Neuton Brokrrage - Region 10 Education Service Center

281 596 4588
Neuton Brokrrage
Hau 10 14 03154a
SPEC:AL CONDiT10NS FOR DELttRIES
shOud‖ be detemmed by dherthe Mun卜 Regbnd Co‐ Op:KILEEN iSD,orawaded vendors lhat rlore
than once de“ very a weekto any ofthe dЮ p sk湾
洒hn the school DIstrcts is necess劉 :pleaSe nst any
addⅢ ond fees bebw Be specnc 6 10fomulas,fees,or any other charges inttred.
Minimum number of
c6es or pounds to be delivered ead shipmenti
Additional fee if any for
otnr
warehouse
Le“ me brddi“ nes#ddギ
)
disficts: 0/ n
s ′十 #dWeek,s●
“
Please provide any other additjonal information below:
Vendor
Authorized ComPanY Offcial's Nanc:
stgnature ofCompany
Comdete and remm面 h RoD∝ J
P.17
Hau 10 14 03:54a
281 596 4588
Neruton Brokerage
P。
18
FELONY CONⅥ C¬ ON NOTiFiCAT10N
No ll Seclion 44 034,NolintOn Or chmh」
Httlow,Subsecton(a),
靡 穏問 筒祠「M鮮珊 i麟欄 即
State ol Texas Legidaive senale Bi‖
げ
:‰ T龍
noice rrlust hdude a generaldesc"pttt Ofhe condu
柵 魃 珊饂i鰺 蝠
魃 粽常梶
珊慌胤覇柵 剛肌:鵬職 ‰e∞ nh∝・
職 躙
1‖
Thb Notce L NotRequired ofa PuЫ bV Heu CorpOrattm
VendorsName S Aに こOY
Fο い う
S民
Auhorized Company Oficial's Name (Printed):
A. My frm is a publiCly held corporalon;therefoc,Olも
_
にし
とに
repo面 ng ttquirementis nOt app‖ cable.
Signature of ComPanY Official:
B.
-
Myfim b notowned noroperated
S'rgnatureof
C.
Companyomciar: ttO
J-
by anyonevuho
hm been convbtedofahbny'
r.'a,-SNJ
U-
-
ual(s) wtro haVlrave been convicted of a felony'
My flrm is owned or operabd by the following ifl"dlvk
Name of Felon(s):
Details of Convbtion (s):
SQnalure of ComPanY Offcial:
Comdete and retum面 th PЮ 00SJ
Mav 10 14 03855●
281 596 4588
Ncuton Brokerage
P・
19
cenncatiOn Regardhg Lobbying
面高面]詭 鋼∞000
蔽誦
高
轟
高
票面
瓢扇扇
孫
高高
再
面
面
扇
h R“
劇
Funds.
such fallure
The undesoned Ce:憮 ,tO
edge and belbr,hat:
he bestof ns or her kno口
t
∞n甑 硼出l黒 酬嗽鵬瀾
泄“
辮 淵朧硼 鵠
:躙 踏瞥
SAは E工π ■)。 bS
|<(tr-eoock,
に
Mme/Mdress of Organization
建`ゾ 。
鯉
J・
鵬識舗話論
「
DredSNp RFP#2044‐ 10
FL 33138
281 596 4588
t{rruton Brokcrag:
Maョ 10 14 03155a
P.20
RequestfOr ProDOSJ
NOTARIZEDSTATEttNTVttDATIЮ
Rsglon 10 Education
To:
ttopOSALCO旺 Ⅲ S
NON COLLuSON STATEMENr
Soilic! Center
l %ο bS Lし
Frolni S長 に(E ψ
VendorshallnotpreparethisProposalincollusionwitharyotherVendorsaldhecontentsofthisProposal
or agent
ovlhis orqanization nor by an employee
pdor
as to orices, terms o, .onaruon. ,r,iiioir.
activity
ot business
..rrr.*eo
.ngio"d in hi, type
of tris
tris Proposal is not and has
pmposal due date. H;ilu"?, il;;'ril;riz&- aqenr or od*r signhg
to tre offciat
conditions and/ or
oncemeo ln any agreement to control tire
oiiniirearv
aireclv
monrc,
six
for
been,
not
purpose thereon'
any personto propose or not
prkrs of services propo."o, o' h* noii;llul'lt"d
or to any other person,
organization to any ofirer vendor
jn the
lhawredthecompleteProposalRFP#201&10FULLLINEGROCERYITEMSWAREHOUSE'DIRECT
the accuracy of all information mntained
.nJ*,it1t
in
sHrp fo, member disfiicb
Mrfii;ilioop
Proposal.
