TO: - Jefferson County, Alabamajeffconline.jccal.org/OnlineBidSearch/PACABIDS/itbs/341… · Web viewThe word COUNTY refers ... preventative maintenance services for diesel and

JEFFERSON COUNTY COMMISSIONPURCHASING DIVISION

ROOM 830 COURTHOUSEBIRMINGHAM, AL 35203-0009

OFFICE: (205) 325-5381 / FAX: (205) 214-4034

DOROTHEA ROBINSON, PRINCIPAL BUYER APRIL 15, 2016MICHAEL MATTHEWS, C.P.M., PURCHASING AGENT MUNIS ITB 16022 (ITB: 61-16)

TO: Prospective BiddersMUNIS ITB NUMBER: 16022 ( Bid must be submitted online at https://mss.jccal.org/mss)SEPARATE SEALED BIDS FOR: ESD Standby Generator Preventative Maintenance

INVITATION TO BID RESPONSES WILL BE RECEIVED BY:

Dorothea Robinson, Principal Buyer716 Richard Arrington Jr. Blvd North, Room 830 Courthouse Birmingham, AL 35203-0009

***IMPORTANT SOLICITATION DATES***

NOTIFICATION OF INTENT:All recipients of this solicitation notice must indicate intent to submit a bid. Bidders providing a Notification of Intent will be sent any related addendum, answers to inquiries, etc. pertaining to this solicitation. The Notification of Intent form located on Sheet 19 of the Bid must be sent to the attention of Dorothea Robinson via fax 205-214-4034 or emailed to [email protected]. Contact Dorothea Robinson via email: [email protected] for full copy of ITB.

PLEASE RESPOND NO LATER THAN FRIDAY MAY 6, 2016 WITH YOUR INTENT.

TELEPHONE INQUIRIES – NOT ACCEPTED:Telephone inquiries with questions regarding clarification of any and all specifications of the bid will not be accepted. All questions must be submitted to Dorothea Robinson via email [email protected] or fax 205-214-4034.

Submissions may be withdrawn, modified, and resubmitted prior to the formal bid due date. Any submission modifications submitted after the “ITB Due Date” will not be considered.

Jefferson County (henceforth referred to as “The County” reserves the right to accept or reject any or all bids, or any part of any bid, and to waive any informalities or irregularities in the bid.

All costs incurred by the company to respond to this solicitation will be wholly the responsibility of the Bidder. All copies and contents of the bid, attachments, and explanations thereto submitted in response to this ITB, except copyrighted material, shall become the property of the Jefferson County Commission regardless of the Consultant selected. Any materials submitted in response to this solicitation shall not be returned. Response to this solicitation does not constitute an agreement between the Bidder and the County.

The County is not responsible for delays occasioned by the U.S. Postal Service, the internal mail delivery system of the County, or any other means of delivery employed by the Bidder. Similarly, the County is not responsible for, and will not open, any bid responses, which are received later than the date and time, indicated above. Late bids will be retained in the bid file, unopened.

RELEASED BY:

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BID DUE DATE: BID OPENING DATE:MAY 11, 2016 by 11:59 PM

(Central Standard Time)MAY 12, 2016 at 2:00 PM (Central Standard Time)

PARTICIPANTS MUST SUBMIT BID ONLINE AT HTTPS://MSS.JCCAL.ORGINSTRUCTIONS ARE LOCATED IN THE VSS “RESOURCES SECTION” OR CAN BE OBTAINED BY

CONTACTING THE BUYER LISTED WITHIN THIS DOCUMENT. VENDORS MUST BE REGISTERED IN MUNIS/VENDOR SELF SERVICE TO ACCESS BID 16022 (ITB 61- 16)

BID OPENING WILL BE HELD AT: Jefferson County Courthouse

Purchasing Department, Room 830 Courthouse716 Richard Arrington Jr. Blvd NorthBirmingham, Alabama 35203-0009

mailto:[email protected]



https://MSS.JCCAL.ORG/

https://mss.jccal.org/mss



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


INVITATION TO BID# 16022 (ITB 61 – 16)INVITATION TO BID# 16022 (ITB 61 – 16)

“ESD Standby Generator Preventative Maintenance”“ESD Standby Generator Preventative Maintenance”

Dorothea Robinson, Principal Buyer Dorothea Robinson, Principal Buyer

Room 830*716 Richard Arrington Jr. Room 830*716 Richard Arrington Jr. Blvd NBlvd N

Birmingham, Alabama 35203Birmingham, Alabama 35203

Phone: (205) 325-5381Phone: (205) 325-5381Email: Email: [email protected]@jccal.org

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


INVITATION TO BIDINVITATION TO BID

Sealed bids marked "ESD Standby Generator Preventative Maintenance" will be received ONLINE AT HTTPS://MSS.JCCAL.ORG/MSS by the Purchasing Manager. Bid opening will be held at Room 830 * 716 Richard Arrington Jr. Blvd N, Birmingham, Alabama.

Bids will be accepted until 11:59 P.M. central time (standard or daylight savings time, as applicable) on Wednesday, MAY 11, 2016. Bids submitted after this date and time will not be considered.

Bids will be publicly opened at 2:00 P.M. on Thursday, MAY 12, 2016. The County is not responsible for delays occasioned by the U.S. Postal Service, the internal mail delivery system of the County, or any other means of delivery employed by the bidder. Similarly, the County is not responsible for, and will not open, any bid/proposal responses, which are not received later than the date and time, indicated above. Late bids/proposals will be retained in the bid/proposal file, unopened.

TERM OF CONTRACT: Any contract resulting from this ITB will become effective upon bid award (or within 30 days of award notification, approval of the County Commission and purchase order is issued). Contract will be for one (1) year with the County’s option to renew for two (2) additional one (1) year terms OR for 3 years based on the needs of the County. Contractor shall commence work within 2 weeks of receiving the Notice-to-Proceed.

