Document cortlandcountyny_gov_doc_a790096276

BID SPECIFICATIONS Purchase of a New Highway Aggregate Spreader Prepared by: Cortland County Department Of Highways 60 Central Ave. Cortland, NY 13045 February 2017 ---PAGE BREAK--- GENERAL NOTES: Sealed bid proposals for the purchase of a New Highway Aggregate Spreader will be received at the County Highway Department Offices located at 4267 Traction Drive, Cortland, New York 13045, until 2:00 P.M. local time on March 13th, 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  “Bid to Cortland County for the Purchase of a New Highway Aggregate 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 2:00 p.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 new DOMOR R600C Aggregate Spreader, or approved equal. If equipment proposed is different from the DOMOR R600C Series, Cortland County reserves the right to determine if the proposed equipment is equal to the DOMORE R600C Series Aggregate Spreader. To be considered, the proposed Aggregate Spreader shall meet the following requirements, at a minimum:  Adjustable aggregate spreading depth control ranging from 2”-22”  Capable of spreading aggregate to a width of ranging from 10.5’-16’, with adjustable width control in 1’ increments  Shaped internal moldboard with independent side height control  Self-contained hydraulic system for moldboard adjustments  Slotted cutting edge, adjustable to produce up to a 3% crown  Individually adjustable wheel assemblies  Capability to quickly attach to either a dozer blade or wheel loader bucket  Must be able to be attached to, and used in conjunction with a Volvo L120 wheel loader  Come with a 1-year warranty on manufacturing defects, minimum ---PAGE BREAK--- SPECIAL CONDITIONS: Expected number of units to purchase: One Delivery Date: The subsequent low bidder shall deliver the Aggregate Spreader to the Cortland County Highway Maintenance Facility located at 4267 Traction Drive, Cortland, NY 13045 no later than June 1, 2017 or within 30 days of receipt of payment, whichever comes first. Delivery Price: Price bid for the proposed Chip Spreader shall include shipping FOB Cortland County Highway Maintenance Facility. Any customs, duties, and/or other charges shall be included in the shipping price. 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 Aggregate Spreader. Delivery Condition: The proposed Chip Spreader shall be in conformance with all specifications at time of 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). The Bid Specifications may be downloaded from the Cortland County website on or after February 28th, 2017 at the following website address: http://www.cortland-co.org/Bids.aspx under the link entitled: “Purchase of a New Highway Aggregate 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 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 Forms* Section B Required Certifications and Requirements: 1. Bid Proposal Signature Form * 2. Acknowledgement of Receipt of Addenda * 3. Bidder Information Sheet * 4. Offerer’s Affirmation of Understanding of an Agreement Pursuant to State Finance law Sect. 139-j(3) and Sect. 139-j * 5. Offerer Disclosure of Prior Non-Responsibility Determinations * 6. Certification of Compliance with the State Finance Law* 7. Equipment Information Sheet * Section C Sample Agreement Form EXHIBIT A Drug Free Workplace * EXHIBIT B Acknowledgement and Agreement to Comply with Standard Clauses for New York State Contracts (Appendix A) * EXHIBIT C Non Collusive Billing Certificate Required by Section 139-D of the State Finance Law * EXHIBIT D Conflict of Interest Disclosure * APPENDIX A Standard Clauses for New York State Contracts * To be completed by All Bidders and Returned with Bid. To be completed by the Apparent Low Bidder. ---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. A Bid price shall be entered both in words and numerically in the spaces provided for each item. BASE BID ITEM 1: DOMOR R600C Aggregate Spreader or equal written NUMERICALLY in dollars and cents for the Lump Sum Price of: ITEM 1: DOMOR R600C Aggregate Spreader or equal written in WORDS in dollars and cents for theLump 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 none, 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 is required YEAR OF MANUFACTURE: EQUIPMENT MAKE: EQUIPMENT MODEL: EQUIPMENT SERIAL NUMBER: ENGINE SERIAL NUMBER (if required): HOUR METER READING (if required): READING DATE: CLOSEST DEALER TO PROVIDE PARTS AND/OR SERVICE: NAME OF DEALER: DEALER ADDRESS: DEALER TELEPHONE: DEALER CONTACT NAME: DEALER CONTACT EMAIL: 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 Signature: Date: ---PAGE BREAK--- SECTION C SAMPLE AGREEMENT FORM ---PAGE BREAK--- SAMPLE AGREEMENT THIS AGREEMENT, entered into this , by and between the COUNTY OF CORTLAND, New York, (the “COUNTY”), a municipal corporation organized and existing under the laws of the State of New York with offices at 60 Central Avenue, Cortland, New York 13045, and (the “CONTRACTOR”), with offices located at WITNESSETH, that the COUNTY and the CONTRACTOR, for the consideration hereafter named, agree as follows: ARTICLE 1. WORK TO BE DONE AND CONSIDERATION THEREFORE The CONTRACTOR shall furnish (Describe the work to be done; if a proposal for the work exists, attach same as an exhibit and cite said exhibit herein.) ARTICLE 2. TERM The CONTRACTOR agrees to perform the services and/or supply goods beginning 20___ and ending 20___ . ARTICLE 3. ACCEPTANCE AND FINAL PAYMENT Upon receipt of written notice that the Contract has been fully performed and the COUNTY agrees that the Contract has been fully performed, the CONTRACTOR shall file with the COUNTY an itemized voucher and the COUNTY shall pay the CONTRACTOR within its normal payment period. ARTICLE 4. CONTRACTOR’S INSURANCE The CONTRACTOR shall not commence work under this Contract until he/she/it has obtained all insurance required