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GENESEE COUNTY PURCHASING DEPARTMENT
ROOM 200, COUNTY ADMINISTRATION BLDG.
1101 BEACH STREET
FLINT, MICHIGAN 48502 TELEPHONE
(810) 257-3030
ERIC F. HOPSON FAX
Purchasing Director (810) 257-3380
January 14, 2011
GENESEE COUNTY REQUEST FOR PROPOSALS #11-006
Sealed proposals will be received until 3:00 p.m. (EST), Thursday, February 3, 2011, at
the Genesee County Purchasing Department, 1101 Beach Street, Room 200, Flint, MI,
48502 for PHARMACEUTICAL SERVICES FOR THE GENESEE VALLEY
REGIONAL CENTER.
This procurement is conducted in accordance with the Genesee County Purchasing
Regulations, a copy of which is on file and available for inspection at the Genesee
County Purchasing Department.
Each proposer must submit one copy of their 2011 CERTIFICATE TO DO BUSINESS
WITH GENESEE COUNTY. For further information on this requirement, contact the
Genesee County Office of Equity and Diversity, 1101 Beach Street, Room 343, Flint,
Michigan 48502, (810) 257-3028, fax (810) 768-7943.
Each offeror is responsible for labeling the exterior of the sealed envelope containing
the proposal response with the proposal number, proposal name, proposal due date
and time, and your firm’s name. The proposal request number and due date for this
RFP are:
DUE DATE: THURSDAY, FEBRUARY 3, 2011, 3:00 PM
PROPOSAL REQUEST NUMBER: #11-006
Eric F. Hopson
____________________________________________
ERIC F. HOPSON, PURCHASING DIRECTOR
bid2\2011\11-006
Attachments
GENESEE COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER
RFP #11-006 1
TABLE OF CONTENTS
INSTRUCTION TO PROPOSERS................................................................................. 3
STANDARD TERMS AND CONDITIONS ..................................................................... 4
ADDITIONAL TERMS AND CONDITIONS ................................................................... 7
SCOPE OF WORK ........................................................................................................ 9
EVALUATION CRITERIA............................................................................................ 12
PROPOSAL FORM BULK PRESCRIPTIONS ............................................................ 13
PROPOSAL FORM INDIVIDUAL PRESCRIPTIONS.................................................. 14
SIGNATURE PAGE..................................................................................................... 15
GENESEE COUNTY INSURANCE CHECKLIST........................................................ 16
REFERENCES ............................................................................................................ 17
ATTACHMENT #1 CONTRACT FOR PURCHASE OF GOODS ................................ 18
ATTACHMENT #2 - MODEL EQUITY AND DIVERSITY PLAN ................................. 28
RFP #11-006 2
RFP #11-006 PHARMACEUTICAL SERVICES FOR THE
GENESEE VALLEY REGIONAL CENTER
INSTRUCTION TO PROPOSERS
1. Sealed proposals will be received until 3:00 p.m., Thursday, February 3, 2011 at
the Genesee County Purchasing Department, 1101 Beach Street, Room 200,
Flint, MI, 48502. Label the envelope containing the proposal response as
described on page 1. LATE PROPOSALS AND PROPOSALS SENT BY
FACSIMILE OR E-MAIL WILL NOT BE ACCEPTED.
2. Submit one original, and one (1) hardcopy of the proposal, and one adobe
PDF Format of your proposal. All proposals become the property of Genesee
County. The County will not photocopy your proposal documents for the
purpose of complying with this provision requiring duplicate copies. Failure to
provide the required number of complete duplicate copies may result in rejection
of your proposal.
3. To be considered for award, each offeror must submit a 2011 Certificate To Do
Business With Genesee County. For further information on this requirement,
contact the Genesee County Office of Equity & Diversity, 1101 Beach Street,
Room 343, Flint, Michigan 48502, telephone 810 257-3028, fax 810 768-7943.
A Model Equity & Diversity plan is enclosed for your use. Genesee County
utilizes these plans for informational purposes only. The content of any
proposer’s plan is not considered in either the evaluation of the proposal
or the decision to award a contract to a specific vendor.
4. The County’s Standard Proposed Contract is attached to this RFP. After the
award is made to the successful proposer(s), the County and the successful
proposer(s) will negotiate a final contract that substantially conforms to the
Standard Proposed Contract. Any exceptions to the terms and conditions of the
Standard Proposed Contract or this RFP must be clearly set forth in your
proposal and referenced on company letterhead. The County will not entertain
negotiations to change any terms and conditions of the Standard Proposed
Contract or RFP unless those changes are requested in your proposal.
5. All prospective offerors shall be responsible for routinely checking the
Genesee County Purchasing Department website
(http://www.co.genesee.mi.us/Purchasing/currentbids.htm) for issued addenda
and other relevant information. Genesee County shall not be responsible
for the failure of a prospective offeror to obtain addenda and other
information issued at any time, related to this RFP.
RFP #11-006 3
6. The County of Genesee requires a signed Insurance Checklist with each
proposal submitted. Insurance required per the specifications governing this
work must be provided prior to the contract starting date and kept in full effect
and compliance during entire contract period. Failure to comply with these
provisions will cause termination of the contract.
7. The contractor agrees to be responsible for any loss or damage to property or
persons due to the performance of services herein contracted and further agrees
to protect and defend the County of Genesee against all claims or demands
whatsoever, and to hold the County of Genesee harmless from any loss or
damage resulting there from.
8. Proposals must be submitted in the format outlined In INFORMATION
REQUIRED FROM PROPOSERS (proposal format) page 12 to be deemed
responsive.
STANDARD TERMS AND CONDITIONS
1. Genesee County Purchasing Regulations All procurements are conducted in
accordance with the Genesee County Purchasing Regulations, a copy of which is on file
and available for inspection at the Genesee County Purchasing Department, 1101
Beach Street, Room 200, Flint, Michigan, 48502.
2. Evaluation and Award The contract will be awarded to the responsible offeror whose
proposal is determined to be most advantageous to the County, based on the
evaluation criteria set forth in the RFP. Genesee County reserves the right to reject any
or all bids, to waive any informality or irregularity in any bid, and to negotiate with the
apparent successful offeror in the best interest of Genesee County.
3. Discussion with Responsible Offerors and Revisions to Proposals Discussions
may be conducted with responsible offerors who submit proposals determined to be
reasonably susceptible of being selected for award for the purpose of clarification to
assure full understanding of, and conformance to, the solicitation requirements. If
provided in the RFP, revisions of proposals may be permitted after submissions and
prior to award for the purpose of obtaining best and final offers. Unless otherwise
indicated in the Request for Proposals, Genesee County reserves the right to award the
contract in whole or in part, by item, by group of items, or by section where such action
serves the best interests of Genesee County.
4. Cancellation; Rejection of Proposals The Request for Proposals may be canceled
by Genesee County at any time for any reason. Any proposal received may be rejected
in whole or in part when in the best interests of Genesee County.
5. Equity & Diversity To be considered for award, each offeror must submit a current
Certificate To Do Business With Genesee County. For further information on this
requirement, contact the Genesee County Office of Equity & Diversity, 1101 Beach
Street, Room 343, Flint, Michigan 48502. Telephone 810 257-3028, Fax 810 768-7943.
