal, state, or local law, policy, or regulatians or a directive by a regulatory agency; or (b�) for any traditianai business reason that is specific to the custorner or potentiai customer and nat based salely on an entity's ar association`s status as a firearm entity or firearm trade as5ociation. TEx. Gov'r Co�e §ZZ7h.Q0�(3) (effeckive September l, 2021). By signature on the Cnmpliance Forms 5ignature Page, to the ex[ent applicable, I eertify and verify that Vendor does not boycott Israel, boycott energy companies, ar discriminate agai�st a�rearm entity or firearm trade association and will nat do so during the term of any contract awarded under this Proposal Invitat�or�, that this certificati�� is true, complete and aceurate, and that I am autharized by my company io make this certification. Initial: � •� . Page 14 of 71 Proposal Forms COMMJSVCS vAB.lI.202i ' Boar�V . vuacNasrHc cooPEeb r+vE 12007 Research Baulevard � Austin, Texas 78759-2439 • PH: 800-695-2919 ' b�board.�om NO EXCLUDED NATIQN OR FOREIGN TERRORIST ORGAN�ZATTON GERTIFICATION Chapter 2Z5� of the Texas Government Code provides that a Texas governmentai entity may nflt enter into a �ontract with a company engaged in acti�e business operations with S�dan, Iran, ar a foreign terrorist organization — specifically, ar�y company identi�ed on a list prepared and mafntai�ed by the Texas Camptroller under Texas Governrrient Code ��8a6.d51, 807.D5i, or 2252.153. {A company that the U.S. Government affirmatively declares to be excluded fram its federal sanctions regime relating to Sudan, Iran, ar any federal sancEions regime relating to a foreign terrarist organization is not subject to the contract prohib�tion.} 6y signature on fhe Compliance Forms Signature Page, I certify a�d verify that Ver�dor is nat on the Texas Comptroller's list identified above; that this certifcatian is krue, complete and accurate; and that I am authorized by my company to make this certificafion. HISTORICALLY UNDERUTILIZED BUSINE,SS CERTIFICATION A Propaser that has been certified as a Historically Underutilized Business (also known �s a Minority�Women Business Enterprise ar "MWBE" and a!I reFerred ta in this Form as a"HUB'� is encouraged to indicate its HUB certification status when responding to this Proposai Invitation. The BuyBoard website will inditate HUB certification5 far awarded V�ndor5 th�t properly indicate and dacument their HUB certification on this form. P�ease check (�j all that a���lv: � I certify thaE my company has been certified as a HUS in the foliowing categories: � Minori#y Owned Business ❑ Women �wned Bvsiness ❑ Service-Disabfed Veteran Owned Business (veteran defned by 38 U.S.C. §101{2), who has a service-connected disability as defined by 38 U.S.C. � 101(16), and wha has a disability rating of 20% or more as �etermined by the U, 5. Department of Veterans Affairs or Department of Defense) Certi�ca�ion Number: �a-�2-�2g33; �2o3�ssssasao Name of Certifying Age�ty: �ity of Houston tNSE Hl1B ❑ My company has NOT been certiFed as a HUB. ACKNOWLEDGEMENT OF BUYBQARD TECHNICAL RE UIREM�NTS Vendor shall review the BuyBaard iechnical Requirements included in this Proposal Invitatian. By signature on the Campliance Forms Signature Page, the undersigned afFirms that Praposer has obtained a copy flf the BuyBoard Technical Requirements, has read and understands the requirements, and certifies that Vendor is able to meet and will comply with those requirements except as follows: �List and �xplain BuyBoard Technrca/ Requiremen�s, if any, to which your company cannot or wrll not c'omp/Y J Nate: in accordance with the General Terms and Conditions aF the Contrack, to the extent Vendor is awarded a Contract under this Proposal Invitation but is unable or unwifiing to rneet the applicable BuyBoard Technical Requirernents, the information available on �he BuyBoard for Vendor's awarde� products ar services may be limited, potentially placing Vendor at a disadvantage and impacting fhe ability of Cooperative members to search, find, review, and purchase Vendor's awarded praducts and senrices on the BuyBoard we6site. Further, to the extent Vendor h�s acknowledged �bility to m�et dnd Comply with the Buy6oard Technical Requirements, any su6sequent faiiure or ref�saf by Vendor to promptly provide informativ� upon request to the Cooperati�e administrator in accordance with �hose technical requirer�-ients may be deemed an event af default under the Contract. Initial• �•1J • Page 15 06 71 Prpppsal Fprms COMMJSVCS v.08.11.20�1 � Boar�m PURCHAS�AC COOPENA T1YE 12007 Res2ar[h Baulevasd • Austin, Texas 78759-2439 • PH: 800-595-�919 ' bE,.y_board.com CONSTRUCTION-RELATED GOODS AND SERVICES AFFIRMATION The Cooperative issued the BuyBoard �rocurement and Construc[ion-Reiated Goods and Services Advisory far �exas Members {"Advisory"}, which pravides information specificaiiy relevant to the procurernent of construction-r�lated goads and services by Texas Coaperative members. The Advisory, availabfe at buvboard.carn/VendolResources as�, provides an overview of certain legaf requirements that are potentiafly relevant to a Caoperative member's procurement of c�nstructiar� or c�nstruc�ifln-related goods and services, including those for projects that may involve or require architecture, engineering or independent testing servfces. A copy of the Advisory can also be provided upon request. Because many BuyBoarcf contracts include goods or installation services that might be considered construc�ian-related, PrapQser must make this Canstruction Related-Goods and Services Affirrrtation regardless of type of gaads or services associated wikh this Proposa{ Invitation. A contract awarded under this Propasal invitation covers only the specific goods and�or ser�ices awarded by the Cooperati�e. As explained in the Ad�isary ("Advisory"), Texas law prohibits the procurement of architecture or engineering services through a purchasing cooperative. This Propasal Inr►itatian and any Contract awarded thereunder does not include such services. Architecture or engineering ser�ices must �e proc�red by a Cooperative member separately, in accordance witi� the Professional Serrrices Pracurement Act (Chapter 2254 of the Texas Government Code) and other applicable law �nd local polity. By signature on the Compliante Forms Signature Page, Proposer affirms that Proposer has obtained a iopy of the Advisory, has read and understands the Advisory, and is autharized by Proposer to make this affirmation. If Proposer �ells construt�ion- related goods or servites to a Cooperative member under a Contract awarded under this Proposal Invitatian, Propaser will comply with the Advisory and applicabke legai requirements, make a good faith effart �o make its Cooperative member customers ar potential Cooperative member customers aware of such requirements, and provide a Cooperative member with a copy of the Advisory befare accepting the member's Purchase Qrder or other agreement far construction-related goods or services. Initial�• �• f'age 16 af 71 Proaosai Forms CaMMlsvcs v.oa.�l.2an ' Boar�� . PURCHA SlML CDOP£RA iI VF 12007 Research Boulevard � Austin, Texas 78759-�439 • PH: 800-695-�919 • buyboard.com DEVIATION AND COMPLIANCE If your company intends to deviate fram fhe General Terms and Conditions, Proposal 5pecification5 or other requirements assoeiated with this Praposal Invitation, you MUST list all such deviations on this forrn, and pro�ide complete and detailed infarmation regarding the daviations an this form or an attachment to this form. Pr�or to co�nplet�ng this form, Vendor shall review the General Terms and Conditions seciion B.4 (Deviations from Item Specifications and General Terms and Canditions). Please note that, as pravided in sectian B.4, certain pro�isions of the General 7erms and Conditians are NOT svbject to de�iation, and certain de�iations will be deemed rejected without further action by the Coaperative. Any attempted deviation, whet�er directly or indirectfy, to pro�isions identified in this Proposal in�itation as not subje�ct to de�iation shall be deemed rejected by the Cooperati�e and, uniess otherwise withdrawn by Vendor, may result in Vendor's Praposal beiRg rejected in its entirety. The Cooperative will consider any deviations in its contract award decEsian and reserves the right to accept or rejeck a proposal based upon any su6mitted deviation. In the absence of any de�iatian identif[ed and described in accordance with the abo�e, your company must fully comply with the General Terms and Ca�d+tions, Proposaf Specifications and all other requirements associated with tf�is Proposal InviCat9on if awarded a Cantract under this Proposal Invitation, A deviatian will nat be e�Fective unless accepted by the Cooperative. T�e Coflperative, by and through the Cooperative administratar, may, in its sole discretian, seek clarificatian from and/or communicate with Proposer{5) regarding any submitted de�iation, consistent with general procurement principles of fair competition. The Cooperative reserves the right to accept or reject a Proposal based upon any submitted deviation. Please_check {�) one of the following_ ❑■ N�; Deviations ❑ Yes; Deviations List and Fukly exp�ain any �eviations you are submittir�g; IRitial: �• Page 7.7 of 71 Proposa! Forms COM M/SI/CS v.08.11.2021 � B�ar�� ➢URCHd S1kC COOPER671 YE i2Q07 ReSearch Boulevard � Austin, Texas 78759-2439 • PH: BQO-695-2919 • buvboard,com VENDOR CONSENT FOR NAME BRAND USE BuyBoard members seelcing to make purc�ases using a Contract awarded under this Prapasal Invitation may view information regarding awarded Vendors, including but not limite� to proc#uct catalogs, pricelists, prieing, and Proposals, thraugh the BuyBoard website. To improve and enhance the experience af BuyBoard members seeking to procure goads and services under the Conkract utilizing the BuyBoard website, any Vendor logo, praduc� images, and similar brand and trademark inforrnation pro�ided by Vendor for purposes of the Can�ract ("Vendflr Infarmation"} may be posted on the BuyBoard website, You acknawledge that, by submitting your Proposal, unless you specifically opt out below, you consent to use of yoe�r company's Vendor Information on the BuyBoard website if awarded a Cantract. You further acknowledge that whether, where, and when ta include the Vendor Ir�FormaCion on the BuyBoard websEte shall be at the sole discretion of the BuyBoard Administrator. Vendor retains, however, the right of generai quality control over the 6uyBoard Administrator`s authorized display of praprie�ary Vendor Infarmakion. Neither the BuyBoard rsar its administratar will be responsible for the use or distri�ution of Vendor Information by BuyBoard members or any other third parly using the BuyBaard website. This Vendor Consent shall be effective far the full term of the Cantract, incfuding renewals, unless Vendor provides a signed, written notice revolcing consent to corttractadminCabuybaard.carr�. BuyBoard shall ha�e up to thirty days from the date of receipt of a termination or revocation of a Vendor Consent to remove Vendar information fram the BuyBoard website. ihis Vendor Cansent is subject to the T�rms and Conditions of the Co�tract, including, but not limited to, those terms pertaining to Disclaimer of Warranty and Limitation of Liability, Indemnification, and Intellectuai Property I�fringerr�ent. Vendar loga files must be submittet! in one of the formats set forth in the BuyBoafd 7echnical Requirements. Proposers are requested to su�mit this informatron with Vendor`s Praposal, (This consent shall not autharize use of your campany's Vendor Information by BuyBoard if your company is not awarded a Contract.