under this paragraph and the COUNTY has approved such insurance. The COUNTY requires the following insurance coverage and amounts: Comprehensive General Liability, including personal injury coverage of $1,000,000.00 per occurrence and $2,000,000.00 in the aggregate and property damage coverage in the amount of $500,000.00 per occurrence and $1,000,000.00 in the aggregate. Automobile coverage with a combined single limit of $1,000,000.00. Statutory Worker’s Compensation Disability Coverage, and Unemployment Insurance. Professional Liability Insurance in the amount of $1,000,000.00 where applicable. ---PAGE BREAK--- The CONTRACTOR shall submit at the time of the execution of this agreement, certificates of insurance properly executed by an authorized representative of its insurance underwriter, evidencing such insurance policies to be in full force and effect, naming the COUNTY which shall assume to include its officers, employees, agents and representatives as additional insured. The certificates of insurance shall name specifically “Cortland County, 60 Central Avenue, Cortland, New York 13045” as an additional insured. Notice of termination of any such policies must be provided to the COUNTY at least ten (10) days in advance. CONTRACTOR shall, on or before this 10-day period, provide the COUNTY with a prospective Certificate of Insurance with the above coverage and limits for the balance of the term of this agreement. All insurance coverage required to be purchased and maintained by the CONTRACTOR under this agreement shall be primary for the defense and indemnification on any action or claim asserted against the COUNTY and/or the CONTRACTOR for work performed under this agreement, regardless of any other collectible insurance or any language in the insurance policies which may be to the contrary. Any accident shall be reported to the COUNTY as soon as possible and not later than twenty-four (24) hours from the time of such accident. A detailed written report must be submitted to the COUNTY as soon thereafter as possible and not later than three days after the date of such accident. ARTICLE 5. REPRESENTATIONS OF CONTRACTOR The CONTRACTOR represents and warrants: That he/she/it is financially solvent and that he/she/it is experienced in and competent to perform the services as described in Article 1 above, That he/she/it is familiar with all Federal, State, municipal and departmental laws, ordinances and regulation which may in any way affect the work or those employed therein. ARTICLE 6. PERMITS AND REGULATIONS The CONTRACTOR shall procure and pay for all permits and licenses necessary for the services to be rendered hereunder. ARTICLE 7. COUNTY’S RIGHT TO STOP WORK OR TERMINATE CONTRACT The COUNTY shall have the right to stop work or terminate the Contract if: The CONTRACTOR is adjudged bankrupt or makes an assignment for the benefit of creditors; or ---PAGE BREAK--- A receiver or liquidator is appointed for the CONTRACTOR or for any of his/her/it’s property and is not dismissed within twenty (20) days after such appointment or the proceedings in connection therewith are not stayed on appeal within said twenty (20) days; or The CONTRACTOR refuses or fails to prosecute the work or any part thereof with due diligence; or The CONTRACTOR fails to make prompt payment to persons supplying labor for the work; or The CONTRACTOR fails or refuses to comply with all applicable laws or ordinances; or The CONTRACTOR violates any provision of the Contract; In any event, the COUNTY, without prejudice to any other rights or remedy it may have, may by seven days notice to the CONTRACTOR, terminate this contract pursuant to the grounds stated herein. In such case, the CONTRACTOR shall not be entitled to receive any further payment until the work is complete. If the unpaid balance of the compensation to be paid to the CONTRACTOR hereunder exceeds the expense of completing the work, such excess shall be paid to the CONTRACTOR. If such expense exceeds such unpaid balance, the CONTRACTOR shall be liable to the COUNTY for such excess. COUNTY may terminate this contract upon thirty (30) days written notice to the CONTRACTOR if deemed in the best interest of the COUNTY. COUNTY may terminate if the contract is not funded. ARTICLE 8. INDEMNIFICATION / HOLD HARMLESS The CONTRACTOR shall indemnify, defend and hold the COUNTY, its Departments, and its officers, employees, contractors, representatives and agents harmless from and against any and all claims, fines, demands, losses, damages and expenses, including attorney’s fees, relating to or arising out of any negligent or intentional acts and/or omissions of the CONTRACTOR or any of its directors, officers, employees, contractors, representatives, or agents. ARTICLE 9. INDEPENDENT CONTRACTOR The CONTRACTOR, including all its officers, employees and agents agrees that their relationship to the COUNTY and any of its Departments or units, is that of an independent contractor, and said CONTRACTOR covenants and agrees that they will not conduct themselves as, nor hold themselves out as, nor claim to be an officer or employee of the COUNTY by reason hereof and that they will not claim, demand or make an application to or for any right or privilege applicable to an officer or employee of the COUNTY, including, but not limited to, Worker’s Compensation coverage, Unemployment Insurance benefits, Social Security coverage, medical and/or dental benefits, or retirement membership or credit. ARTICLE 10. ASSIGNMENT Neither party may assign or sub-contract this contract or any portion thereof, without prior written consent of the other party hereto. ---PAGE BREAK--- ARTICLE 11. REQUIRED PROVISIONS OF LAW Each and every provision of law and clause required by law to be inserted in this Contract shall be deemed to have been inserted herein. If any such provision is not inserted, through mistake or