Cities Index.
Original RFP

Fresno City Council
December 14, 2023

Document
Original RFP
Meeting
December 14, 2023
Body
Fresno City Council
Pages
2
Original file
1.3 MB
Text extracted from the city's file for reading and search. Open the original on legistar2.granicus.com. That file is the official record.

ATTACHMENT NO. 3

REFERENCES

PROPOSER REFERENCES FROM CLIENTS

Proposers are required to provide three (3) client references, including contact information, for similar projects that the Proposer has completed within the past five (5) years. It is preferred that at least one (1) client reference be a government sector client.

The Proposer is required to include the three (3) references in the Proposal submitted to the City.

CITY OF KCMO REFERENCE CHECK

GENERAL INFORMATION

Name of Proposer
Subcontractor/Third Party
Product or Service
Reviewed

REFERENCE CHECK INFORMATION

Business/Firm Name
Business/Firm Address
Contact Name
Title
Telephone Number
Fax Number
E-mail Address

EV2370 ISSUE DATE: 09/06/2017
(REV. 06-17-13)

Page 2 of 2 ends

To submit a reference, please respond to the following questions:

1. What services did the Business/Firm provide for you?

2. Were the services performed satisfactorily?

3. Were the invoices detailed and accurate?

If the invoicing was not accurate, explain how easy or difficult it was to reconcile or have the invoicing updated.

4. Were there any staffing disputes? If so, explain how easy or difficult it was to have staff replaced.

5. Were you happy with the cost of your services?

6. Are you still using this Business/Firm for these services?

7. Do you plan to continue this relationship?

8. Additional Comments:

Name of Client Contact (Print) Signature and Date

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HRD INSTRUCTIONS

FOR REQUESTS FOR QUALIFICATIONS/PROPOSALS

PART A. MINORITY/WOMEN BUSINESS ENTERPRISE REQUIREMENTS I. City’s MBE/WBE Program.

A. The City has adopted a Minority/Women Business Enterprise (“MBE/WBE”) Program (Sections 38- 84 through 38- 100.8, Code of Ordinances) (the “ Program”) to implement the City’s policy of supporting the fullest possible participation in City contracts and change orders of firms owned and controlled by minorities and women. Each construction project may have an MBE and/or WBE goal for participation. An MBE or WBE goal is a numerical objective the City has set for the c ontract. Goals are stated as a percentage of contract dollars. For example, if an MBE goal for a contract is 10% a nd a Proposer submits a proposal of $100,000, the goal for MBE participation would equal $10,000. The specific MBE/WBE goals on this project are set forth elsewhere in the proposal specifications.

B. By submitting a proposal, the Proposer agrees, as a material term of the contract, to carry out the City’s MBE/WBE Program by making good faith efforts to include certified MBE/WBEs in the project work to the extent of the goals listed for the project and to the fullest extent consistent with su bmitting the best proposal to the City. Proposer agrees that the Program is incorporated into this document and agrees to follow the Program .

Although it is not a requirement that a Proposer in fact meet or exceed both the MBE and WBE Goals, it is a req uirement for approval of the proposal that a Proposer objectively demonstrate to the City that good faith efforts have been made to meet the Goals.

C. The following HRD Forms are attached and must be used for MBE/WBE submittals:

1. Affidavit of Intended Utilization (HRD Form 13); and

2. Contractor Utilization Plan/Request for Waiver (HRD Form 8A); and

3. Letter of Intent to Subcontract (HRD Form 00450.01); and

4. Timetable for MBE/WBE Utilization (HRD Form 10); and

5. Request for Modification or Substitution (HRD Form 11); and

6. Contractor Affidavit for Final Payment (Form 01290.14); and

7. Subcontractor Affidavit for Final Payment (Form 01290.15).

Warning: The City only g ives MBE/WBE credit for a Proposer ’s use of City certified MBE/WBEs. A certified MBE/WBE firm is a firm that has been certified by the City’s Human Relations Departme nt as such . Certified MBEs and WBEs are listed in the M/W/DBE Kansas City Mo. Online Directory, which is available on the City’s website at www.kcmo.org. Before a Proposer submits a proposal, Proposer should contact HRD and consult the directory to make s ure any firm proposed for use for MBE/WBE participation has been certified.

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II. Required Submissions with Proposal.

A. Proposer must submit the following document with its proposal:

1. Affidavit of Intended Utilization (HRD Form 13). This form states a Proposer ’s intent to use certified MBE/WBEs in the performance of the contract.

III. Required Submissions Prior to Contract Award.

A. Proposer must submit the following documents prior to contract award.

1. Contractor Utilization Plan/Request for Waiver (HRD Form 8). This form states a Proposer ’s plan to use specific certified MBE/WBEs in the performance of the contract and includes the following:
a. The work to be performed by each MBE/WBE and the amounts each is to be paid for the work; and
b. The name, address, race or ethnic origin, gender and employer identification number or social security number of each MBE/WBE that will perform the work.
c. An automatic reques t for waiver in the event Proposer has not met or exceeded the MBE and/or WBE goals for the contract but believes that it has made good faith efforts to meet or exceed the goals and desires a waiver of the goals. If a waiver is reques ted, HRD will examine the Proposer’s documentation of good faith efforts and make a recommendation to grant or deny the waiver. HRD will recommend a waiver be granted only if the Proposer has made good faith efforts to obtain MBE/WBE participation.

2. Letter(s) of Intent to Subcontract (HRD Form 00450.01). A letter must be provided from each MBE/WBE listed on the Contractor Utilization Plan.

These letters verify that the MBE/WBE has agreed to execute a formal agreement for the work and indicate the scope of work to be performed and the price agreed upon for the work.

IV. Additional Required Submissions when Requested by City.

A. Proposer must submit the following documents when requested by City:

1. Timetable for MBE/WBE Utilization (HRD Form 10).

2. Documentation of good faith efforts.

V. Required Monthly Submissions during term of Contract.

A. Proposers must submit the following document on a monthly ba sis if awarded the contract:

1. M/WBE Monthly Utilization Report (HRD Form 00485.01). This report must be submitted to the Director by the 15
th of each month. Failure to submit timely reports
may result in delays in processing of current and future contract approvals and payment applications.

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VI. Required Submittals for Final Contract Payment.

