PULASKI COUNTY SPECIAL SCHOOL DISTRICT 1101-A East Dixon Road/P.O. Box 8601

Little Rock, Arkansas 72216

Request for Proposals (RFP17-009) Custodial Services

(501) 234-2000

May 20, 2016

To Whom It May Concern: The Pulaski County Special School District (PCSSD) invites your offer to provide custodial services per the scope of work in the attached request for proposals.

In a sealed envelope, return your original and four (4) copies of your proposal to the Purchasing Department, 1101-A East Dixon Road, Little Rock, AR 72216, no later than 8:00 a.m., Friday, June 10, 2016. Please reference on the outside of the envelope(s) the bid number, opening date and time. Pre-Proposal Meeting and Walk-Thru schedule for 10:00 a.m., Friday, June 3, 2016. Offers will be taken under advisement upon opening and the District will notify the apparent most qualified vendor(s) for further negotiations as needed. Do not contact any district official concerning this RFP without first receiving permission from the Director of Purchasing. The District reserves the right to reject any or all responses and waive any irregularities or formalities in proposals received. The District reserves the right to negotiate with the apparent acceptable vendor(s). Price alone will not be the determining factor. Award will be based upon those considerations, which are in the best interest of the District and will be made to the responsive, responsible offerer whose proposal is judged to be the most effective and economical for the purpose intended, according to the requirements and specifications stated in the Request for Proposal.

________________________________________________________________________________ VENDOR PERTINENT INFORMATION FOR RFP17-009 We, the undersigned, have read all the requirements set forth in this bid proposal including specifications, instructions, conditions and pertinent information regarding the articles being bid on and we agree to furnish these articles at the prices stated. Arkansas Sales or Use Tax Register No. State Contractor License Federal ID NO. _______________________________ Company Name:___________________________________________________________________________________ Address: ________________________________________________________________________________________ Telephone No.

___________

Fax No.

________

E-mail ______________________________

Name & Title: _____________________________________________________________________________________ (Person authorized to sign bids) (Print)

Signature ________________________________________________________________________________________ BIDS ARE SUBJECT TO REJECTION UNLESS SUBMITTED ON THIS FORM

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The following General Instructions, Terms and Conditions (Section I); Special Instructions and Terms (Section II); and Scope of Work (Section III) will become part of any contract entered into in the event any or all of the proposal is accepted by the Pulaski County Special School District. Any Special Instructions and Terms included in the Request for Proposals override the General Instructions, Terms and Conditions. SECTION I: GENERAL INSTRUCTIONS, TERMS AND CONDITIONS DEFINITION OF TERMS RFP shall mean Request for Proposals. The words vendor, bidder, offerer, company, proposer and contractor may be used synonymously in this document. The terms “District”, “Owner”, or “PCSSD” are used interchangeably and refer to the Pulaski County Special School District. SUBMISSION OF PROPOSAL Proposals must be submitted to this office using the forms included on or before the date and time specified for proposal opening. Each proposal should be placed in a separate envelope completely and properly identifying the proposal number, proposal title and proposal opening date/time. Late proposals will not be considered under any circumstances. Failure to sign the proposal will result in disqualification. The person signing the proposal should show title or authority to bind his/her firm to a contract. Signature must be in ink. Proposal must be typed in Microsoft Word. ASSIGNMENTS Neither this contract nor any interest therein or claim there under may or shall be assigned or transferred by the contractor except as expressly authorized in writing by the District. No contract, subcontract or agreement shall be made by the contractor with any other party for furnishing any of the product, work or services herein contracted without the written approval of the District. CONFLICT OF INTEREST By submitting a proposal, the contractor represents and warrants that no director or employee of the District is in any manner interested directly or indirectly in the proposal or contract which may result from the proposal or in any of the expected profits which might arise there from; further, that no attempt has been made to influence or gain favorable advantage by communicating directly or indirectly with any official of the PCSSD. It is understood that any action taken which might tend to degrade the integrity of the competitive proposal process will be considered as grounds for disqualification or a breach of this contract. CONTRACT AGREEMENT The contract between the District and the contractor shall consist of (1) the Request for Proposal (RFP) and any amendments thereto, (2) these General Instructions, Terms and Conditions, and (3) the offer/contract submitted by the contractor in response to the RFP. In the event of a conflict in language between (1) and (3) referenced above, the provisions and requirements set forth and/or referenced in the RFP shall govern. However, the Purchasing Director reserves the right to clarify any contractual relationship in writing with the concurrence of the contractor, and such written clarification shall govern in case of conflict with the applicable requirements stated in the RFP or the contractor’s offer/contract. In all

