Request for Proposal - Campbell County Schools

Request for Proposal
Local and Long Distance Telephone Service
for The Campbell County Board of Education
12/21/2011

REQUEST FOR PROPOSAL
1. INTRODUCTION ...............................................................................................3
1.1. Purpose ........................................................................................................3
1.2. Proposal Submittal ........................................................................................3
1.3. Schedule .....................................................................................................3
2. GENERAL CONDITION ....................................................................................4
2.1. Conformity with RFP ...................................................................................4
2.2. Uniformity of Proposals ...............................................................................4
2.3. Additional Information ................................................................................4
2.4. Contract .....................................................................................................4
2.5. Non-Collusion ..............................................................................................4
2.6. Right to Reject Proposals .............................................................................4
2.7. Liability and Insurance .................................................................................5
2.8. Price Protection ............................................................................................5
2.9. Right to Purchase from Any Source ............................................................5
2.10. Delivery Date ..............................................................................................5
2.11. Vendor Commitment ..................................................................................5
2.12. Maintenance/Support .................................................................................5
2.13. Systems Responsibility ...............................................................................5
2.14. Rights to Submitted Material ......................................................................6
2.15. Disclaimer and Cancellation .......................................................................6
3. SELECTION PROCESS .....................................................................................7
3.1. Request for Proposal (RFP) ..........................................................................7
3.2. Solution Requirements ..................................................................................7
3.3. Evaluation Criteria ........................................................................................11
3.4. Solution Demonstrations ..............................................................................13
3.5. Selection .....................................................................................................13
4. PROPOSAL FORMAT .......................................................................................13
5. SCHOOL SYSTEM DESCRIPTION ..................................................................14
6. VENDOR AFFIDAVIT AND HOLD HARMLESS RELEASE .......................16
7. VENDOR PURCHASE ORDER MEMORANDUM OF 10/16/10 FORM........18

1.0 INTRODUCTION
1.1 Purpose
This Request for Proposal (RFP) is offered to solicit proposals from qualified vendors for
Local and Long Distance Telephone Service for the Campbell County Board of
Education, 172 Valley Street, Jacksboro, TN 37757. In order to receive consideration,
the proposed system must meet the requirements of the aforementioned as here in
described.
1.2 Proposal Submittal
Jeff Marlow, Campbell County Financial Management System Director, will accept
Sealed Proposals, P.O. Box 843, Jacksboro, TN 37757 no later than time 2:30 p.m._ .
Date 2/9/2012__ at the Campbell County Board of Education, 172 Valley Street,
Jacksboro, TN 37757. All Proposals must be in accordance with the conditions and
instructions provided herein.
1.3 Schedule
RFP released - ___12/21/11__________________________
Closing date for proposal submittal - ___ __2/9/2012______
Oral presentations and system demonstration – (to be scheduled if needed)
Evaluation completed and vendor recommended – (to be scheduled)
This schedule is intended as a guideline for the timing of various events in this effort.
Management requirements and other factors may cause certain of these dates to vary
from original intentions. In no event, however, shall the deadline for proposal submittal
be changed.

2.0 GENERAL CONDITIONS
2.1 Conformity with RFP
All Proposals must conform to the requirements presented in this RFP. Proposals not in
conformity may be rejected. Exceptions to any requirement must be clearly noted in
vendor’s response.
2.2 Uniformity of Proposals
To facilitate evaluation, all proposals must be submitted in a uniform format as described
in Section 4 of this RFP.
2.3 Additional Information
All inquiries or requests for information relative to this RFP should be directed to the
Campbell County Board of Education, Technology Department, 172 Valley Street,
Jacksboro, TN 37757, Telephone # (423) 562-0521, Facsimile (423) 562-9605. All
material submitted by the Campbell County Board of Education must be treated as
confidential and cannot be used for any other purpose than the response to this RFP.
Information submitted by any vendor will be considered confidential to the Campbell
County Board of Education and will not be used for any other purpose than evaluating
vendor responses.
2.4 Contract
The selected vendor MAY BE REQUIRED TO EXECUTE A CONTRACT WRITTEN
FOR AND BY Campbell County. The Campbell County Board of Education may not
execute the vendor’s standard contract. All Proposals should contain a statement
indicating the vendor’s willingness to accept a written contract. The vendor should
indicate if this RFP and the vendor’s written material could be included in the contract.
Any exemptions to this requirement must be noted in the vendor’s response.
2.5 Non-Collusion
Each Proposal shall contain a vendor affidavit, a copy of which is enclosed in Appendix
IV.
2.6 Right to Reject Proposals
The Campbell County Finance Director reserves the right to reject any or all proposals, to
waive technicalities or informality and to accept any proposal deemed to be in the best
interest of the County.

