JEFFERSON COUNTY COMMISSION PURCHASING DIVISION ROOM 830 COURTHOUSE BIRMINGHAM, ALABAMA 35203-0009 OFFICE: (205)325-5381/FAX: (205)325-5221 PRINCIPAL BUYER: DONALD DENNIS ITB #78-11 Prospective Bidders ITB #78-11 at www.paca.jccal.org SEALED BIDS FOR : TV TRUCK FOR SEWER INSPECTION Donald Dennis, Principal Buyer INVITATION TO BID RESPONSES 716 Richard Arrington Jr. Blvd North, Room 830 WILL BE RECEIVED BY: Birmingham, AL 35203-0009 ***IMPORTANT SOLICITATION DATES*** BID DUE DATE: 3-16-2011 BID OPENING DATE: 3-17-2011 5:00 p.m. 2:00 p.m. (Central Standard Time) (Central Standard Time) Return responses to this Invitation to Bid in a sealed envelope marked: “TV TRUCK FOR SEWER INSPECTION” BID OPENING WILL BE HELD AT: Jefferson County Courthouse Purchasing Department, Room 830 716 Richard Arrington Jr. Blvd North Birmingham, Alabama 35203-0009 NOTIFICATION OF INTENT: All recipients of this solicitation notice must indicate intent to submit a bid no later than March 7, 2011 by 5:00 P.M. CST. Those vendors submitting a Notification of Intent will be sent any related addendum, answers to inquiries, etc. pertaining to this ITB. Notification of intent must be faxed to (205) 325-4888 or e-mailed to Donald Dennis at dennisd@jccal.org or Analory Holmes at holmesa@jccal.org TO: INVITATION TO BID NUMBER: TELEPHONE INQUIRIES – NOT ACCEPTED: Telephone inquiries with questions regarding clarification of any and all specifications of the ITB will not be accepted. All questions must be written and faxed to (205)325-4888 or e-mailed to Donald Dennis at dennisd@jccal.org Submissions may be withdrawn, modified, and resubmitted prior to the formal bid opening due date. Any submission modification(s) submitted after the “Bid Opening Due Date” will not be considered. The County reserves the right to accept or reject any or all proposals, or any part of any proposal, and to waive any informalities or irregularities in the proposal. All costs incurred by the company to respond to this solicitation will be wholly the responsibility of the Bidder. All copies and contents of the proposal, attachments, and explanations thereto submitted in response to this ITB, except copyrighted material, shall become the property of the Jefferson County Commission regardless of the Consultant selected. Response to this solicitation does not constitute an agreement between the Bidder and the County. The County is not responsible for delays occasioned by the U.S. Postal Service, the internal mail delivery system of the County, or any other means of delivery employed by the bidder. Similarly, the County is not responsible for, and will not open, any bid responses which are received later than the date and time indicated above. Late bid responses will be retained in the bid file, unopened. Released by: _____________________________________________________________ INVITATION TO BID #78-11 “TV TRUCK FOR SEWER INSPECTION” BID DUE DATE: 3/16/11 Donald Dennis, Principal Buyer Room 830*716 Richard Arrington Jr. Blvd North Birmingham, Alabama 35203 Phone: (205) 325-5381 Email: dennisd@jccal.org PURCHASING ASSOCIATION OF CENTRAL ALABAMA TO ALL BIDDERS: The attached Request for Proposal presents a cooperative proposal for the Purchasing Association of Central Alabama (PACA) members below: Adamsville Alabama School of Fine Arts Alabaster, City of Bessemer, City of Bessemer Board of Education Bibb County Commission Bibb County Firefighters Assoc Birmingham Board of Education Birmingham-Jefferson Civic Center Birmingham Public Library Birmingport Fire Districts Brighton, City of Brookside, City of Cahaba Valley Fire & Rescue Center Point, City of Chelsea, City of Chilton/Shelby Mental Health Board Clay, City of Concord Fire Department Copeland Ferry Fire Department Eastern Valley Volunteer Fire Dept Fairfield, City of Fairfield Board of Education Forestdale Fire Department Four Mile Fire Department Fultondale, City of Glennwood Fire District Gardendale, City of Helena, City of Homewood, City of Hoover, City of Hueytown, City of Irondale, City of Jefferson County Board of Education Jefferson County Commission Jefferson County Assisted Housing Corp Jefferson County Housing Authority Jefferson County Library Coop Jefferson State Community College Kimberly, Town of Lakeview Fire Department Lakeview, Town of Lawley Fire Department Lawson State Community College Leeds Board of Education Leeds, City of McAdory Fire Departments Midfield, City of Midfield Board of Education Minor Heights Fire Department Morris, City of Mountain Brook, City of Mountain Brook Board of Education Mt Olive Fire & Rescue Mulga, Town of North Shelby Fire Department Palmerdale Fire Department Pelham, City of Pelham Civic Center Pelham Water Department Pell City Fire Department Pleasant Grove, City of Rocky Ridge Fire/Rescue Shannon Fire Department Shelby County Board of Education Shelby County Community Corrections Storm Water Management Authority Sylvan, Town of Tarrant, City of Tarrant City Board of Education Trafford, City of Trussville Board of Education Trussville Volunteer Fire Department Tuscaloosa County Board of Education Tuscaloosa County Commission Tuscaloosa County Firefighters Assn Vestavia Hills, City of Vestavia Hills Board of Education Warrior, City of Warrior River Fire & Rescue Service Water River Water Authority West Blocton Volunteer Fire & Rescue Westwood Rescue 209 Other government entities and all school systems within Jefferson County and counties adjoining thereto may elect to participate in this cooperative bid. Vendors must agree that if any additional government entity does join the Association, vendors shall honor prices on this Invitation to Bid for those additional entities that may join the Association. ITB/RFP #: Commodity: Buyer: Telephone: 78-11 TV TRUCK FOR SEWER INSPECTION DONALD DENNIS (205) 325-5384 The proposal award will be made by the Jefferson County Commission on behalf of the Association in accordance with the provision of