Wire EDM Machine

I CALHOU N COTWI tWI UN ITY COLLEGE Post Office Box 221 6 . Decatur, Alabama 35609-22 I 6 . Phone 256-306-2500 . w.calhoun.edu December 5,2022 To Whom It May Concern: Calhoun Community College will receive sealed bids for the following item(s): , Bid #23-04: Wire EDM Machine Bids will be received in the Business Office until2:30 P.M. on December 20,2022. All bids received after this time will not be considered. Bids will be opened and read aloud. Please mail your bid response to: Calhoun Community College, Attention: Purchasing Office, P.O. Box 221.6, Decatur, Alabama 35609 or 6250 Highway 31 North, Tanner, Alabama 35671,. Bids must be received by the time and date listed above, not postmarked. Please note that Fed-Ex, UPS, and USPS have experienced delivery delays. Bidders may also hand deliver a bid response to the Purchasing Office in the Math, Science, and Administration Building on the Tanner Campus during regular business hours, Monday-Thursday 8:00 AM-4:30 PM. If you wish to

partake in the bid opening, you may teleconference into the opening by dialing216-306-2686. lf your comftany will not be submitting a bid, you must complete the "No Bid Response Eorm" and it to the address in order to remain on bid lists. Any questions regarding the specifications of this bid may be directed to Vanessa Looney, at256-306-2686 or vanessa.looney@calhoun.edu. Thank you for your interest in Calhoun Community College. Sincerely, Ua*o^aLcnwr, {) Vanessa Looney Director of Purchasing and Accounts Payable Page 1 of 21 a J 4 5 CALHC)UN CON/I\,4UNITY COLLEGE P4t Offlco Box 2216 . De.rli Alabam. 3 5609-22 t 6 . phoo256-106,2500. \l1e,responsibility for damage in transit. Page 2 of 2! 6. Bid prices are not to include tax. The College is an Institution of the State of Alabama. If your company gives a discount, this must be included in the quote. I CALHOUN COTVI'VI U N ITY COLLEGE Po.t Ofaice Sox 221 6 . D...tui Alabatu 35609-2216 . Phone256-106-2500. wlv,alhoun.ed! 9. It is the responsibility of the bidder to inspect the facilities (grounds, road access, and buildings) for delivery method, installation and/or set-up of materials, supplies and/or equipment. Failure to inspect the facilities will not relieve the bidder of responsibility to provide for delivery or additional costs associated with delivery, installation and set-up as requested in the bid. 1.0. Reference in the specifications to name brands, cataloe numbers, etc. are used to indicate levels of oualitv. If vou are unable to furnish an item as specified and desire to offer a substitute. eive a full description of the item and send anv descriptive literature. manufacture's specifications, alons with anv supplemental additional soecifications necessarv to comoare the item of equipment bid on with the requirements set forth in the bid sDEcifications. Failure to supplv these specifications mav resuIt in the reiection of the bid. When the bidder does not state brand name or catalog number it is understood 11. Unless otherwise indicated, items furnished under the request must be new. Guarantees/warranties are to be furnished by the vendors as provided by the manufacturer. The responsibility of determining the acceptance of any products offered rests solely with the College. 12. Quantities listed on the specification sheet are believed to be correc! however, the College reserves the right to alter or vary the quantities for a period of sixty days following the bid opening. 13. The contract may be extended for a period of two additional years if no changes are made in the specifications, and/or pricing by the vendor' College and the vendor must agree in writing for the contract extension. 14. The College may cancel any agreement with a successful bidder at any time with a 30-day written notice. 15. The Successful bidder shall be required to submit proof of general liability, automobile, professional liability/ errors and omissions liability and worker's compensation insurance coverages in amounts acceptable to the CoIIege. 16. Bidder shall, at its sole expense, procure and keep in effect all necessary permits and licenses required for its performance of the requested work or service. 