BELTON INDEPENDENT SCHOOL DISTRICT

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1 BELTON INDEPENDENT SCHOOL DISTRICT Purchasing Department, 400 N. Wall Street, Belton, Texas Phone (254) or Fax (254) Date: April 2, 2015 REQUEST FOR PROPOSAL RFP # , Fundraising Products and Services The Belton Independent School District ( District ) invites qualified companies to submit Proposals for Technology Parts, Supplies and Services. This Request for Proposal can be reviewed and downloaded from the following website: If you are an interested company, the District invites your firm to submit a Proposal Response to: Belton Independent School District Purchasing Department 400 N. Wall Street Belton, TX Proposals responses will be received in the Office of the Director of Purchasing until 10:00 A.M., May 20, Proposals are to be sealed and returned in an envelope marked on the outside with the Vendor s name and proposal number or by to purchasing@bisd.net. Vendors are encouraged to submit responses as soon as possible. Proposals will be evaluated as they are received. Applicants will be notified of the District s decision upon approval by the Board of Trustees after the next regularly scheduled Board meeting. This is a negotiated procurement, and as such, the District reserves the right to negotiate any terms, conditions, or pricing with a Proposer prior to an award. The Board of Trustees reserves the right to reject any and/or all proposals, to award contracts for individual products or services as may appear advantageous, and to negotiate separately in any manner necessary to serve the best interest of the District. Sincerely, Tammy Shannon Purchasing Director, Belton ISD Cover Page

2 BELTON INDEPENDENT SCHOOL DISTRICT Purchasing Department, 400 N. Wall Street, Belton, Texas Phone (254) or Fax (254) Request for Proposal PROPOSAL TITLE: RFP , Fundraising Products and Services PROPOSAL DEADLINE TIME/DATE: Wednesday, May 20, 2015 at 10:00 A.M. This Solicitation includes the following sections: SECTION I: Scope of Services Contact: Tammy Shannon SECTION II General Instructions Phone: (254) SECTION III: Special Instructions SECTION IV: Certifications/Representations SECTION V: Proposal Response Form The Board of Trustees of Belton ISD or its designee reserve the right to reject any and/or all proposals, to make awards as they may be of the best value or advantageous to the District, and to waive all formalities and irregularities. Please plainly write, Fundraising Products and Services on the outside of the mailing envelope. Vendor s Acceptance Form Date Bid Completed: Please Print Name of Company/Vendor: Prepared By: Title: Signature: Telephone Number: Fax Number: Order Address: City: State: Zip Code: Remit Address: City: State: Zip Code: 1

3 SECTION I- SCOPE OF SERVICES 1. SCOPE The Belton Independent School District ( BISD or the District ) is seeking to establish an agreement with multiple Businesses, Public or Private Organizations, or other entities that wish to provide Fundraising Products and Services to the District. 2. DISTRICT OVERVIEW 2.1 Belton ISD is located 60 miles north of Austin and 40 miles south of Waco on IH-35. BISD covers an area of approximately 200 square miles in Bell County. 2.2 BISD current has one (1) traditional high school, one (1) new tech high school, one (1) ninth grade center, three (3) middle schools, nine (9) elementary schools and one (1) early childhood school. 3. CATEGORIES Please check the categories that you represent in your catalog: o o Fundraising Products Fundraising Services o Other: 4. AWARD LETTER An awarded Proposer, hereby known as a Fundraiser Company, is required to present their Fundraiser Award Letter issued by the Purchasing Department, after approval by the School Board on July 20, 2015, to the school secretary when entering a campus/department. This letter is not an endorsement of the product or service, or guarantee of service acceptance by individual campuses. 5. FUNDRAISER SELECTION PROCESS 5.1 Individual clubs, groups or organizations within a campus will determine which fundraiser company they wish to use based on the following, but not limited to: commission; suitability of fundraiser to the campus need; and whether the fundraiser will be beneficial to the campus and its community. 5.2 Campus Sponsors will be allowed to select a Fundraiser Company from the approved vendor list. 5.3 The District reserves the right for individual clubs, groups or organizations to negotiate with a Fundraiser Company, the terms, conditions, pricing, and other aspects of the Fundraiser Company s services or products during the term of the contract. 6. DISTRICT ACCESS 6.1 Fundraiser Companies are not authorized to make unsolicited contacts with individual campuses. If/when a campus has an interest in a particular fundraiser product/service; the campus will make contact with the Fundraiser Company. 6.2 Once services are requested by the campus, Fundraiser Companies are asked to limit their contacts with District representatives to only those times necessary to conduct appropriate fundraiser activities. 6.3 Fundraiser Companies are encouraged to contact a campus or department prior to their visit to arrange for an appropriate time to meet with District personnel. It is the option of the District personnel to determine if the Fundraiser Company will be granted an appointment. 7. PAYMENT TERMS Shall be negotiated with the individual campus/department for each fundraiser. 8. INVOICING AND PAYMENT Shall be negotiated with the individual campus/department for each fundraiser. 9. CATALOGS The successful Vendor(s) will provide (1) catalog to the Purchasing Department at the address listed on the front page. Additional catalogs should be sent directly to the campuses. The addresses can be found on the District website or by contacting The Purchasing Department at the telephone number or website listed on the first page of this Proposal. Please include a label on the front of the catalog with the title Fundraising Products & Services and RFP

