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Contract No. 1328-124eeVendor Name: DELL MARKETING, Lp,
AMENDHHENT NO 1
This Amendment modifies Cohtract No. 1328-12468, for Products and Services Agreement by andbetween the County of Cook, Hlinois, herein refermd to as "County" and Dell Marketing, LP., authorized todo business in the Sate of Hlinois hereinafter refened to as "Contractor':
RECITALS
Whereas, the County and Contrada have entered into a Contract approved by the County Board pnOctober 23, 2013, (hereinafter refened to as the "Contract"), wherein the Contractor is to provide Productsand Services Agreement Services (hereinafter referred to as the "Services") from November 1, 2013Htrough October 31,2016, with two (2) additional two (2) year renewal options, in an amount not to exceed$14,000;000.00;and
Whereas, the Contract will expire October 31,2016, and the agreed upon Services are sbll required; and
Wluseas, an renewal is desired for the continuation of Services; and
Whereas, the County and Contractor desire to renew the Contract for twenty-four (24) months beginning on. November 1, 2016 through October 31, 2018.
Now therefore, in consideration of mutual covenants contained herein, it is agreed by and between thepaNes to amend the Contract as folbws;
1. The Contract is renewed through October 31,2018.
2. Article 5 Ib) IMethod of Pavmenti of the Agreement is deleted in its engrety and is revised asfoHowe:
AH invoices submitted by the Consultant shaH be In accordance with the cost provisions contained
in the Agreement and shall contain a detailed description of the Deliverables, including the quantity
of the Deliverables, for which payment is requested; AH invoices for services shall include itemized
entries indicagng the date or time period in which the senrices were provided, the amount of fime
spent perlorming the senrices, and a detaHed description ofihe services provided during the period
of the invoice. AH invoices shall reflect the amounts invtriced by and the amounts paid to theConsultant as of the date of the invoice. Invoices for new charges shall not include "past due"
amounts, if any, which amounts must be set forth on a separate invoice. Wilh respect to payments
form County funds, a senrice charge of 2% per month shaHbe applied to ag ovwdue amounts.
With respect to payments made from County funds, in accordance with Secgon 34-177 of the CookCounty Procurement. Code, the County shag have a right to setoff and subtract from any irwoice(s)or Contract price, a sum equal to any fines and penalbes, including interest, for any tax or feedelinquency and any debt or obligation owed by the Consugant to the County.
Rev lnlla
Contract No. 1328-12468Vendor Name: DELL MARKETING, LP.
The Consultant acknowktdges its duty to ensure the accuracy of all invoices submitted to theCounty for payment. By submitting the invoices, the Consultant certifies that all itemized entriesset forth in the invoices are true and correct. The Consultant acknowledges Nat by submitting theinvoices, it certifies that it has delivered the Deliverables, i.e., the goods, supplies, services orequipment set forlh in the Agreement to the Using Agency, or that it has properly performed theservices set forth in the Agreement. The invoice(s) must also reflect the dates and amount of timeexpended in the provision of services under the Agreement. The Consultant acknowledges that
. any inaccurate statements or negligent or intentional misrepresentations in the invoices shall resultin the County exercising all remedies available to it in law and equity including, but not limited to, adelay in payment or non1yayment to the Consultant, and reporting the mager to the Cook CountyOIce of the Independent Inspector General,
When a Consultant receives any payment from the County for any supplies, equipment, goods, orservices, it has provided to the County pursuant to its Agreement, the Consultant must makepayment to its Subcontractors within fifteen (15) days after receipt of payment from the County,provided thai such Subcontractor has satisfactorily provided thd supplies, equipment, goods orservices in accordance with the Contract and provided the Consultant with all of the documentsand informa5on required of the Consultant. The Consultant may delay or postpone payment to aSubcontractor when the Subcontractor's supplies, equipment, goods, or services do not complywith the requirements of the Contract; the Consultant is achng in good faiN, and not in retaliationfor a Suboontractor exercishg legal or contractual rights.
3 The attached Economic Disclosures Statement (EDS), Identification of Sub.Contractors/Suppliers/Subonsultants Form and MBE/WBE Utilizahon Plan forms areincorporated and made a part of this Contract
4. All other terms and conditions remain as stated in the Contract.
In witness whereof, the County and Contractor have caused this Amendment No. 1 to be executed on thedate and year last written below.
County of Cook, Illinois Dell Marketing, L.P.
ChiefPr ureme tOfficer-
/PState's Attomej (ff applicable)
Dudley McClellan
Type or print name
D,h,; bt I)&le'8)l(t
Contracts Manager
Title
Date September 27, 2016
Rer t/t/15
Contract No. 1326-12468Vendor Name: DELL MARKET1NG, LP,
ATTACHMENT
ECONOMIC DISCLOSURE STATEMENT (EDSj
IDENTIFICATION OF SUBCONTRACTOR/SUPPLIER/ SUBCONSULTANT FORM
MBE / WBE UTILIZATION PLAN
Rev Irr /is
CONTRACT NO 1325-12455
COOK COUNTYECONONIIC DISCLOSURE STATEIISENT
AND EXECUTION DOCUMENT1NDEX
Instructions for Completion of EDS
CertBcations
Economic and Other Disctosures, Affidavit of ChildSupport Obligations, Disclosure of Ownership interest
and Familial Relagonship Disclosrse Form
Cook County Affidavit for Wage Theft Ordinance
Contract and EDS Execution Page
Cook County Signature Page
EDS i - fi
EDS 1-2
EDS 3 —12
EDS 13-14
EDS 15-17
EDS 18
CONTRACT NO 1328.f2488SECTION 1
INSTRUCTIONS FOR COISPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT
This Economic Dktciosure Statement and Execution Document ("EDS") is to be completed and executedby every Bidder on a Coun'ontract, every Proposer responding to a Request for Proposals, and everyRespondent responding to a Request for Qualifications, snd others as required by the Chief ProcurementOflicer. The exscufion of the EDS shall serve as fhe execution of a contract awarded by the County TheChief P'rocurement Officer reserves the right to request that the Bidder or Proposer, or Respondentpmvide an updated EDS on an annual basis.
Definitions. Terms used In this EDS and not otherwise defined herein shall have the meanings given tosuch terms in the Instructions to Bidders, General Conditions, Request for Proposals, Request forQualEcafions, as appficsble.
Aifiliete means a person that directly or indirectly through one or more intermediadies, Controls lsControlled by, or is under common Control with the Person specified.
Applicant means a person who executes this EDS.,
Bidder means any person who submits a Bid.
Code means the Code of Ordinances, Cook County, illinois available on municode.corn.
Contract shall include any written document to make Procurements by or on behalf ofCook County.
Confrsctw or Conbacling Party means a person that enters Into a Contract with theCounty,
Consol means the unfettered authority to directly or indirectly manage governance,administration, work, and afi other aspects of a business.
EDS means this complete Economic Disckxiure Statement and Execution Document,including afi sections listed. in the Index and any attachments.
Joint Ventum means sn association of two or more Persons proPosing to p'erform a for-profit business enterprise. Joint Ventures must have an agreement in wriTing specifyingthe terms and conditions of the relationship between the partners and their relationshipand respecfive responsibfiity for the Contract
Lobby or lobbying means to, for compensafion, attempt to influence s County official orCounty employee with respect to any County matter.
Lobbyist means any person who lobbies.
Person or Pemons means any individual, corporation, partnership, Joint Venture, trust,association, Limited Liability Company, sole proprietorship or other legal entity.
Prohibited Acts means any of the scfions or occurrences which form ths basis fordisqualification under the Code, or under ths Certificatlons hereinafter sst forth.
Proposal means a response to an RFP.
Proposer means a person submitting a Pmposal.
Response means response to an RFQ.
Respondent means s person responding to an RFQ.
RFP means a Request for Proposals issued pursuant to this Procurement Code.
RFQ means a Request for Qualifications issued to obtain the quafiflcetlons of interested parhes,
EDS-i sl2015
CONTRACT NO, 1328-12455
INSTRUCTIONS FOR COfillPLETION OFECONOMIC DISCLOSURE STATEMENT AND EXECUTION DOCUMENT
Secgon 1:InstrucSons. Section 1 sets forth the instructions for completing and executing this EDSSection 2: Certifications. Secbon 2 sets forth ceitificaticns that are required for contmctlng parties underthe Cade and other applicable laws. Execution of this EDS constitutes s warranty that all the stafismentsand certifications contained, snd ag the facts stated, in the Certifications are true, correct and complete asof the date of execution.
Secgon Si Economic and Other Disclosures Statement. Section 3 ls the County's required Economicand Other Disdosures Statement form. Exscufion of this EDS constitutes a warranty that afi theinformation provided in the EDS is true, correct and complete ss of the date of execugon, and binds theApplicant to the wananties, representations, agreements and ackncwledgements contained therein.
Required Updates. The Applicant is required to keep afi information provided in this EDS current andaccurate. In ths event of any change in ths Informa5on provided, including but not limited to any changewhhh would render Inaccurate or'incomplete any certlflcagon or statement made in this EDS, theApplicant shall supplement this EDS up to the time the County lakes action, by filing sn amended EDS orsuch other documentation as is rixtuired.
Additional Informagon. The County's.Governmental Ethics and Campaign Financing Ordinancesimpose certain duges and obligations on persons or enfities seeking County contracts, work, business, ortransactions, and the Applicant is expected tc comply fully with these ordinances. For further informationplease contact the Director of Ethics st (312) 5034304 (Sg W, Washington St, Suite 3040, Chicago, IL60502) cr visit ths web-sits at cookcountyfi.gcv/ethics-boardwf.
Authorized Signete of Contract and EDS Execution Page. If ths Applicant is a corporation, thepresident and Sscrebiry must execute the EDS. In.the event that this EDS is executed by someone olherthan the President, attach hereto a certified copy of that section of the Corporate By-Laws or otheraulhorizatlon by the Corporation, sagsfactcry to the County that permits the person tc execute EDS'orsaid corporatlori. If the corporation is not registered In ths State of lfiinols, s copy of ths Cerggcats ofGood Standing fmm ths state of Incorporation must be submitted with this Signature Page.If the Applicant ii a partnership or joint venture, afi partners or joint venturers must execute the EDS,unless one partner or joint venture has been augiorized to sign for the paitne'rship or joint venture, inwhich case, the paitnership agreement, resolution or evidence of such authority satisfactory to the Officeof the Chief Procurement Oflicer must be submitted wfih this Signature Page.
