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University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 1 INVITATION FOR BIDS Issue Date: 06/23/20 BID NUMBER Refer ALL Inquiries To Lynn Barello Requisition: 1000574522 3000008466 Phone Number 919/962-0265 OPENING DATE 07/09/20 NOTICE TO BIDDERS Bids must delivered electronically either eBid or by email. Bids are subject to the conditions made a part hereof and will be received at this office until 3:00 PM on the opening date shown above and will then be opened. Bids will include the supplies, materials, and/or services as described below, delivered "FOB destination Chapel Hill, NC" with all transportation charges prepaid and included in the bid price, Requested delivery date : 08/14/2020 Bids and/or addenda submitted via facsimile (FAX) machine in response to this Invitation for Bids will not be

acceptable. Bids are subject to rejection unless submitted on this form. Offer shall be valid for 60 days from date of bid opening unless otherwise stated here ----------------------- days Prompt Payment Discount ---------------------- % -------------------- days DELIVERY: Early delivery is requested and bidder is urged to state earliest guaranteed delivery. Delivery will be made from -------------------------------------------------(city and state) within -------------------------days after receipt of order LIST: Name, address and telephone number from which service and parts are available. [ ] YES [ ] NO Mandatory Site Visit/Pre-bid Conference Date: 06/23/2020 Time: 7:09:07 AM Eastern Time Instructions: It shall be MANDATORY that each Vendor representative be present for a pre-bid site visit on _____________. Attendees must meet promptly at ______________ Eastern Time at ____________________. All attendees must sign in upon arrival, and on-time attendance will be strictly enforced. Bids received from prospective Vendors that were not present for the entire site visit/pre-bid conference may be disqualified from award consideration. The purpose of this visit is for all prospective Vendors to apprise themselves with the conditions and requirements which will affect the performance of the work called for by this IFB. No allowances will be made for unreported conditions that a prudent Vendor would recognize as affecting the work called for or implied by this bid. Vendors are cautioned that any information relayed to attendees during the site visit, other than that involving the physical aspects of the facility referenced above, and which conflicts with, supersedes, or adds to requirements in this IFB, must be confirmed by written addendum before it can be considered to be a part of this bid. x University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 2 EXECUTION Certification: By executing this bid, the undersigned Vendor certifies that: (i) this bid is submitted competitively and without collusion (G.S. 143-54), (ii) none of its officers, directors, or owners of an unincorporated business entity has been convicted of any violations of Chapter 78A of the General Statutes, the Securities Act of 1933, or the Securities Exchange Act of 1934 (G.S. 143-59.2), (iii) it is not an ineligible vendor as set forth in G.S. 143-59.1, (iv) no gift has been offered, extended, or promised by any of its employees or representatives to any University employee associated with preparing plans, specifications or estimates for this IFB, or in awarding or administering the contract to result from this IFB, or in inspecting or supervising the services to be rendered (G.S. 133-32), (v) if any of the services to be performed under this IFB will be performed outside the United States by the Vendor or Vendor's subcontractors, Vendor has disclosed such information in writing to the University (G.S. 147-33.97); (vi) it acknowledges that the University's internal auditor and State of North Carolina auditors have the right under North Carolina law to access upon request the Vendor's records and representatives to audit fees and performance associated with procurement contracts (G.S. 147-64.7), (vii) it and each of its subcontractors for any contract resulting from this IFB complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its employees through the federal E-Verify system (G.S. §143-48.5). False certification may constitute a Class I felony under North Carolina law. Failure to execute/sign bid prior to submittal shall render bid invalid and it WILL BE REJECTED. Late bids cannot be accepted. BIDDER FEDERAL TAX ID NUMBER STREET ADDRESS PO BOX NUMBER ZIPCITY & STATE IL TELEPHONE NUMBER TYPE OR PRINT NAME & TITLE OF PERSON SIGNING TOLL FREE TELEPHONE NUMBER AUTHORIZED SIGNATURE DATE FAX NUMBER Offer valid for at least 60 days from date of bid opening, unless otherwise stated here: ______ days. After this time, any withdrawal of offer shall be made in writing, effective upon receipt by the University. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 3 UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL IFB # ______________________________________________________ For internal processing, please provide your company's Federal Employer Identification Number or alternate identification number (e.g. Social Security Number). Pursuant to North Carolina General Statute 132-1.10(b) this identification number shall not be released to the public. This page will be removed and shredded, or otherwise kept confidential, before the procurement file is made available for public inspection. This page is to be filled out and returned with your bid. Failure to do so may subject your bid to rejection. ID Number: ______________________________________________________ Federal ID Number or Social Security Number ___________________________________________________ Vendor Name University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 4 Table of Contents 1.0 PURPOSE AND BACKGROUND……………………........................................................................ 5 2.0 GENERAL INFORMATION....................................................................... ......................................... 5 2.1 INVITATION FOR BIDS DOCUMENT............................................................................................ 5 2.2 IFB SCHEDULE………….................................................................................................................. 5 2.3 BID QUESTIONS…............................................................................................................................ 6 2.4 BID SUBMITTAL………………………………………................................................................... 6 2.5 BID CONTENTS…............................................................................................................................. 6 2.6 DEFINITIONS, ACRONYMS, AND ABBREVIATIONS.................................................................7 2.7 NOTICE TO VENDORS REGARDING TERMS AND CONDITIONS........................................... 7 3.0 METHOD OF AWARD AND BID EVALUATION PROCESS...........................................................7 3.1 METHOD OF AWARD.......................................................................................................................8 3.2 BID EVALUATION PROCESS..........................................................................................................8 4.0 REQUIREMENTS....................................................................... .......................................................... 8 4.1 PRICING....................................................................... ...................................................................... 8 4.2 PRODUCT IDENTIFICATION.......................................................................................................... 8 4.3 TRANSPORTATION AND IDENTIFICATION................................................................................9 4.4 DELIVERY……………………………………….............................................................................. 9 4.5 WARRANTY....................................................................................................................................... 9 4.6 REFERENCES.....................................................................................................................................9 4.7 SAMPLES/DEMONSTRATION/DESCRIPTIVE LITERATURE.................................................... 9 4.8 INVOICES........................................................................................................................................... 10 ATTACHMENT A: LOCATION OF WORKERS UTILIZED BY VENDOR............................................ 11 ATTACHMENT B: INSTRUCTIONS TO BIDDERS................................................................................. 