the intergovernmental agreement between the Jefferson County Commission and the members of the Association. Each participating governmental entity of the Association will be responsible for issuing its own purchase orders, delivery instructions, invoicing, insurance requirements, and issue its own tax exemption certificate as required by vendors. This cover letter is considered an integral part of this Request for Proposal document and shall be included by reference into any contract. Acknowledged by _______________________________________________ Vendor Name __________________________________________ Authorized Signature/Title JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID #78-11 PAGE 4 INVITATION TO BID Sealed bids marked "TV TRUCK FOR SEWER INSPECTION" will be received by the Purchasing Manager, Room 830 * 716 Richard Arrington Jr. Blvd N, Birmingham, Alabama. ATTENTION BIDDERS: Included as a part of this contract is a cover PAGE that lists members of the Purchasing Association of Central Alabama (PACA), who will be entitled to utilize this bid when awarded. Bidders who submit bids are thereby agreeing to provide commodities and services included in this contract to present and future members of the Purchasing Association of Central Alabama (PACA). Bids will be accepted until 5:00 P.M. central time (standard or daylight savings time, as applicable) on WEDNESDAY, MARCH 16, 2011. Bids submitted after this date and time will not be considered. The County is not responsible for delays occasioned by the U.S. Postal Service, the internal mail delivery system of the County, or any other means of delivery employed by the bidder. Similarly, the County is not responsible for, and will not open, any bid/proposal responses, which are not received later than the date and time, indicated above. Late bids/proposals will be retained in the bid/proposal file, unopened. Bids will be publicly opened at 2 p.m. on THURSDAY MARCH 17, 2010. Jefferson County expressly reserves the right to reject any or all bids, and to make the award or awards as the best interest of the County appears. CONTRACT PERIOD: Contract Period is from 4/1/2011 to 4/1/2012, with the County’s option to renew until 4/1/2014. GENERAL CONDITIONS: DELIVERY TO: Fleet Management 1717 Vanderbilt Road Birmingham, AL Contact: De’Borah Henley – (205) 325-4830 and various locations of members of the Purchasing Association of Central Alabama F.O.B. – Destination via best way. Enter in the blank space your anticipated delivery date after receipt of purchase order _______________________ CANCELLATION: Failure to deliver as specified and in accordance with the bid submitted, including promised delivery date will constitute sufficient grounds for cancellation of the order resulting from this bid at the option of Jefferson County. TERMINATION OF CONTRACT: This contract may be terminated by the County with a thirty (30) day written notice to the other party regardless of reason. Any violation of this agreement shall constitute a breach and default of this agreement. Upon such breach, the County shall have the right to immediately terminate the contract and withhold further payments. Such termination shall not relieve the Contractor of any liability to the County for damages sustained by virtue of a breach by the Contractor. Failure to deliver as specified and in accordance with the bid submitted, including promised delivery will constitute sufficient grounds for cancellation of the order at the option of the County Commission. Jefferson County Commission reserves the right to award canceled contract to the next lowest and best bidder as it deems to be in the best interest of the county. {CONTINUED ON SHEET 5} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID #78-11 PAGE 5 INVITATION TO BID BIDDERS ARE REQUIRED TO SUBMIT THE ORIGINAL COPY OF THEIR BID AND TWO (2) ADDITIONAL COPIES OF THEIR BID AND ALL SUPPORTING INFORMATION SEPERATED INTO THREE (3) INDIVIDUAL PACKAGES. All equipment will meet applicable Federal Motor Vehicle Standards, including O.S.H.A. and will include fire extinguishers (5 lb. ABC for cars and light trucks, 10 lb. ABC for larger equipment) and safety triangle reflectors as well as all applicable safety items required by Federal and State DOT regulations. Fire extinguishers will be mounted in accordance with locations selected by the County. Federal standards will take precedence over County specifications in case of variance. Questions pertaining to this invitation to bid should be addressed to Mr. Donald Dennis, Principal Buyer at (205) 325-5384, dennisd@jccal.org. If mutually agreed upon, additional contracts may be executed, based upon this bid for the same item(s) or related types and/or sizes. Proprietary specifications may be waived for functional equivalents offered if approved by the County’s designated authorized representative. Use of specific names and numbers is not intended to restrict the bidding of any seller and/or manufacturer, but is solely for the purpose of indicating the type, size and quality of materials, products, service, or equipment considered best adapted to the County's intended use DELIVERY Will be to: Jefferson County Commission Fleet Management Facility 1717 Vanderbilt Rd. Birmingham, AL 35217 Attn: Charles Tyler F.O.B. destination via best way PRICES: Include transportation and Alabama Certification of Title and Registration. Title is to be made to JEFFERSON COUNTY COMMISSION or to individual member of PACA. It is REQUIRED that the bidder give the County and other PACA members credit for any manufacturer's fleet incentive program or governmental concession program benefits received. If mutually agreed upon within 36 months of bid opening this bid may be used as the basis for additional purchases. Prices for auxiliary equipment will include installation. Bidders agree that Jefferson County and other members of PACA will be charged no more for item(s) bid than the State of