Moving of Voting Equipment

Montgomery County Specification Download Acknowledgement Invitation to Bid MOVING OF VOTING Project # 22-47 EQUIPMENT ELECTIONS VENDORS MUST IMMEDIATELY RETURN THIS FORM BY EMAIL: purchasing@mectx.org ee OS ee ee see ee ee eee eae eee aes : Vendor Responsibilities *. a a Z o Vendors must download and complete any addenda z o Vendors must submit responses in accordance with requirements : 5 stated on cover of document 7 a o Vendor must submit 1295 form with Bid/Proposal ci = Detailed information regarding 1295 can be found under item 49 in the attached Terms and Conditions. a a Texas Ethics Commission website for 1295: a a https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm z a a 4 For completing the 1295: Contract ID:__ 3991 Description:_Project #22-47 ev Pee U UU UU Montgomery County will not be responsible

for inaccurate or incomplete specifications and/or addenda pertaining to any bid/proposal that is received electronically. Legal Name of Contracting Company Contact Person Complete Mailing Address Telephone Number Email Address Signature Date P./Forms/Disclaimer Forms/Specs Download Request GILBERT D. JALOMO, JR., CPPB OFFICE OF COUNTY PURCHASING AGENT 501 N. Thompson MONTGOMERY COUNTY 936.539.7980 Suite 405 FAX: 936.760.6976 Conroe, Texas 77301 www. mctx.org September 28, 2022 Invitation to Bid Sealed bids one (1) original and one (1) copy will be received in the Office of the Montgomery County Purchasing Agent, Attn: Gilbert D. Jalomo, Jr., CPPB, 501 N. Thompson, Suite 405, Conroe, Texas 77301 until 2:00 p.m., October 12, 2022. PROJECT 22-47 MOVING OF VOTING EQUIPMENT ELECTIONS Prospective bidders may obtain specifications at the Office of the Montgomery County Purchasing Agent, 501 N. Thompson, Suite 405, Conroe, Texas 77301 any time after 8:00 a.m. on September 28, 2022. Specifications are also available via download at the Purchasing website: www.mctx.org. All bids shall be submitted on the basis of unit pricing as provided in the bid specifications. Payment to successful bidder shall be net thirty (30) days after receipt of products, materials, services or invoices, whichever is later unless otherwise stated in specifications. The right is reserved, as the interest of Montgomery County Commissioners Court may require rejecting any one or all bids and to waive any informality in bids received. All bids received after the above designated closing time will be returned unopened. Montgomery County is an Affirmative Action/Equal Opportunity Employer. Vendors are responsible for monitoring the Office of the Montgomery County Purchasing Agent website at www.metx.org for any Addenda, which may be issued. For any questions relating to the specifications or the submission of this bid, contact Melanie Tadlock, Senior Buyer via email at Melanie.Tadlock@mctx.org. or by calling 936.539.7975. Your consideration of this bid request is appreciated. Sincerely, fdal, CPPO, CPPB, NIGP-CPP Assistant County Purchasing Agent CONTRACT This agreement is made and entered into on the date of execution hereof by and between Montgomery County, hereinafter referred to as "County", a body corporate and politic under the laws of Texas, whose address for the purposes hereof is: Commissioners' Court, Alan B. Sadler Commissioners Court Building, 501 N. Thompson, Conroe, Texas 77301, and a ; whose address for the purposes hereof is hereinafter called "Offeror". WITNESSETH WHEREAS, the County Commissioners Court did on award to Offeror a contract for supplying in quantities and at the prices therein set out; and WHEREAS, the parties thereto now desire to memorialize said contract in writing in accordance with the bid or proposal submitted by Offeror and specifications and terms and conditions of County; NOW THEREFORE, know all men by these presents, the following contract is entered into by County and the undersigned Offeror. 1, (a.) The bid or proposal documents submitted by Offeror (hereinafter the bid documents); (b.) County "Standard Purchase Terms and Conditions"; (c.) County "Specifications"; (d.) "Recommendation" of County Purchasing Agent; and (e.) any scientific analysis submitted to the County are attached hereto and by this reference become part hereof. If there is any conflict between the bid documents and/or the County Standard Purchase Terms and Conditions, County Specifications, Recommendation of the County Purchasing Agent and scientific analysis submitted to the County as attached, the documents described in (b.) through (e.) above shall control. 2. Offeror represents that it possesses all right, title, and ownership to the goods, materials or services which are to be conveyed to County under the terms of this agreement. ENTIRE AGREEMENT: This contract contains the whole agreement between the County and Offeror in respect to the purchase and sale contemplated hereby, and there are no representations, terms, conditions, or collateral agreements, other than expressly set forth herein and the documents described in paragraph 1 above. PROPOSAL PACKAGE CHECK LIST Only items marked with an X are applicable to this proposal. Respondents should review the package thoroughly. If additional information is needed, contact Montgomery County Purchasing Dept. at 936-539-7980. Respondent must check each task as it is completed. Include this form with the appropriate proposal documents. Required v Required REQUIRED FORMS GENERAL REQUIREMENTS AND X Must be completed and signed in ink. Failure to do TERMS So may cause response to be rejected. x Respondent should be familiar with all General Requirements and Terms. Contract Israel Boycott Statement References Conflict of Interest Questionnaire (CIQ) Vendor Information Form Disclosure of Interested Parties (Form 1295) PA | P | p | PX Acknowledgement Ethics Training* completed and Certificate of Completion included with proposal response * click on link to complete training W-9 submittal SUBMITTING PROCEDURE Bidder/Offeror Self Certification > Company Name Certification Regarding Lobbying Project Number % & ey fe ** Opening Date Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion RY a Project Title Certificate of Independent Price Determination s PA | Ph |r [PS [PS] MIPS PKS AFTER AWARD IS MADE, THE FOLLOWING DOCUMENTS MUST BE PROVIDED Check if you are prepared to provide these after award, as required. Required v Required TEST REPORTS SAFETY DATA SHEETS PERFORMANCE BOND PAYMENT BOND REQUIREMENTS REQUIREMENTS This Bond applies to bids that exceed $25,000 as This Bond applies to bids that exceed $100,000 as stated in the Montgomery County Terms and stated in the Montgomery County Terms and Conditions. Conditions. INSURANCE INFORMATION Required v Required WORKERS COMPENSATION ACTIVE VENDOR Check if you are prepared to provide this after Check here only if your company has X swan, as reaauired, if applicable: xX conducted business with Montgomery AUTOMOBILE LIABILITY County within the past year; AND all Check if you are prepared to provide this after current insurance certificates are on file at xX award, as required, if applicable. this time. GENERAL AND PROFESSIONAL LIABILITY xX Check if you are prepared to provide this after award, as required, if applicable. It is the Respondents responsibility to be thoroughly familiar with all Requirements and Specifications. MONTGOMERY COUNTY SPECIFICATIONS FOR Moving of Voting Equipment SCOPE It is the intent of Montgomery County to secure pricing and availability for the moving of voting equipment to be utilized by Montgomery County Elections. TERM OF CONTRACT This contract will commence upon the award by Commissioners Court or after the expiration date of the current contract and will expire one (1) year from that date. All pricing must be firm during the contract. RENEWAL OPTION Upon mutual agreement between Montgomery County and the Vendor, before the expiration date of the initial term of the contract, this contract may be renewed annually thereafter for up to five (5) one year renewal periods. Renewal shall be subject to all terms, conditions, requirements, and specifications as listed herein, unless specifically noted and agreed to by both parties. GENERAL REQUIREMENTS Two sets (I original and I copy) of the bid shall be submitted. Original bid shall be clearly marked "ORIGINAL" and contain all original signatures. If quantities are listed, the quantities should be considered as approximate and based on the best available information. The vendor may not limit an order or shipment of an order with a "Minimum Dollar Amount or Quantity Amount. In reference to new product/service bids, quantity usage may be stated as one or more. When "Extended Prices" and/or "Grand Total" are listed in the bid and there is an error in the mathematical calculations, the unit price shall govern for evaluation purposes. Specifications may reference name brands and model numbers, It is not the intent of Montgomery County to limit or restrict bids, but to establish a desired level of quality, service, and performance. The vendor will be responsible for damages to County property. (the paint, walls, woodwork, doors) Usage Report: Upon request, the vendor will provide a report of items purchased on this contract, at no charge to Montgomery County If applicable, Safety Data Sheets must be furnished as required to comply with the law. Pricing must be all inclusive, with no additional charges for shipping, handling, delivery or any other charge not specifically set out and agreed to by the County. All standard Montgomery County Terms and Conditions apply unless stated otherwise. All orders will be issued on an AS NEEDED basis. Montgomery County does not guarantee an order. If a bidder does not wish to bid at this time but wishes to remain on the bid list for this commodity, please submit a NO BID following the same procedures indicated for bidding. It is the responsibility of the bidders to monitor the Purchasing website at www.metx.org for any addenda that may be issued pertaining to this bid. No addendum will be issued three (3) days prior to bid opening date unless otherwise approved by the Purchasing Agent. Montgomery County reserves the right, at its discretion, to procure the awarded item(s)/service(s) from other sources, if it is found to be in the Countys best interest. If applicable, contracts will not be awarded to any party that has been debarred, suspended, excluded or ineligible for participation in federal assistance programs. If applicable, in the event an awarded party or their subcontractor(s) become debarred, suspended, excluded or ineligible for participation in federal assistance programs after award of contract, the awarded contract shall be cancelled without notice. EVALUATION Compliance with afl bid requirements, delivery, pricing, warranty, work history and the needs of the using department will be considered when evaluating bids. ALTERNATE VENDOR(S) An award will be made to the vendor submitting the lowest bid. Montgomery County will refer to the award as the PRIME AWARD. Also, for the department(s), there may be an ALTERNATE(S) LOW BID(S), which will be a bid in and of itself, and will be given the designation ALTERNATE(S). Commissioners Court reserves the right to make an award to more than one (1) alternate, and to place an order with an alternate vendor whose bid provides the County with a lower cost or more appropriate product in particular circumstances, The departments will be allowed to utilize the service from the Alternate source if the service of the prime awarded vendor is not performed acceptably (does not meet the specifications), or if the prime awarded vendor is not