PURCHASING DEPARTMENT by jolinmilioncherie


									                                   PURCHASING DEPARTMENT
                                     3051 Ira E. Woods Avenue
                                       Grapevine, TX. 76051

You are hereby invited by the Grapevine-Colleyville Independent School District (“District”) to
submit a Proposal for published sheet music. Proposals will be accepted in the Purchasing
Department until 3:00 p.m. on Wednesday, October 6, 2010. Immediately following, a
meeting in the GCISD’s Purchasing Services Department will be held for the purpose of publicly
acknowledging the receipt of each proposal. The enclosed Request for Proposal (“RFP”)
Response Form must be used to record and submit your proposal. It and any other requested
information shall be submitted within a sealed envelope clearly marked with
“RFP # 015-10-11/Sheet Music; Attention: Rheanne Clark.”


To provide the District with a procurement contract for published sheet music that will be
utilized by the band and choir programs of the District. The proposal request is a flat discount
to be applied to the publisher’s list price. This does not include the purchase of special
arrangement music. The District currently exceeds $25,000 per budget year for sheet music.

Release RFP:                                           Friday, September 17, 2010
Deadline for Submittal of Proposal:                    3:00pm on Wednesday, October 6, 2010
Recommendation to Board of Trustees:                   Monday, October 19, 2010
Board Meeting:                                         Monday, October 25, 2010
Effective Date of Coverage:                            November 1, 2010

Standard Terms and Conditions:

1.        The request for proposal invitation, terms and conditions, the specifications, the
          received proposal and the subsequently issued purchase order(s), form the contract and
          they shall be fully part of the contract, as if thereto attached, or therein repeated.
          These documents represent the entire agreement between the successful vendor and
          the school district and supersede any prior discussions or negotiations, representations
          or agreements, either written or oral.

2.        Respondents are cautioned to read this invitation carefully, to complete all entries, and
          submit all documents or information requested. Failing to do so may be materially non-
          responsive and result in non-consideration of the proposal.

3.        For evaluation purposes, respondents shall submit one (1) original and one (1)
          electronic (pdf format CD) copy of the proposal response forms. However, respondents
          also have the option to submit their completed proposals via our secure email address at
          bids@gcisd.net. If this option is used for submittal, original copy and pdf formatted CD
          is not necessary.

4.        This contract, once accepted, will include the period between November 1, 2010 and
          October 31, 2011. Any purchase order dated and issued within these dates will be
          subject to the terms and conditions of this contract.

5.        After the initial term, the contract will automatically renew at the anniversary date and
          ultimately expire on October 31, 2015.

6.        Auto-renewing the contract would imply doing so under the same terms and conditions.
          If a vendor is requesting a change in discount percentage or a change in the terms and
          conditions of this contract, the vendor shall notify the District’s Purchasing Services
          Department three (3) months prior to the anniversary date of this contract with their
          request. The request must be in writing.

7.        Contracts are considered in force during the period stipulated by the proposal or until
          replaced by a subsequent contract for the same goods and services.

8.        If for any fiscal year (July 1 through June 30) of this contract, the Board of Trustees for
          any reason, fails to appropriate funds for these services, the District will notify the
          vendor immediately and will no longer be obligated under the contract.

9.        Proposals received in the District’s Purchasing Office after the date and time specified
          will not be considered. The District is not responsible for lateness or non-delivery of
          mail, carrier, etc., and the date/time stamp in the Purchasing Office shall be the official
          time of receipt. Proposals may not be submitted by facsimile.

10.       The District reserves the right to accept or reject any and all proposals and to waive any
          formalities or technicalities if deemed in the best interest of the District. The District
          also reserves the right as sole judge of quality and equality.

11.       Proposals meeting the requirements of this document shall be considered. Respondents
          taking exception to any of the terms, conditions or offering substitutions shall state
          these exceptions plainly on the Exceptions Page of this document.

12.       Any interpretations, corrections, additions or changes to the RFP will be made by
          addendum or an amendment to the RFP. The sole issuing authority of addendum or
          amendment(s) shall be vested in the District’s Purchasing Department. Addendum or
          amendment(s) will be mailed to all that are known to have received a copy of the RFP.

13.       Each respondent agrees to hold their offer open for acceptance by the District for no
          less than sixty (60) days from the RFP response date and time.

14.       Under this contract, the each campus Fine Arts Department will have the responsibility
          to ensure compliance with contract requirements, such as but not limited to acceptance
          and inspection of equipment and services provided. The campus Fine Arts Department
          will serve as the liaison between the District’s Purchasing Department (which has the
          overall contract administration responsibilities) and the successful vendor.

15.       No right or interest in this contract shall be assigned or delegation of any obligation
          made by the vendor to another vendor. Any attempted assignment or delegation by the
          vendor shall be wholly void and totally ineffective for all purposes.

16.       Each respondent, by making his proposal, represents that he has read and understands
          the request for proposal.

17.       The successful vendor(s) must be able to accept purchase orders via facsimile.

18.       The District limits its purchases through the use of properly drawn and authorized
          purchase orders. Consequently, the District is not responsible for items not ordered via
          this method. Therefore, the purchase order number shall appear on ALL itemized
          invoices to ensure payment.

19.       The vendor shall submit itemized invoices within a timely manner during the District’s
          fiscal year in which the items were purchased.

20.       Invoices shall indicate the District’s purchase order number. Invoices shall be issued for
          only items received. Payment shall not be due until the invoice(s) are submitted after
          delivery. Pursuant to Texas Government Code 2251.021, payments will be made within
          thirty (30) days. Invoices may be sent electronically in pdf format to invoice@gcisd.net
          or by mailing directly to:

                      Grapevine-Colleyville Independent School District
                                 Attn: Financial Services
                                3051 Ira E. Woods Avenue
                                   Grapevine, TX. 76051

21.       In lieu of a mailed check, the successful vendor may choose payment for goods received
          by Accounts Payable ACH. Please note on the vendor response form that this is your
          preference. The District will request the required bank account information from the
          successful vendor once this contract is approved and awarded by the Grapevine-
          Colleyville ISD Board of Trustees.

22.       The District is exempt from payment of any Texas Sales Tax or Federal Excise Tax
          allowed by law. Do not include tax in your bid totals. Tax exemption certificates will be
          furnished upon request.

23.       All District property and facilities are a “drug free zone”. No one may use, consume,
          carry, transport or exchange tobacco, cigarettes, or illegal drugs while in a school district
          building or while on school district property. The vendor, its company, and its
          employees shall adhere to this policy.

24.       Each respondent must give notice to the District if a person, owner or operator of the
          business has been convicted of a felony. The notice must include a general description
          of the conduct resulting in this conviction of a felony (this requirement does not apply to
          a publicly-held corporation). The District may terminate a contract with a person or
          business if the District determines that the person or business failed to give such notice
          or misrepresented the conduct resulting in the conviction. (Felony Conviction Notification
          is enclosed with this RFP).

25.       If at any time, a vendor fails to fulfill or abide by the terms, conditions or specifications
          of the contract, or to perform by providing the items at the price submitted or within the
          specified time frame, the District reserves the right, upon written notice to the vendor to
          cancel the contract.