Autrorized Vendor
O{fi
Mハ ルlハ 00こ
t4A't
cer
´ し
てにコD`“
5小 │て こくて
My Oom耐 ssion eゅ i蔭 On
he亜_dり d∠ と,の ″
.
1
22
zrlh
Maョ
10 14 03:558
281 596 4588
lleu,ton Brokerage
P.21
ATTACHMENT B
粥鮒
軋 鮮翻 鰈 鼈懸
‖
躙欄鞘∫
my d he statemett d mS Cen鰤
‰き
‖
」
蹴l鳳 ∬
出:鐵叩満器潮乳∬
ぬ
鴫釧
s Proposal.
#場備
輔
癬
lding suspenSbn and10rdebanTlent_
鰤脂:瀾棚
柵溜淵よ
1淵
:出
lMも
bam艦澁 nw:ふ 器懺
ged ciЮ umstances.
聰
i榊憩
輻
PObniJ Vendor Name S卜
1と ム
■le dAuholiZed Rpresmtalivel`¬
Mal‖ ng
SIgnature:
P。
こ■
i
口
ιι鮨 Dこ
)ο
∼
80Zη ヨ
ゝS
Lし
ιノ
了
M“
`め
Oι
女
Fじ 33
281 596 4580
Neuton Broker€ge
Mav 10 14 03:56●
P.22
A■ACHMENT C
l‖
¨―
・―
瑯ユ…"… や‐―・
●Ч
Ⅲ
羹rlmentll entlwl
C● de by a pe口 Dndoln3b 品繰 ith thei“
G● vem"ent
local
filcd with the rEcords adtirinh-tsator ofthe
ry hw thi5 questionnaire must be
th"
f.."r than the 7th busin.56 da1 elbr the date
f :'::P,1:●
●
*""r".""r:r*
語iL雇 ││:.●15輛 "1760"L●
:]電 冨認L椛 凝諾
persoh■ 10tttes Secti● 71 patt
,n commits an OffenSe■ 1に
●●●●Or・
К
An dttnSe under thiS■ 爛oh iS I Ctall C"isd●
So*trr Fr*
l・
ll
:G● verhh節 t
“
p回 ouコ vⅢ 熙 Ч… …‐…… …
"0■
ng薔 Ⅲけ け n改
苗 a"中 山
・
"価
S輌
tnatYou,*
-'"**;;";|arra*a
W"qJた
IrhE
l.w
。
reqdte3
al
工 G¨ ernment
Fh引
lemuⅢ ■ FTJ」 :li露 驚 tn 聖so,ton
出on 176
006ta)′ r.cal6oiernment
176.06(a),
… the year for wtrl'
Lter than septlernber“ !df
quesuqnnalre
rrled
i"'n'ss aiv atter *re aae th€ drBnalrY
H::i;;#; ;;; ;'"' i*"t
I「
蔽 雨 面 悪 iV。
・
are flling an uP“
1“
"f
9,コ `,7‐・
l FVeロ ロ
Vee OrOntrac● r ofthe 10中
'■
Of雌
80VemmentalehttW Wlth repecttO expenditures ofmorlev
●local goVerlrnent。 1陶 け
…
or burinesi iettthGhiP'
I".Ju" uru
"murti*
f.fcJ6
w卜 ●appui"σ Ⅲ
m'.::!lHl"l;il:lit"ffi ffi ;ffiJffi
POVS‐ l pvernme膏 型
;;;;;f
望 lli■
the arnriation or business
Ad6rt d r!02r2m5
Mau 10 14 03:56a
lleuton Brokerage
281 596 4588
P。
23
oti.er
verllm,“ ●
I:“ `口・
・‐
・ ・'P''
― 可 wt
Name of b“ :g●
toqrrtuncrfi
,・
高 品
I酪
冨
:高 ふ け lt籠 :― F"へ 勁
n,item S inClu`lⅢ
5■
""│● 綸lia● o● or● ther
ller"as●
"CISVESI
r eaCh Ottcer with WhOm
St be C●
bpa“
,│leted f●
thts Form ClQas neCessary
1,pages●
い
う
Ch●
Jdi“
nship.A‐
●
rdl●
“
A′
β,C● D;“
轟嘔
繋
棚
鷺 襦蹴
1慇
ξ脚
場
T冨
嗽 調 e
I顎
…
ド
m oratthe
redVIngOr‖ kew“ reCeive tanble incOmeお
B L the nler ofthe que● onnaiた
Om
ment offiCer named in this sattOn ANDthettX3bleinCOrneiS not■
direction ofthe:● Cal…
local Eovemmcntalcntity?
