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HomeMy WebLinkAboutResolution - 5448 - Agreement - SECO, GSC - Professional Services - 03_27_1997Resolution No.5448 Item # 16 March 27, 1997 BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock an Agreement by and between the City of Lubbock and the State Energy Conservation Office of the General Services Commission, attached hereto and which shall be spread upon the minutes of the Council and shall constitute and be a part of this Resolution as if fully copied herein in detail. Passed by the City Council this 27th day of March 1997. wmff:A. d I fWig ATTEST: kaythAdbarnell, City Secretary APPROVED AS TO CONTENT: Massengale, Director of Electric Utilities APPROVED AS TO FORM: -QX old Willard, Assistant City ttorney HW/Ss1 ccdocs%Sr&rag.rcs March 18, 1997 Resolution No. Item 116 March 27, 1997 STATE OF TEXAS COUNTY OF TRAVIS STATE ENERGY CONSERVATION OFFICE (SECO) CONTRACT AGREEMENT Revised 12/17/96 CONTRACT# g:loalcontmctljanelcitolubb.sam/brs I. Parties This contract and agreement is made and entered into by the following parties: The Agency: General Services Commission State Energy Conservation Office (SECO) Insurance Annex 221 East 1Ith Street Austin, Texas 78711 The Contractor: City of Lubbock P.O. Box 2000 Lubbock, Texas 79457 The parties hereto have severally and collectively agreed and by the execution hereof are bound to mutual obligations and to the performance and accomplishments of the tasks hereinafter described. II. Recitals The services to be performed under this contract are in accordance with the Alternative Energy Program of the State Energy Plan in accordance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq) as amended by the Energy Conservation and Production Act (42 U.S.C. 6326 et seq); and the Oil Overcharge Restitutionary Act, Chapter 2305, Texas Government Code. This contract is funded by the Exxon Oil Overcharge fund. III. Statement of Services The parties hereto do hereby agree that the Contractor, in consideration of the compensation hereinafter described, shall provide the services with Agency approval and/or supervision as specifically described in and certified to Attachment A, which is attached hereto and incorporated herein for all purposes. The Contractor shall submit such records, information, and reports in such form and at such times as may be required by the Agency. The reports required of the Contractor shall include, but not be limited to, the reports specified in Attachment A. W. Compensation and Payment For and in consideration of the delivery of the herein described services by the Contractor, the Agency agrees and covenants to provide -as compensation to the Contractor an amount up to and not to exceed the sum of Seventy -Five Thousand Dollars and No Cents ($75,000.00) for reimbursement of allowable expenses incurred pursuant to the budget provided in Attachment B, which is attached hereto and incorporated herein for all purposes. Each request for payment shall be made by an approved State of Texas voucher supported by an invoice detailing expense by budget category. Said invoice shall be fully supported by actual receipts and such other documentation which in the judgment of the Agency allows for full substantiation of costs incurred. Requests for reimbursement and required performance reports shall be submitted as stipulated in Attachment A, but no more frequently than monthly. In the interest of timely administration and in accordance with Agency reporting and reimbursement guidelines, requests for reimbursement under this contract must be received by the Agency not later than sixty (60) days from the incurrence of the expense by the Contractor. Failure by the Contractor to comply timely with the above requirement may act to reduce the liability of the Agency to the sum of the requests for payment received as of the deadline referenced above. To ensure full performance by the Contractor, final payment in an amount equal to ten percent (10%) of the contract total shall be withheld until delivery and approval of the final report and/or all deliverables required herein. Travel shall be reimbursed under this contract only if travel is a budget category in Attachment B. If travel is included in Attachment B it shall be reimbursed at the approved State of Texas employee rate. The Contractor under this agreement shall not purchase any equipment and/or computer software not specifically called for in Attachment B (Budget) without prior written approval from the Agency. Equipment is defined as tangible personal property having a useful life of more than one year and an acquisition cost of One Hundred dollars ($100.00) or more per unit. Upon termination of the contract and Agency determination that all deliverables are satisfactory and complete, title to any equipment purchased under this demonstration project shall remain with the Contractor as long as it is being used for the purpose for which it was intended under the terms of this contract. At the discretion of the Agency and upon written memorandum to the contract file, budget flexibility within categories shall be allowed to the extent that the resulting total by any one category does not exceed one hundred ten percent (110%) of the original budgeted amount. Larger deviations shall require a formal contract amendment, which shall be fully executed prior to the termination of the contract date, as amended. V. Inspection and Monitoring The Contractor shall permit the Agency to inspect and shall make available to the Agency for inspection any and all pertinent records, files, information and other written material pertaining to the operation of programs and expenditure of funds hereunder which is maintained by the Contractor or by any other person or other entity with whom any portion of its performance hereunder has been subcontracted. The Contractor further agrees to maintain, keep and preserve at its principal office all such records for a period of three years and make the same available to the Agency or agencies of the state and/or federal government for purposes of audit. The Contractor further agrees that the Agency may carry out monitoring and evaluation activities to ensure adherence by the Contractor to the work program which is the subject of this contract and to make available copies of all financial audits and related management letters of the Contractor and any subcontractors when required under state and federal guidelines. The Contractor agrees to the specific monitoring requirements, in addition to the general requirements of this Article, that are stated in Attachment A. VI. Intellectual Property Provisions The Contractor and its subcontractors agree to the provisions of, Attachment G, attached hereto and incorporated, herein, which are applicable to this agreement. 