6. Receipt of Proposals It is solely the responsibility of the offeror to assure the timely
receipt of its proposal at the location indicated in the bid announcement. LATE
PROPOSALS AND PROPOSALS SENT BY FACSIMILE WILL NOT BE
CONSIDERED.
7. Tax Genesee County is a Michigan Municipal Corporation and as such it is exempt
from Federal Excise Tax and Michigan Sales Tax.
RFP #11-006 4
8. Non-Discrimination The successful bidder/Contractor covenants that it will not
discriminate against an employee or applicant of employment with respect to hire,
tenure, terms, conditions, or privileges of employment, or a matter directly or indirectly
related to employment, because of race, color, religion, national origin, age, sex, height,
weight, marital status or a disability that is unrelated to the individual’s ability to perform
the duties of a particular job or position, and that it will require the same non-
discrimination assurances from any subcontractor who may be used to carry out duties
described in this contract. Breach of this covenant shall be regarded as a material
breach of this contract.
9. Performance Bond If a performance bond is required, the bond must be issued by a
company authorized to do business in the State of Michigan.
10. Conflict of Interest Each offeror, by submitting a bid, represents that the offeror has
no knowledge that any employee, representative or agent of the offeror is a County
employee who has directly or indirectly participated on behalf of the County in the
contemplated procurement, or that any County employee who has so participated or
any member of such an employee’s immediate family has a financial interest pertaining
to the contemplated procurement from the offeror, and represents that the offeror
reasonably believes that no employee, representative or agent of offeror is a County
employee who has so participated and that no County employee who has so
participated or member of that employee’s immediate family has a financial interest in
the contemplated procurement from the offeror.
11. Inspection All goods are received subject to inspection and testing. If goods are
defective or fail to meet the bid specifications, Genesee County shall have the right to
reject the goods or to correct the defects. The contractor shall pay Genesee County for
expenses incurred in correcting defects. Rejected goods will be held for forty-five days
after delivery awaiting instructions from the contractor. After the forty-five day period,
Genesee County will dispose of the goods without further liability to Genesee County.
The contractor is responsible for the costs of handling, packing, and transportation
incurred in returning or disposing of defective or non-conforming goods.
12. Offeror’s Representations Each offeror, by submitting a proposal, represents as
follows:
1) That the offeror has read and understood the RFP documents and has
submitted its proposal in accordance therewith;
2) That the proposal has been submitted by a duly authorized owner, partner, or
corporate officer;
3) That the proposal submitted has been prepared independently without collusion,
agreement, understanding, or planned common course of action with any other
supplier of the goods or services described in the RFP, designed to limit
independent offers or competition.
13. Independent Contractor Offeror agrees that if awarded a contract, it shall be an
independent contractor and not an employee of Genesee County. The contractor shall
secure, at its own expense, all personnel required in supplying goods or services under
the awarded contract. All such personnel shall have no contractual relationship with
Genesee County and shall not be considered employees of Genesee County.
14. Insurance Each offeror must submit a completed Bidder’s Insurance Checklist, if so
stipulated in the RFP. The required coverage and minimum limits may vary dependent
upon the dollar amount of the contract, length of time of the contract, and the hazard
level of the work or services to be performed. The types of insurance coverage may
include: workers compensation, general liability, auto liability and/or professional
liability. The insurer, insurance retention group, pool, or self-insurer must be
RFP #11-006 5
authorized/licensed to provide such coverage within the State of Michigan and meet
minimum financial ratings, if applicable, as supplied by Best or S & P.
15. Indemnification The successful offeror shall defend, indemnify, and hold harmless
Genesee County and its officers and employees from and against all claims, losses,
damages, and expenses including, but not limited to, attorney’s fees arising out of or
resulting from the performance of the contract.
16. Warranty The offeror warrants that all goods and services furnished under a contract
resulting from the RFP shall be in conformance with the RFP documents, and that the
goods are of merchantable quality as described in the Uniform Commercial Code,
Section 2-314, and fit for the purpose for which they are sold. This warranty is in
addition to any manufacturer’s standard warranty which may apply or any warranty
provided by law, and is in addition to all other express warranties made by the offeror.
17. Year 2000 The offeror warrants that each hardware, software, and firmware product
delivered under a contract resulting from the RFP shall be able to accurately process
date data (including, but not limited to, calculating, comparing, and sequencing) from,
into, and between the twentieth and twenty-first centuries, including leap year
calculations, when used in accordance with the product documentation provided by the
contractor. The offeror warrants that all such calculations, comparisons, and
sequences will be recognized and accommodated and will not, in any way, result in
hardware, software, or firmware failure. Genesee County, at its sole option, may require
the contractor, at any time, to demonstrate the procedures it intends to follow in order to
comply with the obligations contained herein. The obligations contained herein apply to
products provided by the contractor, its subcontractors, or any third party involved in the
creation of the products to be delivered to Genesee County under the contract. Failure
to comply with any of the obligations contained herein, may result in Genesee County
availing itself of all its rights under the law and under this contract including, but not
limited to, its rights pertaining to termination or default. The warranties contained herein
are separate and discrete from any other warranties specified in the contract, and are
not subject to any disclaimer of warranty or limitation of the contractor’s liability which
may be specified in the contract documents.
18. Applicable Law Any contract resulting from the RFP shall be governed by the laws of
the State of Michigan. Unless otherwise provided in the contract documents, the
contractor shall secure and pay for all permits, fees, duties, licenses, inspections, and
approvals necessary for the execution and completion of the contract. The contractor
shall give all notices and comply with all laws, ordinances, rules, regulations, and lawful
orders of any public authority bearing on the performance of the contract.
19. Right to Inspect Genesee County may, at reasonable times, inspect the plant, place
of business, or work site of a contractor or subcontractor which is pertinent to the
performance of a contract or potential contract.
20. Right to Audit Genesee County may at reasonable times and places, audit the books
and records of any contractor who has submitted cost or pricing data as a part of its
proposal, to the extent that such books and records are pertinent to such cost or pricing
data for a period of three years from the date of final payment under the contract.
Genesee County shall be entitled to audit the books and records of a contractor or
subcontractor other than a firm fixed-price contract to the extent that such books and
records are pertinent to the performance of such contract or subcontract. Such books
and records shall be maintained by the contractor for a period of three years from the
date of final payment under a prime contract and by the subcontractor for a period of
three years from the date of final payment under a subcontract.
21. Safety Genesee County, as the owner of the premises where the service or work is to
be performed, or as the purchaser of goods received, requires that all applicable
RFP #11-006 6
Michigan Occupational Health & Safety (MIOSHA) Rules and Regulations are followed
by your employees and that the goods meet the applicable safety regulation. All Center
of Disease Control guidelines (CDC) incorporated by reference within the MIOSHA
regulations must be followed.
The following County buildings were all built prior to 1981. In accordance with OSHA
regulations, you must consider that “presumed asbestos containing materials” (“PACM”)
exist in these buildings.