4 10. DELIVERY The terms for delivery will be the negotiated terms and conditions for each fundraiser. SECTION II- GENERAL INSTRUCTIONS 1. DESCRIPTION BISD is accepting Proposal Responses for a multiple award contract for Technology Parts, Supplies and Services in accordance with the instructions, terms, conditions, and requirements/specifications contained in this Solicitation. 2. SUBMISSION OF PROPOSALS Proposals can be submitted either by or mail prior to the deadline stated here within. No facsimile proposals will be accepted. 2.1 Electronic proposals may be sent electronically to purchasing@bisd.net with the proposal number referenced in the subject line. 2.2 Mailed proposals shall be sealed and returned in an envelope marked on the outside with the vendor s name, address and proposal number. 2.3 Proposals must be returned to the following address in sufficient time to be received and time stamped on or before the time and date shown on this Solicitation and can be either hand delivered, mailed or ed. Belton Independent School District Attn: Purchasing Department 400 N. Wall Street Belton, TX Proposals shall represent a true and correct statement and shall contain no cause for claim of omission or error. 2.5 Before submitting a proposal, all proposers shall examine the complete contract documents, including Scope of Services, General Instructions, Special Instructions and the Proposal Response Form, all of which are part of the proposal documents. 2.6 Proposals will not be considered received unless the Proposal is physically received within the Purchasing Office at the address listed on the front page of this proposal prior to the Proposal opening. 2.7 Any interpretations, corrections or changes to this proposal will be made in the form of an addendum. The Director of Purchasing will issue any addenda to all who are known to have received a copy of this proposal. IN ORDER TO RECEIVE ADDENDA, ALL INTERESTED VENDOR S ARE REQUIRED TO SUBMIT CONTACT INFORMATION, INCLUDING ADDRESS AND PHONE NUMBER, TO THE PURCHASING DEPARTMENT at the address listed below. 2.8 Any questions concerning this proposal should be submitted via to the Director of Purchasing at tammy.shannon@bisd.net, no later than 5 days prior to the bid opening. This is to allow BISD sufficient time to respond to inquiries and provide information to all interested vendors by addenda. 3. PROPOSAL RESPONSE 3.1 The District will be accepting Proposal Responses on a continual basis from the issue date of this proposal until 10:00 A.M. on May 20, Proposal response must contain; The Proposal Response Form in its entirety; Certifications/Representations Documents; Vendor Catalog(s) or price list; Any additional documents required by this Solicitation. 3.3 The District reserves the right to reject any Proposal Responses that the District considers inappropriate. The District shall be the sole judge of acceptable Proposal Responses. 3.4 Withdrawal of Proposals. Any Vendor(s) who is extended the privilege of withdrawing a Proposal because of having proven mechanical error in his or her Proposal may not be allowed to submit a Proposal on similar items for a period of one year unless the prohibition is waived by the Superintendent. 3.5 Proposals submitted are encouraged to be in type-written or in print format. Due to high volume of responses, any illegible proposals may be rejected. 3.6 Faxed submission is prohibited unless specifically authorized by the Solicitation. 3