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other matters not affected by the written clarification, if any, the RFP shall govern. The successful offerer will receive written notification of intent to award containing any clarifications and/or approved modifications. CONTRACT CHANGES In no event shall any understanding or agreement, contract modification, change order or other matter which would constitute a deviation from the terms of this contract be effective or binding upon the District unless expressly stated and agreed to in writing executed by the Director of Purchasing or his designee. CONTRACT GUIDELINES Offerers agree that a contract does not become effective until it is awarded and a written agreement, purchase order, award letter, or other notice to proceed is executed or issued by the District. INDEMNIFICATION AND LEGAL COMPLIANCE The contractor shall at all times observe and fully comply with any and all Federal, State and local laws, statutes, orders, ordinances and regulations. The contractor agrees to save, hold harmless and to indemnify the District, its agents, employees, officers and board members against any and all liability, losses, claims or costs of whatsoever kind or nature relative to the performance of the contract or any occurrence or accident in connection with inadequate design, breach of contract, material failure, default or the performance of any work, services or products supplied, pursuant to the award, whether to property or persons. Further, contractor shall indemnify, hold harmless and defend the District, its agents, employees, officers and board members from any lawsuits, causes of action, claims, liabilities and damages, of any kind and nature, including but not limited to, attorney’s fees and costs, arising out of the performance of this contract whether attributable in whole or in part to any act, omission or negligence of the District, its agents or employees, including, but not limited to, any and all lawsuits, causes of action, claims, liabilities, and damages which the District, its agents or employees may sustain by reason of any failure by contractor to indemnify as provided herein, or any failure by contractor to otherwise perform its obligations pursuant to this contract, or by reason of the injury to or death of any person or persons or the damage to, loss of use of or destruction of any property resulting from work undertaken herein. MINORITY BUSINESS POLICY It is the policy of the District that minority business enterprises shall have the maximum opportunity to participate in the District’s purchasing process. Therefore, the District encourages all minority businesses to compete for goods, services, and construction contracts. NON-COLLUSIVE AFFIDAVIT By submitting a proposal, the company and the individual personally signing the proposal represent and warrant that such proposal is genuine and is neither collusive nor made for or on behalf of any person not named, and that he has neither induced nor solicited any other company to place a sham proposal nor directly or indirectly caused another company to refrain from or be unable to present a proposal. NON-DISCRIMINATION The company shall not discriminate against , or segregate, a person or a group of persons on account of race, color, creed, religion, sex, sexual orientation, marital status, familial status, national origin, ancestry, disability or condition of acquired immune deficiency syndrome (AIDS) or AIDS-related complex in carrying out its duties and obligations pursuant to this agreement nor shall the company or any person claiming under or through the company establish or permit any such practice or practices of discrimination or segregation. The company must include in any and all subcontracts a provision similar to the preceding.

