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Notice of Intent to Award - Sourcewell Nat'l Contract (Ambulance) 2026
BID #: N/A
ISSUED: 5/20/2026
DUE: 6/1/2026
VALUE: $409,734.00
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Executive Summary
The Township of Jefferson is issuing a notice of intent to award a contract for the procurement of a Type I Classic 170, Ford F-550 4x4 Gas Ambulance through the Sourcewell National Cooperative Purchasing Service. This procurement leverages Sourcewell Contract No. 122123-PLC, "Ambulance and Emergency Medical Services Vehicles," with P.L. Custom Body and Equipment Co. Inc. The contract term with Sourcewell and the vendor is February 28, 2024, through February 28, 2028. The comment period for this notice ends on June 1, 2026. This process adheres to New Jersey statutes allowing participation in national cooperative purchasing agreements for efficiency and cost savings.
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Bid Postings • Notice of Intent to Award - Sourcewell Nat'l Skip to Main Content Closing Alert All Municipal Offices closing at 2:00 PM 5/22 Read On... Create a Website Account - Manage notification subscriptions, save form progress and more. Website Sign In Facebook Twitter Instagram Search About Us Departments Programs Resources How Do I? Shop Local Home Bid Postings Print Sign up to receive a text message or email when new bids are added! Print Bid Title: Notice of Intent to Award - Sourcewell Nat'l Contract (Ambulance) 2026 Category: Bid Postings Status: Open Description: Notice of intent to Award Contract under National Cooperative Purchasing Agreement. The Township of Jefferson intends to participate in the Sourcewell National Cooperative procurement service to procure a Type I Classic 170, Ford F-550 4x4 Gas Ambulance Publication Date/Time: 5/20/2026 12:00 AM Closing Date/Time: 6/1/2026 11:59 PM Related Documents: Notice of Intent to Award - Sourcewell Nat'l Contract (Ambulance) 2026 (PDF) Return To Main Bid Postings Page Live Edit BILLS LIST PUBLIC NOTICES Tax Record Search Agendas & Minutes OPRA Request Online Bill Pay Legal Notices RAVE Emergency Alerts Sign Up Town Council Agendas and Minutes Boards and Commissions Public Notices Camp Jefferson Summer Day Camp /QuickLinks.aspx Home Contact Us Accessibility Site Map Copyright Notices Privacy Policy /QuickLinks.aspx Township of Jefferson 1033 Weldon Road, Lake Hopatcong, NJ 07849 Phone: 973-697-1500 Fax: 973-697-8090 Municipal Building Hours: Mondays - Thursdays 9:00 AM - 4:30 PM Fridays 8:00 AM - 3:30 PM Government Websites by CivicPlus® Loading Loading Do Not Show Again Close Arrow Left Arrow Right [] Slideshow Left Arrow Slideshow Right Arrow
Document Text
--- Document: Notice of Intent to Award - Sourcewell Nat'l Contract (Ambulance) 2026 (PDF) ---
TOWNSHIP OF JEFFERSON
COUNTY OF MORRIS
STATE OF NEW JERSEY
NOTICE OF INTENT TO AWARD
Notice of intent to Award Contract under National Cooperative Purchasing Agreement.
The Township of Jefferson intends to participate in the Sourcewell National Cooperative procurement
service to procure a Type I Classic 170, Ford F-550 4x4 Gas Ambulance.
The Township of Jefferson intends to utilize Sourcewell Contract No. 122123-PLC, entitled "Ambulance
and Emergency Medical Services Vehicles" with P.L. Custom Body and Equipment Co. Inc.
The term of the contract between Sourcewell and P.L. Custom Body and Equipment Co. Inc. is February
28, 2024 through February 28, 2028.
The Township of Jefferson joined the Sourcewell National Cooperative on July 18, 2018.
The Township of Jefferson is permitted to join national cooperative purchasing agreements under the
authority of N.J.S.A. 52:34-6.2(b)(3).
It is the intent of the Township of Jefferson to execute a contract with P.L. Custom Body and Equipment
Co. Inc., for a Type I Classic 170, Ford F-550 4x4 Gas Ambulance.
The length of the contract shall be from contract award date until the receipt of the above referenced
equipment including any applicable service and warranty terms.
Information regarding the contract may be found at the Township of Jefferson's Finance Department
during regular business hours, as well as their website www.jeffersontownship.net and on the Sourcewell
website www.sourcewell-mn.gov.
Comment period ends at the end of the business day on June 1, 2026.
Debra Millikin
Business Administrator
TOWNSHIP OF JEFFERSON
COUNTY OF MORRIS, NJ
CONSENT AGENDA RESOLUTION#26-XX
"RESOLUTION AUTHORIZING THE PURCHASE OF A FORD F-550 TYPE I CLASSIC 170 4X4 (GAS ENGINE)
AMBULANCE FROM P.L. CUSTOM BODY & EQUIPMENT CO., INC. UNDER THE SOURCEWELL NATIONAL
SERVICE COOPERATIVE"
WHEREAS, pursuant to P.L. 2011, c. 139 all contracting units are permitted to use contracts awarded by national or
regional cooperatives that were already competitively bid without competitively bidding the goods or services
themselves; and
WHEREAS, on July 18, 2018, the Township Council authorized the Township to enter into an agreement with the
Sourcewell National Cooperative to purchase goods and/or services in order to make the procurement process more
efficient and to provide cost savings to the Township; and
WHEREAS, the Sourcewell National Service Cooperative awarded Contract No. 122123-PLC entitled "Ambulance
and Emergency Medical Services Vehicles" to P.L. Custom Body and Equipment Co., Inc., 2201 Atlantic Avenue,
Manasquan, NJ 08736; and
WHEREAS, the Township of Jefferson wishes to purchase one (1) Ford F-550 Type I Classic 170 4X4 Gas Engine
Ambulance from P.L. Custom Body & Equipment Co., Inc., 2201 Atlantic Avenue, Manasquan, New Jersey,
08736 for an amount not to exceed $409,734.00; and
WHEREAS, the Township is in receipt of the requisite documentation required in order to award this contract through
the Sourcewell National Cooperative contract; and
WHEREAS, the use of the Sourcewell National Cooperative shall result in cost savings, after all factors, including
charges for service, material and delivery, have been considered; and
WHEREAS, the Sourcewell National Cooperative's bidding process for contractors meets the requirements of the
"fair & open" definition required by N.J.S.A. 19:44A-20.7; and
WHEREAS, the determination by the Township to award this contract under this National Cooperative was previously
advertised on the Township of Jefferson website; and
WHEREAS, pursuant to N.J.A.C. 5:30-5.5(b) a certificate showing availability of funds has been provided to the
Township by the Chief Financial Officer of the Township, certifying that the funds for said contract are available and
are designated to a line item appropriation as designated below.
C-04-55-926-016-903
NOW, THEREFORE, BE IT RESOLVED by the Township Council of the Township of Jefferson, County of Morris,
State of New Jersey, that the Township Administrator is authorized to one (1) Energreen ILF Kommunal Mower with
related Equipment from P.L. Custom Body & Equipment Co., Inc., 2201 Atlantic Avenue, Manasquan, New
Jersey, 08736 in an amount not to exceed $409,734.00; and
ATTEST:
AMANDA NEVINS, DEPUTY TOWNSHIP CLERK
Dated: June 10, 2026
COUNCIL OF THE TOWNSHIP OF JEFFERSON:
JOSH KALISH, COUNCIL PRESIDENT
NAME
Garruto
Schultz
Senatore
Kalish
Birmingham
MOTION
SECOND AYE NAY ABSENT ABSTAIN
DRAFT
CERTIFICATION: I, Amanda Nevins, Deputy Township Clerk of the Township of Jefferson, County of Morris, State of
New Jersey, do hereby certify the foregoing to be a true and exact copy of a resolution adopted by the Jefferson
Township Council at a meeting held on June 10, 2026.
Amanda Nevins, RMC, Deputy Township Clerk
Use of National Cooperative Purchasing Contracts
National Cooperative Name:
Contract Name:
Contract Number:
Vendor Name:
Description of Item for Purchase:
Sourcewell Cooperative Purchasing Service
Ambulance and Emergency Medical
Services Vehicles
122123-PLC
P.L. Custom Body and Equipment Co. Inc.
Type I Classic 170, Ford F-550 4x4 Gas
Ambulance with Related Equipment, Options &
Services
The Township of Jefferson is permitted to join national cooperative purchasing agreements under
the authority of N.J.S.A. 52:34-6.2(b)(3).
•
The Township of Jefferson joined the Sourcewell Co-Operative Purchasing Service in 2018.
Resolution No. 2018-185 dated July 18, 2018
Member ID No. 31515
Per NJ State regulations including Local Finance Notice 2012-10, the following three (3) requirements
must be met to utilize a National Cooperative Contract:
1. The national cooperative contract must have been awarded through a "competitive bidding
process."
•
Sourcewell solicited Request for Proposal#122123 for "Ambulance and Emergency
Medical Services Vehicles" starting on November 2, 2023.
Bids were received and opened on December 21, 2023.
Contract was awarded to PL Custom Body and Equipment Co. on February 28, 2024.
Contract expires February 28, 2028.
2. New Jersey Procurement rules requires that the contract being awarded pursuant to the
national cooperative model must have been awarded by a contracting unit as defined in c.
139, and cannot have been awarded by a non-profit or private organization, even if a
member of the cooperative.
•
Sourcewell is a State of Minnesota local government agency and Service Cooperative that
offers cooperative procurement solutions to its members.
It was created by the Minnesota Legislature as a local unit of government per Minnesota
Constitution Article XII, Section 3.
Sourcewell is governed by local elected municipal officials and school board members.
3. The original bid must have been advertised as a national cooperative contract (or a
regional contract that includes New Jersey in its region) – not as a strictly local contract
that is made "national" or "regional" after the receipt of bids.
•
Sourcewell provided public notice in various publications beginning November 2, 2023 for
RFP#122123 for "Ambulance and Emergency Medical Services Vehicles."
Page 1 of the RFP, indicates that the Sourcewell contract is open to its current and
potential member agencies, which includes all governmental, higher education, K-12
education, not for profit, tribal government, and all other public agencies located in the
United States and Canada.
COST
SAVINGS
DETERMINATION
Cost Savings Determination
New Jersey Law requires a "Cost Savings" Determination when using National Purchasing
Cooperative contracts.
The Law requires that a contracting unit can use national cooperatives only when the contracting unit
determines "that the use of the cooperative purchasing agreement shall result in cost savings after all
factors, including charges for service, material, and delivery, have been considered."
METHODOLOGY
The Township of Jefferson received proposal from an authorized dealer showing:
1) The discount percentage pricing per the Sourcewell Contract.
COST ANALYSIS
The Sourcewell Contract No. 122123-PLC for "Ambulance and Emergency Medical Services Vehicles"
requires a 5% percentage discount off the MSRP price.
The proposal submitted by P.L. Custom Body and Equipment Co. Inc. indicates Sourcewell pricing in the
amount of $281,948.60 and includes a 5% discount in the amount of $14,839.40 on the base cost of the
ambulance.
ITEM/DESCRIPTION
LIST
PRICE*
SOURCWELL
PRICE
SAVINGS
AMOUNT
SAVINGS
%
TYPE I CLASSIC 170 AMBULANCE
FORD F-550, 4x4 GAS
296,788.00
281,948.60
(14,839.40)
-5%
There were also various options totaling $127,785.40 which were not subject to the Sourcewell Contract
5% discount.
The total savings is estimated to be at least $14,839.
Additional savings are also achieved by not going out to bid for this item but those savings are difficult to
quantify.
