rfp no. 18-19-06 request for proposal · rfp #18 -19-06 – uniform rental and laundry services...

RFP No. 18-19-06 REQUEST FOR PROPOSAL

FOR

UNIFORM RENTAL AND LAUNDRY SERVICES

Antioch Unified School District

Purchasing Manager Pamela Gengler

510 G Street Antioch, CA 94509-1259

REQUEST FOR PROPOSALS

NOTICE IS HEREBY GIVEN THAT THE ANTIOCH UNIFIED SCHOOL DISTRICT of Contra Costa County, California, acting by and through its Governing Board, is requesting Statement of Qualifications and Proposals for Uniform Rental and Laundry Services for the Antioch Unified School District.

The Request for PROPOSAL (RFP) may be downloaded from the District's website at: http://www.antiochschools.net/purchasing, beginning April 12, 2019. It is the Proposer's responsibility to check the website for notification of clarification and/or responses to questions. Questions regarding this RFP shall be directed to Pamela Gengler, Purchasing Manager, at [email protected] no later than 10:00 a.m., April 23, 2019 . Responses to questions or clarifications will be posted on the above website by April 25, 2019 by 4:30 p.m. A follow-up phone call is required to verify receipt of any emails sent to the District on this RFP. Please call Mrs. Pamela Gengler at 925.779.7600 ext. 42800.

Sealed proposals must be received up to but no later than 2:00 p.m. on May 3, 2019 at:

Antioch Unified School District Purchasing Manager

Pamela Gengler 510 G Street, Antioch, CA 94509-1259

The Antioch Unified School District reserves the right to reject any or all proposals, to accept or to reject any one or more items of a proposal, or to waive any irregularities or informalities in the proposals or in the bidding.

Publication Dates: April 12, 2019 and April 19, 2019

http://www.antiochschools.net/purchasing

mailto:[email protected]

RFP #18-19-06 – Uniform Rental and Laundry Services Page 2

NOTICE REGARDING DISCLOSURE

OF

CONTENTS OF DOCUMENT

All responses to this Request for PROPOSAL (RFP) accepted by the Antioch Unified School District (District) shall become the exclusive property of the District. Upon opening, all proposals accepted by the District shall become a matter of public record and shall be regarded as public information, with the exception of those elements of each proposal which are identified by the preparers as business or trade secrets and plainly marked as "trade secret," "confidential" or "proprietary." Each element of a proposal that an applicant desires not to be considered a public record must be clearly marked as set forth above, and any blanket statement (i.e., regarding entire pages, documents, or other non-specific designations) shall not be sufficient and shall not bind the District in any way whatsoever. The California Public Records Act requires disclosure (despite the preparer's request for confidentiality), and the District shall not, in any way, be liable or responsible for the disclosure of any such records or part thereof.

RFP #18-19-06 – Uniform Rental and Laundry Services Page 3

Table of Contents

Page Number Bidders Registration Form .................................................................................................................. 4

Section I – Introduction ...................................................................................................................... 5

Section II - Project Description and Scope of Services ....................................................................... 6

Section III - Submittal Format and Content ....................................................................................... 8

Section IV - Pre-Submittal Activities .................................................................................................. 11

Section V - Evaluation of Qualification Proposals ............................................................................. 11

Section VI - Contract Award ............................................................................................................... 12

Section VII - Rejection and Waiver of Proposals ............................................................................... 12

Section VIII - Schedule of Events ....................................................................................................... 13

Section IX - General Provisions .......................................................................................................... 14

Bid Proposal Form .............................................................................................................................. 16

Attachment “A” – Cost Proposal ........................................................................................................ 17

Non-Collusion Declaration ................................................................................................................. 19

Certificate Regarding Worker’s Compensation .................................................................................. 20

Drug-Free Workplace Certification .................................................................................................... 21

RFP #18-19-06 – Uniform Rental and Laundry Services 4

RFP No. 18-19-06 UNIFORM RENTAL AND LAUNDRY SERVICES

Bidders Registration Form

E-MAIL or FAX BACK THIS SHEET ONLY

Attn: Pamela Gengler E-Mail:[email protected] FAX: (925) 779-7601

Antioch Unified School District Bids and Proposals are available on line. If you downloaded a Bid or Proposal without receiving an invitation, you are required to email or fax the following information to (925) 779-7601 so that you may be added to the vendor list to receive addendums to this proposal.