Animal Shelter Galliver Building
County Administration Building Mt. Morris 67th District Court Building
County Courthouse
Based on the above, Contractors are notified that their workers must be properly trained
and accredited in accordance with OSHA regulation 29CFR 1910.
ADDITIONAL TERMS AND CONDITIONS
1. Issuing Office: This RFP is issued by the Genesee County Purchasing
Department on behalf of the Genesee Valley Regional Center (GVRC). The sole
point of contact for this RFP is Ms. Cindy Carnes, Genesee County Purchasing
Manager, e-mail: ccarnes@co.genesee.mi.us, Fax (810) 257-3380 and Telephone
(810) 257-3030. E-mail is the preferred method of contact.
2. Questions: from proposers regarding this RFP, must be submitted in writing and
must arrive at the Genesee County Purchasing Department no later than Tuesday,
January 25, 2011 by 5:00 p.m. Questions in writing should be directed to Ms.
Cindy Carnes, Genesee County Purchasing Manager, e-mail:
ccarnes@co.genesee.mi.us, 1101 Beach Street, Room 200, Flint, MI 48502, Fax
(810) 257-3380. E-mail is the preferred method of delivery. Written answers to
questions to clarify the RFP will be posted at
http://www.co.genesee.mi.us/Purchasing/currentbids.htm.
3. Addenda: Genesee County reserves the right to amend and provide clarification of
this RFP prior to the date for proposal submission. In such an event, an addendum
will be posted on the Purchasing Department website
(http://www.co.genesee.mi.us/Purchasing/currentbids.htm.). Further, all proposers
1
shall acknowledge having seen any and all addenda issued (1, 2, 3, etc.) on the
Signature Page.
4. Proposal Considerations: All costs incurred in the preparation of a response to
this RFP or any costs prior to approval of the contract by Genesee County and
formal notification to the selected proposer(s) will be the responsibility of the
proposer, and will not be reimbursed by Genesee County. Proposals should be
prepared simply and economically, providing a straightforward, concise description
of the proposer’s ability to meet the requirements of this RFP.
5. Right To Reject: Genesee County reserves the right to reject any and all
proposals received in response to this RFP.
RFP #11-006 7
6. Disclosure: All information in an offeror’s proposal is subject to disclosure under
the provisions of Public Act N. 442 of 1976, as amended, known as the “Freedom of
Information Act”. This Act also provides for the complete disclosure of contracts
and attachments thereto.
7. Errors, Omissions, And Discrepancies: If a proposer discovers any ambiguity,
conflict, discrepancy, omission, or other error in the RFP, it shall immediately notify
the Genesee County Purchasing Director of such error, in writing, and request
modification or clarification of the document prior to the deadline for submitting
questions. Genesee County will make modifications by issuing a written addendum.
The proposer is responsible for clarifying any ambiguity, conflict, discrepancy,
omission, or other error in the Request for Proposals prior to submitting a proposal
or it shall be waived by the proposer.
8. Acceptance of Proposal Content: It is proposed that, if a contract is entered into
as a result of this RFP, the RFP and the standard purchase contract (Attachment
#1) will serve as the basis for the contract. The contents of the proposal of the
successful offeror and its Best and Final Offer (if applicable) may become
contractual obligations if a contract is issued. Failure of the successful offeror to
accept these obligations will result in cancellation or termination of contract award.
9. Termination for Misrepresentation: If the successful proposer receives a contract
and is subsequently found to have misrepresented any information in its proposal,
discussions and/or Best and Final Offer submission, the contract may be terminated
at the discretion of Genesee County.
10. Acceptable Deviations: The decision of Genesee County shall be final as to what
constitutes acceptable deviations from all terms, conditions, specifications or
requirements associated with this solicitation.
11. Exceptions: The proposer shall furnish a statement on company letterhead giving
a complete description of all exceptions to the terms, conditions, and specifications
set forth in the Standard Proposed Contract and this RFP. Failure to furnish this
statement shall mean that the proposer agrees to meet all requirements set forth in
this solicitation.
12. Prime Contractor Responsibilities: The successful proposer shall be required to
assume responsibility for all services offered in the proposal regardless of who
produces them. Further, the County will consider the successful proposer to be the
sole point of contact with regard to contractual matters, including payment of any
and all charges resulting from the contract.
RFP #11-006 8
SCOPE OF WORK
Genesee County is soliciting proposals for PHARMACEUTICAL SERVICES FOR THE
GENESEE VALLEY REGIONAL CENTER. Services shall consist of providing and
delivering of bulk prescriptions and/or individual prescriptions to GVRC.
BACKGROUND
The Genesee Valley Regional Center (GVRC) provides secure residential detention for
male and female juveniles 10 through 17 years of age who have been court ordered
into secure detention. The average length of stay is one (1) month. This facility
operates 24 hours a day 365 days a year.
Weekly individual prescriptions tend to be about 20 to 30 per week. Individual
prescriptions cost GVRC approximately $27,000 annually which is estimated to be
about 30% of the total cost of individual prescriptions. It will be the pharmacy’s
responsibility to diligently pursue payment from Medicaid or private insurance, at times
this will require multiple requests for payment from insurance.
Bulk orders are generally ordered every three months. The annual spend on bulk
prescriptions is under $3,000.
All prescriptions are to be in blister packs and delivered to GVRC at 4287 West
Pasadena Avenue, Flint, MI 48504.
BULK PRESCRIPTIONS
These medications are dispensed out of the GVRC clinic per doctor’s prescription. The
medications will be ordered in bulk quantities; usually enough to treat eight patients.
For example eight (three times a day, for ten day treatment regimen) blister packs,
Zithromax is ordered in one dose packets in a quantity of six packets.
Typical prescriptions ordered, but not limited to, include, Drixoral, Doxycycline 100mg,
Zithromax 1gm, Motrin 600mg, Keflex 500mg, Amoxicillin 500mg.
Order Placement, orders are typically placed via fax, information provided for alternate
ordering methods will be considered.
Delivery, all prices are quoted “F.O.B. delivered” with transportation charges prepaid on
all orders. All orders shall be delivered within 5 calendar days after receipt of the order.
Billing, all invoices shall be on a monthly basis. Detailed invoices shall include, but not
be limited to, the following:
• Date of delivery or order date, • delivery fee (if any), and
• detailed prescription information, • extended total price.
• prescription price,
Any discrepancies in invoicing shall be referred back to the contractor for further
explanation and/or adjustment.
Order Minimums, the county will not be subject to minimum order requirements.
RFP #11-006 9
Return Policy, accept returns of items within six months of expiration date and up to
one year after expiration date with guaranteed return of any items and payment by
check for any debit balance that results from said return. Returns typically only occur
for an individual and generally will be immediately or within a month.
Pharmacist Support, it would be preferred, however not mandatory, that there be a
pharmacist available to answer medication related questions 24 hours 7 days a week.
Price, quoted prices are for a period of one (1) year from the date the contract becomes
effective. Prices may be subject to revision at the end of each one (1) year period if
there are changes in the general industry. Evidence of such changes must accompany
the request. Revisions may be either increases or decreases and may be requested by
either party. The prices quoted shall be firm for one (1) year. Requests for price
changes shall be received in writing at least thirty (30) days prior to their effective date
and are subject to written acceptance before becoming effective.