COST SAVINGS FOR USE OF NATIONAL PURCHASING COOPERATIVE
PURCHASING CO-OP NAME:
SOURCEWELL (FORMERLY NATIONAL JOINT POWERS ALLIANCE)
CONTRACT No. 122123-PLC
CONTRACT NAME: AMBULANCE AND EMERGENCY MEDICAL SERVICES VEHICLES
VENDOR: PL CUSTOM EMERGENCY VEHICLES
AUTHORIZED DEALER: NEW JERSEY EMERGENCY VEHICLES
ITEM(S)/DESCRIPTION: TYPE I CLASSIC 170, FORD F-550 4x4 GAS AMBULANCE
ITEM/DESCRIPTION
TYPE I CLASSIC 170 AMBULANCE
TOTAL OPTIONS
WITH RELATED EQUIPMENT, OPTIONS & SERVICES
MODEL
FORD F-550, 4x4 GAS AMBULANCE
PROPOSAL
PRICE
281,948.60
127,785.40
409,734.00
SAVINGS ANALYSIS:
ITEM/DESCRIPTION
TYPE I CLASSIC 170 AMBULANCE
TOTAL OPTIONS
ESTIMATED TOTAL SAVINGS
MODEL
FORD F-550, 4x4 GAS AMBULANCE
LIST
PRICE*
296,788.00
127,785.40
SOURCWELL
PRICE
281,948.60
127,785.40
SAVINGS
AMOUNT
(14,839.40)
SAVINGS
%
-5%
(14,839.40)
(14,839.40)
Township of Jefferson
1033 Weldon Road
Lake Hopatcong, NJ 07849
Sourcewell Membership ID Number 31515
NJEV
New Jersey
Emergency Vehicles
A PL Custom Company
SOURCEWELL AMBULANCE PROPOSAL
DATE
SALESPERSON
EST. SHIPPING DATE
F.O.B.
TERMS
April 21, 2026
Jamey Pallitto
See proposal
Manasquan, NJ SEE BELOW
Qty
Description
1
Type I Classic 170, Ford F-550 4x4 Gas Ambulance-PLC12
Sourcewell Member Discount - Member #31515
Ford F-550 4x4 Super Duty -XL Trim
Lifetime Structural & Electrical Warranty
Total
$296,788.00
-($14,839.40)
SAE J3057 & KKK Rev. F Compliant
Whelen Emergency Lighting Package
FRC 360* Camera System with DVR
Inverter with battery charger
Custom Paint and Lettering
Total options as per attached specifications A7238-0002
$127,785.40
TOTAL PRICE PER SOURCEWELL CONTRACT RFP#122123
$409,734.00
APPROVED SIGNATURE:
PRINT CONTACT NAME AND PHONE NUMBER
DATE:
Purchase Order #
TERMS:
1. Includes dealer prep, fully fueled at time of delivery
2. Vehicle payment is due upon delivery
3. Proposal pricing is valid for 60 days
Sales and Service
2201 Atlantic Avenue, Suite 2
Manasquan, NJ 08736
732.223.1411
732.223.1164 (fax)
PL CUSTOM
EMERGENCY VEHICLES
RESCUE
MMALLEY
NEW JERSEY EMERGENCY VEHICLES (NJEV, LLC.) IS A DIVISION OF P.L. CUSTOM BODY AND EQUIPMENT CO., INC.
QUOTATION
New Jersey Emergency Vehicles
Milton First Aid Squad
Frank Parete, Chief
45 Milton Road
PO Box 118
Oakridge, NJ 07438
973-697-2197
New Jersey Emergency Vehicles
Jamey Pallitto
2201 Atlantic Ave.
Manasquan, NJ 08736
(732) 223-1411 ext. 176
(732) 223-1164
jpallitto@njev.net
Exp. Date:
Quote No:
06/30/2026
A7238-0002
04/21/2026
PART NO
DESCRIPTION
Page 1
QTY
== Type 1 Classic, 170" 108"CA - 34.110 04/23/25 ==
PL Ambulance - Release 34.13 effective 01/30/26
** Quote Terms **
All chassis are subject to availability.
Quoted body pricing is valid for 30 days from receipt or until the next data release.
1
1
Chassis pricing for PL Supplied chassis is subject to any OEM chassis manufacturer surcharges
and model year increases.
An ambulance or rescue vehicle order, submitted utilizing a chassis that cannot be provided or
ordered, (chassis order banks not open, no available allocation, or otherwise unknown), will
NOT be processed until such time that the chassis can be ordered and assigned.
Upon receipt of chassis VIN and firm chassis production schedule, or chassis receipt, the vehicle
order can then be considered "buildable".
Once entered into "buildable' order status and when loaded into the PL Custom production
schedule, prioritized by order entry date, the body can then be processed for approval and
priced on most current pricing and data release in place.
This applies to both PL Custom and customer/dealer supplied chassis.
00-00-0100
00-05-0100
00-11-7065
170" CLASSIC BODY, 72" Headroom, w/Drop Skirt
Overall Vehicle Dimensions:
Length: 308"
Width: 99"
Height: 112" (+/- 2")
Exterior Modular Body Dimensions:
Length: 170"
Width: 97"
Height: 91"
Interior Modular Body Dimensions:
Length: 165"
Width: 90 3/4"
Height: 72"
03-00-1060
Chassis Type -Ford F-Series
Chassis paint must be reviewed/edited when changing chassis type
EXTERIOR
10-10-1100
Modular Body Construction
SAE J3057 Compliant
10-10-2000
Structural Integrity Warranty
The structural integrity of the body shall be guaranteed for the life of the unit, as long as the
original purchaser shall own it.
1
1
1
TOWNSHIP OF JEFFERSON
CHECKLIST for NATIONAL COOPERATIVE CONTRACTS
The following is a checklist of requirements to be fulfilled in order to comply
New Jersey Public Law 2011, Chapter 139:
ITEMS NEEDED FROM VENDOR AT TIME OF SUBMISSION:
INITIALS
A. POLITICAL CONTRIBUTION DISCLOSURE FORM
B. BUSINESS REGISTRATION CERTIFICATE
C. STOCKHOLDER DISCLOSURE CERTIFICATION FORM
D. NON-COLLUSION AFFIDAVIT
E. MANDATORY EQUAL OPPORTUNITY REQUIREMENTS
F. MANDATORY EQUAL OPPORTUNITY LANGUAGE
G. AMERICAN WITH DISABIITIES - EQUAL OPPORTUNITY STATEMENT
H. AMERICAN WITH DISABIITIES - COMPLIANCE CERTIFICATION
1. DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN
J. CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED
ACTIVITIES IN RUSSIA OR BELAURS PERSUANT TO P.L.2002, C.3
K. NEW JERSEY'S "BUY AMERICAN" LAW
L. INSURANCE REQUIREMENTS & ACKNOWLEDGEMENT
M. NATIONAL CO-OPERATIVE CONTRACT INFORMATION
N. CONTRACT & PRICING SCHEDULE
(PRICING PROPOSAL SHALL INCLUDE APPLICABLE NATIONAL CO-OP ITEMIZED PRICING CODES)
O. OSC RECORD RETENTION LANGUAGE
P. IRS FORM W-9
THE UNDERSIGNED HEREBY ACKNOWLEDGES THE ABOVE LISTED REQUIREMENTS
NAME OF PROPOSER:
P.L. Custom Body and Equipment Co., Inc.
Person, Firm or Corporation
BY:
Deborah L. Thomson
(NAME)
SIGNATURE
President
(TITLE)
5/4/26
DATE
Township of Jefferson
Non-Fair & Open Packet
Page 2
ITEM A
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant To N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the local unit
no later than 10 days prior to the award of the contract.
Part I-Vendor information
Vendor Name:
P.L. Custom Body and Equipment Co., Inc.
Address: 2201 Atlantic Ave.
City:
Manasquan
State: NJ
Zip:
08736
The undersigned being authorized to certify, hereby certifies that the submission provided herein represents compliance with
the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions accompanying this form.
Deborahos
Signature
Part II - Contribution Disclosure
Deborah L. Thomson
Printed Name
President
Title
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable political
contributions (more than $200 per election cycle) over the 12 months prior to submission to the committees of
the government entities listed on the form provided by the local unit.
Check here if disclosure is provided in electronic form.
Contributor Name
Recipient Name
Date
Dollar Amount
$
Check here if the information is continued on subsequent page(s)
Township of Jefferson
Non-Fair & Open Packet
Page 3
ITEM A
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a "fair and
open" process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of N.J.S.A. 19:44A-20.26. This law
provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions to:
* any continuing political committee (a.k.a., political action committee)
* any candidate committee of a candidate for, or holder of, an elective office:
O of the public entity awarding the contract
O of that county in which that public entity is located
O of another public entity within that county
or of a legislative district in which that public entity is located or, when the public entity is a
county, of any legislative district which includes all or part of the county
The disclosure must list reportable contributions to any of the committees that exceed $200 per election cycle that were
made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on
reportable contributions.
N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a
natural person. This includes the following:
individuals with an "interest" ownership or control of more than 10% of the profits or assets of a business
entity or 10% of the stock in the case of a business entity that is a corporation for profit
all principals, partners, officers, or directors of the business entity or their spouses
any subsidiaries directly or indirectly controlled by the business entity
IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity
and filing as continuing political committees, (PACS).
When the business entity is a natural person, "a contribution by that person's spouse or child, residing therewith, shall be
deemed to be a contribution by the business entity." [N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the
disclosure.
Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an
amount to be determined by the Commission which may be based upon the amount that the business entity failed to
report.
The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official
and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor's responsibility to
identify the specific committees to which contributions may have been inade and need to be disclosed. The disclosed
information may exceed the minimum requirement.
The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a
signed cover sheet) may be used as the contractor's submission and is disclosable to the public under the Open Public
Records Act.
The contractor must also complete the attached Ownership Disclosure Certification. This will assist the agency in meeting
its obligations under the law. NOTE: This section does not apply to Board of Education contracts.
Township of Jefferson
Non-Fair & Open Packet
Page 4
ITEM A
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
List of Agencies with Elected Officials Required for Political Contribution Disclosure - N.J.S.A. 19:44A-20.26
County Name: Morris
State: Governor Mikie Sherrill
State Senators and State Assemblymen or State Assemblywomen from Legislative District #26
Morris County:
Any member of the Board of County Commissioners
Morris County Clerk
Morris County Sheriff
Morris County Surrogate
Municipalities (Mayor and Members of Governing Body, regardless of title):
Boonton Town
Chatham Township
Dover Town
Harding Township
Long Hill Township
Mine Hill Township
Morristown Town
Netcong Borough
Riverdale Borough
Victory Gardens Borough
Boonton Township
Chester Borough
East Hanover Township
Jefferson Township
Madison Borough
Montville Township
Mount Arlington Borough
Parsippany-Troy Hill Twsp
Rockaway Borough
Washington Township
Butler Borough
Chatham Borough
Chester Township
Denville Township
Florham Park Borough
Hanover Township
Kinnelon Borough
Mendham Borough
Morris Plains Borough
Mount Olive Township
Pequannock Township
Rockaway Township
Wharton Borough
Lincoln Park Borough
Mendham Township
Morris Township
Mountain Lakes Borough
Randolph Township
Roxbury Township
Boards of Education (Members of the Board):
Boonton Town
Denville Township
Hanover Park Regional
Kinnelon Borough
Mendham Borough
Morris
Mount Olive Township
Pequannock Township
Rockaway Township
Washington Township
Boonton Township
Dover Town
Hanover Township
Lincoln Park Borough
Mendham Township
Morris Hills Regional
Mountain Lakes Borough
Randolph Township
Roxbury Township
West Morris Regional
Fire Districts (Board of Fire Commissi
Hanover Twsp Fire District No. 2
Montville Twsp Fire District No. 2
Butler Borough
East Hanover Township
Harding Township
Long Hill Township
Mine Hill Township
Morris Plains Borough
Netcong Borough
Riverdale Borough
School Dist of the Chathams
Wharton Borough
Chester Township
Florham Park Borough
Jefferson Township
Madison Borough
Montville Township
Mount Arlington Borough
Parsippany-Troy Hills Twsp
Rockaway Borough
Victory Gardens
Hanover Twsp Fire District No. 3
Montville Twsp Fire District No. 3
Parsippany-Troy Hills Twsp FD No. 2
Parsippany-Troy Hills Twsp FD No. 5
Parsippany-Troy Hills Twsp FD No. 8
Parsippany-Troy Hills Twsp FD No. 3
Parsippany-Troy Hills Twsp FD No. 6
Montville Twsp Fire District No. 1
Parsippany-Troy Hills Twsp FD No. 1
Parsippany-Troy Hills Twsp FD No. 4
Parsippany-Troy Hills Twsp FD No. 7
Township of Jefferson
Non-Fair & Open Packot
Page 5
ITEM B
BUSINESS REGISTRATION CERTIFICATE
Pursuant to N.J.S.A. 52:32-44, Township of Jefferson ("Contracting Agency") is prohibited from entering
into a contract with an entity unless the bidder/proposer/contractor, and each subcontractor that is required
by law to be named in a bid/proposal/contract has a valid Business Registration Certificate on file with the
Division of Revenue and Enterprise Services within the Department of the Treasury.