12 ATTACHMENT C: DESCRIPTION OF EXECUTIVE ORDER #50 AND CERTIFICATION.................16 ATTACHMENT D: PRICING FORM…...................................................................................................... 20 ATTACHMENT E: CERTIFICATION OF FINANCIAL CONDITION................................................... 21 University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 5 1.0 PURPOSE AND BACKGROUND Bids shall be submitted in accordance with the terms and conditions of this IFB and any addenda issued hereto. 2.0 GENERAL INFORMATION 2.1 INVITATION FOR BIDS DOCUMENT The IFB is comprised of the main body of this IFB document, plus the attachments, and any addenda released before contract award. All attachments and addenda released for this IFB in advance of any contract award are incorporated herein by reference. All terms in this IFB shall be enforceable as contract terms. The use of phrases such as "shall," "must," and "requirements" are intended to create enforceable contract conditions. 2.2 IFB SCHEDULE Event Responsibility Date and Time Issue IFB University Hold Pre-bid Meeting/Site Visit University Submit Written Questions Vendors Provide Response to Questions University Submit Bids Vendors Contract Award University (date subject to change) 6/23/2020 NA 7/6/2020 by 3:00PM (EST) 7/8/2020 7/9/2020 by 3:00PM (EST) 7/10/2020 University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 6 2.3 BID QUESTIONS Upon review of the IFB, Vendors may have questions regarding the IFB. Vendors shall submit any such questions by the above due date listed in the section titled "IFB Schedule" above. Written questions shall be e-mailed to lynnbare@email.unc.edu by the date and time specified above. No phone calls will be accepted. Vendors should enter "IFB #3000008466: Questions" as the subject for the email. Questions submittals should include a reference to the applicable IFB section and be submitted in a format shown below: Reference Vendor Question IFB Section, Page Number Vendor question…? Questions received prior to the submission deadline date, the University's response, and any additional terms deemed necessary by the University will be posted in the form of an addendum to the Interactive Purchasing System (IPS), http://www.ips.state.nc. us, and shall become an Addendum to this IFB. No information, instruction or advice provided orally or informally by any University personnel, whether made in response to a question or otherwise in connection with this IFB, shall be considered authoritative or binding. Vendors shall rely only on written material contained in an Addendum to this IFB. 2.4 BID SUBMITTAL Electronic responses ONLY will be accepted for IFB3000008466. Please disregard below and move forward with Section 2.5. Mailing address for delivery of bid via US Postal Service Office Address of delivery by any other method (special delivery, overnight, or any other carrier) IFB NUMBER: 3000008466 University of North Carolina – CH Procurement Services 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 IFB NUMBER: 3000008466 University of North Carolina – CH Procurement Services 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 IMPORTANT NOTE: All bids shall be delivered to the office address listed above on or before the bid deadline in order to be considered timely. All risk of late arrival due to unanticipated delay—whether delivered by hand, U.S. Postal Service, courier or other delivery service is entirely on the Vendor. All Vendors are urged to take the possibility of delay into account when submitting a bid. Attempts to submit a bid via facsimile (FAX) machine, telephone or electronic means, including but not limited to e-mail, in response to this IFB shall NOT be accepted. a) Submit one (1) signed, original executed bid response, photocopies, and electronic copy on CD, DVD or flash drive. b) Submit your bid in a sealed package. Clearly mark the package with: (1) Vendor name; (2) the IFB number; and (3) the due date. Address the package for delivery as shown in the table above. If Vendor is submitting more than one (1) bid, each bid shall be submitted in separate sealed envelopes and marked accordingly. For delivery purposes, separate sealed envelopes from a single Vendor may be included in the same outer package. Bids are subject to rejection unless submitted with the information above included on the outside of the sealed bid package. c) The electronic copy of your bid must be provided on separate read-only CD's, DVD's or flash drives. The electronic files must NOT be password protected and must be capable of being copied to readable media such as Microsoft Word or Microsoft Excel. 2.5 BID CONTENTS Vendors shall complete all of the applicable portions of this IFB that require the Vendor to provide information and include an authorized signature where indicated. a) Completed and signed version of EXECUTION PAGE, and signed receipt pages of any addenda released in conjunction with this IFB b) Completed version of ATTACHMENT A: LOCATION OF WORKERS UTILIZED BY VENDOR c) ATTACHMENT B: INSTRUCTIONS TO BIDDERS d) Completed and signed version of ATTACHMENT C: DESCRIPTION OF EXECUTIVE ORDER #50 form that confirms that a price matching opportunity is requested 0 0 http://www.ips.state.nc.us http://www.ips.state.nc.us University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 7 e) ATTACHMENT D: PRICING FORM f) ATTACHMENT E: CERTIFICATION OF FINANCIAL CONDITION 2.6 DEFINITIONS, ACRONYMS, AND ABBREVIATIONS a) CONTRACT LEAD: Representative of the University who corresponds with potential Vendors in order to identify and contract with that Vendor providing the greatest benefit to the University and who will administer the contract for the University. b) END USER DEPARTMENT: The department or unit of the University that receives the products procured from the Vendor. c) FOB-DESTINATION: Title transfers from Vendor to purchaser at the destination point of the shipment; Vendor owns commodity in transit and files any claims, and Vendor pays all freight and any related transportation charges. A solicitation may request Vendors to separately identify freight charges in their bid, but no amount or charge not included as part of the total bid price will be paid. d) IFB: Invitation for Bids. e) QUALIFIED BID: A responsive bid submitted by a responsible Vendor. f) STATE: The State of North Carolina, including any of its sub-units recognized under North Carolina law. g) UNIVERSITY: The University of North Carolina at Chapel Hill. h) VENDOR: The supplier, bidder, proposer, company, firm, corporation, partnership, individual or other entity submitting a response to this Invitation for Bids. 2.7 NOTICE TO VENDORS REGARDING TERMS AND CONDITIONS It shall be the Vendor's responsibility to read the Instructions, the University's terms and conditions, all relevant exhibits and attachments, and any other components made a part of this IFB, and comply with all requirements and specifications herein. Vendors also are responsible for obtaining and complying with all Addenda and other changes that may be issued in connection with this IFB. If Vendors have questions, issues, or exceptions regarding any term, condition, instruction or other component within this IFB, those must be submitted as questions in accordance with Section 2.4 BID QUESTIONS. If the University determines that any changes will be made as a result of the points raised, then such decisions will be communicated in the form of an IFB addendum. The University may also elect to leave open the possibility for later negotiation of specific components of the contract that have been addressed during the question and answer period. Other than through this process, the University will reject and shall not be required to evaluate or consider any additional or modified terms and conditions or Instructions to Bidder submitted with Vendor's response. This applies to any language appearing in or attached to the document as part of the Vendor's response that purports to vary any terms and conditions or Vendors' instructions herein or to render the bid non-binding or subject to further negotiation. By execution and delivery of a bid in response to this Invitation for Bids, Vendor agrees that any additional or modified terms and conditions, including Instructions to Bidders, whether submitted purposely or inadvertently, or any purported condition to the offer shall have no force or effect, and will be disregarded. Noncompliance with, or any attempt to alter or delete, this paragraph shall constitute sufficient grounds to reject Vendor's bid as nonresponsive. If a Vendor desires modification of the terms and conditions of this solicitation, it is urged and cautioned to inquire during the question period, in accordance with the instructions in Section 2.4 BID QUESTIONS, about whether a specific, proposed modification is acceptable to or will be considered by the University. Identification of objections or exceptions to the University's terms and conditions in the bid itself shall not be allowed and shall be disregarded or the bid rejected. By executing and submitting its bid in response to this IFB, Vendor understands and agrees that the University may exercise its discretion not to consider any and all proposed modifications a Vendor may request. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 8 3.0 METHOD OF AWARD AND BID EVALUATION PROCESS 3.1 METHOD OF AWARD The University may obtain bids from one or more potential vendors. All bids will be evaluated and award will be based on lowest responsive bid meeting specifications While the intent of this IFB is to award a contract to single vendor for all line items, the University reserves the right to make separate awards to different Vendors for one or more line items, to not award one or more line items or to cancel this IFB in its entirety without awarding a contract, if it is considered to be most advantageous to the University to do so. If a Vendor selected for award is determined by the University to be a non-resident of North Carolina, all responsive bids will be reviewed to determine if any of them were submitted by a North Carolina resident Vendor who requested an opportunity to match the price of the winning bid, pursuant to Executive Order #50 and G.S. 143-59 (for more information, please refer to ATTACHMENT C: DESCRIPTION OF EXECUTIVE ORDER #50 AND CERTIFICATION. If such bid(s) are identified, the University will then determine whether any such bid falls within the price-match range, and, if so, make a contract award in accordance with the process that implements G.S. 143-59 and Executive Order #50. 3.2 BID EVALUATION PROCESS 1. Bids are requested for the items as specified, or item(s) equivalent in design, function and performance. The University reserves the right to reject any bid on the basis of fit, form and function as well as cost. All information furnished on this bid may be used as a factor in determining the award of this contract. 2. At that date and time specified as the bid opening, the package containing the bids from each responding firm will be opened publicly and the name of the Vendor and the price(s) bid announced. 3. The University shall review all Vendor responses to this IFB to confirm that they meet the specifications and requirements of the IFB. The University reserves the right to waive any minor informality or technicality in bids received. 4. For all responses that pass the initial review process, the University will review and assess the Vendors' pricing. The University may request additional formal responses or submissions from any or all Vendors for the purpose of clarification or to amplify the materials presented in any part of the bid. Vendors are cautioned, however, that the University is not required to request clarification, and often does not. Therefore, all bids should be complete and reflect the most favorable terms available from the Vendor. Prices bid cannot be altered or modified as part of a clarification. 5. Bids will be evaluated, based on the award criteria identified in Section 3.1 METHOD OF AWARD. Upon completion of all evaluations, the University will make award(s) based on the evaluation and post the award(s) to IPS under the IFB number for this solicitation. Award of a contract to one Vendor does not mean that the other bids lacked merit, but that, all factors considered, the selected bid was deemed most advantageous and represented the best value to the University. Vendors are cautioned that this is an invitation for bids, not a request or an offer to contract, and the University reserves the unqualified right to reject any and all offers at any time if such rejection is deemed to be in the best interest of the University. 4.0 REQUIREMENTS This Section lists the requirements related to this IFB. By submitting a bid the Vendor agrees to meet all stated requirements in this Section as well as any other specifications, requirements and terms and conditions stated in this IFB. If a Vendor is unclear about a requirement or specification or believes a change to a requirement would allow for the University to receive a better bid, the Vendor is urged and cautioned to submit these items in the form of a question during the question and answer period in accordance with Section 2.4. 4.1 PRICING Bid price shall constitute the total cost to End User Department for delivery fully assembled and ready for use, including all applicable charges for shipping, delivery, handling, administrative and other similar fees. Vendor shall not invoice for any amounts not specifically allowed for in this IFB. Complete ATTACHMENT D: PRICING FORM and include with Bid. 4.2 PRODUCT IDENTIFICATION [ ] MAKE AND MODEL Manufacturer's name and model/catalog numbers used are for the sole purpose of identification and to establish general quality level desired. Such references are not intended to be restrictive and comparable products of other manufacturers will be considered. However, Vendors are cautioned that any deviation from specifications must be pointed out in its bid. Also Vendor must include with its bid sufficient documentary evidence to demonstrate the qualitative, functional, operational, organizational and conformational equivalence of the bid item to the specified item. OR [ ] BRAND SPECIFIC Manufacturer(s) name and product descriptions used in this solicitation are product specific. The items offered in response to this x University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 9 solicitation must be the manufacturer and type specified. These specific products are needed due to compatibility and continuity of support. Failure to comply with this requirement shall be a sufficient basis for disqualifying a bid from further consideration. 4.3 TRANSPORTATION AND IDENTIFICATION The Vendor shall deliver Free-On-Board (FOB) Destination to any location requested by the University with all transportation costs included in the total bid price. The purchase order number shall be shown on all packages and shipping manifests to ensure proper identification and payment of invoices. A complete packing list shall accompany each shipment. Vendors shall not ship any products until they have received an order. 4.4 DELIVERY The Vendor shall deliver Free-On-Board (FOB) Destination to the following location(s): 140 Dental Cir Brauer Hall-352 Chapel Hill, NC 27514 USA Successful Vendor must complete delivery within__________consecutive calendar days after receipt of purchase order. For completion by Vendor: Delivery will be made from __________________________________________ (city, state) within _____ consecutive calendar days after receipt of purchase order. Promptness of delivery may be used as a factor in the award criteria. Delivery shall not be considered to have occurred until installation has been completed. Upon completion of the installation, the Vendor shall remove and properly dispose of all waste and debris from the installation site. The Vendor shall be responsible for leaving the installation area clean and ready to use. 4.5 WARRANTY Manufacturer's standard warranty shall apply. Vendors shall include a copy of the manufacturer's standard warranty with the bid response. Vendor warrants that all equipment furnished under this IFB will be new, of good material and workmanship. The warranty will be for a minimum period of twelve (12) months from date equipment is put into operation. Such warranty shall cover the cost of all defective parts replacement, labor, freight, and technicians travel at no additional cost to the University. The report of a problem does not presuppose that every call must result in an "on-site" visit for service/repair. The Vendor and/or service sub-contractor shall utilize best efforts to resolve problems in a timely fashion through the use of acceptable servicing methods to include, but not limited to, verbal problem analysis and remote diagnosis. The warranty requirement does not impose any additional duty on the University to make other than normal and good faith problem resolution efforts or expenditures of time. Vendor is responsible for compliance with warranty terms by any third-party service provider. Vendor is authorized by manufacturer to repair equipment offered during the warranty period? [ ] YES [ ] NO Will the Vendor provide warranty service? [ ] YES [ ] NO, an authorized third party will perform warranty service Contact information for warranty service provider: Company Name: _______________________________________________ Company Address: _____________________________________________ _____________________________________________ Contact Person (name): _________________________________________ Contact Person (phone number): __________________________________ Contact Person (email): _________________________________________ 4.6 [ ] REFERENCES Vendors shall provide at least three (3) references for which your company has provided goods and services of substantially the University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 10 same features and quantity to those solicited herein. 