Snow Plowing and Removal Services – Petoskey & Harbor Springs

1 | P a g e RFP# EC-03-2023 #10 REQUEST FOR PROPOSALS Snow Plowing and Removal Services – Petoskey & Harbor Springs RFP # EC-03-2023 #10 ESTIMATED TIMELINE – RFP Released March 23, 2023 Deadline to Submit Written Questions April 3, 2023 @ 3:00 PM EST Response to Questions April 7, 2023 @ 3:00 PM EST Proposal Due Date & Public Bid Opening – Admin Conf. Room April 27, 2023 @ 3:00 PM EST Project Review and Award Date Pending BOC Approval May 8, 2023 (tentative) *BOC = Board of Commissioners OPTIONAL SITE VISIT – call Maintenance Department Manager Jeff Summers to schedule: (231) 348-1779 RFP PROCUREMENT CONTACT – Michele Murray, mmurray@emmetcounty.org Emmet County is soliciting proposals from prospective vendors to provide the County with snow plowing and removal services for five (5) Emmet County facilities including equipment, labor and supplies for three (3) winter seasons beginning in the fall of 2023. A copy of this RFP

and any subsequent addenda or communications may be obtained from the County’s Purchasing page as well as on the BidNet Direct website at https://www.bidnetdirect.com. Emmet County Administration Office • 200 Division Street, Suite G70 • Petoskey, Michigan 49770 www.emmetcounty.org https://www.bidnetdirect.com/ 2 | P a g e RFP# EC-03-2023 #10 A. PROJECT BACKGROUND Emmet County is in the northern most part of the Lower Peninsula of Michigan. The population was 34,112 at the 2020 census. Its northern tip bumps into the Straits of Mackinac and Lake Michigan outlines its western boundary. Emmet County is a place where natural beauty and prosperity harmonize in a desirable and sustainable community. Snow plowing, snow removal and salting services enable the community to access the county’s quality public services, such as EMS, Sheriff’s Office and Courts. B. SCOPE OF WORK The purpose of this request for proposal is to invite prospective vendors to submit a proposal to supply Emmet County with snow plowing and removal services. The Vendor shall provide the following related to this particular RFP: I. Core Services The scope of work consists of snow plowing and removal services for five (5) Emmet County facilities. The snow season shall be defined as the period from October through April of each calendar year. However, the County reserves the right to request services at any time during the contract period if the need arose. All staking will be completed before mid-November of each year (as defined during the annual walkthrough, as applicable for new contractors). Driveways, parking areas (including walkways within the lots), garage and shed doors and gates will be cleared and periodically checked as required during snow events, so that snow accumulations shall not exceed three (3) inches. Snow piles/banks shall not be placed in such a manner as to block the view of a standard vehicle or block any parking space(s). Snow plowing and removal services must conform to the County's current operating schedule at the discretion of the County maintenance department manager. When requested by the County maintenance department manager, the contractor will load and haul snow to Emmet County fairgrounds on Charlevoix Avenue. The dumping of the County snow will be at no additional charge. County driveways and parking areas must be cleared and available for use by 6:30 AM ET. During times of continuous snowfall, if snow accumulations reach three (3) inches again in the same day, these areas must be cleared before 4:00 PM ET. II. Locations a. County Building, 200 Division Street, Petoskey  One (1) lot on Lake Street  One (1) lot on Division and Lake Streets  One (1) lot on Bay Street b. Jail, 450 Bay Street, Petoskey  One (1) lot on Lake Street  One (1) lot on Bay Street c. EMS Station #1, 1201 Eppler Road, Petoskey d. EMS Station #2, 8269 Harbor-Petoskey Road, Harbor Springs e. ECSD Road Patrol Building, 3460 Harbor-Petoskey Road, Harbor Springs ArcGIS Web Map - 200 Division Street & 450 Bay Street - Source: Esri, Maxar, Earthstar Geographics, and the GIS User Community Tax Parcels Ortho2022_6In Red: Band_1 Green: Band_2 Blue: Band_3 3/21/2023, 4:03:36 PM r Map Produced Using the Emmet County Internet Mapping Portal Author: ArcGIS Web AppBuilder Date: 3/21/2023 This map is for general reference purposes only. It is not intended as a replacement, a substitute for, or duplication of a survey. Ü 0 0.030.015 mi Emmet County Building and Jail Lots RFP# EC-03-2023 #10 3 | P a g e mmurray Highlight mmurray Highlight mmurray Highlight mmurray Highlight ArcGIS Web Map - EMS Station #1, 1201 Eppler Rd, Petoskey Source: Esri, Maxar, Earthstar Geographics, and the GIS User Community Tax Parcels Ortho2022_6In Red: Band_1 Green: Band_2 Blue: Band_3 3/21/2023, 4:06:29 PM r Map Produced Using the Emmet County Internet Mapping Portal Author: ArcGIS Web AppBuilder Date: 3/21/2023 This map is for general reference purposes only. It is not intended as a replacement, a substitute for, or