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PENALTY FOR COLLUSION If at any time it shall be found that the person, firm or corporation to whom a contract has been awarded has, in presenting any proposal, colluded with any other party or parties, then, in the sole discretion of the District, the contract so awarded shall be null and void or considered breached and the contractor shall be liable to the District for any and all loss and damage of whatsoever nature, which the District may suffer and the District may seek a new contractor. PROPRIETARY INFORMATION All information submitted in response to this RFP is public and will be available to interested parties after an award is made by the PCSSD. The bidder should not include as a part of the response to the RFP any information which the bidder believes to be a trade secret or otherwise privileged or confidential. If the bidder needs to include such material with a proposal, then the material should be supplied under separate cover and identified as confidential. The District does not warrant or agree to, but will endeavor to, keep that information confidential. Contractor acknowledges that information in the possession of the District may be subject to the provisions of the Arkansas Freedom of Information Act. REJECTION OF PROPOSALS The PCSSD may reject any and all proposals or any part thereof and may reject a proposal of any party who has failed to perform, been unfaithful and/or delinquent in any former relationship with the District. The District reserves the right to waive any irregularities or formalities in any solicitation or proposal response. The District shall be the sole judge as to which proposal is best and in determining that fact, may consider the contractor’s business integrity, financial resources, experience, facilities and/or capacity for performing the work. RESERVATIONS This RFP does not commit the District to award a contract, to pay any costs incurred in the preparation of a proposal in response to this request, or to procure or contract for services or supplies. The District reserves the right to accept, or reject, in part or its entirety, any proposal received as a result of this RFP, if it is in the best interest of the District to do so. SEVERABILITY The finding or determination of any part or parts of the General Instruction, Terms and Conditions is void, unenforceable, invalid or voidable shall result in only that part being stricken with the remainder to continue in full force and effect. STATEMENT OF EXPERIENCE AND QUALIFICATIONS The company may be required, upon request, to prove to the satisfaction of the District that they have the skill, experience and the necessary facilities and financial resources to perform the contract in a satisfactory manner and within the required time. If the evidence of competency is not satisfactory, the proposal of such company may be rejected. WITHDRAWAL OF PROPOSAL A proposal may be withdrawn before the expiration of the time during which proposals may be submitted, without prejudice, by submitting a written request for its withdrawal to the Director of Purchasing.

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SECTION II: SPECIAL INSTRUCTIONS AND TERMS PROPOSAL EVALUATION The PCSSD will negotiate, as appropriate, with the apparent acceptable offerer. The proposal(s) deemed to be the most practical and advantageous will receive major consideration. The proposed costs, fee or expense, will weigh heavily in the award of any resulting contract but will not necessarily be the determining factor. Apparent successful bidder may be asked to participate in a pre-award meeting with the District representatives to discuss and clarify contract requirements as pertains to performance expectations, response time, and other aspects of services, as appropriate. Agreements, terms or conditions resulting from this meeting will be written into the resulting contract and will be subject to normal contract enforcement. The District will utilize but not be limited to the following criteria in reviewing the proposer’s submission: 1. Demonstrate an understanding and acceptance of the scope of work and RFP requirements. 2. Demonstrate the ability to meet the requirements of the scope of work; 3. Relevant experience, qualifications and capabilities of the Contractor and key personnel; 4. Price and value of cost proposal; 5. Best efforts to employ certified disadvantaged business enterprise(s); 6. Vendors list of equipment used to execute the contract. INITIAL SCREENING A District committee will evaluate all proposals received. An initial review of proposals will be conducted to determine overall responsiveness. PCSSD will disqualify any proposal that is determined to be incomplete or non-responsive. After the evaluation committee reviews all of the submitted responses, selected firms MAY be asked to make a formal presentation to the committee. After these presentations, the committee will select firm(s) to enter into contract negotiations. If the parties fail to agree on the terms of a contract, the District reserves the right to terminate negotiations and either negotiate with the next qualified firm(s) or issue a new RFP. ORAL AND/OR WRITTEN PRESENTATIONS If requested, offerers shall make oral/written presentations to more fully explain their proposal. These presentations and demonstrations, if requested, will be held subsequent to the opening of the proposals to provide an opportunity for offerers to clarify their proposal. PCSSD may also conduct site visits to customer sites where proposer has previously installed similar systems. The Purchasing Department will coordinate time and location for presentations. If an offerer refuses to honor the request, it will result in the rejection of that offerer’s proposal. AWARD The District reserves the right to award multiple contracts based on proposals received and what is in the best interest of the District. Failure to comply will result in rejection of proposal. Proposal shall include 4 completed separately bound copies. Cost proposals must be in a separate sealed envelope. Submit proposals in a sealed envelope with offeror’s name, RFP number, and project name clearly indicated. Failure to comply may result in rejection of proposal. The contract will be awarded to the qualified offerer whose offer, conforming to the conditions and requirements of this request for proposal will be more advantageous to Pulaski County Special School District. The committee’s evaluation of criteria, cost, and other factors will be taken into consideration. The District reserves the right to reject any or all offers and to waive informalities and minor irregularities in proposals received. This Request for Proposal does not commit PCSSD to contract for any requirements for this solicitation. A written award or contract furnished to the successful offerer, within the time for acceptance specified in the offer, shall be deemed to result in a binding contract without further action by either party.