A. Proposer must submit the following documents with its request for final payment under the contract:

1. Contractor Affidavit for Final Payment (Form 01290.14)

2. Subcontractor Affidavit(s) for Final Payment (Form 01290.15) VII. Additional Submittals.

A. Proposer may be required to make additional submittals during the term of the Contract, including Request for Modification or Substitution (HRD Form 11) . Refer to Section X, Modification of the Contractor Utilization Plan or Substitution of an MBE/WBE, for additional instructions on when this form must be submitted.

VIII. MBE/WBE Participation Credit.

A. The following shall be credited towards achieving the goals:

1. The total contract dollar amount that a prime contractor has paid or is obligated to pay to a subcontractor that is a qualif ied MBE or WBE , except as otherwise expressly provided for herein.

2. Twenty-five percent (25%) of the total dollar amount paid or to be paid by a prime contractor to obtain supplies or goods from a supplier who is a qualified MBE or WBE.

3. Ten percent (10%) of the total dollar amount paid or to be paid by a prime contractor to obtain supplies or goods from a supply broker who is a qualified MBE or WBE.

4. One hundred percent (100%) of the total dollar amount paid or to be paid by a prime contractor to a manufactur er of construction supplies who is a qualified MBE or WBE.

5. Subcontractor participation with a lower tier MBE/WBE subcontractor using one of the above methods of participation.

B. NO CREDIT, however, will be given for the following:

1. Participation in a contract by a MBE or WBE that does not perform a commercially useful function as defined by the Program; and

2. Any portion of the value of the contract that an MBE or WBE subcontractor subcontracts back to the prime contractor or any other contractor who is not a qualified MBE/WBE; and

3. An MBE or WBE prime contractor’s own participation in its contract with City; and

4. Materials and supplies used on the contract unless the MBE/WBE is responsible for negotiating the price, determining quality and quantity, ordering the m aterials and installing (where applicable) and paying for material itself; and

5. Work performed by an MBE or WBE in a scope of work other than that in which the MBE or WBE is currently certified.

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IX. Methods for Securing Participation of MBE/WBEs and Good Faith Efforts.

A. A Proposer is required to make good faith efforts to achieve the MBE/WBE goals. Good faith efforts are efforts that, given all relevant circumstances, a Proposer actively and aggressively seeking to meet the goals can reasonably be expected to make. Good faith efforts must be made before the Proposer submits a Contractor Utilization Plan/Request for Waiver (HRD Form 8)
Warning: Efforts to obtain MBE and/or WBE participation made after a Contractor Utilization Plan is submitted c annot be used to show the Proposer made good faith efforts.

B. In evaluating good faith efforts, the Director of HRD w ill consider whether the Proposer has performed the following, along with any other relevant factors:

1. Advertised opportunities to participate in the contrac t in general circulation media, trade and professional association publications, small and minority business media, and publications of minority and women’s business organizations in sufficient time to allow MBE and WBE firms to participate effectively.

2. Provided notice to a reasonable number of minority and women’s business organizations of specific opportunities to participate in the contract in sufficient time to allow MBE and WBE firms to participate effectively.

3. Sent written notices, by certified mail o r facsimile, to qualified MBEs and WBEs soliciting their participation in the contract in sufficient time to allow them to participate effectively.

4. Attempted to identify portions of the work for qualified MBE and/or WBE participation in order to increase t he likelihood of meeting the goals, including breaking down contracts into econom ically feasible units. A Proposer should send letters by certified mail or facsimile to those MBE/WBE contractors identified by HRD listed in those categories which are in those subcontractors’ scope of work. The portion of work for which a proposal from an MBE/WBE is being solicited shall be as specific as possible. Letters which are general are not acceptable.

5. Requested assistance in achieving the goals from the Director and acted on the Director’s recommendations.

6. Conferred with qualified MBEs and WBEs and explained the scope and requirements of the work for which their bids or proposals were solicited.

7. Attempted to negotiate in good faith with qualified MBEs and WBEs to perform specific subcontracts; not rejecting them as unqualified without sound reasons based on a thorough investigation of their capabilities. Documentation of good faith negotiations with MBE/WBEs from whom proposals were received in an effort to reach a mutually acceptable price should include:
a. Names, addresses and telephone numbers of MBE/WBEs that were contacted and date of contact;
b. The information provided to MBE/WBEs regarding the plans and HRD 06 RFQ/P Instructions 013012
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specifications for portions of the work to be performed by them; c. The reasons no agreement was reached with any MBE/WB E, including the basis for any b id rejection (i.e., availability, price, qualifications or other);
d. Descriptions of attempts to provide technical assistance to MBE/WBEs to obtain necessary insurance and/or to obtain necessary supplies at the best prices available.

C. A Proposer will be required to give the City documentation to prove that it made good faith efforts. The Proposer will be contacted by the City with further instructions about when this documentation must be submitted.

X. Modification of the Contractor Utilization Plan or Substitution of an MBE/WBE.

A. A Proposer may need to substitute an MBE and/or WBE or request that the amount of MBE/WBE participation listed in its Contractor Utilization Plan be modified. Proposer must file a Request for Modification or Substitution (HRD Form 11) prior to actual substitution a nd within a reasonable time after learning that a modification or substitution is necessary. The Director may approve substitutions or modifications and upon approval, the modifications and substitutions will become an amendment to the Contractor Utilization Plan. Modifications or substitutions may be approved when:

1. The Director finds that the Proposer made and provided evidence of good faith efforts to substitute the MBE/WBE listed on the Contractor Utilization Plan with other certified MBE/WBEs for the scope of work or any other scope of work in the contract; AND

2. The Director also finds one of the following:
a. The listed MBE/WBE is non-responsive or cannot perform; or b. The listed MBE/WBE has increased its previously quoted price to the bidder, proposer or contractor without a corresponding change in the scope of the work; or
c. The listed MBE/WBE has committed a material default or breach of its contract with the contractor; or
d. Requirements of the scope of work of the contract have changed and render subcontracting not feasible or not feasible at the levels required by the goals established for the contract; or
e. The listed MBE/WBE is unacceptable to the contracting department; or f. The listed MBE/WBE thereafter had its certification revoked; or g. The Proposer or Contractor has not attempted intentionally to evade the requirements of the Program and it is in the best interests of the City to allow a modification or substitution.

