Audit of Weatherization Operational and Fiscal Compliance Requirements Request for Proposal 2010 013 DUE DATE September 13 2010 10 00 a m

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					      Audit of Weatherization Operational and Fiscal Compliance Requirements
                           Request for Proposal 2010-013

               DUE DATE: September 13, 2010, 10:00 a.m.**


                        Administrative Services Department
                           8700 Tesoro Dr., Suite 700
                             San Antonio, TX 78217

                                  (210) 362-5200

Request for Proposal Release Date:                 August 16, 2010, 10:00 a.m. **

Pre-proposal Conference for Proposers
Conference Room 7-B, Suite 700,
8700 Tesoro Drive, San Antonio, TX 78217           August 25, 2010, 10:30 a.m. **

Written Requests for Additional
Clarification & Information Due By:                August 27, 2010, 4:00 p.m. **

Will Post Answers to Pre-proposal
Conference and Written Requests for
Additional Clarification & Information
on the AACOG Website By:                           September 1, 2010, 5:00 p.m. **

Response Due Date:                                 September 13, 2010, 4:00 p.m. **

         ** All times are as observed by AACOG at its 8700 Tesoro Drive,
                         San Antonio, Texas 78217 location
I. General Information

  A. The Alamo Area Council of Governments (AACOG) requests proposals from firms,
     preferably those familiar with Federal and State weatherization guidelines, to
     perform a forensic audit of approximately 900 weatherization case files for the
     period March 2010 through July 2010 and the associated billings to the State of
     Texas for weatherization work performed during that period. Purpose of the audit is
     to test operational and fiscal compliance.

  B. AACOG issues this request for proposal (RFP) in accordance with requirements of
     the Uniform Grant Management Standards, Part III, Subpart C Section 36.

  C. Prospective proposers may obtain the specifications at (click on
     “Bid Opportunities”) or from AACOG, 8700 Tesoro Drive Suite 700, San Antonio,
     Texas 78217 after the date and time specified on the cover page for “Request for
     Proposal Release Date”.

  D. Proposers desiring additional information or clarification may submit requests, in
     writing only, by fax at 210-225-5937 or email to no later
     than the date and time specified on the cover page for “Written Requests for
     Clarifications & Additional Information Due By”. We will not honor verbal
     requests for clarification other than that provided at the Pre-proposal
     Conference. We will post responses to requests for clarification at
     (click on “Bid Opportunities”) by the date and time specified on the cover page for
     “Will Post Answers to Requests for Clarifications & Additional Information on
     the AACOG Website By”.

  E. We encourage proposers desiring additional information or clarification to attend the
     Pre-proposal Conference listed on the cover page for “Pre-proposal Conference
     for Proposers”. We will post questions and responses from that conference at by the date and time specified on the cover page for “Will Post
     Answers to Pre-proposal Conference Questions on the AACOG Website By”.

  F. Deadline for receipt of proposals is that specified on the cover page for “Response
     Due Date”. All times are as observed by AACOG at its 8700 Tesoro Drive, San
     Antonio, TX 78217 location.

  G. It is AACOG policy to encourage participation by small and historically underutilized
     businesses (HUBS, addressed in Texas Government Code, Chapter 2161) as
     contractors to AACOG.

     1. A historically underutilized business is an entity with its principal place of
        business in Texas that is:
         a. A corporation formed for the purpose of making a profit in which 51 percent
            or more of all classes of the shares of stock or other equitable securities are

                                          Page 1
              owned by one or more economically disadvantaged persons who have a
              proportionate interest and actively participate in the corporation's control,
              operation, and management;
          b. A sole proprietorship created for the purpose of making a profit that is
             completely owned, operated, and controlled by an economically
             disadvantaged person;
          c. A partnership formed for the purpose of making a profit in which 51 percent
             or more of the assets and interest in the partnership are owned by one or
             more economically disadvantaged persons who have a proportionate interest
             and actively participate in the partnership's control, operation, and
          d. A joint venture in which each entity in the venture is a historically
             underutilized business, as determined under Government Code Chapter
             2161; or
          e. A supplier contract between a historically underutilized business as
             determined under Government Code, Chapter 2161, and a prime contractor
             under which the historically underutilized business is directly involved in the
             manufacture or distribution of the goods or otherwise warehouses and ships
             the goods.