4.7 SAMPLES/DEMONSTRATION/DESCRIPTIVE LITERATURE [ ] SAMPLE Sample of items offered must be furnished, free of expense, and if not destroyed will, upon request, be returned at the Vendor's expense. A written request for return must be made no later than thirty (30) days after the bid award, and Vendor must provide prepaid, pre-addressed shipping label suitable for return of the sample(s). Otherwise the samples will become University property. Each individual sample must be labeled with the Vendor's name, bid number, and item number. A sample on which an award is made, will be retained until the contract is completed, and then returned, if requested, as specified above. Forward samples to: BID NUMBER: 3000008466 Attention: ______________________ _______________________________ Vendor requests samples be returned after evaluation and/or contract completion? [ ] YES [ ] NO If return is requested, Vendor must provide prepaid, pre-addressed shipping label with bid. Samples are not required prior to bid opening date; however, if required later, Vendor agrees to furnish samples of items offered at no expense to the University within _______consecutive calendar days after request is made by the University. Vendors who do not comply with this requirement are subject to having their bids rejected without further consideration. [ ] DEMONSTRATION The University reserves the right to require a demonstration of the exact model of equipment offered for the purpose of assessing suitability of the offered equipment for the intended use. Such demonstration will be performed at user's facility by Vendor or his authorized representative before award of contract, upon request by and without charge to the University. Failure of Vendor or his authorized representative to perform a satisfactory demonstration (if requested) in accordance with these requirements shall be a sufficient basis for rejection of the bid. The results of such demonstration will be considered in the award of contract. [ ] DEMONSTRATION Vendor must be capable of demonstrating proposed equipment within _____ consecutive calendar days after notification to do so, at no additional cost to the University. If required, this will be a comprehensive demonstration at a site designated by the University with hands-on participation by University operator(s) if necessary or appropriate. Failure of Vendor or his authorized representative to perform a satisfactory demonstration (if requested) in accordance with these requirements shall be a sufficient basis for rejection of the bid. The results of such demonstration will be considered in the award of contract. [ ] DESCRIPTIVE LITERATURE/CERTIFICATION Each bid must be accompanied by complete descriptive literature, specifications, certifications, and all other pertinent data necessary for thorough evaluation of the item(s) bid and sufficient to determine compliance of the item(s) with the specifications. Failure to include such information to shall be a sufficient basis for rejection of the bid. 4.8 INVOICES Invoices must include detailed line item information to allow End User Department to verify pricing at point of receipt matches the correct price from the original date of order. At a minimum, the following fields must be included on all invoices: Vendor's Billing Address, Vendor's Federal ID Number, Order Date, Manufacturer Part Numbers, Vendor Part Numbers, Item Descriptions, Price, Quantity, and Unit of Measure. a) Invoices must be submitted to the End User Department at the following address: University of North Carolina at Chapel Hill 104 Airport Dr Campus box 1220 Chapel Hill, NC 27599-1220 b) Invoices should bear the purchase order number to ensure prompt payment. The Vendor's failure to include the correct purchase order number shall cause delay in payment. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 11 ATTACHMENT A: LOCATION OF WORKERS UTILIZED BY VENDOR In accordance with NC General Statute §143-59.4, the Vendor shall detail the location(s) at which performance will occur, as well as the manner in which it intends to utilize resources or workers outside of the United States in the performance of this contract. The University will evaluate the additional risks, costs, and other factors associated with such utilization prior to making an award. Please complete items a, b, and c below. a) Will any work under this Contract be performed outside the United States? [ ] YES [ ] NO If the Vendor answered "YES" above, Vendor must complete items 1 and 2 below: 1. List the location(s) outside the United States where work under this contract will be performed by the Vendor, any sub- contractors, employees, or other persons performing work under the contract: 2. Describe the corporate structure and location of corporate employees and activities of the Vendor, its affiliates or any other sub-contractors that will perform work outside the U.S.: b) The Vendor agrees to provide notice, in writing to the University, of the relocation of the Vendor, employees of the Vendor, sub-contractors of the Vendor, or other persons performing services under the contract outside of the United States [ ] YES [ ] NO NOTE: All Vendor or sub-contractor personnel providing call or contact center services to the State of North Carolina under the contract shall disclose to inbound callers the location from which the call or contact center services are being provided. c) Identify all U.S. locations at which performance will occur: University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 12 ATTACHMENT B: INSTRUCTIONS TO BIDDERS 1. READ, REVIEW AND COMPLY: It shall be the Bidder's responsibility to read this entire document, review all enclosures and attachments, and any addenda thereto, and comply with all requirements specified herein, regardless of whether appearing in these Instructions to Bidders or elsewhere in this IFB document. 2. NOTICE TO BIDDERS: All bids are subject to the provisions of the General Terms and Conditions for Commodities and Services/Procurements of Information Technology Goods, and the specifications. The University objects to and will not evaluate or consider any additional terms and conditions submitted with a Bidder's response. This applies to any language appearing in or attached to the document as part of the Bidder's response. DO NOT ATTACH ANY ADDITIONAL TERMS AND CONDITIONS. By execution and delivery of this document, the Bidder agrees that any additional terms and conditions, whether submitted purposely or inadvertently, shall have no force or effect. 3. EXECUTION: Failure to sign the EXECUTION or Signature section will render bid invalid and it shall be rejected. 4. TABULATIONS: Written or verbal tabulations of the bids and award information may be obtained by contacting the purchaser named on the cover page. It shall be within the discretion of the named purchaser to format and present the tabulation and award information. 5. TIME FOR CONSIDERATION: Unless otherwise indicated on the first page of this document, Bidder's offer shall be valid for 60 days from the date of bid opening. Preference may be given to the bids allowing not less than 60 days for consideration and acceptance. 6. PROMPT PAYMENT DISCOUNTS: Bidders are urged to compute all discounts into the price offered. The University's standard payment terms are net, 30 days. If a prompt payment discount is offered, it will not be considered in the award of the contract except as a factor to aid in resolving cases of identical prices. 7. MAILING INSTRUCTIONS: Mail only one fully executed bid document, unless otherwise instructed, and only one bid per envelope. Address envelope and insert bid number as shown below: Bid No 3000008466 UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL, PURCHASING SERVICES, 104 AIRPORT DR, SUITE#2700, CB 1100, CHAPEL HILL, NC 27599-1100. It is the responsibility of the Bidder to have the bid in this office by the specified time and date of opening. 