Attachment A Contractor Reference Form
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1 Attachment A Contractor Reference Form Offerors shall complete a Contractor Reference Form for each provided reference in accordance with Section III Part B - Tab 15 of the RFP. Offerors shall provide at least five (5) County/municipal government clients with whom the Offeror has worked during the past three (3) years that are of similar size and complexity to the County. Further, the references provided shall meet the following criteria. o One (1) must be a Virginia client (per Section 1.9 Minimum Qualifications). o Three (3) references that have been live with the software for a minimum of two (2) years. o Two (2) references that have been live with the current software version for less than one (1) year. In the event the Offeror cannot provide the required five references, Offeror may substitute other organizations to ensure five (5) total references are provided. Offerors shall indicate how these substitute references deviate from the requested characteristics. If possible, the County prefers references that utilized the same Project Manager as will be recommended for this Project, and the same scope of functional areas. Offerors shall provide an affirmative statement that the Offeror grants its consent for the County to contact the Offeror s references for purposes of evaluating the Offeror for this Project and acknowledges that any information obtained from the Offeror s references will not be disclosed to the Proposer. Offerors should also include the contact information for three (3) similarly-sized County /municipal governments with which the County may conduct site visits. The County prefers that site visit references be provided for Virginia clients. 1. General Background Name of Client: Number of Employees: Operating Budget: Project Manager/Contact: Phone Number: Address: Title: Address: Summary of Project and Current Status: 2. Project Scope Please indicate all modules that were implemented as part of the project: General Ledger and Financial Reporting Human Resources Fixed Assets Payroll Budgeting Tax Billing Purchasing, Bids, and Contract Management Collections Accounts Payable Miscellaneous Taxes Accounts Receivable Real Estate Cash Receipts Personal Property Project Accounting Business Equipment Grant Management Business Licensing Time Entry 3. Project Information Total Project Budget: Project Start Date: Project End Date: Page 1 of 10
2 Attachment E Ownership of Deliverables Form Offerors shall complete Table E-03 below based on whether the roles identified are supported by the proposed approach and implementation methodology. The roles are defined in Table E-01 and Table E-02 contains the indicators Contractors shall use to report their support of the identified roles. Any conflicts shall be noted with a comment. In the event additional deliverables are proposed, Offerors shall identify the roles for both the County and Contractor Project Teams. The resource hours provided as part of Attachment D Resource Hours Worksheets should be appropriate based on the roles identified for each Project deliverable. Table E-01: Definition of s Lead Assist Participate Owns Share None Summary The party ultimately responsible for the development of the deliverable. The party provides active assistance in development of the deliverable The party provides passive assistance in the development of the deliverable. The party is solely responsible for the development of the deliverable. Both parties share equal responsibility for the development of the deliverable. The party has no role in the development of the deliverable. Table E-02: Summary of Response Indicators Indicator Response Description S C Supports Conflict The proposed supports the prescribed ownership roles with its proposed implementation methodology and approach. The proposed has a conflict with the prescribed ownership roles and proposed alternate ownership in its proposed implementation methodology and approach Table E-03: Ownership of Deliverables No Deliverable Vendor County Vendor Response Comments 1 Implementation Project Plan Lead Assist 2 System Interface Plan Lead Assist 3 Data Conversion Plan Lead Assist 4 Testing and Quality Assurance Plan Share Share 5 Pre- and Post-Implementation Support Plan Share Share 6 Training Plan Lead Participate 7 System Documentation Owns None 8 Risk Register Share Share Page 2 of 10
3 Attachment F Obligation of Offeror OBLIGATION OF OFFERER Obligation of Offeror: By submitting a proposal, the offeror covenants and agrees that he has satisfied himself, from his own investigation of conditions to be met, that he fully understands his obligation and that he will not make any claim for, or have right to cancellation or relief from the resulting contract because of any misunderstanding or lack of information. Offeror further agrees that conditions herein have been carefully read and this proposal is submitted subject to all requirements stated herein. The undersigned hereby acknowledges and agrees, if this proposal is accepted, to furnish all services agreed upon in strict accordance with the contract. Name and Address of Firm: Date: By: (Signature in Ink) Name: (Please Print) Title: (Please Print) FEI/FIN NO. State Corporation Commission (SCC) NO. Phone: ( ) Fax: ( ) ACKOWLEDGE RECEIPT OF: Addendum 1 Addendum 2 Addendum 3 Page 3 of 10
