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Home My WebLink AboutContract 62518Cooperative Purchase Page 1 of 5 CITY OF FORT WORTH COOPERATIVE PURCHASE AGREEMENT This Cooperative Purchase Agreement is entered into by and between the City of Fort Worth ,municipality, and VP Imaging, Inc. d/b/a DocuNav Solutions Vendor,a Texas corporation. City and Vendor 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 BuyBoard 716-23 Pricing Index ; 3. Exhibit B BuyBoard 716-23 Cooperative Agreement; and 4. Exhibit C Conflict of Interest Questionnaire. Exhibits A, B, and C which are attached hereto and incorporated herein, are made a part of this Agreement for all purposes. Vendor agrees to provide City with the services and goods included in Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto. City shall pay Vendor in accordance with the pricing index in Exhibit A and the provisions of this Agreement. Total payment made annually under this Agreement by City shall not exceed One Hundred Thousand and 00/100 dollars ($100,000.00). Vendor shall not provide any additional items or services or bill for expenses incurred for City not specified by Exhibit A of this Agreement unless City requests and approves in writing the additional costs for such items, services, and/or expenses. 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 shall be effective beginning on the date signed by the Deputy City and ending on November 30, 2025. City shall be able to renew this agreement for one (1) one-year option by written agreement of the parties, subject to the terms of BuyBoard Cooperative Contract 716-23. 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 workspace 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) Cooperative Purchase Page 2 of 5 received by the other party by United States Mail, registered, return receipt requested, addressed as follows: To CITY: City of Fort Worth Attn: Mark McDaniel, Deputy City Manager 100 Fort Worth Trail Fort Worth, TX 76102-6314 Facsimile: (817) 392-8654 at same address To VP IMAGING, INC. dba DOCUNAV SOLUTIONS: VP Imaging, Inc. dba DocuNav Solutions ATTN: Legal Department 8501 Wade Blvd #1440 Frisco, TX 75034 IP Indemnification. Vendor agrees to indemnify, defend, settle, or pay, at its own cost and for infringement of any patent, copyright, trade mark, service mark, trade secret, or other intellectual property right arising from City's use of the Deliverable(s), or any part thereof, in accordance with the Agreement, it being understood that the agreement to indemnify, defend, settle or pay shall not apply if City modifies or misuses the Deliverable(s). So long as Vendor bears the cost and expense of payment for claims or actions against the City pursuant to this section, Vendor shall have the right to conduct the defense of any such claim or action and all negotiations for its settlement or compromise and to settle or compromise any such claim; however, City shall have the right to fully participate in any and all such settlement, negotiations, or lawsuit as necessary to agrees to cooperate with Vendor in doing so. In the event City, for whatever reason, assumes the responsibility for payment of costs and expenses for any claim or action brought against the City for infringement arising under the Agreement, the City shall have the sole right to conduct the defense of any such claim or action and all negotiations for its settlement or compromise and to settle or compromise any such claim; however, Vendor shall fully participate and cooperate with the City in defense of such claim or action. City agrees to give Vendor timely written notice of any such claim or action, with copies of all papers City may receive ity under the Agreement. If the Deliverable(s), or any part thereof, is held to infringe and the use thereof is enjoined or restrained or, if as a result of a settlement or compromise, such use is materially adversely restricted, Vendor shall, at its own expense and as City's sole remedy, either: (a) procure for City the right to continue to use the Deliverable(s); or (b) modify the Deliverable(s) to make them/it non-infringing, provided that such modification does not materially adversely affect City's authorized use of the Deliverable(s); or (c) replace the Deliverable(s) with equally suitable, compatible, and functionally equivalent non-infringing Deliverable(s) at no additional charge to City; or (d) if none of the foregoing alternatives is reasonably available to Vendor, terminate the Agreement, and refund all amounts paid to Vendor by the City, subsequent to which termination City may seek any and all SECURED BY THE REQUISITE INSURANCE COVERAGE REQUIRED BY CITY. Cooperative Purchase Page 3 of 5 Data Breach. Vendor further agrees that it will monitor and test its data safeguards from time to time, and to adjust its data safeguards from time to time in light of relevant circumstances or the results of any relevant testing or monitoring. If Vendor suspects or becomes aware of any any unauthorized person or third party, or becomes aware of any other security breach relating to Personal Data held or stored by Vendor under the Agreement or in connection with the event or stop such Data Breach. In the event of such Data Breach, Vendor shall fully and immediately comply with applicable laws and shall take the appropriate steps to remedy such Data Breach. Vendor will defend, indemnify and hold City, its Affiliates, and their respective officers, directors, employees and agents, harmless from and against any and all claims, suits, causes of action, liability, loss, costs and damages, including reasonable attorney fees, arising out of or relating to any third party claim arising from breach by Vendor of its obligations contained in this Section, except to the extent resulting from the acts or omissions of City. All Personal Data to which Vendor has access under the Agreement, as between Vendor and City, will remain the property of City. City hereby consents to the use, processing and/or disclosure of Personal Data only for the purposes described herein and to the extent such use or processing is necessary for Vendor to carry out its duties and responsibilities under the Agreement, any applicable Statement(s) of Work, or as required by law. Vendor will not transfer Personal Data to third parties other than through its underlying network provider to perform its obligations under the Agreement, unless authorized in writing by and indemnify City shall remain in full effect if the Data Breach is the result of the actions of a third party. All Personal Data delivered to Vendor shall be stored in the United States or other jurisdictions approved by City in writing and shall not be transferred to any other countries or jurisdictions without the prior written consent of City. No Boycott of Israel. If Vendor has fewer than 10 employees or the Agreement is for less than $100,000, this section does not apply. Vendor acknowledges that in accordance with Chapter 2270 of the Texas Government Code, City is prohibited from entering into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. The 808.001 of the Texas Government Code. signature provides written verification to City that Vendor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the Agreement. Prohibition on Boycotting Energy Companies. Vendor acknowledges that in accordance with Chapter 2274 of the Texas Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2, the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more that is to be paid wholly or partly from public funds of the City with a company with 10 or more full-time employees unless the contract contains a written verification from the company that it: (1) does not boycott energy companies; and (2) will not boycott energy companies meaning ascribed to those terms by Chapter 2274 of the Texas Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 13, § 2. To the extent that Chapter 2274 of the Government Code signature provides written verification to the City that Contractor: (1) does not boycott energy companies; and (2) will not boycott energy companies during the term of this Agreement. Cooperative Purchase Page 4 of 5 Prohibition on Discrimination Against Firearm and Ammunition Industries. Vendor acknowledges that except as otherwise provided by Chapter 2274 of the Texas Government Code, as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1, the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more that is to be paid wholly or partly from public funds of the City with a company with 10 or more full-time employees unless the contract contains a written verification from the company that it: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate during the term of the contract against a firearm entity or firearm t Code, as added by Acts 2021, 87th Leg., R.S., S.B. 19, § 1. To the extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Vendor certifies -nature provides written verification to the City that Contractor: (1) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not discriminate against a firearm entity or firearm trade association during the term of this Agreement. [Signature Page Follows] The undersigned represents and warrants that he or she has the power and authority to execute this Agreement and bind the respective Vendor. [Executed effective as of the date signed by the Deputy City Manager below.] / [ACCEPTED AND AGREED:] City: By: vff�>v� Name: Mark McDaniel Title: Deputy City Manager Date: Dec 23, 2024 VP Imaging, Inc. dba DocuNav Solutions ��e• £lsZf Title: VP of Operations Date: 12/19/2024 CITY OF FORT WORTH INTERNAL ROUTING PROCESS: Approval Recommended: By: Name: Kevin Gunn Title: Director IT Solutions Approved as to Form and Legality: M.Kevin AndetL IIBy: M. Kevin Anders, II (Dec 23, 2024 08:57 CST) Name: M. Kevin Anders, TI Title: Assistant City Attorney Contract Authorization: M&C:NIA Approval Date: NIA Form 1295: NI A Cooperative Purchase 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: Steven Vandever (Dec 20, 2024 11:02 CST) Name: Steven Vandever Title: Sr. IT Solutions Manager City Secretary: By: Name: Jannette Goodall Title: City Secretary Page 5 ofS � r.+ ..w � � � W � a ti ni o 0 0 o r� o 0 o co m v�n o a m o 0 0 0 0 0 0 o rn o o m ry m o 0 o m o 0 o m o m m m a � co n o 00 � m m ni v n'+ a r� �n co vi r� o 0 0 0 0 0 0 o rn o io m n c o 0 0 � o �n o v oo � o�n .n m o m �.-i � v�i o v co v N o ai � vi ui vi o 0 0 0 o vi o vi v o oi � � co r+i o 0o vi vi .-i r+i v ai ri �ri ai RC � a M N N.--I .--I .--I .--I .--I .--I .--I 01 O u1 Vl �--� .-I N O N M Vl N M lD N O M O V 00 N 00 CO lD W � � 00 N�--� O N M V.--I lD .--I V O M .--I N V N V Ol lD � c� c-i N M/ rl c-I rl '� v� 1/T i/1 VT 1/? VT 1/? VT i/? VT i/? VT N t/T N t/T i/? VT i/? l/? N VT N VT N t/T VY VT N VT VY VT VY VT VY VT i/? 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J W 3 � J � i �� W Q Q Q Q Q Q Q Q � V ln = H= H �❑ �❑ J U� J U J J �c W W C � � a V/ O�.--I N M V O N � � LL a� O � C ¢ o o r r r r � d r m u x c7 � c7 �"' `^ � r z a a a 2 2 2 Y Y Y Y[C K V d d F Vul Vu1 Vui Q Q Q h N N d d d d LL Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z �y � 0 O 0 � 0 � �❑ ❑ O � � � O � � l7 w w � � � a V/ O�.--I N M V O N Q a LL a� O � L ¢ o o r r r r a a � d r muxc7�c7�""^ � r zaaa 2 2 2 Y Y Y Y[C K V 2 a F Vul Vu1 Vul Q Q Q h N� d d d d LL Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z � 0 O 0 � � �❑❑ ❑ ❑ � � � O � v v 0 � a v o � u � � � o 0 � u - � ~ ~ � u C v � - U V V C @ � � L � O V v � C � _ U in �n " E E c �o @ c - �j � o `o � c o '° o- �`w -o � .--I N M V C � O � � �� O t0 � N Ul N Ul � tV O u � N C � C C7 d O O F� F�� I I 3 i O W W O C a� 2 I I I I �� o,� a a �� c c u N o o u u u u o`o �� "a v " o� o c 'c �' � v � m m�� m o Z.� o � �o o,� o � ` o �n .�-i � w m w v a a �— � ,a � c � ~ ~ c v� v� v� v� f° a � c o o v � -o v -o ° o \ a � - - ° - • . �c v v_ v C! � C! � E E •`> o ¢ a � > > � �- �- '� L L L C C C C LL LL L ^-. � N N � p Vt Vt Vl � � � � O O Q Q H > > > > > > > > > > C E � � > > > > L L L l6 14 l0 14 f6 14 @ 14 l0 R � v ], ], l0 @ fO @ V V Z Z Z Z Z Z Z Z Z z > t�a � � Z Z C Z w w w J 3 3 3� 3�� - U U U U U U U � '- � p p U U U U � d d O O O O O O O O O O � _ = O O O O J J J � � O � � 0 � 0 � Ci �. � � 0 O � �u��,��.