NEW YORK STATE Office of Information Technology Services ... · Web viewCE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability

IFB # C000579 – NYEnet Fiber Maintenance and Locating Services

Attachment 1-Bidder Information Form

Name of Company Bidding: Bidder Firm's Federal Tax Identification No.:

Street City

State Zip County Country

Contact Name:

Title:

Phone: ( ) - ext ( ) Toll Free Phone: ( ) - ext ( )

Fax : ( ) - ext ( ) Toll Free Fax : ( ) - ext ( )E-mail Address: Company Web Site:

Bidder Firm’s NYS Statewide Financial System Supplier Identification Number, if known:

Attachment 1 Page 1

IFB C000579 – NYeNet Fiber Maintenance and Locating Services, NDA1

NEW YORK STATE Office of Information Technology Services (ITS) NYeNet Fiber Maintenance and Locating Services

IFB #C000579

CONFIDENTIALITY & NON-DISCLOSURE AGREEMENT

ITS Invitation for Bids (IFB) No. C000579 – NYeNet Fiber Maintenance and Locating Services contains information regarding critical infrastructure currently part of the NYS ITS data communications network, the contents of which contain information the general release of which may pose a threat to the security of the State’s assets. ITS is authorized to release this information only to those Vendors properly executing the following confidentiality and non-disclosure agreement:

THIS AGREEMENT is hereby executed between the State of New York (State), acting by and through the New York State Office of Information Technology Services (ITS), having its principal place of business at State Capitol, ESP, P.O. Box 2062, Albany, New York 12220-0062, and , having a principal place of business at (hereinafter “Vendor” or “Custodian”), executed by , an individual who is Vendor’s Authorized Representative (hereinafter “Authorized Representative”), in relation to Invitation for Bids Entitled “ITS IFB C000579 – NYeNet Fiber Maintenance and Locating Services” hereinafter “IFB.

Certification & AffirmationThe Authorized Representative, by signing this Agreement in the name and on behalf of the Vendor, subscribes and affirms the following:

1. that he/she is the authorized representative of a Vendor which is qualified to respond to the above referenced IFB;

2. that he/she is signing this Agreement on behalf of and as the act and deed of the Vendor named below intending to bind said Vendor to the representations made herein;

3. that the Vendor will comply with all requirements of this Agreement; and

4. that the Vendor will certify the return or destruction of Confidential Information received as specified in this Agreement.

PART 1. DEFINITIONS

A. Confidential Information‘Confidential Information’ (hereinafter “Confidential Information”) shall be defined to include any information that ITS or the State, regardless of form or medium of disclosure (e.g., verbal, hard copy, or electronic) or source of information (e.g., ITS, other state agencies, state employees, electronic systems, or third-party contractors) provides to Vendor, or which Vendor obtains, discovers, derives or otherwise becomes aware of solely as a result of this IFB other than:

(a) information that is previously rightfully known to the Vendor without restriction on disclosure;

(b) information that is or becomes, from no act or failure to act on the part of the Vendor, generally known in the relevant industry or in the public domain; and

(c) information that is independently developed by Vendor without the use of Confidential Information.

Title to all Confidential Information remains the property of the State. Confidential Information is provided


an “as is” basis, and the State of New York makes no warranties, guarantees or representations of any kind express or implied, or arising by custom or trade usage, as to any matter whatsoever, without limitation, and specifically makes no implied warranty of fitness for any particular purpose or use, including but not limited to adequacy, accuracy, completeness or conformity to any representation, description, sample or model.

B. Authorized Use“Authorized Use” shall be defined as the use of Confidential Information by Vendor, its employees, consultants and subcontractors, solely for the purpose of submitting a proposal to the IFB and, if awarded a Contract, performing the services as agreed to by the Parties, as now or hereafter modified or amended. Disclosure, display, use, duplication, storage or transmittal of Confidential Information, in any form, for any purpose other than that set forth in the engagement, including extrapolation or retention of summary information, data or business processes, even if without specific identifiers, shall be deemed an “unauthorized use”.

C. Authorized Person“Authorized Person” shall be defined as those persons within Vendor’s employ or control identified by Vendor to ITS as having a need to receive, possess, store, access, or view Confidential Information for an Authorized Use.

PART 2. CONFIDENTIALITY & NON-DISCLOSURE REQUIREMENTS

A. Duty to Protect Confidential InformationUpon proper execution of this Agreement, Vendor will be granted a non-exclusive, non-transferable license to display, use, duplicate, store, and disclose Confidential Information only for an Authorized Use. Vendor shall safeguard all Confidential Information which is delivered from the State to the Vendor to ensure its authorized use and to protect and prevent its unauthorized use or disclosure.

“Safeguard all Confidential Information” shall be defined as Vendor taking either one, or a combination of the following security measures, whichever standard is higher:

(1) Where Vendor has established security procedures for its own confidential, sensitive business information which impose security requirements for the protection of its own trade secret, proprietary or confidential information, Vendor shall protect the Confidential Information using the same means; and/or

(2) Where Vendor has not established such internal procedures, Vendor shall take the commercial measures defined below, to protect the Confidential Information.

Commercial Measures to Protect Confidential InformationFor purposes of this Agreement, “commercial measures” shall be defined to include all of the following responsibilities to be undertaken by the Vendor:

I. Use RestrictionConfidential Information shall only be received, possessed, stored, accessed and/or viewed by Authorized Persons.

II. Access by Authorized Person(s)a. Vendor shall be responsible for identifying those persons within its employ or control who

have a need to receive, possess, store, access, or view Confidential Information for an authorized use (hereinafter “Authorized Person(s)”).

b. Vendor shall be required to take commercially reasonable steps to inform each Authorized Person of their individual obligation to protect the security of Confidential Information in accordance with the requirements of this Agreement.

c. Vendor shall not permit Confidential Information to be received, possessed, stored, accessed, or viewed by any Authorized Person until such person has agreed to comply with the required security obligations set forth below.


III. Access by Subcontractors and Consultantsa. Vendor shall be responsible for identifying those consultants and subcontractors who

have a need to receive, possess, store, access, or view Confidential Information for an authorized use.

b. Vendor shall not permit Confidential Information to be received, possessed, stored, accessed, or viewed by any consultant or subcontractor until such entity’s legal representative has been made aware of and has agreed to comply with the required security obligations of this Agreement.

c. Consultants and subcontractors shall not be allowed to further disseminate or distribute Confidential Information, other than to provide access by Authorized Person(s) within consultant’s or subcontractor’s control and oversight.