Alabama, and that in the event of a price reduction; the County will receive the benefit of such reduction on any undelivered portion of contract. QUANTITIES: Quantities shown are estimates, and are not a guarantee to buy in the amount shown. Purchase orders will be issued as deliveries are required. {CONTINUED ON SHEET 6} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID #78-11 PAGE 6 ADDITIONAL PURCHASES: If mutually agreed upon within twelve (12) months from bid opening date, this bid may be used as the basis for additional purchases. PARTS AND SERVICE: A local factory designated parts and repair/service dealership within ten (10) miles of Jefferson County borders and considered adequate by the County will be required. Proprietary specifications may be waived for functional equivalents offered, if approved by requesting department. Bidder must submit a letter stating differences between County specifications and specifications of item(s) offered as part of the bid response in order for response to be evaluated. PRODUCT EVALUATION: If requested by the County, bidder will arrange to demonstrate the TV Truck for Sewer Inspection at no cost to the County. The time and place of demonstration will be determined by Jefferson County. Said demonstration will be subject to guidelines established by the Purchasing Manager. The Jefferson County Commission expressly reserves the right to reject any or all bids, or parts of bids, or to re-bid, and to make the award or awards as the best interest of the County appears. Jefferson County has the right to re-bid any bid in the best interest of the County; however if the bid has been publicly opened all bidders who submitted a bid response has a right to view the responses. A copy of the bid tabulations should be provided to all bidders. Bidder must submit a copy of their Jefferson County business license within 7 days of receipt of notice of intent to award. Failure to submit the requested information will result in the notice of intent to award being revoked. MANUALS Vendor will supply two (2) hard copies and 2 copies on CD-ROM (four (4) copies total), of shop manual, operating manual, parts book and wiring manuals. The said manuals should address all components of the unit, i.e. hydraulic systems, all engines, etc. The vendor will quote a unit price for extra OPERATING MANUALS. BID EVALUATION: Items submitted in response to this bid request will be evaluated by Jefferson County on the basis of 1. 2. 3. 4. Their ability to perform the work required by Jefferson County, Their reliability/performance as compared to existing County equipment performing the required work, The availability of repair/parts facilities and The cost of the equipment as configured by the requesting County department. BID SUBMITTAL REQUIREMENTS: FAILURE TO INCLUDE THE FOLLOWING COULD RESULT IN THE DISQUALIFICATION OF BID RESPONSE: 1. Original and two (2) hard copies of bid response, including specifications. 2. Warranty – MUST ATTACH AS PART OF BID RESPONSE. 3. Bidder must submit a signed EEOC Form (non-discrimination form attached to this ITB) and return as part of bid response (Form is included in this ITB). 4. Signed and notarized Non-Collusion Affidavit (Form is included in this ITB). 5. Completed bid pricing Page included in this bid document. 6. Completed and signed Signature Page included as the last page of this bid document. CLARIFICATION: Respondent may be requested to provide additional information and/or clarify contents of their Bid package. Other than information requested by the County, no bidder will be allowed to alter the Bid or add new information after the final filing date. {CONTINUED ON SHEET 7} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID #78-11 PAGE 7 SINGLE BID: If a single bid response is received for this ITB, the bid will be rejected in accordance with Title 41-16-50-a-1 of the Alabama Code. The bid will be opened, but will not be read publicly. We will proceed with negotiations for a lower price with the rejected bidder and other bidders by means of sealed quotes. The rejected bidder’s initial offer will not be disclosed to other bidders, prior to the awarding of a contract. The award will be made to the company offering the lowest negotiated quotation, provided that all conditions and specifications required by the County are met. NEGOTIATIONS: Jefferson County reserves the right to enter into contract negotiations with the selected bidder. If the County and the selected bidder cannot negotiate a successful contract, the County may terminate negotiations and begin negotiation with the next selected bidder. This process will continue until a contract has been executed or all proposals have been rejected. No bidder shall have any rights against the County arising from such negotiations. PUBLIC DISCLOSURE: Subject to applicable law or regulations, the content of each Bidder’s Proposal shall become public information upon the effective date of any resulting contract. GOVERNING LAW/DISPUTE RESOLUTION: Any contract agreement that is issued based on this ITB, the parties shall agree that the contract agreement is made and entered into in Jefferson County, Alabama, and that all services, materials and equipment to be rendered pursuant to said contract agreement are to be delivered in Jefferson County, Alabama. The interpretation and enforcement of this contract agreement will be governed by laws of the State of Alabama. The parties agree that jurisdiction and venue over all disputes arising under this contract agreement shall be the Circuit Court of Jefferson County Alabama, Birmingham Division. INVOICING: All invoices must agree with the purchase order in description and price and include the following information: 1) Purchase Order Number; 2) Ship-to department name and address. In order to ensure prompt payment, ALL ORIGINAL INVOICES MUST BE SENT TO: Jefferson County Commission Finance Department Room 820 County Courthouse 