8. SPECIFICATIONS: Any deviation from specifications indicated herein must be clearly pointed out; otherwise, it will be considered that items offered are in strict compliance with these specifications, and the Bidder will be held responsible. Deviations shall be explained in detail. The Bidder shall not construe this paragraph as inviting deviation or implying that any deviation will be acceptable. 9. ORDER OF PRECEDENCE: In cases of conflict between specific provisions in this solicitation or in any resulting contract, the order of precedence shall be (high to low) (1) any special terms and conditions specific to this IFB, including any negotiated terms; (2) specifications, and (3) the University of North Carolina at Chapel Hill Terms and Conditions noted on the IFB. 10. INFORMATION AND DESCRIPTIVE LITERATURE: Bidder shall furnish all information requested and in the spaces provided in this document. Further, if required elsewhere in this bid, each Bidder must submit with their bid sketches, descriptive literature and/or complete specifications covering the products offered. Reference to literature submitted with a previous bid will not satisfy this provision. Bids which do not comply with these requirements will be subject to rejection. 11. RECYCLING AND SOURCE REDUCTION: It is the policy of this University to encourage and promote the purchase of products with recycled content to the extent economically practicable, and to purchase items which are reusable, refillable, repairable, more durable and less toxic to the extent that the purchase or use is practicable and cost-effective. The University encourages and promotes using minimal packaging and the use of recycled/recyclable products in the packaging of commodities purchased. However, no sacrifice in quality of packaging will be acceptable. The Bidder remains responsible for providing packaging that will adequately protect the commodity and contain it for its intended use. Bidders are strongly urged to bring to the attention of purchasers those products or packaging they offer which have recycled content and that are recyclable. 12. SUSTAINABILITY: To support the sustainability efforts of the State of North Carolina we solicit your cooperation in this effort. Pursuant to Executive Order 156 (1999), it is desirable that all responses meet the following: • All copies of the bid are printed double sided. • All submittals and copies are printed on recycled paper with a minimum post-consumer content of 30%. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 13 • Unless absolutely necessary, all quotes and copies should minimize or eliminate use of non-recyclable or non-reusable materials such as plastic report covers, plastic dividers, vinyl sleeves, and GBC binding. Three-ringed binders, glued materials, paper clips, and staples are acceptable. • Materials should be submitted in a format which allows for easy removal, filing and/or recycling of paper and binder materials. Use of oversized paper is strongly discouraged unless necessary for clarity or legibility. 13. CLARIFICATIONS/INTERPRETATIONS: Any and all questions regarding this document must be addressed to the purchaser named on the cover sheet of this document. Do not contact the user directly. Any and all revisions to this document shall be made only by written addendum from the University's Procurement Services. The Bidder is cautioned that the requirements of this bid can be altered only by written addendum and that verbal communications from whatever source are of no effect. 14. REFERENCES: The University reserves the right to require a list of users of the exact item offered. The University may contact these users concerning these items. Such information may be considered in the evaluation of the bid. 15. HISTORICALLY UNDERUTILIZED BUSINESSES: Pursuant to General Statute 143-48 and Executive Order 150 (1999), the University invites and encourages participation in this procurement process by businesses owned by minorities, women, disabled business enterprises and non-profit work centers for the blind and severely disabled. 16. AWARD OF CONTRACT: Qualified bids will be evaluated and acceptance made of the lowest and best bid most advantageous to the University as determined upon consideration of such factors as: prices offered; the quality of the articles offered; the general reputation and performance capabilities of the Bidders; the substantial conformity with the specifications and other conditions set forth in the bid; the suitability of the articles for the intended use; the related services needed; the date or dates of delivery and performance; and such other factors deemed by the University to be pertinent or peculiar to the purchase in question. The University reserves the right to reject any and all bids, to waive any informality in bids and, unless otherwise specified by the Bidder, to accept any item in the bid. Unless otherwise specified by the University or the Bidder, the University reserves the right to accept any item or group of items on a multi-item bid. If either a unit price or extended price is obviously in error and the other is obviously correct, the incorrect price will be disregarded. 17. CONFIDENTIAL INFORMATION: To the extent permitted by applicable statutes and rules, the University will maintain confidential trade secrets that the Bidder does not wish disclosed. As a condition to confidential treatment, each page containing trade secret information shall be identified in boldface at the top and bottom as "CONFIDENTIAL" by the Bidder, with specific trade secret information enclosed in boxes or similar indication. Cost information shall not be deemed confidential under any circumstances. Regardless of what a Bidder may label as a trade secret, the determination whether it is or is not entitled to protection will be determined in accordance with G.S. 132-1.2. Any material labeled as confidential constitutes a representation by the Bidder that it has made a reasonable effort in good faith to determine that such material is, in fact, a trade secret under G.S. 132-1.2. Bidders are urged and cautioned to limit the marking of information as a trade secret or as confidential so far as is possible. The obligations of non-disclosure shall not apply to the following: • Information which, at the time of disclosure is in the public knowledge; • Information which, after disclosure becomes part of the public knowledge by publication or otherwise, except by breach of this agreement; • Information which was in possession of the University at the time of disclosure and which was not acquired, directly or indirectly by the recipient from the disclosing party, and which prior possession can be proven by documentary evidence; • Information received from third parties, provided such information was not obtained to their knowledge by said third parties, directly or indirectly, on a confidential basis; • Information which is independently developed by the University's personnel not privy to the information. 18. TAXES: Except for construction bids, taxes shall not be included in bid prices. Prices offered shall not include any personal property taxes, nor any sales or use tax (or fees) unless required by the North Carolina Department of Revenue. The University of North Carolina at Chapel Hill, being an agency of the State of North Carolina, is exempt from the Federal Excise Tax. 19. SAMPLES: Sample of items, when required, must be furnished as stipulated herein, free of expense, and if not destroyed will, upon request be returned at the Bidder's expense. Request for the return of samples must be made within 10 days following date of bid opening. Otherwise the samples will become University property. Each individual sample must be labeled with the Bidder's name, bid number and item number. A sample on which an award is made, will be retained until the purchase order is completed, and then returned, if requested, as specified above. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 14 20. MANUFACTURER'S NAMES: Except for requirements identified as "brand specific" any manufacturers' names, trade names, brand names, information and/or catalog numbers used herein are for the purpose(s) of description and establishing general quality levels. Such references are not intended to be restrictive and products of any manufacturer may be offered. 21. OWNERSHIP: For printing services, all copy, art, negatives, photos, etc., that are required for this job remain or become the property of the University and shall be returned to the University upon request in excellent reusable condition. Any charge for this shall be included in all prices quoted herein. Printer shall be held liable for any/all damages to materials. 