KELLER INDEPENDENT SCHOOL DISTRICT REQUEST FOR QUALIFICATIONS INSTRUCTIONS AND SPECIFICATIONS FOR: #1412-29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School

DEADLINE: December 4, 2014 at 2:00PM (CST)

************ IMPORTANT SUBMITTAL INFORMATION ************ Please duplicate the following label and affix to the outside of your sealed submittal envelope. Vendor’s name and return address should be printed on the submittal envelope. FOR U.S. MAIL

KELLER ISD PURCHASING DEPARTMENT 350 Keller Parkway KELLER, TX 76248 RFQ #1412-29—Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School DO NOT OPEN UNTIL: Thursday, December 4, 2014 2:00 P.M. (CST)

FOR HAND DELIVERY/COURIER SERVICES

KELLER ISD PURCHASING DEPARTMENT 350 Keller Parkway KELLER, TX 76248 RFQ #1412-29—Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School DO NOT OPEN UNTIL: Thursday, December 4, 2014 2:00 P.M. (CST)

It is your responsibility to meet the submittal requirements. We recommend that you verify the label data with the title page; the latter prevails.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 2

Legal Notice Request for Qualifications #1412-29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School for Keller Independent School District The Keller Independent School District will accept Sealed Qualifications for RFQ# 1412-29 Construction Manager at Risk services at: Keller ISD Purchasing Department 350 Keller Parkway Keller, TX 76248 (Please include four (4) copies, one (1) original and three (3) copies)

until 2:00 P.M. (CST) on December 4, 2014. The Construction Manager, selected in a two-step process, will provide construction services at a contracted fee and provide consultation to the school district during and after the design of the facility. The project to be constructed is “Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School for the Keller Independent School District”.

The Request for Qualifications (RFQ) packet may be obtained by contacting the following District office: Sherri Lane Planning & Facility Project Management Department Keller I.S.D. 11300 Alta Vista Road Keller, Texas 76244 (817) 744-3970 Keller I.S.D. reserves the right to waive any informality and to reject any or all Proposals.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 3

PROJECT AND ANTICIPATED SCHEDULE The following project narratives are to assist you in responding to the RFQ. Building Addition and Renovation to Career and Technology Campus This project includes an addition to Career and Technology Campus, which will be approximately 60,000 s.f. of new construction. Scope includes construction of an addition, including concrete piers and foundation, steel structure and metal roofing, brick façade on metal stud construction. Finishes include drywall with paint, tile, carpet, lay-in ceilings, CMU partitions, VCT and finished cabinetry. Site work includes landscaping, irrigation, and concrete paving. All associated mechanical, electrical, and plumbing are included. In addition, renovation of existing structure, approximately 135,000 s.f. Scope includes moving/adding walls, moving/adding mechanical, electrical and plumbing. Finishes include drywall with paint, tile, carpet, lay-in ceilings, CMU partitions, VCT and finished cabinetry. Renovation to Indian Springs Middle School This project includes renovation of existing facilities at Indian Springs Middle School, which will be approximately 4,700 s.f. Scope includes moving/adding walls, moving/adding mechanical, electrical and plumbing. Finishes include drywall with paint, tile, carpet, lay-in ceilings, CMU partitions, VCT and finished cabinetry for the Keller Independent School District

Construction Budget:

$ 32,000,000 – Career and Technology Campus, addition and renovation $ 820,000 – Renovations to Indian Springs Middle School

Career and Technology Campus Addition & Renovation (Current South Keller Intermediate School Location) Construction Start: Construction Completion:

May 2015 November 2016

Indian Springs Middle School Construction Start: Construction Completion:

May 2016 August 2016

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 4

Keller Independent School District

CONSTRUCTION MANAGER SELECTION SCHEDULE  Request for Sealed Proposal First Advertisement

November 17th, 2014

 Request for Sealed Proposal Second Advertisement

November 24th, 2014

•

Question submission deadline**

December 1, 2014

3:00P.M. (CST)

