NOTICE TO VENDORS CONTRACT NO IB

Similar documents
FEDERAL CERTIFICATIONS Sponsored Center

REMOVAL OF MATERIAL FROM GREASE TRAPS Bid # October 22, 2013

Contract to Purchase Pre-Plated Meals

San Angelo I.S.D. Competitive Sealed Proposal, Grease Traps #18-15 Page 1 of 15

MILK BID Damaged or partially filled containers must not be used at any time. Leaking cartons will be returned.

NEW YORK CITY TRANSIT AUTHORITY. Division of Materiel. Schedule F

PARK HILL SCHOOL DISTRICT Nutrition Services Department 8500 NW Riverpark Drive Pillar 116 Parkville, MO 64152

Required Federal Forms

Ice Cream Competitive Sealed Proposal #15-2. March 31, 2014

REGION III EDUCATION SERVICE CENTER 1905 Leary Lane, Victoria, Texas Phone: (361) Fax: (361)

Butte School District #1 Request for Proposal (RFP)

PARK HILL SCHOOL DISTRICT NUTRITION SERVICES DEPARTMENT 8500 NW Riverpark Drive Pillar 116 Parkville, MO Phone/Fax / 4099

Request for Proposal for Temporary Staffing Services #001. DATE: June 11, 2018

SPECIAL CONDITIONS PROGRAM REGULATIONS

Section 5310 (Formerly Section 16)/ Community Transportation NON-VEHICLE 8/20/2009

ARTICLES AND DESCRIPTION. specified) from the day set for submission of bids. When no bid is returned, the vendor is removed from our vendor list.

Pittsburgh Public Schools Food Services Department

RFP # OFFICE SUPPLIES PROPOSAL OPENING DATE: July 16, 2015

This is NOT AN ORDER, it is an invitation for a competitive sealed proposal.

Dairy Products Bid #11-1. May 17, 2010

Appendix 1 Terms for Federal Aid Contracts / Florida Department of Transportation

I. NOTICE OF REQUEST FOR PROPOSALS FOR SCHOOL FOOD SERVICE MANAGEMENT SERVICES REQUEST FOR PROPOSAL. Silver Falls School District

Policy Memorandum Subject: Meal Pattern Contribution of Convenience Food Products Date Issued: March, 1987

2 C.F.R and 2 C.F.R. Part 200, Appendix II, Required Contract Clauses

Bid & Contract Provisions CDBG/HOME Guidebook

U.S. DEPARTMENT OF AGRICULTURE. Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions

ATTACHMENT U.3. Representations, Certifications and Other Statements of Offerors/Bidders

X. FEDERAL TRANSIT ADMINISTRATION REQUIREMENTS

MANOR ISD VENDOR CERTIFICATION FORM

M a r y l a n d H e a l t h B e n e f i t E x c h a n g e. I n v i t a t i o n f o r B i d s

Bidders shall execute the following forms and return the signed original with their proposal.

IT Department Invitation to Bid

FEDERAL TRANSIT ADMINISTRATION REQUIREMENTS FOR PROFESSIONAL SERVICES CONTRACTS > $10,000

Request for Qualifications (RFQ) for Engineering/Architectural/Surveying Services - Cover Letter

Eanes Independent School District Purchasing Department 601 Camp Craft Road Austin TX Fax REQUEST FOR PROPOSAL (RFP) C

Addendum # 1 BL Rhodes Jordan Park Multi-Purpose Field Conversion

Invitation for Bid Caustic Soda 50% T. F. Green Airport, Warwick, RI

CITY OF CULVER CITY 9770 CULVER BOULEVARD, CULVER CITY, CALIFORNIA

OFFEROR S ASSERTION OF COMMERCIALITY. Part No(s) and Description(s) Supplier s Name:

EDGAR CERTIFICATIONS ADDENDUM FOR PROCUREMENT CONTRACTS

EDGAR CERTIFICATIONS ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT

Certifications. Form AD-1047 (1/92)

REQUEST FOR PROPOSAL

REQUEST FOR PROPOSAL FOR COMMERCIAL VEHICLE LEASING BID #FY DATE: June 15, 2017

SEALED BID - REQUEST FOR PROPOSALS # FOR THE SALE OF PROPERTY OWNED AND OPERATED BY DALLAS COUNTY SCHOOLS

REQUEST FOR STATEMENT OF QUALIFICATIONS (SOQ) FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES DIVISION OF ADMINISTRATION

Butte School District #1 Request for Proposal (RFP)

The LCISD Fundraising packet is for fundraising vendors only (i.e. popcorn, cookie dough, candy, etc.)

