S.T.E.A.M. Programs and Workshops

expired opportunity(Expired)
From: City of Takoma Park(City)
# RD-2022-06-03

Basic Details

started - 03 Jun, 2022 (23 months ago)

Start Date

03 Jun, 2022 (23 months ago)
due - 06 Feb, 2024 (2 months ago)

Due Date

06 Feb, 2024 (2 months ago)
Bid Notification

Type

Bid Notification
# RD-2022-06-03

Identifier

# RD-2022-06-03
Recreation Department

Customer / Agency

Recreation Department
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CITY OF TAKOMA PARK, MARYLAND REQUEST FOR PROPOSALS (“RFP”) RFP # RD-2022-06-03 S.T.E.A.M. PROGRAMS AND WORKSHOPS RFP Issuance Date: June 3, 2022 Proposal Submission Deadline: June 30, 2022 at 12:00 p.m. (noon) Contact: Kristen Boone, Recreation Manager City of Takoma Park 7500 Maple Avenue, Takoma Park, MD 20912 Phone: 301-891-7282 Email: KristenB@takomaparkmd.gov mailto:KristenB@takomaparkmd.gov 2 SECTION I – PURPOSE AND BACKGROUND. A. PURPOSE. The City of Takoma Park (“City”) is soliciting proposals for local organizations to provide S.T.E.A.M. (Science, Technology, Engineering, Art, Math) recreation programs, camps and workshops for teen and young adult residents. It is the intent of this RFP to secure a source for S.T.E.A.M. programming for a period of 1 year (July 18 2022 - June 30 2023), with 3 additional 1-year options possible. Funding for subsequent
years will be contingent upon satisfactory performance in the preceding contractual period, and the approval of funding from the Takoma Park City Council. B. SCHEDULE. Issuance of Request for Proposals (“RFP”): June 3, 2022 Deadline for Submission of Proposals: June 30, 2022, at 12:00 p.m. (noon) Evaluation Period: July 1-8, 2022 Contract Award (estimate): July 15, 2022 Contract to Start: July 18, 2022 C. BACKGROUND. The City of Takoma Park is a municipality of approximately 17,000 persons in Montgomery County, Maryland, adjacent to Prince George’s County and the District of Columbia. The Takoma Park Recreation Department offers a variety of recreational classes, workshops, sports leagues, events, and activities for youth, teens, adults, and seniors regardless of ability. The Recreation Department’s mission is to strengthen our community by providing services and facilities to residents that emphasize a healthy lifestyle, physical well-being, personal development, citizen involvement, integration of differing cultural and economic communities, and fun. 3 SECTION II – PROGRAM SPECIFICATIONS AND FUNDING. A. ELIGIBILITY REQUIREMENTS. 1. The S.T.E.A.M. programs and workshops must be offered by a public or private non-profit organization. 2. All programs and/or activities must take place in the City of Takoma Park. 3. Special consideration will be given to: (a) organizations that have prior experience providing cultural, artistic, community and/or recreational activities and programs; and (b) organizations that will incorporate service experiential opportunities for City’s teens and young adults as part of the proposed community recreation activities and programs. B. ELIGIBLE COMMUNITY RECREATION ACTIVITIES AND PROGRAMS. 1. Program starting and ending dates must occur between July 18, 2022, and June 30, 2023. 2. Funds may be awarded for administrative costs, equipment costs, instructors, and staff. Facility rental costs for special programs may be allowed. 3. All promotional and/or printed material for the community recreation activities and programs funded through this grant program must include the following statement: “This program is in partnership with the City of Takoma Park.” Examples of where this statement will be required include: performance programs, enrollment and registration materials and forms, posters, advertising, brochures, newsletters, websites, flyers, newspaper ads, etc. Copies of printed and promotional materials will be required to be submitted as part of the final program evaluation. 4. A written evaluation of each event/program and a final budget must be provided to the City within 30 days from the end of each event/program, including but not limited to: a. Semiannual report (if applicable) of progress, submitted electronically to review program progressing in meeting planned objectives submitted in application b. Final report submitted electronically, with a summary of progress toward accomplishing each program objective with supporting data or data representations to include an assessment of program quality and recommendations for improvements. Additional supporting materials are not required but recommended as part of the progress monitoring: participant work samples (virtual media, student narratives, etc.), and participant photos (if applicable). 5. Approved grant funds must be spent as outlined in the Program Budget or an approved revision to the Program Budget. 4 6. All events must be family friendly and open to teens and young adults (teens being grades 6-12). 