2.7 Liability and Insurance
The selected vendor will save and hold harmless The Campbell County Board of
Education from any and all legal liability arising out of the infringement of any patent or
copyright in respect to the normal use of proposed software.
2.8 Price Protection
Price quoted in the proposal shall be firm prices and not subject to increase during the
term of any contractual agreement arising between The Campbell County Board of
Education and a vendor. Vendors will quote on prices less any Federal Excise Tax.
Vendors should stipulate the expiration date of their quoted price.
2.9 Right to Purchase from Any Source
The Campbell County Board of Education reserves the right to purchase any desired
equipment, software, or services from any source or sources in part or in whole as set
forth in the Board of Education directives.
2.10 Delivery Date
Vendors will specify in proposals the delivery date of their equipment, services and/or
products (i.e., how long from time of order to delivery of hardware and/or software).
2.11 Vendor Commitment
Vendors must state their commitment to maintain, support and upgrade their services at
the current or the public-released level for at least the term of the contract.
2.12 Maintenance/Support
Vendors must supply the names and addresses of all service organizations that will
provide support and maintenance on all products proposed herein. If appropriate, vendors
must also specify the maximum time to elapse between the time a service call is made
and the time a service representative arrives on site.
2.13 Systems Responsibility
Notwithstanding the contents of the RFP, it is the responsibility of the vendor to verify
the completeness, accuracy, and suitability of the vendor’s proposal to meet the
requirements of The Campbell County Board of Education.
The vendor without claim for additional payment shall provide any additional equipment
required after installation to meet The Campbell County Board of Education’s
requirements, even if not specifically mentioned herein. It is understood that a complete
solution, which operates effectively and to the satisfaction of The Campbell County

Board of Education, is required. The successful vendor will be obligated to provide a
solution that meets all guarantees in their proposal for the price contained therein and that
all products provided operates successfully with The Campbell County Board of
Education’s existing telecommunication infrastructure and related systems and networks.
All products must be completely new.
2.14 Rights to Submitted Material
All proposals, responses, inquiries, or correspondence relating to or in reference to this
RFP, and all reports, charts, displays, schedules, exhibits, and other documents provided
by vendors will become the property of The Campbell County Board of Education when
received. Supporting technical manuals will be returned at the request of the vendor. The
Campbell County Board of Education retains the right to use any or all system ideas
presented in any proposal, whether amended or not amended. Selection or rejection of a
proposal does not affect this right.
2.15 Disclaimer and Cancellation
The Campbell County Board of Education reserves the right and to waive any informality
received where such acceptance, rejection, or waiver is considered to be in the best
interest of the Campbell County School District. Campbell County Board of Education
also reserves the right to reject any proposal where evidence or information submitted by
the Vendor does not satisfy the Campbell County Board of Education that the vendor is
qualified to carry out the requirements of the contract documents.
This RFP does not commit the Campbell County Board of Education to any specific
course of action. The Campbell County Board of Education reserves the right to not
select any vendor or purchase any goods or services resulting from this RFP. The
Campbell County Board of Education may choose not to purchase these services if the
Campbell County Board of Education does not receive USF funding for this project.