INTERPRETATIONS AND ADDENDA: No interpretation or modification made to any respondent as to the meaning of the Bid shall be binding on the Jefferson County Commission unless repeated in writing and distributed as an addendum by Jefferson County Purchasing. Interpretations and/or clarifications, or questions shall be requested in writing and directed to Dorothea Robinson, Jefferson County Purchasing Division, 830 Courthouse, 716 Richard Arrington Jr. Blvd. North, Birmingham, AL 35203, Fax 205-214-0434 or email: [email protected] . Verbal information obtained otherwise will not be considered in awarding of contracts. Facsimile and/or e-mail shall be considered an acceptable method for the transfer of written documents for this purpose. All addenda shall become part of the contract documents and shall be acknowledged and dated on the Signature Page.

LANGUAGE, WORDS USED INTERCHANGEABLY: The word COUNTY refers to the JEFFERSON COUNTY COMMISSION and/or JEFFERSON COUNTY, ALABAMA throughout this document. Similarly, RESPONDENT, VENDOR, and BIDDER refer to the person or company submitting an offer to sell its goods or services to the COUNTY. The words PROPOSAL, QUOTATION, and ITB are all offers from the BIDDER. The County has established for the purposes of this RFP that the words SHALL, MUST or WILL are equivalent in this ITB and indicate a mandatory requirement or condition, the material deviation from which shall not be waived by the County. A deviation is material if, at the sole discretion of the County, the deficient response is not in substantial accord with this ITB’s mandatory condition requirements. The words SHOULD and MAY is equivalent in the BID and indicates very desirable conditions or requirements but are permissive in nature. Deviation from, or omission of, such a desirable condition or requirement will not in and of itself cause automatic rejection of a proposal, but may result in being considered as not in the best interest of the County.

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https://MSS.JCCAL.ORG/MSS



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


INVITATION TO BID – CONT’D

SCOPE OF SERVICES: The purpose of this solicitation is to secure contract pricing from qualified organizations to provide preventative maintenance services for diesel and natural gas standby generators at multiple locations including wastewater treatment plants and sewage pump stations. The preventive maintenance tasks will include 1st

inspection, annual, and as needed services per each generator unit as set in the Task List and Equipment List and as described herein.

The following materials are to be included in the Annual Preventive Maintenance:• Filters including air filters and oil filters – must be manufacturer’s brand or recommended brand(s)• Oil - must be manufacturer’s brand or recommended brand(s)• Coolant – must be manufacturer’s brand or recommended brand(s)• Belts – must be manufacturer’s brand or recommended brand(s)• Hoses – must be manufacturer’s brand or recommended brand(s)

The Contractor is responsible for proper disposal of all used oil, coolant, materials, and parts.

All preventive maintenance inspection findings and tasks completed must be recorded and submitted in PDF format with reference. Preventive maintenance will not be considered complete (nor will payment be made) until all relevant reports have been finalized and submitted per asset. All parts or equipment that are identified for replacement should be listed in the report. Reports shall be emailed to [email protected] and a copy shall be submitted with each monthly invoice. Copies of oil and fluid analysis reports shall also be submitted in PDF format with reference to the asset number.

PERMITS, CODES & REGULATIONS: All equipment, construction, and installation will comply with City, County, State and Federal codes and Regulations. Successful bidder will obtain and pay for all permits necessary, notify proper authorities for inspections and furnish any certificates required for the work.

PROPRIETARY DOCUMENTS: Any documents considered proprietary by the Bidder must be clearly marked as proprietary. Documents will be handled in compliance with the rules of Jefferson County Commission and the Bid Laws of the State of Alabama.

AWARD: The award may be made on all or none basis. The County shall award this contract to the lowest responsible and responsive bidder who best meets the terms and conditions of this bid. The County expects to award contract for secured pricing and services for a minimum of 12 months. Bidders are asked to submit pricing for 1 year and 3 year agreements (with available discounts). The county will award based on what is in the best interest of the County.

SINGLE BID: If a single bid response is received for this ITB, the bid will be rejected in accordance with Title 41-16-50-a-1 of the Alabama Code. The bids will be opened, and read publicly. We will proceed with negotiations for a lower price with the rejected Bidders and other Bidders by means of sealed quotes. The rejected Bidders initial offer will not be disclosed to other Bidders, prior to the awarding of a contract. The award will be made to the company offering the lowest negotiated quotation, provided that all conditions and specifications required by the Jefferson County Commission are met.

NEGOTIATIONS: Jefferson County reserves the right to enter into contract negotiations with the selected bidder. If the County and the selected bidder cannot negotiate a successful contract, the County may terminate negotiations and begin negotiation with the next selected bidder. This process will continue until a contract has been executed or all proposals have been rejected. No bidder shall have any rights against the County arising from such negotiations.

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



TAX: Jefferson County is exempt from all tax. Provided however, bidder shall be responsible for payment of all sales, use, lease ad valorem and any other tax that may be levied or assessed by reason of this transaction.

PRICES: Include transportation (including fuel surcharge, if applicable), labor, equipment and material shall remain firm for the term of the contract.

EXAMINATION OF SITE: If necessary, all bidders are expected to visit the site of the work to ascertain existing conditions. Failure to do so will in no way relieve the successful bidder from the necessity of furnishing all materials and equipment, and performing all work required for completion of the contract(s).

INVOICING: All invoices must agree with the purchase order in description and price and include the following information: 1) Purchase Order Number; 2) Ship-to Department name and address.In order to ensure prompt payment, ALL ORIGINAL INVOICES* MUST BE SENT TO:

Jefferson County CommissionFinance DepartmentRoom 820, Courthouse 716 Richard Arrington Jr. Blvd, NorthBirmingham, AL 35203

*If invoice does not agree with purchase order, credits or a corrected invoice will be required in order for the County to process payment. INVOICES THAT DO NOT REFERENCE AN AUTHORIZED PURCHASE ORDER WILL BE RETURNED TO THE VENDOR.

Partial payment will be made monthly per unit of work performed per the Bid Form.

THIRD-PARTY “REMIT-TO”: If Bidder has a third-party “remit-to” company, that information must appear on the Bidder’s response. Jefferson County will send payment to the company designated by Bidder on its response, but will not be responsible for resolving payment issues, should the Bidder change payment processing companies after a payment has been mailed or without forty-five (45) days written notification to the Purchasing and Accounting division of Jefferson County.

PRE-PAYMENTS: No prepayments of any kind will be made prior to work performed.