0 VII. Termination Either party to this contract shall have the right to terminate by notifying the other party in writing of such termination at least 30 days prior to the effective date of termination. Upon receipt of notice of termination from the Agency, the Contractor shall have thirty (30) days in which to complete projects which have been substantially performed. The Contractor shall cancel, withdraw or otherwise terminate any outstanding orders or subcontracts of this contract and shall otherwise cease to incur any costs. In no event shall the Agency be liable to the Contractor, subcontractors or Contractor's creditors for expenses incurred after the termination date. VIII. Independent Contractor It is expressly understood and agreed by both parties hereto that the Agency is contracting with the Contractor as an independent contractor and that the Contractor, as such, agrees to hold the Agency harmless to the extent permitted under the laws and the Constitution of the State of Texas from and against any and all claims, demands, and causes of action arising from the negligent acts or omissions of the Contractor, its employees or agents in connection with the performance of services by the Contractor or any of its subcontractors under this contract. IX. Indemnification It is expressly understood and agreed by both parties hereto that the Agency is contracting with the Contractor to obtain services described in Attachment A, but that the Contractor may contract with subcontractors to provide such services. The Contractor agrees, to the extent permitted by the laws and the Constitution of the State of Texas, to hold the Agency harmless and to indemnify it from and against any and all claims, demands, and causes of action of every kind and character arising out of, or in connection with, the performance of services by the Contractor or any of its subcontractors under this contract. X. Subcontracting The Contractor shall subcontract for the performance specified herein only with the prior written approval of such subcontract and subcontractors by the Agency. The Contractor, in subcontracting any of its performance hereunder, shall legally bind subcontractors to perform and make such subcontractors subject to all the duties, requirements, and obligations of the Contractor specified herein. It shall be the Contractor's duty to obtain all necessary permits, licenses, easements, waivers and permissions of whatsoever ldnd required to perform the work specified herein. In no event shall any provision of this Article, specifically including the requirement that the Contractor obtain the prior approval of the Agency on the Contractor's subcontracts, be construed as relieving the Contractor of the responsibility for insuring that the services rendered under all subcontracts are rendered so as to comply with all the terms and provisions of this contract as if the services and assurances rendered were rendered by the Contractor hereunder. The Contractor shall furnish the Agency with copies of all subcontracts prior to execution and any amendments, assignments, cancellations or terminations of said subcontracts, upon request. 3 XI. Amendment and Changes Any alteration, addition, or deletion to the terms of this contract, other than decisions of the Agency to allow budget flexibility pursuant to the last paragraph of Article IV, shall be by amendment hereto in writing and executed by both parties hereto on or before the proposed effective date of said amendment. 3M. Assurances and Certifications The Contractor must complete the following Attachments which are attached hereto and incorporated herein; the Assurance of Compliance form, Attachment C; Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion -Lower Tier Covered Transactions form, Attachment D; Certifications Regarding Lobbying; Debarment; Suspension and Other Responsibility Matters; and Drug -Free Workplace Requirements form, Attachment E; Assurances -Non -Construction Programs form, Attachment F; and the Historically Underutilized Business forms, Attachments H and return them with this Agreement. The Contractor shall obtain completed Assurance of Compliance form, Attachment C, from all of its subcontractors that no person shall, on the grounds of race, creed, color, handicap, national origin, sex, religion, political affiliation or beliefs, be excluded from, be denied the benefit of, or be subjected to discrimination under any program or activity funded in whole or in part under this agreement. All applicable rules, regulations and all other requirements imposed by law, including but not limited to, those pertinent rules and regulations of the State of Texas and those of federal agencies providing fiords to the State of Texas are incorporated hereto by reference as if specifically written herein. XI11. Funding It is expressly understood and agreed by the parties hereto that the performance on the part of the Agency of its obligations hereunder is contingent upon and subject to actual receipt by the Agency of sufficient and adequate funds from the sources contemplated by this contract. To the extent the performance of this contract transcends the biennium in which this contract is entered into, this contract is specifically contingent upon the continued authority of the Agency and appropriations therefor. XIV. Term of Contract The term of this contract shall be from January 1, 1997 until December 31, 1997 unless terminated earlier in accordance with other provisions of this contract. 4 XV. Signatory Having agreed to the terms herein, the undersigned signatories hereby represent and warrant that they are either an official of the Agency or an agent for the Contractor for which they are executing this contract and that they have full authority to enter into this contract. AGENCY: General Services Commission on behalf of the State Energy Conservation Office (SECO) by Tom Treadway 61 Executive Director 5 CONTRACTOR City of Lubbock by 1$i4�6&Sd( Windy S i tton Mayor ATTACHMENT A Contract No. Professional Services/Demonstration Project Agreements Statement of Services To Be Performed A. Contractor shall perform the services described herein ("services') including the furnishing of personnel and the procurement of any equipment, supplies, and other items necessary to provide those services. The Contractor agrees to review and implement Agency recommendations so that the services may be expeditiously and satisfactorily completed. Contractor further agrees to meet with the Agency at such times as the Agency may reasonably request to discuss the progress of this program and any other matters that may arise in regard to this contract. B. The Contractor agrees to provide the following services during the period of this contract: 1. Purchase, install, operate, maintain and monitor the performance of an ENTECH-PV system for Breedlove Dehydrating. 2. Interconnect the PV-array with the local electric utility through a net billing meter to be installed by Lubbock Power & Light. Two-thirds of all energy requested by this meter shall be credited on a KWH to KWH basis against any energy billed to Breedlove. If this credit exceeds the actual energy billed, LPL will further credit Breedlove's monthly bill at a rate equal to the lesser of the actual fuel cost on a $/KWH basis or the actual purchased power cost on a $/KWH basis. 