7. The City will designate a liaison to oversee the grant contract, including reviewing reports and evaluations, monitoring the budget, and coordinating special requests. C. FUNDING. Grant funds for Fiscal Year 23 (FY23) of up to $20,000 are available through the Community Partnership Program (CP2) for qualified non-profit organizations to provide a variety of STEAM- based recreational activities and programs for teen and young adult city residents. If an organization is planning to apply for funds to conduct more than one activity or program, please separately itemize the expenses per activity or program. The award period for this grant program contract is for FY23 (July 1, 2022, through June 30, 2023). SECTION III – PROPOSAL SUBMITTAL INSTRUCTIONS. A. PROPOSAL DUE DATE. The deadline for proposals submissions is 12:00 p.m. (noon) on June 30, 2022. Requests for extensions of the proposal due date and time will not be granted and no late proposal or late request for modifications will be considered. B. METHOD OF SUBMISSION. Proposals shall be emailed to Kristen Boone, Recreation Manager, City of Takoma Park, at KristenB@takomaparkmd.gov. The email subject line should read “Proposal for S.T.E.A.M. Programs and Workshops, RFP # RD-2022-06-03”. The proposal document should be a single PDF attachment. (A confirmation email will be sent within 24 hours of the receipt of a proposal email. If no confirmation is received within that timeframe or before the deadline date and time, please contact Recreation Manager, Kristen Boone at 301-891-7282 to confirm that the proposal was received.) C. PROPOSAL REQUIREMENTS. All proposals must include the following information to be considered complete. The City reserves the right to disregard any incomplete proposal responses. 1. TECHNICAL FORMAT. a. General: Title page/cover letter on the Organization’s business stationary. The purpose of this letter is to provide a record of the transmittal of the proposal and an acknowledgement of any amendments, addendums, and changes to the RFP. The letter should be signed by an individual who is authorized to commit the Organization to the services and requirements stated in this RFP. 5 The letter should include the RFP name and number, and provide the name and address of the individual or organization, and contact information for the individual or organization (telephone number and email). The attached Qualification and Certification Statement must be completed and included with the proposal. b. Design, Methodology, and Approach: The Organization shall submit a narrative description of the proposed activities and programs to be offered to residents of the City. This project narrative should identify the approach, methodology, goals and objectives, and a timeline/project schedule. The narrative shall also describe how programs, camps and workshops will be evaluated and how it will be determined if the program goals and objectives have been met. Please complete and submit a Program Proposal form attached as Exhibit 1 for each recreation activity or program included in the RFP response. c. Qualifications and Experience: Provide a brief description of the non-profit organization, including the types of services or programs provided. Describe the organization’s background and prior recreation program experience, and any experience providing recreational activities and programs in the City. The Organization should also provide a listing of past projects of similar size and scope. d. References: Provide at least three references, including the organization name, contact person’s title and contact information (address, telephone, and e-mail), name of project, location and project description, personnel of the Organization involved in the project work, contract value, and completion date. D. APPENDIX. Appendices, which are important to the explanation of Respondent’s program to provide science, technology, engineering, arts, and mathematics-based programming to City residents may be included; however, they should be concise and limited to a maximum of 10 pages. E. REQUIRED CERTIFICATIONS AND ATTACHMENTS TO PROPOSAL. a. Living Wage Requirements Certification (or basis for exemption) b. Certification of Non-Involvement in the Nuclear Weapons Industry c. Qualification and Certification Statement d. COVID Vaccination Attestation (or basis for exemption) e. References f. Exhibit 1-Program Proposal g. Exhibit 2-Contract Template 6 F. GENERAL. 1. Confidentiality: Proposals will be available for public inspection after the award announcement, except as to the extent that an Organization designates trade secrets or other proprietary data to be confidential. Material designated as confidential must be readily separable from the remainder of the proposal to facilitate public inspection of the non-confidential portion of the proposal. An Organization’s designation of material as confidential will not necessarily be conclusive, and the respondent may be required to provide justification why such material should not be disclosed, on request, under the Maryland Public Information Act (“PIA”), Title 4 of the General Provisions Article (“GP”) of the Annotated Code of Maryland. 