} OPT OUT: If your company wishes to opt out af the Vendor Consent for Name Brand Use, yau must check the opt aut box beaow. DO NOTselect this 6ox unless your company is opting out of this Vendor Consent for Name Brand Use, ❑ By checking this box, Vendor hereby declines to pravicie consent for use of Vendor Information (as cfefined herein) on the BuyBaard website. By opting aut, Vendor acknowledges antf agrees that, if Vendor is awarded a Contract uncter this Propasal In�itation, informatian avai�able on the BuyBoard for Vendor's awarded products or services may be lim�ted, potentially placing Vendor at a disadvantage and impacting the ability of Caoperat't�e members to search, find, review, and purchase Vendor's awarded prade�cts and services on the BuyBoard website. Initial:� Page 18 of 71 propQsal Forms COMM/SVCS v,08.11.2p21 ' Boardv . PURCNASiHG COOPERATIYE 12007 Research Boulevard • Austin, TexaS 78759-Z439 • PH: 800-b95-2919 ' buyboard.com CONFIDENTIAL PROPRIETARY INF�RMATION A. Public Distlosure Laws All Proposals, forms, documentation, catalogs, pri�elists, or other materials submitted by Vendar to tt�e Cooperative in response to this Proposal Invitation, rnay be subject to the disclasure requirements of the Texas Public Information Act (Texas Go�ernment Code chapter 552.OQ1, et. seq.) or similar disdosure law. �ropaser must clearly identify on this form any in�ormation in its Proposaf (including forms, documentation, or other materials submitted with the Proposal) that Proposer consider5 proprietary or confidential. If Prap�ser fails to properly identify the information, the Caoperative shal� have no obfigation to notify Vendor or seek protection of su�� information from pubfic disclosure shou�d a member of the publi� or flther third party request access to the information under the Texas Public Informatian Act ar simiiar disclosure law. When required by the Texas Public Informatfon Act or ather cfisclosure law, Proposer may be natifed af any third-�arty request for information in a Proposal that Proposer has identified in this form as proprietary ar confidential. Does your Proposaf (including forms, dacumentatian, catalags, pricelists, or ofher materials submitted with the Proposal) contain information which Vendor cansiders proprietary or confident+al? Please check (�jl one of the followina: � N0, I certify that none of khe information included with this Proposal is considered confidential or proprietary. � YE$, I certify iriat this Proposal contains information considered confideRtia! or pro�rietary and all suc3� information is specifically identified on this form. If yau responded "YE5", you must cleariy identify below the specific information you consider confidential or proprietary. List each page number, form number, ar other infarmatian sufficient ta make the information readily identifiabie. The Cooperative and �ooperative administrator shall not be respansible far a Proposer's failure to clearly identify information considered canfdent€al or proprietary. Further, by submitting a Pro�osal, Proposer acknowledges that the Cooperative and Coaperative admini5trator will disclose information when required by law, even if such information has been identified herein as informatian Vendor considers confidential or proprietary. Con�dential � Proprietary Information: (Altach additional sheets if needed.) Ini�i�l'�� �• Page 19 of 71 Proposal Forms COMM/SVGS v.08.11.2p21 ' Board� . PURCH65l7VC CODPERATlYE 12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH; 800-695-2919 ' buybaard.com B. Coavrinht Infarmation Daes yaur Proposaf (including forms, documentatian, pricelists, catalags, or other materials submitted with the Proposal} contair� copyright information? Please check one of the fallowin : � N0� Proposal (includsng forrr�s, doc�mentatior�, pricelists, catafogs, or other materiais submiE#ed with the Proposal) does not contain cppyright information. ❑ YES, Proposal (inc�uding forms, doc�amentation, pricelists, [atalogs, ar other materiais submi�ted with the Proposal) does contain copyright information. If you respanded "YES", clearly identify below the specific documents or pages containing copyright inFormatian. Copyrig�t Infarmafion: (Attach additronal sheeg if needed. J n nt to R lea n�cier�tial Pro ri o ri ht Information to Bu Boerd Members BuyBaard rnembers (Cooperative and nonprofit members} seeking to r�ake purchases through the BuyBoard may wish to �iew informatian induded in the ProposaEs af awarded Vendors. If you fdentified informatian on this farm as confidential, propri�tary, or subject to copyright, and you are awarded a BuyBaard contract, your acceptance of the BuyBoard co�tract award constitutes your consent to the disclosure of such information to BuyBoard rr�embers, including posfing af such informatian on the secure BuyBoard website far members. Note: Neither the Caoperative nor CaopeTatE�e administrator wall be respansible far the �se or distribution of inforrnation by BuyBoard members or any other party. . Con nt t Rel Pra I Tab lation Notwithskanding anything in this Confidential/Proprietary Enfarmation form ta the contrary, by submit�ing a Proposal, Vendar consents and agr2es that, upon Gontract award, fhe Caoperative may publicly rel�ase, including posting on the pubbic SuyBoard website, a Copy of the proposal tabuEation and award information for the Contract induding Vendor name; proposed catalog/pricelist name(s); prflposed percentage discount{s), �ourly labor rate(s), or other specif�ed pricing; and Vendor award or non-award infarmation. Inttial•� �U . Page 2Q of 71 Proposal �ormy Cf7?�E�1;yVC5 u p8.i: 202] ' Board'v . Pl1RCHA5ING LOOPERATIVE 12007 Research 8oulevard ' Austin, Texas 7$759-Z439 • PH: 800-645-2919 • buyboard.com EDGAR VENDOR CERTIFICATION (2 CFR Part 20q and Appendix II) When a Cooperative member seelcs to procure goods and services using funds under a federal grant or cor�tract, specific federal laws, regulations, and requirements may apply in additian to those under state kaw. This includes, but is not limited to, the proct�rement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requireme�ts for Federal Awards, 2 CFR ZDO (sometirr�es referred to as the "Uniform Guidance" or new "EDGAR'�. All Vendors submitting a Propasal must complete this EDGAR Certification Form regarding Vendor's willingness and abflity to comply with certain requirements which may be applicable to specific Cooperative member purchases using federal grant funds. Compfeted forms wi11 be made available to Cooperati�e members for their use while cansidering their purchasing flptions when using federa! grant Funds. Cooperative members may also require Vendors to enter into ancillary agreements, in addition to the terms and conditions of the BuyBoard contract, to address the membar's specific cantractual needs, irtcluding contract requirements far a procurement using federal grants or contracts. For each of the items 6elow, Vendor should certify Vendar's agreement and a6ility to comply, where applica6le, by having Vendnr's authorired representative check the applica6le 6oxes, rnitial each page, and srgn the Camp/rance FormS Signature Page. If you fail to comp/ete any item irr this form, Che Cooperative will consider and may Irst the Vendor's response on the BuyBoard as "NO,"the Vendor is unable ar unwrNing to comply. A°NO" response ta any of the iterns may, if applicable, irr�pact khe a�ility of a Caoperative member ta purchase from the Vendor using federal funds. 1. Vendar violatian or Breach of Contract Terms: Cantracts far more than the simplifed acquisition threshold, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Counci! and the Defense Acquisition Regufations Cauncil (Councils} as authorized by 41 USC 1908, must address administrati�e, contractual, or legal remedies in instanc�s where contractors violate or breach contrad terms, and provide for such san�ions and penalties as appropriate. Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.1$, Remedies for Default and Termination oF Contract, Any Contract award wi�t be subject �o such BuyBaard General Terms and Conditions, as well as any additional terms and canditions in any Purchase Order or Caoperative member ancillary contract agreed upon by Vendor and the Cooperative member which must be consi5tent with and protect the Cooperative member at least to the same extent as the BuyBoard Terms and Cpnditions. The remedies under the Contract are in addEtion ta any other remedies that may be av�ilable under law or in equity. By subrnitting a Proposal, ynu agree to these Vendor violatian and breach af contract terms. � YES, I agree. ❑ NO, I c!o not agree. 2. Termination for Cause or Con�enience: For any Cooperati�e member purchase or contratt irs excess of $10,000 made using federai funds, yau agree that the following term and condition shall appfy: The Cooperative member may terminate or cance/ any Purchase Order under this Contract at any time, with or without cause, 6y providing seven (7J 6usiness days advance written notice to the I/endar. If thrs Agreement is terminated in accordance wrth �his Paragraph, the Cooperative mem6er shall only be required to pay 1lendor for goods or services delivered to the Cooperatrve memGer prror to the terrrfinatran and not otherwise returned in accordance with �endar's return policy. If the Cooperative mem6er has paid t/endor for goods or servites not yet provided as of the date of termination, i/endor shall immediately refund such payment(s). If an alternate provisian for terminatian of a Codperative member purchase for cause and canvenience, including the manner by which it wifl be effected and th� basis for settlement, is included in the Cooperative member's P�rcha�e Qrder ar ancillary agreement agreed ta by the Vendar, the Cooperative merr�ber's pravision shall cnntrol. � YES, I agree. ❑ NO, I do nat agree. Initial: �•�- page 21 of 71 Proposal Forms COMM/SYCS v.p8.1LZ421 ' Boara�V r PURCHASING COQPERA iI VE 120p7 Research Boulevard • Austin, T�xas 78759-2439 � PN; 8Q0-695-2919 • buvbaard.com 3. Equal Employrrfer�t Oppartunity: Except as otherwise provided under 41 CFR Part 60, all Coaperative member purchases or contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause provided und�r 41 CFR 60-1.4(b}, in accordan�e with Executive Order 11246, "�qual Employment Oppartunity° (30 FR 12319, 12935, 3 C�R Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Oppartunity," and implementing regula�ions at 41 CFR Pa�t 60, "Of#ice of Federal Co�tract Compliance Pragrams, Equal Employment Opportunity, Department of Labor," The equal opportunity clause pro�ided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees t�aE such provision applies to any Caoperative member purchase ar contract that meets the definition of "federally assisted construction contract" in 41 CFR Part 64-1,3 and Vendor agrees that it sha�l comply with such provision. � YES, I agree. ❑ NO, I do not agree. 4. Da�is-Bacon Act: When required by Federal pragram legisiatian, Vendor agrees that, for all Coaperati�e member prime co�struction contracts/purchases in excess of $2,000, Ve�dor shall comply with the Davis-Bacan Ac� (40 llSC 3141-3144, anc� 3146-31�48) as supplemented by Department of Labor regulafions (29 CFl2 ParC 5, "Labor Standards Provisions Applicable to Contracts Co�ering Federally Fir�anced and Assisted Construction"). In accordance wfth the statute, Vendor is required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified tn a wage determinate made by the Secretary of Labor. In additi�n, Vendar shaEl pay wages not iess than once a week. Current prevaili�g wage determinatio�s issued by the Department of Labar are avaiiable at beta.sam,gay. Vendor agrees that, for any purchase to which this requirement applies, the award of the purchase to the Vendor is condit�oned upan Vendor's acceptance of ti�e wage determination. Vendor further agrees that it shall also comply with the Copeiand "AntE-Kickback" Act (40 USC 3145}, as supplemented by Department of Labar regulations (24 CF9� Part 3, "Contractors and Subcontractors or� Public Building or Public Work Financed in Whale or in Part by Loans or Gran�s from the United States'�. The Act pro�ides that each contractar ar subrecipier�t must be prohibited Fram inducing, by any means, any person employed in the construction, completion, or repair o� public wark, to give up any park af �he compensation to which he or she is otherwise entitled. � YES, I agree. ❑ NO, I�o not agree. 5. Cnntratt Work Hours and Safety S#andard5 Act: Where appficable, for all Cooperati�e member cantracts ar purchases in excess of $10a,000 that involve the employment of rr�echanics or faborers, Vendor agrees to �omply with 40 USC 37p2 ar�d 37D�}, as suppEemented by Department of Labar regulatians (�9 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages af every mechanic and laborer on the basis of a standard work weeic of 40 hours. Work i� excess of the standard work week is permissible provided that the worker is campensated at a rate of not tess tf�an one and a haif times the basic rate of pay for all hours warked in excess of 4D hours in the work week. The requirements of 40 L15C 3704 are applicable to construction work and provide �hat na laborer ar mechanic must be required to work in surroundings or under warking conditions which are unsanitary, hazarcfous ar dangerous. These requirement5 do no� apply to the purchases of suppfies or materials or articles ordinarily available an the open market, or contracts for transportation or transmission of intelligence. � YES, i agree. ❑ NO, Y do nat agrse. Initial:�U • Page �2 of 71 Rf060531 FOffl'15 COM11i�/SVCS v.OB.IS.