�� = . so�uTioNs VP Imaging Inc, dba DocuNav Solutions 8501 Wade Blvd #1440 Phone: 800-353-2320 Frisco, TX 75034 Email: sales@docunay.com Customer City of Fort Worth Brian Johnson (817)392-8868 brian. k.johnson@fortworthtexas.gov Quote #: Date: Expires On Q-00815-4 11/26/2024, 12:53 PM 12/23/2024 FORT WORTHa SALESPERSON EXT EMAIL PAYMENT METHOD Kacey Lambert klambert@docunay.com Net 30 Services aty 50.00 Product Code � Product Name � Product Description DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. �Professional Services time estimate is based upon Appendix A: Project Notes �Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. "(Fixed Rate) Project Management (Discovery, Documentation and Delivery of Updated Repository) BuyBoard Contract #716-23 applied to total - 4% off PST 181.00 DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. *Professional Services time estimate is based upon Appendix A: Project Notes *Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. *(Estimated) for Engineering (Redesign for City Secretary repository and Update to Best Practices) Hours not used will be transferrable for other projects BuyBoard Contract #716-23 applied to total - 4% off PST Unit Price I Total Price $180.00 $8,640.00 $180.00 Services SUBTOTAL: Services Total: Quotation $31,276.80 $41, 580.00 $39,916.80 Page 1 of 2 Subtotal $39,916.80 Tax $0.00 Total $39,916.80 Dec 23, 2024 Sign Here: ��"/� � �� Date: / / Terms & Conditions Payment Terms: All payments are Net 30 from date of invoice issued. Preferred payment method: check or ACH payment. Subscription terms will renew on the anniversary of the date of your pocuNav Annual Support Agreement unless you provide cancellation notice 45 days before the end of the agreement. On-site Professional Services Time: billing rate quoted does not include travel expenses for out of market professional services time. Pre- purchased hours or daily units expire after 3 years from invoice date. Page 2 of 2 �u��,��.�� = . so�uTioNs VP Imaging Inc, dba DocuNav Solutions 8501 Wade Blvd #1440 Phone: 800-353-2320 Frisco, TX 75034 Email: sales@docunay.com Customer City of Fort Worth Brian Johnson (817)392-8868 brian. k.johnson@fortworthtexas.gov Quote #: Date: Expires On Q-00816-8 11/26/2024, 1:01 PM 12/23/2024 FORT WORTHa SALESPERSON EXT EMAIL PAYMENT METHOD Kacey Lambert klambert@docunay.com Net 30 Services aty 50.00 Product Code � Product Name � Product Description DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. �Professional Services time estimate is based upon Appendix A: Project Notes �Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. "(Fixed rate) for Project management (Discovery, Documentation and Delivery of Updated Repository) BuyBoard Contract #716-23 applied to total - 4% off PST 181.00 DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. *Professional Services time estimate is based upon Appendix A: Project Notes *Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. *(Estimated) for Engineering (Redesign Police Reports repository and Update to Best Practices) Hours not used will be transferrable for other projects BuyBoard Contract #716-23 applied to total - 4% off PST Unit Price I Total Price $180.00 $8,640.00 $180.00 $31,276.80 Services SUBTOTAL: $41,580.00 Services Total: $39,916.80 Subtotal $39,916.80 Quotation Page 1 of 2 Tax $0.00 Total $39,916.80 `� `'(�u�� "` Dec 23, 2024 Sign Here: �� Date: / / Terms & Conditions Payment Terms: All payments are Net 30 from date of invoice issued. Preferred payment method: check or ACH payment. Subscription terms will renew on the anniversary of the date of your pocuNav Annual Support Agreement unless you provide cancellation notice 45 days before the end of the agreement. On-site Professional Services Time: billing rate quoted does not include travel expenses for out of market professional services time. Pre- purchased hours or daily units expire after 3 years from invoice date. Page 2 of 2 �u��,��.�� = . so�uTioNs VP Imaging Inc, dba DocuNav Solutions 8501 Wade Blvd #1440 Phone: 800-353-2320 Frisco, TX 75034 Email: sales@docunay.com Customer City of Fort Worth Brian Johnson (817)392-8868 brian. k.johnson@fortworthtexas.gov Quote #: Date: Expires On Q-00817-5 11/26/2024, 1:10 PM 12/23/2024 FORT WORTHa SALESPERSON EXT EMAIL PAYMENT METHOD Kacey Lambert klambert@docunay.com Net 30 Services aty 50.00 Product Code � Product Name � Product Description DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. �Professional Services time estimate is based upon Appendix A: Project Notes �Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. "(Fixed rate) for Project management (Discovery, Documentation and Delivery of Updated Repository) BuyBoard Contract #716-23 applied to total - 4% off PST 181.00 DN-PST-PP Pre-Purchased DocuNav Solutions Installation, Professional Services Configuration, Project Management, Time (Hourly) Stakeholder Meetings or Training Time. *Professional Services time estimate is based upon Appendix A: Project Notes *Pre- purchased block of hours billed at time of order and can be used as needed at any time during the project. *(Estimated) for Engineering (Redesign Employee Records repository and Update to Best Practices) Hours not used will be transferrable for other projects BuyBoard Contract #716-23 applied to total - 4% off PST Unit Price I Total Price $180.00 $8,640.00 $180.00 $31,276.80 Services SUBTOTAL: $41,580.00 Services Total: $39,916.80 Subtotal $39,916.80 Quotation Page 1 of 2 Tax $0.00 Total $39,916.80 Dec 23, 2024 Sign Here: �-'��2�'!�'� ��J Date: / / Terms & Conditions Payment Terms: All payments are Net 30 from date of invoice issued. Preferred payment method: check or ACH payment. Subscription terms will renew on the anniversary of the date of your pocuNav Annual Support Agreement unless you provide cancellation notice 45 days before the end of the agreement. On-site Professional Services Time: billing rate quoted does not include travel expenses for out of market professional services time. Pre- purchased hours or daily units expire after 3 years from invoice date. Page 2 of 2 v.02.01.2021 October 9, 2023 Sent Via Email: cjbettis@docunav.com CJ Bettis DocuNav Solutions 8501 Wade Blvd #1440 Frisco, TX 75034 Welcome to BuyBoard! Re: Proposal Invitation No. 716- 23, Copy/Print and Document Management Services 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 December 1, 2023 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. 716-23 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 Cooperatives 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. Once the contract is active, 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 bids@buyboard.com. Sincerely, Stacy Finn, Bid Analyst Texas Association of School Boards, Inc., Administrator for The Local Government Purchasing Cooperative October 10, 2023 Sent Via Email: cjbettis@docunav.com CJ Bettis DocuNav Solutions 8501 Wade Blvd #1440 Frisco, TX 75034 Welcome to BuyBoard! Re: Proposal Invitation No. 716-23, Copy/Print and Document Management Services Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a BuyBoard® contract based on the above-referenced Proposal Invitation. The contract is effective for an initial one-year term of December 1, 2023 through November 30, 2024, and may be subject to two possible one-year renewals. Please refer to the Proposal Invitation for the contract documents, including the National Purchasing Cooperative Vendor Award Agreement and General Terms and Conditions of the Contract. To review the items your company has been awarded, please review Proposal Tabulation No. 716-23 at www.buyboard.com/vendor. Only items marked as awarded to your company are included in this contract award, and only those awarded items may be sold through the BuyBoard contract. All sales must comply with the contract terms and must be at or below the awarded pricing as set forth in the General Terms and Conditions. The contract will be posted on the BuyBoard website as an online electronic catalog(s). You are reminded that, in accordance with the General Terms and Conditions, all purchase orders from National Cooperative members must be processed through the BuyBoard. Except as expressly authorized in writing by the Cooperatives administrator, you are not authorized to process a purchase order received directly from a National Cooperative member that has not been processed through the BuyBoard or provided to the Cooperative. If you receive a purchase order directly from a National Cooperative member that you have reason to believe has not been received by the National Cooperative or processed through the BuyBoard, you must promptly forward a copy of the purchase order by e-mail to info@buyboard.com A list of National Cooperative members is available on the buyboard.com website. Once the contract is active, the BuyBoard vendor relations staff will be contacting you to assist with resources available and provide any support you may need as an awarded BuyBoard vendor. On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any questions, feel free to contact me at bids@buyboard.com. Sincerely, Stacy Finn, Bid Analyst Texas Association of School Boards, Inc., Procurement Administrator for the National Purchasing Cooperative v.02.01.2021 PROPOSAL FORMS COMM/SVCS V.08.11.2021 PROPOSER’S ACCEPTANCE AND AGREEMENT Proposal Invitation Name Copy-Print and Document Management Services Proposal Due Date/Opening Date and Time June 8, 2023, at 4:00 PM Proposal Invitation Number 716-23 Location of Proposal Opening Texas Association of School Boards, Inc. BuyBoard Department 12007 Research Blvd. Austin, TX 78759 Contract Term December 1, 2023, through November 30, 2024, with two possible one-year renewals. Anticipated Cooperative Board Meeting Date October 2023 ________________________________________________ _______________________________________________ Name of Proposing Company Date ________________________________________________ _______________________________________________ Street Address Signature of Authorized Company Official ________________________________________________ _______________________________________________ City, State, Zip Printed Name of Authorized Company Official ________________________________________________ _______________________________________________ Telephone Number of Authorized Company Official Position or Title of Authorized Company Official ________________________________________________ _______________________________________________ Fax Number of Authorized Company Official Federal ID Number Page 10 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 PROPOSAL FORMS PART 1: COMPLIANCE FORMS INSTRUCTIONS: Proposer must review and complete all forms in this Proposal Forms Part 1: Proposal Acknowledgements Felony Conviction Disclosure Resident/Nonresident Certification Debarment Certification Vendor Employment Certification No Boycott Verification No Excluded Nation or Foreign Terrorist Organization Certification Historically Underutilized Business Certification Acknowledgement of BuyBoard Technical Requirements Construction-Related Goods and Services Affirmation Deviation and Compliance Vendor Consent for Name Brand Use Confidential/Proprietary Information EDGAR Vendor Certification Compliance Forms Signature Page An authorized representative of Proposer where indicated and complete and sign the Compliance Forms Signature Page. Proposer’s failure to fully complete, initial, and sign forms as required may result in your Proposal being rejected as non-responsive. PROPOSAL ACKNOWLEDGEMENTS The proposing company (“you” or “your”) hereby acknowledges and agrees as follows: 1. You have carefully examined and understand all information and documentation associated with this Proposal Invitation, including the Instructions to Proposers, General Information, General Terms and Conditions, attachments/forms, appendices, item specifications, and line items (collectively “Requirements”); 2. By your response (“Proposal”) to this Proposal Invitation, you propose to supply the products or services submitted at the pricing quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or exceptions are noted in the Proposal; 3. By your Proposal, you acknowledge and certify all items set forth in the General Terms and Conditions, Section B.12 (Certifications), including all non-collusion certifications and certifications regarding legal, ethical, and other matters set forth therein. 