HomeMy WebLinkAbout110520 TRAFFIC SIGNAL CONTROLS INC - PURCHASE ORDER - 9123008City of
F6rt'Co.11-ins
/11��
'PURCHASE,ORDER
PO Number Page
91230W 1 of 13
l This,numb�er.tnust appeqr
71
on 'invoices, packing
slips �and 'labels.
Date: 05/22/2012
Vendor: 110520 Sfiio'fo:- TRAFFIC OPERATIONS
TRAFFIC SIGNAL.CONTROLS INC CITY OF FORT COLLINS
W 255EAVER PARK RD#160' 626 LINDEN.
DEN STREET
LON b M0NT Coloraido 80504
FORT.COLLINS Colorado 810524.
Delivery Date: 05/22/201.2 Buyer: -JOHN STEPHEN
Note:
Line Description -Quantity- Extended
'Ordered :Price'
UOM, Unit Price
1 Traffic Signal Cabinet - 333SD 11 LS 10,5 . 95.0000 w 116,545.00
With Battery Backup
Per terms and conditions of Bid 7386
Delivery Dates per the bid schedule.
2 Traffic Signal Cabinet -.332,D
2 LS 1 11;7bomoo.• 23,400.00
With Battery Backup and Auxiliary Output File
Delivery Date per Bid,schedule
FEDERAL TRANSIT ADMINISTRATION. ,
1 , , - - ....
1. NO GOVERNMENT OBLIGATION TO THIRD PARTIES
No Obligation by the Federal Government.
(1) The Purchaser and Contractor acknowledge and agree, that,i notwithstanding any concurrence by the Federal
Government in or approval of the solicitation or award of the underlying contract, absent the express written
consent by the Federal •G;overnment; the Federal Government is not a'party to this contract andshall:nof be,-
subject to any obligations:or liabilities.to.t.he.Purchaser; Contractor, 6rany other' party (whether or not 6 party to
that contract),pertaining to any matter resultingfromthe, underlying contract'
(2) The Contractor agrees to include the above clause in each subc6ntract financediin whole or in part with!
Federal assistance provided by FTA. It is further agreed that the clause shall not be*rfi6difi&d,*except to identify
the subcontractor who will be subject to its provisions.
7 I
2. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS AND RELATED ACTS
Invoice -Address:--
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000 unless signed by James B. O'Neill 11, CPPO City of F&ft Collins
R -6oil i City of F6 ns Purchasing, PO BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Fax: 970-221 '6707 Email:purchasing@fcgov.com POrBoX 580-'
Fort Collins, CO 80522-0560
PURCHASE ORDER PO Number Page
• CI�/ Of. ' - ' � 9123008 . - 10 of 13
Fort Collins This number must appear
on all invoices, packing
slips and labels.
Line' Description Quantity UOM Unit Price Extended
Ordered Price
a civil penalty of not less than $10,000 and not more than $100,000 for each such expenditure or.failurej.
The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of
its certification and disclosure, if any.. In addition, the.Contractor understands and agrees that the provisions of
31,,U.S.C. A 3801; ,et seq., .apply to this certification and disclosure, if any..
Signature of Contractor's Authorized Official
Name and Title of;Contractors Authorized Official
Date
13. CLEAN AIR
Clean Air -
(1) The Contractor agrees to comply with aliapplicable:standards, orders or regulations issued pursuant to the
Clean Air Act, as amended, 42 U.S.C. §§ 7401 et seq . The Contractor agrees to report each violation to the
Purchaser and understands and agrees that the Purchaser,will, in turn; report each violation as required to
assure notification to FTA and the appropriate EPA Regional Office. .
(2) The Contractor also agrees to include these requirements_ in each subcontract exceeding $100,000 financed.
in whole or in part with Federal assistance provided by FTA.
14. CLEAN WATER REQUIREMENTS
Clean Water - (1) The.Contractor_agrees to comply with all applicable standards, orders or regutationsiissued
pursuant to the Federal Water; Pollution Control Act, as amended, 33 U.S.C. 1251 et ,seq The, Contractor
agrees to report each violation to the Purchaser and understands andagrees that,the -Purchaser will,.in ;turn,
report each violation as required to assure notification to FTA and the appropriate EPA Regional Office.
(2) The.Contractor also agrees to include these, requirements in each subcontract exceeding $100,000 financed.
in whole to� iri part with Federal assistance provided by, FTA.
15. CARGO PREFERENCE REQUIREMENTS
Cargo Preference; ;Use of.United States -Flag Vessels-. The, contractor agrees;, a. to use privately,owned
United States -Flag commercial vessels to ship at least 50 percent of the gross tonnage (computed separately for
dry bulk carriers, dry cargo liners, and tankers) involved, whenever shipping any equipment, material, or
commodities pursuant to the underlying.contract to the extent such vessels are available at fair_ and. reasonable,
rates.for United States -Flag commercial vessels; b. Ito furnish within 20 working days.following.the date -of
loading for shipments originating within the United, States or,within 30 working days_following,the date:of leading
for shipments originating outside the United States, a legible copy of a rated, "on -board" commercial ocean bill -of
-lading in English for each shipment of cargo described in thepreceding.paragraph to the Division of National, -
Cargo,;Offce of Market Development„Maritime Administration,,Washington,,DC 20590 and to the FTA recipient
through the contractor in the case of a subcontractors bill -of -lading.) c. to include these requirements in all
subcontracts issued._pumant to this contract when the,subcontract may involve the transport of equipment,. ,...
material, or commodities by ocean vessel.
16. FLY AMERICA;REQUIREMENTS
_ Invoice Address:
City of Fort Collins Director of Purchasing and Risk Management , -
This order is not valid over $5000 unless signed by James B. O'Neill II, CPPo City of°Fort.Collins
City of Foi Collins Pui�chasing,'PO'BOX 580, Fort Collins, Co 80522-0580 Accounting Department
Phone:970-221-6775 Fax..970.221-6707 Email:purchasing@fcgov.com P.O BOX 580
Fort Collins, CO 80522-0580
-City_of PURCHASE .ORDER PO Number Page
/� ' 9123008- �1:°f.1s
Fort.-Collins
lThis'riumber must appear- -
\� on`all invoices, packing
slips�andaabels.
