HomeMy WebLinkAboutRFQ - SCADA Support - SLOThe City of San Luis Obispo is committed to including disabled persons in all of our services, programs and activities.
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Notice Requesting Proposals / Qualifications for SCADA Support Services
The City of San Luis Obispo is requesting sealed proposals for SCADA Support services.
All firms interested in receiving further correspondence regarding this Request for Qualifications (RFQ)
will be required to complete a free registration using BidSync (https://www.bidsync.com/bidsync-app-
web/vendor/register/Login.xhtml). All proposals must be received via BidSync by the Department of
Finance at or before June 8, 2023 when they will be opened electronically via BidSync on the proposal end
date and time.
The preferred method for bid submission is electronic via BidSync. However, if you wish to submit a paper
copy, please submit it in a sealed envelope to the Department of Finance, City of San Luis Obipso, 990
Palm Street, San Luis Obispo, CA, 93401.
Project packages and additional information may be obtained at the City’s BidSync website at
www.BidSync.com. Please contact Josh Erquiaga, jerquiag@slocity.org, with any questions.
For technical help with BidSync please contact BidSync tech support at 800-990-9339.
TABLE OF CONTENTS
A. INTRODUCTION ........................................................................................................................................... 1
B. SCOPE OF WORK ......................................................................................................................................... 1
C. GENERAL TERMS ........................................................................................................................................2
D. SPECIAL TERMS .........................................................................................................................................4
E. PROPOSAL CONTENT..................................................................................................................................6
F. INSURANCE.................................................................................................................................................10
G. SUBMITTAL FORM......................................................................................................................................13
H. REFERENCES................................................................................................................................................14
I. STATEMENT OF PAST DISQUALIFICATIONS..................................................................................................16
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A.INTRODUCTION
Experience: Respondents must demonstrate experience with one or more of the following:
1.Allen Bradley PLCs
2.GE iFix
3.Ignition Perspective
B.SCOPE OF WORK
Technical Support:
1.Routine and Emergency troubleshooting: Provide the City with tiered technical support
as follows:
a.Immediate telephone support, available on a 24/7 basis. During business hours,
the City will call project personnel directly. For support after working hours, provide
a single telephone number for a person or an answering service who can contact the
appropriate Consultant personnel for a call back within one hour. Consultant shall
begin remote troubleshooting within two hours of receipt of notification by the
City.
b.Escalation to on-site support if deemed necessary to resolve the problem.
Consultant shall be on site within 24 hours of receipt of notification that on-site
support is necessary.
2.Programming support: Provide the City with PLC programming support. PLC programs
developed for the City shall conform to the standards developed by the City.
Capital Project Support: In addition to on-call technical support, from time to time, the City may have
capital improvement projects that will require the addition or modification to facilities that are
monitored and controlled by the SCADA system. When such projects occur, the City requires the SCADA
System Integrator to implement the SCADA system design associated with the project. The Consultant’s
scope of work associated with capital improvement projects will generally include the following tasks.
1.Design Support: During the design phase of a capital improvement project, the
Consultant shall participate in design meetings with the City. Determine with the City how
the project will be integrated, provide input regarding the project’s interface to the SCADA
system, conduct workshops to develop functional specifications detailing the PLC I/O,
alarms, set points, and control strategies, and review design submittals as they relate to
SCADA.
2.Construction Phase Support: Review facility construction contractor submittals
applicable to SCADA.
a.Develop new and/or modify existing detailed SCADA supervisory control logic,
screens, reports, etc.
b.Implement and test PLC and HMI programming to the specifications.
c.Conduct Factory Acceptance testing of revised SCADA system programming.
d.Deploy the approved software to the live SCADA system, ensure the field
equipment communicates properly, and conduct a witnessed site acceptance test
showing the resulting system works to the specifications. All Deployments must be
scheduled and coordinated with City Staff.