If you have any questions, please email [email protected]

Name

Title_

Organization

Street Address_

Address (cont.)

City

State/Province_

Zip/Postal Code_

Work Phone_

Fax

E- mail_



REQUEST FOR PROPOSAL (RFP) UNIFORM RENTAL AND LAUNDRY SERVICES

SECTION I: INTRODUCTION

The Antioch Unified School District (“District”) is requesting Proposals from qualified persons, firms, partnerships corporations, associations or professional organizations for Uniform Rental and Laundry Services.

Local agencies within District boundaries as well as firms from within the greater Bay Area are encouraged to submit an RFP.

Firms that intend to submit a Proposal must be insured and appropriately qualified.

Interested agencies are invited to submit a Proposal as described below, with one unbound (1) original, four (4) copies and one (1) electronic copy of requested materials to:

Questions regarding this RFP must be received in writing and directed to Pamela Gengler, at [email protected], on or before Tuesday, April 23, 2019, no later than 10:00 a.m.

All Statements of Proposals must be received on or before Friday, May 3, 2019 , no later than 2:00 p.m.

Faxed, electronically transmitted, or late responses will not be accepted.

This Request for PROPOSAL does not commit the Antioch Unified School District to award a contract or pay

any costs incurred in the preparation of a proposal responsive to this request. The District reserves the right to

accept all or part of any RFP or to cancel in part or in its entirety this Request for PROPOSAL. The District further

reserves the right to accept the proposal(s) that it considers to be in the best interest of the District.

Pamela Gengler Purchasing Manager

Antioch Unified School District 510 G Street, Antioch, CA 94509-1259


SECTION II: PROJECT DESCRIPTION AND SCOPE OF SERVICES

A. General Information

The Antioch Unified School District is seeking qualified service providers to furnish uniform/mop head/towel supply, rental and laundry service to the following sites and departments:

Antioch High School (7 employees)

Antioch Middle School (1 employee)

Belshaw Elementary School (2 employees)

Bidwell Continuation School (2 employees)

Black Diamond Middle School (3 employees)

Carmen Dragon Elementary School (3 employees)

Deer Valley High School (8 employees)

Diablo Vista Elementary School (1 employee)

Dallas Ranch Middle School (2 employees)

Dozier Libby High School (2 employees)

Fremont Elementary School

Grant Elementary School (2 employees)

Kimball Elementary School (2 employees)

Lone Tree Elementary School (2 employees)

London Elementary School (1 employee)

Maintenance/Grounds – Bus Garage – Warehouse Departments (24 employees)

Marsh Elementary School (2 employees)

Mission Elementary School (1 employee)

Muir Elementary School (2 employees)

Orchard Park School (2 employees)

Prospects High School (1 employee)

School Services Building (1 employee)

Sutter Elementary School (2 employees)

Turner Elementary School (2 employees)

Nutritional Services – Deer Valley High School (4 employees)

Transportation – (70 employees)

Services shall include laundering and repair of rented uniforms/mop heads/towels. The bidder shall provide new, unused uniforms at no extra cost when the garment has reached the end of its lifespan. Bidder will furnish all materials and labor services required to provide this service as described in these specifications:

B. Specifications

Clothing:

New garments to be provided at the beginning of this contract and each two-year period thereafter.

Eleven (11) shirts and eleven (11) pants should be inventoried for each employee.

Number of changes per week; five (5) shirts and five (5) pants.

Shirts – Executive type dress shirt

Shirts – 65% Dacron, 35% cotton or 65% polyester, 35% cotton

Shirts – wrinkle resistant, button front, with button through chest pockets, convertible collar w/stays.


Shirts – Polo

Shirts – Fire Rated; Class – HRC2, ARC Rating – ATPV 8.0 cal/cm2 (minimum)

Long Pants – poly/cotton blend

Short Pant – poly/cotton blend

Coveralls

Outerwear Jacket – rain resistant

Color – A variety of colors to be specified and/or confirmed at time of fitting.

