ACKNOWLEDGEMENT OF RECEIPT OF RFP PACKAGE by jf8fmfif9d

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									                      CITY OF SANDY SPRINGS
                 INVITATION TO BID NUMBER 10-322
                       Fire Hoses & Equipment


The City of Sandy Springs is accepting sealed bids from qualified firms for Fire
Hoses & Equipment for use primarily by the City Fire Department. Sealed bids
will be received no later than 11:00 A.M., November 20, 2009 in the City of
Sandy Springs Purchasing Division, 7840 Roswell Road, Suite 500, Sandy
Springs, Georgia, 30350 at which time bids will be opened and publicly read
aloud. Bids received after the above time or in any other location other than the
Purchasing Division will not be accepted.

Bids shall be presented in a sealed opaque envelope with the bid number and
name (10-322) Fire Hoses clearly marked on the outside of the envelope. The
name of the company or firm submitting a bid should also be clearly marked
on the outside of the envelope. ONE (1) ORIGINAL AND TWO (2) COPIES
OF THE BID MUST BE SUBMITTED.

All bidders must comply with all general and special requirements of the bid
information and instructions enclosed herein.

Bid packages are available at the Sandy Springs City Hall, Purchasing Division,
7840 Roswell Road, Sandy Springs Suite 500. Additional information, and bid
packages, may be obtained by visiting the city web site www.sandyspringsga.org.
Please refer to Bid #10-322 and bid name (Fire Hoses & Equipment) when
requesting information.

The City of Sandy Springs reserves the right to reject any or all bids and to waive
technicalities and informalities, and to make award in the best interest of the City
of Sandy Springs.

Bid shall be exclusive to all items and quantity’s described within. Partial bids will
be rejected.
        ACKNOWLEDGEMENT OF RECEIPT OF BID
                   PACKAGE

               INVITATION TO BID NUMBER 10-322
                     Fire Hoses & Equipment


     Upon receipt of documents, please fax this page to:
                            City of Sandy Springs – Purchasing Division
                            Attention: Lynn Taylor, Purchasing Manager
                            7840 Roswell Road, Suite 500
                            Sandy Springs, Georgia 30350
                            Fax: 770-206-1480



I hereby acknowledge receipt of documents pertaining to the above referenced BID.

COMPANY NAME: ______________________________________________________

CONTACT PERSON: _____________________________________________________

ADDRESS: _____________________________________________________________

CITY: _________________________________ STATE ______________ ZIP ________

PHONE: (       )_________________________ FAX: (           )______________________

E-MAIL: _______________________________________________________________


_________________________________________________                _______________
(Signature)                                                      (Date)
                                         CITY OF SANDY SPRINGS
                                      GENERAL TERMS & CONDITIONS
                                         BID FORM – PAGE 3 OF 13
                                       MUST BE RETURNED WITH BID




Date: __________________________

City of Sandy Springs
Purchasing Division
7840 Roswell Road, Suite 500
Sandy Springs, Georgia 30350


Re:      Bid Number # 10-322

      I. Bids will be received by the Purchasing Office at the address shown on the cover of the   Invitation to
         Bid until the date and time set for the bid opening.

      II. Bid is based on supply of Fire Hoses & Equipment per the specifications as indicated in the bid
          document.

      III. Anticipated delivery of Fire Hoses is no later than December 30, 2009. Any item(s) not delivered by
           5:00 P.M. on the established date will be subject to a $100.00 per day deduction from the final cost
           received in the bid.

      IV. In the event there is a discrepancy between the unit price and extended price, the unit price shall
          govern.

      V. Bid responses containing a minimum order/ship quantity or dollar value, unless otherwise called for in
         the Invitation to Bid, may be treated as non-responsive and may not be considered for award.

      VI. This bid may not be revoked or withdrawn after the time set for deadline receipt of bids and shall
          remain open for acceptance for a period of ninety (90) days following such time.

      VII.Bidder shall place the following information on the outside, lower left corner of the envelope
          containing the bid. Failure to include such information may delay opening of the bid.

