asus, inc. subcontractor information · asus, inc. subcontractor information packet thank you for...
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ASUS, Inc. Subcontractor Information Packet
Thank you for your interest in qualifying as an approved Subcontractor. This information will enable you to be Pre‐
Qualified and able to view current and upcoming RFP’s posted to the Bid Sync Web Portal.
Please review the enclosed information identified below:
Qualification Application
Non‐Disclosure Agreement and Acknowledgement
o Contractors/Engineers
o Professional Service Providers
Insurance Certificate Requirements
o Proof of Insurance Only for Pre‐Qualification
Summary of Small Business Size Standards (by Industry) – Reference
Small Business Administration Small Business Designation Requirements ‐ Reference
Bid Sync Information Letter ‐ Reference
Please submit the following documents in order for your request to be processed:
1. Qualification Application (must be completed, signed and dated)
2. Non‐Disclosure Agreement ‐Signed and dated
3. Acknowledgement – Signed and dated
4. Proof of Insurance – Current COI
Please return completed forms to ASUS’s Supplier Diversity Professional, Susi Cleveland by fax 540‐301‐0145 or by email
For additional questions regarding one of our subsidiaries, please see the base listing below:
Location Contact Name E‐mail Phone _____
Joint Base Andrews, MD Debby Craig/Drucilla Jones [email protected] 757‐888‐0484
Ft. Eustis & Story, VA Debby Craig/Drucilla Jones [email protected] 757‐888‐0484
Ft. Bragg, NC Tomeika McClean [email protected] 910‐495‐1311
Ft. Bragg, NC Vanessa McCormick [email protected] 910‐495‐1311
Ft. Jackson, SC Cody Climp [email protected] 915‐564‐1332
Eglin AFB, FL Tomeika McClean [email protected] 910‐495‐1311
Eglin AFB, FL Jennifer Beekman [email protected] 909‐305‐2400
Fort Bliss, TX Pat Hernando/Cody Climp [email protected] 915‐564‐1332
1 (Rev. 10/05/2011)
QUALIFICATION APPLICATION Contractors, Consultants and Vendors
Section A: Company/Organization Profile Full Company/DBA/Entity Name: Year Established: No. of Years Using Current Name:
Remit to Address: Former Company/DBA/Organization Names(s):
City: State: Zip Code: Primary NAICS No:
DUNS No.: Federal Tax ID No.:
Contact Information | Company/Organization Type
Name: Corporation General Partnership
Title: Limited Liability Co
Individual / Sole Proprietorship
Office Ph: Limited Partnership
Limited Liability Partnership
Cell Ph: Limited Liability Partnership
State of Incorporation or Partnership:
Fax Number:
S.A.M. (System for Award Management) Registration is REQUIRED. To register, go to: www.aquisition.gov
E-Verify Company Profile is REQUIRED. To complete, go to: https://e-verify.uscis.gov/enroll/StartPage.aspx?JS=YES
Email Address:
Web Site Address:
‡Business Size Category | Primary Business Activities
Large Accounting Maintenance
Small Analytical Office Equipment/Supplies
Small Disadvantaged Business Building Painting
Indian Owned SB General Construct. Pipeline Contractor
Woman Owned SB Chemicals Professional Services
Veteran Owned SB Computer Hardware/Software
Pump Maintenance
Service Disabled Veteran Owned SB Consulting Reservoir/Tank Construction/ Maintenance
Alaskan Native Owned SB Contracting Security
HUBZone SB Federal Only Engineering Survey
Historically Black College & University/Minority Institution
Environmental Training & Education Specify:____________________
Other:________________________ Inspection
Waterworks Material Supplier
2 (Rev. 10/05/2011)
Trade or Professional Licenses / State Certifications
Approximate Number of Current Employees
Estimated Annual Gross Revenue Prior Three (3)
Fiscal Years
Indicate the type of contractor, professional service, or specialty trade license(s) or certificate(s) maintained by your firm:
10 or fewer 10-50 50-100 100-500 Over 500
Year: Amount:
20___ $___________
20___ $___________
20___ $___________
Number:
Please attach a copy of each license or certification.
Bank Reference
Brief Financial Statement Name of Bank:
Phone Number:
Please attach a brief financial statement, or a current balance sheet, or bank and credit information.
Type of Account:
Account Number:
Type of Account:
Account Number: Please check the ASUS Subsidiaries with whom you desire to do work: Section B: Bondability and Insurance
Fort Bliss Water Service Company
Is your company currently bondable? (ASUS may require performance and payment bonds.)
Yes No N/A
Old Dominion Utility Services, Inc.
Has your company previously been bonded?
Yes No N/A
Old North Utility Services, Inc.
What is your Bond Limit Amount (Aggregated)?
Would your company meet the following minimum insurance requirements: Palmetto State Utility Services, Inc.
State required Worker’s Compensation?
Yes No N/A
Other: State required Automobile Insurance?
Yes No N/A
Emerald Coast Utility Services, Inc.