4. Any and all deviations and exceptions to the Requirements have been noted in your Proposal on the required form and no others will be claimed; Initial: _____ Page 11 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 5. If the Cooperative accepts any part of your Proposal and awards you a Contract, you will furnish all awarded products or services at the pricing quoted and in strict compliance with the Requirements (unless specific deviations or exceptions are noted on the required form and accepted by the Cooperative), including without limitation the Requirements related to: a. conducting business with Cooperative members, including offering pricing to members that is the best you offer compared to similarly situated customers in similar circumstances; b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation; c. the possible award of a piggy-back contract by the National Purchasing Cooperative or nonprofit entity, in which event you will offer the awarded products and services in accordance with the Requirements; and d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to activation of your Contract; 6. You have clearly identified on the included form any information in your Proposal that you believe to be confidential or proprietary or that you do not consider to be public information subject to public disclosure under the Texas Public Information Act or similar public information law; 7. The individual submitting this Proposal is duly authorized to enter into the contractual relationship represented by this Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any individual signing a form or Proposal document) is authorized and has the requisite knowledge to provide the information and make the representations and certifications required in the Requirements; 8. You have carefully reviewed your Proposal, and certify that all information provided is true, complete, and accurate to the best of your knowledge, and you authorize the Cooperative to take such action as it deems appropriate to verify such information; and 9. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, will be grounds for disqualifying you from consideration for a contract award under this Proposal Invitation, termination of a contract award, or any other remedy or action provided for in the General Terms and Conditions or by law. FELONYCONVICTIONDISCLOSURE Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor) states: “A person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony.” Section 44.034 further states in Subsection (b): “A school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract.” My company is a publicly-held corporation. (Advance notice requirement does not apply to publicly-held corporation.) My company is not owned or operated by anyone who has been convicted of a felony. My company is owned/operated by the following individual(s) who has/have been convicted of a felony: Name of Felon(s): ___________________________________________________________________________________ Details of Conviction(s): _______________________________________________________________________________ __________________________________________________________________________________________________ Initial: _____ Page 12 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 RESIDENT/NONRESIDENT CERTIFICATION Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who are not Texas residents. Under the statute, a “resident” proposer is a person whose principal place of business is in Texas, including a contractor whose ultimate parent company or majority owner has its principal place of business in Texas. A “nonresident” proposer is a person who is not a Texas resident. Please indicate the status of your company as a “resident” proposer or a “nonresident” proposer under these definitions. I certify that my company is a Resident Proposer. I certify that my company is a Nonresident Proposer. If your company is a Nonresident Proposer, you must provide the following information for your resident state (the state in which your company’s principal place of business is located): ________________________________________________ _______________________________________________ Company Name Address ________________________________________________ ___________ ________________________________ City State Zip Code A. Does your resident state require a proposer whose principal place of business is in Texas to under-price proposers whose resident state is the same as yours by a prescribed amount or percentage to receive a comparable contract? Yes No B. What is the prescribed amount or percentage? $_______________ or ______________% DEBARMENT CERTIFICATION By signature on the Compliance Forms Signature Page, I certify that neither my company nor an owner or principal of my company has been debarred, suspended or otherwise made ineligible for participation in Federal Assistance programs under Executive Order 12549, “Debarment and Suspension,” as described in the Federal Register and Rules and Regulations. Neither my company nor an owner or principal of my company is currently listed on the government-wide exclusions in SAM, debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory or regulatory authority. My company agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or seeking to purchase from my company if my company or an owner or principal is later listed on the government-wide exclusions in SAM, or is debarred, suspended, or otherwise excluded by agencies or declared ineligible under any statutory or regulatory authority. VENDOR EMPLOYMENT CERTIFICATION Section 44.031(b) of the Texas Education Code establishes certain criteria that a school district must consider when determining to whom to award a contract. Among the criteria for certain contracts is whether the vendor or the vendor’s ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii) employs at least 500 people in Texas. If neither your company nor the ultimate parent company or majority owner has its principal place of business in Texas, does your company, ultimate parent company, or majority owner employ at least 500 people in Texas? Yes No Initial: ______ Page 13 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 NO BOYCOTT VERIFICATION A Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel and will not boycott Israel during the term of the contract (TEX. GOV’T CODE Ch. 2271), (2) does not boycott energy companies and will not boycott energy companies during the term of the contract (TEX. GOV’T CODE Ch. 2274 effective September 1, 2021), and (3) does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association and will not discriminate during the term of the contract against a firearm entity or firearm trade association (T EX. GOV’T CODE Ch. 2274 effective September 1, 2021). Accordingly, this certification form is included to the extent required by law. “Boycott Israel” means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. TEX. GOV’T CODE §808.001(1). “Boycott energy company” means, without an ordinary business purpose, refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations with a company because the company: (A) engages in the exploration, production, utilization, transportation, sale, or manufacturing of fossil fuel-based energy and does not commit or pledge to meet environmental standards beyond applicable federal and state law; or (B) does business with a company described by Paragraph (A). T EX. GOV’T CODE §809.001(1) (effective September 1, 2021). “Discriminate against a firearm entity or firearm trade association” means, (A) with respect to the entity or association, to: (i) refuse to engage in the trade of any goods or services with the entity or association based solely on its status as a firearm entity or firearm trade association; (ii) refrain from continuing an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; or (iii) terminate an existing business relationship with the entity or association based solely on its status as a firearm entity or firearm trade association; and (B) does not include: (i) the established policies of a merchant, retail seller, or platform that restrict or prohibit the listing or selling of ammunition, firearms, or firearm accessories; and (ii) a company’s refusal to engage in the trade of any goods or services, decision to refrain from continuing an existing business relationship, or decision to terminate an existing business relationship: (aa) to comply with federal, state, or local law, policy, or regulations or a directive by a regulatory agency; or (bb) for any traditional business reason that is specific to the customer or potential customer and not based solely on an entity’s or association’s status as a firearm entity or firearm trade association. T EX. GOV’T CODE §2274.001(3) (effective September 1, 2021). By signature on the Compliance Forms Signature Page, to the extent applicable, I certify and verify that Vendor does not boycott Israel, boycott energy companies, or discriminate against a firearm entity or firearm trade association and will not do so during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this certification. Initial: _____ Page 14 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 NOEXCLUDEDNATIONORFOREIGNTERRORISTORGANIZATIONCERTIFICATION Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization – specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051, 807.051, or 2252.153. (A company that the U.S. Government affirmatively declares to be excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign terrorist organization is not subject to the contract prohibition.) By signature on the Compliance Forms Signature Page, I certify and verify that Vendor is not on the Texas Comptroller’s list identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make this certification. HISTORICALLY UNDERUTILIZED BUSINESS CERTIFICATION A Proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women Business Enterprise or “MWBE” and all referred to in this form as a “HUB”) is encouraged to indicate its HUB certification status when responding to this Proposal Invitation. The BuyBoard website will indicate HUB certifications for awarded Vendors that properly indicate and document their HUB certification on this form I certify that my company has been certified as a HUB in the following categories: Minority Owned Business Women Owned Business Service-Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2), who has a service-connected disability as defined by 38 U.S.C. § 101(16), and who has a disability rating of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of Defense) Certification Number: ___________________________________________________ Name of Certifying Agency: _______________________________________________ My company has NOT been certified as a HUB. ACKNOWLEDGEMENT OF BUYBOARD TECHNICAL REQUIREMENTS Vendor shall review the BuyBoard Technical Requirements included in this Proposal Invitation. By signature on the Compliance Forms Signature Page, the undersigned affirms that Proposer has obtained a copy of the BuyBoard Technical Requirements, has read and understands the requirements, and certifies that Vendor is able to meet and will comply with those requirements except as follows: Note: In accordance with the General Terms and Conditions of the Contract, to the extent Vendor is awarded a Contract under this Proposal Invitation but is unable or unwilling to meet the applicable BuyBoard Technical Requirements, the information available on the BuyBoard for Vendor’s awarded products or services may be limited, potentially placing Vendor at a disadvantage and impacting the ability of Cooperative members to search, find, review, and purchase Vendor’s awarded products and services on the BuyBoard website. Further, to the extent Vendor has acknowledged ability to meet and comply with the BuyBoard Technical Requirements, any subsequent failure or refusal by Vendor to promptly provide information upon request to the Cooperative administrator in accordance with those technical requirements may be deemed an event of default under the Contract. Initial: _____ Page 15 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 CONSTRUCTION-RELATED GOODS AND SERVICES AFFIRMATION The Cooperative issued the BuyBoard Procurement and Construction-Related Goods and Services Advisory for Texas Members (“Advisory”), which provides information specifically relevant to the procurement of construction-related goods and services by Texas Cooperative members. The Advisory, available at buyboard.com/Vendor/Resources.aspx, provides an overview of certain legal requirements that are potentially relevant to a Cooperative member’s procurement of construction or construction-related goods and services, including those for projects that may involve or require architecture, engineering or independent testing services. A copy of the Advisory can also be provided upon request. Because many BuyBoard contracts include goods or installation services that might be considered construction-related, Proposer must make this Construction Related-Goods and Services Affirmation regardless of type of goods or services associated with this Proposal Invitation. A contract awarded under this Proposal Invitation covers only the specific goods and/or services awarded by the Cooperative. As explained in the Advisory (“Advisory”), Texas law prohibits the procurement of architecture or engineering services through a purchasing cooperative. This