          INVITATION TO BID #: 10-322
          BID CLOSING DATE:    NOVEMBER 20, 2009
          BID COLOSING TIME: 11:00 A.M.
                                       CITY OF SANDY SPRINGS
                                       BID FORM – PAGE 4 OF 13
                                     MUST BE RETURNED WITH BID

VIII. Bidder shall provide the following documentation with the bid packet submittal.

           Proof of a minimum of 5 years in business.
           Proof that the Vendor or Company has a physical address that’s within 50 miles of Sandy
           Springs Georgia to assist with any warranty/repair needs if they were to arise.
           A list of five (5) fire departments in Georgia who are currently using the vendor’s products.
           The list shall contain the agency name, point of contact, and phone number.
           Vendor must provide documentation if asked that will validate any claims made herein about
           the manufacturing or testing procedures described in the specifications.
           Vendor must provide a copy of certification issued by the Underwriters Laboratory that the
           manufacture of said product(s) meets the minimum requirements established by Underwriters
           Laboratory Inc.
           Vendor must provide proof that the product manufacture for fire hose meets the inspection
           guidelines as established by the Department of Defense MIL-I-45208A.


IX. This agreement shall be governed in all respects by the laws of the State of Georgia.


X. GENERAL SPECIFICATIONS:
   No specification implied or expressed is intended to limit competition. The “Basic Requirements”
   attached are intended as a guide for Fire Hoses on which vendors are to submit a bid. These
   requirements and other specifications are not designed to prevent any vendor from submitting a bid.
   All equipment should comply with the requirements within a generally acceptable range.


       A. The Fire Hoses offered shall meet with the detailed requirements listed in the bid form of this
          bid. Bidders are to indicate exactly what they are offering in the bid submission. All goods
          and/or services supplied pursuant to a purchase order shall, unless otherwise stated, conform
          exactly to all of the descriptions, specifications, and attachments contained in the Invitation to
          Bid upon which an order is based; and the terms, conditions, and specifications of the Invitation
          to Bid are incorporated herein by reference and made a part thereof.


       B. Bidder’s must furnish specification sheets, or similar data to support statements made in bid
          submission. Failure to furnish required data may be consideration as cause for rejection of bid.


       C. All items omitted from these specifications, including manufacturer’s standard equipment
          items, and accessory equipment supplied by the equipment dealer that is clearly necessary for
          the complete operation of the equipment shall be considered a requirement although not directly
          specified in these specifications. No specifications expressed or implied shall be construed as
          any type of restrictive specification that would limit competition.
                                        CITY OF SANDY SPRINGS
                                        BID FORM – PAGE 5 OF 13
                                      MUST BE RETURNED WITH BID




       D. All deliveries are to bid FOB, City of Sandy Springs, and Sandy Springs, Georgia 30350. All
          freight and delivery charges must be incorporated as part of the base bid amount. Vendor shall
          transfer and deliver to the department named all of the goods and/or services described herein
          for the consideration set forth herein. Risk of loss of the goods shall pass to the department
          upon acceptance only. Title to the goods shall remain with vendor until acceptance by the
          department.

       E. At time of delivery, the successful bidder shall furnish the City with equipment warranty for
          each unit as specified in the bid documents. All warranties shall be effective the day the
          equipment is placed into service by the City.

       F. The City reserves the right to inspect and evaluate any or all items of proposed responsive of
          equipment before award of bid. The City reserves the right to reject any or all bids based on this
          inspection and evaluation.

       G. The City will award to the vendor(s) that are the most responsive, and responsible bidder. This
          bid will not be solely based on cost. All proposed responses will be considered and evaluated to
          ensure safety and conformity with bidding requirements.

       H. The City in its sole discretion may award to more than one vendor, if it is determined to be in
          the best interest of the city to do so. The City may award to multiple vendors by line item if
          deemed to be in its best interest.

XI. The City shall pay the amount set out in the attached Schedule for any service/equipment provided.
Payments shall be made each month according to invoice. Payment terms are Net30.

XII. The City shall not be bound by any terms and conditions included in any Vendor packaging, invoice,
catalog, brochure, technical data sheet, or other document which attempts to impose any condition in
variance with or in addition to the terms and conditions contained herein.

XIII. The terms, conditions and specifications of the Invitation to Bid and the award made in connection
with this Contract are incorporated herein by reference and made a part hereof just as if they had been fully
set out herein.