3. Photograph installation process and installed PV array. 4. Operate PV-array and collect performance data and maintenance and operating costs for the contract period following installation. 5. Maintain adequate maintenance records, perform warranty and preventative maintenance as recommended by manufacturer, and identify and correct any problem condition. 6. Identify members of the target audience, arrange and conduct a minimum of six tours of the demonstration facility, and provide a log of demonstration site visitors. 7. Provide information detailing the PV energy system and its performance to date for publication in an Agency -produced demonstration project summary. 8. Prepare and file monthly reports regarding the operating history, performance and generation. 9. Prepare a final report summarizing installed project cost and energy savings achieved by this project, and establishing baseline performance figures for this application of an alternative energy technology in this location. C. The Contractor agrees to provide the following services as required by the Agency during the period of this contract. The Agency may request additional records, information or reports related to the services hereinafter described and funded by the Agency pursuant to Attachment B. The services are as follows: Deliverables & Milestones Schedule Remove PV installation from 3M/Austin, prepare Dec 96 July 97 site in Lubbock and install system in Lubbock at Breedlove Start up system Secure interconnection agreement Photograph installation process Operate array and collect performance, maintenance and operating data for two years Maintain adequate records, perform any maintenance strategies, as recommended by the manufacturer Identify target audiences Arrange and conduct a minimum of six tours of the demonstration facility and keep a log of visitors Provide information about this project for SECO Prepare and file progress reports regarding operation, performance and generation Prepare and submit final report Aug 97 Apr 97 Ongoing Ongoing Ongoing Ongoing July -Dec 97 Ongoing Monthly Dec 31, 97 d ATTACHMENT B Contract No. BUDGET PERSONNEL' Lubbock Power and Light ENTECH TRAVEL2 Air fare, mileage and per diem SUBCONTRACTUAL Printing, site prep, installation, Texas Tech Controls, drive, bearing, J-box upgrade, array, inverters, and other OTHER DIRECT OPERATING EXPENSES Site clean-up, miscellaneous supplies and materials, rentals, and other SECO $15,000.00 MATCH $124,000.00 $0.00 $30,000.00 $0.00 $78,000.00 $60,000.00 $0.00 $11,000.00 $107,000.00 TOTAL DIRECT COSTS $75,000.00 TOTAL MATCH $350,000.00 TOTAL PROJECT COSTS $425,000.00 ' Contractor agrees that Robert Massengale (LPL) shall be the Project Director and shall be responsible for the overall supervision and conduct of the project on behalf of the contractor. Any change of Project Director shall be subject to the prior written approval of the Agency. 2 Out -of --state travel requires prior written approval of the agency. All Travel will be reimbursed at state authorized rates. 8 ATTACHMENT C Contract No. Assurance of Compliance Nondiscrimination in State Assisted Programs City of Lubbock (Hereinafter called the "Applicant") HEREBY AGREES to comply with Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), Section 16 of the Federal Energy Administration Act of 1974 (Pub. L. 93-275), Section 401 of the Energy Reorganization Act of 1974 (Pub. L. 93-438), Title IX of the Education Amendments of 1972, as amended (Pub. L. 92-318, Pub. L. 93-568, and Pub. L. 94-482), Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), the Age Discrimination Act of 1975 (Pub. L. 94-135), Title VM of the Civil Rights Act of 1968 (Pub. L. 90-284), the Department of Energy Organization Act of 1977 (Pub. L. 95-91), and the Energy Conservation and Production Act of 1976, as amended, (Pub. L. 94-385). In accordance with the above laws and regulations issued pursuant thereto, the Applicant agrees to assure that no person in the United States shall, on the ground of race, color, national origin, sex, age, or handicap, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity in which the Applicant receives State assistance from the Department of Energy. Applicability and Period of Obligation In the case of any service, financial aid, covered employment, equipment, property or structure provided, leased, or improved with State funding extended to the Applicant by the Agency, this assurance obligates the Applicant for the period during which the Agency assistance is extended. In the case of any transfer of such service, financial aid, equipment, property, or structure, this assurance obligates the transferee for the period during which the Agency assistance is extended. If any personal property is so provided, this assurance obligates the Applicant for the period during which it retains ownership or possession of the property. In all other cases, this assurance obligates the Applicant for the period during which the State assistance is extended to the Applicant by the Agency. Employment Practices Where a primary objective of the State assistance is to provide employment or where the Applicant's employment practices affect the delivery of services in programs or activities resulting from State assistance extended by the Agency, the Applicant agrees not to discriminate on the ground of race, color, national origin, sex, age, or handicap, in its employment practices. Such employment practices may include, but are not limited to, recruitment, recruitment advertising, hiring, layoff or termination, promotion, demotion, transfer, rates of pay, training and participation in upward mobility programs, or other forms of compensation and use of facilities. Subrecipient Assurance The Applicant shall require any individual, organization, or other entity with whom it subcontracts, subgrants, or subleases for the purpose of providing any service, financial aid, equipment, property, or structure to comply with laws cited above. To this end, the subrccipient shall be required to sign a written assurance form, however, the obligation of both recipient and Subrecipient to ensure compliance is not relieved by the collection or submission of written assurance forms. Data Collection and Access to Records The Applicant agrees to compile and maintain information pertaining to programs or activities developed as a result of the Applicant's receipt of State assistance from the Agency. Such information shall include, but is not limited to the following: (1) the manner in which services are or will be provided and related data necessary for determining whether any persons are or will be denied such services on the basis of prohibited discrimination; (2) the population eligible to be serviced by race, color, national origin, sex, age and handicap; (3) data regarding covered employment, including use or planned use of bilingual public contact employees serving