       2. It is AACOG’s goal to include HUBs in at least 10% of the total value of contracts
          awarded annually.

       3. AACOG maintains an active program for identification and placement of small
          and HUB businesses on bidder mailing lists and to provide information and other
          assistance to facilitate use of such firms as contractors to the maximum extent
          practical. Small and HUB businesses seeking contracting opportunities should
          file a Request to be Added to Bidder/Vendor List with the AACOG Administrative
          Services Office, 8700 Tesoro Dr., Suite 700, San Antonio, TX 78217.

   H. Proposers certify, as a condition of submitting this RFP and for purposes of any
      future award, that they:
       1. Have not given, offered to give, nor intend to give at any time any economic
          opportunity, future employment, gift, loan, gratuity, special discount, trip, favor,
          service, or other inducement to a public servant in connection with this
       2. Have not engaged in collusion with other providers or anyone else in relation to
          preparation and/or submittal of their response for this project.

II. Responses to the RFP

Each response to this RFP shall conform to the format guidelines presented in this section.

                                            Page 2
A. We will not accept use of the term “As Specified” or “A/S” as a suitable response.

B. Bind, seal, and address four (4) copies of your response to this proposal request
          Gloria C. Arriaga
          Executive Director
          8700 Tesoro Dr., Suite 700
          San Antonio, Texas 78217.

   1. Place paper copies of the response in one or more opaque envelopes and
      clearly mark the front and back of the envelope(s) with the following words in
      large letters: “RFP 2010-013 RESPONSE for [Name of Organization]”. If
      there are multiple envelopes, mark them as 1 of X, 2 of X, etc.
   2. Provide one digital (CD-ROM or 3.5-inch DS/HD computer diskette) copy of all
      submitted materials in one of the envelopes described at II.B.1.
   3. If sending responses by express mail, priority mail, or parcel delivery (UPS,
      FedEx, etc.), or if placing response envelopes in a box or other container, place
      the sealed responses inside the delivery container addressed and marked as
      specified above. Address and mark the delivery container in the manner
      indicated at II.B.1.

C. Provide your response by the “Response Due Date” indicated on the cover of the

D. AACOG will not be liable for any costs incurred in preparing or submitting

E. Send responses by mail or hand delivery (personally, courier, parcel delivery).
   1. AACOG will not accept facsimile or email responses.
   2. AACOG encourages proposers to personally hand-deliver their responses.
      Since parking is not always available nearby, we caution proposers to allow
      ample time for delivery of your response by the established deadline. AACOG
      will not consider responses received after the established deadline, which
      is based upon the clock in use at the AACOG reception desk (8700 Tesoro
      Dr., Suite 700).
   3. AACOG accepts no responsibility for late or misdirected mail or deliveries. Take
      into account mailing/delivery times and the potential for delays to ensure
      responses arrive within the established deadline.

F. Responses may be withdrawn prior to the response due date.

                                       Page 3
G. AACOG will honor proposals only from parties that:
   1. Are free of all obligations and interests that might conflict with the best interests
      of AACOG; and
   2. Have the capacity of providing services on a timely basis.

H. Submission of a proposal shall be prima facie evidence that the proposer has full
   knowledge of the scope, nature, quantity, and quality of work to be performed; the
   detailed requirements of the specifications; the conditions under which the work is to
   be performed; and the manner in which proposals are to be submitted.

I. Proposers shall furnish AACOG such additional information as AACOG may
   reasonably require.

J. AACOG reserves the right to conduct pre-contract negotiations with any and/or all

K. AACOG reserves the right to conduct personal interviews of proposers prior to
   selection. AACOG will not be liable for any costs incurred by the proposer in
   connection with such interview (i.e. travel, accommodations, etc.). AACOG will
   perform these interviews via telephone whenever practicable.

L. AACOG reserves the right to reject any and all proposals and accept proposals it
   considers most favorable to AACOG's best interest. AACOG further reserves the
   right to reject all proposals and seek new proposals when such procedure is
   reasonably in the best interest of AACOG.

M. The response to the RFP is a firm offer that shall be irrevocable and open for
   acceptance by AACOG for ninety (90) calendar days from the established deadline
   for submission of responses. AACOG will furnish a written award of acceptance to
   the successful bidder, as well as issue a purchase order, resulting in a binding
   contract without further action by either party. Submission of a response shall
   indicate the proposer’s agreement with this provision.