26.       Prior to the cancellation of the contract for default, the District’s Purchasing Department
          will advise the vendor, in writing, of their intentions, and the reasons for such intentions.
          The vendor will be allowed fifteen (15) days to cure the default condition. If such
          condition is not cured to the satisfaction of the District after that time, then the
          cancellation of the contract may be executed.

27.       Please note that a “gift to a public servant” is a Class A misdemeanor offense if the
          recipient is a government employee who exercise some influences in the purchasing
          process of the governmental body. This would certainly apply to anyone who helps
          establish specifications or is involved in product selection or directs a purchase.

28.       This contract shall be governed by the Uniform Commercial Code. Wherever the term
          “Uniform Commercial Code” is used, it shall be construed as meaning the Uniform
          Commercial code as adopted in the State of Texas as effective and in force on the date
          of this agreement. Vendors are advised that all District contracts are subject to all legal
          requirements provided for in the Local, State and Federal Statutes.

29.       Respondents shall note any and all relationships that might be a conflict of interest and
          include such information with the proposal.

30.       A Conflict of Interest Questionnaire should be filed, in accordance with Chapter 176,
          Local Government Code, by a person who has a business relationship as defined by
          Section 176.001(1-a) with a local government entity and the person meets requirements
          under 176.006(a). By law this questionnaire must be filed with the Grapevine-Colleyville
          ISD Records Administrator 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. An offense under this section is a Class C misdemeanor.
          Additional information may be obtained from the Texas Ethics Commission’s website at
          http://www.ethics.state.tx.us. For convenience, the vendor questionnaire is attached
          with this RFP. Completed forms may be faxed to the GCISD Purchasing Services
          Department at 817-251-6507.

31.       The District reserves the right to utilize other District contracts, State of Texas contracts,
          contracts awarded by other governmental agencies, other school boards, or cooperative

          agreements in lieu of any offer received or award made as a result of this proposal, if it
          is in its best interest to do so.

32.       Respondents to this RFP #015-10-11 are advised that interlocal agreements exist
          between GCISD and Northwest ISD, Keller ISD, Birdville ISD and GCISD and the
          Educational Purchasing Cooperative of North Texas (EPCNT). Any of the parties to
          these interlocal agreements may utilize the services provided by the successful vendor
          pursuant to RFP #015-10-11. The awarded vendor(s) will need to provide pricing for
          that specific school district’s facilities. Please note on the RFP Response Form if this is
          agreeable to your company.

33.       Both parties agree that venue for any litigation arising from this contract shall lie in
          Tarrant County, Texas.

34.       Respondents shall submit all questions about the proposal to Rheanne Clark, Buyer,
          Purchasing Services. Questions may be submitted by email to rheanne.clark@gcisd.net
          or facsimile to (817) 251-6507. A reply will be sent to all vendors known to have
          received an RFP if the answer provides clarification or will have an impact on the
          proposal response.

Submissions and Specifications:

1.        A proposal, in order to be considered, must include the properly executed RFP Response
          Form and those other items and/or attachments as specified in this proposal.

2.        A respondent must affirmatively demonstrate responsibility through a satisfactory record
          of performance. Each respondent is required to submit with their proposal a list of three
          (3) references of institutions for which they currently or have provided sheet music
          within the last two years. The list shall include the company/entity name, address,
          contact name, email address and telephone number.

3.        Vendor(s) shall indicate if they maintain a comprehensive supply of materials
          appropriate to the District’s needs (all levels) or if the vendor is able to acquire such

                 a.      UIL Band, Choir, Solo and Ensemble music
                 b.      Comprehensive selection of methodology, beginning instrumental
                         methods, sight reading methods, technique studies, etc.

4.        Please indicate the percentage discount to be applied to the publisher’s list price.

5.        With the proposal, the respondent may include a list of all currently in-stock music and a
          list of the publishers from which the vendor can obtain sheet music.

6.        Please indicate if a minimum dollar order is required. If so, indicate the dollar amount.

7.        Please indicate if shipping/handling charges are applicable. If so, please indicate the
          dollar amount.

8.        Respondents shall indicate on their proposal response form what the percentage of
          orders placed are filled.

9.        Respondents shall indicate on their proposal response form if special programs are
          available; for example, an area store or an internet address for on-line browsing. Also,
          indicate any unique feature or special services your company offers.

10.       Respondents may be required to furnish evidence in writing that they maintain
          permanent places of business and have adequate places of business and have adequate
          equipment, finances, and personnel to furnish the items offered satisfactorily and

11.       Respondents taking exception to the terms and conditions or specifications of this
          proposal shall state these exceptions plainly on the Exception Page of the proposal
          document. If no exceptions are indicated on the submitted form, it will be assumed that
          your proposal complies with our document.

Evaluation and Award:

1.        The published sheet music utilized by District music departments varies, hence the
          necessity of establishing a contract with multiple vendors to allow the purchase of sheet
          music on an as-needed basis.

2.        Each music department will be given the option to purchase their sheet music from a list
          of qualified awarded vendors as a result of this RFP. It will be their responsibility, along
          with the Director of Curriculum and Assessment, to ensure the District is receiving the
          “best value” when making their purchases, in accordance with Subchapter B §44.031 of
          the Texas Education Code. Purchasing Services will recommend to the user of this
          contract that they receive at least three (3) quotes whenever practical and/or possible,
          from the list of qualified vendors, prior to making their purchases.

3.        Respondents are required to complete the questionnaire included in the RFP Response
          Form. Multiple vendors will be selected based on the criteria set for in §44.031B, as
                   The purchase price;
                   The reputation of the vendor and of the vendor’s goods or services;
                   The quality of the vendor’s goods or services;
                   The extent to which the goods or services meet the District’s needs;
                   The vendor’s past relationship with the District;
                   The impact on the liability of the district to comply with laws and rules
                    relating to historically underutilized businesses;
                   The total long-term cost of the District to acquire the vendor’s goods or
                    services; and
                   Any other relevant factor that a private business entity would consider in
                    selecting a vendor.

4.        The Board of Trustees for the District is expected to take action on this proposal on
          Monday, October 25, 2010. If awarded, the successful vendor(s) will receive written
          notification of acceptance by award letter mailed or otherwise furnished, which when
          received by the vendor results in a binding contract without further action by either

                                     RFP RESPONSE FORM
                                     PROJECT #015-10-11
                                        SHEET MUSIC

To:       Grapevine-Colleyville ISD
          Attention: Rheanne Clark, Buyer, Purchasing Services
          3051 Ira E. Woods Ave.
          Grapevine, TX. 76051

From: _____________________________________
      Company Name
      Area Code/Telephone Number
      Fax Number
      Federal Tax Identification Number
      DUNS Number

I, the undersigned, as the owner or legally authorized representative of the above named
company, by signing the following statement, agree that I have READ and UNDERSTAND all of
the Instructions and Specifications contained herein, and that if accepted by the Grapevine-
Colleyville Independent School District, all of the provisions are part of a binding contract
between the Grapevine-Colleyville Independent School District and our company. I also certify
that this bid is made without previous understanding, agreement, or connection with any
person, firm, or corporation making a proposal for the same contract, and is in all ways fair and
without collusion of fraud.