716 Richard Arrington Jr. Blvd. North Birmingham, AL 35203 *If invoice does not agree with purchase order, credits or a corrected invoice will be required in order for the County to process payment. Invoices that do not reference an authorized Purchase Order will be returned to the vendor. THIRD-PARTY “REMIT-TO”: If Bidder has a third-party “remit-to” company, that information must appear on the Bidder’s response. Jefferson County will send payment to the company designated by Bidder on its response, but will not be responsible for resolving payment issues, should the Bidder change payment processing companies after a payment has been mailed or without 45-day written notification to the Purchasing and Accounting division of Jefferson County. PRE-PAYMENTS No prepayments of any kind will be made prior to shipment. {CONTINUED ON SHEET 8} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS EBRUARY 11, 2011 BID #78-11 PAGE 8 INVITATION TO BID – CONT’D PRICES: Include freight charges (including fuel surcharge, if applicable), handling, packaging, and service charges. Bidder agrees that Jefferson County will be charged no more for item(s) bid than the State of Alabama, and that in the event of a price reduction; the County will receive the benefit of such reduction on any undelivered portion of contract. PRICE REDUCTION: In the event of a general price reduction, the County will receive the benefit of such reduction on any undelivered portion of contract. TAX: Jefferson County is exempt from all tax. Provided however, bidder shall be responsible for payment of all sales, use, lease, ad valorem and any other tax that may be levied or assessed by reason of this transaction. INSURANCE: The successful bidder will maintain such insurance as will protect him and the County from claim under Workmen's Compensation Acts, and from claims for damage and/or personal injury, including death, which may arise from operations under this contract. Insurance will be written by companies authorized to do business in Jefferson County, Alabama and shall include Jefferson County, Alabama as Added Additional Insured By Endorsement including a thirty (30) day(s) written cancellation notice. Evidence of insurance will be furnished to the Purchasing agent not later than seven (7) day(s) after Purchase Order/contract date. Successful bidder is also required to include the bid number on the evidence of insurance. Insurance Minimum Coverage Contracting party shall file the following insurance coverage and limits of liability with the County's Human Resource Department and Purchasing Department before beginning work with the County. General Liability: $1,000,000 - Bodily injury and property damage combined occurrence $1,000,000 - Bodily injury and property damage combined aggregate $1,000,000 - Personal injury aggregate Comprehensive Form including Premises/Operation, Products/Completed Operations, Contractual, Independent contractors, Broad Form property damage and personal injury Automobile Liability: $1,000,000 - Bodily injury and property damage combined coverage Any automobile including hired and non-owned vehicles Workers Compensation and Employers Liability: $100,000 - Limit each occurrence Umbrella Coverage: $1,000,000 - Each occurrence $1,000,000 – Aggregate Added Additional Insured By Endorsement: Jefferson County, Alabama 30 day(s) written cancellation notice Under Description of Operations/Locations/Vehicles/Exclusions Added by Endorsement/Special Provisions enter the BID/ITB Number, Project Number or Purchase Order Number Covered by the Certificate of Insurance {CONTINUED ON SHEET 9} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FBRUARY 11, 2011 BID #78-11 PAGE 9 INVITATION TO BID – CONT’D HOLD HARMLESS AGREEMENT: Contracting party agrees to indemnify, hold harmless and defend Jefferson County, Alabama, its elected officers and employees (hereinafter referred to in this paragraph collectively as “County”), from and against any and all loss expense or damage, including court cost and attorney’s fees, for liability claimed against or imposed upon County because of bodily injury, death or property damage, real or personal, including loss of use thereof arising out of or as a consequence of the breach of any duty or obligations of the contracting party included in this agreement, negligent acts, errors or omissions, including engineering and/or professional error, fault, mistake or negligence of Integrator, its employees, agents, representatives, or subcontractors, their employees, agents or representatives in connections with or incident to the performance of this agreement, or arising out of Worker’s Compensation claims, Unemployment Compensation claims, or Unemployment Disability compensation claims of employees of company and/or its subcontractors or claims under similar such laws or obligations. Company obligation under this Section shall not extend to any liability caused by the sole negligence of the County, or its employees. Before beginning work, contract party shall file with the County a certificate from his insurer showing the amounts of insurance carried and the risk covered thereby. Liability insurance coverage must be no less than $1,000,000. During performance the company must effect and maintain insurance from a company licensed to do business in the State of Alabama. Coverage required includes 1) Comprehensive General Liability; 2) Comprehensive Automobile Liability; 3) Worker’s Compensation and Employer’s Liability. NON- DISCRIMINATION POLICY: The Jefferson County Commission is strongly committed to equal opportunity in solicitation of ITB’s and RFP’s. The County encourages bidders and proposers to share this commitment. Each bidder submitting a proposal agrees not to refuse to hire, discharge, promote, demote, or to otherwise discriminate against any person otherwise qualified solely because of race, creed, sex, national origin or disability by signing the attached Jefferson