N. AACOG will not be liable for any costs not provided for in the proposal and
   subsequent contract(s).

O. AACOG will award the contract to the proposer whose proposal provides the
   greatest value against our needs.

P. Proposals will remain on file and available for public inspection in accordance with
   the Texas Open Records Act (the “Act”). However, we will redact or remove
   proprietary information prior to review in accordance with the Act.

Q. Contract period. An awarded contract shall commence upon execution by both

                                        Page 4
      AACOG and the awarded party. Due date for deliverables and termination date of
      the contract shall be negotiated after selection of a contractor.

   R. AACOG reserves the right to cancel an awarded contract with a thirty (30) day
      written notice if performance, in the exclusive judgment of AACOG, is
      unsatisfactory. No penalty and/or fee may be imposed if a contract is cancelled or
      not renewed.

III. Scope of Work

   A. Background.
      1. The Alamo Area Council of Governments (AACOG) is a voluntary association of
         governmental units throughout the twelve counties of the Alamo Area Region:
         Atascosa, Bandera, Bexar, Comal, Frio, Gillespie, Guadalupe, Karnes, Kendall,
         Kerr, Medina, and Wilson. AACOG is both a planning agency and provider of
         human and governmental services. Among those services provided is a
         weatherization program whose purpose is to help low-income customers control
         their energy costs through consumer education and installation of weatherization
         materials designed to improve energy efficiency of the residence.
      2. The following is a general overview of the weatherization process. AACOG
         reserves the right to modify this process at any time with or without notice.
         a. Through an outreach program, AACOG advertises program eligibility criteria
         and solicits applicants. AACOG places eligible applicants (could be single-family
         residences or multi-family apartments) on a waiting list and offers services to
         applicants as they become available. If the applicant has been on the waiting
         list in excess of 12 months, AACOG must re-verify eligibility.
         b. Each applicant’s residence receives an initial assessment (performed either
         by an AACOG employees or assessment subcontractor) to determine if the unit
         is a viable candidate for weatherization, identify potential weatherization
         measures to implement, provide the property owner education for saving energy,
         and determine the target level of improvement for the unit.
         c. Assuming the unit is a good candidate for weatherization, AACOG uses a
         computer program (known as the EASY Audit) to evaluate the potential
         weatherization measures, determine the materials and labor needed to perform
         each measure, calculate costs, and identify which measures will pay for
         themselves in energy savings over a defined period of time and fit the allowable
         budget for each unit.
         d. AACOG furnishes a prioritized list of those measures that “rank” to an
         installation subcontractor who then performs the weatherization work on the
         residential unit. The subcontractor may identify additional weatherization
         measures for consideration by the EASY Audit and propose those to AACOG for

                                         Page 5
      evaluation and addition to the project. Work proceeds under standards laid out
      by Federal and State guidelines. The subcontractor performs various tests
      throughout the installation process to check for improvements and again at the
      conclusion of the work to verify achievement of the desired level of
      e. Upon completing a given single-family unit or an entire multi-family project,
      the installation subcontractor furnishes AACOG a Statement of Work (SOW) to
      itemize the work performed and the associated costs. AACOG evaluates the
      SOW to ensure the subcontractor performed all requested work, and no more.
      The SOW triggers a final inspection of the work.
      f. An AACOG employee or inspection subcontractor performs a thorough
      review of the work performed and tests the unit(s) for achievement of the desired
      level of improvement. If the inspector identifies deficiencies in the work, those
      are noted and the installation subcontractor must make those good. Once all
      work is satisfactorily completed, the inspector reviews the work with the property
      owner and obtains a certification that he/she is satisfied with the work
      performed. The inspector also ensures the owner is educated about how to
      maintain the improvements as well as tips to further reduce energy consumption.
      g. Upon acceptance by the property owner and AACOG, the installation
      subcontractor furnishes AACOG an invoice of work performed. AACOG
      reconciles the invoice and prepares a billing statement for submission to the
      h. Upon receipt of funds from the State, AACOG pays the installation
      subcontractor and closes the case file.
      i. All assessments, EASY Audits, measures installation, materials, client
      education, final inspection, closeouts, and associated paperwork must adhere to
      well-defined guidelines established at the Federal and State levels.

