RFQ 2021-04 Architectural/Engineering Design and Project Management Services

1 101 Dennis Holloway Drive Jackson, Mississippi, 39203 Contact: Sandra Robinson, Executive Director of Facilities Operations Email: sarobinson@jackson.k12.ms.us Telephone No.: (601) 960-8784 REQUEST FOR STATEMENTS OF QUALIFICATIONS FOR ARCHITECTURAL/ENGINEERING DESIGN AND PROJECT MANAGEMENT SERVICES RFQ Issue Date: September 23, 2021 Submission Deadline and Time: October 13, 2021 @ 10:00 A.M. RFQ 2021-04 Name of Proposal: RFQ for Architectural/Engineering Design and Project Management Services PLACE COVER PAGE (15) IN THE FRONT OF PROPOSAL. INSERT PAGE NUMBERS WHEN SUBMITTING ELECTRONIC PROPOSALS. SUBMIT RFQ DOCUMENTS IN THE ORIGINAL FORMAT ALONG WITH OTHER SUPPORTING DOCUMENTS ATTACHED TO PROPOSAL AND UPLOAD TO www.centralbidding.com WEBSITE PORTAL. Proposals shall be submitted to the Business Office of the Jackson Public School District

located at 662 South President Street, Jackson, MS 39201. Sealed proposals shall be delivered to the listed address at any time prior to, but not later than, 10:00 a.m. CST on October 13, 2021. Proposals received after this time will not be accepted (hand or mailed delivery) will be returned unopened to the vendor and the proposal will be automatically disqualified from the process. The district is not liable for any costs incurred by proposers in replying to this RFQ. ee PUBLIC SCHOOLS Transforming Iivesthrough lives through excellent education mailto:sarobinson@jackson.k12.ms.us http://www.centralbidding.com/ 2 PROPOSAL FORM Board of Trustees Jackson Public School District Jackson, Mississippi Ladies and Gentlemen: I/We, propose to furnish and deliver all items and/or to perform all services according to all sections of this RFQ document (Proposal Form, Instructions and Conditions, detailed written Specifications, and Addendum if applicable) and in the quantities at the indicated prices, as called for in the document(s). All quantities indicated have been checked very closely, and both unit price and total price (where requested) have been submitted with the understanding that we shall be responsible for making complete and satisfactory delivery accordingly, within the time frame agenda (if applicable). All items contained in this RFQ shall be as specified or JPSD approved equal. For any item(s) proposed which is other than as specified, a complete and detailed cut and description for each item(s) must accompany the RFQ, if the item(s) is to be considered. Please carefully read each section of this RFQ. Acceptance of Proposals: The Jackson Public School District reserves the right to: Have sole discretion to waive minor irregularities in proposals. A minor irregularity is a variation from the proposal that does not affect the proposal, or gives one Offeror an advantage or benefit not enjoyed by other Offerors, or adversely impacts the interests of the school district. Accept the "lowest and best" RFQ which in their judgment assures JPSD the product(s) or service(s) having the best performance and the highest level of function, quality and value. Not accept the lowest priced proposal. Proposals that do not comply with the requirements stated within this RFQ or which are submitted after the deadline are subject to disqualification. Request additional information or conduct discussions with one or more respondents after the RFQ deadline, to secure a final selection to award RFQ should such action be in the best interest of JPSD. See Page Five (5) for further instructions I/WE UNDERSTAND AND AGREE THAT NEITHER THE AWARD OF THIS RFQ TO ME/US BY THE DISTRICT'S BOARD OF TRUSTEES NOR RECEIPT BY ME/US OF A NOTICE OF ACCEPTANCE OF THIS RFQ SHALL CONSTITUTE THE MAKING OF A CONTRACT BETWEEN JPSD AND ME/US, WHICH SHALL BE CONDITIONED UPON THE EXECUTION BY BOTH JPSD AND ME/US OF A FORMAL, WRITTEN AGREEMENT. RESPECTFULLY SUBMITTED, COMPANY __________________________________________________________________________________ ADDRESS __________________________________________________________________________________ __________________________________________________________________________________ PHONE ______________________________________ FAX _______________________________________ E-MAIL ADDRESS __________________________________________________________________________________ SIGNED __________________________________________________________________________________ PRINT NAME __________________________________________________________________________________ TITLE __________________________________________________________________________________ DATE ___________________________________________________________________________________ CIRCLE THE OPERATING STATUS OF YOUR BUSINESS AS INDICATED: WOMAN OWNED NON-MINORITY MINORITY 3 Post Office Box 2338 - Jackson, Mississippi 39225-2338 Telephone: 601-960-8799 Fax: 601-960-8967 Email: bjones@jackson.k12.ms.us REQUEST TO ADD