2. Proposal Expenses: The City is not responsible for expenses incurred in preparing and submitting proposals. 3. Rejection of Proposals: The City reserves the right, in its sole discretion, to reject any and all proposals, in part or as a whole, to waive technical defects, and to select the proposal(s) deemed most advantageous to the City, and to elect not to proceed with the process set forth in this RFP. 4. Duration of Prices: The price proposal submitted is irrevocable for a period of 90 days from the proposal due date. 5. Acceptance of Terms and Conditions: By submitting a proposal, an Organization accepts the terms and conditions set forth in this RFP. 6. Procurement Law: This RFP and any contract entered into as a result of this RFP are governed by Takoma Park Code, Title 7, Division 1 (Purchasing), as amended. SECTION IV - EVALUATION CRITERIA AND SELECTION PROCESS. A grant contract award will be made on the basis of a recommendation made by an evaluation panel composed of City staff and authorized by formal action of the Takoma Park City Council. The criteria are listed in order of their evaluation. The evaluation panel may request interviews and conduct negotiations with any or all respondents to this RFP before making a recommendation: 1. Program Design a. Project understanding, approach and methodology utilized in performing the scope of services for the project described in this RFP. b. Knowledge and experience in implementing inclusive STEAM recreation activities and programs. c. Project provides innovative recreational S.T.E.AM. programs and activities for teens and young adults. 7 d. Curriculum of programs, camps and workshops have specific, measurable, and achievable objectives and performance measures. 2. Experience and Qualifications a. Organization has demonstrated history and experience coordinating STEAM activities and programs. b. Past projects completed on time and on budget. c. References. d. Qualifications and experience of key personnel to be assigned to this project. 3. Cost a. High priority will be given to cost-effective programs. b. Reasonableness of costs in relation to project and program plans. c. Price proposal within the City’s grant funding limits. 8 CITY OF TAKOMA PARK, MARYLAND GENERAL CONDITIONS The General Conditions set out below shall apply to all formal solicitations and competitive bid or proposal process of the City of Takoma Park, Maryland. Proposers are responsible for informing themselves of these requirements prior to submission of proposals. The term "bid" and "bidder" as used in these General Conditions shall include the term "proposal" and "offeror" or “respondent.” A sample of the terms applicable to any contract resulting from this RFP are attached hereto as Exhibit 2. 1. Receipt of Proposals Proposals or amendments received after the date and time specified as the proposal due date will not be considered. No liability shall attach to the City for the premature opening of an improperly addressed or improperly identified proposal. 2. Proposal Due Date a. Thursday, June 30, 2022 at 12:00 p.m. (noon) EST. b. Unless otherwise specified by the City, proposals submitted may not be withdrawn after bid opening and shall be binding for City acceptance for ninety (90) days from the proposal due date. 3. Award or Rejection of Proposals a. A contract shall be awarded to a responsive and responsible bidder. The City reserves the right, in its sole discretion, to: 1) accept a proposal in part or as a whole; 2) reject any or all proposals; 3) re-advertise the Request for Proposals; 4) waive any required information or any technical or formal defect in a proposal; 5) select a proposal and make a contract award which best serves the most effective and efficient performance of the contract services and the interests of the City; 6) reject any and all proposals that comply with the Request for Proposals specifications; 7) elect not to proceed with the process set forth in the Request for Proposals; or 8) accept a higher proposal that complies with the Request for Proposals specifications, provided that, in the judgment of the City, the services or items offered under the higher proposal have additional values or functions justifying the difference in price. b. The City reserves the right to independently investigate or request clarification of the contents of any proposal, including requesting that the bidder provide additional information or make one or more presentations. The City also has the right to personally interview bidders and to inspect the bidder’s place of business, inventory, supplies and equipment prior to making a contract award. 