otherwise, then upon the application of either party, this Contract shall be physically amended to make such insertion. ARTICLE 12. VENUES AND DISPUTES The exclusive means of disposing of any dispute arising under this Agreement shall be decided in a New York State Court of competent jurisdiction located within Cortland County, New York. There shall be no right to binding arbitration. Pending final resolution of a dispute, the CONTRACTOR shall proceed diligently with performing the terms of this Agreement. The CONTRACTOR waives any dispute or claim not made in writing and received by the COUNTY within thirty (30) days of the occurrence giving rise to the dispute or claim. The claim must be in writing for a sum certain and any money requested must be fully supported by all cost and pricing information. ARTICLE 13. REMEDIES The remedies specified herein shall be cumulative and in addition to any other remedies available of law or in equity. Waiver of a breach of any provision of this Agreement shall not constitute a waiver of any other or future breach of the same provision or any other provision of the Agreement. ARTICLE 14. NOTICES All notices of any nature referred to in this agreement shall be in writing and sent by registered or certified mail, postage pre-paid, to the respective addresses set forth below or to such other addresses as the respective parties may designate in writing. To the CONTRACTOR: To the COUNTY: Chairman of the Legislature County of Cortland 60 Central Avenue Cortland, New York 13045 ---PAGE BREAK--- ARTICLE 15. SEVERABILITY In the event any provision hereof shall be held for any reason to be illegal, invalid or unenforceable, such illegality, invalidity or unenforceability shall not affect the remaining provisions of this agreement, which shall continue in full force and effect. ARTICLE 16. WAIVER No waiver of any breach of any condition of this Agreement shall be binding unless in writing and signed by the party waiving said breach. No such waiver shall in any way affect any other term or condition of this Agreement or constitute a cause or excuse for a repetition of such or any other breach unless the waiver shall include the same. ARTICLE 17. MODIFICATION This Agreement constitutes the complete understanding of the parties. No modification of any provisions thereof shall be valid unless in writing and signed by both parties. ARTICLE 18. EXECUTORY CLAUSE The COUNTY shall have no liability under this Agreement to the CONTRACTOR or to anyone else beyond funds appropriated and available for this Agreement. ARTICLE 19. RECORDS RETENTION AND AUDIT The CONTRACTOR agrees to retain all books, records and/or other documents relevant to this Agreement for six years after the expiration or termination of this agreement or six years after final payment, whichever is later, unless otherwise agreed to by the parties in writing. New York State auditors and/or any other persons duly authorized by the COUNTY shall have full access to and the right to examine any of the above-mentioned documents during the above- stated time period. ARTICLE 20. APPLICABLE LAW This Agreement is governed by the laws of the State of New York. ---PAGE BREAK--- IN WITNESS WHEREOF, the parties hereto have executed, or caused to be executed by their duly authorized officials, this Agreement in duplicate (2 copies) each of which shall be deemed an original on the date written. COUNTY OF CORTLAND DATE: BY: Donnell Boyden, Chair, Cortland County Legislature Acknowledgement STATE OF NEW YORK ) COUNTY OF CORTLAND ) ss.: On this______ day of before me, the undersigned, a Notary Public in and for said State, personally appeared Donnell Boyden, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, that by his/her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Notary Public CONTRACTOR (name of company) DATE: BY: (NAME OF SIGNATORY) (CORP. OFFICER/POSITION) Acknowledgement STATE OF NEW YORK ) COUNTY OF ) ss.: On this______ day of before me, the undersigned, a Notary Public in and for said State, personally appeared personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, that by his/her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Notary Public ---PAGE BREAK--- EXHIBIT A – DRUG FREE WORKPLACE Whenever two or more Bids which are equal with respect to price, quality and service are received by the State or by any political subdivisions for the procurement of commodities or contractual services, a Bid received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing the Bids will be followed if none of the tied vendors have a drug free workplace process. In order to have a drug-free workplace program, a business shall: 1) Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2) Inform employees about the dangers of drug abuse in the workplace, the business’ policy of maintaining a drug free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3) Give each employee engaged in providing the commodities or contractual services that are under Bid a copy of the statement specified in Subsection 4) In the statement specified in Subsection notify that employees, that, as a condition of working of the commodities or contractual services that are under bid, the employee will abide by the terms of the statement and will notify the employee of any conviction of, or plea of guilty or nolo contendere to, any violation of any controlled substance law in the United States or any state or Cortland County, for a violation occurring in the workplace no later than five days after such conviction. 5) Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program, if such is available in the employee’s community, by any employee who is so convicted. 