VENDOR To be completed by JPS School/Location: School/Department Requesting Vendor Addition ______________________________________ To Be Completed by Vendor: Please complete all sections and return by fax or email. Will your company accept purchase orders? _____Yes _____No Note: An original JPS purchase order is required for all material purchases. Do not accept any order without a purchase order. Are you an employee of the Jackson Public School District? ____Yes or ____No Product Line ___________________________________________________________ PARENT COMPANY NAME: ______________________________________________ Doing Business As (dba) NAME: ___________________________________________ Order Address: _________________________________________________________ City: __________________________ State: ____________ Zip: _______________ Physical Address: ________________________________________________________ City: __________________________ State: ____________ Zip: _______________ REMITTANCE ADDRESS: Vendor Name: __________________________________________________________ Address: _______________________________________________________________ City: ___________________________ State: ______________ Zip: _________ Contact Person: _________________________________________________________ Phone: (_____) _____________________ Fax (_____) __________________ Email Address: __________________________________________________________ Parent Company Tax ID#___________________________________________________ D/B/A Federal Tax ID/Social Security #: _______________________________________ Select One This information will be used to track purchases from minority vendors. Minority Code: _____Woman & Minority _____Minority _____Non-Minority _____Woman Select One Type of Entity _____Individual/Sole Proprietor _____Corporation _____Partnership _____Other ___________ ****JPS accepts no responsibility for orders filled without a valid purchase order**** Submitted By: Signature Date FOR INTERNAL USE ONLY Vendor Number: _____________________ 1099: _____Yes _____No Completed By: _______________________ Date: __________________ Companys W-9 must accompany this form for IRS purposes. Revised 11-08-18 bj JACKSON PUBLIC SCHOOLS Transforming lives through excellent education mailto:bjones@jackson.k12.ms.us 4 The Board of Trustees of the Jackson Public School District (hereafter referred to as "JPSD") is soliciting sealed, written formal RFQ proposals from qualified vendors (hereafter referred to as "Vendor") for the purchase of furniture, equipment, supplies, materials, labor or services as outlined in the following specifications. Sealed RFQs shall be received by JPSD, in the Business Office of the Jackson Public Schools, 662 South President Street, Jackson, Mississippi, until the time specified on the RFQ Opening Schedule (front page of the formal RFQ document), at which time all RFQs shall be publicly opened and read aloud. Neither dating of the RFQ form nor placing the RFQ in the mail by this date shall meet legal requirements; the formal RFQ document must be received in the Business Office of the Jackson Public School District on or before the date and time stated. JPSD reserves the right to reject any and all RFQs received and to waive any and all informalities. Vendors are encouraged to very carefully read all sections of this RFQ document prior to submitting an RFQ proposal. It is the basic philosophy of JPSD to extend to all responsible Vendors equal consideration and the assurance of unbiased judgment in determining whether their product or service meets specifications and the educational needs of the school district. JPSD shall fairly evaluate all formal RFQ proposals submitted and base all decisions on the "lowest and best" RFQ concept, purchasing only those products and/or services which meet the specifications as written. All decisions rendered shall strive to achieve the greatest value from every tax dollar expended. JPSD shall make no discrimination based on race, color, creed, religion, or national origin, in either the product evaluation process or in transacting business with Vendors or Vendor representatives. The advertising and publishing of this RFQ has met all legal requirements (Mississippi Code of 1972, Annotated, 31-7-13), hence the requirement to offer public notice of the intent of JPSD to solicit RFQs via this RFQ document has been satisfied. This document is to serve as an invitation to all qualified vendors to extend to JPSD, an offer, for the sale of all products and/or services specified herein. It is the purpose of this RFQ document to clearly define "open" and "competitive" product or service RFQ specifications. All items on this RFQ are to be as specified or JPSD approved equal. Addendum: Vendor shall acknowledge the receipt of all addendums that may have been during the course of this RFQ. If specified in the text of the addendum, in addition to acknowledging