If ths Applicant is a member-managed LLC sg members must execute the EDS, unless otherwisepmvided in the operating agreement, resolution or other corporate documents. If the Applicant is amanager-managed LLC, the manager(s) must execute the EDS. The Applicant must attach either acertlgsd copy of the opemting agreement, resolution or other augiorlzagon, satisfactory to the County,demonstrating such person has the authority to execute the EDS on behalf of the LLC. If the LLC Is notregistered in the State of lfiinois, a copy cf a current Certificate of Good Standing from the stats ofincorporation must be submitted with this Signature Page.
If the Applicant is a Sole Propdstorship, the sole proprietor must execute the EDS.
A partnership" "Joint Venture" or Sole.Prcpriekxship" operating under an Assumed Name must beregistered with the Illinois county in which it is located, as provided in.805 ILCS 405 (2012), anddocumentation evidencing registration must be submitted with the EDS.
EDS-Ii 8/2015
SECTION 2
CERTIFICATIONS
CONTRACT NO.: 1328.12488
THE FOLLOWING CERTIFICATIONS ARE MADE PURSUANT TO STATE LAW AND THE CODE. THE APPLICANT IS CAUTIONEDTQ CAREFULLY READ THESE CERTIFICATIONS PRIOR TO SIGNING THE SIGNATURE PAGE, SIGNING THE SIGNATUREPAGE SHALL CONSTITUTE A WARRANTY BY THE APPLICANT THAT AIL THE STATEMENTS, CERTIFICP TIQNS AHQINFORMATION SET FORTH WITHIN THESE CERTIFICATIONS ARE TRUE, COMPLETE AND CORRECT AS OF THE DATE THESIGNATURE PAGE IS SIGNED. THE APPLICANT IS NOTIFIED THAT IF THE COUNTY LEARNS THAT ANy PF THEFOLLOWING CERTIF ICATIONS WERE FALSELY MADE, THAT ANY CONTRACT ENTERED INTO WITH THE APPLICANT SHALLBE SUBJECT TD TERMINATION.
A.
B.
PERSONS AND ENTITIES SUBJECT TO DISGUALIFICATION
No person or buriiness entity shall be awarded s conbact or sub-contracL for a periad af five (5) years fram the date ofconvidion or entry of a plea or admission of guilt, civil ar clinical, if that person or business enmy;
1) Has been convicted af an act committed, within Ihe Slate of filinois, of bribery or afiempting to bribe an officer oremployee of a unit of stale, federal or iocsl government cr school district In the Sbrie of ifilnols in that officers oremployee's affidel capacity;
2) Has been convicfad by fedwal, slate or local government of an act of bid-rigging or afiempting to rig bids as definedin the Shsnnin Anti-Trust Act and Cisyton AcL Act. 15 U.S.C.Section 1 el ssq.;
Has been comricted of bid-rigging or attempting to rig bids under Ihe Isws of federal, slate or local government;'as been aorwlrried of nn act committed, within the State, of price4xlng or attempfing to fix prices ss defined by the
Sherman Anfi-Trust Act and the Clayton Aot. 15 U.S.C.Section 1, ef secu
Hss been convicted of price-fbdng or sttempting.to fix prices under the laws the Shrie;
Hss been oawictsd of dehauding or sttsmpfing to defraud any unit of state or local government or school distriotwithin the Sbrie of illinois;
3)
4)
5)
6)
BID45GGING OR BID ROTATING
THE.APPLICANT HEREBY CERTIFTES THATr In arxxxdance wilh 720 ILCS 5t33 E-ff, neither the Appficanf nar anyA5Bafed EnNy is baaed fram award of gris Conimct as a msufi of s convicfion for the viobtficn of Slate laws prahibBng bid-
ngyng or bid rafafing.
7) Has made an admission of guilt of such conduct as set forth In subsections (1) thmugh (6) above which admission is5 matter af record, whether or not such person or business enNy was subject to prosecufion far the ofisnss oroffenses admitted to; or,
8) Has entered a plea of nolo acrrienders to charge of bribery, pric-fcdng, bid-rigging, or fraud, as set forth in sub-paragraphs (1)through (6) abave.
In Ihe case of bribery ar attempting la bribe, a business snfity may not be awarded a contract if an oflicial, agent ar employeeof such business enlfiy committed the Prohibited Act on behalf of the business entity and pursuant to the direction orauthorizatlon of sn afficer, director ar oNer responsible aBrfal of the business enfity, and such Prohibited Act occurred withinthms years prior to the award of the contract. In add(gon, a business enfity shall be dbrqualBed If an owner, partner orshareholder contraling, directly Or Indirarrily, 20M or mom af the business entity, or an aBcer af the business entity hasperhnned any Prohibited Act within five years prior to Ihe award of lhe Conbact.
fffEAPPLICAHT HEREBY CERTIFIES THAT The Appficsnt has read the provisions of Section A, Persons and EntitiesSubjerri to Disqualilicafion, that ths Appficant has nct committed any Prahib'ried Act set forth ih Section A, snd'that award ofthe Cantmct to the Applicant would not violate the provisions of such Secfion ar of the Code.
C. PRUS FREE WORICPLACE ACT
THEAPPVCANT HEREBY CERTIFIES THAT The APPlhant will Provide a drug free workPlace, as required by (30 ILC8 580/3).
EDS-1 8I2015
D.CONTRACT NO. 1328 12468
DELINQUENCY IN PAYNENT OF TAXES
THE APPLICANT HEREBY CERTIRES 77IA7: Ths APPfcant is not an ower are Parly resPonsibfs for Ihe Payment ofany taxor fee adminfstsrsd by Cook County, by s local municipslÃy, or by the Illinois Department of Revenue, which such tax or fee Isdsgnqusnf, such ss bar sward ofa conbacf or subcontract pursuant Io the Code, Chapter 34, Secgon 34-171.
E. HUBIAN RIGHTS ORDINANCE
No person who is a party to a contract with Cook County ("County" ) shall engage in unlawful discrimination or sexual harassmentagainst any individual in the terms or condigons of employment, credit, public accommodations, housing, or pnndsion of'ountyfadgges, services or progmms (Code Chapter 42, Section 42-30 sl seq.).
ILUNOIS HUINAN RIGHTS ACT
THE APPLICANT HEREBY CERTIFIES THAT: It is In comPIIancs with the IBnois Human Rfghts Act (775 ILCS 5r2-105j, andagrees to abide by Ihs nuluirsmsnts ofpm Act as part ofgs contractual OMgrdkurs.
INSPECTOR GENERAL (COOK COUNTY CODE, CHAPTER 34, SECTION 34-174 and 8ecgon 34450)
The Applicant has not wlllfugy failed to cooperate In sn investigation by the Cook County Independent inspector General or tomport to the Independent Inspector Gensml any and all information concerning conduct which they know to invohm corrupgon, orogrsr cdminal activity, by another county employee or ogicial, which concerns his or her office of employment or County relatedtransaction.
The Applicant has reported directly and wilhout any undue delay any suspected or known fiaudulsnt activity kr the County'sProcurement process to Ihs Olllcs of ths Cook County Inspector General.
CAMPAIGN CONTRIBUTIONS (COOK COUNTY CODE, CHAPTER 2, SECTION 2485)
THE APPUCANT CERTIFIES THAT: It has read and shall comply with gte Cook County's Ordinance concerning campaign, coreibutlons, which is codified at Chapter 2, Division 2, Subdivision ll; Section 585, and can be read in gs entirety at
wow.munlcods.corn.
GIFT BAN, (COOK COUNTY CODE, CHAPTER 2, SECTION 2 574)
THE APPLICANT CERTIFIES'THAT: II has read end shall comply with the Cook County's Ongnancs concerning mcelvlng andsogciling gifts and favors, which is codiTied st Chapter 2, Division 2, Subdivision II, Ssdion 574. and can be mad in Its entirety atwww.municode.corn.
UVING WAGE ORDINANCE PREFERENCE (COOK COUNTY CODE, CHAPTER 34, SECTION 34-185
Unless expressly waived by the Cook County Board of Commissioners, the Code mqulres that e living wage must bs paid toindividuals employed by a Contractor which has a County Contract and by sg subcontractors of such Colltiuctor under a CourityConhact, throughout the duration of such Couniy Contrack The amount cf such IMng wage is annually by the Chef FinancialOBcer of ths County, and shall be posted on the Chief Pmcursment Officer's wehute.
The term "Contract" as used in Section 4, I, of this EDS, spscBcslly excludes contracts with the following
1) Not-For ProSt Organizations (deSned as a corporsdon having tax wmrnpt status under Section 801(C)(3)of the UnitedState Internal Revenue Cods and recognized raider the illinois State not-for -profit Isw);
2) Communily Development Block Grants;
3) Cook Counly Works Department;
4) sheriBs work Altsrnafive Pfot)mm; and
5) Department of Correction inmates.
EDS-2 8/2015
CONTRACT NO. 1328.12488
SECTION 3
REQUIRED DISCLOSURES
1. 'HBCLOSURE OF LOBBYIST CONTACTS
List all persons that have made lobbying contach on your behalf with respect to this contract;
Name
blot Applicable
Address
LOCAL BUSINESS PREFERENCE STATEMENT (CODE, CHAPTER 34, SECTION 34 230)
Looai business means a Person, induding a foreign corpcradcn authorized to transact business In Illinois, having a bona fideesteblishmerit located witlrin the County at which it is transacting business on the date when a Bid is submitted to the County, andwhich emfdoys the majority of ils regular, full-time work force within the County. A Joint Venture shall constitute a Local Business it'neor'ore Persons that qualify as a "Local Business" hald interesls totaling over 50 percent in the Joint Venture, even if gm Joint Verituredoes not, et the time of the Bid submittal, have such a bona fide establishment within the County,
a) la Applicant a "Local Business" asdellned above?
Yes:
b) If yes, list business addresses within Cook County:
NIA
c) Does Applicant employ ths majority of its regular fug-time workforce within Cook County7
No: X
THE CHILD SUPPORT ENFORCEMENT ORDINANCE (CODE, CHAPTER 34, SECTION 34-172)
Every Applicant for a County Privksge shall be in ful compliance with any child support order before such Applicant ls enSlsd to receive orisrnew e County privilege. When delinquent chikl support adsts, tlw County shell nol issue or mnew any County Prhslege, and mayrevoke sny County Privilege.
