request for proposal for resident feedback effort for … · hathaway in writing, either through us...

REQUEST FOR PROPOSAL

For

RESIDENT FEEDBACK EFFORT

For

THE KING COUNTY HOUSING AUTHORITY

Request for Proposal Issued: May 15, 2019

Proposal Due: June 28, 2019 by 3:00 PM

This RFP includes the following documents:

1) Proposal

2) Exhibit A - Fee Schedule

3) Exhibit B - Section 3 Information and Certification

a. Exhibit B-1 – Section 3 Clause

b. Exhibit B-2 – Section 3 Supplemental Instructions to Applicants

c. Exhibit B-3 – Section 3 Income Guidelines

d. Exhibit B-4 – Section 3 Business Certification

e. Exhibit B-5 – Section 3 Subcontractor Work Plan

f. Exhibit B-6 – Section 3 Individual Certification Form

g. Exhibit B-7 – Section 3 Evaluation Criteria

4) Exhibit C – Equal Opportunity Clause

5) Exhibit D - HUD Form #5369-B

6) Exhibit E - HUD Form #5369-C

7) Exhibit F - HUD Form #5370-C

8) Exhibit G - HUD Form #50071

9) Exhibit H – HUD SF-LLL

REQUEST FOR PROPOSALS


King County Housing Authority RFP – Resident Feedback Effort

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The King County Housing Authority (KCHA) is issuing a competitive Request for Proposal (RFP) for

qualified companies/individuals (Applicant) to design and implement a process for collecting resident

feedback.

Obtaining the RFP: Visit www.kcha.org to obtain the RFP package. There will be no cost for

requesting a package.

Questions: Any questions or requests for further information or clarification must be directed to Shawli

Hathaway in writing, either through US mail (please use certified mail) or email [email protected] no

later than Friday, June 21st at 3:00 PM PST.

Submission Deadline: Sealed proposals, in accordance with conditions defined in the RFP, must be

received via USPS Certified mail, overnight delivery services (UPS, Fed Ex, etc.), hand delivered to the

KCHA Central Office or e-mailed no later than 3:00 PM PST on Friday, June 28, 2019 at the address

below. All submissions will be date stamped upon receipt. No submittals will be accepted after this

time. Faxed submittals will not be accepted. Women and Minority owned businesses are strongly

encouraged to submit a proposal.

Submission Instructions: If mailing submit a sealed proposal marked “RFP Resident Feedback

Effort” to Shawli Hathaway, c/o King County Housing Authority, 700 Andover Park West, Tukwila,

WA 98188 or e-mail to [email protected]. No proposals shall be opened or viewed before the

submission deadline. If an Applicant has submitted a proposal in error, the original proposal may be

picked up and resubmitted before the submission deadline. Submissions will not be publicly opened. It is

the responsibility of the Applicant to indicate which parts of the RFP are “confidential” or “proprietary”,

as bid documents are considered public records, subject to inspection upon written request.

Evaluation: Based upon the evaluation criteria set forth in the RFP, KCHA expects to select one

Applicant that is best qualified to provide the services described in this RFP. KCHA reserves the right to

waive any information or irregularities in submittals, or to reject any and/or all proposals.

http://www.kcha.org/

mailto:[email protected]




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A. INTRODUCTION

The King County Housing Authority (KCHA) provides rental housing and housing assistance to more

than 20,000 low-income households through both federally-funded and local programs. KCHA operates

in King County outside the cities of Seattle and Renton, and owns over 10,400 low and moderate income

apartment units across the region.

Through its federally funded programs, KCHA serves a diverse subset of the region’s lowest income

residents. Of those served in 2017, 81% earned less than 30% of the area median income (AMI) - $32,100

per year for a family of four. 30% of households served were elderly, 29% were non-elderly households

with a disability, and 41% were families with children. 26% of KCHA’s residents identified a language

other than English as their primary language.

Project Background: KCHA has a history of regularly measuring satisfaction and gathering feedback

from the 3,500 households living in our federally subsidized housing through the use of satisfaction

surveys. Past surveys have been administered through the mail and online and the development,

administration, and analysis of results was carried out by KCHA staff. KCHA has conducted surveys

annually, alternating between its family sites and sites serving the elderly and people with disabilities.

When the surveys were first administered, KCHA used a HUD-mandated questionnaire. In 2009, the

survey requirement was waived and KCHA developed our own instrument with the goal of using resident

feedback to inform housing management and service delivery. KCHA has identified a need to gather

feedback that is more representative of the entire KCHA resident population and feedback that is

actionable for KCHA staff to inform their work, programs, and services provided to residents.

B. SCOPE OF WORK

This Request for Proposal (RFP) seeks a qualified contractor to design and implement a process for

collecting resident feedback related to these four areas: 1. perceptions of safety, 2. general satisfaction, 3.

service needs and 4. physical property needs. The population includes approximately 3,500 respondents

living in KCHA-owned and managed properties with diverse backgrounds and languages spoken. The

feedback process should be conducted in KCHA’s eight most commonly spoken languages1, including

English.

KCHA intends to use this information to inform short-term improvements and long-term planning in

order to best serve current and future resident needs. Learning questions include:

1. What is the level of satisfaction among residents related to:

a. Management and maintenance services

b. Availability and quality of resident services offered

c. Condition of property

2. What is the perception of safety among residents at KCHA properties?

3. What is the level of understanding related to KCHA’s policies and procedures?

4. How do residents prefer to be engaged and communicated with?

The selected contractor shall also advise KCHA on all aspects of the feedback collection process,

including but not limited to design, outreach strategy, implementation, and analysis of results.

KCHA will accept proposals from qualified applicants interested in providing services related to this

project, including:

Feedback process design in partnership with KCHA

1 Somali, Russian, Vietnamese, Spanish, Arabic, Farsi, and Korean.




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Outreach strategy development and implementation. Strategy must address how to reach different

KCHA households including older adults, families, residents who are living with disabilities and

residents who may have limited or no ability to read, write, or speak English. Strategy must also

address how to reach all KCHA residents given the wide geographic spread of King County.

Process administration

Data collection

Analysis and presentation of results

C. DURATION OF WORK AND ANNUAL BUDGET

The budget is not to exceed $50,000. The duration of the contract shall be for 12 months (June 1, 2019

to May 31, 2020) with possible 12-month extensions for up to six years.

D. INFORMATION TO BE SUBMITTED WITH THE PROPOSAL

KCHA reserves the right to request additional information, if necessary, in order to complete the

evaluation and selection process. The Proposal must present the contractor’s experience and

qualifications to undertake the work specified above and should address, in order, the issues

described in each of the sections below. Respondents may incorporate additional information

relating to each of the sections outlined below to respond to the evaluation criteria. Respondents

choosing to provide additional materials, e.g., brochures, profiles, etc. should include them in a

separate section of the proposal.