Receive Sealed Proposal

December 4th, 2014

2:00 P.M. (CST)

 Interview (if deemed beneficial to KISD)

December 8th, 2014

 Receive sealed proposal and negotiate cost

December 9th, 2014

 Recommend Construction Managers to Board of School Trustees

December 18th, 2014

**Questions to be submitted via email to Lori Tudor, Director of Purchasing at [email protected]

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 5

Keller Independent School District

REQUEST FOR QUALIFICATIONS Pursuant to the provisions of the Government Code Section 2269.056, it is the intention of the Keller Independent School District to select one or more Construction Manager at Risk firms in a two-step process for the construction of a Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School. Sealed submittals are to include the information requested in this package in the sequence and format prescribed. In addition to and separate from the requested information, submitting organizations may provide supplementary materials further describing their capabilities and experience (under separate cover). Four (4) copies, one original and three copies are to be submitted to: Keller I.S.D. Purchasing Department 350 Keller Parkway Keller, Texas 76248 No later than: 2:00 P.M.(CST) on December 4, 2014. Immediately thereafter, the District will review the information. The district will use a two-step selection process. At a time to be determined, the District will review and rank the qualification information through an Administrative Committee. Questions pertaining to the Projects and Request for Qualification Packages should be addressed to: Sherri Lane Planning & Facility Project Management Department Keller I.S.D. 11300 Alta Vista Road Keller, Texas 76244 (817) 744-3970 (817) 744-3960 Fax [email protected]

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 6

Keller Independent School District

REQUEST FOR SEALED QUALIFICATIONS QUESTIONNAIRE Please provide the following information in the sequence and format prescribed by this questionnaire. Supplemental materials providing additional information may be included under separate cover attached, but the information requested below is to be provided in this format. 1. Firm Information: Name of firm: Address of principal office: Phone: Fax: Form of Business Organization (Corporation, Partnership, Individual, and Joint Venture, other?): Year Founded: Primary Individual to Contact: 2. Organization 2.1 How many years has your organization been in business in its current capacity? 2.2 How many years has your organization been in business under its present name? Under what other or former names has your organization operated? 2.3 If your organization is a corporation, please provide date of incorporation, State of incorporation and list all officers of the corporation. 2.4 If your organization is a partnership, answer the following: Date of organization, type of partnership (if applicable), and names of managing partner. 2.5 If your organization is individually owned, answer the following: Date of organization, name of owner. 2.6 If the form of your organization is other than those listed above, describe it and name the principals. 3. Licensing 3.1 List jurisdictions and trade categories in which your organization is legally qualified to do business and indicate registration or license numbers, if applicable. 3.2 List jurisdictions in which your organization’s partnership or trade name is filed. 4. Experience 4.1 List the categories of work that your organization normally performs with its own forces. Would you propose to do any work with your own forces or to bid all work to subcontractors? 4.2 List any subcontractors in which your organization has some ownership and list the categories of work those subcontractors normally perform. 4.3 Claims and suits (If the answer to any of the questions below is yes, please attach details). 4.3.1 Has your organization ever failed to complete any work awarded to it? RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 7