B. Project Description.
   1. AACOG desires to have an outside party evaluate AACOG’s Weatherization
      Program’s compliance with established Federal and State guidelines. The
      selected contractor will perform a 100% review of critical elements of all
      weatherization cases completed between March 2010 and July 2010 to assess
      compliance with the issues presented below. Concurrently, the selected
      contractor will evaluate the billings to the State of Texas associated with those
      case files for completeness, accuracy, and compliance. Given the level of detail
      involved, AACOG prefers the selected contractor have a working knowledge of
      the weatherization program and how it functions in the State of Texas; however,
      such knowledge is not mandatory.
   2. AACOG will make all guidelines, policies, and procedures available for review.
      AACOG will also make its staff available to explain operational and management
      processes, case documentation, billing processes, and other issues pertinent to

                                       Page 6
   this evaluation. The selected contractor will schedule interviews in a manner
   that minimizes the effect on production.
3. For each case presented, AACOG desires the selected contractor to evaluate
   the following operational aspects of the program for compliance with Federal
   and State guidelines. For any item with a double asterisk, place special
   emphasis on checking specifically for potential evidence indicating the actual
   dates may not be as documented. All items will be reviewed for potential
   a. AACOG inspectors or contractor staff properly documented an initial
   assessment of each unit served.
        i.   ** Verify assessors completed all required assessment documents and
             did so prior to assignment of the case to an installation subcontractor.
       ii.   ** Verify assessors documented an initial blower door test.
      iii.   ** If the assessment recommended replacement of appliances, verify
             assessors documented proper evaluation of existing appliances.
   b. AACOG staff properly executed and documented an EASY Audit for each
   unit served.
        i.   Verify documentation of the EASY Audit.
       ii.   Verify AACOG staff performs EASY Audits prior to start of work.
      iii.   Verify EASY Audit calculations are consistent with information
             provided from the assessment.
      iv.    Verify inspectors properly factored utility bills and consumption
             history into the calculations.
       v.    Verify support documentation for any health and safety measures
   c. ** Work started on each unit while the client was eligible. The State defines
   “work started” as the date AACOG turns the case over to the installation
   subcontractor for installation of measures. Eligibility exists if the information
   making the client eligible is current within the 12 months preceding the date work
   d. Proper closeout procedures for each unit served.
        i.   ** Verify the installation subcontractor completed and signed-off a
             concluding blower door test prior to final inspection.
       ii.   ** Verify the installation subcontractor submitted its Statement of Work
             (SOW) only after installing all measures.
      iii.   Verify the SOW submitted by the installation subcontractor is
             consistent with the ranked measures authorized on the EASY Audit
             and any subsequent update. If not, is there documentation justifying
             any discrepancy.

                                    Page 7
         iv.    ** Verify an inspector documented a final blower door test and it was
                done on or before the date of client acceptance.
          v.    ** Verify installation subcontractors corrected discrepancies identified
                during final inspection and an inspector cleared all work performed
                prior to client certification of completed work.
         vi.    ** Verify an inspector completed final inspection and the client certified
                acceptance of the work prior to submission of the subcontractor’s
         vii.   Verify the Building Weatherization Report (BWR) is consistent with the
                Statement of Work.
        viii.   Verify the final Invoice is consistent with the approved Statement of
      e. Amounts spent are within the per-unit limits authorized.
   4. Perform a sampling of completed homes sufficient to provide a statistically
      significant assurance all work paid for was completed. While performing these
      samples, interview the property owners and tenants, as applicable, to:
      a. Determine if there are any concerns with the weatherization process and the
      work done to their properties.
      b. Determine if the property owner or tenant freely signed the certification that
      she/he was satisfied with the work performed and that the certification was made
      only after all work had been completed.
   5. AACOG desires the selected contractor to evaluate the following fiscal aspects
      of billings to the State for the months of March through July 2010. Specifically,
      AACOG wishes to evaluate the following issues for each billing package:
      a. Did the Weatherization Program submit billings for processing only after
         completing all work for all units identified on that billing?
      b. Is there any indication that any billing requested payment for work
         unsubstantiated by case file documentation?
      c. Are there adequate controls (policies, procedures, practices – formal and
         informal) to ensure the billings reflect work actually completed and approved
         upon final inspection?