ls the nler ofth`quい
E ttd
[va
│。 nnalre attllla腱 d with a corp●
"l"Vernment
OfncO
口 N0 se_●
口 Y‐
0l^
atbn or other buslnSS● ntlty that the
′
S an ottCeror arect.r.Orholds an―
erShip of 10 percent or
ゃlP
relationshiP'
Descrih€ each affiliation or butinii5r
/
し
°
や°
tヤ
粋
│ユ 17● 721● ●
A● ●●
'FULL
Orect Shb RFP
L$lE GROCERY ITEMS WAREHOUSE'
* 201't-10
Page 22 of29
N.uton Brokcragc
Mau 10 14 03:578
201 596 4588
P.24
Disclosure of Lobbying Activities to disclosc lob-byi'rg Edivilics punustrt to 31 u s'c' 1352
'-'public burdeD disclosure')
"*"p'ii"iitt-ti{See n"rt p"g. for
Approvcd bY
OMB
1.
2. Stetus
Typc ot Fcderal Action:
LJ
-
r-!
LJ
L contflct
5. 916111
c. coopcrative agreemeol
3. Repott TYPG:
ofFcdenl Aciion:
F't
8. b idloffcr/Epp licriiotr
b. ioitial rwrrd
lJ
c. Posr'awrrd
varr
lorn ioiutanca
4. Name and
□
ioitiEl filing
datc of lasl
d. loan
e. loan gullarltle
L
a.
b. matcrial change
For Mrtcrirl Chsnga OnlY:
5.
Addr.s! of Rcpordng Eolity:
Prme
quirtefreport-
lf Rcpodi!8 Entity h No' 4 is Subs{ardce'
Enle' N8,l0e
□ 習
Ptogtlrn Nalnc / Dcadiprioni
5,
Fcdoral DcPanm.nt / Agency:
雨
」
itti需 “
奄
"“
oFindividual,last name,
t°
mNα ma沖
¨
m anら
n that apply):
ザ
・“
? .. rctaiocr
? b. oDcdme fce
? c. cooDi$siotr
t . ffi. of Psyo"nt ("h"ck 8ll lhat appty)
…
? a. cssh
? d. costitrgcttt iec
2 ., dalcttcd
? b. ir.tiDd; spocify: oorutt
vallre
? f. olboc 5P..ifY:
emJり 0,∝ Mem¨ 0
“
耐¨
¨お
“
常:¨
Shec($) SF'LLL'A' if occcssrrY)
ilG)
ffi;"*tt*
I肥 器
sF'LLL'A stlached: ? Ycs ?No
器料譜躙 帯咄
聾
獣
留
霊朧Ⅷ
糀
椰
i咄fi賦 ギ
r‐
"ntNm●―
―′
I
^一 ‐゛
―
■ハυハυ。こ Sヽ にGか ヽ
:
1111[II器
il囃
撤
:ざ Itt■詰;i“
:詰 猛
,CKl…
li]il_ヽ
__^、 __・ ・・・
・
Autlorizcd fot Locat Reptoduciioo
Statrdard From
∽ mdeb and retum輸
面
OR∝ ERY
DreCt Slp RFP#2014・ 10
' LLL
PrO● OSJ
Page 23 of29
Maョ
281 596 4588
Neurton Brokersg€
10 14 03857●
P。
25
PROCUREMENT
Lotbying Aclivr'ti€s
lns{nrclbns for Complelion d SF-L[, Dkdosure ol
the inilielion oI
Yihehef.subewadee or orime Federal reclpient' d
This discloe,re form srral te cunpreeo
fteflingof a
1352
section
u.S.C.