receipt of the addenda below, the addenda may require additional information required for the RFQ (e.g., pricing), in which case the Addendum shall not only be acknowledged below but shall be completed and attached to the RFQ at the time the RFQ proposal is submitted. Receipt of the following Addendum issued during the course of this formal RFQ is hereby acknowledged: Addendum Number Date Addendum Number Date Addendum Number Date It is acknowledged that this RFQ proposal consists of the following sections: PROPOSAL FORM, INSTRUCTIONS AND CONDITIONS, SPECIFICATIONS and any ADDENDUM (if applicable). Net Prices In all cases, prices quoted are to be net including all applicable discounts. A separate price shall be offered for each item and not in combination with other items (unless the grouping of items is otherwise allowed as defined in the specifications). Unit price shall prevail in case of a conflict between unit and total price (extension); written price shall prevail in case of a conflict between written and enumerated pricing. Vendors are instructed to round off all unit pricing and extensions to the nearest whole cent; i.e., round the pricing to two places to the right of the decimal point only. The JPSD mainframe computer database is designed to accept only pricing which is stated in this manner. All items for which pricing is submitted which is other than two places to the right of the decimal shall be accepted; however, all digits beyond a whole cent (more than two places to the right of the decimal) shall be ignored in the RFQ analysis process and the unit price indicated on the purchase order shall be to the nearest whole cent for each item involved. 5 Payment and Invoicing Unless otherwise indicated in the detailed specifications of this RFQ document; JPSD shall make remittance in a single lump sum payment following satisfactory delivery of all items listed on the purchase order or following satisfactory performance (final inspection) of all services as specified in the contract. JPSD remits by "completed purchase order" only; remittance shall not be made upon receipt of partial shipments or performance, or the receipt of invoicing for same, but only after all items included on the purchase order or contained in the contract are delivered and/or satisfied. It is mutually understood that invoices submitted against Multi-Year or Open Purchase Orders, remittances are processed based on the contracted scheduled agreement prior to the purchase order being generated. Only Multi-Year and Open Purchase Orders have multiple invoices received for remittance for payment. Professional Services, materials and other such services; invoices are submitted for payment in intervals following satisfactory delivery of ALL services and /or performance of ALL services indicated in the contracted agreement between said vendor and JPSD for that time period, following inspection if applicable. Default and Delays Upon failure of the Vendor to deliver all of the items ordered or to render service, within the time set or allowed, the successful Vendor shall be considered in default, in which case JPSD reserves the right to terminate the purchase order or contract and to purchase similar supplies, services, or furniture and equipment, on the open market or secure the manufacture, delivery, and installation thereof by contract or otherwise. The Vendor shall be charged with any cost occasioned by JPSD whether said cost is the same as originally accepted or any excess cost. Damage to School Property Any damage or loss to JPSD property as a result of any action by the Vendor in the delivery, execution or performance of any item or service stated in these specifications shall be repaired or replaced to the satisfaction of designated JPSD personnel, at the Vendor's cost, within a reasonable time. Guarantee Each Vendor, by presenting an RFQ under these specifications, binds himself to make positive that all goods are fully up to the standards set by the specifications. Should it be discovered within a reasonable period of time from the date of purchase order or contract that such goods or services are not up to standard, JPSD shall have the right to have such goods or services replaced by others conforming to the standard requirements and the entire expense be borne by the Vendor. The Vendor shall agree to guarantee and warrant all equipment provided as a result of this RFQ for a period equal to the stated guaranty/warranty in the specifications. All such warranties shall provide the coverage as indicated in the specifications. Acceptance and Award of RFQ Proposals The Vendor's RFQ proposal, once submitted and accepted as a valid RFQ by JPSD, shall be deemed by both parties to constitute a legal and binding offer on the part of the Vendor to sell to JPSD as per the terms of the RFQ specifications, all products and/or services contained therein. RFQ proposals are subject to acceptance by JPSD