beneficiaries of the programs where necessary to permit effective participation by beneficiaries unable to speak or understand English; (4) the location of existing or proposed facilities connected with the program and related information adequate for determining whether the location has or will have the effect of unnecessarily denying access to any person on the basis of prohibited discrimination; (5) the present or proposed membership by race, color, national origin, sex, age and handicap, in any planning or advisory body which is an E ATTACHMENT C Contract No. (continued) integral part of the program; and (6) any additional written data determined by the Agency to be relevant to the obligation to assure compliance by recipients with laws cited in the first paragraph of this assurance. The Applicant agrees to submit requested data to the Agency regarding programs and activities developed by the Applicant from the use of State funds extended by the Agency. Facilities of the Applicant (including the physical plants, buildings, or other structures) and all records, books, accounts, and other sources of information pertinent to the Applicant's compliance with the civil rights laws shall be made available for inspection during normal business hours on request of an officer or employee of the Agency specifically authorized to make such inspections. Instructions in this regard will be provided by the Director, the Agency and the State of Texas. This assurance is given in consideration of and for the purpose of obtaining any and all State grants, loans, contracts (excluding procurement contracts), property, discounts or other State assistance extended after the date hereto, to the Applicants by the Agency, including installment payments on account after such date of application for State assistance which are approved before such date. The Applicant recognizes and agrees that such State assistance will be extended in reliance upon the representations and agreements made in this assurance and that the State of Texas shall have the right to seek judicial enforcement of this assurance. This assurance is binding on the Applicant, its successors, transferees, and assignees, as well as the person whose signature appears below and who is authorized to sign this assurance on behalf of the Applicant. March 27, 1997 Date City of Lubbock Name of Applicant P.O. Box 2000, Lubbock, TX 79457 Address e A c /L-1�� z�i� Mayor Signature of Autd6rized Official IWNDY SITT(N Title (806) 767-2000 Applicants Telephone Number 10 ATTACHMENT D Contract No. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion -Lower Tier Covered Transactions Instructions for Certification 1. The prospective lower tier participant is required to sign the attached certification. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principle," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 11 ATTACHMENT D Contract No. (continued) (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. City of Lubbock Organization Name Windy Sitton, Mayor Name and Title of Authorized Representative 4��" March 27, 1997 Signature Date 12 ATTACHMENT E Contract No. CERTIFICATIONS REGARDING LOBBYING; DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS; AND DRUG -FREE WORKPLACE REQUIREMENTS Applicants should refer to the regulations cited below to determine the certification to which they are required to attest. Applicants should also review the instructions for certification included in the regulations before completing this form. Signature of this form provides for compliance with certification requirements under 34 CFR Part 82, "New Restrictions on Lobbying," and 34 CFR Part 85, "Government -wide Debarment and Suspension (Nonprocurement) and Government -wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a material representation of fact upon which reliance will be placed when the Department of Energy determines to award the covered transaction, grant, or cooperative agreement. 1. LOBBYING The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) N any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prere-quisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $ 10,000 and not more than $ 100,000 for each such failure. 2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS (1) The prospective primary participant certifies to the best of its knowledge and belief, that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; 13 ATTACHMENT E Contract No. (continued) (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 3. DRUG -FREE WORKPLACE This certification is required by the Drug -Free Workplace Act of 1988 (Pub. L. 100-690, Title V, Subtitle D) and is implemented through additions to the Debarment and Suspension regulations, published in the Federal Register on January 31, 1989, and May 25, 1990. ALTERNATE I (GRANTEES OTHER THANINDIVIDUALS) (1) The grantee certifies that it will or will continue to provide a drug -free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing an ongoing drug -free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The grantee's policy of maintaining a drug -free workplace; (3) Any available drug.counseling, rehabilitation, and employee assistance programs; and (4) The penalties that my be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph (a) that, as a condition of employment under the grant, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employer in writing, of his or her conviction for a violation of criminal drug statute occurring in the workplace not later than five calendar days after such conviction, (e) Notifying the agency, in writing, within ten calendar days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the 14 ATTACHMENT E Contract No. (continued) Federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant; (f) Taking one of the following actions, within 30 calendar days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination, consistent with the requirements of the Rehabilitation Act of 1973, as amended; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug -free workplace through implementation of paragraphs (a), (b), (c), (d), and (f). (1) The grantee may insert in the space provided below the site(s) for the performance of work done in connection with the specific grant: Place of Performance: (Street, address, city, county, state, and zipcode) Breedlove Dehydration Plant 1702 N. MLK Blvd., Lubbock, TX 79403 ALTERNATEII (GRANTEES WHOAREINDIP7DUALS) (1) The grantee certifies that, as a condition of the grant, he or she will not engage in the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance in conducting any activity with the grant. (2) If convicted of a criminal drug offense resulting from a violation occurring during the conduct of any grant activity, he or she will report the conviction, in writing, within 10 calendar days of the conviction, to every grant officer or other designee, unless the Federal agency designates a central point for the receipt of such notices. When notice is made to such a central point, it shall include the identification number(s) of each affected grant. As the duly authorized representative of the applicant, I hereby certify that the applicant will comply with the above certifications. NAME OF APPLICANT PR/AWARD NUMBER AND/OR PROJECT NAME PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE SIGNATURE 15 DATE ATTACHMENT F Contract No. ASSURANCES — NON -CONSTRUCTION PROGRAMS OMB Approval No. 0348-0040 Note: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the awarding agency. Further, certain Federal awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant, I certify that the applicant: Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project costs) to ensure proper planning, management and completion of the project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States, and if appropriate, the State, through any authorized representative, access to and the right to examine all records, books, papers, or documents related to the award; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. 4. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 5. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§ 4728-4763) relating to prescribed standards for merit systems for programs funded under one of the nineteen statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 6. Will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§ 523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. 290 dd-3 and 290 ee-3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statute(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statute(s) which may apply to the application. Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal or federally assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. Will comply with the provisions of the Hatch Act (5 U.S.C. §§ 1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. IV ATTACHMENT F Contract No. (continued) 9. Will comply, as applicable, with the provisions of the Davis -Bacon Act (40 U.S.C. §§ 276a to 276a-7), the Copeland Act (40 U.S.C. § 276c and 18 U.S.C. §§ 874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 327-333), regarding labor standards for federally assisted construction sub -agreements. 10. Will comply, if applicable, with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93- 234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 11. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91-190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§ 1451 et seq.); (f) conformity of Federal actions to State (Clear Air) Implementation Plans under Section 176(c) of the Clear Air Act of 1955, as amended (42 U.S.C. § 7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended, (P.L. 93-523); and (h) protection of endangered species under the Endangered Species Act of 1973, as amended, (P.L. 93-205). 12. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§ 1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 13. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. 469 a-1 et seq.) 14. Will comply with P.L. 93-348 regarding the protection of human subjects involved in research, development, and related activities supported by this award of assistance. 15. Will comply with the Laboratory Animal Welfare Act of 1966 (P.L. 89-544, as amended, 7 U.S.C. 2131 et seq.) pertaining to the care, handling, and treatment of warm blooded animals held for research, teaching, or other activities supported by this award of assistance. 16. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§ 4801 et seq.) which prohibits the use of lead based paint in construction or rehabilitation of residence structures. 17. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act of 1984. 18. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations and policies governing this program. Signature or Authorized Certifying Official City of Lubbock Applicant Organization 17 Mayor Date Submitted ATTACHMENT G Contract No. Intellectual Property Provisions AUTHORIZATION AND CONSENT (41 CFR 9-9.102-1) The Government hereby gives its authorization and consent (without prejudice to any rights of indemnification) for all use and manufacture, in the performance of this grant or any part hereof or any amendment hereto or any subcontract hereunder (including all lower -tier subcontracts hereunder), of any invention described in and covered by a patent of the United States. (a) embodied in the structure or composition of any article, the delivery of which is accepted by the Government under this grant, or (b) utilized in the machinery, tools, or methods, the use of which necessarily results from compliance by the Grantee or the using subcontractor with (i) specifications or written provisions now or hereafter forming a part of this grant, or (ii) specific written instructions given by the Contracting Officer directing the manner of performance. The entire liability to the Government for infringement of a patent of the United States shall be determined solely by the provisions of the indemnity clauses, if any, included in this grant or any subcontract hereunder (including all lower -tier subcontracts hereunder), and the Government assumes liability for all other infringement to the extent of the authorization and consent herein above granted. PATENT INDEMNITY (41 CFR 9-9.103-1) If the amount of this contract is in excess of $10,000 the contractor shall indemnify the Government and its officers, agents, and employees against liability, including costs, for infringement of any United States letters patent (except U.S. letters patent issued upon an application which is now or may hereafter be kept secret or otherwise withheld from issue by order of the Government) arising out of the manufacture or delivery of supplies or out of construction, alteration, modification, or repair of real property (hereinafter referred to as "construction work") under this contract, or out of the use or disposal by or for the account of the Government of such supplies or construction work. The foregoing indemnity shall not apply unless the contractor shall have been informed as soon as practicable by the Government of the suit or action alleging such infringement, and shall have been given such opportunity as is afforded by applicable laws, rules, or regulations to participate in the defense thereof, and further, such indemnity shall not apply to: (a) an infringement resulting from compliance with specific written instructions of the Contracting Officer directing a change in the supplies to be delivered or in the materials or equipment to be used, or directing a manner of performance of the contract not normally used by the contractor; (b) an infringement resulting from addition to or change in, such supplies or components furnished or construction work performed which addition or change was made subsequent to delivery or performance by the contractor; or (c) a claimed infringement which is settled without the consent of the contractor, unless required by final decree of a court of competent jurisdiction. NOTICE AND ASSISTANCE REGARDING PATENT