4 Attachment G Statement of Non-Collusion Form The undersigned, acting on behalf of, does hereby certify in connection with the procurement to which this Certification of No Collusion is incorporated and attached that: This proposal/bid is not the result of, or affected by, any act of collusion with another person engaged in the same line of business or commerce: nor is this proposal/bid the result of, or affected by, any act of fraud punishable under Article 1.1 of Chapter 12 of Title 18.2 Code of Virginia, 1950, as amended ( et seq.) By Print Name Title Name of Company Date ACKNOWLEDGEMENT The foregoing Certification of No Collusion was acknowledged before me this day of, 20, by. My commission expires: Notary Registration Number: Notary Public Page 4 of 10
5 Attachment H - Responsibility of Data Conversion Activities Form Vendors shall complete Table H-03 below based on whether the roles identified are supported by the proposed data conversion methodology and approach. The roles are defined below. Any conflicts shall be noted with a comment. In the event additional activities are proposed, the Proposers shall identify the roles for both the County and Implementation Vendor Project Teams. Lead Assist Participate Share None Table H-01: Definition of s Summary The party ultimately responsible for the activity. The party provides active assistance for the activity. The party provides passive assistance for the activity. Both parties share equal responsibility for the activity The party has no role in the activity. Table H-02: Summary of Response Indicators Indicator Response Description S C Supports Conflict The proposal supports the prescribed responsibility roles with its proposed data conversion methodology and approach. The proposal has a conflict with the prescribed responsibility roles and proposed alternate responsibility in its proposed data conversion methodology and approach Table H-03: Responsibility of Deliverables No Data Conversion Activity Vendor County Response Other Comments 1 Conversion Analysis Lead Participate 2 Crosswalk Development Lead Participate 3 Provide Conversion Data None Lead 4 Provide File Layouts/Data Maps of Existing System None Lead 5 Proof Data Provided Assist Lead 6 Analysis of Data to be Converted Lead Assist 7 Developing and Testing Conversions Lead None 8 Review and Correct Errors Share Share 9 Load Converted Data into Training Database Lead Participate 10 Confirmation of Converted Data in Training Database None Lead 11 Approval/Sign-Off of Converted Data in Training Database None Lead 12 Load Converted Data into Live Database Lead Participate 13 Confirmation of Converted Data into Live Database None Lead 14 Approval/Sign-Off of Converted Data in Live Database None Lead Page 5 of 10
6 Attachment I Company Background and History Form Offerors shall complete a Company Background and History Form in accordance with Section III - Part B - Tab 4 of the RFP. If a partnership with third-party companies is a part of a Proposal, the company background and history form shall be provided for all third-party companies. It is expected that all of the points shall be addressed for each company involved in a Proposal, prime or third party. Table I-01: Company Background and History Metric Total number of employees Total number of employees committed to the product and support being proposed Office locations Total number of active clients Total number of active government clients Total number of active County government clients Total number of Virginia clients Total number of Virginia County clients Total number of combined County/School clients (or other clients with multiple separate legal entities) Total number of completed implementations of the proposed product and version Total number of active government clients using the proposed product version Total years offering government financial systems Largest active government installation including population Smallest active government installation including population Other products offered by company Response Page 6 of 10
7 Attachment J Contractor Project Team Resumes Form Offerors shall complete a Contractor Project Team Resume Form in accordance with Section III Part 5 - Tab 5 of the RFP. Resumes shall be specific to the actual personnel to be assigned to this Project for all primary roles. Name and Title: on the Project: Home office location: Educational Background: Professional registrations and memberships: Professional references: Additional relevant information: Description of Project s and Responsibilities: implemented the proposed product: implemented other software products: Name and Title: on the Project: Home office location: Educational Background: Professional registrations and memberships: Professional references: Additional relevant information: Description of Project s and Responsibilities: implemented the proposed product: implemented other software products: Name and Title: on the Project: Home office location: Educational Background: Professional registrations and memberships: Professional references: Additional relevant information: Description of Project s and Responsibilities: implemented the proposed product: implemented other software products: Page 7 of 10