County EEO Certification, which shall be attached to bid response, becoming permanent part of the bid. GUARANTEE Bidder certifies by bidding, that he is fully aware of the conditions of service and purpose for which item(s) included in this bid are to be purchased, and that his offering will meet these requirements of service and purpose to the satisfaction of the Jefferson County Commission and its agent. GENERAL The Jefferson County Commission expressly reserves the right to reject any or all bids, or parts of bids, or to re-bid and to make the award or awards as the best interest of the County appears. REQUIREMENTS: PAINT: Color to be white. Trucks to be painted with acrylic enamel w/hardener. Truck bodies to be painted with minimum 2 mils primer coat 4 mils polyurethane. KEYS: There shall be a minimum of FIVE sets of keys for each vehicle. If vehicles are to be keyed alike, four sets plus two sets for each vehicle are required. Units with service bodies containing locks shall have all vehicle service body locks keyed alike. ANTI-FREEZE: Radiators and cooling systems will be protected with ethylene glycol permanent type anti-freeze to -34 degrees Fahrenheit, minimum. {CONTINUED ON SHEET 10} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 10 INVITATION TO BID (CONT’D) MAINTENANCE KIT: A maintenance kit to include and identify all filters, ENGINE belts and ENGINE hoses (NO HYDRAULIC OR AIR-CONDITIONING) must be bid as a separate item for each TYPE unit bid. SPECIAL TOOLS: A listing of any special tools by part number, manufacturer and price required for normal servicing of the type unit bid will be furnished as part of the bid so the County at its option may purchase these required tools. This listing must include pricing on any computer software and hardware necessary for servicing and diagnosing the ENGINE, HYDRAULIC SYSTEM, CAB, INSTRUMENT PANEL and (if so equipped) the AUTOMATIC TRANSMISSION. WARRANTY: Warranty submissions on items purchased under this bid which are different from the following County warranty requirements are specifically rejected by the County and the vendor, by acceptance of the County Purchase Order, agrees to the specific County warranty requirements of this bid unless the vendor warranty provisions exceed those required by the County or the County, in writing, specifically agrees to the lesser warranty provisions submitted by the vendor. WARRANTY SERVICE MUST BE PROVIDED WITHIN OR CONTIGUOUS TO JEFFERSON COUNTY, ALABAMA. OUT OF COUNTY VENDORS MUST MAKE ARRANGEMENTS FOR WARRANTY SERVICE AS PRESCRIBED. WARRANTY SERVICE IS PRESUMED TO OCCUR WITHIN OR CONTIGUOUS TO JEFFERSON COUNTY AT THE VENDOR’S LOCATION. IF IT IS NOT PRACTICAL FOR JEFFERSON COUNTY TO MOVE THE DEFECTIVE UNIT TO THE VENDOR’S SHOP, JEFFERSON COUNTY WILL NOT PAY TRAVEL TIME OR EQUIPMENT USAGE CHARGES FOR FIELD WARRANTY WORK. IF VENDOR DOES NOT PROVIDE LOCAL WARRANTY SERVICE, VENDOR AGREES BY ACCEPTANCE OF A PURCHASE ORDER AND SUBSEQUENT DELIVERY OF PURCHASED UNITS THAT JEFFERSON COUNTY MAY BILL THEM FOR WARRANTY WORK PERFORMED LOCALLY BY COUNTY FORCES OR OTHERWISE. BASIC warranty is defined to cover all parts and labor for the greater of the manufacturers warranty period or a period of 12,000 miles/1,500 hours or 12 months from the in-service date of the unit.. The in-service date shall commence no later than six months after receipt of the unit. The basic warranty shall cover defects in any parts required for the unit to operate as designed, engine to operate or parts required for the unit to move as well as any other defect in the unit attributable to the manufacturing of the unit. On minor warrantable repairs the County may choose to make the repair using its own forces. In such cases the vendor hereby agrees to give the County credit for the warrantable part upon presentation of the part and required paperwork within 30 days of the repair. EXTENDED WARRANTY is defined to cover all items identified in the basic warranty for an additional length of time and number of miles as specified in the bid pricing pages. BODY WARRANTY is defined to cover all parts and labor for the greater of the manufacturer’s warranty period or six months from the in-service date of the unit and shall cover any defects in material or workmanship. Donald Dennis, Principal Buyer {CONTINUED ON SHEET 11} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 11 INVITATION TO BID (CONT’D SPECIFICATIONS ITEM 1: Sewer TV Truck New, latest model Ford E-450 Hi Cube, or approved equal, Sewer TV Truck. It is the desire of Jefferson County to establish a multiyear purchasing contract for these units and we are therefore requesting a quote for pricing on year models 2011, 2012 & 2013. QUANTITY: One or more Bidder will state exceptions to specifications in spaces provided below and guarantee that he will meet or exceed all County specifications, unless so stated. COMPONENT LIST: 1 Ford E-450 16’ hi-cube van, 16,500 GVWR, 6.4L diesel engine 2 Full width rear bumper steps, high grip tread 1 Backup alarm 2 Arrow bars, 1ea mounted front and rear, with controls in cab 2 Adjustable floodlights, mounted above rear doors 2 Amber strobe lights, 1ea mounted front and rear of roof, with controls in cab 1 Four-way flashers 1 Back-up camera ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ 1 Hi-cube “Command Center” Control room interior including: 1 Lonplate-I black floor covering 1 Gray Formica laminated surface wall covering 1 White embossed ceiling cover 1 Bulkhead wall with Plexiglas window and swing passage door to equipment room 1 Roof mounted air conditioner, 13500 BTU with 5600 BTU heat strip 1 Modular control center, 19” rack mounted above corner of desktop 1 Ergonomically contoured and finished control desk 1 Fluorescent lighting system ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 12} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 12 INVITATION TO BID (CONT’D 2 1 1 1 1 1 1 Quad grounded 120V AC