______________________________________                     ________________________
Owner or Legally Authorized Representative                 Title

______________________________________                     ________________________
Signature                                                  Date

                                   PROPOSAL RESPONSE FORM
                                    #015-10-11/Sheet Music

Ordering Address:                                     Remittance Address: (If Different)

____________________________                          ____________________________
Company Name                                          Company Name

___________________________                           ____________________________
Address                                               Address

____________________________                          ____________________________
State/City/Zip                                        State/City/Zip

Local Representative Name: ______________________________

Phone Number:                   ______________________________

Fax Number:                     ______________________________

E-Mail Address:                 ______________________________

Customer Service Ph. No.:       ______________________________


1.        Is your company set up for ACH Accounts Payable processing? YES _____ NO _____
          Is this your preference in processing payments?             YES _____ NO _____

2.        Does your company accept purchase orders ?                 YES _____      NO _____

3.        Please indicate if your company maintains a supply or can acquire the following materials:
                  A.     UIL Band, Choir, Solo and Ensemble Music ________________________

                 B.   Comprehensive selection of methodology, beginning instrumental methods,
                      sight reading methods, technique studies, etc.: _______________________

4.        Please indicate the percentage discount to be applied to the publisher’s list price: _______

5.        Please indicate if there is a current in-stock inventory list and available publisher’s list
          Included: _________________________________________________________________

6.        Please indicate if a minimum dollar purchase order is required and the dollar amount: ___

7.        Please indicate if a shipping, freight or handling charge is required, if so, please include the
          dollar amount: ____________________________________________________________

8.        Please indicate the hours and days of operation: _________________________________

9.        Please indicate your guaranteed average fill rate per order: ________________________%

10.       Please indicate time required to file a claim either for damage or shortage ____________

11.       Please identify any special services, programs or unique features your company offers:

                                EXCEPTION PAGE

Please list below, in complete detail, any exception to the specifications in this
invitation. THE ITEM NUMBER MUST BE REFERENCED. If extra space is needed
attach sheets as necessary:


List below three (3) institutions/companies for whom you have done work involving sheet music in the
past 12 months.

1.        Institution/Company Name ________________________________________________
          Street Address ____________________________________________________________
          City/State/Zip ____________________________________________________________
          Contact Name ____________________________________________________________
          Telephone Number ________________________________________________________
          Email Address ___________________________________________________________
2.        Institution/Company Name ________________________________________________
          Street Address ___________________________________________________________
          City/State/Zip ____________________________________________________________
          Contact Name ____________________________________________________________
          Telephone Number ________________________________________________________
          Email Address ___________________________________________________________
3.        Institution/Company Name ________________________________________________
          Street Address ___________________________________________________________
          City/State/Zip ____________________________________________________________
          Contact Name ____________________________________________________________
          Telephone Number ________________________________________________________
          Email Address ___________________________________________________________

                        FORMS CHECKLIST

_____      Completed - RFP Response Form

_____      EPCNT Interlocal Agreement Form – Please Complete

_____      Notice of Criminal History of Contractor – Please Complete

_____      GCISD Contractor Certification – Please Complete

_____      Conflict of Interest Disclosure Statements – Please Complete

_____      Resident Bidder’s Certification – Please Complete

_____      Buy American Provision, Pursuant to TEC 44.042 – Initial Only

_____      USDA Clean Air and Water Act – Initial Only

_____      Debarment or Suspension Certificate – Please Complete

_____      US Dept of Agriculture Certification Regarding
           Lobbying/Disclosure of Lobbying Activities – Please Complete

_____      W-9 Form – Please Complete

_____      No Bid Notification – Please Complete only if applicable


                                                                      August 2010
Several governmental entities around the Grapevine-Colleyville Independent School District
have indicated an interest in being included in this contract. Should these governmental
entities elect to participate in this contract, would you (the vendor), agree that all terms,
conditions, specifications, and pricing would apply?

                       _______ YES                    _______ NO

                    If you (the vendor) checked YES, the following will apply:

Governmental entities utilizing Internal Governmental contracts with the Grapevine-Colleyville
Independent School District will be eligible, but not obligated, to purchase materials/services
under the contract(s) awarded as a result of this solicitation. All purchases by governmental
entity other than Grapevine-Colleyville Independent School District will be billed directly to that
governmental entity and paid by that governmental entity. Grapevine-Colleyville Independent
School District will not be responsible for another governmental entity’s debts. Each
governmental entity will order their own material/service as needed.

For information regarding the Educational Purchasing Cooperative of North Texas, please visit
their website at the following address: http://lisd.net/purchasing/EPCNThomepage1.htm.

       Vendor Name: ______________________________________________
       Signature: ___________________________________
       Title: _______________________________________
       Date: _______________________________________
                                         PURCHASING DEPARTMENT
                                          3051 Ira E. Woods Avenue
                                           Grapevine, Texas 76051


Pursuant to Texas Education Code (TEC) Chapter 44, Subchapter B, section 44.034 states that 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. In addition, TEC Chapter 21, Subchapter B, section 21.060 includes a person or business
entity that has been convicted of a felony or misdemeanor offense relating to the duties and
responsibilities of the education profession, including: (1) an offense involving moral turpitude; (2)
an offense involving a form of sexual or physical abuse of a minor or student or other illegal conduct
in which the victim is a minor or student; (3) a felony offense involving the possession, transfer, sale
or distribution of or conspiracy to possess, transfer, sell, or distribute a controlled substance as
defined by Chapter 481, Health and Safety Code, or by 21 U.S.C. Section 801 et seq.; (4) an offense
involving the illegal transfer, appropriation, or use of school district funds or other district property;
or (5) an offense involving an attempt by fraudulent or unauthorized means to obtain or alter a
professional certificate or license issued under this sub-chapter.

The notice must include a general description of the conduct resulting in the conviction of a
misdemeanor and/or felony. 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
TEC 44.034 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
does not apply to a publicly held corporation.

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

VENDOR’S NAME: ____________________________________________________________________

AUTHORIZED COMPANY OFFICIAL’S NAME (PRINTED): __________________________________

A. My firm is a publicly-held corporation; therefore, this reporting requirement is not applicable.

        Signature of Company Official: __________________________________________________

B. My firm is not owned nor operated by anyone who has been convicted of a misdemeanor and/or felony, as
described above:

        Signature of Company Official: __________________________________________________

C. My firm is owned or operated by the following individual(s) who has/have been convicted of a misdemeanor
and/or felony, as described above:

        Name of Felon(s): ______________________________________________________________
        Details of Conviction(s): _________________________________________________________
        Signature of Company Official: ________________________________________________
                                           GCISD Contractor Certification

Texas Education Code chapter 22 requires service contractors to obtain criminal history record information regarding
covered employees and to certify to the District that they have done so. Covered employees with disqualifying
convictions are prohibited from serving at a school district.


Covered employees: All employees of a contractor who have or will have continuing duties related to the service to be
performed at the District and have or will have direct contact with students. The District will be the final arbiter of what
constitutes direct contact with students.