AND COPYRIGHT INFRINGEMENT (41 CFR 9-9.104(b)) The provisions of this clause shall be applicable only if the amount of this grant exceeds $10,000. (a) The Grantee shall report to the Contracting Officer, promptly and in reasonable written detail, each notice of claim of patent or copyright infringement based on the performance of this grant of which the Grantee has knowledge. (b) In the event of any claim or suit against the Government on account of any alleged patent or copyright infringement arising out of the performance of this grant or out of the use of any supplies furnished or work or services performed hereunder, the Grantee shall furnish to the Government, when requested by the 18 ATTACHMENT G Contract No. (continued) Contracting Officer, all evidence and information in possession of the Grantee pertaining to such suit or claim. Such evidence and information shall be furnished at the expense of the Government except where the Grantee has agreed to indemnify the Government. (c) This clause shall be included in all contracts and subgrants under this grant. REPORTING OF ROYALTIES (41 CFR 9-9.110) If this grant is in an amount which exceeds $10,000 and if any royalty payments are directly involved in the grant or are reflected in the grant price to the Government, the Grantee agrees to report in writing to the Patent Counsel (with notification by Patent Counsel to the Contracting Officer) during the performance of this grant and prior to its completion of final settlement the amount of any royalties or other payments paid or to be paid by it directly to others in connection with the performance of this grant together with the names and addresses of licensors to whom such payments are made and either the patent numbers involved or such other information as will permit the identification of the patents or other basis on which the royalties are to be paid. The approval of DOE of any individual payments or royalties shall not stop the Government at any time from contesting the enforceability, validity or scope of, or title to, any patent under which a royalty or payments are made. RIGHTS IN TECHNICAL DATA (SHORT FORW (a) Definitions. The definitions of terms set forth in DEAR 927.401 apply to the extent these terms are used herein. (b) Allocation of Rights. (1) The Government shall have: (i) Unlimited rights in technical data first produced or specifically used in the performance of this grant; (ii) The right of the Contracting Officer or his representatives to inspect, at all reasonable times up to three years after final payment under this grant, all technical data first produced or specifically used in the grant (for which inspection the Grantee or its contractor or subgrantee shall afford proper facilities to DOE); and (iii) The right to have any technical data first produced or specifically used in the performance of this grant delivered to the Government as the Contracting Officer may from time -to -time direct during the progress of the work, or in any event as the Contracting Officer shall direct upon completion or termination of this grant. (2) The Grantee shall have: The right to use for its private purposes, subject to patent, security or other provisions of this grant, technical data it first produces in the performance of this grant provided the date requirements of this grant have been met as of the date of the private use of such data. The Grantee agrees that to the extent it receives or is given access to proprietary data or other technical, business or financial data in the form of recorded information from DOE or a DOE contractor or subcontractor, the Grantee shall treat such data in accordance with any restrictive legend contained thereon, unless use is specially authorized by prior written approval of the Contracting Officer. 19 ATTACHMENT G Contract No. (continued) (c) Copyrighted Material. (1) The Grantee agrees to, and does hereby grant to the Government, and to others acting on its behalf: (i) A royalty -free, nonexclusive, irrevocable, worldwide license for Governmental purposes to reproduce, distribute, display, and perform all copyrighted material first produced or composed in the performance of this grant by the Grantee, its employees or any individual or concern specifically employed or assigned to originate and prepare such material and to prepare derivative works based thereon; and (ii) A license as aforesaid under any and all copyrighted or copyrighted work not first produced or composed by the Grantee in the performance of this grant but which is incorporated in the material furnished under the grant, provided that such license shall be only to the extent the Grantee now has, or prior to completion or close-out of the grant, may acquire the right to grant such license without becoming liable to pay compensation to others solely because of such grant. (2) The Grantee agrees that it will not knowingly include any material copyrighted by others in any written or copyrighted material famished or delivered under this grant without a license asprovided for in subparagraph (c) (1) (ii) of this section, or without the consent of the copyright owner, unless it obtains specific written approval of the Contracting Officer for the inclusion of such copyrighted material. RIGHTS TO PROPOSAL DATA (TECHNICAL) (48 CFR 52.227-23) It is agreed that as a condition of award of this grant or modification and notwithstanding the conditions of any notice appearing on the proposal(s), the Goverment shall have the right to use, duplicate, and disclose and have others to do so for any purpose whatsoever, the technical data contained in the proposal(s) upon which the grant or modification is based. City of Lubbock Organization Name Windy Sitton, Mayor" Name and Title of Authorized Representative Signature Date 20 ATTACHMENT H Contract No. Historically Underutilized Business (HUB) Subcontracting Program REPORTING POLICY In keeping with the Governor's Executive Order AWR93-7 and Title 10, Subtitle D, Chapter 2161 of the State General Services Commission, contractors under the State Energy Conservation Office (SECO) program are expected to make a good faith effort to encourage historically underutilized businesses (HUBs) to bid on SECO projects and to report grant dollars contractually awarded to HUBs. A historically underutilized business may be defined as (1) corporation formed for profit in which at least 51 % of the equity is owned by one or more women, Black, Hispanic, Asian Pacific, or Indian Americans; (2) a sole proprietorship 100% owned, operated, and controlled by such person(s); (3) a partnership in which such person(s) owns at least 51 % of its assets and interest and has proportionate control of partnership affairs; (4) a joint venture of HUBs; (5) A supplier contract between a HUB and a prime contractor under which the HUB manufactures, distributes, or warehouses and ships the supplies. The General Services Commission's SECO is required to track oil overcharge funds expended on HUB contractors. SECO will collect this information from contractors on a form which will accompany the required quarterly reports. 