XIV. For good cause and as consideration for executing this Contract or placing this order, Vendor acting
herein by and through its duly authorized agent hereby conveys, sells, assigns, and transfers to the State of
Georgia all rights, title, and interest to and to all causes of action it may now or hereafter acquire under the
antitrust laws of the United States and the State of Georgia relating to the particular goods or services
purchased or acquired by the State of Georgia pursuant hereto.
                                            CITY OF SANDY SPRINGS
                                            BID FORM – PAGE 6 OF 13
                                          MUST BE RETURNED WITH BID

                             General Specifications 5” Supply Hose
                          Please quote on the following items, per these specifications


Hose Construction
Hose shall be made from 100 percent high tenacity synthetic yarn, circularly woven and completely protected and
locked-in by tough highly resistant synthetic nitrile rubber, forming a single homogeneous construction without the
use of glues or adhesives of any type; meeting all requirements of NFPA 1961.


                                            COMPLIANCE                    EXCEPTION

Lining Properties
Ultimate Tensile Strength: Tensile strength of the lining and cover shall not be less than 1750 PSI.

Ultimate Elongation: 500 percent
       minimum.

Accelerated Aging Test: The tensile strength and ultimate elongation of the vulcanized rubber compound which has
been subjected to the action of oxygen at a pressure of 300 PSI (±10 PSI) and a temperature of 158° (±18°F) for a
period of 96 hours shall retain 60 percent of its originally stated properties.

                                           COMPLIANCE                      EXCEPTION

Hydrostatic Pressure Tests
      Diameter:                        5"
      Service Test Pressure:           200psi
      Acceptance Test Pressure:        400psi
      Burst Pressure:                  600psi

                                           COMPLIANCE                      EXCEPTION


Abrasion Resistance
Hose shall withstand 30,000 cycles on the Taber Abrasion Machine (H-22 Wheel: 1 kg).


                                           COMPLIANCE                      EXCEPTION

Ozone Resistance
Hose shall show no visible signs of cracking to the lining or cover when tested in accordance to ASTM D518 Procedure
-B, 100pphm/118°F/70 hours.

                                           COMPLIANCE                      EXCEPTION
                                                   CITY OF SANDY SPRINGS
                                                   BID FORM – PAGE 7 OF 13
                                                 MUST BE RETURNED WITH BID


 Chemical Resistance
 Exposure to sea water and contamination by most chemical substances, hydrocarbons, oils, alkalis, acids and greases
 must have no effect on the short or long term performance of the hose.

                                           COMPLIANCE                        EXCEPTION
 Cold Resistance
 Hose shall have a capability of use down to -35°F. Hose shall have no apparent damage to cover, reinforcement or lining
 when subjected to the following cold bending test: a 50 ft. length of dry hose is to be firmly coiled and placed in a cold box
 at -35°F for a duration of 24 hours. Immediately after removal of the hose from the box, hose should be uncoiled and laid
 out by one operator. Following this procedure, the hose shall not leak nor show any damage to the reinforcement when
 subjected to the hydrostatic acceptance test stated above.

                                               COMPLIANCE                    EXCEPTION


 Heat Resistance
 The hose, when subjected to a static pressure of 100 PSI, shall be capable of withstanding a surface temperature of
 1200°F for a minimum of two minutes without rupture or damage to the synthetic reinforcement.

                                            COMPLIANCE                       EXCEPTION

 Hose Weight and Coil Diameters
 The hose shall conform to the following average weights and diameters: (Uncoupled 100’ Lengths)
 Diameter:                       5”
 Weight/ft. Uncoupled:           1.04 lbs
 Coil Size Uncoupled:            27”

                                            COMPLIANCE                    EXCEPTION

 Color
 The color shall be of HI-VISIBILITY yellow.

                                            COMPLIANCE                    EXCEPTION

 Couplings
 As required by purchaser; expansion ring threaded 5” STORZ clamp ring, etc.

                                             COMPLIANCE                      EXCEPTION

Lengths
Hose to be available in 25’ and 100' lengths.

                                         COMPLIANCE                        EXCEPTION
Warranty

Hose shall carry a five year written warranty.

                                            COMPLIANCE                     EXCEPTION
                                                 CITY OF SANDY SPRINGS
                                                 BID FORM – PAGE 8 OF 13
                                               MUST BE RETURNED WITH BID


                      General Specifications 1-3/4” and 2-1/2” Attack Hose
                              Please quote on the following items, per these specifications

                                            FIRE HOSE SPECIFICATIONS
                                              DOUBLE JACKET, 800PSI
              The fire hose assembly supplied under this specification shall be constructed with superior quality
             materials. NFPA 1961 standards shall be observed in production of the assembly, in order to ensure
                                                 its quality and durability.