Disqualifying conviction: One of the following offenses, if at the time of the offense, the victim was under 18 or enrolled
in a public school: (a) a felony offense under Title 5, Texas Penal Code; (b) an offense for which a defendant is required
to register as a sex offender under Chapter 62, Texas Code of Criminal Procedure; or (c) an equivalent offense under
federal law or the laws of another state.

Company/contractor agrees to check the criminal history of personnel being provided to GCISD under the agreement
pursuant to Chapter 22, Subchapter C, Section 22.0834 of the Texas Education Code and hereby certifies that
company/contractor has received all criminal history record information on said personnel. Furthermore,
company/contractor agrees to provide only those personnel with an appropriate background pursuant to Chapter 22,
Subchapter C, Section 22.085 of the Texas Education Code.

On behalf of _______________________________________________ ("Contractor"), I certify that [check one]:

[ ]   None of Contractor's employees are covered employees, as defined above.
[ ]   Some or all of Contractor's employees are covered employees. If this box is selected, I further certify that:

(1)   Contractor has obtained all required criminal history record information, through the Texas Department of Public
      Safety, regarding its covered employees. None of the covered employees has a disqualifying conviction.
      Contractor has taken reasonable steps to ensure that its employees who are not covered employees do not have
      continuing duties related to the contract services or direct contact with students.
(2)   If Contractor receives information that a covered employee has a disqualifying conviction, Contractor will
      immediately remove the covered employee from contract duties and notify the District in writing within 3
      business days.
(3)   Upon request, Contractor will make available for the District's inspection the criminal history record information of
      any covered employee. If the District objects to the assignment of a covered employee on the basis of the covered
      employee's criminal history record information, Contractor agrees to discontinue using that covered employee to
      provide services at the District.

Noncompliance by Contractor with this certification may be grounds for contract termination.

___________________________________________________                        _______________________________________
Printed Name                                                               Title

___________________________________________________                        _______________________________________
Signature                                                                  Date

                                            Notice to Vendors
                               Conflict of Interest Disclosure Statements
                              Texas Local Government Code, Chapter 176

Vendors are required to file a Conflict of Interest Questionnaire with the District if a relationship exists between
the vendor’s company and an officer of the District. Vendors are encouraged to review and become familiar
with all disclosure requirements of Texas Local Government Code, Chapter 176.

Disclosure is required from vendors regarding each affiliation or business relationship between the vendor and:

1.      an officer of the District;
2.      an officer of the District that results in the officer or family member receiving taxable income;
3.      an officer of the District that results in the vendor receiving taxable income that does not come from
        the District;
4.      a corporation or other business entity in which an officer of the District serves as an officer or director,
        or holds an ownership interest of 10% or more;
5.      an employee or contractor of the District who makes recommendations to an officer of the District
        regarding the expenditure of money;
6.      an officer of the District who appoints or employs an officer of the District that is the subject of the
        questionnaire; and
7.      any person or entity that might cause a conflict of interest with the District.

Forms must be filed:

1.      No later than the seventh business day after the date that the person begins contract discussions or
        negotiations with the government entity, or submits to the entity an application, response to a request
        for proposal or bid, correspondence, or other writing related to a potential agreement with the entity.

2.      The vendor also shall file an updated questionnaire:

        a.      no later than September 1 of each year in which a covered transaction is pending; and
        b.      the seventh business day after the date of an event that would make a statement in the
                questionnaire incomplete or inaccurate.

3.      A vendor is not required to file an updated questionnaire if the person had filed an updated statement
        on or after June 1, but before September 1 of the year.

(No one is required to file a disclosure under this statute before January 1, 2006.)

Officers of the Grapevine-Colleyville Independent School District are:

                                   Charlie Warner, President
                               Jesse G. Rodriguez, Vice President
                                      Leon Leal, Secretary
                                     Karen Deakin, Member
                                       Lisa Hall, Member
                                   Jorge Rodriguez, Member
                                    Becky St. John, Member
                            Dr. Robin Ryan, Superintendent of Schools
    CONFLICT OF INTEREST QUESTIONNAIRE                                                                                  FORM      CIQ
    For vendor or other person doing business with local governmental entity

This questionnaire reflects changes made to the law by H.B. 1491, 80th Leg., Regular Session.                 OFFICE USE ONLY

This questionnaire is being filed in accordance with Chapter 176, Local Government Code                 Date Received
by a person who has a business relationship as defined by Section 176.001(1-a) with a local
governmental entity and the person meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental
entity 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.
A person commits an offense if the person knowingly violates Section 176.006, Local
Government Code. An offense under this section is a Class C misdemeanor.
1   Name of person who has a business relationship with local governmental entity.

           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 the 7th business day after the date the originally filed questionnaire becomes incomplete or inaccurate.)
    Name of local government officer with whom filer has employment or business relationship.

                                                        Name of Officer

     This section (item 3 including subparts A, B, C & D) must be completed for each officer with whom the filer has an
     employment or other business relationship as defined by Section 176.001(1-a), Local Government Code. 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, other than investment
     income, from the filer of the questionnaire?

                           Yes                  No

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

                           Yes                  No

     C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local
     government officer serves as an officer or director, or holds an ownership of 10 percent or more?

                           Yes                 No

     D. Describe each employment or business relationship with the local government officer named in this section.


             Signature of person doing business with the governmental entity                         Date

                                                                                                                        Adopted 06/29/2007
                                   PURCHASING DEPARTMENT
                                    3051 Ira E. Woods Avenue
                                     Grapevine, Texas 76051

                               RESIDENT BIDDER’S CERTIFICATION

Texas Government Code Chapter 2252.001A (3) and (4) defines “nonresident bidder” and “resident
bidder” as follows:

Chapter 2252.001A (3) “Nonresident bidder” refers to a person who is not a resident.

Chapter 2252.001A (4) “Resident bidder” refers to a person whose principal place of business is in this
state (Texas), including a contractor who ultimate parent company or majority owner has its principal
place of business in the state of Texas.

Chapter 2252.002 states “A governmental entity may not award a governmental contract to a
nonresident bidder unless the nonresident underbids the lowest bid submitted by a responsible resident
bidder by an amount that is not less than the amount by which a resident bidder would be required to
underbid the nonresident bidder to obtain a comparable contract in the state in which the nonresident’s
principal place of business is located.”

I certify that ______________________________________________________ is a resident bidder of
                        (Company Name)
Texas as defined in Texas Government Code 2252.001A (4).

                                                 Signature ____________________________________

                                                 Print Name ___________________________________

I certify that ______________________________________________________ is a nonresident bidder
                        (Company Name)
of Texas as defined in Texas Government Code 2252.001A (4) and our principal place of business is:

City and State _____________________________________________________

                                                 Signature ____________________________________

                                                 Print Name ___________________________________
                                      Buy American Provision

Schools and institutions participating in the National School Lunch Program and School Breakfast
Programs are required by law to use Child nutrition funds, to the maximum extent practicable, to buy
domestic commodities or products for meals served under these programs. A “domestic commodity or
product” is defined as one that is either produced in the U.S. or is processed in the U.S. substantially
using agricultural commodities that are produced in the U.S. The term “substantially” means that over 51
percent of the final processed product consists of agricultural commodities that were grown domestically.
Therefore, when Child Nutrition funds are used to acquire foods, schools and institutions must ensure that
the items are in compliance with this requirement.