IV. Security Obligations Regarding Confidential InformationAny person(s) who receive, possess, store, access, or view Confidential Information from either the Vendor or its approved Subcontractor or Consultant (hereinafter “Custodian”) shall be subject to the following security obligations:

a. Custodian is the SOLE entity authorized to duplicate, distribute or otherwise transmit Confidential Information.

b. Custodian’s legal representative must approve any process used to duplicate, distribute or otherwise transmit Confidential Information to Authorized Person(s), and may NOT approve or use any process which involves the use of any public internet or other non- secure medium.

c. Unless otherwise authorized by Custodian’s legal representative, Confidential Information may NOT be stored on personal (non-business) computing or other electronic devices, or taken or removed in any form outside of the physical premises of Custodian.

d. Confidential Information may only be duplicated, distributed or otherwise transmitted “as is”, without alteration of any kind. “Confidential” or “Copyright” notices, whether originally in physical or electronic medium, shall not be removed from and shall be duplicated on Confidential Information when such information is duplicated, distributed or otherwise transmitted pursuant to (b) above.

e. Other than as set forth in (a-d), above, Confidential Information may not be duplicated, distributed, stored or otherwise transmitted or communicated to or by any person or system. Authorized Person(s) may not copy, re-duplicate, re-transmit or re-distribute Confidential Information, in any form, whether whole or in part, or in any medium, whether electronic or hard copy.

f. Upon termination of employment, Authorized Person(s) shall be required to return Confidential Information to Custodian’s legal representative, and/or to certify that all electronic, optical or other copies have been destroyed within any electronic storage or other medium.

V. Chain of CustodyVendor shall be required to keep a record of all copies of the Confidential Information that have been made and distributed to those persons within the employ of Vendor, and to those consultants or subcontractors who have a need to access Confidential Information for such authorized use.

Those consultants or subcontractors which receive Confidential Information from the Vendor shall, as a condition of accessing such information, certify that such entity shall keep a record of all copies of the Confidential Information that have been made and distributed to those persons within the employ of such entity, and that such entity will provide its written certification of compliance with the provisions of this Agreement to the Vendor as provided in paragraph VI, below.

TerminationThe license to use Confidential Information terminates automatically upon the happening of any of the following: (a) breach of this agreement; or, (b) completion of Vendor’s work if awarded a Contract pursuant


to the IFB; or (c) Non-award of a Contract pursuant to the IFB.

ComplianceThe failure of Vendor to furnish the required certification and comply with the terms of this Agreement will be deemed a breach of the Agreement and, if applicable, grounds for non-payment. Breach of this Agreement may be considered by the State as an issue of responsibility as to such entity in future contracting opportunities with the State.

In addition to the foregoing, if Vendor breaches or threatens to breach this Agreement, the State shall have all equitable and legal rights (including the right to obtain injunctive relief) to prevent such breach and/or to be fully compensated (including reasonable attorney’s fees) for losses or damages resulting from such breach. Vendor are deemed to acknowledge that compensation for damages may not be sufficient and that injunctive relief to prevent or limit any breach of confidentiality may be the only viable remedy to fully protect the Confidential Information.

Governing LawsThis Agreement shall be governed by and construed in accordance with the laws of the State of New York. If any provision of Agreement is declared by a court of competent jurisdiction to be invalid, illegal, or unenforceable, the other provisions shall remain in full force and effect.

ContactsVendor shall fill out Attachment A and return a copy with this Agreement. The person designated as the contact will receive instructions on how to access the Confidential Information.

IN WITNESS WHEREOF, Vendor has caused this Non-Disclosure Agreement to be signed as of the date set forth below.

By:

Print Name:

Title:

Date:

STATE OF )

COUNTY OF )) SS:

On this day of , 20 , before me personally came , to me known, who, being duly sworn by me, did depose and say that he/she is the (title) of (name of company) and that he/she has authority to sign on behalf of said company.

Notary Public

Notary Public

; and further that s/he is the of ., the corporation described in said instrument; that, by authority of the Board of Directors of said corporation, s/he is authorized to execute the foregoing instrument on behalf of the corporation for purposes set forth therein; and that, pursuant to that authority, s/he executed the foregoing instrument in the name of and on behalf of said corporation as the act and deed of said corporation.

of State of , County of ,

Onthe dayof ,20 ,beforemepersonallyappeared: , known to me to be the person who executed the foregoing instrument, who, being duly sworn by me did depose and say that s/he maintains an office at ,Town/City

CORPORATE ACKNOWLEDGMENTSS.:

STATE OF

COUNTY OF


CERTIFICATION OF RETURN OR DESTRUCTION OF CONFIDENTIAL INFORMATION BY VENDOR.

PURSUANT TO CONFIDENTIAL NON-DISCLOSURE AGREEMENT DATED

Vendor, having a principal place of business at (hereinafter ), and having entered into a Confidential Non-Disclosure Agreement (NDA) with the NYS Office of Information Technology Services (ITS) on for the purpose of bidding on ITS Invitation for Bids No. C000579 – NYeNet Fiber Maintenance and Locating Services, and having been provided by ITS with Confidential Information in accordance with that NDA, now certifies on behalf of itself and all Authorized Persons provided Confidential Information under the IFB, as to the following:

i. that the documented chain of custody, attached hereto, names all Authorized Person(s)to whom the Confidential Information was duplicated, distributed or transmitted, and

ii. as to such Authorized Person(s), that the Confidential Information provided by the State has been returned to the State, and that all duplicates, regardless of format, have been destroyed or permanently deleted from all forms of electronic storage, and

iii. Vendor has attached certifications of Authorized Person(s) to whom the Confidential Information was duplicated, distributed or transmitted, that all copies of Confidential Information have been returned to Vendor and that the Authorized Person has destroyed or permanently deleted all duplicates of Confidential Information from all forms of electronic storage.