Central Coast Purchasers Cooperative

Eastern Kentucky PRIDE, Inc. Request for Qualification (RFQ) For Appalachian Wildlife Center Feasibility Study (AML) Pilot Project RFQ ELK

REQUEST FOR QUALIFICATIONS (RFQ) FOR ARCHITECTURAL/ENGINEERING SERVICES FOR SHERMAN INDEPENDENT SCHOOL DISTRICT

Request for Vendor Contract Update

Vendor Packet 1 Revised October 2017

INVITATION TO BID. Kenai Peninsula Borough Personal Property Tax Account Number:

REQUEST FOR STATEMENT OF QUALIFICATIONS FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES DIVISION OF ADMINISTRATION

Persons submitting this form should refer to the regulations referenced below for complete instructions:

Contract Assurances Attachment 4. Contract Assurances

Notice to Interested Parties

CERTIFICATION FORMS FORM 1 OF 3 CERTIFICATION & SWORN STATEMENT PURSUANT TO SECTION (3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES

AGREEMENT FOR CONSULTING SERVICES FOR PORT ARTHUR INDEPENDENT SCHOOL DISTRICT

CITY OF SOUTH BAY INVITATION TO BIDS ON CITY OWNED SURPLUS REAL ESTATE. BID No

Lancaster Independent School District

TERMS AND CONDITIONS OF THE INVITATION TO BID

Notice to Interested Parties

Memorandum. August 23, 2017 HCDE Vendor Jesus J. Amezcua, Ph.D., CPA, RTSBA Assistant Superintendent for Business Services New Vendor Packet

ATTENTION ALL BIDDERS

Enhanced Mobility of Seniors and Individuals with Disabilities Program

OSWEGO COUNTY PURCHASING DEPARTMENT. Purchasing Director Purchasing Clerk Purchasing Clerk

1. You could not reasonably have been expected to know of the discriminatory act within the 180-day period;

REQUEST FOR PROPOSAL Enterprise Asset Management System

REPRESENTATIONS, CERTIFICATIONS, AND ACKNOWLEDGEMENTS

and ments Repre Page 1 of 122 RFP No Operations

LETTER OF INTEREST NOTICE FOR RAPID RE-HOUSING PROGRAM

Attachment C Federal Clauses & Certifications

ATTENTION ALL BIDDERS

OZARK REGIONAL TRANSIT INVITATION FOR BIDS

CITY OF PEACHTREE CITY MICROSOFT OFFICIAL LICENSE ADDENDUM #1

Invitation For Bid. Filters, Brake Drums & Brake Shoes IFB B

ASSOCIATION OF UNIVERSITIES FOR RESEARCH IN ASTRONOMY, Inc. REPRESENTATIONS AND CERTIFICATIONS (Must be completed and returned)

REQUEST FOR PROPOSALS (RFP)

Tuesday, April, 26, 2016 at 9:00am PAGE 1 OF 30

Request for Proposal. RFP # Non-Profit, Sports Photography

HAZARD MITIGATION GRANT PROGRAM SUPPLEMENTAL CONDITIONS

Notice to Interested Parties

Kuali Coeus Research Management (KCRM) Subawards: Print Template and Attachments Mapping Guide. Version 1. : April Contents.

RFQ # Page 1 of 25. REQUEST FOR QUALIFICATIONS #16-03 Professional Services Airport Engineer and Consultant

STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES NORTHEAST FLORIDA STATE HOSPITAL

INVITATION FOR BID Annual Water Meter Purchase

COUNTY OF OSWEGO PURCHASING DEPARTMENT

H. Assurances and Certifications Form

AGREEMENT- OKLAHOMA COMMISSION ON CHILDREN AND YOUTH

PART III GENERAL INFORMATION, INSTRUCTIONS AND CONDITIONS FOR BIDDERS

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS

III. For which Fiscal Year (FY) is this recommendation being made: Estimated Start Date Estimated Completion Date

KENTUCKY EDUCATIONAL DEVELOPMENT CORPORATION REQUEST FOR PROPOSALS. for. Guaranteed Energy Savings Contracts. Addendum #1

ATTENTION ALL BIDDERS

REQUEST FOR QUOTATION SUBMIT BID TO PURCHASING DIVISION SHAWNEE COUNTY COURTHOUSE Room 201 Topeka, Kansas 66603

CERTIFICATION OF PROSPECTIVE CONTRACTOR REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION

CITY OF ROANOKE, VIRGINIA REQUEST FOR PROPOSAL FOR EXECUTIVE SEARCH SERVICES RFP NUMBER OPENING DATE: JULY 23, 2009 OPENING TIME 2:00 P.M.