Proposal Invitation and any Contract awarded thereunder does not include such services. Architecture or engineering services must be procured by a Cooperative member separately, in accordance with the Professional Services Procurement Act (Chapter 2254 of the Texas Government Code) and other applicable law and local policy. By signature on the Compliance Forms Signature Page, Proposer affirms that Proposer has obtained a copy of the Advisory, has read and understands the Advisory, and is authorized by Proposer to make this affirmation. If Proposer sells construction-related goods or services to a Cooperative member under a Contract awarded under this Proposal Invitation, Proposer will comply with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative member customers or potential Cooperative member customers aware of such requirements, and provide a Cooperative member with a copy of the Advisory before accepting the member’s Purchase Order or other agreement for construction- related goods or services. Initial: ______ Page 16 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 DEVIATION AND COMPLIANCE If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements associated with this Proposal Invitation, you MUST list all such deviations on this form, and provide complete and detailed information regarding the deviations on this form or an attachment to this form. Prior to completing this form, Vendor shall review the General Terms and Conditions section B.4 (Deviations from Item Specifications and General Terms and Conditions). Please note that, as provided in section B.4, certain provisions of the General Terms and Conditions are NOT subject to deviation, and certain deviations will be deemed rejected without further action by the Cooperative. Any attempted deviation, whether directly or indirectly, to provisions identified in this Proposal Invitation as not subject to deviation shall be deemed rejected by the Cooperative and, unless otherwise withdrawn by Vendor, may result in Vendor’s Proposal being rejected in its entirety. The Cooperative will consider any deviations in its contract award decision and reserves the right to accept or reject a proposal based upon any submitted deviation. In the absence of any deviation identified and described in accordance with the above, your company must fully comply with the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal Invitation if awarded a Contract under this Proposal Invitation. A deviation will not be effective unless accepted by the Cooperative. The Cooperative, by and through the Cooperative administrator, may, in its sole discretion, seek clarification from and/or communicate with Proposer(s) regarding any submitted deviation, consistent with general procurement principles of fair competition. The Cooperative reserves the right to accept or reject a Proposal based upon any submitted deviation. No; Deviations Yes; Deviations List and fully explain any deviations you are submitting: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Initial: _____ Page 17 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 VENDOR CONSENT FOR NAME BRAND USE BuyBoard members seeking to make purchases using a Contract awarded under this Proposal Invitation may view information regarding awarded Vendors, including but not limited to product catalogs, pricelists, pricing, and Proposals, through the BuyBoard website. To improve and enhance the experience of BuyBoard members seeking to procure goods and services under the Contract utilizing the BuyBoard website, any Vendor logo, product images, and similar brand and trademark information provided by Vendor for purposes of the Contract (“Vendor Information”) may be posted on the BuyBoard website. You acknowledge that, by submitting your Proposal, unless you specifically opt out below, you consent to use of your company’s Vendor Information on the BuyBoard website if awarded a Contract . You further acknowledge that whether, where, and when to include the Vendor Information on the BuyBoard website shall be at the sole discretion of the BuyBoard Administrator. Vendor retains, however, the right of general quality control over the BuyBoard Administrator’s authorized display of proprietary Vendor Information. Neither the BuyBoard nor its administrator will be responsible for the use or distribution of Vendor Information by BuyBoard members or any other third party using the BuyBoard website. This Vendor Consent shall be effective for the full term of the Contract, including renewals, unless Vendor provides a signed, written notice revoking consent to contractadmin@buyboard.com. BuyBoard shall have up to thirty days from the date of receipt of a termination or revocation of a Vendor Consent to remove Vendor information from the BuyBoard website. This Vendor Consent is subject to the Terms and Conditions of the Contract, including, but not limited to, those terms pertaining to Disclaimer of Warranty and Limitation of Liability, Indemnification, and Intellectual Property Infringement. Vendor logo files must be submitted in one of the formats set forth in the BuyBoard Technical Requirements. Proposers are requested to submit this information with Vendor’s Proposal. (This consent shall not authorize use of your company’s Vendor Information by BuyBoard if your company is not awarded a Contract.) OPT OUT: If your company wishes to opt out of the Vendor Consent for Name Brand Use, you must check the opt out box below. By checking this box, Vendor hereby declines to provide consent for use of Vendor Information (as defined herein) on the BuyBoard website. By opting out, Vendor acknowledges and agrees that, if Vendor is awarded a Contract under this Proposal Invitation, information available on the BuyBoard for Vendor’s awarded products or services may be limited, potentially placing Vendor at a disadvantage and impacting the ability of Cooperative members to search, find, review, and purchase Vendor’s awarded products and services on the BuyBoard website. Initial: _____ Page 18 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 CONFIDENTIAL/PROPRIETARY INFORMATION A. Public Disclosure Laws All Proposals, forms, documentation, catalogs, pricelists, or other materials submitted by Vendor to the Cooperative in response to this Proposal Invitation, may be subject to the disclosure requirements of the Texas Public Information Act (Texas Government Code chapter 552.001, ) or similar disclosure law. Proposer must clearly identify on this form any information in its Proposal (including forms, documentation, or other materials submitted with the Proposal) that Proposer considers proprietary or confidential. If Proposer fails to properly identify the information, the Cooperative shall have no obligation to notify Vendor or seek protection of such information from public disclosure should a member of the public or other third party request access to the information under the Texas Public Information Act or similar disclosure law. When required by the Texas Public Information Act or other disclosure law, Proposer may be notified of any third-party request for information in a Proposal that Proposer has identified in this form as proprietary or confidential. Does your Proposal (including forms, documentation, catalogs, pricelists, or other materials submitted with the Proposal) contain information which Vendor considers proprietary or confidential? NO, I certify that none of the information included with this Proposal is considered confidential or proprietary. YES, I certify that this Proposal contains information considered confidential or proprietary and all such information is specifically identified on this form. If you responded “YES”, you must clearly identify below the specific information you consider confidential or proprietary. List each page number, form number, or other information sufficient to make the information readily identifiable. The Cooperative and Cooperative administrator shall not be responsible for a Proposer’s failure to clearly identify information considered confidential or proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and Cooperative administrator will disclose information when required by law, even if such information has been identified herein as information Vendor considers confidential or proprietary. Confidential / Proprietary Information: _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Initial: _____ Page 19 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 B. Copyright Information Does your Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) contain copyright information? NO, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does not contain copyright information. YES, Proposal (including forms, documentation, pricelists, catalogs, or other materials submitted with the Proposal) does contain copyright information. If you responded “YES”, clearly identify below the specific documents or pages containing copyright information. Copyright Information: ________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ C. Consent to Release Confidential/Proprietary/Copyright Information to BuyBoard Members BuyBoard members (Cooperative and nonprofit members) seeking to make purchases through the BuyBoard may wish to view information included in the Proposals of awarded Vendors. If you identified information on this form as confidential, proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract award constitutes your consent to the disclosure of such information to BuyBoard members, including posting of such information on the secure BuyBoard website for members. Note: Neither the Cooperative nor Cooperative administrator will be responsible for the use or distribution of information by BuyBoard members or any other party. D. Consent to Release Proposal Tabulation Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal, Vendor consents and agrees that, upon Contract award, the Cooperative may publicly release, including posting on the public BuyBoard website, a copy of the proposal tabulation and award information for the Contract including Vendor name; proposed catalog/pricelist name(s); proposed percentage discount(s), hourly labor rate(s), or other specified pricing; and Vendor award or non-award information. Initial: ______ Page 20 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 EDGAR VENDOR CERTIFICATION (2 CFR Part 200 and Appendix II) When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards, 2 CFR 200 (sometimes referred to as the “Uniform Guidance” or new “EDGAR”). All Vendors submitting a Proposal must complete this EDGAR Certification Form regarding Vendor’s willingness and ability to comply with certain requirements which be applicable to specific Cooperative member purchases using federal grant funds. Completed forms will be made available to Cooperative members for their use while considering their purchasing options when using federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in addition to the terms and conditions of the BuyBoard contract, to address the member’s specific contractual needs, including contract requirements for a procurement using federal grants or contracts. A “NO” response to any of the items may, if applicable, impact the ability of a Cooperative member to purchase from the Vendor using federal funds. 1. Vendor Violation or Breach of Contract Terms: Contracts for more than the simplified acquisition threshold, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as authorized by 41 USC 1908, must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate. Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.18, Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms and Conditions, as well as any additional terms and conditions in any Purchase Order or Cooperative member ancillary contract agreed upon by Vendor and the Cooperative member which must be consistent with and protect the Cooperative member at least to the same extent as the BuyBoard Terms and Conditions. The remedies under the Contract are in addition to any other remedies that may be available under law or in equity. By submitting a Proposal, you agree to these Vendor violation and breach of contract terms. YES, I agree. NO, I do not agree. 