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e.Perform SCADA-related startup activities, assist with the startup of new
processes, and conduct SCADA System Site Acceptance Testing.
f.Provide training to the City’s operators on the changes to the SCADA system
implemented on the project. The City will provide a location for the training to occur
as well as equipment.
C. GENERAL TERMS AND CONDITIONS
PROPOSAL REQUIREMENTS
1.Requirement to Meet All Provisions. Each individual or firm submitting a proposal (bidder) shall
meet all the terms, and conditions of the Request for Qualifications (RFQ) project package. By
virtue of its proposal submittal, the bidder acknowledges agreement with and acceptance of all
provisions of the RFQ specifications.
2.Proposal Submittal. Each proposal must be submitted on the form(s) provided in the
specifications and accompanied by any other required submittals or supplemental materials.
Proposal documents shall be submitted electronically via BidSync. However, if you can’t submit
electronic please send your bid copy in a sealed envelope to the Department of Finance, City of
San Luis Obispo, 990 Palm Street, San Luis Obispo, CA, 93401. To guard against premature
opening, the proposal should be clearly labeled with the proposal title, project number, name of
bidder, and date and time of proposal opening. No FAX submittals will be accepted.
3.Insurance Certificate. Each proposal must include a certificate of insurance showing:
a.The insurance carrier and its A.M. Best rating.
b.Scope of coverage and limits.
c.Deductibles and self-insured retention.
The purpose of this submittal is to generally assess the adequacy of the bidder’s insurance
coverage during proposal evaluation; as discussed under paragraph 12 below, endorsements are
not required until contract award. The City’s insurance requirements are detailed in Section E.
4.Proposal Quotes and Unit Price Extension. The extension of unit prices for the quantities
indicated and the lump sum prices quoted by the bidder must be entered in figures in the spaces
provided on the Proposal Submittal Form(s). Any lump sum bid shall be stated in figures. The
Proposal Submittal Form(s) must be totally completed. If the unit price and the total amount
stated by any bidder for any item are not in agreement, the unit price alone will be considered as
representing the bidder’s intention and the proposal total will be corrected to conform to the
specified unit price.
5.Proposal Withdrawal and Opening. A bidder may withdraw its proposal, without prejudice prior
to the time specified for the proposal opening, by submitting a written request to the Director of
Finance for its withdrawal, in which event the proposal will be returned to the bidder unopened.
No proposal received after the time specified or at any place other than that stated in the “Notice
Inviting Bids/Requesting Proposals” will be considered. All proposals will be opened and declared
publicly. Bidders or their representatives are invited to be present at the opening of the
proposals.
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6.Submittal of One Proposal Only. No individual or business entity of any kind shall be allowed to
make or file, or to be interested as the primary submitter in more than one proposal, except an
alternative proposal when specifically requested; however, an individual or business entity that
has submitted a sub-proposal to a bidder submitting a proposal, or who has quoted prices on
materials to such bidder, is not thereby disqualified from submitting a sub-proposal or from
quoting prices to other bidders submitting proposals.
7.Communications. All timely requests for information submitted in writing will receive a written
response from the City. Telephone communications with City staff are not encouraged but will
be permitted. However, any such oral communication shall not be binding on the City.
CONTRACT AWARD AND EXECUTION
8.Proposal Retention and Award. The City reserves the right to retain all proposals for a period of
60 days for examination and comparison. The City also reserves the right to waive non-substantial
irregularities in any proposal, to reject any or all proposals, to reject or delete one part of a
proposal and accept the other, except to the extent that proposals are qualified by specific
limitations. See the “special terms and conditions” in Section C of these specifications for
proposal evaluation and contract award criteria.
9.Competency and Responsibility of Bidder. The City reserves full discretion to determine the
competence and responsibility, professionally and/or financially, of bidders. Bidders will provide,
in a timely manner, all information that the City deems necessary to make such a decision.
10.Contract Requirement. The bidder to whom award is made (Contractor) shall execute a written
contract with the City within ten (10) calendar days after notice of the award. The contract shall
be made in the form adopted by the City and incorporated in these specifications.