4.3.2 Are there any judgments, claims, arbitration proceedings or suits filed or outstanding against your organization or its officers for the last 5 years? 4.3.3 Has your organization filed any lawsuits or requested arbitration with regards to construction contracts within the last five years? 4.4 Within the last three to five years, has any officer or principal of your organization ever been an officer or principal of another organization when it failed to complete a construction contract? (If the answer is yes, please attach details.) 4.5 Current work: List the major construction projects your organization has in progress (noting method of selection, i.e.: CM at Agent, Bid, Proposal or other), giving the name and location of project, owner, architect, contract amount, percent complete and scheduled completion date. 4.6 Work over last 3 years: List major projects (particularly educational facilities) constructed by your firm including major renovations and additions while the facility remained in service. For each project, provide the name, nature of the project/function of the building, size (SF), location, cost, completion date, owner, architect, and method of selection, i.e.: CM at risk, bid, proposal or other. 5. Financial Information: 5.1 Attach a financial statement, preferably audited, including your organization’s latest balance sheet and income statement showing the following items: • Current assets (e.g., cash, joint venture accounts, accounts receivable, notes receivable, accrued income, deposits, materials inventory, and prepaid expenses). • Non-current assets (e.g., net fixed assets, other assets). • Current liabilities (e.g., accounts payable, notes payable (current), accrued expenses, provision for income taxes, advances, accrued salaries and accrued payroll taxes). • Non-current liabilities (e.g., notes payable). • Capital accounts and retained earnings (e.g., capital, capital stock, authorized and outstanding shares par value, earned surplus and retained earnings). 5.2 Name and address of firm preparing attached financial statement and date thereof. 5.3 Is the attached financial statement for the identical organization named under item 1 above? If not, explain the relationship and financial responsibility of the organization whose financial statement is provided (e.g., parent - subsidiary). 5.4 Will the organization whose financial statement is attached act as guarantor of the contract for construction? 5.5 Provide name, address, and phone for bank reference. 5.6 Surety: Provide the name of your bonding company, name and address of agent, and a letter from your agent stating your current standing. Performance and Payment Bonds for 100% of the construction cost will be required upon submission of the GMP. Is your surety listed as an acceptable surety in the Department of the Treasury Circular 570 and licensed to issue such bonds in the State of Texas?

6. Experience with concepts for working as a Construction Manager at Risk. 6.1 Describe your organization’s concepts for working in a team relationship with the Owner and Architect during the design and construction of major projects. Describe your organization’s methods for estimating costs, and for scheduling during the design/document phases. Describe how your company will benefit this project using Construction Manager at risk. 6.2 Cost Estimates: RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 8

Attach a sample conceptual cost estimate prepared during the design phase of a project and a sample of the final cost estimate/breakdown used to fix the contract amount for the construction of the same project. (The identity of the project may be concealed. The intent is to see the nature and format of the cost information provided). 6.3 Fees: Pre-construction Phase Service Fee Describe your organization’s ideology as it pertains to the pre-construction phase fee, i.e., items and services to be included in the fee. Construction Phase Services Fee Describe your organization’s ideology as it pertains to the construction phase fee, i.e., fixed fee, percentage fee, and particular items to be included and/or excluded from the fee. 6.4 Savings: Describe your organization’s concept for the disposition of savings realized during construction. Is the full amount or a percentage thereof returned to the Owner? 6.5 Contingencies: Describe your organization’s concept for cost contingencies during design? During construction? What is your organization’s concept for the disposition of contingency funds after the completion of the project? Give a history of project cost based on bid cost versus final cost noting reasons and amounts of change orders. 6.6 Cost Information: Your firm would be required to make all cost information during design and construction available to owner and architect. Describe how this information would be furnished and how the owner and architect would be assured that it is complete and accurate. 6.7 Provide an Example of a Pay Application, with back up billing information, that has been provided by your firm in the past and would be the standard practice for the proposed project(s). 7. Safety Provide information as pertains to your firm’s accident frequency rate and modifier for the last three to five years. List any OSHA citations in the last three to five years. List any deaths that have occurred on your projects in the last five years. 8. Schedules Provide samples of schedules that will be used to control various project phases. Give a history of your ability to deliver projects on time for the past 3 years. Describe methods employed to keep projects on schedule and methods of corrective action to overcome schedule deficiencies. 9. References For the projects listed above (re: item 4.6), identify a representative of the owner and a representative of the architect (provide name, phone/fax numbers) whom we could contact as references regarding your organization’s services. Ideally, some of the references should be for educational projects of comparable scope.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 9

Keller Independent School District

CRITERIA FOR SELECTION Per the Government Code 2269.055 and 2269.253. Keller I.S.D. may consider the following in determining to whom to award the contract for Construction Manager at Risk services. 1) 2) 3) 4) 5) 6) 7) 8)

the price; the offeror’s experience and reputation; the quality of the offeror’s goods or services; the impact on the ability of the government entity to comply with rules relating to historically underutilized businesses; the offeror’s safety record; the offeror’s proposed personnel; whether the offeror’s financial capability is appropriate to the size and scope of the project and any other relevant factor specifically listed in the request for bids, proposals, or qualifications.