B. A modification shall not be made unless the modification or substitution has first been requested and approved by the Director.

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XI. Appeals. (Applicable only if the RFQ/P is for a construction project) A. In conformance with the Act, appeals may be made to the City Fairness in Construction Board on the following:

1. The grant or denial of a Request for Waiver;

2. Substitution for an MBE/WBE listed on a Contractor Utilization Plan;

3. Modification of the percentage of MBE/WBE participation on a Contractor Utilization Plan;

4. Liquidated Damages;

5. The amount of MBE/WBE credit the Contractor may receive for MBE/WBE participation identified in the contractor utilization plan.

B. Any appeal must be filed in writing with the Director within ten (10) working days of notice of the determination. Mailing, f axing, personal delivery or posting at HRD of determinations shall constitute notice. The appeal shall state with specificity why the Proposer or Contractor believes the determination is incorrect C. Failure to file a timely appeal shall constitute a waiver o f a Proposer ’s or Contractor’s right to appeal such determination and such person shall be estopped to deny the validity of any determination which could have been timely appealed.

XII. Access to Documents and Records.

A. By submitting a proposal, each Proposer agrees to permit the City, its duly authorized agents or employees, access at all reasonable times to all book s and business records of Proposer as may be necessary to ascertain compliance with the requirements of this document and the Act, within ten (10) days of the date of the written request.

B. All Proposers agree to cooperate with the contracting department and HRD in studies and surveys regarding the MBE/WBE program.

XIII. Miscellaneous.

A. A Proposer or Contractor shall bear the burden of proof with regard to all issues on appeal.

B. In the event of any conflict between this document and the Program , the provisions of the Program shall control. The terms used in this document are defined in the Program.

C. Oral representations are not binding on the City.

D. The City Co uncil may waive the requirements of this document and the Program and award the contract to the best proposer if the City Council determines a waiver is in the best interests of the City.

XIV. Liquidated Damages – MBE/WBE Program.

A. If Contractor fails to achieve the MBE/WBE goals stated in its Contractor Utilization Plan, as amended, the City will sustain damages, the exact extent of which would be difficult or impossible to ascertain. Therefore, in order to liquidate those damages, the HRD 06 RFQ/P Instructions 013012
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monetary difference between the amount of the MBE/WBE goals set forth in the Contractor Utilization Plan, as amended, and the amount actually paid to qualified MBEs and WBEs for performing a commercially useful function will be deducted from the Contractor’s payments as liquidated damages. In determining the amount actually paid to qualified MBEs and WBEs, no credit will be given for the portion of participation that was not approved by the Director, unless the Director determines that the C ontractor acted in good faith. No deduction for liquidated damages will be made when, for reasons beyond the control of the Contractor, the MBE/WBE participation stated in the Contractor Utilization Plan, as amended and approved by the Director is not met.

[Specifier: The remainder of this document is applicable ONLY IF the RFQ/P is for a construction project that the City estimates will require more than 800 construction labor hours and cost in excess of $324,000.00 to construct. If this is not applicable to your RFQ/P, delete the remainder of this document. Be sure to delete this note before printing]

PART B. CONSTRUCTION EMPLOYMENT PROGRAM REQUIREMENTS
(THIS PART IS APPLICABLE TO CITY CONSTRUCTION CONTRACTS ESTIMATED BY THE CITY PRIOR TO SOLICITATION AS REQUIRING MORE THAN 800 CONSTRUCTION LABOR HOURS AND COSTING IN EXCESS OF $324,000.00.) I. City’s Construction Employment Program.

A. The City has adopted a Construction Employment Program (Sections 38-83.1 through 38-

83.13, Code of Ordinances) (the “Program”) to implement the City’s policy of supporting the fullest possible utilization of minority and women workers in the construction industry. A person or firm who is awarded a contract to construct, reconstruct, improve, enlarge or alter any fixed work that is estimated by the City prior to solicitation as requiring more than 800 construction labor hours, has an estimated costs that exceeds $324,000.00, and involves the expenditure of public funds, is subject to company-wide construction employment goals. The minimum goals are currently set at 10% for minorities and 2% for women, but public recognition may be provided if the Proposer achieves at least twice the minimum participation. The successful Proposer may meet these company-wide goals by counting the Proposer’s utilization of minorities and women throughout the Kansas City metropolitan statistical area.

B. By submitting a proposal, the Proposer agrees, as a material term of the contract, to carry out the City’s Construction Employment Program by making good faith efforts to utilize minority and women workers on the Proposer’s job sites to the fullest extent consistent with submitting the best proposal to the City. Proposer agrees that the Program is incorporated into this document and agrees to follow the Program. Although it is not a requirement that a Proposer in fact meet or exceed the construction employment goals to receive approval from HRD, a Proposer not doing so is required to objectively HRD 06 RFQ/P Instructions 013012
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demonstrate to HRD that good faith efforts have been made.

C. The following HRD Forms are to be used for Construction Employment Program submittals:

1. Project Workforce Monthly Report (HRD Form 00485.02)

2. Company-Wide Workforce Monthly Report (HRD Form 00485.03) II. Required Monthly Submissions during Term of Contract.

A. Proposer must submit the following documents on a monthly basis if awarded the contract:

1. Project Workforce Monthly Report (HRD Form 00485.02). This report is contract specific. Two copies of this report must be submitted to the Director by the 15th of each month. The first copy will be utilized to report the Proposer ’s own workforce compliance data with regard to the City’s construction contract . The second copy will be utilized to report consolidated workforce compliance data for every subcontractor retained on the City’s construction contract . Failure to submit timely reports may result in delays in processing of current and future contract approvals and payment applications.

2. Company-Wide Workforce Monthly Report (HRD Form 00485.03). This report is not contract specific; it is used to report on the utilization of females and minorities, by trade, company-wide. Two copies of this report must be submitted to the Director by the 15
th of each month. The first copy will be utilized to report the Proposer’s own workforce compliance data with regard to every contract (both privately and publicly funded) Proposer has in progress throughout the Kansas City metropolitan statistical area. The second copy will be utilized to report consolidated workforce compliance data for every subco ntractor retained by Proposer on every contract Proposer has in progress throughout the Kansas City metropolitan statistical area. Failure to submit timely reports may result in delays in processing of current and future contract approvals and payment applications.