CONTRACT PERFORMANCE
11.The City’s contract terms and conditions that [Contractor/Consultant] will be expected to execute and
be bound by are attached hereto as Exhibit A
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SPECIAL TERMS AND CONDITIONS
1.Contract Award. Subject to the reservations set forth in Paragraph 9 of Section B (General Terms
and Conditions) of these specifications, the contract will be awarded to the lowest responsible,
responsive proposer.
2.Sales Tax Reimbursement.
For sales occurring within the City of San Luis Obispo, the City receives sales tax revenues.
Therefore, for bids from retail firms located in the City at the time of proposal closing for which
sales tax is allocated to the City, 1% of the taxable amount of the bid will be deducted from the
proposal by the City in calculating and determining the lowest responsible, responsive proposer.
3.Labor Actions.
In the event that the successful proposer is experiencing a labor action at the time of contract
award (or if its suppliers or subcontractors are experiencing such a labor action), the City reserves
the right to declare said proposer is no longer the lowest responsible, responsive proposer and to
accept the next acceptable low proposal from a proposer that is not experiencing a labor action,
and to declare it to be the lowest responsible, responsive proposer.
4.Failure to Accept Contract.
The following will occur if the proposer to whom the award is made (Contractor) fails to enter into
the contract: the award will be annulled; any bid security will be forfeited in accordance with the
special terms and conditions if a proposer's bond or security is required; and an award may be
made to the next lowest responsible, responsive proposer who shall fulfill every stipulation as if
it were the party to whom the first award was made.
5.Contract Term.
The supplies or services identified in this specification will be used by the City for five years. The
prices quoted for these items must be valid for the entire period indicated above unless otherwise
conditioned by the proposer in its proposal.
6.Contract Extension.
The term of the contract may be extended by mutual consent for an additional one-year, and
annually thereafter, for a total of four years.
7.Supplemental Purchases
Supplemental Purchases. Supplemental purchases may be made from the successful proposer
during the contract term in addition to the items listed in the Detail Proposal Submittal Form. For
these supplemental purchases, the proposer shall not offer prices to the City in excess of the
amounts offered to other similar customers for the same item. If the proposer is willing to offer
the City a standard discount on all supplemental purchases from its generally prevailing or
published price structure during the contract term, this offer and the amount of discount on a
percentage basis should be provided with the proposal submittal.
8.Contractor Invoices.
The Contractor may deliver either a monthly invoice to the City with attached copies of detail
invoices as supporting detail, or in one lump-sum upon completion.
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9 Non-Exclusive Contract. The City reserves the right to purchase the items listed in the Detail
Proposal Submittal Form, as well as any supplemental items, from other vendors during the
contract term.
10.Unrestrictive Brand Names. Any manufacturer's names, trade names, brand names or catalog
numbers used in the specifications are for the purpose of describing and establishing general
quality levels. Such references are not intended to be restrictive. Proposals will be considered for
any brand that meets or exceeds the quality of the specifications given for any item. In the event
an alternate brand name is proposed, supplemental documentation shall be provided
demonstrating that the alternate brand name meets or exceeds the requirements specified
herein. The burden of proof as to the suitability of any proposed alternatives is upon the proposer,
and the City shall be the sole judge in making this determination.
11.Delivery. Prices quoted for all supplies or equipment to be provided under the terms and
conditions of this RFP package shall include delivery charges, to be delivered F.O.B. San Luis
Obispo by the successful proposer and received by the City within 90 days after authorization to
proceed by the City.
12.Start and Completion of Work. Work on this project shall begin immediately after contract
execution and shall be completed within 90 calendar days thereafter, unless otherwise negotiated
with City by mutual agreement.
13.Change in Work. The City reserves the right to change quantities of any item after contract award.
If the total quantity of any changed item varies by 25% or less, there shall be no change in the
agreed upon unit price for that item. Unit pricing for any quantity changes per item in excess of
25% shall be subject to negotiation with the Contractor.