17. Successful bidder must provide a copy o{ current state, county or city business license, general contractor's license or applicable license as required by law. Page 3 of 21 the offer is exactly as specified. a CALHOU N CON4 N/ U NITY C)LLEGE Post Ofti.e Box 2216 . Decalui Alabama 15609-2216 . Phone 25 6-3 06-2500 ! wlv,alhoun.€du 18. Alabama Law (Section 41-4-1,16, Code of Alabama 1975) provides that every bid submitted and contract executed shall contain a certification that the vendor, contractor, and all of its affiliates that make sales for delivery into Alabama or leases for use in Alabama are registered, collecting, and remitting Alabama state and local sales, use, and/or lease tax on all taxable sales and leases into Alabama. BY SUBMITTING THIS BID, THE BIDDER IS HEREBY CERTIFYING THAT THEY ARE IN FULL COMPLIANCE WITH ACT NO. 2006-557, they are not barred from bidding or entering into a contract pursuant lo 4'1.-4-1L6, and acknowledge that the awarding authority may declare the contract void if the certification is false. 19. Al1 items are to be free from defects in material and workmanship. If items are found to be defective or damaged or are non-conJorming to the bid specifications, or there is unsatisfactory installation, items shall be corrected to the College's satisfaction by the successful bidder at no additional cost to the College. If a company is awarded a bid and the company cannot honor the terms of the bid, the company may be removed from the College's preferred vendor list. 20. Payment shall be contingent upon the College's inspection of and satisfaction with completed work or supplied materials. 21. As an entity of the State of Alabama, the parties recognize and agree that College cannot and will not agree to indemnify any Party to an agreement resulting from this bid. 22. Atter the bids are opened., all bids become the property of the College and will be made available for public inspection. 23. The proposal is to be made without connections with any other person/ company/ or party making a bid proposal and is to be in all resPects fair and in good faith, and without collusion or fraud. 24. The College reserves the right to purchase according to availability of funds. Bid awards are subject to change or cancellation due to unanticipated decrease in funding (including tuition, local, state or federal). Bid awards are also subject to change or cancellation due to changes in local, state, federal laws, regulations or policies or in changes in the policies of the Board of Trustees of the Alabama Community College System or the Alabama Community College System. Page 4 of 21 I CALHOUN COIVITVIUNITY COLLEGE Pdt OItice Box 2215 . Deatqr. Alabda 35609-2215 . Phone 256-106-2500 . wt*,qlhosn.ed! 25. In the event of proration of the fund from which payment under which this agreement is to be made, the agreement will be subject to termination. 26. The College will not accept prepay terms for the items and services in this bid. 27. All bidders are required to complete a Disclosure Statement. Act 2001-955 requires the Disclosure Statement (included with this bid request) be completed and filed with all proposals, bids, contracts, or Srant proposals to the State of Alabama in excess of $5,000.00. Any changes to the status of the inJormation on this form will require the submission of an updated form to the College. 28. Nonresident Bidder Information: Section 39-3-5 of the Alabama Code provides as follows: Preference to resident contractors in letting of certain public contracts: reciprocity. (a) In the letting of public contracts in which any state, county, or municipal funds are utilized, except those contracts funded in whole or in part with funds received from a federal agency, preference shall be given to resident contractors, and a nonresident bidder domiciled in a state having laws granting preference to local contractors shall be awarded Alabama public contracts only on the same basis as the nonresident bidder's state awards contract to Alabama contractors bidding under similar circumstances; and resident contractors in Alabama, as defined in Section 39-2-12, be they corporate, individuals, or partnerships, are to be granted preference over nonresidents in awarding of contracts in the same manner and to the same extent as provided by the laws of the state of domicile of the nonresident. (b) Nonresident bidders must accompany any written bid documents with a written opinion of an attorney at law licensed to practice law in such nonresident bidders' state of domicile, as to the preferences, if any or none, granted by the law of that state to its own business entities whose principal places of business are in that state in the letting of any or all public contfacts. (c) A summary of this law shall be made a part of the advertised specifications of all projects affected by this law. (Acts 1984, No. 84-228, p. 348; Act 2001'-637, s1.) 