This Certification is hereby executed

By:

Name

Title

Date

IFB # C000579- NYEnet Fiber Maintenance and Locating Services[TO BE COMPLETED ON OFFEROR’S LETTERHEAD]

Date

Susan MartinContract Management Specialist Empire State PlazaSwan Street Building, Core 4 Albany, NY 12223

Dear Susan Martin:

RE: IFB C000579, NYEnet Fiber Maintenance and Locating Services

Firm Offer to the State of New York and Conflict of Interest Disclosure

[INSERT OFFEROR NAME] hereby submits this firm and binding offer to the State of New York in response to New York State Invitation for Bids (IFB) # C000579- NYEnet Fiber Maintenance and Locating Services by the New York State Office of Information Technology for IFB C000579 - NYEnet Fiber Maintenance and Locating Services. The Bid hereby submitted meets or exceeds all terms, conditions and requirements set forth in the above-referenced IFB. This formal offer will remain firm and non-revocable for a minimum period of 180 days from the date proposals are due to be received by the State, or until a Contract is approved by the NYS Comptroller and executed by the State.

[INSERT OFFEROR NAME]’s complete offer is set forth in two, separately bound volumes as follows:

Technical Proposal: The Bidder must submit one (1) electronic copy (email) of its Technical Proposal in the file formats used in Microsoft Word, Microsoft Excel and/or Adobe Acrobat. No individual electronic document should be greater than 25 MB. Do not include information/files from the Financial Proposal or Administrative Proposal or any Cost Data in electronic document which contains the Technical Proposal. No individual electronic document should be greater than 25 MB.

Financial/Administrative Proposal: The Bidder must submit one (1) electronic copy (email) of its Administrative and Financial Proposal in the file formats used in Microsoft Word, Microsoft Excel and/or Adobe Acrobat. Separate electronic media submissions must be made for the Technical, Financial and Administrative Proposals. Do not include information/files from the Technical Proposal in the electronic media which contains the Financial or Administrative Proposals. All prices must be represented in U.S. dollars. Incomplete Financial Proposals, or Financial Proposals containing modifications, alterations, qualifiers, ranges, or exceptions will be rejected. No individual electronic document should be greater than 25 MB.

[INSERT OFFEROR NAME] hereby affirms that the solution proposed by the Offeror in the Bid meets or exceeds the service level requirements set forth in the above-referenced IFB, including referenced attachments.

IFB # C000579- NYEnet Fiber Maintenance and Locating Services[INSERT OFFEROR NAME] hereby affirms that, at the time of bid submission, Offeror knows of no factors existing at time of bid submission or which are anticipated to arise during the procurement or Contract term, which would constitute a potential conflict of interest in successfully meeting the contractual obligations set forth in the above-referenced IFB and the Bid hereby submitted, including but not limited to:

1. No potential for conflict of interest on the part of the Offeror or any Subcontractor due to prior, current, or proposed contracts, engagements, or affiliations; and

2. No potential conflicts in the sequence or timing of the proposed award under this procurement relative to the timeframe for service delivery, or personnel or financial resource commitments of Offeror or proposed subcontractors to other projects.

To comply with the Vendor Responsibility Requirements outlined in Appendix C – ITS Standard Clauses of the above-referenced IFB, C000579- NYEnet Fiber Maintenance and Locating Services hereby affirms that (enter an “X” in the appropriate box):

□ An on-line Vendor Responsibility Questionnaire has be updated or created within the last six months, at the Office of the State Comptroller’s website:

https://portal.osc.state.ny.us/wps/portal

□ A hard copy Vendor Responsibility Questionnaire is included with this proposal and is dated within the last six months.

□ A Vendor Responsibility Questionnaire is not required due to an exempt status. Exemptions include governmental agencies, public authorities, public colleges and universities, public benefit corporations, and Indian Nations.

By signing, the undersigned individual affirms and represents that he has the legal authority and capacity to sign and make this offer on behalf of, and has signed using that authority to legally bind [INSERT OFFEROR NAME] to the offer, and possesses the legal capacity to act on behalf of Offeror to execute a Contract with the State of New York. The aforementioned legal authority and capacity of the undersigned individual is affirmed by the enclosed Resolution of the Corporate Board of Directors of [INSERT OFFEROR NAME].

Signature[INSERT OFFEROR NAME]

[INSERT TITLE] [INSERT COMPANY NAME]

Corporate Seal

IFB # C000579- NYEnet Fiber Maintenance and Locating Services

STATE OF

COUNTY OF

CORPORATE ACKNOWLEDGMENT:ss.:On the day of in the year 20 ,before me

personally came: , to me known, who, being by me duly sworn, did depose and say that he/she/they reside(s) in ; that he/she/they is (are) (the President or other officer or director or attorney in fact duly appointed) of , the corporation described in and which executed the above instrument; and that he/she/they signed his/her/their name(s) thereto by authority of the board of directors of said corporation.

Signature and Office of Person Taking Acknowledgment

On the day of in the year 200 ,before me personally came: to me known, who, being by me duly sworn, did depose and say that he reside(s) in ; that he is (the General/Managing Partner or other officer or attorney in fact duly appointed) of , the partnership described in said instrument; that, by the terms of said partnership, _he is authorized to execute the foregoing instrument on behalf of the partnership for the purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name and on behalf of said partnership as the act and deed of said partnership.

Signature and Office of Person Taking Acknowledgment

PARTNERSHIP ACKNOWLEDGMENT}:ss.:}

STATE OF

COUNTY OF

Notary Public

appeared: , known to me to be the person who executed the foregoing instrument, who, being duly sworn by me did depose and say that _he resides at , Town of , County of , State of ; and that _he executed the foregoing instrument in his/her name and on his/her own behalf.

INDIVIDUAL ACKNOWLEDGEMENT:ss.:On the day of in the year 20 ,before me personally

STATE OF

COUNTY OF


Attachment 5 - OSC CONSULTANT DISCLOSURE REPORTING REQUIREMENTS CONTRACTOR INSTRUCTIONS

Background:Pursuant to New York State Finance Law Section 163(4)(g), state agencies must require all contractors, including subcontractors, that provide consulting services for State purposes pursuant to a contract to submit an annual employment report for each such contract, such report to include for each employment category within the contract: (i) the number of employees employed to provide services under the contract,(ii) the number of hours they work, and (iii) their total compensation under the contract. Consulting services are defined as analysis, evaluation, research, training, data processing, computer programming, engineering, environmental, health, and mental health services, accounting, auditing, paralegal, legal, or similar services.