C. Deliverables are:
   1. Summary of findings from review of case files.
   2. Summary of findings from review of billings and fiscal process.

D. Work Timeline. AACOG would like to complete the project within one month after
   providing the awardee adequate orientation to our processes.

                                        Page 8
IV. Information Requested from the Proposer

To achieve a uniform review process and obtain the maximum degree of comparability,
proposers shall organize their proposals into the following sections (in the order presented
below) and providing the information requested. Format of each section shall be at the
proposer’s discretion.

   A. Title Page

       List the RFP subject, the name of the proposer's firm, local address, telephone
       number, fax number, email address, name of contact person, and date.

   B. Table of Contents

       Clearly identify the material by section and page number.

   C. Letter of Transmittal

       Limit to one or two pages.
       1. Briefly state your understanding of the service(s) or product(s) requested and
          make a positive commitment to perform the service(s) or provide the product(s)
          in a timely, quality manner.
       2. Give the name(s) of the person(s) authorized to make representations and
          commitments for your organization relative to this RFP, their titles, addresses,
          fax numbers, email addresses (if applicable), and telephone numbers.

   D. Proposer Profile
       1. Indicate:
          a. Whether your organization is national, regional, or local.
          b. Your headquarters location, primary telephone number, and web address (if
          c. The size of your organization and its location(s).
       2. Identify:
          a. The address of the office that will oversee fulfillment of the response if your
             organization receives the contract.
          b. The address of the office(s) that will perform the work if your organization
             receives the contract.
       3. Describe your organization’s experience with evaluations/audits of operational
          and fiscal management issues.

                                           Page 9
   4. Describe your organization’s experience with weatherization programs. If there
      is little or no experience with weatherization, describe other experience the firm
      has with work similar in nature to the work proposed and describe how your
      organization can transfer that experience to the project described.
   5. Provide a list of public sector clients to whom you have provided evaluative/audit
      services during the last five years, indicating the type(s) of service(s) performed,
      year(s) of engagement, and contact information for your clients’ coordinator for
      each project. For those cases involving weatherization expertise, identify the
      nature of the weatherization issues involved.
   6. Describe professional/technical experience and applicable certifications of each
      person you will ask to work on this project. Where there is specific experience
      with weatherization, identify the extent of that experience in terms of time and
   7. Indicate which agencies and/or organizations with which you hold licenses
      and/or certifications.
   8. Certify that your organization is in good standing with your licensing/certification
      organizations and that your organization is currently free from legal or criminal
      action and that you have been for at least the last ten years. If you cannot make
      any part of this certification, describe the circumstances and current status of
      those situations that work against full and honest certification.

E. Proprietary and Copyrighted Information

   1. Clearly identify submitted information your organization considers to be
      proprietary and should be exempt from public disclosure under the Texas Open
      Records Act.
   2. Ensure all copyrighted material is clearly marked as such.
   3. Proposers, by responding to this RFP, certify they understand non-proprietary
      information is subject to public review under the Texas Open Records Act.

F. Proposal
   Provide the following information.
   1. Proposed plan of action. Describe in whatever manner makes sense to
      communicate your proposal:
      a. The sequence of events and time required for each.
      b. What you propose to do within each step.
      c. How you will approach each task.
      d. Your likely approach to providing the deliverables requested.

                                        Page 10
      2. Number of persons you intend to assign to the project.
      3. Whether you find the two-month window for completion of the project to be
      4. If you believe the stated timeline to be infeasible, indicate the time you believe to
         be realistic for completing this project.
      5. Provide fee structure and proposed cost of project. Item 5 should be on a
         separate page(s).

   G. Certification Sheet

      Complete the attached Certification Sheet. Include as Attachment A.

   H. Acknowledgement Form

      Complete the attached Acknowledgement form. Include as Attachment B.

   I. Conflict of Interest Questionnaire

      Complete the attached Conflict of Interest Questionnaire. Include as Attachment C.

   J. Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary
      Exclusion for Contracts and Grants

      Complete attached Certification Regarding Debarment. Include as Attachment D.

   K. Request to be Added to Bidder’s/Vendor’s List

      Complete the attached Request to be Added to Bidder’s/Vendor’s List. Include as
      Attachment E.