Ag Applicants are requlmd to nwiew the Cook County ANdavft of Child Support Obllgadons albtched to this EDS (EBS'}andcomplete the ANdavit, based on the instrucdons in the ANdavlk
EDS-3 8/2015
4. REAL ESTATE OWNERSHIP DISCLOSURES.CONTRACT NO. 1325-12468
The Applicant must indicate by checking the appmpriate provision below and providing ag required information that either.
s) Ths following is a complete list of all real estate owned by the Applicant in Cook County:
PERMANENT INDEx NUMBER)8); IIIA
(ATTACH SHEET IF NECESSARY TO LIST AIXHTIONAL INDEXNUMBERS)
ORr
b) d The Applicant owns no reel estate in Cook County.
S. EXCEPTIONS TO CERTIFICATIONS OR DISCLOSURES.
lf the Ap plicara is unable to cergfy to any of the Ceiglicaticns or sny other statements conlain ed in this EDS and not explained elsewhere irlthis EDS, the Applicant must expktin below:
lf the legate, "NA", the word 'None" or "No Response" appears above, or if the space is left blank, it will be conclusively presumed that theApplicant certlfred tc ell CsrtBcagons and other easements contained in this EDs.
ED'/2015
CONTRACT NO. 1328.12468
COOK COUNTY DSBCLOSURE OF OWNERSHIP INTEREST STATEMENT
The Cook County Code of Ordinances ($2-810 ef srxf.) requlme that any Applicant for any County Actkm must dlsdose informationconcerning ownemhlp Interests in the Applicant. Thhr Disclosure of Ownership Interest Statement must be completed with allInformation current as of the date gtis Statement is signed. Furthermore, this Statement must bs kept current, by filing an amendedStatement, ungt such time as the County Board or County Agency shall take action on Ihe application. The information contaified ingila Statement vali be maintained in a database and made available for public viewing.
8 you are asked to list names, but there are no applicable names to gst, you must slate NONE. An incomplete Statemenl will bereturned and sny action regarding INs corrlract wgl be delayed. A failure to fully comply with the ordinance msy result in the actiontaken by the County Board or County Agency being voided.
"App//can/" means any Entihi or person making an application tc the County for any County Action.
County Action" means sny acgon by a Counly Agency, a County Department, or the County Board regarding sn ongnance orordinance amendment, a County Board approval, or other County agency approval. with respect to contracts, leases, or sale orpurchase of real estate.
Ftenron" "Energy" or 'Legs/ Engfy" means a sole pmpdetoishlp, corporation, partnership, association, business trust, estele, tse oimori persons having a ]oint or common interest, trustee of a land trust, other commercial or,. legal entity or any benegciary orbeneficiaries thereof.
This Disclosure of Ownership Interest Statement must be submitted by:
1.An Applicant for County Action and
2. A Person that holds stock or a bsne8clal Interest in ths Applicant fgg[ is listed on the Applicant's Statement (a "Hotdog must Se aStatement end oxnplets ¹Ionly under Ownership Interest Declaragon.
please print or type responses dearly and legibly. Add additional pages if needed, being careful to idenfify each portion of gle fomi towhich each addigonsl page refers
This Statement is being made by the [ g ]Applicant or [ ]Stock/Beneitdal Interest Holder
This Stahsnent ls an
Identifying Information:
Horne Dell Marketing L.P.
D/B/A:
Street Address: One Dell Way
Cgy Round Rock
Phone No - (512) 338-4400
FEIN NQ~ 74-2B18805
State- Texas
Fax Number (512) 283-9092Ztp Cods: 28682
Email:
[ i/ ] Original Statement or [ ]Amended Statement
Cook County Business Rsgistragon Numbsn(Sole Proprietor. Joint Venture Partnership)
Corporate Fih Number (if appgcsble):
Form of Legal Entity:
[ ] Sole Proprietor [ ] Partnership [ ] Corporatiorl [ ] Trustee of Land Trust
[ ] Businstis Trust [ ] Estate [ ] Association [ ] Joint Venture
[v] aber (describe) Limited PartnershiP
EDS-6 8/2015
CONTRACT NO, 1328-12468
Ovtynerehip Interest Declsrs5ani
List the name(s), addmss, and penxynt ownership of sech Person having 8 legal or bsnefiaal interest (mdudrng owrwmh'more than five perceint (5%) in ths Applicant/Holder.
Name Address Percentage Interest In
Applicaiil/HaldsfDell Marketing LP LLC One Dell Way, Round Rock, Tx 78682 99%Dell Markegng Corporation One Dell Way, Round Rock, Tx 78682 100%Dell International LLC One Dell Way, Round Rock, TX 78682 100%Dell Inc. Ons Dell Wsy, Round Rock, Tx 78682 100%Denali Intermediate Inc. One Dell Way, Round Rock, Tx 78682 100%Dell Technologies Inc. One Dell Way, Round Rock, Tx 78682 1 00%Michel Dell One Dell Way, Round Rock, Tx 78682 43.15%
2, i(me interest of any Parson Sated in (1)abave is held es an agent or agents, are nominee ar Aomkyese, list the nmrm andaddress of 'lhs principal OA wllose hshatf ihs Interest Is hold.
Name of Agent/Nominee Name of Principal Principal'8 Address
ie the Applicant construdtvsly contralkyd by another parson or Legal Fntilyy [ v/ ) Yes ', ) No
lf yes, state the name, address and percentage af bsnslicisl Interest of suoh person, snd the relaeanship under whmh euahcontml kf balAg ar mey be exercised.
Nan18 Address Peraentage of RslsiionshipBeneeckfl Irasrssi
Deil Inc. One Dell Way, Round Rock, Texas - 78682 See below P IC~PPlllddtldLPD f II dPMhlPDIIMttlgdPLLCDCM lltdt lyPyhlh
g IP d ttgf D filth hd DLPLLC., If I II Ibdlt btllty P y I h I II It dp d
(99%).All ef these entities are wholly-owned subsidiaries of Dell Inc., a Delaware company.
Carpanste Onicem, Members end Partnem Information:
For all corporations, list the names, addresses, end terms for all cofporete Nicsrs. For ell limited liability companies, list Ihe mense,addresses for all members. For all psrtnershlps snd joint ventures, liel ths names, addresses, far each partner ar joint venture
Name Address Title (spedfy tide afOface, or vyhethsr manageror partner/joint venture)
Pl I Ih 'III Igpg I Ilb tl I Id I~DIMC I LP
Term af Office
Dsclamgan (check the applicsbls box):
[v" ] I state under oath that the Applicant nss withheld ira rllscloeurs as ta ownership Interest in the Applicant nar fs&rvedany infannetlon, data or plan as ta the intended use or purpose for which Ihs Applicant seeks County Board or other countyAgerlcy actkyn.
[ [ I stats AAd8f arith dmt the Hoidsf has u/rthheld An dIsctasufe as to awAsfshlp bite/est Aaf fesefv8d SAy Infonnsdan mytuiied tabe (Ssdased.
CONTRACT NO. 1328-f2488
512-723-6527Phone Number
COOK COUNTY DISCLOSURE OF OWNERSHIP INTEREST STATEMENT SIGNATURE PAGEDudley McClsllan Contracts ManagerName of Authorized Ap ll older Represenlahve (please print or type) TMe
M~78" September 27, 2016igr/aturIF Date
dudley [email protected]
E-mag address
Subscribed to and sworn before methis Wl day of~,20~i
Notary Public Sgneture
My commission «x 'a
VALLAR/ESNCLAIR
«) MYNoh/ylD8125539381
Ex///m January 15, 2018
Notary Seal
sraarumusaemnaaml%1unwrurrsm
Name
I Dell, Michael
( Dell, Michael
Sweet, Thomas W.
Clarke, Jeffrey W
Haas, Marlus
Swalnson, John
Johnson il, Tyler Wise
McReynolds, Iaaya G.
Vagone, Thomas
Wright, Janet Bawcom
Wright, Janet Bswcom
l Rothberg, Richard Jay
I Quintos, Karen
Rothberg, PJchard Jay
Sweet, Thomas W.
l Johnson 0, Tyler Wise
Rothherg, Richanl Jay
Quintos, Kamn
l McReynolds, Maya G.
ll Address
One Dell Way, Round Rock, TX-78882
One Dell Way, Round Rock, TX-78882
II
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Title
Chairman INON BOARD)
Chief.Executive OMcer
(( Chief Financial ONcer
President
President
President
(( . Vlcc President
(( Vice President
l( Vice Pres/dent
Vice President
((Assistant Secretiry INON BOAR
ll General Counsel
(( Senior Vice President
Senior Vice President
(( Senior Vice President
ll Treasurer
Secretary INON BOARD)
(( Chief Marketing Omcer
(( Chmf Account/ng Oflicer US
([ Apponitment (II 01/01/2007 l
II 01I01/2007, (ll 01/24/2014 l
11/14/201 3
11/14/2013
][ 02/08/2012
I l 01/28/2013
l [ 01/24/2014
([ OSNf/2010
(( 10N1/2009
D}l[ .. 10/91/2009 l
l( 11N5/2013
([ 10N1/201 0 ](( 11/05/2013
ill... 01/24/2014
II 01/28I201 3 (
(( 11N5/201 3
(( foNf/2010
(( 01/24/2014
EDS-8 8/2015
CONTRACT NO. 1328-12468
COOK COUNTY BOARD OF ETIIICS69 W. WASHINGTON STREET, SUITE 3040
CHICAGO, ILLINOIS 60602312/603-4304 OIfice 3 12/603-998$ Fax
FAMILIAL RKLATIONSFIIP DISCLOSURE PROVISION
Nenotlsm Disdosure Reanimiaent:
Doing a significsnt amount ofbusiness with the County requires that you disclose to the Board of Ethics the existence of any fiuriIEnIrelationships with any County employee or aay person holding elective offic in the State of Iignois, the County, cr in anymunicipality within the County. The Ethics Ordinance defines a significant amomit of business for the purpose of this disclosurerequirement as more than $25,000 in aggregate County leases, coiuracts, purchases or sales in any caleadar year.
Ii'ou are unsure of whether the business you do with the County or a County agency will cross this threshold, err on the side ofcaution by cmnpleting the attached familial disclosure form bocause, among other potential penalties, any parson found guilty ofSailing to maire a required disclosure or knowingly fiiing a firlse, misleadbig, or incomplete dlsclosme will be prohibited fiom doingany business with the County for a period of three years. The requked disclosure should be iliad with the Board ofEthics by JanuaryI of each calendar year in which you are doing business with dte County and again with each bid/proposaVquotation to do businesswith Cook Couoty. The Bomd ofEthics may assess a late filing gsc of$100 per day idler an initial 30-day grace period.