14.Submittal of References. Each proposer shall submit a statement of qualifications and references
on the form provided in the RFP package.
15.Statement of Contract Disqualifications. Each proposer shall submit a statement regarding any
past governmental agency bidding or contract disqualifications on the form provided in the RFP
package.
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PROPOSAL CONTENT
1.Proposal Content. Your proposal must include the following information:
Submittal Forms
a.Proposal submittal summary.
b.Certificate of insurance.
c.References from at least three firms for whom you have provided similar services.
Qualifications
d.Experience of your firm and those of sub-consultants in performing work and projects
relevant to the Scope of Services outlined and described in the request.
e.Resumes of the individuals who would be assigned to this project, including any sub-
consultants, with their corollary experience highlighted and specific roles in this project
clearly described.
f.Standard hourly billing rates for the assigned staff, including any sub-consultants.
g.Statement and explanation of any instances where your firm or sub-consultant has been
removed from a project or disqualified from proposing on a project.
Work Program
h.Detailed description of your approach to completing the work.
i.Detailed schedule by task and sub-task for completing the work.
j.Estimated hours for your staff in performing each phase and task of the work, including
sub-consultants, so we can clearly see who will be doing what work, and how much time
it will take.
k.Detailed budget by task and sub-task for completing the work.
l.Services or data to be provided by the City.
m.Services and deliverables provided by the Consultant(s).
n.Any other information that would assist us in making this contract award decision.
o.Description of assumptions critical to development of the response which may impact
cost or scope.
Requested Changes to Terms and Conditions
p.The City desires to begin work soon after selecting the preferred Consultant Team and
expects the Consultant to execute the City’s contract and all of the terms therein, as set
forth in Exhibit A. To expedite the contracting process, each submittal shall include
requested redlined changes to terms and conditions, if necessary. Please be advised that
Consultant’s requested changes to the City’s terms and conditions will be considered by
City staff when scoring and determining the competency and responsibility of the bidder.
Proposal Length
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q.Proposal length should only be as long as required to be responsive to the RFQ, including
attachments and supplemental materials.
2.Proposal Evaluation and Selection. Proposals will be evaluated by a review committee and
evaluated on the following criteria:
a.Understanding of the work required by the City.
b.Quality, clarity and responsiveness of the proposal.
c.Demonstrated competence and professional qualifications necessary for successfully
performing the work required by the City.
d.Recent team experience in successfully performing similar services.
e.Creativity of the proposed approach in completing the work.
f.Value
g.Writing skills.
h.References.
i.Background and experience of the specific individuals managing and assigned to this
project.
j.Information about how your company mitigates the environmental impact of its services,
such as greenhouse gas emissions, amount of waste generated, water and energy use, or
other areas related to your products and services.
As reflected above, contract award will not be based solely on price, but on a combination of factors as
determined to be in the best interest of the City. After evaluating the proposals and discussing them
further with the finalists or the tentatively selected contractor, the City reserves the right to further
negotiate the proposed work and/or method and amount of compensation.
3.Proposal Review and Award Schedule. The following is an outline of the anticipated schedule for
proposal review and contract award:
a.Issue RFP May 18, 2023
b.Receive proposals June 8, 2023
c.Complete proposal evaluations June 15, 2023
d.Conduct finalist interviews and finalize recommendation June 20, 2023
e.Execute contract June 22, 2023
4.Ownership of Materials. All original drawings, plan documents and other materials prepared by
or in possession of the Contractor as part of the work or services under these specifications shall
become the permanent property of the City and shall be delivered to the City upon demand.
5.Release of Reports and Information. Any reports, information, data, or other material given to,
prepared by or assembled by the Contractor as part of the work or services under these
specifications shall be the property of the City and shall not be made available to any individual
or organization by the Contractor without the prior written approval of the City.
