MiraCosta Community College District
Purchasing & Material Management
1 Barnard Dr., Bldg. T-600
Oceanside, CA 92056
Phone: (760) 795-6792
FAX: (760) 795-6795
BID DOCUMENTS
for
BID # 09-13
Science Equipment & Supplies
Bid Due Date & Time: Thursday, March 21, 2013 at 2:00 PM
To: Prospective Bidders
* * ATTENTION: Please review this document as soon as you receive it. * *
No Bidder questions or requests for clarification will be accepted after the date specified in the Calendar
of Events.
Any requests for interpretation or corrections must be made in accordance with the Information for Bidders and according
to the Calendar of Events
The District reserves the right to reject any or all bids, to accept or to reject any one or more items on a bid, or to waive
any irregularities or informalities in the bids or in the bidding process.
If you wish to bid, your completed bid must be returned in a sealed envelope no later than the Bid Opening Date and
Time as stated in the Notice to Bidders.
Please submit in writing all questions and requests for clarification as specified in the Information for Bidders to:
Laurel McMillen, Buyer
MiraCosta Community College District
1 Barnard Drive
Oceanside, CA 92056
Phone: 760-795-6792
Fax:
760-795-6795
Email: lmcmillen@miracosta.edu
Table of Contents
Bid # 09-13 Science Equipment & Supplies
Table of Contents .................................................................................................................................................................. 2
Notice to Bidders .................................................................................................................................................................. 3
Calendar of Events ................................................................................................................................................................ 4
Campus Maps ........................................................................................................................................................................ 5
General Provisions ............................................................................................................................................................... 8
Information for Bidders ...................................................................................................................................................... 13
Notice of “No Bid” ............................................................................................................................................................... 16
Agreement............................................................................................................................................................................ 17
Specifications / Bid Form ................................................................................................................................................... 18
Non-Collusive Bidding Declaration ................................................................................................................................... 21
Workers’ Compensation Certification ............................................................................................................................... 22
Payee Data Record .............................................................................................................................................................. 23
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Notice to Bidders
Bid # 09-13 Science Equipment & Supplies
MIRACOSTA COMMUNITY COLLEGE DISTRICT
REQUEST FOR BID
NOTICE IS HEREBY GIVEN that MiraCosta Community College District, acting by and through its Governing Board,
hereinafter referred to as the District, will receive up to, but not later than 2:00 p.m. on Thursday, March 21, 2013 sealed
Submissions for the following:
DISTRICT BID # 09-13:
Science Equipment & Supplies
Such submissions shall be received at the location specified below, and shall be opened at the stated place:
MiraCosta Community College District
Purchasing and Material Management Department
Attention: Laurel McMillen, Buyer
One Barnard Drive, Building T-600
Oceanside, California 92056
Each submission must conform and be responsive to this invitation, the Bid General Provisions, Information for Bidders,
Agreement, Bid Form and all other documents comprising the pertinent Bid Documents. Copies of the Bid Documents are
now on file and may be obtained from the Purchasing and Material Management office at the above address or by calling
Laurel McMillen at 760-795-6792 or from http://www.miracosta.edu/administrative/purchasing/bidopportunities.html
beginning Monday, March 4, 2013.
The District reserves the right to reject any or all submissions or to waive any irregularities or informalities in the bids or in
the proposing. No Bidder may withdraw his bid for a period of thirty (30) days after the date set for the opening of the
bids.
Susan C. Asato, C.P.M.
Director of Purchasing & Material Management
MiraCosta College District of San Diego County, California
Publication & Dates: North County Times
March 3, 2013
March 10, 2013
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Calendar of Events
Bid # 09-13 Science Equipment & Supplies
Bid Schedule
Advertisement ..................................................................................................................... March 3, 2013 & March 10, 2013
Distribution of Bid ............................................................................................................................. Beginning March 4, 2013
Last Day to Submit Questions and/or Clarifications......................................................................................... March 14, 2013
Bid Due Date .................................................................................................................................................... March 21, 2013
Review of Bids.................................................................................................................................... Week of March 25, 2013
Approximate PO Issuance Date ..............................................................................................................Week of April 1, 2013
Clarifications
Requests by a Bidder for questions, clarifications or additional information must be received by the District prior to the
deadline set forth in the Bid Schedule above. Requests for questions, clarifications or additional information received after
that time will not be responded to. All requests for questions, clarifications or additional information must be in writing and
shall be delivered, by hand delivery, mail, fax or e-mail between the hours of 8:00 a.m. and 4:30 p.m. and prior to the
applicable deadline in the Bid Schedule to the following:
Laurel McMillen, Buyer
MiraCosta Community College District
1 Barnard Drive
Oceanside, CA 92056
Phone: 760-795-6792
Fax:
760-795-6795
Email: lmcmillen@miracosta.edu
Bid Submission
Interested companies must submit their clearly marked and sealed bids to:
MiraCosta Community College District
1 Barnard Drive, Building T600
Oceanside, CA 92056
ATTN: Laurel McMillen, Buyer
RE: Bid # 09-13 Science Equipment & Supplies
RESPONSES MUST BE RECEIVED BY PERSONAL DELIVERY, COURIER SERVICE OR BY U.S. MAIL AT OR
BEFORE 2:00 PM ON MARCH 21, 2013 TO THE ABOVE LISTED ADDRESS. LATE SUBMITTALS SHALL BE
DEEMED NON-RESPONSIVE, AND THE DISTRICT SHALL REJECT ANY SUBMITTALS RECEIVED AFTER THE
DEADLINE STATED ABOVE.
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Campus Maps
Bid # 09-13 Science Equipment & Supplies
Bid Deivery Location (T600)
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General Provisions
Bid # 09-13 Science Equipment & Supplies
1. AWARD: At its sole discretion, MiraCosta Community College District may award an agreement based on bids which
offer the best value, cost effectiveness and other criteria that may be requested in the specifications including, but not
limited to, references and other performance criteria.
2. BIDDERS INTERESTED IN MORE THAN ONE BID: No person, firm or corporation shall be allowed to make or file
or be interested in more than one bid for the same work, unless alternate bids are called for. A person, firm or
corporation submitting a sub-bid to a bidder, or who has quoted prices on materials to a bidder, is not thereby
disqualified from submitting a sub-bid or quoting prices to other bidders.
3. ASSIGNMENT OF CONTRACT: No assignment by the Contractor of any contract to be entered into hereunder or
any part thereof, or of funds to be received thereunder by the Contractor, will be recognized by the District unless
such assignment has had the prior approval of the District and the surety has been given due notice of such
assignment in writing and has consented thereto in writing.
4. REQUIRED RESOURCES VERIFICATION: Prior to contract award, MiraCosta Community College District must be
assured that the bidder selected has all of the resources required to successfully perform under the contract. This
includes, but is not limited to, personnel with skills required, equipment/materials and financial resources sufficient to
provide services called for under this contract. If during the evaluation process, MiraCosta Community College
District is unable to assure itself of the Bidder’s ability to perform under the contract, MiraCosta Community College
District has the option of requesting from the Bidder, any information that the District deems necessary to determine
the bidder’s capabilities. If such information is required, the bidder will be notified and will be permitted seven (7)
working days to submit the requested information.
5. PERMITS AND LICENSES: The bidder and all of the bidder's employees or agents shall secure and maintain in
force all such licenses and permits as are required by law, in connection with the furnishing of materials, articles, or
services listed herein. All services operations and materials shall be in accordance with all applicable Federal, State,
County and City regulations.
6. INVOICES. Separate invoices are required for each purchase order. Invoices shall be submitted in duplicate and
shall contain the following information: purchase order number, item number and description, quantity, unit price and
extended totals for items delivered.
Sales tax, where applicable, shall be shown separately.
