Alabama A&M University
Two (2) 2017 Dodge Charger Police Vehicles for
Public Safety Department
Invitation to Bid (ITB) –
2K17-04B
GENERAL CONDITIONS & GUIDELINES
1. Requirements: Alabama Agricultural and Mechanical University (“AAMU”, “the
Awarding Authority”) must receive each vendor’s bid/proposal package by mail or hand
delivered no later than 2:00 P.M. Central Time on the bid/proposal submission deadline,
which will also be the date and time of the bid/proposal opening. Unless otherwise noted,
the bid/proposal opening will take place at:
Alabama Agricultural and Mechanical University
Purchasing Department
4900 Meridian Street
Patton Hall, Room 305
Normal, AL 35762
All bids/proposals received must be provided in a sealed envelope. (Ala. Code § 41-16-54
(b)) A faxed or emailed bid/proposal does not meet the requirements of the statute because
it is not sealed, and all such bids/proposals will be deemed ineligible for award. (Attorney
General’s Opinion # 91-016)
Mailed sealed bids/proposals sent to the Purchasing Department by logistics carriers
FedEx, DHL, or Airborne Express must be sent to the following address:
Alabama A&M University
Purchasing Department
4900 Meridian Street
Patton, Hall, Room 305
Normal, AL 35762
Mailed sealed bids/proposals sent to the Purchasing Department by the United States Postal
Service (USPS) must be sent to the following address:
Alabama A&M University
Purchasing Department
P.O. Box 1627
Normal, AL 35762
2. Bid/Proposal Preparation: Alabama Agricultural and Mechanical University
bid/proposal forms must be completed and returned as a part of the bid quote/proposal.
Bids/proposals should be as thorough and detailed as possible so that AAMU may be able
to properly evaluate a bidder’s capabilities to provide the required products or services. All
bidders must send descriptive literature and/or manufacturer’s specifications along with
any supplemental specifications necessary to compare the items bid/proposal with the
requirements set forth in the bid/proposal form. All bids/proposals must be submitted
within a sealed package with the bid number, opening date and time, and bidder’s
name and address clearly indicated on the envelope. Bidders are required to submit all
items required in the bid/proposal package.
An authorized representative of the Bidding Agency shall sign ITB bid/proposal
documents. All information requested must be submitted. Failure to submit all information
requested may result in rejection of the bid/proposal. Mandatory requirements are those
required by law or regulation or are such that they cannot be waived and are not subject to
negotiation.
All supporting documentation submitted with the bid/proposal should be bound in that
single volume.
Ownership of all data, materials, and documentation originated and prepared for the
University pursuant to the ITB shall belong exclusively to AAMU and be subject to public
review.
3. Oral Presentation: Bidders who submit a bid/proposal in response to this ITB/proposal
may be required to give an oral presentation of their bid/proposal to the Awarding
Authority. This will provide an opportunity for the Bidding Agency to clarify or elaborate
on the bid/proposal but will in no way change the original bid/proposal. If an oral
presentation is to be required, the Awarding Authority will schedule the time and location
of these presentations. Oral presentations are an option of the Awarding Authority and
may not be required to be conducted.
4. Bid Bonds: It is required for any contract exceeding $10,000 that the bidder submit with
his or her bid a bid bond payable to Alabama A&M University in the amount not less than
five percent (5%) of the base bid/proposal to not exceed $10,000. Bid bonds must be
submitted in a form of a cashier’s check, certified check, postal money order, irrevocable
letter of credit, or U.S. Treasury Notes in lieu of a bid bond. No personal checks or
company checks will be accepted. If a bid bond, when required, is not included in a bid
package, the bidder’s bid package will not receive further consideration.
5. Award: Alabama Agricultural and Mechanical University (“AAMU”, the Awarding
Authority) reserves the right to accept or to reject any or all bids/proposals and is not
bound to accept the lowest bid if that bid is contrary to the best interests of the University.
In making an award, intangible factors such as a bidder’s service, integrity, conformity
with specifications, transportation charges, terms of delivery, facilities, equipment,
reputation, and past performance history will be weighed along with the quality displayed
in the samples submitted (Ala. Code § 41-16-57 (a)). Bids may be awarded either item by
item, in product groups, or all or none, whichever appears to be in the best interests of the
University. Selection shall be made of one bidder deemed to be fully qualified and best
suited among those Bidders that submitted bids/proposals on the basis of the evaluation
factors included in this ITB. Financial criteria shall be considered, but will not be the sole
determining factor. After reviews have been conducted, the Awarding Authority shall
select the Bidding Agency which has made the best bid/proposal and shall award the
bid/proposal to that Bidding Agency. The Awarding Authority may cancel this ITB or
reject any and all bids/proposals at any time prior to an award.
A bid/proposal accepted in error as the lowest responsible bid/proposal is null and void and
AAMU, upon discovery of the error, may accept the lowest bid/proposal and award the
contract to that bidder. (Attorney General’s Opinion # 2002-071)
Under Ala. Code § 41-16-57 (c), the Awarding Authority may consider lifecycle costs in
making its determination of the lowest responsible bidder.
Under Ala. Code § 41-16-57 (b), the Awarding Authority shall give preference to
commodities produced in Alabama or sold by Alabama companies provided there is not a
loss in price or quality. However, when the lowest bidder is a foreign entity, meaning that
the vendor does not have a place of business within the State of Alabama, AAMU may
award the contract to an “in-state” responsible bidder if his or her bid/proposal is within
ten percent (10%) of the foreign entity’s lowest responsible bid/proposal. AAMU may
also award the contract to any of the following “in-state” responsible Bidders that are
within ten percent (10%) of the foreign entity lowest bidder:
A. A woman-owned enterprise
B. A small business enterprise
C. A minority-owned business enterprise
D. A veteran-owned business enterprise
E. A disadvantaged-owned business enterprise
If an “in-state” vendor is not within ten percent (10%) of the foreign entity lowest
responsible bidder, the contract will be awarded to the foreign entity.
6. Second Lowest Responsible Bidder: An Awarding Authority can award the bid/proposal
to the second lowest responsible bidder if the lowest responsible bidder defaults on the
contract after the award has been made, but only under any of the following circumstances:
A. The lowest responsible bidder notifies the Awarding Authority in writing that he or
she will no longer comply with the contract’s terms.
B. The Awarding Authority documents the default in writing.
The second lowest responsible bidder shall only receive the award given that he or she
agrees to all the terms and conditions in the original bid/proposal.
7. Bid/Proposal Withdrawal: No bids/proposals may be withdrawn without approval from
Alabama Agricultural and Mechanical University’s Purchasing Department. Any requests
for withdrawal must be in writing to the Purchasing Department within five (5) days after
the bid/proposal opening date with justification or reason for the withdrawal. More than
two (2) such requests could result in removal from our bid/proposal list. No bid/proposal
may be withdrawn after the issuance of a purchase order. If a withdrawal is made after the
purchase order is issued, the vendor will be considered in default. Refer to “Default of
Contractor.”
Alabama Agricultural and Mechanical University may remove any vendor from the
Bidders List after a vendor fails to respond to three consecutive Invitation to Bid/proposal
(ITB) requests.
8. Bid/Proposal Rejection: The Awarding Authority may reject any bid/proposal if the price
is deemed excessive or the quality of the product inferior. (Ala. Code § 41-16-57 (c)) In
the event only one bidder responds to an invitation to bid/proposal, the Awarding Authority
may reject the bid/proposal and negotiate the purchase or contract, provided that the
negotiated price is lower than the bid/proposal price and there are no change in
specifications. (Ala Code § 41-16-50 (a) and Attorney General’s Opinion # 98-140). In
the event only one bidder responds to an invitation to bid/proposal, the Awarding Authority
may also advertise for and seek other competitive bids/proposals. Where only one
responsible and responsive bid/proposal is received, AAMU may only negotiate for a price
lower than the single bid/proposal received.
9. Prices and Payment Terms: Bidders should quote applicable cash discounts. The
University will not take into consideration in the bid/proposal evaluation any cash discount
of less than thirty (30) days of duration. However, we will take advantage of all discounts
for which we are eligible. Identify these discounts in your bid/proposal response.
Bids/proposals containing “payment in advance” or “cash on delivery (COD)
requirements may be rejected.
10. Applicable Law: It is agreed that this quotation is valid to the extent that it does not violate
the constitution or the laws of the State of Alabama.
