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' T Oわ Nmledttmi SAに 耐 目 Date: s Address響 Name/Tlue: Phone#: Fax#: Ъg LLO ゆ =響留等 電い `cυ 昇‐lο ο ηキ 旬 〔 q+t、 f?「―Oqt。 t´ SS or Fed lD#: PROPOSAL ENVELOPES SHOULD BE PLAINLY MARKED: IRFPIttЮ 14‐ 101 MuliRe」 ond C● 。ppuMsE,DRECT Requtt brPЮ “ Fhattd m∞ 鼎 :冊 盟1器 2蹴』 400 East Spring Va::Oy賊 賂 hard30口 ,Texag 75004 DUE:Thu● day:Mav 29,2014 at430 pm : SHP' r t{AY 2 2 20t4
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