III. Submittal Required for Final Contract Payment.

A. The last Project Workforce Monthly Report(s) and Company -Wide Workforce Monthly Report(s) shall serve as the final reports and must be submitted before final payment will be made and/or retainage released. Proposer shall note the submittal of the final reports by notation in the box entitled “Final Cumulative Report” IV. Methods for Securing Workforce Participation and Good Faith Efforts.

A. A Proposer is required to make good faith efforts to achieve the construction employment goals. If a Proposer will be unable to secure enough minority and female participation to meet or exceed the construction employment goals, a Proposer must, within a reasonable time after so learning, request a waiver or modification of the goals by the Director of HRD. The Director will examine the Proposer’s request and the Proposer ’s documentation of good faith efforts and grant or deny a waiver or modification. The Director will grant a waiver or modification only if the Proposer has made good faith HRD 06 RFQ/P Instructions 013012
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efforts to secure minority and female participation.

B. In evaluating good faith efforts, the Director will consider whether the Proposer has performed the following:

1. For those Proposers that are not signatories to a collective bargaining agreement with organized labor:
a. Requested in writing the assistance of the Director with respect to efforts to promote the utilization of minorities and women in the workforce and acted upon the Director’s recommendations; and
b. Advertised in minority or women trade association newsletters and/or minority or women owned media at least 15 calendar days prior to the utilization of any construction services on the city construction contract and used terminology that sufficiently describes the work available, the pay scale, the application process, and anything else that one might reasonably be expected to be informed of relevant to the position being advertised; and c. Maintained copies of each advertisement and a log identifying the publication and date of publication; and
d. Conducted real and substantial recruitment efforts, both oral and written, targeting resident, minority and women community -based organization, schools with a significant mino rity student population, and training organizations serving the recruitment area; and
e. Established and maintained a current list of resident, minority and women recruitment sources, providing written notification to the recruitment sources of available employment opportunities, and maintained records of the notices submitted to the organizations and any responses thereto; and f. Maintained a current file for the time period of the city construction contract with the name, address, and telephone number of each r esident, minority and woman job applicant, the source of the referral, whether or not the person was hired, and in the event that the applicant was not hired, the reason therefore; and
g. Promoted the retention of minorities and women in its workforce with t he goals of achieving sufficient annual hours for minorities and women to qualify for applicable benefits; and
h. Required by written contract that all subcontractors comply with the above efforts.

2. For those Proposers that are signatories to collective bargai ning agreements with organized labor:
a. Supported the efforts of the Joint Apprenticeship Training Committee (JATC), a joint effort of Labor Unions and contractors, or some other apprenticeship program, whose purpose is to recruit, train and employ new worke rs for a full time career in the construction industry; and
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b. Requested in writing from each labor union representing crafts to be employed that:
i. the labor union make efforts to promot e the utilization of residents of the City, minorities and women in the workforce; and
ii. the labor union identify any residents of the City, minorities and women in its membership eligible for employment; and
iii. the JATC take substantial and real steps to increase the participation of minorities in the union apprenticeship programs i n the aggregate to 30% by 2011 and encourage other labor unions to do the same; and iv. the JATC take substantial and real steps to increase the participation of women in the union apprenticeship programs in the aggregate to 5% by 2011 and encourage other labor unions to do the same; and v. the JATC partner with workforce preparedness programs, community based organizations, employment referral programs and school - sponsored programs to accomplish these goals.
c. Collaborated with labor unions in promoting mentoring programs intended to assist minorities and women in increasing retention with the goals of achieving sufficient annual hours to qualify for applicable benefits; and d. Maintained a current file with the name, address, and telephone number of each resident, m inority and women worker identified by the labor union, whether or not the person was hired, and in the event the person was not hired, the reason therefore.
e. To the extent the good faith efforts applicable to Proposers that are signatories to collective bargaining agreements with organized labor conflict with the procedures implemented by the Proposer in order to comply with the relevant bargaining agreement, the Proposer shall substitute other procedures as may be approved by the Director in writing.

C. A Proposer will be required to give the City documentation to prove that it made good faith efforts. The Proposer will be contacted by the City with further instructions about when this documentation must be submitted.

V. Appeals.

A. In conformance with the Program , appeals may be made to the Construction Workforce Board on the following:

1. Determinations by the Director that a contractor did not meet the construction employment goals and did not make a good faith effort to meet the goals;

2. Recommendations by the Director to assess liquidated damages;

3. Recommendation by the Director that a contractor be declared ineligible to receive any city construction contract for a period of time up to one year.

B. Any appeal must be filed in writin g with the Director within ten (10) working days of HRD 06 RFQ/P Instructions 013012
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notice of the recommendation or determination. The appeal shall state with specificity why the Proposer believes the recommendation or determination is incorrect.

C. Failure to file a timely appeal s hall co nstitute a waiver of a Proposer ’s right to appeal such determination or recommendation and such person shall be estopped to deny the validity of any order, determination, recommendation or action of HRD which could have been timely appealed.

VI. Access to Documents and Records.

A. By submitting a proposal, each Proposer agrees to permit the City, its duly authorized agents or employees, access at all reasonable times to all book s and business records of Proposer as may be necessary to ascertain compliance with t he requirements of this document and the Program , within ten (10) days of the date of t he written request. Each Proposer further agrees to require, if awarded the contract, that every subcontractor permit the City the same access to documents and records.

B. All Proposers agree to cooperate with the contracting department and HRD in studies and surveys regarding the construction employment program.

VII. Miscellaneous.

A. A Proposer shall bear the burden of proof with regard to all issues on appeal.

B. The successful P roposer may be required to meet with the Director of HRD or the Director’s designee for the purpose of discussing the construction employment program, the Proposer’s efforts to realize the goals, and any other problems and/or issues affecting the realization of the goals or the program in general.

C. In the event of any conflict between this document and the Program , the provisions of the Program shall control. The terms used in this document are defined in the Program.

D. Oral representations are not binding on the City.

VIII. Liquidated Damages; Suspension – Workforce Program.

A. If a Proposer fails to achieve the construction employment goals without having previously obtained a waiver or modification of those goals, the City will sustain damages, the exact extent of which would be difficult or impossible to ascertain. These damages are magn ified if the failure to abide by the requirements of the Workforce Program is recurring. Therefore, in order to liquidate those damages, City shall be entitled to deduct and withhold the following amounts:

If Proposer failed to meet or exceed the minimum e mployment goals or otherwise establish that Proposer is entitled to a waiver under circumstances in which Proposer has failed to meet or exceed the goals on one prior occasion within the twenty-four month period immediately preceding the completion of the work under the Contract, the sum of three thousand dollars ($3,000.00).