The person that is doing bminess with tile County must disclose his or her kmilial relationships. Ifthe person on the County lease orcontract or purchasing fiom or selling to the County is a business entity, then the business entity must disclose the famfiialrelationships of the individuals who are and, during the year prior to doing business with the County, were:
~ bs board of dhectors,~ its «IIiceis>~ its employees or independent contractors responsible for the general administration of the entity,~ its agents authorized to execute documents on behalf of the entity, ande ks employees who directly engage or engaged in doing work with the County on behalf ofthe entity.
Do not hesgate to contact the Board of Etldcs at (312) 603-4304 for assistance in determining the scope of any requhed familialrelathmship disclosure.
Additional Definitions:
"punil/al re/o//unship" means a person who is a spouse, domestic partner or civil union partner of a County employee or State,County or municipal offlcial, or any person who is related to such an employee or oiEcial, whether by blood, marriage «r adoption, asa:
0 Parent0 Child0 Brother0 Sister0 Aunt
0 Uncle0 Niece0 Nephew
Oi Grandparent0 Grandchild0 Father-in-law0 Mother-ln-law0 Son-bt-law0 Daughter-in-law
Bmther-in-law0 Sister-in-law
0 Stepfather0 Stepmother0 Stepson0 Stepdaughter0 Stepbrother0 Stepsister0 Half-brother0 Half-sister
EDS-9 8/2016
CONTRACT NQ. 132832466COOk COUNTY BOARD OF ETHICS
i>AMH IAL RELATIONSHIP DHCLOSURE PORN
I>KllSON )EQIWG OR bEEKING TO DO BUSINESS WITH THR COUNTY
Name ofP<'mon Doing Business with Se Cauu<y, Dell Maiketlng L.P.
Address af Person Doing Business with tbc county: One Dell VVay, Round Rock, Tx - 78682
phone n'umbel" df Pemon Doing Business with thi, County; {512)338MOO
nail address ofPe<sar< Doing Bean<ass'1th 'd<e County
lt person Doing Business with tbe County fs a Business Entity, provide Se name, title and contact 'inlbrmation lbr theindivldusi c<nnpieting this disclosure on beha1f af the Person Doing Business with ths Co<mty;
~Oudle McCieiian, Contracts Manager, dudley,mucieiiandellteam.corn; 512-723-6527
DESCRIPTION OF BIJSINRSS WITH THK COUNTYrippend add<<iona! pages ar needed and frv'ach Caaniy tease, carne acr, perches» ar»a>>e»augh< and>or oh>ain»dduring fh» cal»aihsryear »fthm d>kclasr<r» fcr rhe prr>a»»diag calmnSr year ifdirclarurc Jr mad» an danudry JAidrnr>'fy>
Tbe )esse number, contract number, purchase order number, request far propose) number anChor request ibr auaEBcmiannmnber a»societal with se business you ure doing or seeking io da with <he-County: Amendrrmnt Na, 1 to
cent>uct No. 1328.12456 for ptaduas and Services Agfeement between the County of Caok, 1<hnois ana Dell MarkatinK Lp,
Ti<c aggregate dollar value of the business yau <<re doing or seekfug to do with the ca<uuy: 5 14,000.000.00
The name, tide and ca<u«ct tufa<ms<ton far the County olBciai(s) cr en<playee(s) involved in negotiating <bc busmem voa aredab<5 or seeking to do with the County: Office of Chief Procurement Officer: Cynthia Park, Deputy procurement Officer,312-602-3075; and, Angels Sanchez, Procurement Analyst, 312-603-2691;Bureau of Technology: Jim Gavin, Contract VendorManager, 312-603-3262.
The name, title snd contact information for'he county ofdciai(s) or employee(s) involved in managing tbe business yau areore»ski'rig<a da with the County: Bureau of Technology: Jim Gavin, Contract Vendor Manager, 312 603 3262
DISCLQSIJRK OF FAMILIAL RELATIONSHIPS FPITH COUNTY EMPLOYERS OR 8'fATR. COUNTY QRt<>IUNICIPAI Rl ECTED QFFICIAI 5
CA»eh the ho» the applier and p>v>vide »Slated htfar>aaria» <rh»re needed
Q The Person Doing Business with the County is au buBvidualend Sere is no famgial r<datiunship benvecn tM» jndjviduaJand any Cack County en<playa» ar any person boiding elective cBire in the State of illinois, Cook County, ar anymunidpslity within Cook County,
'lbe person Doing Business With the County is a business entity snd them is nn fandlbd relaftonship between sny <ac<aber
at Sh business euufty's board of db actors, oflicrrs, penmns responsible for gencmi a<hmnistration of dm busb<essantity,
agents authorised to execute documents on beha1f of the business entity or employees direcdy engaged in connuctaa) workwub d<e Co<mty on behalf of the business entity, au<1 any Cook Caunty e<uplayce or <u<y person holding elective oUic<'in the
State ofIllinois, Cook County, or any municipality within Caak County.
CONTRACT NO. 1328-12488COOK COUIsIVV BOARD OV LITHICE
FAIVIILIAL RELATION SIIIP WSCI,OSVRE FORM
'fhe Person Doing Business with the county ls sn htdividusl and there is a famginl rtdsttonshtp between this iodivitlualnnd st ieust one Cook County emPloyee and/ore Person or Pmsons holding elective oifice in the State of illinois, CookCxntnty, and/or uny municipality within Cook County. The familial rehtionships nre as follows;
Name of Individual l)oiug
Business with th«CountyName of Rmated County Title snd Pruittcc cflt«ietudEmployee or State, Camny or Comity Employee or State, Cmmty
ssuniclpsl Elected Official or Ivlumicipsl Elected Oflicia
Nut ur«of
Ferns
wl
Relatilmship
Not Applicable
Ifmars space Bneeded, anach an additional sheet fa/Iow/ng the above formaL
The Person Doing Business with the County is a business entity and there is a fanu'lial relatioaship between nt least oncmember of this business entity's board ofdirectors, otytcets, persons responsible for general mhnini stration of the bus jilessdntity, agents authorirsd to execute documents on behalf of Ibe business entity end/or employees direr tiy engaged jncontractual work with the County on behalf of the business entity, on the one hand, and at least one Cook County employeeand/or n person holding elective office in the State of Illinois, Cook Cotmty, and/ur any nlunicipallty within Cook courtty, onthe other. The familial relationships are as follows:
Naelc ofRelated ConstrEelptcycc or State, Cotmty
cl'unicipsiBc«ted Ogiciul
Nmne of Member of Boardot'Director for Business
Ilntity Doing Business with
the County
Not Applicable
Tui«ecd Position ot RelatedColmty Einployc«cl State, Cou cryor Munimpal Elected Otgciat
Nature or Femine i
R«lstionship
Name of Otllov for Business Name of Releled Cuuuty "11tie snd Position cfRelet«dEntity Doing Business with Employee or State, County or County Psnployrc or State. Countytile Civvy Municipal Elected IINicisl or Muuicipal Bc«ted Offtstel
Not Applicable
Nature ot'amilialRelationship
CONTRACT NO. 1328-124BBName ofPerson Responsible Nmue of Related Cmmty Title md Position of Related N stum ofFamilialtor the Genmal Employee or Stele. County or Couaty Employee or Stme, County RelationshipAdministration of the Municipal Elected Otgcial or Municipal Elected OtgdatBusiness Entity DoingBusiness with the County
Not applicable
Name of Agent Authorised Name ofRelated County Title and Position of Related Nature ofFamlgalto Execute Documents for Employee or State, County or County,Employee or Stets, County Relationship"Business Entity Doing Municipal Elected Otgcial or Municipal Elected OigchdBusiness with the County
Mot applicable
Name ofEmployee ofBusiness Enthy DirectlyEngaged in Dohtg Businemwith the County
Not applicable
Name ofRelated County Title and Pmition ofRelatedEmployee or Sane, County or Couaty Employee or State, CountyMunicipal Elected OfBcial or Municipal Elected OtEcial
Nature ofPamilielReladoushtp
ifmore space is needed, attach an uddnionol sheet following the above format.
VERIFICATION: To the best of my knowledge, the information I have provided on this disclosure form is accurate and complete. Iacknowledge that an btnccuruts or incomplete disclosmu is punishable by law, including but not limited to Ence and debarment.
September 27, 2016. r-
S gn ~+ p%dley McClellan, Contracts Manager, Sell
SUBMIT COMPLETED IsORM TO: Cook County Board ofEthics69 West Washington Street, Suits 3040, Chicago, Illinois 6060201Ece (312) 603-4304- Fax (312)603-9988CookCounty.Ethicscookcountyil.gov
'pouse, domestic partner, civil union partner or parent, child, sibling, aunt, uncle, niece, nephew, grandparent or gnmdchiidby blood, marriage (i.a in hws and steP relations) or adoPtion.
EDS-12 8/2016
CONTRACT NO. 1328.12456SECTION 4
COOK COUNTY AFFIDAVIT FOR WACK THEFT ORDINANCE
'ffective Iusy 1, 2015, every pettmn fnwudfna stdtdrsftffdf ownem, seekinfi s contract wfih Cook Gounbf must comply with ths cook county wage ThefiOrdinance set forth In.Chapter 34, fktficls IV, Secfion 179. Any Pemon/Sutntsntlsl Owner, who Nfis to comply wkh Gook County wage Theft ordl«nos,may request that the Chief Procummsnt Gfficsr 5twit s mdu dion or waiver in accordance with secfian 34-178(d).
contrecf mesne sny written daaunwat ta make Pnxmsnwntg by or on behalf of cook Goutay.
pefnorf means any individual, cctporsttcn, partnemhlp Joint Venture, Irust. association, limfisd fisblfity company, sots pro pn std ra hip or other legal enfity
procummenf nwsns obtsinlnfi suppfies, eaulpmsnl, goods, or services of any kind.
sutwlantlsf Gwndf" means sny pmsan or persons who own or hold a twenty-five pemsnt (25%) ar more percsntsfis of Interest in any business enutyseskfng 'a County privilege, indudinfi thads shareholders, general or fimlted partners, bensfidarled snd principab; svcspt where a business entity is snindividual ar saks proprietorship, Substantial Owner mesne that individual sr sole proprietor.