6) Make a good faith effort to continue to maintain a drug free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies with the above requirements. Print Name: Date: Signature: ---PAGE BREAK--- EXHIBIT B – ACKNOWLEDGEMENT AND AGREEMENT TO COMPLY WITH STANDARD CLAUSES FOR NEW YORK STATE CONTRACTS (APPENDIX A) I hereby acknowledge that I have read, understand and agree to comply with the terms as outlined in Appendix A – Standard Clauses for New York State Contracts. Failure to comply may result in immediate termination of this agreement with potential legal recourse by the County. Signed: Date: Title: ---PAGE BREAK--- EXHIBIT C: 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 ---PAGE BREAK--- Treasurer Identifying Data: 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--- EXHIBIT D - 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--- APPENDIX A STANDARD CLAUSES FOR NEW YORK STATE CONTRACTS PLEASE RETAIN THIS DOCUMENT FOR FUTURE REFERENCE. ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A TABLE OF CONTENTS 1. Executory Clause 2. Non-Assignment Clause 3. Comptroller’s Approval 4. Workers’ Compensation Benefits 5. Non-Discrimination Requirements 6. Wage and Hours Provisions 7. Non-Collusive Bidding Certification 8. International Boycott Prohibition 9. Set-Off Rights 10. Records 11. Identifying Information and Privacy Notification 12. Equal Employment Opportunities For Minorities and Women 13. Conflicting Terms 14. Governing Law 15. Late Payment 16. No Arbitration 17. Service of Process 18. Prohibition on Purchase of Tropical Hardwoods 19. MacBride Fair Employment Principles 20. Omnibus Procurement Act of 1992 21. Reciprocity and Sanctions Provisions 22. Compliance with New York State Information Security Breach and Notification Act 23. Compliance with Consultant Disclosure Law 24. Procurement Lobbying 25. Certification of Registration to Collect Sales and Compensating Use Tax by Certain State Contractors, Affiliates and Subcontractors 26. Iran Divestment Act ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A STANDARD CLAUSES FOR NYS CONTRACTS The parties to the attached contract, license, lease, amendment or other agreement of any kind (hereinafter, "the contract" or "this contract") agree to be bound by the following clauses which are hereby made a part of the contract (the word "Contractor" herein refers to any party other than the State, whether a contractor, licenser, licensee, lessor, lessee or any other party): 1. EXECUTORY CLAUSE. In accordance with Section 41 of the State Finance Law, the State shall have no liability under this contract to the Contractor or to anyone else beyond funds appropriated and available for this contract. 2. NON-ASSIGNMENT CLAUSE. In accordance with Section 138 of the State Finance Law, this contract may not be assigned by the Contractor or its right, title or interest therein assigned, transferred, conveyed, sublet or otherwise disposed of without the State’s previous written consent, and attempts to do so are null and void. Notwithstanding the foregoing, such prior written consent of an assignment of a contract let pursuant to Article XI of the State Finance Law may be waived at the discretion of the contracting agency and with the concurrence of the State Comptroller where the original contract was subject to the State Comptroller’s approval, where the assignment is due to a reorganization, merger or consolidation of the Contractor’s business entity or enterprise. The State retains its right to approve an assignment and to require that any Contractor demonstrate its responsibility to do business with the State. The Contractor may, however, assign its right to receive payments without the State’s prior written consent unless this contract concerns Certificates of Participation pursuant to Article 5-A of the State Finance Law. 3. COMPTROLLER'S APPROVAL. In accordance with Section 112 of the State Finance Law (or, if this contract is with the State University or City University of New York, Section 355 or Section 6218 of the Education Law), if this contract exceeds $50,000 (or the minimum thresholds agreed to by the Office of the State Comptroller for certain S.U.N.Y. and C.U.N.Y. contracts), or if this is an amendment for any amount to a contract which, as so amended, exceeds said statutory amount, or if, by this contract, the State agrees to give something other than money when the value or reasonably estimated value of such consideration exceeds $10,000, it shall not be valid, effective or binding upon the State until it has been approved by the State Comptroller and filed in his office. Comptroller's approval of contracts let by the Office of General Services is required when such contracts exceed $85,000 (State Finance Law Section 163.6-a). However, such pre-approval shall not be required for any contract established as a centralized contract through the Office of General Services or for a purchase order or other transaction issued under such centralized contract. 4. WORKERS' COMPENSATION BENEFITS. In accordance with Section 142 of the State Finance Law, this contract shall be void and of no force and effect unless the Contractor shall provide and maintain coverage during the life of this contract for the benefit of such employees as are required to be covered by the provisions of the Workers' Compensation Law. 5. NON-DISCRIMINATION REQUIREMENTS. To the extent required by Article 15 of the Executive Law (also known as the Human Rights Law) and all other State and Federal statutory and constitutional non-discrimination provisions, the Contractor will not discriminate against any employee or applicant for employment because of race, creed, color, sex (including gender identity or expression), national origin, sexual orientation, military status, age, disability, predisposing genetic characteristics, marital status or domestic violence victim status. Furthermore, in accordance with Section 220-e of the Labor Law, if this is a contract for the construction, alteration or repair of any public building or public work or for the manufacture, sale or distribution