(b) In determining the award of a contract under this chapter, the governmental entity shall: (1) consider and apply any existing laws, including any criteria, related to historically underutilized businesses; and (2) consider and apply any existing laws, rules, or applicable municipal charters, including laws applicable to local governments, related to the use of women, minority, small, or disadvantaged businesses.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 10

The following criteria will be considered in selecting the construction manager. EXPERIENCE – (20% of scoring) 2) the reputation of the vendor and of the vendor’s services; the relevant experience of the vendor; 3) the quality of the vendor’s goods or services; 8) past performance of the vendor; 8) the vendor’s past relationship with the District;  How substantial is the firm’s recent experience in the construction of projects of comparable size and complexity?  How substantial is the firm’s experience in providing construction services for educational facilities of comparable size and complexity?  Is the firm knowledgeable about or experienced in the North Texas construction market?  How substantial is the firm’s recent experience in providing pre-construction services for projects of comparable size and complexity?  Has the firm worked for KISD in the past? If so, was that work satisfactory to the District? Was the project finished on time? Was the project finished in budget? DISTRICT’S NEEDS – (20% of scoring) 8) the extent to which the goods or services meet the District’s needs;  Does the description provided by the firm of its pre-construction services evidence both understanding and capabilities of the process in general and as it applies to these projects for the District.  Does the construction manager appear to have the capability to meet the District’s schedule objectives? COST ISSUES – (40% of scoring) 1) the price; 8) the total long-term cost to the District to acquire the vendor’s services;  Is the format/nature of cost estimates prepared by the firm during the design phases informative/useful for the District/Architect? Are the initial and final estimates consistent in nature and format?  If savings are realized during construction, what percentage of those savings is returned to the District? 100? Less?  What is the firm’s concept for the disposition of any unused contingency included in the project cost? 100% to the District? Less? ORGANIZATION, LICENSING, FINANCIAL INFORMATION, PERSONNEL, REFERENCES, SAMPLE CONTACT – (20% of scoring) 5) vendor’s safety record. 6) proposed personnel for the project. 7) whether the offeror’s financial capability is appropriate to the size and scope of the project and 8) any other relevant factor that a private business entity would consider in selecting a vendor.  Does the vendor have a good safety record and active safety program  How long has the firm been in business providing the type of services sought by the District?

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 11

   

Does the firm’s organizational structure, licensing and financial information indicate that the firm is capable of undertaking these projects? Do the personnel proposed for the project appear to have the appropriate experience, capabilities? Did the reference list (both owners and architects) have a favorable experience with the organization? Would they work with them again? How comparable was their project to these projects? Is AIA Document A121/CMc-AGC Document 565, 1991 Edition acceptable as modified by the District?

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 12

44.034.

NOTIFICATION OF CRIMINAL HISTORY OF CONTRACTOR

a) A person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony. b) A school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business for work or materials provided or accomplished. c) This section does not apply to a publicly held corporation. Added by Acts 1995, 74th Leg., ch. 260, ss.1, eff. May 30, 1995

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 13

NOTICE OF NO SUBMISSION FORM Dear Vendor: Please check the appropriate box below, complete the remainder of this form and return it by the scheduled date and time:  Our company cannot provide the products, supplies and/or services listed in this request. Please MOVE our name and address to the following category (ies) so that we may propose at a later date: Category (ies):____________________________________________________ 

We have chosen NOT to submit a proposal at this time, but would like to remain on your list for this proposal category. We did not submit a proposal because: Reason(s):______________________________________________________ ______________________________________________________



Please REMOVE our name from all Keller ISD lists until further notice. Reason(s):______________________________________________________