Line Description Quantity UOM Unit Price Extended
Ordered Price
The Contractor agrees to comply with 49 U.S.C. 40118 (the " Fly America" Act) in accordance with the General
Services Administration' s regulations at 41 CFR Part 301-10, which provide that recipients and subrecipients of
Federal funds and their contractors are required to use U.S. Flag air carriers for U.S Government -financed
international air travel and transportation of their personal effects or property, to the extent such service is
available, unless travel by foreign air carrier is a matter of necessity, as defined by the Fly America Act. The
Contractor shall submit, if a foreign air carrier was used, an appropriate certification or memorandum adequately
explaining why service by a U.S. Flag air carrier was not available or why it was necessary to use a foreign air
carrier and shall, in any event, provide a certificate of compliance with the Fly America requirements. The
Contractor agrees to include the requirements of this section in all subcontracts that may involve international air
transportation.
17. ENERGY CONSERVATION REQUIREMENTS
Energy Conservation - The contractor agrees to comply with mandatory. standards and policies relating to
energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy
Policy and Conservation Act.
18. RECYCLED PRODUCTS
Recovered Materials - The contractor agrees to comply with all the requirements of Section 6002 of the
Resource Conservation and Recovery Act (RCRA), as amended (42 U.S.C. 6962), including but not limited to the
regulatory provisions of 40 CFR Part 247, and Executive Order 12873, as they apply to the procurement of the
items designated in Subpart B of 40 CFR Part 247.
19: ADA Access
Accessibility. Facilities to be used in public transportation service must comply with 42 U.S.C. Sections 12101 et
seq . and DOT regulations, " Transportation Services for Individuals with Disabilities (ADA)," 49 CFR Part 37;
and Joint ATBCB/DOT regulations, " Americans with. Disabilities (ADA) Accessibility Specifications for
Transportation Vehicles," 36 CFR Part 1192 and 49 CFR Part 38. Notably, DOT incorporated by reference the
ATBCB' s " Americans with Disabilities Act Accessibility Guidelines" (ADAAG), revised July 2004, which include
accessibility guidelines for buildings and facilities, and are incorporated into Appendix A to 49 CFR Part 37. DOT
also added specific provisions to Appendix A modifying the ADAAG, with the result that buildings and facilities
must comply with both the ADAAG and amendments thereto in Appendix A to 49 CFR Part 37.
20. CITY OF FORT COLLINS BID PROTEST PROCEDURES
The City of Fort Collins has a protest procedure, covering any phase of solicitation or award, including but not
limited to specification or award. The protest procedures are available from the Purchasing Department, City of
Fort Collins, 215 N. Mason, Street, 2nd Floor, P. O. Box 580, Fort Collins, CO. 80522. You may also request a
copy of the procedures by emailing:
Purchasing@fcgov.com <mailto:Purchasing@fcgov.com> or calling 970-221-6775.
qu,� 2. 01W_Qk .7F
City of Fort Collins Director of Purchasing and Risk Management
This order is not.valid oven$5000 unless signed by James B. O'Neill 11, CPPO
City of Fort Collins Purchasing, PO BOX 580, Fort Collins, CO 80522-0580
Phone:970-221-6775 Fax:970-221-6707 Email:purchasing@fcgov.com
Invoice Address:
City, ofFok Collins
Accounting Department
PO'Box 580 • `
Fort Collins, CO 80522-0580
tt PURCHASE ORDER PO Number Page
Clty. DI//''�� . ' 91 2300$ 12 of 13
FOrt( O«in]T.Ihis.numbermust appear -
V J so
lips invoices; packirig.
slips and labels.
Total $139,£
Invoice. Address: -
City of Fort Collins Director of Purchasing and Risk Management
This order Is not valid over $5000 unless signed by James B. O'Neill II, CPPO, - City of. Fort�Collins
City of Fort Collins Purchasing, 'PO BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Fax:970-221'6707 Email: purchasing@fcgov.com -00 BOX 580
Fort Collins, CO 80522-0580
Purchase Order Terms and Conditions
Page 13 of 13
I. COMMERCIAL DETAILS.
Tax exemptions. By samee the City of Fan Collins is exempt from state antl local taxes. Our Exemption Number is 11. NON WAIVER.
98-04502. Federal Excise Tax Exemption Ceniftcate of Registry 84-6000587 is registered with the Collector of Failure of the Purchaser to insist upon strict performance of the terns slid conditions hereof, failure or delay to
trammel Revenue, Denver, Colorado (Ref. Colorado Revised Statutes 1973, Chapter 39-26, 114 (a). exercise any rights or remedies provided herein or by law, failure to promptly notify the Seller in the event ofs
breach, the acceptance of or payment for goods hereunder or approval ofthe design, shall not release the Seller of
Goods Rejected. GOODS REJECTED due to failure to men specifications, either when shipped or due to defects of any of the warranties or obligations of this purchase order and shall not be deemed a waiver ofany right of the
damage in lransit, may be returned to you for credit and are not to be replaced except upon receipt of wrinen purchaser to insist upon strict performance hereofor any of its rights or manci is as to any such goods, regardless
instructions from the City of Fort Collins. of when shipped, received or accepted, as to any prior or subsequent default hereunder, nor shall any purported
coal mad fication or rescission of this purchase order by the Purchaser operate as a waiver of any of the terns
Justice, ion. GOODS are subject to the City of Fort Collins inspection on arrival. hereof.
Final Acceptance. Receipt of the merchandise, services or equipment in response to this order can result in 12.ASSIGNMENT OF ANTITRUST CLAIMS.
authorized payment on the pan of the City of Fort Collins. However, it is to be understood that FINAL Seller and the Purchaser recognize that in actual economic practice, overcharges resulting from antitrust
ACCEPTANCE is d pendent upon completion ofall applicable required inspection procedures. violations are in fan borne by the Purchaser. Theretofore, for good cause and as consideration for executing this
purchase order. the Seller hereby assigns to the Purchaser an and all claims it ma now have or h fi
Freight Tents. Shipments must be F.O.B., City of FortCollins, 700 Wood St., Fan Collins, CO 80522, unless
otherwise specified on this order. If permission is given to prepay freight and charge separately, the original freight
bill must accompany invoice. Additional charges for packing will not be accepted.
Shipment Distance. Where manufacturers have distributing paints in various pans of the country, shipment is
expecicd from the nearest distribution point to destimntion, and excess freight will be deducted from Invoice when
shipments arc made from greater distance.