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RENEWAL OPTION PCSSD reserves the right to renew this agreement annually for up to six (6) additional one (1) year periods upon agreement of contractor.

SECTION III: SCOPE OF WORK PURPOSE The purpose of this Request for Proposal is to solicit proposals from qualified vendors for custodial services for Pulaski County Special School District. NATURE OF PROPOSAL Each interested vendor shall be responsible for the review of information contained herein, other information which may be requested, site visitation as required, and other efforts as necessary for the submission of a comprehensive proposal which will represent the vendor’s best offer as a supplier of custodial services for Pulaski County Special School District. Each proposal shall be complete, and it shall be outlined and identified by sections of this Request to facilitate evaluation and to prevent evaluators from unnecessary search/arranging materials for evaluation purposes. In the preparation of each proposal attention should be given to the criteria referenced herein which will be used for purposes of evaluation and award determination purposes. PROGRAM REQUIREMENTS I.

General The contractor shall furnish all management, supervision, cleaning personnel, equipment, cleaning supplies, tools, and other materials as required for custodial services for the following Pulaski County Special School District sites: Central Office, Special Education Complex, Robinson Elementary and Oakbrooke Elementary.

II.

Level of Cleanliness It will be the responsibility of the vendor to provide custodial services for the individual locations in keeping with high standards for an educational institution from the perspectives of sanitation, public relations, and protection of the physical facility. Therefore, the intent of this proposal request is to approach this matter from a level of cleanliness concept, and a detailed cleaning schedule is included.

SCOPE OF PROGRAM I.

General In general, the overall requirement is to provide complete custodial services as required for the District for the following schools: Central Office, Special Education Complex, Robinson Elementary and Oakbrooke Elementary.

II.

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SPACE

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Through actual measurements will be provided on attached floor plans, use of existing drawings and/or other means, it shall be the responsibility of the vendor to verify measurements as deemed applicable for the submission of a proposal.

III.

SPECIAL REQUIREMENTS FOR THE SUBMISSION OF A PROPOSAL A.

Qualifications Each vendor shall submit evidence of qualifications which would influence the ability to satisfactorily perform the custodial services defined elsewhere in this document (see evaluation criteria for additional pertinent details.)

B.



Vendor must have been in the custodial services business for a minimum of five (5) years.



Vendor must currently have a contract with at least one school district.



Vendor must demonstrate ability to manage a large school with current references and management expertise.

Pre-Proposal meeting and walk through of facilities Only those vendors who attend the pre-proposal meeting along with a walk through immediately following on Friday, June 3, 2016 @ 10:00 a.m. to be held at Purchasing Conference Room, 1101 A East Dixon Road, Little Rock, AR 72206 shall be eligible for submission of a proposal. For additional tours, it shall be the sole responsibility of the vendor to visit each facility to acquaint themselves with the nature and extent of work involved by arranging with each facilities Principal.

IV.

Firm Offer Each vendor must agree in advance in written form to submit a proposal with cost figures which will be firm for at least one (1) year after the opening of the proposals.

V.

Unit and Total Cost Each proposal shall include monthly unit and total cost figures, and the same shall be shown for an annual basis.

VI.

Noncompliance of the Contract Upon noncompliance of the contract by the contractor for completeness and thoroughness in the duties as judged by the District, the District shall so inform the contractor in writing thereof. The District shall notify the contractor of noncompliance and will reserve the right to have the duties completed by other means. The District shall reduce the contractor’s invoice an hourly rate of $15.00 per man-hour for an amount equal to such time as is required. Noncompliance shall be cause for the District cancellation of this agreement. The contractor shall be given ninety (90) day notice of cancellation.

VII.

EVALUATION OF PROPOSALS

A.