Service Life
Hose furnished under these specifications will have a potential service life warranty of not less than ten years;
barring mistreatment that would render it unfit for service. Upon delivery, the hose shall be free from defects in
workmanship and materials. Any defective hose will be replaced at no charge whatsoever.

                                          COMPLIANCE                       EXCEPTION

Jacket Construction The jackets will be woven evenly and be free of defects, Including knots, lumps, or
unsightly disfigurations that could jeopardize the integrity of the hose assembly. The warp yarn shall consist of
staple polyester yarn. The use of filament or entangled yarn is expressly forbidden due to the lack of inherent
abrasion resistance. The filler yarns shall be constructed of high strength, low elongation, filament polyester to
reduce weight and increase flexibility.

                                          COMPLIANCE                       EXCEPTION

Abrasion Impregnation
Hose assemblies are available with polymer impregnation that provides additional abrasion resistance. Colors
include: yellow, orange, red, tan, black, blue and green. Color shall be pure and even in each hose. Impregnated
hose shall meet the requirements of Mil-H-24606B for abrasion resistance.

                                          COMPLIANCE                       EXCEPTION

Finished Hose
Markings: Beginning at a point not less than four feet from the end, each fifty foot section shall be stenciled in
indelible ink with letters at least one inch high stating the name of the manufacturer, month and year of
manufacture, and service test to 400 PSI. The ink used will be of a contrasting color.

Methods Testing: All measurements and tests necessary to determine compliance of the fire hose specified
requirements shall be made with ASTM, UL and NFPA 1961 designation, unless otherwise prescribed.

                                          COMPLIANCE                       EXCEPTION

Color
Hose shall be available in the following colors: Yellow, Red, Blue, and Orange.
                                        COMPLIANCE                      EXCEPTION


                                              CITY OF SANDY SPRINGS
                                               BID FORM – PAGE 9 OF 13
                                            MUST BE RETURNED WITH BID

Lining
         The rubber lining shall be a single-ply extruded tube of synthetic EPDM compounded to resist ozone. The
         finished form shall be free of pits or other imperfections and have a smooth finish. No reclaimed rubber
         shall be used. Plastic tubes that sacrifice durability of the hose life for the sake of weight are not
         acceptable.

         Backing: The backing shall be of adequate thickness to create a smooth waterway but not greater than
         .020. The fire hose constructed under this specification shall be manufactured fully backed using a
         calendared EPDM. The use of adhesives of any kind is unacceptable and expressly forbidden. Tensile
         Strength & Ultimate Elongation: Shall meet the standards of Underwriters Laboratories, Inc. TM as well as
         all other properties of UL-19 for rubber lined hoses. A valid U.S. underwriter’s inspection procedure shall
         be in force.

                                          COMPLIANCE                     EXCEPTION

Hydrostatic Testing
      Hose Size:                        1-3/4”                 2-1/2”
      Length:                           50 Ft. Section         50 Ft. Section
      Test Pressure:                    800psi                 800psi
      Elongation:                       6%                     6%
      Twist/Ft:                         15o Right              10o Right
      Warp:                             10”                    10”
      Rise:                             -0-                    -0-
      Burst Test:                       1300psi                1250psi
      Kink Test:                        750psi                 750psi


                                          COMPLIANCE                     EXCEPTION

Weights & Measures
      Hose Size:                        1-3/4”                 2-1/2”
      Bowl Size:                        2-1/8”                 3”
      Wt/50'-Uncoupled:                 19Lbs                  28Lbs
      Wt/50'-Coupled:                   20Lbs                  30Lbs


                                          COMPLIANCE                      EXCEPTION

Couplings
Hose shall have lightweight aluminum threaded couplings with NST threads. Imported couplings will not be
accepted.