Clothing to be delivered each week to the various sites/departments, on hangers and sorted by employee.

Sample and fitness testing:

Bidders are required to submit at their own expense to be tested by the District. The samples are due,

with the bid package, no later than 10:00 a.m. and must be delivered to:

Antioch Unified School District Purchasing Manager

Pamela Gengler 510 G Street, Antioch, CA 94509-1259

Quantity Shirt Size Type

1 3XL Knit Polo (100% poly without pocket)

1 M Long Sleeve Work Shirt ARC Rating 8.7

1 XL Short Sleeve Work Shirt (poly/cotton blend)

1 M Long Sleeve Work Shirt (poly/cotton blend)

1 XL Long Pants (poly/cotton blend)

1 XL Outerwear Jacket (Rain resistant)

1 XL Short Pants (poly/cotton blend)

Launder:

Bidder shall launder and press rented garments. On occasion, District employee may launder rented

garments themselves.

Emblems and Name Tags:

District to supply emblems

District will maintain possession of excess emblems until needed for new employees

Vendor to provide name tags on garments for each employee. Nametag specifications shall be silk

screened with a narrow stitched boarder.

If clothing is exchanged for any reason, vendor will transfer old emblems and nametags to new

garments.

Vendor shall provide uniform locker and enclosed soiled garment storage at Maintenance and

Transportation Departments located at 701 W. 18th Street, Antioch, California.

Fitting: Each person must be individually measured and fitted prior to first delivery of garments. During the

first two weeks of service, vendor shall make necessary adjustments and provide necessary replacements at no additional cost.


Inventory Control: The vendor will be required to furnish a complete listing of garments delivered each week by

site/department and detailed by individual. Amy garments lost by vendor shall be replaced at no additional cost.

Service Tag Number:

Some type of tag system must be provided so that employees can call attention to needed repairs, etc.

Replacement of Garments: Vendor must maintain clothing in good, serviceable condition throughout the term of the service

agreement.

District will be responsible for lost and damaged garments by the employee.

There is no provision for the employee to change between short and long sleeves throughout the year.

Mops and Towels:

• Vendor shall provide mops and towels in the following sizes:

Mops Towels

38” 18 x 18 - Purple

50” 14 x 16 - Yellow

60”

Additions and Deletions: The number of garments or other rental items may be increased or decreased from time to time.

Notification will be given to the vendor when changes are necessary. In any case, the unit prices shall remain the same as the original proposal.

Property of Vendor: • All garments or other merchandise furnished under the rental agreement shall remain property of vendor.

C. Term of Contract

The contract awarded through this RFP is expected to be effective for a three (3) year period July 1, 2019 to June

30, 2022, with two (2) one-year options at the District’s discretion. Contract or price increases (other than what is

agreed to by the District and the Bidder in the agreement) will not be allow.

SECTION III: SUBMITTAL FORMAT AND CONTENT

A. General

Proposals must be submitted in the format and order outlined below. The Proposal should present all information in a concise manner, neatly arranged, legible, and in terminology understandable for evaluation by the District’s Proposal Evaluation Committee. All information requested is to be addressed directly and completely. It is more desirable to give additional information than less when the answer could be misinterpreted. There should be no attachments, enclosures, or exhibits other than those considered by the Proposer to be essential to a complete understanding of the Proposal submitted.


It is required that one (1) unbound original and four (4) copies as well as 1 digital copy be submitted with Sample and fitness testing (see page 7). B. Contents

Each proposal submission package should be presented so that it can be readily viewed and labeled in the following tab order, indexed by each section.

1. Bid Proposal Form - with signed Addenda Acknowledgment (if applicable)

2. District Forms: a. Non-Collusion Affidavit b. Bidder’s Certificate Regarding Workers’ Compensation c. Drug-Free Workplace Certificate

3. Submittal Letter - The Proposer will provide a cover letter describing a brief history of the Proposer and its organization. The letter will indicate the principal or officer of the Proposer organization who will be the District’s primary point of contact during clarifications or negotiations. This individual must have the authority to clarify and/or negotiate all aspects on the scope of products and services on behalf of the Proposer. An officer authorized to bind the Proposer to the terms and conditions of this RFP must sign the cover letter transmitting the proposal. An unsigned proposal or one signed by an individual unauthorized to bind the Proposer may be rejected.