PRICE REDUCTION: In the event of a general price reduction, the County will receive the benefit of such reduction on any undelivered portion of contract.

Bidder agrees that the County will be charged no more for item(s) bid than the State of Alabama, and that in the event of a price reduction; the County will receive the benefit of such reduction on any undelivered portion of contract

OTHER BENEFITS AND COMPENSATION: There are no other benefits or compensation except as listed in Method of Payment below

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



CANCELLATION: Failure to deliver as specified and in accordance with the bid submitted, including promised delivery will constitute sufficient grounds for cancellation of the order at the option of the County Commission.

TERMINATION OF CONTRACT: This contract may be terminated by the County with a thirty (30) day written notice to the other party regardless of reason. Any violation of this agreement shall constitute a breach and default of this agreement. Upon such breach, the County shall have the right to immediately terminate the contract and withhold further payments. Such termination shall not relieve the contractor of any liability to the County for damages sustained by virtue of a breach by the contractor.

PERFORMANCE BOND: Successful bidder will furnish surety bond equal to the amount of contract at no cost to the County, to guarantee that all conditions and specifications of this Invitation will be fulfilled. Bond will be furnished to the Purchasing Agent not later than 14 days if requested. Bidders may submit a Cashier’s Check or Letter of Credit payable to Jefferson County in the amount of the bond and drawn on a local Alabama Bank. The condition of the check or letter of credit shall be the same condition as the proposal bond, above.

BREACH AND DEFAULT: Any violation of this Agreement shall constitute a breach and default of this agreement shall be cause for termination. Upon such termination Contractor shall immediately refund to the County all amounts paid by the County pursuant to this Agreement.

ADDITIONAL PURCHASES:If mutually agreed upon within twelve (12) months from bid opening date, this bid may be used as the basis for additional purchases.

The County reserves the right to add or delete units as needed.

GUARANTEE: Bidder certifies by bidding, that he is fully aware of the conditions of service purpose for which the maintenance/services contract included in this bid is to be purchase, and that his offering will meet these requirements of service and purpose to the satisfaction of the Jefferson County Commission and its Agent.

GOVERNING LAW/DISPUTE RESOLUTION: Any contract agreement that is issued based on this ITB, the parties shall agree that the contract agreement is made and entered into in Jefferson County, Alabama, and that all services, materials and equipment to be rendered pursuant to said contract agreement are to be delivered in Jefferson County, Alabama. The interpretation and enforcement of this contract agreement will be governed by laws of the State of Alabama. The parties agree that jurisdiction and venue over all disputes arising under this contract agreement shall be the Circuit Court of Jefferson County Alabama, Birmingham Division.

STATEMENT OF CONFIDENTIALITY: Offeror agrees that any information accessed or gained in performance of those duties will be maintained in absolute confidence and will not be released, discussed, or made known to any party or parties for any reason or purpose whatsoever, except as required in the conduct of duties required, or where the disclosure is required by law or mandated by a court of law.

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



INSURANCE: The successful bidder will maintain such insurance as will protect him and the County from claim under Workmen's Compensation Acts, and from claims for damage and/or personal injury, including death, which may arise from operations under this contract. Insurance will be written by companies authorized to do business in Jefferson County, Alabama and shall include Jefferson County, Alabama as Added Additional Insured By Endorsement including a thirty (30) day(s) written cancellation notice. Evidence of insurance will be furnished to the Purchasing agent not later than seven (7) day(s) after Purchase Order/contract date. Successful bidder is also required to include the bid number on the evidence of insurance.

Insurance Minimum Coverage:Contracting party shall file the following insurance coverage and limits of liability with the County's Human Resource Department and Purchasing Department before beginning work with the County.

General Liability:$1,000,000 - Bodily injury and property damage combined occurrence$1,000,000 - Bodily injury and property damage combined aggregate$1,000,000 - Personal injury aggregate, Comprehensive Form including

Premises/Operation, Products/Completed Operations, Contractual, Independent contractors, Broad Form property damage and personal injury.

Automobile Liability:$1,000,000 - Bodily injury and property damage combined coverage

Any automobile including hired and non-owned vehicles

Workers Compensation and Employers Liability:$100,000 - Limit each occurrence

Umbrella Coverage:$1,000,000 - Each occurrence$1,000,000 - Aggregate

Added Additional Insured By Endorsement:Jefferson County, Alabama30 day(s) written cancellation notice

PURCHASE ORDER NUMBER AND/OR BID NUMBER MUST APPEAR ON THE FACE OF THE CERTIFICATE OF INSURANCE DOCUMENT

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



HOLD HARMLESS AND INDEMNIFICATION: Contracting party agrees to indemnify, hold harmless and defend Jefferson County, Alabama, its elected officers and employees (hereinafter referred to in this paragraph collectively as “County”), from and against any and all loss expense or damage, including court cost and attorney’s fees, for liability claimed against or imposed upon County because of bodily injury, death or property damage, real or personal, including loss of use thereof arising out of or as a consequence of the breach of any duty or obligations of the contracting party included in this agreement, negligent acts, errors or omissions, including engineering and/or professional error, fault, mistake or negligence of Integrator, its employees, agents, representatives, or subcontractors, their employees, agents or representatives in connections with or incident to the performance of this agreement, or arising out of Worker’s Compensation claims, Unemployment Compensation claims, or Unemployment Disability compensation claims of employees of company and/or its subcontractors or claims under similar such laws or obligations. Company obligation under this Section shall not extend to any liability caused by the sole negligence of the County, or its employees. Before beginning work, contract party shall file with the County a certificate from his insurer showing the amounts of insurance carried and the risk covered thereby. Liability insurance coverage must be no less than $1,000,000. During performance the company must effect and maintain insurance from a company licensed to do business in the State of Alabama. Coverage required includes 1) Comprehensive General Liability; 2) Comprehensive Automobile Liability; 3) Worker’s Compensation and Employer’s Liability.

LAWS AND REGULATIONS: All applicable State of Alabama and federal laws, ordinances, licenses and regulations of a governmental body having jurisdiction shall apply to the award throughout as the case may be, and are incorporated here by reference. A Jefferson County business license will be required before work begins. Any contract executed based on award of this Bid must stipulate that governing law will be the State of Alabama.