1) Letter of Interest: The letter of interest should briefly summarize the Contractor’s

qualifications. An Officer of the Company authorized to execute contracts or other

similar agreements must sign the letter.

2) General qualifications, experience and fees:

Provide a description of the Contractor’s

a) History, experience, qualifications, procedures/ability to communicate effectively

with both residents and staff from diverse backgrounds.

History, experience, including experience working on feedback collection

methods targeting low-income families, people with disabilities, and/or people

with limited English language ability and on large projects;

Capacity to undertake this work;

b) Provide a project proposal that includes milestones, timeline, and associated costs.

c) Provide a list of clients of comparable size and scope that the Contractor has provided

similar services for within the last five years.

d) Provide two letters of reference dated after the release date of this RFP from two

recent clients, preferably from clients for whom you did similar work. Letters should

be on client’s letterhead and signed by appropriate representative.

e) Executed HUD form #5369-C “Certifications and Representations of Officers Non-

Construction Contract” in Exhibit C.

E. EVALUATION CRITERIA

All responses to this RFP that are received on or before the stated deadline will be evaluated by a review

panel according to the criteria listed below




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Criteria Points

a) History, experience, qualifications, procedures/ability to communicate effectively

with both residents and staff from diverse backgrounds.

History, experience, , including experience working on feedback collection

methods targeting low-income families, people with disabilities, and/or

people with limited English language ability and on large projects;

Capacity to undertake this work

25

b) Project proposal that includes milestones, timeline, and associated costs. 25

c) Provide a list of clients of comparable size and scope that the Contractor has

provided similar services for in the last five years.

10

d) Two letters of reference dated after the release date of this RFP from two recent

clients, preferably from clients for whom you did similar work. Letters should be on

client’s letterhead and signed by appropriate representative.

20

e) Executed HUD form #5369-C “Certifications and Representations of Officers Non-

Construction Contract” in Exhibit C.

5

f) Section 3 qualifications** 15

Total points available: 100 **See Exhibit B and attached documents for Section 3 of the Housing and Urban Development Act of 1968

requirements, preference for Section 3 businesses, evaluation instructions and documentation requirements.

Respondents who meet the Section 3 business categories must indicate in this proposal under which

category they are qualified and are responsible for providing all documentation or other information which

supports the respondent’s declared category.

F. INTERVIEWS

KCHA reserves the right to conduct interviews with any and all applicants submitting proposals.

Interviews shall take place after the evaluations by the review panel. The purpose of the interview is

to seek clarifications or to ask additional questions. The review panel reserves the right to change the

evaluation criteria scores based upon the results of the interview.




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G. CONDITIONS OF PROPOSAL:

See attached form HUD 5369-B “Instructions to Offerors, Non-Construction” (Exhibit E), form HUD

5369-C “Certification and Representations of Offeror, Non-Construction Contract” (Exhibit F), and

form HUD 5370-C “General Contract Conditions, Non-Construction” (Exhibit G).

In addition, KCHA reserves the right: 1) to reject/cancel any or all proposals; 2) to award the contract

to one contractor or a number of contractors; 3) to award the contract in different phases based on

budget condition; 4) to define and waive any informalities in the RFP; 5) to make a final judgment

whether the proposals are responsive or non-responsive to the RFP after carefully evaluating the RFP

results, and considering all of the factors; and 6) to make contract awards only to responsible/qualified

companies who meet KCHA’s standards for a specific project as indicated below. All non-responsive

proposals or proposals received from non-responsible or unqualified firms will be rejected.

KCHA also reserves the right to obtain clarification of any point in a contractor’s proposal or to obtain

additional information necessary to properly evaluate a particular proposal. Failure of a firm to

respond to such a request for additional information or clarification could result in rejection of the

firm’s proposal.

This RFP does not commit KCHA to pay any costs incurred by any firm in the submission or

presentation of a proposal, or in making the necessary studies for the preparation thereof.

H. CONTRACT NEGOTIATIONS AND ADDITIONAL REQUIREMENTS

The review panel will rate all proposals according to the evaluation criteria set forth above. KCHA

and the highest rated applicant(s) will negotiate the terms and conditions of a contract. KCHA

reserves the right to modify the scope of work, expand or modify the terms and conditions specifically

set forth in this RFP. In the event KCHA and the highest rated applicant(s) cannot agree on contract

terms and conditions acceptable to both parties, KCHA reserves the right, at its sole discretion, to enter

into negotiations with the next highest ranked applicant(s) and will be relieved of on any obligation to

negotiate with or contract for services with the highest ranked applicant(s).

In addition, prior to contract execution, the successful applicant must provide details on applicant’s

equipment and resources. At minimum, applicant must have her/his own computer, printer, high speed

internet connection (for online applications), fax, telephone, administrative support, etc. to use as a

resource for this job. Applicant is expected to work outside of KCHA offices and may come in to

KCHA offices for occasional meetings. KCHA will not reimburse for the purchase or maintenance of

equipment, standard computer programs/software, and/or costs related to telecommunications (phones,

fax, Internet connection, etc.).

I. INDEMNIFICATION AND HOLD HARMLESS

A. (Agency, Consultant, or Contractor - use as appropriate) agrees to defend, indemnify and hold

harmless KCHA, its officers, officials, employees, volunteers, partners, property managers,

lenders, and agents (“all hereafter Indemnities”) from and against any and all claims of third

parties for physical injury, including death, to persons or property to the extent caused by the

negligence of the (Agency, Consultant, or Contractor - use as appropriate) or its subcontractors,

employees, partners, volunteers, or agents, invitees, or anyone else acting on the (Agency’s,

Consultant’s, or Contractor’s - use as appropriate) behalf, in connection with the (Agency’s,

Consultant’s, or Contractor’s - use as appropriate) services and/or activities on KCHA property as

described in this Contract. Provided, however, that (Agency, Consultant, or Contractor - use as




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appropriate) shall not be required to indemnify any Indemnities against liability for damages

caused by or resulting from the concurrent negligence of Indemnities.

B. Furthermore, the (Agency, Consultant, or Contractor - use as appropriate) acknowledges that the

foregoing indemnity is specifically and expressly intended to constitute waiver of the (Agency,

Consultant, or Contractor - use as appropriate) immunity under Washington’s Industrial Act,

RCW Title 51, and that this waiver has been specifically negotiated and agreed upon by the

parties.

C. The (Agency, Consultant, or Contractor - use as appropriate) hereby agrees to require any

subcontractors in connection with or incidental to the performance of this Contract to execute an

indemnity clause identical to the preceding clause, specifically naming KCHA as indemnitee, and

failure to do so shall constitute a material breach of this Contract by the (Agency, Consultant, or

Contractor - use as appropriate).