Terrapin Utility Services, Inc.
3 (Rev. 10/05/2011)
The following outlines the general minimum insurance limits
Type of Insurance Major
Construction
Minor
Construction
General Consulting, Management or
Engineering Services
Specialized Consulting
Work
Professional Services
General Liability
General Aggregate $2,000,000 $500,000 $2,000,000 $500,000 $2,000,000
Products-Completed Operations
$2,000,000 $500,000 $2,000,000 N/A $2,000,000
Personal & Advertising Injury $1,000,000 $100,000 $1,000,000 N/A $1,000,000
Each Occurrence $1,000,000 $100,000 $1,000,000 $500,000 $500,000
Auto Liability (any auto)
Company owned vehicles - Combined Single Limit
$1,000,000 $500,000 $500,000 $500,000 $500,000
Hired and non-owned vehicles - Combined Single Limit
$1,000,000 $1,000,000 $1,000,000 $500,000 $500,000
Company owned vehicles - Combined Single Limit - Applicable to Hazardous Material Suppliers
*$5,000,000 N/A N/A N/A N/A
Workers’ Compensation Statutory Statutory Statutory Statutory Statutory
Employers’ Liability
Each Accident $1,000,000 $500,000 $1,000,000 $500,000 $500,000
Disease – Policy Limit $1,000,000 $500,000 $1,000,000 $500,000 $500,000
Disease – Each Employee $1,000,000 $500,000 $1,000,000 $500,000 $500,000
Professional Liability (Errors & Omissions)
Each Claim N/A N/A $1,000,000 N/A $1,000,000
Annual Aggregate N/A N/A $1,000,000 N/A $1,000,000
Professional Liability Insurance? Yes No N/A
Please attach a sample copy of the applicable insurance certificates.
Note: *$1,000,000 primary and $4,000,000 in excess liability
Pollution Liability (To be solicited from construction subcontractors but not a requirement for pre-qualification)
Covering sudden and accidental discharges of hazardous materials
Aggregate $2,000,000
Per Occurrence $1,000,000
4 (Rev. 10/05/2011)
Section C: Health and Safety Experience Modification Rate
Is your firm subject to the EMR? Yes No
If yes, please provide rating for the past three (3) years.
Year EMR Year EMR Year EMR
20___ _____ 20___ _____ 20___ _____
OSHA Recordable Incident Rate Is your firm exempt from OSHA record keeping because of size (e.g. 10 or fewer employees) and/or industry type? Yes No N/A
If no, list your firm’s OSHA Recordable Incidence Rate for each of the past three (3) years.
Year Rate Year Rate Year Rate
20___ _____ 20___ _____ 20___ _____
Check the appropriate boxes below:
1. Does your firm have a written safetyprogram? Yes No N/A
2. Does your firm currently have a writtensafety plan which complies with currentOSHA standards? Yes No N/A
3. Does your firm currently have a writtensafety plan which complies with currentOSHA standards? Yes No N/A
4. Ever had a period when your firm waswithout required worker’s compensationinsurance or approved self-insurance? Yes No N/A
5. Has your firm experienced either a State orFederal Occupational Safety and HealthAdministration serious violation, or citation,or been assessed penalties?
If yes, number of instances?
Yes No N/A
6. Has your firm experienced either a State orFederal Environmental Protection Agency(EPA) issued Notice of Violation (NoV)and/or assessed any penalties?
If yes, number of instances?
Yes No N/A
7. Has your firm experienced a work-relatedfatality or an accident that resulted in thehospitalization of four (4) or moreemployees?
Yes No N/A
If you answered YES to any of the above questions, please attach an explanation for each.
5 (Rev. 10/05/2011)
Section D: Contractual / Financial / Legal Check the appropriate boxes below:
1. Does your firm have a written Code of Conduct?
Yes No N/A
2. Does your firm have any apparent or actual conflict of interest with GSWC, or with any of its employees, or are you a relative of any GSWC employee? If yes, please explain:
Within the last five (5) years, has your firm:
Yes No N/A
3. Files for bankruptcy (voluntary or involuntary)?
Yes No N/A
4. Had a state license or certification suspended or revoked?
Yes No N/A
5. Been suspended, debarred, disqualified, or otherwise prevented from bidding on, or completing any utility, local, state or federal agency project?
Yes No N/A
6. Had a client or owner submit a claim for arbitration against your firm? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
7. Submitted for arbitration a claim against a client or owner concerning work on a project or any contract? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
6 (Rev. 10/05/2011)
8. Had a contract terminated for cause or default by a client or owner? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
9. Defaulted on a contract forcing a Surety to suffer a loss?
Yes No N/A
10. Experienced a client or owner making a demand on your payment or performance bonds?
Yes No N/A
11. Has a surety made payments on your firm’s behalf to satisfy a claim made against a payment or performance bond? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
12. Been unable to obtain a bond or been denied a bond for a contract?
Yes No N/A
13. Had an insurance carrier, for any form of insurance, cancel or deny any form of insurance or refuse to renew an insurance policy for your firm? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
14. Are there any current outstanding liens or stop notices for labor and/or material filed against your firm on any contracts?