9 c. The City also reserves the right, in its sole discretion, to reject the proposal of a bidder who has previously failed to satisfactorily perform or to timely complete a contract of a similar nature (whether for the City or for a different jurisdiction or entity) or a proposal of a bidder who, upon investigation, is not in position to perform the contract. d. A written notice of the contract award (or acceptance of the bid) will be provided to the successful bidder within the specified acceptance period. The successful bidder will be expected to sign the City’s contract. e. Specific requirements as to bid bonds shall be incorporated in individual proposal specifications, if required. Although performance and/or payment bonds may be directly addressed in the specifications, the City reserves the right to require a performance and/or payment bond if the City deems it to be in the City’s best interests to require a performance and/or payment bond at the time of award or upon execution of the City contract. 4. Payment Invoices for payment for contract services must be submitted in duplicate. An original invoice and one copy shall be forwarded to the City. Payment will be made upon the City’s acceptance of the services or items represented by the invoice. Payment terms are net 30 unless special arrangements have been established. 5. Taxes Prices proposed under any bid shall not include federal, state or local sales or use taxes. The City of Takoma Park is exempt from such taxes; however, the City’s contractors or vendors are not agents and/or employees of the City. 6. Subcontractors a. Bidders may not assign or sublet the contract services or any part thereof without the prior written consent of the City Manager, or his or her duly appointed representative. Bidders must request approval in writing for any such assignment or subcontracting, including the name of such assignee or subcontractor(s) he or she intends to use, the specific services or materials to be furnished by such assignee or subcontractor, the assignee or subcontractor’s place of business, and other information as the City Manager may require. b. Bidders shall not legally or equitably assign any of the monies payable under the contract, or its claim thereto, unless by and with the prior written consent of the City Manager. 10 7. Compliance with Specifications Bidders should address and clearly satisfy the requirements of this Request for Proposals. Failure to clearly respond to the requirements of the Request for Proposals may result in the bid or proposal as not being responsive. Bidders shall abide by and comply with the true intent of the specifications of this Request for Proposals and not take advantage of any unintentional error or omission. 8. Changes in Specifications If it becomes necessary to revise or alter any part of this RFP, addenda will be provided on the City website during the proposal period. It is the responsibility of bidders to check the City website for any addenda. All such addenda and changes shall be deemed a part of this RFP and shall become part of the information contained in the RFP as originally issued. 9. Bidder’s Certification of Non-Involvement in the Nuclear Weapons Industry In order to comply with the provisions of Takoma Park Code Chapter 14.04, Nuclear-Free Zone, section 14.04.060.C, bidders must certify, by a notarized statement, that the bidder is not knowingly or intentionally a nuclear weapons producer. 10. Living Wage Requirement This Request for Proposals is subject to the City of Takoma Park’s living wage requirement for service contracts. The “Living Wage Requirements Certification” must be completed and submitted with the proposal. If a bidder fails to submit and complete the required material information on the Living Wage Requirements Certification, then the proposal is unacceptable under City of Takoma Park law and will be rejected. The current mandatory living wage rate, payable by a contractor to employees under the City’s living wage law, is $15.40 per hour through June 30, 2022. The living wage rate is adjusted as of July 1 of each year to reflect the most current Montgomery County living wage rate and shall be applicable to any contract awarded thereafter until the date of the next adjustment. Notice of adjustments to the living wage rate can be found on the City’s website (www.takomaparkmd.gov). Also, the City’s living wage law–Takoma Park Code section 7.08.180 et. seq. is available at the same website (click on Code). 11. Conflict of Interest The bidder will be required to warrant and represent that no employee or official of the City, or his or her immediate family member, is directly or indirectly interested in the proposal or will share in or benefit from any contract that results from the proposal. http://www.takomaparkmd.gov/ 11 12. Brokerage Fees, Commissions, Contingency Fees, and Other Compensation a. No brokerage fees, finder’s fees, commissions, or other compensation or consideration will be payable by the City in connection with the award of a contract under the proposal. The City will not pay any costs or losses incurred by a bidder including, but not limited to, any costs incurred to respond to this Request for Proposals, any requests for supplemental information made by the City, or for actions by the bidder in connection with any negotiations, including, but not limited to, actions to comply with the requirements of the City. b. The bidder warrants that no member of the bidder’s firm has employed or retained any representative, individual, or firm, other than a bona fide employee working solely for the bidder firm, to solicit or secure any contracts hereunder and further warrants that there has not been any payment or promise or agreement to pay anyone a fee, commission, percentage, gift or any other consideration contingent upon or resulting from the award of a contract under the proposal. 