�O2i � Boara�� PURCHAS�NG LOO�ERA iIYE 120fl7 Research Boulevard ' Austin, Texas 7$759-2439 ' PFi: 800-595-Z9f9 ' buyboard.c�n� 6. Right to inventions Made Under a Contract or Agr�emen�: If the Cooperative merr�ber's Federal award meet5 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 nonpraft organization regarding the substit�tion of parties, assignment ar performance ar experimental, developrr�ental, or research wark under that "funding agreement," the recipient or subrecipient must camply with the requiremenfis of 37 CFR Part 401, "Rights to Inventians Made by Nonprofit Organizations and Sm�ll Business Firms Under Go�ernment Grants, Contracts and Coopera�ive Agreements," and any implementing regulations issued by the awarding agency. Vendor agrees to compEy with the abave requirements when appaicable. � YES, I agree. ❑ NO, I do nok agree. 7. Clean Air A�# and Federal Water Pollutinn Cnntrol Act: Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 U5C i251-1387), as amended — Contracts and subgrants of amounts in excess af $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 fo the Clean Air Act (42 USC 7401-7571c�.) and the Federal Water Palfution Control Act, as arnended (33 USC 1251-1387}. Violatians must be reparted to the Federal awarding agency and the Regional O�ce of t�e Environmental Protectian Agency (EPA}, When required, Vendar agrees to camply wifh all applicable standards, orders, or reg�alatians issued pursuant to the Clean Air Act and the Federal Water Pollution Cankral Acfi. � YES, I agree, ❑ NO, I do not agree. 8. Debarment and Suspension: Debarment and 5uspension {Executive Orders 12549 and 12589) — A�ontract award {see 2 CFR 160.220) rrEust nat be made to parties listed on the government-wide exclusians in the System far Award Managemer�t (SAM), in accordance with the OMB guidelines at 2 CFR 180 thai implement Executi�e Orders 12��}4 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusians contains the names af parties debarred, suspended, or otherwise excluded by agencfes, as well as parties declared ineligible under statutory or regu�atory authority other than Executive Qrder 12549. Vendor certifies that Vendor is not currenCly IisCed aR the govemrr�ent-wide exclusions in SAM, is not debarred, suspended, or atherwise excluded by agencies o� declared ineiigible under statutory or regu�atory authority other than Executi�e �rder 12549. Vendor further agrees to immediately notify the Cooperative and all Cooperative members wiCh pending purchases or seeking to purchase from Vendor if Vendo� is later listed on the government-wide exclusion5 in SAM, or is debarred, s�spended, or otherwise excluded by agencies or declared Fneligible under statutary ar regulatory authority other t�an Executive Order 12549. � YES, I agree. ❑ NO, I do not agree. 9. 8yrd Anti-�obbying Amendment: Byrci Anti-Lobbyi�g Amendme�t (31 USC 1.352} - Vendors that apply ar bid for an award exceeding $1D0,000 must file the r�quired certifcation. Each #ier certifies to the tier abave that it will not and has not used FederaE appro{�riated funds to pay any person or organization for influencing or attempting ta inFlue�ce an officer ar employee �f any ager�ty, a member of Congress, officer or employee of Congress, or an employee of a member of Congress irt connection with obtaining ar�y Federal contract, grar�t or any other award co�ered by 31 USC 1352. Each tier must alsa disciose any lobbying wit� non-Federal funds that take5 place in connectian with obtaining any Federal award. Such disclos�res are forwarded frortt tier to tier up to the non-Federal award. As applicable, Vendor agrees to file all certifications and disclosures required by, and otherwise comply with, the Byrd Anti-Lobbying Amendment {31 USC 1352). � YFS, i agree. � NO, I do not agree. Initial.�•U • Fage 23 of 71 Proposal Forms COMMISVCS v.09.11.2o21 ' Boardu . �urr��sasir�c coaaEaarrve 12007 Research Baule�ard • Austin, iexas 78759-Z439 ' PH: 80Q-695-2919 ' buyboard.tom 10. ProcuremeMt qf Recovered Materials: Far Caoperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Reca�ery Act where applicable and provide such informatian and certifications as a Coaperative member may require to confirm estimates and otherwise camply. The requirements of Sectian 6002 include pracuring only items designated in guidelines af the Enviranmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicabEe, cor�sistent with maintaining a satisfactory leve! of competition, where the purchase price of the iterr� exceeds $l0,Ofl0 or the value oF the quantity acquired during the preceding fiscaE year exceeded $14,Oa0; procuring salid waste management 5ervices in a manner that maximizes energy and resaurce recovery, an� establishing an a�rmative procurement pragram for procurement of recovered materials Edentified in the EPA guidelines. � YES, I agree. ❑ NO, I do no� agree. 11. Damestic Preferences for Procurements: Where appropriate and cons+stent with law, 2 CFR §200.322 contains certain considerations far domestic preferences for procurements which may be appficable to Caoperative members using federal funds. When required by a Caoperative member, Vendor agree5 to provide �uch infflrrr�ation or certification as may reasonably be requested by the Caaperative member regarding Vendor`s products, including whether goods, products, or materials are praduced in the United States. � YES, I agree. ❑ NO, I do nat agree. 12. Prohibition vn Certain Telecommunicatio�s and Video Surveillance Services nr Equipment 2 CFR �20�.21b prohibits expendfng federal laan or gra�t funds to procure or obta�n certain telecommunications and video surveillance services or equipment, To the extent applicable and when required by a tooperative member, Vendar agrees tfl provide such information or certification �s rriay reasanably be requested by the Cooperative member to confirm whether any telecommunications or �ideo surveillance sen+ites or equipment pra�ided by Vendor is co�ered equipment or cavered services under 2 CFR §200.216. � YES, i agree. ❑ NO, I do not agree. 13. Profit as a Separate Element of Price: For purchases using federal funds in excess af the 5implified Acquisition Threshold, a Cooperati�e member may be required to negatiaCe profit as a separate element of the price. 5ee, 2 CFR 200.3Z4(b). When required by a Cooperative member, Vendor agrees to provide informatio� and �egotiate with the Cooperative member regarding proFt as a separate element of the price for a particular purchase. However, Vendor agrees that the total price, in�fuding profit, tharged by Vendor to the Cooperative member �ha41 not exceed the awarded pricing, including any applicable discount, under Vendor's Cooperative Contract. � YES, I agree, ❑ N0, I da not agree. 14. Generai Compliance and Cooperation with Cooperative Members: In addition to the foregoing specific requirements, Versdor agrees, in accepting any Purchase Orcier from a Caoperative member, it 5hall make a good faith efFort to work with Caoperative members to �rovide such information and to satisfy such requirements as may apply ta a particular Cooperati�e member purchase ar purchases including, but not limited to, applieabie re�ordkeeping and recard retention requirement5. � YES, I agree. ❑ N0, I da not ag�ee. Initiaf:-�•v • Page �� af 71 Proposal Forms COMMj5VC5 v,08.11.2021 � Board il PURCkASING CUOPERATIYE 1Z007 Researeh Boulevard • Austin, Texas 78759-2439 • PH: 800-645-2919 • bu �o�__..ard.com COMPLIANCE FORMS SIGNATURE PAGE By ir�itialing pages and by signature below, I certify that I have reviewed the fallowing forms; that the informatian provided therein is true, camplete, and accurate; and that I am authorized by my company to make all certifcations, consents, acknowledgements, and agreements cantained herein: • Proposal Acknnwledgements � Felony Con�i�tion piselosure � Debarment Certification • Resident/�onresident Certification • Vendor Ernplayment Certifcation ■ No Boycott Verificatiar� • No Excluded Nation or Foreign Terrorist Organizatior� Certification • Historically Underutilized Business CertificatioR • C�nstructior�-Related Goods and Services Affi�-matian • Acknowledgement of BuyBoard Technital Requirerr�ents • Deviation and Campliance • Vendor Consent for Name Brand Use • Confidential/Proprietary I�formation • EDGAR Vendor Certification RAINBQW WATER PURIFICATION Company N e .0 Signature of Authorized Company pfficial Giovanni Varela Sr. - Owner Printed Name and Title 09/21/2022 Date Page 25 of 71 Prppc:sal Forms COMM/SVCS v.08.11.202F � B�ar�f� PURCHdSfNG LOOPERAYIYE 12007 Research Boulevard ' Austin, Texas 78759-2439 • PH; SDO-645-Z919 • buvboard.com PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS INSTRUCTIONS: Proposer must compietefy and accurately pro�ide aii information requested in the fallawing Vendor Informatian Fflrms or your Propasal may be rejected as r�on-responsive: • Vendor Business Name ■ Vendor Contact Information ■ Fed�ral and State/Purchasing Cooperative Experience ■ Go�ernmental References • Company ProFle • Tcxas Regional Service Designatian ■ State Service besignation ■ Nationa� Purchasing Coaperative Vendor Award AC� 1'221'3'12Cit (I/endors ser✓iny outside Texas onlyJ ■ LocalJAuthorized Seller Listings ■ Manufacturer D�aler Designatian • Propasal Invitation Questiannaire ■ Vendor Request to Self-Report BuyBoard PufChe5�5 (OpkanaQ To the extent any informakion requested is not applicable to yaur company, you must so indicate on the form. VEND4R BUSINESS NAME By submitting a Proposal, Vendor is seelcing to enter into a kegal cantract with the Cooperative. As such, Vendor must be an indi�idual or legal business e�tity capable of entering into a binding contract. ryam�afP�opas��9compa��: RAINBOW WATER PURIFICATION (List the Ieaal name of the cpmpany seekmg to contract wrth the Cooperah"ve. Do NOT list an assumed name, d6a, aka, etc here. Suth mformation may 6e provrded below. If you are submrtt'ing a joint proposal with another erttiry to provide the same propased yoods or services, earh su6mitting entity should compleCe a separate vendor rnformation form. Separately operating lega/ busrness entitres, even rf a�liate�d entrtres, tvhich propo,5e to provide gaads or servrces separafely must suGmrf their own Proposals. J Please check fJl one of the followina• Tvqe of Business; � Individual/Sole Proprietor ❑ Corporation ❑ Limited Liabi�ity Company ❑ Partnership ❑ Other (Specify: State of Incarporation ��f apprcabie�: TE%�1�15 Federal Emulover ldentification Number 2��3168580 (�endor must rndude a completed �� form wrth their ProposalJ Name by witith Vendor, if awarded, wishes to be identified an the BuyBaard: (Note.• Ifdifferentthan thelVame ofFroposing Company listed aGove, only valyd trade names (dba, aka etc, j of the Proposmg Company may be used and a capy of ypur Assumed Name Certrfrcate(s), if applicable, must be attached.) RAINBOW WATER PURiFICATION Page 26 of 71 a,�s�i Fn�„s camsMlsvcs � oa.u.xox� Form �� V (Rev. October 2618} �epartment of the Treasury Irrtemai Revenue Sarvice Give form #o the requester, bo not send to the IRS. 1 Name (as shown on ynur income tax retum). Name is required on this line; do not leave this line 6lank. RAINBdW WATER PURIFICATION 2 B�siness name/disregarded entiry name, if di#ferent frorri abQve c� m � a c 0 a e no �� o � - C � a � v � �s � a. � m a� � 3 Check appropriate box for federal tax dassificatian af the person whose name is ente�ed on line t. Check only ane of ihe 4 fxemptions (codes apply ortly to following seven boxes. certain entities, not indivicivals; see instructions on page 3): ❑� IndividuaVsoie proprietor or ❑ C Corporation ❑ S Corpora#ion ❑ Partnership ❑ trusUesiate single-member LLC Exempt payee code (iiany) NIA ❑ Limited liabtlity company. Enter the tax ciassificatioh (C=C corpor'atiorr, 5=S corporation, P=Partnership} ► Nnte: Check the appropriste box in the Eine above fnr the tax classificatVon of the single-member owner. �o not check Exemption !rom FA7CA reporting LLC 'rf 1he LLC is ciassified as a single-member LLC that is disregarded from the owner unless tha owner of the LLG is code (if any) �/�1 another LLC that 4s not disregarded from the owner for U.S, federal tax purposes. Otherwise, a single-member LLC that is disr�arded from the owner should check the appropriate box far the tax classitication ot its owner. U Other (see instructians} ► 6 Address (number, street, and apt, or 12002 CA55ANDRA LANE 6 City, sfate, and ZIP code !