sockets Operator chair, swivel with casters Hinged padded bench seat with storage underneath and hold open device Storage shelf above padded bench seat Full height cabinet, 24"W x 20"D, (1) fixed and (2) removable shelves 2-drawer file cabinet, mounted below the desktop Side access door and steps 1 Hi-cube van equipment room interior including: 1 Aluminum treadplate flooring 1 Kemlite laminated surface wall covering 1 White embossed ceiling cover 2 Quad electrical outlets, 120V AC grounded 2 Interior fluorescent light fixtures with switch 1 Set equipment storage brackets and hooks 1 Work bench with ABS worktop and vise 1 Storage shelves over work bench approximately 4’ long with fluorescent light underneath 1 Down hole pole mounting bracket 1 Tie down brackets along floor 1 Fire extinguisher, 10 BC rating 1 12V dome light ________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ 1 Water wash down system for equipment clean-up including: 1 Water storage tank, 25-gallon 1 Set of fill, vent and drain connections 1 Water tank demand pump 1 25’ retractable wash down hose with spring-loaded hand nozzle __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ 1 Wash sink with faucet, drain and 8-gallon gray water tank under vehicle __________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 13} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 13 INVITATION TO BID (CONT’D 1 7,500W quiet, diesel powered, commercial grade generator, 120V, 60 Hz, with electric local and remote start/stop control to include: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Quiet diesel engine package, 71dB at 10ft under full load Generator enclosure lined with fire retardant and noise reduction material Hinged, ventilated cover with lock mechanism and air spring supports Set exhaust hose and power cables Auxiliary battery, 12V DC and case Auxiliary battery charger, 10A Electric power transfer system, house or generator Electric distribution panel and circuit breaker box House power exterior connection with cover 25’ house power cord with plug and socket System engineering panel to include: Generator volt meter Generator frequency meter Generator hour meter Generator start/stop switch ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ _______________________________________________________________________________________________________ 1 Toilet closet complete with carpentry, door and vent including: 1 Soap dispenser, towel rack, and toilet paper dispenser 1 Chemical toilet and drain 1 Vent fan and overhead light ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ 1 1 1 1 1 1 Color TV power control unit, multi-conductor, modular control center mount, with: Camera power supply with adjustable voltage and amp level, DC amp and voltmeters, on/off switch and circuit breaker TV camera light head intensity control with on/off switch and circuit breaker Light head power supply with DC amp and voltmeters, switch and circuit breaker Light head power selector switch, 5-position with light head bulb overdrive auto resetting protective circuit breaker Set pre-wired connections for tractor and/or pan and tilt camera controllers ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 14} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 14 INVITATION TO BID (CONT’D 3 15” LCD flat panel multimedia monitor 2 Mounted to control room desktop 1 Mounted rear facing in the equipment room _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ 1 DVD/VCR combination recording unit, including: 1 Modular control center tray mounts for combination recording unit. 1 DVD/VHS recorder with one-touch DVD or VHS dubbing 1 Audio recording microphone 1 Set power and video cabling 1 2-hour 1/2" recording tape cassette 5 Blank DVDs __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ 1 Pipetech Scan software and license ___________________________________________________________________________________________________________ 1 Rack-mounted computer and video overlay system, including: 1 VL3100 data logging overlay module, rack mounted 1 Industrial hardened case with air filtering, vibration dampening hard drive mounts, peripheral cards support bar, 19” rack with: VGA Video card per PipeTech, Linksys wireless card, 4 GiG of RAM, Terabyte Harddrive; 360Gig external Hard drive, Quad Core motherboard, On-board sound DVD-R/W drive, 3.5”, 1.44MB floppy disk drive, 104 key enhanced heavy duty keyboard, and Microsoft optical mouse. 1 Windows XP Pro operating system, 1 UPS back-up battery system, 1Ink Jet printer, color, HP, parallel port. ________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 15} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 15 INVITATION TO BID (CONT’D 2 Aries PE2610 “Illumi-Zoom” multi-conductor, pan and tilt radial view, LED-illuminated, zoom, color sewer TV camera, consisting of: 1 1 1 1 1 Maintenance-free directional camera LED light system for 6" to 72" pipes and ducts Built-in diagnostics system to monitor camera operating conditions Camera storage and transport case Spare parts kit Test cable, components to 12-pin PCU connector Camera features include: 360˚ continuous axial rotation 300˚ pan & tilt rotation 40X zoom (10X optical & 4X digital) Automatic or remote adjustable focus Automatic or remote adjustable iris Automatic home feature with forks at side of camera head Automatic white balance circuitry NTSC color imaging module SMARTEK internal diagnostic system 0.1 Lux low-light STARLITE mode 1 Desktop camera controller including: joystick for axial rotation and pan and tilt angle; remote focus; remote iris; zoom in/out; diagnostics pushbutton; and home switch 1 Television cable reel with power level wind, electric motor drive, and multi-ratio manual transmission, to include: 1 Footage meter on TV reel level wind assembly with local mechanical footage readout and encoder for footage signal to remote video data display system 1 Transmission control linkage at control console 1 Local