29. Personal Property or contractual services In{ormation, 41-16-57 provides as follows: (b) The awarding authority in the purchase of or contract for goods or services shall give preference, provided there is no sacrifice or loss in price or quality, to commodities produced in Alabama or sold by Alabama persons, firms, or corporations. Notwithstanding the foregoin& no county official, county Page 5 of 21 I CALHOUN COIVIN/UNITY COLLEGE Post Om.€ Box 2216 . D*alui Alabih. 35609-22 I 6 . Phone 256-305-2500 . M.c.lhoun,edu commissio& city council or city councilmen, or other public official charged with the letting of contracts or purchase of goods or services may specify the use of materials or systems by a sole source, unless: (1) The governmental body can document that the sole source goods or services is of an indispensable nature, all other viable alternatives have been explored, and it has been determined that only these goods or services will fulfill the function for which the product is needed. Frivolous features will not be considered. (2) No other vendor offers substantially equivalent goods or services that can accomplish the purpose for which the goods or services are required. (3) All information substantiating the use of a sole source specification is documented in writing and is filed into the project file. 30. The successful bidder will be required to complete the Alabama Immigration Law Compliance Documents. Alabama laws require that, as a condition for the award of a contract by a college to a business entity or employer with one or more employees working in Alabama, the business entity or employer must provide documentation of enrollment in the E-Verify Program. During the performance of the contract, the business entity or employer shall participate in the E-Verify program and shall verify every employee that is required to be verified according to the applicable federal rules and regulations include an ex Memorandum of Understanding upon completion in the E-verify enrollment process located at the federal web site www.uscls. v/everifv. The Alabama Department of Homeland Security 1mm1 ation.alabama. has also established an E- Verify employer agen t account for any business entity or employer with 25 or fewer employees that will provide a participating business entity or employer with the required documentation of enrollment in the E-Verify program. An Employer Identification Number (EIN), also known as a Federal Tax Identification Number, is required to enroll in E-verify or to establish an E-verify employer agent account. By signing this contract, the contracting parties affirm, for the duration of this agreement, ttr-at ttrey will not violate federal immigration law or knowingly employ, hire, for employment, or continue to employ an unauthorized alien within the state of Alabama. Furthermore, a contracting party found to be in violation of this provision shall be deemed in breach of this agreement and shall be responsible for all damages resulting there from. Page 6 of 21 An entity can obtain the E-Verify I CALHOUN COMN/IUNITY COLLEGE Po.t ofii.e B6x 2216 . Dor covering Limestone County, Alabama. d. This Agreement shall be governed by and construed in accordance with the laws of the State of Alabama without giving effect to any choice or conflict-of-laws, provisions or rules (whether of the State of Alabama or any other judsdiction) that inrould cause the application of the laws of any jurisdiction other than those of the State of Alabama. e. These terms and conditions shall supersede any contrary language in any agreement entered into by the parties. A11 terms shall be reduced to writing and will not rely on any oral terms, nor shall any oral terms or agreement be incorporated herein. f. By signing this contract, the contracting parties affirm, for the duration of the uiruu--"rrt, that they will not violate federal immigration law or knowingly employ, hire for employment, or continue