If Proposer failed to meet or exceed the minimum employment goals or otherwise establish that Proposer is entitled to a waiver under circumstances in which Proposer has failed to meet or exceed the goals on two or more prior occasions HRD 06 RFQ/P Instructions 013012
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within the twenty-four month period immediately preceding the completion of the work under the Contract, the sum of seven thousand dollars ($7,000.00).

B. In addition, Proposer shall be required to attend mandatory compliance training or be declared ineligible to contract with the City for a term provided herein, and as authorized by City’s Code of Ordinances:

If Proposer failed to meet or exceed the minimum employment goals or otherwise establish that Propose r is entitled to a waiver under circumstances in which Proposer has not previously failed to meet or exceed the goals within the twenty - four month period immediately preceding the completion of the work under the Contract, Proposer shall be required to attend a mandatory training class on Workforce Program compliance.

If Proposer failed to meet or exceed the minimum employment goals or otherwise establish that Proposer is entitled to a waiver under circumstances in which Proposer has failed to meet or e xceed the goals on one prior occasion within the twenty-four month period immediately preceding the completion of the work under the Contract, Proposer shall be suspended from participating, either as a contractor or subcontractor, on any future contract with the City for a period of thirty (30) days. Proposer waives any right to invoke any proceeding or procedure under Sections 2- 1649 or 2- 1801 of City’s Code of Ordinances with regards to any suspension arising hereunder.

If Proposer failed to meet or exceed the minimum employment goals or otherwise establish that Proposer is entitled to a waiver under circumstances in which Proposer has failed to meet or exceed the goals on two or more prior occasions within the twenty-four month period immediately preceding the completion of the work under the Contract, Proposer shall be suspended from participating, either as a contractor or subcontractor, on any future contract with the City for a period of six (6) months. Proposer waives any right to invoke any proceeding or procedure under Sections 2- 1649 or 2- 1801 of City’s Code of Ordinances with regards to any suspension arising hereunder.

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CONTRACTOR UTILIZATION PLAN/REQUEST FOR WAIVER

Project Number ____________________________________________

Project Title _______________________________________________

______________________________________________________ _____________________ (Department Project) Department

______________________________________________________________________________ (Bidder/Proposer)

STATE OF ____________________ )
) ss
COUNTY OF __________________ )

I, _______________________________, of lawful age and upon my oath state as follows:

1. This Affidavit is made for the purpose of complying with the provisions of the MBE/WBE submittal requirements on the above project and the MBE/WBE Program and is given on behalf of the Bidder/Proposer listed below. It sets out the Bidder/Proposer ’s plan to utilize MBE and/or WBE contractors on the project.

2. The project goals are __________ % MBE and __________ % WBE. Bidder/Pro poser assures that it will utilize a minimum of the following percentages of MBE/WBE participation in the above project:

BIDDER/PROPOSER PARTICIPATION:________% MBE _______% WBE

3. The following are the M/WBE subcontractors whose utilization Bidder /Proposer warrants will meet or exceed the above-listed Bidder/Proposer Participation. Bidder/Proposer warrants that it will utilize the M/WBE subcontractors to provide the goods/services described in the applicable Letter(s) of Intent to Subcontract, copies of which shall collectively be deemed incorporated herein). (All firms must currently be certified by Kansas City, Missouri)

a. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

00450 HRD 08 Utilization Plan & Req. for Waiver 050113 2 of 4 Contract Central

b. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

c. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

d. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

e. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

f. Name of M/WBE Firm ______________________________________________ Address __________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. ________________________________________________________

(List additional M/WBEs, if any, on additional page and attach to this form)

4. The following is a breakdown of the percentage of the total contract amount that Bidder/Proposer agrees to pay to each listed M/WBE:

MBE/WBE BREAKDOWN SHEET

MBE FIRMS:

Subcontract Weighted % of Total
Name of MBE Firm Supplier/Broker/Contractor Amount* Value** Contract _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ 00450 HRD 08 Utilization Plan & Req. for Waiver 050113 3 of 4 Contract Central

_____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______

TOTAL MBE $ / TOTAL MBE %: $____________ ______% ______________________________________________________________________________

WBE FIRMS:

Subcontract Weighted % of Total
Name of WBE Firm Supplier/Broker/Contractor Amount* Value** Contract

_____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ _____________________ _____________________ __________ _______ _______ TOTAL WBE $ / TOTAL WBE %: $____________ ______% _____________________________________________________________________________ *“Subcontract Amount” refers to the dollar amount that Bidder/Proposer has agreed to pay each M/WBE subcontractor as of the date of contracting and is indicated here solely for the purpose of calculating the percentage that this sum represents in proportion to the total contract amount.

Any contract amendments and/or change orders changing t he total contract amount may alter the amount due an M/WBE under their subcontract for purposes of meeting or exceeding the Bidder/Proposer participation.

**“Weighted Value” means the portion of the subcontract amount that will be credited toward s meeting the Bidder/Proposer participation. See HRD Forms and Instructions for allowable credit and special instructions for suppliers.

5. Bidder/Proposer acknowledges that the monetary amount to be paid each listed M/WBE for their work, and which is approved here in, is an amount corresponding to the percentage of the total contract amount allocable to each listed M/WBE as calculated in the MBE/WBE Breakdown Sheet. Bidder/Proposer further acknowledges that this amount may be higher than the subcontract amount list ed therein as change orders and/or amendments changing the total 00450 HRD 08 Utilization Plan & Req. for Waiver 050113 4 of 4 Contract Central

contract amount may correspondingly increase the amount of compensation due an M/WBE for purposes of meeting or exceeding the Bidder/Proposer participation

6. Bidder/Proposer acknowledges that it is responsible for considering the effect that any change orders and/or amendments changing the total contract amount may have on its ability to meet or exceed the Bidder/Proposer participation. Bidder/Proposer further acknowledges that it is responsible for submitting a Request for Modification or Substitution if it will be unable to meet or exceed the Bidder/Proposer participation set forth herein.