Vendor Name

Vendor Address

Signature of Company Representative

Printed Name of Company Representative


                              Compliance with Clean Air and Water Act

USDA requires Districts to comply with the Clean Air and Water Act in contracts that exceed $ 100,000.
The following verbiage should be included in bids for the prospective vendors to complete. I,
______________________, am in compliance with all applicable standers, orders or regulations issued
pursuant to the Clean Air Act of 1970, as Amended (42 U.S.C. 1857(h)), Section 508 of the Clean Water
Act, as amended (33 U.S.C. 1368), Executive Order 117389 and Environmental Protection Agency
Regulation, 40 CFR Part 15 as required under OMB Circular A-102, Attachment O, Paragraph 14(1)
regarding reporting violations to the grantor agency and the United States Environment Protection
Agency Assistant Administrator of the Enforcement.

Vendor Name

Vendor Address

Signature of Company Representative                      Date

Printed Name of Company Representative
U.S. Department of Agriculture
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion—
Lower Tier Covered Transactions
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 4722‐
4733). Copies of the regulations may be obtained by contacting the Department of Agriculture 
agency with which this transaction originated.
     (Before completing certification, read attached instructions.)
     (1)  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. 
     (2)  Where 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 
Organization Name                                                 PR/Award Number or Project 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 which 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 school food authorities (SFAs) that 
      knowingly enter into contracts with suspended/debarred persons.   

Texas Department of Agriculture — February 2010                                Procurement 17.25
Certification Regarding Lobbying
Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts Exceeding $100,000 in 
Federal Funds.
Submission of this certification is a prerequisite for making or entering into this transaction and 
is imposed by section 1352, Title 31, U.S. Code. This certification is a material representation of 
fact upon which reliance was placed when this transaction was made or entered into. 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.
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 any agency, a Member of Congress, an officer or employee of congress, or an employee of 
     a Member of Congress in connection with the awarding of a Federal contract, the making of 
     a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and 
     the extension, continuation, renewal, amendment, or modification of a 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 grant or cooperative agreement, the undersigned 
     shall complete and submit Standard Form‐LLL, “disclosure Form to Report Lobbying,” in 
     accordance with its instructions. 
(3)  The undersigned shall require that the language of this certification be included in the 
     award documents for all covered subawards exceeding $100,000 in Federal funds at all 
     appropriate tiers and that all subrecipients shall certify and disclose accordingly. 
Name/Address of Organization
Name/Title of Submitting Official
_____________________________________________________                __________________________ 
Signature                                                            Date

Procurement 17.26                                        Texas Department of Agriculture — February 2010
Disclosure of Lobbying Activities 
                              Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 
                                                                  (See reverse for public burden disclosure)                                                   Approved by OMB 
 1.       Type of Federal Action:                                  2.       Status of Federal Action:                   3.      Report Type: 
               a. contract                                                     a. bid/offer/application                            a. initial filing 
                   b. grant                                                        b. initial award                                    b. material change 
                   c. cooperative agreement                                        c. post‐award                                       For material change only: 
                   d. loan                                                                                                                     Year _______ quarter _______ 
                   e. loan guarantee                                                                                                          Date of last report___________ 
                   f. loan insurance                                                                                        
 4.       Name and Address of Reporting Entity:                                                   5.      If Reporting Entity in No. 4 is Subawardee,  
          Prime          Subawardee                                                                       Enter Name and Address of Prime:   
                                        Tier______, if Known:                                      
         Congressional District, if known:                                                                Congressional District, if known:  
 6.    Federal Department/Agency:                                                         7.      Federal Program Name/Description:   
                                                                                          CFDA Number, if applicable: ______________________ 
 8.    Federal Action Number, if known:                                                   9.      Award Amount, if known:     
 10. a. Name and Address of Lobbying Entity                                               b.  Individuals Performing Services  
         (if individual, last name, first name, MI):                                            (including address if different from No. 10a) (last name, first name, 
                                                                (Attach Continuation Sheet(s) SF‐LLL‐A, if necessary 
 11. Amount of payment (check all that apply):                                            13.   Type of Payment (check all that apply): 
 $_________________________          Actual                          Planned                          a. retainer 
                                                                                                      b. one‐time fee 
 12. Form of Payment (check all that apply):                                                          c. commission 
         a. cash                                                                                      d. contingent fee 
         b. in‐kind; specify: nature ___________________                                              e. deferred 
                                 value ____________________                                           f. Other, specify: _______________________ 

 14.  Brief Description of Services Performed or to be Performs and Date(s) of Service, including officer(s), employee(s), or Member(s) 
       contacted, for Payment Indicated in Item 11: 
                                                                (Attach Continuation Sheet(s) SF‐LLL‐A, if necessary 

 15.  Continuation Sheet(s) SF‐LLL‐A attached:                     Yes           No 
 11.  Information requested through this form is authorized by                              
 title 31 U.S.C. section 1352.  This disclosure of lobbying activities                     Signature: _____________________________________ 
 is a material representation of fact upon which reliance was                               
 placed by the tier above when this transaction was made or                                Print Name: ____________________________________ 
 entered into. This disclosure is required pursuant to 31 U.S.C. 
 1352. This information will be reported to the Congress semi‐
 annually and will be available for public inspection. Any person 
                                                                                           Title: __________________________________________ 
 who fails to file the required disclosure shall be subject to a civil                      
 penalty of not less than $10,000 and not more than $100,000 for                           Telephone No.: _____________________ Date: _______ 
 each such failure. 
                                                                                                                                        Authorized for Local Reproduction 
 Federal Use Only:                                                                                                                      Standard Form ‐ LLL (Rev. 7‐97) 