J. GENERAL CONDITIONS

1) Basic Eligibility: The successful Agency must be licensed to do business in the State of

Washington, must have a state UBI number and be properly authorized and be licensed (if

required by law) to perform the services proposed. In addition, the successful respondent must

not be debarred, suspended or otherwise ineligible to contract with KCHA, and must not be

included on the General Services Administration’s (GSA) “List of Parties Excluded From Federal

Procurement and Nonprocurement Programs” or HUD’s “Limited Denial of Participation” list.

2) Addenda: In the event there are changes or clarifications to this RFP, KCHA shall issue an

addendum. Addenda will only be sent to those parties who have registered with KCHA as having

received an official copy of the RFP from KCHA. It is the responsibility of the respondent to

check with KCHA prior to submittal deadline to ensure that all addenda issued by KCHA have

been received or to call the KCHA contact named in this RFP.

3) Rights reserved by KCHA: KCHA reserves the right to waive any irregularities or informalities

in the RFP and to reject any and/or all Statements of Qualification. KCHA will generally not

disclose the number of responses received, the names of the respondents, or the status of

negotiations until the Executive Director or his assignee has approved the award of the contract.

4) Records made Public: All documents submitted to KCHA will become public record, as per

RCW 42.56. If you are submitting information which you think is “confidential” and/or

“proprietary” to your business, KCHA recommends that you do not submit that information and

KCHA cannot guarantee that type of information will be withheld from a public disclosure

request.

5) Payment Requirements: No advance payments will be made to the awarded Agency, who must

have the capacity to meet all expenses in advance of payments by KCHA.

6) Minority-owned and Women-owned Business Enterprises: KCHA strongly encourages

minority-owned and women-owned businesses, socially and economically disadvantaged

business enterprises, and small businesses to submit proposals, to participate as partners, or to

participate in other business activity in response to this RFP.

7) Section 3 Requirements: Section 3 of the Housing and Urban Development Act of 1968

requires that KCHA to the greatest extend feasible to provide employment opportunities to

Section 3 residents. Section 3 residents include residents of KCHA communities and other low

income residents of King County.

K. INSURANCE

General Requirements for Insurance: The (Agency, Consultant, or Contractor - use as appropriate)

shall procure and maintain for the duration of the Contract insurance against claims for injuries to




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persons or damages to property, which may arise from (i) the (Agency’s, Consultant’s, or Contractor’s

- use as appropriate) performance or non-performance under the Contract, or (ii) any basis in

connection with the Contract. All insurance shall be carried with companies that are financially

responsible and admitted to do business in the State of Washington, and carrying an A- : VII rating,

according to A.M. Best’s Insurance Rating Guide, most recent edition. The cost of such insurance

shall be borne solely by the (Agency, Consultant, or Contractor - use as appropriate).

Minimum Required Insurance Coverage and Limits:

Commercial General Liability: Commercial General Liability coverage with a minimum limit of

$1,000,000.00 per occurrence covering bodily injury, personal injury and property damage. Coverage

shall be on an “occurrence basis”.

Commercial Automobile Liability: Commercial Automobile Liability coverage (any auto) with a

minimum limit of $1,000,000 bodily injury and property damage liability - combined single-limit.

Coverage shall be on an “occurrence basis”.

Worker’s Compensation (Washington statutory) and Employer’s Liability: $1,000,000 per accident for

Bodily Injury or Disease.

The (Agency’s, Consultant’s, or Contractor’s - use as appropriate) general liability and automobile

liability policies shall contain, or be endorsed to contain clauses that implement or execute the

following:

(1) KCHA, its officers, officials, employees, partners, volunteers, and agents are to be covered as

additional insured with respect to liability arising out of, or in connection with, the

performance or non-performance under this Contact by the (Agency, Consultant, or Contractor

- use as appropriate) or by those acting on behalf of the (Agency, Consultant, or Contractor -

use as appropriate).

(2) The (Agency’s, Consultant’s, or Contractor’s - use as appropriate) insurance coverage shall be

primary insurance as respects KCHA, et al, and any insurance or self-insurance maintained or

expired by Indemnitees shall be excess of the (Agency’s, Consultant’s, or Contractor’s - use as

appropriate) insurance and shall not contribute with it.

(3) Each insurance policy required by this clause shall be endorsed to state that coverage shall not

be canceled or materially changed, except after thirty (30) days [ten (10) days for cancellation

for non-payment of premium] prior written notice by certified mail, return receipt requested,

has been given to KCHA.

Maintenance of Insurance: Maintenance of the proper insurance for the duration of the Contract is a

material element of the Contract. Material changes in the required coverage or cancellation of the

coverage shall constitute a material breach of the Contract.

Deductibles and Self-insured Retentions: Deductibles and self-insured retentions in excess of

$25,000 must be declared to and approved by KCHA. At KCHA’s discretion, either (i) the insurer

may be required to reduce or eliminate such deductibles or self-insured retentions as respects KCHA,

et al, or (ii) the Agency may be required to provide financial guarantee satisfactory to KCHA

guaranteeing payment for losses and expenses incurring within the subject deductibles and self-insured

retentions.




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Certificates of Insurance and Endorsements: The (Agency, Consultant, or Contractor - use as

appropriate) and each subcontractor shall furnish KCHA with certificates of insurance and relevant

endorsements as proof the required insurance is in force. All certificates and endorsements shall be

provided KCHA in sufficient time to permit the (Agency, Consultant, or Contractor - use as

appropriate) to correct any deficiencies before performance commences under the Contract. KCHA

reserves the right to require at any time the production of certified copies of (Agency’s, Consultant’s,

or Contractor’s - use as appropriate), insurance policies and endorsements, or pertinent parts thereof,

related to insurance required under the Contract.

Verification of Coverage

Company shall furnish KCHA with original certificates of insurance and amendatory endorsements

effecting coverage required by this clause. All endorsements are to be received and approved by

KCHA before the Company’s products and/or services are delivered. KCHA reserves the right to

require complete, certified copies of all required insurance policies, or pertinent parts thereof,

including endorsements affecting the coverage required by these specifications at any time.

L. SUBCONTRACTORS

Any subcontractor shall include contractor as Additional Insured under its policies. Contractor shall

be responsible for subcontractor complying with such requirement, and failure to confirm compliance

shall constitute breach of contract by the Contractor. All coverage for subcontractors shall be subject

to all the requirements stated herein.

M. FAIR HOUSING Subject: Accessibility Notice: Section 504 of the Rehabilitation Act of 1973; the Americans with

Disabilities Act of 1990; the Architectural Barriers Act of 1968 and the Fair Housing Act of 1988.