to employ an unauthorized alien within the staie of Alabama. Furthermore, a contracting party found to be in violation of this provision shall be deemed in breach of the agreement and shall be responsible for all damages resulting therefrom." g. In compliance with Act 2016-312, the contractor hereby certifies that it is not" currentiy engaged in, and will not engage in, the boycott of a person or an entity based in or doing business with a jurisdiction with which this state can enioy open trade. h. This agreement constitutes the sole and entire aSleement of the- parties of this agreerient with respect to the subject matter contained herein, and supersedes all Page 7 of 2! a 31. 32 CALHOUN COIVIN/I UNITY COLLEGE Po.tOmc€ Box 2216 ' D€arui Al.bda 15509-2216 . Phone 256-306-2500 ' M..alhoun.€du prior and contemporaneous understandings, negotiations, and agreements, both oral and writterL with respect to such subject matter. This agreement may be executed in counterparts, each of which shall be deemed and original, but all of which together shall be deemed to be the same agreement. Equipment purchases using Federal grant funds: When purchasing equipment using Federal grant funds, the College will give preference to bidders of diversity and minority owned businesses' Please note on the Collusion/Fraud statement whether this applies to your company. In compliance with Division B, Title V, Section 505 of Public Law 115-245, Consolidated Appropriations Act, 2019: 1. One hundred percent (100%) of the cost for the service/product will be financed with Federal funds. 2. The dollar amount of Federal funds for this project/service will not exceed $200,000. Once $200,000 is reached, the product/service will be re-bid. 3. No part of the project/service will be financed by non-governmental sources. Page 8 of 21 I CALHOU N COI\,4IV1 U N ITY COLLEGE Post Ofiice Box 2216 . De.rui Alab a 35609-2216 . Phone 256'306-2500 . wlg.€lhoun,edu Bid #23-04 Wire EDM Machine Specifications EDM MACHINE FEATURES . Submerged Machining to 8.7 inch with stainless steel work tank with self-cleaning stainless steel seal plate and seal plate movement transfer mechanism. . Automatic Level Control sets the DI fluid level to the correct height according to the Z-axis position. . Vertical Movement Machining Tank Door space saving door designed to operate in two easy motions without removing your hands from the door. Equipped with a safety switch that will not allow a tank fill with the door open or ajar. . Fine Grain Dianite Casting Material designed using CAE (computer aided engineering) . Split-Axis Design The X and Y-axis ways mount directly to the "T" shaped cast base moving the table in X and the column in Y providing thermal stability and rigidity for handling workpiece weights of up to 1100 lbs. . AC-Servo (Closed Loop) Torque Control Wire Tensioning System with finer, more stable wire tensioning and increased part accuracy and consistency. . Linear Shaft Motors that provide a noncontact zero wear drive system in X, Y axes that insures accurate table movement with zero backlash. . Linear Motion Guide Ways support all the machine axes. The size, spacing and location of these ways promote stable operation throughout the entire machining range. . Optical Servo Drive System uses all fiber optics between the control, servo amps and linear shaft motors providing 4x faster communications speed improving IesPonse time which allows cutting accuracy and high-speed positioning. . All-Axes Absolute Control System enables high-accuracy positioning without returning to the zero point after a power failure. . Linear Glass Scales, new (50nm) 2 millionths absolute scales, standard equipment on theX&Yaxes. Page 9 of 21 I CALHOU N COI\./t tvl U NITY COLLEGE P6.t office B6x 22r6 ' Dsolutions for the operator and system software updating via USB flash drive o High speed positioning and graphical part plotting o Multi-tasking control allows complete graphic program checking of the next job while the current job is in progress. o High Accuracy Edge Positioning provides edge and center pickup modes for the workpiece positioning. o Consumables Management allows the oPerator to set estimated life cycles for each consumable and then displays the status on the control screen. Remote End User Monitoring (phone, tablet, computer) Remote Diagnostics & Fault Remote Support Service POWERSUPPLY . v350 Type V Anti-Electrolysis Power supply and DMx-s (Digital Matrix control Sensor), specifically shape each spark to improve surface finish, reduce vibration and minimize electrode wear. V350-V means HIGH-SPEED. 