available to provide service on the day it is needed. SPECIFICATIONS (SCOPE OF WORK) The successful moving contractor must provide all moving services to include personnel, equipment, protective coverings, and insurance as necessary to conduct the move in accordance with this bid. The moving contractor will be responsible for determining an adequate number of personnel required to complete the specified job. The voting equipment kept at the Montgomery County Building, 400 Conroe Park W. Dr., Conroe, TX, 77303 will be delivered to and picked up from early voting locations and election day locations as noted in Exhibit 1 and 3. General Information There are two (2) uniform election days per year with elections conducted on either Tuesday or Saturday. Additionally, primary elections are conducted every other year on even numbered years. The next primary election will be 2024. Special elections may be called on days other than the uniform election days. Equipment to be Delivered Approximately three hundred thirty-five (335) caddies containing voting equipment - each caddy measures 32 x 32 x 65, Weight fully loaded is approximately three hundred (300) pounds. Each caddy holds (four) 4 Duos plus accessories and each Duo weighs thirty-five (35) pounds. Equipment delivered to between six (6) and ten (10) early voting locations will also include supply crates and signs. Timeframes for Delivery 1. Delivery of early voting equipment For early voting delivery, equipment must be delivered to each of the six (6) to ten (10) early voting sites, on a date to be specified prior to the date early voting begins. The equipment to be delivered would be two (2) to thirteen (13) caddies 32" x 32"x 65 per location weighing three hundred (300) pounds, plus supply crate and signs. Exhibit 1 is a list of the current ten (10) early voting locations. Montgomery County reserves the right to add or delete voting locations. 2. Delivery of Election Day voting equipment Adequate resources would need to be dedicated for delivery to be accomplished five (5) days prior to the election. For elections occurring on Tuesday, delivery is to be completed by Thursday of the prior week. Any missed deliveries are to be completed by Thursday and Friday of the week before the election. For example, for the election to be conducted November 8, 2022, delivery should begin October 31 and be completed by November 3 with any missed or delayed deliveries to be accomplished on Thursday- Friday November 3-4. For elections that are held on Saturday, deliveries are to be made Monday through Wednesday of the same week with any missed or skipped deliveries to be completed on Thursday. Exhibit 3 is a list of 111 locations to which equipment may be delivered. Locations may be changed and the number of deliveries to be made for any election may vary, depending on the type of election to be conducted. For some elections, it may be necessary to establish routes or zones grouping delivery locations. Exhibit 2 is an example of the routes required for a full deployment of equipment to all 111 polling locations. Deliveries are grouped in six (6) routes. Delivery of three (3) routes per day would be required to accomplish delivery in a timely manner. The moving company will be required to make contact by telephone with each location prior to delivery to assure that someone will be available to accept the voting equipment. Equipment may not be left unattended at any location without the prior consent of Election Central. A list of phone numbers will be given to the mover prior to the deliveries. A delivery receipt will be required showing the date, name and signature of the individual accepting delivery, except for those sites for which prior consent was given. An application on a tablet, to be provided by Election Central, is used to collect the information and generate the receipt. If attempts to deliver equipment are unsuccessful, the moving company must contact Election Central for instructions. Pickup Information For Election Day Equipment For elections held on Tuesday, pickup of equipment should begin on Wednesday and be completed by Thursday of the same week as the election. For elections held on Saturday, pick up shall begin on Monday of the week following the election and should be completed by Tuesday. Handling of Equipment Caddies are equipped with casters. Ramps may not be used without express prior approval and used only with a specially equipped dolly provided by Election Central. Moving company will be liable for any damage to casters, caddies or equipment during transit. Insurance Required Cargo insurance and $1,000,000 liability coverage will be required. Cargo insurance should be for replacement value and in an amount sufficient to cover $25,000 per caddy included in the shipment. For example, an 8x15 truck has a capacity sufficient to hold fifteen (15) caddies, the cargo insurance required would be $375,000. Montgomery County shall be named as an additional insured. A certificate of insurance will be required for the term of the contract. Protection of Equipment In the event of inclement weather, the moving company must provide the means to adequately protect equipment from the elements. MONTGOMERY COUNTY BID FORM DESCRIPTION/SPECIFICATIONS: Moving of Voting Equipment DELIVERY: All delivery and freight charges (FOB Montgomery County Destination, Inside Delivery, Prepaid and Allowed) are to be included in the bid price. While in transit, the successful vendor will pay all transportation costs and will assume all risk of loss. The vendor is required to fill out the price per unit. MONTGOMERY COUNTY RESERVES THE RIGHT TO INSPECT ALL ITEMS BEFORE ACCEPTING AND TO RETURN ALL ITEMS THAT DO NOT FOLLOW THESE SPECIFICATIONS. The bid price shall be full compensation for all materials, labor, tools, equipment and incidentals necessary to complete the work. Bidder must state the brand quoted even if bidder is providing the brand specified. Please e-mail Melanie Tadlock Montgomery County Purchasing Department, Melanie.tadlock@metx.org with any questions relating to these requirements. When inquiring about a bid, please state Project# 22-47 : Montgomery County reserves the right to accept or reject all or any part of the bid submitted. Payment Terms: Net 30 after receipt of product(s), material(s), service(s) or invoice(s), whichever is latest. In addition to all other warranties, whether expressed or implied herein, Vendor warrants to County that items and/or services furnished hereunder will be of good quality and new unless otherwise required or permitted and that the work will be free from defects and will conform to the requirements of the Contract Documents. Items and/or services not conforming to these requirements shall be deemed defective and shall be replaced or performed again at the discretion of Montgomery County. Bidders will fill out the following bid form in its entirety. Failure to do so may result in bid disqualification. Pricing is requested in three (3) formats. For county-wide elections, all 111 locations may be used. One all inclusive price is requested for delivery to all 111 locations. However, for some consolidated elections fewer polling locations are required. Pricing on a per precinct basis is requested for consolidated or less than county-wide elections where fewer polling locations may be used. ITEM# DESCRIPTION APPROX. UNIT EXTENDED QTY PRICE TOTAL 1. Early Voting Location (Delivery and Pick up) 10 $ $ 2, Election Day Voting Location (Delivery and Pick up) 111 $ $ 3. Consolidated Election Day Voting Locations Delivery/Pickup Per Precinct __ 60 $uo = = = 4,Hourly charge for various deliveries (per hour) $ $ GRAND TOTAL: $ GRAND TOTAL AMOUNT IS FOR EVALUATION PURPOSES ONLY. Please specify: Inside delivery date to be days after order is placed. How much notice is required prior to a move? days The vendor may not limit an order or shipment of an order with a "Minimum Dollar Amount." NOTE: "ANY MATERIAL REQUESTED TO BE CONSIDERED AS CONFIDENTIAL IN NATURE MUST BE PLACED IN A SEPARATE ENVELOPE CLEARLY MARKED CONFIDENTIAL; PROVIDED, SUCH MATERIAL WILL BE TREATED AS CONFIDENTIAL BY MONTGOMERY COUNTY ONLY TO THE EXTENT ALLOWABLE IN THE GOVERNMENT CODE, CHAPTER 552 OF THE PUBLIC INFORMATION ACT AND EXCEPT WHERE REQUIRED BY A COURT WITH COMPETENT JURISDICTION TO RELEASE INFORMATION. IF ITEMS ARE NOT PLACED IN AN ENVELOPE AND MARKED CONFIDENTIAL, MONTGOMERY COUNTY WILL NOT BE LIABLE FOR DISCLOSING THE INFORMATION." COMPANY NAME Are all bid Specifications met? Yes No If requested, can you provide insurance required for the following? (a) Workers' Compensation Yes No (b) Comprehensive General Liability Yes No (c) Automobile Liability Insurance Yes No Submitted by: Company Name: Address: (Mailing) (Physical) Telephone: Contact: (PRINT) Fax Number: Email: Officer's Signature COMPANY NAME COMMENTS: ADDENDA If applicable, bidder acknowledges receipt of the following Addenda: Addendum #1 Date Addendum #2 Date Addendum #3 Date Addendum #4 Date MONTGOMERY COUNTY ELECTIONS EXHIBIT 1 2022 EARLY VOTING POLLING LOCATIONS Polling Location Address Central Library 104 1-45 North Conroe 77301 North Montgomery County Community Center 600 Gerald Street Willis 77378 Lone Star Community Center 2500 Lone Star Parkway Montgomery 77356 West Montgomery County Community Development Center 31355 Friendship Drive Magnolia 77355 Magnolia Event Center 11659 FM 1488 Magnolla 77354 South County Community Center 2235 Lake Robbins Drive Z The Woodlands 77380 Spring Creek Greenway Nature Center 1300 Riley Fuzzel Road Spring 77386 George and Cynthia Weods Mitchell Library 8125 Ashlane Way The Woodlands 77382 East Montgomery County Fair Association Bullding 21675A McCleskey Road | New Caney 77357 East Montgomery County Community Development Center 16401 st Street, Suite 100 | LL Splendora 77372 EXHIBIT 2 2022 Montgomery County Election Day Polling Locations Delivery Route Information IG 41 57 Calvary Road Baptist Church 12621 Calvary Road Willis 77318 5 Long Street Community Center 20240 Bays Chapel Road Richards 77873 9 Dobbin - Dacus Community Center 695 South FM 1486 Montgomery 77316 2 3 4 19. City of Montgomery City Hall 5 6 101 Old Plantersville Road Montgomery 77316 22 =~ Lake Conroe Hills Community Building 13621 Lake Breeze Lane Willis 77318 38 Montgomery County West Annex 19380 Highway 105 W., Suite 507 Montgomery 77356 7 39 Lake Creek High School 20639 FM 2854 Montgomery 77316 8 50. Far Hills Utility District Building 10320 Cude Cemetery Road Willis 77318 9 63 Walden Community Church 12400 Walden Road Montgomery 77356 10 72. Bentwater Yacht Club 200 Bentwater Harbor Drive Montgomery 77356 11 77 ~=~April Sound Church 67 1/2 April Wind Drive South Montgomery 77356 12 105 Lone Star Community Center 2500 Lone Star Parkway Montgomery 77356 10 11 12 44 43 23 83 12 17 55 110 60 The Lone Star Convention Center 9055 Airport Road Conroe 77303 Panorama Village Fire Station 97 Hiwon Drive Panorama Village 77304 Willis Community Building 109 West Mink Street Willis 77378 North Montgomery County Community Center 600 Gerald Street Willis 77378 Browder Community Center 14865 County Line Road Willis 77378 Security Community Center 18760 Highway 105 East Cleveland 77328 Security Community Center 18760 Highway 105 East Cleveland 77328 First Baptist Church Groceville 19256 FM 1484 Conroe 77303 Austin Elementary School 14796 Highway 105 East Conroe 77306 Conroe Seventh-Day Adventist Church 3601 South Loop 336 East Conroe 77301 Bonnie Wilkinson Elementary School 2575 Ed Kharbat Drive Conroe 77301 Montgomery County Juvenile Facility 200 Academy Drive Conroe 77301 10 11 16 52 26 93 