4. Staffing Model – Please provide the names, resumes and certifications of staff who would be working with the District. Specifically provide the organization’s leadership structure and staffing model for the services outlined in the RFP.

5. Experience – Proposer must indicate prior experience in providing the services; as detailed herein. Include sufficient detail to demonstrate the relevance of such qualifications and experience. The Proposer should include all other similar services performed by Proposer. Information should include location of each service, a management-level contract representative at the organizations referenced along with contact telephone number. The District reserves the right to interview, and if applicable, visit referenced clients.

6. Cost Proposal – Attachment “A” – Cost Proposal

Antioch Unified School District will not pay for services before it receives them. Therefore, do not propose contract terms that call for upfront payments or deposits.


7. References –List three (3) references that Proposer is successfully providing similar services. By providing such references, the Proposer authorizes the District to contact references and hereby authorizes such references to provide information to the District, without liability to either the District or the reference source, which Proposer hereby waives as a condition of such information being furnished.

1. Company Name ________________________________________________________________ Address _______________________________________________________________________ Phone Number _____________________________ Fax Number _________________________ Contact Name ______________________________ E-Mail ______________________________ Provide the dollar amount and description of the products and services provided: ____________ _____________________________________________________________________________ _____________________________________________________________________________ 2. Company Name ________________________________________________________________ Address _______________________________________________________________________ Phone Number _____________________________ Fax Number _________________________ Contact Name ______________________________ E-Mail ______________________________ Provide the dollar amount and description of the products and services provided: ____________ _____________________________________________________________________________ _____________________________________________________________________________ 3. Company Name ________________________________________________________________ Address _______________________________________________________________________ Phone Number _____________________________ Fax Number _________________________ Contact Name ______________________________ E-Mail ______________________________

Provide the dollar amount and description of the products and services provided: ____________ _____________________________________________________________________________ _____________________________________________________________________________


SECTION IV: PRE-SUBMITTAL ACTIVITIES

A. Questions Concerning Request for Proposals

All questions, interpretations or clarifications, either administrative or technical must be requested via email by

10:00 a.m. on Tuesday, April 23, 2019 and directed to:

Antioch Unified School District Pamela Gengler

[email protected]

B. Revision to the Request for Proposal

The District reserves the right to revise the RFP until the date specified in the Schedule of Events. The District expressly

reserves the right to alter the Schedule of Events.

SECTION V: EVALUATION OF QUALIFICATION PROPOSALS

Proposals will be evaluated by the Selection Advisory Committee on a variety of criteria as described below, which

includes, but is not limited to, background/experience, responsiveness, references, proposed costs and qualifications.

Based on this review of the Proposals, and any potential interviews, the District shall rank the proposals, with the top-

ranking going to the Proposal deemed most advantageous to the District. The District will award a contract to the

proposer with the most advantageous proposal based on the above-described evaluation. This means the lowest cost

proposal may not be selected. The District may, at its sole discretion, award to a proposer based on their proposal and

interview alone without further consideration or the District may interview several proposers.

After the proposals are evaluated, vendors may be invited to an interview as part of the evaluation process at the

discretion of the RFP committee. Proposals will be reviewed and evaluated based on the following evaluation criteria:

Evaluation Criteria:

Background/Experience – Proposer shall provide work background and experience as identified in the Scope of Services section of this RFP.

Cost Information – Proposer shall provide cost information aligned to the proposed services (Attachment “A”). Qualifications – Detailed and comprehensive evidence that all services requested by the RFP can be delivered. Responsiveness – Overall responsiveness of the proposal in clearly stating and understanding the scope of work, and in meeting the requirements of the RFP.

References – Proposer is to list three (3) references where Proposer has successfully furnished similar services. By providing such references, the Proposer authorizes the District to contact references and hereby authorizes such references to provide information to the District, without liability to either the District or the reference source, which Proposer hereby waives as a condition of such information being furnished.