5 SECTION II- GENERAL INSTRUCTIONS continued 4. GENERAL TERMS, CONDITIONS AND REQUIREMENTS FOR SOLICITATIONS This solicitation shall be governed by the following documents; unless an exception is otherwise taken within this Solicitation. Documents are incorporated by reference only, and are not attached as part of this Solicitation. 4.1 Texas Education Code Purchasing and Acquisition, BISD Policy CH (Legal.) 4.3 Purchasing and Acquisition, BISD Policy CH (Local.) 5. TERM OF CONTRACT 5.1 Contracts created by this Solicitation shall be in effect from the date of award or August 1, 2015, whichever is later, through June 30, BISD reserves the right to extend the contract at the District s sole option for three (3) additional years, one year at a time. 5.3 The District reserves the right to re-evaluate the contract during the contract period and cancel the contract with a thirty (30) day written notice. 5.4 BISD, may at its sole option, extend this bid for an additional sixty (60) days from the date of expiration, under the same pricing and terms and conditions if it is determined by the District that additional time is required to avoid a contract lapse. 6. EVALUATION OF PROPOSALS 6.1 Each proposal will be evaluated based on the requirements set forth in Section III, Special Instructions. 6.2 The District reserves the right to reject any and or all proposals which comply with these specifications, or to accept a higher Proposal which complies, provided that, in the judgment of the District, the item offered under the higher proposal has additional value or function which justifies the difference in price. 6.3 All deviations from the specifications must be noted in detail by the Proposer, in writing, at the time of submittal of the formal proposal. The absence of a written list of specification deviations at the time of submittal of the proposal will hold the Proposer strictly accountable to the District to the specifications as written. Any deviations from the specifications as written, as required by the above, will be grounds for rejection of the material and or item when delivered. 6.4 Value added services included in the proposal will be considered for award of contract. All value added services must be declared in detail by the Proposer, in writing, at the time of submittal of the formal proposal. 6.5 The District reserves the right to increase or decrease the given quantity. In the event quantities are increased or decreased, the amount added or deducted shall be based upon the unit price quoted. 7. FELONY CONVICTION CERTIFICATION AND NON-COLLUSION STATEMENT Proposer is required to submit a completed copy of the Felony Conviction Certification and Non-Collusion Statement. Copies of the forms are included with these specifications and must be completed and returned with the proposal. 8. REFERENCES Three (3) references must be submitted with this proposal 9. SIGNATURES ON PROPOSALS Proposals, to be valid, must be manually signed in ink by authorized person in the space provided. By such signature, Proposer agrees to strictly abide by the terms, conditions, and specifications embodied in this proposal. 10. CONFLICT OF INTEREST 10.1 Disclosure of Certain Relationships with Local Government Officials Any individual or business entity that contracts or seeks to contract for the sale or purchase of property, goods, or services with Belton ISD must file a Conflict of Interest Questionnaire with the BISD Purchasing Office in accordance with Texas Local Government Code Chapter 176, no later that the 7 th business day after the recipient becomes aware of facts that require filing This requirement applies to a person who is an agent of a vendor in the vendor s business with the District All proposers must disclose the name of any Belton ISD employee who owns, directly or indirectly, an interest in the Proposers firm or any of its branches Form is included in this proposal or can be downloaded at W-9 INDENTIFICATION NUMBER CERTIFICATE Proposer shall submit with their Proposal Response a copy of their W-9 Identification Number Certificate to expedite the payment process if awarded a contract. Form is included in this proposal or can be downloaded at 4

6 SECTION II- GENERAL INSTRUCTIONS continued 12. TAXATION BISD is exempt under the Sales Tax and Use Tax Laws, and the Vendor(s) shall not include taxes. 13. PURCHASE ORDERS Purchase Orders are signed by the Director of Purchasing and will be issued prior to all purchases. The District will not be responsible for any purchases made prior to the issuance of a purchase order. 14. INVOICING AND PAYMENT 14.1 Invoices should be submitted showing the list price of each individual item with the discount being applied against the total of the order Invoices (IN TRIPLICATE) shall be sent to: Belton Independent School District Attn: Accounts Payable PO Box 269 Belton, TX Phone # (254) Payment terms will be Net 30 days unless otherwise authorized by the District Payment period does not commence until receipt and approval of the entire order by the ordering department. SECTION III- SPECIAL INSTRUCTIONS The following information is to provide the Fundraiser Company with the needed information on how to complete and submit their Proposal response. 1. DEFINITION For the purpose of this Solicitation, a fundraiser is known as a company or firm whose purpose is to assist schools or organizations with the raising of funds by selling products or services. 2. BACKGROUND To ensure the appropriateness of fundraising services supplied to the District, the District established a qualification process in selecting fundraiser companies. The process is comprised of two (2) steps: a). an evaluation committee determines the qualified applicants based on pre-established evaluation criteria and these approved applicants are then identified on a roster distributed to each campus; b). each campus makes the final determination on which fundraising company is the most suitable in meeting their needs by selecting from the applicants recorded on the approved roster. 3. EVALUATION CRITERIA Each application will be evaluated on the following criteria. To be considered for an award, a Proposal Response must be considered Acceptable. The criteria are: 3.1 Basic description of company and the types of products or services offered; 3.2 The range of unit costs and suggested retail prices of the product or service; 3.3 Anticipated profit percentage for the product or service; 3.4 How the product or service is marketed; 3.5 Product or service guarantee; 3.6 Support services provided by the Fundraising Sales Representative; and 3.7 Ability to receive credit for unsold merchandise. 4. APPLICATION PROCESSING TIME It is anticipated that the review process may take 2-3 weeks. However, the process may be delayed due to an increased number of Proposals. 5. AWARD 5.1 Awards will be made throughout the open period of this Solicitation. 5.2 Awards will be made upon acceptance of Proposal. 5.3 Each applicant will be contacted in writing of their approval. No contact with the campuses shall take place until receipt of approval. 5