14 82 94 95 37 Polling Place Splendora ISD Administration Building 23419 FM 2090 Splendora 77372 Splendora ISD Instructional Services 26175 FM 2090 Splendora 77372 New Caney Central Administration Office 21580 Loop 494 New Caney 77357 New Caney Elementary School 20501 FM 1485 New Caney 77357 East Montgomery County Fair Association Building 21675A McCleskey Road New Caney 77357 Valley Ranch Elementary School 21700 Valley Ranch Crossing Drive Porter 77365 Robert L. Crippen Elementary School 18690 Cumberland Boulevard Porter 77365 Bens Branch Elementary Schoo] 24160 Briar Berry Lane Porter 77365 Lone Star College - Kingwood, Performing Arts Center 500 Royston Drive Kingwood 77339 Kings Manor Elementary Schoo] 21111 Royal Crossing Drive Kingwood 77339 Friendship United Methodist Church 22388 Ford Road Porter 77365 111 42 64 36 96 56 15 108 98 104 34 75 fling Grangerland Community Center 15636 FM 3083 Grangerland 77302 Ben Milam Elementary School 16415 FM 3083 Conroe 77302 Moorhead Junior High School 13475 FM 1485 Conroe 77306 Whispering Pines Baptist Church 15200 FM 1485 Conroe 77306 Allendale Baptist Church 14535 Allendale Lane Conroe 77302 Gerald D. Irons, Sr. Junior High School 16780 Needham Road Conroe 77385 The Woodlands Emergency Training Center 16135 IH-45 South The Woodlands 77385 Comerstone Church 100 Mosswood Drive Conroe 77302 Voting Box 108 Building 14900 Interstate 45 S Conroe 77384 KC Event Center 2655 FM 1488 Conroe 77384 Foster's Ridge Club House 14100 Denali Wilderness Parkway Conroe 77384 Needham Fire Department Station 64 15341 Lake Lamond Road Conroe 77384 Windsor Hills Homeowners' Association Club House 1 East Windsor Hillis Circle The Woodlands 77384 10 11 12 69 59 78 71 61 101 74 66 olling Piac George P. Mitchell Intermediate School 6800 Alden Bridge Drive The Woodlands 77382 George P. Mitchell Intermediate School 6800 Alden Bridge Drive The Woodlands 77382 Barbara Pierce Bush Elementary School 7420 Crownridge Drive The Woodlands 77382 Powell Elementary School 7332 Cochrans Crossing Drive The Woodlands 77381 Roger L. Galatas Elementary School 9001 Cochrans Crossing Drive The Woodlands 77381 Buckalew Elementary School 4909 West Alden Bridge Drive The Woodlands 77382 George and Cynthia Woods Mitchell Library 8125 Ashlane Way The Woodlands 77382 The Woodlands High Schoo! Ninth Grade Campus 10010 Branch Crossing Drive The Woodlands 77382 Coulson Tough Flex School Grades K-6 11660 Crane Brook Drive The Woodlands 77382 Deretchin Elementary School 11000 Merit Oaks Drive The Woodlands 77382 Cedric C. Smith Elementary School 28747 Hardin Store Road Magnolia 77354 Outback Western Wear Event Hall 30405 Dobbin Huffsmith Road Magnolia 77354 10 11 12 13 14 35 70 58 62 49 48 79 45 32 84 67 33 Polling Place. Knights of Columbus Hall 29327 South Plum Creek Drive Spring 77386 Robinson Road Community Center 27434 Robinson Road Oak Ridge North 77385 The Woodlands Recreation Center at Bear Branch Park 65310 Research Forest Drive The Woodlands 77381 Lone Star College System 5000 Research Forest Drive The Woodlands 77381 Collins Intermediate School 6020 Shadowbend Piace The Woodlands 77381 David Elementary School 5301 Shadowbend Place The Woodlands 77381 Sally K. Ride Elementary School 4920 West Panther Creek Drive The Woodlands 77381 McCullough Junior High School - Nancy Bock Center for Performing Arts 3800 South Panther Creek Drive The Woodlands 77381 Glen Loch Elementary School 27505 Glen Loch Drive The Woodlands 77381 Timber Lakes/Timber Ridge Pavilion 25610 Timber Lakes Drive Spring 77380 Neal Knox Junior High School 12104 Sawmill Road The Woodlands 77380 South Montgomery County Fire Station #1 335 Volunteer Lane Spring 77380 Lamar Elementary School 1300 Many Pines Road The Woodlands 77380 South County Community Center 2235 Lake Robbins Drive The Woodlands 77380 10 24 80 92 87 100 47 103 46 88 Shenandoah Municipal Complex 29955 I-45 North Shenandoah 77381 Emmit E. Houser Elementary School 27370 Oak Ridge School Road Conroe 77385 Imperial Oaks Neighborhood Center - Recreation Center 31110 Imperial Oaks Boulevard Spring 77386 George C. Kaufman Ill Elementary School 2760 Northridge Forest Drive Spring 77386 Birnham Woods Elementary School 31150 Birnham Woods Drive Spring 77386 Grand Oaks High School 4800 Riley Fuzzel Road Spring 77386 South Montgomery County Fire Station #4 28830 Birnham Woods Drive Spring 77386 C.D. York Junior High School 3515 Waterbend Cove Spring 77386 Spring Creek Greenway Nature Center 1300 Riley Fuzzel Road Spring 77386 Ann K. Snyder Elementary School 28601 Birnham Woods Drive Spring 77386 1 10 11 12 99 106 76 89 97 30 28 13 65 29 18 91 Jean Stewart Elementary School 680 Fish Creek Thoroughfare Montgomery 77316 Grace Life Church 3636 Honea Egypt Road Montgomery 77316 Westwood Landowners Association Building 406 Mackintosh Drive Magnolia 77354 Bear Branch Elementary School 8909 FM 1488 Magnolia 77354 Magnolia Event Center 11659 FM 1488 Magnolia 77354 Magnolia High School 14350 FM 1488 Magnolia 77354 Decker Prairie Elementary School 27427 Decker Prairie Rosehill Road Magnolia 77355 Decker Prairie Community Center 32434 Decker Prairie Road Magnolia 77355 J. L. Lyon Elementary School 27035 Nichols Sawmill Road Magnolia 77355 West Montgomery County Community Development Center 31355 Friendship Drive Magnolia 77355 Magnolia Community Center 422 Melton Street Magnolia 77354 Magnolia West High Schoo! 42202 FM 1774 Magnolia 77355 10 11 12 86 11 102 21 20 10 51 73 27 109 90 gr Cryar Intermediate School 2375 Montgomery Park Boulevard Conroe 77304 Living Branch Church 13229 Highway 105 West Conroe 77304 Lake Conroe Forest Community Building 610 Navajo Drive Montgomery 77316 John V. Peet Junior High School 1895 Longmire Road Conroe 77304 Conroe High School Ninth Grade Campus 400 Sgt Ed Holcomb Boulevard N Conroe 77304 Travis Intermediate School 1100 North Thompson Street Conroe 77301 Booker T. Washington High School 507 Dr. Martin L. King, Jr. Place North Conroe 77301 Central Library 104 1-45 North Conroe 77301 City of Conroe, Dean Towery Service Center 401 Sgt. Ed Holcomb Boulevard South Conroe 77304 Rivershire Club House 206 Scarborough Drive Conroe 77304 City of Conroe Westside Recreation Center 10245 Owen Drive Conroe 77304 The Palm Community Building 285 Central Pine Street Montgomery 77316 Woodbranch City Hall 58 A Woodbranch Drive New Caney 77357 Peach Creek Baptist Church 25425 FM 1485 East New Caney 77357 Northridge Baptist Church 10681 FM 1484 Conroe 77303 MONTGOMERY COUNTY ELECTIONS EXHIBIT 3 2022 ELECTION DAY POLLING LOCATIONS | Precinet Namie of Facility Zs Physical Address Zip LOL [Willis Community Bullding 109 West Mink Street 77378 02 Conroe Seventh-Day Adventist Church 3601 South Loop 336 East 77301 03 |The Woodlands High School Ninth Grade Campus 110010 Branch Crossing Drive 04 = [McCullough Junior High School - Nancy Bock 3800 South Panther Creek Drive Center for Performing Arts The Woodlands [77382 The Woodlands = |77381 os Long Street Community Center 20240 Bays Chapel Road Richards 77873 06 |Deretchin Elementary School 41000 Merit Oaks Drive The Woodlands _|77382 \"07__ |New Caney Elementary School 20501 FM 1485 New Caney 08 Browder Community Center 14865 County Line Road Willis 71378 99 Dobbin - Dacus Community Center 695 South FM 1486 Montgomery 10 Booker T. Washington High Schoal 507 Dr. Martin L. King, Jr. Place North Conroe 11 |Lake Conroe Forest Community Building 610 Navajo Drive Montgomery 12 ~~ {Security Community Center 18760 Highway 105 East Cleveland . Decker Prairle Community Center 32434 Decker Prairie Road Magnolia 14 Robert L. Crippen Elementary School 18690 Cumberland Boulevard Porter 15 [Cornerstone Church ~ 100 Mosswood Drive Conroe 16 _|Splendora ISD Instructional Services 26175 FM 2090 Splendora First Baptist Church Groceville 19256 FM 1484 Conroe 18 Magnolia Community Center 422 Malton Street Magnolia City of Montgomery Community Building 14420 Liberty Street Montgomery 77356 Travis tntermediate School 1100 North Thompson Street Conroe 77301 | Conroe High School Ninth Grade Campus 400 Sgt Ed Holcomb Boulevard N Conroe 77304 Lake Conroe Hills Community Building 13621 Lake Breeze Lane an 77318 North Montgomery County Community Center [600 Gerald Street pt 77378 Emmit E, Houser Elementary School 27370 Oak Ridge School Road Conroe 77385 Grangerland Community Center 15636 FM 3083 Grangerland 77302 East Montgomery County Fair Association 21675A McCleskey Road New Caney 77357 Rivershire Club House 206 Scarborough Drive Conroe 77304 Decker Prairle Elementary Schaol _. [27427 Decker Prairie Rosehill Road Magnolia 77355 West Montgomery County Community 31355 Friendship Drive ~ Magnolla Development Center Magnolia High School 14350 FM 1488 Magnolia Shenandoah Municipal Complex _____ 29955 |-45 North ~~ Shenandoah Neal Knox Junior High School 12104 Sawmill Road i Woodlands South County Community Center 2235 Lake Robbins Drive The Woodlands Needham Fire Department Station 64 15841 Lake Lamond Road Conroe 35 {Oak Ridge North Municipal Building 27424 Robinson Road Oak Ridge North 177385 ____ |14535 Altendale Lane Conroe 22388 Ford Road Porter 19380 Highway 105 W., Sulte 507 Montgomery 20639 FM 2854 Montgomery 2375 Montgomery Park Boulevard Conroe 23419 FM 2090 Splendora 36 [Allendale Baptist Church 37 __ [Friendship United Methodist Church 38 jMontgomery County West Annex 39 [Lake Creek High School 40 |Cryar Intermediate School _41___{Splendora ISD Administration Bullding Page 4 of 3 Precinct Name of Facility Physical Addrass Clty Zip Moorhead Junior High School een 8475 FM 1485 _ Conroe 77306 Panorama Village City Hall $9 Hiwon Drive Panorama Village |77304 The Lone Star Convention Center [9055 Alrport Road Conroe 77303 Timber Lakes/Timber Ridge Pavilion 25610 Timber Lakes Drive spring s 7780 Spring Creek Greenway Nature Center 1300 Riley Fuzzel Road Spring 77386 South Montgomery County Fire Station #4 28830 Birnham Woods Drive Spring 77386 Sally K, Ride Elementary School 4920 West Panther Creek Drive The Woodlands {77381 77381 David Elementary School 5301 Shadowbend Place "|The Woodlands Far Hills Utility District Bullding 10320 Cude Cemetery Road Willis 77318 Central Library 104 1-45 North Conroe 77301 New Caney Central Administration Office 21580 Loop 494 New Caney 77357 {Woodbranch City Hall 58 A Woodbranch Drive New Caney 7ST L_ Peach Creek Baptist Church __...|25425 FM 1485 East __[New Caney 77357 | 55 {Austin Elementary School ee 14796 Highway 105 East Conroe 177306 | [56 _ |The Woodlands Emergency Training Center 16135 IH-45 South the Woodlands [77385 | [ 57 [Calvary Road Baptist Church 12621 Calvary Road Willis 77318 "58 {Lone Star Collage System 5000 Research Forest Drive the Woodlands _ |77381 | 59 | Powell Elementary School 7332 Cochrans Crossing Drive The Woodlands 0 | Montgomery County Juveniie Facility 200 Academy Drive __|Conroe 61 ~ |George and Cynthia Woods N Mitchell Library 8125 Ashlane Way ee 7 The Woodlands 62 |Collins Intermediate School 6020 Shadowbend Place ihe Woodlands 63 Walden Community Church 12400 Walden Road Montgomery 77356 G4 __|Whlspering Pines Baptist Church 15200 FM 1485 Conroe 77306 65 J. L. Lyon Elementary School . 27035 Nichols Sawmill Road Magnolia 66 {Outback Western Wear Event Hall 30405 Debbin Huffsmith Road Magnolia 67 ~ [Lamar Elementary Si School 1300 Many Pines Road _. The Woodlands ~Tknights of Columbus Halil 29327 South Plum Creek Drive Spring [6 Barbara Plerce Bush Elementary School 7420 Crownrldge Drive The Woodlands 70 |The Woodlands Recreation Center at Bear 5310 Research Forest Drive The Woodlands 71 ~~ |Buckatew Elementary School . 4909 West Alden Bridge Drive The Woodlands |__72 __|Bentwater Yacht Club . 