)ut persons/Subtdsntist Cwnem ars rsquimd to complete this affidavit snd comply with the Cook County Wage Theft Ordinance bemfe sny Contract isswarded, Signature. of this folrtl constltgitw s csflificskon ttls infatlrlstion prmrid dc below is aclrsat snd complete, mnl fist thti indtvidlmt(d) sipnlnp this fiomlhss/havs csmonsl knawlsdos afsuch infatmstlan.
I. Contract Infarmagom
Contract Number: Amendment No. 1 lo Conhem No 1328-12488 for pnnmcts end Services Agnmment between the Coenly of Cook, glinors end Dell Merkeling, L.p.
County Using Agency (requesting Procuremenl):
II. Pemon/Substangat Owner Informagon:
pemtln (Cotpomte Engty Nm«). Dell Marketing L.P.
Substantial Owner Complete Name: O«Defi Why
FEIN¹ 74-2616805
Date of Birth: A
Street Address; One Dell Way
Qty Round Rock
Home Phone:
III. Compganoe with Wage Laws:
Email address:
Stetdr Texas
Ddvers Ucense No: N/A
Zjp 76652
Within the past tive years has the Person/Subslangal Owner, in any judicial or administrative proceeding, been convicted af, entered aplea, made an admission of gugt or llabifity, or'had an administragve finding made for committing a repeated or willful violation of any ofthe following laws:
Igrmls Wage fsayment end Co//so(Ion Acf, 520 ILCS 115/1 et ssq.,
Iifinais Minimum Wage Act, 820 ILCS 105/f st ssqo YES orO
YES aQNl
/Errata yyafksr At(fusbnsnl and Refmifdng No//ffcagan Acf, 820 ILCS 65/1 et aeq., YES orO
EmpfOyee C/aaa//iCegOn ACt, 520 ILCS 185/I et Seqo YES Or(89)
Fair Labor Sfandenfs Acfof 1588, 29 U SC. 201, et seq., YES orAny oompamb/e shds sta/ufs or mguhSan of any state, which governs the payment of wages YES or
If the psrsan/Subslantial Owner answered "Yea" to any of the questions abave, it is ineligible to enter into s Contract wfih CookCounty, but can request a reducfian or waiver under Secgon IV.
EDS-13 5/2015
CONTRACT NO. 1328-12468
tY. Request for Waiver or Reduction
f P IS b ta tial Owner answwed "Yss" to any of the questions above, it may mqusst a reducgon or waiver imsssdancs with Sedicn 34-178(d), pmvfdsd thai the request for reduction of waiver is made on ths ba s of one or moro ofsithe folowlng acgons thai have taken place:
Them has been s bans drie change in ownership or Canfmf af lhe ineligible Person or Substsnbsi Owner
Oisryplinsor scion as sention hss been taken against the individual(s) mspansibis for the acts giving rise to lhe vloietlonYES or HO
Remedial ection hss been taken to prevent s rscummcs of the acts giving riss to the dlsqusillfcaten or defaugvBS or HO
Ogmr factors that gm. Person or Subslangsi Owner believe sm rsie vent.YES or NO
Tho Pemonlgubstengel Owner mus su mI submit dacumentetian ta suaoari the Basis af hs mauest ibr s mducdon ar um ver Ths ChiefProcurement r mservssnt OS'erves the riaht la make sddfgansl Inauiries end nmuast sdddcnsi dacumenteNan.
V. AtllrmatlonThe Person/Subsfanfbd Owner affirms gmt ail statements contained in the Atgdavit are true, accurate and com~e
oats. September 27, 2016
Name of person signing (print>; DUdley McClellan Ttfe: Contracts Manager
Subscribed and sworn ta before me ibis 2~ day of CXii~rAYl';~',~ ,20 (
xNotary PubNc Slgnatum Notary Seal
Nots: The shove Infbnnagon ls suit(act to verlgcsdon prior lo the sward of dm Contract.
EOS-14 8/2015
SECTION 5CONTRACT NO. 1328.12468
CONTRACT AND EDS EXECIJTION PAGEPLEASE EKECIITE TTIREE ORIGINAL PAGES OF EDS
Ths Appgcent hereby celUUsa and warrants Uxd al of Uts atatsmenla, certlflcatlona and repreaentsgona aet forth in Sia EDS ars truecomplete and correct; that the Applicant ls In full compf ance and wig continue to be in compfshce throughout the term of the Contract orCounty P/tvgege issued to Ihs Applicant with ag Ole policies and requirements aet Uxlh in this EDS; and that aU facts and informationprovided hy the Applicant in gia EDS are true. complete and corn/ca The Applicant agrees to inform the Chief Procuaement QfUcar jntnvidng if any of such etatsmema, cerNicagons, reptsaentagona, fata or informagon becomes or is found to be untrue, incompleteinconect during the term of Ihe Contract or Cotatty Privilege.
Execution by Corporation
Corporsfron's Name Ptaaident'a Printed Name and Signatum
Telephone Emag
Secretary Signature
Execugon by LLC
LLC Name "Member/Manager Printed Name and Signature
Date Telephone and Errvil
Dell Markegng, LP.Partnership/Joint Venture Name
September 27, 201B
Data
. Execution by Psrtnershlp/Joint Venture
Dudley McClellan (Contracts Manager|~'Partner/Joint Venturer Printed Name and Sigrlature
512-723-6527; dudley mcclegengftdeg.corn
Telephone and Email
Execution by Sole Proprietorship
Printed Name Signature Aaewned Nemo gf appgcsble)
Date Telephone and Email
Subscribed and sworn to before me this2.1 day of~,20@.
'll/Itttl'~Notary Public Signature
jg Q~r VALiARIE SINCLAIR
afy Notary 10 5125555551,~SJy%1,@ Eaairaa January 15, 2015
My commission expires:
Notary Seal
*if the operagng agreement, psrtnemhlp agreement or governing documents requiring execuUon by muNple members, managers,partners, oriotnt ventursra, phase complete and execute additional contract and.EDs Execution pages.
EDS-15 8/2015
OFFICE OF CONTRACT COMPLIANCE
'ACQUEUNE GOMEZ
DIRECTOR
113 N. Clark, County Building, Room 1020 o Chicago, Illinois 60602 e (312) 603-5502
September 26, 2016
TONI IsRECKWINKLE
PRESIDENT
Cook County Board
of Commissioners
RICHARD R. BOYKIN
1st District
ROBERT STEELE
2nd District
Ms. Shannon E. Andrews
Chief Procurement Oflicer
118N. Ciark Street
County Building-Room 1018
Chicago, IL 60602
JERRY BUTLER
3rd District
STANLEY MOORE
4th District
Rs: Dell Marketing, LP
Contract No. 1 328-12468 (Amendment No. 1)Products and Services
Bureau of Technology
DEBORAH SIMS
5th DistrictDear Ms. Andrews:
JOAN PATRICIA MURPHY
6th Distdict
JESUS G GARCIA
7th District
The Office of Contract Compliance is in receipt of the above-referenced contract amendment and has
reviewed this contract for compliance with the Minority- and Women- owned Business Enterprises (MBE/WBE)
Ordinance. After careful review of our records as reported by the vendor, it has been determined the vendor is
in compliance with the MBE/WBE Ordinance.
LUIS ARROYO, JR
8th DistnctSincerely,
PETER N. SILVESTRI
9th District
BIIIDGET GAINER
10th District
JOHN P. DALEY
11th Distnct
Jacqueline Gomez
Contract Compliance Director
JG/ate
JOHN A. FRITCHEY
12th Distdct
IARRY SUFFREDIN
13th District
Cc: Angela Sanchez, OCPO
Jim Gavin, BOT
GREGG GOSUN
14th Dlstnct
TIMOTHY O. SCHNEIDER
15th Distnct
JEFFREY R. TOBOLSIII
16th District
SEAN M. MORRISON
17th District
$ Fiscal Responsibility g Innovative leadership Transparency SI Accountability QJ Improved Services
OF FICE OF CONTRACT COMPLIANCE
JACQUEUNE GOMEZ
DIRECTOR
118 N. Clark, County Building, Room 1020 e Chicago, Illinois 60602 e (312) 603-5502
September 26, 2016
TONI PRECKWINKLE
PRESIDENT
Cook County Board
of Commissionors
RICHARD R.BOYKIN
1st District
Ms. Shannon E. Andrews
Chief Procurement Oflicer
County Building-Room 1018
Chicago, IL 60602
ROBERT STEELE
2nd District
JERRY BUTLER
3rd District
STANLEY MOORE
4th Distnct
DEBORAH SIMS
9th District
JOAN PATRICIA MURPHY
6til District
Re: Contrast No. 1328-12468
Products and Services
Bureau of Technology
Dear Ms. Andrews:
The vendor has requested to modify their MBW/WBE utilization plan for the remainder of the contract term.
Effective as of September 26, 2016, the MWBE participation is as follows.
Bidden Dell Marketing, LP.Bid Amount: $14,000,000.00
JESUS G. GARCIA
7th District
LUIS ARROYO, JR
8th Distnct
MBE/WBE
Level-1 Global Solutions, LLC
Wynndalco Enterprises, LLC
Solai 8 Cameron
Status
MBE (6)MBE (9)WBE (8)
Certifvino Aoencv
City of Chicago
City of Chicago
City of Chicago
Total
Commitment'2.5%
(Direct); 1% (Indirect)
8.75% (Direct); 1% (Indirect)
8 75% (Direct) 1% lindirecti
60% (Direct); 3% (Indirect)PETER N. SILVESTRI
9th D istiict
BRIDGET GAINER
10th Drstrict
'Commitment is based on the total value of services within the specific task category.
Attached are the revised forms used in the determination of the responsiveness of this contract.