24 sq." /hr. with .012" brass wire. 38 sq."/hr. with.012" Type D wire. . AE II Processing, full anti-electrolysis protection from the rough cut through the finish skim cuts the loss of hardness on the machined surface as the invisible cracking throughout the part surface. Page 13 of 21 I CALHOUN COIVItVI UNITY COLLEGE Post Office Box22l6 . Decatur, Alabama 35609-2216 . Phone 256-306-2500 . w.calhoun.edu Bid #23-04 Wire EDM Machine Specifications (Continued) The AE II Power Supply ... * eliminate electrolytic deterioration and corrosion. * Increases carbide punch/die life by reducing the depletion of the cobalt binder. * Reduces polishing required in molds to remove the effects of electrolytic corrosion created with standard EDM processing * Helps prevent iron-based materials from rusting. * Helps prevent titanium and aluminum alloys from oxidizing. * Increases DI resin life . SL Control finish control system that greatly reduces lines or fine steps in varying thicknesses of workpieces while improving part straightness. . MP Circuit fine-pulse control technology that allows more precise discharge energy resulting in shorter machining times, particularly with fine wire sizes. . RL Circuit high voltage, high off time, fine pulse control technology that allows precise discharge energy and machining of low conductivity materials . HL Circuit designed to be used when part straightness is of absolute priority. . Adaptive Control protects against wire breaks, accuracy losses, and finish disruptions. . PI Circuit a voltage modulation type power source for edge pick-up or wire squaring with no damage to the workpiece, wet or dry. POWER SUPPLY GENERAL SPECIFICATIONS Power Requirement .....3 phase 208 *5% VAC Page L4 of 27 I CALHOUN COMN,/lUNITY COLLEGE Post Olfice Box 2216 . Oeatui Alabe. 15609"22 1 5 ' Phohe 255-305-2500 . ww.olhoun.ed! Bid #23-04 Wire EDM Machine Specif ications (Continued) WIRE CUT EDM SPECIFI CATIONS Max. Workpiece Dimensions (in) Workpiece Weight (lbs) ................ Table Dimensions (in) (3-sided) Machining Range (in) ............ U/V Travel (in) Resolution (in) (Absolute Scales) ......... Taper Angle ........... Table Rapid Feed (in / min) Wire Diameter (in) ......... Minimum Wire Tfuead Start Hole (in) ........... Maximum Workpiece AT Height (in) ......... Wire Tension (g) ......... 000002 (2 Millionths) 150 @ 8.0" ...31.9 x 27.6 x8.5 ..1,100 .....,......25.2 x 17.7 15.7 x1'1".8x8.7 !2.4xt2.4 .5L.2 004-.012 (.010 std.) ...020 ...8.7 50 - 2500 Wire Spooling Speed (in / sec) ......................0 - 11.8 ...................Paper cartridge (2x)Filter System Filter Precision .5 micron Ion-Exchange Resin ........... 11P. (6.4 gal. dry) Filter Tank Capacity (gallons) 1,45 Dielectric System Dimensions (i") ............ dimensions Dielectric System Weight (lbs.) weight Overall Machine Unit Dimensions (in) ........... .....79.7 x105.4x79.3 Machine Weight (lbs.) ....... STANDARD FEATURES Intelligent Auto-Threader Chiller FTS 10 KG (221b) Wire Spool Wire Alignment Gauge Auto Oiler Auto Power Recovery Advanced Hand Pendant Box (Provides extended features and LCD screen) 3-Sided Table (Three-Piece Hardened Stainless) Basic Workpiece Clamping Kit (Directly clamps parts to the machine) TableOne set of 0.010" Round Diamond GuidesFast FiIl Pump ....Included in machine Included in machine ....5,952 Page 15 of 21 I CALHOUN COMN,4 UNITY COLLEGE P6t of,lce Box 2215 ' Osrtui Alabama 35609-2216 . Phohe256-306.2500. ww.calhoun.edu Bid, *2344 Wire EDM Machine Specif ications (Continued) 16-Step Programmable Flushing Control Angle Master (Guides and flush cups not included) Linear Scales X, Y (50nm) 2 millionths absolute scales) Cylinderical LSM Drives (Linear Shaft Motors X, Y) Small Wire Device .004" (Does not include guides) DI Resin System (1.4 cu. ft. fiberglass cylinder 2x) 2 USB Ports DNC Hardware (Ethernet FTP) Remote 360 (Included throughout the standard warranty period) Preventative Maintenance (PM) One (1) Year Warranty (Covers all parts & labor, travel/ shipping costs) TRAINING: Price includes attendance, at any time for up to (4) individuals throughout