of materials, equipment or supplies, and to the extent that this contract shall be performed within the State of New York, Contractor agrees that neither it nor ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A its subcontractors shall, by reason of race, creed, color, disability, sex, or national origin: discriminate in hiring against any New York State citizen who is qualified and available to perform the work; or discriminate against or intimidate any employee hired for the performance of work under this contract. If this is a building service contract as defined in Section 230 of the Labor Law, then, in accordance with Section 239 thereof, Contractor agrees that neither it nor its subcontractors shall by reason of race, creed, color, national origin, age, sex or disability: discriminate in hiring against any New York State citizen who is qualified and available to perform the work; or discriminate against or intimidate any employee hired for the performance of work under this contract. Contractor is subject to fines of $50.00 per person per day for any violation of Section 220-e or Section 239 as well as possible termination of this contract and forfeiture of all moneys due hereunder for a second or subsequent violation. 6. WAGE AND HOURS PROVISIONS. If this is a public work contract covered by Article 8 of the Labor Law or a building service contract covered by Article 9 thereof, neither Contractor's employees nor the employees of its subcontractors may be required or permitted to work more than the number of hours or days stated in said statutes, except as otherwise provided in the Labor Law and as set forth in prevailing wage and supplement schedules issued by the State Labor Department. Furthermore, Contractor and its subcontractors must pay at least the prevailing wage rate and pay or provide the prevailing supplements, including the premium rates for overtime pay, as determined by the State Labor Department in accordance with the Labor Law. Additionally, effective April 28, 2008, if this is a public work contract covered by Article 8 of the Labor Law, the Contractor understands and agrees that the filing of payrolls in a manner consistent with Subdivision 3-a of Section 220 of the Labor Law shall be a condition precedent to payment by the State of any State approved sums due and owing for work done upon the project. 7. NON-COLLUSIVE BIDDING CERTIFICATION. In accordance with Section 139-d of the State Finance Law, if this contract was awarded based upon the submission of bids, Contractor affirms, under penalty of perjury, that its bid was arrived at independently and without collusion aimed at restricting competition. Contractor further affirms that, at the time Contractor submitted its bid, an authorized and responsible person executed and delivered to the State a non-collusive bidding certification on Contractor's behalf. 8. INTERNATIONAL BOYCOTT PROHIBITION. In accordance with Section 220-f of the Labor Law and Section 139-h of the State Finance Law, if this contract exceeds $5,000, the Contractor agrees, as a material condition of the contract, that neither the Contractor nor any substantially owned or affiliated person, firm, partnership or corporation has participated, is participating, or shall participate in an international boycott in violation of the federal Export Administration Act of 1979 (50 USC App. Sections 2401 et seq.) or regulations thereunder. If such Contractor, or any of the aforesaid affiliates of Contractor, is convicted or is otherwise found to have violated said laws or regulations upon the final determination of the United States Commerce Department or any other appropriate agency of the United States subsequent to the contract's execution, such contract, amendment or modification thereto shall be rendered forfeit and void. The Contractor shall so notify the State Comptroller within five business days of such conviction, determination or disposition of appeal 105.4). 9. SET-OFF RIGHTS. The State shall have all of its common law, equitable and statutory rights of set-off. These rights shall include, but not be limited to, the State's option to withhold for the purposes of set-off any moneys due to the Contractor under this contract up to any amounts due and owing to the State with regard to this contract, any other contract with any State department or agency, including any contract for a term commencing prior to the term of this contract, plus any amounts due and owing to the State for any other reason including, without limitation, tax delinquencies, fee delinquencies or monetary penalties relative thereto. The State shall exercise its set-off rights in accordance with normal ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A State practices including, in cases of set-off pursuant to an audit, the finalization of such audit by the State agency, its representatives, or the State Comptroller. 10. RECORDS. The Contractor shall establish and maintain complete and accurate books, records, documents, accounts and other evidence directly pertinent to performance under this contract (hereinafter, collectively, "the Records"). The Records must be kept for the balance of the calendar year in which they were made and for six additional years thereafter. The State Comptroller, the Attorney General and any other person or entity authorized to conduct an examination, as well as the agency or agencies involved in this contract, shall have access to the Records during normal business hours at an office of the Contractor within the State of New York or, if no such office is available, at a mutually agreeable and reasonable venue within the State, for the term specified above for the purposes of inspec- tion, auditing and copying. The State shall take reasonable steps to protect from public disclosure any of the Records which are exempt from disclosure under Section 87 of the Public Officers Law (the "Statute") provided that: the Contractor shall timely inform an appropriate State official, in writing, that said records should not be disclosed; and (ii) said records shall be sufficiently identified; and (iii) designation of said records as exempt under the Statute is reasonable. Nothing contained herein shall diminish, or in any way adversely affect, the State's right to discovery in any pending or future litigation. 