Committee

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Evaluation of proposals submitted in response to the solicitation will be conducted by officials of the District. In the process of evaluation the total vendor’s proposal will be considered. However, particular attention will be paid to those criteria which are referenced in Section II. Each response will be assigned a numeric score rating by each evaluator, and the reward which will be made by Committee assigned by the District will be predicated upon the composite ratings of officials referenced above with total cost for the program considered. The evaluated proposal costs shall be calculated by dividing the proposal price by the total point score, then by multiplying by the maximum score. During the process of evaluation the committee may need additional information. This need will be communicated through the District and each vendor shall be responsible to respond in written form or by appearance before the committee as requested. B.

Criteria Specific criteria which will be utilized by the committee referenced above and the relative weight given to each are listed below and must be included with the proposal. Please provide in your proposal in the order listed below, information addressing each item that will be evaluated.

VII.

CONTRACT A.

Award It is the full intent, assuming that satisfactory proposals are received, to award a contract. If an award is made it will be for a one-year period, beginning on the date of the contract, with provisions for four (4) one-year extensions. Extensions will be made based upon the recommendations of the authorized representatives of Pulaski County Special School District and the vendor. Final approval for any extensions shall be made by the Director of Maintenance Department or appointed staff. In case of extensions, the cost per month which was submitted in the vendor’s proposal may be increased or decreased. During extensions this cost figure may be changed in accordance with any change which may have occurred in the United States Consumer Price Index over the preceding twelve months effective 30 days prior to the termination of the contract period in question and not to exceed 5%.

B.

Termination/Cancellation The District reserves the right to cancel the contract upon ninety days written notice for reasons of non-performance within the terms and conditions of this request for proposal or conditions beyond control, such as inadequate funding. A ninety day “cure period’ shall be in place to allow contractor to resolve any problems.

C.

Payments Payment for services received will be made on a monthly basis. After approval the invoice will be forwarded for payment. Payment shall be made within 20 days of invoicing.

D.

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Insurance

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The vendor shall purchase and maintain in force the following kinds of insurance for operations under the contract as specified. Insurance certificates in the amounts shown and under the conditions noted shall be provided to the District before the commencement of any work: 1. Commercial/Comprehensive General Liability a. $1,000,000 Bodily Injury Per Person’ b. $1,000,000 Bodily Injury Aggregate Limit c. $ 500,000 Property Damage Per Occurrence d. $1,000,000 Property Damage Aggregate Limit 2. Comprehensive Automobile Liability a. $1,000,000 Property Damage Per Occurrence 3. Workmen’s Compensation and Employers’ Liability a. $ 500,000 Bodily Injury Per Person 4. Umbrella or Excess of Loss Coverage a. $10,000,000 Per Occurrence 5. The bidder will provide an insurance certificate within 21 days after acceptance of contract. 6. PCSSD must have 10 day notice of cancellation or change in insurance coverage and give its approval. The District shall be named as an additional insured by Endorsement on the vendor’s policy as to the subject contract. E.

Addenda Any “Addenda” or Instruction to Bidders issued by PCSSD prior to the time for receiving proposals shall be covered in the proposal and, in closing a contract, they shall become a part thereof.

VIII.

RESPONSIBILITES OF CONTRACTOR: A.

Personnel All matters pertaining to the recruitment, screening, hiring, and retention shall be the exclusive responsibility of the contractor. These matters shall be done fully in compliance with existing statutes and regulations pertaining to affirmative action, non-discrimination, wage and hour and any other stipulations germane to prudent personnel management. Only those personnel who have been properly trained shall be assigned duties under this contract. All personnel shall be dressed in a manner authorized by the contractor. The personnel shall be neat and clean in appearance. Name tags shall be required and furnished by contractor and worn at all times. No employee who has a police record other than minor traffic violations may be assigned duties under this contract. Contractor shall be responsible for the submission of a criminal background check before any employee begins work. A copy must be kept on file in the District’s Maintenance Department. Contractor will pay at least minimum wage rate. Contractor will pay all taxes pertaining to his employees as required by law. Any employee whose work habits and/or conduct is deemed objectionable shall be

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removed from the work force upon request of the authorized representative of the District. Day Porters There will be a minimum of one (1) Full time Day Porter at each location. B.

Safety The Contractor shall be responsible for the training as necessary in the application of chemicals and the use of equipment to facilitate safe conditions for the employees and the District’s students, staff, and faculty. In addition, the contractor shall provide evidence of training and certification of its personnel on the Global Harmonization System (GHS) and Asbestos Awareness (2hrs).