200 Bentwater Harbor Drive Montgomery [73 | City of Conroe, Dean Towery Service Center 401 Sat. Ed Holcomb Boulevard South |Conroe 1 74 _|Cedric C. Smith Elementary School 28747 Hardin Store Road Magnolia 77354 75 [Windsor Hills Homeowners Association Club 1 East Windsor Hills Circle The Woodlands |77384 House 76 Westwood Landowners' Association Building 1406 Mackintosh Drive Magnolia 77354 77 {April Sound Church 67 1/2 April Wind Drive South Montgomery 78 Roger 1. Galatas Elementary School 9001 Cochrans Crossing Drive The Woodlands | 79 [Glen Loch Elementary Schoot 27505 Glen Loch Drive The Woodlands 80 Imperial Oaks Neighborhood Center - Recreation |31110 Imperial Oaks Boulevard Spring 81 George P. Mitchell Intermediate School _. {8800 Alden Bridge Drive The Woodlands 82 Bens Branch Elementary School 24160 Briar Berry Lane Porter 77365 83 Security Community Center 18760 Highway 105 East Cleveland 77328 | ~ South Montgomery County Fire Station #1. 335 Volunteer Lane Spring 77380 85 Northridge Baptist Church 106841 FM 1484 ~ Conroe 77303 "86 Living Branch Church 13229 Highway 105 West Conroe 77304 a Birnham Woods Elementary School 31150 Birnham Woods Drive Spring 77386 Ann K. Snyder Elementary School 28601 Blrnham Woods Drive Spring eee [ ae [Bear Branch Elementary School 8909 FM 1488 a [77354 Page 2 of 3 Precinct Name of Facllity The Palm Community Bullding Magnolia West High School |George C, Kaufman ill Elementary School alley Ranch Elementary School 2760 Northridge Forest Drive 21700 Valley Ranch Crossing Drive Lone Star College - Kingwood, Performing Arts [500 Royston Drive Kingwood Center 95 Kings Manor Elementary School 241.11 Royal Crossing Drive | Kingwood 96 | Gerald D. lrons, Sr. Junior High School 16780 Needhara Road ____|Conroe 97 _|Magnolia Event Center 11659 FM 1488 Magnolia 98 |KC Event Center 2655 FIM 1488 Conroe 99 Jean Stewart Elementary Schoot 680 Fish Creek Thoroughfare Montgomery 100 |Grand Oaks High School 4800 Riley Fuzzel Road Spring 101 _ [Coulson Tough Flex School Grades K-6 11660 Crane Brook Drive The Woodlands F402 [John Vv. Peet Junior High School __ ___|1895 Longmire Road Conroe 03 (C.D. York Junior High School 3515 Waterbend Cove ~ Spring 104 | Foster's Ridge Club House 141.00 Denall Wilderness Parkway Conroe [ 105 Lane Star Community Center 2500 Lone Star Parkway Montgomery 77356 [06 |Grace Life Church 3636 Honea Egypt Road Montgomery 77316 107 George P. Mitchell Intermediate School 6800 Alden Bridge Drive The Woodlands |77382 108 |Voting Box 108 Bullding (No Name on Building) _|44900 interstate 455 Conroe 77384 109 City of Conroe Westside Recreation Center ~|10245 Owen Drive Conroe 77304 110 [Bonnie Wilkinson Elementary School 2575 Ed Kharbat Drive Conroe 111 [Ben Milam Elementary Schoo! 16415 FM 3083 Conroe 111 Total Precincts Page 3 of 3 MONTGOMERY COUNTY STANDARD PURCHASE TERMS AND CONDITIONS PLEASE READ THIS ENTIRE DOCUMENT CAREFULLY, YOU ARE RESPONSIBLE FOR FULFILLING ALL SPECIFICATIONS AND REQUIREMENTS, 1, BID FORM COMPLETION: MONTGOMERY COUNTY is aware of the time and effort you expend in preparing and submitting bids to the County. Please let us know of any bid requirements which are causing you difficulty in responding to our bids. We want to make the process as easy as possible so that all responsible vendors can compete for the Countys business. Fill out completely and return the number of copies specified per the Invitation to Bid in a sealed envelope properly marked with NAME OF BID ITEM and clearly stating DO NOT OPEN IN MAIL ROOM. Original bid shall be clearly marked ORIGINAL and contain all original signatures. Electronic Signatures can be accepted on documentation that requires signatures. If there is a question regarding the authenticity of the signature Montgomery County Reserves the right to request verification. Bidder shall provide with the bid response, all documentation required herein. Failure to provide this information may result in rejection of bid. LUMP-SUM OR UNIT PRICE METHOD: A purchase may be proposed on a lump-sum or unit price basis. If the County chooses to use unit pricing in its notice, the information furnished bidders will specify the approximate quantities estimated on the best available information, but the compensation paid the bidder will be based on the actual quantities purchased. Extended totals and/or the sum of all extended totals will be used for evaluation purposes. Where there is an error in the extension of prices, the unit price shall govern. Vendors shall take due care when extending prices. MINIMUM STANDARDS FOR RESPONSIBLE PROSPECTIVE BIDDERS: A prospective Bidder must affirmatively demonstrate Bidders responsibility. A prospective Bidder must meet the following requirements: a) have adequate financial resources, or ability to obtain such resources as required; b) be able to comply with the required or proposed delivery schedule; } have a satisfactory record of performance; d) be otherwise qualified and eligible to receive an award. Montgomery County may request representation and other information sufficient to determine Bidders ability to meet the minimum standards listed above. REFERENCES: Montgomery County requests Bidders to supply, in response to this Invitation to Bid, a list of at least five (5) references where like services have been supplied by the bidder. Include name of firm, contact person, address, telephone number and fax number. A negative reference can result in a vendor not receiving a bid award. Rev: 2/2022 5. REQUIRED BID BOND: If the contract is for the construction of public works, including, but not limited to, the construction, alteration, or repair of any public building, bridge, road, or like improvement, Bidder shall submit a bid bond in the amount of (5%) of the bid amount. County may, by special provision, require submission of a bid bond in the amount of (5%) of the bid amount for any other contract where the bid amount shall exceed $100,000.00, Commissioners Court also has the option to require a bid bond in the amount of (5%) of the bid amount if the total bid amount is less than $100,000.00. Where required, the bid bond shall accompany submission of the bid and must be executed by a corporate surety authorized to do business in the State of Texas. 6. REQUIRED PERFORMANCE BOND: If the contract is for the construction of public works, including, but not limited to, the construction, alteration, or repair of any public building, bridge, road or like improvement, and the contract price shall exceed the sum of $100,000.00, the successful Bidder may be required to submit a performance bond conditioned upon the faithful performance of the work in accordance with the plans, specifications, and contract documents. County may, by special provision, require the submission of a performance bond for any other contract where the contract price shall exceed the sum of $50,000.00. Commissioners Court also has the option to require a performance bond for any other contract where the contract price is less than the sum of $50,000.00. Where required, the performance bond shall be submitted by the successful Bidder within twenty (20) days of the award of the bid. Performance bonds shall be in an amount equal to the contract price and must be executed by a corporate surety authorized to do business in the State of Texas. VB REQUIRED PAYMENT BOND: If the contract is for the construction of public works, including, but not limited to, the construction, alteration, or repair of any public building, bridge, road or like improvement, and the contract price shall exceed the sum of $25,000.00, the successful Bidder may be required to submit a Payment Bond for the protection of all claimants supplying labor or materials in connection with the prosecution of the work provided for in the contact. Commissioners Court also has the option to require a Payment Bond if the contract price is less than $25,000.00. Where required, the Payment Bond shall be submitted by the successful Bidder within twenty (20) days of the award of the bid. Payment bonds shall be in an amount equal to the contract price and must be executed by a corporate surety authorized to do business in the State of Texas, 8. AWARD: The Commissioners Court of Montgomery County (County) reserves the right to award the contract to the LOWEST, BEST AND MOST RESPONSIBLE BID in accordance with laws of the State of Texas, to waive any formality or irregularity, to make awards to more than one bidder, to reject all bids or require new bids if deemed in the best interest of the County. By law, County is not obligated to accept a non-compliant low bid, County reserves the right to award bids on the lump sum or unit price basis, whichever is deemed in the best interest of Montgomery County. Alternate bids will not be accepted. To obtain results, or if you have any questions, please contact the Purchasing Office at (936) 539-7980. 9. CONTRACT FULFILLMENT: Bidders shall fill in and sign the attached contract, and attach a copy of vendors Assumed Name Certificate or Corporate Certificate, or supply sufficient proof of the existence of such Certificate, in order for your bid to meet Montgomery County Bid Requirements. The Commissioners Court of Montgomery County must, by law, award all contracts, and the Commissioners Court must execute all contracts and agreements before they become binding on the County. Rev: 2/2022 This bid, when properly accepted by Montgomery County, shall constitute a contract equally binding between the successful Bidder and Montgomery County. No different or additional terms will become a part of this contract, with the exception of Change Orders. Upon acceptance and approval of the Montgomery County Commissioners Court, this bid and its contents become part of the contract between the awarded vendor(s) and Montgomery County for the time period designated. Department heads are NOT authorized to sign any kind of supplemental or binding purchase, lease or rental agreements for goods or services for County. All supplemental agreements are subject to approval of Commissioners Court. Binding agreements shall remain in effect until all products and/or services covered by this contract have been satisfactorily delivered and accepted. If the contract is intended to cover a specific time period, said time will be noted in the specifications. If a bid bond is required, it will be requested in the package. 10. CHANGE ORDERS: No oral statement of any person shall modify or otherwise change, or affect the terms, conditions or specifications stated in the resulting contract. All Change Orders to the contract will be made in writing by the Purchasing Agent and approved by Commissioners Court. 11. PRICING (if applicable): Prices for all goods, and/or services shall be firm for the duration of this contract and shall be stated on the bid sheet. Prices shall be all inclusive. Any price not shown on the bid sheet will not be honored by invoice. All prices must be written in ink or typewritten. Pricing on all transportation, freight or other charge is to be prepaid by the contractor and included in the bid prices, unless otherwise agreed to by both parties. If there are additional charges of any kind, other than those mentioned above, specified or unspecified, Bidder must indicate both items required and attendant costs, or forfeit the right to payment. Payment to Bidder by County in such cases will be made on a pay as you go basis, if a term contract. The delivery ticket shall be submitted to the using department after deliveries are made. Subsequent payment will be made in the regular course of County disbursement. All invoices shall be mailed directly to the Montgomery County Auditor, P.O. Box 539, Conroe, TX, 77305. If during the life of the contract, the successful Bidders net prices to other customers for items awarded herein are reduced below the contracted price, it is understood and agreed that the benefits of such reduction shall be extended to Montgomery County. A price re-determination may be considered by Montgomery County with appropriate backup, substantiated in writing (i.c., manufacturers direct cost, postage rates, Railroad Commission Rates, Wage/Labor Rates, etc.). The Bidders past history of honoring contracts at the bid price will be an important consideration in the evaluation of the lowest and best bid. County reserves the right to accept or reject any/all of the price re-determination as it deems to be in the best interest of Montgomery County. 