warranty period, to Level 1 (Fundamental Operation) and Level 2 (Optimization and Applications) Training Seminars Pricing must include shipping/delivery to: Calhoun Community College 6250 Highway 31 North Tanner, Alabama 35671 Page 16 of 21 I CALHOUN COTVI fV1 U N ITY COLLEGE Post Office Box 2216 . D*atur, Alabama 356O9-2216 . Phone 256-306-2500 . w.calhoun.edu Bid#23-04 Wire EDM Machine Pricing One (1) Wire EDM Machine (as described) Vendors should provide one (1) copy of a response package describing the product offered, as well as, itemization of the price specified above. Comments or other information: $ Name of Company (TypSfPrint in Ink) Authorized Signature (Sign in Ink) Complete Address for Mailing Purchase Order and Payment Type/Print Above Signature City State Zip Title Telephone Number Fax Number Page L7 of 2L Y a CALHOUN COIWIIWl UNITY COLLEGE Post Office Box 221 6 . D*atuG Alabama 35609-22 16 . Phone 256-305-250O . w.calhoun.edu Bid #23-04 Wire EDM Machine No-Bid Response Form I HEREBY SUBMTT THIS AS A'NO BID' FORTHE REASONS CHECKED BELOW: Insufficient time to respond -We do not offer the product or service requested -Our schedule will not permit us to respond to this bid -Keep our company on this bid list for future bids -Remove our company name from this bid list for future bids Other (describe briefly) Name of Company (Type/Print in Ink) Authorized Signature (Sign in Ink) Complete Address for Mailing Purchase Order and Payment Type/Print Above Signature City State Zip Title (Type/Print) Telephone Number Fax Number Page 18 of 21 I CALHOUN COTV1IVIUNITY COLLEGE Post Office Box 221 6 . Deatur, Alabama 35509-2216 . Phone 256-306-2500 . M.€lhoun.edu Bid#23-04 Wire EDM Machine Collusiory'Fraud Statement I certify that I have read the General Conditions and Instructions to Bidders of the bid and this offer is made without prior understanding, or connection with any entity or person submitting a bid for the same materials, supplies or equipment, and is in all respects fair and without collusion or fraud. I am authorized to sign this bid for the bidder. I agree to abide by all conditions of this bid request. Name of Company (Type/Print in Ink) Authorized Signature (Sign in Ink) Complete Address for Mailing Purchase Order and Payment Type/Print Above Signature City State zip Title (TypelPrint) Telephone Number Fax Number NOTARIZATION: Sworn and subscribed before me this the - day of- Please affix seal below Notary Public Signature My commission expires (date) MINORITY INFORMATION If this business is minority owned, please list the qualification status: Page 19 of 21 CALHOUN COIVITVI U N ITY COLLEGE Poit Office Box 221 6 . Deatur, Alabma 35609-22 I 6 . Phone 255-306-2500 . w.qlhoun.edu Bid #23-04 Affidavit of Alabama Immigration Law Compliance In compliance with SECTIONS 9 (a) and (b) BEASON-HAMMON ALABAMA TAXPAYER AND CITIZEN PROTECTION ACT (the "Act"); CODE OF ALABAMA, SECTIONS 31-13-9 (9a) and (b), this Affidavit of Alabama Immigration Law Compliance is to be completed and signed by an officer or owner of a contractor or grantee and notarized, as a condition for the award of any contract by Calhoun Community College to an employer that employs one or more employees in the State of Alabama and is a recipient of funds from Calhoun Community College. Contractors and Grantees are to provide notice to their Subcontractors of their Alabama Immigration Law Compliance obligations. State of Alabama: Countuof : Before me, a notary public, personally appeared (print name) who, is duly authorized by the business entity/employer which appears below, being sworn, says as follows: As a condition for being a contractor or grantee on a project paid for by contract, grant, or incentive by the State of Alabama, or any political subdivision thereof, or any state-funded entity, I hereby attest that in my capacity as (your position) for Grantee does not knowingly employ, hire for employment, or continue to employ an unauthorized alien. Further, Contractor of Grantee affirms that it is providing notice to its subcontractors of their Alabama Immigration Law Compliance obligations. I further attest that said Contractor or Grantee is enrolled in the E-Verify program and have affixed below said Contractor or Grantee's E-Verify Employment Eligibility Verification User Identification Number confirming such program