Prior to contract award or authorization, the contractor shall provide the Contracting Agency with its proof
of business registration and that of any named subcontractor(s).
Subcontractors named in a bid or other proposal shall provide proof of business registration to the
applicant, who in turn, shall provide it to the Contracting Agency prior to the time a contract, purchase
order, or other contracting document is awarded or authorized.
During the course of contract performance:
1. the contractor shall not enter into a contract with a subcontractor unless the subcontractor first
provides the contractor with a valid proof of business registration.
2. the contractor shall maintain and submit to the Contracting Agency a list of subcontractors and their
addresses that may be updated from time to time.
3. the contractor and any subcontractor providing goods or performing services under the contract,
and each of their affiliates, shall collect and remit to the Director of the Division of Taxation in the
Department of the Treasury, the use tax due pursuant to the Sales and Use Tax Act, (N.J.S.A.
54:32B-1 et seq.) on all sales of tangible personal property delivered into the State. Any questions
in this regard can be directed to the Division of Taxation at (609)292-6400. Form NJ-REG can be
filed online at www.state.nj.us/treasury/revenue/busregcert.shtml.
Before final payment is made under the contract, the contractor shall submit to the Contracting Agency a
complete and accurate list of all subcontractors used and their addresses.
Pursuant to N.J.S.A. 54:49-4.1, a business organization that fails to provide a copy of a business
registration as required, or that provides false business registration information, shall be liable for a penalty
of $25 for each day of violation, not to exceed $50,000, for each proof of business registration not properly
provided under a contract with a contracting agency.
The undersigned acknowledges these requirements and understands that this proposal shall be rejected
as non-responsive if said Contractor fails to comply.
Deborah L. Thomson
Printed Name of Authorized Agent
Signature of Authorized Agem
President
Title
5/2/26
Date
P.L. Custom Body and Equipment Co., Inc.
Company Name
Township of Jefferson
Non-Fair & Open Packet
Page 6
STATE OF NEW JERSEY
BUSINESS REGISTRATION CERTIFICATE
FOR STATE AGENCY AND CASINO SERVICE CONTRACTORS
DEPARTMENT OF TREASURY/
DIVISION OF REVENUE
PO BOX 252
TRENTON, NJ 08646-0252
TAXPAYER NAME:
P. L. CUSTOM BODY AND EQUIPMENT CO., INC
TAXPAYER IDENTIFICATION#:
221-922-998/000
ADDRESS:
2201 ATLANTIC AVENUE
MANASQUAN NJ 08736
TRADE NAME:
SEQUENCE NUMBER:
0065030
ISSUANCE DATE:
11/12/02
EFFECTIVE DATE:
10/28/70
FORM-BRC(08-01),
Acti
This Certificate is NOT assignable or transferabi
Director
It must be conspicuously displayed at above address.
ITEM C
STOCKHOLDER DISCLOSURE CERTIFICATION
STATEMENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43)
Vendor Name:
P.L. Custom Body and Equipment Co., Inc.
Address: 2201 Atlantic Ave.
City, State, Zip:
Manasquan, NJ 08736
Print Name of Authorized Representative*: Deborah L. Thomson
Title of Authorized Representative*: President
PARTI Check the box that represents the type of business organization:
Partnership
Non-Profit Corporation (skip Parts II and III, execute certification in Part IV)
Sole Proprietorship (skip Parts II and III, execute certification in Part IV)
Limited Partnership
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
☑ For-Profit Corporation (any type)
Other (be specific):
PART II
The list below contains the names and addresses of all stockholders in the corporation who own 10 percent
(10%) or more of its stock, of any class; or of all individual partners in the partnership who own a 10 percent
(10%) or greater interest therein; or of all members in the limited liability company who own a 10 percent
(10%) or greater interest therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION)
OR
No one stockholder in the corporation owns 10 percent (10%) or more of its stock, of any class; or no
individual partner in the partnership owns a 10 percent (10%) or greater interest therein; or no member in the
limited liability company owns a 10 percent (10%) or greater interest therein, as the case may be.
(SKIP TO PART IV)
Name of Individual or Business Entity
CFD Trust
Alex N. Cherepakhov Irrevocable Trust Florida
Dana M. Cherepakhov Irrevocable Trust Florida
Home Address (for Individuals) or Business Address
107 Clubhouse Drive Naples, FL 34105
107 Clubhouse Drive Naples, FL 34105
107 Clubhouse Drive Naples, FL 34105
(Please attach additional sheets if more space is needed)
PART III Disclosure of Ten Percent (10%) Or Greater Ownership In the Stockholders, Partners, Or LLC
Members Listed in Part II
If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent
(10%) or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security
and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links
to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign
equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the
publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each
such person.
Website (URL) containing the last annual SEC (or foreign equivalent) filing
Page #'s
(Please attach additional sheets if more space is needed)
9
PART III (Continued)
Please list the names and addresses of each stockholder, partner or member owning a 10 percent (10%) or greater
interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part II other than
for any publicly traded parent entities referenced above. The disclosure shall be continued until names and
addresses of every non-corporate stockholder, and individual partner, and member exceeding the 10 percent (10%)
ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed.
Stockholder/Partner/Member and
Corresponding Entity Listed in Part II
Home Address (for Individuals) or Business Address
(Please attach additional sheets if more space is needed)
Part IV Certification
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the
best of my knowledge are true and complete. I attest that I am authorized to execute this certification on behalf
of the bidder/proposer; that the Township of Jefferson is relying on the information contained herein and that I am
under a continuing obligation from the date of this certification through the completion of any contracts with the
Township of Jefferson to notify the Township of Jefferson in writing of any changes to the information contained
herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification,
and if I do so. I am subject to criminal prosecution under the law and that it will also constitute a material breach of my
agreement(s) with the Township of Jefferson and that the Township of Jefferson at its option may declare any
contract(s) resulting from this certification void and unenforceable.
Full Name (Print):
Signature:
Deborah L. Thomson
Title:
President
Date:
5/2/26
ITEM D
NON-COLLUSION AFFIDAVIT
FAILURE TO COMPLETE AND RETURN THIS AFFIDAVIT WILL RENDER THE BID/PROPOSAL
SUBMISSION NON-RESPONSIVE AND IS CAUSE FOR AUTOMATIC REJECTION.
Deborah L. Thomson
(print name)
in the County
of
Monmouth
(name of county)
residing in
Manasquan
(name of municipality)
and State
of
New Jersey
(name of state)
of full age, being duly sworn according to law on my oath depose and say
that: I am
President
(title/position)
for the within named bidder/applicant and I execute this bid/proposal on their behalf with full authority
to do so; and
1. That said applicant has not directly or indirectly entered into any agreement, participated in any
collusion or otherwise taken any action in restraint of free, competitive applicant in connection with
this bid; and
2. That all statements contained in and submitted with the RFP Documents and in this Affidavit are true
and correct and were made with the full knowledge that the Township of Jefferson, County of Morris,
its officers and employees, relies upon the truth of the statements made herein in awarding the
contract for this RFP.
3. I further warrant that no person or selling agency has been employed or retained to solicit or secure
such contract upon an agreement or understanding for a commission, percentage, brokerage or
contingent fee, except bona fide employees of or bona fide established commercial selling agencies
maintained by the applicant.
I hereby certify under the penalties for perjury that the facts and information contained in this Affidavit and
submitted with this bid//proposal are true and correct.
Deborah L. Thomson
Printed Name of Authorized Agent
Signature of Authorized Agent
Sworn and subscribed to before me on this
2026
4
day of May
Lena Marie Goodwin
Printed Name of Notary. ID# and
Expiration Date
2297439,24/21/128
Signature of
Notaumon
LENA MARIE GOODWIN
NOTARY PUBLIC
STATE OF NEW JERSEY
COMM. EXP. 4-21-2
11
ITEM E
MANDATORY
EQUAL EMPLOYMENT OPPORTUNITY REQUIREMENTS
TOWNSHIP OF JEFFERSON
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY NOTICE
(N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq.)
GOODS, PROFESSIONAL SERVICES AND GENERAL SERVICE CONTRACTS
This form is a summary of the successful professional service entity's requirement to comply with the
requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq.
The successful professional service entity shall submit to the Township of Jefferson, one of the following
three documents as forms of evidence:
(a) A photocopy of a valid letter that the vendor is operating under an existing Federally
approved or sanctioned affirmative action program (good for one year from the date of the
letter);
OR
(b) A photocopy of a Certificate of Employee Information Report approval, issued in
accordance with N.J.A.C. 17:27-1.1 et seq.; OR
(c) A photocopy of an Employee Information Report (Form AA302) provided by the
Division of Contract Compliance and distributed to the Township of Jefferson to be completed by
the vendor in accordance with N.J.A.C. 17:27-1.1 et seq.
The successful professional service entity may obtain the Employee Information Report (AA302) from the
Township of Jefferson during normal business hours.
The successful professional service entities must submit the appropriate copies of the AA302 (Employee
Information Report) to the Division of Contract Compliance and Equal Employment Opportunity in Public
Contracts (Division).
The undersigned professional service entity certifies that he/she is aware of the commitment to
comply with the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq. and agrees to
furnish the required forms of evidence.
The undersigned professional service entity further understands that his/her submission shall be
rejected as non-responsive if said professional service entity fails to comply with the requirements
of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq.
COMPANY: P.L. Custom Body and Equipment Co., Inc.
SIGNATURE:
TITLE: President
of PRINT NAME: Deborah L. Thomson
DATE: 5/4/26
12
ITEM F
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
N.J.S.A. 10:5-31 et seq., N.J.AC. 17:27
EXHIBIT A
GOODS PROFESSIONAL SERVICES AND GENERAL SERVICE CONTRACTS
During the performance of this contract, the contractor agrees as follows:
The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for
employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual
orientation, gender identity or expression, disability, nationality or sex. Except with respect to affectional or sexual
orientation and gender identity or expression, the contractor will take affirmative action to ensure that such applicants
are recruited and employed, and that employees are treated during employment, without regard to their age, race,
creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression,
disability, nationality or sex. Such action shall include, but not be limited to the following: employment, upgrading,
demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of
compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous
places, available to employees and applicants for employment, notices to be provided by the Public Agency
Compliance Officer setting forth provisions of this nondiscrimination clause.
The contractor or subcontractor, where applicable, will, in all solicitations or advertisements for employees placed by
or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without
regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender
identity or expression, disability, nationality or sex.
The contractor or subcontractor, where applicable, will send to each labor union or representative or workers with
which it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the
agency contracting officer advising the labor union or workers' representative of the contractor's commitments under
this act and shall post copies of the notice in conspicuous places available to employees and applicants for
employment.
The contractor or subcontractor where applicable, agrees to comply with any regulations promulgated by the
Treasurer pursuant to N.J.S.A. 10:5-31 et seg, as amended and supplemented from time to time and the Americans
with Disabilities Act.
The contractor or subcontractor agrees to make good faith efforts to employ minority and women workers consistent
with the applicable county employment goals established in accordance with N.J.A.C. 17:27-5.2, or a binding
determination of the applicable county employment goals determined by the Division, pursuant to N.J.A.C. 17:27-5.2.
The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies including, but not
limited to, employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate
on the basis of age, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender
identity or expression, disability, nationality or sex, and that it will discontinue the use of any recruitment agency which
engages in direct or indirect discriminatory practices.
The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personal
testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the
State of New Jersey, and as established by applicable Federal law and applicable Federal court decisions.
