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B Purc BID S chase C Depa SPEC of a U Prep Cortlan artmen 60 C Cortlan Ma CIFIC Used C pared by nd Co nt Of H Central Ave nd, NY 130 ay 2017 ATIO Chip S y: unty Highwa e. 045 7 ONS pread ays der ---PAGE BREAK--- GENERAL NOTES: Sealed bid proposals for the purchase of a used Chip Spreader will be received at the County Highway Department Offices located at 4267 Traction Drive, Cortland, New York 13045, until 10:00 A.M. local time on May 17th, 2017, at which time they will be opened and read aloud. Bid proposals shall be placed in a sealed envelope with the following clearly marked on the front of the envelope: Bidder’s Name and Address “Cortland County- Purchase of a Used Chip Spreader” Date and time of Bid opening Bid proposals may be hand delivered to the Highway Department Offices at the location mentioned above beginning at 9 a.m. local time on the day of the bid until the time of the bid opening. Bid proposals may also be mailed using regular mail to the following address: Cortland County Highway Department 60 Central Avenue Cortland, NY 13045 Bid proposals may also be “overnight” or otherwise shipped to the following address: Cortland County Highway Department 4267 Traction Drive Cortland, NY 13045 Bid proposals that are mailed using regular mail must be received in the regular Highway Department mail delivery the day before the bid opening. Bids received after this time will not be opened and will be returned to the bidder. Such bids shall not be considered. Bid proposals that are “overnight” or otherwise shipped must be received by 10:00 a.m. local time on the day of the bid opening. Bids received via “overnight” or “express” mail after this time will not be opened and will be returned to the bidder. Such bids shall not be considered. EQUIPMENT SPECIFICATIONS: Equipment shall be a used Etnyre K Series Chip Spreader, or approved equal. If equipment proposed is different from the Etnyre K Series, Cortland County reserves the right to determine if the proposed equipment is equal to the Etnyre K series Chip Spreader. To be considered, the proposed Chip Spreader shall meet the following requirements, at a minimum: model year 1995 or newer 4500 machine hours or less capable of extending to a chipping width of 10-16 feet have an adjustable operator’s station hydrostatic drive (2-wheel drive is acceptable, 4-wheel drive is preferred) diesel engine Air operated valves & gate mechanisms Computer controlled distribution Headlights, stop/tail lights, and turn signals w/ flasher switch ---PAGE BREAK--- SPECIAL CONDITIONS: Expected number of units to purchase: One Delivery Price: Price bid for the proposed Chip Spreader shall include shipping FOB Cortland County Highway Maintenance Facility (4267 Traction Drive, Cortland, NY 13045). Any customs, duties, and/or other charges shall be included in the shipping price. The County reserves the right to purchase the machine only and arrange for delivery at its own expense. Delivery Date: The County reserves the right to arrange for delivery of the machine at its own expense. The delivery cost included in the bid shall be accepted at the County’s discretion. The subsequent low bidder shall either 1) deliver the Chip Spreader to the Cortland County Highway Maintenance Facility located at 4267 Traction Drive, Cortland, NY 13045, if required OR 2) make the unit available for pick up by the County no later than June 15, 2017 or within 30 days of receipt of payment, whichever comes first. Payment: Payment shall be processed using purchase order and vendor invoice. All bidders shall include a completed IRS W-9 form with the submitted proposal. Equipment Condition: The apparent low bidder shall provide any and all operators/service manuals along with any and all additional attachments/accessories that would normally accompany a piece of equipment upon delivery of the proposed Chip Spreader. Prior to delivery, the low bidder shall perform a full service of the equipment at his own shop. Servicing shall include engine tune-up, lubrication, changing of all fluids and their associated filters, and all necessary adjustments for proper machinery operation. Delivery Condition: The proposed Chip Spreader shall be in conformance with all specifications at time of delivery. The County reserves the right to inspect the unit prior to delivery. Delivery shall be coordinated with the Cortland County Highway Department and shall occur only during normal work hours (Monday-Friday, 7:00 am – 3:30 pm). Bid Specifications may be downloaded from the Cortland County website on or after May 