Bidder represents and warrants that all article and services covered by this bid/proposal
meet or exceed the safety standards established and promulgated under the Federal,
Occupational Safety and Health Act of 1970, No. 2006, and its regulations in effect or
proposed as the date of this bid/proposal.
The furnishing of materials, supplies, equipment, or service to Alabama Agricultural and
Mechanical University under this purchase order, contract, solicitation for bids/proposals,
or construction specification constitutes assurance by the vendor or contractor of his
compliance with applicable provisions of an pertinent regulations promulgated under
Executive Order 11246, date September 28, 1965 issued by the President of the United
States of America, and Public Law 88-352, 88
th
Congress, the “Civil Rights Act of 1964.”
11. Non-Collusion: Any agreement or collusion among Bidders or prospective Bidders in
restraint of freedom of competition, by agreement to bid/proposal at a fixed price or to
retrain from bidding, or otherwise, shall render the bids/proposals of such Bidders void.
Each bidder certifies that he has not been a party to such an agreement by signing this
bid/proposal.
12. New Products: Unless specifically called for in the bid/proposal, all products for purchase
must be new, never previously used, and the current model and/or packaging. No
remanufactured or refurbished, demonstrator, used, or irregular product will be considered
for purchase unless otherwise specified in the bid/proposal. The manufacturer’s standard
warranty will apply unless otherwise specified in the bid/proposal. All requests should be
supplied complete, ready to be installed, including all cabling and connectors, where
applicable.
13. Bonds: Bid/proposal and performance security bond, when required will be indicated.
14. Bid/Proposal Submission: Failure to submit a bid/proposal on the official Alabama
Agricultural and Mechanical forms provided for that purpose shall be a cause for rejection
of the bid/proposal. Return of the complete document is required. Modification of or
additions to any portion of the solicitation may be cause for rejection of the bid/proposal;
however, AAMU reserves the right to decide, on a case-by-case basis, in its sole discretion,
whether or not to reject such a bid/proposal as non-responsive.
Before submitting proposal, each Bidder shall examine carefully all documents pertaining
to the purchase.
Submission of bid will be considered presumptive evidence that the Bidder is conversant
with the requirements of the documents and has made due allowance in his or her bid for
all contingencies.
All information shall be typewritten or handwritten in the appropriate spaces on the forms.
Mistakes may be crossed out and corrections inserted before submission of your
bid/proposal. Corrections shall be initialed in ink by the person signing the bid/proposal.
All bids/proposals must be submitted in a sealed envelope bearing on the outside the
name and address of the vendor, proposal number, name of the project, and date.
All bids/proposals must be signed. Failure to do so will result in rejection of the
bid/proposal.
15. Delivery: Time of delivery shall be stated as the number of calendar days following receipt
of the order by the vendor, to receipt of the goods by Alabama Agricultural and Mechanical
University.
Delivery time may be a criterion in awarding bids/proposals. Specify earliest possible
delivery after receipt of order. Failure to deliver within the time the vendor specified in
the bid/proposal will constitute a default and may cause cancellation of the contract. Refer
to “Default of Contractor.”
All prices quoted are to include Free on Board (F.O.B.) shipping to Alabama Agricultural
and Mechanical University, Central Receiving Building, 453 Buchanan Way, Normal, AL
35762 (unless another F.O.B. point is stated by the University on the bid/proposal form).
The successful bidder must assume all responsibility for damage in transit. When
installation is required, it will be stated in the bid/proposal requirements. If you are not
quoting a delivered price, you must indicate your shipping provider / logistics carrier and
all related transportation costs itemized in your bid/proposal for evaluation purposes.
16. Bid/Proposal Terms: Bidders must show unit prices, extensions, and total price, where
applicable. In the event of a discrepancy between the unit price and the extension, the unit
price shall govern. Bids/proposals shall remain firm for a minimum of thirty (30) days
from the date of bid/proposal opening and any exceptions must be clearly stated.
17. Bid/Proposal Opening: Bidders may attend the bid/proposal opening, but no information
or opinions concerning the ultimate award will be given at the bid/proposal opening or
during the evaluation process. After the public opening of this bid/proposal, the results
will not be available to Bidders not attending the opening until after an award is made.
18. Bids/Proposals are Public Record: All bids/proposals become a matter of public record
at bid/proposal award. Alabama Agricultural and Mechanical University accepts no
responsibility for maintaining confidentiality of any information submitted with
bid/proposal whether labeled confidential or not.
19. Standards of Quality: When a material, article, or piece of equipment is identified in
these specifications by reference to manufacturer’s or vendor’s name, trade name, catalog,
and stock numbers, etc., it is intended merely to establish a standard; and, any material,
article or equipment of other manufacturer and vendor which will perform equally the
duties imposed by the general design, provided the material, article, or equipment
proposed, is in the opinion of the Purchasing Agent of equal substance and function. It
shall not be purchased or installed by the contractor without the Purchasing Agents’ written
approval.
The bidder is responsible to clearly and specifically indicate the product being offered and
to provide sufficient descriptive literature, catalog cuts and technical detail to enable
AAMU to determine if the product offered meets the requirements of the Invitation to
Bid/proposal (ITB). Normally in competitive sealed bidding only the information
furnished with the bid/proposal will be considered in the evaluation. Failure to furnish
adequate data for evaluation purposes may result in declaring a bid/proposal non-
responsive. Unless the bidder clearly indicates in its bid/proposal that the product offered
is an “Equal” product, such bid/proposal will be considered to offer the brand name product
referenced in the invitation. References to manufacturers, suppliers, catalog numbers, etc.
are intended to establish quality standards and does not exclude bids/proposals from others
as long as quality standards are met. Offers of equal items must state the brand and quality
standard. Alabama Agricultural and Mechanical University will be the sole judge of Equal
items bid.
20. Vendor Authorization: Vendor must be an authorized distributor/agent to sell products
proposed in this bid/proposal request. When it is deemed to be in the best interest of the
University, the Purchasing Department may request an on-site premise visit to examine the
facility.
21. Default of Contractor: Where the University has determined the contractor to be in
default, the University reserves the right to purchase any or all products or services covered
by the contract on the open market and to charge the contractor with cost in excess of the
contract price. Until such assessed charges have been paid, no subsequent bid/proposal
from the defaulting contractor will be considered.
22. Fiscal Funding Clause: The continuation of this contract is contingent upon the
appropriation of funds to fulfill the requirements of the contract by the legislature. If the
legislature fails to appropriate sufficient monies to provide the continuation of a contract,
the contract shall terminate on the date of the beginning of the first fiscal year for which
funds are not appropriated.
23. Contract Cancellation: The Purchasing Department has the right to cancel any contract,
in accordance with Purchasing Rules and Regulations, for cause, including, but not limited
to, the following: (1) failure to deliver within the agreed upon contract duration; (2) failure
of the product or service to meet specifications, conform to sample quality, or to be
delivered in good condition; (3) misrepresentation by the contractor; (4) fraud, collusion,
conspiracy, or other unlawful means of obtaining any contract with the state; (5) conflict
of contract provisions with constitutional or statutory provisions of state or federal law;
and (6) any other breach of contract.
24. Warranties: Should merchandise described on this bid/proposal contain a manufacturer’s
warranty, Bidders must state the warranty terms in the space provided on the bid/proposal.
Bids/proposals offered for merchandise when no warranty applies must clearly state: “NO
WARRANTY COVERAGE.” Warranty information may be criteria in making this award.
Failure of Bidders to furnish this data may cause rejection of the complete bid/proposal as
being non-responsive.
25. Disclosure Statement: The successful bidder will be required to file with the Purchasing
Department a disclosure statement of relationship between contractors/grantees and
employees/officials of the University. This form must be completed prior to issuance of
the Purchase Order by Alabama Agricultural and Mechanical University.
Alabama
AS{M
UI\TIVERSITY
Purchasing
Department
P.
O. Box 1627
Normal,Alabama
35762
(256)
372-5227
Office
(256\
372-5223
Fax
Certification Pursuant
To Act
No. 2006-557
The following
statement is
applicable
to all Requests
for Formal
Bid
and
Contracts
for Professional
Services
that are required
on all taxable
sales
and leases into
Alabama:
Alabama Law
(Section
4l-4-l16,
Code of
Alabama
1975)
provides
that every bid
submitted and
contract executed
shall contain a certification
that
the vendor,
contractor, and
all of its affiiiates that make
sales for delivery
into Alabama
or
leases for
use
in
Alabama are registered,
collecting, and remitting
Alabama
state
and local sales,
use, andlor lease tax
on all taxable sales and leases
into Alabama.