3.0 SELECTION PROCESS
The selection of a provider for Local and Long Distance Telephone Service by The
Campbell County Board of Education will involve both objective and subjective
elements. The process to be used to make this selection is outlined below.
3.1 Request for Proposal (RFP)
The RFP is intended to provide interested vendors with uniform information concerning
The Campbell County Board of Education requirements for Local and Long Distance
Telephone Service. In responding to this RFP, VENDORS MUST ADHERE TO THE
INCLUDED FORMAT AND USE ANY REQUIRED FORMS.
3.2 Requirements
3.2.1 Three (3) copies of your completed proposal should be submitted.
3.2.2 This request includes approximately 70 phone lines with local and long distance
service for all locations in the Campbell County School District. The individual telephone
numbers currently in use are listed below. It is most desirable that one vendor provides
service to all locations; however, proposals will be accepted for only specified exchanges.
3.2.3 The proposed contract should be for up to one year. Quoted prices must be planned
to be effective starting July 1, 2012 and extend through June 30, 2013. Any new lines
added after July 1, 2012 must be added to the current contract and expire on June 30,
2013. Proposal must include disconnect, line cancelation, installation, connection, or
activation fees if applicable.
3.2.4 The successful vendor will be required to participate in the Universal Service Fund
(USF) and will provide the appropriate discounts if applicable to this project. If the
Campbell County School District does not receive USF funding for this project, the
Campbell County School District may chose not to purchase these services. Please
provide your SPIN identification number and USF listed company name. The vendor
must also provide, at the end of the annual contracted period and without additional cost,
a complete copy of all serviced bills from all contacted locations, for use in facilitating
USF applications.
3.2.5 The proposal should include a contract for proposed services. If the vendor does
not wish to submit an actual contract with the proposal, a sample contract would be
submitted with the proposal.
3.2.6 Local and Long Distance services are to conform to industry standards as to
availability and location.

3.2.7 The proposal must have the option of receiving one comprehensive bill for all
locations, or for having individual sites billed separately. The billing format must clearly
define Local and Long Distance services. Long Distance calls shall be clearly delineated
by time, length, number and location called.
3.2.8 Sites are to be given the option of utilizing codes for individuals such that Long
Distance usage can be monitored. If sites do not wish to utilize this option, it can still be
made available at a later date.
3.2.9 911 service and Directory Assistance services will be provided as part of the local
service to be billed as part of the local service. Caller ID and Hunting must be an option
at all locations.
3.2.10 Delivery of such services shall be in accordance with FCC regulations and
Industry standards for telephony services as long as there is no interruption in service.
Acceptable methods could be digital/analog/copper wiring; wireless or networking
technology.
3.2.11 Proposers must describe their solution for how the existing local numbers would
be used or would have to be changed to support any change in service. Vendors must
clearly state if existing numbers can be retained. If number portability is available,
vendors must describe fully what is needed from the school systems in order to support
implementation of their choice to keep existing numbers intact. If numbers must be
changed, vendors must submit an implementation plan which addresses new number
reservation procedures, recorded announcement intercept treatment for old numbers, and
coordination of responsibility for changes in white, blue and yellow pages directory
listings.
3.2.12 State whether the proposed service is a “reseller”, “facilities based business”, or
both. If both, state the quantity based percentage of each service provided.
3.2.13 Describe the geographic location, manufacturer and model for each proposed
switch.
3.2.14 Identify the type of transport, if applicable, used in each service area (i.e., fiber,
coax, etc.)
3.2.15 Identify all types of local service offered. The list should include two-way trunks,
one-way trunks, ESSX or Centrex stations, and hunting. The following items may be
provided in a matrix to readily see the experience of the potential vendor, the capabilities
of each type of local service, the limitations, and the geographic area covered. For each
type of service, list the number of customers potential vendor has and the quantity of
services. Identify any tariff references that are applicable.