10th, 2017 at the following website address: http://www.cortland-co.org/Bids.aspx under the link entitled: “Purchase of a Used Chip Spreader” It is the responsibility of the Bidder to check the Website for addenda. The final date for posting addenda to the Website will be 3 working days prior to the bid opening date. Questions regarding the contract documents for this project may be directed to Mr. James Morse, Jr., Deputy Superintendent of Highways, at (607) 753-9377. All Bids must be written in ink on the forms provided. The Bidder must submit 2 copies: the original and one extra copy. If a successful low bidder should fail to deliver the equipment specified above in the condition and time frame stated, the County shall reserve the right to purchase from the next lowest bidder. All bidders will be required to sign a statement of non-collusion, which is included in the Proposal. Non-Collusion and State Finance Law certifications shall apply to this bid, and they must be signed and submitted by the bidder with the bid. The County of Cortland reserves the right to accept or reject any or all bids, to waive any informality in any bids, and to award the Contract in the County’s best interest. The County reserves the right to make the award within forty-five (45) days after the date of the bid opening, during which period bids shall not be withdrawn. ---PAGE BREAK--- TABLE OF CONTENTS SECTION DESCRIPTION Section A Bid Proposal Form Section B Required Certifications and Requirements: 1. Lump Sum Bid Proposal Signature Form 2. Acknowledgement of Receipt of Addenda 3. Bidder Information Sheet 4. Offerer’s Affirmation of Understanding of an 5. Agreement Pursuant to State Finance law Sect. 139-j(3) and Sect. 139-j 6. Offerer Disclosure of Prior Non-Responsibility Determinations 7. Equipment Information Sheet 8. State Finance Law Certification 9. Non Collusive Billing Certificate Required by Section 139-D of the State Finance Law 10. Conflict of Interest Disclosure Section C Checklist of Documents to be Submitted with Bid ---PAGE BREAK--- SECTION A BID PROPOSAL FORMS ---PAGE BREAK--- BID PROPOSAL FORM The Contractor shall furnish a used Chip Spreader in conformance with all aforementioned specifications and addenda as defined herein. The total Bid price shall be the sum of the Chip Spreader cost plus the cost to deliver the unit and all related components to the Cortland County Highway Department Vehicle Maintenance Facility. It should be noted that the County reserves the right to waive the delivery cost and secure delivery at its own expense. A Bid price shall be entered both in words and numerically in the spaces provided for each item. BASE BID ITEM 1: Etnyre K Series Chip Spreader or equal written NUMERICALLY in dollars and cents for the Lump Sum Price of: ITEM 1: Etnyre K Series Chip Spreader or equal written in WORDS in dollars and cents for the Lump Sum Price of: ITEM 2: Delivery Cost written NUMERICALLY in dollars and cents for the Lump Sum Price of: ITEM 2: Delivery Cost written in WORDS in dollars and cents for the Lump Sum Price of: TOTAL AMOUNT BID (ITEM 1 + ITEM 2) written NUMERICALLY in dollars and cents for the Lump Sum Price of: TOTAL AMOUNT BID (ITEM 1 + ITEM 2) written in WORDS in dollars and cents for the Lump Sum Price of: ---PAGE BREAK--- SECTION B REQUIRED CERTIFICATIONS AND CONTRACT REQUIREMENTS ---PAGE BREAK--- LUMP SUM BID PROPOSAL In submitting this bid, the undersigned declares that he is or they are the only person or persons interested in the bid; that it is made without any connection with any person making another bid for the same contract; that the bid is in all respects fair and without collusion, fraud or mental reservation; and that no official of the County or any person in the employ of the County is directly or indirectly interested in the bid or in the supplies or work to which it relates, or in any portion of the profits thereof. The undersigned also declares that he has or they have carefully examined the specifications and form of contract, and has or have satisfied himself or themselves as to all the full scope of the contract and understands that in signing this proposal, he or they waive all rights to plead any misunderstandings regarding the same. The undersigned further agrees to accept the aforesaid Lump Sum Bid as compensation for the purchase of a used Chip Spreader as detailed in the contract documents. Dated: , 20 Legal Name of Person, Firm or Corporation By: Must be Signed in Ink ---PAGE BREAK--- ACKNOWLEDGMENT OF RECEIPT OF ADDENDA The undersigned acknowledges receipt of the following addenda to the subject