CORRECTIONS/AUTHORIZED SIGNATURE Bids having any erasures or corrections must be initialed in ink. Bid must be signed in ink by an official authorized representative. RESPONSES CAN NOT CONTAIN LIQUID PAPER (WHITE OUT).

BUSINESS LICENSEIn the event you receive a notification of intent to award letter, you will be required to provide your Jefferson County business license within 7 days of receipt of notice of intent to award. If you are not currently registered with Jefferson County Revenue Department, and do not have a business account number, applications may be obtained by logging on to http://jeffconline.jccal.org/revenue. Once you have logged on, click on Business License and then **New Applicants. Failure to submit the requested information may result in the notice of intent to award being revoked.

NON- DISCRIMINATION POLICY:The Jefferson County Commission is strongly committed to equal opportunity in solicitation of ITB’s and ITB’s. The County encourages bidders and proposers to share this commitment. Each bidder/contractor submitting a proposal will not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability or veteran status. The Bidder/Contractor will ensure that qualified applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, national origin, age, disability or veteran status. Such action shall include, but not be limited to the following: employment, promotion, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship.

PUBLIC DISCLOSURE: Subject to applicable law or regulations, the content of each Bidder’s Proposal shall become public information upon the effective date of any resulting contract.

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http://jeffconline.jccal.org/revenue



OFFICE: (205) 325-5381 / FAX: (205) 214-4034



PROTECTION DAMAGE: Successful bidder(s) will be responsible for any damage to property of the county or others caused by him, his employees or subcontractors, and will replace and make good such damage. The contractor will maintain adequate protection to prevent damage to his work and property of others, and take all necessary precautions for the safety of his employees and others.

GENERAL: Jefferson County expressly reserves the right to reject any or all bids, or parts of bids, or to re-bid and to make the award on merit and/or features of design and quality, delivery, and availability of parts and service as the best interest of the County appears.

Dorothea RobinsonPrincipal Buyer

{REMAINDER OF PAGE INTENTIONALLY LEFT BLANK}

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


REQUIRED FORMS

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


BID PRICING SHEETDESCRIPTION BID AMOUNT

SITE ADDRESS 1ST

Inspection Annual PM Oil Change Coolant Charge Total

3900 Veona Daniels Rd. Hoover, Al. 35244 7301- Cahaba South Generator # 1CATERPILLAR 3516 4XF005123900 Veona Daniels Rd. Hoover, Al. 35244 7301- Cahaba Middle Generator # 2CATERPILLAR 3516 4XF005113900 Veona Daniels Rd. Hoover, Al. 35244 7301- Cahaba North Generator # 3CATERPILLAR 3516 4XF005133500 Chapel Lane Hoover, Al. 35244 7301-Alsier Standby Generator # 10.CATERPILLAR 3516 25Z040583500 Chapel Lane Hoover, Al. 35244 7301-Alseir Standby Generator # 11CATERPILLAR 35163410 Happy Lane Fultondale, Al. 35068 Generator 1 CUMMINGS QSK60-G63410 Happy Lane Fultondale, Al. 35068 Generator 2CUMMINGS QSK60-G63410 Happy Lane Fultondale, Al. 35068 Generator 3CUMMINGS QSK60-G6800 Helen Street - Leeds, Alabama 35094 7303- Skinner Standby GeneratorCATERPILLAR 3512 24Z05563325 City Hall Dr. Trussville, Al. 35173 7304-Trussville Standby GeneratorCATERPILLAR 3516 4EK01021700 Blackburn Lane Warrior, Al. 35180 Caterpillar Generator "Warrior"CATERPILLAR 3512 1KZ023141440 Pleasant Hill Rd. B'ham 35224 7307-Biological Natural Gas Generator # 1CATERPILLAR 3616 4CG00210

* (Prices to Include Labor, Travel and All Associated Charges)

NAME OF YOUR COMPANY_______________________________________________________________

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


BID PRICING SHEET (CON’TD)DESCRIPTION BID AMOUNT

SITE ADDRESS 1ST

Inspection Annual PM Oil Change Coolant Charge Total

1440 Pleasant Hill Rd. B'ham 35224 7307-Biological Natural Gas Generator # 2CATERPILLAR 3616 4CG002111440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 3 CATERPILLAR 3616 4CG002091440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 4 CATERPILLAR 3616 4CG002121440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 5 CATERPILLAR 3616 ACG001961440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 6 CATERPILLAR 3616 4CG001971440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 7 CATERPILLAR 3616 4CG001991440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological Natural Gas Generator # 8 CATERPILLAR 3616 4CG001981440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Dewatering Natural Gas Generator # 1 CATERPILLAR 3512 7NJ005641440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Dewatering Natural Gas Generator # 2 CATERPILLAR 3512 7NJ005631441 Pleasant Hill Rd. B'ham, Al. 35224 7307-Primary Natural Gas Generator # 1CATERPILLAR 3516 4EK014681442 Pleasant Hill Rd. B'ham, Al. 35224 7307-Primary Natural Gas Generator # 2CATERPILLAR 3516 4EK014661443 Pleasant Hill Rd. B'ham, Al. 35224 7307-Primary Natural Gas Generator # 3CATERPILLAR 3516 4EK014671444 Pleasant Hill Rd. B'ham, Al. 35224 7307-Water tank black start natural gas generator.CATERPILLAR 3406 CTS00271



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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



SITE ADDRESS 1ST

InspectionAnnual

PM Oil Change Coolant Charge Total

1440 Pleasant Hill Rd. B'ham, Al. 35224 7307- Biological power center black start natural gas generator.OLYMPIAN1440 Pleasant Hill Rd. B'ham, Al. 352247307- Influent pump station black start natural gas generator. CUMMINGS 4BT39-G4 46224561500 Water Trail Graysville, Al. 35073Generator 1, Prudes Creek PlantCATERPILLAR 3512 1KZ02144500 Water Trail Graysville, Al. 35073 Generator 2, Pump Station No. 1KOHLER 4BT-3.9 441889677137 Disposal Plnt Rd. Pinson, Al. 35126 Standby Generator #1 "Turkey Creek"CATERPILLAR 3512 1LZ004727137 Disposal Plnt Rd. Pinson, Al. 35126 Standby Generator #2 "Turkey Creek"CATERPILLAR 3512 1LZ004693923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 08BCATERPILLAR 3516 6HN05423923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 09BCATERPILLAR 3516 6HN05593923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 10BCATERPILLAR 3516 1HZ021983923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 11BCATERPILLAR 3516 1HZ021963923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 12BCATERPILLAR 3516 1HZ021973923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 01ACATERPILLAR 3516 1HZ02883