Texas Department of Agriculture — February 2010                                                                                      Procurement 17.27
Instructions for Completion of SF‐LLL, Disclosure of Lobbying 
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient, at the initiation or 
receipt of a covered Federal action, or a material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a 
form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action. Use the SF‐LLL‐A Continuation Sheet for additional information if the space 
on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the 
implementing guidance published by the Office of Management and Budget for additional information.
1.    Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a 
      covered Federal Action. 
2.    Identify the status of the covered Federal Action. 
3.    Identify the appropriate classification of this report.  If this is a follow‐up report caused by a material change to the information 
      previously reported, enter the year and quarter in which the change occurred.  Enter the date of the last previously submitted 
      report by this reporting entity for this covered Federal Action. 
4.    Enter the full name, address, city, state and zip code of the reporting entity.  Include Congressional District, if known.  Check 
      the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient.  
      Identify the tier of the subawardee, e.g., the first subawardee of the prime is the 1st tier.  Subawards include but are not limited 
      to subcontracts, subgrants, and contract awards under grants. 
5.    If the organization filing the report in item 4 checks “Subawardee,” then enter the full name, address, city, state and zip code of 
      the prime Federal recipient.  Include Congressional District, if known. 
6.    Enter the name of the Federal Agency making the award or loan commitment.  Include at least one organizational level below 
      agency name, if known.  For example, Department of Transportation, United States Coast Guard. 
7.    Enter the Federal program name or description for the covered Federal action (item 1).  If known, enter the full Catalog of 
      Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 
8.    Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for 
      Proposal (RFP) number; Invitation for Bid (IFB) number; grant announcement number; the contract, grant, or loan award 
      number; the application proposal control number assigned by the Federal agency).  Include prefixes, e.g., “RFP‐DE‐90‐001.” 
9.    For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal 
      amount of the award/loan commitment for the prime entity identified in item 4 or 5. 
10.  (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in 
        item 4 to influence the covered Federal action.
      (b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a).  Enter Last 
        Name, First Name, and Middle Initial (MI).
11.  Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying 
      entity (item 10).  Indicate whether the payment has been made (actual) or will be made (planned).  Check all boxes that apply.  
      If this is a material change report, enter the cumulative amount of payment made or planned to be made. 
12.  Check the appropriate box(es).  Check all boxes that apply.  If payment is made through an in‐kind contribution, specify the 
      nature and value of the in‐kind payment. 
13.  Check the appropriate box(es).  Check all boxes that apply.  If other, specify nature. 
14.  Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and 
      the date(s) of any services rendered.  Include all preparatory and related activity, not just time spent in actual contact with 
      Federal officials.  Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of 
      Congress that were contacted. 
15.  Check whether or not a SF‐LLL‐A Continuation Sheet(s) is attached. 
16.  The certifying official shall sign and date the form, print his/her name, title, and telephone number. 
Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for 
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing 
the collection of information.  Send comments regarding the burden estimate or any other aspect of this collection of information, 
including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348‐0046), 
Washington, D.C.  20503.

Procurement 17.28                                                                 Texas Department of Agriculture — February 2010
(Rev. November 2005)
                                       W-9                                          Request for Taxpayer                                                       Give form to the
                                                                                                                                                               requester. Do not
Department of the Treasury
                                                                          Identification Number and Certification                                              send to the IRS.
Internal Revenue Service
                                       Name (as shown on your income tax return)
See Specific Instructions on page 2.

                                       Business name, if different from above
           Print or type

                                                                    Individual/                                                                                     Exempt from backup
                                                                                         Corporation       Partnership   Other
                                       Check appropriate box:       Sole proprietor                                                                                 withholding
                                       Address (number, street, and apt. or suite no.)                                            Requester’s name and address (optional)

                                       City, state, and ZIP code

                                       List account number(s) here (optional)

      Part I                                 Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid                                         Social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident                                                  –           –
alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is
your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3.                                                         or
Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose                                               Employer identification number
number to enter.                                                                                                                                    –
      Part II                                Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal
   Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
   notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person (including a U.S. resident alien).
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. (See the instructions on page 4.)

Sign                                       Signature of
Here                                       U.S. person                                                                           Date

