RFP # 98140002
FOOD SERVICE RFP
Required Forms
Attachment #
A Terms and Conditions of Request for Proposal
B Vendor Binding Authority
C Vendor Letter of Intent to Bid
D Authorization for Reference Check
E Conflict of Interest Stipulation
F Sworn Statement of Vendor
G Cover Sheet for the Technical Proposal
H Cover Sheet for the Pricing Proposal
I Vendor References
J Conflicts of Interest and Prohibited practices
K Equal Employment Opportunity Certificate
L Equal Opportunity Policy
M Certification regarding Debarment and Suspension
N Additional disclosures
O Hotline Flier
P Audit Services Division Hotline
Q Designation of Confidential and Proprietary Information
R Certification for Indemnity and Insurance Requirements
S Minimum Wage Ordinance Compliance (applicable to HOC JJC Proposals Only)
T DBE Forms (applicable to HOC and JJC Proposals Only)
U Cost Proposal Response Packet
Attachment A Terms and Conditions of Request for Proposal
Attachment B
Milwaukee County
Food Service RFP
(on Vendor’s Letter head)
VENDOR BINDING AUTHORITY
Re: Milwaukee County
I am an officer and/or have the authority to bind our company to any and all contractual agreements with the contract holder.
I have reviewed our response to the bid/proposal specifications and certify that it is an accurate representation of our organization, capabilities, and proposed services, and is in agreement with the RFP requirements except as stated or referenced below (or on the attached page).
______
Company Name Signature
______
Date Title
Milwaukee County Attachment C
Food Service RFP
VENDOR LETTER OF INTENT TO BID
The undersigned hereby acknowledges the terms and conditions of this Request for Proposal (RFP) and intends to respond to Milwaukee County Food Services RFP. We understand that Milwaukee County will post all modifications or updates to this RFP at http://county.milwaukee.gov/bop. It is our responsibility to check the site frequently, as all revisions/amendments to the RFP and the written answers to the questions will be posted on the website. It is the responsibility of the applicant to respond to all requirements as they appear in the posted revisions.
______
Representative’s Signature Date
______
Representative’s Printed Name
______
Company Name and Legal Name for Business within Wisconsin
______
Telephone Number & Extension Facsimile Number E-mail Address (required)
We will be participating in the Pre-Proposal conference and facilities tour. The below is a list of attendees (limit 3)*:
Name Title
1.______
2.______
3. ______
This form is mandatory if the vendor intends to or has any interest in response to this RFP. The attendee information is required to obtain security clearance for individuals scheduled to attend the Pre-Proposal Meeting (if applicable). No more than three individuals may participate for any one vendor. However, neither this letter of intent to bid nor the company’s participation in the Pre-Proposal meeting obligates the vendor to actually submit a proposal in response to this RFP. Government issued photo identification is required to enter the facilities.
*County reserves the right to limit the number of participant from each proposing vendor on the tour.
Milwaukee County Attachment D
Food Service RFP
AUTHORIZATION FOR REFERENCE CHECK
This authorization should be on company letterhead.
Do not modify the contents of this letter.
The undersigned hereby authorizes the recipient of this authorization (or a copy thereof) to furnish Milwaukee County any and all information that said recipient may have concerning the undersigned’s contract performance history.
This information is to be furnished to Milwaukee County for the purposes of evaluating the ability of the undersigned to perform Food Service for Milwaukee County.
The undersigned further authorizes any person contacted to give Milwaukee County any and all information concerning the undersigned’s (and the employees of the undersigned) education, work experience, and character which they may have, personal or otherwise, and releases all parties from all liability for any damage that may result from furnishing the same to Milwaukee County.
A photocopy of this authorization shall be deemed equivalent to the original.
Dated this ______day of ______, 20 ____.
Authorized Signature ______
Title ______
Name of Firm ______
Milwaukee County Attachment E
Food Service RFP
CONFLICT OF INTEREST STIPULATION
For purposes of determining any possible conflict of interest, all vendors submitting a proposal in response to this RFP must disclose if any Milwaukee County employee, agent or representative or an immediate family member is also an owner, corporate officer, employee, agent or representative of the business submitting the bid. This completed form must be submitted with the proposal. Furthermore, according to the Milwaukee County Code of Ethics, no person may offer to give to any County Officer or employee or immediate family member, may solicit or receive anything of value pursuant to an understanding that such County representative’s vote, official actions or judgment would be influenced thereby.