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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



SITE ADDRESS 1ST

InspectionAnnual


3923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 01BCATERPILLAR 3516 6HN005633923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 02ACATERPILLAR 3516 1HZ028913923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 02BCATERPILLAR 3516 6HN005513923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 03ACATERPILLAR 3516 1HZ028883923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 04BCATERPILLAR 3516 1HZ021913923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 05BCATERPILLAR 3516 1HZ021943923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 06BCATERPILLAR 3516 1HZ021903923 Clearwater Dr. Bessemer, Al. 35023Generator Genset 07BCATERPILLAR 3516 6HN05552421 Acton Road Vestavia 35243ACTON RD GENERATORCATERPILLAR 3508 29A018655004 Hazelwood Road Adamsville 35005ADAMSVILLE GENERATOR CATERPILLAR 3116-DL 2SG006011327 Atkins-Trimm Blvd Hoover PINEWOOD GENERATORCATERPILLAR 3506 66S127833150 Morgan Road Bessemer 35022Generator RICE CREEK GENERATORCATERPILLAR 3116-DL 2SG00711



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OFFICE: (205) 325-5381 / FAX: (205) 214-4034



SITE ADDRESS 1ST

InspectionAnnual


5380 Freeman Avenue Bessemer 35022 FIVE MILE WEST GENERATORCATERPILLAR 3408 78Z017075100 Newfound Road Mt. Olive NEWFOUND 1 GENERATORCATERPILLAR 3412 7DB012044802 Newfound Road Mt. Olive NEWFOUND 2 GENERATORCATERPILLAR 3406 4FD012181885 Montgomery Hwy Hoover RIVERCHASE GENERATORCATERPILLAR 3512 7DB012622920 Highway 150 Hoover 35244Generator PATTON 1 GENERATORCATERPILLAR 3512 81Z119883989 Lorna Road Birmingham 35244 PATTON 2 GENERATOR CATERPILLAR 3306BD1 85Z086791356 Oak Grove Rd Birmingham 35209 SCOTTS BRANCH GENERATORCATERPILLAR 3508 DITA 23Z041832715 Docena Cut Off Rd Birmingham 35224 MINOR PARKWAY GENERATORCATERPILLAR 3516 SITA 1HZ02194901 Decatur Hwy 35071K-MART GENERATOR CATERPILLAR 3306 TSA09924



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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


BID PRICING SHEET (CON’TD)

GENERATOR FOLLOW-UP REPAIR WORK BID AMOUNT

Straight Time (Per Hour)

Overtime (Per Hour)

Sunday & Holiday Time (Per Hour)

Material Markup if applicable (% over cost)

Do you offer free evaluations? If NO, quote your price for evaluation

Approximate turnaround time for repair

Warranty on repairs

How long in business

Delivery is guaranteed no later than __days after receipt of order.



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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


TASK LIST Task Descriptions for the PM of Diesel and Natural Gas Generators

Task Descriptions for the PM of Diesel and Natural Gas Generators Diesel Gas PM Type Description of TasksFuel System: · Check fuel level in tank notifying customer X Annual Report.

· Check operation of fuel level circuitsX Annual

Verify that the high and low level tank level circuits are functioning and that the moisture probes are functional.

· Change fuel filters X X 1ST Inspection Change fuel filters with approved type according to engine specifications.

· Check day tank operationX Annual

Verify that fuel pumps are operational and that controls for filling the tank are operational.

· Check Governor operation X X Annual Verify that governors are properly lubricated and functioning per engine design.

· Check natural gas regulators and fuel pressures X 1ST Inspection

Verify operation of gas pressure regulators and set gas pressures according to engine design specifications.

· Check spark plugs X 1ST Inspection Verify that spark plug are not broken and are functioning as designed.

Lubricating System: · Inspect for proper oil level X X Annual Check engine oil levels.· Inspect unit for oil leaks X X Annual Visual inspection for engine oil leaks.

· Change Lube Oil and Filters X X As Needed

Replace engine oil and filters with lubricant and filters according to engine specifications.

· Obtain oil sample for analysis and supply report X X Annual

Obtain engine oil sample for analysis and supply a report for county records.

Cooling System: · Inspect coolant level and degree of protection X X Annual

Verify that engine coolant is at the proper level and report the degree of protection.

· Inspect hoses and drive beltsX X Annual

Check for cracked hoses and frayed or damaged belts. Especially look for signs of eminent failure.

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034


TASK LIST – CONT’D· Replace hoses and drive belts X X As Needed Replace damaged drive belts or hoses as needed.

· Inspect radiator for obstructionX X Annual

Ensure that the engine radiator is free from obstructions which would inhibit proper air flow.

· Verify proper operation of water jacket heater X X Annual

Verify that the water jacket heaters are maintaining the correct engine coolant temperature per engine specifications.

· Visual inspect for leaks X X Annual Look for coolant leaks and verify that the radiator cap is working as designed.

· Lubricate fan drive as needed X X Annual Lubrication task.· Obtain coolant sample for analysis and supply report X X Annual

Obtain coolant sample for analysis and supply a report for county records.

· Drain and replace coolant

X XSample / Replace As

Needed

Replace with coolant designed to function according to engine specifications. The recommended coolant change interval for our coolant is every six years. In the interim, based on annual sample analysis, maintain the coolant by adding SCA as needed.

Exhaust System:

· Inspect condition of exhaust X X Annual Inspect exhaust system for leaks or damaged mufflers and expansion joints.

· Inspect rain cap X X Annual Check that rain cap is functioning as designed per engine specifications.

Air Intake System: · Inspect air inlet X X Annual Check that air inlet is free from obstructions.

