Restaurant Food Health Inspectors

1 SOLICITATION FOR: IFB # 23-55 Restaurant Food Health Inspectors CITY OF SOMERVILLE, MASSACHUSETTS RELEASE DATE: 4/6/23 QUESTIONS DUE: 4/19/23 by 12PM EST DUE DATE AND TIME: 4/26/23 by 1PM EST Anticipated Contract Award 5/1/23 Est. Contract Commencement Date 7/1/23 Est. Contract Completion Date 6/30/24 Est. Renewal Years Two additional one-year renewals DELIVER TO: City of Somerville Procurement & Contracting Services Attn: Jordan T. Remy Senior Procurement Manager jremy@somervillema.gov 93 Highland Avenue Somerville, MA 02143 CITY OF SOMERVILLE, MASSACHUSETTS Enclosed You Will Find a Request for Bid For: IFB # 23-55 Restaurant Food Health Inspectors SECTION 1.0 GENERAL INFORMATION ON BID PROCESS 1.1 General Instructions Copies of the solicitation may be obtained from the Procurement & Contracting Services Department on and after 4/6/23 per the below-noted City Hall hours of operation. All Responses Must be Sealed and

Delivered To: Procurement & Contracting Services Department City of Somerville 93 Highland Avenue Somerville, MA 02143 It is the sole responsibility of the Offeror to ensure that the bid arrives on time at the designated place. Late bids will not be considered and will be rejected and returned. Bid Format: Submit one, original (1) sealed bid package; it must be marked with the solicitation title and number. In an effort to reduce waste, we discourage the use of 3-ring binders. All bids must include all forms listed in the Bidders Checklist (and all documents included or referenced in Sections 2.0 - 4.0). If all required documents are not present, the bid may be deemed non-responsive and may result in disqualification of the bid unless the City determines that such failure(s) constitute(s) a minor informality, as defined in Chapter MGL 30B. A complete bid must also include a cover letter signed by an official authorized to bind the Offeror contractually and contain a statement that the bid is firm for ninety (90) days. An unsigned letter, or one signed by an individual not authorized to bind the Offeror, may be disqualified. The Offeror’s authorized official(s) must sign all required bid forms. The Price Form in Section 3.0 must be completed. No substitute form will be accepted unless otherwise stated. Pricing must remain firm for the entire contract period. All information in the Offeror’s response should be clear and concise. The successful response will be incorporated into a contract as an exhibit; therefore, Offerors should not make claims to which they are not prepared to commit themselves contractually. The successful Offeror must be an Equal Opportunity Employer. The City of Somerville values a diverse workforce and believes it contributes to a work product and customer experience that best reflects the community in our city. Applicants are highly encouraged to include any certifications and documents that recognize the diversity of the Offeror’s work force, including ownership of the offering firm/organization, executive leadership, management, and employees proposed for the work in Somerville, including diversity of sub-consultants. Please use City Hall Hours of Operation: Monday – Wednesday 8:30 a.m. and 4:30 p.m. Thursday 8:30 a.m. to 7:30 p.m. Friday 8:30 a.m. to 12:30 p.m. the supplier diversity form (see Section 4.0) with supporting documentation to share your diversity data with the City. 1.2 Bid Schedule Key dates for this Invitation for Bids: IFB Issued 4/6/23 Deadline for Submitting Questions to IFB 4/19/23 by 12PM EST Bids Due 4/26/23 by 1PM EST Anticipated Contract Award 5/1/23 Est. Contract Commencement Date 7/1/23 Est. Contract Completion Date 6/30/24 Responses must be delivered by 4/26/23 by 1PM EST to: City of Somerville Procurement & Contracting Services Attn: Jordan T. Remy 93 Highland Avenue Somerville, MA 02143 1.3 Submission Instructions If you are submitting your bid online via Bidexpress.com, then you do not need to also submit a sealed bid package as instructed below. Email is not an acceptable method of submission of bids. Please submit one sealed bid package with the following contents and marked in the following manner: Contents of Sealed Bid Package Marked As Envelope 1: Sealed Bid: Shall Include (1) original and one (1) electronic copy. [Electronic copies are to be submitted on USB drives and are to be saved in Adobe Acrobat format. (“Read only” files are acceptable.)] To Be Marked: IFB # 23-55 Restaurant Food Health Inspectors Please send the complete sealed package to the attention of : Jordan T. Remy Senior Procurement Manager Procurement & Contracting Services Somerville City Hall 93 Highland Avenue Somerville, MA 02143 Live Bid Opening Link Join Zoom Meeting https://us06web.zoom.us/j/89745159141?pwd=bnYrcFRjb0lZaDh0dzZnM1FsaW9BQT09 Meeting ID: 897 4515 9141 Passcode: 703655 Methods of Bid Submission Bidders may submit bids in any of the following ways. All bids will be timestamped and must be received no later than due date and time. 1) Deposit your sealed bid package in the black drop box located by the School Street entrance to City Hall, located near the corner of School Street and 93 Highland Avenue. 2) Sealed bids can be sent to City Hall through the US Postal Service or other delivery service (e.g. FedEx, UPS). 3) BidExpress.com is an online bidding platform where bidders can submit all required documents. The fee to use this service is approximately $40.00 unless your company has a subscription with BidExpress. You can access the bid package and forms via the City of Somerville BidExpress page at: https://www.bidexpress.com/businesses/33100/home A user guide is attached for your reference. 4) For any technical assistance while submitting the online bid, please contact the BidExpress Customer support team at www.bidexpress.com. Bidders may submit bids in any of the following ways. All bids will be timestamped and must be received no later than due date and time. http://www.somervillema.gov/BidExpress https://www.bidexpress.com/businesses/33100/home http://www.bidexpress.com/ Bid Format Responses shall be prepared on standard 8.5 x 11 inch paper (charts may be landscaped but must be on 8.5 x 11 inch paper) and shall be in a legible font size (12). All pages of each response shall be appropriately numbered (and with consecutive page numbering across tabs). In an effort to reduce waste, please DO NOT USE 3- RING BINDERS. Elaborate format and binding are neither necessary nor desirable. All bids will clearly identify the Offeror’s name, solicitation number, and formal solicitation title. Cover Letter Submit a cover letter that includes the official name of the firm submitting the bid, mailing address, e-mail address, telephone number, fax number and contact name. The letter must be signed by an official authorized to bind the bidder contractually and contain a statement that the bid is firm for ninety (90) days. An unsigned letter, or one signed by an individual not authorized to bind the Offeror, may be disqualified. Qualifications & Experience The Offeror shall include qualifications and experience of the firm (or sole proprietor). The Offeror shall identify the year the firm was established, the total number of employees currently employed, and the number of employees focused on this engagement. This section should also describe work that is similar in scope and complexity that the Offeror has undertaken in the past. A discussion of the challenges faced, and solutions developed are highly recommended. The Offeror may include any additional literature and product brochures. The Quality Requirements Form (Section 2), or set of basic business standards, must be submitted with bid. References The Offeror shall list at least three relevant references, which the City may contact. The City of Somerville reserves the right to use ourselves as a reference. References shall include the following information: ●The name, address, telephone number, and email address of each client listed above. ●A description of the work performed under each contract. ●The amount of the contract. ●A description of the nature of the relationship between Offeror and the customer. ●The dates of performance. ●The volume of the work performed. 