PLEASE RETURN THIS FORM TO: Keller ISD Purchasing Department Notice of "No-Submission" – RFQ #1412-29—Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School 350 Keller Parkway Keller, TX 76248 Company Name: _______________________________________________________ Representative: (please print) _____________________________________________ Address: ______________________________________ Phone ( ) _____________ Name of Proposal and Opening Date: _______________________________________ Authorized Signature: _____________________________________________________ Title: ___________________________________________ Date: ___________________ VENDORS WHO RESPOND TO THIS INVITATION WITH A COMPLETED PROPOSAL FORM WILL REMAIN ON OUR MAILING LIST. VENDORS MAKING NO RESPONSE AT ALL WILL BE REMOVED FROM THAT LISTING.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 14

Felony Conviction Notification State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states “a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or owner or operator of the business entity has been convicted of a felony.” The notice must include a general description of the conduct resulting in the conviction of a felony. Subsection (b) states “a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract.

This notice is not required of a publicly held corporation

I, the undersigned for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge.

Please select ONE choice below: My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. My firm is not owned or operated by anyone who has been convicted of a felony. My firm is owned or operated by the following individuals who has/have been convicted of a felony. Name of individual (s): _______________________________________________ Details of conviction (s): ______________________________________________ ________________________________________________

Please complete the information below: Name of Vendor: ________________________________________________________________ (Please type or print) Name of Company Official: ________________________________________________________________ (Please type or print) Signature of authorized agent: ______________________ Date: __________

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 15

Conflict of Interest Questionnaire

FORM CIQ

For vendor or other person doing business with local government entity

This questionnaire is being filed in accordance with chapter 176 of the Local Government Code by a person doing business with the governmental entity. By law this questionnaire must be filed with the records administrator of the local government not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006, Local Government Code.

OFFICE USE ONLY Date Received:

A person commits an offense if the person violates Section 176.006, Local Government Code. An offense under this section is a Class C misdemeanor. 1. Name of person doing business with local government entity.

2.

Check this box if you are filing an update to a previously filed questionnaire: (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than September 1st of the year for which an activity described in Section 176.006(a), Local Government Code, is pending and no later than the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate)

3. Describe each affiliation or business relationship with an employee or contractor of the local governmental entity who makes recommendations to a local government officer of the local governmental entity with respect to expenditure of money.

4. Describe each affiliation or business relationship with a person who is a local government officer and who appoints or employs a local government officer of the local governmental entity that is the subject of this questionnaire.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 16

FORM CIQ

Conflict of Interest Questionnaire Page: 2

For vendor or other person doing business with local government entity 5. Name of local government officer with whom filer has affiliation or business relationship. (Complete this section only if the answer to A, B, or C is YES) This section, item 5 including subparts A, B, C & D, must be completed for each officer with whom the filer has affiliation or business relationship. Attach additional pages to this Form CIQ as necessary.

A. Is the local government officer named in this section receiving or likely to receive taxable income from the filer of the questionnaire? ______ Yes

______ No

B. Is the filer of the questionnaire receiving or likely to receive taxable income from or at the direction of the local government officer named in this section AND the taxable income is not from the local governmental entity? ______ Yes

______ No

C. Is the filer of this questionnaire affiliated with a corporation or other business entity that the local government officer serves as an officer or director, or holds an ownership of 10 percent or more? ______ Yes

______ No

D. Describe each affiliation or business relationship:

6. Describe any other affiliation or business relationship that might cause a conflict of interest.

7. X_______________________________________ Signature of person doing business with the local governmental entity

___________ Date

**This form must be signed and dated**

CERTIFICATION REGARDING LOBBYING RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 17

CERTIFICATION FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE AGREEMENTS The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying", in accordance with its instruction. (3) The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub grants and contracts under grants, loans, and cooperative agreements) and that all sub recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, US Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. _______________________________________

_______________________________________

Company

Authorized Representative (Print)

_______________________________________ Date

________________________________ Signature

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 18

Certification Regarding Debarment, Suspension, Ineligibility and Voluntary ExclusionLower Tier Covered Transactions ______________________________________________________________________________ U.S Department of Agriculture This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Section 3017.510, Participants’ responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 47224733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. (Before completing certification, read the instructions below.) Please check one choice below:  The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency.  When the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal.