INDIVIDUAL PRESCRIPTIONS
These medications should be priced as delivered to the facility same day if called in
prior to 11:30 a.m. Prescriptions called in after that time may be delivered the next day.
Medications are to be packaged in blister packs. “One a day” prescriptions must be
packaged with each day of the week indicated. If the specific medication is to be
dispensed more than one time a day, there must be a separate blister pack for each
time the medication is to be given. For example medications requiring dispensing at
8:00 a.m., 2:00 p.m., and 8:00 p.m. would have three blister packs with the dispensing
time noted on each pack. In this example morning, afternoon, and evening would be
appropriate labels for the respective packs.
Typical prescriptions ordered, but not limited to, include, Trileptal, Risperdal, Seroquel,
Depakote, Abilify, Adderall, Concertal, Strattera, Prozac, Celexa, Clonidine, Zoloft,
Ritalin, Bactrim DS, Advair Inhaler, Albuterol Inhaler, Flagyl.
Order Placement, orders are typically placed via fax, information provided for alternate
ordering methods will be considered.
Delivery, all prescriptions are to be delivered by 4:30 p.m. same day if ordered before
11:30 a.m. Prescriptions called in after that time may be delivered the next day.
Billing, all invoices shall be on a monthly basis. Detailed invoices shall include, but not
be limited to, the following:
• Date of delivery or order date, • delivery fee (in any,) and
• detailed prescription information, • extended total price.
• prescription price,
Any discrepancies in invoicing shall be referred back to the contractor for further
explanation and/or adjustment.
RFP #11-006 10
Order Minimums, the county will not be subject to minimum order requirements.
Return Policy, accept returns of items within six months of expiration date and up to
one year after expiration date with guaranteed return of any items and payment by
check for any debit balance that results from said return. Returns typically only occur
for an individual and generally will be immediately or within a month.
Price, quoted prices are for a period of one (1) year from the date the contract becomes
effective. Prices may be subject to revision at the end of each one (1) year period if
there are changes in the general industry. Evidence of such changes must accompany
the request. Revisions may be either increases or decreases and may be requested by
either party. The prices quoted shall be firm for one (1) year. Requests for price
changes shall be received in writing at least thirty (30) days prior to their effective date
and are subject to written acceptance before becoming effective
Pharmacist Support, it would be preferred, however not mandatory, that there be a
pharmacist available to answer medication related questions 24 hours 7 days a week.
CONTRACT AWARD
GVRC reserves the right to split the contract between bulk and individual suppliers if
this provides an economical benefit.
RFP #11-006 11
INFORMATION REQUIRED FROM PROPOSERS
(PROPOSAL FORMAT)
Responsive Proposals: To ensure consideration, all prospective proposers must
submit a complete response to this RFP using the following format.
One original, one (1) additional hardcopy of the proposal, and one
electronic copy, adobe PDF or Word format of your proposal
Submitted to the Genesee County Purchasing Department, 1101 Beach Street,
Room 200, Flint, MI 48502.
All proposals received shall remain valid for a period not less than ninety (90)
days from the due date of this RFP.
All Proposals are to include:
Cover Letter - A letter generally describing your firm’s interest in this solicitation
with a brief overview of the firm. Describe how your firm will meet the delivery
requirements listed in the Scope of Work, include current order fill rates.
RFP #11-002, pages 1 - 27, includes:
• Proposal Form(s) and Delivery Vehicle Narrative
Delivery Vehicle, due to the requirement of the vendor to deliver individual
prescription(s), a brief narrative of how this will be accomplished must be
included in the proposal submission. Include type of vehicle(s) to be used
and approximate delivery times.
• Executed Insurance Checklist
• References
• Signed Signature Page
• 2011 Certificate To Do Business With Genesee County. (If you do not have a
Certificate at the time of submission, include a letter indicating the date your company
Equity & Diversity plan was submitted to the Genesee County Equity & Diversity Office
for review.)
EVALUATION CRITERIA
It is the intent of Genesee County to conduct a comprehensive, fair and impartial
evaluation of proposals received. Award shall be made to the responsible proposer(s)
whose proposal is determined to be the most advantageous to Genesee County.
Evaluation criteria listed in order of importance are as follows:
Ability to properly package the prescriptions;
Delivery schedule and narrative explaining ability to deliver;
Cost of prescriptions;
Pharmacist Support;
Experience of the firm;
Past performance with Genesee County, quality of service;
References;
Responsiveness of proposals.
RFP #11-006 12
RFP#11-006 PHARMACEUTICAL SERVICES
PROPOSAL FORM BULK PRESCRIPTIONS
Pricing
Ordered in bulk quantities; usually enough to treat eight patients. All prices are quoted
“F.O.B. delivered” with transportation charges prepaid on all orders. All orders shall be
delivered within 5 calendar days after receipt of the order. All of these orders will be
directly billed to GVRC. The formula is Average Wholesale Price - % discount +
dispensing fee = GVRC cost. The dispensing fee is to include any delivery fee.
Generic prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Name Brands prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Or
All prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Other charges (with explanation) please explain any additional charges:
ORDER PLACEMENT
List the phone number, fax number, email and/or internet address where orders can be
placed.
LOCATION AND HOURS
List the address of each location where prescriptions will be filled.
1
2
Can orders be accepted 24 hours a day 7 days a week? _____ yes _____ no
Is a pharmacist available 24 hours a day 7 days a week? _____ yes _____ no
All deliveries are made to:
Genesee Valley Regional Center
4287 West Pasadena Avenue
Flint, MI 48504
Company Name _________________________________________________
RFP #11-006 13
RFP#11-006 PHARMACEUTICAL SERVICES
PROPOSAL FORM INDIVIDUAL PRESCRIPTIONS
Pricing
Pricing includes same day delivery to the facility before 4:30 p.m. on orders placed
before 11:30 a.m. or delivered next day for orders placed after 11:30 a.m.
All individual prescriptions will first be billed to Medicaid or the child’s private insurance,
only those prescriptions not covered will be billed to GVRC at the price indicated by the
formula below. The formula is Average Wholesale Price - % discount + dispensing fee
= GVRC cost. The dispensing fee is to include any delivery fee.
Generic prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Name Brands prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Or
All prescriptions: AWP - _____ % discount + $_____ fee = GVRC cost
Other charges (with explanation) please explain any additional charges:
LOCATION AND HOURS
List the address, phone, and fax number of each location where prescriptions will be
filled.
1
2
Can orders be accepted 24 hours a day 7 days a week? _____ yes _____ no
Is a pharmacist available 24 hours a day 7 days a week? _____ yes _____ no
All deliveries are made to:
Genesee Valley Regional Center
4287 West Pasadena Avenue
Flint, MI 48504
Company Name _________________________________________________
RFP #11-006 14
SIGNATURE PAGE
GENESEE COUNTY RFP #11-006
The undersigned represents that he or she:
1. is duly authorized to make binding offers on behalf of the company,
2. has read and understands all information, terms, and conditions in the RFP,
3. has not engaged in any collusive actions with any other potential proposers for
this RFP,
4. hereby offers to enter into a binding contract with Genesee County for the
products and services herein offered, if selected by Genesee County within 120
days from proposal due date,
5. acknowledges the following addenda ___________________ issued as part of
the RFP:
Name (Typed):
Signature:
Title:
Company:
Date:
Contact Person
Please indicate name, telephone number, fax number, mailing address, and e-mail
address of company representative for matters regarding this RFP.