-IOUSTON, 7EXA5 77064 7 List accou�t number(s) here {aptiona Request fo� Taxpayer �dentification Number and Certification ► Go to www.irs.gov/FormWS for instructions and the latest irsformation. (�rer ro accounrs ma;nramed ou�sida tne u.s,) name an� aoaress BUY BOARD 12007 Research Baule�ard A�tstin, Texas 78759 rer ldentification Number Enter your TiN in the apprapriate 6ox. The tIN provided must match the r�ame given on iine 1 to avoid backttp w9thholdir�g, For individuals, this is generaEly your social security number {5SN). Hawever, for a resider�t alien, soEe proprietor, or disregarded entity, see the 9nstructions for part I, later_ For other entities, k is your ernployer identification number {EIN). If you do nat ha�e a number, see Now to gef a T1N, lat�r. Note� If the account is in more than ane name, see the ins#ructions for line 1. Also see 4Nhat Name and Number To Give the Requester for guidelines on whvse number to enter, � Social seeurity number � _� vr �00�0���0� Under penalties of perjury, I certity that� 1. The number shown on #his form €s rny correct #axpayer identification numk�er {or I am waiting for a number to be issued to me); and 2. I am not subject to backup withhalding 6ecause: (a) ! am exem�t from backup withholding, or (bj I have not been notified by the Internal Revenue Service (IRS] that I am subject to f�ackup withholding as a resuit of a failure to report aA interest or dividends, or (cj the I�tS has notified rr�e that I arn no longer suhject to backup witf�holding; and 3. I am a U.S. citizen or other �l.S. person (defined belowJ; and 4, The FATCA code{s) entered on this forrr€ (if any) indicaking khat I am exempt from FATCA reporting is carrecf. Certification instructians. You must cross out iterr� 2 above if you have 6een notified by the IRS that ypu are curren#iy subject fo backup withholding beca�se you have failed to report all interest and divitfends on your tax return. For resl estate transactions, item 2 does not apply. Fo► mortgage interest paid, acquisition or abandonment af secured property, cancellatian of debt, contribuEions to an individual retirement arrangement (1RAj, and generally, payments other than interest and dividends, you are not required to sign the certificatior�, but you must provide your corcect TIN. See the instructions for ParS II, iater. S�g� 5ignature of W�re U.S. person ► r U General Instructions Date► � ! — �, l � ���� Se�tion references are to the Intemai Revenue Code unless otherwise nated. Future developments. For the latest information about developments related to Forrn W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/For-mW9. Purpose of Form An individual or entity {Form W-9 requester) who is required to file an inforrnation return with t1�e 1RS must obtain yaur correct taxpayer identifieati4re reumber (flNj w�tich may 6e your social security number (SSN), individual taxpayer iderttification number (ITIN), adaption taxpayer identifir,ation number (FtTIN), or empEoyer identi€icatian number (EIN), to repnrt on an information retum the amount paid to you, or other amount reportable on an information return. Examples of inEormation returns include, but ara nvt limited to, the following. • Form 1099-INT (interest earned pr paid) • Form � 099-�kV {dividends, incfuding those from stocks or mutual funds) • Form 1099-M15C (various types of income, pri2es, awards, or gross proceeds) • Form 1099-8 [stock or mutual fund sales and certain other transactions by brokers) • Form 1099-5 (proceeds fram real estata transactions} • Farm 1099-K (merchant card and third party network transactions) • Farm 1098 (home mortgage interestj, 1098-E (student loan interest), 1098-F (tuition} • Form 1099-G (canceled debtj • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 oniy if you are a U.S. person (including a resident aiien), to provsde your carrect TIN. !f you do not return Form W-9 fo the requester with a T�N: you mrght 6e subject fv backup wifhholding. 5ee What is 6ackup withholding, �ater. cat. No. yo2syx For� W-9{r�ev. io-zoie} ' Board� . PURtHASrNG COOPERATlYE 1Z007 Research Boulevard • Austin, Texas 78759-2439 • PH: 8�0-695-2919 • bu�t�aard.com VENDOR CONTACT INFORMATION Vendor shall pro�ide the requested Vendor Contact Information in the e]ectronic proposa/ submission system including cantract, purchase order, RFQ, and fnvoice cantacts (or, ifsubmittiny a hard copy Proposal, t�mely request and comp/ete the Vendar Contact Information farm in accordance with the Instructions to Proposers). FEDERAL AND STATE/PURCHASING COOPERATNE EXPERIENCE 1"he Caoperative strives to provide Cooperative members with the best services ar�d products at the best prices available from Vendors with the technical resources and abiiity to serve Caoperative members. Please respand ta tf�e following questians. Provide the dollar value of sales to or through purchasing cooperatives at ar based on an established catalag or market price during the previous 12-month period or the last fiscal year: $ �20.400 .(The period of the 12-month periad is 202� 12a22 ). In the event that a dollar value is not an appropriate measure af the saies, pro�ide and describe your own measure of the sales of the item(s), 2, By submitting a proposal, you agree that, based orr your written discounting policies, the discounts you offer the Cooperative are equal to ar better than the best price you offer other purchasing cooperati�es for the same items under eq�ivalent circumstances. Pro�ide the information requested below for other purchasing coaperatives for which Proposer turrently serves, or in the past has served, as an awarded vendar. Raws should be added to accommadate as many purchasing cooperatives as required. CURRENT BUYBOARD VENDQRS If yau are a current BuyBoard �endor in the same contract category as proposed in this Proposal Invitation, indicate the di5count for your current BuyBoard contract and the proposed discount in this Proposal. Explain any differen�e between yaur current and prapased discounts. Current �isCount (°10): 25°/0 Explanatior�: NnN� Proposed Discaunt (%): 25°ia Page Z7 of 71 Proposal Fams COMM�SVCS v.06.11.2021 ❑ MY COMPANY DOE5 NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYFE CONTRACTS. ' Boara�� . PURckas�xc coo�Rnnve 12007 Research Boulevard • Austir�, Texas 78759-2439 • PH; 800-695-2914 ' buvboard,com G�VERNMENTAL REFERENCES For yaur Pr�posal to be considered, you must supply a minimum of five (S) individual governmental entity references. The Coaperative may contac# any and all references provided as part of the Proposal evaluation. Provide the infarmation requested below, including the existing pricing/discounts you ofFer each customer. The Coaperativ� may determine whether pricing/discounts are fair and reasonable by comparing pritir�g/discounts stated in yflur Prapasal with the pricing/discounts you offer other governmental custamers. Attach additianal pages if necessary. Quantity/ Entity Name Contact Phone# Email Address Discount _ Voiume � Katy ISD-Mr.EulogEo Avila 281-642-529 eulogioavila@katyisd.org 25% no limit z CY-Fair iSD-Mr.Carey Ramsey 281-517-2�87 carey.ramsey@cfisd.net 25% no limit 3 UTMD AndersonCC- Mr.Dani�{ Radriguez 713-745-819$ dpradriguez@mdanderson.org 25% na limit 4 Texas A&M Corpus Chrisit- Mr.Scott Meares 361-945-9230 scott.meares@tamucc.edu 25°/fl no limit � UT Austin- Mr.Chad Johnson 512-797-2798 c�ad.johnson@austin.utexas.ed� 25% no limit Do you ever modify your written policies or standard governmental sales practices as identified fn the abo�e chart to gi�e better discounts (Eower pridng) than indicated? YES ❑ NO ❑� If YES, please explain: COMPANY PROFILE Information on awarded Cooperative Contracts is a�ailable to Cooperative Members on the BuyBoard website. If your company is awarded a Contrac# uncler this Proposal Invitation, please provide a brief campany description that you would like to have included with your company profife on the B�ayBoard website. Submit yaur company profie in a separate file, in Word format, with your Propasal. (Nate: Vendar is soleiy responsible far any content pravided for inclusion on the BuyBoard website. The Coaperative reserves the right to exclude or remove any content in its soie discretion, with or without priar notice, including but not limited to any content deemed by the Coaperative to be inappropriate, irrelevant ta the Contract, inaccurate, or misleading.) Page 28 vf 71 woposa� rro�m5 coMM�svcs v.oaii.zo-zi 12002 Cassandra LaneHouston, TexasUSA77064 Office:(281) 874-9736 Fax: (281) 874-9706 Email: sales@rwptexas.com-Website: www.RWPTexas.com DUNS: 021523308 CAGE CODE: 4T7Z6 NAICS CODES: 561210, 5692910, 221310, 423840, 423830,423720,423850 Rainbow Water Purification Total Service Support for all Water Treatment Systems Water Resourcesare finite and precious and must be measured, monitored and managed to optimize requirements, productivityand inherent cost. Rainbow Water Purification offers engineered water treatmentsystem and support to public and private clients in order to maximize performancewhile protecting public health and the environment. Capabilities Boiler & Cooling Water Treatment Commercial -Industrial Process Water Waste Water Metals Removal Pre-EngineeringDesign Support High Purity PharmaceuticalWater PotablePublicDomestic WaterK-12 Field Installation& Preventive Maintenance Emergency RentalSystems 24/7/365 Full Technical Service Support Products & Services Water SoftenersIon Exchange Reverse OsmosisDesalination DeionizationDemineralizers Water Treatment Chemicals Ultra Violet Bacteria Treatment MaintenanceRepairs Contracts Analytical Instrumentation Calibration Distribution Pumps, Automated Valves & Pipes � � oar�� PURCHASINC C00?ERA TI VE 12007 Research Boulevard � Austin, Texas 78759-Z439 ' PY1: 8Q0-695-Z919 ' buyboartl.com TEXAS REGIONAL SERVICE DESIGNATION This form must be comp/eted ln the electronic praposal su6mission system r if mit in har o The Coaperative (referred to as "Texas Cooperative" in this form and in the State Senrice Designation form) affers ve�dors the appartunity to ser�ice its membe�s throughou� the entire 5tate of Texas. In the electronic proposal submission system, you must indicate if you wtll ser�ice Texas Cooperative members statewide or, if you do nat plan to service a!f Texas Cooperative members statewide, you �nust indicate the specifc regions you will service. If yau propose to serve different regions for difFerent products or services included in your Proposal, you must compfete a�d submit a separate Texas Regional Service Designation form For Each group of praducts and clearly indicate the products ar services ta whith the designation applies. (A�ditional forms can be obtained by contacting bids�abu�oard,com at least five 5 business da s rior to the Proposal Due,_Date. ] By designating a region or regions, you are certifying that you are authorired and willing to provide the proposed producrs and servites in those regions. Designating regions rn tirhich yau are either una6/e or unwilling to provide the specified praducts and services shall be grounds for either rejertion of yaur Proposal or, If awarded, termination af your Contract. Additianally, if you do not plan to servic� Texas Cooperative members (i.E., if you wiil service anly states other than Texas), vou must so indicate on t�e form in the electronicpraposal submission system. Regional Educa#Eon Service Centers � . ; . , . ,�s � � .. , . ; �. � '. � �L -' Page 29 of 71 Regio� and Headnua,r�ers 1 Edinburg 2 Carpus Christi 3 Victaria 4 Houstfln 5 Beaumont 6 Hunts�ille 7 Kilgore B Mount P4easant 9 Withita Fal�s 10 Richardson 11 Fart Worth 12 Waco 13 Austin 14 Abilene 15 San Ange{o 16 Amarillo 17 Lubbock 18 Midland 19 EI Pasa 20 San Antonio Proposa� Forms caMMIsvCS v.o8.11.zou � Boards PI1RCkASING CDOPERATIVE 12007 Research Boulevard • A�stin, Texas 7$754-2439 � PH; 800-695-2919 • buYboard,com STATE SERVICE DESIGNATION This farm must 6e completed rn the e/ectronic proposal su6missian system (v_r, if��bmitting a hard copy As