FLORIDA DEPARTMENT OF LAW ENFORCEMENT

Transcription:

Food Service Department Darin Crawford, Food Service Director DATE: March 16, 2015 SUBJECT: PAPER BOXES FOR FOOD SERVICE NOTICE TO VENDORS Cypress-Fairbanks Independent School District invites your firm to submit a proposal for PAPER BOXES FOR FOOD SERVICE. Attached are the conditions, requirements, and specifications for this contract. Sealed proposals for PAPER BOXES FOR FOOD SERVICE are to be addressed to Ms. Kristine Johnston, Director of Purchasing, Cypress-Fairbanks Independent School District, and delivered to Windfern Administrative Annex, 12510 Windfern Road, Houston, Texas 77064-3108, until 1:00 P.M. on Monday, March 30, 2015 at which time they will be publicly opened and read. Additional bid forms and/or questions are handled by the Buyer for Food Service, Chelsea Aitken, at 281-517-6552. Proposal envelope should be plainly marked: SEALED PROPOSAL: PAPER BOXES FOR FOOD SERVICE DO NOT OPEN UNTIL 1:00 P.M., MONDAY, MARCH 30, 2015 Any proposal received later than the specified time, whether delivered in person or by mail shall be disqualified. The District reserves the right to reject any and/or all bids, to accept any proposal deemed most advantageous to the Cypress-Fairbanks Independent School District, and to waive any informalities in the bidding process. Sincerely, Darin Crawford Food Service Director

GENERAL CONDITIONS 1.0 SCOPE OF PROPOSAL: 1.1 It is in the intention of Cypress-Fairbanks Independent School District (CFISD and/or the District) to purchase: Item: PAPER BOXES FOR FOOD SERVICE 1.2 This proposal is in twelve (12) parts: Notice to Vendors, General Conditions, Proposal Authorization Form, Felony Conviction Notice, Compliance with the Clean Air and Clean Water Act, U.S. Department of Agriculture, Certification Regarding Lobbying, Disclosure of Lobbying Activities, Instructions for Completion of SF-LLL, Specification Sheet, Food Service Department Bid Form, and the No Proposal Notification Form. 1.3 Contract Period: April 1, 2015 April 30, 2015 2.0 APPLICABILITY: These conditions are applicable and form a part of the contract documents and a part of the terms of each purchase order for items included in the specifications and proposal form issued herewith. 3.0 SPECIFICATIONS: The use of manufacturer's specifications (Design Guide) by the District is to be considered informative giving the bidder information as to the exact quality and value requirement. The bidder shall note in writing any deviations from specifications and shall submit those changed specifications as an alternate. Buy American Provision Schools and institutions participating in the NSLP and SBP are required by law to use CN funds, to the maximum extent practicable, to buy domestic commodities or products for meals served under these programs. A domestic commodity or product is defined as one that is either produced in the U.S. or processed in the U.S. substantially using agricultural commodities that are produced in the U.S. The term substantially means that over 51 percent of the final processed product consists of agricultural commodities that were grown domestically. 4.0 EVALUATION: In evaluating qualified proposals, the following considerations will be taken into account for award recommendations: 4.1 the purchase price; 4.2 the reputation of the vendor and of the vendor's goods or services; 4.3 the quality of the vendor's goods or services; 4.4 the extent to which the goods or services meet the needs of the District; 4.5 the vendor's past relationship with the District; 4.6 the long-term cost to the District to acquire the vendor's goods or services; Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 2 of 14

