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for not less than sixty (60) calendar days from the date that proposals are due, and that this proposal may not be withdrawn or modified during that time.I hereby certify that this proposal is genuine and not a false or collusive proposal, or made in the interests or on behalf of any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.

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.

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.

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. Professional Liability or Errors and Omissions Insurance: If the Contractor provides services such as analysis, consulting, counseling, daycare, legal, medical, nursing, pastoral, medical, or other services that require professional licensing.Abuse and Molestation: If the Contractor will be working directly with youth under the age of 18, elderly, disabled or other vulnerable populations.Cyber/Privacy and Security Insurance: If the Contractor is doing work that could give the Contractor access to personal or sensitive information from within the County's network or on the Contractor's personal computer, or lead to breaches of security, leading to a loss of privacy or identity theft. Crime/Employee Dishonesty Insurance: If the Contractor is in the custody or control of Pierce County funds such as cash, credit cards, checks or physical property.Other insurance(s) applicable to services being purchased: Such as Excess or Umbrella Liability Insurance if the contract is in excess of $500,000.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.

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.

I understand that all potentially successful Proposers will be required to complete a financial risk assessment prior to a formal contract offer. This audit requires the organization to submit detailed financial information about the organization’s financial history, current status, and details regarding boards, internal processes, and controls. The results of the risk assessment shall be utilized to determine the potential financial risk and stability of the organization. The County reserves the right to take all content of the Risk Assessment into consideration when making contracting and funding decisions. If you have questions regarding risk assessments, please submit a question through the "Question & Answer" section of this RFP.

Please provide the name and title of the individual authorized to execute a contract on behalf of the organization.

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.

Please provide the organization's Federal Tax Number (EIN).

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.

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.

Please provide the name, phone, and email for:Executive Director/CEO/PresidentFinancial Manager/CFOContract Manager

Describe your proposed facility use and, where applicable, detail the ways in which your residential facility may support the Pierce County Behavioral Health Plan.

Please describe your service delivery model and the anticipated length of stay of individuals in the proposed facility. Please describe your organization’s experience operating licensed behavioral health programs for compliance history and demonstrated client outcomes?

What makes the site a good fit for the program you intend to run?

What is the current land use? Is there a building to be demolished or renovated? Is the building occupied? Will relocation be triggered?

Have you completed initial site feasibility?

What is the zoning for your proposed site and is your proposed facility compatible with the jurisdiction’s current zoning regulations? If no or unknown, please detail your plan for meeting zoning requirements.

Has a Phase I Environmental Site Assessment (ESA) been completed? If a Phase I ESA has not been completed yet, when do you expect it to be available?

If an ESA has been completed, please attach here.

Does this project involve rehabilitation of existing structures?

Has a Hazardous Materials Survey been completed?

If a Hazardous Materials Survey has been completed, please attach here.

Does this project propose construction on unimproved land? Are there wetlands on or adjacent to your proposed site? If so, has the Washington State Department of Ecology been consulted, formally or informally, regarding issues with the site and/or structures on the site?

Please attach any wetland reports or correspondence with the Department of Ecology or other regulatory agencies here.

According to the Survey and Title Report, are there any known encumbrances on the title?

If yes, please detail the encumbrances.

Are you aware of any other studies required by the Permitting Jurisdiction? If yes, please detail any additional site feasibility studies that are required.

Do you have site control on the property?

What form of site control does your organization have?

Based on your response to question 9.4.1 above, please upload the following: If you selected "Own building," please provide the Deed.If you selected "Long-term lease from unrelated 3rd party," please provide copy of current lease documents.If you selected "Lease from related entity or partner," please provide ownership entity structure and copy of current lease documents.If you selected "Purchasing property," please provide acceptable evidence of site control in the form of a purchase and sale agreement or purchase option.If you selected "Other," please describe in question 9.4.3. below.

If you selected "Other" to question 9.4.1 above, please describe here.

Has the project undergone initial design and permitting?

Please describe the planned development approach, including a) any demolition, b) specific construction scope, c) square footage, d) design features, e) type of construction, f) input from third party cost consultant on construction cost, g) how costs were arrived at, and h) plans to obtain all required permits and licensure.

Please provide the most recent set of design plans and specifications, if available.

Has construction started on the project?

Please describe your procurement plans for a general contractor and other construction activities. How are development team members selected? Is your organization employing a competitive procurement process? Do costs address applicable wage rate requirements, and if so, how has this been determined?

Is your project operationally ready?

What obstacles or issues are anticipated to most directly impact timely completion of the project (e.g., zoning, community approval, design review or other issues)? What are your plans for dealing with these obstacles?

Please describe your experience siting a behavioral health facility.

Please describe your organization's fiscal policies and procedures, including information on budget decision-making processes, internal control processes around cash management, and separation of duties surrounding capital and program management. Please include complete descriptions of any short- and long-term liabilities shown on your balance sheets, what are they, how much they are, and how long to mature. Please describe your organization's financial standing and any concerns about taking on a program of this scale.

Please describe your experience and plans for meeting all required permits and licensures.

If available, please provide copies of Department of Health (DOH) licenses and certifications, along with any reports or audits conducted by DOH (Pierce County Human Services reserves the right to contact DOH for background information on your agency’s record).

Please describe any past or planned future efforts to engage the surrounding community in the project. Has any community feedback been solicited?

Upload completed Attachment A: Combined Funders Application Budget Workbook (Excel) here.

Please download the below documents, complete, and upload the Pre-Award Risk Assessment and all required supplemental materials as listed in the attachment.