13. Indemnification and Insurance a. The commencement of any negotiation does not represent any obligation or agreement on the part of the City. No bid or proposal shall be deemed accepted until authorized by the City Council and a contract or purchase order between the City and the bidder is executed. Either the City or the bidder may terminate negotiations at any time with or without cause. If negotiations are terminated by either party, neither the City nor the bidder will have any rights against or liabilities to the other party. b. The selected bidder is responsible for any loss, personal injury, death, property damages, and any other damages of every name and description that may be done or suffered by reason of the bidder’s negligence or failure to perform any contractual obligations. The selected bidder shall defend, indemnify, and hold harmless the City of Takoma Park, its employees, officials, and agents, from and against all losses, liabilities, claims, demands, damages, suits, costs, and expenses of any kind, including attorney’s fees and litigation expenses, whether for personal injury, property damage or other liability arising out of or in any way connected with the bidder’s acts or omissions under the Request for Proposals or under any contract resulting from the Request for Proposals. c. The selected bidder must obtain at its own cost and expense, and keep in force and effect during the term of any contract with the City for the contract work, including all extensions and renewals, the insurance specified below, with an insurance company licensed or qualified to do business in the state of Maryland. A certificate of insurance must be submitted to the City prior to the commencement of any work under the contract and prior to any contract modification extending the term of the contract, as evidence of compliance with this provision. The City of Takoma Park must be named as an additional insured 12 on all liability policies. A minimum of thirty (30) days written notice to the City of cancellation or material change in any of the policies is required. In no event may the insurance coverage be less than that shown below, unless the requirements of this section are waived, in whole or in part, in writing by the City Manager. Coverage Amount or Limits Workers Compensation (for bidders with employees) Bodily injury by Accident (each) $100,000.00 Disease (policy limits) $500,000.00 Disease (each employee) $100,000.00 Commercial General Liability $1,000,000.00 (Minimum combined single limit for bodily injury and property damage per occurrence, including contractual liability, premises and operations, and independent contractors.) Minimum Automobile Liability (Including owned, hired and non-owned automobiles.) Bodily injury, each person $500,000.00 Bodily injury, each occurrence $1,000,000.00 Property damage, each occurrence $300,000.00 Professional Liability (for professional services contracts only) For errors, omissions, and negligent acts, per claim and Aggregate, with one-year discovery period and maximum Deductible of $25,000.00 $1,000,000.00 14. Changes a. The City may, at any time, by written order, make changes to the Scope of Services as set forth in the Request for Proposals. If such changes cause an increase or decrease in the bidder’s cost or time required for performance of any project service, an equitable adjustment, if applicable, may be made and the parties’ contract modified in writing accordingly. b. Any claim of the bidder for adjustment under this clause must be asserted in writing within fourteen (14) days from the date of receipt, by the bidder, of the notification of the change order, unless the City grants a further period of time. c. No service for which additional compensation will be charged by the bidder shall be furnished without the written authorization of the City. 13 15. Attachments a. Certification of Non-Involvement in Nuclear Weapons Industry b. Living Wage Requirements Certification c. References d. Qualification and Certification Statement e. COVID Vaccination Attestation (or basis for exemption) f. References g. Exhibit 1-Program Proposal h. Exhibit 2-Contract Template 14 CITY OF TAKOMA PARK, MARYLAND CERTIFICATION OF NON-INVOLVEMENT IN THE NUCLEAR WEAPONS INDUSTRY KNOW ALL PERSONS BY THESE PRESENTS: Pursuant to the requirements of Chapter 14.04 of the Takoma Park Code, the Takoma Park Nuclear Free Zone Act, the undersigned person, firm, corporation or entity hereby certifies that he/she/it is not knowingly or intentionally a nuclear weapons producer. Note: The following definitions apply to this certification per