4.0 EVALUATION (continued) GENERAL CONDITIONS (continued) 4.7 for a contract for goods and services, other than goods and services related to telecommunications and information services, building construction and maintenance, or instructional materials, whether the vendor or the vendor's ultimate parent company or majority owner: (A) has its principal place of business in this state; or (B) employs at least 500 persons in this state; 4.8 any other relevant factor specifically listed in the request for bid or proposal. 5.0 APPROPRIATED FUNDS: The purchase, which arises from this solicitation, is contingent upon the availability of appropriated funds. CFISD shall have the right to cancel this contract at the end of the then current fiscal period if funds are not allotted for the next fiscal year to continue this contract. If funds are withdrawn or do not become available, CFISD can cancel the service contract by giving the vendor written notice of its intention to cancel not less than thirty (30) days prior to the end of the term year without penalty. Upon cancellation of the contract, CFISD shall not be responsible for any payment of any services that are received or that occur after the end of the current fiscal year contract period. 6.0 WARRANTY CONDITIONS: Supplies shall carry the manufacturer s maximum standard warranty. 7.0 TERMS OF PAYMENT: The Cypress-Fairbanks Independent School District policy is to honor an early payment discount whenever possible. All invoices should specify discount terms and conditions to insure the earliest possible payment. Otherwise, funds for completed contracts concerning this proposal will be available within forty-five (45) days of delivery and acceptance by the District. 8.0 FACSIMILE PROPOSALS: Cypress-Fairbanks Independent School District does not accept receipt of faxed proposals. The attached Proposal Acknowledgment Form in a sealed envelope is the only acceptable form of proposal submittal. 9.0 NO PROPOSAL RESPONSE: A vendor choosing not to submit a proposal should return the No Proposal Notification Form. Failure to respond by submitting a proposal response or a No Proposal Notification form may remove your name from the District vendor list. 10.0 CONFLICT OF INTEREST QUESTIONNAIRE: This document and instructions are located on-line at https://app.cfisd.net/ciq/index.aspx. All vendors are required to file an updated Conflict of Interest Questionnaire annually. 11.0 TEXAS PUBLIC INFORMATION ACT (TPIA): Contractor acknowledges that the Cypress- Fairbanks Independent School District (CFISD) is subject to the Texas Public Information Act (TPIA). As such, upon receipt of a request under the TPIA, CFISD is required to comply with the requirements of the TPIA. Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 3 of 14

GENERAL CONDITIONS (continued) 11.0 TEXAS PUBLIC INFORMATION ACT (TPIA) (continued) For purposes of the TPIA, public information is defined as information that is written, produced, collected, assembled, or maintained under a law or ordinance or in connection with the transaction of official business: 11.1 by CFISD; or 11.2 for CFISD and CFISD 11.2.1 owns the information; or 11.2.2 has a right of access to the information; or 11.2.3 spends or contributes public money for the purpose of writing, producing, collecting, assembling, or maintaining the information; or 11.3 by an individual officer or employee of CFISD in the officer s or employee s official capacity and the information pertains to official business of the CFISD. Contractor is expected to fully cooperate with the CFISD in responding to public information requests. This includes, but is not limited to, providing the CFISD with requested documentation. In the event that the request involves documentation that Contractor has clearly marked as confidential and/or proprietary, CFISD will provide Contractor with the required notices under the TPIA. Contractor acknowledges that it has the responsibility to brief the Attorney General's Office on why the documents identified as confidential and/or proprietary fall within an exception to public disclosure. 12.0 REQUIRED SIGNATURE PAGES: Vendors choosing to reply to this proposal are required to complete the following signature pages per manufacturer or distributor: Proposal Authorization Form Felony Conviction Notice Compliance with Clean Air and Clean Water Act U.S. Department of Agriculture Certification Regarding Lobbying Disclosure of Lobbying Activities The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the basis of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited basis will apply to all programs and/or employment activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 4 of 14

PROPOSAL AUTHORIZATION FORM PAPER BOXES FOR FOOD SERVICE Having carefully examined the Proposal Notice, General Conditions, and Proposal Authorization Form, the undersigned hereby proposes and agrees to furnish goods and/or services in strict compliance with the specifications and conditions at the prices quoted. The bidder affirms that to the best of his knowledge the proposal has been arrived at independently and is submitted without collusion with anyone to obtain information or gain any favoritism that would in any way limit competition or give them an unfair advantage over other vendors in the award of this proposal. The bidder certifies that neither it nor any of its principals has been proposed for debarment, debarred or suspended by a federal agency. I affirm that, to the best of my knowledge, the company I represent meets Equal Employment Opportunity Commission standards and American Disability Act standards in employment practices. Please indicate with a check the type of company you represent: Broker Other Distributor Vendor Name (not broker): Broker Name (if appropriate): Address: City, State, Zip: Phone Number & Ext.: Fax Number: Send Purchase Order To: Address: City, State, Zip: Phone Number: Fax Number: Email Address: Send Payment To/Invoice From: (Name that will appear on invoice) Address: City, State, Zip: Phone Number: Fax Number: _ Email Address: (required) Signature of Bidder: Printed Signature: Position with Company: Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 5 of 14