SECTION VI: CONTRACT AWARD

The Governing Board of the District reserves the right to accept or reject any or all RFPs, to select a qualified firm with or

without interviews and to negotiate with any or more than one of the responsible submitters. Submitters shall be

responsible for any and all expenses that they may incur in preparing proposals. Responses received from this RFP will

be used as the foundation for the development of an agreement and contract with specific provisions subject to review,

negotiations and approval of the Antioch School District Board of Trustees and District Superintendent or his designee.

SECTION VII: REJECTION AND WAIVER OF PROPOSALS

This request for proposal does not commit the District to award a contract or pay any costs incurred in the preparation

of a proposal in response to this request. The District reserves the right to accept or reject any or all proposals received,

to negotiate with qualified firm(s) or cancel the request, and to waive any minor irregularities in the proposal or proposal

process.

The District may require the firm to submit additional data or information the District deems necessary to substantiate

the costs presented by the firm. The District may also require the firm to revise one or more elements of its proposal in

accordance with contract negotiations.


SECTION VIII: SCHEDULE OF EVENTS

The District anticipates the following time line for the process of selecting a firm and project development:

Action Date Release of Request for Proposals April 12, 2019 Deadline for Submission of Email Questions April 23, 2019 by 10:00 a.m. Revisions/Clarifications/Questions Answered April 25, 2019 by 4:30 p.m. Posted on Website Deadline for Receipt of Proposals May 3, 2019 by 2:00 p.m. Select and Notify Recommended Firm May 8, 2019 Recommendation to the Board of Education May 22, 2019


SECTION IX: GENERAL PROVISIONS

Insurance

A selected firm shall maintain insurance that is sufficient to protect the firm's business against all applicable risks, and

such coverage shall meet, at a minimum, the District's insurance requirements.

General Liability $5,000,000

Automobile Liability $1,000,000

Professional Liability $1,000,000

Workers’ Compensation $1,000,000

Insurance companies must be lawfully authorized to do business in California as admitted carriers, have an "A" policy

holders rating and a financial size rating of at least Class VII in accordance with the most current Best's Key Rating Guide,

Property-Casualty.

Proof of insurance coverage must be provided for any consultant or sub-consultant personnel.

Warranty

All warranties must be clear, concise and in writing. Warranties shall be specific as to what is and is not covered along

with the exact term (in calendar days) of each covered item.

Signature(s)

Any signature required on the proposal forms must be signed in the name of the Vendor and must bear the signature in longhand of the person or person(s) duly authorized to sign the proposal on behalf of the bidder in permanent ink.

Non-Collusion

By submittal and signing the proposal, the firm is certifying that the proposal document is genuine and not a sham or collusive, and not made in the interest of any person not named and that the firm has not induced or solicited others to submit a sham offer, or to refrain from proposing.

Compliance with Laws and Regulations

The firm shall comply with federal, state and local laws, regulations, and industry standards. The firm shall also comply

with the Drug Free Workplace Act requirements of California Government Code Sec 8350 et. Seq.


Withdrawal of RFP

The Proposer may withdraw its proposal by submitting a written request signed by the Proposer's authorized

representative, prior to the time and date specified for proposal submission to the District contact person identified in

this RFP.

Proposals may be withdrawn and resubmitted in the same manner if done so before the proposal submission deadline.

Withdrawal or modification offered in any other manner will not be considered.

Reservations

The District reserves the right to cancel this RFP at any time prior to contract award without obligation in any manner for

proposal preparation, fee negotiation or other marketing costs associated with this RFP. The District further reserves the

right not to contract for the services described in the RFP.

District may reject any or all proposals and may waive any immaterial deviation(s) in a proposal. District's waiver of an

immaterial deviation shall in no way modify the RFP documents or excuse the Proposer from compliance with the other

provisions of this RFP.

Confidentiality and Disposition of Proposals

Proposals become the property of the District and may be returned only at the District's option and at the Proposer's

expense. Information, excluding Proposer's financial information and proprietary information, as clearly marked by

Proposer, contained therein shall become public documents subject to the Public Records Act. Proposer must notify the

District in advance of any proprietary or confidential materials contained in the proposal and provide justification for not

making such material public. The District shall have sole discretion to disclose or not disclose such material subject to any

protective order which proposer may obtain.