11. IDENTIFYING INFORMATION AND PRIVACY NOTIFICATION. Identification Number(s). Every invoice or New York State Claim for Payment submitted to a New York State agency by a payee, for payment for the sale of goods or services or for transactions leases, easements, licenses, etc.) related to real or personal property must include the payee's identification number. The number is any or all of the following: the payee’s Federal employer identification number, (ii) the payee’s Federal social security number, and/or (iii) the payee’s Vendor Identification Number assigned by the Statewide Financial System. Failure to include such number or numbers may delay payment. Where the payee does not have such number or numbers, the payee, on its invoice or Claim for Payment, must give the reason or reasons why the payee does not have such number or numbers. Privacy Notification. The authority to request the above personal information from a seller of goods or services or a lessor of real or personal property, and the authority to maintain such information, is found in Section 5 of the State Tax Law. Disclosure of this information by the seller or lessor to the State is mandatory. The principal purpose for which the information is collected is to enable the State to identify individuals, businesses and others who have been delinquent in filing tax returns or may have understated their tax liabilities and to generally identify persons affected by the taxes administered by the Commissioner of Taxation and Finance. The information will be used for tax administration purposes and for any other purpose authorized by law. The personal information is requested by the purchasing unit of the agency contracting to purchase the goods or services or lease the real or personal property covered by this contract or lease. The information is maintained in the Statewide Financial System by the Vendor Management Unit within the Bureau of State Expenditures, Office of the State Comptroller, 110 State Street, Albany, New York 12236. 12. EQUAL EMPLOYMENT OPPORTUNITIES FOR MINORITIES AND WOMEN. In accordance with Section 312 of the Executive Law and 5 143, if this contract is: a written agreement or purchase order instrument, providing for a total expenditure in excess of $25,000.00, whereby a contracting agency is committed to expend or does expend funds in return for labor, services, supplies, equipment, materials or any combination of the foregoing, to be performed for, or rendered or furnished to the contracting agency; or (ii) a written agreement in excess of $100,000.00 whereby a contracting agency is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or renovation of real property and improvements thereon; or (iii) a written agreement in excess of $100,000.00 whereby the owner of a State assisted housing project is committed to expend or does expend funds for the acquisition, construction, demolition, replacement, major repair or renovation of real property and improvements thereon for such project, then the following shall apply and by signing this agreement the Contractor certifies and affirms that it is Contractor’s equal employment opportunity policy that: The Contractor will not discriminate against employees or applicants for employment because of race, creed, color, national origin, sex, age, disability or marital status, shall make and document its conscientious and active efforts to employ and utilize minority group members and women in its work ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A force on State contracts and will undertake or continue existing programs of affirmative action to ensure that minority group members and women are afforded equal employment opportunities without discrimination. Affirmative action shall mean recruitment, employment, job assignment, promotion, upgradings, demotion, transfer, layoff, or termination and rates of pay or other forms of compensation; at the request of the contracting agency, the Contractor shall request each employment agency, labor union, or authorized representative of workers with which it has a collective bargaining or other agreement or understanding, to furnish a written statement that such employment agency, labor union or representative will not discriminate on the basis of race, creed, color, national origin, sex, age, disability or marital status and that such union or representative will affirmatively cooperate in the implementation of the Contractor's obligations herein; and the Contractor shall state, in all solicitations or advertisements for employees, that, in the performance of the State contract, all qualified applicants will be afforded equal employment opportunities without discrimination because of race, creed, color, national origin, sex, age, disability or marital status. Contractor will include the provisions of and above, in every subcontract over $25,000.00 for the construction, demolition, replacement, major repair, renovation, planning or design of real property and improvements thereon (the "Work") except where the Work is for the beneficial use of the Contractor. Section 312 does not apply to: work, goods or services unrelated to this contract; or (ii) employment outside New York State. The State shall consider compliance by a contractor or subcontractor with the requirements of any federal law concerning equal employment opportunity which effectuates the purpose of this section. The contracting agency shall determine whether the imposition of the requirements of the provisions hereof duplicate or conflict with any such federal law and if such duplication or conflict exists, the contracting agency shall waive the applicability of Section 312 to the extent of such duplication or conflict. Contractor will comply with all duly promulgated and lawful rules and regulations of the Department of Economic Development’s Division of Minority and Women's Business Development pertaining hereto. 