enrollment. I have read this Affidavit and swear and affirm that it is true and correct. E-Verify Employment Eligibility verification user Identification Number Signature of Affiant Sworn to and subscribed before me this day of . ) I certify that the affiant if known (or made known) to me to be the identical party he or she claims to be Signature and Seal of Notary Public TO BE RETURNED TO CALHOUN COMMUNITY COLLEGE. Page20 of 27 I **A complete E-Verify printout will be required before the issuance of a purchase order. I CALHOUN C:OIVIN,4 UNITY COLLEGE Port Omce Box 2216 r Deatuir Ala6ama 15609-2216 . Phone256-306-2500. w*v.athoun,ed! Bid,#23-04 Wire EDM Machine Checklist o Bid Pricing Sheet(s) o Collusion/FraudStatement . Vendor Disclosure Statement r Affidavit of Alabama Immigration Law Compliance. If you do not believe these requirements are applicable to your entity, include an explanation justifying such exemption. . Reference Websites: . www.uscis.gov/everify o http://immigration.alabama.gov Page 27 of 2L CALHOUN COMMUNITY COLLEGi E Post Oflice Box 2216 . Decatur, Alabama35609-2216 . Phone 256-306-2500 . www.calhoun.edu To Whom It May Concern: Vendor Disclosure Statement Information and Instructions Act 2001-955 requires the disclosure statement to be completed and filed with all proposals, bids, contracts, or grants proposals to the State ofAlabama inexcess of $s,000.00. The state ofAlabama shall not enter into any contract or appropriate any public funds with any person who refuses to provide information required by Act 2001-955. Pursuant to Act 2001-955, any person who knowingly provides misleading or inconect information on the disclosure statement shall be subject to a civil penalty of ten percent (10%) of the amount of the transaction, not to exceed $10,000.00. Also, the contract or grant shall be voidable by the awarding entity. Delinitions as Provided in Act 2001-955 Family Member of a Public Employee- The spouse or a dependent of the public employee. Family Member of a Public Official- The spouse, a dependent, an adult child and his or her spouse, a parent, a spouse's parent, a sibling and his spouse, of the public official. Family Relationship- A person has a family relationship with a public official or public employee if the person is a family member of the public official or public employee. Person- An individual, fi rm, partnership, association, joint venture, cooperative, or corporation, or any other group or combination acting in concert. Public Ofliciat and Public Emptoyee- These terms shall have the same meaning ascribed to them in Sections 3-25-l(23) and36-25-lQ4), Code of Alabama 1975' (See below) except for the purposes ofthe disclosure requirements ofthis act, the terms shall only include persons in a position to inlluence the awarding ofa grant or contact According to Act 2001-955, Calhoun Community College cannot enter into any contract or appropriate any public funds until the college is in receipt of the attached disclosure form. The following is information and instructions for completing the vendor disclosure form. who are affiliated with the awarding entity. Not withstanding the foregoing, these terms shall also include the Governor, Lieutenant Govemor, members of the cabinet of the Govemor, and members of the Legislature. Section 36-25-l(23), code of Alabama 1975, defines a public employee as any person employed at the state, county or municipal level of government of their instrumentalities, including govemmental corporations and authoritiis, but excluding employees of hospitals or other health care corporations including contract ".ploy.", oithosehospitals or other health care corporations, who is paid in whole or in part from state, county, or municipal funds. For purposes of this chapter, a public "rrrpioy"" does not include a person employed on a part-time basis whoie emp-loyment is timitea to providing professional services other than lobbying, the compensation for which constitutes less than 50 percent of the part-time employee's iniome. S-ection 36-25-1 (24), code of Alabama 1975, defines a pubric official as any person elected to public office, whether or not that person has taken office, by the voie ofthe people at state, county, or municipal hdof govemment or their instrumentalities, - including.govemmental.corporations. For purposes of this chapter, a