Purpose of Form                                                                                              ● An individual who is a citizen or resident of the United
A person who is required to file an information return with the                                              States,
IRS, must obtain your correct taxpayer identification number                                                 ● A partnership, corporation, company, or association
(TIN) to report, for example, income paid to you, real estate                                                created or organized in the United States or under the laws
transactions, mortgage interest you paid, acquisition or                                                     of the United States, or
abandonment of secured property, cancellation of debt, or                                                    ● Any estate (other than a foreign estate) or trust. See
contributions you made to an IRA.                                                                            Regulations sections 301.7701-6(a) and 7(a) for additional
U.S. person. Use Form W-9 only if you are a U.S. person                                                      information.
(including a resident alien), to provide your correct TIN to the                                             Special rules for partnerships. Partnerships that conduct a
person requesting it (the requester) and, when applicable, to:                                               trade or business in the United States are generally required
   1. Certify that the TIN you are giving is correct (or you are                                             to pay a withholding tax on any foreign partners’ share of
waiting for a number to be issued),                                                                          income from such business. Further, in certain cases where a
   2. Certify that you are not subject to backup withholding, or                                             Form W-9 has not been received, a partnership is required to
                                                                                                             presume that a partner is a foreign person, and pay the
   3. Claim exemption from backup withholding if you are a                                                   withholding tax. Therefore, if you are a U.S. person that is a
U.S. exempt payee.                                                                                           partner in a partnership conducting a trade or business in the
   In 3 above, if applicable, you are also certifying that as a                                              United States, provide Form W-9 to the partnership to
U.S. person, your allocable share of any partnership income                                                  establish your U.S. status and avoid withholding on your
from a U.S. trade or business is not subject to the                                                          share of partnership income.
withholding tax on foreign partners’ share of effectively
connected income.                                                                                              The person who gives Form W-9 to the partnership for
                                                                                                             purposes of establishing its U.S. status and avoiding
Note. If a requester gives you a form other than Form W-9 to                                                 withholding on its allocable share of net income from the
request your TIN, you must use the requester’s form if it is                                                 partnership conducting a trade or business in the United
substantially similar to this Form W-9.                                                                      States is in the following cases:
   For federal tax purposes, you are considered a person if you                                              ● The U.S. owner of a disregarded entity and not the entity,
                                                                                                   Cat. No. 10231X                                           Form    W-9   (Rev. 11-2005)
Form W-9 (Rev. 11-2005)                                                                                                         Page   2
● The U.S. grantor or other owner of a grantor trust and not            3. The IRS tells the requester that you furnished an
the trust, and                                                       incorrect TIN,
● The U.S. trust (other than a grantor trust) and not the               4. The IRS tells you that you are subject to backup
beneficiaries of the trust.                                          withholding because you did not report all your interest and
Foreign person. If you are a foreign person, do not use              dividends on your tax return (for reportable interest and
Form W-9. Instead, use the appropriate Form W-8 (see                 dividends only), or
Publication 515, Withholding of Tax on Nonresident Aliens               5. You do not certify to the requester that you are not
and Foreign Entities).                                               subject to backup withholding under 4 above (for reportable
                                                                     interest and dividend accounts opened after 1983 only).
Nonresident alien who becomes a resident alien.
Generally, only a nonresident alien individual may use the              Certain payees and payments are exempt from backup
terms of a tax treaty to reduce or eliminate U.S. tax on             withholding. See the instructions below and the separate
certain types of income. However, most tax treaties contain a        Instructions for the Requester of Form W-9.
provision known as a “saving clause.” Exceptions specified              Also see Special rules regarding partnerships on page 1.
in the saving clause may permit an exemption from tax to
continue for certain types of income even after the recipient        Penalties
has otherwise become a U.S. resident alien for tax purposes.         Failure to furnish TIN. If you fail to furnish your correct TIN
    If you are a U.S. resident alien who is relying on an            to a requester, you are subject to a penalty of $50 for each
exception contained in the saving clause of a tax treaty to          such failure unless your failure is due to reasonable cause
claim an exemption from U.S. tax on certain types of income,         and not to willful neglect.
you must attach a statement to Form W-9 that specifies the           Civil penalty for false information with respect to
following five items:                                                withholding. If you make a false statement with no
    1. The treaty country. Generally, this must be the same          reasonable basis that results in no backup withholding, you
treaty under which you claimed exemption from tax as a               are subject to a $500 penalty.
nonresident alien.                                                   Criminal penalty for falsifying information. Willfully
   2. The treaty article addressing the income.                      falsifying certifications or affirmations may subject you to
    3. The article number (or location) in the tax treaty that       criminal penalties including fines and/or imprisonment.
contains the saving clause and its exceptions.                       Misuse of TINs. If the requester discloses or uses TINs in
    4. The type and amount of income that qualifies for the          violation of federal law, the requester may be subject to civil
exemption from tax.                                                  and criminal penalties.
    5. Sufficient facts to justify the exemption from tax under
the terms of the treaty article.                                     Specific Instructions
    Example. Article 20 of the U.S.-China income tax treaty          Name
allows an exemption from tax for scholarship income
received by a Chinese student temporarily present in the             If you are an individual, you must generally enter the name
United States. Under U.S. law, this student will become a            shown on your income tax return. However, if you have
resident alien for tax purposes if his or her stay in the United     changed your last name, for instance, due to marriage
States exceeds 5 calendar years. However, paragraph 2 of             without informing the Social Security Administration of the
the first Protocol to the U.S.-China treaty (dated April 30,         name change, enter your first name, the last name shown on
1984) allows the provisions of Article 20 to continue to apply       your social security card, and your new last name.
even after the Chinese student becomes a resident alien of               If the account is in joint names, list first, and then circle,
the United States. A Chinese student who qualifies for this          the name of the person or entity whose number you entered
exception (under paragraph 2 of the first protocol) and is           in Part I of the form.
relying on this exception to claim an exemption from tax on          Sole proprietor. Enter your individual name as shown on
his or her scholarship or fellowship income would attach to          your income tax return on the “Name” line. You may enter
Form W-9 a statement that includes the information                   your business, trade, or “doing business as (DBA)” name on
described above to support that exemption.                           the “Business name” line.
    If you are a nonresident alien or a foreign entity not subject   Limited liability company (LLC). If you are a single-member
to backup withholding, give the requester the appropriate            LLC (including a foreign LLC with a domestic owner) that is
completed Form W-8.                                                  disregarded as an entity separate from its owner under
What is backup withholding? Persons making certain                   Treasury regulations section 301.7701-3, enter the owner’s
payments to you must under certain conditions withhold and           name on the “Name” line. Enter the LLC’s name on the
pay to the IRS 28% of such payments (after December 31,              “Business name” line. Check the appropriate box for your
2002). This is called “backup withholding.” Payments that            filing status (sole proprietor, corporation, etc.), then check
may be subject to backup withholding include interest,               the box for “Other” and enter “LLC” in the space provided.
dividends, broker and barter exchange transactions, rents,           Other entities. Enter your business name as shown on
royalties, nonemployee pay, and certain payments from                required federal tax documents on the “Name” line. This
fishing boat operators. Real estate transactions are not             name should match the name shown on the charter or other
subject to backup withholding.                                       legal document creating the entity. You may enter any
    You will not be subject to backup withholding on payments        business, trade, or DBA name on the “Business name” line.
you receive if you give the requester your correct TIN, make         Note. You are requested to check the appropriate box for
the proper certifications, and report all your taxable interest      your status (individual/sole proprietor, corporation, etc.).
and dividends on your tax return.
Payments you receive will be subject to backup                       Exempt From Backup Withholding
withholding if:                                                      If you are exempt, enter your name as described above and
    1. You do not furnish your TIN to the requester,                 check the appropriate box for your status, then check the
    2. You do not certify your TIN when required (see the Part       “Exempt from backup withholding” box in the line following
II instructions on page 4 for details),                              the business name, sign and date the form.
Form W-9 (Rev. 11-2005)                                                                                                                     Page   3
  Generally, individuals (including sole proprietors) are not                       Part I. Taxpayer Identification
exempt from backup withholding. Corporations are exempt
from backup withholding for certain payments, such as                               Number (TIN)
interest and dividends.                                                             Enter your TIN in the appropriate box. If you are a resident
Note. If you are exempt from backup withholding, you                                alien and you do not have and are not eligible to get an SSN,
should still complete this form to avoid possible erroneous                         your TIN is your IRS individual taxpayer identification number
backup withholding.                                                                 (ITIN). Enter it in the social security number box. If you do
                                                                                    not have an ITIN, see How to get a TIN below.
Exempt payees. Backup withholding is not required on any
payments made to the following payees:                                                 If you are a sole proprietor and you have an EIN, you may
                                                                                    enter either your SSN or EIN. However, the IRS prefers that
   1. An organization exempt from tax under section 501(a),                         you use your SSN.
any IRA, or a custodial account under section 403(b)(7) if the
account satisfies the requirements of section 401(f)(2),                               If you are a single-owner LLC that is disregarded as an
                                                                                    entity separate from its owner (see Limited liability company
   2. The United States or any of its agencies or                                   (LLC) on page 2), enter your SSN (or EIN, if you have one). If
instrumentalities,                                                                  the LLC is a corporation, partnership, etc., enter the entity’s
   3. A state, the District of Columbia, a possession of the                        EIN.
United States, or any of their political subdivisions or
                                                                                    Note. See the chart on page 4 for further clarification of
                                                                                    name and TIN combinations.
   4. A foreign government or any of its political subdivisions,
agencies, or instrumentalities, or                                                  How to get a TIN. If you do not have a TIN, apply for one
                                                                                    immediately. To apply for an SSN, get Form SS-5,
   5. An international organization or any of its agencies or                       Application for a Social Security Card, from your local Social
instrumentalities.                                                                  Security Administration office or get this form online at
   Other payees that may be exempt from backup                                      www.socialsecurity.gov. You may also get this form by
withholding include:                                                                calling 1-800-772-1213. Use Form W-7, Application for IRS
   6. A corporation,                                                                Individual Taxpayer Identification Number, to apply for an
   7. A foreign central bank of issue,                                              ITIN, or Form SS-4, Application for Employer Identification
   8. A dealer in securities or commodities required to register                    Number, to apply for an EIN. You can apply for an EIN online
in the United States, the District of Columbia, or a                                by accessing the IRS website at www.irs.gov/businesses and
possession of the United States,                                                    clicking on Employer ID Numbers under Related Topics. You
   9. A futures commission merchant registered with the                             can get Forms W-7 and SS-4 from the IRS by visiting
Commodity Futures Trading Commission,                                               www.irs.gov or by calling 1-800-TAX-FORM
  10. A real estate investment trust,                                                  If you are asked to complete Form W-9 but do not have a
   11. An entity registered at all times during the tax year                        TIN, write “Applied For” in the space for the TIN, sign and
under the Investment Company Act of 1940,                                           date the form, and give it to the requester. For interest and
   12. A common trust fund operated by a bank under                                 dividend payments, and certain payments made with respect
section 584(a),                                                                     to readily tradable instruments, generally you will have 60
                                                                                    days to get a TIN and give it to the requester before you are
  13. A financial institution,                                                      subject to backup withholding on payments. The 60-day rule
   14. A middleman known in the investment community as a                           does not apply to other types of payments. You will be
nominee or custodian, or                                                            subject to backup withholding on all such payments until you
   15. A trust exempt from tax under section 664 or                                 provide your TIN to the requester.
described in section 4947.                                                          Note. Writing “Applied For” means that you have already
   The chart below shows types of payments that may be                              applied for a TIN or that you intend to apply for one soon.
exempt from backup withholding. The chart applies to the                            Caution: A disregarded domestic entity that has a foreign
exempt recipients listed above, 1 through 15.                                       owner must use the appropriate Form W-8.
IF the payment is for . . .                 THEN the payment is exempt
                                            for . . .