   L. W-9

      Complete the attached W-9. Include as Attachment F.

V. Evaluation of Proposals

   A. AACOG will evaluate and score responses using the weighted point system
      presented in the table below to ascertain which response is most advantageous for
      AACOG’s needs.
   B. AACOG will randomly select at least five clients from the list of engagements
      provided to query them regarding the work performed for them.
   C. AACOG will factor pricing against the qualitative portion of the proposal to arrive at a
      determination as to which response provides the greatest VALUE and whether it

                                           Page 11
        can meet our budget constraints.

Proposed Work Plan/Approach                                     35 Points Available
   Soundness                                                     20 points possible
   Ability to meet the preferred time constraint                 15 points possible
Proposer’s Qualifications                                       35 Points Available
   Depth and breadth of experience evaluating operational and    15 points possible
   fiscal issues
   Familiarity with weatherization programs                      15 points possible
   Reference satisfaction                                        15 points possible
                                 PART 2 EVALUATION -- FEE
Fee structure                                                   20 Points Available
Total                                                           100 Points Available

                                               Page 12

 All specifications, terms, and conditions of the RFP have been read.

 Our Company accepts the specifications and conditions unless we otherwise have stated
 an exception in writing within this response.

Company Name:
Mailing Address:
City:                           State                       Zip Code
Phone:                                       Fax:
Web Site:

                   Name of Representative authorized to sign for bidder:

                 (Print name)                                 (Signature)

 (a)       Does your "residence state" (the state in which the principal place of business is
           located) require bidders whose principal place of business is in Texas to underbid
           bidders whose residence state is the same as yours by a prescribed amount or
           percentage to receive a comparable contract?

           YES          NO

 (b)       What is that amount or percentage?

 I certify that the above information is correct:



                                             Page 13
                             ACKNOWLEDGEMENT FORM

 Having carefully examined the terms, conditions, and specifications within this RFP, the
 undersigned Proposer's Agent hereby proposes and agrees to furnish the proposed
 product(s)/service(s) in strict compliance with the specifications as quoted.

 The Proposer affirms that, to the best of his/her knowledge, the response has been
 arrived at independently and is submitted without collusion with anyone to obtain
 information or gain any favoritism that would in any way limit competition or give
 them an unfair advantage over other Proposers in award of this RFP.

 The Proposer affirms he/she has not participated in any act of favoritism, gratuity, or
 inside dealings with any member of the AACOG staff or its Board of Directors.

Company Name:


                                          Page 14

           For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 1491, 80 Leg., Regular            OFFICE
Session.                                                                                     USE ONLY
This questionnaire is being filed in accordance with chapter 176, Local Government Code by a  Received
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 government
entity not later than the 7 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 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.

2.   Check this box if you are filing an update to a previously filed questionnaire.
        (The law requires that you file an updated completed questionnaire with the appropriate filing
        authority not later than the 7 business day after the date the originally filed questionnaire becomes
        incomplete or inaccurate.)
3. Name of local government office with whom filer has employment or business relationship.

     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
     from the local government 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 office named in this section.

     ________________________________________                                  ___________________
      Signature of person authorized to contract                               Date

                                                        Page 15

NAME OF INDIVIDUAL, AGENCY, BUSINESS OR                                   Doing business as (DBA), if
ORGANIZATION:                                                             applicable:

ADDRESS:                                            Applicable Procurement or       Federal Employer Tax
                                                    Solicitation #, if any:         Identification #:

READ CAREFULLY BEFORE SIGNING THIS CERTIFICATION. Federal regulations require contractors,
bidders, and subgrantees to sign and abide by the terms of this certification, without modification, to
participate in certain transactions directly or indirectly involving Federal funds.