duplication of a survey. Ü 0 0.030.015 mi RFP# EC-03-2023 #10 4 | P a g e mmurray Highlight mmurray Highlight mmurray Highlight ArcGIS Web Map - EMS Station #2, 8269 Harbor-Petoskey Rd, Harbor Springs Source: Esri, Maxar, Earthstar Geographics, and the GIS User Community Tax Parcels Ortho2022_6In Red: Band_1 Green: Band_2 Blue: Band_3 3/21/2023, 4:07:22 PM r Map Produced Using the Emmet County Internet Mapping Portal Author: ArcGIS Web AppBuilder Date: 3/21/2023 This map is for general reference purposes only. It is not intended as a replacement, a substitute for, or duplication of a survey. Ü 0 0.0150.0075 mi RFP# EC-03-2023 #10 5 | P a g e mmurray Highlight ArcGIS Web Map - 3460 Harbor-Petoskey Rd, Harbor Springs Source: Esri, Maxar, Earthstar Geographics, and the GIS User Community Tax Parcels Ortho2022_6In Red: Band_1 Green: Band_2 Blue: Band_3 3/21/2023, 4:13:04 PM r Map Produced Using the Emmet County Internet Mapping Portal Author: ArcGIS Web AppBuilder Date: 3/21/2023 This map is for general reference purposes only. It is not intended as a replacement, a substitute for, or duplication of a survey. Ü 0 0.030.015 mi ECSD Road Patrol Building RFP# EC-03-2023 #10 6 | P a g e mmurray Highlight mmurray Highlight 7 | P a g e RFP# EC-03-2023 #10 III. Schedule/Mobilization No less than fifteen (15) days prior to the official start of the snow season (by September 15), the Contractor must provide the name(s) and 24-hour phone number(s) for both primary and back-up contacts for snow event notification. Positive response shall occur within a maximum of one (1) hour after notification is received. IV. Accident Reporting The Contractor’s driver shall immediately report ANY accident upon County property to the Police. As soon as possible thereafter, the driver shall report the same to his or her supervisor who shall then inform the Emmet County maintenance department manager without delay. The supervisor shall perform a cursory investigation of the accident and file a report documenting same with the Emmet County Administrator within 48 hours. V. Property Damage Inspections Property damage inspections will occur at the conclusion of each snow and ice season, usually in May. The contractor will be responsible for repairs to parking lots, lawn and landscaping, irrigation sprinklers systems and their components, curbs, and traffic signs caused by the contractor’s vehicles during the snow and ice removal operation. The Contractor will be wholly financially responsible for any reported damage and will return property to its pre-season condition without delay. All incidental expenses in connection therewith, all costs incurred due to damage or destruction of public or private property and any additional expenses for unforeseen difficulties encountered, for the settlement of damages, and for replacement of defective work and materials are fully the responsibility of the contractor. VI. Contractor Damage Claims The Contractor shall make no claim against the County, its commissioners, or employees for any damages of any description or cost incurred by the Contractor by reason of damage to Contractor’s property or property used by the Contractor. VII. Grounds of Termination of Snow Plowing Contract Satisfactory performance of this contract is directly related to and essential for the safety of all Emmet County employees, residents and visitors. Should the Contractor’s performance during the contract be deemed unsatisfactory by the Emmet County Administrator, the County may terminate the contract based upon such recommendation. Grounds for termination may include but are not limited to: late response for call outs, failure to provide a valid insurance certificate, cancellation of insurance, or actions constituting a danger to the public, private property, public employees, or public property. VIII. Proposal Packet Requirements a. Contractor Inventory of Available Equipment – The potential bidder shall submit as part of their bid submission a complete listing of all equipment available and/or proposed to be used under this contract with information including but not limited to: make, year and model. b. Certification of Truck and Equipment Registration – The Contractor shall certify as part of their bid submission that the equipment listed in Their “Inventory of Available Equipment” have current and valid registrations and that same shall remain for the life of the contract. See Attachment B. 8 | P a g eRFP# EC-03-2023 #10 c. Bidder’s Experience (References)– The Contractor shall submit as part of their bid submission a listing of relevant experience in like snow plowing operations. See Attachment A. d. Pricing Sheet – The Contractor shall complete in its entirety the pricing table as part of their bid submission itemizing the unit costs for each item. See Attachment B. Contract Term (if applicable): The term of the contract shall be for a period of three (3) years from the date of award, with one (1) additional 2-year extension option, which may be