22. PROTEST PROCEDURES: A party wanting to protest a contract award pursuant to this solicitation must submit a written request to the Associate Vice Chancellor for Finance at the address given in the instruction above entitled "Mailing Instructions." This request must be received in the University Procurement Services within thirty (30) consecutive calendar days from the date of contract award, and must contain specific sound reasons and any supporting documentation for the protest. Note: Contract award notices are sent only to those actually awarded contracts and not to every person or firm responding to the solicitation. Offerors may call the purchaser listed on the first page of this document to obtain verbal status of contract award. All protests will be handled pursuant to the North Carolina Administrative Code, Title 1, Department of Administration, Chapter 5, Purchase and Contract, Section 5B.1519. If a ground of a protest is based on a challenge to the qualification of a North Carolina resident Bidder awarded a contract pursuant to Executive Order #50 (price-matching preference), the Associate Vice Chancellor for Finance may request the North Carolina resident Bidder to produce documentation substantiating the North Carolina resident Bidder's qualification for the subject preference. The Associate Vice Chancellor for Finance should request the supporting documentation within the 10-day period he or she has to make the decision on whether to deny or grant a protest meeting and the protest meeting should be scheduled after the anticipated receipt of the documents from the North Carolina resident Bidder. Pursuant to Paragraph 23 below, the North Carolina resident Bidder is required to produce to the University the requested documentation within five (5) business days of the University's request and failure to produce the documents by the end of that time period may result in the cancellation of the contract. Also note that any tax, financial, accounting or banking documents the North Carolina resident Bidder submits to the University in connection with the resolution of a protest shall not be disclosed to the protester pursuant to G.S. § 132-1.1 and 105-259(b) and the University shall preserve the confidentiality of such documents. 23. CONFIDENTIALITY OF BIDS: In submitting its bid, the Bidder agrees not to discuss or otherwise reveal the contents of its bid to any source outside of the using or issuing agency, government or private, until after the award of the contract. All Bidders are advised that they are not to have any communications with the using or issuing agency during the evaluation of the bids (i.e., after the public opening of the bids and before the award of the contract), unless the University's purchaser contacts the Bidder(s) for purposes of seeking clarification. A Bidder shall not: transmit to the issuing and/or using agency any information commenting on the ability or qualifications of any other Bidder to provide the advertised good, equipment, commodity; defects, errors and/or omissions in any other Bidder's bid and/or prices at any time during the procurement process; and/or engage in any other communication or conduct attempting to influence the evaluation and/or award of the contract that is the subject of this IFB. Bidders not in compliance with this provision may be disqualified, at the option of the University, from the contract award. Only those communications with the using agency or issuing agency authorized by this IFB are permitted. 24. MISCELLANEOUS: Masculine pronouns shall be read to include feminine pronouns, and the singular of any word or phrase shall be read to include the plural and vice versa. 25. INFORMAL COMMENTS: The University shall not be bound by informal explanations, instructions or information given at any time by anyone on behalf of the University during the competitive process or after award. The University is bound only by information provided in this IFB and in formal Addenda issued. 26. COST FOR QUOTE PREPARATION: Any costs incurred by Bidder in preparing or submitting quotes are the Bidder's sole responsibility; the University will not reimburse any Bidder for any costs incurred prior to award. 27. BIDDER'S REPRESENTATIVE: Each Bidder shall submit with its quote the name, address, and telephone number of the person(s) with authority to bind the firm and answer questions or provide clarification concerning the firm's quote. 28. INSPECTION AT BIDDER'S SITE: The University reserves the right to inspect, at a reasonable time, the equipment/item, plant or other facilities of a prospective Bidder prior to Contract award, and during the Contract term as necessary for the University determination that such equipment/item, plant or other facilities conform with the specifications/requirements and are adequate and suitable for the proper and effective performance of the Contract. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 15 ATTACHMENT C: DESCRIPTION OF EXECUTIVE ORDER #50 AND CERTIFICATION NORTH CAROLINA RESIDENT VENDORS TAKE NOTE: Pursuant to North Carolina General Statute §143-59 and Executive Order No. 50 (issued February 17, 2010, entitled "Enhanced Purchasing Opportunities for North Carolina Businesses"), a North Carolina resident Vendor may receive an opportunity to obtain an award by agreeing to match the final price(s) of the lowest Vendor on a contract for the purchase of goods, if that lowest price is offered by a non-North Carolina resident Vendor. This opportunity arises when a North Carolina resident Vendor offers a price that is the lowest among all bids by qualified in-State resident Vendors and also is within five percent (5%) or $10,000 (whichever is less) of the non-resident Vendor's overall lowest price. This price-match opportunity applies to a contract awarded under this solicitation. G.S. §143-59(c) (1) defines a "resident Vendor" as a "Vendor that has paid unemployment taxes or income taxes in this State and whose principal place of business is located in this State." All other Vendors are considered to be non-resident Vendors. G.S. §143-59(c)(3) defines a "principal place of business" as the "principal place from which the trade or business of the Vendor is directed or managed." This refers to overall operations for the entire business entity, not merely a division or office location. In order to qualify for this preference, a resident Vendor shall: (1) request the price-match opportunity by marking the appropriate checkbox, below; (2) provide all information requested; and (3) complete and sign the "Resident Vendor's Certification for Price-Matching Preference under Executive Order #50" (hereinafter the "Certification") included at the end of this Section. The Certification may not be submitted after the public opening of the bids. By executing the Certification, the Vendor affirms that the information provided is accurate and agrees to provide any additional information or documentation requested by the University to confirm the above certifications and statements within five (5) business days of request (including but not limited to income tax or unemployment tax returns, reports and/or filings (annual and/or quarterly); banking statements or financial/accounting statements reflecting Vendor's payment of income taxes or unemployment taxes to the State of North Carolina and such other information regarding Vendor's management or directors of its business or trade of its principal place of business). Requesting a price-match opportunity below does not require any resident Vendor to match the lowest price in the event a Vendor qualifies for receiving the opportunity. The University will evaluate the bids in accordance with the award criteria stated in this IFB to determine the lowest Vendor meeting the requirements of the IFB without regard to any Vendor's residency. If the Vendor with the lowest price is a North Carolina resident Vendor, then no consideration of the price-matching procedure is necessary. If the lowest bid by a Vendor meeting all requirements was submitted by a non-resident Vendor and there are no North Carolina resident Vendors that submitted a price bid that was within 5% or $10,000 of the non-resident Vendor's price, then none of the North Carolina resident Vendors qualify for the price-matching preference and no review of a resident Vendor's Certification is required. If the lowest price bid by a Vendor meeting requirements was submitted by a non-resident Vendor and there are one or more North Carolina resident Vendors that submitted a price bid that was within 5% or $10,000 of the non-resident Vendor's price, then the University will determine if the Vendor has requested a price-matching opportunity, review the Certification(s) of the resident Vendor(s) to