Permits. Seller shall procure at sellers salt cost all necessary permits, certificates and licenses required by all
applicable laws, regulations, ordinances and miss of the state, municipality, territory or political subdivision where
the work is performed, or required by any other duly constituted public authority havingjurisdiction over the work
of vendor. Seller fuller agrees m hold the City of Fon Collins harmless from and against all liability and loss
incurred by them by reason of an assened or established violation of any such laws, regulations, ordinances, rules'
and requirements.
Authorization. All parties to this contract agree that the representatives are, in fact, bona fide and possess full and
complete authority to bind said parties.
LIMITATION OF TERMS. This Purchase Order expressly limits acceptance to the terms and conditions stated
herein set forth and my supplementary or additional terns all conditions amexed hereto or incorporated herein by
reference. Any additional or different terms all conditions proposed by seller are objected to and hereby rejected.
2. DELIVERY.
PLEASE ADVISE PURCHASING AGENT immediately if you cannot make complete shipment to arrive on your
premised delivery date as noted. Time is ofthe essence. Delivery and performance must be effected within the time
stated on the purchase order and the documents attached hereto. No acts of the Purchasers including, without
limitation, acceptance ofpvrtial late deliveries, shall operate as a waiver ofthis provision. In the event ofany delay,
the Purchaser shall have, in addition to other legal and equitable munches, the option ofplacing this order elsewhere
and holding the Seller liable for damages. However, the Seller shall not be liable for damages as a result of delays
due to causes not reasonably foreseeable which arc beyond its reasonable control and without its fault ofnegligence,
such acts of God, acts ofeivil or military authorities, governmental priorities, fins, strikes, Hood, epidemics, wars or
riots provided that notice ofthe conditions causing such delay is given to the Purchaser within five (5) days ofthe
time when the Seller first received knowledge thereof. In the event of my such delay, the date of delivery shall be
extended for the period equal to the time actually best by reason ofthe delay.
3. WARRANTY.
The Seller wanams that all goods, articles, materials and work covered by this order will conform with applicable
drawings, specifications, samples and/or other descriptions given, will be lit for the purposes intended, and
performed with the highest degree of cam and competence in accordance with accepted standards for work of a
similar nature. The Seller agrees to hold the purchaser harmless from any loss, damage or expense which the
Purchaser may suffer or incur on account of the Sellers breach of warranty. The Scllcr shall replace, repair or make
good, without cost to the purchaser, any defects or faults arising within one (I) year or within such longer period of
time as may be prescribed by law or by the terns ofany applicable warranty provided by the Seller offer the dale of
acceptance of tits goods furnished hereunder (acceptance not to be unreasonably delayed), resulting front imperfect
or defective work done or materials famished by the Seller. Acceptance or use ofgoods by the Purchaser shall not
constitute a waiver ofany claim under this warranty. Except as otherwise provided in this purchase order, the Sellers
liability hereunder shall extend to all damages proximately caused by the breach ofany of the foregoing warranties
or guarantees, but such liability shall in no event include loss ofprafits or loss of use. NO IMPLIED WARRANTY
OR MERCHANTABILITY OR OF FITNESS FOR PURPOSE SHALL APPLY.
4. CHANGES IN LEGAL TERMS.
The Purchaser may make changes to legal more, by wrinen change order.
5. CHANGES IN COMMERCIAL TERMS.
The Purchaser may make any changes to the terms, other than legal terms, including additions to or deletions from
the quantities originally ordered in the specifications or drawings, by verbal or written change order. If any such
change affects the amount due or the time ofperformmcc hereunder, an equitable adjustment shall be made.
6. TERMINATIONS.
The Purchaser may at any time by wrinen change order, terminate this agreement as to any or all punions of the
goods then not shipped, subject to any equitable adjustment between the panics as m any work or materials then in
progress provided that the Purchaser shall not be liable for any claims for anticipated profits on the uncompleted
ponion of the goods author work, for incidental or consequential damages, and that no such adjustment be made in
favor of the Seller with respect to any goods which are the Sellers standard stock. No such terminalicn shall relieve
the Purchaser or the Seller ofany of their obligations as to any goods delivered hereunder.
7. CLAIMS FOR ADJUSTMENT.
Any claim for adjustment most be mined within thirty (30) days from the date the change or temainalion is
ordcmd.
8. COMPLIANCE WITH LAW.
The Seller wamams that all goods sold hereunder shall have been produced, sold, delivered and famished in mitt
compliance with all applicable laws and regulations to which the goods arc subject. The Seller Shull execute and
deliver such documents as may be required to effect or evidence compliance. All laws and regulations required to be
incorporated in agreements of this character are hereby incorporated herein by this reference. The Seller agrees to
indemnify, and hold the Purchaser harmless from all cases and damages suffered by the Purchaser as a result ofthe
Sellers failure to comply with such law.
9. ASSIGNMENT.
Neither parry shall assign, transfer, or convey this order, or any monies due or to become due hereunder without the
prior written consent of the other party.
10. TITLE.
The Seller marruns full, clear and unrestricted title to the Purchaser for all equipment, materials, and items famished
in perfommnce of this agreement, fore and clear of any and all liens, restrictions, resrvxlions, security interest
encumbrances and claims of others.
y y nee err
acquired under federal or state entitmst laws for such overcharges relating to the particular goods or services
purchased or acquired by the Purchaser persumt 10 this purchase order.
13. PURCHASERS PERFORMANCE OF SELLERS OBLIGATIONS.
Ifthe Purchaser directs the Sclla to correct nouconfomting or defective goods by a date to be agreed upon by the
Purchaser and the Seller, and the Seller thercafier indicates its inability or unwillingness to comply, the Purchaser
may cause the work to be performed by the most expeditious means available to it, and the Seller shall pay all
costs associated with such work.
The Seller situ]] release the Purchaser and its contractors of any tier from all liability and claims ofany nature
resulting from the performance of such work.
This release shall apply even in the even, of fault of negligence of the party released and shall extend to the
dimcmrs, officers and employees ofsuch party.
The Sellefs contractual obligations, including waranty, shall not be deemed to be reduced, in any way, because
such work is perfommed or caused to be performed by the Purchaser.
14. PATENTS.
Whenever the Seller is required to use any design, device, material or process covered by letter, patrols trademark-
orcopyright, the Seller shall indemnify and save harmless the Purchaser front any and all claims for infringement
by reason of the use of such patented design, device, material or process in connection with the contract, and
shall indemnify the Purchaser for any cost, expense or damage which it may be obliged to pay by reason of such
infringement at any time during the prosecution or after the completion ofthe work. In case said equipment, or
any pan thereof or the intended use of the goods, is in such suit held to constitute infringement and the use of
said equipment or pan is enjoined, the Seller shall, at its own expense and at its option, either procure for the
Purchaser the right to continue using said equipment or pans, replace the same with substantially equal but
noninfringing equipment, or modify it so it becomes noninfringing.