Organization Name ________________ Name and Title of Authorized Representative _____ Signature

Date

Instructions For Suspension/Debarment Certification Statement 1. By signing and dating the certification statement, the bidder certifies that neither it nor any of its principals (e.g., key employees) has been proposed for debarment, debarred or suspended by a federal agency on the date signed. 2. The prospective bidder shall provide immediate written notice to the person to whom this proposal is submitted if at any time the prospective bidder learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. Federal and State penalties exist for vendors and districts that knowingly enter into contracts with suspended/debarred persons.

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 19

ACKNOWLEDGEMENT FORM Having carefully read the Standard Terms and Conditions and any Special Conditions listed in this document, the undersigned hereby agrees to furnish all goods and services specified on the Keller ISD Proposal Form at the prices and transportation costs as proposed. By submission of this proposal, the undersigned certifies that: a.

This proposal has been independently arrived at without collusion with any other bidder or any other competitor;

b.

This proposal has not been knowingly disclosed and will not be knowingly disclosed, to any other bidder, competitor or potential competitor, prior to the opening of bids, or proposals for this project;

c.

No attempt has been or will be made to induce any other person, partnership or corporation to submit or not submit a proposal;

d.

The undersigned certifies that he is fully informed regarding the accuracy of the statements contained in this certification, and the penalties herein are applicable to the bidder as well as to any person signing in his/her behalf;

e.

Vendor warrants it has no interest, and shall acquire no interest that would directly or indirectly conflict in any manner or degree with the performance of this proposal. For violation or breach of this warranty, Keller ISD shall have the right to annul this contract without liability:

f.

As required by Local Government Code 176.006, the undersigned acknowledges the requirement of filing a Conflict of Interest Questionnaire if there are any facts that would require such to be filed, and can be obtained directly from the Keller ISD Purchasing Office, 350 Keller Parkway, Keller, TX 76248

g.

The undersigned certifies that to his/her knowledge no Keller ISD employee has any personal or beneficial interest whatsoever in this service or property described herein.

Respondent acknowledges receipt of Addenda number ___ through ___ and has incorporated the provisions therefore into this proposal. ______________________________________________________________________________ AUTHORIZED SIGNATURE PRINT NAME ______________________________________________________________________________ TITLE DATE

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 20

Keller Independent School District EMPLOYEES WORKING ON SITE FORM Contracting Company

Name: Address: Phone:

___________________________ ___________________________ ___________________________ ___________________________

All the below employees listed below are the employees of the above referenced Contracting Company who will have duties related to the contracted services; and the duties are or will be performed on school property or at another location where students are regularly present. If more than fifteen (15) employees will have duties, please attach additional copies of this form as needed. Employee First Name 1. ______________________ 2. ______________________ 3. ______________________ 4. ______________________ 5. ______________________ 6. ______________________ 7. ______________________ 8. ______________________ 9. ______________________ 10. ______________________ 11. ______________________ 12. ______________________ 13. ______________________ 14. ______________________ 15. ______________________

Employee Last Name ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________ ______________________

If the fact that false information has been furnished or there has been suppression of any factual information in the Employee Working on Site Form comes to notice at any time during the services of a contractor, the services would liable to be terminated. By signing this form, you certify you have listed all the names of the employees who will have duties related to the contracted services; and the duties are or will be performed on school property or at another location where students are regularly present. __________________________ __________________________ ____________________ Authorized Signature Title Date

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 21

RFQ #1412‐29 Construction Manager at Risk Building Addition and Renovation to Career and Technology Campus and Renovation at Indian Springs Middle School



Page 22