2. Termination for Cause or Convenience: For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the following term and condition shall apply: If an alternate provision for termination of a Cooperative member purchase for cause and convenience, including the manner by which it will be effected and the basis for settlement, is included in the Cooperative member’s Purchase Order or ancillary agreement agreed to by the Vendor, the Cooperative member’s provision shall control. YES, I agree. NO, I do not agree. Initial: _____ Page 21 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 3. Equal Employment Opportunity: Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, “Equal Employment Opportunity” (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, “Amending Executive Order 11246 Relating to Equal Employment Opportunity,” and implementing regulations at 41 CFR Part 60, “Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.” The equal opportunity clause provided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees that such provision applies to any Cooperative member purchase or contract that meets the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 and Vendor agrees that it shall comply with such provision. YES, I agree. NO, I do not agree. 4. Davis-Bacon Act: When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction contracts/purchases in excess of $2,000, Vendor shall comply with the Davis-Bacon Act (40 USC 3141-3144, and 3146- 3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction”). In accordance with the statute, Vendor is required to pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by the Secretary of Labor. In addition, Vendor shall pay wages not less than once a week. Current prevailing wage determinations issued by the Department of Labor are available at beta.sam.gov. Vendor agrees that, for any purchase to which this requirement applies, the award of the purchase to the Vendor is conditioned upon Vendor’s acceptance of the wage determination. Vendor further agrees that it shall also comply with the Copeland “Anti-Kickback” Act (40 USC 3145), as supplemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States”). The Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. YES, I agree. NO, I do not agree. 5. Contract Work Hours and Safety Standards Act: Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment of mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40 USC 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. YES, I agree. NO, I do not agree. Initial: _____ Page 22 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 6. Right to Inventions Made Under a Contract or Agreement: If the Cooperative member’s Federal award meets the definition of “funding agreement” under 37 CFR 401.2(a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance or experimental, developmental, or research work under that “funding agreement,” the recipient or subrecipient must comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and any implementing regulations issued by the awarding agency. Vendor agrees to comply with the above requirements when applicable. YES, I agree. NO, I do not agree. 7. Clean Air Act and Federal Water Pollution Control Act: Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 1251-1387), as amended – Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non-Federal award to agree to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401- 7671q.) and the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act and the Federal Water Pollution Control Act. YES, I agree. NO, I do not agree. 8. Debarment and Suspension: Debarment and Suspension (Executive Orders 12549 and 12689) – A contract award (see 2 CFR 180.220) must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR Part 1989 Comp. p. 235), “Debarment and Suspension.” SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. Vendor certifies that Vendor is not currently listed on the government-wide exclusions in SAM, is not debarred, suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order 12549. Vendor further agrees to immediately notify the Cooperative and all Cooperative members with pending purchases or seeking to purchase from Vendor if Vendor is later listed on the government-wide exclusions in SAM, or is debarred, suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than Executive Order 12549. YES, I agree. NO, I do not agree. 9. Byrd Anti-Lobbying Amendment: Byrd Anti-Lobbying Amendment (31 USC 1352) - Vendors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC 1352. Each tier must also disclose any lobbying with non- Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award. As applicable, Vendor agrees to file all certifications and disclosures required by, and otherwise comply with, the Byrd Anti-Lobbying Amendment (31 USC 1352). YES, I agree. NO, I do not agree. Initial: _____ Page 23 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 10. Procurement of Recovered Materials: For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such information and certifications as a Cooperative member may require to confirm estimates and otherwise comply. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery, and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. YES, I agree. NO, I do not agree. 11. Domestic Preferences for Procurements: Where appropriate and consistent with law, 2 CFR §200.322 contains certain considerations for domestic preferences for procurements which may be applicable to Cooperative members using federal funds. When required by a Cooperative member, Vendor agrees to provide such information or certification as may reasonably be requested by the Cooperative member regarding Vendor’s products, including whether goods, products, or materials are produced in the United States. YES, I agree. NO, I do not agree. 12. Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment 2 CFR §200.216 prohibits expending federal loan or grant funds to procure or obtain certain telecommunications and video surveillance services or equipment. To the extent applicable and when required by a Cooperative member, Vendor agrees to provide such information or certification as may reasonably be requested by the Cooperative member to confirm whether any telecommunications or video surveillance services or equipment provided by Vendor is covered equipment or covered services under 2 CFR §200.216. YES, I agree. NO, I do not agree. 13. Profit as a Separate Element of Price: For purchases using federal funds in excess of the Simplified Acquisition Threshold, a Cooperative member may be required to negotiate profit as a separate element of the price. See, 2 CFR 200.324(b). When required by a Cooperative member, Vendor agrees to provide information and negotiate with the Cooperative member regarding profit as a separate element of the price for a particular purchase. However, Vendor agrees that the total price, including profit, charged by Vendor to the Cooperative member shall not exceed the awarded pricing, including any applicable discount, under Vendor’s Cooperative Contract. YES, I agree. NO, I do not agree. 14. General Compliance and Cooperation with Cooperative Members: In addition to the foregoing specific requirements, Vendor agrees, in accepting any Purchase Order from a Cooperative member, it shall make a good faith effort to work with Cooperative members to provide such information and to satisfy such requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to, applicable recordkeeping and record retention requirements. YES, I agree.NO, I do not agree. Initial: _____ Page 24 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 COMPLIANCE FORMS SIGNATURE PAGE By initialing pages and by signature below, I certify that I have reviewed the following forms; that the information provided therein is true, complete, and accurate; and that I am authorized by my company to make all certifications, consents, acknowledgements, and agreements contained herein: Proposal Acknowledgements Felony Conviction Disclosure Debarment Certification Resident/Nonresident Certification Vendor Employment Certification No Boycott Verification No Excluded Nation or Foreign Terrorist Organization Certification Historically Underutilized Business Certification Construction-Related Goods and Services Affirmation Acknowledgement of BuyBoard Technical Requirements Deviation and Compliance Vendor Consent for Name Brand Use Confidential/Proprietary Information EDGAR Vendor Certification __________________________________________ Company Name __________________________________________ Signature of Authorized Company Official __________________________________________ Printed Name and Title __________________________________________ Date Page 25 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS INSTRUCTIONS: Proposer must completely and accurately provide all information requested in the following Vendor Information Forms or your Proposal may be rejected as non-responsive: Vendor Business Name Vendor Contact Information Federal and State/Purchasing Cooperative Experience Governmental References Company Profile Texas Regional Service Designation State Service Designation National Purchasing Cooperative Vendor Award Agreement Local/Authorized Seller Listings Manufacturer Dealer Designation Proposal Invitation Questionnaire Vendor Request to Self-Report BuyBoard Purchases To the extent any information requested is not applicable to your company, you must so indicate on the form. VENDOR BUSINESS NAME By submitting a Proposal, Vendor is seeking to enter into a legal contract with the Cooperative. As such, Vendor must be an individual or legal business entity capable of entering into a binding contract. Name of Proposing Company: _________________________________________________________________________________________________ Type of Business: Individual/Sole Proprietor Corporation Limited Liability Company Partnership Other (Specify: ________________________) State of Incorporation (if applicable): ___________________________ Federal Employer Identification Number: ___________________________ Name by which Vendor, if awarded, wishes to be identified on the BuyBoard: __________________________________________________________________________________________________ Page 26 of 70 Fo�n, W-9 (Rev_ OCtober 20f8� �epartmam of tne Treasurq In�emal Revenue Servze Request for Taxpayer Identi#ication Number and Certification ► Ga to www.irs.gov/FarmW9 for instructions and the iatest information. Give Form to the requester. �n not send ta the IRS. ias snown on your 3ncome tax If1C 2 6usiness namerd+sregarded en1Ry name. DocuNav Solutions oi N O7 m a 0 ai o �v `02 �' N c � a V U Q1 Q N � � on tn35 >>nE: 00 n0[ I@av0 tnfs IInB anove 3 Check appropriate box Fa feeieral tax classificavon ot the person whose narrse is entered on line 1. Check only one of the 4 Exernp[ions (codes apply nNy to following seven boxes. certain entnies, not indfviduals; 58e instructions on page 3�: ❑ IndividuaVsole prpprietor or ❑ C Corporation ❑✓ 5 Corpnratipn ❑ Partnership ❑ 7rusVestaie single-member LLC Exempt payee code (ii any) ❑ Limited Ilabili4y company. Enter the tax classiiication {G=C corporation, S=5 carporetion, P=Partnershfp) ► Nate: Check the appropriate box in the line above For the 1ax classification oi the single-memher owner. Dp not check Exemption From FATCA reporting LLC it the LLC is classified as a single-member LLC that ls disregarded frpm the ownar unless the owner of the LLC is code {if any� anpther LLG tha� is not disregarded from the owner for U.S- federal tax purposes. Othenvise, a single-member LLC that is disregarded trom tl�e owner should check the appropriate box for the lax classification p} its owner. Other fsee insEructions} ► �ress inumber. street. and apt. or suite no.} See instructions. 3501 Wade Bl�d #1440 fi Cit�. state, and ZIP code Frisco, TX 75034 7 Liss accauni numqer{si �ere Identification Ne�mber rbnp�+es ro sceaunes me,marred aunfda the u s.) Requester's name and address {optional� Enaer your T1N in fhe appropr;ate box_ The TEN prov+ded must match the name given ort line 1 to 8vo�d backup w�thnolding For indiv�tlu3ls. this �s gererally your social secunty number (SSNy. liowever, for a resideM alien, s0le proprietor, or disregarded entity, see the knstruCtion5 for P�rt I, later. Fpr other entities. it fs your empioyer identifiCat�on number {EIN). if yo� do not have a number. see Now fo ge! a TlN, later. Noie: If the account is in more than ane name, see the instructions for hne 1. Also see What Name and Number To Give fhe Requesfer for guidelines on whose number to enter. Social security num6er or _� number 0�00�� j� Certification Under penalties of per�ury. I Certify that: 1. The number shown pn this form is my eorrect taxpayer identification number (pr I am waiting for a number to be issued to me}; and 2. 