Contractors selected for award on the basis of a procurement issued by OSC (Request for Proposals, Request for Quotations, Mini-Bid, or Invitation for Bids) must complete Form A, State Consultant Services– Contractor’s Planned Employment from Contract Start Date through the End of the Contract Term upon notification of award. The completed Form A must include information for all employees that will be providing services under the contract, whether employed by the contractor or by a subcontractor.

Contractors selected for award are also required to complete Form B, State Consultant Services Contractor’s Annual Employment Report annually for each year of the contract term, on a State fiscal year basis. The first report is due May 15 for the period April 1 through March 31 of the most recently concluded State fiscal year or portion thereof.

Form A must be submitted to OSC as the contracting agency, and Form B must be submitted to OSC (as the contracting agency), the Department of Civil Service, and the Consultant Reporting Section of the Bureau of Contracts at OSC, at the addresses provided in these instructions.

Instructions:FORM A:Upon notification of contract award, use Form A, State Consultant Services Contractor’s Planned Employment From Contract Start Date Through the End of the Contract Term, attached to these instructions, to report the necessary planned employment information prospectively from the start date through the end of the contract term. This is a one-time reporting requirement.

Complete Form A for contracts for consulting services in accordance with the following:

Employment category: the specific occupation(s), as listed in the O*NET occupational classification system, which best describe the employees anticipated to be providing services under the contract. (Note: Access the O*NET database, which is available through the US Department of Labor’s Employment and Training Administration website at www.online. onet center.org .)

Number of employees: the total number of employees in the employment category employed anticipated to provide services under the contract, including part time employees and employees of subcontractors.

Number of hours to be worked: the total number of hours anticipated be worked by the employees in the employment category.



Amount payable under the contract: the total amount payable by the State to the State contractor under the contract, for work by the employees in the employment category, for services to be provided during the Report Period.

Submit completed Form A within 48 hours of notification of selection for award to OSC (as the contracting agency) at the address listed below.FORM B:Use Form B, State Consultant Services Contractor’s Annual Employment Report, attached to these Instructions, to report the annual employment information required by the statute. This form will capture historical information, detailing actual employment data for the most recently concluded State fiscal year (April 1 – March 31). Submit Form B to OSC (as the contracting Agency), the Department of Civil Service (DCS), and to the Consultant Reporting Section of the Bureau of Contracts at OSC at the addresses listed below.

Complete Form B for contracts for consulting services in accordance with the following:

Scope of Contract: a general classification of the single category that best fits the predominate nature of the services provided under the contract.

Employment Category: the specific occupation(s), as listed in the O*NET occupational classification system, which best describe the employees providing services under the contract. (Note: Access the O*NET database, through the US Department of Labor’s Employment and Training Administration website at www.online. onet center.org .)

Number of Employees: the total number of employees in the employment category employed that provided services under the contract during the Report Period, including part time employees and employees of subcontractors.

Number of hours worked: the total number of hours worked during the Report Period by the employees in the employment category.

Amount Payable under the Contract: the total amount paid or payable by the State to the State contractor under the contract, for work by the employees in the employment category, for services provided during the Report Period.



Submit the completed Form B by May 15 for the period April 1 through March 31, and annually by May 15th thereafter for each State fiscal year (or portion thereof) the contract is in effect, as follows, to each of the following entities:

To ITS (as the contracting Agency):

NYS Office of Information Technology Services - Procurement & Contract ServicesAttn: Consultant ReportingESP, Swan Street Building - Core 4 Albany, NY 12220

-- and --

To the Consultant Reporting Section of the Bureau of Contracts at OSC:

NYS Office of the State ComptrollerAttn: Consultant Reporting 110 State Street - 11th Floor Albany, New York 12236By fax: (518) 474-8030 or (518) 473-8808

-- and --

To the NYS Department of Civil Service:

NYS Department of Civil Service Attn: Consultant Reporting Albany, New York 12239

New York State Consultant ServicesContractor's Planned Employment

From Contract Start Date Through The End Of The Contract Term

Contract Start Date://Contract End Date://

Agency Business Unit: OSC01Contract Number:

State Agency Department ID: 3050000Contractor Name:

State Agency Name: Office of the State Comptroller

AC 3271-S (Effective 4/12)

FORM A

Employment Category Number of Employees

Number of hours to be worked

Amount Payable Under the Contract

Total this page 0 0 $ 0.00

Grand TotalName of person who prepared this report:

Title: Phone #:

Preparer's Signature:

Date Prepared: / /

(Use additional pages, if necessary) Page of

New York State Consultant ServicesContractor’s Annual Employment Report

Report Period: April 1, to March 31,

FORM B

Contracting State Agency Name: Office of the State ComptrollerContract Number: Agency Business Unit: OSC01Contract Term: / / to / / Agency Department ID: 3050000 Contractor Name:Contractor Address:Description of Services Being Provided:

Scope of Contract (Choose one that best fits):Analysis Evaluation Research Training

Data Processing Computer Programming Other IT consulting

Engineering Architect Services Surveying Environmental Services

Health Services Mental Health Services

Accounting Auditing Paralegal Legal Other Consulting

Employment Category Number of Employees

Number of Hours Worked

Amount Payable Under the Contract

Total this page 0 0 $ 0.00

Grand TotalName of person who prepared this report:

Title: Phone #:

Preparer's Signature:

Date Prepared: / /

(Use additional pages, if necessary) Page of

New York State Department of Taxation and Finance

Contractor Certification to Covered Agency(Pursuant to Section 5-a of the Tax Law, as amended, effective April 26, 2006)

ST-220-CA(12/11)

For information, consult Publication 223, Questions and Answers Concerning Tax Law Section 5-a (see Need Help? on back).Contractor name For covered agency use only

Contract number or descriptionContractor’s principal place of business City State ZIP code

Contractor’s mailing address (if different than above) Estimated contract value over the full term of contract (but not including renewals)

$

Contractor’s federal employer identification number (EIN) Contractor’s sales tax ID number (if different from contractor’s EIN)

Contractor’s telephone number Covered agency name

Covered agency address Covered agency telephone number

I, , hereby affirm, under penalty of perjury, that I am (name) (title)

of the above-named contractor, that I am authorized to make this certification on behalf of such contractor, and I further certify that:(Mark an X in only one box)

G The contractor has filed Form ST-220-TD with the Department of Taxation and Finance in connection with this contract and, to the best of contractor’s knowledge, the information provided on the Form ST-220-TD, is correct and complete.