CONTACT NAME POSITION
E-MAIL
MAILING ADDRESS
MAILING ADDRESS
PHONE FAX
RFP #11-006 15
GENESEE COUNTY INSURANCE CHECKLIST
Title: PHARMACEUTICAL SERVICES FOR GVRC Number: 11-006
Coverages Required Limits (Figures denote minimums)
X 1. Workers' Compensation Statutory limits of Michigan
X 2. Employers' Liability $100,000 accident/disease
$500,000 policy limit, disease
X 3. General Liability Including Premises/operations
$1,000,000 per occurrence with $2,000,000
aggregate
X 4.Professional liability $1,000,000 including errors & omissions
$200,000 per occurrence $600,000 in
aggregate for Medical Malpractice
X 5. Products/Completed operations $1,000,000 per occurrence with $2,000,000
Aggregate [If applicable]
X 6. Automobile liability $1,000,000 combined single limit each
accident- Owned, hired, non-owned
X 7. Genesee County named as an additional insured on other than Workers' Compensation and
Professional Liability via endorsement. A copy of the endorsement or evidence of blanket
Additional Insured language in the policy must be included with the certificate.
X 8. Best's rating: A VIII or better, or its equivalent (Retention Group Financial Statements)
X 9. The certificate must state bid number and title
FAX THIS PAGE TO YOUR INSURANCE AGENT/BROKER
Insurance Agent's Statement
I have reviewed the requirements with bidder named below. In addition:
_____The above policies carry the following deductibles:
__________________________________________________________________________________
Liability policies are occurrence _____ claims made _____
_________________________________ _____________________________________
Insurance Agent Signature
PLEASE NOTE #7 ABOVE. ADDING ADDITIONAL INSURED [AI] TO THE DESCRIPTION
IS NOT ACCEPTABLE. AN ENDORSEMENT OR COPY OF AI LANGUAGE IS REQUIRED
Offeror’s Statement
I understand the insurance requirements and will comply in full if awarded the contract.
________________________________ _________________________________
Bidder Signature
Required general insurance provisions are provided in the checklist above. These are based on the contract and
exposures of the work to be completed under the bid. Modifications to this checklist may occur at any time prior to
signing of the contract. Any changes will require approval by the vendor/contractor, the department and County Risk
Manager. To the degree possible, all changes will be made as soon as feasible.
RFP #11-006 16
REFERENCES
List 3 references of similar projects
1. Company
Contact Name
Address
Phone Number
2. Company
Contact Name
Address
Phone Number
3. Company
Contact Name
Address
Phone Number
RFP #11-006 17
ATTACHMENT #1 CONTRACT FOR PURCHASE OF GOODS
GVRC PHARMECEUTICALS CONTRACT
This Purchase Contract (the “Agreement”) is made this __ day of _______________,
2011, by and between the County of Genesee, a Michigan Municipal Corporation,
whose principal place of business is located at 1101 Beach Street, Flint, Michigan
48502 (the “County”), and Contractor Name, a State Entity, whose principal place of
business is located at Contractor Address (the “Contractor”) (the County and the
Contractor together, the (“Parties”).
1. Term
1.1 Initial Term
The initial term of this Agreement is effective upon approval by the
Genesee County Board of Commissioners (the “Board”) and shall be
effective for two (2) years (the “Initial Term”).
1.2 Extension Terms
The Board has the option to extend this Agreement for up to three (3)
additional one year terms (the “Extension Terms”).
2. Purchase of Goods
The Contractor agrees to sell to the County, and the County agrees to purchase,
the goods identified on Exhibit A (the “Goods”) at the prices indicated therein.
3. Compensation
The County will purchase the Goods from the Contractor at the prices specified
on Exhibit A. The Contractor must provide to the County monthly invoices in a
form acceptable to the County, detailing the items delivered and the price of
each item. The County will pay the Contractor within sixty (60) days of the
County’s acceptance of the invoice and supporting documentation.
4. Taxes
The County is a Michigan Municipal Corporation. The Contractor acknowledges
that the County is exempt from Federal Excise Tax and Michigan Sales Tax.
5. Delivery and Acceptance
The Contractor agrees to deliver all orders as specified in the Scope of Work of
RFP #11-006. All deliveries will be made F.O.B. destination to:
Genesee Valley Regional Center
RFP #11-006 18
Attn: Fred Woelmer
4287 West Pasadena Avenue
Flint, MI 48504
The County reserves the right to reject the Goods, even after it has accepted
delivery, if the Goods are defective or fail to conform to the representations
made by the Contractor.
6. Contract Administrator
The contract administrator for this Agreement is Fred Woelmer (the “Contract
Administrator”). The Contractor acknowledges that the Contract Administrator is
the primary County contact for notices and instructions related to this
Agreement. The Contractor agrees to provide a copy of all notices related to
this Agreement to the Contract Administrator.
7. Inspection and Acceptance
All Goods are received subject to inspection and testing. If Goods are defective
or fail to meet the specifications, the County shall have the right to reject the
goods or to require the Contractor to correct the defects. The Contractor shall
correct the defects at no cost to the County or pay the County for expenses
incurred by the County in correcting the defects. Rejected Goods will be held for
forty-five days after delivery awaiting instructions from the Contractor. After the
forty-five day period, the County will dispose of the Goods and the County shall
have no further liability to the Contractor. The Contractor is responsible for the
costs of handling, packing, and transportation incurred in returning or disposing
of defective or non-conforming Goods.
8. Warranties and Indemnification
8.1 For a period of one (1) year following delivery, or such longer warranty
period as the Contractor offers to its commercial customers, the
Contractor warrants:
8.1.1. that the Goods are merchantable,
8.1.2. that the Goods will conform to the representations made by the
Contractor in response to the County’s written solicitation,
8.1.3. that the Goods are fit the purpose for which they are sold,
8.1.4. that the Goods will be free from any and all defects, and
8.1.5. that the Goods will conform to the specifications provided in the
County’s written solicitation:
RFP #11-006 19
8.2 The Contractor warrants that the Goods will be provided in accordance
with all applicable laws and regulations relating to the Goods.
8.3 The Contractor warrants that the Contractor will comply with all federal,
state, and local laws in the sale of the Goods.
8.4 The Contractor will obtain and maintain all applicable licenses and
permits necessary to sell the Goods for the entire term of this Agreement.
8.5 The Contractor warrants that the Contractor will comply with the
requirements of any federal or state grants used to fund or support this
Agreement.
8.6 The Contractor warrants that the Contractor will maintain a current
Certificate To Do Business with Genesee County issued by the Genesee
County Equity and Diversity Officer.