7. If Bidder/Proposer has not achieved both the M/WBE goal(s) set for this Project, Bidder/Proposer hereby requests a waiver of the MBE and/or WBE goal(s) that Bidder/Proposer has failed to achieve

8. Bidder/Proposer will present documentation of its good faith efforts, a narrative summary detailing its efforts and the reasons its efforts were unsuccessful when requested by the City.

9. I hereby certify that I am authorized to make this Affidavit on behalf of the Bidder/ Proposer named below and who shall abide by the terms set forth herein:

Bidder/Proposer primary contact:

Address: _________
_________
Phone Number: _________
Facsimile number: _________
E-mail Address: _________

By: __________________________________
Title: __________________________________
Date: __________________________________
(Attach corporate seal if applicable)

Subscribed and sworn to before me this ______ day of ___________________, 20__.

My Commission Expires: __________________ _________________________________ Notary Public

00460 HRD 10 Timetable for MBE/WBE Utilization 050113 Contract Central

TIMETABLE FOR MBE/WBE UTILIZATION

(This form should be submitted to the City after contract award.)

I, __________________________________, acting in my capacity as _____________________ (Name) (Position with Firm) of __________________________________, with the submittal of this Timetable, certify that (Name of Firm)
the following timetable for MBE/WBE utilization in the fulfillment of this contract is correct and true to the best of my knowledge.

ALLOTTED TIME FOR THE COMPLETION OF THIS CONTRACT
(Check one only)

15 days ___ 75 days ___ 135 days ___
30 days ___ 90 days ___ 150 days ___
45 days ___ 105 days ___ 165 days ___
60 days ___ 120 days ___ 180 days ___
Other _____________________ (Specify)

Throughout ____________________________ Beginning 1/3 ___________________________ Middle 1/3 _____________________________ Final 1/3 _______________________________ Beginning 1/3 _________% Middle 1/3 _________% Final 1/3 __________%

PLEASE NOTE: Any changes in this timetable require approval of the Human Relations Department in advance of the change.

If you have any questions regarding the com pletion of this form, please contact the Department of Human Relations at: (816) 513-1818.

__________________________________________
(Signature)

__________________________________________
(Position with Firm)

__________________________________________
(Date)

00470 HRD 11 Request for Mod. or Sub. 050113 Page 1 of 2 Contract Central

REQUEST FOR MODIFICATION OR SUBSTITUTION

(This Form must be submitted to HRD to request substitutions for an MBE/WBE listed in the Contractor Utilization Plan or for modification of the amount of MBE/WBE participation listed in the Contractor Utilization Plan. This Form shall be an amendment to the Contractor Utilization Plan.)

BIDDER/PROPOSER/CONTRACTOR: _________________________________________________ ADDRESS: _________________________________________________________________________ PROJECT NUMBER OR TITLE: ______________________________________________________ AMENDMENT/CHANGE ORDER NO: (if applicable) ____________________________________

Project Goals: ________% MBE _______% WBE
Contractor Utilization Plan: ________% MBE _______% WBE

1. I am the duly authorized representative of the above Bidder/Contractor/Proposer and am authorized to request this substitution or modification on behalf of the Bidder/Contractor/Proposer.

2. I hereby request that the Director of HRD recommend or approve: (check appropriate space(s))

a. ____ A substitution of the certified MBE/WBE firm _____________________________, (Name of new firm)
to perform ______________________________________________________, (Scope of work to be performed by new firm)

for the MBE/WBE firm ________________________________ which is currently (Name of old firm)
listed on the Bidder’s/Contractor’s/Proposer’s Contractor Utilization Plan to

perform the following scope of work: _____________________________. (Scope of work of old firm)

b. ____A modification of the amount of MBE/WBE participation currently listed on the Bidder’s/Contractor’s/Proposer’s Contractor Utilization Plan from

______ % MBE ______% WBE (Fill in % of MBE/WBE Participation currently listed on Contractor Utilization Plan)

TO

______% MBE ______% WBE (Fill in New % of MBE/WBE Participation requested for Contractor Utilization Plan)

c. Attach 00450.01 Letter of Intent to Subcontract letter for each new MBE/WBE to be added. d. Attach a copy of the most recent 00485.01 or on-line M/WBE Monthly Utilization Report

3. Bidder/Contractor/Proposer states that a substitution or modification is necessary because: (check applicable reason(s) )

00470 HRD 11 Request for Mod. or Sub. 050113 Page 2 of 2 Contract Central ___The MBE/WBE listed on the Contractor Utilization Plan is non-responsive or cannot perform.

___The MBE/WBE listed on the Contractor Utilization Plan has increased its previously quoted price without a corresponding change in the scope of work.

___The MBE/WBE listed on the Contractor Ut ilization Plan has committed a material default or breach of its contract.

___Requirements of the scope of work of the contract have changed and make subcontracting not feasible or not feasible at the levels required by the goals established for the contract.

___The MBE/WBE listed on the Contractor Utilization Plan is unacceptable to the City contracting department.

___Bidder/Contractor/Proposer has not attempted intentionally to evade the requirements of the Act and it is in the best interests of the City to allow a modification or substitution.

4. The following is a narrative summary of the Bidder’s/Contractor’ s/Proposer’s good faith efforts exhausted in attempts to substitute the MBE/WBE firm named above which is currently listed on the Contractor Ut ilization Plan with other qualified, certified MBE/WBE firms for the listed scope of work or any other scope of work in the project:

________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

5. Bidder/Proposer/Contractor will present documentation when requested by the City to evidence its good faith efforts.

Dated:_____________________________ _______________________________________ (Bidder/Proposer/Contractor)

_______________________________________
By: (Authorized Representative)

HRD 13 Affidavit of Intended Utilization 021108 Page 1 of 2 Contract Central

AFFIDAVIT OF INTENDED UTILIZATION

(This Form must be submitted with your Bid/Proposal)

____________________________________________________________ (Department Project)

____________________________________________________________ (Bidder/Proposer)

STATE OF ____________________)
) ss
COUNTY OF __________________)

I, _______________________________, of lawful age and upon my oath state as follows:

1. This Affidavit is made for the purpose of complying with the provisions of the MBE/WBE submittal requirements in the bid/proposal specifications on the above project and is given on behalf of the Bidder/Proposer listed below.