JOHN P. DALEY
11th District
JOHN A. FRITCHEY
12th District
Sincerely,
LARRY SUFFRED[N
13th District
GREGG GOSUN
14th District
TIMOTHY O. SCHNEIDER
15th District
JEFFREY R. TOBOLSKI
16th Drstnct
q Gomez
Contract Compliance Director
JG/ate
cc: Angela Sanchez, OCPO
Sam Hwang, BOT
Doug Copeland, BOT
SEAN M MORRISON
17th District
$ Fiscal Responsibility p Innovative Leadership III Transparency & Accountability Q Improved Services
NNDEIWBE UTILIEATION PLAN .FORSI 1
BIOPERIPROPOSER HEREBY STATES thai all MBEAWBE frms included in IMs Plan are osrtified MBEsfWBEc by at least cnc cf the ant iiiec gated in ihe SsnersrConditions -Section lg,
SN)DEINPROPOBDIIIBEIWSE STATUS: (obeah the op pro pssb lne)
Blddsrlpio poser is a oeriifiad MBE ar WBE firm. (If so, attach copy of currant laNsr of Cerliricsacn)
BlddariPmpascr is a Joint Vonhas and cns or mors Joint Venture partners am ceriiged MBEc or WBEs. (If sc, attach copies of Loller(c) oiCerbTicslcn, a copy cf Joint Vmdum Agreement dswiy dnuwfung ihs role cf the MBEIWBE finn(s) and iis ownership iruanmt in ihe JointVsniws and a completed Jclnt Venture Affidavit -avstaae wdne al www.ccutvuuabd.ccv/ccntrcdccnmssccnt
B dedPmPaw ls nct e csdilsd MBE or WSE firm, nm a Joint Venture wgh MBEIWBE Pnrlnsrs, but wg ugllze MSE snd WBE limn othe,diiecllycrindiscsy In the parbmnmcs of the Contract, gfso complete Bscgons h tntcw and the Lettsrb) af Intent —Form 2).
g, QgQircct PaNdl&on of INBEIWBEPbms Q. Indirect pa Ndpsgon of NIBEIWBEPhns
hiOTK NNnue goals hoes wl been achhwad Ihrough direct pargdpagon, DldderlPropcser shall Inalude dowmenlsSon ontgnlng sfforfn tomoitlaua Divot Particlpsson st the time of Nstspmposot oubmbeion, indirect Persolposon wgl only be oonsbiscsd alter as efforts loachieuo Dbect Pattbtps8on have boon snhsuated. Only sRer urdSsn documentagon of good Faith D(tmto ls iooeived wgl IndlmctParSclpa0on be considered.
NBEs/WSEa that tdl perform as subconlradors/suppliers/ccnsubants include the Showing:
Wynndalco Enterprises, LLC
Jdd~ 55 W Wacker gth Floor, Chicago, IL 60601—[email protected]
ccniad pemcnDavid Ahdalcio
Phone312-256-9090
Color Amount Partidpagon: g TEID
pomsmnnwuiuWPariicipafcm 8.75% direct and 1% indirect of services tb
*Lattm of Inmnt agachad? „n'CunenlLsNsrof CcrbTicaiicn coached? Yes ~I
MBEIWNEP . Level-1 Global Solutions, LLC
~nap 233 S.Wacker Drive, 84th Floor, Chicago, IL 60606
Event [email protected]
Cc»dfm m. Thomas McElroy 312 202 3340
Color Amount Pargclpslion: S~PenwntAmountof Paitlcipsgcn: 42 5% direct and 1% indirect of services
"Letisrcflnimlaitacbed? Yes (—I Hc
'Cunent tsltmofcerligoagon SNaohed? Yes 'cAfiach afdtfcmd sheefs ec needed.
'eder(s) sf Intent and curmnb Lettem of CsrrryroaNon Dtust be sutmdaod at the Sme ofbhl
bn/VVBE utigzstion Plan -Form 1 Ravlsedi 01/hg/2Ota
EEIEIWBE UTILIZAllOM PLAN - FORM 1
MDDERIPROPOSER NBEIWEE STATUM (check tha appropiiete lne)
BidderiPmpcser iu s cerlllied NBE orwBE firm. (Ifco, rdsch copy cf current LeNsr of Certilcutlou)
BidderApmis e Joint Vsihes and cne or mors Joint Venture psrlnsie emcerglied MBEu or WBEs. Ef so, attach copies ol Letter(u) ofCerlfiqstcn, s copy of Joint Venhm Agreemsnt Nestly describing the rois of the MBFJWBE finn(s) nnd lu ownership internet In the JointVenhrm ed s completed Joint Vimlms Affidevii —svelshle cidne al www ccukcuunbti ccvlucutruuccmuesncut0lf MIMsPmpose is not e csrliied MBE or WSE firm, nor a Joint Venture will traEiwBE parlners, butwll utilize MBE end WEE irma elihsrdtscly ciindhucly in the psrfimnsnce of the Contract (Neo complete Ssclcnu Ilbehrw end ihs LsNm(s) a(Intent —Form 2).
N, g olrsul Fsrffctprdon of MBENNBE Firms Q Indirect Parffchnrson of MhwllBE Fhnm
MOTE Where goals have sot been achhwsd thrcugh direct parliaipaEon, alddsrIPropoaar shel Inalude dacanmntatlon outEnhrg idfode luachieve Dlmct particlpahm at the time of Ndrffpiupceat submission, Indlmet Psrttdpadcn wEI only be constdsmd atlas as sffods toucilleve tEIect Psrtlcipsdon hairs bann «xhauaed. Only afar wrMan documsntsNon of Qood Faith EtfforM ls recehred wEI IndirectPardrdpathn be consldsmd.
MBEsiWSEs Ihnt nil perform as subconbactcm/suppliers/consuNants include the following:
MBEfwBEFSoiai 8 Cameron, Inc.
Addman 3410 W Van Buren, Chicago, IL 60624———--~a;I.—msotai@solsam:corn
CcmsclpummMallar R. Soiai
Phonm773-506-7270
'oter Amount PerffrJpeticn: S TSD
Fsrosninmcumofpedtcipailom 8 75% direct and 1% indirect of services
*Leler cf slant attached? Yeu ~'Cunsnt tahar of Csrtiffcsiion suruhed? Yes ~v
Nc
Nc
glPPERIPROPOSER HEREBY STATES thai ell MBFJITSE Sme included in Ibis Ren ars certified MBEsfWBEs by at least one cf the entitles listed ui the generalCondaons —Ssclou 1g.
MBEIWSE Firm:
Email:
Conlact Fmscn:
Dollar Amount Perlidpslon: S
PsmenlAmountof Panleipsfforz
Phone:
"Letter utlnienl attached? Yes ~'Current LsNerofCerlificstion athuhed? Yes~
No
Nc
Aliach mtNcnd shseie ss nssasd.
'eder(s) of Intent end eurmnt Leltmu of CertacuEon ~mu he suhnEtsd at the time of hhh
NI/WBE Utiffzution Plan —Form t Revised: Ot/NS/BOSS
~LETTER OF INTENT„~ynndatco Enterprises, LLc c, l>,,„A „,Cook County MBE
Certifying Agency:
c I I p David AndalcioCertification Exfnralion Dale
/P
Piioii. 312256-9090Fax
ST2256 g " FEW¹ 26-4337593„„„.d.andalcio(nwynndalco,corn
Participation: @Direct @indirect
Will the kflWBE firm be subcontracting any ol Ihe goods or services of this contract to another firm7
¹FNi> j jYns Please allech explanatiun Prupoxad submmlracloiik)
The undersigned kffWBE is prepared to provide the following commodities/Ssrvcee lor the above named prqec¹ contract frr
inure space is ceeded lo fully dexcnoe iahsE Firm'f proposed recce cr wcrk end/or paymerk scriedule. effech eddkionel xiieelxl
Hardware Deployment: Physical Installation of Hardware, Staging, AssetTagging, Loading of Profiles, Some Imaging, Set up Network Drives, Drivers, General Instalietion
Physcial Instagation of Peripherals such as Pro)actors and Large Monitors, Training: Training
related to the Installation of New Hardware or SORware
indicate Ihs Oogar Amount, percentaae. and the Tenne of pmrmont loi the above dsxcrrbed Commoditmsr servces
8.75%, Direct and t% indirect of services Net 30 Payment Terms
THE UNDERSIGNED PARTIES AGREE that this Letter ol Intent viill become s binding Subcontract Agreement for lhe above
work, conditioned upon (I) Ihs Bidder/Proposer's receipt ol s signed contract from the County ot Cook; (2) Undersigned
Subcontractor remaning compliant with all relevant credentials. codes, ordinances snd statutes required by Contractor, Cook
counly, a slate lu perlrclggte se s kfBElwBE firm lor lhe above work Thar Undersigned Parties do also cerlily thai they
didn Ihei ~lu s ocu~lltarsesundegescriplionof service/su
I endj(erpweracompleled
Signature (ffrtyBE) Siliialuru pliliie Bid/far/frrliprrerrr)
ce.u x.uercu
Wynndalco Enterprises, LLCFirm Name Firm Name
oorzkrkor sDale Date
Subec/ibad cnd sworn before me
Ihisgd day el~~<. u 20
Relay Publir. L/II/C /A /82/ &fly'AYLn-
SEAL
w
OFFICIAL SEAL
TRACEY A BATTIBTONI
Notary Public - Stele ot Iginois
C mission Expires Jul 2, 2OI8/wkyketPer or Intent - Form c
Subscribed and sworn before ms
this day of z/.Notary Public
MBFJWBE LETTER DF INTENT ~ FORM 2
MnJIB FtnnLevel-1 Global solubons, LLc,, City of Chicago
Cenifying Agency
233 s wacker Dove, 84th Floor «Q tyAfrican American
„...,.„„„,Chicago, IL2 60606 tfi 't t't i t . »kurt st 'ite
m Pmflosai/Cortlrar! a
312-202-3300F ~
312-202.3310 30-0007064
Eniu„ tdm@level- 1.Com
Perhupal r1 g ilueol g 'rn;rett
//s a e Afi'/IBE iifmr '. su rofilfstr'h'iq 1nr '. 2'. 1"mll c! fifi'fvii as ct!hn contract to anoaerfirm'tr
Nn 'I.;-please acatr.- eiciaiial I n upcseii un!os sctcrlsi
.noun!le s Vn»1! IV B" .s rmput u! I, I rouse tn fili mrq r i xi!owl»a» Sernas 'nr the above namcd Pioluch Conhact lf
".%sc .c, ". t 'I, ",.:1~ I'.I ix» n i. '..., 's ", '.,ruttxrfil clnntr xfrs hnrrrairttrrnesf I
ecnnical'I lair»!eri ii't u uUpnnr! Dusfi on Bunpon gtur igs Bsl uli Delivery, technology ptofessional Bervlcem
tvmru i ntr lit.cti. U .~ Uec cun -ital,."s e.ut i, nrfii;t»s,i' Bt'rvirvs A!reuse t lro'deosunreif laura
'1 tfit use oix Dotter ntmounl ptfrcsntstLe and Irt T~fms o p1yment '."4'e,lbt re otisuttx t conirriodillesf servwes
42 5% Direct and 1% Indirect of Services. Rates to be determiriecroiihourry
piieng'e»
iqlicfi O'Servtice Suep an Fee»Costwere compte!ed
C
Signature me arfdedpropoterl
Dudley McClsgan, Contracts Manager. Dell Legal
Pnnt h'arne
Dell Marketing LP
rrnenl unhl all ait.aS urea
Angela F. O'EtanionPnnl !lame
Level-1 Global Solutions, LLC
,NE,iNcgnsi =,-" n'cg /GRFE:la!!/rs i "!r el I "u'4»as bec,ine a oindsig Swor!!ta I n Ireenmnl fci the above
mrs cuidrlUn -; .I, ', '," B lltr -'uss» I taut.o! d U»tg4eu uai! ttc', ',!om ae tmu"I/ ot cock, i2! Iftlderstgned
s„bimnlraclcr rswcin „;rci priv> sur as re!le an: creosnhais sodas nroinance and statutes required br Conliaclor. Cook
cofir!1 and Ihe "..a!v u nan:»pile ss a!IB«vlBE urrt ior fl e abi e wc"k The Underngned Parties do also certdy Ihei they
=.rm Nanie
9/20/2016Date
Subscribed abri nvorn before me
dfi/O'. 3,-'. B - .28!t
lvoterv Pubhc
Finn Name
September 21, 2016Dale
Subscnbed and sworn, Imfors ms
~day ot A@duu »IU tnt /Tgufl -.1
NofmyPublic~VI 'LLL»
FARRIS V. RARDLKOFFIClAL SEAL
igotstiy Pttbitc - State of illinoisBgv Commission Expires
I,MJNBE Get ttgiatytnfyfftt2 rut!Bit 2
~--~ tt
MONICA G, CABAREZ
m
My Notsty ID S t24488811
Expires July 21, 2019
=== = ~se: 2/29 zs
MBE/WBE LETTER OF
Solai 8 Cameron Inc
contact personMal al' Solal
Add«s. 3410 W Van Buren
ci«s„tw Chicago, IL a, 60624
773-506-2720F
779-505-2717Phone: Fax:
Emailm so I a i @ so I ca rn .