13
ITEM F
MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE
In conforming with the applicable employment goals, the contractor or subcontractor agrees to review all procedures
relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken without regard to age,
creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression.
disability, nationality or sex, consistent with the statutes and court decisions of the State of New Jersey, and
applicable Federal law and applicable Federal court decisions.
The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and
services contract, one of the following three documents:
Letter of Federal Affirmative Action Plan Approval
Certificate of Employee Information Report
Employee Information Report Form AA302
The contractor and its subcontractor shall furnish such reports or other documents to the
Division of Contract Compliance & EEO as may be requested by the Division from time to time in order to carry out
the purposes of these regulations, and public agencies shall furnish such information as may be requested by the
Division of contract Compliance & EEO for conducting a compliance investigation pursuant to Subchapter 10 of the
Administrative Code at N.J.A.C. 17:27.
We are aware of the obligation pursuant to the Mandatory Equal Opportunity Language
N.J.S.A. 10:5-31 et seq., N.J.A.C. 17:27.
Vendor Name:
Address:
City, State, Zip:
Print Name of Authorized Representative*:
Title of Authorized Representative*:
P.L. Custom Body and Equipment Co., Inc.
2201 Atlantic Ave.
Manasquan. NJ 08736
Deborah L. Thomson
President
Signature of Authorized Representative
Subscribed and sworn before me this
2026
May
My Commission expires:
4 day of
4/21/128
14
5/4/26
Date
(Notary/Affiant)
Lena Marie Guadin
(Print name & title of notary/affiant) (Seal)
"
NA MARIE GOODWI
NOTARY PUBLIC
THE STATE
STATE OF NEW JERSE
COMM. EXP. 4-21-2
ITEM G
AMERICANS WITH DISABILITIES ACT OF 1990
Equal Opportunity for Individuals with Disabilities
The contractor and the owner do hereby agree that the provisions of Title 11 of the Americans with
Disabilities Act of 1990 (the "Act") (42 U.S.C. S121 01 et seq.), which prohibits discrimination on the
basis of disability by public entities in all services, programs, and activities provided or made
available by public entities, and the rules and regulations promulgated pursuant there unto, are made
a part of this contract. In providing any aid, benefit, or service on behalf of the owner pursuant to this
contract, the contractor agrees that the performance shall be in strict compliance with the Act. In the
event that the contractor, its agents, servants, employees, or subcontractors violate or are alleged to
have violated the Act during the performance of this contract, the contractor shall defend the owner in
any action or administrative proceeding commenced pursuant to this Act. The contractor shall
indemnify, protect, and save harmless the owner, its agents, servants, and employees from and
against any and all suits, claims, losses, demands, or damages, of whatever kind or nature arising
out of or claimed to arise out of the alleged violation. The contractor shall, at its own expense,
appear, defend, and pay any and all charges for legal services and any and all costs and other
expenses arising from such action or administrative proceeding or incurred in connection therewith.
In any and all complaints brought pursuant to the owner's grievance procedure, the contractor agrees
to abide by any decision of the owner which is rendered pursuant to said grievance procedure. If any
action or administrative proceeding results in an award of damages against the owner, or if the owner
incurs any expense to cure a violation of the ADA which has been brought pursuant to its grievance
procedure, the contractor shall satisfy and discharge the same at its own expense.
The owner shall, as soon as practicable after a claim has been made against it, give written notice
thereof to the contractor along with full and complete particulars of the claim, if any action or
administrative proceeding is brought against the owner or any of its agents, servants, and
employees, the owner shall expeditiously forward or have forwarded to the contractor every demand,
complaint, notice, summons, pleading, or other process received by the owner or its representatives.
It is expressly agreed and understood that any approval by the owner of the services provided by the
contractor pursuant to this contract will not relieve the contractor of the obligation to comply with the
Act and to defend, indemnify, protect, and save harmless the owner pursuant to this paragraph. It is
further agreed and understood that the owner assumes no obligation to indemnify or save harmless
the contractor, its agents, servants, employees and subcontractors for any claim which may arise out
of their performance of this Agreement. Furthermore, the contractor expressly understands and
agrees that the provisions of this indemnification clause shall in no way limit the contractor's
obligations assumed in this Agreement, nor shall they be construed to relieve the contractor from any
liability, nor preclude the owner from taking any other actions available to it under any other
provisions of the Agreement or otherwise at law.
15
ITEM H
AMERICANS WITH DISABILITIES ACT OF 1990
COMPLIANCE CERTIFICATION
Discrimination on the basis of disability in contracting for the purchase of goods and services is prohibited.
If awarded the contract, the contractor is required to comply with requirements related to the Americans
with Disabilities Act as provided in this RFP Document. The contractor is obligated to comply with the Act
and to hold the owner harmless for any violations committed under the contract.
In providing any aid. benefit, or service on behalf of the Owner pursuant to this contract, the contractor
agrees that the performance shall be in strict compliance with the Act.
The undersigned certifies that that the applicant is aware of the commitment to comply with the
requirements of the Americans with Disabilities Act of 1990 as stated on the following page.
Deborah L. Thomson
Prorate
Signature of Authorized Agent
Deborah L. Thomson
Printed Name of Authorized. Agent
President
Title
P.L. Custom Body and Equipment Co.. Inc.
Company Name
5/4/26
Date
hos
ITEM I
Disclosure of Investment Activities in Iran
Person or Entity
P.L. Custom Body and Equipment Co., Inc.
Part 1: Certification
COMPLETE PART 1 BY CHECKING EITHER BOX.
Pursuant to Public Law 2012, c. 25, any person or entity that is a successful bidder or proposer, or
otherwise proposes to enter into or renew a contract, must complete the certification below to attest, under
penalty of perjury, that neither the person or entity, nor any parent entity, subsidiary, or affiliate is identified
on the State Department of Treasury's Chapter 25 list as a person or entity engaging in investment activities
on Treasury's website
in
Iran.
The
list
is
found
at
www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf.
The Chapter 25 list must be reviewed prior to completing the below certification. If a vendor or contractor
is found to be in violation of law, action may be taken as appropriate and as may provided by law, rule or
contract, including but not limited to imposing sanctions, seeking compliance, recovering damages,
declaring the party in default and seeking debarment or suspension of the party.
I certify, pursuant to Public Law 2012, c. 25, that neither the person or entity
listed above, nor any parent entity, subsidiary, or affiliate thereof is listed on the
N.J. Department of the Treasury's list of entities determined to be engaged in
prohibited activities in Iran pursuant to P.L. 2012, c. 25 ("Chapter 25 List"). I
further certify that I am the person listed above, or I am an officer or
representative of the entity listed above and am authorized to make this
certification on its behalf. I will skip Part 2 and sign and complete the
Certification below.
OR
I am unable to certify as above because the person or entity and/or a parent entity,
subsidiary, or affiliate thereof is listed on the N..J. Department of the Treasury's
Chapter 25 list. I will provide a detailed, accurate and precise description of the
activities in Part 2 below sign and complete the Certification below.
17
Part 2: Additional Information
PLEASE PROVIDE FURTHER INFORMATION RELATED TO INVESTMENT ACTIVITIES IN
IRAN.
You must provide a detailed, accurate and precise description of the activities of the person or entity, or
a parent entity, subsidiary, or affiliate thereof engaging in investment activates in Iran below and, if
more space is needed, on additional sheets provided by you.
Part 3: Certification of True and Complete Information
I, being duly sworn upon my oath, hereby represent and state that the foregoing information
and any attachments there to the best of my knowledge are true and complete. I attest that I am
authorized to execute this certification on behalf of the above-referenced person or entity.
I acknowledge that the Township of Jefferson is relying on the information contained herein
and thereby acknowledge that I am under a continuing obligation from the date of this certification
through the completion of any contracts with the Township of Jefferson to notify the Township of
Jefferson in writing of any changes to the answers of information contained herein.
I acknowledge that I am aware that it is a criminal offense to make a false statement or
misrepresentation in this certification, and if I do so, I recognize that I am subject to criminal
prosecution under the law and that it will also constitute a material breach of my agreement(s) with
the Township of Jefferson and that the Township of Jefferson at its option may declare any
contract(s) resulting from this certification void and unenforceable.
Full Name
(Print)
Signature
Deborah L. Thomson
Title
President
Date
5/4/26
18
ITEM J
CERTIFICATION OF NON-INVOLVEMENT IN PROHIBITED
ACTIVITIES IN RUSSIA OR BELARUS
Pursuant to N.J.S.A. 52:32-60.1, et seq. (L. 2022, c. 3) any person or entity (hereinafter "Vendor") that seeks to enter into or
renew a contract with a State agency for the provision of goods or services, or the purchase of bonds or other obligations, must
complete the certification below indicating whether or not the Vendor is identified on the Office of Foreign Assets Control
(OFAC) Specially Designated Nationals and Blocked Persons list, available here: https://sanctionssearch.ofac.treas.gov/. If
the Department of the Treasury finds that a Vendor has made a certification in violation of the law, it shall take any action as
may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking
compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.
1, the undersigned, certify that I have read the definition of "Vendor" below, and have reviewed the Office of Foreign Assets
Control (OFAC) Specially Designated Nationals and Blocked Persons list, and having done so certify:
A.
B.
C.
(Check the Appropriate Box)
That the Vendor is not identified on the OFAC Specially Designated Nationals and Blocked Persons list on
account of activity related to Russia and/or Belarus.
OR
That I am unable to certify as to "A" above, because the Vendor is identified on the OFAC Specially
Designated Nationals and Blocked Persons list on account of activity related to Russia and/or Belarus.
OR
That I am unable to certify as to "A" above, because the Vendor is identified on the OFAC Specially
Designated Nationals and Blocked Persons list. However, the Vendor is engaged in activity related to Russia
and/or Belarus consistent with federal law, regulation, license or exemption. A detailed description of how
the Vendor's activity related to Russia and/or Belarus is consistent with federal law is set forth below.
(Attach Additional Sheets If Necessary
Signature of Vendor's Authorized Representative
Deborah L. Thomson, President
Print Name and Title of Vendor's Authorized Representative
P.L. Custom Body and Equipment Co., Inc.
Vendor's Name
2201 Atlantic Ave.
Vendor's Address (Street Address)
Manasquan, NJ 08736
Vendor's Address (City/State/Zip Code)
5/4/26
Date
Vendor's FEIN
732-223-1411
Vendor's Phone Number
732-223-1164
Vendor's Fax Number
jpallitto@njev.net
Vendor's Email Address
Vendor means: (1) A natural person, corporation, company, limited partnership, limited liability partnership, limited liability company, business
association, sole proprietorship, joint venture, partnership, society, trust, or any other nongovernmental entity, organization, or group: (2) Any
governmental entity or instrumentality of a government, including a multilateral development institution, as defined in Section 1701(c)(3) of the
International Financial Institutions Act, 22 U.S.C. 262r(c)(3); or (3) Any parent, successor, subunit, direct or indirect subsidiary, or any entity
under common ownership or control with, any entity described in paragraph (1) or (2).
19
ITEM K
AMERICAN GOODS AND PRODUCTS TO BE USED WHERE POSSIBLE
Only manufactured and farm products of the United States, wherever available,
shall be used pursuant to N.J.S.A. 40A:11-18.
Acknowledgement:
Debo
(Signature)
Deborah L. Thomson, President
(Printed Name and Title)
20
5/4/26
(Date)
ITEM L
INSURANCE REQUIREMENTS AND ACKNOWLEDGEMENT FORM
TOWNSHIP OF JEFFERSON
Certificate(s) of Insurance shall be filed with the Township Administrator's Office
upon award of contract by the Mayor and Council of the Township of Jefferson.
The minimum amount of insurance to be carried by the Professional Service Entity
shall be as follows:
LIABILITY INSURANCE
Limits shall be a minimum of $1,000,000.00 for each claim and $1,000,000.00
aggregate each policy period.
The Township of Jefferson shall be named as Additional Insured.
Acknowledgement of Insurance Requirement:
Death
(Signature)
Deborah L. Thomson, President
(Printed Name and Title)
21
5/4/26
(Date)
ITEM M
NATIONAL COOPERATIVE CONTRACT INFORMATION
VENDOR NAME: P.L. Custom Body and Equipment Co., Inc.