Yes No N/A
15. Been sued? Indicate the:
Yes No N/A
7 (Rev. 10/05/2011)
Number of claims Type Client Verification information Case No(s)
16. Filed suit? Indicate the:
Number of claims Type Client Verification information Case No(s)
Yes No N/A
If you answered ‘yes’ to any of the above, please attach an explanation and details including the Agency, Client, name of Court and case numbers, etc.
17. What size projects is your company comfortable undertaking in view of existing capabilities and available financial resources? Single project value: $ Total value work in progress: $
18. Does your firm have an Accounting System, approved by either an agency of the US Government (e.g., DCAA) or any state government? Yes* No *If ‘yes’, please specify which agency:
19. What is the date of the last approval of your Accounting System by the specified agency?
Section E: Performance References A. Business References: List two (2) general business references:
Contact Company Phone Years?
1.
2.
B. List the two (2) highest value contracts completed in the prior three (3) years:
Owner/Client Contact & Phone Job Description
Contract Amount: Original $
Completed $
Complete Date:
Original Actual
1. $
$
2. $
$
8 (Rev. 10/05/2011)
C. List two (2) Subcontractors or Subconsultants (as applicable):
Company Service(s) Provided Contact Name Phone
1.
2.
D. List two (2) current Material Suppliers or Vendors:
Company Material or Service
Provided Contact Name Phone
1.
2.
Section F: Service(s) Provided
Check a maximum of five (5) type(s) of service(s) your firm performs in its own name. Do not include services that your firm subcontracts.
A B
Accountant A14 Barricades B03
Acquisitions A16 Bearings B04
Advertising A08 Blue Prints B05
Air Conditioning – Heating A02 Bolts B06
Air Conditioning Maintenance A03 Booster Pumps B01
Architects A06 Building Maintenance B02
Armored Services A07 Building Materials and Supplies B07
Asbestos & Lead Paint A01 C
Asphalt A09 Calibration C10
Audio Visual A05 Carpentry C01
Auto Repair A04 Carpet/Carpet Cleaning C11
Automobile – Lease A15 Catering/Food Services C12
Automobile – Parts A10 Cement/Concrete Supplies C13
Automobile – Rentals A11 Chemical Delivery C02
Automobile – Tires A13 Chlorine Equipment/Supplies C14
Automobile – Truck Purchases A12 Circuit Breakers C15
9 (Rev. 10/05/2011)
Clamps C16 Excavation E06
Coffee/Soft Drink Supplies C18 Exterminator E10
Compressors C22 Event Planner E07
Computer-Hardware C19 Event Rentals E08
Computer – Services/Maintenance C07 F
Computer – Software C20 Fencing F01
Concrete Contractor C23 Field Testing F02
Conservation C05 Financial Consultant F10
Construction Clean-up C03 Fire Extinguishers/Services F04
Consulting/Engineering C04 Fire Hydrants F03
Consulting – Engineers C21 First Aid Supplies F11
Contributions C17 Flashers F05
Corporate Gifts C24 Fleet F12
Corrosion Engineering/Insp. C06 Flooring F07
Courier Services/Maintenance C08 Floral Décor F13
Crane Rental C25 Flush Line F06
D Flush Out F08
Demolition Contractor D06 Franklin Quest Products F09
Development D01 G
Disaster Recovery D03 Gardening/Landscaping Services G06
Distribution Maintenance D02 Gas Chlorination Parts G03
Drafting Supplies D05 General Construction G01
Ductile Iron Pipe D04 General Contractor G04
E General Engineering G02
Earthwork E01 Generators G05
Electrician/Electrical E02 Geotechnical Services G08
Energy Efficiency Consultant E09 Graffiti Removal G07
Engineering Services E04 Graphic Design G09
Environmental Engineering E03 H
Equipment Rental E05 Hauling H02
10 (Rev. 10/05/2011)
Hazardous Waste Removal H01 Mailing Equipment M10
I Mailing Services M06
Industrial Oils I02 Manufacture M04
Industrial Supplies I03 Market Research & Communication M14
Inspection I01 Mechanical – Repairs M09
Investments I05 Media M13
IT Services I04 Medical Supplies M08
J Meter Boxes M12
Janitorial Services J01 Meter Installation M05
L Meter Reading M02
Laboratories Sampling L03 Meter Repairs M03
Laboratory Equipment/Testing L04 N
Language Interpreter L11
Land Leasing L15 O
Land Use Entitlement L14 Office Design O03
Landscaping L01 Office Machine Maintenance O01
Large Meter – Replacement L06 Office Relocation O02
Large Meter – Testing L07 Office Supplies O06
Large Water – Meters L10 Office Supplies – Equipment O04
Legal Consulting L12 Office Supplies – Furniture O05
Lineman’s Equipment L05 P
Locksmith L13 Paint/Decoration P01
Low Voltage Communities L02 Paving P02
Lubricating Products L08 Pest Control P09
Lumber L09 Photography P11
M Pipe Fittings and Valves P12
Machinery & Pumps M01 Pipeline P03
Maintenance Supplies M07 Pipeline Install & Convey P04
Maintenance Work M11 Plant Work P14