                                          COMPLIANCE                     EXCEPTION


Environmental Resistance
All hose will be 100% immune to mildew and rotting.
                                         COMPLIANCE                      EXCEPTION


                                                CITY OF SANDY SPRINGS
                                               BID FORM – PAGE 10 OF 13
                                              MUST BE RETURNED WITH BID


                    General Specifications 2-1/2” Light-Weight Attack Hose
                              Please quote on the following items, per these specifications

                                   FIRE HOSE SPECIFICATIONS
                           DOUBLE JACKET, POLYURETHANE LINED, 600PSI
           The fire hose assembly supplied under this specification shall be constructed with superior quality
         materials. NFPA 1961 standards shall be observed in production of the assembly, in order to ensure its
                                                quality and durability.


Service Life
Hose furnished under these specifications will have a potential service life warranty of not less than ten years;
barring mistreatment that would render it unfit for service. Upon delivery, the hose shall be free from defects in
workmanship and materials. Any defective hose will be replaced at no charge whatsoever.

                                         COMPLIANCE                       EXCEPTION


Jacket Construction
The jackets will be woven evenly and be free of defects, Including knots, lumps, or unsightly disfigurations that
could jeopardize the integrity of the hose assembly. The warp yarn shall consist of staple polyester yarn. The use
of filament or entangled yarn is expressly forbidden due to the lack of inherent abrasion resistance. The filler
yarns shall be constructed of high strength, low elongation, filament polyester to reduce weight and increase
flexibility.

                                          COMPLIANCE                      EXCEPTION


Abrasion Impregnation
Hose assemblies are available with polymer impregnation that provides additional abrasion resistance. Colors
include: yellow, orange, red, tan, black, blue and green. Color shall be pure and even in each hose. Impregnated
hose shall meet the requirements of Mil-H-24606B for abrasion resistance.

                                          COMPLIANCE                      EXCEPTION


Lining
The lining shall be a single-ply extruded tube of synthetic polyurethane to resist ozone. The polyurethane tube
shall adhere to the jacket to prevent delamination. The finished product will meet and exceed all potable water
MIL-H-24606B standards for the manufacturing of lightweight fire hose. The use of polyurethane lines fire hose is
designed to increase packing ability and applications where lightweight fire hose is desired.

                                          COMPLIANCE                      EXCEPTION
                                                 CITY OF SANDY SPRINGS
                                                BID FORM – PAGE 11 OF 13
                                               MUST BE RETURNED WITH BID

Hydrostatic Testing
      Hose Size:                        2-1/2"
      Length:                           75 Ft Section
      Test Pressure:                    600psi
      Elongation:                       6%
      Twist/Ft.:                        10o Right
      Warp:                             10"
      Rise:                              -0-
      Burst Test:                       900psi
      Kink Test:                        500psi

                                          COMPLIANCE                       EXCEPTION

Finished Hose
Markings: Beginning at a point not less than four feet from the end, each fifty foot section shall be stenciled in
indelible ink with letters at least one inch high stating the name of the manufacturer, month and year of
manufacture, and service test to 300 PSI. The ink used will be of a contrasting color.

Methods Testing: All measurements and tests necessary to determine compliance of the fire hose specified
requirements shall be made with ASTM, UL and NFPA 1961 designation, unless otherwise prescribed.

                                          COMPLIANCE                       EXCEPTION


Weights & Measures
      Hose Size:                        2-1/2"
      Bowl Size:                        3"
      Wt/75ft.-Uncoupled:               33 LBS
      Wt/75ft.-Coupled:                 35 LBS

                                          COMPLIANCE                       EXCEPTION


Couplings
Hose shall have lightweight aluminum threaded couplings with NST threads. Imported couplings will not be
accepted.

                                          COMPLIANCE                       EXCEPTION


Color
The color shall be Green

                                        COMPLIANCE                        EXCEPTION


Environmental Resistance
All hose will be 100% immune to mildew and rotting.

                                        COMPLIANCE                       EXCEPTION
The Vendor will be bidding on the following number of hose sections:
Description of Hose                                          Total Number of Sections

5” Supply Hose 100Ft. sections                               96     (Hi Visibility yellow)

5” Supply Hose 25Ft. sections                                14     (Hi Visibility yellow)

2 ½” Attack Hose-Light-Weight 75Ft. sections                 18     (Green)

2 ½” Attack Hose 50Ft. sections                              39     (Yellow)

1 ¾” Attack Hose 50Ft. sections                              168    (Red, Blue, and Orange)


The Vendor will be bidding on the following appliances/equipment:
Vendor will need to provide pricing for all items and quantities listed below.