FELONY CONVICTION NOTICE PAPER BOXES FOR FOOD SERVICE State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states, A person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony. Subsection (b) states, A school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed before the termination of the contract. This Notice is not required of a Publicly Held Corporation. I, the undersigned agent for the firm named below, certify that the information concerning notification of felony convictions has been reviewed by me and the following information furnished is true to the best of my knowledge. Firm Name: Authorized Company Official s Name (Printed): A. My firm is a publicly held corporation; therefore, this reporting requirement is not applicable. Signature of Company Official: B. My firm is not owned or operated by anyone who has been convicted of a felony. Signature of Company Official: C. My firm is owned or operated by the following individual(s) who has/have been convicted of a felony: Name of Individual(s): Details of conviction(s): Signature of Company Official: Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 6 of 14

COMPLIANCE WITH THE CLEAN AIR AND CLEAN WATER ACT PAPER BOXES FOR FOOD SERVICE I, the vendor, am in compliance with all applicable standards, orders or regulations issued pursuant to the Clean Air Act of 1970, as amended (42 U.S.C. 1857 Ch), Section 508 of the Clean Water Act, as amended (33 U.S.C. 1368), Executive Order 117389 and Environmental Protection Agency Regulation, 40 CFR Part 15 as required under OMB Circular A-102, Attachment O, Paragraph 14(1) regarding reporting violations to the grantor agency, and to the United States Environmental Protection Agency Assistant Administrator for the Enforcement. Firm Name: Signature of Company Official: Position with Company: Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 7 of 14

U.S. Department of Agriculture Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 7 CFR Part 3017, Section 3017.510, Participant s responsibilities. The regulations were published as Part IV of the January 30, 1989, Federal Register (pages 4722-4733). Copies of the regulations may be obtained by contacting the Department of Agriculture agency with which this transaction originated. (Before completing certification, read the instructions below.) 1. By signing and dating the certification statement, the bidder certifies that neither it nor any of its principals (e.g. key employees) has been proposed for debarment, debarred or suspended by a federal agency on the date signed. 2. The prospective bidder shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective bidder learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. Federal and State penalties exist for vendors and districts that knowingly enter into contracts with suspended / debarment persons. (1) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Organization Name RP / Award Number or Project Name Name and title of Authorized Representative Signature Date Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 8 of 14

Certification Regarding Lobbying Applicable to Grants, Subgrants, Cooperative Agreements, and Contracts Exceeding $100,000.00 in Federal Funds Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by section 1352, Title 31, U.S. Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. The undersigned 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 any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the award of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and the extension continuation, renewal, amendment, or modification of a Federal contract, grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influence or attempting to influence an officer or employee of any agency, a Member of Congress, an officer of employee of Congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, disclosure Form to Report Lobbying, in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all covered subawards exceeding $100,000.00 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly. Name of Organization Address of Organization Name / Title of Submitting Official Signature Date Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 9 of 14

Disclosure of Lobbying Activities Approved by OMB 038-0046 Complete this form to disclose lobbying activities pursuant to 31 U.S.C>. 1352 (See next page for public burden disclosure.) 1. Type of Federal Action: a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 2. Status of Federal Action: a. bid / offer/ application b. initial award c. post award 3. Report Type a. initial filing b. material change For Material Change Only: Year Quarter date of last report 4. Name and Address of Reporting Entity: Prime Subawardee Tier if known: 5. If Reporting in No. 4 Subawardee, Enter Name and Address of Prime: Address of Prime Congressional District, if known : 6. Federal Department / Agency: 7. Federal Program Name / Description: CFDA Number, if applicable 8. Federal Action Number, if known: 9. Award Amount, if known: 10. a. Name and Address of Lobbying Entity: (if individual, last name, first name, MI ): $ b. Individuals Performing Services (including address if different from No 10a (last name, first name, MI): 11. Amount of Payment (check all that apply): $ actual planned 12. Form of Payment (check all that apply): a. cash b. in-kind; specify: nature value 13. Type of Payment (check all that apply): a. retainer b. one-time free c. commission d. contingent fee e. deferred f. other; specify 14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted for Payment Indicated in Item 11: (Attach Continuation Sheets SF-LLL-A if necessary) 15. Continuation Sheet(s) SF-LLL-A if necessary) Yes no 16. Information required through this form is authorized by article 31 U.S.C. section 1352. This disclosure of lobbying activities is a maternal representation of fact upon which reliance was placed by the tier above when the transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1353. This information will be reported to the Congress semi-annually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure. Signature Title Print Name Telephone Number: Date Federal Use Only: Authorized for Local Reproduction Standard Form -LLL Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 10 of 14