project (if no addenda are issued, state "NONE"): Addendum No. Dated Addendum No. Dated Addendum No. Dated Receipt is hereby acknowledged for all addenda listed above. Signature of Bidder Date ---PAGE BREAK--- BIDDER INFORMATION SHEET NAME OF BIDDER: * ADDRESS: PHONE NUMBER: EMAIL ADDRESS: TYPE OF ENTITY: CORPORATION PARTNERSHIP INDIVIDUAL IF A NON-PUBLICLY OWNED CORPORATION: NAME OF CORPORATION: LIST OF PRINCIPAL STOCKHOLDERS (HOLDING OVER 5% OF OUTSTANDING SHARES): LIST OF OFFICERS: LIST OF DIRECTORS: DATE OF ORGANIZATION: IF A PARTNERSHIP: PARTNERS: NAME OF PARTNERSHIP: DATE OF ORGANIZATION: * IF THE BUSINESS IS CONDUCTED UNDER AN ASSUMED NAME, A COPY OF THE CERTIFICATE REQUIRED TO BE FILED UNDER THE NEW YORK GENERAL BUSINESS LAW MUST BE ATTACHED. ---PAGE BREAK--- Offerer’s Affirmation of Understanding of an Agreement pursuant to State Finance Law §139-j and §139-j Offerer affirms that it understands and agrees to comply with the procedures of the Government Entity relative to permissible Contracts as required by State Finance Law §139-j and §139-j By: Date: Signature Name: Title: Contractor Name: Contractor Address: ---PAGE BREAK--- Offerer Disclosure of Prior Non-Responsibility Determinations Name of Individual or Entity Seeking to Enter into the Procurement Contract: Address: Name and Title of Person Submitting this Form: Contract Procurement Number: Date: 1. Has any Governmental Entity made a finding of non-responsibility regarding the individual or entity seeking to enter into the Procurement Contract in the previous four years? (Please circle): No Yes If yes, please answer the next questions: 2. Was the basis for the finding of non-responsibility due to a violation of State Finance Law §139-j (Please circle): No Yes 3. Was the basis for the finding of non-responsibility due to the intentional provision of false or incomplete information to a Governmental Entity? (Please circle): No Yes 4. If you answered yes to any of the above questions, please provide details regarding the finding of non- responsibility below. Governmental Entity: Date of Finding of Non - responsibility: Basis of Finding of Non - responsibility: (Add additional pages as necessary) 5. Has any Governmental Entity or other governmental agency terminated or withheld a Procurement Contract with the above-named individual or entity due to the intentional provision of false or incomplete information? (Please circle): No Yes 6. If yes, please provide details below. Governmental Entity: Date of Termination or Withholding of Contract: Basis of Termination or Withholding: (Add additional pages as necessary) Offerer certifies that all information provided to the Governmental Entity with respect to State Finance Law §139-k is complete, true and accurate. By: Date: Signature Name: Title: ---PAGE BREAK--- EQUIPMENT INFORMATION SHEET Each bidder is required to complete this form providing all relative information for the specified used Chip Spreader. The County reserves the right to reject any proposal if the apparent low bidder attempts to deliver a used chip spreader differing from the machine described below. **Completion of this form in its entirety is required** YEAR OF MANUFACTURE: EQUIPMENT MAKE: EQUIPMENT MODEL: EQUIPMENT SERIAL NUMBER: ENGINE SERIAL NUMBER: HOUR METER READING: READING DATE: FOR THE FOLLOWING, CIRCLE EITHER YES OR NO: OPERATORS/OWNERS MANUAL PRESENT? YES NO PARTS/SERVICE MANUAL PRESENT? YES NO MACHINE IS IN GOOD WORKING ORDER? YES NO I hereby certify that the equipment described above is the equipment that will be delivered should I be the apparent low bidder at time of award. PRINT NAME: SIGNATURE: TITLE: DATE: ---PAGE BREAK--- STATE FINANCE LAW CERTIFICATION Every bid or proposal hereafter made to a political subdivision of the state or any public department, agency or official thereof where competitive bidding is required by statute, rule, regulation or local law, for work or services performed or to be performed or goods sold or to be sold, shall contain the following statement subscribed by the bidder and affirmed by such bidder as true under the penalties of perjury: a. "By submission of this bid, each bidder and each person signing on behalf of any bidder certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of its knowledge and belief that each bidder is not on the list created pursuant to paragraph of subdivision 3 of section 165-a of the state finance law." Authorized Name, Title Authorized Signature: Date: ---PAGE BREAK--- NON COLLUSIVE BILLING CERTIFICATE REQUIRED BY SECTION 139-D OF THE STATE FINANCE LAW Section 139D, Statement of Non-Collusion