12. DELIVERY: The successful Bidder shall not deliver products or provide services as part of this contract without a Montgomery County Purchase Order signed by the Purchasing Agent. Successful Bidder shall not deliver products or services which exceed the amounts specified on the Purchase Order. All items shall be shipped FOB INSIDE DELIVERY unless otherwise stated in the specifications. This shall be understood to include delivering merchandise to the appropriate room designated by the using department. Receiving times may vary by department. Generally, deliveries may be made between 8:30 a.m. and 4:00 p.m. Monday through Friday, except during the noon hour. Bidders are advised to consult the using department for instructions. The fastest, most reasonable delivery time shall be indicated by the Bidder in the proper place on the bid sheet. Any special information concerning delivery from the Bidder should also be included, on a separate sheet if necessary, or under the Comment Section. All delivery and freight charges (FOB Montgomery County destination) are to be included in the bid price. Rev: 2/2022 13. 14. 15. 16. 17. 18. 19. 20. 21, PACKING SLIPS; Packing Slips or other suitable shipping documents shall accompany each special order shipment and shall show: a) name and address of successful Bidder; b) name and address of receiving department and/or delivery location; c) Montgomery County Purchase Order Number; and d) descriptive information as to the item(s) delivered, including product code, item number, quantity, number of containers, etc. TERMINATION: During the term of the contract, County retains the right to immediately cancel any agreement between the parties hereto should goods, materials, or services supplied by Bidder not meet specifications. County also retains the right to cancel the contract due to budget restraints. In any case, with or without cause, County may terminate any agreement upon thirty (30) days written notice deposited in the United States mail. PAYMENT TERMS: Unless otherwise specified by Montgomery County Commissioners Court, payment terms will be Net 30 after receipt of product(s), material(s), service(s) or invoice, whichever is later. RECORDS: Contractors shall maintain records for one year after project has been accepted by Montgomery County. NAME BRANDS: Specifications may reference name brands and model numbers. It is not the intent of County to limit or restrict bids, but to establish the type and desired quality level of merchandise. Bidders may offer comparable items and the burden of proof rests with them. Any reference to model and/or make/manufacturer used in Bid Specifications is descriptive, not restrictive. Bids on items of like quality will be considered. County shall act as sole judge in determining equality and acceptability of items offered. Design, strength, and quality of materials must conform to the highest standards of manufacturing practice. To qualify an item as equal to that specified, the Bidder shall submit evidence that the material is equal in quality, workmanship, performance, etc. COLOR SELECTION: The determination of colors of woods, vinyl, fabrics or any other materials is a right reserved by the using department unless otherwise specified in the bid. When colors are not specified, a color chart must be provided. If the Bidder fails to get color approval prior to delivery of merchandise, the using department may refuse to accept the items and demand correct shipment without penalty, subject to other legal remedies. INSPECTIONS: County reserves the right to inspect any item(s) or service location for compliance with specifications and requirements. When requested, demos or samples shall be furnished free of expense to Montgomery County. If a Bidder bids on an item and cannot furnish a sample of said item for review, County reserves the right to reject the offer as inadequate. MAINTENANCE: Maintenance shall, if possible, be available to County for bid equipment. Cost for this service shall be shown on the bid sheet as an annual cost. If the County opts to include maintenance, said cost will be shown on the bid sheet and will commence only upon expiration of applicable warranties, FUNDING OUT: It is expressly understood and agreed that County has available the total maximum sum of funds hereinafter certified available by the County Auditor for the purpose of satisfying Countys obligations under the terms and provisions of the agreement; and not withstanding anything to the contrary or that may be construed to the contrary, the liability of County is limited to said sum, plus additional amounts of funds from time to time certified available for the purpose of satisfying the Countys Rev: 2/2022 22. 23. 24, 25. 26. 27. 28. obligations under the terms and provisions of the contract. The sole and exclusive remedy of Bidder shall be to take possession of any goods or materials not fully purchased by County or to terminate the contract. Funds for payment have been provided through the Montgomery County budget approved by the Montgomery County Commissioners Court for this fiscal year only. State of Texas Statutes prohibit the obligation and expenditure of public funds beyond the fiscal year for which a budget has been approved. Therefore, anticipated orders or other obligations that may arise past the end of the current Montgomery County fiscal year shail be subject to budget approval. TAXES: County is a body corporate and political subdivision under the laws of the State of Texas and claims exemption from Limited Sales and Use Tax to the State of Texas, under Texas Tax Code Ann. Section 151.309, as amended. Exemption Certificates will be provided to Bidder upon request. County is subject to Federal Excise Tax. LICENSES: Seller is responsible for obtaining and keeping current requisite licenses and permits necessary for the activities under the contract, including ensuring that any drivers employed by Bidder are properly licensed. ASSIGNMENT: County shall have the right to sell, transfer or assign, in whole or in part, all of its rights and obligations hereunder. In such event and upon the assumption of such transfer of Countys obligations hereunder, no further liability or obligation shall thereafter accrue against County. The successful Bidder shall not sell, assign, transfer or convey this contract, in whole or in part, without the prior written consent of Montgomery County Commissioners Court or appointed agent. WARRANTY: Successful Bidder shall warrant that goods, materials, or services delivered to County shall conform to the proposed specifications and/or all warranties as set forth therein and stated in the Uniform Commercial Code and be free from all defects in material, workmanship and title. Bidder shall furnish all data pertinent to warranties or guarantees which apply to items in the bid. Items supplied under this contract shall be subject to Montgomery Countys approval. Items found defective or not meeting specifications shall be picked up and replaced by the successful Bidder at the next service date at no expense to the County. If item is not picked up within reasonable time after notification, the item will become a donation to the County for disposition. NOTICE: All notices required hereunder shall be deemed to have been properly given when made in writing and sent by mail with adequate postage in the United States mail. SAVINGS CLAUSE: Notwithstanding any of the terms and provisions hereof being in violation of, or prohibited by, any law, statute or ordinance of the United States, or County, or municipality, such terms and provisions shall be deemed severable without right in such instance to have such offending clause herein reformed to comply with the applicable law, both parties hereby agreeing to act in good faith with diligence to reasonably effect such reformation. WAIVER: The failure of either party hereto, in any or more than one instance, to insist upon the performance of any other terms, covenants, or conditions of this Agreement or to exercise any right or privilege, or the waiver by either party of any breach of any of the terms, covenants, or conditions of this agreement, shall not be construed as thereafter waiving any such terms, covenants, conditions, rights or privileges, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. Rev: 2/2022 44. FUEL PRICE ESCALATION: Due to the inability to foresee fuel prices in todays market, a fuel adjustment will be considered when the following procedures are met: 1. Pricing must remain firm for the first six (6) months after the award of contract and can only be reviewed for adjustment every three (3) months thereafter. 2. Awarded Vendor must submit request for fuel adjustment in writing. 3. The fuel surcharge will be listed as a separate item on the Vendors invoice. 4. The awarded Vendor may not have price increases and fuel increases simultaneously. Upon receiving the above information from the Vendor, Montgomery County will review the increase request and recommend to the Montgomery County Commissioners Court one (1) of the following: 1. Accept the increase 2. Reject the increase 3. Re-bid the entire contract NOTE REGARDING BLANKET CONTRACTS: If this bid is a Blanket Contract, all orders will be issued on an as required basis with a Purchase Order Number. Vendor is responsible for providing per unit price and the purchase order number on the invoice for each purchase. Montgomery County reserves the right to add and/or delete item(s) from the contract when in the best interest of the County. 45. 46. 47. ANNUAL CONTRACTS: Bidders may be disqualified and their bids not considered, among other reasons, for any of the following specific reasons: 1. The Bidder being interested in any litigation between both parties. 2. The Bidder being in arrears on any existing contract or having defaulted on a previous contract. 