G The contractor has previously filed Form ST-220-TD with the Tax Department in connection with (insert contract number or description)

and, to the best of the contractor’s knowledge, the information provided on that previously filed Form ST-220-TD, is correct and complete as of the current date, and thus the contractor is not required to file a new Form ST-220-TD at this time.

Sworn to this day of , 20

(sign before a notary public) (title)

General informationInstructions

When to complete this formTax Law section 5-a was amended, effective April 26, 2006. On or after that date, in all cases where a contract is subject to Tax Law section 5-a, a contractor must file (1) Form ST-220-CA, Contractor Certification to Covered Agency, with a covered agency, and(2) Form ST-220-TD with the Tax Department before a contract may take effect. The circumstances when a contract is subject to section 5-a are listed in Publication 223, Q&A 3. See Need help? for more information on how to obtain this publication. In addition, a contractor must file a new Form ST-220-CA with a covered agency before an existing contract with such agency may be renewed.

Note: Form ST-220-CA must be signed by a person authorized to make the certification on behalf of the contractor, and the acknowledgement on page 2 of this form must be completed before a notary public.

As set forth in Publication 223, a contract is subject to section 5-a, and you must make the required certification(s), if:

i. The procuring entity is a covered agency within the meaning of the statute (see Publication 223, Q&A 5);

ii. The contractor is a contractor within the meaning of the statute (see Publication 223, Q&A 6); and

iii. The contract is a contract within the meaning of the statute. This is the case when it (a) has a value in excess of $100,000 and (b) is a contract for commodities or services, as such terms are defined for purposes of the statute (see Publication 223, Q&A 8 and 9).

Furthermore, the procuring entity must have begun the solicitation to purchase on or after January 1, 2005, and the resulting contract must have been awarded, amended, extended, renewed, or assigned on or after April 26, 2006 (the effective date of the section 5-a amendments).

Need help?Visit our Web site at get information and manage your taxes onlinecheck for new online services and featuresTelephone assistance

Sales Tax Information Center:To order forms and publications:Text Telephone (TTY) Hotline (for persons with hearing and speech disabilities using a TTY):

(518) 485-2889(518) 457-5431

(518) 485-5082Persons with disabilities: In compliance with the Americans with Disabilities Act, we will ensure that our lobbies, offices, meeting rooms, and other facilities areaccessible to persons with disabilities. If you have questions about special accommodations for persons with disabilities, call the information center.

Page 2 of 2 ST-220-CA (12/11)

STATE OF }

Individual, Corporation, Partnership, or LLC Acknowledgment

: SS.:COUNTY OF }

On the day of in the year 20 , before me personally appeared ,

known to me to be the person who executed the foregoing instrument, who, being duly sworn by me did depose and say that

he resides at ,

Town of ,

County of ,

State of ; and further that:

[Mark an X in the appropriate box and complete the accompanying statement.]

G (If an individual): _he executed the foregoing instrument in his/her name and on his/her own behalf.

G (If a corporation): _he is the

of , the corporation described in said instrument; that, by authority of the Boardof Directors of said corporation, _he is authorized to execute the foregoing instrument on behalf of the corporation for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said corporation as the act and deed of said corporation.

G (If a partnership): _he is a

of , the partnership described in said instrument; that, by the terms of said partnership, _he is authorized to execute the foregoing instrument on behalf of the partnership for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said partnership as the act and deed of said partnership.

G (If a limited liability company): _he is a duly authorized member of , LLC, the limited liability company described in said instrument; that _he is authorized to execute the foregoing instrument on behalf of the limited liability company for purposes set forth therein; and that, pursuant to that authority, _he executed the foregoing instrument in the name of and on behalf of said limited liability company as the act and deed of said limited liability company.

Notary Public

Registration No.

Privacy notificationThe Commissioner of Taxation and Finance may collect and maintain personal information pursuant to the New York State Tax Law, including but not limited to, sections 5-a, 171, 171-a, 287, 308, 429, 475, 505, 697, 1096, 1142, and 1415 of that Law; and may require disclosure of social security numbers pursuant to 42 USC 405(c)(2)(C)(i).

This information will be used to determine and administer tax liabilities and, when authorized by law, for certain tax offset and exchange of tax information programs as well as for any other lawful purpose.

Information concerning quarterly wages paid to employees is provided to certain state agencies for purposes of fraud prevention, support enforcement, evaluation of the effectiveness of certain employment and training programs and other purposes authorized by law.

Failure to provide the required information may subject you to civil or criminal penalties, or both, under the Tax Law.

This information is maintained by the Manager of Document Management, NYS Tax Department, W A Harriman Campus, Albany NY 12227; telephone (518) 457-5181.

IFB # C000579 – NYEnet Maintenance and Locating ServicesAttachment 7: Workers Compensation and Disability Insurance

Requirements

Sections 57 and 220 of the New York State Workers’ Compensation Law (WCL) provide that ITS shall not enter into any Contract unless proof of workers’ compensation and disability benefits insurance coverage is produced. Prior to entering into a Contract with ITS successful Bidders will be required to verify for ITS on forms authorized by the New York State Workers’ Compensation Board, the fact that they are properly insured or are otherwise in compliance with the insurance provisions of the WCL. The forms to be used to show compliance with theWCL are listed below. ITS would prefer Bidders to submit this insurance verification information with their bids if possible. Any questions relating to either workers’ compensation or disability benefits coverage should be directed to the State of New York Workers’ Compensation Board,Bureau of Compliance at (518)486-6307. Failure to provide verification of either of these types of insurance coverage by the time winning bids have been selected and Contracts are ready to be executed will be grounds for disqualification of an otherwise successful bid.

Workers’ Compensation Requirements under WCL § 57: To comply with coverage provisions of the WCL, businesses shall:

a) be legally exempt from obtaining workers’ compensation insurance coverage; orb) obtain such coverage from insurance carriers; orc) be self-insured or participate in an authorized group self-insurance plan.