8 Attachment K Proposed Functional Areas Form Offerors shall complete Table K-01 in accordance with Section III Part B - Tab 2 of the RFP. Proposed modules that are required to satisfy the requirements associated with the functional areas identified in Table K-01 cannot be proposed complementary or optional. Table K-01: Proposed Functional Areas/Modules No. Functional Area Proposed Module(s) To Address Requested Functional Area Third-party Partnerships and/or Solutions Successfully Integrated* with, in the Past Licensing Model (Concurrent, Named User, Site License, etc.) 1 General Ledger and Financial Reporting 2 Fixed Assets 3 Budgeting 4 Purchasing Bids, and Contract Management 5 Accounts Payable 6 Accounts Receivable 7 Cash Receipts 8 Project Accounting 9 Grant Management 10 Time Entry 11 Human Resources 12 Payroll 13 Tax Billing 14 Collections 15 Miscellaneous Tax 16 Real Estate 17 Personal Property 18 Business Equipment 19 Business Licensing 20 Student Activity Reporting *Successful integration should include only those instances where both the software and the client are in production environments. Page 8 of 10
9 Attachment L SCC Form Proof Of Authority To Transact Business In Virginia THIS FORM MUST BE SUBMITTED WITH YOUR PROPOSAL. FAILURE TO INCLUDE THIS FORM MAY RESULT IN REJECTION OF YOUR PROPOSAL Pursuant to Virginia Code , an Offeror organized or authorized to transact business in the Commonwealth pursuant to Title 13.1 or Title 50 of the Code of Virginia shall include in its proposal the identification number issued to it by the State Corporation Commission ( SCC ). Any Offeror that is not required to be authorized to transact business in the Commonwealth as a foreign business entity under Title 13.1 or Title 50 of the Code of Virginia or as otherwise required by law shall attach to this form a statement describing why the Offeror is not required to be so authorized. Any Offeror described herein that fails to provide the required information shall not receive an award unless a waiver of this requirement is granted by the SCC.If this quote for goods or services is accepted by Louisa County, Virginia, the undersigned agrees that the requirements of the Code of Virginia Section have been met. Please complete the following by checking the appropriate line that applies and providing the requested information. A. Offeror is a Virginia business entity organized and authorized to transact business in Virginia by the SCC and such vendor s Identification Number issued to it by the SCC is: B. Offeror is an out-of-state (foreign) business entity that is authorized to transact business in Virginia by the SCC and such vendor s Identification Number issued to it by the SCC is C. Offeror has applied for, but has not yet received, an Identification Number from the SCC and requests that it be granted an extension of five calendar days to provide its Identification Number to the County s Purchasing Division. D. Offeror does not have an Identification Number issued to it by the SCC and is not required to be authorized to transact business in Virginia in accordance with Section(s) of the Code of Virginia and the reasons stated on the attached document(s). Please attach additional sheets if you need to explain why such Offeror is not required to be authorized to transact business in Virginia. Legal Name of Company (as registered to do business and in agreement with IRS FEIN/TIN designation letter) Legal Name of Authorized Representative for Offeror Title of Authorized Representative for Offeror Signature of Authorized Representative for Offeror Date Page 9 of 10
10 Attachment M Contractor Certification relating to Background Checks CONTRACTOR CERTIFICATION RELATING TO BACKGROUND CHECKS LOUISA COUNTY I,, [Name] [Title] of/for, certify to Louisa County [Contractor] that no representative or employee of who will [Contractor] provide services under this contract, and who will have direct contact with students on school property during regular school hours or during school-sponsored activities, has been convicted of a felony or any offense involving the sexual molestation or physical or sexual abuse or rape of a child. I understand that I can be found guilty of a Class 1 misdemeanor for making a materially false statement in this Certification of Contractor and that a conviction for making a materially false statement in this Certification of Contractor shall be grounds for the revocation of my firm or business s contract with Louisa County. [Date] [Signature] [Title] [Company] Page 10 of 10
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