Answer below either YES or NO to the question of whether any employee, agent or representative or immediate family member is involved with your company in any way:
YES ______
NO ______
If the answer to the question above is YES, then identify the name of the individual, the position with Milwaukee County and the relationship to your business:
Name ______
County Position ______
Business Relationship ______
The appropriate corporate representative must sign and date below:
Printed Name ______
Authorized Signatory ______
Title ______
Date ______
Milwaukee County Attachment F
Food Service RFP
SWORN STATEMENT OF VENDOR
I, being first duly sworn at ______,
City, State
On oath, depose and say I am the ______
Official Title
Of the Vendor, ______,
Name of Company
Do state the following: that I have fully and carefully examined the terms and conditions of this Request for Proposal, #______, and prepared this submission directly and only from the RFP and including all accessory data. I attest to the facts that:
· I have reviewed the RFP, and all related attachments and information provided through Milwaukee County, in detail before submitting this proposal.
· I unconditionally accept all of the Milwaukee County requirements in our response unless we clearly address the specific issue(s) within our response.
· I have indicated review, understanding and acceptance of the RFP (or relevant service component being bid upon) by initials on each page of the RFP.
· I certify that all statements within this proposal are made on behalf of the Vendor identified above.
· I have full authority to make such statements and to submit this proposal as the duly recognized representative of the Vendor.
· I further stipulate that the said statements contained within this proposal are true and correct and this sworn statement is hereby made a part of the foregoing RFP response.
______
Signature
______
Legal Address
Subscribed and sworn to before me
This ______day of ______, 20_____
Notary Public, ______County
State of ______
My commission expires ______
Attachment G
COVER SHEET FOR THE TECHNICAL PROPOSAL
(on Vendor’s Letterhead)
In submitting and signing this proposal, we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free trade or competition; that no attempt has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been independently arrived at without collusion with any other vendor, competitor, or potential competitor; that this proposal has not knowingly been disclosed prior to the opening of the proposals to any other vendor or competitor; that the above statement is accurate under penalty of perjury.
In submitting signing this proposal, we represent that we have thoroughly read and reviewed this Request for Proposal and are submitting this response in good faith. We understand the requirements of the program and have provided the required information listed within the Request for Proposal.
The undersigned certifies and represents that all data, pricing, representations, and other information of any sort or type, contained in this response, is true, complete, accurate, and correct. Further, the undersigned acknowledges that Milwaukee County is, in part, relying on the information contained in this proposal in order to evaluate and compare the responses to the RFP.
Vendor’s Name ______
Title ______
Signature ______
Date ______
Attachment H
COVER SHEET FOR THE PRICING PROPOSAL
(on Vendor’s Letter Head)
In submitting and signing this proposal, we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free trade or competition; that no attempt has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been independently arrived at without collusion with any other vendor, competitor, or potential competitor; that this proposal has not knowingly been disclosed prior to the opening of the proposals to any other vendor or competitor; that the above statement is accurate under penalty of perjury.
In submitting signing this proposal, we represent that we have thoroughly read and reviewed this Request for Proposal and are submitting this response in good faith. We understand the requirements of the program and have provided the required information listed within the Request for Proposal.
The undersigned certifies and represents that all data, pricing, representations, and other information of any sort or type, contained in this response, is true, complete, accurate, and correct. Further, the undersigned acknowledges that Milwaukee County is, in part, relying on the information contained in this proposal in order to evaluate and compare the responses to the RFP.