To verify your compliance with the above, ITS shall receive one of the following properly executed Workers’ Compensation Board forms from the Contractor, theContractor’s insurance carrier or the Workers’ Compensation Board, depending on which form is appropriate:

1. CE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability Benefits Coverage; OR

2. C-105.2, Certificate of Workers’ Compensation Insurance. (The Contractor’s insurance carrier will send this form to ITS upon the Contractor’s request.)

Please Note: The State Insurance Fund provides its own version of this form, the U-26.3; OR

3. SI-12, Certificate of Workers’ Compensation Self-Insurance (the Workers’ Compensation Board’s Self Insurance Office will send this form to ITS upon the Contractor’s request), OR

4. GSI-105.2 – Certificate of Participation in Workers’ Compensation Group Self-Insurance (theContractor’s Group Self-Insurance Administrator will send this form to ITS upon the Contractor’s request).

IFB # C000579 – NYEnet Maintenance and Locating ServicesAttachment 7: Workers Compensation and Disability Insurance

Requirements

Disability Benefits Requirements under WCL § 220(8):

To comply with the coverage provisions of the Disability Benefits Law, businesses shall:

a) be legally exempt from obtaining disability benefits insurance coverage; ORb) obtain such coverage from insurance carriers; ORc) be self-insured.

To verify your compliance with the above, ITS shall receive one of the following properly executed Workers’ Compensation Board forms from the Contractor, the Contractor’s insurance carrier or the Workers’ Compensation Board, depending on which form is appropriate:

1. CE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability Benefits Coverage; OR

2. Either the DB-120.1 – Certificate of Disability Benefits Insurance OR the DB-820/829Certificate/Cancellation of Insurance (the Contractor’s insurance carrier will send one of these forms to ITS upon the Contractor’s request); OR

3. DB-155 – Certificate of Disability Benefits Self-Insurance (the Workers’ CompensationBoard’s Self Insurance Office will send this form to ITS upon request the Contractor’s request).

Attachment 8 - Minimum Bidder QualificationsIFB C000579 – NYEnet Fiber Maintenance and Locating Services

Qualification 1

Within the past ten (10) years, the Bidder must have a minimum of five (5) years of fiber optic cabling installation, locating, and maintenance experience.

☐ Yes ☐No*Qualification 2

The Bidder must have five (5) years of experience of maintaining a minimum of thirty (30) miles of fiber optic backbone cabling along highway and municipality right of ways (ROW) infrastructure. This must include a minimum of ten (10) miles of buried conduit and fiber.

☐ Yes ☐No*

*A “No” Response to any of the minimum qualifications will result in disqualification.

Certification

By signing you certify your express authority to sign on behalf of the Bidder and that all information provided is complete, true and accurate.

Date:

Legal Business Name of Company Bidding:

D/B/A - Doing Business As (if applicable):

Signature:

Printed Name:

Title:

AC 3290-S (Rev. 9/13)NEW YORK STATE

VENDOR RESPONSIBILITY QUESTIONNAIREFOR-PROFIT BUSINESS ENTITY

The person(s) completing the questionnaire must be knowledgeable about the vendor’s business and operations. An owner or officer must certify the questionnaire and the signature must be notarized.

COMPLETION & CERTIFICATION

The Vendor ID is a ten-digit identifier issued by New York State when the vendor is registered on the Statewide Vendor File. This number must now be included on the questionnaire. If the business entity has not obtained a Vendor ID, contact the IT Service Desk at or call 866-370-4672.

NEW YORK STATE VENDOR IDENTIFICATION NUMBER (VENDOR ID)

All underlined terms are defined in the “New York State Vendor Responsibility Definitions List,” found at These terms may not have their ordinary, common or traditional meanings. Each vendor is strongly encouraged to read the respective definitions for any and all underlined terms. By submitting this questionnaire, the vendor agrees to be bound by the terms as defined in the "New York State Vendor Responsibility Definitions List" existing at the time of certification.

DEFINITIONS

Every question must be answered. Each response must provide all relevant information which can be obtained within the limits of the law. However, information regarding a determination or finding made in error which was subsequently corrected is not required.Individuals and Sole Proprietors may use a Social Security Number but are encouraged to obtain and use a federal Employer Identification Number (EIN).

RESPONSES

Each vendor must indicate if the questionnaire is filed on behalf of the entire Legal Business Entity or an Organizational Unit within or operating under the authority of the Legal Business Entity and having the same EIN. Generally, the Organizational Unit option may be appropriate for a vendor that meets the definition of “Reporting Entity” but due to the size and complexity of the Legal Business Entity, is best able to provide the required information for the Organizational Unit, while providing more limited information for other parts of the Legal Business Entity and Associated Entities.

REPORTING ENTITY

An Associated Entity is one that owns or controls the Reporting Entity or any entity owned or controlled by the Reporting Entity. However, the term Associated Entity does not include “sibling organizations” (i.e., entities owned or controlled by a parent company that owns or controls the Reporting Entity), unless such sibling entity has a direct relationship with or impact on the Reporting Entity.

ASSOCIATED ENTITY

The questionnaire is organized into eleven sections. Section I is to be completed for the Legal Business Entity. Section II requires the vendor to specify the Reporting Entity for the questionnaire. Section III refers to the individuals of the Reporting Entity, while Sections IV-VIII require information about the Reporting Entity. Section IX pertains to any Associated Entities, with one question about their Officials/Owners. Section X relates to disclosure under the Freedom of Information Law (FOIL). Section XI requires an authorized contact for the questionnaire information.

STRUCTURE OF THE QUESTIONNAIRE

You have selected the For-Profit Non-Construction questionnaire which may be printed and completed in this format or, for your convenience, may be completed online using the New York State VendRep System.

NYS Vendor ID: 000000000AC 3290-S (Rev. 9/13)

NEW YORK STATEVENDOR RESPONSIBILITY QUESTIONNAIRE

FOR-PROFIT BUSINESS ENTITY

Page 2 of 10

I. LEGAL BUSINESS ENTITY INFORMATIONLegal Business Entity Name* EIN

Address of the Principal Place of Business (street, city, state, zip code) New York State Vendor Identification Number

Telephoneext.

Fax

Email Website

Additional Legal Business Entity Identities: If applicable, list any other DBA, Trade Name, Former Name, Other Identity, or EIN used in the last five (5) years and the status (active or inactive).