determine whether the resident Vendors have properly executed the Certification and ensure that the information and documentation provided in or with the Certification or otherwise submitted to the University supports the resident Vendor(s) qualification to exercise the price-match opportunity. The University may seek clarification of the Certification and/or information in a resident Vendor's Certification and request additional information and documentation, if needed. If any resident Vendor's award is challenged in a bid protest, based on the accuracy of that Vendor's claim of qualification for the price-matching, the resident Vendor shall provide additional information and/or documents to the University within five (5) business days of receiving a request from the University for such information and/or documentation, or its award shall be subject to cancellation. Pursuant to G.S. §132-1.1, §105-259(b) and Paragraph 13 of the Instructions to Bidders, the University is prohibited from making public disclosure of the Vendor's tax information and documents submitted (subject to those exceptions set out in G.S. §105-259 (b)) and the University shall preserve the confidentiality of the tax information and/or documents received in response to a request for clarification or to resolve a bid protest challenging a resident Vendor's qualification for the price-matching preference in accordance with applicable law. In order to further preserve the confidentiality of any Vendor's tax information and documentation provided to the University, the Vendor shall comply with Paragraph 12 of the Instructions to Bidders and mark "CONFIDENTIAL" at the top and bottom of each page of such information and documentation. After review of all relevant material, the University shall include in its recommendation for award a finding that the North Carolina resident Vendor(s) is or is not qualified for the price-matching opportunity. If more than one North Carolina resident Vendor qualifies for the price-matching opportunity, then the University will prioritize the qualified North Carolina resident Vendors according to the prices bid, from lowest to highest, so that the qualified North Carolina resident Vendor that submitted the lowest bid receives the first opportunity to match the bid price of the lowest non- resident Vendor that met all IFB requirements. If the lowest qualified North Carolina resident Vendor that met all IFB University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 16 requirements declines to accept contract award, then the contract will be offered to the next lowest qualified North Carolina resident Vendor meeting all IFB requirements and continue in this manner until either a qualified North Carolina resident Vendor accepts the contract award or the award is made to a non-resident Vendor if no qualified North Carolina resident Vendor agrees to match the lowest price bid. If two resident Vendors qualify for the price-matching opportunity, and both score the same on price, then the University may: (1) consider the information provided in those Vendors' Certifications or publicly available information to determine with which Vendor the contract award would have a greater impact of stimulating or sustaining the North Carolina economy and/or is most likely to create or save jobs (e.g., if the choice is between a resident broker and a resident manufacturer of the subject goods, then the contract will be awarded to the resident manufacturer); (2) consider the unemployment rates in the municipality or county where each Vendor's principal place of business is located; (3) seek clarification from the Vendors to ascertain the impact on their respective businesses if offered the award of the contract; or (4) utilize any other approved method of deciding between equal bids. If a resident Vendor requests and qualifies for the price-matching preference, the resident Vendor will be notified of its opportunity to agree to match the lowest price and receive contract award, and it will have two (2) business days from the date and time of such notification to indicate its response, either agreeing or declining to match the lowest responsible non-resident Vendor's price and receive the contract award based on that price match. If the IFB requests bids on alternative configurations or components, then the price match shall apply to the actual alternative chosen by the University. If at any time during or after the procurement process (including but not limited to clarifications and resolution of bid protests) the University determines that: any certifications or information in the Certification is false, substantially inaccurate, materially misleading or that the Vendor failed to provide, within the specified time period, any additional information requested, then the University may: (1) Cancel any award, contract and/or purchase order that was awarded to such Vendor based on the price-matching preference, and the resident Vendor shall be liable for all costs incurred as a result of the cancellation, including any increased costs the University may incur as a result of awarding the contract to another Vendor; (2) Bar the Vendor from all price-matching opportunities in future University procurements for a period of time not to exceed three (3) years, exclusive of any debarment period; (3) Take action against the Vendor under the False Claims Act, G.S. §1-605 through §1-617, inclusive, for submitting a false Certification for the price-matching preference under Executive Order #50 (including but not limited to treble damages and civil penalties); and/or (4) Debar Vendor from doing business with the State of North Carolina for a period of time not to exceed three years, as determined by the University. Any such debarment period shall not begin to run until all damages, costs and penalties as may be assessed against such Vendor have been fully paid. ALL VENDORS (BOTH RESIDENT AND NONRESIDENT) SHOULD ANSWER QUESTION #1. A RESIDENT VENDOR REQUESTING A PRICE-MATCHING OPPORTUNITY MUST ANSWER BOTH QUESTIONS: 1. Vendor is a resident of North Carolina as defined in G.S. §143-59? [ ] YES [ ] NO 2. Resident Vendor requests a price-matching opportunity? [ ] YES [ ] NO University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 17 The following Sections shall be completed if a resident Vendor is requesting a price-matching opportunity: a) PART I – EO50 Please check the applicable boxes below, in order to be considered for the price-matching preference under Executive Order #50 and G.S. §143-59(c)(1). [ ] I hereby certify that the Vendor paid unemployment taxes to the State of North Carolina for the most recent quarter or annually, and has specifically done so for the last such payment period. [ ] I hereby certify that the Vendor paid income taxes to the State of North Carolina each calendar quarter, or otherwise annually, and has specifically done so for the last such payment period. b) PART II – EO50 1. I hereby certify that the Vendor's principal place of business is located in North Carolina. A. Business Type (Please check the applicable box): [ ] Corporation (all types) [ ] Limited Liability Company [ ] General Partnership [ ] Limited Partnership [ ] Limited Liability Partnership [ ] Sole Proprietorship [ ] Individual [ ] Unincorporated Association [ ] Other: _________________________________________ B. Provide address of principal place of business: _____________________________ Street Address (no P.O. Box number) _____________________________ City, State, Zip Code Is the above address the location of Vendor's headquarters? [ ] YES [ ] NO If Vendor has a public website, provide the link/address: _________________________________ C. ATTACH A COPY OF VENDOR'S MOST RECENT FILINGS WITH THE NORTH CAROLINA SECRETARY OF STATE (such as Vendor's Certificate of Authority, Annual Report or such other filing that discloses a North Carolina business address for the Vendor). OR (check the box below) [ ] Vendor certifies that its business is not required to make filings with the North Carolina Secretary of State. University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 18 RESIDENT VENDOR'S CERTIFICATION FOR PRICE-MATCHING OPPORTUNITY UNDER EXECUTIVE ORDER #50 NOTICE: The Price-Matching Opportunity will only be given to Vendors that fully complete this affidavit (i.e., all information must be provided, all supporting documents must be attached, the affidavit must be signed by an authorized representative of the Vendor and the affidavit must be notarized) and demonstrate their qualifications for the Price-Matching Preference through the certification and information provided in this affidavit and any other required information. Affidavit of ______________________________________________________ (name of resident Vendor, hereinafter the "Vendor"). The undersigned hereby certifies that he or she has read this certification, that all information provided in Part I and Part II, above, is true and accurate, and that he or she is an officer, member, partner, owner or such managing employee of the Vendor (the "Authorized Representative") that is authorized to execute this affidavit and to bind the Vendor to the certifications, statements and agreements herein. Name of Authorized Representative: ______________________________________________ Signature: _______________________________________________ Title: _______________________________________________ Date: ______________________________________________ NOTARY: State of ________________________________, County of __________________________ Subscribed and sworn to before me this ___________ day of _______________ 20_______ Notary Public: _________________________ My commission expires _________________ [Stamp] University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 19 ATTACHMENT D: PRICING FORM FURNISH AND DELIVER THE FOLLOWING Item Quantity Unit Description Unit Price Total Price Vendors Response (for University use only) Products/ Services offered meets specifications (for University use only) QUESTIONS ABOUT THIS INVITATION-FOR-BID MAY BE EMAILED TO LYNNBARE@EMAIL. UNC.EDU. PLEASE INCLUDE ¿65- 3000008463 QUESTIONS¿ IN THE EMAIL SUBJECT LINE. THE DEADLINE FOR SUBMITTING QUESTIONS FOR THIS INVITATION-FOR-BID IS 07-06- 2020 AT 3:00 EST. ***FOR BID RESULTS REGARDING THIS IFB GO TO THE STATE OF NORTH CAROLINA INTERACTIVE PURCHASING SYSTEM (IPS): WWW.IPS.STATE. NC.US/IPS/PUBMAIN.ASP.***** THIS INVITATION-FOR-BIDS REQUIRES AN ELECTRONIC BID RESPONSE ONLY, EMAIL BID RESPONSES WILL BE ACCEPTED. QUESTIONS RECEIVED PRIOR TO THE QUESTIONS DEADLINE AND THEIR ANSWERS WILL BE INCLUDED IN AN ADDENDUM TO THIS INVITATION-FOR-BID AND POSTED TO THE STATE OF NORTH CAROLINA INTERACTIVE PURCHASING SYSTEM (IPS). PLEASE NOTE OUR ORDERS ARE FOB TO INCLUDE ALL COSTS OF DISTRIBUTION, FREIGHT, AND HANDLING. PLEASE INCLUDE ALL SUCH COSTS IN YOUR QUOTATION. DELIVERY: UNLESS OTHERWISE STATED BY THE BIDDER ON THE EXECUTION PAGE OF THE BID/QUOTE, SUCCESSFUL BIDDER WILL COMPLETE DELIVERY PER REQUESTED DELIVERY DATE. THE UNIVERSITY'S GENERAL TERMS AND CONDITIONS FOR PROCUREMENT OF COMMODITIES AND SERVICES (00000223.DOC 12) GOVERN THIS PROCUREMENT. 1 10.00 EA Planmeca PlanCad Easy-Design & Mill (FE004261) [ Y ] [ N ] [ Y ] [ N ] 2 10.00 EA Planmeca Emerald Scanner Cradle (15682501) [ Y ] [ N ] [ Y ] [ N ] 3 1.00 EA Planmeca Scheduled Phone Support for SW Projects (SERVICE PS) [ Y ] [ N ] [ Y ] [ N ] 4 10.00 EA Planmeca Emerald S Loyalty (15600004-L) [ Y ] [ N ] [ Y ] [ N ] 5 10.00 EA Planmeca Compare Software License - Dental School Only (40000099) [ Y ] [ N ] [ Y ] [ N ] 6 1.00 EA Integration Training 1-Day in-office for up to 4 people [ Y ] [ N ] [ Y ] [ N ] University of North Carolina at Chapel Hill Procurement Services CB#1100, 104 Airport Drive Suite 2700 Chapel Hill, NC 27599-1100 Telephone 919-962-2251 FAX 919-962-0636 BID NUMBER MUST APPEAR ON ALL QUOTATIONS AND RELATED CORRESPONDENCE 20 Bid Number: 3000008466 ATTACHMENT E: CERTIFICATION OF FINANCIAL CONDITION Name of Vendor: The undersigned hereby certifies that: [check all applicable] [ ] The Vendor is in sound financial condition and, if applicable, has received an unqualified audit opinion for the latest audit of its financial statements. Date of latest audit: _____________________________ [ ] The Vendor has no outstanding liabilities, including tax and judgment liens, to the Internal Revenue Service or any other government entity. [ ] The Vendor is current in all amounts due for payments of federal and state taxes and required employment- related contributions and withholdings. [ ] The Vendor is not the subject of any current litigation or findings of noncompliance under federal or state law. [ ] The Vendor has not been the subject of any past or current litigation, findings in any past litigation, or findings of noncompliance under federal or state law that may impact in any way its ability to fulfill the requirements of this Contract. [ ] He or she is authorized to make the foregoing statements on behalf of the Vendor. Note: This shall constitute a continuing certification and Vendor shall notify the Contract Lead within 15 days of any material change to any of the representations made herein. If any one or more of the forgoing boxes is NOT checked, Vendor shall explain the reason in the space below: _____________________________________________________________________________________________ Signature: _______________________________ Date: _____________________________ Printed Name: ____________________________ Title: ______________________________ [This certification must be signed by an individual authorized to sign/execute for the Vendor.] The University of North Carolina at Chapel Hill Accounts Payable, Attn: Vendor Coordinator 104 Airport Drive, CB #1220 Chapel Hill, NC 27599-1220 vendor_coordinator@unc.edu T 919-843-5049 F 919-962-2356 The University of North Carolina at Chapel Hill requires all campus vendors to complete this form in order to establish an electronic payment method. The University requires payees to receive payments electronically. Your payments will be deposited into the checking or savings account of your choice. You may also elect to receive email notifications of direct deposit. To receive payments electronically, please complete this form, print, attach a voided check and return it to the Vendor Coordinator via US Mail, or email (addresses above). This form authorizes ACH direct deposit payments (not wire transfers). Account Holder Name: Federal ID (TIN/SSN): Bank Name: Bank Routing Number: Account Number: Checking Savings Remit Address(s) for Applicable Accounts(s): Email address for payment notification: Authorized Signature Printed Name: Date: Electronic Payment Authorization for Vendors Revised 5/2/2018 1218.1.2f Direct Deposit Authorization Form for Vendors mailto:vendor_coordinator@unc.edu VENDOR COORDINATOR Accounts Payable & Travel Services 104 AIRPORT DRIVE, Suite 3500 CHAPEL HILL, NC 27599-1220 T 919.843.5049 Submit by email to: vendor_coordinator@unc.edu 1218.1.3f VENDOR MASTER FILE RECORD DATA FORM (HUB Form) IRS INFORMATION: Complete IRS form W-9 and return with this form. https://www.irs.gov/pub/irs-pdf/fw9.pdf CONTACT INFORMATION: REMIT TO: ORDER FROM: SAME AS REMIT TO Vendor Name: Vendor Name: Contact Name: Contact Name: Address 1: Address 1: Address 2: Address 2: City: State: Zip: City: State: Zip: Phone: Phone: E-Mail: E-Mail: Website: Website: NC HUB Certified: Yes No (attach documentation) for more information, visit: www.doa.nc.gov/hub Black Female Asian American Hispanic Disabled Disadvantaged American Indian Federal Certifications: Certified with SBA/VA or self-certified with Federal Government Yes No (attach documentation), for more information, visit https://certify.sba.gov/am-i-eligible SDB (small disadvantaged business) SBE (small business enterprise) HubZone (historically underutilized small business) VOSB (Veteran-owned small business) DVOSB (service-disabled Veteran-owned small business) WOSB (women-owned small business) SIZE OF BUSINESS: Small Large To determine if business is small or large, visit SBA site: https://www.sba.gov/document/support--table-size-standards I CERTIFY THAT (1) I AM DULY AUTHORIZED TO COMPLETE THIS FORM; (2) THE LEGAL ORGANIZATION SHOWN ON THIS FORM IS CORRECT, AND (3) I am not on the Federal Debarred Vendor list https://www.sam.gov/portal/SAM/#1#1 or the NC Debarred Vendor list https://ncadmin.nc.gov/government-agencies/procurement/contracts/debarred-vendors SIGNATURE TITLE DATE PRINT NAME WBE (women business enterprise) HBCU/MI (historically black colleges and universities or minority institutions) MBE (minority business enterprise) Alaska Native Corporations and Indian Tribes Other SBA 8(a) certifications and programs: (specify) Updated 8-03-2018 https://www.irs.gov/pub/irs-pdf/fw9.pdf http://www.doa.nc.gov/hub https://certify.sba.gov/am-i-eligible https://www.sba.gov/document/support--table-size-standards https://www.sam.gov/portal/SAM/#1 https://ncadmin.nc.gov/government-agencies/procurement/contracts/debarred-vendors Form W-9 (Rev. November 2017) 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. 11-2017) Form W-9 (Rev. 11-2017) 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 28% 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. 11-2017) 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. 11-2017) 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 a