set forth in the Propasal In�itation, it is the Coaperative's ir�tent that other gavemmental entities in the United States have the opportunity to purchase goods ar services awarded under the Contract, subject to applicabEe state law, through a piggy- back award or similar agreement through the National Purchasing Coaperative BuyBoard. If you plan to service the entire United States or only specific states, ynu must complete the State Service Designatian infarmation in the electronic proposal su6mission system. (Note: If you plan to service Texas Cooperative mem6ers, 6e sure thaC you camplete the %xas Regional Service Designation farm.) In addition fa this form, to 6e considered far a piggy-back award by the National Purchasing Coop�rative, you must have an authorized representative sign the National Purchasing Cooperative Vendor Award Agreement �hat follows this page. If you ser�e difFerQnt sta�es for different products or services included in your Praposai, yau musk complete and submit a separate 5tate Service Designation form for �ach group of products and clearly indicate the praducts or services to which the designation appiies. (Additional forms can be obtained by contacting bids@buyboard.com at least five L business daYs pri_or ta_the_ Proqosal pue pate.) By designating a state or states, you are certifying that you are autharized and rvilling to provide the proposed products and services in those states. Desiqnating states in which you are either una6le or unwilling to pro vrde the specified products and services sha/l 6e grounds for erther rejectian of your Proposal ar, if awarded, termination of your Contract. • I will service all states in the Unite� States. • I will not service ail states in the l}nited States. Alabama Alaska Arizona Arkansas California (Pubfic Contract Code 20118 & 20652) CoEarado Connecticut Defaware District of Calumbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kans�s Kentucky Louisiana Maine Maryland Massachusetts Miehigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico EVew York North Carolina North Dakota Ohio Oklahoma Oregan Pennsylvania Rhode Island 5auth Carolina Sauth Dakota Tennessee Texas Uta#� Verman[ Virginia Washington West Virginia Wisconsin Wyoming PropoShc Forms COMM/SVCS v.08.11.2621 Page 30 of 71 � Boar�� PURCHASIHG COdP£RATIVE I2007 Research B4ulevard ' Austin, Texas 78J59-2434 • PH: $00-695-2919 • bu bo__.,y__ ard_com NAT�ONAL PURCHASING COOPERATNE VENDOR AWARD AGREEMENT In accordance wit1� the Ter�s and Canditions assaciated with this Proposai Invitation, a contract awarded under this Prapasal Invitation may be "piggy-backed" by another govemmental entity. The National Purthasir�g Coop�rative is an intergaver�mental purchasing cooperative formed by certain school districts oufside of Texas to serve its �nembers throughaut the United States, If you agree to be considered for a piggy-�ack award by the National Purchasing Cooperative, you agree ta the follawing terms and agree to serve National Purchasing Cooperative members in the states you have indicateci on the State Se�i�e Designation form, in your Proposal. By signing this form, Proposer {referred to in �his Agreement as "Vendor"} agrees as follows: 1. Vendor acknowledges that if The Local Govemment Purchasing Caoperative {"Texas Caoperative"} awards Vendor a contract under thi5 Propasal Invitation {"Underlying Award"), the National �urchasing Cooperafive ("Natianal Cooperative") may - but i5 not required ta -"piggy-back" ort or re-award all or a partian of that Underlying Award ("Piggy-Back Award'�. By signing this National Caoperative Vendor Award Agreement {"Agreement`�, Vendor accepts and agrees to be bound by any such Piggy-Back Award as provided For herein, 2. In the event Natianal Cooperative awards Vendor a Piggy-Back Award, the National Coaperative Administrator {"BuyBoard Administrator"� will notify Vendar in wrfting of �uch Piggy-Back Award, which award shall commence on the effecti�e date stated in the No�ice and end on the expiration date of the llnderlying Award, subject to annual renewals as authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or ather action is requir�d of Vendor in order for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or changes to this Agreemen� by Vendor will be binding on National Cooperative, unless such changes are agreed to by its BuyBoard Administrator in writing, 3. Vendor agrees that it sh�li offer its goods and ser�ices to National Cooperative members at the same unit prieing and same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying Aw�rd. However, nothjng in this Agreer�ent prevents Vendor from offering National Cooperative members better (i.e., lawer) competitive pr€cing and mare favorable terms and conditions than those in the Underlying Award. 4. Vendor hereby agrees and canfirms that it will serve those states it has designated on the Stafe 5ervice Designation Form af this Proposal In�itation. Any changes to the states designated on the State Service Designation Farm must be appro�ed in writing by the BuyBoard AdmiRistrator. 5. Vendor agrees to pay National Cooperative the service fee provided far ir� the UnderEying Award based on the amount of purchases generated from Natiflnal Cooperative me�nbers thraugh the Piggy-Back Award. Vendor shall remit payment to 1�ational Cooperative on such schedule as it specifies (which shall not be more often than monthly}. Further, upon request, Vendor shall pro�i�e National Cooperative with copi�s af aff purchase orders generated from National Cooperative members, vendor invoices, and/or such other documentation regarding those �urchase orders as the CQoperative's administrators may require in their reasonable discretion f�r purposes af re�iewing and verifying purrhase acfivity. Vendor further agrees that National Cooperative shall haWe the rig�t, upon reasonable written natice, to review Vendor's records pertaining to purchases made by National Cooperative members in order to verify the accuracy of service fees. 6. Vendor agrees that the Underlying Award, incl�ding its General Terms and Conditions, are adopted by reference to the fullest extent such provisions can reasonably apgly to the post-proposal/contract award phase. The rights and responsibilities ti�at wfluld ordinarily inure to the Texas Cooperative purs�ant to the Ur�derlying Award shall inure to National Cooperative; and, canversely, the rights and respansibilities that would ordinarily inure to Vendor in the Underlying Award shall inure to Vendor in this Agreement. Vendor recagnizes a�d agrees thsat Ver�dor and Natiana� Caape�ati�e are the only parties to this Agreemen�, and that nathing in this Agreement has application to ather third parties, including the Texas Cooperati�e. In the �vent of conflict between Ehis Agreement and �he terms of the Underlying Award, the terms of this Agreement shall control, and then only to the extent necessary to reconcile the confliet. Proposal Forms COMMJSUfS v.68.11.2021 Page31of71 � Board� PUfiCMASfHG COOPERdTlYE 120p7 Research 8oulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 � buyboard,com 7. This Agreement shall be go�erned and construed in accordance with the laws of the State of Rhode Island and venue for any dispute shall lie in the federal district court of Alexandria, Virginia. 8. Vendor acknowfedges a�d agrees that the award of a Piggy-Back Award is within the soie discretio� of Natianal Cnoperative, and that this Agreement da2s nat take effect unless and until National Caoperative awards Vendar a Piggy-Back Award and the BuyBoard Administratar notifies Vendor in writing of such Piggy-Back Award as pra�ided far herein. WHEREFORE, by signing beiow Vendor agree5 to the foregoing and warrants that it has the authority to ente� into this Agreernent. RAINBOW WATER PURIFECATION Name of Vendor .0 5ignature of Authorized Company Official 691-23 Propnsal Ynvitation Number Giovanni Varela Sr. - Owner Printed Name of Authorized Company Official 09/21/2022 €�aEe Praposal Forms C4MM/,NCS v_OB 11.2021 Page 32 of 72 � Boar�� PUfiCH4S+HG COOPERdTIV{ 12007 Research Boulevard � Austin, Texas J8759-2439 � PH; 500-595-2919 • buvboard.com LOCATION/AUTHORIZED SELLER LISTINGS If you have morE than one location/authorized seller that will service a ContracE awarded under this Proposal Invitation, please list each location/authorized seller below. If additianal sheets are required, please dtaplicate this form as necessary, NOTE: Awarded Vendors shall remain respon5ibie for all aspects of the Contract, including processing of P�archase Orders, and shall be responsibie far the performance �f ali locations and authorized seilers under and in accordance with the Cantract. If you are a product manufacturer and wish to designate Oesignated Dealers as defined in the General Terms and Conditions to receive Cooperatrve mem6er Purchase �rders on yaur 6ehalf, you must romplete the Manufacturer Designated Dealer form. , , � -, . . � � � ��4 �. ' � nla nla nia PrpppSal Forms COMMISVCS v Q8.11,2021 Page 33 of 71 � Board� P11RC+�ASING GODPfRAifVE i2007 Research 8oulevard • Austin, Texas 78759-Z439 • PH: $a0-695-2919 • buvboard.com MANUFACTURER DEALER DESIGNATION If Vendor is a manufacturer that sells pfoducts througi� a dealer network and wi5hes to designate a dealer or multiple dealers ("besignated Deaiers"} to receive Cooperative member �urchase Orders on Vendor's behalf, you must complete this form far each dealer you wish to designate. Regardless of any Designated Dealers submitted by Vendor, Vendar specifically agrees and atknowledges that any such designations are for Vendar's con�enience anEy and shall �ot, if Vendor is awarded a Contract, reiieve Vendor of any obligations under the Contract, including payment of Cooperati�e service fees on all Purchase Orders subrnitted to Vendor or any Designated �ea�er. In accordance with the General Terms and Conditions, an awarded Vendor shall remain respansible and liable for all of its abligations under the Contrad and the perFormaace of both Vendor and any af Vendor's besignated Dealers under and in accordance with the Contract and remairt subject to ai] remedies For defauit thereunder, including, but not limited to suspension and termination of Vendor's Cor�tract Far nanpayment of service fees. If awarded, Vendor authorizes the Caoperati�e, in its sole discretion, to list any Vendor Designated Qealers in the BuyBoard system and to receive Purchase Orders directiy from Cooperative members on behalf af Vendor. To the extent a Vendor with Resignated Dealers receives a Purchase Order directly, it shall be the respansibility of Vendor to appropriately process such Purchase Order in accordance with the Contract, intluding �ut not limited ta tirnely forwarding such Purchase Order to a Designated Dealer for processing. The Coaperative reserves the right, in its sale discretion, to refuse addition of, or request removal of, any Designated Dealer, ar�d Vendar agrees to immediately require such Designated Dealer to cease accepting Purchase Orders ar otherwise acting on Vendor's behalf under the Co�tract, Further, the Cooperative administrator shall be au�horized to remo�e or suspend any or all Designated aeaiers from the BuyBoard at any time in its sole discretion. If you wish to designate a dealer ta service a contract awarded under this Proposal Invitation, please li5t the Designated Dealer below. If you wis� to designate multiple dealers, please duplicate this f�rm as r�ecessary. nla Designated Dealer �Vame nla Designated Dealer Address nla Clty nla Phone Number nla State nla Designated Dealer Contact Person nla Fax Number nla Zip nla nla Email address Designated Dealer Tax ID Number* (*attach W-9) Page 34 of 71 Proposal Forms COMMJSVCS v.48.iL2021 � Board� � PlJRCHA SING COOPf RA f I Jf 12007 Research Boulevard ' Aus[in, Texas 78759-2439 � PFI: 800-695-295.9 • b�boartl.com PROPOSAL_INVITATIQN QUESTIONNAIRE The Cooperative will use your responses to the q�estions below in evakuating your Proposal and technical and financial resourCeS to provide the goods and perfarm the se�vices ("Work"} ur�der the BuyBaard cantract cantemplated by this Proposal Invitation ('�Contract'�. Propasers rr�ust fully answer each question, numbering your respanses to correspond to the questions/numbers below. Proposers must compiete below ar attach your responses to this questionnaire and su�mit in one document with your Proposal. You must subm€t the questionnaire and responses with your Proposal or the Propasal will not be considered. 