reel mount electrical and mechanical control 1 Remote desktop electrical and mechanical controls 1 Sealed continuous contact collector assembly, 12 slip rings minimum 1 Drop down cable guide assembly 1 24-pin switchover and test cable system 1 Drip pan with drain __________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 16} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 16 INVITATION TO BID (CONT’D 1 Combination TV transmission and tow cable assembly, .43" diameter, Kevlar armored, 2,000 lb. rating, 1,000' Red Maxx, to include: 1 Cable terminal connector, 12-pin 1 Dummy plug, 12-pin 1 Tow/tag line bridle set, multi-conductor cable 1 Cable terminal repair kit ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ___________________________________________________________________________________________________________ 1 Aries TR3100 “Mini-Badger” self-propelled wheeled camera transporter for 6” to 30” lines, components include: 1 Tractor assembly with continuous duty drive motor 1 Set each of 3”, 4” and 5” rubber tires for 6” to 30” sewer lines 1 Set transmission couplings and weighted adjustment bars for operation in 8” to 30” sewer lines 1 Foot pedal controller, under desktop 1 Foot pedal controller, rear of vehicle 1 Plywood storage and shipping box with removable cover 1 Set maintenance parts 1 Desktop transporter controller with speed adjustment and forward/reverse __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ 1 Cable manhole guide system including: 1 Manhole top roller assembly 2 Manhole bottom roller assembly and adapter hook 8 Steel quick lock extension poles 1 Insertion and extractor pole assembly and tractor adapter 1 Tiger tail bottom cable guide __________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 17} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 17 INVITATION TO BID (CONT’D 2 2 1 1 1 1 Manuals – operation and maintenance Spare parts catalogs Training video – TV Systems Operating Procedures Training video – Troubleshooting and Cable Repair Procedures Maintenance tool kit Spare level wind pawl 1 Delivery of system 3 Days of training 1 One-year warranty, TV system ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ Name of your company: ________________________________________________________ {CONTINUED ON SHEET 18} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 18 INVITATION TO BID (CONT’D Special Note To all Bidders: You must be able to provide “Operator Training” and “Mechanic Training” once the equipment is delivered to the county. You must schedule a time for this to take place with the Fleet Management Department and user department with in two days of delivery. Please provide a plan on how this would be done, along with this bid. Name of Your Manufacturer & Product Number _________________________ (Attach Manufacturer's Catalog Sheets) Delivery is guaranteed not later than _______ days after order date. Name of your company: ________________________________________________________ {CONTINUED ON SHEET 19} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 19 BID (Bidder must use this form) Fill in all spaces. All prices to include Alabama Certificate of Title and Registration, to be delivered with unit. Title will be in the name of Jefferson County Commission, 1717 Vanderbilt Road, Birmingham, Alabama 35234 or to the other member of PACA issuing a purchase order. VENDOR MUST SUBMIT A LISTING OF ALL OPTIONS AVAILABLE ON THE UNIT HE IS BIDDING. THE LIST PRICE LESS ________ % (State your discount) ITEM NO. 1) Sewer TV Truck ……………………….$___________ EACH 1A) MAINTENANCE KIT……………………………$___________EACH 1B) Extended Warranty Options on Truck………….$___________ EACH 1C) Percent increase for model year 2012………….. %_____________ Percent increase for model year 2013………….. %_____________ Name of your company: ________________________________________________________ Delivery is guaranteed not later than _______ days after order date. {CONTINUED ON SHEET 20} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 20 Bidder agrees by bidding, that all offers will be guaranteed firm for orders placed within SIXTY (60) days after bid opening. PRICE GUARANTEE FOR ENTIRE CONTRACT PERIOD: Bidder agrees that he will deliver any items awarded to him, that such items will be manufactured to quoted specifications that prices billed will be no higher than those quoted herein and that delivery will be made within the time specified herein or within a reasonable time, if not so specified. Bidder hereby guarantees delivery of all items awarded to him hereunder, without any qualification or limitation whatsoever. In making this guarantee, bidder confirms that he has secured the subject items or has obtained guarantee of their availability sufficient to his satisfaction. Bidder further agrees that in the event bidder fails to deliver any items awarded to him in accordance herewith for any reason whatsoever, Jefferson County may, at its option, accept the next lowest and best bid for such items, or re-bid such items, or obtain substitute items elsewhere. Such substitutes may include later year models, where current year models are not reasonably available. Bidder agrees to pay Jefferson County the difference between the bidder's bid for such items and the cost to Jefferson County to obtain the items elsewhere, if greater, and other incidental and consequential damages. Jefferson County may elect not to affect such cover, and may enforce all remedies authorized by law. {CONTINUED ON SHEET 21} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, AL 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID 78-11 PAGE 21 INVITATION TO BID (CONTINUED Non-Collusion Affidavit I, ___________________________________________________, an authorized agent/representative of ________________________________attest 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 Offeror has not directly or indirectly induced or solicited any other Offeror to put in a false or