The Contractor agrees to correct any and all defects in the Goods appearing
within the warranty period by repairing any such defect or replacing the Goods
subject to such defect at no cost to the County and to the County’s satisfaction.
The Contractor agrees to indemnify and hold the County, its officials, officers,
agents, and employees harmless from any and all claims, damages, or liability
arising out of the Contractor’s breach of these warranties.
9. Termination
9.1 Termination for Cause
If the Contractor is in breach of any provision of this Agreement, and such
breach continues for fourteen (14) days after written notice is issued to
the Contractor by the County of the breach, the County may terminate
this Agreement. Such termination for cause is effective upon receipt of
the notice of termination by the Contractor.
In addition for any other remedies provided by law or this Agreement, the
Contractor shall be responsible for all costs incurred by the County as a
result of the Contractor’s breach and termination, including any costs to
obtain substitute performance.
9.2 Immediate Termination
If the County, in its discretion, determines that the Contractor’s breach of
this Agreement constitutes a threat to public health, safety, or welfare, the
County may terminate this Agreement immediately upon notice to the
Contractor.
RFP #11-006 20
In addition for any other remedies provided by law or this Agreement, the
Contractor shall be responsible for all costs incurred by the County as a
result of the Contractor’s breach and termination, including any costs to
obtain substitute performance.
9.3 Termination for Convenience
If the County determines that it is in the County’s best interests, the
County may terminate this Agreement upon thirty (30) days’ written notice
to the Contractor.
The County shall pay for all Goods properly delivered up to the effective
date of the notice of termination.
10. Insurance Requirements and Indemnification
The Contractor agrees to obtain insurance coverage of the types and amounts
required as set forth in the Insurance Checklist attached as Exhibit B and keep
such insurance coverage in force throughout the life of this Agreement.
10.1 Insurance Certificate and Additional Insured Coverage
The Contractor further agrees to provide certificates of insurance to the
County evidencing the coverages specified in the Insurance Checklist,
and including the County as an additional insured. Additional insured
coverage is to be by proof of blanket additional insured coverage within
the general liability policy or as provided by an endorsement specifically
the County as an additional insured to the policy. Contractor’s agent
must provide a copy of the endorsement or language from the policy with
the certificate of insurance.
10.2 Indemnification
The Contractor agrees to indemnify and hold the County, its officials,
officers, agents, and employees harmless from any and all claims,
damages, or liability, including defense costs, arising out of the
Contractor’s performance of the Services or presence on the County’s
property or worksite.
11. Independent Contractor
The Contractor and its agents and employees are independent contractors and
are not the employees of the County.
RFP #11-006 21
12. Freedom of Information Act
This Agreement and all attachments, as well as all other information submitted
by the Contractor to the County, is subject to disclosure under the provisions of
MCL 15.231, et seq., known as the “Freedom of Information Act”.
13. Audit Rights
13.1 Certification of Accurate Information
Contractor certifies that all information provided to the County by the
Contractor relating to the award or modification of this Agreement, or any
payment or dispute related to this Agreement, is true and correct. The
Contractor further certifies that its accounting system conforms to
generally accepted accounting principles.
13.2 Inspection
The Contractor agrees that the County may inspect the Contractor’s
plant, place of business, or worksite to ensure compliance with the terms
of this Agreement. If this Agreement is funded or supported with any
state or federal grant funds, the state or federal agencies responsible for
administering the applicable grants may examine the Contractor’s plant,
place of business, or worksite to ensure compliance with the terms of this
Agreement and the terms of the applicable grant.
13.3 Audit
The Contractor agrees that the County may examine the Contractor’s
records to ensure compliance with the terms of this Agreement. If this
Agreement is funded or supported with any state or federal grant funds,
the state or federal agencies responsible for administering the applicable
grants may examine the Contractor’s records to ensure compliance with
the terms of this Agreement and the terms of the applicable grant.
13.4 Records Retention
The Contractor agrees to maintain any business records related to this
Agreement or the Contractor’s performance under this Agreement for a
period of at least three (3) years after final payment.
14. Nondiscrimination
The Contractor covenants that it will not discriminate against an employee or
applicant of employment with respect to hire, tenure, terms, conditions, or
privileges of employment, or a matter directly or indirectly related to
employment, because of race, color, religion, national origin, age, sex, height,
weight, marital status or a disability that is unrelated to the individual’s ability to
RFP #11-006 22
perform the duties of a particular job or position, and that it will require the same
non-discrimination assurances from any subcontractor who may be used to
carry out duties described in this contract. Contractor covenants that it will not
discriminate against businesses that are owned by women, minorities or persons
with disabilities in providing services covered by this Contract, and that it shall
require the same assurances from subcontractors. Breach of this covenant shall
be regarded as a material breach of this contract.
15. Identity Theft Prevention
15.1 In the event that the Contractor will obtain identifying information during
the delivery of the Goods, the Contractor must take reasonable
precautions to ensure that such identifying information is protected from
unauthorized disclosure and is used only for the purpose of performing
the Services.
15.2 For the purposes of this Paragraph, “identifying information” means any
name or number that may be used, alone or in conjunction with any other
information, to identify a specific person, including but not limited to
name, address, telephone number, social security number, date of birth,
driver’s license number, taxpayer identification number, or routing code.
16. General Provisions
16.1 Entire Agreement
This Agreement, along with any Exhibits attached thereto, embodies the
entire agreement between the Parties. There are no promises, terms,
conditions, or obligations relating to the Services other than those
contained herein. In the event of a conflict between this Agreement and
any Exhibit, the terms of this Agreement shall control.
16.2 Modification
This Agreement may be modified only in writing executed with the same
formalities as this Agreement.
16.3 Binding Effect
The provisions of this Agreement shall apply to and bind the heirs,
executors, administrators, and assigns all of the parities hereto.
16.4 Headings
The paragraph headings in this Agreement are used only for ease of
reference, and do not limit, modify, construe, and or interpret any
provision of this Agreement.
RFP #11-006 23
16.5 Governing Law and Venue
This Agreement is entered into under the laws of the State of Michigan.
Any litigation between the Parties arising out of this Agreement must be
initiated within two years of the cause of action accruing and must be
brought in a court of competent jurisdiction in Genesee County, Michigan.
16.6 Severability and Survival
In the event that any provision of this Agreement is deemed by any court
of competent jurisdiction to be legally ineffective, such decision shall have
no effect on the remaining provisions of this Agreement.
16.7 Interpretation
Each Party has had opportunity to have this Agreement reviewed by legal
counsel and has had equal opportunity to contribute to its contents. In
the event of any dispute concerning the interpretation of this Agreement,
there shall be no presumption in favor of any interpretation solely
because the form of this Agreement was prepared by the County.
16.8 Remedies
All remedies specified in this Agreement are non-exclusive. The County
reserves the right to seek any and all remedies available under this
Agreement and applicable law in the event that the Contractor fails to
abide by the terms of this Agreement.
RFP #11-006 24
IN WITNESS WHEREOF, the Parties have caused this Agreement to be
executed by their duly authorized agents.