By
submitting this bid,
the bidder is
hereby certifying
thut they
ure infull
compliunce
with Act IYo.
2006-557,
they are not
barred from
bidding or
entering
into a contract pursuant
to 4l-4-1
16,
and acknowledges
that the
awarding authority
may
declare the
contract
void if the
certification is
false.
Contractor’s E-Verify Clause and Affidavit
Effective immediately, this notice shall be included in all Requests for Proposals (RFPs) or
Invitations to Bid to provide labor, supplies, or services for Alabama A&M University pursuant to
contracts to be signed on or after January 1, 2012.
E-VERIFY NOTICE (RFP)
The Beason-Hammon Alabama Taxpayer and Citizen Protection Act, Act No. 2011-535, Code of
Alabama (1975) § 31-13-1 through 31-13-30” (also known as and hereinafter referred to as the
Alabama Immigration Act”) is applicable to contracts with Alabama A&M University (the
“University”). As a condition for the award of a contract and as a term and condition of the contract
with the University, in accordance with § 31-13-9 (a) of the Alabama Immigration Act, any business
entity or employer that employs one or more employees shall not knowingly employ, hire for
employment, or continue to employ an unauthorized alien and shall attest to such by sworn affidavit
signed before a notary. Such business entity or employer shall provide a copy of such affidavit to the
University as part of its bid or proposal for the contract along with documentation establishing that
the business entity or employer is enrolled in the E-Verify program. The required affidavit form is
included at the end of this notice. A response to this RFP/Invitation which does not include the
required affidavit and proof of E-Verify enrollment will be considered non-conforming and non-
responsive. The University at its sole discretion may allow a reasonable period, not to exceed ten
(10) business days, for non-conforming bids to be amended to comply with the Alabama
Immigration Act. However, the University has no duty to alert any bidder that their response is
non-conforming in any aspect.
At the time of execution of the awarded contract, the contractor will be required to execute
another affidavit in substantially the same form. In addition, during the performance of the
contract, such contracting business entity or employer shall continue to participate in the E-Verify
program and shall verify every employee that is required to be verified according to the applicable
federal rules and regulations. The contracting business entity or employer shall assure and require
that every subcontractor performing under the contract shall also comply with §31-13-9(c), and the
contracting business entity or employer shall maintain records that are available upon request by
the University, state authorities, or law enforcement to verify its compliance and the compliance of
all subcontractors with the requirements of the Alabama Immigration Act. Failure to comply with
these requirements may result in breach of contract, termination of the contract or subcontract,
and possibly suspension or revocation of business licenses and permits in accordance with §31-13-9
(e) (1) & (2) or in the case of a subcontractor, in accordance with §31-13- 9 (f) (1) & (2).
E-Verify Affidavit
Compliance with the requirements of the Beason-Hammon Alabama Taxpayer and Citizen
Protection Act, Act No. 2011-535, Code of Alabama (1975) § 31-13-1 through 31-13-30” (also known
as and hereinafter referred to as “the Alabama Immigration Act”) is required for Alabama A&M
University contracts as a condition of the contract performance. Please provide a duly executed and
notarized affidavit in the appropriate form as describe below.
AFFIDAVIT 1
I, _____________________________________, a duly authorized officer or agent of
________________________________(contractor), do execute this affidavit on behalf of
________________________________(contractor) and by executing this affidavit, the undersigned
contractor verifies that it is a sole proprietorship, partnership, corporation or other business entity
(circle one) that has no employees.
The undersigned agrees that, should it employ or contract with any subcontractor(s) in connection
with the physical performance of services pursuant to this contract with Alabama A&M University,
that the Contractor will secure from such subcontractor(s) verification of compliance with Code of
Alabama (1975) § 31-13-9 in a form substantially similar to this affidavit. Contractor further agrees
to maintain records of such compliance and provide a copy of each such verification to Alabama
A&M University, at the time the subcontractor is retained to perform such services.
______________________________________
Name of Contractor
_____________________________________
Signature of Authorized Officer or Agent of Contractor
_____________________________________
Title of Authorized Officer or Agent of Contractor
______________________________________
Printed Name of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE ____ DAY OF __________, 20__.
_______________________________________
Notary Public
My commission Expires:____________________
OR
AFFIDAVIT 2
I, _____________________________________, a duly authorized officer or agent of
________________________________(contractor), do execute this affidavit on behalf of
________________________________(contractor) and by executing this affidavit, the undersigned
contractor verifies its compliance with the Beason-Hammon Alabama Taxpayer and Citizen
Protection Act, Act No. 2011-535 (Code of Alabama (1975) § 31-13-9), stating affirmatively that it
does not knowingly employ, hire for employment, or continue to employ an unauthorized alien and
that the sole proprietorship, partnership, or corporation or other business entity (circle one) which
is contracting with Alabama A&M University has registered with and is participating in the federal
work authorization program known as “E-verify”, web address https://e-verify.uscis.gov/enroll
operated by the United States Citizenship and Immigration Service Bureau of the United States
Department of Homeland Security to verify information of newly hired employees, pursuant to the
Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603, in accordance with the applicability
provisions of the Alabama Immigration Act.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in
connection with the physical performance of services pursuant to this contract with Alabama A&M
University, that the Contractor will secure from such subcontractor(s) verification of compliance
with Code of Alabama (1975) § 31-13-9 in a form substantially similar to this affidavit. Contractor
further agrees to maintain records of such compliance and provide a copy of each such verification
to Alabama A&M University, at the time the subcontractor is retained to perform such services.
______________________________________
E-Verify Employment Eligibility Verification User Identification Number
______________________________________
Name of Contractor
_____________________________________
Signature of Authorized Officer or Agent of Contractor
_____________________________________
Title of Authorized Officer or Agent of Contractor
______________________________________
Printed Name of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE ____ DAY OF __________, 20__.
_______________________________________
Notary Public
My commission Expires:____________________
Proof of Citizenship Demonstration and Declaration
(To be provided with Affidavit Form 1)
In order for an individual, including an individual who is a sole proprietor, a partner in a partnership, a
general partner in a limited partnership, a partner in a non-registered limited liability partnership, or a sole
member of a single member limited liability company, who is a U.S. Citizen to receive a public benefit or
conduct a business transaction with Alabama A&M University, each such citizen must declare his or her
U.S. citizenship by executing the declaration at the bottom of this form, and must demonstrate his or her
U.S. citizenship by presenting a legible copy of one of the following items.
Note that if the presented item does not include picture identification, please also provide a copy of a
valid form of picture identification, and if the presented item does not show the person’s current legal
name, please also provide a copy of a supporting document to verify the legal name change. Please check
which of the listed items has been provided:
Driver’s license or non-driver’s identification card (issued by Alabama or the division of motor
vehicles or the equivalent governmental agency of another state within the United States if the agency
indicates on the applicant’s driver’s license or non-driver’s identification card that the person has
provided satisfactory proof of United States citizenship).
Birth certificate
Pertinent pages of a United States valid or expired passport (identifying the applicant and the
applicant’s passport number),
United States naturalization documents or the number of the certificate of naturalization. (If
only the number of the certificate of naturalization is provided, the applicant shall not be awarded any
contract until the number of the certificate of naturalization is verified with the United States Bureau of
Citizenship and Immigration Services by the designated City Official, pursuant to 8 U.S.C. § 1373(c)).
Other documents or methods of proof of United States citizenship (issued by the federal
government pursuant to the Immigration and Nationality Act of 1952, and amendments thereto).
Bureau of Indian Affairs card number, tribal treaty card number, or tribal enrollment
number.
Consular report of birth abroad of a citizen of the United States of America.
Certificate of citizenship (issued by the United States Citizenship and Immigration Services).
Certification of report of birth (issued by the United States Department of State).
American Indian card, with KIC classification, (issued by the United States Department of
Homeland Security).
Final adoption decree (showing the applicant’s name and United States birthplace).
Official United States military record of service (showing the applicant’s place of birth in the
United States).
Extract from a United States hospital record of birth (created at the time of the applicant’s birth
indicating the applicant’s place of birth in the United States).
CITIZENSHIP DECLARATION
Under penalty of perjury, I, ______________________________________, (print name of
undersigned) the undersigned do hereby declare that I am a citizen of the United States of America.