Shipping/handling/delivery charges shall also be shown separately and shall include the original or a copy of the
prepaid bill of lading. Failure to enter the above information on the invoice shall cause a delay in payment. All
invoices shall be submitted to the following address:
MiraCosta Community College
Attn: Accounts Payable
One Barnard Dr.
Oceanside, CA 92056
7. PAYMENTS AND TERMS: Within thirty-five (35) days after delivery of any or all of the items set forth herein and
their acceptance by the District, the District agrees to pay to the Contractor, and the Contractor agrees to accept in full
payment therefore, the sums set opposite each item.
8. ESCALATION: The Contractor also agrees that no price change will be effective until the request for price change,
with supporting documentation satisfactory to the District, has been accepted in writing by the District. Until the
change has been accepted, the Contractor must continue to accept orders with the original bid price, terms and
conditions. Notwithstanding the generality of the foregoing, in no event shall said price increase be more than five (5)
percent of the current bid price unless caused by unforeseen national/international economic conditions .
9. FORCE MAJEURE. The Contractor shall be excused from performance hereunder during the time and to the extent
that he is prevented from performing by act of God, fire, strike, lockout or commandeering of materials or facilities by
the government, when satisfactory evidence thereof is presented to the District, provided that it establishs that the
non-performance is not due to the fault or neglect of the party not performing.
10. DISTRICT'S RIGHT TO WITHHOLD CERTAIN AMOUNTS AND MAKE APPLICATION THEREOF: The District
may authorize the withholding of a sufficient amount or amounts of any payment otherwise due to the Contractor, as
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in its judgment may be necessary to cover defective items not remedied. The District may apply such withheld amount
or amounts to the payment of such claims, at its discretion.
11. NOTICE TO PROCEED AND COMPLETION: Contractor shall begin performance of the Contract promptly upon
delivery and acceptance by the Purchasing & Material Management Department of all Bonds (if required) and receipt
by the Contractor of a fully executed Agreement and Purchase Order. The Contractor is obligated to completely and
satisfactorily perform the Contract within the period or periods specified in the Contract Documents.
12. LATE FEES: Late deliveries or service performance in excess of twenty (20) calendar days shall be assessed late
delivery charge. This late charge shall be assessed at 2.5% per calendar day of the total dollar value (before tax) of
the late delivered goods or services. This penalty shall commence on the first day following the end of the specified
delivery period. This penalty shall be taken as a credit against the Contractor's invoice to the District. Assessment of
late fees shall not negate any of the other rights and remedies stipulated in the Contract.
13. INDEPENDENT CONTRACTOR: The parties intend that the awarded Contractor, in performing the services herein
specified, shall act as an independent contractor and shall have control of the work and the manner in which it is
performed. Contractor is not to be considered an agent or employee of District and is not entitled to participate in any
pension plans, insurance, bonus or similar benefits District provided to its employees.
14. INDEMNIFICATION: To the fullest extent permitted by law, and as a material part of this agreement, the Contractor
shall indemnify, hold harmless and defend, the District, its Board of Trustees, officers, agents, employees and
volunteers against any and all liability, claims, damages, losses and expenses, including reasonable attorneys’ fees,
arising from all acts or omissions to act of the Contractor or its officers, agents, employees, volunteers and
subcontractors, excluding, however, such liability claims, losses, damages, or expenses arising from the District’s sole
and active negligence or willful acts. Contractor assumes complete liability for any goods or materials furnished by
the District to the Contractor in connection with this agreement. Contractor agrees to pay for such tools or materials
spoiled by it or not otherwise accounted for to the District’s satisfaction. The furnishing to Contractor of any goods or
materials in connection with this agreement shall not be construed to vest title thereto in Contractor.
The District shall not be liable for any accident, loss, assault, battery, defamation, false arrest, false imprisonment,
invasion of privacy, intentional or negligent infliction of emotional distress, injury (including death) or damages
happening or accruing during the term of the performance of the work to persons and/or property, and Contractor’s
shall fully indemnify and protect the District from and against the same.
15. INSURANCE REQUIREMENTS. The Contractor and its officers, employees, agents and subcontractors shall, at their
expense and effort, maintain and comply with Insurance Requirements #a-f below to protect Contractor and the
District from any and all claims for personal injury, bodily injury and property damage arising from, pertaining to or
relating to the scope of work under this agreement.
a. Commercial General Liability. Minimum limits of $1,000,000 per occurrence and $2,000,000 general aggregate
for personal injury, bodily injury an d property damage including products and completed operations, under
Insurance Services Office Occurrence Number CA 00 01, (any auto).
b. Automobile Liability. $1,000,000 per accident for bodily injury and property damage under Business Automobile
Liability Coverage Form Number CA 00 01, (any auto).
c. Any insurance or self-insurance maintained by the District shall be excess of the Contractor’s insurance and shall
not contribute with it.
d. Waiver of Subrogation. Contractor agrees that in the event of loss due to any perils for which it has agreed to
provide Commercial General and Automobile Liability insurance, Contractor shall look solely to its insurance
carrier(s) for recovery and grants a waiver of any right to subrogation which any such insurer of Contractor may
acquire against the District by virtue of payments of any loss under this insurance.
e. Certificate of Insurance. Contractor shall furnish the District with original certificates of insurance and all
amendatory endorsements affecting coverage required by this Agreement and indicating a thirty (30) day
cancellation notice or notice of reduction in coverage.
f. Additional Insured. Insurance shall name the District and its Board of Trustees, officers, employees, agents and
volunteers as Additional Insured under said policy.
Premiums on all insurance policies shall be paid by Contractor and shall be deemed included in this contract.
16. NON-DISCRIMINATION ENDORSEMENT. It is the policy of the District that the Contractor and District mutually
agree that they will comply with all applicable Federal and California state anti-discrimination laws and regulations
and agree not to unlawfully discriminate against any prospective or active employee engaged in the work on the basis
of race, color, age, ancestry, national origin, sex, religious creed, marital status, or physical or mental disability, or
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sexual orientation or any other category protected by law, including but not limited to, the California Fair Employment
Practice Act, beginning with Labor Code Section 1410, and Labor Code Section 1735. In addition, the Contractor
agrees to require like compliance by all subcontractors employed. Contractor and District mutually agree that they will
comply with all applicable federal and state anti-discrimination laws and regulations, and agree not to unlawfully
discriminate against Students on the basis of race, color, creed, religion, sex, age, national origin, ancestry, marital
status, physical or mental disability, sexual orientation, or any other category protected by law.
17. PROVISIONS REQUIRED BY LAW DEEMED INSERTED: Each and every provision of law and clause required by
law to be inserted in this contract shall be deemed to be inserted herein, and the contract shall be read and enforced
as though it were included herein, and if through mistake or otherwise any such provisions is not inserted, or is not
correctly inserted, then upon application of either party, the contract shall forthwith be physically amended to make
such insertion or correction.
18. ELECTRONIC AND INFORMATION TECHNOLOGIES. The Contractor hereby warrants that the goods or services
to be provided to the District comply with the accessibility requirements of Section 508 of the Rehabilitation Act of
1973, as amended (29 U.S.C. '794d), and its implementing regulations set forth at Title 36, Code of Federal
Regulations, Part 194. The Contractor agrees to promptly respond to and resolve any complaint regarding
accessibility of its products or services. Contractor further agrees to indemnify and hold harmless the District from
any claim arising out of its failure to comply with the aforesaid requirements. Failure to comply with these
requirements shall constitute a breach and be grounds for termination of this order or agreement.