· Inspect air cleaner X X Annual

Check that air cleaner is free from debris and that is functioning according to engine design.

· Inspect air service indicator, engine runningX X Annual

Look for any irregularities with the air service indicator while the engine is running.

· Inspect Turbocharger for bearing wearX X 1ST Inspection

Check that turbocharger bearings are not worn and that proper lubrication is being supplied to the turbocharger.

Control System: · Inspect operation of meters and gauges X X Annual Ensure that all meters and gauges are in working order.

· Inspect shutdown and pre-alarms X X Annual Check each engine shutdown and pre-alarm for proper operation.

TASK LIST – CONT’DPage 18 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


· Inspect annunciator panel operation X X Annual Ensure that all annunciators are functioning.Engine Electrical: · Clean batteries and cables X X Annual Clean battery cables and apply corrosion inhibiter.

· Replace batteries and / or cablesX X

Test / Replace As Needed

Replace batteries according to engine manufacturer speciation’s as needed. Make sure that the install date is visible on the battery.

· Add distilled water and check gravityX X Annual

Clean the battery before opening and add distilled water as needed. Check and record the battery specific gravity.

Generator:

· Inspect intake and exhaust areas X X Annual Check that the generator is free from obstructions that would inhibit air flow for cooling.

· Compare voltage to normal line X X Annual Ensure that the generator voltage is within tolerance of normal power voltage.

· Check slip rings and brushes (if applicable)X X Annual Check for signs of arcing and wear for slip rings and brushes.

· Inspect bearing and grease as needed X X Annual Check outboard bearing and grease according to procedure.· Check that generators load share properly (where applicable) X X 1 st Inspection

For multiple generators in parallel, insure that all units load share as designed.

General: · Inspect unit for unusual vibration X X Annual Check and identify the source of unusual vibrations.

· Inspect connections X X Annual Look for loose connections in the generator power and control wiring.

· Run generator under load where practicalX X Annual

County personnel will work with contractor to run the generators under plant load.

· Record all readings and present reportsX X Annual

Reports should contain engine run times, emissions values, analysis sample results, and all data necessary to comply with EPA regulations.

· Notify of required repairs if any X X Reporting. A PDF and an electronic copy of all EPA required reports will be provided.

· Document verification on ATS load sheet

X X Annual

Reporting. A PDF and an electronic copy of all EPA required reports will be provided. A receiving or packing slip with a reference number will be provided after each “completed” inspection, PM or repair.

Page 19 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


EQUIPMENT LIST

Asset Description Manufacturer ModelSerial Number Kilowatts Division Class

Generator model number

Generator serial number. Fuel Type Site address.

GEN-0107301-Cahaba South Generator # 1 CATERPILLAR 3516 4XF00512 2000 7301 GEN SR-4 8FD00658 Diesel

3900 Veona Daniels Rd. Hoover, Al. 35244

GEN-0117301-Cahaba Middle Generator # 2 CATERPILLAR 3516 4XF00511 2000 7301 GEN SR-4 8FD00660 Diesel


GEN-0127301-Cahaba North Generator # 3 CATERPILLAR 3516 4XF00513 2000 7301 GEN SR-4 8FD00659 Diesel


GEN-0137301-Alsier Standby Generator # 10. CATERPILLAR 3516 25Z04058 1750 7301 GEN SR-4 6SA02065 Diesel

3500 Chapel Lane Hoover, Al. 35244

GEN-0147301-Alseir Standby Generator # 11 CATERPILLAR 3516 25Z04057 1750 7301 GEN SR-4 6SA02062 Diesel

3500 Chapel Lane Hoover, Al. 35244

GEN-015 Generator 1 CUMMINGS QSK60-G6 3166306 1825 7302 GEN2000DQKC-6015 K060993659 Diesel

3410 Happy Lane Fultondale, Al. 35068

GEN-016 Generator 2 CUMMINGS QSK60-G6 33166152 1825 7302 GEN2000DQKC-6015 060992118 Diesel


GEN-017 Generator 3 CUMMINGS QSK60-G6 33166179 1825 7302 GEN2000DQKC-6015 060992119 Diesel


GEN-0207303-Skinner Standby Generator CATERPILLAR 3512 24Z05563 1562 7303 GEN SR 4 6PA02009 Diesel

800 Helen Street - Leeds, Alabama 35094

GEN-0217304-Trussville Standby Generator CATERPILLAR 3516 4EK01021 1055 7304 GEN SR-4B 3BM00537

Natural Gas

325 City Hall Dr. Trussville, Al. 35173

GEN-022Caterpillar Generator "Warrior" CATERPILLAR 3512 1KZ02314 1250 7316 GEN SR-4B 2FN02598 Diesel

700 Blackburn Lane Warrior, Al. 35180

GEN-023

7307-Biological Natural Gas Generator # 1 CATERPILLAR 3616 4CG00210 3430 7307 GEN A271030000 14116-07

Natural Gas

1440 Pleasant Hill Rd. B'ham 35224

GEN-024


Natural Gas

1440 Pleasant Hill Rd. B'ham 35224

GEN-025


Natural Gas

1440 Pleasant Hill Rd. B'ham, Al. 35224

GEN-026


Natural Gas


GEN-027

7307-Biological Natural Gas Generator # 5 CATERPILLAR 3616 ACG00196 3430 7307 GEN A271030000 14116-01

Natural Gas


Page 20 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


EQUIPMENT LIST – CONT’D




GEN-0287307-Biological Natural Gas Generator # 6 CATERPILLAR 3616 4CG00197 3430 7307 GEN A271030000 14116-02 Natural Gas






GEN-0317307-Dewatering Natural Gas Generator # 1 CATERPILLAR 3512 7NJ00564 570 7307 GEN SR4 Z3207G6 Natural Gas


GEN-0327307-Dewatering Natural Gas Generator # 2 CATERPILLAR 3512 7NJ00563 570 7307 GEN SR4 Z3207G7 Natural Gas


GEN-0337307-Primary Natural Gas Generator # 1 CATERPILLAR 3516 4EK01468 1040 7307 GEN SR-4B 2FN00868 Natural Gas






GEN-0367307-Water tank black start natural gas generator. CATERPILLAR 3406 CTS00271 240 7307 GEN SR4 CBP00196 Natural Gas