3.2.16 Submit a geographic map or exchange listing that includes clear detail that defines
the type of service available in each coverage area. Specify the coverage for each
exchange.
3.2.17 List all optional features by geographic location, which are available with the type
of local service (i.e., call forwarding, call conferencing, caller ID, etc.)
3.2.18 Identify all limitations that exist relative to the termination of local telephone
service in any type of telecommunications equipment or communication device (i.e., fax
machines, modems, specific PBX equipment, ACD equipment, etc.) Clearly define the
geographic locations where the limitations are to be considered.
3.2.19 Identify any and all customer provided equipment that may be required to
complete the termination of local telephone service.
3.2.20 Identify any requirements that may exist relative to defining where, on customer
premise, the local telephone service line will terminate (point of demarcation). Will the
potential vendor extend the demarcation point? If so, identify the costs involved.
3.2.21 Identify your maintenance procedures on local telephone service. Define the
process for reporting service problems on a 7 day x 24-hour basis. Define whether
maintenance is provided on a 7 day x 24-hour basis. Identify the primary location of
maintenance personnel that will respond to service problems. (Within the county and/or
in an adjacent county is an important consideration)
3.2.22 If the potential vendor is a reseller of local telephone service, potential vendor will
detail current and proposed procedures relative to the resolution of problems between
them and the facilities based provider. The potential vendor will be responsible for
problem resolution with the penalty of no payment for services while any and all
problems are unresolved.
3.2.23 Proposals must provide information on schedules for installation of all local
service offerings. Describe by service offering the timeframes required to complete the
installation.
3.2.24 Proposals must include a sample copy of a customer bill for local service. At a
minimum, billing will be done on a per line basis providing the local service telephone
number and the address at which it terminates (including zip code). It will also contain
the customer name and customer code, a list of any individual numbers billed with the
master number, all options listed individually and one-time charges listed individually,
clearly detailing individual charges.
3.2.25 Billings must be available in hard copy. Vendor will provide a summary statement
of services on a monthly basis. Billing must be able to be customized based on customer
requirements and multiple cost centers. Billing must be able to be combined reflecting
one bill for all services or aggregated by customer-specified units or divisions.

3.2.26 Proposal must include a detailed transition plan from an existing provider to your
proposed solution.
3.2.27 Proposal must include pricing elements for all available services. This listing of
prices should be a simple catalog that can be used by a school to determine what will be
purchased.
3.2.28 Some school and administrative offices have existing Centrex service and
therefore have special needs. A) Provide explanation of how proposed solution will
interface to all types of premise equipment, including 1-A type switchboard, PBX and
key systems of various manufacturers, standard telephone sets, uniform and automatic
call distribution systems, voice mail, message/voice on-hold, fax and modems. B)
Explain features, and detail cost of each feature in a cost matrix, including any mileage
charges. C) Identify any limitations in configuring ESSX or Centrex stations as inward,
outward and combination trunks in a PBX system or Key system, as well as stand-alone
stations. D) Describe ratio of Network Access Registers to stations and links to support
stations and whether there is any cost differential for various ratios. E) Describe any
limitations when multiple Central Offices must serve system wide service.
3.2.29 Proposal must include:
Company Information- List your company’s legal name, address, and telephone number.
Include parent company information if applicable.
Vendor Authorizations- Provide Company authorizations
Technical Support Details- Provide normal support hours. Provide description of support
options, maximum and minimum response times and appropriate details relative to how
to initiate and use support options. Provide technical certifications of all staff members.
Universal Service Participation- Vendor must participate in the Universal Service Fund
program and provide SPIN.
Vendor Affidavit, Hold Harmless Release, and Purchasing Procedures Forms-Fill out
appropriately and include in proposal.
3.2.30 Proposal must include cost of complete proposed solution as well as costs for
individual sites and numbers.