Instructions for Completion of SF-LLL, Disclosure of Lobbying Activities This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient at the initiation or receipt of a covered Federal action, or a material change to a previous filling, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency; a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and the material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and / or has been secured to influence the outcome of a covered Federal Action. 2. Identify the status of the covered Federal Action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal Action. 4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or subaward recipient. Identify the tier of the subawardee, e.g. the first subawardee of the prime is the 1 st tier. Subawards include but are not limited to subcontracts, subgrants, and contract awards under grants. 5. If the organization filing the report in item 4 checks Subawardee then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known. 6. Enter the name of the Federal Agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, contract, grant, or loan award number, the application proposal control number assigned by the Federal agency). Include prefixes, e.g., RFP-DE-90-001. 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award / loan commitment for the prime entity identified in item 4 or 5. 10. (a) Enter the full name, address, city, state and zip code for the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b) Enter the full names of the individual(s) performing services, and include full addresses if different from 10(a). Enter Last Name, First Name and Middle Initial (MI). 11. Enter the amount compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es). Check all boxes that apply. If other, specify nature. 13. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), or Member(s) of Congress that were contacted. 14. Check whether or not a SF-LLL-A Continuation Sheet(s) is attached. 15. The certifying official shall sign and date the form, print his/her name, title and telephone number. Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Projects (0348-0046), Washington, D.C. 20503 Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 11 of 14

SPECIFICATION SHEET PAPER BOXES FOR FOOD SERVICE Specification: Box, Paper, Printed 4 15/16 x 2 7/8 x 1 3/4 Manufacturer: Core Packaging Manufacturer #: 2457 1. Custom printed paper box for serving chicken bites 2. Dimensions 4 15/16 x 2 7/8 x 1 3/4 3. Custom print logo to include 3 colors plus coating 4. Style: TT/AB 5. Material: 16 pt SBS 6. Packed 400 per case 7. Maximum 14 day lead time for delivery 8. Bulk order of 1800 cases needed two weeks from award date 9. Sample required for alternate Include specification sheet. Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 12 of 14

Subject: PAPER BOXES FOR FOOD SERVICE Contract Number: 15-02-4418-IB Category: Paper for Food Service Cypress-Fairbanks Independent School District Food Service Department Bid Form April 1, 2015 April 30, 2015 Item# Unit Estimated Quantity Item Manufacturer Manuf. # Price per Unit Delivery Information 1 CS 1800 Box, Paper, Printed 4 15/16 x 2 7/8 x 1 3/4 Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 13 of 14

NO PROPOSAL NOTIFICATION PAPER BOXES FOR FOOD SERVICE Please complete this page only if submitting a no proposal response and return prior to the proposal opening date. Check below: 1. We have chosen not to submit a proposal for the reason listed below but wish to remain on the vendor list for this proposal in the future. 2. The products/services we represent should be listed in another category. (Specify) 3. We wish to be removed from the vendor list for the reason listed below. Company Name: Attention: Bid Mailing Address: Purchase Order Mailing Address: City: State: Zip: City: State: Zip: Phone Number: ( ) Fax Number: ( ) Email Address: Website Address: Typed Name and Title: Signature: Date: Mail to: Ms. Kristine Johnston Director of Purchasing, Cypress-Fairbanks Independent School District, Windfern Administrative Annex, 12510 Windfern Road, Houston, TX 77064. Failure to return this No Proposal Notification or an actual proposal response may result in the removal of your company name from the vendor list. Paper Boxes for Food Service, Contract #15-02-4418-IB, Page 14 of 14