1.4 Questions Questions are due: 4/19/23 by 12PM EST Questions concerning this solicitation must be delivered in writing to: Jordan T. Remy Senior Procurement Manager Somerville City Hall Procurement & Contracting Services Department 93 Highland Avenue Somerville, MA 02143 Or emailed to: jremy@somervillema.gov Or faxed to: 617-625-1344 Answers will be sent via an addendum to all Offerors who have registered as bid holders. Bidders are encouraged to contact the Procurement & Contracting Services Department to register as a bid document holder to automatically be alerted as to addenda as they are issued. It is the responsibility of the Offeror to also monitor the bid portal on the City’s website for any updates, addenda, etc. regarding that specific solicitation. The web address is: https://www.somervillema.gov/procurement If any bidders contact City personnel outside of the Procurement & Contracting Services Department regarding this bid, that bidder may be disqualified. 1.5 General Terms Estimated Quantities The City of Somerville has provided estimated quantities, which will be ordered/purchased over the course of the contract period. These estimates are estimates only and not guaranteed. Bid Signature A response must be signed as follows: 1) if the Offeror is an individual, by her/him personally; 2) if the Offeror is a partnership, by the name of the partnership, followed by the signature of each general partner; and 3) if the Offeror is a corporation, by the authorized officer, whose signature must be attested to by the clerk/secretary of the corporation (& with corporate seal). Time for Bid Acceptance and City Contract Requirements The contract will be awarded within 90 days after the bid opening. The time for award may be extended for up to 45 additional days by mutual agreement between the City of Somerville and the Offeror that is most advantageous and responsible. The Offeror’s submission will remain in effect for a period of 90 days from the response deadline or until it is formally withdrawn, a contract is executed, or this solicitation is canceled, whichever occurs first. The Offeror will be required to sign a standard City contract per the City’s general terms included herein as Appendix A. Holidays are as follows: New Year’s Day Martin Luther King. Jr. Day Washington's Birthday Patriots’ Day Memorial Day Juneteenth Independence Day Independence Day Labor Day Indigenous Peoples’ Day Veterans’ Day Thanksgiving Day Thanksgiving Friday Christmas Eve (half day) Christmas Day Please visit http://www.somervillema.gov/ for the City’s most recent calendar. *Under State Law, all holidays falling on Sunday must be observed on Monday. If the awarded Offeror for their convenience desires to perform work during other than normal working hours or on other than normal work days, or if the Offeror is required to perform work at such times, the Offeror shall reimburse the City for any additional expense occasioned the City, thereby, such as, but not limited to, overtime pay for City employees, utilities service, etc. UNLESS otherwise specified in these provisions, services will be performed during normal work hours. When required services occur on holidays, work will be performed on either the previous or following work day, unless specified otherwise. Unforeseen Office Closure If, at the time of the scheduled bid opening, the Procurement & Contracting Services Department is closed due to uncontrolled events such as fire, snow, ice, wind, or building evacuation, the bid due date will be postponed until 2:00 p.m. on the next normal business day. Bids will be accepted until that date and time. In the event of inclement weather, the Offeror is responsible for listening to the media to determine if the City has been closed https://www.somervillema.gov/procurement http://www.somervillema.gov/ due to weather. Changes & Addenda If any changes are made to this solicitation, an addendum will be issued. All proposers on record as having picked up the solicitation will be alerted via email as to the posting of all addenda. The City will also post addenda on its website (https://www.somervillema.gov/procurement). No changes may be made to the solicitation documents by the Offerors without written authorization and/or an addendum from the Procurement & Contracting Services Department. Modification or Withdrawal of Bids, Mistakes, and Minor Informalities An Offeror may correct, modify, or withdraw a bid by written notice received by the City of Somerville prior to the time and date set for the bid opening. Bid modifications must be submitted in a sealed envelope clearly labeled "Modification No.__" to the address listed in Section 1. Each modification must be numbered in sequence and must reference the original solicitation. After the bid opening, an Offeror may not change any provision of the bid in a manner prejudicial to the interests of the City or fair competition. Minor informalities will be waived or the proposer will be allowed to correct them. If a mistake and the intended bid are clearly evident on the face of the bid document, the mistake will be corrected to reflect the intended correct bid, and the proposer will be notified in writing; the proposer may not withdraw the bid. A proposer may withdraw a bid if a mistake is clearly evident on the face of the bid document, but the intended correct bid is not similarly evident. Right to Cancel/Reject Bids The City of Somerville may cancel this solicitation, or reject in whole or in part any and all bids, if the City determines that cancellation or rejection serves the best interests of the City. Unbalanced Bids The City reserves the right to reject unbalanced, front-loaded, and conditional bids. Brand Name “or Equal” Any references to any brand name or proprietary product in the specifications shall require the acceptance of an equal or better brand. The City has the right to make the final determination as to whether an alternate brand is equal to the brand specified. Electronic Funds Transfer (EFT) For EFT payment, the following shall be included with invoices to the point of contact: • Contract/Order number; Contractor’s name & address as stated in the contract; • The signature (manual or electronic, as appropriate) title, and telephone number of the Offeror’s