1 am not sub}ect to backup w�thhokdfng beeause: (a} I am exempi irom backup withholding, or (b) I ha�e not been notiiied by the Internal Reven�e Servfce {IRSj that I arn subject to backup withholdmg as a resu3t of a failure to report all mterest or dividends. or (c} the IRS has notified m� Yhat I am no longer sutl�ect io backup withholding; and 3. I am a US. citizen or other U.S. person (tlefined below}; and 4. The FATCA code(sj entered on this form (if anyj indicating that I am exempi trom FATCA reporting is carrect. CertificaGon instructions. You must Cross out itern 2 above Yf you ha�e been notifiEd by the IAS that you are currently subjeCt to backup withholdfng because you ha�e tailed to report all mterest and dividends on your tax r�tum. For real esYate trensactions. item 2 does not apply. For mortgage interest paid. acquisition or abandonment of secured property, cancellaiion of debt. contn6utions to an indi�iduai retirement arrengement (IRAj, and generally, payments other than interest and dividends, yo� are not reqwred to sigr�the certifcat�on. put you m�st p�ovide your correct TIN. See the instruttions far Pan II, later. sign 5ignature or h Here u.s. ��on s � General Instructions� � 5ect�on reterences are to the Intemal Revenue Code unless otherwise noted. Future develapments. For the latest information about developmeRts related ta Form W-9 and its instructions, such as legislat�on enacted after they were publ�shed. go to www.irs.gov/FprmW9. Purpose of Form An indfvidual or entity �Form W-9 requesterj who is required to file an information retum with the IRS must obtain your correCt taxpayer identificalion number (TW} which may be your social security number {5SN), indivlduaE taxpayer identitication number (ITWJ. adoption taxpayer identiffcation numher (ATINJ, Or employer identifiCation num3�er {EIN), to report on an infarrnation return the amount paid to you, or other amount reportable on an iniormation return. Examptes of information returns �nclude, but ara not Icmited to. the fo!low�ng. • Form ?p99-INT f�nterest e3rned orpaiciJ Date ► rj,► �`5 • Form 1099-ON {dividends, kncluding those from stocks or mutual tundsj + Form 1099-MISC [vanous types of income. prizes, awarrJs, or gross proceeds) • Form 1099-8 (stock or mutual fund sales and certain ather transactions by brokers} • Form 1099-5 (proceeds from real estate transactions) • Fprm 1098-K (merchant card and third party network transactfons) • Form � 098 (home mortgage interest), 1098-E {studeni ioan fnierest), �098-7 {tuitionj • Form 1099-C (CanCeled debt} • FOrm 7 099-A {acquisitfon or abandonment oi secured prpperty� Use Form W 9 only if you are a U.S. person {Inctuding a resident aiien}, ta provide your carrect TIN. !f you do npi reium FoRn W-9 to the requester with a T1N, yau m�ght be subJect [o baCkt�p withhalding. See What is backup withhold�ng, later. Gai. No 1023tX Form{iii-�(Rev, 10-20tS1 PROPOSAL FORMS COMM/SVCS V.08.11.2021 VENDOR CONTACT INFORMATION FEDERAL AND STATE/PURCHASING COOPERATIVE EXPERIENCE The Cooperative strives to provide Cooperative members with the best services and products at the best prices available from Vendors with the technical resources and ability to serve Cooperative members. Please respond to the following questions. 1. Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or market price during the previous 12-month period or the last fiscal year: $______________. (The period of the 12-month period is _________/_________). In the event that a dollar value is not an appropriate measure of the sales, provide and describe your own measure of the sales of the item(s). 2. By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items under equivalent circumstances. 3. Provide the information requested below for other purchasing cooperatives for which Proposer currently serves, or in the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing cooperatives as required. PURCHASING GROUP CURRENT VENDOR? (Y/N) FORMER VENDOR (Y/N)? – IF YES, LIST YEARS AS VENDOR AWARDED COMMODITY CATEGORY(IES) 1. Federal General Services Administration 2. T-PASS (State of Texas) 3. OMNIA Partners 4. Sourcewell (NJPA) 5. E&I Cooperative 6. Houston-Galveston Area Council (HGAC) 7. Choice Partners 8. The Interlocal Purchasing System (TIPS) 9. Other MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS. CURRENT BUYBOARD VENDORS If you are a current BuyBoard vendor in the same contract category as proposed in this Proposal Invitation, indicate the discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between your current and proposed discounts. Current Discount (%): _________________________ Proposed Discount (%):_______________________ ________________________________________________________________________________________ Page 27 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 GOVERNMENTAL REFERENCES For your Proposal to be considered, you must supply a minimum of five (5) individual governmental entity references. The Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the information requested below, including the existing pricing/discounts you offer each customer. The Cooperative may determine whether pricing/discounts are fair and reasonable by comparing pricing/discounts stated in your Proposal with the pricing/discounts you offer other governmental customers. Attach additional pages if necessary. Quantity/ Entity Name Contact Phone# Email Address Discount Volume 1._______________________________________________________________________________________________ 2._______________________________________________________________________________________________ 3._______________________________________________________________________________________________ 4._______________________________________________________________________________________________ 5._______________________________________________________________________________________________ Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give better discounts (lower pricing) than indicated? YES NO If YES, please explain: ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ COMPANY PROFILE Information on awarded Cooperative Contracts is available to Cooperative Members on the BuyBoard website. If your company is awarded a Contract under this Proposal Invitation, please provide a brief company description that you would like to have included with your company profile on the BuyBoard website.Submit your company profile in a separate file, in Word format, with your Proposal. (Note: Vendor is solely responsible for any content provided for inclusion on the BuyBoard website. The Cooperative reserves the right to exclude or remove any content in its sole discretion, with or without prior notice, including but not limited to any content deemed by the Cooperative to be inappropriate, irrelevant to the Contract, inaccurate, or misleading.) Page 28 of 70 --12 - - a PROPOSAL FORMS COMM/SVCS V.08.11.2021 TEXAS REGIONAL SERVICE DESIGNATION The Cooperative (referred to as “Texas Cooperative” in this form and in the State Service Designation form) offers vendors the opportunity to service its members throughout the entire State of Texas. In the electronic proposal submission system, you must indicate if you will service Texas Cooperative members statewide or, if you do not plan to service all Texas Cooperative members statewide, you indicate the specific regions you will service. If you propose to serve different regions for different products or services included in your Proposal, you must complete and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the products or services to which the designation applies.(Additional forms can be obtained by contacting bids@buyboard.com .) Additionally, if you do not plan to service Texas Cooperative members (i.e., if you will service only states other than Texas), Region and Headquarters 1 Edinburg 2 Corpus Christi 3 Victoria 4 Houston 5 Beaumont 6 Huntsville 7 Kilgore 8 Mount Pleasant 9 Wichita Falls 10 Richardson 11 Fort Worth 12 Waco 13 Austin 14 Abilene 15 San Angelo 16 Amarillo 17 Lubbock 18 Midland 19 El Paso 20 San Antonio Page 29 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 STATE SERVICE DESIGNATION 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, If you serve different states for different products or services included in your Proposal, you must complete and submit a separate State Service Designation form for each group of products and clearly indicate the products or services to which the designation applies. (Additional forms can be obtained by contacting bids@buyboard.com I will service all states in the United States. I will not service all states in the United States. Alabama Montana Alaska Nebraska Arizona Nevada Arkansas New Hampshire California (Public Contract Code 20118 & 20652) New Jersey Colorado New Mexico Connecticut New York Delaware North Carolina District of Columbia North Dakota Florida Ohio Georgia Oklahoma Hawaii Oregon Idaho Pennsylvania Illinois Rhode Island Indiana South Carolina Iowa South Dakota Kansas Tennessee Kentucky Texas Louisiana Utah Maine Vermont Maryland Virginia Massachusetts Washington Michigan West Virginia Minnesota Wisconsin Mississippi Wyoming Missouri Page 30 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal Invitation may be “piggy-backed” by another governmental entity. The National Purchasing Cooperative is an intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members throughout the United States. If you agree to be considered for a piggy-back award by the National Purchasing Cooperative, you agree to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the State Service Designation form, in your Proposal. By signing this form, Proposer (referred to in this Agreement as “Vendor”) agrees as follows: 1. Vendor acknowledges that if The Local Government Purchasing Cooperative (“Texas Cooperative”) awards Vendor a contract under this Proposal Invitation (“Underlying Award”), the National Purchasing Cooperative (“National Cooperative”) may - but is not required to - “piggy-back” on or re-award all or a portion of that Underlying Award (“Piggy-Back Award”). By signing this National Cooperative Vendor Award Agreement (“Agreement”), Vendor accepts and agrees to be bound by any such Piggy-Back Award as provided for herein. 2. In the event National Cooperative awards Vendor a Piggy-Back Award, the National Cooperative Administrator (“BuyBoard Administrator”) will notify Vendor in writing of such Piggy-Back Award, which award shall commence on the effective date stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of Vendor in order for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are agreed to by its BuyBoard Administrator in writing. 3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same unit pricing and same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e., lower) competitive pricing and more favorable terms and conditions than those in the Underlying Award. 4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be approved in writing by the BuyBoard Administrator. 5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of purchases generated from National Cooperative members through the Piggy-Back Award. Vendor shall remit payment to National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon request, Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members, vendor invoices, and/or such other documentation regarding those purchase orders as the Cooperative’s administrators may require in their reasonable discretion for purposes of reviewing and verifying purchase activity. Vendor further agrees that National Cooperative shall have the right, upon reasonable written notice, to review Vendor’s records pertaining to purchases made by National Cooperative members in order to verify the accuracy of service fees. 6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and responsibilities that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to National Cooperative; and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying Award shall inure to Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control, and then only to the extent necessary to reconcile the conflict. Page 31 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 7. This Agreement shall be governed and construed in accordance with the laws of the State of Rhode Island and venue for any dispute shall lie in the federal district court of Alexandria, Virginia. 8. Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole discretion of National Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy- Back Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy-Back Award as provided for herein. WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this Agreement. ________________________________________________ _______________________________________________ Name of Vendor Proposal Invitation Number ________________________________________________ _______________________________________________ Signature of Authorized Company Official Printed Name of Authorized Company Official _________________________________ Date Page 32 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 LOCATION/AUTHORIZED SELLER LISTINGS If you have more than one location/authorized seller that will service a Contract awarded under this Proposal Invitation, please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary. NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders, and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the Contract. Location/Authorized Seller Name Contact Person Contact Information (Mailing Address, Phone, Fax, Email) Page 33 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 MANUFACTURER DEALER DESIGNATION If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple dealers (“Designated Dealers”) to receive Cooperative member Purchase Orders on Vendor’s behalf, you must complete this form for each dealer you wish to designate. Regardless of any Designated Dealers submitted by Vendor, Vendor specifically agrees and acknowledges that any such designations are for Vendor’s convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any obligations under the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor or any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall remain responsible and liable for all of its obligations under the Contract and the performance of both Vendor and any of Vendor’s Designated Dealers under and in accordance with the Contract and remain subject to all remedies for default thereunder, including, but not limited to suspension and termination of Vendor’s Contract for nonpayment of service fees. If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor with Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process such Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to a Designated Dealer for processing. The Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated Dealer, and Vendor agrees to immediately require such Designated Dealer to cease accepting Purchase Orders or otherwise acting on Vendor’s behalf under the Contract. Further, the Cooperative administrator shall be authorized to remove or suspend any or all Designated Dealers from the BuyBoard at any time in its sole discretion. If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated Dealer below. If you wish to designate multiple dealers, please duplicate this form as necessary. ________________________________________________ _______________________________________________ Designated Dealer Name Designated Dealer Contact Person ___________________________________________________________________________________________________ Designated Dealer Address ________________________________________________ ___________ ________________________________ City State Zip Code ________________________________________________ _______________________________________________ Phone Number Fax Number ________________________________________________ _______________________________________________ Email address Designated Dealer Tax ID Number* (*attach W-9) Page 34 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 PROPOSAL INVITATION QUESTIONNAIRE The Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial resources to provide the goods and perform the services (“Work”) under the BuyBoard contract contemplated by this Proposal Invitation (“Contract”). Proposers must fully answer each question, numbering your responses to correspond to the questions/numbers below. Proposers must complete below or attach your responses to this questionnaire and submit in one document with your Proposal. You must submit the questionnaire and responses with your Proposal or the Proposal will not be considered. 1. List the number of years Proposer has been in business and former business names (if applicable). Note whether your company is currently for sale or involved in any transaction that would significantly alter its business or result in acquisition by another entity. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this Contract. State the number and summarize the experience of company personnel who may be utilized for the Work, including those who will be available to Cooperative members for assistance with project development, technical issues, and product selection for Work associated with this Contract. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 3.Marketing Strategy: For your Proposal to be considered, you must submit the Marketing Strategy you will use if the Cooperative accepts all or part of your Proposal. Attach additional pages if necessary. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Page 35 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 4. Describe Proposer’s financial capability to perform the Contract. State or describe the firm’s financial strength and rating, bonding capacity, and insurance coverage limits. State whether the firm, or any of the firm’s past or present owners, principal shareholders or stockholders, or officers, have been a debtor party to a bankruptcy, receivership, or insolvency proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position with your firm. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 5. Does your company have any outstanding financial judgments and/or is it currently in default on any loan or financing agreement? If so, provide detailed information on the nature of such items and prospects for resolution. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 6. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or that have been terminated for any reason. For each such contract, provide the project name, scope, value and date and the name of the procuring entity. Fully explain the circumstances of the default, failure to complete or deliver the work, or termination. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ 7. List all litigation or other legal proceedings (including arbitration proceedings), if any, in the last 10 years brought against your firm, or any of the firm’s past or present owners, principal shareholders or stockholders, officers, agents or employees, that relate to or arise from a contract similar to this Contract or the Work contemplated under this Contract. Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), nature of the claim, and resolution or current status. _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Page 36 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 VENDOR REQUEST TO SELF-REPORT BUYBOARD PURCHASES The General Terms and Conditions require that all Purchase Orders generated by or under any Contract awarded under this Proposal Invitation be processed through the BuyBoard and, except as expressly authorized in writing by the Cooperative administrator, Vendors are not authorized to process Purchase Orders received directly from Cooperative members that have not been processed through the BuyBoard or provided to the Cooperative. In accordance with this provision, Vendor may request authorization of the Cooperative administrator to self-report Cooperative member purchases if awarded a Contract under this Proposal Invitation. By making such a request, Vendor acknowledges and agrees that self-reporting is specifically subject to and conditioned upon (1) Vendor’s agreement to the Additional Terms and Conditions for BuyBoard Self-Reporting which are included in this Proposal Invitation and incorporated herein for all purposes and (2) approval of this request in writing by the Cooperative administrator. Any request to self-report will not be effective, and Vendor shall not be authorized to self-report BuyBoard member purchases, unless and until (1) Vendor is awarded a Contract under this Proposal Invitation, and (2) the request has been approved in writing by the Cooperative administrator. NAME OF VENDOR:_________________________________________________________________________________ ___________________________________________________________________________________________________ Signature of Vendor Authorized Representative Printed Name:_____________________________________________________________________________________ Title:______________________________________________________________________________________________ Date:__________________________________ ( Approved by BuyBoard Administrator:______________________________________ Effective/Start Date for Self-Reporting:____________________________________ Page 37 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 REQUIRED FORMS CHECKLIST Reviewed/Completed:Proposer’s Acceptance and Agreement PROPOSAL FORMS PART 1: COMPLIANCE FORMS Reviewed/Completed:Proposal Acknowledgements Reviewed/Completed: Felony Conviction Disclosure Reviewed/Completed: Resident/Nonresident Certification Reviewed/Completed: Debarment Certification Reviewed/Completed: Vendor Employment Certification Reviewed/Completed: No Boycott Verification Reviewed/Completed: No Excluded Nation or Foreign Terrorist Organization Certification Reviewed/Completed: Historically Underutilized Business Certification Reviewed/Completed: Acknowledgement of BuyBoard Technical Requirements Reviewed/Completed: Construction-Related Goods and Services Affirmation Reviewed/Completed: Deviation and Compliance Reviewed/Completed: Vendor Consent for Name Brand Use Reviewed/Completed: Confidential/Proprietary Information Reviewed/Completed: EDGAR Vendor Certification Reviewed/Completed: Compliance Forms Signature Page PROPOSAL FORMS PART 2: VENDOR INFORMATION FORMS Reviewed/Completed: Vendor Business Name Reviewed/Completed: Vendor Contact Information ( Reviewed/Completed: Federal and State/Purchasing Cooperative Experience Reviewed/Completed: Governmental References Reviewed/Completed: Company Profile Reviewed/Completed: Texas Regional Service Designation ( Reviewed/Completed: State Service Designation ( Reviewed/Completed: National Purchasing Cooperative Vendor Award Agreement Reviewed/Completed: Local/Authorized Seller Listings Reviewed/Completed: Manufacturer Dealer Designation Reviewed/Completed: Proposal Invitation Questionnaire Reviewed/Completed: Vendor Request to Self-Report BuyBoard Purchases Reviewed/Completed: Proposal Specifications Page 39 of 70 PROPOSAL FORMS COMM/SVCS V.08.11.2021 PROPOSAL SPECIFICATION SUMMARY The categories and items specified for this Proposal Invitation are summarized below. For full Proposal Specifications, you must review and complete the Proposal Specification information in the electronic proposal submission system in accordance with the Instructions to Proposers (or, if submitting a hard copy Proposal, timely request and complete the Proposal Specification Form in accordance with the Instructions to Proposers). __________________________________________________________________________________________________ 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. Section I: Copy and Print Services 1. Discount (%) off catalog/pricelist for Black and White Copy and Print Services. 2. Discount (%) off catalog/pricelist for Color Copy and Print Services. 3. Discount (%) off catalog/pricelist for Flyers, Brochures, and Postcards (Black and White). 4. Discount (%) off catalog/pricelist for Flyers, Brochures, and Postcards (Color). 5. Discount (%) off catalog/pricelist for Banners, Signs, and Posters (Black and White). 6. Discount (%) off catalog/pricelist for Banners, Signs, and Posters (Color). 7. Discount (%) off catalog/pricelist for Business Cards and Company Letterheads (Black and White). 8. Discount (%) off catalog/pricelist for Business Cards and Company Letterheads (Color). 9. Discount (%) off catalog/pricelist for Presentations and Manuals (Black and White). 10. Discount (%) off catalog/pricelist for Presentations and Manuals (Color). 11. Discount (%) off catalog/pricelist for Decals, Vehicle and Promotional Magnets (Black and White). 12. Discount (%) off catalog/pricelist for Decals, Vehicle and Promotional Magnets (Color). 13. Discount (%) off catalog/pricelist for Photo Posters and Canvas Prints (Black and White). 14. Discount (%) off catalog/pricelist for Photo Posters and Canvas Prints (Color). 15. Discount (%) off catalog/pricelist for All Types of Business Forms, NCR Forms, and Envelopes. 16. Discount (%) off catalog/pricelist for Copy and Print Finishing Services. 17. Discount (%) off catalog/pricelist for All Other Types of Copy and Print Services. Section II: Graphic Design and Layout Services 18.Hourly Labor Rate for Graphic Design and Layout Services, Not to Exceed hourly labor rate for Graphic/Design and Layout Services. (Hourly Labor Rate is inclusive of proofs to be provided prior to custom work). Section III: Document Management Services 19. Discount (%) off catalog/pricelist for Document Imaging and Data Management Services (comprehensive lifecycle management of documents and digital imaging). 