pubric offrcilr includes the chairs and vice-chairs or the equivalent offices ofeach state politicaipu.ty u. defined in Section l7-16-2, Code ofAlabama1975. Instructions complete all lines as indicated in btue ink lf an item does not apply, denote N/A (not applicable). If you cannot incrude required information in ttre space p.ovided, attaJ additional she^ets as necessary, The form must be signed, dated- and notarized prior to submission. Once you have completed the form, pl&se retum orisinals to: Calhoun Community College Attn: Accounts Payable P.O. Box 2216 Decatur, Alabama 35609-2216 lf you should need additional information, please contact m e at (256) 306-26g6. Sincerely, Ut,tr*u Vanessa Looney Director of Purchasing State of Alabama Disdosure Statement Requlr€d by Artlde 38 of TlUe 41, Code ofAhbama 1975 ENNTYCO PI.EI}IG FORT4 ADDREgII CITY, EWE. ZP XIJTEER SIATE AOEIiCY,SnARn"IAITT}l^I lvll! RECEIVE cooos, sERr/tcES, oR ls RESFONS|AIE FOR CALHOUN COMMUNITY COLLEGE AOOSESS 6 a? MAI8ER DECATUR AL 356,0&2216 25&306-2500 Thls brm is prcidd€d wIh: I co.,*"t D pr**a fJ nequest rr eropoeat fl trwrffi* oeia ! or"r,t prop*r Haw 1ou or any of lour partrers' ([trltlons, (r atty rCsbd hldnseq unltB prwiaoly perffi uork or pltoudad goo& b any q8b Agrancy/Dspartnert ln lhe qrnant or last f,Bcal year? En" nNo tf t€8' ldontify bglolf, the stab AgBncy/Deparhent that ro@lwd tho goods or serviegs, fro typ€(s) d goods or seryicos g busly pm- vlded, and tho arnount r€cor'r€d br the ryo\rlgion of such goods a servt"es. srarE AGENcy/DEpaRt{uiNt TYPE OF GOOOSTSERVICES AI.JOUNT RECEIVIO Ha\ra ltou or arry of AgBncy/DQfftn€nt lo1r per0lsfs' dMdon8, or any rdat€d h/slness units g€vlorrsly appEed and rsceh,a(, ary $anb trom any slab lfl the orr€r or lest fscal ysa/f Evo Exo f y68. idgntlfy he slab &Ency/De9artnent that a!,yarded th6 grant tfie date srrch gnant ti,as asaded, and th€ arnount ot lhg grant. ]OUNT OF GRANI S IATE AGENCY OEPARTTIiENT DATE GRANT AWAROED AODRESSNAIllE OF PUBLIC OFFICIALIENiPLOYEE Page 1 ot 2 l. Llst b€lo,Y lhe nam€(s) ard address(as) of ell publb ohctals/puuic Bmplotees with wttofli you, momban of your hmediato bmfly, or any of pur emplolBes ha\€ a family reladon3hlp and who may dir€dy per8onally b€nefltfrnadally fiom the proposed tansaibn. ldendfy th€ SbtE OePartrnent/Agoncy tor whlch tho public ofidals/publb emptoyees wort. (Atach addruonal she€[s f n€cessary.) I I I 2. LH bels ttrc narre(s) and addreee(es) of all famlly msnbers d publlc ofrdaldpubllc emplrya wllh tifiorn you, members J*, immedhb tsmlly, or any d your enrplryees hao a lbmlly relaflonehlp and who may direcfly personally benefit frnanciallY fiom the propeed bansacdon. ldantfy fie puUlc offidalsrprlbllc employees afd Sffi Departnent/Agensy frr whidt he publc otffict'als/publlc employees rc*. (Attaofi addidonalstteeb if necessary.) lf you Hen0fied lndlvlduale ln lbms one and/or turc ah€, descrlbe in detall tblorr the dlreci flnanclal benefitb be Saln€d by the publlc offidals, puUlc emplqeeq ard/or thelr hmily memberg as tt€ result of the conEact, proposal, requast fur proposal, invtbton b bid, or grant propqoal.Ona* addt$onal sheeB lf rrecessary.) Deecribe in detail belorv aly lridhect finandal benefits b be galned by arry plbllc fficiril, public emplryee, and/or tsmlly members of tre publlc ofrcial or puUlc emplryee as the rcsult of fre conbact, proposal, request for proposal, invlhflon b bld, or grant proposal. (Aftacft addltlonal sheets lf List below the nann(s). and addreso(es) of alt paH consulEnb andlor lo@{sts udlkod b otrtaln the ontract, proposal, reguet fur pro- posal, lnvtbtlon b bE, orgnant proposal: Bystgnlng Hw'l wdfy und*uh awl gtaltydpturythatdl s&ttqtlrints onorat{glcherxbt lsfglrm arctue andcrlnect /iofrl€f€Eito/frny laowlaSe.lfurilr* unfus8irdthatacfldll pwallyof tur pqcont(fl0%o) of {nanountof Uzntansrr;fiorr,t ot (o ucead$r4A0A.@, b apf,ted for ktwlng[y gr,,oldleng firclorrttr;t or mb&sri/lrry lnfonna&ln. Slgnature Date I I $ -t NAINE OF FAIV]ILY METiiBER NAi.JIE OF PUBLIC OFFICIALI PUBLIC ET.,jlPLOYEE STATE DEPARTfulENTI AGENCY iT/IIERE EIiIPLOYEDADDRESS Nota4/s Signature Date Date Notary Expires Articb B of fiile 41, We of Nabama 1975 requiras fne drscbsrre *funent to be ompWed and fited yuft, all prryosrrts, btd$, c,o,tuads; ugrant ry*ts b flre Sraf€ dilahmatn exoessofg6,@0. P age 2 of Z tutbcnnn.,s