representative authorized to provide sensitive information; • Name of financial institution; Financial institution nine (9) digit routing transit number; • Offeror’s account number; Type of account, i.e., checking or saving. Other Applicable Laws In addition to applicable federal and state laws, the City has several ordinances that apply to the services requested in this contract. Such ordinances include but are not limited to: living wage ordinance, ordinance to protect vulnerable road users,[1] and ordinance to protect against wage theft. Workplace safety is of paramount importance to all workers who perform services on City contracts and all bidders must certify that they will disclose any citations they may have received for OSHA violations. https://www.somervillema.gov/procurement file:///C:/Users/anosnik/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/759P8TMY/Model%20IFB%20comments.doc%23statute file:///C:/Users/anosnik/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/Content.Outlook/759P8TMY/Model%20IFB%20comments.doc%23cancel https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH2AD_ARTVIIIFI_DIV3LIWAOR_S2-399LIWA https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH2AD_ARTVIIIFI_DIV3LIWAOR_S2-399LIWA https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH12STSIOTPUPL_ARTVIIIORSAVUROUS https://gbc-word-edit.officeapps.live.com/we/wordeditorframe.aspx?ui=en%2DUS&rs=en%2DUS&actnavid=eyJjIjoxNDI5MDA4NTM0fQ&wopisrc=https%3A%2F%2Fsomervillema-my.sharepoint.com%2Fpersonal%2Fmwoods_somervillema_gov%2F_vti_bin%2Fwopi.ashx%2Ffiles%2F5e5e65da50f4458fa2ccbebbe6b732e8&wdenableroaming=1&mscc=1&wdodb=1&hid=C74708A0-105F-C000-86CD-F0CFA347888A&wdorigin=Other&jsapi=1&jsapiver=v1&newsession=1&corrid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&usid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&sftc=1&mtf=1&sfp=1&instantedit=1&wopicomplete=1&wdredirectionreason=Unified_SingleFlush&preseededsessionkey=54e2960f-955a-eaf7-37fe-8eebf435706b&preseededwacsessionid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&rct=Medium&ctp=LeastProtected#_ftn1 https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH9OFMIPR_ARTIIIOFAGPE_DIV2WATH https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH9OFMIPR_ARTIIIOFAGPE_DIV2WATH [1] The ordinance to protect vulnerable road users applies to contracts where the contractor’s heavy vehicles are entering the City of Somerville to perform the work of the contract. Notice and Certification Pursuant to Somerville Wage Theft Ordinance All Offerors, bidders, respondents have an affirmative duty to report to the Procurement & Contracting Services Department and provide a copy of any criminal or civil judgment, administrative citation, or final administrative determination, order, or debarment, relating to wage theft, against the bidder or any of its subcontractors entered within the five years prior to bid submission. If you are the successful bidder, you and any of your subcontractors have an affirmative duty to report any criminal or civil judgment, administrative citation, final administrative determination, order, or debarment against the bidder or any its subcontractors while your contract with the City is in effect, within five business days of receipt. You may not contract with the City if you have been either voluntarily or involuntarily debarred by the federal government, any agency of the Commonwealth of Massachusetts or any other state for the entire term of the debarment. You may not use any subcontractor who has been debarred by the federal government or any state government during the period of that subcontractor's debarment. You must post notices in accordance with M.G.L. c. 151 § 16 in a conspicuous location accessible to all of their employees in English and the primary language of the employee(s) at the particular workplace. If not all employees would have reasonable access to the notice if posted in a single location, then you must inform the purchasing agent or other City Department of the number and location of postings in order to ensure that you provide reasonable notice to all of your employees. As a condition of this bid, the bidder (a.k.a. Offeror, respondent) hereby certifies that neither the bidder nor any of the bidder's subcontractors have been subject to a criminal or civil judgment, administrative citation, final administrative determination, order, or debarment resulting from a violation of M.G.L. c. 149, M.G.L. c. 151, or 29 U.S.C. § 201 et seq. within five years prior to bid submission. In the alternative, the Bidder hereby discloses a criminal or civil judgment, administrative citation, administrative determination, or debarment, within five years prior to bid submission. Included with the Bid is a copy of the same, in addition to documentation demonstrating that all damages, fines, costs, and fees have been paid. https://gbc-word-edit.officeapps.live.com/we/wordeditorframe.aspx?ui=en%2DUS&rs=en%2DUS&actnavid=eyJjIjoxNDI5MDA4NTM0fQ&wopisrc=https%3A%2F%2Fsomervillema-my.sharepoint.com%2Fpersonal%2Fmwoods_somervillema_gov%2F_vti_bin%2Fwopi.ashx%2Ffiles%2F5e5e65da50f4458fa2ccbebbe6b732e8&wdenableroaming=1&mscc=1&wdodb=1&hid=C74708A0-105F-C000-86CD-F0CFA347888A&wdorigin=Other&jsapi=1&jsapiver=v1&newsession=1&corrid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&usid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&sftc=1&mtf=1&sfp=1&instantedit=1&wopicomplete=1&wdredirectionreason=Unified_SingleFlush&preseededsessionkey=54e2960f-955a-eaf7-37fe-8eebf435706b&preseededwacsessionid=da8b7526-cb31-d1f0-89fd-5c2dad2ab841&rct=Medium&ctp=LeastProtected#_ftnref1 IFB # 23-55 SECTION 2.0 RULE FOR AWARD / SPECIFICATIONS/SCOPE OF SERVICES Rule For Award The contract shall be awarded to the responsible and responsive Bidder submitting the lowest total price. The contract will be awarded within ninety (90) days after the bid opening. The time for award may be extended for up to 45 additional days by mutual agreement between the City and the apparent lowest responsive and responsible bidder. Scope of Services/Specifications Vendor shall provide food inspectors that are qualified in accordance with the Massachusetts Department of Public Health requirements to conduct interim routine food inspections and re-inspections in compliance with the 105CMR590.00, the 2013 Federal Food Code and all applicable local regulations and ordinances, using a risk-based HACCP approach. Vendor provided inspectors will conduct routine inspections and re-inspections at approximately 550 food establishments in the City of Somerville. The number of food establishments is an estimate based upon recent activity within the City. The number is subject to change based upon Somerville marketplace conditions. Vendor shall be available twice weekly for office hours to review permit applications and meet with applicants regarding MA food service health requirements. Vendor will be required to use the City’s online permitting software (CitizenServe) for completion of reviews and inspection documentation. Vendor to provide necessary tools and materials to ensure inspections are adequately conducted in accordance with all local, state and federal codes and regulations, which shall include but not be limited to