VENDOR ADDRESS:
2201 Atlantic Ave Manasquan, NJ 08736
NATIONAL COOPERATIVE (NATIONAL CO-OP) PURCHASING ENTITY NAME:
Sourcewell
NATIONAL CO-OP CONTRACT NAME/DESCRIPTION: Public Safety Emergency Response
CONTRACT NUMBER (If Applicable): 122123-PLC
CERTIFICATION:
The undersigned hereby certifies under the penalties for perjury that the vendor is authorized to enter into
the above referenced National Contract.
Deborah L. Thomson
Printed Name of Authorized Agem
President
Title
P.L. Custom Body and Equipment Co., Inc.
Company Name
22
De
Signature of Authorized Agent
5/4/26
Date
ITEM N
CONTRACT AND/OR PRICING SCHEDULE
Pricing Proposal should include applicable itemized codes from the national contract.
23
ation
it.
Township of Jefferson
1033 Weldon Road
Lake Hopatcong, NJ 07849
Sourcewell Membership ID Number 31515
NJEV
New Jersey
Emergency Vehicles
A PL Custom Company
SOURCEWELL AMBULANCE PROPOSAL
DATE
SALESPERSON
EST. SHIPPING DATE
F.O.B.
TERMS
April 21, 2026
Jamey Pallitto
See proposal
Manasquan, NJ SEE BELOW
Qty
Description
1
Type I Classic 170, Ford F-550 4x4 Gas Ambulance-PLC12
Sourcewell Member Discount - Member #31515
Ford F-550 4x4 Super Duty -XL Trim
Lifetime Structural & Electrical Warranty
Total
$296,788.00
-($14,839.40)
SAE J3057 & KKK Rev. F Compliant
Whelen Emergency Lighting Package
FRC 360* Camera System with DVR
Inverter with battery charger
Custom Paint and Lettering
Total options as per attached specifications A7238-0002
$127,785.40
TOTAL PRICE PER SOURCEWELL CONTRACT RFP#122123
$409,734.00
APPROVED SIGNATURE:
PRINT CONTACT NAME AND PHONE NUMBER
DATE:
Purchase Order #
TERMS:
1. Includes dealer prep, fully fueled at time of delivery
2. Vehicle payment is due upon delivery
3. Proposal pricing is valid for 60 days
Sales and Service
2201 Atlantic Avenue, Suite 2
Manasquan, NJ 08736
732.223.1411
732.223.1164 (fax)
PL CUSTOM
EMERGENCY VEHICLES
RESCUE
MMALLEY
NEW JERSEY EMERGENCY VEHICLES (NJEV, LLC.) IS A DIVISION OF P.L. CUSTOM BODY AND EQUIPMENT CO., INC.
QUOTATION
New Jersey Emergency Vehicles
Milton First Aid Squad
Frank Parete, Chief
45 Milton Road
PO Box 118
Oakridge, NJ 07438
973-697-2197
New Jersey Emergency Vehicles
Jamey Pallitto
2201 Atlantic Ave.
Manasquan, NJ 08736
(732) 223-1411 ext. 176
(732) 223-1164
jpallitto@njev.net
Exp. Date:
Quote No:
06/30/2026
A7238-0002
04/21/2026
PART NO
DESCRIPTION
Page 1
QTY
== Type 1 Classic, 170" 108"CA - 34.110 04/23/25 ==
PL Ambulance - Release 34.13 effective 01/30/26
** Quote Terms **
All chassis are subject to availability.
Quoted body pricing is valid for 30 days from receipt or until the next data release.
1
1
Chassis pricing for PL Supplied chassis is subject to any OEM chassis manufacturer surcharges
and model year increases.
An ambulance or rescue vehicle order, submitted utilizing a chassis that cannot be provided or
ordered, (chassis order banks not open, no available allocation, or otherwise unknown), will
NOT be processed until such time that the chassis can be ordered and assigned.
Upon receipt of chassis VIN and firm chassis production schedule, or chassis receipt, the vehicle
order can then be considered "buildable".
Once entered into "buildable' order status and when loaded into the PL Custom production
schedule, prioritized by order entry date, the body can then be processed for approval and
priced on most current pricing and data release in place.
This applies to both PL Custom and customer/dealer supplied chassis.
00-00-0100
00-05-0100
00-11-7065
170" CLASSIC BODY, 72" Headroom, w/Drop Skirt
Overall Vehicle Dimensions:
Length: 308"
Width: 99"
Height: 112" (+/- 2")
Exterior Modular Body Dimensions:
Length: 170"
Width: 97"
Height: 91"
Interior Modular Body Dimensions:
Length: 165"
Width: 90 3/4"
Height: 72"
03-00-1060
Chassis Type -Ford F-Series
Chassis paint must be reviewed/edited when changing chassis type
EXTERIOR
10-10-1100
Modular Body Construction
SAE J3057 Compliant
10-10-2000
Structural Integrity Warranty
The structural integrity of the body shall be guaranteed for the life of the unit, as long as the
original purchaser shall own it.
1
1
1
Sourcewell
DocuSign Envelope ID: 702332B0-09E9-4827-8620-868EED278362
122123-PLC
Date of opening: December 21, 2023
Proposal Opening Record
Sourcewell posted Request for Proposal #122123, for the procurement of Ambulance and Emergency Medical
Service Vehicles, on the Sourcewell Procurement Portal [proportal.sourcewell-mn.gov] on Thursday, November
2, 2023, and the solicitation remained in an open status within the portal until December 21, 2023, at 4:30 pm
CT. The RFP required that all proposals be submitted through the Sourcewell Procurement Portal no later than
4:30 pm CT on December 21, 2023, the date and time specified in the Solicitation Schedule.
The undersigned certify that all responses received on Request for Proposal #122123 were submitted through
the Sourcewell Procurement Portal, and that each Proposer's response material was digitally sealed upon
submission and remained inaccessible until the due date and time specified in the Solicitation Schedule.
Responses were received from the following:
Air-Flo MFG. CO., Inc. - Submitted Thu Dec 21, 2023 7:15:27 AM
Atlantic Emergency Solutions, Inc. - Submitted Thu Dec 21, 2023 2:32:59 PM
Crossroads Ambulance Sales & Service, LLC - Submitted Fri Dec 15, 2023 2:54:29 PM
Demers Ambulances USA, Inc. - Submitted Wed Dec 20, 2023 3:08:18 PM
Excellance, Inc. - Submitted Thu Dec 21, 2023 1:36:03 PM
FR Conversions, Inc. - Submitted Wed Dec 20, 2023 1:46:16 PM
Medix Specialty Vehicles, LLC - Submitted Thu Dec 21, 2023 1:12:39 PM
P.L. Custom Body and Equipment Co., Inc. - Submitted Tue Dec 19, 2023 9:44:58 AM
REV Group Inc. (REV Ambulance Group Division) - Submitted Wed Dec 20, 2023 4:50:40 PM
Talkspace, Inc. - Submitted Thu Dec 21, 2023 3:21:11 PM
Tesco Specialty Vehicles, LLC - Submitted Thu Dec 21, 2023 2:40:41 PM
The Proposals were opened electronically, and a list of all Proposers was made publicly available in the
Sourcewell Procurement Portal, on December 21, 2023, at 4:30 pm CT. All responsive proposals were then
submitted for review by the Sourcewell Evaluation Committee.
DocuSigned by:
James Voelker
15F6CCFFA61E4A0...
James Voelker, CPCM, CFCM, Procurement Supervisor
DocuSigned by:
Carol Jackson
6EE63AEDED5F46E...
Carol Jackson, Procurement Analyst
SERVING GOVERNMENT AND EDUCATION
Sourcewell
Possible Points
Conformance to RFP Requirements
50
Financial Viability and Marketplace
Success
Ability to Sell and Deliver Service
Marketing Plan
Value Added Attributes
Warranty
75
100
50
75
50
Depth and Breadth of Offered Equipment,
Products, or Services
200
Pricing
400
Total Points
1,000
Rank Order
Proposal Evaluation
Ambulance and Emergency Medical Service Vehicles RFP #122123
Air-Flo MFG. CO., Inc.
Atlantic Emergency Solutions Crossroads Ambulance Sales &
Inc.
Service, LLC
Demers Ambulances USA Inc
Excellance, Inc
FR Conversions Inc.
38
54
75
35
52
34
41
43
42
38
55
71
32
50
42
65
85
41
63
40
56
57
73
78
31
50
36
52
42
37
158
165
165
159
140
279
332
321
321
299
725
788
823
781
730
P.L. Custom Body and
Medix Specialty Vehicles, LLC
Equipment Co., Inc.
REV Group Inc.
Possible Points
Conformance to RFP Requirements
50
40
46
46
Financial Viability and Marketplace
Success
75
58
66
66
Ability to Sell and Deliver Service
100
77
85
88
Marketing Plan
50
37
44
45
Value Added Attributes
75
Warranty
50
40
55
64
45
44
65
Depth and Breadth of Offered Equipment,
Products, or Services
200
164
179
180
Pricing
400
304
353
341
Total Points
1,000
775
882
875
-DocuSigned by:
James Voelker
15F6CCFFA61E4A0...
James Voelker, CPCM, CFCM, Procurement Manager
DocuSigned by:
Lisa truax
04A338655E9E49E...
Lisa Truax, Procurement Analyst II
Talkspace Inc.
Tesco Specialty Vehicles, LLC
41
60
78
39
53
42
116
303
732
DocuSigned by:
Bhandar Tour
7BCA93CD6377421...
Brandon Town, NIGP-CPP, SPSM, CPSD, Senior Procurement Analyst
DocuSigned by:
Scott Dobereiner
AF205E004379430...
Scott Dobereiner, CPPO, NIGP-CPP, Procurement Analyst II
Sourcewell
DocuSign Envelope ID: 702332B0-09E9-4827-8620-868EED278362
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Solicitation Number: RFP #122123
CONTRACT
This Contract is between Sourcewell, 202 12th Street Northeast, P.O. Box 219, Staples, MN
56479 (Sourcewell) and P.L. Custom Body and Equipment Co., Inc., 2201 Atlantic Avenue,
Manasquan, NJ 08736 (Supplier).
Sourcewell is a State of Minnesota local government unit and service cooperative created
under the laws of the State of Minnesota (Minnesota Statutes Section 123A.21) that offers
cooperative procurement solutions to government entities. Participation is open to eligible
federal, state/province, and municipal governmental entities, higher education, K-12 education,
nonprofit, tribal government, and other public entities located in the United States and Canada.
Sourcewell issued a public solicitation for Ambulance and Emergency Medical Service Vehicles
from which Supplier was awarded a contract.
Supplier desires to contract with Sourcewell to provide equipment, products, or services to
Sourcewell and the entities that access Sourcewell's cooperative purchasing contracts
(Participating Entities).
1. TERM OF CONTRACT
A. EFFECTIVE DATE. This Contract is effective upon the date of the final signature below.
EXPIRATION DATE AND EXTENSION. This Contract expires February 28, 2028, unless it is
cancelled sooner pursuant to Article 22. This Contract allows up to three additional one-year
extensions upon the request of Sourcewell and written agreement by Supplier. Sourcewell
retains the right to consider additional extensions beyond seven years as required under
exceptional circumstances.
B. SURVIVAL OF TERMS. Notwithstanding any expiration or termination of this Contract, all
payment obligations incurred prior to expiration or termination will survive, as will the
following: Articles 11 through 14 survive the expiration or cancellation of this Contract. All
other rights will cease upon expiration or termination of this Contract.
2. EQUIPMENT, PRODUCTS, OR SERVICES
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A. EQUIPMENT, PRODUCTS, OR SERVICES. Supplier will provide the Equipment, Products, or
Services as stated in its Proposal submitted under the Solicitation Number listed above.
Supplier's Equipment, Products, or Services Proposal (Proposal) is attached and incorporated
into this Contract.
All Equipment and Products provided under this Contract must be new and the current model.
Supplier may offer close-out or refurbished Equipment or Products if they are clearly indicated
in Supplier's product and pricing list. Unless agreed to by the Participating Entities in advance,
Equipment or Products must be delivered as operational to the Participating Entity's site.