Interest and dividend payments              All exempt recipients except
                                            for 9

Broker transactions                         Exempt recipients 1 through 13.
                                            Also, a person registered under
                                            the Investment Advisers Act of
                                            1940 who regularly acts as a

Barter exchange transactions                Exempt recipients 1 through 5
and patronage dividends

Payments over $600 required                 Generally, exempt recipients
to be reported and direct                   1 through 7
sales over $5,000 1
    See Form 1099-MISC, Miscellaneous Income, and its instructions.
    However, the following payments made to a corporation (including gross
    proceeds paid to an attorney under section 6045(f), even if the attorney is a
    corporation) and reportable on Form 1099-MISC are not exempt from
    backup withholding: medical and health care payments, attorneys’ fees; and
    payments for services paid by a federal executive agency.
Form W-9 (Rev. 11-2005)                                                                                                                         Page      4
Part II. Certification                                               What Name and Number To Give the
To establish to the withholding agent that you are a U.S.            Requester
person, or resident alien, sign Form W-9. You may be
                                                                     For this type of account:                   Give name and SSN of:
requested to sign by the withholding agent even if items 1, 4,
and 5 below indicate otherwise.                                          1. Individual                           The individual
   For a joint account, only the person whose TIN is shown in            2. Two or more individuals (joint       The actual owner of the account
Part I should sign (when required). Exempt recipients, see                  account)                             or, if combined funds, the first
Exempt From Backup Withholding on page 2.                                                                        individual on the account 1
Signature requirements. Complete the certification as                    3. Custodian account of a minor         The minor 2
indicated in 1 through 5 below.                                             (Uniform Gift to Minors Act)
                                                                         4. a. The usual revocable               The grantor-trustee
  1. Interest, dividend, and barter exchange accounts                          savings trust (grantor is
opened before 1984 and broker accounts considered                              also trustee)
active during 1983. You must give your correct TIN, but you                 b. So-called trust account           The actual owner       1

do not have to sign the certification.                                         that is not a legal or valid
   2. Interest, dividend, broker, and barter exchange                          trust under state law
accounts opened after 1983 and broker accounts                           5. Sole proprietorship or               The owner
considered inactive during 1983. You must sign the                          single-owner LLC
certification or backup withholding will apply. If you are           For this type of account:                  Give name and EIN of:
subject to backup withholding and you are merely providing                                                                      3
                                                                      6. Sole proprietorship or                  The owner
your correct TIN to the requester, you must cross out item 2             single-owner LLC
in the certification before signing the form.                                                                                       4
                                                                      7. A valid trust, estate, or               Legal entity
   3. Real estate transactions. You must sign the                        pension trust
certification. You may cross out item 2 of the certification.         8. Corporate or LLC electing               The corporation
  4. Other payments. You must give your correct TIN, but                 corporate status on Form
you do not have to sign the certification unless you have                8832
been notified that you have previously given an incorrect TIN.        9. Association, club, religious,           The organization
“Other payments” include payments made in the course of                  charitable, educational, or
the requester’s trade or business for rents, royalties, goods            other tax-exempt organization
(other than bills for merchandise), medical and health care          10. Partnership or multi-member             The partnership
services (including payments to corporations), payments to a             LLC
nonemployee for services, payments to certain fishing boat           11. A broker or registered                  The broker or nominee
crew members and fishermen, and gross proceeds paid to                   nominee
attorneys (including payments to corporations).                      12. Account with the Department             The public entity
                                                                         of Agriculture in the name of
   5. Mortgage interest paid by you, acquisition or                      a public entity (such as a
abandonment of secured property, cancellation of debt,                   state or local government,
qualified tuition program payments (under section 529),                  school district, or prison) that
IRA, Coverdell ESA, Archer MSA or HSA contributions or                   receives agricultural program
distributions, and pension distributions. You must give                  payments
your correct TIN, but you do not have to sign the
certification.                                                       1
                                                                         List first and circle the name of the person whose number you furnish. If
                                                                         only one person on a joint account has an SSN, that person’s number must
                                                                         be furnished.
                                                                         Circle the minor’s name and furnish the minor’s SSN.
                                                                       You must show your individual name and you may also enter your business
                                                                       or “DBA” name on the second name line. You may use either your SSN or
                                                                       EIN (if you have one). If you are a sole proprietor, IRS encourages you to
                                                                       use your SSN.
                                                                       List first and circle the name of the legal trust, estate, or pension trust. (Do
                                                                       not furnish the TIN of the personal representative or trustee unless the legal
                                                                       entity itself is not designated in the account title.) Also see Special rules
                                                                       regarding partnerships on page 1.
                                                                     Note. If no name is circled when more than one name is
                                                                     listed, the number will be considered to be that of the first
                                                                     name listed.

Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns
with the IRS to report interest, dividends, and certain other income paid to you, mortgage interest you paid, the acquisition or
abandonment of secured property, cancellation of debt, or contributions you made to an IRA, or Archer MSA or HSA. The IRS
uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this
information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of Columbia, and U.S.
possessions to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, to federal
and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat
   You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 28% of taxable
interest, dividend, and certain other payments to a payee who does not give a TIN to a payer. Certain penalties may also apply.
                                        PURCHASING DEPARTMENT
                                         3051 Ira E. Woods Avenue
                                          Grapevine, Texas 76051

                                            NO BID NOTIFICATION

VENDOR NAME __________________________________ AGENT’S NAME ____________________
ADDRESS _______________________________________ BID NUMBER ______________________
           ________________________________________ DESCRIPTION _____________________

The Grapevine-Colleyville Independent School District is interested in receiving competitive pricing on all
items bid. We also desire to keep your firm as a bidder and supplier of materials and equipment.
Therefore, it is important for us to determine why you are not bidding on this item. We will analyze your
input carefully and try to determine if future changes are needed in our specifications and/or procedures.

I did not bid for the following reason: (PLEASE CHECK ONE OF THE LISTED REASONS)

         _______           Do not supply the requested product

         _______           Quantities offered are too small or too large to be supplied by my company.
                                    (please circle one of the underlined)

         _______           Specifications are “too tight” or written around a particular product.
                           (Please elaborate on this item) _______________________________________

         _______           Cannot bid against manufacturer or jobber on this item.
                                    (please circle one of the underlined)

         _______           Time frame for bidding was too short for my organization.

         _______           Not awarded a contract by GCISD when you felt you were low bidder.

         _______           Other, please state reason ___________________________________________________

Please indicate your choice for remaining on GCISD’s bid list:

_______ I wish to remain on bid list for future bids             _______ I do not wish to remain on bid list

                                                       Vendor’s Signature                                      Date

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