19. CERTIFICATION REGARDING DEBARMENT, SUSPENSION OR OTHER INELIGIBILITY. (applicable to all orders
or agreements funded in part or in whole with federal funds) - The Contractor agrees to comply with applicable
federal suspension and debarment regulations, including, but not limited to, regulations implementing Executive Order
12549 (29 C.F.R. Part 98). The Contractor certifies to the best of its knowledge and belief that it and its principals:
a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
covered transactions by any federal department or agency;
b. Have not, within a three-year period preceding the receipt of this purchase order, been convicted of, or had a civil
judgment rendered against them, for: (1) Commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (federal, state or local) or private transaction or contract; (2) Violation
of Federal or State antitrust statutes; (3) Commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, tax evasion, receiving stolen property, making false claims, or
obstruction of justice; or (4) Commission of any other offense indicating a lack of business integrity or business
honesty that seriously and directly affects Contractor’s present responsibility;
c. Are not presently indicted for, or otherwise criminally or civilly charged by any government entity (federal, state or
local), with commission of any of the offenses enumerated above;
d. Have not, within a three-year period preceding the receipt of this purchase order or agreement, had one or more
public transactions (federal state or local) terminated for cause or default;
e. Shall not, except as otherwise provided under applicable federal regulations, knowingly enter into any lower tier
covered transaction with a person who is proposed for debarment, debarred, suspended, declared ineligible, or
voluntarily excluded by any federal department or agency from participation in such transaction; and
f. Include in all lower tier covered transactions, and all solicitations for covered transactions, provisions substantially
similar to those set forth herein.
20. STORM WATER PERMIT FOR CONSTRUCTION ACTIVITY. The District has adopted a Storm Water Management
Plan (SWMP). The SWMP was prepared in accordance with Waste Discharge Requirements for Storm Water
Discharges from Small Municipal Separate Storm Sewer Systems (General NPDES Permit No. CAS000004) adopted
by the State Water Resources Control Board. Contractor shall comply with the District’s SWMP requirements and
include all costs for compliance in the Contract amount. Contractor shall also comply with the lawful requirements of
other agencies regarding discharges to the storm drain system or other watercourses, including applicable City,
County, State and Federal storm water requirements.
The contractor shall, if required, shall be solely responsible for preparing and implementing a Storm Water Pollution
Prevention Plan (SWPPP) prior to initiating work. The contractor shall be responsible for complying with the provisions
of the Permit and the SWPPP, including the standard provisions, monitoring and reporting requirements as required
by Permit. It shall be the responsibility of the contractor to evaluate and include in the bid the cost of complying with
the SWPPP and any necessary revisions to the SWPPP. The contractor shall also include in their bid the cost of
monitoring as required by the SWPPP Permit. All trade contractors are responsible for repair and replacement of
SWPPP control measures disturbed by own operations. All trade contractors are responsible for adhering to the
approved SWPPP plan.
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21. COMPLIANCE WITH LOCAL, STATE AND FEDERAL REGULATIONS. The Contractor shall comply with all lawful
requirements of the United States, the State of California, the District, and all applicable municipalities and local
agencies.
22. CONFLICTS CHECK: The District reserves the right, before any contract award is made, to require any contractor to
whom it may make a contract award, to do a conflicts check and disclose all actual and potential conflicts to the
District. In the event a conflicts check is required, the District will provide a list of major vendors doing a significant
amount of business with the District. The potential contractor must disclaim in writing any conflict of interest.
Furthermore, the District reserves its rights to reject the selected contractor if its conflicts check reveals actual
conflicts, and go to the next preferred contractor.
23. ANTI-KICKBACKS AND FRAUD: Under Federal Pub. L. 99-634, Section 51 to 58 of the “Anti-Kickback Act of 1986”,
which is an amendment of 1946, “the practice of subcontractors of paying fees or kickbacks, or of granting gifts or
gratuities or employees of cost-plus-a-fixed-fee or cost-reimbursable prime contractors, for the purpose of securing the
ward of contract...” These practices are illegal and the District will not condone or participate in any such practices.
Penalties include a maximum 10-year prison terms and a $250,000 fines ($1,000,000 for business entities). The State of
California 1990 Public Contract-Disciplinary Procedure SB No. 2290, otherwise known as KOPP and SEYMOUR Acts,
Section 7115, prohibits fraud and collusion in an attempt to fix prices and kickbacks.
24. TERMINATION FOR DEFAULT: If the Contractor fails or neglects to supply or deliver any of said goods, articles, or
service at the prices named and at the time and place stated, the District may, without further notice or demand,
cancel and rescind this contract or may purchase said goods, supplies, or services elsewhere, and hold the
Contractor responsible and liable for all damages which may be sustained thereby, or on account of the failure or
neglect of the Contractor in performing any of the terms and conditions of this contract; it being specifically provided
and agreed that time shall be of the essence in this agreement. The foregoing provisions are in addition to and not in
limitation of any other rights or remedies available to the District.
25. DOCUMENT MODIFICATIONS: This writing is intended both as the final expression of the Agreement between the
parties hereto with respect to the included terms and as a complete and exclusive statement of the terms of the
Agreement. No modification of this Agreement shall be effective unless and until such modification is evidenced by a
writing signed by both parties.
26. TRANSFER OF RIGHTS: Contractor assigns to the District all rights throughout the work in perpetuity in the nature
of copyright, trademark, patent, right to ideas, in and to all versions of the plans and specifications now or later
prepared by Contractor in connection with the project, if any. Contractor agrees to take such actions as are
necessary to protect the rights assigned to the District in this Agreement, and to refrain from taking any action which
would impair those rights. Contractor’s responsibilities under this contract include, but are not limited to, placing
proper notice of copyright on all versions of the plans and specifications as Contractor may direct, and refraining from
disclosing any versions of the plans and specifications to any third party without first obtaining written permission of
the District.
27. EXTRA (CHANGED) WORK: Only the Director of Purchasing and Material Management or designee may authorize
extra (and/or changed) work. The parties expressly recognize that District and College personnel are without
authorization to either order extra (and/or changed) work or waive contract requirements. Failure of the Contractor to
secure proper authorization for extra work shall constitute a waiver of any and all right to adjustment in the contract
price or contract time due to such unauthorized extra work and the Contractor thereafter shall be entitled to no
compensation whatsoever for the performance of such work.
28. OWNERSHIP OF WORK PRODUCT: The District shall be the owner of and shall be entitled to immediate
possession of accurate reproducible copies of any design computations, plans, correspondence or other pertinent
data and information gathered or computed by the Contractor prior to termination of any Agreement by the District or
upon completion of the work pursuant to an Agreement.
29. ATTORNEYS' FEES: If suit is brought by either party to this Agreement to enforce any of its terms (including all
component parts of the Contract Documents), and the District prevails in such suit, the Contractor shall pay all
litigation expenses incurred by the District, including attorneys' fees, court costs, expert witness fees and investigation
expenses.
30. CONTRACTOR'S WARRANTY: The District has relied upon the professional ability and training of the Contractor as
a material inducement to enter into any Agreement. The Contractor hereby warrants that all its work will be performed
in accordance with generally accepted professional practices and standards as well as the requirements of applicable
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federal, state and local laws, it being understood that acceptance of Contractor’s work by the District shall not operate
as a waiver or release.
31. TAXES: The Contractor agrees to file federal and state tax returns and pay all applicable state and federal taxes on
amounts paid pursuant to this Agreement. In case the District is audited for compliance regarding any applicable
taxes, the Contractor agrees to furnish the District with proof of payment of taxes on those earnings.
32. DRUG FREE/SMOKE FREE/ALCOHOL FREE POLICY. All District sites are designated drug-free/smokefree/alcohol-free. The use or abuse of controlled substances, tobacco products, and alcohol will not be tolerated.