C.

Security The Contractor shall be responsible for training employees in security requirements of the District, and shall be responsible for the enforcement of the same. Additionally, each employee shall be informed of the following: 1.

2. 3. 4. 5.

6.

7.

D.

The Contractor shall be responsible for safeguarding against loss, theft, or damage of all District property, materials, equipment, and accessories which might be exposed to the contractor’s personnel. Guns, knives, or other dangerous weapons shall not be allowed on campus. Alcohol and drugs are prohibited on campus. Tobacco use (smoking/chewing/etc.) is prohibited on campus. Keys, which may be distributed at the beginning of each work period, shall be returned to the appropriate supervisor at the end of each work period. Keys which will be required by the Contractor and employees will be approved by the District and will be controlled by a person to be named after award of contract. In any event the Contractor shall be fully responsible for the security and appropriate use of the keys which may be issued. Additionally, the Contractor shall be fully responsible for the replacement of any keys that are lost and any additional cost resulting due to loss of keys. Contractor’s personnel shall not allow any unauthorized persons in school buildings (children, friends, or anyone else not authorized by the District.) When it is determined that a building has been left unsecured due to negligence on the part of the Contractor, there will be a charge-back of $15.00 per hour, time determination being from when our on-call person leaves home until when he returns home from securing the building.

Supervision All supervision as required for the execution of those contractual responsibilities assumed by the contractor shall be done by the contractor or his/her designated representative.

E.

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Damage

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The Contractor shall be responsible for the repair/replacement to the satisfaction of the District representative of any damage to the facility caused by any employee of the Contractor. F.

Equipment and Supplies/Materials The procurement and maintenance of all equipment required for the successful execution of this contractual obligation shall be the Contractor’s responsibility. The District will provide locked storage spaces, but not be responsible for losses which may be incurred due to the theft and/or vandalism. All equipment shall be maintained properly, and in clean condition. The Contractor shall be responsible for the acquisition of all chemicals and equipment necessary to fulfill all specifications stated herein. A listing of all chemicals and equipment which will be used by the successful contractor must be submitted for approval prior to initial service under the contract. Changes may be made only after being duly authorized. All chemicals and equipment must meet or exceed OSHA requirements and commonly recognized safety requirements. Material Safety GHS Data Sheets will be maintained on each job site for all chemicals used in the cleaning processes, with copies given to District personnel and updated regularly. The Contractor must furnish all needed safety equipment and protective devices necessary for the safety of all building occupants and property of the District.

G.

Training Contractor must have a training program specifically designed for school technicians, including training to meet all Local, State, and Federal guidelines.

H.

Emergencies All emergency conditions shall be promptly reported to the District authorized representative.

I.

Contractor’s representative A representative of the Contractor shall be appointed within 24 hours after receipt of the contract, and this person shall be available as deemed necessary by the representative for purposes of reporting problems, requesting schedule changes, etc. this individual shall be someone other than the job supervisor and he/she shall be the sole contact person for routine matters.

J.

Scheduling Custodial All custodial shall be done with a minimum of disruption to normal school functions (approved by District Representative).

K.

Program Responsibility The Contractor shall assume full responsibility for the custodial services program as defined herein on Date of award.

L.

Specialties The Contractor shall be responsible for clean up after all school activities, i.e. basketball games, PTO/PTA meetings. Contractor shall not be responsible for

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community functions, banquets, or other rentals of school facilities. Contractor shall be available for emergency services. Emergency work will be determined and authorized by the District. Emergency work will be considered an extra billing and will be added to invoice. M.

Additional Portables If a need arises to add additional portables during the school year, the Contractor will be required to maintain additional square footage.

IX.

RESPONSIBILITIES OF THE DISTRICT A.

Utilities All necessary utilities will be furnished by the District.

B.

Storage The District shall provide storage for the equipment and supplies/materials normally required for the types of services to be provided under this contract. The storage closets must be maintained in a neat, safe and efficient manner.

C.

Trash Disposal The District shall furnish in a reasonably convenient location a container for use by the Contractor in the removal of waste paper, trash, debris, etc.

D.

Keys Keys which may be required by the Contractor and employees will be furnished by the District.