7 SECTION IV - CERTIFICATION/REPRESENTATIONS CERTIFICATION OF FELONY CONVICTION NOTIFICATION Section Subsection (a) of the Texas Education Code requires a person or business entity that enters into a contract with a school district must give advance notice to the district if the person and/or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony. Subsection (b) states "a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract." Subsection (c) this notice is not required of a publicly held corporation. I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge (check only one item). 1. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. 2. My firm is not owned nor operated by anyone who has been convicted of a felony. 3. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony. Name of Felon(s): Details of Conviction(s): STATEMENT OF NON-COLLUSION AND NON DISCRIMINATION "Non-Collusion Statement": "The undersigned affirms that they are duly authorized to execute this contract, that this company, corporation, firm, partnership, etc., or individual has not prepared this bid in collusion (An agreement between two or more persons to deceive the school district or defraud the school district of its rights) with any other bidder, school board member, or school district employee, and that the contents of this bid as to prices, quality of product, terms and/or conditions, etc., have not been communicated by the undersigned nor by any other employee, agent and/or representative of the company, corporation, firm, partnership, etc., or individual to any other person engaged in this type of business prior to the official opening of this bid for the intent or purpose of collusion." Company Name: Submitter s Name: Submitter s Title: Submitter s Signature: 6

8 SECTION IV- CERTIFICATION/REPRESENTATIONS - continued CTPA ADOPTION CLAUSE Central Texas Purchasing Alliance (CTPA) Adoption Clause USE OF CONTRACT(S) BY MEMBERS COMPRISING THE CTPA A. If authorized by the Vendor(s), resultant contract(s) may be adopted by the member districts of the CTPA as indicated below. Authorized members may purchase goods and/or services in accordance with contract pricing and purchasing terms established by the Contract Lead District. B. A list of members that may utilize the Vendor s contract is listed on the CTPA website, C. Any district member wishing to utilize such contract(s) will contact the Vendor to verify that the contract is available to them and will place its own order(s) directly with the successful Vendor. The Successful Vendor may contact the member districts to inform them about the contract award. There shall be no obligation on the part of any participating district to utilize the contract(s). D. A negative reply by the Vendor will not adversely affect consideration of the Vendors Solicitation response. E. Each participating district has the option of executing a separate contract with the successful Vendor(s). F. The Contract Lead District shall not be held liable for any costs or damages incurred by another district as a result of any award extended to that district by the Successful Vendor. BY SIGNATURE BELOW, THE VENDOR HEREBY AUTHORIZES THE MEMBER DISTRICTS AS INDICATED BY CHECK BELOW, TO ADOPT ANY CONTRACT RESULTING FROM THE VENDOR S RESPONSE TO THIS SOLICITATION: YES NO, or YES, with the exception of the following districts: Firms Name: Date: Printed Name of Authorized Company Official: Signature of Company Official: REFERENCES Please print or type three major account references and provide contact names and phone number Company Contact Phone Company Contact Phone Company Contact Phone 7

9 SECTION IV- CERTIFICATION/REPRESENTATIONS - continued CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session. OFFICE USE ONLY Date Received This questionnaire is being filed in accordance with Chapter 176, Local Government Code by a person who has a business relationship as defined by Section (1-a) with a local governmental entity and the person meets requirements under Section (a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section , Local Government Code. A person commits an offense if the person knowingly violates Section , Local Government Code. An offense under this section is a Class C misdemeanor. 1) (In this section provide legal name of company and the name of person who has a business relationship with local governmental entity) 2) Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.) 3) Name of local government officer with whom filer has employment or business relationship. Name of Officer This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section (1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the filer of the questionnaire? Yes No B. Is the filer of the questionnaire receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? Yes No C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? Yes No D. Describe each employment or business relationship with the local government officer named in this section below. (use the space provided above to answer question D ) 4) (Signature of person doing business with the governmental entity) ( Date) If your company does not have a Conflict of Interest with Belton ISD, write company name on line #1, write N/A across the middle of the form and sign on line #4. Proposal package will not be accepted if this form is not completed. 8