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Information for Bidders
Bid # 09-13 Science Equipment & Supplies
1. SECURING DOCUMENTS: Specifications and other contract document forms will be available without charge and
may be secured by prospective bidders at the following website:
http://www.miracosta.edu/administrative/purchasing/bidopportunities.html
2. BIDS: Bids to receive consideration shall be made in accordance with the following instructions:
a. Bids shall be received in the Purchasing and Material Management Department on or before 2:00 PM March 21,
2013 as set for the opening of bids in the Notice to Bidders, attached herein, and published in the North County
Times, which bids shall be enclosed in a sealed envelope bearing the description of the bid call, and the name of
the bidder. It is the responsibility of the bidder to insure that the bid is received in proper time and at the proper
place. Any bids received after the scheduled closing time for receipt of bids shall be returned to the bidder
unopened.
b. The bidder shall submit complete information on the goods and services stated in bid form. Failure to do so may
nullify the bid.
c. Before submitting a bid, bidders shall carefully read the specifications and the forms of other documents. They
shall fully inform themselves as to all existing conditions and limitations, and shall include in the bid a sum to
cover the cost of all items included in the contract. No allowance will be made because of lack of such
examination or knowledge.
d. The decision as to acceptability of the bid or the goods and/or services referenced therein rests solely with the
District, including the right to waive any informality in any bid. The District reserves the right to reject the bid of
any bidder who has previously failed to perform properly or complete on time, contracts of a similar nature.
e. If any person contemplating submitting a bid for the proposed contract is in doubt as to the true meaning of any
part of the specifications, or other proposed contract documents, or finds discrepancies in, or omissions from the
specifications, they are instructed to contact Laurel McMillen, Buyer, at (760) 795-6792, to request an
interpretation or correction thereof. The District may require that such request be in writing, in which case the
person submitting the request will be responsible for its prompt delivery. All requests for questions, clarifications
or additional information must be received by the District prior to the deadline set forth in the Bid Schedule. Any
interpretation or correction of the proposed documents will be made by Addendum duly issued by the Buyer, and
a copy of such Addendum will be mailed or delivered to each person receiving a set of such documents. The
District will not be responsible for any other explanation or interpretation of the proposed documents.
f. Bids shall be made upon the form therefore obtained at the website referenced above and properly executed.
Bids shall be written in ink or by typewriter before submission. Bids are to be verified as they cannot be corrected
after bids are opened. The signature of all persons signing shall be in longhand. The completed form shall be
without interlineations, alterations, or erasures.
g. The District reserves the right to award, at its sole discretion, the items included in this bid as deemed to be in the
best interest of the District.
2. ALTERNATIVE BIDS:
a. The use of the name of a manufacturer, or any special brand or make, in describing any item in the Contract
Documents does not restrict bidders to that manufacturer or specific article. An equal of the named product will
always be given due consideration. The District holds sole discretion and authority in determining equal or better
value of any product or service offered as a substitute.
b. All equipment on which bids are submitted must in all cases be equal or better in quality and utility to those
manufacturers or brands specified by the District.
c. The make or brand and grade of the article on which a bid is submitted should be stated in the bid form. When
the make or brand and grade of the article is not stated, it will be understood to be the specific article named by
the District.
d. Alternative bids will not be considered unless presented concurrently by a letter attached to the bid clearly
outlining the scope and benefit of the alternative bid. The District has the option of accepting or rejecting any
alternative bid, and also reserves the right to be the sole determinant of the viability or equality of such alternate
bids.
3. PRICES:
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a. All bid prices shall include separate bids for each item or unit specified. Bidders must use the pricing format as
provided in the Bid Document. Corrections may be inserted prior to the bid opening. In any case in which the total
bid price does not equal the unit prices times the quantities indicated, unit prices shall govern.
b. No bid shall include California sales or use tax, or Federal excise tax.
c. All bids on items shall be F.O.B. MiraCosta Community College District.
d. No charge for packing, drayage, handling, postage, express, or for any other purpose will be allowed over and
above the prices bid.
e. Bidder is required to state any additional costs or fees related to the goods/services being bid. If not specified
separately, the District will assume these costs or fees are included in the bid price.
4. ADDENDA OR BULLETINS:
a. Any addenda or bulletins issued by the MiraCosta Community College District during the time of proposing or
forming a part of the documents issued to the bidder for the preparation of their bid shall be covered in the bid and
shall be made a part of the contract.
b. Any questions regarding the specifications or the bidding process must be called to the attention of the District
later than March 14, 2013.
5. AGREEMENT: The form of agreement, which the successful bidder, as contractor, will be required to execute, is
included in the contract documents and should be carefully examined by the bidder. The agreement will be executed
in two (2) original counterparts. The complete contract consists of the following documents: The General Provisions,
Notice to Bidders, the Information for Bidders, the Accepted Bid, the Specifications / Bid Form, and the Agreement,
including all modifications thereof duly incorporated therein, and the Purchase Order, if applicable. All of the above
documents are intended to cooperate and be complementary so that any instructions or requirements called for in one
and not mentioned in the other, or vice versa, are to be executed the same as if mentioned in all said documents.
The intention of the documents is to include all labor, materials, equipment, transportation and services necessary for
the proper delivery and installation of all items or services called for in the Contract.
6. SECURITIES, PERFORMANCE BONDS, PAYMENT BONDS: When requested, bids shall be accompanied with a
certified or cashier's check or bidder's bond made out on the form provided by the District, in an amount as indicated
therein, and made payable to the order of the District. Said check or bond shall be given as a guarantee that the
bidder will, if awarded the contract, enter into the contract, a copy of which is contained in the contract documents. In
case of a refusal or failure to enter into said agreement within five (5) days after being requested to do so by the
District, the check or bond, as the case may be, shall be forfeited to the District. If the bid is not accepted by the
District within sixty (60) days after the time set for the opening of bids, or if the successful bidder executes and
delivers said contract, the certified checks or bid bonds will be returned. Any bidder not providing the required bid
security will be considered non-responsive, and the bid shall be rejected. If any other bonds or guarantees are
required by the District of the bidders or the successful bidders, those bonds or guarantees are so stated in the
Specifications of these bid documents.
7. SAMPLES / DEMONSTRATIONS:
a. When requested, bidders shall submit properly marked samples of each such article on which bid is made to the
address referenced above. Each sample submitted must be marked in such a manner that the marking is fixed,
so that the identification of the sample is assured. Such marking shall state (1) the name of the bidder, (2) the bid
number, and (3) the item number. Bid and samples must not be sent in the same package. Samples of items,
when required, must be furnished free of expense to the District, and if not destroyed by tests, will be returned
upon request at the bidders' expense.
b. All articles awarded on contract shall be subject to inspection and rejection. All expenses incurred in connection
with furnishing articles for inspection shall be borne by the bidder.
c. If the District considers a need, bidders shall be required to arrange demonstrations of items or services bid.
Failure to be able to provide such working demonstration may disqualify the bidder's bid submittal. Unless
otherwise requested by the District, bidders shall be required to provide the requested demonstrations at the
designated District facility. All demonstrations shall be provided free of charge to the District. Bidders may be
required to reimburse the District for travel to demonstrations not held at a District facility.
d. All items or services rejected by the District at any time prior to final inspection and acceptance shall at once be
removed from the place of delivery by the Bidder who shall assume and pay the cost thereof without expense to
the District, and shall be replaced by satisfactory items or services.
8. OPENING OF BIDS: Bids will be opened at the time and place scheduled in the NOTICE TO BIDDERS.
9. EQUAL BIDS: When bids are equal, they shall be awarded by a drawing of lots, and shall be witnessed by three (3)
Bid # 09-13 Science Equipment & Supplies |
14
impartial observers.
10. WITHDRAWAL OF BIDS: Any bidder may withdraw its bid, either personally or by a written request, at any time prior
to the scheduled time for opening of bids, but not after. No bidder may withdraw their bid for a period of sixty (60)
days after the date set for the opening.
11. AWARD OR REJECTION OF BIDS: The Contract will be awarded to the lowest responsive and responsible
bidder(s). The Governing Board of MiraCosta Community College District, however, reserves the right to reject any/or
all bids, to accept or reject any one or more items of a bid, and to waive any informality in the bids or in the bidding.