corn
Participation: I/ Direct @indirect
INTENT - FORM 2
certifying Agency'il) of Cl Icago
Certification Expiration Date: Af nl 2016
ahnlcifyAsian
Bid/Proposal/Contract R
FEw 5363990452
Will the M/WBE firm be subcontracting any cf the goods or senrlcss of this contract to another firm>
5/ No Yes - Please attach explanation. Proposed Subconirsctor(s):
Ths undersigned M/WBE is prepared to provide the following Commodities/Services for the above named ProjecV Contract: 5/rrtore space is needed io /g//y de penh a /br/wBE Firm'5 proposed scope g/ work and/or pgymsnl achgdurp, a//adh sdgs/cnsi shag/a)
IT sERvlcEs, Hardware, software, Networking, saibiing, cabling, maintenance, and labor
Indicate the Dollar Amount, Psrcentens, and the Terms of Pavment for the above-described Commodities/ Services:
8.75% or greeter direct pwlwipalion and Its indirect participation of services payment terms psr sec assn with cell
THE UNDERSIGNED PARTIES AGREE thai this Letter of intent will become a binding Subcontract Agreement for the above
work conditioned upon (1) the Bidder/Proposer's receipt of e signed contract hom the County of Cook; (2) Undersigned
Subcontractor rsmwmng compliant wtth all relevant credentials, codes, ordinances and statutes required by Contractor, Cook
County, snd the State lo participaie as a MBE/WBE firm for the above work, The Undersigned Paiges do also cs/gfy gtat they
did not aaix their signstwes to this documegttuntil all areas under Description of Servi and Fdb/Dost were completed.
I~.// // 2 '=M All,>MALLAR R SOLAI
Print Name Print Name
SOLAI 8 CAMERON Ilk)C
Firm Name Firm Name
8/25/2016 n (~~It(Date Date
Subscribed and sworn before ms
this LPdayofh. 48,2'aNotwy Publl X A
aPAMS
7fgggaasgINg s ggATEL I
lsv O5MMIBBolsaaakoat555~Atgggm 15,aoao
M/WSE Letter ot Intent- hov/irz
bb ibr r bi
.wc~ isrwib ~krb '
Revised: 2/29/24
Conuactd: ContraoINo, 1328 12dB~
/2QE(?sky;Cook County I Olaouslirtpdtggg
Off@a of ths Chief Procurement Officer Ql Check Coil)gtttidentification of Subcontractor/Supplier/Subconsultant Form
The. Bidder/Proposer/Respondent ("the contractor") will fully complete and execute and submit an Identification ofSubcontractor/Supplier/Subconsultant Form ("ISFa) with each Bid, Request for proposal, and Request forQualgication. The Contractor must complete the ISF for sech Subcontractor, Supplier or Subconsultant whichshag be used on the Contract. In the event that there are any changes in the utilization of Subcontractors,Suppliers or Subconsullsnts, the Contractor must file an updated ISF.
B.d/RFP/RFO No.Contract No. 1328-12468 (exlenslon)
Bid/RFP/RFQ Nod
Total Bid or Proposal Amount:
Contractor: Dell Marketing, LP
Authorized Contact Dusky Mcolsllsh, Contrada Mshsgsrfor Contractor: Crndi, Rsdsl,Program Contracts Manager
Email Address(Contractor). dudley.mcdeliqnedell,com
Dell Marketing, L.P.,Attn: Contracts Manager, LegalCompany Address
(Contractor):One Dell Way, RR1 33
~Z' tractor>, Round Rock, Texas 78682City, State and
~ZI Contractor):
F x (Contractor)512-723-6527; (fax) 512-283-6161
November I, 201B (start dr rshswsl)Completion Dates Od.her 31, 2018 (ammdsd end date)(Contractor):
Date: October 13.2016
Contract Title: PANS~No lc2s-i2asstNPt~.aha sat caaASNamaai oahyaar'he cauoly ol coah aod oal uasalao, Lp
Subcontractor/Supplier/Subconsultant to be Level-1 Global Solutions, LLCadded or substitute:Authorized ContactforSubcontractor/Supplier/Thomas McElroySubconsultant;Email Address(Subconua~or) " Ig)'evet-t.com
Compan AddressLevel-1 Global Solutions, LLC
City State and Zip(Subcontractor) Chicago, illinois 60606
(Subcontractor). 12 202 3300; (fsx) 312 202 3310Estimated Stari and
November 1. 201Bthrough October St, 2018
(Subcontractor):
Note: Upon request, a copy of ail written subcontractor agreements must be provided to the OCPO,
Total PriceDsscdotlon of Services or Suoolies Subcontract
Services or S~lltuathtaouctaasppod, u .cutup suppod. Natasa dalctp oalaNy, Nasaaasy vtotocccavtuatuctN NN ohIaaatdastura Uoiriad coma adoasona sacuofy syat ma tata sahrtcoc Access cored video sul a saac» aha aaa Uaacai oo plan a2 5% Ihiaci aud 1% ioui
Naaarsc haaad or h
The subcontract documents will incorporate sli requirements of ths ConVact awarded to the Contractor as applicable.The subcontract will in no way hinder the Subcontractor/Supplier/Subconsullani from maintaining its progress on anyother contract on which it is either a Subcontractor/Supplier/Subconsultsnt or principal contractor. This disclosure ismade with the understanding that the Contractor is not under any circumstances relieved of its abilities andobligations, and Is responsible for the organization, perfonnance, and quality of work. This form doss not appmveany proposed changes, revisions or modifications to the contract approved llllBE/WBE Lidltzation Plan. Anychanges to the contract's approved MBE/WBE/Utittmtdon Plan must be submitted to the Office of theContract Compliance.
Dell Marketing, LP
Contractor
by Dudley McClellan
Name
Coritracts Manager, Dell Legal
Odober 13, 2016
Date
Version 1.0
Contract ¹.'Contract Itto. t 325-1246~
QQ~Cook County Disovsliscsggg
ONce of the Chief Procuhsment Officer II Cheoh Ccttn/dgig
Identification of Subcontractor/Supplier/Subcansultant Form
The Bidder/Proposer/Respondent ("the Contractor" ) will fully complete and execute and submit an Identification ofSubcontractor/Supplier/Subconsultant Form ('ISF") with each Bid, Request for Proposal, and Request forQuail(Ication. The Contractor must compiete the ISF for each Subcontractor, Supplier or Subconsultant whichshall be used on the Contract. In the event that there are any changes in ths utilization of Subcontractors,Suppliers or Subconsultants, the Contractor mus1 tilg sn updated I SF.
Contract No. 1 328-12468 (extension)
Total Sid or Proposal Amount:
Contractor', Dell Marketing, LP
Authorized Contact Dudley McClallah, Contracts Manager
for Contractor'Cyndi Rgdel,Program Contracts Manager
(Contractor)dudley.mccleilan@delLcom
Email Address
Dell Marketing, L.P.,Company Address
Attn: Contiacts Manager, l.egalOne Dell Way, RR1-33
Z'C tract ), Round Rock, Texas 78682City, State and
F~ (C „tr t „). 512-723-6527I'(fsx) 512-283-6161m 0
November I, 2016 (start af renewal)ComPletion Dates Ockther 31, 20{6(amended ettd dhth)Contractor);
Date: October 13, 2016Gwttawwo 132312esat Plodsdcand get c sAgwwmwllhetw»en
Contract Title: s c~r oi cook and oea uadteling I.P
Subcontractor/Supplier/Subcansultant to be Wynndalco Enterprises, LLCadded or substituteAuthorized Contact forSubcontractor/Supplier/ David AndalcioSubconsultant:Email Address
), d.andalciotfgwynndalco.corn
Company Addmss Wynndalco EnterPrises, LLC
(Subcantractor):55 W Wacker Dr, gt" Floar
City, State and Zip(Sudcontractork Chicago, IL 60601
Telephone and Fax(Subcontractork
312-256-9090; (fax) 256-9091
Estimated Start and N,p I
November I, 2016 through October 31,2016
{Subcontraciork JNate: Upon request, a copy of all written subcontractor agreements must be provided to the OCPO.