Type Name EIN Status

1.0 Legal Business Entity Type – Check appropriate box and provide additional information:

Corporation (including PC) Date of Incorporation

Limited Liability Company (LLC or PLLC) Date of Organization

Partnership (including LLP, LP or General) Date of Registration or Establishment

Sole Proprietor How many years in business?

Other Date Established

If Other, explain:

1.1 Was the Legal Business Entity formed or incorporated in New York State? Yes No

If ‘No,’ indicate jurisdiction where Legal Business Entity was formed or incorporated and attach a Certificate of Good Standing from the applicable jurisdiction or provide an explanation if a Certificate of Good Standing is not available.

United States State

Other Country

Explain, if not available:

1.2 Is the Legal Business Entity publicly traded? Yes No

If “Yes,” provide CIK Code or Ticker Symbol

1.3 Does the Legal Business Entity have a DUNS Number? Yes No

If “Yes,” Enter DUNS Number

*All underlined terms are defined in the “New York State Vendor Responsibility Definitions List,” which can be found at www.osc.state.ny.us/vendrep/documents/questionnaire/definitions.pdf.




Page 3 of 10

I. LEGAL BUSINESS ENTITY INFORMATION1.4 If the Legal Business Entity’s Principal Place of Business is not in New York State, does the Legal Business

Entity maintain an office in New York State?(Select “N/A,” if Principal Place of Business is in New York State.)

Yes No N/A

If “Yes,” provide the address and telephone number for one office located in New York State.

1.5 Is the Legal Business Entity a New York State certified Minority-Owned Business Enterprise (MBE), Women-Owned Business Enterprise (WBE), New York State Small Business (SB) or a federally certified Disadvantaged Business Enterprise (DBE)?If “Yes,” check all that apply:

New York State certified Minority-Owned Business Enterprise (MBE) New York State certified Women-Owned Business Enterprise (WBE) New York State Small Business (SB)Federally certified Disadvantaged Business Enterprise (DBE)

Yes No

1.6 Identify Officials and Principal Owners, if applicable. For each person, include name, title and percentage of ownership. Attach additional pages if necessary. If applicable, reference to relevant SEC filing(s) containing the required information is optional.

Name Title Percentage Ownership (Enter 0% if not applicable)




Page 4 of 10

II. REPORTING ENTITY INFORMATION

2.0 The Reporting Entity for this questionnaire is: Note: Select only one.

Legal Business EntityNote: If selecting this option, “Reporting Entity” refers to the entire Legal Business Entity for the remainder of the questionnaire. (SKIP THE REMAINDER OF SECTION II AND PROCEED WITH SECTION III.)Organizational Unit within and operating under the authority of the Legal Business EntitySEE DEFINITIONS OF “R EPORTING E NTITY ” AND “O RGANIZATIONAL U NIT ” FOR ADDITIONAL INFORMATION ON CRITERIA TO QUALIFY FOR THIS SELECTION.Note: If selecting this option, “Reporting Entity” refers to the Organizational Unit within the Legal Business Entity for the remainder of the questionnaire. (COMPLETE THE REMAINDER OF SECTION II AND ALL REMAINING SECTIONS OF THIS QUESTIONNAIRE.)

IDENTIFYING INFORMATION

a) Reporting Entity Name

Address of the Primary Place of Business (street, city, state, zip code) Telephone

ext.

b) Describe the relationship of the Reporting Entity to the Legal Business Entity

c) Attach an organizational chart

d) Does the Reporting Entity have a DUNS Number? Yes No

If “Yes,” enter DUNS Number

e) Identify the designated manager(s) responsible for the business of the Reporting Entity .For each person, include name and title. Attach additional pages if necessary.

Name Title




Page 5 of 10

INSTRUCTIONS FOR SECTIONS III THROUGH VII

For each “Yes,” provide an explanation of the issue(s), relevant dates, the government entity involved, any remedial or corrective action(s) taken and the current status of the issue(s). For each “Other,” provide an explanation which provides the basis for not definitively responding “Yes” or “No.” Provide the explanation at the end of the section or attach additional sheets with numbered responses, including the Reporting Entity name at the top of any attached pages.

III. LEADERSHIP INTEGRITYWithin the past five (5) years, has any current or former reporting entity official or any individual currently or formerly having the authority to sign, execute or approve bids, proposals, contracts or supporting documentation on behalf of the reporting entity with any government entity been:

3.0 Sanctioned relative to any business or professional permit and/or license? Yes No Other

3.1 Suspended, debarred, or disqualified from any government contracting process? Yes No Other

3.2 The subject of an investigation, whether open or closed, by any government entity for a civil or criminal violation for any business-related conduct?

Yes No Other

3.3 Charged with a misdemeanor or felony, indicted, granted immunity, convicted of a crime or subject to a judgment for:a) Any business-related activity; orb) Any crime, whether or not business-related, the underlying conduct of which was related to

truthfulness?

Yes No Other

For each “Yes” or “Other” explain:

IV. INTEGRITY – CONTRACT BIDDINGWithin the past five (5) years, has the reporting entity:4.0 Been suspended or debarred from any government contracting process or been disqualified on any

government procurement, permit, license, concession, franchise or lease, including, but not limited to, debarment for a violation of New York State Workers’ Compensation or Prevailing Wage laws or New York State Procurement Lobbying Law?

Yes No

4.1 Been subject to a denial or revocation of a government prequalification? Yes No

4.2 Been denied a contract award or had a bid rejected based upon a non-responsibility finding by a government entity?

Yes No

4.3 Had a low bid rejected on a government contract for failure to make good faith efforts on any Minority- Owned Business Enterprise, Women-Owned Business Enterprise or Disadvantaged Business Enterprise goal or statutory affirmative action requirements on a previously held contract?

Yes No

4.4 Agreed to a voluntary exclusion from bidding/contracting with a government entity? Yes No

4.5 Initiated a request to withdraw a bid submitted to a government entity in lieu of responding to an information request or subsequent to a formal request to appear before the government entity?

Yes No

For each “Yes,” explain:




Page 6 of 10

V. INTEGRITY – CONTRACT AWARDWithin the past five (5) years, has the reporting entity:

5.0 Been suspended, cancelled or terminated for cause on any government contract including, but not limited to, a non-responsibility finding?