The District reserves the right to reject the bid of any bidder who has previously failed to perform properly, or complete
on time, contracts of a similar nature, or to reject the bid of a bidder who is not in a position to perform such contract
satisfactory. The District expressly reserves the right to reject the Bid of any bidder who is in default of payment of
taxes, licenses or other monies due to the District.
12. METHOD OF EVALUATION AND/OR AWARD: Evaluation of bids and subsequent award shall be premised on the
ability to provide the lowest responsive and responsible bid which offers the greatest value to the District. Each bid
may also be evaluated based on the following consideration(s):
a. Appraisal by the District of each bidder's ability to provide consistent, high-quality service and comparative
economic advantage to the District and to successfully service the District's needs, based on, but not limited to,
the following factors:
i. Previous experience;
ii. Successful record of having serviced accounts similar to the District in both size and function;
iii. The District's appraisal of both managerial and technical competence of the bidder;
iv. The District's appraisal of the bidder's operational capacity;
b. Financial consideration as quoted herein.
The District will evaluate and then rank all bids which meet all of the bidding requirements specified herein. Ranking
will be based on lowest price and/or highest value to the District. The District reserves the sole right to determine
acceptability and equivalency of items or services bid.
Bid # 09-13 Science Equipment & Supplies |
15
Notice of “No Bid”
Bid # 09-13 Science Equipment & Supplies
If you choose not to respond to this Request for Science Equipment & Supplies, please indicate below. This will help us
to create and maintain more accurate and effective bidders’ lists:
 We do not wish to bid on this project at this time. Please retain us on the bidders list in consideration of future projects.
 We do not wish to bid on this project, nor on any similar projects in future with regard to this commodity.
Reason for not bidding:
Proper Name of Bidder
Address
Authorized Agent Name and Title
City, State, Zip
Authorized Agent Signature
Phone
E-mail address
Fax
Bid # 09-13 Science Equipment & Supplies |
16
Agreement
Bid # 09-13 Science Equipment & Supplies
[To be executed between the District and the awarded vendor(s)]
This AGREEMENT, made and entered into this
day of
Community College District, hereinafter called the “District”, and
“Contractor”.
, 20
by and between the MiraCosta
, hereinafter called the
WITNESSETH: That the parties hereto have mutually covenanted and agreed, and by these presents do covenant and
agree with each other as follows:
THE CONTRACT DOCUMENTS: The complete contract consists of the following documents: The General Provisions,
Notice to Bidders, the Information for Bidders, the Accepted Bid, the Specifications / Bid Form, and the Agreement,
including all modifications thereof duly incorporated therein, and the Purchase Order, if applicable. Any and all obligations
of the District and the Contractor or fully set forth and described therein or are reasonable inferable that any work called
for in one and not mentioned in the other, or vice versa, is to be executed the same as if mentioned in said documents.
The documents comprising the complete contract are sometimes hereinafter referred to as the Contract Documents, or
the Contract.
THE MATERIALS, SUPPLIES and/or SERVICES: The Contractor agrees to furnish the item(s) of the stated bid listed
herein, and all transportation, service, labor and material necessary to furnish and deliver same in good condition, in the
manner designated in, and in strict conformity with the Request for Bid at the price or prices hereinafter set forth. The
District shall not be responsible for the care or protection of any property, material, or parts ordered against said contract
before date of its delivery and acceptance by the District. It is understood by the Contractor that all items or service will
be promptly delivered to the District. The items and/or services awarded are as follows:
Bid # 09-13 Science Equipment & Supplies
NOTICE TO PROCEED: The Contractor shall not proceed to deliver the awarded items and/or perform the services as
awarded until the District has issued the Contractor an official Notice to Proceed and/or an official District Purchase Order.
EXTRA (CHANGED) WORK: Only the Director of Purchasing and Material Management or designee may authorize
extra (and/or changed) work. Failure of the Contractor to secure proper authorization for extra work shall constitute a
waiver of any and all right to adjustment in the contract price or contract time due to such unauthorized extra work and the
Contractor and the Bidder thereafter shall be entitled to no compensation whatsoever for the performance of such work.
Contractor:
District:
MiraCosta College District
By:
By:
Official Authorized Signature
Official Authorized Signature
Susan Asato
Printed Name
Its:
Printed Name
Its:
Director of Purchasing & Material Management
Title
Title
Date
Date
Bid # 09-13 Science Equipment & Supplies |
17
Specifications / Bid Form
Bid # 09-13 Science Equipment & Supplies
Group 1 - Equipment
Line
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Description
14-386-516 Genysys 10S UV-Vis Spectrophotometer
Microscopes, compound with phase contrast, Meiji ML2855
100x Oil Phase Microscope Objectives, Meiji #MA699
7300 Spectrophotometer #735-001
Peltier #735-301
89050-360 Lab-Aire dryer
97042-602 VWR hotplate
47751-148 cimarec hot plate
33787-028 50mL heating mantle
33787-040 100mL heating mantle
89207-276 biospectrometer basic
80094-120 microcentrifuge
24 V 4602 stereomicroscope
24079 SUPELCOWAX® 10 Capillary GC Column
24160-U Petrocol DH Capillary column 100m
14-386-516 Genesys 10S UV-Vis W/ printer
Aquarium, Salt Water Pump #130-018-01
QTY
2
1
5
2
2
1
2
2
8
8
1
1
6
3
1
1
1
*UOM
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
Price
Extension
Subtotal
Tax
Shipping & Handling
Grand Total
Group 2 – Models
Line
1
2
3
4
5
6
Description
81V1177 - 3B Arm Musculature Model
81V1164 - 3B Leg Musculature Model
81V1048 - Denoyer Geppert Urinary System Model
81V4741 - Bacteriophage Model Set
81V7017 Molymod Mini DNA/RNA Models, 22 base-pairs
81V4018 SOMSO Central Nervous System Model
QTY
1
1
1
1
2
2
*UOM
EA
EA
EA
EA
EA
EA
Price
Extension
Subtotal
Tax
Shipping & Handling
Grand Total
Bid # 09-13 Science Equipment & Supplies |
18
Group 3 – Supplies
Line
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
Description
16007-000 Hemacytometer cover slips PK10
14002-764 Electrode symphon EPXY CMB
53502-253 Pipet pump QKR II GRN 10ML
53502-251 Pipet pump QK RLII BLU 2ML
52456-130 Meter DO HNDHELD w/cable+ probe
840185 Molymod Biochemistry Teacher Set
ME-6814 mini catcher accessory
CI-6538 rotary motion sensor
ME-6829 ballistic pendulum accessory
SN-7927A G-M tube power supply
OS-8537 spectrophotometer accessory
CI-6604 high sensitivity light sensor
ME-6825A mini launcher
OB2067 Slotted Weight Set
CI-6742A motion sensor
CI-6534A low pressure sensor
AP1346 deflagration spoon
AP1367 yellow tape
AP1088 stir bar
AP8716 digital thermometer
wls-8840-b 15mL dropper bottle
wls-8840-e 125mL dropper bottle
wls-8840-g 250mL dropper bottle
WLS-83610-E watch glass 75mm
WLS-83610-F watch glass 90mm
S20 - Skeleton Stand
Z627569-1EA seripettor bottle-top dispenser
QTY
1
18
5
15
2
4
20
10
20
20
20
20
20
5
6
4
20
10
20
20
3
2
2
2
2
1
1
*UOM
CS
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
Price
Extension
Subtotal
Tax
Shipping & Handling
Grand Total
Group 4 – Clay in Action Manikin & Supplies
Line
1
2
3
4
Description
ZSA-MA-1100 Maniken Classic Series 11
ZSF-366 Conversion Kit for Pro 11 Model
ZSR-210 Basic Tool Kit
ZSP-MA-0010 Complete Atlas Set: Vol 1-5, CD
QTY
1
1
1
1
*UOM
EA
EA
EA
EA
Price
Extension
Subtotal
Tax
Shipping & Handling
Grand Total
Bid # 09-13 Science Equipment & Supplies |
19
Group 5 – Equipment & Installation
Line
Description
1
G1561A 6890 FID with EPC assembly kit
2
G1530-00225 6890 rear top panel
QTY *UOM
1 EA
1 EA
Price
Extension
Subtotal
Tax
Shipping & Handling
Installation
Grand Total
Group 6 – Equipment & Installation
Line
Description
1
SG403A HE SterilGARD 403A e3 w/ UV light
2
Installation by Cor-O-Van
3
shipping charge
QTY *UOM
1 EA
1 EA
1 FEE
Price
Extension
Subtotal
Tax
Shipping & Handling
Installation
Grand Total
Bid # 09-13 Science Equipment & Supplies |
20
Non-Collusive Bidding Declaration
Bid # 09-13 Science Equipment & Supplies
[To be Executed by Bidder and Submitted with Bid]
I,
(Name of Bidder's Authorized Officer or Agent) declare as follows:
That I am the
(Title) of
(Legal Name of Bidder), the party making the attached bid; that the bid is not made in the interest of, or on behalf of, any
undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not
collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or
sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put
in a sham bid, or that anyone shall refrain from bidding, that the bidder has not in any manner, directly or indirectly, sought
by agreement, communication, or conference with anyone to fix the bid price of the bidder or any other bidder, or to fix
any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage against
the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in this
bid are true, and, further, that the bidder has not, directly or indirectly, submitted his bid price or any breakdown thereof, or
the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation,
partnership, company, association, organization, bid depository, or to any member or agent thereof to effectuate a
collusive or sham bid.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed
the
day of
, 20
, at
.