11 (Rev. 10/05/2011)
Plastic Service P13 Scrap Disposal S22
Plumbing P10 Security Services S09
Pole Installation P05 Security System S02
Printing – Stationery/Forms P15 Sewage Treatment S03
Professional Services P06 Shipping Services S14
Promotional Items P18 Sign Installation S04
Public Relations Consultant P20 Signs and Banners S15
Publishing/Periodicals P19 Small Meter S12
Pump Maintenance P07 Small Meter – Replacement S17
Pump Testing P08 Small Meter – Testing S18
Pumps/Pumping Equipment P16 Soil & Ground Water S05
Purification P17 Sprinkler Contractor S11
R Sprinkler Controls S19
Radio Repair/Installation R09 Storage Containers S20
Radios R05 Storage Tank Removals S06
Real Estate Acquisitions R10 Storm Drains S07
Real Estate Brokerage R11 Street Lighting & Signal Systems S16
Recruitment and Staffing R12 Structural Steel Fabrication S08
Recycling R07 Surveying S23
Rental/Leasing R04 Switches S21
Reservoir/Tank Construction R02 T
Reservoir/Tank Maintenance R03 Tank Services T06
Rock and Sand R06 Telephone T08
Roofing R01 Telephone – Cellular T07
Roofing Material R08 Telephone Installation T01
S Temporary Services T04
Safety Equipment S25 Tenting T09
Safety Training S10 Tools/Hardware Supplies T10
Sampling S01 Towing Services T11
12 (Rev. 10/05/2011)
Training T05 W
Transporting/Freight T17 Waste Removal W02
Trash Pick Up T12 Water and Sewer Separation W09
Travel Services T14 Water Hauler, Non-Potable W12
Tree Maintenance T02 Water Hauler, Potable W13
Tree Services T13 Water Quality Sampling W03
Trenching T03 Water Treatment Equipment W11
Trucking Services T15 Watershed Survey W10
U Welding W04
Underground Location U01 Welding Supplies W07
Uniforms U02 Well Drilling W05
Utility Equipment U03 Well Maintenance/Repairs W01
V Wiping Material W08
Valve Repairs/Maintenance V01 Wiring Systems W06
Vaults V02
Vendor Certification V03 Other:
Section G: Acknowledgement, Authorization, Certification and Execution
American States Utility Services, Inc. (ASUS) will utilize this Qualification Application and the information listed as part of its qualification and approval process. Applicant hereby authorizes ASUS to check and verify the information, including obtaining Dun and Bradstreet financial reports, conducting reference checks and performing public records reviews in connection with evaluation of this Qualification Application. Applicant certifies under 15 U.S.C. 645(d), any person who misrepresents its business size status shall (1) be punished by a fine, imprisonment, or both; (2) be subject to administrative remedies; and (3) be ineligible for participation in programs conducted under the authority of the Small Business Act. Signature below is self-certification of business size and status in accordance with the requirements of the Federal Code of Regulations 13 CFR 121.411(a). As prescribed in FAR 19.301(d), the U.S. Government may impose a penalty against a firm misrepresenting its business size and/or disadvantaged status for the purpose of obtaining a procurement award. Applicant certifies that the information contained herein is complete and accurate in all details to the best of their knowledge and belief.
The company and/or its principals ( are / are not) presently debarred, suspended, or determined ineligible for an award of a contract by any Federal Agency.
The company and/or its principals ( comply / do not comply) with non-segregated facilities in accordance with FAR 52.222-21.
All services must be performed professionally and properly, under appropriate licenses and certifications and required minimum insurance amounts. No work may be commenced without prior ASUS written
13 (Rev. 10/05/2011)
agreement. Agreements with ASUS include requiring applicable insurance, FOB Destination, and generally pricing on a firm, fixed price basis inclusive of all cost elements such as expenses, fees, G&A, incidentals, labor, overhead(s), profit, supplies, taxes, travel, etc. ASUS may require performance and payment bonds. ASUS expects good faith, good customer service, and full cooperation.
Applicant understands and recognizes that Time is of the Essence in the performance of any ASUS contract. Applicant also understands that completing this Qualification Application and becoming qualified by ASUS does not obligate ASUS to enter into any particular contract or any contract at all with applicant.
This Qualification Application may be submitted to ASUS electronically by email, by fax, or by mail delivery. Applicant represents and certifies to the best of his or her knowledge that the information provided herein is true, accurate and complete as of the date indicated below.