3.3 Evaluation Criteria
A number of factors will influence the Campbell County Board of Education’s decision
in vendor selection. These factors (in order of importance) include cost, vendor
qualification and experience, personnel resources, and the proposed technical solution.
These factors include a technical evaluation based upon the vendor’s ability to deliver
these services in a timely manner. Equally important is a vendor evaluation based upon
vendor reputation, past performance with similar projects, service and support resources,
knowledge of USF policies and procedures, etc.
Please note that the Campbell County Board of Education will evaluate cost-effective
solutions based on features, functionality, implementation difficulties, as well as cost, and
is not obligated to select the lowest price bidder.

The Campbell County Board of Education will use the following point system to evaluate
all proposals that meet the minimum requirements. Proposals not meeting all of one of
the Solution Requirements in Section 3.2 will receive fewer than the maximum points
possible, with the exact amount based upon a subjective view of the impact of this
deficiency upon the usefulness of the solution:
Requirement Maximum
Points Earned
3.2.1 10
3.2.2 20
3.2.3 20
3.2.4 100
3.2.5 100
3.2.6 20
3.2.7 20
3.2.8 10
3.2.9 50
3.2.10 50
3.2.11 100
3.2.12 50
3.2.13 10
3.2.14 10
3.2.15 20
3.2.16 10
3.2.17 50
3.2.18 50
3.2.19 50
3.2.20 20
3.2.21 50
3.2.22 50
3.2.23 20
3.2.24 50
3.2.25 50
3.2.26 50
3.2.27 50
3.2.28 20
3.2.29 100
Bid Price * 200
* Lowest bid will receive 200 points with others receiving points based upon the ratio of
their price to the lowest (i.e. if someone bids twice the lowest price, they will receive half
the maximum points).

3.4 Solution Demonstration
Should demonstration of proposal solution be desired by The Campbell County Board of
Education, the demonstrations shall be arranged in advance at a location acceptable to
The Campbell County Board of Education in order to most effectively accommodate the
scheduling requirements of The Campbell County Board of Education officials and
personnel.
Demonstration should not exceed two hours in length and vendors should demonstrate
equipment and software as similar as possible to that proposed for The Campbell County
Board of Education.
3.5 Selection
Following the evaluation process described above, The Campbell County Board of
Education will make all decision regarding selection of finalists, contract negotiation and
the award of the contract. The decision of The Campbell County Board of Education will
be considered final.
4.0 PROPOSAL FORMAT
Proposals should be written in a concise, straightforward and forthright manner.
Superficial marketing statements and materials should be avoided. Proposals should be
organized in the following manner.
1. Describe the proposed solution. Be very specific relative to how the solution
addresses the requirements listed in Section 3.2. Justify and describe any variance
from the requirements listed in Section 3.2.
2. List the purchase cost for the complete solution. List costs per line site for all sites
listed in Section 5. The telephone numbers list is considered accurate at the time of
RFP issue, but is subject to change. The actual list may vary somewhat at the time of
service start.
3. Estimated time frame for delivering the proposed solution.
4. Describe the solution’s technical support scheme. Specifically list types of support
available (i.e. telephone, email, on-site, etc.) and list hours of availability and any
potential associated costs above and beyond the proposed solution.
5. Provide a list of five (5) references currently serviced by your company using a
similar solution. Provide the organization’s name, address, and name and telephone
number of a contact person.

5.0 SCHOOL SYSTEM DESCRIPTION
The Campbell County Board of Education School System currently has twelve schools
and two Adult Education centers. The distance from the Central Office to individual
schools varies from less than one mile to a maximum of 34 miles. Each location may
receive some of the proposed solution. The bid price must include shipping or delivery
and setup based on purchase order.
Site List with Current Telephone Numbers and Services (The main number for each site
is listed first for each site):
Campbell County Comprehensive High
150 Cougar Lane
Jacksboro, TN 37766
423-562-8308
423-562-0756
423-562-1325
423-562-4173
423-562-8300
423-562-9722
423-562-8309
423-562-8640
423-562-9020
423-562-9058
423-562-9179
423-566-0832
423-566-2019
423-562-0598
423-562-3885
423-562-0959
423-566-4367
Caryville Elementary
120 Cardinal Circle
Caryville, TN 37714
423-562-2687
423-566-8918
423-562-2738
423-566-7330
Elk Valley Elementary
6691 Highway 297
Pioneer, TN 37847
423-784-6866
423-784-5826
East LaFollette Elementary
Adult Ed
300 West Beech St
LaFollette, TN 37766
423-566-5436
423-562-1427
Jacksboro Elementary
P.O. BOX 437
164 JACKSBORO ELEM RD
JACKSBORO, TN 37757
423-562-7433
423-562-9345
423-566-8957
423-562-3271
Jacksboro Middle
150 Eagle Circle
Jacksboro, TN 37757
423-562-3773
423-562-0231
423-562-8994
423-566-9429