Signature of Bidder's Authorized Officer or Agent
Bid # 09-13 Science Equipment & Supplies |
21
Workers’ Compensation Certification
Bid # 09-13 Science Equipment & Supplies
RESPONDENT’S CERTIFICATION REGARDING WORKERS’ COMPENSATION
State of California Labor Code section 3700 in relevant part provides:
Every employer except the State shall secure the payment of compensation in one or more of the following ways:

By being insured against liability to pay compensation in one or more insurers duly authorized to write
compensation insurance in this State.

By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given
upon furnishing proof satisfactory to the Director of Industrial Relations of ability to self-insure and to pay any
compensation that may become due to his employees.
I am aware of the provisions of section 3700 of the Labor Code which require every employer to be insured against
liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of the code, and I will
comply with such provisions before commencing the performance of the work of this contract.
Proper Name of Bidder
Signature of Authorized Agent/Officer
Date
In accordance with article 5 (commencing at section 1860), chapter 1, part 7, division 2 of the Labor Code, the above
certificate must be signed and filed with the awarding body prior to performing any work under this contract.
Bid # 09-13 Science Equipment & Supplies |
22
MiraCosta Community College District
PAYEE DATA RECORD
(Required in lieu of IRS W-9)
PLEASE
RETURN or
FAX TO:
MiraCosta Community College District
Attn: Purchasing Department
One Barnard Drive
Oceanside, CA 92056
Phone: (760) 795-6793
FAX:
(760) 795-6795
PURPOSE: Information contained in this form will be used by
the District to prepare State of California Employment
Development Department DE542 Reporting, Internal Revenue
Form 1099, and for withholding on payments to nonresident
payees. Prompt return of this fully completed form will
prevent delays when processing payment.
(See Privacy Act Notice on page 4 of instructions)
PARTS 1-7 are to be completed by PAYEE
PART 1
PAYEE DATA
Please print
using block
letters
Name (If sole proprietor or single-owner LLC, enter owner’s full name here — Last Name, First Name, and Middle Initial) (See page 2, Specific Instructions):

Business name, if different from above—trade or “doing business as (DBA)” name. (See page 2, Specific Instructions)

Mailing address (Number and Street including Suite No. or Apartment No. – DO NOT USE POST OFFICE BOX ADDRESS):

City, state and zip code:

Phone number:

PART 2
podiatry, psychotherapy, optometry,
chiropractic, etc.)
EXEMPT CORPORATION (Nonprofit)
CHECK ONE BOX
ONLY
PART 3
PAYEE’S
TAXPAYER I.D.
NUMBER
Toll free number:

MEDICAL CORPORATION (including dentistry,
PAYEE ENTITY
TYPE
Fax number:
ALL OTHER CORPORATIONS

PARTNERSHIP
ESTATE OR TRUST
LIMITED LIABILITY PARTNERSHIP (LLP)
INDIVIDUAL/SOLE PROPRIETOR
LIMITED LIABILITY COMPANY (LLC)
ELECTING CORPORATE STATUS ON
FORM 8832
LIMITED LIABILITY COMPANY (LLC)
Single Owner
FEDERAL/STATE/LOCAL GOVERNMENT
SOCIAL SECURITY NUMBER IS REQUIRED FOR INDIVIDUAL/SOLE PROPRIETOR BY AUTHORITY OF THE
REVENUE AND TAXATION CODE SECTION 18646.
IF PAYEE ENTITY TYPE IS A COPORATION, PARTNERSHIP, LLP,
CORPORATE STATUS LLC, ESTATE OR TRUST, OR
FEDERAL/STATE/LOCAL GOVERNMENT, ENTER FEIN:
IF PAYEE ENTITY TYPE IS INDIVIDUAL/SOLE PROPRIETOR,
OR SINGLE OWNER LLC, ENTER SSN:

FEDERAL EMPLOYER’S IDENTIFICATION NUMBER (FEIN)


SOCIAL SECURITY NUMBER (SSN)
PART 4
FOR U.S. PAYEES EXEMPT FROM BACKUP WITHHOLDING (See page 3 of instructions)
PART 5
CHECK APPROPRIATE BOXES
Exempt from
backup withholding
California Resident – Qualified to do business in CA or a permanent place of business in CA
PAYEE
RESIDENCY
STATUS
Nonresident (See page 3 of instructions) Payments to non residents for services may be subject to state withholding
WAIVER OF STATE WITHHOLDING FROM FRANCHISE TAX BOARD ATTACHED
SERVICES PERFORMED OUTSIDE OF CALIFORNIA
PART 6
CERTIFYING
SIGNATURE
NOTE: Payment
will not be
processed without
an accompanying
taxpayer I.D.
number.
NOTE:
a. An estate is a resident if
decedent was a California
resident at time of death.
b. A trust is a resident if at least
one trustee is a California
resident.
(See page 3 of instructions)
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me),
and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the
Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or
(c) the IRS has notified me that I am no longer subject to backup withholding, and
3. I am a U.S. person (including a U.S. resident alien)
Certification Instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to
backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2
does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an
individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the
Certification, but you must provide your correct TIN (See the attached instructions.)
SIGNATURE OF U.S. PERSON
DATE


Payee Data Record
PART 7
TYPE OF
BUSINESS
ENTERPRISE
CHECK IF APPLICABLE AND PROVIDE A COPY OF CERTIFICATION
Disabled Veteran Business Enterprise
Minority Business Enterprise
Woman Owned Business Enterprise
Rev. 1/12
Bid # 09-13 Science Equipment & Supplies |
23
MiraCosta Community College District
PAYEE DATA RECORD
(Required in lieu of IRS Form W-9)
Purpose of Form
1.
You do not furnish your TIN to the requester, or
A person who is required to file an information return with the IRS must obtain your
2.
You do not certify your TIN when required (see the Part 6 instructions given below
for details), or
3.
The IRS tells the requester that you furnished an incorrect TIN, or
4.
The IRS tells you that you are subject to backup withholding because you did not
report all your interest and dividends on your tax return (for reportable interest
and dividends only), or
5.