E.

Expendable Supplies The School District will be responsible for providing all expendable supplies, i.e. toilet tissue, paper towels, hand soap, and trash liners.

F.

Dry Erase Boards “DO NOT ERASE” and the date will be written on all dry erase boards that are not to be cleaned.

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G.

Microwaves will be cleaned inside and out, and all other appliances will be cleaned outside on a daily basis.

H.

Clean all HVAC return and supply air grills in all classrooms and common areas on a monthly basis.

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REFERENCES (must provide 4) (1) Vendor Name: ________________________________________________________________ Representative: _______________________________________________________________ Address: ____________________________________________________________________ ___________________________________________________________________________ Phone: ________________________________ Fax: _________________________________ E-Mail: ______________________________________________________________________ (2) Vendor Name: ________________________________________________________________ Representative: _______________________________________________________________ Address: ____________________________________________________________________ ___________________________________________________________________________ Phone: ________________________________ Fax: _________________________________ E-Mail: ______________________________________________________________________ (3) Vendor Name: ________________________________________________________________ Representative: _______________________________________________________________ Address: ____________________________________________________________________ ___________________________________________________________________________ Phone: ________________________________ Fax: _________________________________ E-Mail: ______________________________________________________________________ (4) Vendor Name: ________________________________________________________________ Representative: _______________________________________________________________ Address: ____________________________________________________________________ ___________________________________________________________________________ Phone: ________________________________ Fax: _________________________________ E-Mail: ______________________________________________________________________

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This form must be completed, notarized and submitted with proposal or offer will be rejected. Bidder Assurances and Disclosure School District Bid

Name of School District:

Pulaski County Special School District

Proposal Description/Number:

REQUEST FOR PROPOSALS (RFP) #17-009 CUSTODIAL SERVICES Proposal Opening Date: June 3, 2016 Assurances: I, ____________________________________________________ hereby state: 1. I am the duly authorized agent of ______________________________________, the bidder submitting the competitive bid which is attached to this statement, for the purpose of certifying the facts pertaining to the existence of collusion among and between bidders and school district officials, as well as facts pertaining to the giving or offering of things of value to school district personnel in return for special consideration in the awarding of any contract pursuant to the bid to which this statement is attached. 2. I am fully aware of the facts and circumstances surrounding the making of the bid to which this statement is attached and have been personally and directly involved in the proceedings leading to the submission of the bid. 3. Neither the bidder nor anyone subject to the bidder’s direction or control has been a party: a. To any collusion among bidders in restraint of freedom of competition by agreement to bid at a fixed price or to refrain from bidding; b. To any collusion with any school district official or employee as to quantity, quality or price in the prospective contract, or as to any other terms of the prospective contract; or c. In any discussions between bidders and any school district official concerning exchange of money or other thing of value for special consideration in the awarding of a contract. 4. I hereby guarantee that the specifications outlined in the bid shall be followed as specified and that deviations from the specifications shall occur only as part of a formal change process approved by the Board of Directors of the school district. Disclosure: 1. Does any school board member or employee of the school district have a financial interest in your business or hold a position as officer, director, trustee, partner, or other top level management?________ Yes _________No 2. Does any school board member or employee of the school district have a family relationship with anyone employed by your business? _______Yes ______No (If the answer is yes to either of the above questions, provide details in a separate attachment to this form.)

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3. Did you or your company assist the school district or any agent of the school district with the development of the bid specifications? _______Yes ________No If yes: a. Were you or your company compensated? ______Yes ________No b. Is your company’s name or identity included anywhere within the specifications? _____Yes _____No c. Were you offered any preferential treatment in the bid evaluation process? _____Yes ______No (If the purchase will be from the school district’s federal child nutrition food service fund, potential bidders cannot have input into the development of specification. – 7 Code of Federal Regulations 3016.60(b)) ____________________________________ Signature

_______________________ Date

___________________________________ Name

________________________ Title

___________________________________ Company Subscribed and sworn to before me this ___________day of ________, 20______. ______________________________________ Notary Public

Any person determined to have made a false statement on the form or any bidder who acts contrary to the provisions of the form after its agent has executed the form shall be guilty of a Class C misdemeanor .

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