the following: • Vehicle and all related costs • Computer, printer, ink cartridges, and paper • Alcohol sanitary wipes • Calibrated thermocouple and permanent registering thermometer • Calibrated pH meter, pH test strips • Chlorine and quaternary test strips • Food Safety related handouts/training materials All routine inspections must be unannounced and MUST occur between 7:30am and 7pm Mondays through Fridays. Quality Requirements Quality requirements, or basic business requirements, are the minimum set of standards that an entity must meet and certify to be considered responsible and responsive. Please complete the Quality Requirements form, below, and submit it with your completed bid. The City of Somerville may disqualify any response that does not meet the minimum quality requirements. A "No” response to items 1, 2, or 3, or a failure to respond to any of the following minimum standards, may result in disqualification of your bid. QUALITY REQUIREMENTS YES NO 1. Proposer has at least 5 years of experience performing MA State required food establishment inspections for municipalities 2. Proposer has at least 3 years of experience working with on-line permitting software 3. Proposer has at least 5 years of experience performing restaurant plan reviews and performing pre-operational inspections 4. Optional: Are you a Mass. Supplier Diversity Office MBE/WBE certified minority or woman owned business? Additional minority designations may be submitted by attaching supporting documentation. In order to provide verification of affirmative responses to items 1, 2, and 3 under the quality requirements listed in the Quality Requirements Form, Offeror must submit written information that details the general background, experience, and qualifications of the organization. Subcontractors, if applicable, must be also included. Period of Performance The period of performance for this contract begins on or about 7/1/23 and ends on or about 6/30/24. If applicable, optional renewal years may be exercised by the sole discretion of the City (see cover page for anticipated contract term). Place of Performance All services, delivery, and other required support shall be conducted in Somerville and other locations designated by the Department point of contact. Meetings between the Vendor and City personnel shall be held at the City of Somerville, Massachusetts, unless otherwise specified. Vendor Conduct The Vendor’s employees shall comply with all City regulations, policies, and procedures. The Vendor shall ensure that their employees present professional work attire at all times. The authorized contracting body of the City may, at his/her sole discretion, direct the Vendor to remove any Vendor employee from City facilities for misconduct or safety reasons. Such rule does not relieve the Vendor of their responsibility to provide sufficient and timely service. The City will provide the Vendor with immediate written notice for the removal of the employee. Vendors must be knowledgeable of the conflict of interest law found on the Commonwealth’s website http://www.mass.gov/ethics/laws-and-regulations-/conflict-of-interest-information/conflict-of-interest- law.html. Vendors may be required to take the Conflict of Interest exam. Vendor Personnel The Vendor shall clearly state the name of the proposed project manager. All proposed staff must demonstrate the ability to carry out the specified requirements. Confidentiality The Vendor agrees that it will ensure that its employees and others performing services under this contract will not use or disclose any non-public information unless authorized by the City. That includes confidential reports, information, discussions, procedures, and any other data that are collected, generated or resulting from the performance of this scope of work. All documents, photocopies, computer data, and any other information of any kind collected or received by the Vendor in connection with the contract work shall be provided to the City upon request at the termination of the contract (i.e., the date on which final payment is made on the contract or at such other time as may be requested by the City or as otherwise agreed by City and the Vendor). The Vendor may not discuss the contract work in progress with any outside party, including responding to media and press inquiries, without the prior written permission of the City. In addition, the Vendor may not issue news releases or similar items regarding contract award, any subsequent contract modifications, or any other contract-related matter without the prior written approval of the City. Requests to make such disclosures should be addressed in writing to the Vendor’s point of contact. Deliverables Vendor shall provide for all day-to-day supervision, inspection, and monitoring of all work performed to ensure compliance with the contract requirements. The contractor is responsible for remedying all defects and or omissions to the supplies or services provided to ensure that said deliverables meet the requirements as detailed in the contract specifications. http://www.mass.gov/ethics/laws-and-regulations-/conflict-of-interest-information/conflict-of-interest-law.html http://www.mass.gov/ethics/laws-and-regulations-/conflict-of-interest-information/conflict-of-interest-law.html IFB # 23-55 SECTION 3.0 PRICING By signing this Price Form, the Proposer certifies the following bulleted statements and offers to supply and deliver the materials and services specified below in full accordance with the Contract Documents supplied by the City of Somerville entitled: Restaurant Food Health Inspectors • The bids will be received at the office of the Chief Procurement Officer, Somerville City Hall, 93 Highland Avenue, Somerville, MA 02143 no later than 4/26/23 by 1PM EST • If the awarded vendor is a Corporation a “Certificate of Good Standing” (produced by the Mass. Sec. of State) must be furnished with the resulting contract (see Section 4.0.) • Awarded Vendor must comply with Living Wage requirements (see Section 4.0; only for services) • Awarded Vendor must comply with all applicable laws, including but not limited to the Somerville Wage Theft Ordinance. • Awarded Vendor must comply with insurance requirements as stated in Section 4.0. • The Chief Procurement Officer reserves the right to accept or reject any or all bids and/or to waive any informalities if in her/his sole judgment it is deemed to be in the best interest of the City of Somerville. • The following prices shall include delivery, the cost of fuel, the cost of labor, and all other charges. • This form to be enclosed in sealed bid package. Please provide Unit Price for the following and include any additional fees not listed: Year 1 Health Inspection Services Unit Annual Estimated Quantities Unit Cost Year 1 Sub-Total Year 1 (Est. Qts. X Unit Cost Yr. 1) Routine Inspection each 450 $ $ Risk Level 1 Routine Inspection each 100 $ $ Re-inspection each 100 $ $ Complaint Inspection each 75 $ $ Pre-operational Inspection each 20 $ $ Foodborne Illness Investigation per hour 10 $ $ Miscellaneous-Hourly Rate (Regular 7:30AM to 7:00PM (M-F)) per hour 832 hrs $ $ Total Estimated Cost for Year 1: $ (space intentionally left blank, please continue to price form on next