You do not certify to the requester that you are not subject to backup withholding
under 4 above (for reportable interest and dividend accounts opened after 1983
only).
correct taxpayer identification number (TIN) to report, for example, income paid to you,
real estate transactions, mortgage interest you paid, acquisition or abandonment of
secured property, cancellation of debt, or contributions you made to an IRA.
U.S. Person. Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN to the person requesting it (the requester) and, when applicable,
to:
1.
Certify that the TIN you are giving is correct (or you are waiting for a number to be
issued,
2.
Certify that you are not subject to backup withholding, or
3.
Claim exemption from backup withholding if you are a U.S. exempt payee.
Certain payees and payments are exempt from backup withholding. See the Part 4
instructions and the separate Instructions for the Requester of Form W-9.
Penalties
Note: If a requester gives you a form other than Form W-9 to request your TIN, you
Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are
must use the requester’s form if it is substantially similar to IRS Form W-9.
subject to a penalty of $50 for each such failure unless your failure is due to reasonable
Foreign Person. If you are a foreign person, use the appropriate Form W-8 (see Pub.
515, Withholding of Tax on Nonresident Aliens and Foreign Entities).
Nonresident alien who becomes a resident alien. Generally, only a nonresident alien
individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain
cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you make a false
statement with no reasonable basis that results in no backup withholding, you are subject
to a $500 penalty.
types of income. However, most tax treaties contain a provision known as a “saving
Criminal penalty for falsifying information. Willfully falsifying certifications or
clause.” Exceptions specified in the saving clause may permit an exemption from tax to
affirmations may subject you to criminal penalties including fines and/or imprisonment.
continue for certain types of income even after the recipient has otherwise become a U.S.
Misuse of TINs. If the requester discloses or uses TINs in violation of Federal law, the
resident alien for tax purposes.
requester may be subject to civil and criminal penalties.
If you are a U.S. resident alien who is relying on exception contained in the saving clause
Specific Instructions
of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must
attach a statement that specified the following five items:
PART 1—PAYEE DATA (NAME)
1.
The treaty country. Generally, this must be the same treaty under which you
claimed exemption from tax as a nonresident alien.
If you are an individual, you must generally enter the name shown on your social security
2.
The treaty article addressing the income.
informing the Social Security Administration of the name change, enter your first name, the
3.
The article number (or location) in the tax treaty that contains the saving clause
and its exceptions.
last name shown on your social security card, and your new last name.
4.
The type and amount of income that qualifies for the exemption from tax.
5.
Sufficient facts to justify the exemption from tax under the terms of the treaty
article.
card. However, if you have changed your last name, for instance, due to marriage without
If the account is in joint names, list first, and then circle the name of the person or entity
whose number you enter in Part 3 of the form.
Sole proprietor. Enter your individual name as shown on your social security card in the
Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for
“Name” box of Part 1. You may enter your business, trade, or “doing business as (DBA)”
scholarship income received by a Chinese student temporarily present in the United States.
name in the “Business Name” box. You may not enter only the business name.
Under U.S. law, this student will become a resident alien for tax purposes if his or her stay
in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol
to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to
continue to apply even after the Chinese student becomes a resident alien of the United
Limited liability company (LLC). If you are a single-member LLC (including a foreign
LLC with a domestic owner) that is disregarded as an entity separate from its owner under
Treasury regulations section 301.7701.3, enter the owner’s name in the “Name” box.
Enter the LLC’s name in the “Business Name” box.
States. A Chinese student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax on his or her
Other entities. Enter your business name as shown on required Federal tax documents
scholarship or fellowship income would attach to Form W-9 a statement that includes the
in the “Name” box. This name should match the name shown on the charter or other legal
information described above to support that exemption.
documents creating the entity. You may enter any business, trade, or DBA name in the
If you are a nonresident alien or a foreign entity not subject to backup withholding,
“Business name” box.
give the requester the appropriate completed Form W-8.
PART 2—PAYEE ENTITY TYPE. Please check appropriate box.
What is backup withholding? Persons making certain payments to you must withhold
Note: You are requested to check the appropriate box for your status (individual/sole
and pay to the IRS 30% of such payments (29% after December 31, 2003; 28% after
proprietor, corporation, etc.).
December 31, 2005). This is called “backup withholding.” Payments that may be subject
PART 3—PAYEE’S TAXPAYER IDENTIFICATION NUMBER (TIN)
to backup withholding include interest, dividends, broker and barter exchange transactions,
rents, royalties, nonemployee pay, and certain payments from fishing boat operators. Real
estate transactions are not subject to backup withholding.
You will not be subject to backup withholding on payments you receive if you give the
requester your correct TIN, make the proper certifications, and report all your taxable
interest and dividends on your tax return.
Payments you receive will be subject to backup withholding if:
Enter your TIN in the appropriate box. If you are a resident alien and you do not
have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer
identification number (ITIN). Enter it in the social security number box. If you do not have
an ITIN, see How to get a TIN below.
If you are a sole proprietor, the District and the IRS prefer that you enter your
social security number. The State of California Employment Development
Department requires your SSN on the DE542 report.
Bid # 09-13 Science Equipment & Supplies |
19
MiraCosta Community College District
PAYEE DATA RECORD
(Required in lieu of IRS Form W-9)
If you are a single-owner LLC that is disregarded as an entity separate from its owner (see
Limited liability company (LLC) in Part 1), enter your SSN. If the LLC is a
The chart below shows types of payments that may be exempt from backup withholding.
The chart applies to the exempt recipients listed above, 1 through 15.
corporation, partnership, etc., enter the entity’s EIN.
Note: See the chart on page 4 for further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an
SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security
Administration office or get this form on-line at www.ssa.gov/online/sst.html. You
If the payment is for…
THEN the payment is exempt for…
Interest and dividend payments
All exempt recipients except for 9
Broker transactions
Exempt recipients 1 through 13. Also, a
may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS
person registered under the Investment
Individual Taxpayer Identification Number, to apply for an ITIN or Form SS-4, Application
Advisers Act of 1940 who regularly acts
for Employer Identification Number, to apply for an EIN. Your can get Forms W-7 and SS-
as a broker
4 from the IRS by calling 1-800-TAX-FORM (1-800-829-3676) or from the IRS’s internet
Barter exchange transactions and
Web Site at www.irs.gov.
If you are asked to complete Form W-9 but do not have a TIN, write “Applied For” in the
Payments over $600 required to be
space for the TIN, sign and date the form, and give it to the requester. For interest and
reported and direct sales over $5,000
dividend payments, and certain payments made with respect to readily tradable
instruments, generally you will have 60 days to get a TIN and give it to the requester
before you are subject to backup withholding on payments. The 60-day rule does not
apply to other types of payments. You will be subject to backup withholding on all such
payments until you provide your TIN to the requester.
Note: Writing “Applied For” means that you have already applied for a TIN or that you
intend to apply for one soon.
Caution: A disregarded domestic entity that has a foreign owner must use the
appropriate Form W-8.
Exempt recipients 1 through 5
patronage dividends
Generally, exempt recipients 1 through 7
1
2
1
See Form 1099-MISC, Miscellaneous Income, and its instructions.
2
However, the following payments made to a corporation (including gross proceeds paid to
an attorney under section 6045(f), even if the attorney is a corporation) and reportable on
Form 1099-MISC are not exempt from backup withholding: medical and health care
payments, attorneys’ fees; and payments for services paid by a Federal executive agency.
PART 5—RESIDENCY STATUS
Each corporation, individual, sole proprietor, partnership, estate or trust doing
business with the MiraCosta Community College District must indicate their residency
PART 4—EXEMPT FROM BACKUP WITHHOLDING
status along with their taxpayer identification number.
If you are exempt, enter your name as described above and check the appropriate box for
A corporation will be considered a “resident” if it has a permanent place of business
your status, then check the “Exempt from backup withholding” box in Part 4.
in California. The corporation has a permanent place of business in California if it is
Generally, individuals (including sole proprietors) are not exempt from backup withholding.