Purpose: The purpose of this Notice is to remind recipients of Federal funds (in this instance, the

Public Housing Authority) of their obligation to comply with pertinent laws and implementing

regulations which provide for non-discrimination and accessibility in Federally funded housing and

non-housing programs for people with disabilities.

Notifications: Public housing agencies (PHAs) and other recipients of Federal PIH funds are

responsible for providing this Notice to all current and future contractors participating in covered

programs/activities or performing work covered under the above subject legislation and implementing

regulations.

To read the full text of the Notice: Go to www.kcha.org, click on “Doing Business with the King

County Housing Authority” and then click on and read “Fair Housing/Accessibility Notice.”

N. COOPERATIVE PURCHASE:

This bid and contract may be anticipated for use by other government agencies. The host agency of

this bid and contract has entered into intergovernmental (Interlocal) purchasing agreements pursuant

to RCW 39.34 with other government agencies. Interlocal purchasing agreements allow either party

to make purchases at the other party's accepted bid price. By submitting an Offer, the Consultant

agrees to make the same bid terms and price, exclusive of freight and transportation fees, available to

other such governmental agencies. The host agency will in no way whatsoever incur any liability in

relation to specifications, delivery, payment, or any other aspect of purchases by such agencies.

http://www.kcha.org/



EXHIBIT A - FEE SCHEDULE

Phone:

Email:

WMBE (This is for informational purposes only) .

Is your Company a woman and/or minority owned business? Yes No

Unit Price/Unit

1. Personnel/Staffing

2.

3.

4.

5.

1.

2.

3.

5

Contact:

Applicant:

Address:

Itemize hourly rates for services

Description

Other Charges (please itemize other expenses and rate/unit)

4

____________________________________________

King County Housing Authority

RFP - Resident Feedback Effort

Exhibit A - Fee Schedule

Page 1 of 1



EXHIBIT B-1 – SECTION 3 CLAUSE

____________________________________________

King County Housing Authority RFP - Resident Feedback Effort

Exhibit B-1 – Section 3 Clause

A. The work to be performed under this contract is subject to the requirements of Section 3 of the Housing

and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (Section 3). The purpose of Section 3 is

to ensure that employment and other economic opportunities generated by HUD assistance or HUD-assisted

projects covered by Section 3, shall, to the greatest extent feasible, be directed to low- and very low-income

persons, particularly persons who are recipients of HUD assistance for housing.

B. The parties to this contract agree to comply with HUD's regulations in 24 CFR part 135, which implement

Section 3. As evidenced by their execution of this contract, the parties to this contract certify that they are

under no contractual obligation or other impediment that would prevent them from complying with the part

135 regulations.

C. The contractor agrees to send to each labor organization or representative of workers with which the

contractor has a collective bargaining agreement or other understanding, if any, a notice advising the labor

organization or workers' representative of the contractor's commitments under this Section 3 clause, and will

post copies of the notice in conspicuous places at the work site where both employees and applicants for

training and employment positions can see the notice. The notice shall describe the Section 3 preference,

shall set forth minimum number and job titles subject to hire, availability of apprenticeship and training

positions, the qualifications for each; and the name and location of the person(s) taking applications for each

of the positions; and the anticipated date the work shall begin.

D. The contractor agrees to include this Section 3 clause in every subcontract subject to compliance with

regulations in 24 CFR part 135, and agrees to take appropriate action, as provided in an applicable provision

of the subcontract or in this Section 3 clause, upon a finding that the subcontractor is in violation of the

regulations in 24 CFR part 135. The contractor will not subcontract with any subcontractor where the

contractor has notice or knowledge that the subcontractor has been found in violation of the regulations in 24

CFR part 135.

E. The contractor will certify that any vacant employment positions, including training positions, that are

filled (1) after the contractor is selected but before the contract is executed, and (2) with persons other than

those to whom the regulations of 24 CFR part 135 require employment opportunities to be directed, were not

filled to circumvent the contractor's obligations under 24 CFR part 135.

F. Noncompliance with HUD's regulations in 24 CFR part 135 may result in sanctions, termination of this

contract for default, and debarment or suspension from future HUD assisted contracts.

G. With respect to work performed in connection with Section 3 covered Indian housing assistance, Section

7(b) of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450e) also applies to the

work to be performed under this contract. Section 7(b) requires that to the greatest extent feasible (i)

preference and opportunities for training and employment shall be given to Indians, and (ii) preference in the

award of contracts and subcontracts shall be given to Indian organizations and Indian-owned Economic

Enterprises. Parties to this contract that are subject to the provisions of Section 3 and Section 7(b) agree to

comply with Section 3 to the maximum extent feasible, but not in derogation of compliance with Section

7(b).



EXHIBIT B-2 – SECTION 3 SUPPLEMENTAL INSTRUCTIONS TO APPLICANTS

____________________________________________


Exhibit B-2 – Section 3 Supplemental Instructions to Applicants

The Owner’s, or King County Housing Authority’s (KCHA), goal for this project is to participate in Section 3

activities by including efforts that will provide employment opportunities to Section 3 residents and contracting

opportunities to Section 3 businesses. (Section 3 Residents and Section 3 Businesses are defined below and in 24

CFR 135.)

The Contractor and its Subcontractors at all tiers for this specific contract will partner with the Owner to contribute

to the Owner’s overall “Section 3” goals, as described below.

Because local hiring and contracting requirements are defined under Section 3 of the Housing and Community

Development Act of 1968, these requirements are commonly referred to as Section 3. The definitions and goals are

defined in Sections A and B below. Section C describes the process. Section D discusses consequences of non-

compliance with Section 3 goals and Section E describes some local hiring resources. For more information on the

Owner’s employment and training efforts, or compliance with Section 3, please contact: Andrew Zimmerman by

email at [email protected] or by telephone at 206-574-1217.

A. Section 3 Definitions

For the purposes of this solicitation:

1. Section 3 resident means:

i. a public housing resident; or

ii. an individual who resides in the metropolitan area or non-metropolitan county in which the

proposed contract will be performed and is a low-income or very low-income person (80

percent of the area median income or less, based on household size).

2. Business concern means a business entity formed in accordance with State law, and which is

licensed under State, county, or municipal law to engage in the type of business activity for which

it was formed.

3. Section 3 business means a business:

i. that is 51% or more owned by KCHA residents at the site(s) where the work will take place

or 30% or more of the business’ regular, full-time employees reside at the sites(s) where the

work will take place (Category 1); or

ii. that is 51% or more owned by KCHA residents at other KCHA developments or 30% or

more of business’ regular, full time, employees reside at other KCHA developments

(Category 2); or

iii. that is a HUD Youthbuild company (Category 3); or

iv. that is 51% or more owned by a Section 3 person, or 30% or more of business’s regular,

full time employees are Section 3 persons, or plans to subcontract 25% or more of the

estimated contract value to Category 1 or 2 businesses (Category 4); or

v. that will subcontract 25% or more to Category 3 or 4 businesses (Category 5).