This Contract offers an indefinite quantity of sales, and while substantial volume is anticipated,
sales and sales volume are not guaranteed.
B. WARRANTY. Supplier warrants that all Equipment, Products, and Services furnished are free
from liens and encumbrances, and are free from defects in design, materials, and workmanship.
In addition, Supplier warrants the Equipment, Products, and Services are suitable for and will
perform in accordance with the ordinary use for which they are intended. Supplier's dealers
and distributors must agree to assist the Participating Entity in reaching a resolution in any
dispute over warranty terms with the manufacturer. Any manufacturer's warranty that extends
beyond the expiration of the Supplier's warranty will be passed on to the Participating Entity.
C. DEALERS, DISTRIBUTORS, AND/OR RESELLERS. Upon Contract execution and throughout
the Contract term, Supplier must provide to Sourcewell a current means to validate or
authenticate Supplier's authorized dealers, distributors, or resellers relative to the Equipment,
Products, and Services offered under this Contract, which will be incorporated into this
Contract by reference. It is the Supplier's responsibility to ensure Sourcewell receives the most
current information.
3. PRICING
All Equipment, Products, or Services under this Contract will be priced at or below the price
stated in Supplier's Proposal.
When providing pricing quotes to Participating Entities, all pricing quoted must reflect a
Participating Entity's total cost of acquisition. This means that the quoted cost is for delivered
Equipment, Products, and Services that are operational for their intended purpose, and
includes all costs to the Participating Entity's requested delivery location.
Regardless of the payment method chosen by the Participating Entity, the total cost associated
with any purchase option of the Equipment, Products, or Services must always be disclosed in
the pricing quote to the applicable Participating Entity at the time of purchase.
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A. SHIPPING AND SHIPPING COSTS. All delivered Equipment and Products must be properly
packaged. Damaged Equipment and Products may be rejected. If the damage is not readily
apparent at the time of delivery, Supplier must permit the Equipment and Products to be
returned within a reasonable time at no cost to Sourcewell or its Participating Entities.
Participating Entities reserve the right to inspect the Equipment and Products at a reasonable
time after delivery where circumstances or conditions prevent effective inspection of the
Equipment and Products at the time of delivery. In the event of the delivery of nonconforming
Equipment and Products, the Participating Entity will notify the Supplier as soon as possible and
the Supplier will replace nonconforming Equipment and Products with conforming Equipment
and Products that are acceptable to the Participating Entity.
Supplier must arrange for and pay for the return shipment on Equipment and Products that arrive
in a defective or inoperable condition.
Sourcewell may declare the Supplier in breach of this Contract if the Supplier intentionally
delivers substandard or inferior Equipment or Products.
B. SALES TAX. Each Participating Entity is responsible for supplying the Supplier with valid tax-
exemption certification(s). When ordering, a Participating Entity must indicate if it is a tax-
exempt entity.
C. HOT LIST PRICING. At any time during this Contract, Supplier may offer a specific selection
of Equipment, Products, or Services at discounts greater than those listed in the Contract.
When Supplier determines it will offer Hot List Pricing, it must be submitted electronically to
Sourcewell in a line-item format. Equipment, Products, or Services may be added or removed
from the Hot List at any time through a Sourcewell Price and Product Change Form as defined
in Article 4 below.
Hot List program and pricing may also be used to discount and liquidate close-out and
discontinued Equipment and Products as long as those close-out and discontinued items are
clearly identified as such. Current ordering process and administrative fees apply. Hot List
Pricing must be published and made available to all Participating Entities.
4. PRODUCT AND PRICING CHANGE REQUESTS
Supplier may request Equipment, Product, or Service changes, additions, or deletions at any
time. All requests must be made in writing by submitting a signed Sourcewell Price and Product
Change Request Form to the assigned Sourcewell Supplier Development Administrator. This
approved form is available from the assigned Sourcewell Supplier Development Administrator.
At a minimum, the request must:
• Identify the applicable Sourcewell contract number;
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• Clearly specify the requested change;
• Provide sufficient detail to justify the requested change;
• Individually list all Equipment, Products, or Services affected by the requested change,
along with the requested change (e.g., addition, deletion, price change); and
• Include a complete restatement of pricing documentation in Microsoft Excel with the
effective date of the modified pricing, or product addition or deletion. The new pricing
restatement must include all Equipment, Products, and Services offered, even for those
items where pricing remains unchanged.
A fully executed Sourcewell Price and Product Change Request Form will become an
amendment to this Contract and will be incorporated by reference.
5. PARTICIPATION, CONTRACT ACCESS, AND PARTICIPATING ENTITY REQUIREMENTS
A. PARTICIPATION. Sourcewell's cooperative contracts are available and open to public and
nonprofit entities across the United States and Canada; such as federal, state/province,
municipal, K-12 and higher education, tribal government, and other public entities.
The benefits of this Contract should be available to all Participating Entities that can legally
access the Equipment, Products, or Services under this Contract. A Participating Entity's
authority to access this Contract is determined through its cooperative purchasing, interlocal,
or joint powers laws. Any entity accessing benefits of this Contract will be considered a Service
Member of Sourcewell during such time of access. Supplier understands that a Participating
Entity's use of this Contract is at the Participating Entity's sole convenience and Participating
Entities reserve the right to obtain like Equipment, Products, or Services from any other source.
Supplier is responsible for familiarizing its sales and service forces with Sourcewell contract use
eligibility requirements and documentation and will encourage potential participating entities
to join Sourcewell. Sourcewell reserves the right to add and remove Participating Entities to its
roster during the term of this Contract.
B. PUBLIC FACILITIES. Supplier's employees may be required to perform work at government-
owned facilities, including schools. Supplier's employees and agents must conduct themselves
in a professional manner while on the premises, and in accordance with Participating Entity
policies and procedures, and all applicable laws.
6. PARTICIPATING ENTITY USE AND PURCHASING
A. ORDERS AND PAYMENT. To access the contracted Equipment, Products, or Services under
this Contract, a Participating Entity must clearly indicate to Supplier that it intends to access this
Contract; however, order flow and procedure will be developed jointly between Sourcewell and
Supplier. Typically, a Participating Entity will issue an order directly to Supplier or its authorized
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subsidiary, distributor, dealer, or reseller. If a Participating Entity issues a purchase order, it
may use its own forms, but the purchase order should clearly note the applicable Sourcewell
contract number. All Participating Entity orders under this Contract must be issued prior to
expiration or cancellation of this Contract; however, Supplier performance, Participating Entity
payment obligations, and any applicable warranty periods or other Supplier or Participating
Entity obligations may extend beyond the term of this Contract.
Supplier's acceptable forms of payment are included in its attached Proposal. Participating
Entities will be solely responsible for payment and Sourcewell will have no liability for any
unpaid invoice of any Participating Entity.
B. ADDITIONAL TERMS AND CONDITIONS/PARTICIPATING ADDENDUM. Additional terms and
conditions to a purchase order, or other required transaction documentation, may be
negotiated between a Participating Entity and Supplier, such as job or industry-specific
requirements, legal requirements (e.g., affirmative action or immigration status requirements),
or specific local policy requirements. Some Participating Entities may require the use of a
Participating Addendum, the terms of which will be negotiated directly between the
Participating Entity and the Supplier or its authorized dealers, distributors, or resellers, as
applicable. Any negotiated additional terms and conditions must never be less favorable to the
Participating Entity than what is contained in this Contract.
C. SPECIALIZED SERVICE REQUIREMENTS. In the event that the Participating Entity requires
service or specialized performance requirements not addressed in this Contract (such as e-
commerce specifications, specialized delivery requirements, or other specifications and
requirements), the Participating Entity and the Supplier may enter into a separate, standalone
agreement, apart from this Contract. Sourcewell, including its agents and employees, will not
be made a party to a claim for breach of such agreement.
D. TERMINATION OF ORDERS. Participating Entities may terminate an order, in whole or
in part, immediately upon notice to Supplier in the event of any of the following events:
1. The Participating Entity fails to receive funding or appropriation from its governing body
at levels sufficient to pay for the equipment, products, or services to be purchased; or
2. Federal, state, or provincial laws or regulations prohibit the purchase or change the
Participating Entity's requirements.
E. GOVERNING LAW AND VENUE. The governing law and venue for any action related to a
Participating Entity's order will be determined by the Participating Entity making the purchase.
7. CUSTOMER SERVICE
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A. PRIMARY ACCOUNT REPRESENTATIVE. Supplier will assign an Account Representative to
Sourcewell for this Contract and must provide prompt notice to Sourcewell if that person is
changed. The Account Representative will be responsible for:
• Maintenance and management of this Contract;
• Timely response to all Sourcewell and Participating Entity inquiries; and
• Business reviews to Sourcewell and Participating Entities, if applicable.
B. BUSINESS REVIEWS. Supplier must perform a minimum of one business review with
Sourcewell per contract year. The business review will cover sales to Participating Entities,
pricing and contract terms, administrative fees, sales data reports, performance issues, supply
issues, customer issues, and any other necessary information.
8. REPORT ON CONTRACT SALES ACTIVITY AND ADMINISTRATIVE FEE PAYMENT
A. CONTRACT SALES ACTIVITY REPORT. Each calendar quarter, Supplier must provide a
contract sales activity report (Report) to the Sourcewell Supplier Development Administrator
assigned to this Contract. Reports are due no later than 45 days after the end of each calendar
quarter. A Report must be provided regardless of the number or amount of sales during that
quarter (i.e., if there are no sales, Supplier must submit a report indicating no sales were
made).
The Report must contain the following fields:
• Participating Entity Name (e.g., City of Staples Highway Department);
• Participating Entity Physical Street Address;
• Participating Entity City;
• Participating Entity State/Province;
• Participating Entity Zip/Postal Code;
• Participating Entity Contact Name;
• Participating Entity Contact Email Address;
• Participating Entity Contact Telephone Number;
• Sourcewell Assigned Entity/Participating Entity Number;
• Item Purchased Description;
• Item Purchased Price;
• Sourcewell Administrative Fee Applied; and
• Date Purchase was invoiced/sale was recognized as revenue by Supplier.
B. ADMINISTRATIVE FEE. In consideration for the support and services provided by Sourcewell,
the Supplier will pay an administrative fee to Sourcewell on all Equipment, Products, and
Services provided to Participating Entities. The Administrative Fee must be included in, and not
added to, the pricing. Supplier may not charge Participating Entities more than the contracted
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price to offset the Administrative Fee.
The Supplier will submit payment to Sourcewell for the percentage of administrative fee stated
in the Proposal multiplied by the total sales of all Equipment, Products, and Services purchased
by Participating Entities under this Contract during each calendar quarter. Payments should
note the Supplier's name and Sourcewell-assigned contract number in the memo; and must be
mailed to the address above "Attn: Accounts Receivable" or remitted electronically to
Sourcewell's banking institution per Sourcewell's Finance department instructions. Payments
must be received no later than 45 calendar days after the end of each calendar quarter.
Supplier agrees to cooperate with Sourcewell in auditing transactions under this Contract to
ensure that the administrative fee is paid on all items purchased under this Contract.
In the event the Supplier is delinquent in any undisputed administrative fees, Sourcewell
reserves the right to cancel this Contract and reject any proposal submitted by the Supplier in
any subsequent solicitation. In the event this Contract is cancelled by either party prior to the
Contract's expiration date, the administrative fee payment will be due no more than 30 days
from the cancellation date.
9. AUTHORIZED REPRESENTATIVE
Sourcewell's Authorized Representative is its Chief Procurement Officer.
Supplier's Authorized Representative is the person named in the Supplier's Proposal. If
Supplier's Authorized Representative changes at any time during this Contract, Supplier must
promptly notify Sourcewell in writing.
10. AUDIT, ASSIGNMENT, AMENDMENTS, WAIVER, AND CONTRACT COMPLETE
A. AUDIT. Pursuant to Minnesota Statutes Section 16C.05, subdivision 5, the books, records,
documents, and accounting procedures and practices relevant to this Contract are subject to
examination by Sourcewell or the Minnesota State Auditor for a minimum of six years from the
end of this Contract. This clause extends to Participating Entities as it relates to business
conducted by that Participating Entity under this Contract.