Description of Item                                                                Total Count

Kochek 2-in-1 adaptor 3" F-SW NST x 5" STZ X 2.5 30 degree elbow                   7

Kocheck 5" STZ x 4.5" FNST LH Swivel                                               8

Kocheck 5" FNST(LH) x 5" STZ 30 degree elbow                                       4

Elkhart Gated Manifold 5" STZ x (4) 2.5" MNST x (1) 5" STZ                         3

Elkhart 5" STORZ base for stingers                                                 4

Elkhart 2.5" playpipe nozzle w/shutoff & pistol grip w/stack-tips                  7

Elkhart 5" STZ x 6" FNST piston intake valve                                       7

Red Head 2.5' x MNST x 2.5" MNST double male adaptor                               7

Red Head 2.5" FNST x 2.5" FNST double female adaptor                               7

Groves Mobile Hose Cart 3 Tier capable of holding 3000Ft of 2 ½” hose              8
 
Snap-Tite 2-firefighter hose roller                                                7

Set of 4 Storz spanner wrenches with bracket                                       4

Herbert M40 Up to 6” hose clamp                                                    7
                                          BID SCHEDULE

Description of Hose                                         Total Number of Sections

5” Supply Hose 100Ft. sections                      96      (Hi Visibility yellow) $__________

5” Supply Hose 25Ft. sections                       14      (Hi Visibility yellow) $__________

2 ½” Attack Hose-Light-Weight 75Ft. sections        18      (Green)               $__________

2 ½” Attack Hose 50Ft. sections                     39      (Yellow)              $__________

1 ¾” Attack Hose 50Ft. sections                     168     (Red, Blue, and Orange) $_________

Appliances/Equipment

Kochek 2-in-1 adaptor 3" F-SW NST x 5" STZ X 2.5 30 degree elbow          7      $__________

Kocheck 5" STZ x 4.5" FNST LH Swivel                                      8      $__________

Kocheck 5" FNST(LH) x 5" STZ 30 degree elbow                              4      $__________

Elkhart Gated Manifold 5" STZ x (4) 2.5" MNST x (1) 5" STZ                3      $__________

Elkhart 5" STORZ base for stingers                                        4      $__________

Elkhart 2.5" playpipe nozzle w/shutoff & pistol grip w/stack-tips         7      $__________

Elkhart 5" STZ x 6" FNST piston intake valve                              7      $__________

Red Head 2.5' x MNST x 2.5" MNST double male adaptor                      7      $__________

Red Head 2.5" FNST x 2.5" FNST double female adaptor                      7      $__________

Groves Mobile Hose Cart 3 Tier capable of holding 3000Ft of 2 ½” hose 8          $__________
 
Snap-Tite 2-firefighter hose roller                                       7      $__________

Set of 4 Storz spanner wrenches with bracket                              4      $__________

Herbert M40 Up to 6” hose clamp                                           7      $__________

Subtotal of Hoses $______________

Subtotal of Appliances/Equipment $_____________                     Total Cost $_______________
                                   BID PRICE CERTIFICATION



In compliance with the attached Specification, the undersigned offers and agrees that if this Bid is
accepted, by the City Council of the City of Sandy Springs that within Thirty (90) days of the date of
Bid opening, that he/she will provide any or all of the Items upon which Prices are quoted, at the
Price set opposite each Item, delivered to the designated point(s) within the time specified in the Bid
Schedule.

COMPANY______________________________________________________________________________________

ADDRESS_______________________________________________________________________________________

AUTHORIZED SIGNATURE________________________________________________________________________


PRINT / TYPE NAME _____________________________________________________________________________
                       CERTIFICATION OF CONTRACTOR
             GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT

     I hereby certify that I am a principle and duly authorized representative of
_____________________________________________, (“Contractor”), whose address is
__________________________________________________,    __________________________,
___________________ _______.

        Contractor hereby agrees to comply with all applicable provisions and requirements of the
Georgia Security and Immigration Compliance Act of 2006 (the “Act”), as codified in O.C.G.A.
Sections 13-10-90 and 13-10-91 and regulated in Chapter 300-10-1 of the Rules and Regulations of
the State of Georgia, "Public Employers, Their Contractors and Subcontractors Required to Verify
New Employee Work Eligibility Through a Federal Work Authorization Program," accessed at
http://www.dol.state.ga.us, as further set forth below.