20. Discount (%) off catalog/pricelist for Records Management and Storage Services (secure solutions for offsite records storage). 21. Discount (%) Off Catalog/Pricelist for Document Imaging Software (software for access to imaged information). 22. Discount (%) Off Catalog/Pricelist for Secure Document/Record Shredding Services (compliant document destruction for one-time and periodic shredding onsite or offsite). Section IV: Document Courier Services 23. Discount (%) off catalog/pricelist for Document Courier Services. Page 38 of 70 ADDENDUM NO. 1, PROPOSAL INVITATION NO. 716-23 THE LOCAL GOVERNMENT PURCHASING COOPERATIVE ADDENDUM NO. 1 Proposal Invitation No. 716-23 Copy-Print and Document Management Services The following addendum is issued to Proposal Invitation No. 716-23, Copy-Print and Document Management Services and shall become a permanent part of the Proposal Invitation document: NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT The National Purchasing Cooperative Vendor Award Agreement form included in the original Proposal Invitation is deleted and replaced with the attached form. Vendors seeking to be considered for a piggyback award to the National Purchasing Cooperative as set forth in the Proposal Invitation must sign and submit the attached National Purchasing Cooperative Vendor Agreement form. Please sign and return one copy of this Addendum with your proposal as verification of your receipt and compliance with the information contained in this Addendum. __________________________________________________________________________________________________ Company Name: ________________________________________________________________________________ Address: _______________________________________________________________________________________ Signature of Authorized Company Official: _____________________________________________ Title: ________________________ Telephone Number: ___________________________________________ Date: ________________________ Page 1 of 3 PROPOSAL FORMS COMM/SVCS V.04.28.2023 NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal Invitation may be “piggy-backed” by another governmental entity. The National Purchasing Cooperative is an intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members throughout the United States. If you agree to be considered for a piggy-back award by the National Purchasing Cooperative, you agree to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the State Service Designation form, in your Proposal. By signing this form, Proposer (referred to in this Agreement as “Vendor”) agrees as follows: 1. Vendor acknowledges that if The Local Government Purchasing Cooperative (“Texas Cooperative”) awards Vendor a contract under this Proposal Invitation (“Underlying Award”), the National Purchasing Cooperative (“National Cooperative”) may - but is not required to - “piggy-back” on or re-award all or a portion of that Underlying Award (“Piggy-Back Award”). By signing this National Cooperative Vendor Award Agreement (“Agreement”), Vendor accepts and agrees to be bound by any such Piggy-Back Award as provided for herein. 2. In the event National Cooperative awards Vendor a Piggy-Back Award, the National Cooperative Administrator (“BuyBoard Administrator”) will notify Vendor in writing of such Piggy-Back Award, which award shall commence on the effective date stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of Vendor in order for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are agreed to by its BuyBoard Administrator in writing. 3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same pricing and same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e., lower) competitive pricing and more favorable terms and conditions than those in the Underlying Award. 4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be approved in writing by the BuyBoard Administrator. 5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of purchases generated from National Cooperative members through the Piggy-Back Award. Vendor shall remit payment to National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon request, Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members, vendor invoices, and/or such other documentation regarding those purchase orders as the Cooperative’s administrators may require in their reasonable discretion for purposes of reviewing and verifying purchase activity. Vendor further agrees that National Cooperative shall have the right, upon reasonable written notice, to review Vendor’s records pertaining to purchases made by National Cooperative members in order to verify the accuracy of service fees. 6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and responsibilities that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to National Cooperative; and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying Award shall inure to Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the only parties to this Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control, and then only to the extent necessary to reconcile the conflict. Page 2 of 3 PROPOSAL FORMS COMM/SVCS V.04.28.2023 7. This Agreement shall be governed and construed in accordance with the laws of the State of Texas and venue for any dispute shall lie in the federal district court of Travis County, Texas. 8. Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole discretion of National Cooperative, and that this Agreement does not take effect unless and until National Cooperative awards Vendor a Piggy- Back Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy-Back Award as provided for herein. WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this Agreement. ________________________________________________ _______________________________________________ Name of Vendor Proposal Invitation Number ________________________________________________ _______________________________________________ Signature of Authorized Company Official Printed Name of Authorized Company Official _________________________________ Date Page 3 of 3 Exhibit C C�NFLICT flF INTEREST QIJESTI�NNAIRE FORM CI� For �endar daing business with iacal gavernmentai entity This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Aegular 5ession. OFFICEUSE�NLY This questionnaire is being filed in a��ardance with Chapter 17fi, Local Gpvernment Code, by a vendor wh❑ pate aeceivad has a business relatianship as deiined by 5ecfian 175.p61{1-a) with a locai go�ernmental entity and the vendor meets req�irements under Sectivn i7fi.D46{a}. By law this questionnaire rnus! be filed with the records administrator of the Iocal ga�ernmenta� entity not ]ater than the 7th business day after the date the �endvr be�ames aware af facfs that require the statement to he filed. See Seciion i 76.OD6�a-1}, Local Gavernment Cade. A vendor cammits an o4fense ii the vendor knowingky viqlates Se�tion 17B.D�E, Local Gv�ernment Gode. An aftense under this se�tion is a m€sdemeanor. � Name of vendor who has a business relationship with local go�ernmental entity. DocuNav Solutions � � Check this hax if you are filing an update to a pre�ious{y #ilecf questionnaire. �The law requires that you file an updated completed questiannaire with tf�e appropriate filing authority not fater than the 7th business day after the date on which you �ecame aware that the ariginally fiied questionnaire was incomp�ete or ina�curate.] � Name vi lacal go�ernment officer about whvm the infarmation is baing disclaseci. n/a Name of Officer � aescrihe ea�h emp[oyment nr other husiness relationship with the focal go�ernment affi�er, or a family member vf the atfi�er, as described by Se�tion 176.�03{a}{2J{A]. Alsa describe any family relationshi� with the locai government afficer. Camplete suF�parts A and 6 far each emplayment Qr business relatianship descrif7e[i. Attach additional pages ta this Form Cl� as necessary. n/a A. Is the laca[ govarnment offi�er or a family member a# the ❑fficer receiving ar likely ta receive taxable ir�came, other than invesfrnent incorne, from the �endor? �Yes �No B. is ihe vendor receiving or like�ly to receive taxabls incame, ather than investment incame, fram or at the direction �f the facal go�ernment offi�er or a famify member of the offi�er AN❑ the taxable incame is not re�ei�ed from the lo�al go�ernmental entity? � Yes � N❑ � Descril7e each emplayment vr business relationship that the �endor named in Section 1 maintains with a corporativn or otl�er business entity with respeci ta which the local go�er�ment officer ser�es as an afficer ar direator, or holds an ownership interest of ane percent or more. n/a 6 ❑ Gheck this box if the vendor has given the local gavernment of{icer or a family member o# the afficer one ar more gifts as described in Se�tion 17fi3OD3{a]{2){B}, excluding gifts described in Sect€an i76.OD3{a-1}. 7 � 12/19/2024 Signature pf �endor doing business with ihe ga�ernmental entity aaie Form pro�ided by 7exas Ethi�s Commission www.ethi�s.state.tx.us Re�ised i11l2023 C�NFLiCT OF INTEREST qUESTI�NNAIRE For ►►endar doing business with local ga�ernmental en#ity A�omplete capy of Chapter 176 of the Local Go�ernr►�ent Code r►�ay be found at http:llwww.statutes.legis.state.tx.usl Do�sILGIF�trrilLG.17F.htm. Far easy reference, helow are same of the sectiflns cited on this farm. Local Go�ern_ment Cade §_1_76.001{1-a]: "Business relationship" means a �annection betweer� twa or m�re par#ies �ased or� commer�ial activity af one of the parties. �he term does not include a�onnection based o�: {A} a transaction tF�at is sui�ject ta rate ar fee regulation {�y a federal, state, ar local governmental entity or an agency of a federal, state, or local ga�ernmental en#ity; {B} a transaction canducted at a price and subject ta terms availa�[e to the publi�; or {C} a purchase or lease of goods �r services from a persor� that is chartered by a state or federal agency ar�d that is subject to regular examination by, and reporting to, that agen�y. LoCal Gavernment Cvde § 116.OQ3[al[2][A1 and [6]: {a} A local go�ernment a#ficer sf�all file a conflicts disclosure statement with respect #o a vendar if: .*� �2} the ver�dor: {A} has an empfayment or other business relatianship with t�e local go�ernment o#ficer or a famify memk�er af the officer that results in the afficer ar family memher re�eiving taxable income, other than investrr�ent Encame, that exceeds $2,500 during the 12-rr3onth period preceding the date that fhe officer becames aware that {ij a cantract between the loca� goverrsmental entity and vendor has been executed; vr �il} the IQcal gaver�mental entity is ca�sidering entering inta a car�tract with the vendor; {B} has gi�en to the iocal go�ernment officer or a family member of the officer ane or more giits that have an aggregate value of mare than $1 QO in the 12-man#h period �receding the date the officer becames aware that: �ij a cantract k�etween ihe Eocai governmental entity and vendar has been executed; or �ii} the local gavernme�tal entity is eonsldering entering into a contract with the vendar. Local Ga�ernment Co�ie § 175.006{a} and [a-i] {a} A�endor shall file a campleted conflict af interest questiannaire ifi the �endQr has a business relationship with a lo�al gavernmental entity and: (1 y has an empiayment ar other business relatianship with a local go�ernrr�ent affi�er of that [ocal gavernmenial entity, or a family member of the officer, des�rihed by 5ection � 75.003{a}�2}{A}; {2y has gi�en a iacal gavernment a#ficer of that focal gavernmen#al entity, or a farr�ily mem�er af the officer, ane or more gifts with the aggregate vafue specified by Section 176.Od3{a]{2}{B}, excluding any gift described f�y Section 176.003�a-1 }; or {3} has a family refatio�ship with a lacai gavernment af#icer of that local governmental entity. {a-1 } The completed conflict oi interest questiannaire must be filed with the appropriate recorc{s administrator nat later #�an the seventh business day after the later af: �1} the date that the vendor: {A} �egins discussians or neg�tia#ior�s ta enter into a contract with the lacal gavernmental entity; ar {Bj submits to the loca! gaverr�rnental entity an applicatiar�, respanse to a request for propasals vr bids, carrespondence, ❑r another writing related ta a patential contra�t with the [acal gavernmental entity; or [�j the dafe the vendor �aecomes aware: {A} of an employment ar otf�er business relationship with a locai government officer, ar a famify mem�er af the offkcer, described by Subs�ctian �a}; {B} that the vendor has gi�en one or mare gifts described by 5uk�sectian {a}; or {C} of a family re3ationship with a local governrr3ent afficer. Fvrm provided byTexas Ethi�s Commission www.ethics.sta[e.tx.us Re�ised 71112fl21