15. INSOLVENCY.
If the Seller shall become insolvent or barklept, make an assignment for the bmcfit of creditors, appoint a
receiver or trustee for any of the Sellers property or business, this order may forthwith be canceled by the
Purchaser without liability.
16. GOVERNING LAW.
The definitions ofmrms used or the interpretation ofthe agreement and the rights ofall parties hereunder shall be
consttued under and governed by the laws ofthe State of Colomdo, USA.
The following Additional Conditions apply only in cases where the Seller is to perform work hereunder,
including the services of Sellers Represenoative(sk on the premises of others.
17. SELLERS RESPONSIBILITY.
The Seller shall curry on said work at Se11Ms own risk until the same is fully completed and accepted, and shall,
in case of any accident, dcstmction or injury to the work and/or materials before Sellers final completion and
acceptance, complete the work at Seller's own expense and to the satisfaction ofthe Purchaser. When materials
and equipment arc furnished by others for installation or erection by the Seller, the Seller shall receive, unload,
store and handle same at the site and become responsible therefor as though such materials mefor equipment
were being furnished by the Seller under the order.
18. INSURANCE.
The Seller shall, at his own expense, provide for the payment ofworksrs compensation, including occupational
disease benefits, to its employes employed on or in connection with the work covered by this purchase order,
and/or to their dependents in accordance with the laws of the stoic in which the work is to be done. The Seller
shall also carry comprehensive general liability including, but not limited to, contmetuvl and automobile public
liability insurance with bodily injury and death limits ofm least S300,000 for any one person, S500,000 for any
one accident and property damage limit per accident of $400,000. The Seller shall likewise require his
connectors, if any, to provide for such compensation and insurance. Before any of the Sellers or his contractors
employees shall do any work upon the premises of others, the Seller shall furnish the Purchaser with a eenificslc
that such compensation and insurance have been provided. Such certificates shall specify the date when such
compensation and insurance hove been provided. Such cenificams shall specify the date when such compensation
and insurance expires. The Seller agrees that such compensation and insurance shall be maintained until after the
entire work is completed and accepted
19. PROTECTION AGAINST ACCIDENTS AND DAMAGES.
The Seller hereby assumes the entire responsibility and liability for any and all damage, loss or injury ofany kind
or nature whatsoever to pnsns or property caused by or resulting from the execution ofthe work provided for in
this purchase order or in connection herewith. The Seller will indemnify and hold harmless the Purchaser and any
or all of the Purchase, officers, agents and employees from and against any and all claims, losses, damages,
charges or expenses, whether direct or indirect, and whether to persons or property to which the Purchaser may
be put or subject by reason of any act, action, neglect, omission or default on the part of the Seller, any of his
contractors, or any of the Sellers or contractors officers, agents or employes. In case any suit or other
proceedings shall be brought against the Purchaser, or its otfccm, agents or employees at any time on account or
by reason of any act, action, neglect, omission or default of the Seller of any ofhis convenors or any of its or
their officers, agents or employees as aforesaid, the Seller hereby agrees to assume the defense thereof and to
defend the same at the Sellers own expense, to pay any and all costs, charges, attorneys fees and other expenses,
any and all judgments that may be incurred by or obtained against the Purchaser or any of is or their officers,
agents or employees in such suite or other proceedings, and in case judgment or other lien be placed upon or
obtained against the property ofibe Purchaser, or said parties in or as a result ofsucb suits or other proceedings,
the Seller will al once cause the same to be dissolved and discharged by giving bond or otherwise. The Seller all
his contractors shall mke all safety precautions, furnish and install all guards necessary for the prevention of
accidents, comply with all laws and regulations with regard to safety including, but without limitation, the
Occupational Safety and Health Act of 1970 and all rules and regulations issued personal thereat.
Revised 03/2010
PURCHASE ORDER PO Number Page
City. of .... 9123008 ,z of 13
FOI ` CdtinS This number must appear
/v ` �7 on all-umbe m packing
/ ~�, slips and labels.
Line Description Quantity UOM Unit Price Extended
Ordered Price
Program Fraud and False or,Fraudulent Statements or Related Acts.
(1) The Contractor acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1986, as;
amended, 31 U.S'.C.'§.3801 et -'seq.: and U.S. DOT regulations, "Program Fraud'Civil Remedies;" 49 C.F.R: '
Part 31; apply to its actions pertaining to this Project. Upon execution of the underlying contract, the Contractor
certifies or affirms the truthfulness and accuracy of any statement it has made, it makes, it may make, or causes
to be made, pertaining to the underlying contract or the FTA assisted project for which this contract work is being
performed. In addition to other penalties that may be applicable, the Contractor further acknowledges that if it
makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification, the
Federal Government reserves the right to impose the penalties of the Program Fraud Civil
<'-.:.Remedies Act of.1986 on the Contractor to the extent the Federal Government deems appropriate.
(2) The Contractor also acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent
claim, statement, submission, or certification to the Federal Government under a contract connected with a
project that is financed in whole or in part with Federal assistance originally awarded by FTA under the authority
of 49 U.S:C.' § 5307, the G6veWnment reseryesthe right to impose the penalties of 18 U:S.C. § 1001 and 49
U.'S.C.'§ 5307(n)(1) on the Contractor, to the extent the Federal'Govemment deems appropriate.
(3) The Contractor agrees to include the above two clauses in each subcontract financed in whole or in part with
Federal assistance provided by FTA. It is further agreed that the clauses shall not be modified, except to identify
the subcontractor who will be subject to the provisions.
3. ACCESS TO RECORDS AND REPORTS
Access to Records - The following access to records requirements apply to this Contract:
A. Where the'Purchaser is not a State but a local government and is the FTA Recipient ora•subgrantee-of the
FTA Recipient in accordance with 49 C.F.R. 18.36(i), the Contractor agrees to provide the Purchaser, the FTA
Administrator, the Comptroller General of the United States or any of their authorized representatives access to
any books, documents, papers and records of the Contractor which are directly pertinent -to this:cohtract for the
purposes of making audits, examinations, excerpts and transcriptions. Contractor also agrees; pursuant to 49
C.F.R. 633.17 to provide the FTA Administrator or his authorized representatives including any PMO Contractor
access to Contractor's records and construction sites pertaining to a major capital project, defined at 49,U.S.C.