4. The greatest extent feasible means:

a. Completing and submitting a Section 3 Work Plan to designated Owner staff prior to contract

signing (template to be provided by the Owner).

b. If contracting with Section 3 businesses:

i. Placing qualified business enterprises on solicitation lists.

ii. Dividing total requirements, when economically feasible, into smaller tasks or

quantities to permit maximum participation of qualified Section 3 businesses.

iii. Using the services and assistance of the U.S. Small Business Administration, the

Minority Business Development Agency of the U.S. Department of Commerce and





____________________________________________



State and local governmental small business agencies to identify potential Section 3

businesses.

iv. Ensuring that small and minority businesses and women’s business enterprises are

solicited whenever they are potential sources.

c. If hiring Section 3 residents:

i. Post job opportunities for a mutually agreed upon length of time through the Owner’s

employment agency service partners and at project site as appropriate.

ii. Conduct interviews with qualified Section 3 residents.

iii. Notify designated Owner (KCHA) staff of all new hires.

d. For both: Complete Section 3 compliance and tracking paperwork as necessary.

B. Section 3 Goals

The Owner will require, to the greatest extent feasible, for the Contractor to demonstrate participation in

the local hiring and contracting requirements as defined under Section 3 of the Housing and Community

Development Act of 1968.

1. Bidders shall demonstrate compliance with the Section 3 goals by making a best faith effort to

achieve the following goals:

a. Employment of Section 3 Residents: fill a minimum of 30% of the aggregate number of new

positions which result from the work performed under this contract with Section 3 residents;

and

b. Contracts with Section 3 business concerns: subcontract for at least 10% of the total dollar

amount of this contract with one or more Section 3 business concerns.

2. The successful bidder and covered subcontractors shall direct their efforts to provide Section 3

employment opportunities to Section 3 residents in the following order of priority:

First Priority: Current residents of KCHA development(s) benefitting from project.

Second Priority: Other Owner public housing and Section 8 voucher-assisted residents.

Third Priority: Participants in HUD Youthbuild programs.

Fourth Priority: Other low or very low income individuals in the Housing Authorities

metropolitan area (Puget Sound region) who are at or below the Area’s Low Income

calculation.

3. The Contractor and covered subcontractors shall direct their efforts to award contracts to Section 3

business concerns in the following order of priority:

First Priority: A subcontractor that is 51% or more owned by KCHA residents at the site(s)

where the work will take place or 30% or more of the business’ regular, full-time employees

reside at the sites(s) where the work will take place.

Second Priority: A subcontractor that is 51% or more owned by KCHA residents at other

KCHA developments or 30% or more of business’ regular, full time, employees reside at

other KCHA developments.

Third Priority: A subcontractor that is a HUD Youthbuild company.

Fourth Priority: a subcontractor that is 51% or more owned by a Section 3 person, or 30%

or more of business’s regular, full time employees are Section 3 persons, or plans to

subcontract 25% or more of the estimated contract value to Category 1 or 2 businesses.

Fifth Priority: a subcontractor that will subcontract 25% or more to Category 3 and 4

businesses.

C. The Process (The following is applicable for contracts valued over $500,000)

1. Section 3 orientation with Owner. Once the Notice of Award has been issued to the successful

bidder/contractor, Owner’s staff will contact that bidder/contractor and arrange for a meeting to

discuss local hiring and contracting goals and strategies in greater detail. At this meeting, the




____________________________________________



bidder/contractor will be provided a packet that will include a Section 3 overview, Section 3

certification form, and all Section 3 compliance and tracking forms that will be used throughout the

contract.

2. Contractor reports on Section 3 utilization monthly.

FOR CONTRACTS EXCEEDING $500K ONLY:

3. Contractor submits Section 3 Work Plan, including hiring and subcontracting activities, prior to

contract execution. Owner reviews and approves work plan prior to contract execution. Section 3

Work Plan shall be included in contract. Owner issues Notice to Proceed, providing all

requirements are met. .

4. Section 3 Work Plan implemented throughout the duration of contract.

D. Penalties for Non-compliance

Owner’s commitment to this program is reflected in part by the cost of administering the program. Failure

to make a good faith effort to the greatest extent feasible above negates such funding and impairs the

Owner’s efforts to promote workforce diversity and to provide fair and equal opportunities to the public as

a whole as a result of the expenditure of public funds. Therefore, if awarded this contract, the parties will

mutually agree that failure to meet the requirements, including but not limited to the submission of required

documentation, constitutes a material breach of contract. In the event of such breach, Owner may take any

or all of the actions as contained in the contract documents.

E. Local Hiring Resources:

Contact Andrew Zimmerman by email at [email protected] to obtain a list of local hiring resources.




EXHIBIT B-3 – SECTION 3 INCOME GUIDELINES

Location Income

limit

1 person 2 person 3 person 4 person 5 person 6 person 7 person 8 person

30% of

median$17,400 $19,850 $22,350 $25,100 $29,420 $33,740 $38,060 $42,380

Very low

income$28,950 $33,050 $37,200 $41,300 $44,650 $47,950 $51,250 $54,550

Low

income$46,300 $52,900 $59,500 $66,100 $71,400 $76,700 $82,000 $87,300

30% of

median$22,500 $25,700 $28,900 $32,100 $34,700 $37,250 $39,850 $42,400

Very low

income$37,450 $42,800 $48,150 $53,500 $57,800 $62,100 $66,350 $70,650

Low

income$56,200 $64,200 $72,250 $80,250 $86,700 $93,100 $99,550 $105,950

30% of

median$15,700 $17,950 $20,780 $25,100 $29,420 $33,740 $38,060 $42,380

Very low

income$26,150 $29,850 $33,600 $37,300 $40,300 $43,300 $46,300 $49,250

Low

income$41,800 $47,800 $53,750 $59,700 $64,500 $69,300 $74,050 $78,850

Tacoma

(Pierce County)

Residents of the following metropolitan area and nonmetropolitan county may be qualified as a Section 3 resident.

Bremerton Silverdale

(Kitsap County)

Seattle Bellevue

Everett

(King/Snohomish

Counties)


RFP - Resident Feedback Effort

Exhibit B-3 – Section 3 Income Guidelines



EXHIBIT B-4 – SECTION 3 BUSINESS CERTIFICATION

____________________________________________


Exhibit B-4 – Section 3 Business Certification

Section 3 - Business Certification Form

Company Name: ________________________________ Contact Name: _________________________________

Address: ____________________________________________________ Phone: _______________________ ___

Current Number of Regular, Full-Time Employees (Puget Sound Region): _______________

Type of Trade or Business: _______________________________________________________________________

Project: ______________________________________________________________________________________

1. Is 51% or more of your business owned by KCHA residents at the site(s) where the work will take place or are 30% or more of the business’ regular, full-time employees residents at the sites(s) where the work will take place?