GEN-037

7307-Biological power center black start natural gas generator. OLYMPIAN 60 7307 GEN G60F1 G0542A/001 Natural Gas


GEN-038

7307-Influent pump station black start natural gas generator. CUMMINGS

4BT39-G4 46224561 93 7307 GEN 140P0565 Diesel


GEN-130Generator 2, Pump Station No. 1 KOHLER 4BT-3.9 44188967 63/145 7315 GEN 50R0Z201 204071 Diesel

500 Water Trail Graysville, Al. 35073

GEN-131Standby Generator #1 "Turkey Creek" CATERPILLAR 3512 1LZ00472 1750 7305 GEN SR-4B 7GM01003 Diesel

7137 Disposal Plnt Rd. Pinson, Al. 35126

GEN-132Standby Generator #2 "Turkey Creek" CATERPILLAR 3512 1LZ00469 1750 7305 GEN SR-4B 7GM01002 Diesel

7137 Disposal Plnt Rd. Pinson, Al. 35126

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OFFICE: (205) 325-5381 / FAX: (205) 214-4034






GEN-001 Generator, Genset 08B CATERPILLAR 3516 6HN0542 25000 7306 GEN Diesel3923 Clear Water Dr Bessemer, Ala 35023

GEN-002 Generator, Genset 09B CATERPILLAR 3516 6HN0559 7306 GEN Diesel3923 Clear Water Dr Bessemer, Ala 35023

GEN-116 Generator, Genset 10B CATERPILLAR 3516 1HZ02198 7306 GEN Diesel3923 Clear Water Dr Bessemer, Ala 35023



GEN-119 Generator, Genset 01A CATERPILLAR 3516 1HZ02883 7306 GEN 3516 1HZ02883 Diesel3923 Clear Water Dr Bessemer, Ala 35023


GEN-121 Generator, Genset 02A CATERPILLAR 3516 1HZ02891 7306 GEN Diesel3923 Clear Water Dr Bessemer, Ala 35023


GEN-123 Generator, Genset 03A CATERPILLAR 3516 1HZ02888 7306 GEN 3516 1HZ02888 Diesel3923 Clear Water Dr Bessemer, Ala 35023






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OFFICE: (205) 325-5381 / FAX: (205) 214-4034






GEN-039ACTON RD GENERATOR CATERPILLAR 3208 29A01865 100 7313 GEN 3208 29A01865 Diesel

2421 Acton Road Vestavia 35243

GEN-040ADAMSVILLE GENERATOR CATERPILLAR 3116-DI 2SG00601 125 7313 GEN 3116-DI 2SG00601 Diesel

5004 Hazelwood Road Adamsville 35005

GEN-041PINEWOOD GENERATOR CATERPILLAR 3406 66S12783 155 7313 GEN 3406 66S12783 Diesel

1327 Atkins-Trimm Blvd Hoover 35226

GEN-042RICE CREEK GENERATOR CATERPILLAR 3116 DL 2SG00711 100 7313 GEN 3116 DL 2SG00711 Diesel

3150 Morgan Road Bessemer 35022

GEN-043FIVE MILE WEST GENERATOR CATERPILLAR 3408 78Z01707 350 7313 GEN 3408 78Z01707 Diesel

5380 Freeman Avenue Bessemer 35022

GEN-045NEWFOUND 1 GENERATOR CATERPILLAR 3412 7DB01204 400 7313 GEN 3412 7DB01204 Natural Gas

5100 Newfound Road Mt. Olive 35117

GEN-046NEWFOUND 2 GENERATOR CATERPILLAR 3406 4FD01218 255 7313 GEN 3406 4FD01218 Natural Gas

4802 Newfound Road Mt. Olive 35117

GEN-047RIVERCHASE GENERATOR CATERPILLAR 3412 7DB01262 425 7313 GEN 3412 7DB01262 Natural Gas

1885 Montgomery Hwy Hoover 35244

GEN-049 PATTON 1 GENERATOR CATERPILLAR 3412 81Z11988 500 7313 GEN 3412 81Z11988 Diesel2920 Highway 150 Hoover 35244

GEN-050 PATTON 2 GENERATOR CATERPILLAR 3306BD1 85Z08679 257 7313 GEN 3306BD1 85Z08679 Diesel3989 Lorna Road Birmingham 35244

GEN-051SCOTTS BRANCH GENERATOR CATERPILLAR

3508 DITA 23Z04183 7313 GEN 3508 DITA 23Z04183 Diesel

1356 Oak Grove Rd Birmingham 35209

GEN-074MINOR PARKWAY GENERATOR CATERPILLAR

3516 SITA 4EK03028 1040 7313 GEN 3516 SITA 4EK03028 Natural Gas

2715 Docena Cut Off Road Birmingham 352

GEN-134 K-MART GENERATOR CATERPILLAR 3306 TSA09924 7313 GEN 3306 TSA09924 Diesel

901 Decatur Hwy 35071

Page 23 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


Non-Collusion Affidavit

I, ___________________________________________________, an authorized agent/representative of

____________________________________________ attest that the Invitation to Bid is not made in the interest of,

or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the

Invitation to Bid is genuine and not collusive or sham; that the Bidder has not directly or indirectly induced or

solicited any other Bidder to put in a false or sham ITB, and has not directly or indirectly colluded, conspired,

connived, or agreed with any Bidder or anyone else to put in a sham ITB, or that anyone shall refrain from

proposing; that the Bidder has not in any manner, directly or indirectly sought by agreement, communication or

conference with anyone to fix the ITB of the Bidder or any other Bidder, or to fix any overhead, profit, or cost

element of the ITB price or of that of any Bidder, or to secure any advantage against the public body awarding the

contract of anyone interested in the proposed contract; that all statements contained in the ITB are true; and further,

that the Bidder has not, directly or indirectly, submitted his/her ITB price or any breakdown thereof, or the contents

thereof, or divulged information or data relative thereto, or paid, and will not pay any fee to any corporation,

partnership, company, association, organization, ITB depository, or to any member or agent thereof, to effectuate a

collusive or sham ITB.