o a m'aeiiriil'",gJri-. p"r*s fling, pursuant b line 31
r€ce.tpt of a mvered Feoera *ton,
iiil re;ffi.iW,
";:GrrL.
ffi
c*pr"c
il'H""ffi;
ilil[r,;;il;;r,i;;prtrst'*
tiv
u'"
6ll rbms hat aPplv ror bob he.inilial,
c'ir* oir'rtna'id"int
ano
additional infrrmauon'
e'dsettu
l.ldentifyhetypeofooveredFed6dactionfirwhidrlobbyngadivltyhand/orhasbe€fiseon€dtoiflftjenceheoutcome
of a
covecd Federd Adi([l'
h s'e
a fr, o,+up reput caused by a mat€riarchanse
ol he last
dde
0|e
Enbr
in
is
r
:' kxxt.;:ffir*T$-trJ,f,:i*,
wtria ud *;go ocqxl€d.
q."cr
r.ri*.ty ,"portui"Ji, i"" i"-.J
this
Aaion'
prJ.rirv.,]urm.o i"port uytiis reporting enmv f"t qi: t"*q flBtal rnuuoe Cmgressbnd Distrid' if known' che{k
of
rc
titi' t#
-r
Ent€r he fiil nane
ar|a'd recipienl
"po'tng'enflv'
"ti +-io"
it ulr emece b be, a prime o{ sub
;",y i"t l*si
ulo appropride dasdfic*" ;'i;;r#,rg
pi'nt it't'" t' titt suba{Erds indrde but a'e not
ili
ldenlifv tre lier ot he
hturmarion
4.
a*",
*
*:;y:f^g^lt
*"#il,'I['
,"'
ont€r t'"
1i##m:ffiW'ffi*,Hf$5s###:$en
krn"{n'
Dbtdcl
p,,* rt*id'*ipiot tnu'le congcasbnal
Lii ;il;
tun name' addoss' citv'
slab a'|d zip
ir
at least one organizdional
o' tment lndude
a*"Jllffi ii*g"t" A -or
6. Enbr the nane of lheil **"}ffiion'
Gudd'
Coast
stal6
ur*bd
Oi'artnslr fnanslorrton'
belor agslc, narne,
lfknown,entelhetu[cahlosot
7. Entsrh€Federat program#;ffIffiffiTimcou*or*"Jirt*iicill).
ft grarts' cooperdive arancnr' bare ard loaflincommitnenb
br
Fa&ral Domestic Assi*t*itiini**['
rr m?.ata aaon iaentteo iem l (e'g Request
l0a1
granl'
or
mntract,
8. Entsr r,re 16r appropriae rsilil#niffi rrilu"r-ir"*il.
tE
rnvt[tJ'tffi] 1ra1 numbor; grant.a[ram@rnent numbe{
avaro
level
ton
,
pmposal (RFp) numuer:
p'opo'"l to'tot
awad numbe[ fie apPbat*
number
s[ned
by
fe
federaf agency)
trdu& trd)Gq
e'9' 'RFP'oE-
9S@1."
g.Folacow€dFeffiac.tionwhoretrerehasb€enana,Eld,or.loancornitn€ntbythBFedeEl4lency,enErhe
he pdr€ { ity idenh'f ed in ibm 4 u 5'
Fedecl arnount of fE *"d'i't- t"*nit-tftr
-
10la'lEnbrthofullnan",taa'"o'tlty'tre*dziPcod€olholobbf"Jiitty*Sts"dbyhorspqdngenttyidenlifi€dh
l'Sll*tn:H|Hf 'ffffi'ffiS*n *"*'
lmffiffiJfffi:rff,,i$l)6
,,of. ,"on *JfiHrifrr'*.,
,,,,
r€sonably expecbd
entity
(i*n
10 (a)' Enter Last
ard hcrudo nrn adress trdnerent from
bre
tE repstirs enlilv t*m 4).to the lobbvir'
hat
rirr u. r.o" (itunnua)' Chack d boxes
pa'r, b,,
r'* tir*-ra.L*u,"fi
"
apply.lfthisisamaEndd;;"p"ffiE;tledrmuhr'wanEuntolDavIrEr[madootCann€dtobemade'
12'checkth6approp,i"rm*G,i.cni."r."rrboxesthatady'lfpayn-i['i,.aut'..,,sl,dli|},kindconf&Ut.lon,speofyt|e
'-
and vilue d lhe intird
chsck ut€ 4propdae uo*
;auc
payment
mtre'
4ply lf o[ra'spedfY
to perbrm'
tifdt** afl uoxes tratr"ri#
13.