page) https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH9OFMIPR_ARTIIIOFAGPE_DIV2WATH https://library.municode.com/ma/somerville/codes/code_of_ordinances?nodeId=PTIICOOR_CH9OFMIPR_ARTIIIOFAGPE_DIV2WATH Year 2 Health Inspection Services Unit Annual Estimated Quantities Unit Cost Year 2 Sub-Total Year 2 (Est. Qts. X Unit Cost Yr. 2) Routine Inspection each 450 $ $ Risk Level 1 Routine Inspection each 100 $ $ Re-inspection each 100 $ $ Complaint Inspection each 75 $ $ Pre-operational Inspection each 20 $ $ Foodborne Illness Investigation per hour 10 $ $ Miscellaneous-Hourly Rate (Regular 7:30AM to 7:00PM (M- F)) per hour 832 hrs $ $ Total Estimated Cost for Year 2 $ Year 3 Health Inspection Services Unit Annual Estimated Quantities Unit Cost Year 3 Sub-Total Year 3 (Est. Qts. X Unit Cost Yr. 2) Routine Inspection each 450 $ $ Risk Level 1 Routine Inspection each 100 $ $ Re-inspection each 100 $ $ Complaint Inspection each 75 $ $ Pre-operational Inspection each 20 $ $ Foodborne Illness Investigation per hour 10 $ $ Miscellaneous-Hourly Rate (Regular 7:30AM to 7:00PM (M- F)) per hour 832 hrs $ $ Total Estimated Cost for Year 3 $ Total Price (Total Estimated Cost of Years 1+2+3) Total Price in numbers (123) $ Total Price in words (abc) $ Name of Company/Individual: Address, City, State, Zip: Tel # Email: Signature of Authorized Individual Please acknowledge receipt of any and all Addenda (if applicable) by signing below and including this form in your bid package. Failure to do so may subject the proposer to disqualification. ACKNOWLEDGEMENT OF ADDENDA: Addendum #1 ____ #2 ____ #3____ #4____ #5____ #6____ #7____ #8____ #9____ #10____ IFB # 23-55 SECTION 4.0 Restaurant Food Health Inspectors BIDDERS’ CHECKLIST Please ensure all documents listed on this checklist are included with your bid. Failure to do so may subject the proposer to disqualification. Required with Sealed Bids ____ Cover Letter ____ Price Form (Section 3.0) ____ Acknowledgement of Addenda (if applicable) ____ Quality Requirements (Section 2.0) ____ Somerville Living Wage Form (if applicable) ____ Certificate of Non-Collusion and Tax Compliance ____ Certificate of Signature Authority ____ Reference Form (or equivalent may be attached) ____ Supplier Diversity Form ____ W9 Required with Contract, Post Award _____ Certificate of Good Standing (will be required of awarded Vendor; please furnish with bid if available) _____ Insurance Specifications (will be required of awarded Vendor; furnish sample certificate with bid, if possible) APPENDIX A City’s General Terms and Conditions Form:___ CITY OF SOMERVILLE Rev. 04/14/2022 Contract Number:________ Online at: https://www.somervillema.gov/departments/finance/procurement-and-contracting- services Page 1 of 3 SOMERVILLE LIVING WAGE ORDINANCE CERTIFICATION FORM CITY OF SOMERVILLE CODE OF ORDINANCES SECTION 2-397 et seq*. Instructions: This form shall be included in all Invitations for Bids and Requests for Proposals which involve the furnishing of labor, time or effort (with no end product other than reports) by vendors contracting or subcontracting with the City of Somerville, where the contract price meets or exceeds the following dollar threshold: $10,000. If the undersigned is selected, this form will be attached to the contract or subcontract and the certifications made herein shall be incorporated as part of such contract or subcontract. Complete this form and sign and date where indicated below on page 2. Purpose: The purpose of this form is to ensure that such vendors pay a “Living Wage” (defined below) to all covered employees (i.e., all employees except individuals in a city, state or federally funded youth program). In the case of bids, the City will award the contract to the lowest responsive and responsible bidder paying a Living Wage. In the case of RFP’s, the City will select the most advantageous proposal from a responsive and responsible offeror paying a Living Wage. In neither case, however, shall the City be under any obligation to select a bid or proposal that exceeds the funds available for the contract. Definition of “Living Wage”: For this contract or subcontract, as of 7/1/2022 “Living Wage” shall be deemed to be an hourly wage of no less than $15.96 per hour. From time to time, the Living Wage may be upwardly adjusted and amendments, if any, to the contract or subcontract may require the payment of a higher hourly rate if a higher rate is then in effect. CERTIFICATIONS 1. The undersigned shall pay no less than the Living Wage to all covered employees who directly expend their time on the contract or subcontract with the City of Somerville. 2. The undersigned shall post a notice, (copy enclosed), to be furnished by the contracting City Department, informing covered employees of the protections and obligations provided for in the Somerville Living Wage Ordinance, and that for assistance and information, including copies of the Ordinance, employees should contact the contracting City Department. Such notice shall be posted in each location where services are performed by covered employees, in a conspicuous place where notices to employees are customarily posted. 3. The undersigned shall maintain payrolls for all covered employees and basic records relating hereto and shall preserve them for a period of three years. The records shall contain the name and address of each employee, the number of hours worked, the gross wages, a copy of the social *Copies of the Ordinance are available upon request to the Procurement & Contracting Services Department. https://www.somervillema.gov/departments/finance/procurement-and-contracting-services https://www.somervillema.gov/departments/finance/procurement-and-contracting-services Form:___ CITY OF SOMERVILLE Rev. 04/14/2022 Contract Number:________ Online at: https://www.somervillema.gov/departments/finance/procurement-and-contracting- services Page 2 of 3 security returns, and evidence of payment thereof and such other data as may be required by the contracting City Department from time to time. 4. The undersigned shall submit payroll records to the City upon request and, if the City receives information of possible noncompliance with the provisions the Somerville Living Wage Ordinance, the undersigned shall permit City representatives to observe work being performed at the work site, to interview employees, and to examine the books and records relating to the payrolls being investigated to determine payment of wages. 5. The undersigned shall not fund wage increases required by the Somerville Living Wage Ordinance by reducing the health insurance benefits of any of its employees. 