Section 14.04.090: “Nuclear weapons producer” is any person, firm, corporation, facility, parent or subsidiary thereof or agency of the federal government engaged in the production of nuclear weapons or its components. “Production of nuclear weapons” includes the knowing or intentional research, design, development, testing, manufacture, evaluation, maintenance, storage, transportation or disposal of nuclear weapons or their components. “Nuclear weapon” is any device the sole purpose of which is the destruction of human life and property by an explosion resulting from the energy released by a fission or fusion reaction involving atomic nuclei. “Component of a nuclear weapon” is any device, radioactive substance or nonradioactive substance designed, knowingly and intentionally, to contribute to the operation, launch, guidance, delivery or detonation of a nuclear weapon. IN WITNESS WHEREOF, the undersigned has signed this Certification this _____ day of __________________, 2022. Firm Name: By: (SEAL) Signature Print Name & Title State of , County of : Subscribed and sworn to before me this day of , 2022. Notary Public 15 My commission expires: 16 LIVING WAGE REQUIREMENTS CERTIFICATION (Takoma Park Code, section 7.08.170.B) Business Name: Address: City, State, Zip Code: Phone Number: Fax Number: E-Mail: Please specify the contact name and information of the individual designated by your business to monitor your compliance with the City’s living wage requirements, unless exempt under Section 7.08.160 (see item B below): Contact Name: Title: Phone Number: Fax: E-Mail: CHECK ALL APPROPRIATE LINES BELOW THAT APPLY IN THE EVENT THAT YOU ARE AWARDED THE CONTRACT AND BECOME A “CONTRACTOR.” A. Living Wage Requirements Compliance _____ This Contractor as a “covered employer” will comply with the requirements of the City of Takoma Park Living Wage Law (Takoma Park Code, Section 7.08.150 et. seq.). Contractor and its subcontractors will pay all employees who are not exempt from the wage requirements and who perform measurable work for the City related to any contract for services with the City, the living wage requirements in effect at the time of the City contract. The bid price submitted under this procurement solicitation includes sufficient funds to meet the living wage requirements. B. Exemption Status (if applicable) This Contractor is exempt from the living wage requirements because it is: _____ The total value of the contract for services (based on the bid or proposal being submitted under this procurement solicitation) is less than $20,000.00. _____ A public entity. _____ A nonprofit organization that has qualified for an exemption from federal income taxes under Section 501c(3) of the Internal Revenue Code. _____ A contract procured through an emergency procurement, sole source procurement, or cooperative procurement. 17 _____ A contract for electricity, telephone, cable television, water, sewer or similar service delivered by a regulated public utility. _____ A contract for the purchase or lease of goods, equipment or vehicles. _____ A contractor who is prohibited from complying with the City’s living wage requirements by the terms of an applicable federal or state program, contract, or grant requirement. (Must specify the law and/or furnish a copy of the contract or grant.) C. Living Wage Requirements Reduction. _____ This Contractor provides health insurance to the employees who will provide services to the City under the City contract and it desires to reduce its hourly rate paid under the living wage requirements by an amount equal to, or less than, the per employee hourly cost of the employer’s share of the health insurance premium. This Contractor certifies that the per employee hourly cost of the employer’s share of the premium for that health insurance is $ . (Must submit supporting documentation showing the employee labor category of all employee(s) who will perform measurable work under the City contract, the hourly wage the Contractor pays for that employee labor category, the name of the health insurance provider and plan name, and the employer’s share of the monthly health insurance premium.) Contractor Certification and Signature Contractor submits this certification in accordance with Takoma Park Code section 7.08.170.B. Contractor certifies, under penalties of perjury, that all of the statements and representations made in this Living Wage Requirements Certification are true and correct. Contractor and any of its subcontractors that perform services under the resultant contract with the City of Takoma Park, will comply with all applicable requirements of the City’s living wage law. Authorized signature: Print name: Title of authorized person: Date: 18 CITY OF TAKOMA PARK, MARYLAND REFERENCES Respondent shall furnish a representative list of at least three (3) references involving work as specified in the Request for Proposals. Failure to submit the required information with the Proposal may be cause for rejection of the Proposal. The City may make such investigation, as