Authorized Company/DBA/Firm/Organization Representative:
______________________________________ _____________________________ ___________ Please Print Name Title Date
______________________________________ Signature
Return completed Qualification Application to:
American States Utility Services, Inc. Attn: Susi Cleveland
3715 Latimers Knoll Court, Suite 103 Fredericksburg, Virginia 22408-7361
eFax: (540) 301-0145 email: [email protected]
‡American States Utility Services, Inc. fully supports legislation pertaining to the employment of Disadvantaged,
Women, Small, Disabled Veteran and HUBZone Small Business Enterprises. Under Federal, State, City and Local requirements, we are required to know the classification of your company. Each classification with a brief explanation is listed below.
1. SMALL DISAVANTAGED BUSINESS ENTERPRISE - A Small Business Concern as defined under Item 3 below and which is owned and controlled by socially and economically disadvantaged individuals. The term "Small Business Concern owned and controlled by socially and economically disadvantaged individuals" means a Small Business Concern.
· That is at least 51 percent unconditionally owned by one or more socially and economically disadvantaged individuals; or, in case of any publicity owned business, at least 51 percent of the stock of which is unconditionally owned by one or more socially or economically disadvantaged individuals; and
· Whose management and daily business operations are controlled by one or more such individuals. Subcontractor/Supplier shall presume that socially and economically disadvantaged individuals include Black Americans, Hispanic Americans, Native Americans (such as American Indians, Eskimos, Aleuts, and Native Hawaiians), and other minorities or any other individuals found to be disadvantaged by the Small Business Administration pursuant to Section 8(a) of the Small Business Act. (Must be certified through SBA see website www.sba.gov)
2. WOMAN SMALL BUSINESS ENTERPISE - Same as Small Business Enterprise (below except a woman owned and controlled whose management and daily business operations are controlled by one or more women.
3. SMALL BUSINESS ENTERPISE - A firm is generally considered such if its average annual receipts for its preceding 3 fiscal years do not exceed $12 million for Special Trades Contractors and $28.5 million for Heavy Construction, pursuant the governing regulations of the Small Business Administration (13 CFR Part 121 and FAR Part 19). (See website www.sba.gov/size)
4. DISABLED VETERAN BUISNESS ENTERPISE - Must be at least 51 percent owned who manages and controls the business is not required to be the disabled veteran business owner(s); and your home office must be located and the U.S. Disabled Veteran must be domiciled in California.
5. HUBZONE SMALL BUSINESS ENTERPRISE - a Small business concern that appears on the list of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration. (Must be certified through SBA see website www.sba.gov)
6. LOCAL SMALL DISAVDANTAGED BUSINESS ENTERPISE - Certification through the Office of Local Business Development in the District of Columbia. (Business must be listed in the LSDBE Certified Contractors List). (See website http://olbd.dc.gov)
7. VETERAN-OWNED SMALL BUSINESS ENTERPRISE - A Small Business Concern, not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101 (2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and the management and daily business operations of which are controlled by one or more veterans.
8. SERVICE DISABLED VETERAN-OWNED SMALL BUSINESS ENTERPRISE - Small Business Concern, not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned not less than 51 percent of the stock or which is owned by one or more service-disabled veterans; and the management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. Service-disabled veteran means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is a service-connected, as defined in 38 U.S.C. 101(16).
9. MINORITY-OWNED LARGE BUSINESS ENTERPRISE - A business concern at least 51 percent of which is owned by, and whose management and daily business operations are controlled by, one or more members of a socially and economically disadvantaged minority group, namely, U.S. citizens who are Black Americans, Hispanic Americans, Native Americans, Asian-Pacific Americans, or Asian-Indian Americans (“Native Americans” means American Indians, Eskimos, Aleuts, and Native Hawaiians. “Asian Pacific Americans” means U.S. citizens whose origins are Japanese, Chinese, Filipino, Vietnamese, Korean, Samoan, Laotian, Kampuchean, Taiwanese or in the U.S. Trust Territories of the Pacific Islands. ”Asian-Indian Americans” means U.S. citizens whose origins are the Indian Subcontinent). Exceeds the size standards of Small Business Concern (See Small Business Enterprise above).
10. WOMAN-OWNED LARGE BUSINESS ENTERPRISE - Women-Owned and controlled business whose management and daily business operations are controlled by one or more women (not a small woman-owned business). Exceeds the size standards of Small Business Concern (See Small Business Enterprise above).
11. LARGE BUSINESS ENTERPRISE - Any business that exceeds the Small Business Concerns criteria.
1 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
CONFIDENTIALITY AGREEMENT NO: ________
ISSUED BY:
American States Utility Services, Inc. (“ASUS”) –
A wholly owned subsidiary of American States Water Company.
ISSUED TO:
_______________________________________
(the “ENGR/CONTR”)
ADDITIONAL PARTIES: American States Water Company and all subsidiaries of ASUS.
