Flowers Baking Company of Tyler - Region 10 Education Service ...

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Reouest for BldATTACHMENT ATo:From:Reglon 10 Education Service Center-Flowers Baking Co of Tyler, LLC.Organization NameVendor shall not prepare this Bid in collusion with any other Vendors and the contents ofthis Bid as to prices, terms or conditions may not be communicated by this organizationnor by an employee or agent of this organization to any other Vendor or to any otherpersons engaged in this type of business activity prior to the official Bid due date.However, the authorized agent or officer signing this Bid is not and has not been, for sixmonths, directly or indirectly concerned in any agreement to controlthe conditions and/ orprices of seruices proposed, or has not influenced any person to propose or not purposethereon.I have read the complete Proposal RFB #2012-09 FRESH BREAD ITEMS and verify theaccuracy of all information contained in the Bid.John GilmerTyped nameNOTARY PUBLIC5-Zz-tZ\Jt^$"--n^My commission expires on the ?rd- day of &pl , 2o tSCATHYTOWET{Mv @mmleslon ExPllESeptember@' 20lAComplete and return with BidFresh Bread RFP # 2012-09Paoe 26 ol 30
ATTACHMENT Bln accordance with Executive Order 12549 DEBARMENT AND SUSPENSION, theprospective vendor certifies by submission of this Bid, that neither it nor it's principals ispresently debarred, suspended, proposed for debarment, declared ineligible, orvoluntarily excluded from participating in this transaction by any Federal department oragency.Where the prospective offeror is unable to certify to any of the statements of thiscertification, such prospective pafticipant shall attach an explanation to this Bid.The certification in this clause is material representation of the fact upon which reliancewas placed when this transaction was entered into. lf it is later determined that theprospective offeror knowingly entered an erroneous certification, in addition to otherremedies available tqthe- Eederal Government*the MultLRegional Co:Op -may pursueany and all available remedies, including suspension andlor debarment.Additionally, the prospective vendor shall provide immediate written notice to the personto which this Bid is submitted if at any time the prospective offeror learns that it'scertification was erroneous when submitted or has become erroneous by reason ofchanged circumstances.The prospective vendor agrees by submitting this form that, should the proposed coveredtransaction be entered into, it shall not knowingly enter into any transactions with a personor firm who is debarred, suspended, declared ineligible, or voluntarily excluded fromparticipation in this covered transaction, unless authorized by the Multi-Regional Co-Op.Except for transactions authorized under the previous paragraph, if a prospective offerorin a covered transaction knowingly enters into a transaction with a person who issuspended, debarred, ineligible, or voluntarily excluded from participation in thetransaction, in addition to other remedies available to the Federal Government, the Multi-Regional Co-Op may pursue and all available remedies, including suspension and/ordebarment.PotentialVendor Name:Flowers Baking Co of Tyler, LLC.Title of Authorized Representative:John Gilmer1200 West Enruin, Tyler, TX75702Mailing Address:Fresh Bread RFP # 2O12-Og Page 27 of 30
Page 2 and 3: FELONY CONVICTION NOTIFICATIONState
Page 4 and 5: Clean Air and Water Act. l, the Ven
Page 6 and 7: f n stru cti onEf o r Ce rtlf l c-a
Page 8 and 9: **Flowers Baking Co of Tyler, LLC.
Page 12 and 13: CONFLICT OF INTEREST QUESTIONNAIREF
Page 14: TO: Education Service Center Region

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