1. List the number of years Praposer has been in b�siness and former �usiness names {if applicable). Note whether your campany is currently fnr sale or invfllved in any transaction that would significantly alter its b�siness or result in acquisition by another entity. Rainbow Water Purification has been in business €or 22 plus years. RWP is not sale or involved in any acquisition transaction. 2. Describe the resources Proposer has to manage staff and successfully perfarm the Work contemplated under this Contract. Sfate the number and summarize the experience af company personnel who may be utilized fo� the Work, including those who will be available to Coaperative members for assistance with project deveiapmenf, tech�nical issues, and product selection for Woris assaciated with this Corstract. Vtiie have aur own #ools, trucks forklifts and experienced technical knowledge of �arious HVAC water treatment chemical supplies and services 3. Marketina Strateau: For yaur Proposal to be cansidered, you must submit the Marketing Strategy you will use if the Coaperative accepts all or part of yaur Proposal. (Ex�e.' Exp/air� how ypur company will inrtially inform Cooperative mem6ers of your BuyBoard Contract, and how you will cantinue t'o support the BuyBoard for the durat'ion of the Contracl� term.) Attach additional pages i� necessary. Rainbow Water Purificatian will rrEarket the Buy Board Logo on our website, brochures and participate in vendor out reach expos. RWP has created new business cards with the buv board loao RWP will continue to encouge members to participate in buyboard �rtiposal Forms COMM/SVCS v.�8,11.2U21 Page 35 of 71 ' Boardu . PURCMASING COaPERd�IYE 12007 Research Boulevard ' Austin, Texas 78759-Z439 � PH: 800-695-z914 • buyboard.tom 4. Describe Proposer's financial capability to perfarm the Contract. State ar describe the firm's financia� stre�gth and rating, bflnding capacity, and insurance coverage limits. State whether the firm, or any of the firm's past or present awners, principal �hareholders or stockhalders, or oFFcers, have been a debtor party to a bankruptcy, receivership, or insalvency praceeding in the last 7 years, and ic�entify any such debtor party 6y name and rekatianship to ar �osition wit� your firm. nla 5. Does your company have any outstanding financial judgments and�or is it currently in default on any loan or financing agreement? if so, pro�id� detaiied information on the nature of suc� items and prospects for resolution. none 6. List all contracts, if any, in the last 10 years an which Prflposer has defaulted, failed ta complete or deliver the work, or that ha�e been terrr�inated for any reason. For each such cantract, provide the project r�ame, scope, �alue and date and the name of the procuring entity, Fully explain the circumstantes of the default, failure to complete or deli�er the work, or terminatian. none 7. List all fitigation or other legal proceedir�gs {including arbitration proceedings), if any, in the fast 10 years brought again5t yaur firm, or any of the firm's past or present owners, principal sharehoiders flr stockholders, ofFcers, agents or employees, that re]ate to or arise f�om a cantra�t similar to this Cantract or the Work contemplated under this Cantract. Pravide the style of the lawsuit or pra�eeding (name of parties and court or tribunal in which filed}, nature af the ciaim, and resolution or current status. none Proposal Fwms COMM/SVCS v.08.11,2�21 Page 36 of 71 s Board� Pf1P,CHASIMG �DOPERAiiVE 12067 Res2arch Boulevard • AuSkin, Texas 7$759-2439 � PH: 800-695-2919 • buyboard.com 7. This AgrEement shall be governed and construed in accordance with the law5 of the State of Rhade island and �enue for any dispute shall lie in the federal district court of Alexandria, Virginia. 8. Vendor acicnawledges and agrees that the award of a Piggy-Back Award is wit�in the sole discretion of 1Vational Cooperative, and that this Agreement daes not take efFect unless and until National Cooperative awards Vendor a Piggy-Back Award and the BuyBaard Adrninistrator notiFes Vendor in writing of such Piggy-Back Award as provided for herein. WHEREFORE, by signing belaw Vendor agrees to the foregoing and warrants that it has the autharity to enter into this Agreement. RAINBOW WAT�R PURIFICATION Name of Vendar _--� l - v � Signature of Authorized Company Officia� 691-23 Propasal Invttation Number Giovanni Varela Sr. - Qwner Printed IVame af Authorized Company Q�cial 09/21/2022 Date Proposal Fnrms COMMj5vC5 v.E}8.11.2021 Page 32 of 71 � Board° PURCHASINCCOOPERA7IVE 12007 Research Boulevard • Aus#in, Texas 7&759-2439 � PH; 800-695-2919 ' THE LOCAL GOVERNMENT PURCHASING C�OPERATIVE ADDENDUM NU. 1 Proposal Invitation No. 591-23 Water Treatment Chemicals and Pi e Burstin E ui ment The following addenda are issued to Praposal Invitation 541-23, Water Treatrrsent Chemicals and Pipe Bursting Equiprr�ent, and 5hall become a permanent part af the Proposal In�itatian document: A�DENDUM TO PROPOSAL SPECIFICAYYONS Proposal speciflcation Line Item No. 4 has been updat�d as listed below. This line item has been updated in the electranic proposal submission system and in the Praposal Specification Summary. 4. Discour�t (%) off catalog/pricelist far Municipal Water and Wastewater Parts {actuatars, gates, joints, �al�es, and other mvnicipal water and wastewater related parts). Please sign and return o�e copy of this Addendum wit� your praposal as verifcatian of your receipt and compliance with the information cantained in this Addendum. �ompany Name: RAINBOW WATER PURIFICATION ad���SS. 12002 CASSANDRA LANE Signature of Authorized � ��% Company Offcial: I• ��_�—� TeEephor�e N�mee�: 713-245-9807 Title; SALES MANAGER p�t�: 09/21/2022 Addendurn No. 1, Proposal lnvitation No. 691-z3 Page 1 of I RAINBOW WATER PURIFICATION Information Contact: Giovanni Varela Sr. Address: 12002 Cassandra Lane HOUSTON, TX 77064 Phone: (281) 874-9736 Fax: (281) 874-9706 Toll Free: (281) 874-9736 Email: sales@rwptexas.com Web Address: www.rwptexas.com By submitting your response, you certify that you are authorized to represent and bind your company. Giovanni Varela Sr. geo@rwptexas.com Signature Email Submitted at 9/22/2022 11:12:02 AM (CT) Requested Attachments BuyBoard Proposal Invitation No. 691-23 Water Treatment Chemicals and Pipe Bursting Equipment RWP 691-23 PROPOSAL20220922_10501595.pd f REQUIRED-In PDF format, upload all proposal invitation documents available for download at vendor.buyboard.com including any additional pages, as necessary. NOTICE: DO NOT complete proposal forms in internet browser. No data will be stored. Download file to computer and complete proposal forms prior to submitting. (Please DO NOT password protect uploaded files.) Catalog/Pricelist Rainbow Water Purification 691-23.pdf REQUIRED-In Excel or PDF format, upload catalog(s)/pricelist(s) in accordance with proposal invitation instructions. Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or Proposal will not be considered. No paper catalogs or manufacturer/vendor websites will be accepted. File size must not exceed 250MB. (Please DO NOT password protect uploaded files.) Addendum No. 1 ADDENDUM#1 691-2320220921_10450939.pdf REQUIRED - In PDF format, upload addendum document available for download at vendor.buyboard.com including any additional pages, as necessary. (Please DO NOT password protect uploaded files.) Exceptions and/or Detailed Information Related to Discount % and/or Hourly Labor Rate Proposed No response In PDF format and if necessary, vendor shall attach detailed information regarding exceptions to pricing and/or discount percentage and define the services that are proposed to be provided. NOTE: IF DETAILED INFORMATION IS NOT SUBMITTED, PROPOSAL MAY NOT BE CONSIDERED. (Please DO NOT password protect uploaded files.) Company Profile RWPTEXAS CAPABILITY BROCHURE.pdf REQUIRED-Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company description that you would like to have included with your company profile on the BuyBoard website. Submit your company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.) IRS Form W-9 Request for Taxpayer Identification Number and Certification RWP W9 691-2320220921_10501225.pdf REQUIRED-In PDF format, upload W-9 form. (Please DO NOT password protect uploaded files.) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 3 of 32 pages Bid Attributes 1 Federal Identification Number Federal Identification Number 203168580 2 HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification HUB/No Israel Boycott Certification/No Excluded Nation or Foreign Terrorist Certification 3 No Israel Boycott Certification A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. (TEX. GOV’T CODE Ch. 2270). Accordingly, this certification form is included to the extent required by law. “Boycott Israel” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. TEX. GOV’T CODE §808.001(1). By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor does not boycott Israel and will not boycott Israel during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this certification. No 4 No Excluded Nation or Foreign Terrorist Organization Certification Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization – specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign terrorist organization is not subject to the contract prohibition.) By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas Comptroller’s list identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make this certification. No 5 MWBE/HUB Status Certification A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women Business Enterprise or “MWBE” and all referred to in this form as a “HUB”) is encouraged to indicate its HUB certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications for awarded Vendors that properly indicate and document their HUB certification on this form. I certify that my company has been certified as a MWBE/HUB in the following categories:(Please check all that apply) 6 Minority Owned Business Minority Owned Business Minority Owned Business (Yes) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 4 of 32 pages 7 Women Owned Business Women Owned Business Women Owned Business (Yes) 8 Service-Disabled Veteran Owned Business Service-Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a service-connected disability as defined by 38 U.S.C. § 101(16), and who has a disability rating of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of Defense) Service-Disabled Veteran Owned Business (Yes) 9 Certification Number Certification Number No response 10 Name of Certifying Agency Certifying Agency No response 11 Non-MWBE/HUB My company has NOT been certified as a MWBE/HUB Non-HUB (Yes) 12 Vendor General Contact Information Proposal/Contract General Contact Information 13 Vendor Proposal/Contract Contact Name Vendor Proposal/Contract Contact Name 691-23 Water Treatment Chemicals and Pipe Bursting Equipment 14 Vendor Proposal/Contract Contact E-mail Address Vendor Proposal/Contract Contact E-mail Address g@rwptx.com 15 Vendor Proposal/Contract Mailing Address Vendor Proposal/Contract Mailing Address 12002 Cassandra Lane 16 Vendor Proposal/Contact Mailing Address - City Vendor Proposal/Contact Mailing Address - City Houston 17 Vendor Proposal/Contact Mailing Address - State Vendor Proposal/Contact Mailing Address - State (Abbreviate State Name) TX 18 Vendor Proposal/Contact Mailing Address - Zip Code Vendor Proposal/Contact Mailing Address - Zip Code 77064 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 5 of 32 pages 19 Vendor Proposal/Contact Phone Number Vendor Proposal/Contact Phone Number (xxx-xxx-xxxx) 713-245-9807 20 Vendor Proposal/Contact Extension Number Vendor Proposal/Contact Extension Number No response 21 Company Website Company Website (www.XXXXX.com) www.rwptx.com 22 Purchase Orders Contact Information All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their orders. Please select options below for receipt of Purchase Orders and provide the requested information: I will use the internet to receive Purchase Orders at the following address Yes 23 Purchase Order E-mail Address Purchase Order E-mail Address sales@rwptx.com 24 Purchase Order Contact Name Purchase Order Contact Name Giovanni Varela Sr. 25 Purchase Order Contact Phone Number Purchase Order Contact Phone Number (xxx-xxx-xxxx) 713-245-9807 26 Purchase