________________________________________
(Declarant’s Signature and Date)
Verification, Demonstration, and Declaration of Lawfully Present Alien
(To be provided with Affidavit Form 1)
A. SAVE Verification. In order for an individual, including an individual who is a sole proprietor, a
partner in a partnership, a general partner in a limited partnership, a partner in a non-registered
limited liability partnership, or sole member of a single member limited liability company, who is
a lawfully present alien to receive a public benefit or conduct a business transaction with the City,
the City must verify, using the Systematic Alien Verification of Entitlement (SAVE) Program,
that such alien is lawfully present in the United States. In order to obtain such verification, each
such alien must provide: (1) his or her Alien Registration Number, which is as follows:
________________________________; and (2) a copy of non-citizen immigration documents.
B. Presumptive Lawful Presence. In order for an individual, including an individual who is a sole
proprietor, a partner in a partnership, a general partner in a limited partnership, a partner in a non-
registered limited liability partnership, or sole member of a single member limited liability
company, who is a lawfully present alien to receive a public benefit or conduct a business
transaction on a temporary basis pending final verification, each such alien must declare that he
or she is a lawfully present alien, by executing the declaration at the bottom of this form, and
must demonstrate presumptive lawful presence, by presenting a legible copy of one of the
following items.
Note that if the presented item does not include picture identification, please also provide a valid
form of picture identification, and if the presented item does not show the person’s current legal
name, please also provide a copy of a supporting document to verify the legal name change.
Please check which of the listed items has been provided:
A valid, unexpired Alabama driver’s license.
A valid, unexpired Alabama non-driver identification card.
A valid tribal enrollment card or other form of tribal identification (bearing a
photograph or other biometric identifier).
Any valid United States federal or state government issued identification document
(bearing a photograph or other biometric identifier, if issued by an entity that requires proof of
lawful presence in the United States before issuance).
A foreign passport with an unexpired United States Visa and a corresponding stamp
or notation (by the United States Department of Homeland Security indicating the bearer’s
admission to the United States).
A foreign passport issued by a visa waiver country (with the corresponding entry stamp
and unexpired duration of stay annotation or an I-94W form by the United States Department of
Homeland Security indicating the bearer’s admission to the United States).
DECLARATION OF LAWFULLY PRESENT ALIEN
Under penalty of perjury, I, ______________________________________, (print name of
undersigned) the undersigned do hereby declare that I am a lawfully present alien in the United States
of America.
________________________________________ (Declarant’s Signature and Date)
BID # 2K17-04B PRODUCT SPECIFICATIONS & BIDDING CONSIDERATIONS
Alabama A&M University’s Public Safety Department seeks to purchase two 2017 Dodge
Charger police vehicles meeting the following specifications:
A. Two (2) Police equipped full-size sedan vehicles
B. Color: White or Black
C. Sedans shall be law enforcement pursuit rated with gear selector on column so that police
radio and console can be mounted between split front seats.
D. Sedans shall also include a prewired package to install emergency light package.
E. Quoted price for two 2017 Dodge Charger Police vehicles must include all specifications
included in the base price and all options listed below. There is no need to itemize the cost
for each of the specifications listed below. The total bid price for the two vehicles requested
is sufficient.
a. 2017 Dodge Charger Police Vehicle: Base Price Standard Features
1. Black Vinyl Floor Covering STD
2. 3.6L V6 290 HP, Gear Selector on Column
3. 5-Speed Automatic Transmission
4. ABS Disc Braker
5. Power Driver Seat, Cloth Front Bucket and Rear Bench
6. Window Locks
7. Air Conditioning
8. Tilt & Cruise
9. AM/FM Radio, CD Player
b. With Required Options
10. Cloth Front Bucket/Rear Bench
11. 507 HEMI V8 ILO 3.6L V6
12. WBA Full Wheel Covers
13. LNF Driver Spot Lamp
14. Deactivate Rear Door & Windows
F. Vehicles shall be ready for AAMU to use within sixty (60) calendar days after notice of bid
award. Vehicles shall be delivered to:
Department of Property Management
453 Buchanan Way
Normal AL 35762
G. Vehicles shall each include at a minimum a 3-year bumper to bumper warranty.
H. The requested vehicles are referenced on the State of Alabama Department of Finance
Division of Purchasing Master Agreement Modification under Master Agreement
Number: MA 999 16000000003, which was awarded to Opelika Chrysler Dodge Jeep Ram
located at 801 Columbus Pkwy., Opelika, AL 36801. This Master Agreement expires on
November 15, 2017.
a. Line 3 of this Master Agreement refers to the requested vehicle, a 2017 Dodge
Charger, pursuit rated full-size sedan at a unit price of $21,595.30, which
represents the awarded base price.
b. The actual quote from Opelika Chrysler Dodge Jeep Ram [See Attached.] in
reference to the required Alabama A&M University specifications takes the
awarded base price and adds the costs of the non-standard options to equal
$23,977.30, which for Alabama A&M University Bid No. 2K17-04B will serve as the
not to exceed unit cost bid threshold.
1. Bidders whose bids are in excess of Opelika Chrysler Dodge Jeep
Ram’s unit cost quote of $23,977.30 will automatically be disqualified from
further consideration unless the following proves true:
i. Opelika Chrysler Dodge Jeep Ram confirms in writing that they
cannot deliver the requested vehicles due to shortage of supply or
their inability to meet the required delivery date.
I. The total bid price is to include the furnishing of the specified vehicles, service and part
manuals, warranties, and all other provisions necessary for the proper completion of the
purchase except as may be otherwise expressly provided in the Contract Documents.
J. Furthermore, the total bid price is expected to include the furnishing of the specified
vehicles, all costs of material, equipment, allowance, guarantees, title transfer, licensing
and contingencies, with overhead and profit necessary to produce a complete sale of the
vehicles covered by the specifications on which proposal is made without further cost to
Alabama A&M University.
a
ALABAMA
AGFIICULTURAL
AND
MECHANICAL
UNIVERSITY
PUBCHASING
DEPARTMENT
POST
OFFICE
BOX 1627
305
PATTON
HALL
NORMAL,
ALABAMA
35762
TELEPHONE:
(2s6)
972-s227
REQUEST
FOR
FORMAL
BID
coNTAcr
Delores Hudson
PHONE
256
372-5227
E
N
n
n
R
CONDITIONS
OF
THIS
BID
VENDOB NO.
r
-
--
E-E------
--
E-
--.1
1
ALL
BIDS
MUST
BE SIGNED,
SEALED, AND
RETURNED
IN
AN
T
T
ENVELOPE
WITH
THE BID
NUMBER AND
OPENING DATE
NOTED
I
f
ON FRONT.
FORWARD
ALL BtDS
TO THE ADDFESS
tNDtCATED
r
r
ABOVE,
FATLURE
TO
COMPLY WILL
RESULT IN
A'NO
BID-
RE-
I
I
SPONSE
tN ACCOBDANCE
WITH ALABAMA
COMPET|T|VE
BtD
I
I
'
LAW 41-16-24
sub-oart
b.
L--E----r--E-E-----J
RESPONSE
DUE BY
2:00 P.M.
L)tf,t c
DATE
BID NUMBER
ALL BIDS
WILL
BE
PUBLICLY
OPENED
ON THE
OPENING
DATE
DESIGNATED
AT
ALABAMA
AGRICULTURAL
AND
MECHANICAL
UNIVEFISITY,
PURCHASING
OEPARTMENT,
PATTON
HALL,
NOFMAL.
ALABAMA
35762.
BIDS RECEIVED
AFTER
THE
SPECIFIED
TIME
ON THE
oPENTNG
DATE
Wl.L_L_!!gl,
BE CONSTDERED.
FEOUEST.
SIGNATURE
NO.
QUANTITY
UNIT
DESCRIPTION
UNIT
PRICE
EXTENSION
I
SHOULD
A
PURCHASE
ORDER BE
ISSUED,
THE
FOREGOING
AND THE
TERMS
AND CONDITIONS
ON THE AITACHEO
SHEET
SHALL
BE APPLICABLE
AND
BIND.