5302(a)1, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307,
5309 or 5311.
B. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to
copy excerpts and transcriptions as -reasonably needed. i
C. The Contractor. agrees to maintain all, books; records, accounts and reports required under•this contract for a
period of;not less than three years,afterthe date.of termination or expiration of.this contract; except in the event `
of litigation or settlement of claims arising;from,the,.performance of-this,contract, in which case Contractor agrees'
to maintain same until the Purchaser, the FTA Administrator, the Comptroller General, or any of their duly
authorized representatives,, -have disposed of alhsuchditigation, appeals, claims or exceptions related thereto'.
Reference,49 CFR 18.39(i)(11)..
D. FTA does not require the inclusion of these requirements in subcontracts.
Requirements for Access to Records and Reports by Types of Contract
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000 unless signed by JamesB. O'Neill 11, CPPO
City of Fort Collins Purchasing', PO BOX 580, Fort Collins, CO 80522-0580
Ph6ne:970-221-6775 Fax:-970-221=6707 Email:purchasing@fcgov.com
— - Invoice Address: - -
City of Fort Collins
Accounting Department
P.O'lBtix 580
Fort Collins, CO 80522-0580
City of
art Collins
PURCHASE ORDER
PO Number Page
9123008 .'1
3 of 13
This number must appear
on all invoices, packing
slips and labels.
Line Description Quantity UOM Unit Price Extended
Ordered Price
-760 Contract Characteristics 'Operational Service Contract Turnkey Construction Architectural
Engineering <shading="10%'5 Acquisition of Rolling Stock Professional Services
-760 ..I State Grantees a. Contracts below SAT. ($100;000) . b. Contracts above $100,000/Capit6l
Projects None None unless.1 non-competitive award Those imposed on state pass thru to Contractor
None Yes, if non-competitive award or if funded thru 2 5307/5309/5311 None None unless non-
competitive award None None unless non-competitive award None No6e unless non-competitive award
-760 II Non State Grantees a. Contracts below SAT ($100,000) b. Contracts above $100,000/Capital
Projects Yes 3 Yes 3 Those imposed on non -state Grantee pass thru to Contractor Yes Yes Yes
Yes Yes Yes Yes Yes
Sources of Authority: 1:49 USC 5325 (a) 2 49 CFR'633.17 '3'18 CFR 18:36 (i) *'
Ai FEDERAL CHANGES,,:• r<
Federal Changes - Contractor shall at all times comply with all applicable "FTA regulations policies procedures
and directives; including without limitation those listed directly'or byrefe'fence in the Master Agreement' between
Purchaser and FTA,'as they may be amended or promulgated from time to time during the term of this contract.
Contractor's failure to so comply shall constitute a material breach of this contract.
5. TERMINATION
a. Termination for Convenience (General Provision) The City may terminate
this contract; in whole or'inpart, at any time by written notice to'the Contractor when it is in the Government's
best interest: The Contractor shall be'paid its costs, including'contract close-out costs;'and piofit'on work
performed up to the time,of•termination.' The Contractor, shall promptly submit its"termination claim to the City, to
be paid tfie-Contractor. If the!Contractor has'any property n its possession belonging -to the Ciig,-the Contractor
will account.for the same,'and dispose of it in the manner the City directs. "
b. Termination for Default -[Breach or Cause] -(General Provision) If the Contractor does not deliver supplies in
accordance with the contract deliveryschedule, or, if the contract'is for services, tfie'Contractor fails to perform in
the manner called for in the contract, or if the Contractor fails to -comply with any other provisions of the contract,
the City may terminate this contract for default. Termination shall be effected by serving a notice'of termination
on the contractor setting forth the manner in which the Contractor is in default. The contractor will only be paid.
the contract price for supplies delivered and accepted, or services performed in accordance with the manner of
performance set forth in the contract:
If it is later determined by the City that the Contractor had an excusable reason for not performing, such as a
strike, fire, or flood, events which are not the fault of or are beyond the control of the Contractor, the City, after
setting up a new delivery of performance schedule,'mayallow the'Contractor'to continue work,'or treatthe
termination as a termination for convenience '
c. Opportunity. to Cure (General Provision) The'Cityin its sole discretion may, in the case of a termination for
breach or default, allow the Contractor [an appropriately short per& bf time] in which to cure the defect. In such
case, the notice of termination will state the time period in which cure is permitted and other appropriate
conditions '
If Contractor fails to remedy to the City' s satisfaction the breach or default of any of the terms, covenants, or
conditions of this Contract within [ten (10) hays] after receiptby Contractor of written notice from the City setting
Invoice' Address:
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid'over$5000 unless signed by James B. O'Neill 11, CPPO City Hof Fort Coll
City of Fort Collins Purchasing, PO BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Faz: 970=221=6707 Email:purchasing@fcgov.com PO Box 580
Fort Collins, CO 80522-0580
PURCHASE ORDER PO Number Page
C117/ Of///��1 9123008., ¢of 13
Fort ( [tins
This number must appear.
{ V J on:all invoices, packing
Islips*brid labels.
Line Description Quantity ,UOM Unit Price Extended
Ordered Price -
forth the nature of said breach or default; the City shall have the right to terminate the Contract without any
further obligation to Contractor. Any such termination for default shall not in any way operate to preclude the City
from also pursuing all available remedies aga.insf.Contractor and its sureties fonsaid breach.or default.
6.,CIVIL RIGHTS REQUIREMENTS
Civil Rights.- The following.requirements apply to the underlying contract:
(1) Nondiscrimination - In accordance with Title VI of the Civil Rights Act, as amended, 42 U.S.C. § 2000d,
section 303 of the Age Discrimination Act of 1975, as amended, 42 U.S.C: § 6102, section 202 of the, Americans
with Disabilities Act of 1990, 42 U.S.C. § 12132, and Federal transit law at 49 U.S.C. § 5332, the Contractor
agrees that it will not discriminate against any employee or applicant for employment because of race, color,
creed, national origin, sex, age, or disability. In addition, the Contractor agrees to comply with.applicable?Federal
implementing regulations and other implementing requirements FTA may issue.