CONTRACTOR NAME GENESEE COUNTY BOARD OF
COMMISSIONERS
By: By:
Name of Contractor Signatory Jamie Curtis
Title of Contractor Signatory Chairperson
RFP #11-006 25
EXHIBIT A
Goods and Prices
List the Goods and their prices.
RFP #11-006 26
EXHIBIT B
Insurance Checklist
Title: PHARMACEUTICAL SERVICES FOR GVRC Number: 11-006
Coverages Required Limits (Figures denote minimums)
X 1. Workers' Compensation Statutory limits of Michigan
X 2. Employers' Liability $100,000 accident/disease
$500,000 policy limit, disease
X 3. General Liability Including Premises/operations
$1,000,000 per occurrence with $2,000,000
aggregate
X 4.Professional liability $1,000,000 including errors & omissions
$200,000 per occurrence $600,000 in
aggregate for Medical Malpractice
X 5. Products/Completed operations $1,000,000 per occurrence with $2,000,000
Aggregate [If applicable]
X 6. Automobile liability $1,000,000 combined single limit each
accident- Owned, hired, non-owned
X 7. Genesee County named as an additional insured on other than Workers' Compensation and
Professional Liability via endorsement. A copy of the endorsement or evidence of blanket
Additional Insured language in the policy must be included with the certificate.
X 8. Best's rating: A VIII or better, or its equivalent (Retention Group Financial Statements)
X 9. The certificate must state bid number and title
RFP #11-006 27
ATTACHMENT #2 - MODEL EQUITY AND DIVERSITY PLAN
NOTE: This attachment is not part of RFP 11-006, it is provided as a convenience to
any prospective offeror who may not yet have a current Certificate To Do Business
With Genesee County. Each offeror must submit a Model Equity and Diversity plan,
which once reviewed, by the Genesee County Office of Equity and Diversity
Department, will issue a Current Certificate To Do Business With Genesee County.
Genesee County utilizes these plans for informational purposes only. The content of
any proposer’s plan is not considered in either the evaluation of the proposal or the
decision to award a contract to a specific vendor. For further information on this
requirement, contact the Genesee County Office of Equity and Diversity, 1101 Beach
Street, Room 343, Flint, Michigan 48502. Telephone 810-257-3028, Fax
810-768-7943.
RFP #11-006 28
Genesee County
Office Of Equity & Diversity
MODEL EQUITY & DIVERSITY PLAN
Instruction Sheet
1. ALL SECTIONS OF THE GENESEE COUNTY MODEL EQUITY & DIVERSITY PLAN
MUST BE COMPLETED.
2. FULLY RESPOND TO EACH QUESTION.
3. IF ANY SECTION IS NOT APPLICABLE TO YOUR COMPANY, WRITE N/A.
4. COMPLETE DOCUMENT, SIGN AND MAIL OR FAX THIS ORIGINAL DOCUMENT TO:
5. SHOULD YOU HAVE ANY QUESTIONS, PLEASE CALL 257-3028.
Genesee County Office of Equity & Diversity
1101 Beach St., Room 343
Flint, MI 48502
FAX 810.768.7943
Genesee County utilizes these plans for informational purposes only. The Content of any
proposer’s plan is not considered in either the evaluation of the proposal or the decision to
award a contract to a specific vendor.
Genesee County Office of Equity & Diversity
Genesee County Administration Building
1101 Beach Street, Room 343 Flint, MI 48502
Phone (810) 257-3028 Fax (810) 768-7943
MODEL EQUITY & DIVERSITY PLAN
FOR: Genesee County Vendors (i.e. Suppliers, Contractors, or Subcontractors)
COMPANY NAME: __________________________________________________________________
dba if different from Company Name______________________________________________________
ADDRESS: __________________________________________________________________
__________________________________________________________________
PHONE: ______________________ FAX: _______________________
Email:_________________________________________________
If any of your mailing information has changed since last year, please make note of the change below
NEW COMPANY NAME: ____________________________________________________________
NEW ADDRESS: __________________________________________________________________
__________________________________________________________________
NEW PHONE: _____________________ NEW FAX: _________________________
Check one or more below if applicable:
White Owned Business
Person with Disabilities Owned Business
Woman Owned Business
Minority Owned Business (check those that apply below)
African-American
Hispanic
Asian-Pacific Islander
American Indian or Alaskan Native
IN ORDER TO BE RECOGNIZED AS A MINORITY, PERSON WITH DISABILITIES, OR WOMAN OWNED BUSINESS, YOUR BUSINESS MUST
BE AT LEAST 51 % OWNED, CONTROLLED, AND OPERATED BY MINORITY, WOMEN, OR PERSONS WITH DISABILITIES SEE PAGE 5
FOR DEFINITIONS.
1 OF 8
1. EQUAL EMPLOYMENT OPPORTUNITY POLICY
If you do not have a written equal opportunity policy, this model policy statement been provided for
you to adopt by simply filling in your company name and having the CEO sign at the end.
“It is the policy of ____________________________________ to provide Equal Employment
Opportunity for all persons regardless of race, color, religion, national origin, age, marital status,
height, weight, arrest record, sex, or disability. We acknowledge the Equal Employment Opportunity
(EEO) is a legal, social, and economic necessity for our company.”
2. STEPS TO PROMOTE EQUAL OPPORTUNITY
Please provide the names, addresses and phone numbers of your recruitment
Recruitment: (Indicate which sources of media, agencies, organizations colleges and schools,
community groups, and others who have special contacts with women, minority, and disability
groups you are currently contacting for recruitment purposes.)
Name Address Phone #
Do you include a copy of your EEO policy when sending letters to your recruitment sources?
Yes No
Do you use the “EEO/Equity & Diversity” tag line as a statement of your commitment?
Yes No
Are you willing to send a copy of your job announcements to the Genesee County Office of Equity &
Diversity?
Yes No
If you answered no to any of the above questions please explain: _________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
2 OF 8
3. SELECTION PROCEDURE
Describe methods used for applicant selections (e.g., application forms, interviews, tests, reference checks,
etc.):
_____________________________________________________________________________________
_____________________________________________________________________________________
Explain what practices are implemented to insure that an equal and unbiased selection process is
conducted______________________________________________________________________
Who has the final hiring authority? _________________________________________________________
_____________________________________________________________________________________
Upward Mobility System:
Describe what practices are implemented and your policy to insure equal treatment in terms of the
following job situations:
(1) Assignments _____________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(2) Promotions and transfers ____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(3) Training _________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
(4) Benefits and conditions of employment _________________________________________
______________________________________________________________________________
______________________________________________________________________________
(5) Layoff, recall, discharge, demotion and disciplinary action __________________________
______________________________________________________________________________
______________________________________________________________________________
3 OF 8
4. DEFINITIONS:
A. White (not of Hispanic Origin): All persons having origins in any of the original
peoples of Europe, North Africa, or the Middle East.
B. Minority: All persons of the United States who are African American, Hispanic,
Asian-Pacific Islander or American Indian or Alaskan Native.
C. Black (not of Hispanic origin): All persons having origins in any of the Black racial
groups of Africa, and are regarded as such by the community of which the person
claims to be a part.