3. Lack of competency as revealed by a financial statement, experience and equipment, questionnaires, etc. 4. Uncompleted work, which in the judgment of the County, will prevent or hinder the prompt completion of additional work, if awarded. Due Care and diligence has been used in preparation of this information, and it is believed to be substantially correct. However, the responsibility for determining the full extent of the exposure and the verification of all information presented herein shall rest solely with the proposer. Montgomery County and its representatives will not be responsible for any errors or omissions in these specifications, nor the failure on part of the proposer to determine the full extent of the exposure. SCANNED OR RE-TYPED RESPONSE: If in its response, offeror either electronically scans, re-types or in some way reproduces the Countys published bid package, then in the event of any conflict between the terms and provisions of the Countys published bid package, or any portion thereof, and the terms and provisions of the response made by offeror, the Countys bid package as published shall control. Furthermore, if an alteration of any kind to the Countys published bid package is only discovered after the contract is executed and is not being performed, the contract is subject to immediate cancellation. DIGITAL FORMAT: If offeror obtained the bid specifications in digital format in order to prepare a response, the bid must be submitted in hard copy according to instructions contained in this bid package. If, in its bid response, offeror makes any changes whatsoever to the Countys published bid specifications, the Countys bid specifications as published shall control. Furthermore, if an alteration of any kind to the Countys published bid package is only discovered after the contract is executed and is not being performed, the contract is subject to immediate cancellation. Rev: 2/2022 48. CONTACT RESTRICTIONS: Responders shall not contact any County personnel, to include all entities/persons contracted to do business with the County, during the process, other than Gilbert Jalomo, Jr., Purchasing Agent, without the express permission from the Office of the County Purchasing Department. Any Responder who has made site visits, contacted personnel, or distributed any literature without authorization may be disqualified. The County Purchasing Department may initiate discussion with Responders. Discussions may not be initiated by Responders. The County Purchasing Department expects to conduct discussions with Responder personnel authorized to contractually obligate the Responder with an offer. 49. DISCLOSURE OF INTERESTED PARTIES: Per Government Code, Statute 2252.908, effective January 1, 2016 all contracts executed by Commissioners Court, regardless of the dollar amount, will require completion of Form 1295 "Certificate of Interested Parties" by the participating vendor. Form 1295 is also required for any and all contract amendments, extensions or renewals. A sample of the form will be included in every Bid, RFP and RFQ. Vendors are required to visit the Texas Ethics Commissions website (https://www.ethics.state.tx.us/whatsnew/elf_info form1295.htm) and create a 1295 Certificate. After creating the form it must be printed, signed and notarized and included with the bid/proposal submission. Publicly owned companies are exempt from the 1295 requirement 50. FORCE MAJEURE: Definitions In this Clause, "Event of Force Majeure" means an event beyond the control of the County and the Contractor, which prevents a Party from complying with any of its obligations under this Contract, including but not limited to: a) an act of God (such as, but not limited to, fires, explosions, earthquakes, drought, and floods); b) war, hostilities (whether war be declared or not), invasion, act of foreign enemies, or embargo; c) rebellion, revolution, insurrection, or military or usurped power, or civil war; d) contamination by radio-activity from any nuclear fuel, or from any nuclear waste from the combustion of nuclear fuel, radio-active toxic explosive, or other hazardous properties of any explosive nuclear assembly or nuclear component of such assembly; ) riot, commotion, strikes, go slows, lock outs or disorder, unless solely restricted to employees of the Contractor or of his Subcontractors; or f) acts or threats of terrorism. Consequences of a Force Majeure Event Neither the County nor the Contractor shall be considered in breach of this Contract to the extent that performance of their respective obligations is prevented by an Event of Force Majeure that arises after the Effective Date. The Party (the Affected Party) prevented from carrying out its obligations hereunder shall give notice to the other Party of an Event of Force Majeure upon it being foreseen by, or becoming known to, the Affected Party. If and to the extent that the Contractor is prevented from executing its obligations by the Event of Force Majeure, it shall endeavor to continue to perform its obligations under the Contract so far as reasonably practicable and in accordance with good operating practices. If and to the extent that the Contractor suffers a delay during the Construction Period as a result of the Event of Force Majeure, then it shall be entitled to a reasonable extension for the Time for Completion. Rev: 2/2022 51. PROBHIBITION ON CONTRACTS WITH COMPANIES BOYCOTTING CERTAIN ENERGY COMPANIES: Respondent/Bidder/Proposer represents and warrants that: (1) it does not, and will not for the duration of the contract, boycott energy companies or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If circumstances relevant to this provision change during the course of the contract, Respondent/Bidder/Proposer shall promptly notify Montgomery County. {Per 87(R) S.B. 13 effective 9/1/21] 52, PROHIBITION ON CONTRACTS WITH COMPANIES THAT DISCRIMINATE AGAINST FIREARM AND AMMUNITION INDUSTRIES: Respondent/Bidder/Proposer verifies that: (1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association or (2) the verification required by 2274.002 of the Texas Government Code does not apply to the contract. If circumstances relevant to this provision change during the course of the contract, Respondent/Bidder/Proposer shall promptly notify Montgomery County. {Per 87(R) S.B. 19 effective 9/1/21] 53. DEBARMENTS: Contractor certifies that at the time of submission of its bid, Contractor was not on the federal governments list of suspended, ineligible or debarred contractors and that Contractor has not been placed on this list between the time of its bid submission and the time of execution of the Contract. If Contractor is placed on this list during the term of the Contract, Contractor shall notify the Montgomery County Director of Purchasing. False certification or failure to notify may result in termination of the Contract for default. 54. MONTGOMERY COUNTY ETHICS TRAINING: In compliance with Chapter 161 of the Texas Local Government Code, vendors must complete this training at least once per year when doing business with Montgomery County, Texas.Any vendor involved in a single procurement exceeding $50,000.00 must complete training on the Montgomery County Code of Ethics. This training certificate must be completed and submitted with each bid or proposal, in response to a request for qualifications or proposals, or otherwise contracting with the county. The training must be completed by an officer, principal, or other person with the authority to bind the vendor, The Purchasing Department will confirm that each responder has completed the required training affidavit prior to considering a bid or proposal and shall disqualify responders that have not completed the training. This training requirement does not apply to emergency purchases. Training can be found at https:/Awww.metx.org/departments/departments_d_-_f/ethics_commission/online_training.php Rev: 2/2022 1. COMPANY NAME: CONTACT PERSON: ADDRESS: PHONE NO.: FAX NO.: EMAIL ADDRESS: COMPANY NAME: CONTACT PERSON: ADDRESS: PHONE NO.: FAX NO.: EMAIL ADDRESS: COMPANY NAME: CONTACT PERSON: ADDRESS: PHONE NO.: FAX NO.: EMAIL ADDRESS: COMPANY NAME: CONTACT PERSON: ADDRESS: PHONE NO.: FAX NO.: EMAIL ADDRESS: COMPANY NAME: CONTACT PERSON: ADDRESS: PHONE NO.: FAX NO.: EMAIL ADDRESS: COMPANY NAME REFERENCES a] Gilbert D, Jalomo, Jr., CPPB COUNTY PURCHASING AGENT Montgomery County, Texas (936) 760-6906 County Purchasing Agent Fax (936) 760-6976 Vendor Information Federal ID # or Dun and Bradstreet # 8.8 # Type of Business ___ Corporation/LLC ___ Sole Proprietor/Individual Partnership Tax Exempt Organization Legal Company Name Year Business was Established Remittance Address City/State/Zip Physical Address City/State/Zip County Montgomery County Other: Phone/Fax Number Phone: Fax: Contact Person E-mail Special Notes The Company listed above is a (check all that apply and attached certificate). ___ DBE-Disadvantaged Business Enterprise ___ SBE-Small Business Enterprise Certification # Certification # ____ HUB-Texas Historically Underutilized Business Certification # WBE-Womens Business Enterprise ___ MBE-Minority Business Enterprise Certification # Certification # Companys gross annual receipts: $500,000 $17,000,000-$22,399,999 $500,000-$4,999,999 >$22,400,000 $5,000,000-$16,999,999 Commodities (Please enter all that apply). PLEASE NOTE: W-9 needs to be attached in order to be entered into our system ACKNOWLEDGMENT CORPORATE THE STATE OF COUNTY OF BEFORE ME, the undersigned authority, this day personally appeared ; known to me to be the of the Corporation, who being by me first duly sworn, deposed and said that he/she had executed the above and foregoing Document in the capacity stated as the authorized act and deed of said Corporation. NOTARY PUBLIC Printed Name Commission Expires: PARTNERSHIP THE STATE OF COUNTYOF BEFORE ME, the undersigned authority, this day personally appeared ,a General Partner of the Partnership, who being by me first duly sworn, deposed and said that he/she had executed the above and foregoing Document in the capacity stated as the authorized act and deed of said Partnership, NOTARY PUBLIC Printed Name: Commission Expires: ACKNOWLEDGMENT CONTINUED INDIVIDUAL OR SOLE PROPRIETORSHIP THE STATE OF COUNTY OF __ BEFORE ME, the undersigned authority, this day personally appeared an individual doing business as , who being by me first duly swom, deposed and said that he/she had executed the above and foregoing Document in the capacity stated and for the purposes and consideration set forth therein. NOTARY PUBLIC Printed Name Commission Expires *(EXECUTE APPROPRIATE ACKNOWLEDGMENT FOR CORPORATION, PARTNERSHIP OR INDIVIDUAL CONTRACTOR.) 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Enter the tax classittedllon (G23 corporation, S9 gerporallon, PeParinership) > Note: Oheck the appropriate box ln the line above for tho tax classification of the single member awaer, Do nol chock LLC If the LLG Is dlassified 4s 4 slngle-teniber LLG that Is disregarded from the owner unfess the owner of the LLG Is another LLG that Is not disregarded from the owner for U.S, fedaral tax purposes, Chhenwiag, 8 elngle-mamber LLG that (s disregardod from the owner should check tha appropriate hox for the tax classliigation of Ite over, 071 thor isee Instructions) > @ Addrasa (nursuer, stroai, and apt, or suite ne) See Inatruchona, Exempt payse- code (If any) sn Exemption from PATGA reparting code fil ary) Print or type. See Specific Instructions a Popes In agemuits maintelaed notstide tie WS) . teranrptszeerat Requester'a name and address (optional) City, state, and ZIP code Enter your TIN in the appropriate box, The TIN provided must match tha name given on line 4 to avold backup withhalding, For Individuals, this is generally your social security number (SSN). However, for a resident allen, sole proprietor, or disregarded entity, soe the Instructions for Part J, later, For othar Soclal security nomitier aatities, it le your employer identlilcation number GIN}, If you co net have a number, see How te get a [| TIN, (oir, or Note: If the account ig in more than one name, see the Instructions for line 1, Also seo What Name and [Employar kdeniificstion nuraher ] Number To Giva the Requester for guidelines on whase number to anter, ey ~ ertitication Under penalties of parjury, | certify that: 1. The number shown on this form [s my correct taxpayer identification number (or | am wafting for a number to be Iaaued to me); and 2, Lam not subject to backup withhalding becanae; (a) lam exempt from backup