(2) Equal Employment,Opportunity The;following.equal employment opportunity:requirements apply to the . .
underlying contract:
(a) Race, Color, Creed, National Origin, Sex - In accordance with Title VII of the Civil Rights Act, as amended,
42 U.S.C. § 2000e, and Federal transit laws at 49 U.S.C. § 5332, the Contractor agrees to comply with all
applicable equal employment opportunity requirements of U.S. Department of Labor (U.S. DOL) regulations,
"Office of Federal Contract Compliance Programs, Equal Employment'Opportunity, Department of;Labor," 41
C.F.R,_Parts 60, et seq ., (which implement Executive Order No. 11246; !'Equal,Employment Opportunity," as
amended, by Executive Order No. 11375, "Amending; Executive Order 11246 Relating to -Equal Employment
Opportunity,",42; U.S.C,,§-2000e note); and with,any applicable, Federal statutes; executive orders; regulations,
and,Federal,policies thatmay in.the future. affecttconstruction activities. undertakemin;the course of the,Project.,
The Contractor agrees to take affirmative action to ensure•that.applicants a re;employed,�and that employees are,
treated during employment, without regard to their race, color, creed, national origin, sex, or age. Such action
shall include, but not be limited.to,.the:following:. employ ment;.upgrading; demotion, or.;transfer, recruitment of
recruitment advertising, layoff or termination; rates of,pay. or other forms of compensation; and selection for.
training, including apprenticeship. In addition, the Contractor agrees.to comply with any implementing.
requirements FTA may.issue. ,
(b) Age_,�jn accordance with section 4 of the Age Discrimination in Employment; Act of 1967-,.as amended, 29
U.S.C. § § 623 and Federal transit law at 49 U.S.C. § 5332, the Contractor agrees•to refrain from,discrimination
against present and prospective employees for reason of age. In addition, the Contractor agrees to comply with
any implementing,requirements FTA may.issue.
(c) Disabilities - In ,accordance with section 102 of the Americans with. Disabilities Act, as amended, 42 U.S.C. §
12112, the Contractor agrees that it will comply with the requirements of U.S. Equal Employment Opportunity
Commission, "Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities
Act," 29 C.F.R..Part 1630,.pertaining to employment of persons with disabilities: In addition, the Contractor.:
agrees Io,comply with any implementing requirements FTA may issue.
(3) The Contractor also agrees to include these -requirements in each subcontract financed in whole or in part
with Federal assistance provided by FTA, modified only if necessary to identify the affected parties.
7. DISADVANTAGED BUSINESS ENTERPRISE (DBE)
-. -- Invoice -Address:- ---
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000 unless signed by James B. O'Neill II, CPPO . • • City of-Fort•Collins
City of Fort Collins'Purchasing, PO BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Fax: 970-221=6707 Email: purchasing@fcgov.com PO Box 580
Fort Collins, CO 80522-0580
PURCHASE ORDER PO Number Page
City Of23008 - 5 of I
FortCollins[ This; number must appear
�I a` on all invoices, packing •
slips'and labels:
Line Description Quantity UOM Unit Price Extended
Ordered _ Price.
a. This contract is subject to the requirements of Title 49, Code of Federal Regulations, Part 26, Participation
by Disadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs. The
national goal for participation of Disadvantaged Business Enterprises (DBE)is 10%. The agency''s overall goal
for DBE participation is 9.9 %.
b. The contractor shall not discriminate on the basis of race,' color; national origin, or sex in the performance of
this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and
administration of this DOT -assisted contract. Failure by the contractor to carry out these requirements is a
material breach of this contract, which may'result in the termination of this contract or such other remedy as` City
of Fort Collins deems appropriate. Each subcontract the contrector'signs'wifh a subcontractor must include'the
assurance in this paragraph ( see 49 CFR26.13(b))'.
( If no separate contract goal has been established, use the following) The successful bidder/offeror will be
required to report its DBE participation obtained through race -neutral means throughout the period of
performance.
c. The contractor is required to pay its subcontractors performing work related to this contract for satisfactory
performance of that work no later than 30 days after the contractor' s receipt of payment for that work from the
City of FortCollins . In addition, '[is required to'return any`retainage payments to those subcontractors within 30
days after incremental acceptance of the subcontractor s work by ttie"City of Fort, Collins and contractor' sreceipt
s
of the partial retainage payment related to the subcontractor' work:] ' ' '`
d. The contractor must promptly notify City of Fort Collins whenever a DBE subcontractor performing work
related to this contract is terminated or fails to complete its work; and must make good faith efforts to engage
another DBE subcontractor to perform at least the same amount of work. The contractor may not terminate any
DBE subcontractor and perform that work through -,its own forces or those of ein affiliate without prior' written
consent of City of Fort Collins.
8. INCORPORATION OF FEDERAL TRANSIT ADMINISTRATION (FTA) TERMS`
Incorporation of Federal Transit Administration (FTA) Terms The preceding provisions' include, in part, certain
Standard Terms and Conditions required by DOT, whether 'or not expressly set forth in the preceding contract
Provisions. All contractual provisions required by DOT; as sefforth'in FTA,Circular 4220.1 E, are h6reby'
incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms'shalvbe
deemed to control in the event of a conflict with other provisions contained in this Agreement. The Contractor
shall not perform any act, fail to perform any act, or refuse to comply with any (name of grantee)'requests which
would cause (name of grantee) to be in violation of the FTA terms and conditions.
9. GOVERNMENT -WIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT)
Background and Applicability
In conjunction with the Office of Management and Budget and other affected Federal agencies, DOT published'
an update to 49 CFR Part29 on November 26,12003:'This government=wide regulation implements Executive
Order 12549, Debarment and Suspension , Executive Order 12689, Debarment and Suspension , and 31
U.S.C. 6101 note (Section 2455, Public Law 103-355; 108 Steil. 3327)." '
The provisions of Part 29 apply to all grantee contracts•and subcontracts at any level expected to equal or
exceed $25,000 as well as any contract or subcontract (at any level) for Federally required' auditing services. '49
CFR 29.220(b). This represents a change from prior practice in that the dollar threshold for application of these
rules has been lowered from $100,000 to $25,000.' These are;contracts and subcontracts referred io`in the
9u'.� O' LLQZ
Invoice Address:
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over. $5000 unless signed by James B. O'Neill II, CPPO City Of Fort Collins
City of Fort Collins Purchasing, PO BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Fax: 970-221-6707 Email:purchasing@fcgov.com PO'BOx 580
ForlCollins, CO 80522-0580
PURCHASE ORDER PO Number Page
�.1�/iOfCollins
'� i 9123008 ' 6 of 13
`t ( olI I n �` This number must appear
J on ail invoices, packing
slips and labels.