21 ATTACHMENT H Contract No. (continued) GOOD FAITH EFFORT PROGRAM State agencies are required to make a good faith effort to assist historically underutilized business (HUBS) in receiving contract awards issued by the state, see Tex. Gov't. Code Ann. Title 10, Subtitle D, Chapter 2161. The goal of this program is to promote full and equal business opportunity for all businesses in contracting with the state. The bidder or contractor shall provide a "copy of notice or solicitation" describing available subcontracting opportunities at the time of bid submittal (see Good Faith Effort Program, criteria number 2) or within 14 calendar days of bid opening. The following forms are required to be provided by bidders and contractors in response to the attached invitation for bids in order for the bid to be considered for award: Good Faith Effort Program (GFEP). To be returned with the bid or submitted within 7 working days after the bid opening date. If all or any portion of an awarded contract will be subcontracted, as indicated on the GFEP, the following forms are required within 14 calendar days after the bid opening date: (1) The Historically Utilized Business Solicitation Form (HUB -SF) or other acceptable documentation when the good faith presumption procedures have not been implemented. (2) Determination of Good Faith Effort (DGFE). (3) Historically Underutilized Business Letter of Intent (HUB-LOI). If an award is made, the following documents will be required as shown: (1) Progress Assessment Report By Non -Historically Underutilized Businesses of Work Subcontracted (NON -HUB -PAR). Due quarterly in December, March, June and September. � (2) Progress Assessment Report by Historically Underutilized Business of Work Subcontracted (HUB -PAR -A). Due quarterly in December, March, June and September. All forms are required to be provided to the parties indicated within the time frames specified. Failure to do so will cause disqualification of the bid from consideration for award or revocation of any contract awarded due to noncompliance. 22 ATTACHMENT H Contract No. (continued) Signature: (Conhae WV-dor) Bidders Name: Contract Number: Bid Opening Date: GOOD FAITH EFFORT PROGRAM (GFEP) OTHER SERVICES State agencies are required to make a good faith effort to assist historically underutilized businesses (HUBS) in receiving contract awards issued by the State, see Tex. Gov't. Code Ann. Title 10, Subtitle D, Chapter 2161. The General Services Commission (GSC) Rules, 1 TAC 111.11-111.24, outline the State's policy to encourage the use of HUBS by state agencies and to assist agencies to achieve these goals through race, ethnic, and gender neutral means. The goal of this program is to promote full and equal business opportunity for all businesses in state contracting. In accordance with the State's policy of encouraging the use of HUBs in state procurement, the GSC shall make a good faith effort to utilize HUBs in contracts from commodities and service purchases. GSC will achieve the annual program goals by contracting directly with HUBs or indirectly through subcontracting opportunities. Therefore, any business that contracts with GSC or another State agency shall be required to make a good faith effort to award necessary subcontracts to HUBS in accordance with GSC Rule 111.13 (b). Also, see Rule 111.13 (c) (7). The annual program goal for all other services contracts an agency expects to award in a fiscal year is 33% for Black Americans, Hispanic Americans, Asian Pacific Americans, Native Americans, and American Women. This Good Faith Effort Program goal does not prevent any business group from participating in contracting opportunities with the State of Texas. A subcontractor is a entity that enters into an contract with a contractor (vendor) to provide a portion of the goods or services for which the contractor is responsible under the terms of its contract with the State. By implementing the following procedures, a contractor shall be presumed to have made a good faith effort: 1. To the extent consistent with prudent industry practice, divide the contract work into reasonable lots. 2. Notify HUBS ofhe work that the contractor intends to subcontract The notice shall be in writing. The notice shall include a description of the subcontracting opportunities and identify the location to review contract specifications. The notice shall he provided to potential subcontractors prior to submission of the contractor's bid (Copy of notice or solicitation shall be submitted at the time of bid or within 14 calendar days of bid opening.) 3. The contractor shall provide notice as required in (2) above with sufficient time to allow all interested parties the opportunity to participate effectively. The contractor shall send such notice to at least five businesses in the current GSC directory of certified HUBs that perform the type of work required in the area in which the work will be performed. 4. If a non -HUB subcontractor is selected through means other than competitive bidding, or a HUB bid is the lowest price responsive bidder to a competitive bid, but not selected, the contractor will be required to document the selection process. 5. The contractor shall maintain business records documenting its compliance and shall make a compliance report to the contracting state agency and report in the format required by the contracting state agencys contract documents, provided that reporting shall be required at least once for each calendar quarter during the term of the contract Note: When the contractor is a HUB, it must satisfy the good faith of ort requirements by performing at least 25% of the contract with its employees. The HUB, prime may subcontract the remaining 75% of the contract with HUB or non -HUB contractors. Any contractor that seeks to satisfy the good faith effort requirement in this manner shall report quarterly to the state agency, in the form required by the state agency, the volume of work performed under the contract and the portion of the work that was performed with its employees. If a HUB contractor performs less than 25% of the cumulative total contract with its employees, then for the next quarter, the contractor shall report its subcontractor as required by a non -HUB contractor. Please answer the following questions: 1. If an award is issued, do you plan to utilize a Subcontractor for all or any portion of the contract? Yes No 2. If yes, what percentage of work will be subcontracted with a HUB. % 3. Are you certified as a Texas Historically Underutilized Business (HUB)? _ Yes ! No Note: The contractor will be required to prepare and submit HUB -SUB forms GFEP, DGFE, HUB-LOI, HUB -SF, NON -HUB -PAR, HUB -PAR -A within the designated time period stated on each form. The contracting state agency shall ensure that a contractor has complied with GSC Rule 111.14 as a condition of awarding the contract. RETURN WITH BID OR WITHIN 7 WORKING DAYS OF BID OPENING DATE