Total Price ofDesoriation of Services ar Suoolies Subcontract for
Services or SuooliesHatdaate deployment physhat itslaliaiof of Hstdwste, awtstg Asset Tagens Loadng oi pfos tee howe insigne sel op «I
Nstwolk Ddt es on ets Genafsl hstagstion, phyelwd Inshdlahon of penphetals such oa pray+Iota end Large tewaers TlalningTtaksng Ielaletl to Ihs Inslsnation of Nwr Hardware *I 3ohwetat nho sea Utilhaiiof plan
The subcontract documents will incorporate all requirements of the Contract awarded to the Contractor as applicableThe subcontract will in no way hinder the Subcontractor/Supplier/Subconsultsnt from maintaining its progress on anyether contract on which il is either a Subcontractor/Supplier/Subconsultant or principal contractor. This disclosure ismade with the understanding that the Contractor is not under any ckcumstances relieved of its abilities andobligations, and is responsible for the organization, performance, and quality of work, This form dace nat approveany proposed changes, revisions or mod'dicatians to the contract approved MBE/WBE Utilization Plan. Anychanges to the contract'6 approved MBE/WBE/Utilization Plan must be submitted to the Office of theContract Cognpliance.
Dell Marketing, LP
Contractor
by Dudley McClellan
Name
Contracts Manager, Dell Legal
A4%,%'~Prime C{4I(rector Signature
October 13, 2016
Date
Version 1.0
CONTRACT NO. 132S-(268()
Cook CountyOffice of the Chief Procurement Officer A Dlsaual~ifi
Identification of Subcontractor/Supplier/Subconsultant Farm I
The Bidder/proposer/Respondent (hhe contractor" ) will fully complete snd execute and submit an Identification Dfsubcontractor/supplier/subconaultant Form (iisF") with each Bid, Request for Proposal, and Request forQualification. The Contractor must complete the ISF for each Subcontractor, Supplier or Subconsultsrkf whichshall be used on the Contract. In the event that there are any changes in the utilization of Subcontractors,Suppliers or Subconsultants, the Contractor must file an updated I SF.
/R /RFQ N, Contract Na. 1328-12468 (ext naio )
$14,000,M0.00Total Bid or Proposal Amount:
Contractor: Deil Markeiiag, LP.
Aulhodizsd Contact Dudley Msaeliau, cauiricis Msaigar
for Coritisctor: cynthia Radii, Pragrini caairscis Manager
Email Address(Contractor):
dudley mccieilknksdell.curn
Date: August 31, 201(l
Contract Na. 1328-12458 for Products aud Servicesontract TstieAgreement between the County of Cook iud Dell Marketing, L f .
Subcontractor/Supplier/Subconsultant to be vyynndalco Enterprises, LLCadded or substitute:Authorized Contact forSubcontractor/Supplier/ avid Ands'cia
Subccnsultant:Email Address(subcontrsmor): d.andalciawynndalca,corn
cofrlpany Addressoell Markeiing i.p., Auu:cauiricis Msuiger comparly Address 55 vy. yyaaker Dr., 9th Fiaar(COntraotcr): One Dell Way RR1-33, (Subcontractor);
City, State and Round Rock, Texas 78582Zip (Contractor):Telephone and Fax (512) 723-5527
(Contraator) Fax 512-283-6161
Esffmated Start and November 1, 2016 lsiuri contract
COmPlet(On DateS October 31, 2018 (amended ead
(Contractor}
City, State and Zip(subcontractor). Chlca9a, Illinois 60601
312-256-9090 lax. 312-256-9091(Subcontractor)
renewal) Estimated Start andNovember 1, 2016 throu9h October 31, 2018
(Subcontractor)
Note: Upon request, a copy of all mitten subcontractor agreements must be provided to the Ocpo.
Dascrlotton of Services or Sunnliss
Products and Services
Total Price otSubcontmet for
Services or SuonffesTeo
The subcontract documents will incorporate all requirements of the Contract awarded to the Contractor as applicableThe subcontract will in no way hinder the Subcontractor/Supplier/Subconsultant from maintaining its progress on anyother contract on which it is either a Subcontractor/Supplier/Subconsultant or pdincipal contractor. This dlsdosurs ismade with the, understanding that the Contractor is not under sny circumstances relieved of its atdliTies andobligations, and is responsible for the organization. performance, snd quality cf work. This f'onn doss not approveany proposed changes, revisions or modifications to the contract approved MBE/WBE Utilization Plan. Anychanges to the contract's approved MBE/WBE/Utilization Plan must be submieed to the Office of theContract Compliance.
Dell Marketing, L.P.
by Dudley McClellan, Contracts Manager
" ~.PP5C August 31, 2016Date
~eACORD CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)
I 09/05/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIEATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. T)ESCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBFLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(8), AUTHOR(7EDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the cert(fleets holder ls an ADDITIONAL INSURED, the Policy(les) must be endorsed, lf SUBROGATION IS VVAIVED, sub)ect tothe terms and conditions of the pogcy, certain po(lchrs msy mqulre an endorsement. A stshnnent on this cefdgcate does not conter rights to thecert(fleets holder in Beu of such endorsement(s).
CONTACTpRGUUcER NAME:
MARSH RISK & INSURANCE SERVICES PIIUBE I FAX
345 CALIFORNIA STREET, SUITE 1305 I IA/C. Me~CALIFORNIA LICENSE NO. 0437153SAN FRANCISCO, CA 94104
Agn: Shannon Ws)ker-shannon walkermamhtmm INSUR 8Rl Bl AFFORDING COVE IIAGE
msuhga A, Commeme 8 Industry Insurance Company
IBSURERe: (hteA~)iusunER c, Steadfast Insurance Company
atnunan c ~ National Union Fire Ins Cn Ptltsburgh PA
NAIC ti
19410
INSURSCDell Inc. and its Subsidhries
One Dell Way- RR1-50Round Rack, TX 78682-7000
26387
19445
MSUI(ER E i
1,000,000
1,000,000
5.000
GEN'L AGGREGATE LIMIT AP pLIES PER
1X POLICY ~ Jycf ~ LOC~ PRO-
OTHER
0 AUTOMOBILE UASSJ(Y
X ANY AU)OALL OWNED SCHgDIXEAUTOS AUTOS
KGN-OWNEX HIRED AUTOS AUTOS
5,000,000
5,000N00
1,000,000
msunER p:COVERAGES CERTIFICATE NUEIBER: 5EA-003071660.01 REVISION NUMBER:16
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOT)hffTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMSEXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIM)TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
nnnk sushi poLICY SFF poLlcY ExpTYPE OF INSURANCE ~mo wvnl POUCY NUMBER IMM/nn/YVYYI IIWI/nn/VYYVI Llwrs
A X GQMMERCIAL GENERAL UABIUrv IGL3796534 03/01/2016 03N'I/2017 FACHC(xtmnnhCEUAMAUS TG RENTSU
CLAIMSAIADE QX OCCUR PREMISES JEe dceurrencei 4
MED axp (Anv one person)
PERSONAL n ADV INJURY s 1,000,000
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $$
CA1861277 03/01/20'16 03/01/2017 GUMBINko sINGLB I.IMIT
BODILY INJURY (Per person) $D BODILY INJURY (Per ecudmn) $0 PROPERTY DAMAGE
Jper accident)
$
O X UMBRELLA LMB ~X OCCUR
EXCESS UASI I CLAIMSAIADE
DED I I RETENTIONs
8 woRKERs coaipamsAYIGKAnn EMPLOYERS'IASILITY YIBANY PROPnlEYGR/PAATNER/aXEGUTIVEGFFICBRJMEMBER EXCLUUEU7(Mendetory in NH)lives, devcnhe underDESCRIPTION OF OPERATIONS below
C Professional/E&O/
Technology Errms &Omissions
SEE FOLLOWING PAGE
Wotksm Compeosation excluded
in NO, GH & WA
IPR929660404
03/01/2016 0MI/2017
03/01/2016 03NI/2017
06/01/2015 12NI/2016
EACH OCCURRENCE
AGGREGATE
$
"Is)ATUYE IIER™
E.L. EACH ACCIDENT
EL DISEASE-EAEMPLOYEE $E.L IXSEASE - POLICY LIMIT $
Est(i Quite/Agg/again
(Claims Male)
1,000,000
1,000,000
1,000,000
1,000,000
1,000,000
2,000,000
BEscRIpv/GN oF opERAhons I LOCAhchs I vmtmLEs (AC ORU 1st, Addisenel Remarks schedule, mhy be etta shed
untorn
apace is required)
County of Cook, Cook Caunly Oflice of the Chief Prccumment Officer 118N, Oark St, Room 1018, Chicago. IL 60602 is included as akliTional insured (exmptworkers'ompensation
and profsskkisl liability) where required by wditten contract. Any such coverage extended lo Ihe additional insured ml apply as primary and noncontributory, to
ha extent af liability assumed under contract. Waiver of sulirngation applies h favor of the County at Cask, ils employees, ale clad afaiah, agents cr teaeseehrhes whete
rmluired by wrlgen contract and permigsd by lsw.
CERTIFICATE HOLDER
County of Cook
Cook Courtly
Offic of the Chief Pmctuament Office
118 N, Clark St., Room 1018Chicago,IL 60602
ACORD 28 (2014/01)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIEB BECANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IHACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESSMTATIVEof Marsh Rick a Insurance Services
Stephanie Guaiumi
1SBS-2014ACORD CORPORATION. AE rights reserved.The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 974120LOCSS San Francisco
ACORD
MARSH RISKS INSURANCE SERVICES
POLICY NUMBER
ADDITIONAL REMARKS SCHEDULElsAMECINEUREC
Dell Inc. end its Suhs/diariesOne Dell War. RRI-50Round Rock, TX 78582-7000
Page 2 of 2
EFFECTIVE OATEr
CARRIER
i
NAIC COBE
ADDITIONAL REISARKS
THIS ADDITIONAL REISARKS FORSI IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 26 FORM TITLE; Certificate of Liabilliv InsuranCe
DELL INC. - WORKERS COMPENSATION/EMPLOYERS LIABILITY; EFFECTIVE 3/I/2016 - EXPIRATION 3/I/201 7
Insuer. New Haeeshhe Msurance Co. NAIC923841
WC015519233- All Other States
WC015519237-CA
WC015519235- FL
WC015514034 ~ Wl, WY, IEMPLOYERS UABILITY ONLY FOR THE FOLLOWING STATES ND,OH, WA)
WC01551%32-AK, AZ, IL, KY Nc, NH, 14l, PA, UT, VA, VT
WC015519239- ME
WC0155192%-OR
Insurer. Insurance Cc of the Slate of PA. NAIC519429
WC015519238 ~ MA
ACORD 101 (2000/04 ) 2008 ACORD CORPORATION. AS rights reserved.The ACORD name and logo are registered marks of ACORD