Line Quantity
Description UOM .. Unit Price Extended
Ordered Price
regulation as " covered transactions."
Grantees, contractors, and subcontractors (at any level) that enter into covered transactions are required to verity
that the entity (as well as its principals and affiliates) they propose to contract or subcontractwith is not excluded
or disqualified. They do this by (a) Checking the Excluded Parties List System, (b) Collecting a certification from
that person, or.(c) Adding a clause or condition,to the contract or subcontract. This represents a change from
prior practice in that certification is still acceptable but is no longer required. 49 CFR 29.300.
Grantees„contractors, and subcontractors who enter into covered transactions also must require the entities they
contract with to comply with 49 CFR 29, subpart C and include this. requirement in their own subsequent covered
transactions (i.e., the requirement flows down to subcontracts at all levels). ,
Clause Language
The following clause language is suggested, not mandatory. it incorporates the optional method of verifying that
contractors are not excluded or disqualified by certification.
Suspension and Debarment
Thiscontract is a covered transaction for purposes of 49 CFR Part 29. As such, the contractor is required to
verify that none of the contractor, its principals, as defined at 49:CFR 29.995, or affiliates, as defined at 49 CFR
29.905, are excluded or disqualified as defined at.49 CFR 29.940 and 29.945.
The contractor is required to comply with 49,CFR 29, Subpart C and must include the requirement to comply with
49 CFR 29, Subpart C in any lower tier covered transaction it enters into. _ c
By signing and, submitting its bid orproposal, the bidder or proposer certifies as follows: ,
The certification in this clause is a material representation of fact relied upon by (insert agency name). If it is later
determined that the bidder or proposer knowingly rendered an erroneous certification, in additiornto remedies
available to (insert agency name), the Federal Government may pursue available remedies, including but not
limited to suspension and/or debarment. The bidder or, proposer,agrees.to comply with the requirements of 49
CFR 29, Subpart C while,this offer is valid and.throughout the period of any contract, that may arise from this
offer. The bidder or proposer further agrees to include a provision. requiring such compliance in its lower tier
covered transactions.
10. BUY AMERICA
The contractor agrees to comply with 49 U.S.C. 53236) and 49 C.F.R. Part 661;.which provide that Federal
funds may not be obligated unless steel, iron, and manufactured products used in FTA-funded projects are
produced in the United States, unless.a waiver has been granted. by FTA or the product is subject to a.generai
waiver. General waivers are listed in 49 C.F.R. 661.7, and include final assembly in the United States for 15
passenger vans and 15 passenger wagons produced by Chrysler Corporation, and microcomputerequipment
and software: Separate requirements for rolling stock are set out at 49 U.S.C. 53230)(2)(C) and 49 C.F.R.
661.1 i. Rolling, stock must be assembled in. the United States,and have a 60 percent domestic content.
A bidder or offeror must submit to the FTA recipient the appropriate Buy America certification (below) with all bids
or offers on FTA-funded contracts, except those subject to a general waiver. Bids or offers that are not
accompanied by a completed.Buy America certification•must;be rejectedas nonresponsive. This requirement
does.not apply to lower tier subcontractors.
.Certification -requirement forprocurement of steel, iron, or manufactured products
Invoice Address:
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000,unless signed by James B. O'Neill II, CP_eo - Cityof Fort Collins
City of Fort Collins Purchasing,PO-BOX 580, Fort Collins, CO 80522-0580 Accounting Department
Phone:970-221-6775 Fax:970-221:6707 Email:purchasing@fcgov.com PO.BOX 580.`
.; �7 Fort Collins, CO 80522-0580
City of PURCHASE ORDER
: art Collins
PO Number Page
9123008" 7 of 13
'a
This^qurober must appear
onh,mvoices, packing
slips and latiels:
Line Description Quantity UOM Unit Price Extended
Ordered Price
Certificate of Compliance with 49 U.S.C. 5323Q)(1)
The bidder or offeror hereby certifies that it will meet the requirements of 49 U.S.C. 53230)(1) and the applicable
regulations in 49 C.F.R. Part 661.5.
Date
Signature
Company Name
Title
Certificate of Non -Compliance with 49 U.S.C. 53230)(1)
The bidder or offeror hereby certifies that it cannot comply with the requirements of 49 U.S.C. 53230)(1)'and 49
C.F.R. 661.5, but it may qualify for an exception pursuant to 49 U.S.C. 53230)(2)(A), 53230)(2)(B), or
53230)(2)(D), and 49 C.F.R. 661.7.
Date
Signature
Company Name
Title
Certification requirement for procurement of buses, other rolling stock and associated equipment
Certificate of Compliance with 49 U.S.C. 53230)(2)(C). ' •
The bidder or offeror hereby certifies that it will comply with the requirements of 49 U.S.C`53230)(2)(C) and the
regulations at 49 C.F.R. Part 661.11.
Date
Signature
Company Name
Title
Certificate of Non -Compliance with 49 U.S.C. 53230)(2)(C)
The bidder or offeror hereby certifies that it cannot'comply with the requirements' of 49 U.S.C. 53230)(2)(C) avid
49 C.F.R. 661.11, but may qualify for an exception pursuant to 49 U.S.C. 53230)(2)(A), 53230)(2)(B), or
53230)(2)(D), and 49 CFR 661.7:
Date
Signature
Company Name
C3. Oi1.�uQ,
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over.$5000 unless signed by James B. O'Neill ll, CPPO'
City of Fort Collins Purchasing, PO BOX 580, Fort Collins, CO 80522-0580
Phone:970-221-6775 Fa-x: 070, 221-6707 Email:purchasing@fcgov.com
Invoice"Address:
City of Fort Colliris
Accouriting Department
PO Box 580
Fort Collins, CO 80522-0580
PURCHASE ORDER PO Number Page
City Of, 9123008 $ of 13
Fort Collins
Flips
1 invoi r must appear.
J ll invoices, packing
andiabels.
Line Description Quantity UOM Unit Price Extended
Ordered Price
Title
11. BREACHES AND DISPUTE RESOLUTION
Disputes - Disputes arising in the performance of this Contract which are not resolved by agreement of the
parties shall be decided in writing by the authorized representative of City's [title of employee]. This decision
shall be final and conclusive unless within [ten (10)] days from the date of receipt of its copy, the Contractor mails
or otherwise furnishes a written appeal to the [title of employee]. In connection with any such appeal, the
Contractor shall be afforded an opportunity to be heard and to offer evidence in support of its position: The
decision of the [title of employee] shall be binding upon the Contractor and the Contractor shall abide be the
decision.