exercised at the discretion of Emmet County. C. SUBMITTALS The Vendor shall also provide the following as requested for all County RFPs: A. If applicable, provide continual or annual costs such as warranties or service contracts. B. Description of its invoicing process. Invoices should itemize the date of service, reason for the service, the amount, and the vendor Tax ID number. C. An opportunity for Emmet County to complete a final inspection before acceptance of the work/ product. The Vendor will arrange for the return of all damaged or miss-shipped items. There will be no restocking fee for the return of items damaged or shipped by the vendor in error. All items returned will be credited to invoice within 14 days of receipt. D. Available financing options and terms. E. If applicable, no less than three (3) days of training to ensure adequate education of all personnel at the expense of the company providing the equipment to Emmet County. In responding to this RFP, the vendor accepts full responsibility to understand the RFP in its entirety, and in detail, including making any inquiries to Emmet County as necessary to gain such understanding. The County reserves the right to disqualify any vendor who demonstrates less than such understanding. Further, Emmet County reserves the right to determine, at its sole discretion, whether the vendor has demonstrated such understanding. That right extends to cancellation of award, if award has been made. Such disqualification and/or cancellation shall be at no fault, cost, or liability whatsoever to Emmet County. All information provided by Emmet County in this RFP is offered in good faith. Individual items are subject to change at any time. Emmet County makes no certification that any item is without error. Emmet County is not responsible or liable for any use of the information or for any claims asserted there from. The County intends to select a vendor in May 2023 but it is not obligated to do so. D. EVALUATION CRITERIA Submittals will be evaluated and ranked to determine the best value to the County based on the following criteria: A. Costs for the Services B. Quality of the Work C. Conformity with Specifications and Suitability to the Requirements of the County D. Past Performance of the Vendor E. Industry standards and references ATTACHMENT A – BIDDER'S EXPERIENCE (REFERENCES) Provide three (3) references from projects or services provided that are similar in size and/or scope, preferably from other governmental/municipal, and/or other community-based organizations. By providing the references below, Vendor authorizes any person contacted to give the County any and all information concerning work experience or performance and releases all parties from all liability for any damage that may result from furnishing the same to the County. Reference 1 Customer Name Contact Person Contact Number Contact Email Project Description Reference 2 Customer Name Contact Person Contact Number Contact Email Project Description Reference 3 Customer Name Contact Person Contact Number Contact Email Project Description BY: (Signature of Authorized Representative) Date (Printed Name and Title of Authorized Representative) RFP# EC-03-2023 #10 9 | P a g e ATTACHMENT B – PRICING FORM The undersigned hereby agrees to perform all work in accordance with the specifications, terms, and conditions of the County’s Request for Proposal for the costs described below. The fees proposed will be considered firm and cannot be altered after receipt of the proposal by the County per the terms of this RFP. The pricing cannot change over the term of any contract executed as a result of this RFP. All costs must be identified in Contractor’s response. CONFIRMATION: Do you confirm that you have thoroughly read and reviewed all documents associated with this solicitation? Yes No PRICING BY LOCATION: Complete the price by location. Price will cover all costs of any nature incidental to the work, including labor, material, equipment, transportation, insurance, and all else necessary to perform and complete the work in the manner and within the time specified. Also list the approximate time, from start to finish, to complete a service at each location. Location Rate per Hour Est. Time to Complete 200 Division Street, Petoskey 450 Bay Street, Petoskey 1201 Eppler Road, Petoskey 8269 Harbor-Petoskey Rd, Harbor Springs 3460 Harbor-Petoskey Rd, Harbor Springs EQUIPMENT: By signing below, I also certify that the equipment listed above have current and valid registrations and shall remain the same during the life of the contract. (Signature of Authorized Representative) Date (Printed Name and Title of Authorized Representative) RFP# EC-03-2023 #10 10 | P a g e 11 | P a g e RFP# EC-03-2023 #10 The purpose of this competitive RFP is to promote a fair, most efficient means to obtain the best value to Emmet County, i.e., the proposal offering the best value, which shall be assessed in accordance with the evaluation criteria set forth in