2. Bidder/Proposer assures that it presently intends to utilize the following MBE/WBE participation in the above project if awarded the Contract:

PROJECT GOALS: ________% MBE ______% WBE
BIDDER/PROPOSER PARTICIPATION: ________% MBE ______% WBE

3. To the best of Bidder’s/Proposer’s knowledge, the following are the names of certified MBEs or WBEs with whom Bidde r/Proposer, or Bidder’s/ Proposer’s subcontractors, presently intend to contract if awarded the Contract on the above project: (All firms must currently be certified by Kansas City, Missouri Dept. Of Human Relations)

a. Name of M/WBE Firm ___________________________________________ Address ________________________________________________________ Telephone No. __________________________________________________ I.R.S. No. ______________________________________________________ Area/Scope of work _______________________________________________ Subcontract amount ______________________________________________

b. Name of M/WBE Firm _____________________________________________ Address _________________________________________________________ Telephone No. ____________________________________________________ I.R.S. No. ________________________________________________________ Area/Scope of work _________________________________________________ Subcontract amount _________________________________________________

c. Name of M/WBE Firm _______________________________________________ Address ___________________________________________________________ Telephone No. _____________________________________________________ I.R.S. No. _________________________________________________________ Area/Scope of work __________________________________________________ Subcontract amount __________________________________________________

(List additional MBE/WBEs, if any, on additional pages and attach to this form) HRD 13 Affidavit of Intended Utilization 021108 Page 2 of 2 Contract Central

4. Bidder/Proposer will identify before contract award, those MBE/WBE subcontractors with dollar amounts and scopes of work which apply to or exceed the MBE/WBE goals for the Project on the Contractor Utilization Plan/Request for Waiver (HRD 08).

5. Bidder/Proposer agrees that failure to meet or exceed the MBE/WBE Goals for the above project will automatically render this bid/ proposal non-responsive if Bidder/ Proposer fails to establish good faith efforts towards meeting the goals as set forth in the HRD Forms and Instructions.

6. If applicable, Bidder/Proposer assures that it will meet or exceed the minimum employment goals of 10% minority and 2% women during the term of its contract with City, or request a waiver of the goals. NOTE: This paragraph is applicable ONLY if you are submitting a bid/proposal on a construction contract that was estimated by the City, prior to solicitation, as requiring more than 800 construction labor hours and costing in excess of $324,000.00.

7. I am authorized to make this Affidavit on behalf of the Bidder/Proposer named below as:

_________________________ of ______________________________________ (Title) (Name of Bidder/Proposer)

Dated: _______________________________ By: ___________________________________ (Affiant)

Subscribed and sworn to before me this _____ day of ____________________, 20____.

My Commission Expires: ________________ ______________________________ Notary Public

00450.01 HRD Letter of Intent to Subcontract 050113 Page 1 of 1 Contract Central

LETTER OF INTENT TO SUBCONTRACT

Project Number

Project Title

______________________________________ (“Prime Contractor”) agrees to enter into a contractual

agreement with ________________________________________ (“M/W/DBE Subcontractor”), who will

provide the following goods/services in connection with the above-referenced contract:

(Insert a brief narrative describing the goods/services to be provided. Broad categorizations (e.g., “electrical,” “plumbing,” etc.) or the listing of the NAICS Codes in which M/W/DBE Subcontractor is certified are insufficient and may result in this Letter of Intent to Subcontract not being accepted.)

_____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________,

for an estimated amount of $____________________ or ______________% of the total estimated

contract value.

M/W/DBE Subcontractor is, to the best of Prime Contractor’s knowledge, currently certified with the City

of Kansas City’s Human Relations Department to perform in the capacities indicated herein. Prime

Contractor agrees to utilize M/W/DBE Subcontractor in the capacities indicated herein, and M/W/DBE

Subcontractor agrees to work on the above-referenced contract in the capacities indicated herein,

contingent upon award of the contract to Prime Contractor.

_______________________________________ _________________________________ Signature: Prime Contractor Signature: M/W/DBE Subcontractor

________________________________________ _________________________________ Print Name Print Name

________________________________________ _________________________________ Title Date Title Date

01290.14 Contractor Affidavit for Final Payment 063009 1 of 2 Contract Central

CONTRACTOR AFFIDAVIT FOR FINAL

PAYMENT

Project Number

Project Title

STATE OF )
)SS

COUNTY OF )

The Undersigned, of lawful
(Name)
age, being first duly sworn, states under oath as follows:

1. I am the of who is the general
(Title) (CONTRACTOR)
CONTRACTOR for the OWNER on Project No. and Project Title .

2. All payrolls, material bills, use of equipment and other indebtedness connected with the Work for this Project have been paid and all Claims of whatever nature have been satisfied, as required by the Contract.

3 () Prevailing wage does not apply; or

() All provisions and requirements set forth in Chapter 290, Section 290.210 through and including 290.340, Missouri Revised Statutes, pertaining to the payment of wages to workmen employed on public works projects have been fully satisfied and there has been no exception to the full and complete compliance with these provisions and requirements and the Annual Wage Order contained in the Contract in carrying out the Contract and Work. CONTRACTOR has fully complied with the requirements of the prevailing wage law as required in the Contract and has attached affidavits from all Subcontractors on this Project, regardless of tier, affirming compliance with the prevailing wage law as stipulated in the Contract.

4. I hereby certify that (a) at project completion and pursuant to contractor’s final request for payment, contractor achieved (______%) Minority Business Enterprise (MBE) participation and (_____%) Women Business Enterprise (WBE) participation on this contract, and (b) listed herein are the names of all certified M/WBE subcontractors, regardless of tier, with whom I, or my subcontractors contracted.

1. Name of MBE/WBE Firm ______________________________________________ Address _____________________________________________________________ _____________________________________________________________ Telephone Number (_______) __________________________________________ IRS Number _________________________________________________________ Area/Scope*of Work __________________________________________________ Subcontract Final Amount ______________________________________________

2. Name of MBE/WBE Firm _____________________________________________ Address _____________________________________________________________ _____________________________________________________________ Telephone Number (_______) ___________________________________________ IRS Number _________________________________________________________ Area/Scope*of Work___________________________________________________ Subcontract Final Amount ______________________________________________

01290.14 Contractor Affidavit for Final Payment 063009 2 of 2 Contract Central List additional subcontractors, if any, on a similar form and attach to the bid.