RELATED TO U.S. GOVERNMENT PRIME CONTRACT NO.:
SP0600-04-C-8265 (Fort Bliss, Texas)
SP0600-05-C-8250 (Joint Base Andrews, Maryland)
SP0600-05-C-8252 (TRADOC Fort Eustis and Fort Story, Virginia)
SP0600-05-C-8253 (Fort Lee, Virginia)
SP0600-07-C-8251 (Fort Jackson, South Carolina)
SP0600-07-C-8258 (Ft. Bragg / Pope Army Air Force Base / Camp MacKall, North Carolina)
SP0600-16-C-8231 (Eglin Air Force Base, Florida)
And any others as issued
EFFECTIVE DATE:
___________________
BRIEF DESCRIPTION OF PURPOSE OF CONFIDENTIALITY AGREEMENT:
ENGR/CONTR shall keep certain information confidential as ENGR/CONTR assists ASUS with various
aspects of ASUS’s business including but not limited to ASUS’ contracts with the U.S. Government .
IN WITNESS HEREOF, this CONFIDENTIALITY AGREEMENT is signed, sealed and delivered
as of the effective date referenced above:
ASUS:
By: ______________________________
Name: ______________________________
Title: ______________________________
Date: _____________________
ENGR/CONTR:
By: ______________________________
Name: ______________________________
Title: ______________________________
Date: _____________________
` Confidentiality Agreement No. _________
2 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
WHEREAS, the parties to this Confidentiality Agreement No. _______ (“Agreement”) are ASUS
(including its parent company American States Water and ASUS subsidiaries), as defined on page 1
of the Agreement, and ENGR/CONTR, as defined on page 1 of the Agreement (ASUS and
ENGR/CONTR may be referred to individually as a “Party” or collectively as the “Parties”);
WHEREAS, ASUS and its subsidiaries have entered into water and wastewater utilities privatization
contracts at various locations identified on page 1 with the United States Government (the “UP
Contracts”);
WHEREAS, ENGR/CONTR is an Engineering/Construction/Consulting firm that provides a variety
of services and business opportunities for variety of clients, and provides assistance to companies that
have contracted with the federal government;
WHEREAS, references in this Agreement to ASUS shall include by definition American States Water
and ASUS’ subsidiaries;
WHEREAS, ASUS engages in certain business activities related to the performance of the UP
Contracts, including but not limited to the preparation of proposals and Request for Equitable
Adjustments;
WHEREAS, ENGR/CONTR may assist ASUS in its preparation, strategy and submittals related to
proposals, REAs and engineering and construction plans, among other matters, and
WHEREAS, ASUS may provide ENGR/CONTR certain Confidential Information or Unclassified
Controlled Technical Information, as defined herein, so ENGR/CONTR may assist ASUS in
conducting business.
NOW, THEREFORE, in consideration of the mutual covenants contained herein as well as other
good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the
Parties hereto agree as follows:
1) Any and all information (whether oral, in hardcopy, in electronic format or in any other
medium) disclosed by ASUS or the Government to ENGR/CONTR that relates to the
management, business, finances, operations, products, systems and contracts of ASUS, along
with any and all information, correspondence, communications, deliverables, or Unclassified
Controlled Technical Information or otherwise, and identified as “Confidential Information”
(whether oral, in hardcopy, in electronic format or in any other medium) between the Parties,
shall be deemed “Confidential Information” and shall be kept confidential by ENGR/CONTR.
Confidential Information or Unclassified Controlled Technical Information shall be deemed
confidential regardless of whether such information is marked “confidential.” The rights
and obligations provided by this Agreement shall take precedence over any specific legends
or statements associated with the Confidential Information or Unclassified Controlled
Technical Information when received.
2) ENGR/CONTR understands that such Confidential Information or Unclassified
` Confidentiality Agreement No. _________
3 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
Controlled Technical Information may not be duplicated, copied, or otherwise reproduced
by ENGR/CONTR, or by its employees, agents, subcontractors, representatives, independent
contractors, etc. for any purpose other than those necessary to assist ASUS. ENGR/CONTR
shall use the highest degree of care to protect such Confidential Information or Unclassified
Controlled Technical Information and shall adhere to the requirements under DFARs
252.204-7012 Safeguarding of Unclassified Controlled Technical Information, Dec. 2015, as may
be further amended, and with DFARs 252.239-7010 Cloud Computer Services, Aug 2015, as may
be further amended. PARTIES shall ensure their lower tier subcontractors and vendors (jointly or
singularly Vendors) also meet these requirements prior to distributing any Confidential
Information or Unclassified Controlled Technical Information to, or utilizing Cloud Computer
Services from, such Vendors. Further, at the request of ASUS, ENGR/CONTR shall
promptly return to ASUS all Confidential Information and Unclassified Controlled Technical
Information or upon authorization of ASUS destroy (and certify the destruction of) all
Confidential Information and Unclassified Controlled Technical Information received from
ASUS and all copies thereof and all media in which such Confidential Information or
Unclassified Controlled Technical Information is contained. However, the ENGR/CONTR
is authorized to retain copies of Confidential Information or Unclassified Controlled
Technical Information contained in reports or databases prepared by the ENGR/CONTR
for the United States Government as necessary for historical deliverable
documentation/archival purposes in connection with the purpose set forth herein.