ING
UPON THE
VENDOR,
I ACKNOWLEDGE
TIAT I
HAVE
SIGNATURE
AUTHOFITY
TO
SIGN
ON BEHALF
OF
rHE
CO[,lPANY
AND
HEREBY AG
B
EE TO ALL
GENERAL
CONDITIONS Otr THIS RI N
q
COMPANY
REPRESENTATIVE
An
affirmative
action/equal
oppoftunity institution
05 05 2017
2K17-04B
05 31 2017
1
2
Tim Thornton
EA
Item #
Quantity
Unit Description Unit
Price
Total
Price
Grand
Total:
Bid Number:
Page
of
lf
we
receive
your
order to furnish
items listed hereon
at the
prices
and under the
conditions
indicated. Pricing
on this
page
reflects the
pricing
for the associated specifications.
Signed
FOB Point:
Terms:
Warranty:
Estimated
Delivery:
Your Reference
No.:
Quotation
Effective
Until:
By
Vendor Name
Date
2K17-04B
1
1
2017 DODGE CHARGER POLICE SEDAN
w/ noted required specifications
EA
2
1
Section
41-4-116
Taxation
on sales
and leases
of
tangiLrle
personal
properfy to state
agency'
(a)
For t)re
purpose
of
this
division, the following
terms shall
have
the
respecttve
meanings
ascribed
by
this
section:
(i)
AFFILIATE.
A
reiated pa-rty
as
defined in
subsection
(b)
of
Section
40-23-190
as
that
provision
exists
on January
1,2004.
(2)
STATE DEPARTMENT
or
AGENCY.
Every state office,
deparlrnent,
divisjon,
bureau,
board,
or
commission
of the
State
of Alabama.
(b)
A
stare department
or agency
may not
contract
for
the
purchase
or
lease of
tangible
personal
property
from a
vendor,
contractor.
or an affiliate ofa
vendor
or
contractor,
unless
that
vendor-,
contractor,
and
all
of its affiliates
tl-rat
make
sales
for delivery
into
Alabama
or
leases
for
use
in Alabanra
are
properly
registered,
collecting, and remjtting
Alabama,
state,
and
local
sales,
use, and
lease
tax,
as provided
fol
by Chapter 12, Arlicle
4,
and
Chapter
23,
Ar-ticles
1 and2
of Titie 40
or
by
anv
local
act
or ordinance.
(c)
Each vendor,
contractor,
or
affiliate
of
a vendor
or contractor that is
offered
a contract
to
do
business
wrth
a state
department
or state
agency
shail be required to certify that the
vendor
or
affiliate
is
appropriately
registered
to
collect
and
remit
sales,
use,
and lease tax
as
required
by
this
section
and
submit
to
that
state
denartmenr
nruoFn.\/
certjfication
required by
tire
Alabanta
Department
of
Revenue.
(d)
Every
bid
submitted
and
contract
executed
by the
state
shall contain
a
certificatron
by the
bidder
or contractor
that
the
bidder
or contractor
is
not
barred
from
bidding for
or
ellterlng
into
a
contract
under
this
section
and
that
the
bidder
or contractor
acknowledges
that
the
contracttng
state
agency
may
declare
the
contract
void
if
the
certification
compJeted
rs
false.
(e)
Each
vendor
or
contractor
that
sells
or leases
tangible
personal
property
ro a
state
department
or agency,
and
each
affiliate
of
that
vendor
or contractor
that
makes
sales for
delrvery
into
Alabama,
shall
be required
to
collect
and
remit lhe
Alabama
sale s,
use
,
or lease
tax
on all
its
sales
and
leases
into
the
state.
(Act
2006-557,
p.
I2BI,
gt.)
Note:
ln
order
lor
an allernate
br0
to be consrdered, brdders must
supply current catalogs
or
brochures, including
pictorials
and
sp ecif
ications.
Please
indicate
your
company classification by circling the appropriate initial: Small
Business
(SB),
a
Small Disadvantaged
Business
(SO),
a Black Small
Disadvantaged Business
(BD),
a Woman-Owned Small Business
(WB),
a Woman-Owned
Small
Disad-
vantaged
Business
(WD),
a Black
Woman-Owned
Small Disadvantaged Business
(BW),
a
Large
Business
(LB),
an Individual
(lN),
Educational
(ED),
Non-Profit
(NP),
a Labor Surplus Area Concern
(LS),
Disabled
Veleran-Owned
Small Business
(DV),
Veteran-Owned
Small
Business
(VS), Hislorically
Underutilized
Business
Zone
(UZ),
or a Governmental Agency
(GV).
Certif
ication
pursuant
To
Act
No.
2006-557
Alabama Law
(Section
41-4-116,
Code of Alabama
1975)
provides
that every
bid submitted
and
contract
executed
shall contain a
certification
that the vendor, contractor,
and all oJ its
affiliates that
make sales
for
delivery into Alabama or
leases
for
use
in
Alabama
are registered, collecting,
and remitting Alabama
state and
local sales,
use, and/or
lease
tax
on
all taxable sales
and leases into Alabama. By
submitting this
bid.
the
bidder
i-s
hereby
certifying that they are in full compliance
with
Act
No.2006-557,
they are not
barred
from
bidding or entering
into a contract
pursuant
to 41-4-116,
and acknowledges that the
awarding authority
may
declare
the contract
void if the certif ication is false.
CohrFANir'rar,rE
(rypioR
pnr
Nr)_-__--_-
sGn-r
R s
NntilrVir-o
n FR I Nit----
TELEPHONE
NUMBER
FAX NUMBER
SIGNATUFE
DATE
Alabama
Agricultural and
Mechanical
University
prohibits
the installalion
ol asbestos on
its campus.
Suppliers and contractors
will nol
supply any
equipment,
material,
or supplies,
which
contain asbestos without
prior
written approval.
Failure to designate
Bid Number
and
Opening
Date on the
outside
of
your
sealed
envelope containing
your
bid and more than one bid
submitted
in
this
envelope
will result in a
"No
Bid" response in accordance with Alabama Compelitive
Bid
Law 41-16-24
subpart b.
Alabama Agricullural
and
Mechanical University
will not accept faxed bids.
Any
product that fails to
meet the specifications,
performance
requirements or compatibility
requiremenls will be rejected and returned
to the vendor at
no cost
to the University.
The University
reserves
the right
to award this contract,
in whole, in
part,
or
lo reject
any
and
all
quotations.
Alabama
A& M
University
is an
inslrumentality of the Stale and
is federal,
state
and local tax
exempt.
SPECIAL
NOTE:
Manulacturer's
published
product
data
must be included
with
your
bid response
for any allernate offerings. Any exception
taken to any
portion
ol
this Request
for
Price
Quotation
must be
stated on
the brd response sheets
or
Alabama
A&M University
will assume compliance
with
all
require-
ments as stated.
The successful
bidder
will
be
responsible
and accountable lor
providing
those
items
as specified
in its bid response.
F.O.B.
Poinl
A AAiI I NtrQTINIATI']NI
TEBMS
WA F RANTY
ESTIMATED
DELIVERY
YOUR REFERENCE
NO.' OUOTATION EFFECTIVE UNTIL
-Your
company
relerence number,
if
applicable
with
this bid
quotation.
Form W-9
(Rev. December 2014)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
Give Form to the
requester. Do not
send to the IRS.
Print or type
See Specific Instructions on page 2.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
Individual/sole proprietor or
single-member LLC
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership)
Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
the tax classification of the single-member owner.
Other (see instructions)
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
5 Address (number, street, and apt. or suite no.)
6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN on page 3.
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for
guidelines on whose number to enter.
Social security number
or
Employer identification number
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage
interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.
Sign
Here
Signature of
U.S. person
Date
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), or employer
identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you are a U.S. exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
Cat. No. 10231X
Form W-9 (Rev. 12-2014)
Form W-9 (Rev. 12-2014)
Page 2
Note. If you are a U.S. person and a requester gives you a form other than Form
W-9 to request your TIN, you must use the requester’s form if it is substantially
similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are considered a U.S.
person if you are:
• An individual who is a U.S. citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or organized in the
United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or business in
the United States are generally required to pay a withholding tax under section
1446 on any foreign partners’ share of effectively connected taxable income from
such business. Further, in certain cases where a Form W-9 has not been received,
the rules under section 1446 require a partnership to presume that a partner is a
foreign person, and pay the section 1446 withholding tax. Therefore, if you are a
U.S. person that is a partner in a partnership conducting a trade or business in the
United States, provide Form W-9 to the partnership to establish your U.S. status
and avoid section 1446 withholding on your share of partnership income.