in bids to the State: By submission of this bid, bidder and each person signing on behalf of bidder certifies, and in the case of joint bid, each party thereto certifies as its own organization, under penalty of perjury, that to the best of his/her knowledge, and belief: 1) The prices of this bid have been arrived at independently, without collusion, consultation, communication, or agreement, for the purposes of restricting competition, as to any matter relating to such prices with any other bidder or with any other competitor; 2) Unless otherwise required by law, the prices which have been quoted in this bid have not been knowingly disclosed by the Bidder and will not knowingly be disclosed by the Bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and 3) No attempt has been made or will be made by the Bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting completion. A Bid shall not be considered for award nor shall any award be made where 1, 2, 3 above have not been complied with; provided however, that if in any case, the bidder(s) cannot make the foregoing certification, the bidder shall so state and shall furnish below a signed statement which sets forth in detail the reasons therefore: (Affix addendum to this page if space is required for statement.) Subscribed to me under penalty of perjury under the laws of the State of New York, this day of as the act and deed of said corporation of partnership or sole proprietor. If Bidders are a Partnership, complete the Following: Names of Partners or Principals Legal Residence If Bidders are a corporation, complete the following: Name Legal Residence President Secretary Treasurer President Secretary Treasurer Identifying Data: ---PAGE BREAK--- Potential Contractor: Address: Telephone Title: E-Mail Address: If applicable, Responsible Corporate Officer: Name: Title: Signature: Joint or combined bids by companies or firms must be certified by each participant. Legal name of person or firm Legal name of person or firm Name Name Title Title Address Address ---PAGE BREAK--- CONFLICT OF INTEREST DISCLOSURE Conflict of Interest Disclosure Form Note: A potential or actual conflict of interest exists when commitments and obligations are likely to be compromised by the nominator(s)’other material interests, or relationships (especially economic), particularly if those interests or commitments are not disclosed. This Conflict of Interest Form should indicate whether the nominator(s) has an economic interest in, or acts as an officer or a director of, any outside entity whose financial interests would reasonably appear to be affected by the addition of the nominated condition to the newborn screening panel. The nominator(s) should also disclose any personal, business, or volunteer affiliations that may give rise to a real or apparent conflict of interest. Relevant Federally and organizationally established regulations and guidelines in financial conflicts must be abided by. Individuals with a conflict of interest should refrain from nominating a condition for screening. Date: Name: Position: Please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a conflict of interest: I have no conflict of interest to report. I have the following conflict of interest to report (please specify other nonprofit and for-profit boards you (and your spouse) sit on, any for-profit businesses for which you or an immediate family member are an officer or director, or a majority shareholder, and the name of your employer and any businesses you or a family member own: 1. 2. 3. I hereby certify that the information set forth above is true and complete to the best of my knowledge. Signature: Company: Date: ---PAGE BREAK--- SECTION C CHECKLIST OF DOCUMENTS TO BE SUBMITTED WITH BID: NOTES: This sheet is for use by the bidder and is not required to be returned with the bid. Two copies of the bid documents must be submitted, one original and one photocopy. All bids must be in a sealed envelope clearly labeled with the bidder’s name and address and “Cortland County- Purchase of a Used Chip Spreader”. To be considered a responsive bid, the following forms/documents shall be submitted: Bid Proposal Signature Form Acknowledgement of Receipt of Addenda Bidder Information Sheet Offerer’s Affirmation of Understanding of an Agreement Pursuant to State Finance law Sect. 139-j(3) and Sect. 139-j Offerer Disclosure of Prior Non-Responsibility Determinations Equipment Information Sheet State Finance Law Certification Non Collusive Billing Certificate Required by Section 139-D of the State Finance Law Conflict of Interest Disclosure Valid IRS W-9 form