Supplier** Final Amount: ___________________________________

*Reference to specification sections or bid item number.

() Met or exceeded the Contract utilization goals; or () Failed to meet the Contract utilization goals (attach waiver, substitution or modification); or () No goals applied to this Project.

5. CONTRACTOR certifies that each Subcontractor has received full payment for its respective work in connection with the Contract.

6. If applicable, I hereby certify that (a) at project completion and pursuant to contractor’s final request for payment, contractor achieved, company -wide, at least ten percent (10%) minority workforce participation and two percent (2%) women workforce participation and (2) a true and accurate copy of my final project workforce monthly report (HRD Form 00485.02 and final company -wide workforce monthly report (HRD Form 00485.03) are attached . NOTE: This paragraph is only applicable if you complete d a construction contract that was estimated by the City, prior to solicitation, as requiring more than 800 construction labor hours and costing in excess of $ 324,000.01. If applicable you MUST attach copies of your final monthly workforce reports.

7. This affidavit is made in behalf of the CONTRACTOR for the purpose of securing from Kansas City, Missouri, the certification of completion of the Project and receiving payment therefore.

8. If the Contract amount exceeded $ 123,500.01, CONTRACTOR has submitted proof of compliance with the City tax ordinances administered by the City’s Commissioner of Revenue and has on file proof of tax compliance from all Subcontractors. If the Contract term exceeded one (1) year, CONTRACTOR has provided proof of complia nce with the City tax ordinances administered by the City’s Commissioner of Revenue prior to receiving final payment and has on file proof of tax compliance from all Subcontractors prior to the Subcontractor receiving final payment from CONTRACTOR.

CONTRACTOR

By
(Authorized Signature)

Title

On this day of , , before me

appeared , to me personally known to be the

of the ,

and who executed the foregoing instrument and acknowledged that (s)he executed the same on behalf of

as its free act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal on the day and year first above written.

My commission expires:

Notary Public

01290.15 Subcontractor Affidavit for Final Payment 020408 Contract Central

SUBCONTRACTOR AFFIDAVIT FOR FINAL PAYMENT

Project Number

Project Title

STATE OF MISSOURI )
) ss:

COUNTY OF ______________ )
After being duly sworn the person whose name and signature appears below hereby states under penalty of perjury that:

1. I am the duly authorized officer of the business indicated below (hereinafter Subcontractor) and I make this affidavit on behalf of Subcontractor in accordance with the requirements set forth in Section 290.290, RSMo.

Subcontractor has completed all of the Work required under the terms and conditions of a subcontract as follows:

Subcontract with: __________________________________________________________________, Contractor

Work Performed: ____________________________________________________________________________

Total Dollar Amount of Subcontract and all Change Orders: $_________________________________________

City Certified MBE  WBE  DBE  NA
List certifications: ____________________________________________________________________________

2. Subcontractor fully complied with the provisions and requirements of the Missouri Prevailing Wage Law set forth in Sections 290.210, RSMo through 290.340, RSMo.

Business Entity Type: Subcontractor’s Legal Name and Address (___) Missouri Corporation
(___) Foreign Corporation ___________________________________________ (___) Fictitious Name Corporation
(___) Sole Proprietor ___________________________________________ (___) Limited Liability Company Phone No. __________________________________ (___) Partnership Fax: ______________________________________ (___) Joint Venture E:mail:_____________________________________ (___) Other (Specify) Federal ID No._______________________________

I hereby certify that I have the authority to execute this affidavit on behalf of Subcontractor.

By: ______________________________________ __________________________________________ (Signature) (Print Name)
_______________________________________ __________________________________________ (Title) (Date)
NOTARY

Subscribed and sworn to before me this _____ day of ________________________, 20______.

My Commission Expires:______________________ By_____________________________

__________________________________________ _______________________________ Print Name Title

DISPARITY STUDY ISSUE DATE: 06-02-14
RFP NO. EV1992
(REV. 06-17-13)

Page 1 of 2 ends

AFFIDAVIT

EMPLOYEE ELIGIBILITY VERIFICATION AFFIDAVIT
(Required for any contract with the City of Kansas City, Missouri in excess of $5,000.00)

STATE OF ___________________ )
) ss
COUNTY OF _________________ )

On this ________ day of _______________________, 20___, before me appeared ____________________________________________, personally known by me or otherwise proven to be the person whose name is subscribed on this affidavit and who, being duly sworn, stated as follows:

I am of sound mind, capable of making this affidavit, and personally swear or affirm that the statements made herein are truthful to the best of my knowledge. I am the ______________________________ (title) of _________________________________ (business entity) and I am duly authorized, directed or empowered to act with full authority on behalf of the business entity in making this affidavit.

I hereby swear or affirm that the business entity does not knowingly employ any person in connection with the contracted services who does not have the legal right or authorization under federal law to work in the United States as defined in 8 U.S.C. § 1324a(h)(3).

I hereby additionally swear or affirm that the business enti ty is enrolled in an electronic verification of work program operated by the United States Department of Homeland Security (E-Verify) or an equivalent federal work authorization program operated by the United States Department of Homeland Security to verif y information of newly hired employees, under the Immigration Reform and Control Act of 1986, and that the business entity will participate in said program with respect to any person hired by the business entity to perform any work in connection with the contracted services.

I have attached hereto documentation sufficient to establish the business entity’s enrollment and participation in the required electronic verification of work program . The documentation will consist of the first and last pages of the E -Verify Memorandum of Understanding that the Contractor obtained upon successfully enrolling in the program.

I am aware and recognize that unless certain contractual requirements are satisfied and affidavits obtained as provided in Section 285.530, RSMo, the business entity may face liability DISPARITY STUDY ISSUE DATE: 06-02-14
RFP NO. EV1992
(REV. 06-17-13)

Page 2 of 2 ends

for violations committed by its subcontractors, notwithstanding the fact that the business entity may itself be compliant.

I acknowledge that I am signing this affidavit as the free act and deed of the business entity and that I am not doing so under duress.

______________________________________
Affiant’s signature

Subscribed and sworn to before me this ______ day of ___________________, 20____.

______________________________________
Notary Public

My Commission expires:

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