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6.Copies of Reports and Information. If the City requests additional copies of reports, drawings,
specifications, or any other material in addition to what the Contractor is required to furnish in
limited quantities as part of the work or services under these specifications, the Contractor shall
provide such additional copies as are requested, and City shall compensate the Contractor for the
costs of duplicating of such copies at the Contractor's direct expense.
7.Required Deliverable Products. The Contractor will be required to provide:
a.One electronic submission - digital-ready original .pdf of all final documents. If you wish
to file a paper copy, please submit in sealed envelope to the address provided in the RFQ.
b.Corresponding computer files compatible with the following programs whenever possible
unless otherwise directed by the project manager:
Word Processing: MS Word
Spreadsheets: MS Excel
Desktop Publishing: InDesign
Virtual Models: Sketch Up
Digital Maps: Geodatabase shape files in
State Plan Coordinate System as
specified by City GIS staff
c.City staff will review any documents or materials provided by the Contractor and, where
necessary, the Contractor will be required to respond to staff comments and make such
changes as deemed appropriate.
ALTERNATIVE PROPOSALS
8.Alternative Proposals. The proposer may submit an alternative proposal (or proposals) that it
believes will also meet the City's project objectives but in a different way. In this case, the
proposer must provide an analysis of the advantages and disadvantages of each of the alternative
and discuss under what circumstances the City would prefer one alternative to the other(s).
9.Attendance at Meetings and Hearings. As part of the workscope and included in the contract
price is attendance by the Contractor at up to [number] public meetings to present and discuss
its findings and recommendations. Contractor shall attend as many "working" meetings with staff
as necessary in performing work-scope tasks.
10.Accuracy of Specifications. The specifications for this project are believed by the City to be
accurate and to contain no affirmative misrepresentation or any concealment of fact. Bidders are
cautioned to undertake an independent analysis of any test results in the specifications, as City
does not guaranty the accuracy of its interpretation of test results contained in the specifications
package. In preparing its proposal, the bidder and all subcontractors named in its proposal shall
bear sole responsibility for proposal preparation errors resulting from any misstatements or
omissions in the plans and specifications that could easily have been ascertained by examining
either the project site or accurate test data in the City's possession. Although the effect of
ambiguities or defects in the plans and specifications will be as determined by law, any patent
ambiguity or defect shall give rise to a duty of bidder to inquire prior to proposal submittal. Failure
to so inquire shall cause any such ambiguity or defect to be construed against the bidder. An
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ambiguity or defect shall be considered patent if it is of such a nature that the bidder, assuming
reasonable skill, ability and diligence on its part, knew or should have known of the existence o f
the ambiguity or defect. Furthermore, failure of the bidder or subcontractors to notify City in
writing of specification or plan defects or ambiguities prior to proposal submittal shall waive any
right to assert said defects or ambiguities subsequent to submittal of the proposal.
To the extent that these specifications constitute performance specifications, the City shall not be
liable for costs incurred by the successful bidder to achieve the project’s objective or standard
beyond the amounts provided there for in the proposal.
In the event that, after awarding the contract, any dispute arises as a result of any actual or alleged
ambiguity or defect in the plans and/or specifications, or any other matter whatsoever,
Contractor shall immediately notify the City in writing, and the Contractor and all subcontractors
shall continue to perform, irrespective of whether or not the ambiguity or defect is major,
material, minor or trivial, and irrespective of whether or not a change order, time extension, or
additional compensation has been granted by City. Failure to provide the hereinbefore described
written notice within one (1) working day of contractor's becoming aware of the facts giving rise
to the dispute shall constitute a waiver of the right to assert the causative role of the defect or
ambiguity in the plans or specifications concerning the dispute.
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INSURANCE REQUIREMENTS
The Contractor shall procure and maintain insurance for the duration of the contract against claims for
injuries to persons or damages to property which may arise from or in connection with the performance
of the work hereunder by the Contractor, its agents, representatives, employees, or subcontractors.