Order Contact Extension Number Purchase Order Contact Extension Number No response 27 Alternate Purchase Order E-mail Address Alternate Purchase Order E-mail Address No response 28 Alternate Purchase Order Contact Name Alternate Purchase Order Contact Name No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 6 of 32 pages 29 Alternate Purchase Order Contact Phone Number Alternate Purchase Order Contact Phone Number (xxx-xxx-xxxx) No response 30 Alternate Purchase Order Contact Extension Number Alternate Purchase Order Contact Extension Number No response 31 Purchase Orders Contact Information All Purchase Orders from Cooperative members will be available through the Internet. Vendors need Internet access and at least one e-mail address so that notification of new orders can be sent to the Internet contact when a new purchase order arrives. An information guide will be provided to Vendors to assist them with retrieving their orders. Please select options below for receipt of Purchase Orders and provide the requested information: Purchase Orders may be received by the Designated Dealer(s) identified on my company’s Dealer Designation form as provided to the Cooperative administrator. I understand that my company shall remain responsible for the Contract and the performance of all Designated Dealers under and in accordance with the Contract. Yes 32 Request for Quotes (“RFQâ€) Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs: 33 Request for Quote (RFQ) E-mail Address Request for Quote (RFQ) E-mail Address sales@rwptx.com 34 Request for Quote (RFQ) Contact Name Request for Quote (RFQ) Contact Name Giovanni Varela Sr. 35 Request for Quote (RFQ) Contact Phone Number Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx) 713-245-9807 36 Request for Quote (RFQ) Contact Extension Number Request for Quote (RFQ) Contact Extension Number No response 37 Alternate Request for Quote (RFQ) E-mail Address Alternate Request for Quote (RFQ) E-mail Address No response 38 Alternate Request for Quote (RFQ) Contact Name Alternate Request for Quote (RFQ) Contact Name No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 7 of 32 pages 39 Alternate Request for Quote (RFQ) Contact Phone Number Alternate Request for Quote (RFQ) Contact Phone Number (xxx-xxx-xxxx) No response 40 Alternate Request for Quote (RFQ) Contact Extension Number Alternate Request for Quote (RFQ) Contact Extension Number No response 41 Invoices Your company will be billed monthly for the service fee due under a Contract awarded under this Proposal Invitation.All invoices are available on the BuyBoard website and e-mail notifications will be sent when they are ready to be retrieved. 42 Invoices Please choose only one (1) of the following options for receipt of invoices and provide the requested information: (a) Service fee invoices and related communications should be provided directly to my company at: or (b) In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following billing agent: If Vendor authorizes a billing agent to receive and process service fee invoices, in accordance with the General Terms and Conditions of the Contract, Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the Contract including, but not limited to, payment of all service fees under any Contract awarded Vendor. Service fee invoices and notices direct to company 43 Invoice Company Name Invoice Company Name Rainbow Water Purification 44 Invoice Company Department Name Invoice Company Department Name Accounts Payable 45 Invoice Contact Name Invoice Contact Name Ernesto Varela 46 Invoice Mailing Address Invoice Mailing Address (P.O. Box or Street Address) 12002 Cassandra Lane 47 Invoice Mailing Address - City Invoice Mailing Address - City Houston Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 8 of 32 pages 48 Invoice Mailing Address - State Invoice Mailing Address - State (Abbreviate State Name) TX 49 Invoice Mailing Address - Zip Code Invoice Mailing Address (Zip Code) 77064 50 Invoice Contact Phone Number Invoice Contact Phone Number (xxx-xxx-xxxx) 281-874-9736 51 Invoice Contact Extension Number Invoice Contact Extension Number No response 52 Invoice Contact Fax Number Invoice Contact Fax Number (xxx-xxx-xxxx) No response 53 Invoice Contact E-mail Address Invoice Contact E-mail sales@rwptx.com 54 Invoice Contact Alternate E-mail Address Invoice Contact Alternate E-mail Address No response 55 Billing Agent Company Name Billing Agent Company Name No response 56 Billing Agent Department Name Billing Agent Department Name No response 57 Billing Agent Contact Name Billing Agent Contact Name No response 58 Billing Agent Mailing Address Billing Agent Mailing Address (P.O. Box or Street Address) No response 59 Billing Agent Mailing Address - City Billing Agent Mailing Address - City No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 9 of 32 pages 60 Billing Agent Mailing Address - State Billing Agent Mailing Address - State (Abbreviate State Name) No response 61 Billing Agent Mailing Address - Zip Code Billing Agent Mailing Address - Zip Code No response 62 Billing Agent Contact Phone Number Billing Agent Contact Phone Number (xxx-xxx-xxxx) No response 63 Billing Agent Contact Extension Number Billing Agent Contact Extension Number No response 64 Billing Agent Fax Number Billing Agent Fax Number No response 65 Billing Agent Contact E-mail Address Billing Agent Contact E-mail Address No response 66 Billing Agent Alternative E-mail Address Billing Agent Alternative E-mail Address No response 67 Shipping Via Common Carrier, Company Truck, Prepaid and Add to Invoice, or Other Prepaid and Add to Invoice 68 Payment Terms Note: Vendor payment terms must comply with the BuyBoard General Terms and Conditions and the Texas Prompt Payment Act (Texas Government Code Ch. 2251). net30 69 Vendor's Internal/Assigned Reference/Quote Number Vendor's Internal/Assigned Reference/Quote Number No response 70 State or Attach Return Policy Note: Only return requirements and processes will be deemed part of Vendor’s return policy. Any unrelated contract terms, terms of sale, or other information not specifically related to return requirements and processes included in Vendor’s return policy shall not apply to any awarded Contract unless specifically included as a deviation in the Deviation and Compliance Form and accepted by the Cooperative. No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 10 of 32 pages 71 Electronic Payments Are electronic payments acceptable to your company? Yes 72 Credit Card Payments Are credit card payments acceptable to your company? Yes 73 Texas Regional Service Designation Texas Regional Service Designation - Refer to Form in Proposal Invitation The Cooperative (referred to as “Texas Cooperative” in this form and in the State Service Designation form) offers vendors the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all Texas Cooperative members statewide, you must indicate the specific regions you will service on this form. If you propose to serve different regions for different products or services included in your Proposal, you must complete and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the products or services to which the designation applies. By designating a region or regions, you are certifying that you are authorized and willing to provide the proposed products and services in those regions. Designating regions in which you are either unable or unwilling to provide the specified products and services shall be grounds for either rejection of your Proposal or, if awarded, termination of your Contract.Additionally, if you do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), you must so indicate on this form. 74 Company Name Company Name RAINBOW WATER PURIFICATION 75 Texas Regional Service Designation Select only one of the following options.If you select "I will NOT serve all Regions of Texas", you must then check the individual Regions you wish to serve. All Regions 76 Region 1 Region 1 - Edinburg Region 1 (1) 77 Region 2 Region 2 - Corpus Christi Region 2 (2) 78 Region 3 Region 3 - Victoria Region 3 (3) 79 Region 4 Region 4 - Houston Region 4 (4) 80 Region 5 Region 5 - Beaumont Region 5 (5) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 11 of 32 pages 81 Region 6 Region 6 - Huntsville Region 6 (6) 82 Region 7 Region 7 - Kilgore Region 7 (7) 83 Region 8 Region 8 - Mount Pleasant Region 8 (8) 84 Region 9 Region 9 - Wichita Falls Region 9 (9) 85 Region 10 Region 10 - Richardson Region 10 (10) 86 Region 11 Region 11 - Fort Worth Region 11 (11) 87 Region 12 Region 12 - Waco Region 12 (12) 88 Region 13 Region 13 - Austin Region 13 (13) 89 Region 14 Region 14 - Abilene Region 14 (14) 90 Region 15 Region 15 - San Angelo Region 15 (15) 91 Region 16 Region 16 - Amarillo Region 16 (16) 92 Region 17 Region 17 - Lubbock Region 17 (17) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 12 of 32 pages 93 Region 18 Region 18 - Midland Region 18 (18) 94 Region 19 Region 19 - El Paso Region 19 (19) 95 Region 20 Region 20 - San Antonio Region 20 (20) 96 State Service Designation State Service Designation - Refer to Form in Proposal Invitation. As set forth in the Proposal Invitation, it is the Cooperative’s intent that other governmental entities in the United States have the opportunity to purchase goods or services awarded under the Contract, subject to applicable state law, through a piggy-back award or similar agreement through the National Purchasing Cooperative BuyBoard. If you plan to service the entire United States or only specific states, you must complete this form accordingly. (Note: If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service Designation form.)In addition to this form, to be considered for a piggy-back award by the National Purchasing Cooperative, you must have an authorized representative sign the National Purchasing Cooperative Vendor Award Agreement that follows this form. If you serve different states for different products or services included in your Proposal, you must complete and submit a separate State Service Designation form for each group of products and clearly indicate the products or services to which the designation applies. By designating a state or states, you are certifying that you are authorized and willing to provide the proposed products and services in those states. Designating states in which you are either unable or unwilling to provide the specified products and services shall be grounds for either rejection of your Proposal or, if awarded, termination of your Contract. 97 Company Name Company Name RAINBOW WATER PURIFICATION 98 State Service Designation Select only one of the following options. If you select "I will NOT serve all States", you must then check the individual States you wish to serve. I will not serve all states in the United States 99 Alabama Alabama Alabama (AL) 100 Alaska Alaska Alaska (AK) 101 Arizona Arizona Arizona (AZ) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 13 of 32 pages 102 Arkansas Arkansas Arkansas (AR) 103 California California (Public Contract Code 20118 & 20652) California (CA) 104 Colorado Colorado Colorado (CO) 105 Connecticut Connecticut Connecticut (CT) 106 Delaware Delaware Delaware (DE) 107 District of Columbia District of Columbia District of Columbia (DC) 108 Florida Florida Florida (FL) 109 Georgia Georgia Georgia (GA) 110 Hawaii Hawaii Hawaii (HI) 111 Idaho Idaho Idaho (ID) 112 Illinois Illinois Illinois (IL) 113 Indiana Indiana Indiana (IN) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 14 of 32 pages 114 Iowa Iowa Iowa (IA) 115 Kansas Kansas Kansas (KS) 116 Kentucky Kentucky Kentucky (KY) 117 Louisiana Louisiana Louisiana (LA) 118 Maine Maine Maine (ME) 119 Maryland Maryland Maryland (MD) 120 Massachusetts Massachusetts Massachusetts (MA) 121 Michigan Michigan Michigan (MI) 122 Minnesota Minnesota Minnesota (MN) 123 Mississippi Mississippi Mississippi (MS) 124 Missouri Missouri Missouri (MO) 125 Montana Montana Montana (MT) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 15 of 32 pages 126 Nebraska Nebraska Nebraska (NE) 127 Nevada Nevada Nevada (NV) 128 New Hampshire New Hampshire New Hampshire (NH) 129 New Jersey New Jersey New Jersey (NJ) 130 New Mexico New Mexico New Mexico (NM) 131 New York New York New York (NY) 132 North Carolina North Carolina North Carolina (NC) 133 North Dakota North Dakota North Dakota (ND) 134 Ohio Ohio Ohio (OH) 135 Oklahoma Oklahoma Oklahoma (OK) 136 Oregon Oregon Oregon (OR) 137 Pennsylvania Pennsylvania Pennsylvania (PA) Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 16 of 32 pages 138 Rhode Island Rhode Island Rhode Island (RI) 139 South Carolina South Carolina South Carolina (SC) 140 South Dakota South Dakota South Dakota (SD) 141 Tennessee Tennessee Tennessee (TN) 142 Texas Texas Texas (TX) 143 Utah Utah Utah (UT) 144 Vermont Vermont Vermont (VT) 145 Virginia Virginia Virginia (VA) 146 Washington Washington Washington (WA) 147 West Virginia West Virginia West Virginia (WV) 148 Wisconsin Wisconsin Wisconsin (WI) 149 Wyoming Wyoming Wyoming (WY) Bid Lines Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 17 of 32 pages 1 Section I: Municipal Water Treatment Chemicals, Equipment and Supplies Discount (%) off catalog/pricelist for Municipal Water and Wastewater Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 18 of 32 pages 2 Section I: Municipal Water Treatment Chemicals, Equipment and Supplies Discount (%) off catalog/pricelist for Municipal Water and Wastewater Equipment and Supplies.