3) The confidentiality obligations discussed herein shall commence once ENGR/CONTR
receives any Confidential Information or Unclassified Controlled Technical Information,
regardless of the effective date of this Agreement. The confidential obligations discussed
herein shall survive the completion or termination of this Agreement.
4) ASUS provides the Confidential Information or Unclassified Controlled Technical
Information solely on an “as-is” basis. The Confidential Information or Unclassified
Controlled Technical Information is not warranted to be complete or error-free.
ENGR/CONTR agrees that ASUS will not be liable for any damages arising out of the use of
the Confidential Information or Unclassified Controlled Technical Information.
5) ENGR/CONTR shall not acquire any rights in the Confidential Information or Unclassified
Controlled Technical Information provided by ASUS under this Agreement. No license is
granted by this Agreement by either Party to the other, either directly or by implication,
estoppel, or otherwise.
6) ENGR/CONTR shall not provide any Confidential Information or Unclassified Controlled
Technical Information to any third-party, including United States government agencies
and ENGR/CONTR Vendors, without the express written permission of ASUS. The
ENGR/CONTR shall only provide the Confidential Information or Unclassified
Controlled Technical Information to ENGR/CONTR employees, agents, subcontractors,
representatives, independent contractors, etc. who must view the Confidential
Information or Unclassified Controlled Technical Information for the purposes of
performing work under the ASUS-ENGR/CONTR Contract. All such ENGR/CONTR
` Confidentiality Agreement No. _________
4 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
employees, agents, subcontractors, representatives, independent contractors, etc. must
sign an ASUS-provided Acknowledgement to this Agreement recognizing the terms of
this Agreement..
7) ENGR/CONTR shall not use any Confidential Information or Unclassified Controlled
Technical Information for any purpose other than for the purposes described in this
Agreement.
8) In the event that ENGR/CONTR is required by law or legal process to disclose any
Confidential Information or Unclassified Controlled Technical Information, ENGR/CONTR
shall provide ASUS with prompt oral and written notice of any such requirement within two (2)
business days of receiving notification of such possible disclosure. This notice will allow
ASUS to seek a protective order or other appropriate remedy to preclude or limit the disclosure
of the Confidential Information or Unclassified Controlled Technical Information.
ENGR/CONTR agrees to cooperate with ASUS in any reasonable efforts to obtain such
remedies, and ENGR/CONTR agrees not to disclose the Confidential Information without
ASUS’s prior written consent or Court order (following the exhaustion of all available avenues
of appeal.)
9) ENGR/CONTR shall promptly notify ASUS of any unauthorized disclosure of or access to
Confidential Information or Unclassified Controlled Technical Information of which the
ENGR/CONTR becomes aware and shall provide all reasonable cooperation and assistance in
recovering such Confidential Information or Unclassified Controlled Technical Information.
In addition, in accordance with the requirements of DFARS 252.204-7012 Safeguarding of
Unclassified Controlled Technical Information, ENGR/CONTR shall notify the U. S.
Government via the Department of Defense's DIB Cyber Incident Reporting and Cyber
Threat Information Sharing Portal as well as to ASUS within 72 hours of identification of
such unauthorized disclosure or release.
10) The Parties acknowledge that the breach or threatened breach of this Agreement may result in
immediate and irreparable harm to ASUS and such harm may be in addition to its other
remedies at law or equity (including monetary damages). As such, ASUS shall be entitled to
preliminary and other injunctive relief to restrain any threatened or continued breach of this
Agreement without any showing of irreparable harm or any other special demonstration of
harm.
11) ENGR/CONTR shall indemnify, defend and hold harmless ASUS against any and all losses,
damages, claims, expenses and attorneys’ fees incurred or suffered by ASUS as a result of a
breach or violation of this Agreement (including the unauthorized use or disclosure of the
Confidential Information or Unclassified Controlled Technical Information) by
ENGR/CONTR and/or employees, Vendors, agents, subcontractors, representatives,
independent contractors, etc.
12) Miscellaneous Provisions:
` Confidentiality Agreement No. _________
5 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
(a) This Agreement is governed by the laws of California, without reference to its rules
concerning conflicts of laws. Notwithstanding the provision of any Master Services
Agreement between the parties, any dispute regarding matters provided in or related to
this Agreement shall be resolved in the state or federal courts situated in California.
(b) No act or failure to act by either Party will waive any right contained herein; any
waiver must be specific, in writing and signed by an officer of the waiving Party in
order to be effective.
(c) This Agreement shall be binding upon the respective successors and assigns of each
of the Parties. ENGR/CONTR shall not be permitted to assign this Agreement
without receiving prior express written permission from ASUS.
(d) No amendment to this Agreement shall be valid unless it is in writing and signed by a
duly authorized representative of each Party.
(e) In the event that any provision of this Agreement conflicts with the law under which
this Agreement is to be construed or if any such provision is held invalid by a court
with jurisdiction over the Parties to this Agreement, such provision shall be deemed to
be restated to reflect as nearly as possible the original intentions of the Parties in
accordance with applicable law, and the remainder of this Agreement shall remain in
full force and effect.