sham ITB, and has not directly or indirectly colluded, conspired, connived or agreed with any Offeror or anyone else to put in a sham ITB, or than anyone shall refrain from proposing; that the Offeror has not in any manner, directly or indirectly sought by agreement, communication or conference with anyone to fix the ITB of the Offeror or any other Offeror, to fix any overhead profit, or cost element of the ITB price or of that of any Offeror, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the ITB are true; and further, that the Offeror has not, directly or indirectly submitted his/her ITB price or any breakdown thereof or the contents thereof, of divulged information or data relative thereto, or paid, and will not pay any fee to any corporation, partnership, company, association, organization, ITB depository, or to any member or agent thereof, to effectuate a collusive or sham ITB. I, the undersigned, hereby certify that I have read and understand this Non- Collusion Affidavit and guarantee complete compliance with all the terms, conditions and stipulations. Subscribed and Sworn to Before me this ________ day of ___________ 20____. BY: ___________________________________ Authorized Signature of Offeror Date _____________________________________ Print or Type Name of Offeror ___________________________________ Notary Public of My Commission expires {CONTINUED ON SHEET 22} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID #78-11 PAGE 22 JEFFERSON COUNTY, ALABAMA EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION FORM Contractor/Vendor Name: __________________________________________________ Address: ______________________________________________________________ _______________________________________________________________ The Contractor acknowledges receipt of Jefferson County’s Equal Employment Opportunity Contractor Compliance Administrative Order and certifies that it is an equal opportunity employer and agrees to the requirements of the Policy and the Equal Employment Opportunity Clause therein. It further certifies that it will require all subcontractors to execute an Equal Employment Opportunity statement and certification of compliance in accordance with Jefferson County Administrative Order 08-4 as follows: 1. The Contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, national origin, age, disability or veteran status pursuant to the provisions of Title VII of the Civil Rights Act of 1964, 42 U.S.C. §§ 1981, 1983, 1986 and all amendments thereto relative to discriminatory employment practices. The Contractor will ensure that qualified applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, national origin, age, disability or veteran status. Such action shall include, but not be limited to the following: employment, promotion, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. 2. In the event of the Contractor’s non-compliance with the equal employment opportunity clause of this contract, this contract may not be awarded or may be cancelled, terminated or suspended in whole or in part and the Contractor may be declared ineligible for further County contracts. 3. The Contractor will include the provisions of paragraph (1) in every subcontract or purchase order. 4. The Contractor shall certify to the County its compliance with this policy prior to receipt of any contract or business with the County. The Contractor will furnish to the County, upon request, reports, notices, policies and/or information certifying compliance with this policy. In the event of the Contractor’s non-compliance with the equal employment opportunity clause of this contract, this contract may not be awarded or may be cancelled, terminated or suspended in whole or in part and the Contractor may be declared ineligible for further County contracts. ________________________ Date ___________________________________ Signature ___________________________________ Title {CONTINUED ON SHEET 23} JEFFERSON COUNTY COMMISSION PURCHASING DEPARTMENT ROOM 830 * 716 RICHARD ARRINGTON JR BLVD N BIRMINGHAM, ALABAMA 35203 (205) 325-5384 PRINCIPAL BUYER: DONALD DENNIS FEBRUARY 22, 2011 BID # 78-11 PAGE 23 INVITATION TO BID – CONT’D SIGNATURE PAGE The Jefferson County Commission, or its Agent, shall have the right to waive any informality or irregularity. Under certain limited conditions, the Purchasing Department may apply a local preference option in determining the low bid for purchases of personal property. All provisions of this Invitation are accepted by bidder as part of any contract or purchase resulting there from. Please specify terms of payment below; otherwise, the terms will be Net 30. Date: _______Company Name: ______________________________ Web Address:________________________________ Terms: _______Address:_______________________________________City:_____________________________________ County: _______________State: _____ Zip: ____________ Phone: (_____)____________________ If Jefferson County Business Licenses were issued to your company for the past twelve (12) months, please list numbers: _____________________________________________. Vendor's Federal I.D. Number: ____________________________ I certify that ___________________________ has ___ has not ___ been in operation for one (Company Name) (Check one) year at location(s) zoned for the type of business conducted by my company at the address stated above. ______________________________ (Authorized Signature) ______________________________ (Print Name) ______________________________ (E-Mail Address) Toll Free Phone: _____________________________Fax Number: ____________________________ Return original bid in sealed envelope. Authorized signature of bidder must be in ink. Bids received in our office after the specified date and hour will not be considered. INDICATE THE FOLLOWING ADDRESSES IF DIFFERENT FROM ABOVE: 1. BID AWARD NOTICE ADDRESS 2. PURCHASE ORDER ADDRESS 3. REMITTANCE ADDRESS (AND NAME IF DIFFERENT THAN ABOVE)