it deems necessary to determine the ability of the Respondent to furnish the services and the Respondent shall furnish to the City all such information and data for this purpose as the City may request. The City reserves the right to reject any proposal if the evidence submitted by or investigation of such Firm fails to satisfy the City that such Respondent is properly qualified to carry out the obligations of the contract and deliver the services herein. Organization Name: ____________________________________________________________ Address: _____________________________________________________________________ Contact Person: _____________________________ Phone: ____________________________ E-Mail: _______________________ Contract Value/Completion Date: ____________________ Project Description: _____________________________________________________________ ______________________________________________________________________________ Organization Name: ____________________________________________________________ Address: _____________________________________________________________________ Contact Person: _____________________________ Phone: ____________________________ E-Mail: _______________________ Contract Value/Completion Date: ____________________ Project Description: _____________________________________________________________ ______________________________________________________________________________ Organization Name: ____________________________________________________________ Address: _____________________________________________________________________ Contact Person: _____________________________ Phone: ____________________________ E-Mail: _______________________ Contract Value/Completion Date: ____________________ 19 Project Description: _____________________________________________________________ QUALIFICATION AND CERTIFICATION STATEMENT NAME OF ENTITY Business Address: Telephone Number: _____________________________________________ Fax: Web Site: AUTHORIZED REPRESENTATIVE Name: Title: Telephone Number (office and cell): _________________________________________ ____ E-Mail: ORGANIZATIONAL STRUCTURE Identify the legal structure of the entity responding to the Request for Proposals and include requested information with this submission. _____ A.1. A corporation incorporated under the laws of the State of Maryland, and in good standing to do business in the State of Maryland. _____A.2. List the name of the corporation and the names and titles of the corporation’s directors and officers: _____B.1. A foreign corporation incorporated under the laws (insert jurisdiction): _____B.2. The foreign corporation is registered or qualified and in good standing to do business in the State of Maryland. _____B.3. List the name of the corporation and the names and titles of the corporation’s directors and officers: 20 _____ C. A sole proprietor doing business under his/her individual name. Individual name: _____ D. A sole proprietor doing business under a trade or business name (for example, John Doe t/a Doe Masonry). List individual name and the trade or business name: _____E. A partnership. List the type of partnership and the names of all general partners: _____ F.1. A limited liability company organized under the laws of the State of Maryland and authorized and in good standing to do business in the State of Maryland. _____F.2 List the limited liability company name and the names of all members: _____G.1 A limited liability company organized under the laws of ____________________ (insert jurisdiction name). _____G.2. The foreign limited liability company is authorized and in good standing to do business in the State of Maryland. _____G.3. List the foreign limited liability company name and the names of all members: ______ H. Other (explain): 21 CERTIFICATION The undersigned proposes to furnish and deliver all labor, supplies, material, equipment, or services in accordance with specifications and stipulations contained in the Invitation for Bids or the Request for Proposals for the prices listed on the enclosed Price Proposal Sheet, if any, and/or upon the terms and conditions set forth in the proposal. The undersigned certifies that this bid/proposal is made without any previous understanding, agreement or connection with any person, firm, or corporation submitting a bid or proposal for the same labor, supplies, material, equipment, or services and is, in all respects fair and without collusion or fraud. The undersigned further certifies that he/she is authorized to sign for the Respondent. Respondent Name (print):____________________________________________ By:_______________________________________________________________ (Signature) (Date) Print Name:_______________________________________________________ Title:_____________________________________________________________

7500 Maple Avenue Takoma Park, Maryland 20912Location

Address: 7500 Maple Avenue Takoma Park, Maryland 20912

Country : United StatesState : Maryland

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