(f) This Agreement supersedes all other prior agreements, oral or written, and all other
communications between the Parties relating to its subject.
(g) Any notices, requests, demands and other communications hereunder shall be deemed
to have been duly given to a Party when personally delivered or sent by facsimile,
e-mail, overnight delivery, express mail, or via certified mail, return-receipt
requested, if addressed to such Party at its address set forth herein below. Either
Party may change the address or contact person by providing notice of same to the
other Party.
If to ASUS: Mr. Jim Cotton
Sr. Vice President and Procurement Officer
American States Utility Services, Inc.
3715 Latimers Knoll Court, Suite 103
Fredericksburg, VA 22408
With a copy to: Mr. Jim Gallagher
Vice President of Management Services
American States Utility Services, Inc.
630 East Foothill Boulevard
San Dimas, CA 91773
` Confidentiality Agreement No. _________
6 CONFIDENTIALITY AGREEMENT
ASUS N-100 rev 7/28/2016
PROPRIETARY AND CONFIDENTIAL
If to ENGR/CONTR: ____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
(h) This Agreement may be executed in counterparts.
(Signatures on the cover page.)
CONFIDENTIALITY AGREEMENT ACKNOWLEDGEMENT ASUS N-200 (MAY 10) PROPRIETARY AND CONFIDENTIAL
CONFIDENTIALITY AGREEMENT NO: ________
ACKNOWLEDGEMENT
WHEREAS, American States Utilities Services, Inc. (including its parent and subsidiary companies) (“ASUS”) and (“ENGR/CONTR”) have entered into the above captioned agreement (“the Agreement”); and
WHEREAS, the Agreement imposes upon ENGR/CONTR certain obligations concerning the use and handling of ASUS’ Confidential Information (as defined therein); and
WHEREAS, the Agreement also provides that all employees, agents, subcontractors, representatives, and independent contractors of ENGR/CONTR who require access to ASUS Confidential Information must sign an ASUS-provided form recognizing the terms of the Agreement; and
WHEREAS, the undersigned individual (“Individual”) may require access to ASUS Confidential Information;
NOW, THEREFORE, in consideration of the mutual covenants contained herein as well as other good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, ASUS and Individual agree as follows:
1) Individual has received, read, understood and agrees to abide by the terms and conditions of the Agreement, which is hereby incorporated by reference into this Acknowledgement.
2) The terms and conditions of the Agreement shall apply to Individual to the same extent that
these terms and conditions apply to ENGR/CONTR.
IN WITNESS HEREOF, this CONFIDENTIALITY AGREEMENT ACKNOWLEDGEMENT is signed, sealed and delivered as of the effective date referenced above:
ASUS:
By: ___________________________
Name (Print): _____________________
Title: ___________________________ Date: ______________________
Individual:
By: ____________________________
Name (Print):______________________
Company:_________________________ Date: ______________________
American States Utility Services, Inc.
American States Utility Services, Inc.
3715 Latimers Knoll Court, Suite 103 Fredericksburg, VA 22408
HOW TO REGISTER WITH BIDSYNC FOR ACCESS TO BID OPPORTUNITIES
WITH AMERICAN STATES UTILITY SERVICES AND ITS SUBSIDIARIES
Dear Valued Subcontractor/Vendor: American States Utility Services, Inc. (ASUS) and its Subsidiaries have partnered with BidSync to provide web-based bidding services to their subcontractors and vendors. This partnership makes it easier for you to immediately receive and respond to business opportunities via the Internet. ASUS and its Subsidiaries began posting bid opportunities on BidSync on March 1, 2014. Potential subcontractors and vendors are invited to register for free* on BidSync and review posted business opportunities from ASUS and its subsidiaries listed below:
• American States Utility Services, Inc. – Santa Ana, CA or Fredericksburg, VA • Emerald Coast Utility Services, Inc. Eglin AFB, FL • Fort Bliss Water Services Company – El Paso, TX • Old Dominion Utility Services, Inc. – Fort Eustis, Fort Story, or Fort Lee, VA • Old North Utility Services, Inc. – Fort Bragg, NC • Palmetto State Utility Services, Inc. – Fort Jackson, SC • Terrapin Utility Services, Inc. – Andrews AFB, MD
Each subcontractor or vendor may have one account with multiple users to ensure that you are aware of all bid opportunities. We ask that you do not create more than one account as this will cause unnecessary duplication and require multiple qualifications for your firm. The registration process takes less than five minutes. To register free of charge* with BidSync, enter the following URL address in your internet browser: https://www.bidsync.com/SupplierRegister?ac=register&pathid=1050& Registration gives you access to bid opportunities with American States Utility Services and its Subsidiaries. If you have any difficulties registering, contact BidSync Support at 1-800-990-9339 or via email at [email protected] Warm regards, Jim Cotton Vice President, Contracts & Proposal Development *Other agencies within BidSync's network may assess a fee.