13. CONFLICTING TERMS. In the event of a conflict between the terms of the contract (including any and all attachments thereto and amendments thereof) and the terms of this Appendix A, the terms of this Appendix A shall control. 14. GOVERNING LAW. This contract shall be governed by the laws of the State of New York except where the Federal supremacy clause requires otherwise. 15. LATE PAYMENT. Timeliness of payment and any interest to be paid to Contractor for late payment shall be governed by Article 11-A of the State Finance Law to the extent required by law. 16. NO ARBITRATION. Disputes involving this contract, including the breach or alleged breach thereof, may not be submitted to binding arbitration (except where statutorily authorized), but must, instead, be heard in a court of competent jurisdiction of the State of New York. 17. SERVICE OF PROCESS. In addition to the methods of service allowed by the State Civil Practice Law & Rules ("CPLR"), Contractor hereby consents to service of process upon it by registered or certified mail, return receipt requested. Service hereunder shall be complete upon Contractor's actual receipt of process or upon the State's receipt of the return thereof by the United States Postal Service as refused or undeliverable. Contractor must notify the State, in writing, of each and every change of address to which service of process can be made. Service by the State to the last known ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A address shall be sufficient. Contractor will have thirty (30) calendar days after service hereunder is complete in which to respond. 18. PROHIBITION ON PURCHASE OF TROPICAL HARDWOODS. The Contractor certifies and warrants that all wood products to be used under this contract award will be in accordance with, but not limited to, the specifications and provisions of Section 165 of the State Finance Law, (Use of Tropical Hardwoods) which prohibits purchase and use of tropical hardwoods, unless specifically exempted, by the State or any governmental agency or political subdivision or public benefit corporation. Qualifica- tion for an exemption under this law will be the responsibility of the contractor to establish to meet with the approval of the State. In addition, when any portion of this contract involving the use of woods, whether supply or installation, is to be performed by any subcontractor, the prime Contractor will indicate and certify in the submitted bid proposal that the subcontractor has been informed and is in compliance with specifications and provisions regarding use of tropical hardwoods as detailed in §165 State Finance Law. Any such use must meet with the approval of the State; otherwise, the bid may not be considered responsive. Under bidder certifications, proof of qualification for exemption will be the responsibility of the Contractor to meet with the approval of the State. 19. MACBRIDE FAIR EMPLOYMENT PRINCIPLES. In accordance with the MacBride Fair Employment Principles (Chapter 807 of the Laws of 1992), the Contractor hereby stipulates that the Contractor either has no business operations in Northern Ireland, or shall take lawful steps in good faith to conduct any business operations in Northern Ireland in accordance with the MacBride Fair Employment Principles (as described in Section 165 of the New York State Finance Law), and shall permit independent monitoring of compliance with such principles. 20. OMNIBUS PROCUREMENT ACT OF 1992. It is the policy of New York State to maximize opportunities for the participation of New York State business enterprises, including minority and women-owned business enterprises as bidders, subcontractors and suppliers on its procurement contracts. Information on the availability of New York State subcontractors and suppliers is available from: NYS Department of Economic Development Division for Small Business Albany, New York 12245 Telephone: [PHONE REDACTED] Fax: [PHONE REDACTED] email: [EMAIL REDACTED] A directory of certified minority and women-owned business enterprises is available from: NYS Department of Economic Development Division of Minority and Women's Business Development 633 Third Avenue New York, NY 10017 212‐803‐2414 email: [EMAIL REDACTED] The Omnibus Procurement Act of 1992 requires that by signing this bid proposal or contract, as applicable, Contractors certify that whenever the total bid amount is greater than $1 million: ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A The Contractor has made reasonable efforts to encourage the participation of New York State Business Enterprises as suppliers and subcontractors, including certified minority and women-owned business enterprises, on this project, and has retained the documentation of these efforts to be provided upon request to the State; The Contractor has complied with the Federal Equal Opportunity Act of 1972 (P.L. 92-261), as amended; The Contractor agrees to make reasonable efforts to provide notification to New York State residents of employment opportunities on this project through listing any such positions with the Job Service Division of the New York State Department of Labor, or providing such notification in such manner as is consistent with existing collective bargaining contracts or agreements. The Contractor agrees to document these efforts and to provide said documentation to the State upon request; and The Contractor acknowledges notice that the State may seek to obtain offset credits from foreign countries as a result of this contract and agrees to cooperate with the State in these efforts. 