Jellico Elementary
551 Sunset Trail
Jellico, TN 37762
423-784-6565 Caller ID
423-784-2652
423-784-8196
423-784-2997
423-784-5086
423-784-4886
Jellico High
141 High School Rd
Jellico, TN 37762
423-784-9455 Caller ID
423-784-9456
423-784-9453 Caller ID
423-7849458
423-784-2513
423-784-7563
423-784-4205
LaFollette Elementary
195 Myers Lane.
LaFollette, TN 37766
423-562-3439
423-566-3432
423-562-1957
423-562-1904
423-563-0137
423-562-3161
LaFollette Middle
1309 East Central Ave.
LaFollette, TN 37766
423-562-8448
423-562-2107
423-562-3207
423-562-8449
423-566-5925
Valley View Elementary
1187 Old Middlesboro Hwy.
LaFollette, TN 37766
423-562-5278
423-562-8098
423-566-2256
White Oak Elementary
5634 White Oak Rd.
Duff, TN 37729
423-784-6051 Caller ID
423-784-9386
423-784-9726
Wynn Habersham
174 Habersham Rd.
Duff, TN 37729
423-784-9482
423-784-9380
423-784-9483
423-784-2635

6.0 VENDOR AFFIDAVIT
VENDOR AFFIDAVIT
I, _________________________ representing __________________________,
(company) do hereby request that I have completed the questionnaire submitted with my bid/rfp
and do hereby attest to the accuracy of this information.
I accept that I can be required to demonstrate the features of the equipment and software,
which I have stated, is currently present in the system that I am proposing.
I acknowledge that any misrepresentation of the product will result in immediate
disqualification from any consideration in the proposal process.
I further recognize that The Campbell County Board of Education reserves the right to
make its award for any reason considered advantageous to the jurisdiction. The product solution
selected may be without respect to price and other factors.
Date__________________________________________________
Signature ______________________________________________
Name _________________________________________________
Title __________________________________________________
Firm __________________________________________________
Address _______________________________________________
City _________________ State ______ Zip Code______________
Phone ________________________________________________
Please return this form and the attached questionnaire with your proposal.

MIKE ORICK, CHAIRMAN
P.O. Box 106
Caryville, TN 37714
HOMER RUTHERFORD
VICE CHAIRMAN
132 Wood Haven Lane
LaFollette, TN 37766
RECTOR MILLER
228 Matthew Lane
LaFollette, TN 37766
DAVID LYNCH
922 Cross Valley Road
LaFollette, TN 37766
JOSH PARKER
179 McCarty Road
LaFollette, TN 37766
~oaru
CAMPBELL COUNTY
of ttiuu.caiion
522 Main Street. P.O. Box 445
Jacksboro, Tennessee 37757
Phone: 423-562-8377 • Fax: 423-566-7562
Donnie Poston
Director of Schools
JOHNNY BYRGE
1005 Rose Hill Drive
LaFollette, TN 37766
scorr HILL
223 Hollifield Drive
Jacksboro, TN 37757
EUGENE LAWSON
P.O. Box 149
Caryville, TN 37714
JOHNNY CREEKMORE
950 Indian Mountain Road
Jellico, TN 37762
J.L. "SARGE" COLLINS
201 Old Wooldridge Pike
Jellico, TN 37762
RELEASE
Comes
, an officer, employee or duly
authorized agent, acting with real authority, releases and holds harmless the
Campbell County Board of Education, The Director of Schools, their agents and
employees from any liability resulting from a violation of Tennessee Code
Annotated Section 49-5-413, and specifically acknowledges that all persons in their
or close proximity to school children, as contemplated in said statute, are in full
compliance with the requirements thereof.
Name
Title
Business Name and Address