6. The undersigned agrees that the penalties and relief set forth in the Somerville Living Wage Ordinance shall be in addition to the rights and remedies set forth in the contract and/or subcontract. CERTIFIED BY: Signature: _________________________________ (Duly Authorized Representative of Vendor) Title: ______________________________ Name of Vendor:_________________________________________ Date: ____________________________ https://www.somervillema.gov/departments/finance/procurement-and-contracting-services https://www.somervillema.gov/departments/finance/procurement-and-contracting-services Form:___ CITY OF SOMERVILLE Rev. 04/14/2022 Contract Number:________ Online at: https://www.somervillema.gov/departments/finance/procurement-and-contracting- services Page 3 of 3 INSTRUCTIONS: PLEASE POST NOTICE TO ALL EMPLOYEES REGARDING PAYMENT OF LIVING WAGE Under the Somerville, Massachusetts’ Living Wage Ordinance (Ordinance No. 1999-1), any person or entity who has entered into a contract with the City of Somerville is required to pay its employees who are involved in providing services to the City of Somerville no less than a “Living Wage”. The Living Wage as of 7/1/2022 is $15.96 per hour. The only employees who are not covered by the Living Wage Ordinance are individuals in a Youth Program. “Youth Program” as defined in the Ordinance, “means any city, state or federally funded program which employs youth, as defined by city, state or federal guidelines, during the summer, or as part of a school to work program, or in any other related seasonal or part-time program.” For assistance and information regarding the protections and obligations provided for in the Living Wage Ordinance and/or a copy of the Living Wage Ordinance, all employees should contact the City of Somerville’s Procurement & Contracting Services Department directly. https://www.somervillema.gov/departments/finance/procurement-and-contracting-services https://www.somervillema.gov/departments/finance/procurement-and-contracting-services Form:___ CITY OF SOMERVILLE Rev. 08/01/12 Contract Number:________ Online at: www.somervillema.gov/purchasing Page 1 of 1 Non-Collusion Form and Tax Compliance Certification Instructions: Complete each part of this two-part form and sign and date where indicated below. A. NON-COLLUSION FORM I, the undersigned, hereby certify under penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word "person" shall mean any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Signature: _________________________________ (Individual Submitted Bid or Proposal) Duly Authorized Name of Business or Entity:_________________________________________ Date: ____________________________ B. TAX COMPLIANCE CERTIFICATION Pursuant to M.G.L. c. 62C, §49A, I certify under the penalties of perjury that, to the best of my knowledge and belief, I am in compliance with all laws of the Commonwealth relating to taxes, reporting of employees and contractors, and withholding and remitting child support, as well as paid all contributions and payments in lieu of contributions pursuant to MGL 151A, §19A(b). Signature: _________________________________ (Duly Authorized Representative of Vendor) Name of Business or Entity:_________________________________________ Social Security Number or Federal Tax ID#:___________________________ Date: ____________________________ http://www.somervillema.gov/purchasing� Form:___ CITY OF SOMERVILLE Rev. 08/01/12 Contract Number:________ Online at: www.somervillema.gov/purchasing Page 1 of 1 Certificate of Authority (Corporations Only) Instructions: Complete this form and sign and date where indicated below. 1. I hereby certify that I, the undersigned, am the duly elected Clerk/Secretary of _______________________________________________________________________. (Insert Full Name of Corporation) 2. I hereby certify that the following individual _________________________________ (Insert the Name of Officer who Signed the Contract and Bonds) is the duly elected___________________________________ of said Corporation. (Insert the Title of the Officer in Line 2) 3. I hereby certify that on ___________________________________ (Insert Date: Must be on or before Date Officer Signed Contract/Bonds) at a duly authorized meeting of the Board of Directors of said corporation, at which a quorum was present, it was voted that ______________________________ ______________________________ (Insert Name of Officer from Line 2) (Insert Title of Officer from Line 2) of this corporation be and hereby is authorized to make, enter into, execute, and deliver contracts and bonds in the name and on behalf of said corporation, and affix its Corporate Seal thereto, and such execution of any contract of obligation in this corporation’s name and on its behalf, with or without the Corporate Seal, shall be valid and binding upon this corporation; and that the above vote has not been amended or rescinded and remains in full force and effect as of the date set forth below. 4. ATTEST: Signature: _____________________________ AFFIX CORPORATE SEAL HERE (Clerk or Secretary) Printed Name: _________________________ Printed Title:___________________________ Date: ____________________________ (Date Must Be on or after Date Officer Signed Contract/Bonds) http://www.somervillema.gov/purchasing� Form:___ CITY OF SOMERVILLE Rev. 08/01/12 Contract Number:________ Online at: www.somervillema.gov/purchasing Page 1 of 1 Certificate of Authority (Limited Liability Companies Only) Instructions: Complete this form and sign and date where indicated below. 1. I, the undersigned, being a member or manager of _______________________________________________________________________, (Complete Name of Limited Liability Company) a limited liability company (LLC) hereby certify as to the contents of this form for the purpose of contracting with the City of Somerville. 2. The LLC is organized under the laws of the state of: _______________. 3. The LLC is managed by (check one) a Manager or by its Members. 4. I hereby certify that each of the following individual(s) is: • a member/manager of the LLC; • duly authorized to execute and deliver this contract, agreement, and/or other legally binding documents relating to any contract and/or agreement on behalf of the LLC; • duly authorized to do and perform all acts and things necessary or appropriate to carry out the terms of this contract or agreement on behalf of the LLC; and • that no resolution, vote, or other document or action is necessary to establish such authority. Name Title 5. Signature:__________________________________________ Printed Name: __________________________________________ Printed Title:____________________________________________ Date: ____________________________ http://www.somervillema.gov/purchasing� REFERENCE FORM Bidder: BID#/ Title: Reference:________________________________ Contact:____________________ Address:___________________________________ Phone:____________________ __________________________________________ Email:_____________________ Description and date(s) of supplies or services provided:_______________________ ____________________________________________________________________ ____________________________________________________________________ Reference:________________________________ Contact:____________________ Address:___________________________________ Phone:____________________ __________________________________________ Email:______________________ Description and date(s) of supplies or services provided:________________________ _____________________________________________________________________ _____________________________________________________________________ Reference:________________________________ Contact:____________________ Address:___________________________________ Phone:_____________________ __________________________________________ Email:______________________ Description and date(s) of supplies or services provided:________________________ _____________________________________________________________________ _____________________________________________________________________ SOMERVILLE SUPPLIER DIVERSITY CERTIFICATION FORM Background The City of Somerville is an equal opportunity employer and encourages businesses to apply to work with the City that are representative of the City’s diverse community. In an effort to increase the opportunities for disadvantaged and small businesses within Somerville and surrounding communities, the City recognizes Massachusetts’ Operational Services Division’s Supplier Diversity Office certification program. Application Process Applicable parties may learn more about the Commonwealth’s supplier diversity certification process and apply here https://www.mass.gov/supplier-diversity-office. During the certification process, which takes approximately 30 days, the SDO investigates applicant companies to make sure they meet applicable legal requirements. Under SDO regulations, the applicant firm must prove it is at least 51% owned and dominantly controlled by adult minority, women, Portuguese, or veteran principals who are U.S. citizens or lawful permanent residents. Firms also must be ongoing and independent. Certifications Check all those that apply: □ Minority Business Enterprises (MBE) □ Women Business Enterprises (WBE) □ Veteran Business Enterprises (VBE) □ Portuguese Business Enterprises (PBE) □ Other ________________________________ The undersigned certifies that the applicant has received certification from the Massachusetts Supplier Diversity Office for the SDO category/categories listed above and has provided the City of Somerville with a copy of the SDO certification letter. CERTIFIED BY: Signature: _________________________________ (Duly Authorized Representative of Vendor) Title: ______________________________ Name of Vendor:_________________________________________ Date: ____________________________ https://www.mass.gov/supplier-diversity-office Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification ▶ Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. P ri nt o r ty p e. S ee S p ec ifi c In st ru ct io ns o n p ag e 3. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ▶ Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) ▶ 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. 6 City, state, and ZIP code Requester’s name and address (optional) 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. Social security number – – or Employer identification number – Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Here Signature of U.S. person ▶ Date ▶ General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Form W-9 (Rev. 10-2018) Page 2 By signing the filled-out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, later, for further information. Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien; • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; • An estate (other than a foreign estate); or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners’ share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States. • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. 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 after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items. 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such payments. This is called “backup withholding.” Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the instructions for Part II for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships, earlier. What is FATCA Reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Form W-9 (Rev. 10-2018) Page 3 Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9. a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note: ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single-member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or “doing business as” (DBA) name on line 2. c. Partnership, LLC that is not a single-member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a “disregarded entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, “Business name/disregarded entity name.” If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN. Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3. IF the entity/person on line 1 is a(n) . . . THEN check the box for . . . • Corporation Corporation • Individual • Sole proprietorship, or • Single-member limited liability company (LLC) owned by an individual and disregarded for U.S. federal tax purposes. Individual/sole proprietor or single- member LLC • LLC treated as a partnership for U.S. federal tax purposes, • LLC that has filed Form 8832 or 2553 to be taxed as a corporation, or • LLC that is disregarded as an entity separate from its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes. Limited liability company and enter the appropriate tax classification. (P= Partnership; C= C corporation; or S= S corporation) • Partnership Partnership • Trust/estate Trust/estate Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you. Exempt payee code. • Generally, individuals (including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. • Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. • Corporations are not exempt from backup withholding with respect to attorneys’ fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4. 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment trust 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 Form W-9 (Rev. 10-2018) Page 4 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for . . . THEN the payment is exempt for . . . Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Barter exchange transactions and patronage dividends Exempt payees 1 through 4 Payments over $600 required to be reported and direct sales over $5,0001 Generally, exempt payees 1 through 52 Payments made in settlement of payment card or third party network transactions Exempt payees 1 through 4 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys’ fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with “Not Applicable” (or any similar indication) written or printed on the line for a FATCA exemption code. A—An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or instrumentalities C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(i) E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(c)(1)(i) F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G—A real estate investment trust H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I—A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Note: You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payor changes your address in their records. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. If you are a single-member LLC that is disregarded as an entity separate from its owner, enter the owner’s SSN (or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC is classified as a corporation or partnership, enter the entity’s EIN. Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/Businesses and clicking on Employer Identification Number (EIN) under Starting a Business. Go to www.irs.gov/Forms to view, download, or print Form W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 business days. If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write “Applied For” in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note: Entering “Applied For” means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier. Signature requirements. Complete the certification as indicated in items 1 through 5 below. Form W-9 (Rev. 10-2018) Page 5 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. “Other payments” include payments made in the course of the requester’s trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual The individual 2. Two or more individuals (joint account) other than an account maintained by an FFI The actual owner of the account or, if combined funds, the first individual on the account1 3. Two or more U.S. persons (joint account maintained by an FFI) Each holder of the account 4. Custodial account of a minor (Uniform Gift to Minors Act) The minor2 5. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law The grantor-trustee1 The actual owner1 6. Sole proprietorship or disregarded entity owned by an individual The owner3 7. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i) (A)) The grantor* For this type of account: Give name and EIN of: 8. Disregarded entity not owned by an individual The owner 9. A valid trust, estate, or pension trust Legal entity4 10. Corporation or LLC electing corporate status on Form 8832 or Form 2553 The corporation 11. Association, club, religious, charitable, educational, or other tax- exempt organization The organization 12. Partnership or multi-member LLC The partnership 13. A broker or registered nominee The broker or nominee For this type of account: Give name and EIN of: 14. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments The public entity 15. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)(i)(B)) The trust 1 List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person’s number must be furnished. 2 Circle the minor’s name and furnish the minor’s SSN. 3 You must show your individual name and you may also enter your business or DBA name on the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. 4 List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships, earlier. *Note: The grantor also must provide a Form W-9 to trustee of trust. Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Pub. 5027, Identity Theft Information for Taxpayers. Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. Form W-9 (Rev. 10-2018) Page 6 The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at spam@uce.gov or report them at www.ftc.gov/complaint. You can contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338). If you have been the victim of identity theft, see www.IdentityTheft.gov and Pub. 5027. Visit www.irs.gov/IdentityTheft to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. SECRETARY OF THE COMMONWEALTH’S CERTIFICATE OF GOOD STANDING CERTIFICATE OF GOOD STANDING as provided by the Secretary of the Commonwealth The Awarded Vendor must comply with our request for a CURRENT “Certificate of Good Standing” provided by the Secretary of the Commonwealth’s Office NOTE: A Certificate of Good Standing provided by the Department of Revenue will NOT be accepted. The Certificate must be provided by the Secretary of the Commonwealth’s Office. If you require information on how to obtain the “Certificate of Good Standing” or Certificate of Registration (Foreign Corporations) from the Commonwealth of Massachusetts, please call the Secretary of The Commonwealth’s Office at (617) 727-2850 (Press #1) located at One (1) Ashburton Place, 17 Floor, Boston, MA 02133 or you may access their web site at: http://corp.sec.state.ma.us/CorpWeb/Certificates/CertificateOrderForm.aspx If your company is incorporated outside of Massachusetts and therefore is a “foreign corporation”, but is registered to do business in Massachusetts, please comply with our request for the Certificate of Registration from the Commonwealth of Massachusetts. If your company is a foreign corporation, but is not registered to do business in Massachusetts, please provide the Certificate of Good Standing from your state of incorporation. Please note that without the above certificate (s), the City of Somerville cannot execute your contract. IMPORTANT NOTICE Requests for Certificates of Good Standing by mail may take a substantial amount of time. A certificate may be obtained immediately in person at the Secretary’s Office at the address above. Also, at this time, the Secretary of State’s Office may not have your current annual report recorded. If this is the case, and you are therefore unable to obtain the Certificate of Good Standing, please forward a copy of your annual report filing fee check with your signed contracts. Please forward your original Certificate of Good Standing to the Purchasing Department upon receipt. http://corp.sec.state.ma.us/CorpWeb/Certificates/CertificateOrderForm.aspx INSURANCE SPECIFICATIONS INSURANCE REQUIREMENTS FOR AWARDED VENDOR ONLY: Prior to commencing performance of any work or supplying materials or equipment covered by these specifications, the contractor shall furnish to the Office of the Chief Procurement Officer a Certificate of Insurance evidencing the following: A. GENERAL LIABILITY - Comprehensive Form Bodily Injury Liability..............$ One Million Property Damage Liability........$ One Million B. COVERAGE FOR PAYMENT OF WORKER'S COMPENSATION BENEFIT PURSUANT TO CHAPTER 152 OF THE MASSACHUSETTS GENERAL LAWS IN THE AMOUNT AS LISTED BELOW: WORKER'S COMPENSATION................$Statutory EMPLOYERS' LIABILITY...................$ Statutory C. AUTOMOBILE LIABILITY INSURANCE AS LISTED BELOW: BODILY INJURY LIABILITY..........$ STATUTORY l. A contract will not be executed unless a certificate (s) of insurance evidencing above- described coverage is attached. 2. Failure to have the above-described coverage in effect during the entire period of the contract shall be deemed to be a breach of the contract. 3. All applicable insurance policies shall read: "CITY OF SOMERVILLE” as a certificate holder and as an additional insured for general liability only along with a description of operation in the space provided on the certificate. Certificate Should Be Made Out To: City Of Somerville c/o Procurement and Contracting Services Department 93 Highland Avenue Somerville, MA 02143 Note: If your insurance expires during the life of this contract, you shall be responsible to submit a new certificate(s) covering the period of the contract. No payment will be made on a contract with an expired insurance certificate. CERTIFICATE HOLDER © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY GENERAL LIABILITY PREMISES (Ea occurrence) $ DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). The ACORD name and logo are registered marks of ACORD COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. mgauthier Callout ADD "X" HERETO CERTIFY THAT THE CITY OF SOMERVILLE IS AN ADDITIONAL INSURED mgauthier Callout DESCRIPTION OF PROJECT, SOLICITATION NUMBER AND THAT THE CITY OF SOMERVILLE IS A CERTIFICATE HOLDER AND ADDITIONAL INSURED mgauthier Callout CERTIFICATES SHOULD BE MADE OUT TO: CITY OF SOMERVILLE c/o PURCHASING DEPARTMENT 93 HIGHLAND AVE SOMERVILLE, MA 02143