10 SECTION IV- CERTIFICATION/REPRESENTATIONS - continued W-9 Request for Taxpayer Identification Number and Certification Return form to Belton ISD; do not send this form to IRS Cat. No X Form W-9 Name (as shown on your income tax return) Business name, if different from above or DBA: Check appropriate box: Individual/Sole Proprietor Corporation Partnership LLC (C=Corporation, S=S Corporation, Partnership) Exempt from backup withholding Address (number, street and apt or suite #) City: State: Zip Code: Part 1 Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your Social Security Number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see instructions on how to complete. The official IRS website supplies extensive instructions on how to fill out forms correctly, along with what to do with the filled-out forms. The IRS website also has links to information for local offices, just in case people have a difficult time with the downloadable W-9 forms and decide they would like to talk to an IRS representative face-to-face. Additionally, the site lists phone numbers to call for assistance, if the answer cannot be found online and the person does not want to go into a local office. For other Entities, it is your employer identification number (EIN). If you do not have a number, visit the IRS website to see how to get a TIN. Note: If the account is in more then one name, see the guidelines on how to complete the form at the IRS website to see on whose number to enter. Social Security Number Employer Identification Number or Part 2 Certification Under Penalties of Perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. person (including a U.S. resident alien) Certification Instructions: You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other then interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. (see the official IRS website for instructions on how to fill out forms correctly). (Signature of U.S. person) Signature: Date: Purpose of Form A person who is required to file an information return with the IRS, must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. The official IRS website supplies extensive instructions on how to fill out forms correctly, along with what to do with the filled-out forms. The IRS website also has links to information for local offices, just in case people have a difficult time with the downloadable W-9 forms and decide they would like to talk to an IRS representative face-to-face. Additionally, the site lists phone numbers to call for assistance, if the answer cannot be found online and the person does not want to go into a local office. Note: If a requester gives you a form, other than the Form W-9 provided by the IRS, to request your TIN, you must use the requester s form if it is substantially similar to the Form W-9. 9

11 SECTION V- PROPOSAL RESPONSE FORM PROPOSAL AGREEMENT & RESPONSE FORM If a parent company is submitting more than one subsidiary company, a separate Proposal should be submitted for each company name. Even if you are the sole source of the product(s) in your catalogue we request a response from you; thus eliminating the need to file a sole source letter with each purchase order. The following information must be provided to be reviewed by Belton ISD Purchasing Department and shall provide the District with a basic understanding of the product or service being offered. All information must be completed for the proposal to be considered. 1. Basic description of company and the types of products or services offered (attach copies of product descriptions, promotional literature, sales instructions, etc.) 2. The range of unit costs and suggested retail prices of the product or service: 3. Anticipated profit percentage for the product or service: 4. How is the product or service marketed: 5. Product or service guarantee: 6. Support services provided by the fundraising sales representative above: 7. Catalog title (if applicable) and discount percent offered: 8. Can unsold merchandize be returned to the company and credit issued? YES NO 9. If yes, will it be for full credit? YES NO 10. If no, what percentage will be credited? % 11. List appropriate school levels for products or services. ALL HS (9-12) Middle (6-8) Elementary (K-5) 12. Will Purchase Orders be accepted? YES NO 10

12 SECTION V- PROPOSAL RESPONSE FORM - continued I/we, having carefully read and understood the Scope of Work, General Instructions, and Special Instructions and Conditions. I/we agree to enter into a contract with the Belton Independent School District. I/we, by signature and execution of this proposal, agree to the specified instructions herein. The proposer certifies and represents to the District that it has not now and will not in the future order, confer, or agree to confer a monetary benefit or other item of value to any District employee or trustee in connection with information, submission, or award of this proposal or the performance, delivery, or sale according to this proposal. The undersigned, by his/her signature, represents that he/she is authorized to bind the Vendor to fully comply with the terms and conditions of this Solicitation, including all forms and attachments included and/or referenced herein. Signature: Date List any deviations or exceptions: Please indicate how (Vendor) was notified about this proposal opportunity; Newspaper, BISD Website, or Other, explain 11

13 Please indicate how you were notified about this proposal opportunity; Newspaper, BISD Website, Postcard, or Other, FAILURE TO SUBMIT ANY OF THE REQUIRED INFORMATION MAY BE SUFFICIENT GROUNDS FOR REJECTON OF PROPOSAL. VENDOR S CHECKLIST Vendors Acceptance Form Proposal Response Form Certificate of Felony Conviction Statement of Non-Collusion and Non-Discrimination CTPA Adoption Clause References Conflict of Interest Questionnaire W-9 (Please verify that all the requested documents listed above are present and completed prior to submittal of proposal) 12

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