       Contractor agrees to verify the work eligibility of all of newly hired employees through the
U.S. Department of Homeland Security’s Employment Eligibility Verification (EEV) / Basic Pilot
Program, accessed through the Internet at https://www.vis-dhs.com/EmployerRegistration, in
accordance with the provisions and timeline found in O.C.G.A. 13-10-91 and Rule 300-10-1-.02 of
the Rules and Regulations of the State of Georgia. As of July 1, 2007, the verification requirement
applies to contractors and subcontractors with five-hundred (500) or more employees.

       Contractor understands that the contractor and subcontractor requirements of the Act apply
to contracts for, or in connection with, the physical performance of services within the State of
Georgia.

        Contractor understands that the following contract compliance dates set forth in the Act apply
to the Contract Agreement, pursuant to O.C.G.A. 13-10-91:

       On or after July 1, 2007, to public employers, contractors, or subcontractors of 500 or
       more employees;

       On or after July 1, 2008, to public employers, contractors, or subcontractors of 100 or
       more employees; and

       On or after July 1, 2009, to all other public employers, their contractors, and
       subcontractors.

        To document the date on which the Act is applicable to Contractor, and to document
Contractor’s compliance with the Act, the undersigned agrees to initial one of the three (3) lines
below indicating the employee number category applicable to Contractor, and to submit the indicated
affidavit with the Contract Agreement if the Contractor has 500 or more employees.
          Contractor has:

        ____    500 or more employees [Contractor must register with the
                Employment/Eligibility Verification/Basic Pilot Program and begin work
                eligibility verification on July 1, 2007];
       ____   100-499 employees [Contractor must register with the Employment Eligibility
              Verification/Basic Pilot Program and begin work eligibility verification by July
              1, 2008]; or

       ____   99 or fewer employees [Contractor must begin work eligibility verification by
              July 1, 2009].

        Contractor further agrees to require O.C.G.A. Sections 13-10-90 and 13-10-91 compliance
in all written agreements with any subcontractor employed by Contractor to provide services
connected with the Contract Agreement, as required pursuant to O.C.G.A. 13-10-91.

       Contractor agrees to obtain from any subcontractor that is employed by Contractor to
provide services connected with the Contract Agreement, the subcontractor’s indication of the
employee number category applicable to the subcontractor.

       Contractor agrees to secure from any subcontractor engaged to perform services under this
Contract an executed “Subcontractor Affidavit,” as required pursuant to O.C.G.A. 13-10-91 and
Rule 300-10-1-.08 of the Rules and Regulations of the State of Georgia, which rule can be
accessed at http://www.dol.state.ga.us.

       Contractor agrees to maintain all records of the subcontractor’s compliance with O.C.G.A.
Sections 13-10-90 and 13-10-91 and Chapter 300-10-1 of the Rules and Regulations of the State
of Georgia.


                                     CONTRACTOR:

Date: ___________________            Signature:     ____________________________________
                                     Title:         ____________________________________




:
                                    CERTIFICATION OF SPONSOR
                                     DRUG-FREE WORKPLACE

I     hereby   certify   that   I   am   a   principle   and   duly   authorized   representative   of
_______________________________________________, (“Contractor”), whose address is
____________________________________________________________________________,
________________, ___________________ _______, and I further certify that:


        (1)    The provisions of Section 50-24-1 through 50-24-6 of the Official Code of Georgia
Annotated, relating to the “Drug-Free Workplace Act” have been complied with in full; and
(2)    A drug-free workplace will be provided for Contractor’s employees during the performance
       of the Agreement; and
(3)    Each Subcontractor hired by Contractor shall be required to ensure that the subcontractor’s
       employees are provided a drug-free workplace.            Contractor shall secure from that
       subcontractor the following written certification: “As part of the subcontracting agreement
       with Contractor, ________________________________ certifies to Contractor that a drug-
       free workplace will be provided for the Subcontractor’s employees during the performance
       of this Agreement pursuant to paragraph (7) of subsection (b) of the Official Code of
       Georgia Annotated, Section 50-24-3”; and
(4)    The undersigned will not engage in unlawful manufacture, sale, distribution, dispensation,
       possession, or use of a controlled substance or marijuana during the performance of the
       Agreement.

                                     CONTRACTOR:

Date: __________________             Signature: _________________________________________
                                     Title:     _________________________________________




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