whhholding, or (b) | fave not been notified by the internal Revenue Service (RS} that] am subject to backup withhalding as a result of a fallure to report all Interest or dividends, or {e) the IRS has notified me thal! am no longer subject to backup withholding; and & tam a U.S. eltizen or other U.S, person Walined balow); and 4, The FATCA code(s) entered on this form (if any) indicating that | am exempt fromm FATOA reporting is gotract, Certification Instructions, You miuat croas out item 2 above If you have been noiiiied by the IBS thal you ere currently subject to backup withholding because you have falled to report all interest and dividends on your tax retum, For teal estate transactions, Item 2 does not apply, For mortgage Intereat pal, acquisition or abandonment of secured properly, cancellation of debt, contributions te an Indivieluaf retirement arrangement (IAA), and gonerally, payments olher than Interest and dividends, you ars not required to aign the oeziifloation, but you must provide your correct TIN, See the Instructions for Part I, later, Sigh | signature of Hore U.S. person Rate General lnstructions ; form 1000-DIV (dividends, including these trom stocks or mutual uarvds! Seaton references are to the Intermal Revenue Code unless otherwise + Form 109-MISG (various types of Income, prizes, avaards, or gross procpeds) * Form 1099-8 (stack or mutual fund gales and cartaln other transactions by brokere) * Form 1099S (procasda from real estate vansactions) Future developments. For the latest Information about developments related to Form W-9 and its Instructions, such as legislation enacted after thay ware published, ga to www.irs.gov/FormWa, Purpose of Form Form 1099-I (merchant card and third party aetwork transactions) An Indivicual or entity (For W-9 requester} who Is required to file an * Fora 1096 (home mortgage interest), 1008-1 {student loans Interest), information returt: vith the IRS must obtaln your correct taxpayer 1098-7 (tultion} identifleation number (TIN) which may be your soalal securlly number * Form 1099-6 (canceled debi) (SSN), Individual taxpayer Identification number (TIN} adoption taxpayer Identification number (ATIN}, of employer telentficetton number * Form 1099-A (acquisitfon ar abandonment of secured property} (EIN), to report on an Infermation rotum the amount pald to you, or other Usa Form W-8 only If you ara a U.S, person (including a resident amount reportable on an information retum. Examples of Information allan), to provide your comect TIN, ratuens Include, but are not Hmitecf te, the following, ifyou do not ratum Form W-9 to the requester with a TIN, you might * Farm 1099-INT (interest aamed or paid) be subject to backup withholding. See What Is backup withholding, aber, neannenneennmuntesisintnsainttistintitnantnmanneimajeeneinnuninNitininaniisnuNotinannuesinDteieedinethlNiAntdsaeratintnetnuene Gat. No, 10234X Form We9 (tev. 10-2019) Porta W>8 (Rev, 10-201 8) By signing the filladout fon, your 1. Certily that the TIN you are giving Is corract (or you are waiting for a number to be tagued), 2, Cortily that you are not sublect fo backup withholding, ot 3, Olam exemptlon from backup withholding If you are a US, exempt payed, applicable, you are also cantfying that as a U.S. parson, your allocable share of any partnership Income from a U.S. trade or business ig not aubjeat to the withholding tax an foreign pariners' share of effectively connected income, and 4, Certify that FATOA cade(s) entared on this form (if any) tndloating that you are exempt from the FATCA reporling, Is correct, Seo What fs FATCA reporting, later, for further Information, Note: If you are a U.S, person and a requester gives you a form other than Form Wee te request your TIN, you must use the requester's form If it le substeritially slrallarte this Form W-9, Definition of 4 U.S. parson. For lederal tax purposes, you are considered a U.8, person if you are: + Art Individual wha Is 4 U.S, eltizen or U.S, resident allen; + A partnarship, corporation, company, or assoclation created or organized In the United States or under the laws of the United States; * An estate (other than a foreign eetate); or Adomestie truat (as defined In Regulations geotion 901,7701-7), Speotal rulas for parmershipe, Partnerships that conduct a trade or byalnege In the United States ara generally aquired to pay 9 withholding tax under section 14148 on any forelgn partners share of otfgatively connasted taxable Income trom such business. Further, it cartaln oaaae where & Form W-8 has not bean racelved, the rules under seotlan 1446 requird 4 partnership to presume that a pariver Is a foreign person, and pay the eeotlon 1448 withholding tax. Therefore, If you are. e U.S. person thatia.a partner ia a partnorship conducting 4 trade or business In the United States, provide Farin W-9 to the parinership to establish your U.S, stalus and avoid seation 1446 withnalding on your share of fartnarship income, In the cases below, the following porgon must give Forn W-2 to the patinorship far purposes af getabilshing Ite W.8. status and avoiding withholding on its allocable share of net Income from the partnership canduating a bade or business tn the United States. " nthe eave of a disregarded entily with 4.U.8, owner, the U.S. owner of the disregarded entity and not the satiky;, * Inthe case of a grantor trust with a U.S, grantor or other U.S, owner, generally, the U.S. granter or other U.S, owner of the grantor trust dnd not the trust; and + Inthe case of a U.S, frust (other than a grantor trust), ihe U.S, trust (ther than a grantor trusf} and not the beneficlarles of the trust, Foreign person. [f you are a forolgn parson or the U.S, branch of a foralgn bank that has elected io be treated as a U.S. person, do net use Form W-9. Instead, usa the appropriate Form W-8 or For 823% (seo ee a &, Withholding of Tax on Nonresident Allens and Foreign Entities). Nonresident allen wha becomes a resident alien. Generally, only a nonresident alin individual may use the termes of a tax treaty to reduce oF eliminate U.S. lax on certain types of Incorne, However, most tax treaties contain a provision known as a saving clause. Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even alter the payee has othenvise bacome a U.S. resident alien for tax purposes. if you are a U.S, resident alien who Is valying on an exception corlalned In the saving clause of a tax weaty to claim an exemption from U.S, tac on certain types of Income, you must attach a statement to Form W-9 that spacifies the following five Iterns. 1. The treaty country. Generally, this must be the same treaty under whieh you claimed exertion from tax as a nenroaldent allen, 2. The treaty article addrensing the Incame, 9, The article number (oz location) in the tax treaty that contains the saving clause andl Its exceptions, 4, The type and amount of Income that quallies for the exemption trom tax. , Sulficlent facts ta Justify the exemption from tax under the terms of the trealy article, pestle Pago 2 Example. Article 20 of the U.S.-Ghina Income tax treaty allows an, exemption from tax for achalarghip Income received by a Ohinede atuclant temporarily prasent In the United States, Under U.S, taw, this atudant will bacoma a resident allen for tax purposes if hls or her stay In the United States axceacts 5 calenclar years. However, paragraph 2 of the first Protocol to the US-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even aftor the Chinese student becomes a resident allen of tha United States, A Chinese student who qualifies for this exception (under paragraph 2 of the frat protocof and is relying on this excaption to claim an exemption from tax on his or her scholarship or fellowship income would attaah ta Form W-8 a statement thet Includes the Information described above to support thet exemption, Hyou era a nonresident allan or 9 frelgn entity, give the raquestar the appropriate completed Form W-8 or Form 8238, Backup Withholding What Ie backup withholding? Persons making certain payments to you must under certala conditions withhold and pay to the IAG 2494 of such paymants, This is celled baokup withholding. Payments that may be subject to backup withholding include Interast, tax-oxsrnpt Interast, dividends, broker and barter dxchange transactions, rents, royalties, honemployee pay, payments mada in sattloment of payrient card and third party network transagtions, and cerialn payments trom fishing baat operators. Real astate transeotions are not subject to backup withholding, You will not be subject to backup withhalding on payments you recalve If you give the raquester your correct TIN, make the proper certifications, and raport all your taxable interest and dividends on your tax return. Paytnents you receive will be subject to backup withholding tf: 4, You do not furnish your TIN to the requester, 2. You to not sertify your TIN when required (see the Inetrustions far Part [t for datalie), 3. The IRS tells the requester that you furnished an Incorrect TIN, 4, Toe IRS tells you that you ave subject to backup withholding bachuse you did nat report all your Intereat and dividends on your tax return (or reportable interest and dividends only), or 5. You da nat certify to the requester that you ara not subject to backup withholding uncer 4 above flor reportable Interest and dividend accounts opaned after 1983 onty), Certain payaes and payments are exempt from backup withholding, Seo Exempt payee code, later, and the separate Instructions for the Requester of Forn W-9 for more Information. Also see Special rules for partnerships, earlier, What is FATCA Reporting? The Foreign Account Tax Compliance Act (FATGA) requires a parllclpating foreign financial inetltution to report all United States accqunt holders that are specified United States persons, Certain payers ara exempt trom FATCA raporting. Sea Exemption from FATOA reporting coda, later, and the Insteuctions for the Requester of Form W-0 for more information, Updating Your information You must provide updated information to any person to whom you calmed to be. an exempt payee If you are no longer an exempt payee and anticipate recalving reportable payments ti the future from this person, For example, you may nead to provide updated Information if you are a C corporation that dlacts to be an 8 corporation, or if you no longer ave tax exempt. in addition, you must fumish a naw Form W-9 If the name or TIN changes for the account for example, if the grantor of a grantor Trust clas, Penalties Fallure to furnish TIN, if you fai) te farnieh your corract TIN to a requester, you ere subject to a penalty of $50 for each auch failure unless your failure Is due to reasonable cause and not ta wilful neglect, Civil penalty for folee Information with respect te withholding, If you Thake a falao statement with no reasonable basts that results in ito backup withholding, you ara subject to a $800 penalty, Formn W-8 (Rev, 10-2019) tt asninnmmenennnhaonaneee HPA ARASH ATMA RYN Criminal ponalty for fatsifying information, Willfully falsifying carlitioations or affirmations may eubfeot you to oriminal penalties Including fines and/or imprisonment. Misuee of TINS. if the requaster discloses or uses TINa in violation of focleral law, the requester may be subject to elvil and criminal penalties, Spectiic Instructions Ling 4 You must enter ene of the following on this Ine; do not leave this Ine blank, The nama should matoh the name on your tax retum, if thia Form W-@ le for a Jalnt aecount {other then an account maintatnad by a foreign tinanotal Insthution (FF), list test, and then clrele, the narnia of the persan or entity whose number you entered In Part | of Form W-9, Hf you are providing Forrn W-9 to an PFita dooumant a joint account, each holder of the account that Is a WS. parson must provicle @ Form Wed, a, Individual, Generally, enter the name shown on your tax return, If you have changed your last name without Inforraing the Social Sagurity Administration (SSA) of the name change, entar your first name, the last name as shown on your goolel gecurlly card, and your new last name, Note: ITIN applieant: Enter your Individual name ag it was entered on your Form W-? application, line 1a. This should algo be the same as the hame you entered on the Farm 1040/1 040A/1040E2 you tilad with your application, b, Sole proprietor or eingla-mamiber bc, Enter your Individual name as shown on your 1040/1040A/1 04082 on line 7. You may enter your business, trade, or dalng business an (OBA) name on jine 2. 