_____ Yes _____ No If “yes” is checked, submit the Section 3 Individual Certification form(s) for all regular, full time employees (Puget Sound region).

2. Is 51% or more of your business owned by KCHA residents at other KCHA developments or are 30% or more of your business’ regular, full time, employees KCHA residents at other KCHA developments?

_____ Yes _____ No If “yes” is checked, submit the Section 3 Individual Certification form(s) for all regular, full time employees (Puget Sound region).

3. Does your company offer a HUD Youthbuild Program?

_____ Yes _____ No If “yes” is checked, please provide supporting documentation.

4. Is 51% or more of your business owned by a Section 3 person (A person who earns 80% or less of the median income level for a household of her/his size over the past 12 months)? See attached income guidelines), or are 30% or more of your business’s regular, full time employees Section 3 persons, or do you plan on subcontracting 25% or more of the estimated contract value to Section 3 Category 1 or Category 2 businesses?

_____ Yes _____ No If “yes” is checked, please submit either the Section 3 Individual Certification form(s) or the Section 3 Subcontractor Business work plan form.

5. Do you plan to subcontract 25% or more to Section 3 Category 3 or Category 4 businesses?

_____ Yes _____ No If “yes” is checked, please submit either the Section 3 Individual Certification form(s) or the Section 3 Subcontractor Business work plan form.

I certify, under penalty of perjury, that my company ______ (Is/is not) a Section 3 business.

I further certify that, if my company is awarded the bid, and needs to hire additional employees for the project, we will carry out Section 3 hiring, training and subcontracting requirements to the best of our ability.

Signature: _________________________________ Date: _________________________________

Print Name: _________________________________ Email: _________________________________

Phone Number: _________________________________ Title: _________________________________

If you have more specific questions about Section 3 requirements, contact Andrew Zimmerman by email at [email protected] or by phone at 206-574-1217.




EXHIBIT B-5 – SECTION 3 SUBCONTRACTOR WORK PLAN

____________________________________________


RFP - Resident Feedback Effort Exhibit B-5 – Section 3 Subcontractor Work Plan

Rev: 2015

SECTION 3 SUBCONTRACTOR WORK PLAN

Return this form with the bid if claiming “yes” to question 4 or 5 on the Section 3 Business Certification form.

Company name, address, phone, fax, email Subcontracted tasks Dollar value Percentage

of overall

contract

TOTAL CONTRACT VALUE: $

TOTAL SUBCONTRACT VALUE: $

% OF TOTAL BID: %

For a list of Section 3 certified businesses, contact Andrew Zimmerman by email at [email protected] or by

phone at 206-574-1217.




EXHIBIT B-6 – SECTION 3 INDIVIDUAL CERTIFICATION

____________________________________________


RFP - Resident Feedback Effort Exhibit B-6 – Section 3 Individual Certification

2018 Version

Section 3 - Individual Certification Form

Section 3 of the Housing and Urban Development (HUD) Act of 1968, as amended, requires that Housing Authorities and agencies receiving HUD funding, to the greatest extent feasible, provide economic opportunities to low-income persons. Information provided on this form shall remain confidential and be used for reporting purposes only.

Please provide us with the following information if you are (filling) a full time regular, temporary or seasonal position (Please print):

Name: _________________________________________ Email: ________________________________________

Address: __________________________________________________ Phone: _____________________________

Employer/Company Name: ______________________________________________________________________

Hire Date: ___________________________ Position Title: _____________________________________________

Project: ______________________________________________________________________________________

1. I am a resident in a KCHA Property. _____ Yes _____ No

(If Yes, please list the name of the property and skip Questions 2, 3, and 4 and sign at the bottom)

Property Name: _________________________________________

2. I am currently in KCHA’s Section 8 Program. _____ Yes _____ No

(If Yes, Please skip question 3, and 4 and sign at the bottom)

3. I am a participant in a HUD Youthbuild Program. _____ Yes _____ No

(If Yes, please skip question 4 and sign the bottom)

4. Based on the chart below, my total household income level, _____ Yes _____ No for the past 12 months, was at or below the incomes listed below. Circle the income that best applies to your household (Income from unrelated persons, e.g., roommates, does not count).

2018 income Guidelines

I hereby certify under the penalty of perjury that the information above is true and correct and my total household income, for the last 12 months, has been at or below the income limits designated above.

Signature: __________________________________________________ Date: ___________________

If submitting for a new hire, attach completed forms to New Hire Status Report and submit to project manager. If submitting for Section 3 Business qualification, attach to Section 3 Business Certification Form. If submitting for general Section 3 certification, send to Andrew Zimmerman, Section 3 Coordinator, 700 Andover Park W., Tukwila, WA 98188. For questions, please contact Andrew Zimmerman by email at [email protected] or phone at 206-574-1217.

REGION – AREA 1

PERSON

2

PERSONS

3

PERSONS

4

PERSONS

5

PERSONS

6

PERSONS

7

PERSONS

8

PERSONS Seattle-Bellevue-Everett $56,200 $64,200 $72,250 $80,250 $86,700 $93,100 $99,550 $105,950

Tacoma $41,800 $47,800 $53,750 $59,700 $64,500 $69,300 $74,050 $78,850

Bremerton $46,300 $52,900 $59,500 $66,100 $71,400 $76,700 $82,000 $87,300




EXHIBIT B-7 – SECTION 3 EVALUATION CRITERIA


Exhibit B-7 – Section 3 Evaluation Criteria

Page 1 of 1

Section 3 Business qualifications. For points awarded, see below.

Your business may or may not qualify for only one of the categories below. The points assigned for each

category will not be changed by the scoring committee. In order to receive Section 3 points, your business

must complete the KCHA Section 3 certification process and receive certification from KCHA.

Certification is recommended prior to the submission of an application/bid. Failing to do so may result

in not receiving Section 3 points during the bid evaluation process. To get certified, please contact KCHA’s

Section 3 Coordinator (see below).

Section 3 business—Category I

1) 51% or more owned by KCHA residents at the site where the work will take place, or

2) 30% or more of the business’s permanent, full time employees are KCHA residents at

the site where the work will take place.

15%

Section 3 business—Category II

1) 51% or more owned by KCHA residents at other KCHA developments, or

2) 30% or more of the business’s permanent, full time employees are KCHA residents at

other KCHA developments.

12%

Section 3 business---Category III

HUD Youthbuild program

9%

Section 3 business—Category IV

1) 51% or more owned by Section 3 persons, or

2) 30% or more of the business’s permanent, full time employees are Section 3 persons, or

3) 25% or more of the contract value will be subcontracted to Section 3 businesses to

Category I or II businesses.