Minimum Scope of Insurance. Coverage shall be at least as broad as:
1.Insurance Services Office Commercial General Liability coverage (occurrence form CG 0001).
2.Workers' Compensation insurance as required by the State of California and Employer's Liability
Insurance.
3.Cyber Security and Privacy Liability (for vendors providing hardware, pre-packaged software or
portal access technology or IT consultants, systems analysts, website designers, online services
and content providers, cloud-based providers, computer programmers, and software consultants,
system installation or software personnel.)
4.Cyber Technology Errors and Omissions Insurance (for software as a service for vendors or
consultants, including colocation (shared hosting centers), cloud services, managed dedicated
servers, programmers, and other IT professionals.)
Minimum Insurance Requirements. Contractor shall maintain insurance amounts of no less than:
1.General Liability: $1,000,000 per occurrence for bodily injury, personal injury and property
damage. If Commercial General Liability or other form with a general aggregate limit is used,
either the general aggregate limit shall apply separately to this project/location or the general
aggregate limit shall be twice the required occurrence limit ($2,000,000)
2.Employer's Liability: $1,000,000 per accident for bodily injury or disease.
3.Cyber Security and Privacy Liability: Consultant/Contractor shall procure and maintain Cyber
Liability insurance with limits of $1,000,000 per occurrence/loss, $2,000,000 general aggregate,
which shall include the following coverage:
a. Liability arising from the theft, dissemination and/or use of confidential or personally identifiable
information; including but not limited to personally identifiable information (PII), protected health
information (PHI), security codes, access codes, passwords, etc.
b. Network security liability arising from the unauthorized use of, access to, or tampering with computer
systems, including hacker or denial of service attacks.
c. Liability arising from introducing a computer virus into or otherwise causing damage to vendor (first-
party) or customer’s (third party) computer, computer system, network, or similarly related property and
the data, software, and programs.
d. Liability arising from professional misconduct or lack of the requisite skill required for performing
services defined in the contract or agreement.
e. Costs associated with restoring, updating, or replacing data.
f. Costs associated with a privacy breach, including notification costs, customer support, forensics, crises
management, public relations consulting, legal services of a privacy attorney, credit monitoring, and
identity fraud resolution services for affected individuals.
This coverage may be bundled into one policy or purchased as two separate policies. If coverage is
maintained on a claims-made basis, Consultant/Contractor shall maintain such coverage for an additional
period of three (3) years following termination of the contract.
4.Cyber technology errors and omissions insurance (as applicable). Consultant shall procure and
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maintain insurance with limits of $1,000,000 per occurrence/loss, $2,000,000 general aggregate,
which shall include the following coverage:
a. Liability arising from the unauthorized release of information for which an entity has the legal obligation
to keep private, such as personally identifiable information (PII) and protected health information(PHI).
b. Network security liability arising from the unauthorized use of, access to, or tampering with computer
systems, including hacker or denial of service attacks.
c. Liability arising from the failure of technology products (software and hardware) required under the
contract for Consultant to properly perform the intended services.
d. Claims alleging the failure of computer security that result in the transmission of malicious code,
deletion, destruction or alteration of data, or the denial of service.
e. Electronic Media Liability arising from personal injury, plagiarism or misappropriation of ideas, domain
name infringement or improper deep-linking or framing, and infringement or violation of intellectual
property rights.
f. Liability arising from the rendering, or failure to render, professional services.
g. Defense costs in regulatory proceedings (state and federal) involving a violation of privacy laws or
intellectual property rights.
h. Crisis management and other expert services.
If coverage is maintained on a claims-made basis, the Consultant shall maintain such coverage for an
additional three (3) years following termination of the contract.
Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to
and approved by the City. At the option of the City, either: the insurer shall reduce or eliminate such
deductibles or self-insured retentions as respects the City, its officers, officials, employees, and
volunteers; or the Contractor shall procure a bond guaranteeing payment of losses and related
investigations, claim administration and defense expenses.