Costs

Costs of preparing a Response in response to this RFP are the sole responsibility of the Respondent.

Fingerprinting and Drug-Free Policy

The successful firm shall be required to complete any and all fingerprinting requirements and criminal background checks

required by State law and shall also be required to complete a Drug-Free Workplace Certificate.

Non-Discrimination

The District does not discriminate on the basis of race, color, national origin, religion, age, ancestry, medical condition,

disability or gender in consideration for an award of contract.


ANTIOCH UNIFIED SCHOOL DISTRICT BID PROPOSAL FORM

In accordance with the contract document, the undersigned proposes to supply all of the material and perform all work

specified in the contract documents in accordance with the attached proposal.

Receipt of the following addenda is acknowledged:

Addendum No. _______________________ Date: _____________________________

Addendum No. _______________________ Date: _____________________________

Addendum No. _______________________ Date: _____________________________

Addendum No. _______________________ Date: _____________________________ If the bidder is a corporation, state the capacity/title of the corporate officer signing and affix the corporate seal; if a

partnership all partners should sign under the partnership name. Unsigned bids will not be accepted.

The undersigned declares under penalty of perjury under the laws of the State of California that the representations

made in this bid are true and correct.

Name of Firm: _________________________________________________________________

Address: ______________________________________________________________________

Telephone Number: _____________________________________________________________

Fax Number: ___________________________________________________________________

Federal Tax ID Number: __________________________________________________________

Signature: _____________________________________________________________________

Type or Print Name: _____________________________________________________________

Title: _________________________________________________________________________

Date: _________________________________________________________________________


ANTIOCH UNIFIED SCHOOL DISTRICT ATTACHMENT “A” – Cost Proposal

Item

Qty. per week

Rental Unit Cost per week (each)

Rental Extended price per week

Replacement cost to District for damage to garments, outside of

normal wear and tear

Normal Wear & Tear Period (specify your W & T period, e.g. 12-24-

26 months)

Shirts - Executive type dress shirt $ $

Shirts - 65% Dacron, 35% cotton or 65% polyester, 35% cotton

$ $

Shirts - wrinkle resistant, button front, with button through chest pockets, convertible collar w/stays.

$ $

Shirts – Polo $ $

Shirts – Fire Rated; Class – HRC2, ARC Rating – ATPV 8.0 cal/cm2 (minimum)

$ $

Coveralls $ $

Mop Heads – 38” $ $



Towels – 18” x 18” - Purple

Towels - 14” x 16” - Yellow

GRAND TOTAL

$

$

Vendor: ____________________________________________________________________________________


ANTIOCH UNIFIED SCHOOL DISTRICT ATTACHMENT “A” – Cost Proposal

Item Cost per Unit

Providing and affixing patches with District Logo Providing and affixing patches with individual name Environmental Fees

Other: Enter any additional charges not listed in the proposal. Any charges not listed in the proposal or herein will not be paid.

Alterations: Please list the cost and type of alterations. If left blank it will be considered to be at no cost to the District.

Vendor: ____________________________________________________________________________________ Address: ___________________________________________________________________________________ Email address: _______________________________________________________________________________ Telephone: ___________________________________ Fax: _______________________________________ Authorized Agent: ______________________________ Title: ______________________________________ Signature: __________________________________________________________________________________


NON-COLLUSION DECLARATION TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID

The undersigned declares: 1. I am the ___________ of ____________________________, the party making the foregoing bid. Title Bidder Name

2. The bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation.

3. The bid is genuine and not collusive or sham.

4. The bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid. The bidder has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or to refrain from bidding.

5. The bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other bidder.

6. All statements contained in the bid are true.

7. The bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member or agent thereof, to effectuate a collusive or sham bid, and has not paid, and will not pay, any person or entity for such purpose.