6%

Section 3 business—Category V

1) subcontract in excess of 25% to Category III or Category IV (of items 1 and 2 in

category IV) businesses.

3%

If you have further questions on Section 3 requirements, please contact Andrew Zimmerman, Section 3

Coordinator, at 206-574-1217 or [email protected].

Be sure to sign and return the Section 3 Business Certification Form in this proposal.


REQUEST FOR QUALIFICATIONS


EXHIBIT C – EQUAL OPPORTUNITY CLAUSE


RFQ – Resident Feedback Effort Exhibit C – Equal Opportunity Clause

Page 1 of 1

RETURN WITH PROPOSAL

During the performance of this Contract, the Contractor agrees as follows:

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

color, religion, sex, or national origin, citizenship status, creed, age, marital status, physical or mental

disability, sexual orientation, political ideology, or status as a Vietnam era or specially disabled veteran.

The Contractor will take affirmative action to ensure that applicants are employed and the employees are

treated during employment without regard to the aforementioned conditions. Such action shall include, but

not be limited to, the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment

advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training,

including apprenticeship. The Contractor agrees to post in conspicuous places, available to employees and

applicants for employment, notices to be provided by the Contracting Officer setting forth the provisions of

this nondiscrimination clause.

2. The Contractor will, in all solicitations or advertisements for employees placed by or on behalf of the

Contractor, state that all qualified applicants will receive consideration for employment without regard to

the aforementioned conditions of paragraph 1. above.

3. The Contractor will send to each labor union or representative of workers with which he/she has a

collective bargaining agreement or other contract or understanding, a notice to be provided by the

Department's Contracting Officer, advising the labor union or workers' representative of the Contractor's

commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of

the notice in conspicuous places available to employees and applicants for employment.

4. The Contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of

the rules, regulations and relevant orders of the Secretary of Labor.

5. The Contractor will furnish all information and reports required by Executive Order 11246 of September

24, 1965, and by the rules, regulations and relevant orders of the Secretary of Labor, or pursuant thereto,

and will permit access to his/her books, records and accounts by the Department and the Secretary of Labor

for purposes of investigation to ascertain compliance with such rules, regulations and orders.

6. In the event of the Contractor's non-compliance with the non-discrimination clauses of the Contract or with

any of such rules, regulations or orders, this Contract may be canceled, terminated or suspended in whole

or in part and the Contractor may be declared ineligible for further Government Contracts, in accordance

with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions

may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by

rules, regulation, or order of the Secretary of Labor, or as otherwise provided by law.

7. The Contractor will include the provisions of paragraphs (1) through (7) in every subcontract or purchase

order unless exempted by rules, regulation, or order of the Secretary of Labor issued pursuant to Section

204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each

subcontractor or vendor. The Contractor will take such action with respect to any subcontract or purchase

order as the Department may direct as a means of enforcing such provisions including sanctions for

noncompliance: Provided, however, that in the event the Contractor becomes involved in, or is threatened

with, litigation with a subcontractor or vendor as a result of such direction by the Department, the

Contractor may request the United States to enter into such litigation to protect the interests of the United

States.

By: Title:

(Please Print) Signature: Date:

form HUD-5369-C (8/93)ref. Handbook 7460.8Previous edition is obsolete page 1 of 2

1. Contingent Fee Representation and Agreement

(a) The bidder/offeror represents and certifies as part of its bid/offer that, except for full-time bona fide employees workingsolely for the bidder/offeror, the bidder/offeror:

(1) [ ] has, [ ] has not employed or retained any person orcompany to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any personor company employed or retained to solicit or obtain thiscontract any commission, percentage, brokerage, or otherfee contingent upon or resulting from the award of thiscontract.

(b) If the answer to either (a)(1) or (a) (2) above is affirmative,the bidder/offeror shall make an immediate and full writtendisclosure to the PHA Contracting Officer.

(c) Any misrepresentation by the bidder/offeror shall give thePHA the right to (1) terminate the resultant contract; (2) at itsdiscretion, to deduct from contract payments the amount of anycommission, percentage, brokerage, or other contingent fee; or(3) take other remedy pursuant to the contract.

2. Small, Minority, Women-Owned Business Concern Rep-resentation

The bidder/offeror represents and certifies as part of its bid/ offerthat it:

(a) [ ] is, [ ] is not a small business concern. “Small businessconcern,” as used in this provision, means a concern, includ-ing its affiliates, that is independently owned and operated,not dominant in the field of operation in which it is bidding,and qualified as a small business under the criteria and sizestandards in 13 CFR 121.

(b) [ ] is, [ ] is not a women-owned small business concern.“Women-owned,” as used in this provision, means a smallbusiness that is at least 51 percent owned by a woman orwomen who are U.S. citizens and who also control andoperate the business.

(c) [ ] is, [ ] is not a minority enterprise which, pursuant toExecutive Order 11625, is defined as a business which is atleast 51 percent owned by one or more minority groupmembers or, in the case of a publicly owned business, at least51 percent of its voting stock is owned by one or moreminority group members, and whose management and dailyoperations are controlled by one or more such individuals.

For the purpose of this definition, minority group members are:

(Check the block applicable to you)

[ ] Black Americans [ ] Asian Pacific Americans

[ ] Hispanic Americans [ ] Asian Indian Americans

[ ] Native Americans [ ] Hasidic Jewish Americans

3. Certificate of Independent Price Determination

(a) The bidder/offeror certifies that—

(1) The prices in this bid/offer have been arrived at indepen-dently, without, for the purpose of restricting competi-tion, any consultation, communication, or agreementwith any other bidder/offeror or competitor relating to (i)those prices, (ii) the intention to submit a bid/offer, or(iii) the methods or factors used to calculate the pricesoffered;

(2) The prices in this bid/offer have not been and will not beknowingly disclosed by the bidder/offeror, directly orindirectly, to any other bidder/offeror or competitor be-fore bid opening (in the case of a sealed bid solicitation)or contract award (in the case of a negotiated solicitation)unless otherwise required by law; and

(3) No attempt has been made or will be made by the bidder/offeror to induce any other concern to submit or not tosubmit a bid/offer for the purpose of restricting competition.