Other Insurance Provisions. The general liability and automobile liability policies are to contain, or be
endorsed to contain, the following provisions:
1.The City, its officers, officials, employees, agents and volunteers are to be covered as insureds as
respects: liability arising out of activities performed by or on behalf of the Contractor; products
and completed operations of the Contractor; premises owned, occupied or used by the
Contractor; or automobiles owned, leased, hired or borrowed by the Contractor. The coverage
shall contain no special limitations on the scope of protection afforded to the City, its officers,
official, employees, agents, or volunteers.
2.For any claims related to this project, the Contractor's insurance coverage shall be primary
insurance as respects the City, its officers, officials, employees, agents, and volunteers. Any
insurance or self-insurance maintained by the City, its officers, officials, employees, agents, or
volunteers shall be excess of the Contractor's insurance and shall not contribute with it.
3.The Contractor's insurance shall apply separately to each insured against whom claim is made or
suit is brought, except with respect to the limits of the insurer's liability.
4.Each insurance policy required by this clause shall be endorsed to state that coverage shall not be
suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty
(30) days' prior written notice by certified mail, return receipt requested, has been given to the City.
Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best's rating of no
less than A:VII.
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Verification of Coverage. Contractor shall furnish the City with a certificate of insurance showing
maintenance of the required insurance coverage. Original endorsements effecting general liability and
automobile liability coverage required by this clause must also be provided. The endorsements are to be
signed by a person authorized by that insurer to bind coverage on its behalf. All endorsements are to be
received and approved by the City before work commences.
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PROPOSAL SUBMITTAL FORM
The undersigned declares that she or he has carefully examined [__________] which is hereby made a
part of this proposal; is thoroughly familiar with its contents; is authorized to represent the proposing
firm; and agrees to perform the specified work for the following cost quoted in full:
BID ITEM:
Total Base Price
Sales tax []
Other
TOTAL $
Delivery of equipment to the City to be within _______ calendar days after contract execution and written
authorization to proceed.
Certificate of insurance attached; insurance company’s A.M. Best rating: __________________.
Firm Name and Address
Contact Phone
Signature of Authorized Representative
Date
E NOTES ON THIS SAMPLE FORM
This is the City’s “basic” submittal form, and something like it should accompany all proposals,
even if: a combined “description of work/detailed proposal submittal form” (like Sample E) is
required; or price information is not requested (like Sample F).
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REFERENCES
Number of years engaged in providing the services included within the scope of the specifications under
the present business name: .
Describe fully the last three contracts performed by your firm that demonstrate your ability to provide
the services included with the scope of the specifications. Attach additional pages if required. The City
reserves the right to contact each of the references listed for additional information regarding your firm's
qualifications.
Reference No. 1:
Agency Name
Contact Name
Telephone & Email
Street Address
City, State, Zip Code
Description of services provided
including contract amount, when
provided and project outcome
Reference No. 2:
Agency Name
Contact Name
Telephone & Email
Street Address
City, State, Zip Code
Description of services provided
including contract amount, when
provided and project outcome
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Reference No. 3
Agency Name
Contact Name
Telephone & Email
Street Address
City, State, Zip Code
Description of services provided
including contract amount, when
provided and project outcome
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STATEMENT OF PAST CONTRACT DISQUALIFICATIONS
The proposer shall state whether it or any of its officers or employees who have a proprietary interest in
it, has ever been disqualified, removed, or otherwise prevented from bidding on, or completing a federal,
state, or local government project because of the violation of law, a safety regulation, or for any other
reason, including but not limited to financial difficulties, project delays, or disputes regarding work or
product quality, and if so to explain the circumstances.
◼Do you have any disqualification as described in the above paragraph to declare?
Yes No
◼If yes, explain the circumstances.
Executed on at _______________________________________ under penalty of
perjury of the laws of the State of California, that the foregoing is true and correct.
______________________________________
Signature of Authorized Proposer Representative