this RFP. Proposals will be reviewed by an internal committee where quotes will be evaluated and ranked on a consensus basis. Proposing bidders may be asked to participate in an interview to further discuss qualifications and to answer questions from the committee. Emmet County reserves the right in its sole discretion to accept or reject any or all proposals, in whole or in part, without incurring any cost of liability whatsoever, and to waive informalities and minor irregularities in bids received. The County shall retain the RFP, and all related terms and conditions, exhibits and other attachments, in original form in any archival copy. Any modification of these, in the vendor’s submission, is grounds for immediate disqualification. If the selected vendor and Emmet County are not able to finalize contract terms for the intended goods or services requested in this RFP, the County reserves the right to select another vendor to provide the goods or services. E. REPRESENTATIONS AND CERTIFICATIONS Full name and address of the business with a short description of the business. Include a description of the following: A. Business organization B. Year established C. Federal ID number D. Michigan tax ID number, if applicable. E. The business’ legal formation (e.g. corporation, sole proprietor, etc.) F. State of incorporation, if applicable. G. List the business’ officers (up to three). H. List the location and address of the business’ office in Michigan that will provide the services requested. I. Provide a list of business’ primary services. Provide a list of similar projects completed by the firm. F. REFERENCES RFP reviewers may solicit references from some or all client contacts provided. Please include at least three (3) references as noted in Attachment A. G. COMPENSATION / FEES Identify all costs including expenses to be charged for performing the services necessary to accomplish the objectives of the contract. The respondent is to submit a fully detailed budget including staff costs and any expenses necessary to accomplish the tasks and to produce the deliverables under the contract. The County is tax exempt for state and local taxes, personal property tax, and real property taxes. Prices shall not include taxes, unless the County is not tax-exempt for a specific service or deliverable. Exemption certificates for sales tax will be furnished upon request. H. CONFLICT OF INTEREST Disclose any conflicts or perceived conflicts of interest. Vendor shall to the extent practicable, disclose to the County the identity of vendor employees and relatives of vendor employees who are employed by the County as well as the identity of County employees who are employed by vendor. Identify what procedures your firm utilizes to identify and resolve conflicts of interest. 12 | P a g e RFP# EC-03-2023 #10 I. COPIES OF THE FOLLOWING ITEMS: A. Comprehensive General Liability and Property Damage coverage. (see below requirements) B. Professional Liability (Errors and Omissions) coverage. C. Worker’s Compensation coverage. (see below requirements) D. Automobile Liability (see below requirements) E. Any and all relevant license/registration numbers. J. INSURANCE REQUIREMENTS AND BOND (as applicable) The successful bidder must meet the following minimum insurance requirements and provide proof of coverage on a Certificate of Liability Insurance form submitted with proposal: 1. If selected, a Certificate of insurance naming Emmet County as a certificate holder must be provided prior to the County’s execution of a contract and must bear evidence of all required terms and coverage and provide 30 days’ notice of cancellation or material changes to the coverage. 2. Certificate of insurance must name as an additional insured Emmet County, its agents, officers, officials, employees as additional insureds, as their interest may appear. 3. The Contractor shall be responsible for insuring all its tools, equipment and materials, which it may leave at the Project's work site. The County shall not be responsible for any loss or damage to the Contractor's tools, equipment and materials. 4. General Liability Coverage: a. $500,000 Each Occurrence b. $500,000 Property Damage c. $5,000 Medical Expense d. $500,000 Personal & Advertising Injury e. $1,000,000 General Aggregate f. $1,000,000 Products & Completed Operations 5. Automobile Liability: a. $1,000,000 Combined Single Limit; or b. $1,000,000 Bodily Injury c. $500,000 Property Damage 6. Professional Liability (Errors and Omissions) Insurance: [For contracts for professional services, e.g. Architect, Engineer, Doctors, Dentists, etc.] a. $1,000,000 Each Occurrence b. If on a claim-made basis, the Contractor shall purchase extended reporting period “tail” coverage for a minimum of three (3) years after termination of Agreement. 7. Workman’s Compensation insurance as required State statutory limits. If any proprietor, partner, executive, officer, member, or employee is excluded from worker’s compensation or if the Workers Compensation policy is for certificate purpose only, it must be stated on the certificate. 