(b) Each signature on the bid/offer is considered to be a certifi-cation by the signatory that the signatory:

(1) Is the person in the bidder/offeror’s organization respon-sible for determining the prices being offered in this bidor proposal, and that the signatory has not participatedand will not participate in any action contrary to subpara-graphs (a)(l) through (a)(3) above; or

(2) (i) Has been authorized, in writing, to act as agent for thefollowing principals in certifying that those principalshave not participated, and will not participate in anyaction contrary to subparagraphs (a)(l) through (a)(3)above (insert full name of person(s) in the bidder/offeror’sorganization responsible for determining the prices of-fered in this bid or proposal, and the title of his or herposition in the bidder/offeror’s organization);

(ii) As an authorized agent, does certify that the princi-pals named in subdivision (b)(2)(i) above have not par-ticipated, and will not participate, in any action contraryto subparagraphs (a)(l) through (a)(3) above; and

U.S. Department of Housingand Urban DevelopmentOffice of Public and Indian Housing

Certifications andRepresentationsof OfferorsNon-Construction Contract

Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searchingexisting data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

This form includes clauses required by OMB’s common rule on bidding/offering procedures, implemented by HUD in 24 CFR 85.36, and those requirementsset forth in Executive Order 11625 for small, minority, women-owned businesses, and certifications for independent price determination, and conflict of interest.The form is required for nonconstruction contracts awarded by Housing Agencies (HAs). The form is used by bidders/offerors to certify to the HA's ContractingOfficer for contract compliance. If the form were not used, HAs would be unable to enforce their contracts. Responses to the collection of information arerequired to obtain a benefit or to retain a benefit. The information requested does not lend itself to confidentiality.

form HUD-5369-C (8/93)ref. Handbook 7460.8Previous edition is obsolete page 2 of 2

(iii) As an agent, has not personally participated, and willnot participate in any action contrary to subparagraphs(a)(l) through (a)(3) above.

(c) If the bidder/offeror deletes or modifies subparagraph (a)2above, the bidder/offeror must furnish with its bid/offer asigned statement setting forth in detail the circumstances ofthe disclosure.

4. Organizational Conflicts of Interest Certification

(a) The Contractor warrants that to the best of its knowledge andbelief and except as otherwise disclosed, it does not have anyorganizational conflict of interest which is defined as asituation in which the nature of work under a proposedcontract and a prospective contractor’s organizational, fi-nancial, contractual or other interest are such that:

(i) Award of the contract may result in an unfair competi-tive advantage;

(ii) The Contractor’s objectivity in performing the con-tract work may be impaired; or

(iii) That the Contractor has disclosed all relevant infor-mation and requested the HA to make a determinationwith respect to this Contract.

(b) The Contractor agrees that if after award he or she discoversan organizational conflict of interest with respect to thiscontract, he or she shall make an immediate and full disclo-sure in writing to the HA which shall include a description ofthe action which the Contractor has taken or intends toeliminate or neutralize the conflict. The HA may, however,terminate the Contract for the convenience of HA if it wouldbe in the best interest of HA.

(c) In the event the Contractor was aware of an organizationalconflict of interest before the award of this Contract andintentionally did not disclose the conflict to the HA, the HAmay terminate the Contract for default.

(d) The Contractor shall require a disclosure or representationfrom subcontractors and consultants who may be in a positionto influence the advice or assistance rendered to the HA andshall include any necessary provisions to eliminate or neutralizeconflicts of interest in consultant agreements or subcontractsinvolving performance or work under this Contract.

5. Authorized Negotiators (RFPs only)

The offeror represents that the following persons are authorizedto negotiate on its behalf with the PHA in connection with thisrequest for proposals: (list names, titles, and telephone numbersof the authorized negotiators):

6. Conflict of Interest

In the absence of any actual or apparent conflict, the offeror, bysubmission of a proposal, hereby warrants that to the best of itsknowledge and belief, no actual or apparent conflict of interestexists with regard to my possible performance of this procure-ment, as described in the clause in this solicitation titled “Orga-nizational Conflict of Interest.”

7. Offeror's Signature

The offeror hereby certifies that the information contained inthese certifications and representations is accurate, complete,and current.

Signature & Date:

Typed or Printed Name:

Title:

Previous edition is obsolete form HUD 50071 (01/14) ref. Handbooks 7417.1, 7475.13, 7485.1, & 7485.3

OMB Approval No. 2577-0157 (Exp. 01/31/2017)

Certification of Payments to Influence Federal Transactions

U.S. Department of Housing and Urban Development Office of Public and Indian Housing

Applicant Name

Program/Activity Receiving Federal Grant Funding

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

an agency, a Member of Congress, an officer or employee of

Congress, or an employee of a Member of Congress in connec-

tion with the awarding of any Federal contract, the making of any

Federal grant, the making of any Federal loan, the entering into

of any cooperative agreement, and the extension, continuation,

renewal, amendment, or modification of any Federal contract,

grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have

been paid or will be paid to any person for influencing or

attempting to influence an officer or employee of an agency, a

Member of Congress, an officer or employee of Congress, or an

employee of a Member of Congress in connection with this

Federal contract, grant, loan, 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 subawards

at all tiers (including subcontracts, subgrants, and contracts

under grants, loans, and cooperative agreements) and that all

sub recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which

reliance was placed when this transaction was made or entered

into. Submission of this certification is a prerequisite for making

or entering into this transaction imposed by Section 1352, Title

31, U.S. Code. Any person who fails to file the required

certification shall be subject to a civil penalty of not less than

$10,000 and not more than $100,000 for each such failure.

I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802)

Name of Authorized Official Title

Signature Date (mm/dd/yyyy)

DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB

Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046

(See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. contract a. bid/offer/application a. initial filing b. grant b. initial award b. material change c. cooperative agreement c. post-award For Material Change Only: d. loan year _________ quarter _________ e. loan guarantee date of last report ______________ f. loan insurance

4. Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is a Subawardee, Enter Name and Address of Prime:

Tier ______, if known :

Congressional District, if known : 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 Registrant b. Individuals Performing Services (including address if ( if individual, last name, first name, MI): different from No. 10a )

(last name, first name, MI ):

11. Signature:

Print Name:

Title:

Telephone No.: _______________________

Authorized for Local Reproduction

Standard Form LLL (Rev. 7-97)

Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be available for public inspection. required disclosure shall be subject to a not more than $100,000 for each such failure.

Prime Subawardee

Federal Use Only:

Date:

who fails to file the Any person $10,000 and than civil penalty of not less

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 filing, 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 employeeof any agency, a Member of Congress, an officer or employeeof Congress, or an employeeof a Member of Congress in connectionwith a coveredFederalaction. Completeall items that apply for both the initial filing and 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 appropriateclassification of this report. If this is a followup 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 CongressionalDistrict, if known. Check the appropriateclassification 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 1st 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 organizationallevel 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; the 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 of the lobbying registrant under the Lobbying Disclosure Act of 1995 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 address if different from 10 (a). Enter Last Name, First Name, and Middle Initial (MI).

11. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

According to the Paperwork Reduction Act, as amended, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The valid OMB control number for this information collection is OMB No. 0348-0046. Public reporting burden for this collection of information is estimated to average 10 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 Project (0348-0046), Washington, DC 20503.

request for proposal for resident feedback effort for … · hathaway in writing, either through us...

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