Performance During Dispute - Unless otherwise directed by'City, Contractor shall continue performance under
this Contract while matters in dispute,are being, resolved.,
Claims for Damages - Should either party to the Contract suffer injury or damage to person or, property because
of any act or omission of the party or of any of his employees, agents or others for whose acts he is legally liable,
a claim for damages therefor shall be made in writing to such other party within a reasonable time after the first
observance of such injury of damage.
Remedies - Unless this contract provides otherwise, all claims, counterclaims, disputes and other matters in
question between the City and the Contractor arising out of or relating to this agreement or its breach will.be
decided by arbitration if the parties mutually agree, or in a court of competent jurisdiction within the State in which
the City is located.
Rights and Remedies ,- The duties and obligations imposed by the Contract Documents and the rights and
remedies available thereunder shall be in addition to and not a limitation of any duties„obligations, rights and
remedies otherwise imposed or available bylaw. No action. or failure to act by. the City, (Architect) or Contractor•
shall constitute a waiver of any right or duty afforded any of them under the Contract, nor shall any such action or
failure to act constitute an approval of or acquiescence in any breach thereunder, except as may be specifically
agreed in writing.
12. LOBBYING
Modifications have been made to the Clause pursuant to Section 10 of the Lobbying Disclosure Act of 1995, P.L.
104-65 [to be codified at 2 U.S.C. § 1601, et seq. ]
- Lobbying Certification and Disclosure of Lobbying Activities for third party contractors are mandated by 31
U.S.C. 1352(b)(5), as amended by Section 10 of the Lobbying Disclosure Act of.1995, and DOT implementing
regulation, "New Restrictions on Lobbying," at 49 CFR § 20.110(d)..;
- Language in Lobbying Certification is mandated by 49 CFR Part 19, Appendix A, Section 7, which provides that
contractors file the certification required by 49 CFR Part 20, Appendix A.
Modifications have been made to the Lobbying Certification pursuant to Section 10 of the Lobbying Disclosure
Act of 1995.
- Use of "Disclosure of Lobbying Activities," Standard Form-LLL set forth in Appendix B of 49 CFR Part 20, as
amended by "Government wide Guidance For New Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96) is
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000 unless signed by James B. O'Neill II, CPPO
City of Fort Collins Purchasing;' PO•BOX 580, Fort Collins, CO 80522-0580
Phone:970-221-6775 Fax, 970-221-6707 Email:purchasing@fcgov.com
Invoice Address:- -
City of Fort Collins'
Accounting Department
PO Box.580:: "
Fort Collins, CO 80522-0580
PURCHASE ORDER 9. Number Page
Clty. Of 9123008 9
Fort:CollinslThisiriumberrnustappear
on s a,n,dolab , packing'
slips end'la6els.
Line Description Quantity UOM Unit Price Extended
Ordered _ _ Price
mandated by 49 CFR Part 20, Appendix A.
Byrd Anti -Lobbying Amendment, `31 U.S.C. 1352;'as amended by the Lobbying Disclosure Actof 1995, P.C. 104=
65 [to be codified at 2 U.S.C. § 1601, et seq.] - Contractors who apply or bid for anaward of $100000 or more
shall file the certification required by 49 CFR part 20; "New Restrictions on Lobbying." Each tier certifies to the
tier above that it will not and has not used Federal appropriated funds to pay any person or organization for
influencing or attempting to influence an officer or employee of any agency; a'member of.Congress, officer or
employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal
contract, grant or any other award covered by 31 U.S.C. 1352. Each tier shall also disclose the name of any
registrant under the Lobbying Disclosure Act of 1995 who has made lobbying contacts on its behalf with non -
Federal funds with respect to that Federal contract, grant or award covered by 31 U.S.C. 1352. Such'�disclosures
are forwarded from tier to tier up to the recipient.
APPENDIX A; 49 CFR PART 20--CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements
(To be submitted with each bid or offer exceeding $100,000)
The undersigned [Contractor) certifies; to the best of his or her knowledge and belief,'that.-
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency: a`Memtier-of'Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of
any Federal`contract;.the making of any Federal grani;�the making of any Federal loan,,the entering into of'any
cooperative agreement,'and the extension, continuation; renewal,'amendment, or"modification`of any Federal
contract, grant; loan;'orcoope'rative agreement
(2) If any funds other than Federal appropriated funds have, been paid or will be paid to any person for making
lobbying contacts` to an officer or employee of 'any agency's Member of Congress an officer or employee'of
Congress, or an employee of a Member of Congress in connection with this Federal'conteact, grant,166h; or'
cooperative agreement, the undersigned shall complete and submit Standard Form--LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions [as amended by'"Govemmentwide Guidance for New
Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96). Note: Language in paragraph (2) herein has been
modified in accordance with Section 10:of the Lobbying Disclosure Act of 1995 (P.L. 104-65, to be codified at 2
U.S:C: 1601, "et seq. )1
(3) The undersigned shall require that the language of -this certification be'included in tlie'award documents for all
subawards at all tiers (including. subcontracts; subgebrits,3and contracts under grants, 'loans, and cooperative"
agreements)'and'thatall s66recipients shall certify and'disclose'accordin I
g y'
This certificatiowis a material representation of fact upori which reliance'was placed "when this'transaction was'
nude or entered into. Submission of this certification is a prerequisite for'making'or entering into this transaction
imposed by 31;S: U.C. § 1352 (as'amen'ded by the Lobbying Disclosure A'ctof 1995): 'Any personwho fails`to
file the'required certification shall be subject to'a-civil penalty of n6t.16ssthan $,10;000'66d�not more than
$100,000 for each such failure.
[Note: Pursuant to 31 U.S.C. § 1352(c)(1)-(2)(A), any person who makes a prohibited expenditure or fails to fle
or amend a required certification. or disclosure,form shall be subject to
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $5000 unless signed by James B. O'Neill II, CPPO `
City of Fort Collins Purchasing PO BOX 580, Fort Collins, CO 80522-0580
Phone:970-221-6775 , Fax: 970-221-6707 Email:purchasing@fcgov.com
Invoice Addiressi
City -of Fort Collins
Accounting Department
P.•O Box 580
Fort Collins, CO 80522-0580