B. ASSIGNMENT. Neither party may assign or otherwise transfer its rights or obligations under
this Contract without the prior written consent of the other party and a fully executed
assignment agreement. Such consent will not be unreasonably withheld. Any prohibited
assignment will be invalid.
C. AMENDMENTS. Any amendment to this Contract must be in writing and will not be effective
until it has been duly executed by the parties.
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D. WAIVER. Failure by either party to take action or assert any right under this Contract will
not be deemed a waiver of such right in the event of the continuation or repetition of the
circumstances giving rise to such right. Any such waiver must be in writing and signed by the
parties.
E. CONTRACT COMPLETE. This Contract represents the complete agreement between the
parties. No other understanding regarding this Contract, whether written or oral, may be used
to bind either party. For any conflict between the attached Proposal and the terms set out in
Articles 1-22 of this Contract, the terms of Articles 1-22 will govern.
F. RELATIONSHIP OF THE PARTIES. The relationship of the parties is one of independent
contractors, each free to exercise judgment and discretion with regard to the conduct of their
respective businesses. This Contract does not create a partnership, joint venture, or any other
relationship such as master-servant, or principal-agent.
11. INDEMNITY AND HOLD HARMLESS
Supplier must indemnify, defend, save, and hold Sourcewell and its Participating Entities,
including their agents and employees, harmless from any claims or causes of action, including
attorneys' fees incurred by Sourcewell or its Participating Entities, arising out of any act or
omission in the performance of this Contract by the Supplier or its agents or employees; this
indemnification includes injury or death to person(s) or property alleged to have been caused
by some defect in the Equipment, Products, or Services under this Contract to the extent the
Equipment, Product, or Service has been used according to its specifications. Sourcewell's
responsibility will be governed by the State of Minnesota's Tort Liability Act (Minnesota
Statutes Chapter 466) and other applicable law.
12. GOVERNMENT DATA PRACTICES
Supplier and Sourcewell must comply with the Minnesota Government Data Practices Act,
Minnesota Statutes Chapter 13, as it applies to all data provided by or provided to Sourcewell
under this Contract and as it applies to all data created, collected, received, maintained, or
disseminated by the Supplier under this Contract.
13. INTELLECTUAL PROPERTY, PUBLICITY, MARKETING, AND ENDORSEMENT
A. INTELLECTUAL PROPERTY
1. Grant of License. During the term of this Contract:
a. Sourcewell grants to Supplier a royalty-free, worldwide, non-exclusive right and
license to use the trademark(s) provided to Supplier by Sourcewell in advertising and
promotional materials for the purpose of marketing Sourcewell's relationship with
Supplier.
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b. Supplier grants to Sourcewell a royalty-free, worldwide, non-exclusive right and
license to use Supplier's trademarks in advertising and promotional materials for the
purpose of marketing Supplier's relationship with Sourcewell.
2. Limited Right of Sublicense. The right and license granted herein includes a limited right
of each party to grant sublicenses to their respective subsidiaries, distributors, dealers,
resellers, marketing representatives, and agents (collectively "Permitted Sublicensees") in
advertising and promotional materials for the purpose of marketing the Parties' relationship
to Participating Entities. Any sublicense granted will be subject to the terms and conditions
of this Article. Each party will be responsible for any breach of this Article by any of their
respective sublicensees.
3. Use; Quality Control.
a. Neither party may alter the other party's trademarks from the form provided
and must comply with removal requests as to specific uses of its trademarks or
logos.
b. Each party agrees to use, and to cause its Permitted Sublicensees to use, the
other party's trademarks only in good faith and in a dignified manner consistent with
such party's use of the trademarks. Upon written notice to the breaching party, the
breaching party has 30 days of the date of the written notice to cure the breach or
the license will be terminated.
4. Termination. Upon the termination of this Contract for any reason, each party, including
Permitted Sublicensees, will have 30 days to remove all Trademarks from signage, websites,
and the like bearing the other party's name or logo (excepting Sourcewell's pre-printed
catalog of suppliers which may be used until the next printing). Supplier must return all
marketing and promotional materials, including signage, provided by Sourcewell, or dispose
of it according to Sourcewell's written directions.
B. PUBLICITY. Any publicity regarding the subject matter of this Contract must not be released
without prior written approval from the Authorized Representatives. Publicity includes notices,
informational pamphlets, press releases, research, reports, signs, and similar public notices
prepared by or for the Supplier individually or jointly with others, or any subcontractors, with
respect to the program, publications, or services provided resulting from this Contract.
C. MARKETING. Any direct advertising, marketing, or offers with Participating Entities must be
approved by Sourcewell. Send all approval requests to the Sourcewell Supplier Development
Administrator assigned to this Contract.
D. ENDORSEMENT. The Supplier must not claim that Sourcewell endorses its Equipment,
Products, or Services.
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14. GOVERNING LAW, JURISDICTION, AND VENUE
The substantive and procedural laws of the State of Minnesota will govern this Contract. Venue
for all legal proceedings arising out of this Contract, or its breach, must be in the appropriate
state court in Todd County, Minnesota or federal court in Fergus Falls, Minnesota.
15. FORCE MAJEURE
Neither party to this Contract will be held responsible for delay or default caused by acts of God
or other conditions that are beyond that party's reasonable control. A party defaulting under
this provision must provide the other party prompt written notice of the default.
16. SEVERABILITY
If any provision of this Contract is found by a court of competent jurisdiction to be illegal,
unenforceable, or void then both parties will be relieved from all obligations arising from that
provision. If the remainder of this Contract is capable of being performed, it will not be affected
by such determination or finding and must be fully performed.
17. PERFORMANCE, DEFAULT, AND REMEDIES
A. PERFORMANCE. During the term of this Contract, the parties will monitor performance and
address unresolved contract issues as follows:
1. Notification. The parties must promptly notify each other of any known dispute and
work in good faith to resolve such dispute within a reasonable period of time. If necessary,
Sourcewell and the Supplier will jointly develop a briefing document that describes
the issue(s), relevant impact, and positions of both parties.
2. Escalation. If parties are unable to resolve the issue in a timely manner, as specified
above, either Sourcewell or Supplier may escalate the resolution of the issue to a higher
level of management. The Supplier will have 30 calendar days to cure an outstanding issue.
3. Performance while Dispute is Pending. Notwithstanding the existence of a dispute, the
Supplier must continue without delay to carry out all of its responsibilities under the
Contract that are not affected by the dispute. If the Supplier fails to continue without delay
to perform its responsibilities under the Contract, in the accomplishment of all undisputed
work, the Supplier will bear any additional costs incurred by Sourcewell and/or its
Participating Entities as a result of such failure to proceed.
B. DEFAULT AND REMEDIES. Either of the following constitutes cause to declare this Contract,
or any Participating Entity order under this Contract, in default:
1. Nonperformance of contractual requirements, or
2. A material breach of any term or condition of this Contract.
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The party claiming default must provide written notice of the default, with 30 calendar days to
cure the default. Time allowed for cure will not diminish or eliminate any liability for liquidated
or other damages. If the default remains after the opportunity for cure, the non-defaulting
party may:
• Exercise any remedy provided by law or equity, or
• Terminate the Contract or any portion thereof, including any orders issued against the
Contract.
18. INSURANCE
A. REQUIREMENTS. At its own expense, Supplier must maintain insurance policy(ies) in effect
at all times during the performance of this Contract with insurance company(ies) licensed or
authorized to do business in the State of Minnesota having an "AM BEST" rating of A- or better,
with coverage and limits of insurance not less than the following:
1. Workers' Compensation and Employer's Liability.
Workers' Compensation: As required by any applicable law or regulation.
Employer's Liability Insurance: must be provided in amounts not less than listed below:
Minimum limits:
$500,000 each accident for bodily injury by accident
$500,000 policy limit for bodily injury by disease
$500,000 each employee for bodily injury by disease
2. Commercial General Liability Insurance. Supplier will maintain insurance covering its
operations, with coverage on an occurrence basis, and must be subject to terms no less
broad than the Insurance Services Office ("ISO") Commercial General Liability Form
CG0001 (2001 or newer edition), or equivalent. At a minimum, coverage must include
liability arising from premises, operations, bodily injury and property damage,
independent contractors, products-completed operations including construction defect,
contractual liability, blanket contractual liability, and personal injury and advertising
injury. All required limits, terms and conditions of coverage must be maintained during
the term of this Contract.
Minimum Limits:
$1,000,000 each occurrence Bodily Injury and Property Damage
$1,000,000 Personal and Advertising Injury
$2,000,000 aggregate for products liability-completed operations
$2,000,000 general aggregate
3. Commercial Automobile Liability Insurance. During the term of this Contract,
Supplier will maintain insurance covering all owned, hired, and non-owned automobiles
in limits of liability not less than indicated below. The coverage must be subject to terms
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no less broad than ISO Business Auto Coverage Form CA 0001 (2010 edition or newer),
or equivalent.
Minimum Limits:
$1,000,000 each accident, combined single limit
4. Umbrella Insurance. During the term of this Contract, Supplier will maintain
umbrella coverage over Employer's Liability, Commercial General Liability, and
Commercial Automobile.
Minimum Limits:
$2,000,000
5. Network Security and Privacy Liability Insurance. During the term of this Contract,
Supplier will maintain coverage for network security and privacy liability. The coverage
may be endorsed on another form of liability coverage or written on a standalone
policy. The insurance must cover claims which may arise from failure of Supplier's
security resulting in, but not limited to, computer attacks, unauthorized access,
disclosure of not public data - including but not limited to, confidential or private
information, transmission of a computer virus, or denial of service.
Minimum limits:
$2,000,000 per occurrence
$2,000,000 annual aggregate
Failure of Supplier to maintain the required insurance will constitute a material breach entitling
Sourcewell to immediately terminate this Contract for default.
B. CERTIFICATES OF INSURANCE. Prior to commencing under this Contract, Supplier must
furnish to Sourcewell a certificate of insurance, as evidence of the insurance required under this
Contract. Prior to expiration of the policy(ies), renewal certificates must be mailed to
Sourcewell, 202 12th Street Northeast, P.O. Box 219, Staples, MN 56479 or sent to the
Sourcewell Supplier Development Administrator assigned to this Contract. The certificates must
be signed by a person authorized by the insurer(s) to bind coverage on their behalf.
Failure to request certificates of insurance by Sourcewell, or failure of Supplier to provide
certificates of insurance, in no way limits or relieves Supplier of its duties and responsibilities in
this Contract.
C. ADDITIONAL INSURED ENDORSEMENT AND PRIMARY AND NON-CONTRIBUTORY
INSURANCE CLAUSE. Supplier agrees to list Sourcewell and its Participating Entities, including
their officers, agents, and employees, as an additional insured under the Supplier's commercial
general liability insurance policy with respect to liability arising out of activities, "operations," or
"work" performed by or on behalf of Supplier, and products and completed operations of
Supplier. The policy provision(s) or endorsement(s) must further provide that coverage is
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primary and not excess over or contributory with any other valid, applicable, and collectible
insurance or self-insurance in force for the additional insureds.
D. WAIVER OF SUBROGATION. Supplier waives and must require (by endorsement or
otherwise) all its insurers to waive subrogation rights against Sourcewell and other additional
insureds for losses paid under the insurance policies required by this Contract or other
insurance applicable to the Supplier or its subcontractors. The waiver must apply to all
deductibles and/or self-insured retentions applicable to the required or any other insurance
maintained by the Supplier or its subcontractors. Where permitted by law, Supplier must
require similar written express waivers of subrogation and insurance clauses from each of its
subcontractors.
E. UMBRELLA/EXCESS LIABILITY/SELF-INSURED RETENTION. The limits required by this
Contract can be met by either providing a primary policy or in combination with
umbrella/excess liability policy(ies), or self-insured retention.
19. COMPLIANCE
A. LAWS AND REGULATIONS. All Equipment, Products, or Services provided under this
Contract must comply fully with applicable federal laws and regulations, and with the laws in
the states and provinces in which the Equipment, Products, or Services are sold.
B. LICENSES. Supplier must maintain a valid and current status on all required federal,
state/provincial, and local licenses, bonds, and permits required for the operation of the
business that the Supplier conducts with Sourcewell and Participating Entities.