4, Partnership, LL0 that is not a singlo-momber L1.0, 6 corporation, or corporation, Enter the entity's nama as shown en the eaiy's tax ratumt on tie 1 and any business, trada, or OBA name on Ine 2, d. Other ontities, Enter your nama as shown on required U8. federal tax documents on line 1. This narne should match the name shown on the charter or other legal document ersating the entity, You may enter any business, trade, or DBA name on Ine 2. , Disregarded entity, For U.S, federal tax purposes, an entity that fs disregarded aa an entity separate from Hts ovmer is treated as a "disregarded entity. See Regulations section 801.7761-2(c)(2)(lif), Entar the owner's hame on fine 1. The name of the entity entered on Ine 1 should never be a cisragarded entity. The name on line 1 should be the name shown on the Income tax reture on which the Income should be Teparted. For example, If a forwign LLG that Is treated as a dieragarded entity for U.S. taderat tax purposes hay a alngle owner that Ie a U.S. person, the U.S, owner's name is required to be provided on tine 1. If the direct ovmor of the entity Is alse a disregarded entliy, enter the first owner that ts not disregarded for federal tax purposes, Enter the disregarded entity's name on Ine 2, Buelness name/disregardad entity name, ff the owner of the disregarded entity Is a foreign person, the owner must coniplete an appraprlate Form W-8 instead of a Fann W-9, This is the case even if the foreign persan has a U.S. TIN, Line 2 Ifyou have 2 business name, trade nanie, OBA namie, or disregarded alitity narne, you may enter it an lita 2, Lina 3 Check the appropriate box on line 3 for the U.S, federal tax, alassification of the peraan whose name Is entered on tine 1, Check only one box on line 3. Pago 3 IF the ontity/person on fina 1 ia ala) se. THEN check the box for... Corporation Individualsole proprietor or slngle- member LLG Individual * Sole propietorship, or * Single-member limited lability company (LLC) owned by an Individual and disregarded for U.S. federal tax purposes, : * LLG treated as a partnership for | Liniited llablity company ane enter US. federal tox purposes, the appropriate tex classification. + L106 that has filad Porm 8832 or | (Ps Partnorship; Co: G corporation; 288% to be taxed ax a corporation, | oF Se $ corporation) or * 11.0 that fs dleragardad ag an entity separate from its owner but the owner Is another LLG that Is not disregarded for U.S, fecteral tax purposes, + Partnarshh * Trustfestate Line 4, Exemptions ff you are exempt from backup withholding and/or FATGA reporting, efter in the appropriate space on ling 4 aty code(s) that may apply to you. Bxampt payed code, * Generally, Individuals (including sole proprietors} are not exempt trom backup withholding, * Except as provided belaw, corparations are exempt from backup withholding for certaln payrnants, Including Interest and dividenda. * Corporations are not exempt trem backup withholding for payments inade In sattioment of payment card or third party network transactions. * Corporations are not exempt from backup withholding with respect to attornaye fees or gross proceeds pald te attameys, and corporations that provicis medical or health oars services are not exempt with respect te payments reportable on Form 1090-MISG, The following codes Identify payees that are exempt from backup withholding, Enter the appropriate code In the saace In Ithe 4. 1 An organization exempt from tax under section 801(9), any IRA, or a custodial account under section 403(h)(?) If the account sailties the requiramente of saction 404(9(2) 2'The United States or any of Ite agencies or Instrumentalilles o~A skate, the District of Columbla, a U.S, commonwealth or possession, or any of thelr political subdivisions or Instrumantalittes 4~A foroign government or any of Its political ubdivisions, agencies, or inatrumentalitias 6A corporation 6~A dealer In securities or commodities required to register In the United States, the District of Columbla, of a U.S, commonwealth or passeasion 7A futures commisulon merchant registered with the Commodity Futures Tracing Commission BenA real estate investment trust 9 An aniity ragistered at all times during the tax year under the lnvestment Company Act of 1940 10-A common truat fund operated by a bank under section G84{a) 11A financial Institation 12-~A middleman known in the investment community ag a nominee or custodian ioe trust exempt from tax under seatlon 664 ar desorbed in section Trust/estate BIDDER/OFFEROR SELF CERTIFICATION 1.) The Bidder/Offeror certifies that the manufactured good(s) furnished will meet or exceed the specifications, and/or that the services rendered will comply with the terms of the solicitation or contract. 2.) The Bidder/Offeror certifies that it has read all of the bid, proposal, or contract documents and agrees to abide by the terms, certifications, and conditions thereof. Description of Commodity or Service: SIGNATURE NAME, TITLE COMPANY. DATE CERTIFICATION REGARDING LOBBYING The Bidder/Offeror 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 persons 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 to 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. If 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 [as amended by "Government wide Guidance for New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96). Note: language in paragraph (2) herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of 1995 (PL 104-65, to be codified at 2 U.S.C. 1601, ef seq.)] 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 is placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transactions imposed by 31, U.S.C. 1352 (as amended by the Lobbying Disclosure Act of 1995). 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. [Note: Pursuant to 31 U.S.C. 1352(c)(1)-(2)(A), any person who makes a prohibited expenditure or fails to file or amend a required certification or disclosure form shall be subject to a civil penalty of not less than $10,000 for each such expenditure or failure.] The Bidder/Offeror certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Bidder/Offeror understands and agrees that the provisions of 31 U.S.C. Section A 3801 ef seq., apply to this certification and disclosure, if any. SIGNATURE COMPANY. NAME & TITLE DATE CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS Federal Executive Orders 12549 and 12689 requires Montgomery County to screen each covered potential contractor to determine whether each has a right fo obtain a contract in accordance with federal regulations on debarment, suspension, ineligibility, and voluntary exclusion. Each covered contractor must also sereen each of its covered subcontractors, In this certification contractor refers to both contractor and subcontractor; contract refers to both contract and subcontract, By signing and submitting this certification, the potential contractor accepts the following terms: 1. The certification herein below is a material representation of fact upon which reliance was placed when this contract was entered into, If it is later determined that the potential contractor knowingly rendered an erroneous certification, in addition to other remedies available to the federal governnient, the Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, or Montgomery County may pursue available remedies, including suspension and/or debarment. 2. The potential contractor will provide immediate written notice to the petson to which this certification is submitted if at any time the potential contractor learns that the cerfification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. Th words covered contract, debarred, suspended, ineligible, participant, person, principal, proposal, and voluntarily excluded, as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549, Usage is as defined in the attachment. 4, The potential contractor agrees by submitting this certification that, should the proposed covered contract be entered into, it will not knowingly enter into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this sovered transaction, unless authorized by ihe Department of Health and Human Services, United States Department of Agriculture or other federal department or agency, and/or Montgomery County as applicable. tree C] Ye: No 5. The potential contractor further agrees by submitting this certification that it will include this certification titled Certification Regarding Debarment, Suspension, Incligibility, and Voluntary Exclusion for Covered Contracts without modification, in all covered subcontracts and in solicitations for all covered subcontracts. Do you have or do you anticipate having subcontractors under this proposed contract? ..........00- teense pisenneasnssavesareeceansosees 6. A contractor may rely upon a certification of a potential subcontractor that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered contract, unless it knows that the certification is erroncous. A contractor must, at a minimum, obtain certifications from its covered + subcontractors upon each subcontracts initiation and upon each renewal. 7. Nothing contained in all the foregoing will be construed to require establishment of a system of records in order to render in good faith the certification required by this certification document. The knowledge and information of a contractor is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings, 8. Except for contracts authorized under paragraph 4 of these terms, if a contractor in a covered contract knowingly enters into a covered subcontract with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedics available to the federal government, Department of Health and Human Services, United States Department of Agriculture, or other federal department or agency, as applicable, and/or Montgomery County may pursue available remedies, including suspension and/or debarment. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGISILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS Indicate in the appropriate box which statement applies to the covered potential contractor: The potential contractor certifies, by submission of this certification, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded form participation in this contract by any federal department or agency or by the State of Texas. [| The potential contractor is unable to certify to one or more of the terms in this certification. In this instance, the potential contractor must attach an explanation for each of the abave terms to which he is unable to make certification. Attach the explanation(s) to this certification. Name of Potential Contractor Contract No Gf applicable) Printed/Typed Name and Title of Authorized Representative Page 1 of 2 Signature of Anthorize Representative Date