1. By signing and submitting this certification, the prospective vendor/subgrantee attests to and
   acknowledges the representations set out below.
2. This certification is a material representation of fact upon which the Alamo Area Council of Governments
   (AACOG) will rely when it enters into a transaction with the prospective vendor/subgrantee. If AACOG
   later determines that the prospective vendor/subgrantee knowingly rendered an erroneous certification, in
   addition to other remedies available to Federal or State departments or funding agency(s), AACOG may
   pursue available remedies on its own, including contract termination, suspension, and debarment.
3. The prospective vendor/subgrantee shall provide immediate, written notice to AACOG, Director of
   Administrative Services, 8700 Tesoro Drive, Suite 700, San Antonio, TX 78217, if at any time it
   learns that submitted an erroneous certification or the certification has become erroneous by
   reason of changed circumstances.
4. The terms “covered contract”, “debarred”, “suspended”, “ineligible”, “participant”, “person”, “principal”,
   “proposal”, and “voluntarily excluded”, as used in this certification, have meanings based upon materials in
   the Definitions and Coverage sections of Federal rules implementing Executive Order 12549. You may
   contact the person to which this proposal or contract is submitted for assistance in obtaining a copy of this
5. The prospective vendor/subgrantee agrees, by submitting this certification, that should the proposed
   contract/subgrant be entered into, it shall not knowingly enter into any lower-tier-covered transaction or
   subcontract with a person or entity that is proposed for debarment, debarred, suspended, declared
   ineligible, or voluntarily excluded from participation in this transaction, unless pre-authorized by the
   appropriate Federal or State department or agency, or by AACOG.
    Do you have or do you anticipate having sub-vendors/sub-grantees under this proposed
        Yes          No
6. The prospective vendor/subgrantee further agrees by submitting this certification, that it will include this
   certification titled “Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion
   for Contracts and Grants,” without modification, in all lower-tier-covered transactions and subcontracts
   and all solicitations for lower-tier-covered transactions and sub-contracts.
7. A vendor/subgrantee may rely upon a certification of a prospective participant that it is not proposed for
   debarment, debarred, suspended, ineligible, or voluntarily excluded from the transaction, unless it knows
   that the certification is erroneous. Each vendor/subgrantee is required to check the list of parties
   excluded from Federal and State Procurement and Non-procurement Programs. AACOG checks this
   list for all parties to which it provides funds derived directly or indirectly from the Federal

                                                    Page 16
8. Nothing contained in the foregoing shall be construed to require the establishment of a system of records
   in order to render in good faith the certification required by this certification document. Participants are not
   required to have knowledge and information exceeding that normally possessed by a prudent person in
   the ordinary course of business activity.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a transaction
   knowingly enters into a lower-tier transaction or contract with a person who is proposed for debarment,
   debarred, suspended, ineligible, or voluntarily excluded from participation, in addition to other remedies
   available to the Federal Government, AACOG or its applicable funding agency(s) may pursue available
   remedies, including contract termination, suspension, and/or debarment.

Check the statement that applies to the potential vendor/subgrantee:

        1. The prospective vendor/grantee certifies by submission of this certification, that neither it
           nor its principals:
             (a)   Is presently debarred, suspended, proposed for debarment, declared ineligible, or
                   voluntarily excluded by any Federal or State department or agency; and
             (b)   Have, within a three-year period preceding this certification, been convicted of or had
                   a civil judgment rendered against them for fraud; committed a criminal offense in
                   connection with obtaining, attempting to obtain, or performing a public (Federal,
                   State, or local) transaction or contract; violated Federal or State antitrust statutes;
                   committed embezzlement, theft, forgery, bribery, falsification or inappropriate
                   destruction of records; or received stolen property; and
             (c)   Is presently indicted for or otherwise charged by a government entity (Federal, State,
                   or local) with the commission of any of the offenses enumerated in the preceding
                   paragraph (b) of this certification; and
             (d)   Have, within a three-year period preceding this certification, had one or more
                   contracts or transactions (Federal, State, or local) terminated for cause or default.
        2. The potential vendor/subgrantee is unable to certify to one or more of the terms in this
           certification. In this instance, the potential vendor/grantee must attach a signed and dated
           explanation for each of the above terms, 1(a) through 1(d), to which it cannot certify.


                                                                 Printed/Typed Name & Title of Authorized
      Signature of Authorized Representative

                             Date: __________________________________

                                                     Page 17

 All vendors interested in conducting business with AACOG must complete a “Request to
 be Added to Bidder/Vendor List” packet prior to become eligible to bid for AACOG projects.