20. BANKRUPTCY, DEBARMENT, OR SUSPENSION CERTIFICATION
Supplier certifies and warrants that it is not in bankruptcy or that it has previously disclosed in
writing certain information to Sourcewell related to bankruptcy actions. If at any time during
this Contract Supplier declares bankruptcy, Supplier must immediately notify Sourcewell in
writing.
Supplier certifies and warrants that neither it nor its principals are presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from programs
operated by the State of Minnesota; the United States federal government or the Canadian
government, as applicable; or any Participating Entity. Supplier certifies and warrants that
neither it nor its principals have been convicted of a criminal offense related to the subject
matter of this Contract. Supplier further warrants that it will provide immediate written notice
to Sourcewell if this certification changes at any time.
21. PROVISIONS FOR NON-UNITED STATES FEDERAL ENTITY PROCUREMENTS UNDER
UNITED STATES FEDERAL AWARDS OR OTHER AWARDS
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Participating Entities that use United States federal grant or FEMA funds to purchase goods or
services from this Contract may be subject to additional requirements including the
procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit
Requirements for Federal Awards, 2 C.F.R. § 200. Participating Entities may have additional
requirements based on specific funding source terms or conditions. Within this Article, all
references to "federal" should be interpreted to mean the United States federal government.
The following list only applies when a Participating Entity accesses Supplier's Equipment,
Products, or Services with United States federal funds.
A. EQUAL EMPLOYMENT OPPORTUNITY. Except as otherwise provided under 41 C.F.R. § 60, all
contracts that meet the definition of "federally assisted construction contract" in 41 C.F.R. § 60-
1.3 must include the equal opportunity clause provided under 41 C.F.R. §60-1.4(b), in
accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319,
12935, 3 C.F.R. §, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending
Executive Order 11246 Relating to Equal Employment Opportunity," and implementing
regulations at 41 C.F.R. § 60, "Office of Federal Contract Compliance Programs, Equal
Employment Opportunity, Department of Labor." The equal opportunity clause is incorporated
herein by reference.
B. DAVIS-BACON ACT, AS AMENDED (40 U.S.C. § 3141-3148). When required by federal
program legislation, all prime construction contracts in excess of $2,000 awarded by non-
federal entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. §
3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 C.F.R. § 5,
"Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted
Construction"). In accordance with the statute, contractors must be required to pay wages to
laborers and mechanics at a rate not less than the prevailing wages specified in a wage
determination made by the Secretary of Labor. In addition, contractors must be required to pay
wages not less than once a week. The non-federal entity must place a copy of the current
prevailing wage determination issued by the Department of Labor in each solicitation. The
decision to award a contract or subcontract must be conditioned upon the acceptance of the
wage determination. The non-federal entity must report all suspected or reported violations to
the federal awarding agency. The contracts must also include a provision for compliance with
the Copeland "Anti-Kickback" Act (40 U.S.C. § 3145), as supplemented by Department of Labor
regulations (29 C.F.R. § 3, "Contractors and Subcontractors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that
each contractor or subrecipient must be prohibited from inducing, by any means, any person
employed in the construction, completion, or repair of public work, to give up any part of the
compensation to which he or she is otherwise entitled. The non-federal entity must report
all suspected or reported violations to the federal awarding agency. Supplier must be in
compliance with all applicable Davis-Bacon Act provisions.
Rev. 3/2022
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C. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT (40 U.S.C. § 3701-3708). Where
applicable, all contracts awarded by the non-federal entity in excess of $100,000 that involve
the employment of mechanics or laborers must include a provision for compliance with 40
U.S.C. §§ 3702 and 3704, as supplemented by Department of Labor regulations (29 C.F.R. § 5).
Under 40 U.S.C. § 3702 of the Act, each contractor must be required to compute the wages of
every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess
of the standard work week is permissible provided that the worker is compensated at a rate of
not less than one and a half times the basic rate of pay for all hours worked in excess of 40
hours in the work week. The requirements of 40 U.S.C. § 3704 are applicable to construction
work and provide that no laborer or mechanic must be required to work in surroundings or
under working conditions which are unsanitary, hazardous or dangerous. These requirements
do not apply to the purchases of supplies or materials or articles ordinarily available on the
open market, or contracts for transportation or transmission of intelligence. This provision is
hereby incorporated by reference into this Contract. Supplier certifies that during the term of
an award for all contracts by Sourcewell resulting from this procurement process, Supplier must
comply with applicable requirements as referenced above.
D. RIGHTS TO INVENTIONS MADE UNDER A CONTRACT OR AGREEMENT. If the federal award
meets the definition of "funding agreement" under 37 C.F.R. § 401.2(a) and the recipient or
subrecipient wishes to enter into a contract with a small business firm or nonprofit organization
regarding the substitution of parties, assignment or performance of experimental,
developmental, or research work under that "funding agreement," the recipient or subrecipient
must comply with the requirements of 37 C.F.R. § 401, "Rights to Inventions Made by Nonprofit
Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding agency. Supplier
certifies that during the term of an award for all contracts by Sourcewell resulting from this
procurement process, Supplier must comply with applicable requirements as referenced above.
E. CLEAN AIR ACT (42 U.S.C. § 7401-7671Q.) AND THE FEDERAL WATER POLLUTION CONTROL
ACT (33 U.S.C. § 1251-1387). Contracts and subgrants of amounts in excess of $150,000 require
the non-federal award to agree to comply with all applicable standards, orders or regulations
issued pursuant to the Clean Air Act (42 U.S.C. § 7401-7671q) and the Federal Water Pollution
Control Act as amended (33 U.S.C. § 1251-1387). Violations must be reported to the Federal
awarding agency and the Regional Office of the Environmental Protection Agency (EPA).
Supplier certifies that during the term of this Contract will comply with applicable requirements
as referenced above.
F. DEBARMENT AND SUSPENSION (EXECUTIVE ORDERS 12549 AND 12689). A contract award
(see 2 C.F.R. § 180.220) must not be made to parties listed on the government wide exclusions
in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 C.F.R.
§180 that implement Executive Orders 12549 (3 C.F.R. § 1986 Comp., p. 189) and 12689 (3
C.F.R. § 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the names
of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared
Rev. 3/2022
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122123-PLC
ineligible under statutory or regulatory authority other than Executive Order 12549. Supplier
certifies that neither it nor its principals are presently debarred, suspended, proposed for
debarment, declared ineligible, or voluntarily excluded from participation by any federal
department or agency.
G. BYRD ANTI-LOBBYING AMENDMENT, AS AMENDED (31 U.S.C. § 1352). Suppliers must file
any required certifications. Suppliers must not have used federal appropriated funds to pay any
person or organization for influencing or attempting to influence an officer or employee of any
agency, a member of Congress, officer or employee of Congress, or an employee of a member
of Congress in connection with obtaining any federal contract, grant, or any other award
covered by 31 U.S.C. § 1352. Suppliers must disclose any lobbying with non-federal funds that
takes place in connection with obtaining any federal award. Such disclosures are forwarded
from tier to tier up to the non-federal award. Suppliers must file all certifications and
disclosures required by, and otherwise comply with, the Byrd Anti-Lobbying Amendment (31
U.S.C. § 1352).
H. RECORD RETENTION REQUIREMENTS. To the extent applicable, Supplier must comply with
the record retention requirements detailed in 2 C.F.R. § 200.333. The Supplier further certifies
that it will retain all records as required by 2 C.F.R. § 200.333 for a period of 3 years after
grantees or subgrantees submit final expenditure reports or quarterly or annual financial
reports, as applicable, and all other pending matters are closed.
I. ENERGY POLICY AND CONSERVATION ACT COMPLIANCE. To the extent applicable, Supplier
must comply with the mandatory standards and policies relating to energy efficiency which are
contained in the state energy conservation plan issued in compliance with the Energy Policy
and Conservation Act.
J. BUY AMERICAN PROVISIONS COMPLIANCE. To the extent applicable, Supplier must comply
with all applicable provisions of the Buy American Act. Purchases made in accordance with the
Buy American Act must follow the applicable procurement rules calling for free and open
competition.
K. ACCESS TO RECORDS (2 C.F.R. § 200.336). Supplier agrees that duly authorized
representatives of a federal agency must have access to any books, documents, papers and
records of Supplier that are directly pertinent to Supplier's discharge of its obligations under
this Contract for the purpose of making audits, examinations, excerpts, and transcriptions. The
right also includes timely and reasonable access to Supplier's personnel for the purpose of
interview and discussion relating to such documents.
L. PROCUREMENT OF RECOVERED MATERIALS (2 C.F.R. § 200.322). A non-federal entity that is
a state agency or agency of a political subdivision of a state and its contractors must comply
with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation
and Recovery Act. The requirements of Section 6002 include procuring only items designated in
Rev. 3/2022
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guidelines of the Environmental Protection Agency (EPA) at 40 C.F.R. § 247 that contain the
highest percentage of recovered materials practicable, consistent with maintaining a
satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the
value of the quantity acquired during the preceding fiscal year exceeded $10,000; procuring
solid waste management services in a manner that maximizes energy and resource recovery;
and establishing an affirmative procurement program for procurement of recovered materials
identified in the EPA guidelines.
M. FEDERAL SEAL(S), LOGOS, AND FLAGS. The Supplier cannot use the seal(s), logos, crests, or
reproductions of flags or likenesses of Federal agency officials without specific pre-approval.
N. NO OBLIGATION BY FEDERAL GOVERNMENT. The U.S. federal government is not a party to
this Contract or any purchase by a Participating Entity and is not subject to any obligations or
liabilities to the Participating Entity, Supplier, or any other party pertaining to any matter
resulting from the Contract or any purchase by an authorized user.
O. PROGRAM FRAUD AND FALSE OR FRAUDULENT STATEMENTS OR RELATED ACTS. The
Contractor acknowledges that 31 U.S.C. 38 (Administrative Remedies for False Claims and
Statements) applies to the Supplier's actions pertaining to this Contract or any purchase by a
Participating Entity.
P. FEDERAL DEBT. The Supplier certifies that it is non-delinquent in its repayment of any
federal debt. Examples of relevant debt include delinquent payroll and other taxes, audit
disallowance, and benefit overpayments.
Q. CONFLICTS OF INTEREST. The Supplier must notify the U.S. Office of General Services,
Sourcewell, and Participating Entity as soon as possible if this Contract or any aspect related to
the anticipated work under this Contract raises an actual or potential conflict of interest (as
described in 2 C.F.R. Part 200). The Supplier must explain the actual or potential conflict in
writing in sufficient detail so that the U.S. Office of General Services, Sourcewell, and
Participating Entity are able to assess the actual or potential conflict; and provide any additional
information as necessary or requested.
R. U.S. EXECUTIVE ORDER 13224. The Supplier, and its subcontractors, must comply with U.S.
Executive Order 13224 and U.S. Laws that prohibit transactions with and provision of resources
and support to individuals and organizations associated with terrorism.
S. PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR
EQUIPMENT. To the extent applicable, Supplier certifies that during the term of this Contract it
will comply with applicable requirements of 2 C.F.R. § 200.216.
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T. DOMESTIC PREFERENCES FOR PROCUREMENTS. To the extent applicable, Supplier certifies
that during the term of this Contract will comply with applicable requirements of 2 C.F.R. §
200.322.
22. CANCELLATION
Sourcewell or Supplier may cancel this Contract at any time, with or without cause, upon 60
days' written notice to the other party. However, Sourcewell may cancel this Contract
immediately upon discovery of a material defect in any certification made in Supplier's
Proposal. Cancellation of this Contract does not relieve either party of financial, product, or
service obligations incurred or accrued prior to cancellation.
P.L. Custom Body and Equipment Co., Inc.
Sourcewell
By:
DocuSigned by:
Chad Newsome
74D1CB39CD794C1...
Chad Newsome
Title: National Sales Manager
Date:
2/28/2024 | 10:57 AM CST
By:
DocuSigned by:
Jeremy Schwartz
COFD2A139D06489...
Jeremy Schwartz
Title: Chief Procurement Officer
Date:
2/28/2024 | 11:24 AM CST
Rev. 3/2022
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