Corporations are exempt from backup withholding for certain payments, such as interest
and dividends.
organized and existing under the laws of this state or, if a foreign corporation, has
qualified to transact intrastate business. A corporation that has not qualified to
transact intrastate business (e.g., a corporation engaged exclusively in interstate
commerce) will be considered as having a permanent place of business in this state
Note: If you are exempt from backup withholding, you should still complete this form to
only if it maintains a permanent office in this state that is permanently staffed by its
avoid possible erroneous backup withholding.
employees.
Exempt payees. Backup withholding is not required on any payments made to the
For individuals/sole proprietors, the term “resident” includes every individual who
following payees:
is in California for other than a temporary or transitory purpose and any individual
1.
An organization exempt from tax under section 501(a), any IRA, or a custodial
account under section 403(b)(7) if the account satisfies the requirements of
section 401(f)(2);
domiciled in California who is absent for a temporary or transitory purpose. Generally,
an individual who comes to California for a purpose, which will extend over a long or
indefinite period, will be considered a resident. However, an individual who comes to
2.
The United States or any of its agencies or instrumentalities;
3.
A state, the District of Columbia, a possession of the United States, or any of their
political subdivisions or instrumentalities;
4.
A foreign government or any of its political subdivisions, agencies, or
instrumentalities; or
a permanent place of business in California. An estate is considered a California estate
5.
An international organization or any of its agencies or instrumentalities;
a California trust if at least one trustee is a California resident.
6.
A corporation;
7.
A foreign central bank of issue;
8.
A dealer in securities or commodities required to register in the United States, the
District of Columbia, or a possession of the United States.
9.
A futures commission merchant registered with the commodity Futures Trading
Commission;
For hearing impaired with TDD, call........................................ 1-800-822-6268
10.
A real estate investment trust;
Are You Subject To Nonresident Withholding?
11.
An entity registered at all times during the tax year under the Investment
Company Act of 1940;
Payments made to nonresident payees, including corporations, individuals, partnerships,
12.
A common trust fund operated by a bank under section 584(a);
13.
A financial institution;
14.
A middleman known in the investment community as a nominee or custodian; or
However, no withholding is required if total payments to the payee are $1500 or less for
15.
A trust exempt from tax under section 664 or described in section 4947.
the calendar year.
perform a particular contract of short duration will be considered a nonresident.
For withholding purposes, a partnership is considered a resident partnership if it has
if the decedent was a California resident at the time of death and a trust is considered
More information on residency status can be obtained by calling the Franchise Tax
Board at the numbers listed below:
From within the United States, call ......................................... 1-800-338-0505
From outside the United Sates, call ........................................ 1-916-845-6600
estates and trusts, are subject to withholding. Nonresident payees performing services in
California or receiving rent, lease or royalty payments from property (real or personal)
located in California will have 7% of their total payments withheld for state income taxes.
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MiraCosta Community College District
PAYEE DATA RECORD
(Required in lieu of IRS Form W-9)
A nonresident payee may request that income taxes be withheld at a lower rate or waived
by sending a completed form FTB 588 to the address below. A waiver will generally be
granted when a payee has a history of filing California returns and making timely estimated
Custodian account of a minor
(Uniform Gift to Minors Act)
The minor
4.
a.
The usual revocable savings trust
(grantor is also trustee)
The grantor-trustee
b.
So-Called trust account that is
not a legal or valid trust under
state law
The actual owner
payments. If payee activity is carried on outside of California or partially outside of
California, a waiver or reduced withholding rate may be granted. For more information,
contact:
5.
Franchise Tax Board
Nonresident Withholding Section
Attention: State Agency Withholding Coordinator
PO Box 651 Sacramento, CA 95812-0651
Telephone: (916) 845-4900
FAX: (916) 845-4831
PART 6—CERTIFICATION
Sole proprietorship or single-owner
LLC
Sole proprietorship or single-owner
LLC
The owner—See 5 above and Footnote
3.
7.
A valid trust, estate, or pension trust
Legal entity
8.
Corporate or LLC electing corporate
status on Form 8832
The corporation
9.
Association, club, religious, charitable,
educational, or other tax-exempt
organization
11. A broker or registered nominee
PAYEE DATA RECORD Form. The withholding agent may request you to sign even if items
12. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or prison)
that receives agricultural program
payments
required). Exempt recipients, see Exempt from backup withholding on page 2.
Signature requirements. Complete the certification as indicated in 1 through 5 below.
1
1.
2
Interest, dividend, and barter exchange accounts opened before 1984 and
broker accounts considered active during 1983. You must give your correct
TIN, but you do not have to sign the certification.
2.
Interest, dividend and barter exchange accounts opened after 1983 and
broker accounts considered inactive during 1983. You must sign the
certification or backup withholding will apply. If you are subject to backup
withholding and you are merely providing your correct TIN to the requester, you
must cross out item 2 in the certification before signing the form.
3.
Real estate transactions. You must sign the certification. You may cross out item
The owner—See Footnote 3
6.
10. Partnership or multi-member LLC
For a joint account, only the person whose TIN is shown in PART 2 should sign (when
1
Give name and EIN of:
To establish to the withholding agent that you are a U.S. person, or resident alien, sign the
1, 3, and 5 below indicate otherwise.
1
For this type of account:
If the Franchise Tax Board has authorized a reduced rate of withholding or
waiver, attach a copy to this form.
2
3.
4
The organization
The partnership
The broker or nominee
The public entity
List first and circle the name of the persons whose number you furnish. If only one
person on a joint account has an SSN, that person’s number must be furnished.
Circle the minor’s name and furnish the minor’s SSN.
3
You must show your individual name, but you may also enter your business or
“DBA” name. The District and the IRS prefer that you provide your SSN. The
District needs your SSN for State of California EDD DE542 reporting purposes.
You may provide both you SSN and your EIN. The SSN will only be used for
State of California EDD DE542 reporting; your EIN will be used for IRS
1009MISC reporting
4
List first and circle the name of the legal trust, estate, or pension trust. (Do not furnish
the TIN of the personal representative or trustee unless the legal entity itself is not
designated in the account title.)
Note: If no name is circled when more than one name is listed, the number will be
considered to be that of the first name listed
2 of the certification.
4.
Other payments. You must give your correct TIN, but you do not have to sign the
certification unless you have been notified that you have previously given an
incorrect TIN. “Other payments” include payments made in the course of the
requester’s trade or business for rents, royalties, goods (other than bills for
merchandise), medical and health care services (including payments to
corporations), payments to a nonemployee for services, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to attorneys (including
payment to corporations).
5.
Mortgage interest paid by you, acquisition or abandonment of secured
property, cancellation of debt, qualified state tuition program payments
(under section 529), IRA or Archer MSA contributions or distributions, and
pension distributions. You must give your correct TIN, but you do not have to
sign the certification.
PART 7—TYPE OF BUSINESS ENTERPRISE
Please check every box that applies and attach appropriate certification.
What Name/Number to Give the Requester
For this type of account:
Give name and SSN of:
1.
Individual
The individual
2.
Two or more individuals (joint
account)
The actual owner of the account or, if
combined funds, the first individual on the
account 1
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Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons who must file information returns with the IRS to report interest, dividends, and certain
other income paid to you, mortgage interest you paid, the acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA or Archer MSA. The
IRS uses the numbers for identification purposes and to help verify the accuracy of your tax return. The IRS may also provide this information to the Department of Justice for civil and
criminal litigation, and to cities, states, and the District of Columbia to carry out their tax laws. We may also disclose this information to other countries under a tax treaty, or to Federal
and state agencies to enforce Federal nontax criminal laws and to combat terrorism.
You must provide your TIN whether or not you are required to file a tax return. Payers must generally withhold 30% of taxable interest, dividend, and certain other payments to a payee who does not give a
TIN to a payer. Certain penalties may also apply.
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