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 19 of 32 pages 3 Section I: Municipal Water Treatment Chemicals, Equipment and Supplies Discount (%) off catalog/pricelist for Municipal Water and Wastewater Hardware and Software Systems (including Remote Monitoring Systems). Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 20 of 32 pages 4 Section I: Municipal Water Treatment Chemicals, Equipment and Supplies Discount (%) off catalog/pricelist for Municipal Water and Wastewater Parts (actuators, gates, joints, valves, and other municipal water and wastewater related parts).Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 21 of 32 pages 5 Section I: Municipal Water Treatment Chemicals, Equipment and Supplies Discount (%) off catalog/pricelist for All Other Municipal Water and Wastewater Products.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 22 of 32 pages 6 Section II: HVAC Water Treatment Chemicals Discount (%) off catalog/pricelist for Chilled Water Closed Loop Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 23 of 32 pages 7 Section II: HVAC Water Treatment Chemicals Discount (%) off catalog/pricelist for Cooling Tower Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 24 of 32 pages 8 Section II: HVAC Water Treatment Chemicals Discount (%) off catalog/pricelist for Hot Water Closed Loop Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 25 of 32 pages 9 Section II: HVAC Water Treatment Chemicals Discount (%) off catalog/pricelist for Two Pipe Systems (Hot and/or Cold Loops) Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 26 of 32 pages 10 Section II: HVAC Water Treatment Chemicals Discount (%) off catalog/pricelist for All Other HVAC Water Treatment Chemicals.Catalog/Pricelist MUST be included or proposal will not be considered. Total:35% Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". RWP PRICELIST 2023 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 27 of 32 pages 11 Section III: Pipe Bursting Equipment and Supplies Discount (%) off catalog/pricelist for Pneumatic Pipe Bursting Equipment.Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 28 of 32 pages 12 Section III: Pipe Bursting Equipment and Supplies Discount (%) off catalog/pricelist for Reversible Pneumatic Pipe Bursting Equipment.Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 29 of 32 pages 13 Section III: Pipe Bursting Equipment and Supplies Discount (%) off catalog/pricelist for Static Pipe Bursting Equipment (4" to 48"; all types.)Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 30 of 32 pages 14 Section III: Pipe Bursting Equipment and Supplies Discount (%) off catalog/pricelist for Pipe Bursting Equipment Parts.Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 31 of 32 pages 15 Section III: Pipe Bursting Equipment and Supplies Discount (%) off catalog/pricelist for All Other Pipe Bursting Equipment and Products.Catalog/Pricelist MUST be included or proposal will not be considered. No Bid Item Notes:PROPOSAL NOTE: Vendors shall submit catalog(s)/pricelist(s) with their Proposal response or the Proposal will not be considered. Vendors shall submit catalog(s)/pricelist(s) with the Proposal in a readily available and readable electronic format, with Excel or searchable PDF preferred. No paper catalogs or manufacturer/vendor websites will be accepted. Vendors proposing multiple manufacturer product lines and/or catalog/pricelist per line item must submit the information as follows or proposal may not be considered: Select "Add Alternate" for each additional manufacturer product line and/or catalog/pricelist proposed Vendor’s must list one specific percentage discount for each manufacturer and/or catalog/pricelist listed Item Attributes 1. State Name of Catalog/Pricelist Proposed with Discount Percentage NOTE: Do not include SKU, Reference Numbers, Websites, and/or "See Attached/Enclosed". No response 16 Section IV: Installation and Repair Service Hourly Labor Rate for Installation/Repair Service of Municipal Water Treatment Chemicals, Equipment, Supplies, and Related Products - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products. Quantity:1 UOM:Hourly Labor Rate Price:$155.00 Total:$155.00 17 Section IV: Installation and Repair Service Hourly Labor Rate for Installation/Repair Service of HVAC Water Treatment Chemicals and Products - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products. Quantity:1 UOM:Hourly Labor Rate Price:$95.00 Total:$95.00 18 Section IV: Installation and Repair Service Hourly Labor Rate for Installation/Repair Service of Pipe Bursting Equipment and Products - Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products. Quantity:1 UOM:Hourly Labor Rate No Bid Response Total: $250.00 Vendor: RAINBOW WATER PURIFICATION 691-23 Addendum 1Page 32 of 32 pages Exh i bit C CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor doing business with lacal go�ernmental entity This questionreaire reflects changes made to the law by H.B. 23, 84th Leg_, Regular Session. �fC� �SE ONLY This questionnaire is being tiled in accordance with Chapter 176. Local Government Code, by a vendar whp Date Received has a businass relationship as detined by Section 176.001(1-a) with a local govemmental ent+ty and the vendor meets requirements under 5ectfon 176.006{a). By law lhis questionnaire muss be filed with the records administralar of the local governmental ent+ry not fater than the 71h business day after the date the vendor becomes aware af facts that require 1he statemenl to 6e filed. See 5ection 176.006(a-1 f, Loca[ Gavernment Code. A vendor commits an offen5e if the vendor knowingly violates Section 176.OQ6, Lacal GovernmenE Code. An offense under this section is a misdemeanor. 1 Name oi vendor who �as a business re4ationship with local governmenta! entity. ��^ ��� C ilv �.uC� �•' i��3 r il � C L%�� ���'� x❑ Check ihis box ifi you are filing an update to a previou5ly tiied questionnaire. (The law requires thaf you file an updated completed quest+annaire with the appropraate filing aulhority not later than the 7th business day after the date an which you became aware that the originaNy filed questionnaire was incorrzple4e or inaccurate.) 3 Name ot local governrnent oflicer about whom the information is being disclosed. �UN� �kame af Officer 4 Describe each employmeni or other business relationship witfi� the local government officer, or a family member of the o#ficer, as described by Section 176.OD3(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employmenk or business relationship d�scribed. Attach addiiionai pages to this Form CIO as necessary. A. Is the local governmeni officer or a family member of the officer receiving ar likely !o receive taxai�le income, other Ehan investment income, from the �endor? � � Yes � No B. Is the vendor receiving or likely ta receive taxable income, other t�aan investment income, from or at the direction of the local govemrrtent officer or a family member of the officer AND ihe taxabfe income is not received from the local governmental entity? � Yes �'t l�o� 5 Describe each employment or business relatfonship that the vendor named in Section 1 maintains with a corporation or other business entity w�#h respect to which the local government officer serves as an ofticer or director, or halds a� ownershfp inierest o# one percent or rnore. I�;cN � 6 ❑Check this box if the vendor has given the local govemment officer or a family member af the officer one or more gifts as described in 5ection 176A03(a)(2}(B), excluding gifis described in 5ection i7fi.003{a-1). r __ ,(.��? �-7-ci- ao��1 5ignature of vendor doing business with the governmental entily Date Form provfded by Texas Ethics Commissipn www.ethics.state.ix.us Revised t!il2021 C�NFLICT OF INTEREST QUESTI�NNA�RE For vendor daing busi�ess with local governmental entity A complete copy of Chapter 176 oi the L.ocal Government Code may be found at f�ttp://www.statutes.iegis.state.tx.us/ Docs/LGIhtm/LG.176.htrrr. Far easy reference, bekow are some at the sections ciied on this form. Loca4 Go�ernment Code � 176A01 i-a :"Business relationship" means a connection between two or mare parties based on commereial acti�ity of one of the parties. The term does not incl�de a connection based on: (A) a transaetion that is subject to rate or fee regulation by a federal, state, or local govemmental entity or an agency of a fe�eral, state, or local goverr�mental entity; (B) a transaction conducted at a pric� and subject to ierms available ta the public; or (C) a purchase or lease of goods or servic�s from a person that is chartered by a state or federal agency and that is subject to regular examination by. and reporting to, that ageney. Local Government Code & 176.003(a)(2)(A) and �� (a) A local go�ernment o�ficer s�all file a canflicts disclosure st�tement with respect to a vendor if: ■kk (2) the vendor: (A) has an employment or other business relationship with the local government off+cer or a family member of the ofificer that results in the afficer or family member receiving taxable incame, other than in�estment income, #hat exceeds $2,500 during the 12-month period preceding the date that the of#icer becomes awar� that (i) a contract between the local go�ernmental entity and vendor has been executed; or (ii) the local governmental ent+ty is considering entering into a contract with the �endor; (B} has gi�en to tina local government officer or a family member of the afficer one or more gifts that have an aggregate vakue of more than $10� in the 12-month period precsding the ciate the afficer becomes aware that: (i) a contract between the local governmental entity an� �enclar has been executed; or (ii) the local gpvernmental entity is considering entering into a contracf with the �endor. Local Go�ernment Code § i76.006(a] ancf (a-1 j (a) A vendor s�all file a completed conflict of interest c�uestionnaire if the vendor has a business relatiansfi�ip with a loca! government2l �ntity and: (1) has an empEayment or other business relationship with a local go�ernment officer of that local gavemmental entity, or a family m�mber o# the officer, described by Section 176.003(a}(2)(A); (2� has gi�en a local government oificer of that local go�ernmental entity, or a family member of the officer, ane or more gifts with t�e aggregate value specified by Section � 76.003(a)(2)(B), excluding any gift de5cribeci by Section 176.003(a-1); or (3} has a family relatianship with a local ga�ernment offieer of that local governmental entity. (a-1) The completed conflict of interesi questionnaire must be filed with the appropriate records administrator nat later than the seventh business day after the later o#: (1) the date that the vendor: (AJ begins discussions or r�egotiations to enter into a cantract with the local governmental entity; or (B) submits ta the locai go�ernm�ntal entity an applieation, response to a r�quest for proposals or bids, correspondence, or another writing related to a potential contract with the local go��rnmenta� entity; or {2) the date the vendor becomes aware: (A) of an emplayment or other business relationship with a local go�ernmeni offic�r, or a tamily member of tF�e oificer, described by Subsection (a); (B) that the vendor na5 given one or rnore gifts descrii�ed by Subsection (a}; or (Cj flf a family relationship with a local government officer. Form provided by 7exas Ethics Commission www.eFhics.state.tx.us Revised 11v2UZi