Any person executing this declaration on behalf of a bidder that is a corporation, partnership, joint venture, limited liability company, limited liability partnership, or any other entity, hereby represents that he or she has full power to execute, and does execute, this declaration on behalf of the bidder. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on _______________________________ Date

at __________________________, _______________. City State

________________________________________ Signature

________________________________________ Name Printed or Typed

_________________________________________ ________________________ Address Telephone Number


ANTIOCH UNIFIED SCHOOL DISTRICT BIDDER’S CERTIFICATE REGARDING WORKERS COMPENSATION

Labor Code Section 3700 “Every employee except the state shall secure the payment of compensation on one or more of the following ways: (a) By being insures against liability to pay compensation in one or more insurers duly authorized to write compensation in this state. (b) By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing proof satisfactory to the Director of Industrial Relations of ability to self-insure, and to pay any compensation that may become due to his employee. (c) For any county, city, city and county, municipal corporation, public district, public agency, or any political subdivision of the state, including each member of a pooling arrangement under a joint exercise of powers agreement (but not the state itself), by securing form the Director of Industrial Relations a certificate of consent to self-insure against worker’s compensation claims, which certificate may be given upon furnishing proof satisfactory to the director of ability to administer worker’s compensation claims properly, and to pay worker’s compensation claims that may become due to its employees. On or before May 31, 1979, a political subdivision of the state which, on December 31, 1978, was insured for its liability to pay compensation, shall file a properly completed and executed application for a certificate of consent to self-insure against worker’s compensation claims. The certificate shall be issued and be subject to the provisions of Section 3702.” I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker’s compensation or to undertake self-insurance in accordance with the provisions of the code, and I will comply with such provisions before commencing the performance of the work of this contract. (Proper Name of Contractor) By (Signature of Contractor) In Accordance with Article 5 (commencing at Section 1860), Chapter 1, Part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the awarding body prior to performing any work under this contract.) (Print Name of Signer) (Title of Signer)


DRUG-FREE WORKPLACE CERTIFICATION

This Drug-Free Workplace Certification form is required from all successful bidders pursuant to the requirements mandated by Government Code Section 8350 et seq., the Drug-Free Workplace Act of 1990. The Drug-Free Workplace Act of l990 requires that every person or organization awarded a contract or grant for the procurement of any property or service from any State agency must certify that it will provide a drug-free workplace by doing certain specified acts. In addition, the Act provides that each contract or grant awarded by a State agency may be subject to suspension of payments or termination of the contract or grant, and the contractor or grantee may be subject to debarment from future contracting, if the contracting agency determines that specified acts have occurred. Pursuant to Government Code Section 8355, every person or organization awarded a contract or grant from a State agency shall certify that it will provide a drug-free workplace by doing all of the following: a) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited in the person's or organization's workplace and specifying actions which will be taken against employees for violations of the prohibition; b) Establishing a drug-free awareness program to inform employees about all of the following: 1) The dangers of drug abuse in the workplace; 2) The person's or organization's policy of maintaining a drug-free workplace. 3) The availability drug counseling, rehabilitation and employee-assistance programs; 4) The penalties that may be imposed upon employees for drug abuse violations; c) Requiring that each employee engaged in the performance of the contract or grant, be given a copy of the statement required by subdivision (a) and that, as a condition of employment on the contract or grant, the employee agrees to abide by the terms of the statement. I, the undersigned, agree to fulfill the terms and requirements of Government Code Section 8355 listed above and will publish a statement notifying employees concerning (a) the prohibition of controlled substance at the workplace, (b) establishing a drug-free awareness program, and (c) requiring that each employee engaged in the performance of the contract be given a copy of the statement required by Section 8355(a) and requiring that the employee agree to abide by the terms of that statement. I also understand that if the DISTRICT determines that I have either (a) made a false certification herein, or (b) violated this certification by failing to carry out the requirements of Section 8355, that the contract awarded herein is subject to termination, suspension of payments, or both. I further understand that, should I violate the terms of the Drug-Free Workplace Act of 1990, I may be subject to debarment in accordance with the requirements of Section 8350 et seq. I acknowledge that I am aware of the provisions of Government Code Section 8350 et seq. and hereby certify that I will adhere to the requirements of the Drug-Free Workplace Act of 1990. CONTRACTOR Date:

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