In the cases below, the following person must give Form W-9 to the partnership
for purposes of establishing its U.S. status and avoiding withholding on its
allocable share of net income from the partnership conducting a trade or business
in the United States:
• In the case of a disregarded entity with a U.S. owner, the U.S. owner of the
disregarded entity and not the entity;
• In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally,
the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a
grantor trust) and not the beneficiaries of the trust.
Foreign person. If you are a foreign person or the U.S. branch of a foreign bank
that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use
the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding of Tax
on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident
alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on
certain types of income. However, most tax treaties contain a provision known as
a “saving clause.” Exceptions specified in the saving clause may permit an
exemption from tax to continue for certain types of income even after the payee
has otherwise become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception contained in the
saving clause of a tax treaty to claim an exemption from U.S. tax on certain types
of income, you must attach a statement to Form W-9 that specifies the following
five items:
1. The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the saving
clause and its exceptions.
4. The type and amount of income that qualifies for the exemption from tax.
5. Sufficient facts to justify the exemption from tax under the terms of the treaty
article.
Example. Article 20 of the U.S.-China income tax treaty allows an exemption
from tax for scholarship income received by a Chinese student temporarily present
in the United States. Under U.S. law, this student will become a resident alien for
tax purposes if his or her stay in the United States exceeds 5 calendar years.
However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30,
1984) allows the provisions of Article 20 to continue to apply even after the
Chinese student becomes a resident alien of the United States. A Chinese student
who qualifies for this exception (under paragraph 2 of the first protocol) and is
relying on this exception to claim an exemption from tax on his or her scholarship
or fellowship income would attach to Form W-9 a statement that includes the
information described above to support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you must
under certain conditions withhold and pay to the IRS 28% of such payments. This
is called “backup withholding.” Payments that may be subject to backup
withholding include interest, tax-exempt interest, dividends, broker and barter
exchange transactions, rents, royalties, nonemployee pay, payments made in
settlement of payment card and third party network transactions, and certain
payments from fishing boat operators. Real estate transactions are not subject to
backup withholding.
You will not be subject to backup withholding on payments you receive if you
give the requester your correct TIN, make the proper certifications, and report all
your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester,
2. You do not certify your TIN when required (see the Part II instructions on page
3 for details),
3. The IRS tells the requester that you furnished an incorrect TIN,
4. The IRS tells you that you are subject to backup withholding because you did
not report all your interest and dividends on your tax return (for reportable interest
and dividends only), or
5. You do not certify to the requester that you are not subject to backup
withholding under 4 above (for reportable interest and dividend accounts opened
after 1983 only).
Certain payees and payments are exempt from backup withholding. See Exempt
payee code on page 3 and the separate Instructions for the Requester of Form
W-9 for more information.
Also see Special rules for partnerships above.
What is FATCA reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign
financial institution to report all United States account holders that are specified
United States persons. Certain payees are exempt from FATCA reporting. See
Exemption from FATCA reporting code on page 3 and the Instructions for the
Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you claimed to be
an exempt payee if you are no longer an exempt payee and anticipate receiving
reportable payments in the future from this person. For example, you may need to
provide updated information if you are a C corporation that elects to be an S
corporation, or if you no longer are tax exempt. In addition, you must furnish a new
Form W-9 if the name or TIN changes for the account; for example, if the grantor
of a grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
subject to a penalty of $50 for each such failure unless your failure is due to
reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you make a
false statement with no reasonable basis that results in no backup withholding,
you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying certifications or
affirmations may subject you to criminal penalties including fines and/or
imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of federal law,
the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line blank. The
name should match the name on your tax return.
If this Form W-9 is for a joint account, list first, and then circle, the name of the
person or entity whose number you entered in Part I of Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If you have
changed your last name without informing the Social Security Administration (SSA)
of the name change, enter your first name, the last name as shown on your social
security card, and your new last name.
Note. ITIN applicant: Enter your individual name as it was entered on your Form
W-7 application, line 1a. This should also be the same as the name you entered on
the Form 1040/1040A/1040EZ you filed with your application.
b. Sole proprietor or single-member LLC. Enter your individual name as
shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade,
or “doing business as” (DBA) name on line 2.
c. Partnership, LLC that is not a single-member LLC, C Corporation, or S
Corporation. Enter the entity's name as shown on the entity's tax return on line 1
and any business, trade, or DBA name on line 2.
d. Other entities. Enter your name as shown on required U.S. federal tax
documents on line 1. This name should match the name shown on the charter or
other legal document creating the entity. You may enter any business, trade, or
DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a “disregarded
entity.” See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on
line 1. The name of the entity entered on line 1 should never be a disregarded
entity. The name on line 1 should be the name shown on the income tax return on
which the income should be reported. For example, if a foreign LLC that is treated
as a disregarded entity for U.S. federal tax purposes has a single owner that is a
U.S. person, the U.S. owner's name is required to be provided on line 1. If the
direct owner of the entity is also a disregarded entity, enter the first owner that is
not disregarded for federal tax purposes. Enter the disregarded entity's name on
line 2, “Business name/disregarded entity name.” If the owner of the disregarded
entity is a foreign person, the owner must complete an appropriate Form W-8
instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN.
Form W-9 (Rev. 12-2014)
Page 3
Line 2
If you have a business name, trade name, DBA name, or disregarded entity name,
you may enter it on line 2.
Line 3
Check the appropriate box in line 3 for the U.S. federal tax classification of the
person whose name is entered on line 1. Check only one box in line 3.
Limited Liability Company (LLC). If the name on line 1 is an LLC treated as a
partnership for U.S. federal tax purposes, check the “Limited Liability Company”
box and enter “P” in the space provided. If the LLC has filed Form 8832 or 2553 to
be taxed as a corporation, check the “Limited Liability Company” box and in the
space provided enter “C” for C corporation or “S” for S corporation. If it is a
single-member LLC that is a disregarded entity, do not check the “Limited Liability
Company” box; instead check the first box in line 3 “Individual/sole proprietor or
single-member LLC.”
Line 4, Exemptions
If you are exempt from backup withholding and/or FATCA reporting, enter in the
appropriate space in line 4 any code(s) that may apply to you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from backup
withholding.
• Except as provided below, corporations are exempt from backup withholding
for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments made in
settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to attorneys'
fees or gross proceeds paid to attorneys, and corporations that provide medical or
health care services are not exempt with respect to payments reportable on Form
1099-MISC.
The following codes identify payees that are exempt from backup withholding.
Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 501(a), any IRA, or a
custodial account under section 403(b)(7) if the account satisfies the requirements
of section 401(f)(2)
2—The United States or any of its agencies or instrumentalities
3—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies, or
instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the United
States, the District of Columbia, or a U.S. commonwealth or possession
7—A futures commission merchant registered with the Commodity Futures
Trading Commission
8—A real estate investment trust
9—An entity registered at all times during the tax year under the Investment
Company Act of 1940
10—A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section 4947
The following chart shows types of payments that may be exempt from backup
withholding. The chart applies to the exempt payees listed above, 1 through 13.
IF the payment is for . . . THEN the payment is exempt for . . .
Interest and dividend payments All exempt payees except
for 7
Broker transactions Exempt payees 1 through 4 and 6
through 11 and all C corporations. S
corporations must not enter an exempt
payee code because they are exempt
only for sales of noncovered securities
acquired prior to 2012.
Barter exchange transactions and
patronage dividends
Exempt payees 1 through 4
Payments over $600 required to be
reported and direct sales over $5,000
1
Generally, exempt payees
1 through 5
2
Payments made in settlement of
payment card or third party network
transactions
Exempt payees 1 through 4
1
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2
However, the following payments made to a corporation and reportable on Form
1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys' fees, gross proceeds paid to an attorney reportable under
section 6045(f), and payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify payees
that are exempt from reporting under FATCA. These codes apply to persons
submitting this form for accounts maintained outside of the United States by
certain foreign financial institutions. Therefore, if you are only submitting this form
for an account you hold in the United States, you may leave this field blank.
Consult with the person requesting this form if you are uncertain if the financial
institution is subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with “Not Applicable” (or any
similar indication) written or printed on the line for a FATCA exemption code.