Vendor Certification of Eligibility and Non-Collusion
The undersigned authorized representative(s) state(s) with respect to our Informal Quote, Proposal and/or
Formal Bid submittal to Campbell County, Tennessee, and/or to its applicable departments, officials,
employees and agents:
VWe hereby certify that the preparation and submission of any price quotes provided in response to
informal solicitations, requests for proposals, and/or formal bid solicitations, have been prepared
independently; without consultation, communication, and/or agreement with any other bidder or potential
bidder as to prices, terms, and/or conditions of the goods and/or services being quoted.
VWe hereby certify as follows: If the proposed purchase is awarded to myself and/or to my/our firm, as
applicable, that no member or members of the governing body, elected official or officials, employee or
employees of Campbell County, or any person representing or purporting to represent Campbell County,
or any family member of any of the person( s) and/or groupe s) stated above, including parents, spouse( s),
or child/children, has received or has been promised, directly or indirectly, any financial benefit, by way
of fee, commission, froder's fee or any other financial benefit, of whatsoever type or nature, on account of
the act of awarding and/or accepting and/or executing the subject purchase requisition, purchase order,
proposal, and/or contract which would be considered a bribe, kickback, under the table payment(s), illegal
payment(s), conflict of interest, or any other conduct which is prohibited in any manner under Tennessee
and/or Federal law generally, whether by statutory or common law, as applicable.
VWe hereby certify as a means of full disclosure that if VWe have a family relationship of any kind with
the requisitioning representative(s) of Campbell County to which our response to informal solicitations,
requests for proposals, and/or formal bid solicitations is being submitted for review and consideration,
such family relationship is fully disclosed in the space provided immediately below. VWe further
acknowledge that failure to fully disclose any such relationships may result in our immediate and
permanent disqualification from any consideration in the present or future solicitation processes for
informal solicitations, requests for proposals and/or formal bid solicitations.
VWe hereby certify that Vwe have full authority to bind myself and/or the company named below, as and
to the extent applicable, and that Vwe have personally reviewed the information contained in our response
to this informal solicitation, requests for proposal, and/or bid package, as applicable, and all attachments
and materials and appendices, and do hereby attest to the accuracy of all information contained in
response to this informal solicitation, request for proposal and/or formal bid solicitation, including all
attachments and materials and exhibits, if and as applicable.

I/We hereby certify that this response to informal solicitation, request for proposals and/or formal bid
solicitation is submitted by the undersigned on my/our/its own behalf and not as a front or shill for some
other entity, and that if awarded the response to informal solicitation, request for proposal and/or bid
contract the undersigned is fully qualified to perform same and is not disqualified by reason of any
conflict or other reason of whatsoever type or nature, and that the acceptance and performance of said
proposallbid/contract will not be in violation of any local, state, or federal policies, regulations, contract
requirements, or laws, without limitations.
I/We acknowledge that any misrepresentation will result in immediate and permanent disqualification
from any consideration in the present or future solicitation processes for informal solicitations, requests
for proposals and/or formal bid solicitations.
The undersigned further recognize(s) that Campbell County reserves the right to reject any and all bids
and/or proposals without cause, or to make its award of any and all bids and/or proposals for any lawful
reason.
The use of the singular and plural and gender herein shall be all inclusive and interchangeable
be interpreted as appropriate to the circumstances.
and shall
All statements herein are material to the eligibility of the undersigned to be considered with respect to this
and any future responses to informal solicitations, requests for proposals and/or formal bid solicitations.