at any time within ninety (90) calendar days following the RFQ opening date. Consequently, all price quotations shall be effective for a minimum of ninety (90) calendar days and a maximum period as indicated in the specifications. All RFQs must be valid for the effective dates stated in the specification, if applicable. Award of contract shall be made to the responsible Vendor whose RFQ, conforming to the specifications, is deemed to be the most advantageous to JPSD, price and all other factors considered. The Vendor acknowledges the right of JPSD to reject the RFQ, in part or in total, if the Vendor fails to submit the data required in the specifications, or if the RFQ is in any way incomplete or irregular. Under no circumstances may a Vendor deliver, install, or perform any service as specified in these specifications without written authorization from JPSD (i.e., a duly issued purchase order or signed contract). All formal RFQ proposals shall be approved by the Board of Trustees prior to the award of the RFQ. The Vendor shall be issued a purchase order document, which shall be deemed acceptance of the RFQ proposal offer made by the Vendor, for all items and/or services approved by the Board of Trustees and awarded as a result of this RFQ. However, if in the opinion of JPSD a contract document is required to 6 authorize the award of the RFQ, Vendor agrees to sign and execute all such contract documents as required in the written specifications. NOTE: If Vendor policy requires that JPSD sign Vendor contract documents, a sample of all such documents shall be included with the RFQ proposal and shall become a part of the Vendor's RFQ proposal. All awards are based on the availability of funding. In the event of a reduction of funds, this award can be rescinded at any time. Grievance Procedure JPSD has adopted a Vendor Grievance Procedure to address and resolve any Vendor grievances or disputes resulting from or arising out of JPSDs RFQ process. If Vendor disagrees with any aspect of the RFQ process, Vendor shall adhere to the following procedure. Vendor shall submit a letter or written statement of protest to the Purchasing Agent, with a copy to the Superintendent, identifying the RFQ, including RFQ number, title, opening date and, if applicable, the item number(s) at issue, and explaining, in detail, the nature of and/or reason(s) for the protest. No verbal protest shall be acknowledged by JPSD. Vendor protests must be received by the Purchasing Agent not later than five (5) business days prior to the date of the Board meeting at which the Board is to act upon the RFQ that is the subject of the protest. A review committee, appointed by the Superintendent, shall evaluate the protest and render a decision expeditiously. The decision of the review committee shall be based on evidence presented by the Vendor, the Purchasing Agent and other appropriate parties, to be determined in the discretion of the committee. In the sole discretion of the committee, the committee may conduct a hearing on Vendors protest. The decision of the review committee shall be submitted to the Superintendent for approval. The protesting Vendor shall be informed, in writing, of the Superintendents decision not later than two (2) business days prior to the date of the Board meeting at which the Board is to act upon the RFQ that is the subject of the protest. The Superintendents decision shall be final unless Vendor appeals such decision to the Board of Trustees. If Vendors wishes to appeal the Superintendents decision, Vendor shall deliver its appeal, in writing, to the Office of the Superintendent not later than 12:00 p.m. on the date of the Board meeting at which the Board is to act upon the RFQ that is the subject of the appeal. Appeals shall be presented to the Board at the meeting at which the Board acts upon the RFQ that is the subject of the appeal and Vendor, upon written request, will be granted up to five (5) minutes to appear and present to the Board at such meeting its protest and/or appeal. After the Board takes final action upon an RFQ, no appeals or protests will be acknowledged by JPSD. The decision of the Board shall be final, subject to Vendor's right to pursue a legal remedy. Submission of RFQ Proposals Instructions if not electronically submitted: Responses, once completed, should be placed in an opaque, sealed envelope On the outside of the envelope, list the companys name/address, RFQ number, title, opening date and addressee information as they appear in the RFQ proposal in order that the response may be accurately delivered and registered upon receipt. A designated official who is a legal representative of the Company must list required signatures where noted prior to submitting sealed proposal. Failure to comply with the above submittal instructions will cause proposals not to be registered or cataloged to appropriate file or received timely. The original documents must be displayed in front of all copies submitted by interested parties. Please submit Original RFQ Documents in the Format Outlined along Six (6) Copies and any Documentation submitted with Proposal when Mailed or Hand Delivered. Any proposal not received by the stated submission deadline/time will not be considered and/or opened. The proposal will be returned to the vendor at the vendors expense. The District accepts no liability for late submissions due to the actions of the United States Postal Service, Federal Express, United Parcel Service or any other delivery methods. 