A—An organization exempt from tax under section 501(a) or any individual
retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or possession, or
any of their political subdivisions or instrumentalities
D—A corporation the stock of which is regularly traded on one or more
established securities markets, as described in Regulations section
1.1472-1(c)(1)(i)
E—A corporation that is a member of the same expanded affiliated group as a
corporation described in Regulations section 1.1472-1(c)(1)(i)
F—A dealer in securities, commodities, or derivative financial instruments
(including notional principal contracts, futures, forwards, and options) that is
registered as such under the laws of the United States or any state
G—A real estate investment trust
H—A regulated investment company as defined in section 851 or an entity
registered at all times during the tax year under the Investment Company Act of
1940
I—A common trust fund as defined in section 584(a)
J—A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section 4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g) plan
Note. You may wish to consult with the financial institution requesting this form to
determine whether the FATCA code and/or exempt payee code should be
completed.
Line 5
Enter your address (number, street, and apartment or suite number). This is where
the requester of this Form W-9 will mail your information returns.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
identification number (ITIN). Enter it in the social security number box. If you do not
have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either your SSN
or EIN. However, the IRS prefers that you use your SSN.
If you are a single-member LLC that is disregarded as an entity separate from its
owner (see Limited Liability Company (LLC) on this page), enter the owner’s SSN
(or EIN, if the owner has one). Do not enter the disregarded entity’s EIN. If the LLC
is classified as a corporation or partnership, enter the entity’s EIN.
Note. See the chart on page 4 for further clarification of name and TIN
combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply
for an SSN, get Form SS-5, Application for a Social Security Card, from your local
SSA office or get this form online at www.ssa.gov. You may also get this form by
calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer
Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN online by
accessing the IRS website at www.irs.gov/businesses and clicking on Employer
Identification Number (EIN) under Starting a Business. You can get Forms W-7 and
SS-4 from the IRS by visiting IRS.gov or by calling 1-800-TAX-FORM
(1-800-829-3676).
If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN
and write “Applied For” in the space for the TIN, sign and date the form, and give it
to the requester. For interest and dividend payments, and certain payments made
with respect to readily tradable instruments, generally you will have 60 days to get
a TIN and give it to the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments. You will be
subject to backup withholding on all such payments until you provide your TIN to
the requester.
Note. Entering “Applied For” means that you have already applied for a TIN or that
you intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use the
appropriate Form W-8.
Form W-9 (Rev. 12-2014)
Page 4
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or resident alien,
sign Form W-9. You may be requested to sign by the withholding agent even if
items 1, 4, or 5 below indicate otherwise.
For a joint account, only the person whose TIN is shown in Part I should sign
(when required). In the case of a disregarded entity, the person identified on line 1
must sign. Exempt payees, see
Exempt payee code
earlier.
Signature requirements. Complete the certification as indicated in items 1
through 5 below.
1. Interest, dividend, and barter exchange accounts opened before 1984
and broker accounts considered active during 1983. You must give your
correct TIN, but you do not have to sign the certification.
2. Interest, dividend, broker, and barter exchange accounts opened after
1983 and broker accounts considered inactive during 1983. You must sign the
certification or backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TIN to the requester, you
must cross out item 2 in the certification before signing the form.
3. Real estate transactions. You must sign the certification. You may cross out
item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not have to sign
the certification unless you have been notified that you have previously given an
incorrect TIN. “Other payments” include payments made in the course of the
requester’s trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments made in
settlement of payment card and third party network transactions, payments to
certain fishing boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of secured
property, cancellation of debt, qualified tuition program payments (under
section 529), IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct TIN, but you
do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account:
Give name and SSN of:
1. Individual
The individual
2. Two or more individuals (joint
account)
The actual owner of the account or,
if combined funds, the first
individual on the account
1
3. Custodian account of a minor
(Uniform Gift to Minors Act)
The minor
2
4. a. The usual revocable savings
trust (grantor is also trustee)
b. So-called trust account that is
not a legal or valid trust under
state law
The grantor-trustee
1
The actual owner
1
5. Sole proprietorship or disregarded
entity owned by an individual
The owner
3
6. Grantor trust filing under Optional
Form 1099 Filing Method 1 (see
Regulations section 1.671-4(b)(2)(i)
(A))
The grantor*
For this type of account:
Give name and EIN of:
7. Disregarded entity not owned by an
individual
The owner
8. A valid trust, estate, or pension trust
Legal entity
4
9. Corporation or LLC electing
corporate status on Form 8832 or
Form 2553
The corporation
10. Association, club, religious,
charitable, educational, or other tax-
exempt organization
The organization
11. Partnership or multi-member LLC
The partnership
12. A broker or registered nominee
The broker or nominee
13. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
The public entity
14. Grantor trust filing under the Form
1041 Filing Method or the Optional
Form 1099 Filing Method 2 (see
Regulations section 1.671-4(b)(2)(i)
(B))
The trust
1
List first and circle the name of the person whose number you furnish. If only one person on a
joint account has an SSN, that person’s number must be furnished.
2
Circle the minor’s name and furnish the minor’s SSN.
3
You must show your individual name and you may also enter your business or DBA name on
the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you
have one), but the IRS encourages you to use your SSN.
4
List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the
personal representative or trustee unless the legal entity itself is not designated in the account
title.) Also see Special rules for partnerships on page 2.
*Note. Grantor also must provide a Form W-9 to trustee of trust.
Note. If no name is circled when more than one name is listed, the number will be
considered to be that of the first name listed.
Secure Your Tax Records from Identity Theft
Identity theft occurs when someone uses your personal information such as your
name, SSN, or other identifying information, without your permission, to commit
fraud or other crimes. An identity thief may use your SSN to get a job or may file a
tax return using your SSN to receive a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a notice from
the IRS, respond right away to the name and phone number printed on the IRS
notice or letter.
If your tax records are not currently affected by identity theft but you think you
are at risk due to a lost or stolen purse or wallet, questionable credit card activity
or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit
Form 14039.
For more information, see Publication 4535, Identity Theft Prevention and Victim
Assistance.
Victims of identity theft who are experiencing economic harm or a system
problem, or are seeking help in resolving tax problems that have not been resolved
through normal channels, may be eligible for Taxpayer Advocate Service (TAS)
assistance. You can reach TAS by calling the TAS toll-free case intake line at
1-877-777-4778 or TTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing schemes. Phishing is the
creation and use of email and websites designed to mimic legitimate business
emails and websites. The most common act is sending an email to a user falsely
claiming to be an established legitimate enterprise in an attempt to scam the user
into surrendering private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does
not request personal detailed information through email or ask taxpayers for the
PIN numbers, passwords, or similar secret access information for their credit card,
bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS, forward this
message to phishing@irs.gov. You may also report misuse of the IRS name, logo,
or other IRS property to the Treasury Inspector General for Tax Administration
(TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal
Trade Commission at: spam@uce.gov or contact them at www.ftc.gov/idtheft or
1-877-IDTHEFT (1-877-438-4338).
Visit IRS.gov to learn more about identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct
TIN to persons (including federal agencies) who are required to file information
returns with the IRS to report interest, dividends, or certain other income paid to
you; mortgage interest you paid; the acquisition or abandonment of secured
property; the cancellation of debt; or contributions you made to an IRA, Archer
MSA, or HSA. The person collecting this form uses the information on the form to
file information returns with the IRS, reporting the above information. Routine uses
of this information include giving it to the Department of Justice for civil and
criminal litigation and to cities, states, the District of Columbia, and U.S.
commonwealths and possessions for use in administering their laws. The
information also may be disclosed to other countries under a treaty, to federal and
state agencies to enforce civil and criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers must generally
withhold a percentage of taxable interest, dividend, and certain other payments to
a payee who does not give a TIN to the payer. Certain penalties may also apply for
providing false or fraudulent information.
Vendor Disclosure
Statement
lnformation and lnstructions
Act 2001-955 requires
the
disclosure statement to be completed and filed with all
proposals,
bids, contracts, or
grant
proposals
to the State
of
Alabama in
excess of
$5,000.
The
disclosure
statement is not required for
contracts for
gas,
water,
and electric services where
no competition exits, or
where rates
are
fixed by law
or
ordinance. In circumstances
where a
contract
is
awarded by competitive bid, the disclosure statement shall be
required
only
from
the
person
receiving ihe contract
and shall
be submitted within
ten
('10)
days
of the award.
A
copy of the disclosure
statement shall be filed with
the awarding entity and the
Department of
Examiners
of
Public Accounts
and
if
ii
pertains
to a state conbact,
a copy shall be submitted to the Contract Review
Permanent
Legislative
Oversight Committee. The
address for the Department of Examiners
of Public
Accounts
is
as
follows:
50 N. Ripley
Street,
Room 3201, Montgomery,
Alabama 36130-2101. lf
the
disclosure
statement
is filed with
a contraci, the awarding
entity should include
a copy
with
the contract when
it
is
presented
to the
Contract Review
Permanent
Legislative
Oversight Committee.
