Pierce County
Questionnaire
Community Mobilization Services
26-001-MCE-CMS
Project Questions
1
Proposer Confirmation
Type: confirmation
As an authorized representative of the proposer, having carefully examined the Request for Proposals, propose to furnish services in accordance therewith as set forth in the attached proposal.I further agree that this proposal will remain in effect for not less than sixty (60) calendar days from the date that proposals are due, and that this proposal may not be withdrawn or modified during that time.I hereby certify that this proposal is genuine and not a false or collusive proposal, or made in the interests or on behalf of any person not therein named; and I have not directly or indirectly induced or solicited any Contractor or supplier on the above work to put in a false proposal or any person or corporation to refrain from submitting a proposal; and that I have not in any manner sought by collusion to secure to myself an advantage over any other contractor(s) or person(s).In order to induce the County to consider this proposal, the proposer irrevocably waives any existing rights which it may have, by contract or otherwise, to require another person or corporation to refrain from submitting a proposal to or performing work or providing supplies to Pierce County, and proposer further promises that it will not in the future directly or indirectly induce or solicit any person or corporation to refrain from submitting a response or proposal to or from performing work or providing supplies to Pierce County.
2
Ownership and Copyright of Submitted Materials
Type: confirmation
By submitting a proposal, I agree that all documents, reports, proposals, submittals, working papers, or other materials prepared by the applicant pursuant to this proposal shall become the sole and exclusive property of the County, and the public domain, and not property of the applicant. The applicant shall not copyright, or cause to be copyrighted, any portion of said items submitted to the County because of this solicitation.
3
Supplemental Attachment Confirmations
Type: confirmation
I confirm I have reviewed the content of the following attachments included under this RFP: Sample Agreement and any other documents as identified as "sample" in the Attachments section and acknowledge I understand and agree to these requirements should my organization receive a contract as a result of this proposal.
4
Insurance Requirements
Type: confirmation
By submitting a proposal, I understand and agree that if awarded funding from this RFP, the organization must be able to meet all insurance requirements based on services being purchased, prior to contract execution, and types of insurances may include, but are not limited to:Commercial General Liability Insurance: Required on all contracts. Standard levels are $1M occurrence/$2M aggregate (may be higher/lower, depending on value of contract and type of service).Commercial Automobile Liability Insurance: Required when the Contractor uses owned, rented, or leased automobiles to complete the services as required per the contract. Higher coverages may be required for fleet/large passenger vehicles. Workers Compensation Insurance: As required by Washington State. Abuse and Molestation: If the Contractor will be working directly with youth under the age of 18, elderly, disabled or other vulnerable populations.In addition, Pierce County shall be named as an "Additional Insured,” which must be provided in the insurance endorsement. Insurance requirements also apply to any subcontractors hired by the main Contractor to deliver services, where applicable.Please see "Exhibit D" in the SAMPLE AGREEMENT under attachments to see full insurance requirements. If you have questions regarding insurance requirements, please submit them through the “Question & Answer” section of the RFP.
5
Debarment Certification
Type: confirmation
As an authorized representative of the proposer, I certify to the best of my knowledge and belief that the organization and its principals:Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency;Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; andHave not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State, or local) terminated for cause or default.Does not employ any person nor contracts with any person or agency excluded from participation in federal health care programs under either 42 U.S.C. 1320a-7 (§§1128 or 1128A Social Security Act) or debarred or suspended.By checking the confirmation, I understand that a false statement on this certification may be grounds for rejection of this proposal or termination of any award. In addition, under 18 USC Sec. 1001, a false statement may result in a fine of up to $10,000 or imprisonment for up to 5 years, or both.
6
Proposer Eligibility
Type: sectionHeader
An organization must meet the following eligibility requirements to submit a proposal under this procurement:Be a 501(c)3 non-profit organization.Be located within the City of Tacoma. Must have at least 5 years' experience engaging the neighborhood members, community partners, and youth in proven and research-based strategies designed to build community capacity and increase public safety in Pierce County.Must be a current or former recipient of a State Community Engagement grant under RCW 43.330.545. If you have questions regarding eligibility requirements, please submit a question through the "Question & Answer" section of this RFP.
7
Ownership Type
Type: multipleChoice
Must choose at least two (2) answers: Profit status (1 or 2) and organizational structure (3, 4, 5, or 6).
8
Organization Information
Type: longAnswer
Please provide the legal name, any d/b/a names, years in business, local address, billing address if different, email address, and phone number of the organization making the proposal.
9
Experience
Type: longAnswer
Pease describe how the organization meets the requirement of having 5 years' experience.
10
Proof of Grant Recipient
Type: fileUpload
Please upload proof that the organization is a current or former recipient of a State Community Engagement grant under RCW 43.330.545.
11
Organization Information
Type: sectionHeader
12
Authorized Individual
Type: shortAnswer
Please provide the name and title of the individual authorized to execute a contract on behalf of the organization.
13
Organization Tax ID Number
Type: shortAnswer
Please provide the organization's Federal Tax Number (EIN).
14
UBI Number
Type: shortAnswer
Please provide the organization's Washington State Unified Business Identifier (UBI) number.WARNING: Failure to provide a UBI number may be cause for the application to be disqualified from competition.
15
UEI Number
Type: shortAnswer
An organization must have, at the time of submission, an active UEI number when the funding is identified as federal. Please list your UEI as issued by SAM.gov. Funding may or may not create a subrecipient relationship between the organization and the County. WARNING: Failure to provide a number OR if the UEI number is NOT ACTIVE may be cause for the application to be disqualified from competition.
16
Organization Contacts
Type: longAnswer
Please provide the name, phone, and email for:Executive Director/CEO/PresidentFinancial Manager/CFOContract Manager
17
Proposal Questions (50 points)
Type: sectionHeader
18
Program Description (15 Points)
Type: longAnswer
Please describe your program and how it will provide the services described in the Scope of Work.
19
Service Area (5 Points)
Type: longAnswer
Identify the geographic area(s) this program intends to serve.
20
Community Partnerships (15 Points)
Type: longAnswer
Briefly describe all existing partnerships that this program has (MOU, Contractual, Collaborator, etc.). Please include how these relationships strive for a common goal that serves this program.
21
MOUs / Contracts / Agreements (Scored with 8.3)
Type: fileUpload
Please upload copies of any documents that support Community Partnerships.
22
Outcomes (10 Points)
Type: longAnswer
Please describe how the organization will meet the Outcomes as listed under Section 4.2 of the Scope of Work.
23
Budget Worksheet
Type: download
Budgets are not scored, however budgets will be reviewed for reasonableness, taking into account factors such as alignment with the program scope, proportionality to the proposed services and expected outcomes, and overall program efficiency. Please download the below documents, complete, and upload.
24
Budget Narrative (5 Points)
Type: longAnswer
Provide a brief narrative that explains how requested funds will be allocated to support program implementation/delivery.