na t'"-rourlJt n* p.Jfu*.d, or will be expecled
iiffillin-fih"
ornfr
pmvile
*
conhcl
a
specifc
actral
in
sp€nt
14.
time
ma,o" .l pr"p".oty anii6r.iJ divity, not iust
[lenber(s)
or
and he daE(s) ot.n)| ,#i.riffi,iJ,
ernployee(s)'
u.om.",t.t,
Federal ofttid(s) or empbyee(s) c.ireiJ
wirh Federar oficiars. ldenhf tre
"
ot Conoress ttlsl nsre contadod'
is atmhed'
mi a sF{t'L'A continuation she€t(6)
s itili
i* fotm prlni*vrta name' 'Ue' and tslephons number'
"i
r
16.
The c€rlifying offcia
",t'l[,ii
't'trrt[""tfui'"e
m田 ゛
348‐ 00461,Washh9tOn,0020503
Page 24 of29
H● u
10 14 03158a
281 596 4588
Nruton Brokrragc
職倅鮒∬
籍
P.27
‖ 懲
肌‖冨密
滞 蜃
鵠
n.
絆淵
鰈
浙
駁
翻 櫛黎 癬翼硼
lepanmentOf Hea師
「
DH)
Texas Depament of Health
Manufantred Food DiviSi● n
l100 West49th Std
Auttn TX787駁 H3199
1888)907111
h Proposal.
A copy Ofhe Food Who!esaler ttCense must be inctted哺
sA{r-GEPT
/.
cOpy d Food Wholesabr bcenSe ncbded wih PropOSaL Yes
/
_
Ma3 10 14 03:58●
281 596 4580
lleurton Brokerage
P.20
Clean Air and llYater Act
rcgulations issued pursuant to he
l, the Vendor, am in compliance wilh all applicable standads, oders or
clean water Act,6 amended (33
cr..n lirna'ot rezo, asRmenal 1+z u.s.i. rgsz6t), sedion 508 of he
Regulation, 40 CFR Part 15 as
U,i.i. i3Oii, E *udve grder 117389 and Environmehtd Proteclion Agency
required under OMB Circular A-1 02,
Atlachment
States
reporting violatims to th€ gBntor 4ency and lo the United
ciion'Agency'Assistant Administrator {or the Enforcement.
o, Paragraph 14 (1) regarding
i.ui_*rt p.t
porentiat Vendor
name. S4Q-Ge
r.:i- (-oohs Zr<-
T‖ e ofAuthonzed RepreSentabve:
M師 ng
〈
AddЮ ∬ 泌
Ⅲ
3°
y 3802マ ¬
S19nabre:
Comdete and rdum」 th
PЮ DOSJ
Mav 10 14 03:59a
llau
ton Brokerage
281 596 4588
P.29
cERTtFlcATlotloFPRoPosALSPEC|FEAIoNS,IERMS&coNDlTloNs
#20let0
RFP
propeal hare begn read'
All specifcations, terrns, and csrditions of tlre
in writing to sue Hayes,
tn. ,pecir,carloni .na'.onoition. unless otherwise accepted
om,irr, and Education Service Center Regircn 10'
il[.il*y ;;il,
cfleiiininoir
coMpAr,{Y
NAME'
sa
zcErul' €oa'ss Lt-c--'
Address:
。v
Zμ
sねO Fじ
MuabOcじ
弓3q58
Mハ ιヽハい υ ⊂
Typed Name
RESDENT VENDOR CERTFCATЮ N
ln orderfor pЮ posJ to be conddered,he folbWing hfOmalion must be"vided.Fa‖
ure lo COmobte mav
い面 ectlon dhe Dr000Sall止
―
a“ nd∝ mose plnclJり ace d
鴨
●
醗献
‐
… ― nleans
V"'‐ ●
9“nOn麟
… ndor
‖602a“
'‐ …
AS dttnec Dy leXas nOuw口
.