7 Page (15): Cover page is to be placed on the very front of the vendors submitted proposal. In the event that this page is not displayed when the opening of proposal occurs; it will not be acknowledged or allowed to be presented. Place this page on the very front of the submitted documents. This applies to all submitted proposals weather mailed, hand delivery or electronically mailed. Please submit proposal when mailed or hand delivered to: Jackson Public School District Business Office Attn: Bettie Jones 662 S. President Street Jackson, MS 39201 Or Vendors must be registered with Central Bidding at www.centralbidding.com in order to electronically upload RFQ proposals at no cost. For any questions concerning the process, or how to register, please contact Central Bidding at 225- 810-4814. No copies are warranted if submitted electronically. Please follow the proposal submittal instructions. PLACE COVER PAGE (15) IN THE FRONT OF PROPOSAL. INSERT PAGE NUMBERS WHEN SUBMITTING ELECTRONIC PROPOSALS VIA EMAIL. SUBMIT RFQ DOCUMENTS IN THE ORIGINAL FORMAT ALONG WITH OTHER SUPPORTING DOCUMENTS ATTACHED AND UPLOAD TO CENTRAL BIDDING AT WWW.CENTRALBIDDING.COM FREE, AT NO COST TO THE VENDOR. Please follow the proposal submittal instructions. http://www.centralbidding.com/ http://www.centralbidding.com/ 8 Proposal Cover Page VENDOR INFORMATION Name and Title _______________________________________________________________________ Company Name________________________________________________Date___________________ SUBMISSION COVER SHEET AND CONFIGURATION SUMMARY By my signature below, I hereby represent that I am authorized to and do bind the offeror to the provisions of the attached proposal. The undersigned offers and agrees to perform the specified personal and professional services in accordance with provisions set forth in the Request for Proposals. Furthermore, the undersigned fully understands and assures compliance with the Conditions of Solicitation and Standard Terms and Conditions contained in the RFQ. The undersigned is fully aware of the evaluation criteria to be utilized in vendor selection for approval. I further certify that ___________________________ is an authorized dealer in good standing of the products/services included in the proposal submitted in response to the RFQ. ______________________________ ______________________ Authorized Signature Date ______________________________ Printed Signature ------------------------------------------------------------------------------------------------------------------------------- ----------- ----------- CONFIGURATION SUMMARY Vendor must provide a summary of the main component of services offered in this proposal using 100 words or less. For all questions, see contact information below. Jackson Public School District 101 Dennis Holloway Drive Jackson, MS 39203 Contact Information: Ms. Sandra Robinson Telephone: 601-960-8784 E-mail: sarobinson@jackson.k12.ms.us mailto:sarobinson@jackson.k12.ms.us 9 The Jackson Public School District is seeking Requests for Qualifications (RFQ) for architectural/engineering design and project management services related, but not limited to: ESSER 2 and ESSER 3 funded projects and any other district projects as approved. Responses that are mailed or hand delivered must be sent to the address listed on page seven (7) and must be received no later than October 13, 2021 at 10:00 am CST. Packages or envelopes must be clearly labeled with RFQ # 2021-04, Title, Opening date & time and vendors return address information. NOTE: These federally funded projects must be completed on or before September 30, 2023 for ESSER II and September 30, 2024 for ESSER III. In your submittal, please include the following: 1. Firm background and history. 2. Qualifications, including resumes, of team members and any sub-consultants that will be used. 3. Examples of design experience with relevant K-12 and federally funded projects. 4. Examples of project management experience with K-12 and federally funded projects. 5. Certification that your firm or members of your firm have not been disbarred, suspended, or otherwise excluded from or ineligible for participation in federal assistance programs or activities. 