Vendor’s Name ______
Title ______
Signature ______
Date ______
Milwaukee County Attachment I
Food Service RFP
VENDOR REFERENCES
1) Agency Name ______Agency Address ______
Contact Person ______E-mail______Contact Number______
Number of Sites______Number of Inmates______Number of Patients ______
Facility Type _____Jail _____Prison _____Juvenile _____ Hospital _____Other
Accreditation _____ACA _____NNCHC _____JCAHO _____Other
Contract Term (original, extensions, renewals, rebids) ______Current Contract ___Prior Contract
Contract Terminated Y N (circle one), if so specify by whom _____agency _____vendor
____Lost in Rebid, if so specify award recipient ______
____Other, specify (i.e. returned to self-operated, transition to University)
Reason ______
______
2) Agency Name ______Agency Address ______
Contact Person ______E-mail______Contact Number______
Number of Sites______Number of Inmates______Number of Patients ______
Facility Type _____Jail _____Prison _____Juvenile _____ Hospital _____Other
Accreditation _____ACA _____NNCHC _____JCAHO _____Other
Contract Term (original, extensions, renewals, rebids) ______Current Contract ___Prior Contract
Contract Terminated Y N (circle one), if so specify by whom _____agency _____vendor
____Lost in Rebid, if so specify award recipient ______
____Other, specify (i.e. returned to self-operated, transition to University)
Reason ______
______
VENDOR REFERENCES
Page 2
3) Agency Name ______Agency Address ______
Contact Person ______E-mail______Contact umber______
Number of Sites______Number of Inmates______Number of Patients ______
Facility Type _____Jail _____Prison _____Juvenile ______Hospital _____Other
Accreditation _____ACA _____NNCHC _____JCAHO _____Other
Contract Term (original, extensions, renewals, rebids) ______Current Contract ___Prior Contract
Contract Terminated Y N (circle one), if so specify by whom _____agency _____vendor
____Lost in Rebid, if so specify award recipient ______
____Other, specify (i.e. returned to self-operated, transition to University)
Reason ______
______
4) Agency Name ______Agency Address ______
Contact Person ______E-mail______Contact number______
Number of Sites______Number of Inmates______Number of Patients ______
Facility Type _____Jail _____Prison _____Juvenile ____ Hospital ____Other
Accreditation _____ACA _____NNCHC _____JCAHO _____Other
Contract Term (original, extensions, renewals, rebids) ______Current Contract ___Prior Contract
Contract Terminated Y N (circle one), if so specify by whom _____agency _____vendor
____Lost in Rebid, if so specify award recipient ______
____Other, specify (i.e. returned to self-operated, transition to University)
Reason ______
______
Name (Print)______Title______
Date______
Authorized Signatory______
1 | Page
Attachment J
CONFLICTS OF INTEREST AND PROHIBITED PRACTICES
Interest in Contract
No officer, employee or agent of the County who exercises any functions or responsibilities with carrying out any services or requirements to which this contract pertains has any personal interest, direct or indirect, in this contract.
Interest of Other Public Officials
No member of the governing body of a locality, County or State and no other public official of such locality, County or State who exercises any functions or responsibilities in the review or approval of the carrying out of this contract has any personal interest, direct or indirect, in this contract.
Contractor covenants s/he presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of services under this contract. Any conflict of interest on the part of the Contractor will be disclosed to the County. In the event Contractor has a conflict of interest that does not permit Contractor to perform the services under the contract with respect to any client or recipient, Contractor will notify the County and will provide the County with all records and reports relating to same.
Prohibited Practices
Contractor attests that it is familiar with Milwaukee County’s Code of Ethics, Chapter 9 of Milwaukee County Code of General Ordinances, which states in part, “No person may offer to give any County officer or employee or his immediate family, or no County officer or employee or his immediate family may solicit or receive anything of value pursuant to an understanding that such officer’s or employee’s vote, official action, or judgment would be influenced thereby.”
Said chapter further states, “No person(s) with a personal financial interest in the approval or denial of a contract being considered by a County department or with an agency funded and regulated by a County department, may make a campaign contribution to any candidate for an elected County office that has final authority during its consideration. Contract considerations shall begin when a contract is submitted directly to a County department or to an agency until the contract has reached its final disposition, including adoption, county executive action, proceedings on veto (if necessary) or departmental approval.”
Where Agency intends to meet its obligations under this or any part of this RFP through a subcontract with another entity, Agency shall first obtain the written permission of County; and further, Agency shall ensure it requires of its subcontractors the same obligations incurred by Agency under this RFP.