I, the undersigned, hereby certify that I have read and understand this Non- Collusion Affidavit and guarantee

complete compliance with all the terms, conditions and stipulations.

Subscribed and Sworn to BY ____________________________________________________________________

Authorized Signature of Bidder

Before me this ___________ day of _______________________ 20____.

Date

__________________________________________________

Print or Type Name of Bidder

___________________________________

Notary Public of

My Commission expires ___________________________________

Page 24 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


JEFFERSON COUNTY, ALABAMAEQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION FORM

Contractor/Vendor Name: __________________________________________________

Address: __________________________________________________

__________________________________________________

The Contractor acknowledges receipt of Jefferson County’s Equal Employment Opportunity Contractor Compliance

Administrative Order (attached hereto) and certifies that it is an equal opportunity employer and agrees to the requirements of

the Policy and the Equal Employment Opportunity Clause therein. It further certifies that it will require all subcontractors to

execute an Equal Employment Opportunity statement and certification of compliance in accordance with Jefferson County

Administrative Order 08-4 as follows:

1. The Contractor will not discriminate against any employee or applicant for employment because of race, color,

religion, sex, national origin, age, disability or veteran status pursuant to the provisions of Title VII of the Civil Rights Act of

1964, 42 U.S.C. §§ 1981, 1983, 1986 and all amendments thereto relative to discriminatory employment practices. The

Contractor will ensure that qualified applicants are employed, and that employees are treated during employment, without

regard to their race, color, religion, sex, national origin, age, disability or veteran status. Such action shall include, but not be

limited to the following: employment, promotion, demotion, or transfer; recruitment or recruitment advertising; layoff or

termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship.

2. In the event of the Contractor’s non-compliance with the equal employment opportunity clause of this contract, this

contract may not be awarded or may be cancelled, terminated or suspended in whole or in part and the Contractor may be

declared ineligible for further County contracts.

3. The Contractor will include the provisions of paragraph (1) in every subcontract or purchase order.

4. The Contractor shall certify to the County its compliance with this policy prior to receipt of any contract or business with

the County.

The Contractor will furnish to the County, upon request, reports, notices, policies and/or information certifying compliance

with this policy.

In the event of the Contractor’s non-compliance with the equal employment opportunity clause of this contract, this contract

may not be awarded or may be cancelled, terminated or suspended in whole or in part and the Contractor may be declared

ineligible for further County contracts.

________________________ _______________________________________

Date Signature

_______________________________________

TitlePage 25 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


NOTIFICATION OF INTENT TO RESPOND

Reference ITB 61-16

( ) On behalf of myself/my firm/institution, I hereby certify that I/we intend to submit

a response.

( ) On behalf of myself/my firm/institution, I hereby certify that I/we do not intend

to submit a response.

_____________________________________ ________________________________________ Authorized Signature Individual/Institution/Firm

_____________________________________ ________________________________________ Title Date

Page 26 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


STATEMENT OF COMPLIANCE WITH ALABAMA CODE SECTION 31-13-9

By signing this contract, the contracting parties affirm, for the duration of this agreement, that they will not violate

federal immigration law or knowingly employ, hire for employment, or continue to employ an unauthorized alien

within the State of Alabama. Furthermore, a contracting party found to be in violation of this provision shall be

deemed in breach of the agreement and shall be responsible for all damages resulting therefrom.

_______________________________________________ _____________________________Printed Name Authorized Representative) Title

_______________________________________________ _____________________________Signature Authorized Representative) Date Signed

_______________________________________________ Name of Business

Page 27 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


Affidavit of Contractor

Alabama Act 2011-535

I affirm the following:

1. I will not knowingly employ, hire for employment, or continue to employ an unauthorized alien; and,

2. I affirm that the below listed Business Organization is enrolled in the E-Verify program, that the Business

Organization listed below will remain enrolled in the E-Verify program during the term of the contract and

that every employee that is required to be verified will be verified according to the applicable federal rules and

regulations; and,

3. I acknowledge that §9(e) Alabama Act 2011-535 authorizes the County to terminate this contract for a first

violation of §9(a) of said Act, and requires the County to terminate this contract for a second violate of §9(a)

of said Act.

_______________________________________________________ ____________________________Printed Name of Contractor (or Authorized Representative) Title

_______________________________________________________ ____________________________Signature of Contractor (or Authorized Representative) Date Signed

_______________________________________________________ ____________________________Name of Business Entity Phone Number

State of ____________________________

County of ____________________________

Sworn to and subscribed before me on

This __________ day of ________________, 20 ______.

__________________________________________________________NOTARY PUBLIC

My Commission Expires: ____________________________

Page 28 of 29



OFFICE: (205) 325-5381 / FAX: (205) 214-4034


SIGNATURE PAGE

The Jefferson County Commission, or its agent, shall have the right to waive any informality or irregularity. Under

certain limited conditions, the Purchasing Department may apply a local preference option in determining the low

bid for purchases of personal property.

All provisions of this Invitation are accepted by bidder as part of any contract or purchase resulting therefrom.

Date: ____________ Company Name: __________________________ Web Address: ____________________

Terms: ___________ Address: ____________________________ City: ________________________________

County: ______________________ State: _____________ Zip:_________ Phone:(___) ____________________

If Jefferson County Business License were issued to your company for the past twelve (12) months, please list

numbers. ___________________________________________________________________________________

Vendor’s Federal I.D. Number: ________________________________________________________________

I certify that ________________________ has ____ has not ____ been in operation for one year at location(s)

(Company Name) (Check One)

zoned for the type of business conducted by my company at the address stated above.

___________________________________

(Authorized Signature)

___________________________________

(Print Name)

___________________________________

(E-Mail Address)

Toll Free Phone: _____________________________ Fax Number: _____________________________________

Return original bid in enclosed envelope. Authorized signature of bidder must be in ink.

Bids received in our office after the specified date and hour will not be considered.

INDICATE THE FOLLOWING ADDRESSES IF DIFFERENT FROM ABOVE

1. BID AWARD NOTICE ADDRESS

2. PURCHASE ORDER ADDRESS

3. REMITTANCE ADDRESS, (AND MAKE IF DIFFERENT THAN ABOVE)

Page 29 of 29