6. Three (3) references from different school districts confirming work achievements. Jackson Public Schools will hold a Pre-Submission Conference at 2:00 p.m. CST on Wednesday, October 6, 2021 at 1:30 p.m. at Enoch Administrative Complex, 101 Dr. Dennis Holloway Drive, Jackson, MS 39203. Attendance at the Pre-Submission Conference is not mandatory, but strongly encouraged. 10 Acceptance and Award of RFQ Proposals This RFQ proposal is subject to acceptance by JPSD at any time within ninety (90) calendar days following the RFQ submission deadline. All RFQs must be valid for the effective dates stated in the specification, if applicable. All RFQs not accepted within (90) calendar days will remain in the pool of potential candidates throughout ESSER II and ESSER III or September 30, 2024 whichever comes first. Award of contract shall be made to the responsible Vendor whose RFQ, conforming to the specifications, is deemed to be the most advantageous to JPSD, and all other factors considered. The Vendor acknowledges the right of JPSD to reject the RFQ, in part or in total, if the Vendor fails to submit the data required in the specifications, or if the RFQ is in any way incomplete or irregular. Selection Criteria The proposals will be evaluated on the following criteria: Expertise as demonstrated in the Statement of Qualifications, including referenced experience Resumes provided of team leaders and team members including sub-consultants Work related to federal programs and school districts of similar or greater size and sociodemographic composition Past performance in the Jackson Public Schools on similar or related projects JPSD may conduct additional interviews with the design professionals and request examples of past work. Submission of RFQ Proposals RFQs, once completed, should be placed in an opaque sealed envelope. On the outside of the envelope, list the vendors name/address, RFQ number and title as they appear on the RFQ proposal in order that the RFQ may be accurately registered upon receipt. A responsible official who is a legal representative of the Vendor must sign the attached proposal form, in order for the RFQ to be valid and acceptable. An RFQ which is not signed is not binding on the part of the Vendor and therefore does not constitute an informality which may be waived by JPSD. Please submit proposal to address listed below: Jackson Public Schools will not consider any Statement of Qualifications received after the Deadline. Information for Respondents relating to this Request for Statement of Qualifications ("RFQ") is on file and open for public inspection at the Business Office of Jackson Public Schools. Jackson Public Schools reserves the right to: (1) reject any and all Statement of Qualifications, for any reason, any time before execution of a contract or purchase order with a Respondent selected by Jackson Public School to perform the Services and (2) waive any and all informalities and irregularities in the selection process. 11 ASSURANCES AND SIGNATURE FORM In submitting this application I certify that: 1. The organization will comply with applicable federal, state, and local policies and procedures. 2. Services will be provided under the supervision of highly qualified teachers and/or administrators.* 3. The organization will maintain professionalism and confidentiality. 4. The organization is fiscally sound and will be able to complete services to the local educational agency. 5. The organization will ensure that the services provided are aligned the Mississippi Curriculum Frameworks and scientifically research based practices.* 6. The organization will comply with applicable federal, state, and local health, safety, and civil rights laws. 7. Provisions that subject all individuals employed by or otherwise associated with the approved provider, including volunteers, support staff, etc., who have direct contact with students, to the fingerprint and criminal history record check contained in law, including, Education Laws 305(30), 1125(3), 1604(39), 1604(40), 1709(39), 1709(40), 1804(9), 1804(10), 1950(4)(11), 1950(4)(mm), 2503 (18), 2503(19), 2554(25), 2554(26, 2590-h (20), 2854(3)(a-2), 2854(3)(a-3), and 3035. 8. All services will be secular, neutral, and non-ideological. 9. The organization will provide the local educational agency with information regarding implementation of proposal initiatives in increasing achievement, in a format, and to the extent practicable, a language or other mode of communication such that district personnel, parents / legal guardians, and community members can understand.