RETURN TO: General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 23 ATTACHMENT H Contract No. (continued) Bidders Name: Contract Number: Bid Opening Date: HISTORICALLY UNDERUTILIZED BUSINESS SOLICITATION FORM (HUB -SF) (Please complete this form when soliciting HUBS) Contractor: Vender Identification Number: Address: Phone:-- - GSC Contract #: Contact Name: Specific Subcontract Solicited: Contractor's Estimate of Approximate Dollar Value of Subcontract Advertised: Date of Solicitation Letter: • List each HUB to which a notice or solicitation letter was sent and attach a copy of each notice or solicitation letter. If additional space is needed please attach a separate sheet. Name of HUB Subcontractor/Supplier: Address: Phone: - - Owner: If GSC certified, enter Vendor Identification Number: If not GSC certified, please complete the following information: { } Black American —Male _ Female { } American Indian — Male _ Female { } Hispanic American — Male ! Female { } Woman 2. Name of HUB Subcontractor/Supplier: Address: _ Phone: - - Owner: If GSC certified, enter Vendor Identification Number: If not GSC certified, please complete the following information: { } Black American _ Male _ Female { } American Indian _ Male _ Female { } Hispanic American _ Male _ Female { } Woman 3 Name of HUB Subcontractor/Supplier: Address: _ Phone: - - Owner: If GSC certified, enter Vendor Identification Number: If not GSC certified, please complete the following information: { } Black American _ Male _ Female { } American Indian _ Male r Female { } Hispanic American _ Male _ Female { } Woman Name of HUB Subcontractor/Supplier: Address: Phone: - - Owner: If GSC certified, enter Vendor Identification Number: { } Black American _ Male _ Female { } Hispanic American — Male — Female If not GSC certified, please complete the following information: { } American Indian _ Male Female { } Woman This form must be signed by an authorized representative of the Contractor: Signature: Title: Address: Phone: DUE 14 CALENDAR DAYS AFTER BID OPENING DATE RETURN TO: General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 24 ATTACHMENT H Contract No. (continued) Bidders Name: Contract Number: Bid Opening Date: GENERAL SERVICES COMMISSION Determination of Good Faith Effort (DGFE) In making a determination that a good faith effort has been made, the contracting state agency shall require the contractor (vendor) to complete a checklist, and submit supporting documentation explaining in what ways the contractor has made a good faith effort according to each requirement with a copy of notice or solicitation, within fourteen (14) calendar days following selection but prior to award of the contract. The checklist shall include at least the following: (1) Whether the contractor provided written notices to at least five (5) qualified HUBs or the contractor advertised in general circulation, trade association, and/or minority/women focus media concerning subcontracting opportunities. (2) Whether the contractor provided written notice to at least five (5) qualified HUBs allowing sufficient time for HUBs to participate effectively. (3) Whether the contractor divided the contract work into the reasonable portions in accordance with standard industry practices. (4) Whether the contractor documented reasons for rejection or met with the rejected HUB to discuss the rejection. (5) Whether the contractor provided qualified HUBS with adequate information about bonding, insurance, the plans, the specifications, scope of work and requirements of the contract. (Copy of notice or solicitation.) (6) Whether the contractor negotiated in good faith with qualified HUB's, not rejecting qualified HUBs who are also the lowest responsive bidder. Contractors are encouraged to use the services of available minority and women; community organizations contractor groups; local, state and federal business assistance offices, and other organizations that provide support services to HUBs. This form must be signed by an authorized representative of the Contractor (Vendor) Party. Signature of Contractor (Vendor) Date Title The contracting state agency shall review the checklist and attached documentation submitted by the contractor and issue a written notice of acceptance or deficiency of a good faith effort within fourteen (14) calendar days of the contracting state agency's receipt. The notice of deficiency shall state the reasons for deficiency. DUE 14 CALENDAR DAYS AFTER BID OPENING DATE RETURN TO: General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 25 ATTACHMENT H Contract No. (continued) Bidders Name: Contract Number. Bid Opening Date: HISTORICALLY UNDERUTILIZED BUSINESS LETTER OF INTENT (HUB-LOI) (PLEASE SUBMIT SEPARATE FORM FOR EACH HUB SUBCONTRACTOR/SUPPLIER) For use by Contractor (Vendor) to identify HUB Subcontractors and Suppliers. Contractor (Vendor) : Address: GSC Contract #: Description of Services/Specifications: Time period covered: Vender Identification Number: Contract Amount:$ Phone: Percentage/Amount of contract with HUB Subcontractor/Supplier $ _ % Percentage Name of HUB Subcontractor/Supplier: Phone: -, Proposed Contract Amount: $ Description of materials or services performed under agreement with HUB for amount indicated above: This form must be signed by an authorized representative of the Contractor (Vendor) Party. Signature of Contractor (Vendor) Signature of HUB Subcontractor/Supplier Date Date DUE 14 CALENDAR DAYS AFTER BID OPENING DATE RETURN TO: General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 26 Bidders Name: Contract Number: Bid Opening Date: ATTACHMENT H Contract No., (continued) PROGRESS ASSESSMENT REPORT BY NON -HISTORICALLY UNDERUTILIZED BUSINESSES OF WORK SUBCONTRACTED (NON -HUB -PAR) Date of Award: Total Contract Amount Paid this Period: Contractor: GSC Contract # Vendor Identification Number (VID #): _ e '�,I ,,., x £ f b 8 7 C Cf } } } ��iiCfE� Cfi 3. �%� 3 F'tit i} p C%}:i •M C 6' To be reported quarterly by the following date: RETURN TO: Quarter Months included Deadline First (Sept, Oct, Nov) Second (Dec, Jan, Feb) Third (March, April, May) Fourth (June, July, Aug.) General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 27 Dec. 5 March 5 June 5 Sept. 5 ATTACHMENT H Contract No. (continued) Bidders Name: Contract Number. Bid Opening Date: PROGRESS ASSESSMENT REPORT BY MSTORICALLY UNDERUTILIZED BUSINESSES OF WORK SUBCONTRACTED (HUB -PAR -A) 1. HUB Contractor: 2. GSC Contract #: 2. Vendor Identification Number: 4. Contractor Name: 3. Date of Award: 6. Total Contract Amount Paid this Period:$ : i• a�F a ,� S s ' c a �' i ie 3 t ' ��_'� i� f�� ' ,�s,� 4 To be reported quarterly by the following date: Quarter Months included Deadline First (Sept, Oct, Nov) Dec. 5 Second (Dec, Jan, Feb) March 5 Third (March, April, May) June 5 Fourth (June, July, Aug.) Sept. 5 This form must be signed by an authorized representative of the Contractor (Vendor) Party. Signature: Title: Date: RETURN TO: General Services Commission P.O. Box 13047 Austin, Texas 78711-3047 28