に
_J■
__3^^^“
Attv″
"VV■
洲 y OWner has lls
or rn口
m球柿
^│“ mpany
nt∞
“
:l'…
V…
,詰
o‖
ぃ
bugness ls notin TeXas,but exdudes a conmctor
ou馴
whose――
ultmate
p鵠
●
`_ _^一
‐1月 oni、 ′
anHn′
―
・・ :‐ ‐ 0ぉ
a・ resident VendOr:
し… 試my ωmpanyiS
pal口 ace Ofbugnessi 高 ξ 温品
resu腱
p輌
面
“
Signature
Datel
L問料 織酬 柵灘鰊 明
柵馴 糧
r:‖
Address
Fと οβJ^.` bA
M ttυ)0こ と
36039
7in
Stale
City
0
ろ8o2マ
Name
Company
0
2)Ъ o
LLし
F
げ
飾
Does your
,'residence state" requirc
Hdors
whut
iffiZilornt
威
ot
.u.n
P"rcentage?
1聟 L‖ lTa竪 ギ
賀躙
Typed Nagne
colnぶ
Zlp
to unda Proposal
whose principal place of business is in Texas
amount or percentage to receive a
b;
tre pincipal plm of hrsiness is located'
["-rt ti in"'p1".tgbed
,tn u'ttlti'"';yil;
, ,iJt ; #a*
yES_---_No__y-
vendors whose r€skjence
.ts
comoarable contact?
i
'ittch
%
冨 径 奎 堅 型
=塾
しし
螢 暮 亜 少 Sし
POsition
COmpany Name
話 詰 :温 m wlth D"D03J
Mav 10 14 03846●
281 596 4588
J'lcuton Brokcraga
P。 1
PROPOSAL ACKNOWI.EDGMENI
FULL UNE GROCERY ]IEMS WAREHOT'SE DIRECT SHIP
IRFFf, f201f-l01
TO: Educatirn Service Center Region 10
b
offerors, General
unders'rgned, having carefully red tre lnstuctions
Forms, do
md
Prcposal
to O,ftrcrs, Cfltracl'Sp€cificatlms, Responsibilities of Oftrus,
l, or we, the duly aufrorized
ConOition., Hoti,"
.nter into a conhact witr Regkx tO by torxtering thb ofiof b perftrm the work.required
per specifications
.^oi.i prrlo. trr produ(s) specified in tlris soliitation. l, or rre, will deliver tre produc(s)
certify to he accurrcy of tre
found in this proposal document lor tre prices indirzled. -1, o1re, al59
Act)
(irduding, hd not lmited b, Felony Conv'rction Nothe or Clean Air and Water
*rtt*ti*r
larvs'
"qrired
U,is otfer. l, oi rve, will follow all applicable state or federal
*nUt .o"rp"iy
;""by-.Sr* h
consultatiofl, communication' or
The prices in this ofier have been determined independenty, wihout
related b suoh prices, with any oiher
,g*fii.i fo|. f,. purpose of resfiaini conpetiti,on, ai to rny o,rttuofier
and have nol been a party to anv
;ith any bmpelitor. t, or rrc] ae iu6orized to crbmit this
;i;;;
h ofier at a fixed prite or t0
6ner/oiferors in restaint of lreedom of cornpetition by agrcement
quanlity, qua$ty' or
rfd*S; or with any neglon tO empryee, Board Direc'tor, or consultant as h
in .t V i.t i1t of .the prcopective con6 e)rcept in any auhorized
price in the pospective *ntr..t
pe*nnd; u.in any discussions or acrions between offer/offerors
gi* io,,
,ffrrion
,*rg
ffi;-hr;
;;
[#,r*iGr"iiln'n
d;;
andanyRegion.l0employee,BoardDirecbr,orconsultantconcemingexchangeofmoneyorotherthingsof
vatue Or spiciat cursideration in he awad of hb contract'
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Date:
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Name/Tlue:
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PROPOSAL ENVELOPES SHOULD BE PLAINLY MARKED:
IRFPIttЮ 14‐ 101
MuliRe」 ond C● 。ppuMsE,DRECT
Requtt brPЮ
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400 East Spring Va::Oy賊
賂 hard30口 ,Texag 75004
DUE:Thu● day:Mav 29,2014 at430 pm
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