Download attachment c2 - Workforce Solutions Greater Dallas

ATTACHMENT A
Computer Hardware Purchase
Request for Quotations
COVER SHEET
INFORMATION ABOUT BIDDER
Identification of Bidding Entity: _____________________________________________________________
Legal Name of Organization: _______________________________________________________________
Head of Organization:
Title: __________________
Mailing Address: _________________________________________________________________________
Physical Address (if different): ______________________________________________________________
Phone Number:
Fax Number: ______________________________
Contact Person:
Title: ______________________________
Contact Person Email Address: _____________________________________________________________
Signatory Authority for Bidding Entity: ________________________________________________________
Title:
Tax/Legal Status:
Phone Number: _______________
[ ] Corporation
[ ] Partnership
[ ]
[ ]
Sole Ownership
Other
[ ] Public
[ ] Private
Date Established: _____________________________________
State Controller Identification Number: ___________________
Federal Taxpayer Identification Number: _________________
Small Business?
[ ] Yes
[ ] No
Is bidder certified as a historically underutilized business?
[ ] Yes
[ ] No
Certifying Agency? _________________________________________________________
(If yes, a copy of the certification notice is required as an attachment.)
[ ] Profit
[ ] Not For-Profit
ATTACHMENT B
Narrative
Narrative (Attachment B) to include, but are not limited to, the following:
1.
2.
3.
4.
Bidder’s Qualifications and Experience with Services/Products
Proposed Services/Products for the Workforce Solutions Offices
A statement of commitment to delivery timeline as noted in the RFQ
Cost for proposed services/products:
Computer Hardware Pricing Sheet – 1 (Attachment C1)
Computer Hardware Pricing Sheet – 2 (Attachment C2)
ATTACHMENT C1
Computer Hardware Pricing Sheet - 1
Pricing Summary
Item
A. Intel Core Small Form Computers and related hardware according
to specifications in RFQ
B. 22-inch Flat Panel Display Monitors according to specifications in
the RFQ
Quantity
Unit Cost
Total Cost
Up to 170
Up to 170
C. Total Cost
Please note that proposed pricing for all hardware indicated above must include shipping and handling costs. In
addition, a minimum three (3) Years ProSupport with Next Business Day Onsite Service warranty must be included
with all bids.
Computer Hardware Pricing Sheet - 1 Instructions:
A. In the blank space designated for Unit Cost, indicate cost, including shipping and handling fees, for a single
desktop computer. In addition, in the blank space designated for Total Cost, indicate the total cost for 170
desktop computers based on the Unit Cost shown for a single desktop computer.
B. In the blank space designated for Unit Cost, indicate cost, including shipping and handling fees, for a single
display monitor. In addition, in the blank space designated for Total Cost, indicate the total cost for 170
display monitors based on the Unit Cost shown for a single display monitor.
C. In the blank space designated for Total Cost, this should be the total amount of the Total Cost for A and B.
Bidder’s Signature:
Date: _________________
ATTACHMENT C2
Computer Hardware Pricing Sheet - 2
Pricing Summary
Item
Intel Core 22-inch All-in-One Desktop and related hardware according
to specifications in RFQ
Quantity
Unit Cost
Total Cost
Up to 60
Please note that proposed pricing for all hardware indicated above must include shipping and handling costs. In
addition, a minimum three (3) Years ProSupport with Next Business Day Onsite Service warranty must be included
with all bids.
Computer Hardware Pricing Sheet - 2 Instructions:
In the blank space designated for Unit Cost, indicate cost, including shipping and handling fees, for a single All-inOne desktop computer. In addition, in the blank space designated for Total Cost, indicate the total cost for 60 All-inOne desktop computers based on the Unit Cost shown for a single desktop computer.
Bidder’s signature:
Date: _______________
ATTACHMENT D
Certification Regarding Conflict of Interest
By signature of this bid proposal, Bidder covenants and affirms that:
(1)
no manager, employee or paid consultant of the Bidder is a Director of the Board, the President, or a manager of
the Board;
(2)
no manager or paid consultant of the Bidder is a spouse to a Director of the Board, the President, or a manager of
the Board;
(3)
no Director of the Board, the President or an employee of the Board owns or controls more than a 10 percent
interest in the Bidder;
(4)
no spouse of a Director of the Board, President or manager of the Board is a manager, employee or paid consultant
of the Bidder;
(5)
no Director of the Board, President, or employee of the Board receives compensation from Bidder for lobbying
activities as defined in federal laws or Chapter 305 of the Texas Government Code;
(6)
Bidder has disclosed within the bid proposal any interest, fact or circumstance which does or may present a
potential conflict of interest;
(7)
should bidder fail to abide by the foregoing covenants and affirmations regarding conflict of interest, Bidder shall not
be entitled to the recovery of any costs or expenses incurred in relation to any contract with the Board and shall
immediately refund to the Board any fees or expenses that may have been paid under the contract and shall further
be liable for any other costs incurred or damages sustained by the Board relating to that contract; and
(8)
Bidder shall comply with the standards of conduct stated in the Certifications, Section 11 Conflict of Interest and be
in accordance with Texas Administrative Code, Title 40, Part 20, Chapter 802.
Name of Organization Submitting Bid: __________________________________________
Name and Title of Authorized Signatory: __________________________________________
Signature:
Date:
_______________________
ATTACHMENT E
Texas Corporate Franchise Tax Certification
___________________________________________________________________________________________
Pursuant to Article 2.45, Texas Business Corporation Act, state agencies may not contract with for profit
corporations that are delinquent in making state franchise tax payments. The following certification that the
corporation entering into this contract is current in its franchise taxes must be signed by the individual that is authorized by
the Corporate Board of Directors Resolution, to sign the contract for the corporation.
___________________________________________________________________________________________________
The undersigned authorized representative of the corporation contracting herein certifies that the following indicated
statement is true and correct and that the undersigned understands making a false statement is a material breach
of contract and is grounds for contract cancellation.
Indicate the certification that applies to your corporation:
______ The Corporation is a for-profit corporation and certifies that it is not delinquent in its franchise tax payments to the State of
Texas.
______ The Corporation is a non-profit corporation or is otherwise not subject to payment of franchise taxes to the State of
Texas.
______ Not applicable – bidder is not a corporation.
Name of Applicant Organization:
Typed/Printed Name and Title of Authorized Signatory:
Signature:
Date:
ATTACHMENT F
Non-Discrimination Statement/Policy
Please submit your non-discrimination statement or policy with your quotation.