D. Hispanic: All persons of Mexican, Puerto Rican, Cuban, Central or South American,
or other Spanish culture or origin, regardless of race.
E. Asian or Pacific Islander: All persons having origins in any of the original people of
the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This
area includes, for example, China, India, Japan, Korea, the Philippine Islands, and
Samoa.
F. American Indian or Alaskan Native: All persons having origins in any of the original
peoples of North America, and who maintain cultural identification through tribal
affiliation or community recognition.
Person
With a
Disability: A person with a physical or mental condition or regarded as having a physical or
mental condition which may result from disease, injury, congenital conditions at birth,
or functional disorder.
Ownership: TO BE RECOGNIZED AS A MINORITY, PERSON WITH DISABILITY, OR WOMAN
OWNED BUSINESS, YOUR BUSINESS MUST BE AT LEAST 51 PERCENT
OWNED, CONTROLLED, AND OPERATED BY MINORITY PERSONS, WOMEN,
OR PERSONS WITH DISABILITIES.
4 OF 8
5. ANNUAL GOALS AND TIMETABLE (Current Year End)
In this section, you are asked to set a numerical goal for your company to increase the utilization of minority and
women in your workforce. This requires a good faith effort on your part. A goal is not a quota.
The purpose of setting goals in a timely manner is to allow the employer to measure the success of the steps taken to
implement equal employment opportunity. Failure to meet a goal should alert the company that the Equity & Diversity
Plan is not working and that additional action is necessary. Long range goals should be measured for women and
minorities in each major employment category in relationship to their representation in the civilian labor force. Short
term goals should be measured in terms of realistically moving towards the long range goals on an annual basis.
Employment
Category Women Minorities
Current Utilization Current Utilization
Annual Goal Annual Goal
Officials and number percent number percent number percent number percent
Managers
Professionals
Technicians
Sales Worker
Office and Clerical
Skilled Crafts
Operators
Laborers
Service
Maintenance
TOTAL 0 0 0 0
The Current number of total employees on the payroll is _____.
The approximate employee turnover for our company is ____ employees per year.
TYPES OF PRODUCTS AND SERVICES
Describe in detail any products/services that you provide (submit copies of brochures, catalogs, etc.):
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Type of Supplier (check one):
_____ Retail _____ Manufacturer’s Representative _____ Wholesale
_____ Manufacturer _____ Distributor _____ *Personal/Professional services
_____ Other (explain) _________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
*Personal/Professional services are those services rendered by persons requiring an advanced, specialized type of
knowledge, or expertise, acquired through extensive study or training. These services include, but are not limited to:
accountants, architects, attorneys, clergy, consultants, dentists, engineers, pharmacists, physicians, planners,
veterinarians, etc. 5 OF 8
6. UNION CONTRACT PROVISIONS
Explain how you work with unions to ensure equal treatment in your firm. If your company has a
nondiscrimination agreement with a union, please attach a copy.
An employer should not blame failure to take positive action steps due to barriers in a union
contract. Explain what you do to insure nondiscrimination in union contracts:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Read and adhere to the following seven (7) Equal Opportunity Clauses.
Government contracts:
Except as otherwise provided, each contracting agency shall include the following equal opportunity clauses
contained in Section 202 of Executive Order 11246 of September 24, 1965, in each of its Government
contracts and modifications thereof if not included in the original contract: *During the performance of
this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for employment
because of race, color, religion, national origin, age, marital status, height, weight, arrest record, sex or
handicap. The contractor will take affirmative action to ensure that applicants are employed, and that
employees are treated during employment, without regard to their race, color, religion, national origin, age,
marital status, height, weight, arrest record, sex, or handicap. Such actions shall include, but not be limited
to the following: employment, upgrading, demotion, or transfer, recruitment or recruitment advertising;
layoff or termination; rates of pay or other forms of compensation; and selection for training, including
apprenticeship. The contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices to be provided by the contracting officer setting forth the provisions of
this nondiscrimination clause.
(2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf
of the contractor, state that all qualified applicants will receive consideration for employment without regard
to race, color, religion, national origin, age, marital status, height, weight, arrest record, sex, or disability.
(3) The contractor will sent to each labor union or representative of workers with which he has a
collective bargaining agreement or other contract or understanding a notice to be provided by the agency
contracting officer, advising the labor union or worker’s representative of the contractor’s commitments
under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in
conspicuous places available to employees and applicants for employment.
(4) The contractor will comply with all provisions of Executive Order 11246 of September 24,
1965, and of the rules, regulations and relevant orders of the Secretary Of Labor.
(5) The contractor will furnish all information and reports required by Executive Order 11246 of
September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant
thereto, and will permit access to his books, records and accounts by the contracting agency and the
Secretary of Labor purposes of investigation to ascertain compliance with such rules, regulations, and
orders.
6 OF 8
(6) In the event of the contractor’s noncompliance with the nondiscrimination clauses of this
contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or
suspended in whole or in part and the contractor may be declared ineligible for further Government
contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and
such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of
September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by
law.
(7) The contractor will include the provisions of paragraphs (1) through (7) in every subcontract
or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued
pursuant to Section 204 of Executive Order 11246 of September 24. 1965, so that such provisions will be
binding upon each subcontractor or vendor.
The contractor will take such action with respect to any subcontract or purchase order as the contracting
agency may direct as a means of enforcing such provisions including sanctions for noncompliance:
Provided, however, that in the event that contractor becomes involved in, or is threatened with, litigation by
a subcontractor or vendor as a result of such direction by the contracting agency, the contractor may
request the United States to enter into such litigation to protect the interests of the United States.”
7. SIGNATURES: i.e., Chief Executive Officer, President, Owner (Required for certification)
________________________________ __________________________________
Name EEO Representative
________________________________ ___________________________________
Printed Name (Please print clearly) Printed Name (Please print clearly)
________________________________ ___________________________________
Title Telephone Number
________________________________ ___________________________________
Telephone Number Date
________________________________
Date
7 OF 8
8. COMPLETE THE FOLLOWING OCCUPATIONAL WORK FORCE ANALYSIS.
CURRENT OCCUPATIONAL WORKFORCE ANALYSIS
American
Asian or Indian or
Job GRAND African Pacific Alaskan TOTAL TOTAL NEW HIRES
Category TOTALS White American Hispanic Islander Native MINORITY FEMALE (past 12 months)
TOTAL Total
ALL M F M F M F M F M F M F Min % F % All Min % F %
Officials/ Admin. 0 0 0 0
Professionals 0 0 0 0
Technicians 0 0 0 0
Office/Clerical 0 0 0 0
Skilled Crafts 0 0 0 0
Operators 0 0 0 0
Laborers 0 0 0 0
Sales Workers 0 0 0 0
Service/ Maint. 0 0 0 0
TOTALS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
New Hires data covers period from (month/year): _______________ to ________________
Area Labor Market Statistics for Genesee County: State of Michigan-statewide:
Labor Force Minorities = 21.2% Minorities = 17.0
Labor Force Females = 48.2% Females = 46.8
M = Male F = Female Min = Minority
Rev. 04/07 4A OF 8