 In addition, AACOG has a centralized purchasing function and requires authorization and
 issuance of a purchase order number before processing any order. The contact for
 Purchase Order numbers is Cindy Krueger, Administrative Services Director,

 NOTE: AACOG programs operate on a cost-reimbursement basis with their funding
 sources. AACOG will bill the funding source for purchases subsequent to receipt of goods
 or services and their respective invoices. AACOG requires an invoice for all purchases.
 We will forward payment to the provider upon reimbursement from the funding source.
 Providers should note that this process may require sixty (60) to ninety (90) days for
 payment processing.       Contact for status of payments is Accounts Payable at

        RETURN THIS FORM TO: Alamo Area Council of Governments
                             8700 Tesoro Drive, Suite 700
                             San Antonio, TX 78217
                             ATTN: Administrative Services
                             Phone: 210.362.5200 Fax: 210.225.5937

 I,    _________________________, hereby attest that I have read and understand
 the above terms for conducting business with the Alamo Area Council of


Company Name:
Send Payment(s) to:
  City / State / Zip Code:
Send Purchase Orders to (fill in information for preferred method of receipt):
  City / State / Zip Code:
  Facsimile Number:
  Email Address:
  Website Address:
Refer Billing Inquiries to:
  Telephone Number:

                                            Page 18

      Attach any catalogs/brochures/samples – description of products/services
                                  required below

        Office Supplies                                   General Contractor
        Office Furniture                                  Weatherization Contractor
        Copier Paper/Specialty Paper                      Aging Contractor
        Computers                                         Psychological Services
        Computer Supplies                                 Outreach Items
        Computer Software                                 Printing Services
        Copier Machines (and supplies)                    Security Detail
        Audio/Visual Duplication                          Criminal Justice Supplies
        Audio/Visual Equipment                            Consultant
(       ________________)                                 Data & Phone Cabling
                                                          Vehicle Repairs

        Other:        ______________________________________________________

Please assist us by completing the following:

1.      Type of Request:
New Vendor                    Change of Contact           Updated Information

2.      Ownership:
Sole Proprietorship              Partnership                  Corporation
                                 *Non-Profit                    Other

3.      Tax Identification Number:     ____________
        Attach completed W-9 form unless tax exempt.

4.      Have you done business with AACOG in the past?
Yes              No

                                         Page 19

 5.     Is your business currently certified with the State of Texas’ Centralized
        Master Bidder’s List?

Yes            No

        **Please provide confirmation of your CMBL certification with this vendor

 6.     Is your business currently certified as a HUB with the State of Texas?

Yes            No            N/A

 7.     Is your business currently certified as a HUB outside the State of Texas?

Yes            No            Name of State

 8.     If YES to either question 6 or 7, enter Historically Underutilized Business
        (HUB) Ethnicity and Gender status, if applicable:

Asian Pacific American
                           Hispanic Americans (HI)       American Woman (WO)

 Black American (BL)        Native American (AI)           Male (M) /Female(F)

       *Non-profit organizations are not eligible for HUB certification
 **Provide a copy of your HUB certification to be included as a HUB.

 9.     If applicable, please note if your Texas-based Small, Minority, and/or Women-
        Owned Business Enterprise (SMWBE) is certified with any of the
        organizations listed below:

              City of Austin
              City of Houston
              Dallas/Fort Worth Minority Supplier Development Council
              El Paso Hispanic Chamber of Commerce
              South Central Texas Regional Certification Agency (SCTRCA)
              Southwest Minority Supplier Development Council
              Texas Department of Transportation (TXDOT)
              Women’s Business Council – Southwest
              Women’s Business Enterprise Alliance
 **Please provide confirmation of this certification with this vendor application.
       *If you hold certification with any of the entities noted above, you may qualify

                                          Page 20
       to automatically receive HUB Certification with the State of Texas. Please
       contact TPASS’s Statewide HUB Program at 888-863-5881 for further

10.    Is your principal place of business in the State of Texas?

Yes          No

11.    Is your organization current on State of Texas Franchise taxes?

Yes          No

12.    Are you or anyone in your organization related to an AACOG employee or a
       member of AACOG’s governing board?

Yes          No

       If YES, list each AACOG employee or Board member’s name and

Name                            Relationship

13.  Are you or anyone in your organization a former Workforce Solutions- Alamo
employee and/or board member?

Yes           No

                                       Page 21

Description: Forensic Audit Fee Agreement document sample