The
State of Alabama
shall not enter
into
any contract
or appropriate any
public
funds
with any
person
who
refuses
to
provide
information
required by
Act
2001-955.
Pursuant
to Act 2001-955,
any
person
who
knowingly
provides
misleading
or
ineorrect information
on
the
disclosurestatementshall
besubjecttoacivil
penaltyof
tenpercent(10olo) of theamountof thetransaction, not
to exceed
$
10,000.00. Also,
the contract or
grant
shall
be
voidable by the awarding entity.
Definitions as Provided
in Act 2001-955
Family Member
of a Public Employee
-
The
spouse or a dependent of the
public
employee.
Family Member
of a Public
Official
- The
spouse, a dependent, an
adult
child and his
or
her
spouse,
a
pafent,
a spouse's
parents,
a sibling and his
or
her
spouse, of the
public
official.
Family Relationship -
A
person
has
a
family relationship with
a
public
official or
public
employee if the
person
is a famrly
member of
the
public
official or
public
employee.
Person -
An
individual, firm,
partnership,
association,
joint
venture,
cooperative, or corporation, or
any
other
group
or combination
acting
in
concert.
Public
Official
and Public Employee
-
These
terms shall have
the
same meanings
ascribed to them
in
Sections 36-25-1(23)
and
36-25-1(24),
Code of Alabama 1975,
(see
below) except
for
the
purposes
of
the
disclosure reguiremenis
of
this
act,
the terms shall only
include
persons
in
a
position
to influence
the awarding
of a
grant
or contract
who
are affiliated with
the awarding
entity. Notwithstanding
the
frrregoing,
these
terms
shall also include
the Governor, Lieutenant
Governor,
members of the cabinet
of the Governor, and members of
the
Legislature.
Section 36-25-1(23)
Code
of Alabama
1975,
defines a
public
employee
as any
person
employed at the
state,
county
or municipal level
of
government
or their instrumentalities, rncluding
governmental
corporations and
authorities,
but
excluding employees
of hospitals or
other health care corporations including
contract employees
of those hospitals
or other
health care
corporations,
who
is
paid
ln whole or in
part
from state,
county,
or
municipal
funds. For
purposes
of ihis
chapter, a
public
employee
does
not include
a
person
employed on a
part-
time basis whose
employment
is limited to
providing
professional
services other
than lobbying, the
compensation
for
which
constitutes less
than 50
percent
of the
part{ime
employee's
income.
Section 36-25-1(24),
Code
of Alabama 1975,
defines
a
public
official
as any
person
elected
to
public
office,
whether
or not
that
person
has
taken
office,
by the vote
of the
people
at state,
county, or municipal level
of
government
or their instrumentalities,
including
governmental
corporations,
and any
person
appointed to
a
position
at the state, county,
or
municipal level
of
government
or
their instrumentalities,
including
governmental
corporations.
For
purposes
of this
chapter,
a
public
official
includes
the chairs and
vice-chairs
or
the equivalent
offices of each state
political
party
as defined in
Section 17-16-2, Code of Alabama 1975.
Instructions
Complete all
lines
as indicated.
lf an item does not
apply, denote
N/A
(notapplicable).
lf
you
cannot
include
required
information
in
the space
provided,
attach
additional sheets
as necessary.
The form
must be signed, dated,
and notarized
prior
to submission.
State
ofAlabama
Disclosure
Statement
(Required
by Act
2001-955)
ENT
TY COI\,lPLFIING
FORM
CITY,
STATE,
ZIP
TELEPHONE
NUMBER
()
STATE
AGENCY/DEPARTMFNI
THAT WILL RECEIVE GOODS, SERVICES, OR IS RESPONSIBLE FOR
GRANT
AWARO
ADDRESS
ctry. STAIE. ZtP
TELEPHONE NU[4BER
()
This form
is
orovided with:
n
a"",ra",
n
tt"t"rt
Have
you
or any of
your partners,
divisions, or any related business
units
previously
performed
work or
provided goods
to any State
Agency/Department
in the current
or last fiscal
year?
fl
v",
I
No
lf
yes,
ideniify
below
the
State
Agency/Department
that
received
the
goods
or services,
the type(s) of
goods
or services
previously
pro-
vided,
and
the amount received for the
provision
of such
goods
or services.
Have
you
or any of
your partners,
divisions, or any related business units
previously
applied and received any
grants
from
any State
Agency/Department in the
current or
last fiscal
year?
I
lYes I lNo
lf
yes,
identify the
State
Agency/Department
that awarded
the
grant,
the date such
grant
was awarded, and the
amount of the
grant.
1. List below the
name(s) and address(es) of all
public
officials/public employees
with whom
you,
members
of
your
immediate family,
or
any
of
your
employees have a family relationship and
who
may directly
personally
benefit
financially from the
proposed
transaction.
ldentify the State DepartmenVAgency
forwhich the
public
officials/public
employees
work.
(Attach
additional
sheets
if necessary.)
OVER
2.
List
below the name(s) and
address(es) of
all family members of
public
officials/public
employees
with whom
you,
members
of
your
immediate
family,
or any of
your
employees
have a
fumily
relationship and who may
directly
personally
benefit
financially
from the
proposed
transaction. ldentify the
public
officialsipublicremploydes
and State
DepartmenVAgency
for which
the
public
officials/public
employees
work.
(Attach
additional sheets
if necessary.)
lf
you
identified individuals in items
one
and/or hvo
above,
describe in detail below
the
direct financial
benefit to
be
gained
by the
public
officials,
public
employees, and/or their family
members as
the result
of
the
contract,
proposal,
request for
proposal,
invitation to bid, or
grant proposal. (Attach
additional sheets if necessary.)
Describe in detail below any indirect financial benefits to be
gained
by
any
public
official,
public
employee, and/or
family members of
the
public
official
or
public
employee as
the
result of
the
contract,
proposal,
request
for
proposal,
invitation to bid, or
grant
proposal.
(Atiach
additional
sheets if necessarv.)
List below the name(s)
and
address(es)
of
all
paid
consultants and/or lobbyists utilized
to
obtain
the
contraci,
proposal,
request for
pro-
posal,
invitation to bid, or
grant proposal:
By signing below, I certify
under oath
and
penalty
of
perjury
that all statements
on
or
attached to this
form
are true and correct
fo
fhe besf
of my knowledge. I further
understand that a eivil
penalty
of ten
percent
(10%)
of
the amount of the transaction, not
to exceed
$10,000,00,
is appliad for knowingly
providing
incorrect or misleading information.
Signature
Date
Notary's Signature
Date
Date
Notary Expires
Ad 2AU-955 requires the disclosure
statement
to be completed and filed with all
proposals,
bids, contracts,
or
grant proposals
to
the
State
of Alabama rn
excess of $5.000.
INSTRUCTIONS UNIQUE TO THIS INVITATION TO BID (ITB)
1. The sealed bid package submission deadline is May 31, 2017 at 2:00 P.M.
Central Standard Time (CST). Bids not received by that time will be ineligible
from further consideration. It shall not be sufficient to show that a bid was
postmarked by or before the bid submission deadline.
2. The required delivery date is 60 days after notice of contract award.
3. The lowest responsible bidder must offer a contract price lower than that offered
by the State of Alabama Joint Purchasing Agreement that awarded the state
contract to Opelika Chrysler Dodge Jeep Ram in Opelika, AL unless Opelika
Chrysler Dodge Jeep Ram due to shortage of supply or inability to meet the
required delivery date fails to deliver. Unless Opelika Chrysler Dodge Jeep Ram
proves unresponsive for the reasons listed above, their offered unit cost quote of
$23,977.30 will stand as this bid’s not to exceed bid threshold.
4. The Line # reference from State Bid T191L noted on the attached fleet quote
from Opelika Chrysler Dodge Jeep Ram is in error as mutually recognized by
Opelika Chrysler Dodge Jeep Ram and Alabama A&M University. The correct
Line # is 3.
5. Please type Invitation to Bid responses directly into the PDF you have been
provided. Handwritten responses are accepted but not preferred.
6. This bid is being advertised by AL.com, Vendor Registry through Alabama A&M
University, and the Huntsville Times newspaper.