13 | P a g e RFP# EC-03-2023 #10 8. Cancellation Notice: Workers' Compensation Insurance, General Liability Insurance and Automobile Liability Insurance, as described above, shall include an endorsement stating the following: "It is understood and agreed that Thirty (30) days Advance Written Notice of Cancelation, Non-Renewal, Reduction, and/or Material Change shall be sent to the office of the Emmet County Administrator. If any of the above coverages expire during the term of the contract, the Contractor shall deliver renewal certificates and/or policies to the Emmet County Administrator at least ten (10) days prior to the expiration date. All insurance carriers must be licensed to do business in the State of Michigan and shall have and maintain a minimum A.M. Best’s rating of A-, unless otherwise approved by the County. The insurance company(s) issuing the policy(s) shall have no recourse against the County for subrogation, premiums, deductibles, or assessments of any form. K. INDEMNIFICATION The selected vendor shall be required to indemnify, defend, and hold the County harmless for all claims, incurred by or asserted against the County, its elected and appointed officials, employees, agents and volunteers, by and person or entity, which are alleged to have been caused from the acts or omissions of vendor or vendor’s employees. The County’s right to indemnification is in excess and above any insurance required by the contract. The vendor shall have no right against the County for indemnification, contribution or subrogation. L. AMERICANS WITH DISABILITIES ACT (ADA) AND SECTION 508 COMPLIANCE Vendors shall warrant that end users will be able to access the website in accordance with the accessibility requirements of the ADA and the Rehabilitation Act of 1973. The website will conform, where relevant to Web Content Accessibility Guidelines (WACG) 2.0. M. NON-INFRINGEMENT Vendors shall ensure that the website design will be free of any rightful claim of infringement or similar claim by a third party. N. BACKROUND CHECKS Vendors that are selected to provide services that require access to law enforcement, Court facilities, Pellston Airport, and to other County locations after normal business hours, must undergo a background check by the Emmet County Sheriff’s Department. The County reserves the right to require background checks of vendor employees for other sensitive services. O. NON-DISCRIMINATION Vendor, and its subcontractors, shall not discriminate against an employee or an applicant for employment, in hiring, any terms and conditions of employment or matters of employment for any reason that is unrelated to the person’s ability to perform the duties of a particular job or position, in accordance with applicable federal and state law. 14 | P a g e RFP# EC-03-2023 #10 P. DEBARMENT AND GRANT REQUIREMENTS If a bidder is presently debarred, suspended, proposed for debarment, declared ineligible, or otherwise excluded from doing business with any government agency, which prohibits the bidder from participating in any procurement, the bidder must provide County with that information as part of their response. Failure to provide this information may result in disqualification of the response from consideration or termination of a purchase order or contract, if awarded. To the extent that an awarded contract is funded in whole or in part by any federal or state grant, vendor will be required to comply with all applicable requirements in the grant. Q. TERMINATION OF CONTRACT: When the vendor has not performed or has unsatisfactorily performed the contract or in the event, any of the provisions of the purchase order are violated, the County may serve written notice of its intention to terminate the contract and/or purchase order for default. Upon termination for default, payment will be withheld at the discretion of Emmet County. Failure on the part of a vendor to fulfill the contractual obligations shall be considered just cause for termination of the contract. The vendor will be paid for work satisfactorily performed prior to termination less any excess costs incurred by the County in procuring and completing the work. The County reserves the right to require termination of the contract for its convenience in the contract terms finalized with the selected vendor. If funds are not appropriated or otherwise made available to support continuation of performance, the County may terminate the agreement. Vendor shall be paid for work satisfactorily performed prior to termination. R. RIGHTS AND REMEDIES OF COUNTY FOR DEFAULT: If any item furnished by the vendor fails to conform to specifications, or to the sample submitted by the vendor, the County may reject it. Upon rejection, the vendor must promptly reclaim and remove such item without expense to the County, and shall immediately replace all such rejected items with others conforming to such specification