21. RECIPROCITY AND SANCTIONS PROVISIONS. Bidders are hereby notified that if their principal place of business is located in a country, nation, province, state or political subdivision that penalizes New York State vendors, and if the goods or services they offer will be substantially produced or performed outside New York State, the Omnibus Procurement Act 1994 and 2000 amendments (Chapter 684 and Chapter 383, respectively) require that they be denied contracts which they would otherwise obtain. NOTE: As of May 15, 2002, the list of discriminatory jurisdictions subject to this provision includes the states of South Carolina, Alaska, West Virginia, Wyoming, Louisiana and Hawaii. Contact NYS Department of Economic Development for a current list of jurisdictions subject to this provision. 22. COMPLIANCE WITH NEW YORK STATE INFORMATION SECURITY BREACH AND NOTIFICATION ACT. Contractor shall comply with the provisions of the New York State Information Security Breach and Notification Act (General Business Law Section 899-aa; State Technology Law Section 208). 23. COMPLIANCE WITH CONSULTANT DISCLOSURE LAW. If this is a contract for consulting services, defined for purposes of this requirement to include analysis, evaluation, research, training, data processing, computer programming, engineering, environmental, health, and mental health services, accounting, auditing, paralegal, legal or similar services, then, in accordance with Section 163 (4-g) of the State Finance Law (as amended by Chapter 10 of the Laws of 2006), the Contractor shall timely, accurately and properly comply with the requirement to submit an annual employment report for the contract to the agency that awarded the contract, the Department of Civil Service and the State Comptroller. 24. PROCUREMENT LOBBYING. To the extent this agreement is a "procurement contract" as defined by State Finance Law Sections 139-j and 139-k, by signing this agreement the contractor certifies and affirms that all disclosures made in accordance with State Finance Law Sections 139-j and 139-k are complete, true and accurate. In the event such certification is found to be intentionally false or intentionally incomplete, the State may terminate the agreement by providing written notification to the Contractor in accordance with the terms of the agreement. ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A 25. CERTIFICATION OF REGISTRATION TO COLLECT SALES AND COMPENSATING USE TAX BY CERTAIN STATE CONTRACTORS, AFFILIATES AND SUBCONTRACTORS. To the extent this agreement is a contract as defined by Tax Law Section 5-a, if the contractor fails to make the certification required by Tax Law Section 5-a or if during the term of the contract, the Department of Taxation and Finance or the covered agency, as defined by Tax Law 5-a, discovers that the certification, made under penalty of perjury, is false, then such failure to file or false certification shall be a material breach of this contract and this contract may be terminated, by providing written notification to the Contractor in accordance with the terms of the agreement, if the covered agency determines that such action is in the best interest of the State. 26. IRAN DIVESTMENT ACT. By entering into this Agreement, Contractor certifies in accordance with State Finance Law §165-a that it is not on the “Entities Determined to be Non-Responsive Bidders/Offerers pursuant to the New York State Iran Divestment Act of 2012” (“Prohibited Entities List”) posted at: http://www.ogs.ny.gov/about/regs/docs/ListofEntities.pdf Contractor further certifies that it will not utilize on this Contract any subcontractor that is identified on the Prohibited Entities List. Contractor agrees that should it seek to renew or extend this Contract, it must provide the same certification at the time the Contract is renewed or extended. Contractor also agrees that any proposed Assignee of this Contract will be required to certify that it is not on the Prohibited Entities List before the contract assignment will be approved by the State. During the term of the Contract, should the state agency receive information that a person (as defined in State Finance Law §165-a) is in violation of the above-referenced certifications, the state agency will review such information and offer the person an opportunity to respond. If the person fails to demonstrate that it has ceased its engagement in the investment activity which is in violation of the Act within 90 days after the determination of such violation, then the state agency shall take such action as may be appropriate and provided for by law, rule, or contract, including, but not limited to, imposing sanctions, seeking compliance, recovering damages, or declaring the Contractor in default. The state agency reserves the right to reject any bid, request for assignment, renewal or extension for an entity that appears on the Prohibited Entities List prior to the award, assignment, renewal or extension of a contract, and to pursue a responsibility review with respect to any entity that is awarded a contract and appears on the Prohibited Entities list after contract award. ---PAGE BREAK--- STANDARD CLAUSES FOR NYS CONTRACTS APPENDIX A Checklist of documents to be returned with bid or contract: Exhibit A: Drug Free Workplace Exhibit B: Acknowledgement and Agreement to Comply with Standard Clauses for New York State Contracts Exhibit C: Non-Collusive Bidding Certification Required by Section 139-D of the State Finance Law Exhibit D: Conflict of Interest Disclosure Valid W9 with signature Copy of NYS Certificate of Authority to do Business in New York State Proof that signatory is at least a 50% owner and has the authority to act on behalf of the business