* The undersigned hereby certifies that I am an individual authorized to act on behalf of the organization in submitting this application and assurances. I certify that all of the information provided herein is true and accurate, to the best of my knowledge. I understand that the discovery of deliberately misrepresented information contained herein may constitute grounds for denying the applicants request for approval. Name of Organization Printed Name of Authorized Representative Signature of Authorized Representative Date Signed *For Educational/Instructional proposals 12 INDEPENDENT CONTRACTOR DEBARMENT VERIFICATION FORM (Please print clearly or type) **Appropriate signatures shall certify statements below. FEDERAL DEBARMENT CERTIFICATION: CONTRACTOR hereby certifies that at the execution of a contract with the Jackson Public School District(JPS) that the CONTRACTOR is not on the list for federal debarment on www.sam.gov System for Award Management. STATE OF MISSISSIPPI REGISTRATION: CONTRACTOR hereby certifies that at the execution of a contract with the Jackson Public School District (JPS) that the CONTRACTOR is not on the list for debarment on www.sos.ms.gov for doing business with the State of Mississippi or with any Mississippi State Agency. PARTNERSHIP DEBARMENT CERTIFICATION: CONTRACTOR hereby certify that all entities who are in partnership through this contract or grant with the Jackson Public School District(JPS) (subcontractors, subrecipients, et al.) are not on the federal debarment list on www.sam.gov System for Award Management or the State of Mississippi debarment list. Proof of documentation of partnership verification with SAM shall be kept on file and the debarment status shall be checked prior to submission of every contract/subgrant and modification to JPS. Original Signature of Contractor or Authorized Official Date Subgrantees/Contractors Name Authorized Officials Name Complete Address Contact Number Are you currently registered to do business in the State of Mississippi? (Yes or No) If yes, attach supporting documentation of registration status. If, no please register and provide documentation of registration status. (State/Other fund requirement) JACKSON PUBLIC SCHOOLS Transforming lives through excellent education http://www.sam.gov/ http://www.sos.ms.gov/ 13 INDEPENDENT CONTRACTOR DEBARMENT VERIFICATION FORM* (Please print clearly or type) **Appropriate signatures shall certify statements below. FEDERAL DEBARMENT CERTIFICATION: CONTRACTOR hereby certifies that at the execution of a contract with the Jackson Public School District (JPS), that the CONTRACTOR is not on the list for federal debarment on www.sam.gov System for Award Management. STATE OF MISSISSIPPI REGISTRATION: CONTRACTOR hereby certifies that at the execution of a contract with the Jackson Public School District (JPS),that the CONTRACTOR is not on the list for debarment on www.sos.ms.gov for doing business with the State of Mississippi or with any Mississippi State Agency. Subgrantees/Contractors Name Authorized Officials Name Complete Address Contact Number Are you currently registered with www.sam.gov (Yes or No) If yes, attach supporting documentation and DUNS number must be Active with open access. (Federal fund requirement) Are you currently registered to do business in the State of Mississippi? (Yes or No) If yes, attach supporting documentation of registration status. If not, please register and provide documentation of registration status. (Federal and State/Other fund requirement) JACKSON PUBLIC SCHOOLS Transforming lives through excellent education http://www.sam.gov/ http://www.sos.ms.gov/ http://www.sam.gov/ 14 PARTNERSHIP DEBARMENT CERTIFICATION: CONTRACTOR hereby certifies that all entities who are in partnership through this contract or grant with the Jackson Public School District (JPS) (subcontractors, subrecipients, et al.) are not on the federal debarment list on www.sam.gov System for Award Management or the State of Mississippi debarment list. Proof of documentation of partnership verification with SAM shall be kept on file and the debarment status shall be checked prior to submission of every contract/subgrant and modification to JPS. ______________________________________________ ________________________ Original Signature of Contractor or Authorized Official Date 15 Jackson Public School District 662 South President Street Jackson, MS 39201 RFQ Proposal #_________ RFQ Title ________________________________________________________________ ________________________________________________________________________ Submission Deadline Date and Time: __________________________________________ Participating Vendor Name__________________________________________________ Address_________________________________________________________________ Hand written Signature_____________________________________________________ Addendums Acknowledge Yes_________ or No_________ Combined Proposal Total Cost if Applicable_______________________ This cover page is to be placed on the very front of the vendors submitted proposal. In the event that this page is not displayed when the deadline opening date occurs; it will not be acknowledged or allowed to be presented. Place this page on the very front of the submitted documents. This applies to all submitted proposals weather mailed, hand delivery or electronically emailed. Lo! JACKSON PUBLIC SCHOOLS