and samples. If the vendor fails to do so, the County has the right to purchase in the open market a corresponding quantity of any such items and to deduct from any monies due the vendor the difference between the prices named in the purchase order and the actual cost to the County. If the vendor fails to make prompt delivery of any item, the County has the right to purchase such item in the open market and to deduct from any monies due the vendor the difference between the prices named in the purchase order and the actual replacement cost to the County. The rights and remedies of the County identified above are in addition to any other rights and remedies provided by law or under the purchase order. S. INSTRUCTIONS FOR FIRMS: For your bid to qualify, you must submit three (3) hard copies in your SEALED BID no later than 3:00 p.m. on April 27, 2023 to: EMMET COUNTY FINANCE DEPARTMENT ATTN: Priscilla Meyer, Administration Office 200 DIVISION STREET, SUITE G70 PETOSKEY, MI 49770 1. Response to this RFP MUST be clearly marked RFP# EC-03-2023 #10 – Snow Plowing and Removal Services – Petoskey & Harbor Springs. 15 | P a g e RFP# EC-03-2023 #10 2. Questions shall be submitted in writing to Michele Murray at mmurray@emmetcounty.org no later than 3:00 p.m. on April 3, 2023: 3. This RFP, any addendums, and any potential questions and answers will be posted on the Emmet County website at https://www.emmetcounty.org/open-bids-rfps/. 4. The County reserves the right, in its sole discretion, to reject any and all proposals, or parts of any proposal, for any reason whatsoever and waive technicalities. 5. The County will only accept proposals that are responsive to the RFP and are prepared and submitted in compliance with the requirements set forth in this RFP. 6. Emmet County will not award any proposal to an individual or business having any outstanding amounts due from a prior Contract or business relationship with the County or who owes any amount(s) for delinquent Federal, State or Local taxes, fees and licenses. No late submissions will be accepted. https://www.emmetcounty.org/open-bids-rfps/ 16 | P a g e RFP# EC-03-2023 #10 IRAN LINKED BUSINESS CLAUSE The Respondent who is selected as Consultant shall certify to the County that neither it nor any of its successors, parent companies, subsidiaries, or companies under common ownership or control of the Consultant, are an “Iran Linked Business” engaged in investment activities of $20,000,000.00 or more with the energy sector of Iran, within the meaning of Michigan Public Act 517 of 2012. It is expressly understood and agreed that the Consultant shall not become an “Iran linked business” during the term of this Agreement. NOTE: IF A PERSON OR ENTITY FALSELY CERTIFIES THAT IT IS NOT AN IRAN LINKED BUSINESS AS DEFINED BY PUBLIC ACT 517 OF 2012, IT WILL BE RESPONSIBLE FOR CIVIL PENALTIES OF NOT MORE THAN $250,000.00 OR TWO TIMES THE AMOUNT OF THE CONTRACT FOR WHICH THE FALSE CERTIFICATION WAS MADE, WHICHEVER IS GREATER, PLUS COSTS OF INVESTIGATION AND REASONABLE ATTORNEY FEES INCURRED, AS MORE FULLY SET FORTH IN SECTION 5 OF ACT NO. 517, PUBLIC ACTS OF 2012. CERTIFICATION I hereby state that I have read, understand, and become thoroughly familiar with and understand the terms and scope of work contained in the RFP. I hereby state that all of the information I have provided is true, accurate and complete. I hereby state that I have authority to submit this RFP, which will become the basis for a binding contract if accepted by the Emmet County. I hereby state that this quote will remain valid for ninety (90) days from this certification date. Signature: _____________________________________________________________________________ Print Name: ___________________________________________________________________________ Title: _______________________________________________ Date: _____________________________ Company Name: _______________________________________________________________________ Address: ______________________________________________________________________________ ______________________________________________________________________________ Contact Name: _________________________________________________________________________ Phone: _____________________________________ Email: __________________________________ MINORITY VENDOR CERTIFICATIONS Please check all that apply: The vendor represents that it IS IS NOT a woman or women-owned business. The vendor represents that it IS IS NOT a minority-owned business. The vendor represents that it IS IS NOT a disadvantaged business enterprise. The contractor represents and warrants that the company meets the above and can provide supportive documentation upon request. Any lines left unchecked will be considered as if the “IS NOT” box has been checked. ____________________________________________________ ______________________ Authorized Agent Signature Date ____________________________________________________ Authorized Agent Printed Name