Yes No

5.1 Been subject to an administrative proceeding or civil action seeking specific performance or restitution in connection with any government contract?

Yes No

5.2 Entered into a formal monitoring agreement as a condition of a contract award from a government entity? Yes No


VI. CERTIFICATIONS/LICENSESWithin the past five (5) years, has the reporting entity:

6.0 Had a revocation, suspension or disbarment of any business or professional permit and/or license? Yes No

6.1 Had a denial, decertification, revocation or forfeiture of New York State certification of Minority-Owned Business Enterprise, Women-Owned Business Enterprise or federal certification of Disadvantaged Business Enterprise status for other than a change of ownership?

Yes No


VII. LEGAL PROCEEDINGSWithin the past five (5) years, has the reporting entity:

7.0 Been the subject of an investigation, whether open or closed, by any government entity for a civil or criminal violation?

Yes No

7.1 Been the subject of an indictment, grant of immunity, judgment or conviction (including entering into a plea bargain) for conduct constituting a crime?

Yes No

7.2 Received any OSHA citation and Notification of Penalty containing a violation classified as serious or willful?

Yes No

7.3 Had a government entity find a willful prevailing wage or supplemental payment violation or any other willful violation of New York State Labor Law?

Yes No

7.4 Entered into a consent order with the New York State Department of Environmental Conservation, or received an enforcement determination by any government entity involving a violation of federal, state or local environmental laws?

Yes No

7.5 Other than previously disclosed:a) Been subject to fines or penalties imposed by government entities which in the aggregate total $25,000

or more; orb) Been convicted of a criminal offense pursuant to any administrative and/or regulatory action taken by

any government entity?

Yes No





Page 7 of 10

VIII. FINANCIAL AND ORGANIZATIONAL CAPACITY

8.0 Within the past five (5) years, has the Reporting Entity received any formal unsatisfactory performance assessment(s) from any government entity on any contract?

Yes No

If “Yes,” provide an explanation of the issue(s), relevant dates, the government entity involved, any remedial or corrective action(s) taken and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.

8.1 Within the past five (5) years, has the Reporting Entity had any liquidated damages assessed over $25,000? Yes No

If “Yes,” provide an explanation of the issue(s), relevant dates, contracting party involved, the amount assessed and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.

8.2 Within the past five (5) years, have any liens or judgments (not including UCC filings) over $25,000 been filed against the Reporting Entity which remain undischarged?

Yes No

If “Yes,” provide an explanation of the issue(s), relevant dates, the Lien holder or Claimant’s name(s), the amount of the lien(s) and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.

8.3 In the last seven (7) years, has the Reporting Entity initiated or been the subject of any bankruptcy proceedings, whether or not closed, or is any bankruptcy proceeding pending?

Yes No

If “Yes,” provide the bankruptcy chapter number, the court name and the docket number. Indicate the current status of the proceedings as “Initiated,” “Pending” or “Closed.” Provide answer below or attach additional sheets with numbered responses.

8.4 During the past three (3) years, has the Reporting Entity failed to file or pay any tax returns required by federal, state or local tax laws?

Yes No

If “Yes,” provide the taxing jurisdiction, the type of tax, the liability year(s), the tax liability amount the Reporting Entity failed to file/pay and the current status of the tax liability. Provide answer below or attach additional sheets with numbered responses.

8.5 During the past three (3) years, has the Reporting Entity failed to file or pay any New York State unemployment insurance returns?

Yes No

If “Yes,” provide the years the Reporting Entity failed to file/pay the insurance, explain the situation and any remedial or corrective action(s) taken and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.

8.6 During the past three (3) years, has the Reporting Entity had any government audit(s) completed? Yes No

a) If “Yes,” did any audit of the Reporting Entity identify any reported significant deficiencies in internal control, fraud, illegal acts, significant violations of provisions of contract or grant agreements, significant abuse or any material disallowance?

Yes No

If “Yes” to 8.6 a), provide an explanation of the issue(s), relevant dates, the government entity involved, any remedial or corrective action(s) taken and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.




Page 8 of 10

IX. ASSOCIATED ENTITIESThis section pertains to any entity(ies) that either controls or is controlled by the reporting entity. (See definition of “associated entity” for additional information to complete this section.)

9.0 Does the Reporting Entity have any Associated Entities ?Note: All questions in this section must be answered if the Reporting Entity is either: An Organizational Unit; or The entire Legal Business Entity which controls, or is controlled by, any other entity(ies).If “No,” SKIP THE REMAINDER OF SECTION IX AND PROCEED WITH SECTION X.

Yes No

9.1 Within the past five (5) years, has any Associated Entity Official or Principal Owner been charged with a misdemeanor or felony, indicted, granted immunity, convicted of a crime or subject to a judgment for:a) Any business-related activity; orb) Any crime, whether or not business-related, the underlying conduct of which was related to

truthfulness?

Yes No

If “Yes,” provide an explanation of the issue(s), the individual involved, his/her title and role in the Associated Entity, his/her relationship to the Reporting Entity, relevant dates, the government entity involved, any remedial or corrective action(s) taken and the current status of the issue(s).

9.2 Does any Associated Entity have any currently undischarged federal, New York State, New York City or New York local government liens or judgments (not including UCC filings) over $50,000?

Yes No

If “Yes,” provide an explanation of the issue(s), identify the Associated Entity’s name(s), EIN(s), primary business activity, relationship to the Reporting Entity, relevant dates, the Lien holder or Claimant’s name(s), the amount of the lien(s) and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.

9.3 Within the past five (5) years, has any Associated Entity:

a) Been disqualified, suspended or debarred from any federal, New York State, New York City or other New York local government contracting process?

Yes No

b) Been denied a contract award or had a bid rejected based upon a non-responsibility finding by any federal, New York State, New York City, or New York local government entity?

Yes No

c) Been suspended, cancelled or terminated for cause (including for non-responsibility) on any federal, New York State, New York City or New York local government contract ?

Yes No

d) Been the subject of an investigation, whether open or closed, by any federal, New York State, New York City, or New York local government entity for a civil or criminal violation with a penalty in excess of $500,000?

Yes No

e) Been the subject of an indictment, grant of immunity, judgment, or conviction (including entering into a plea bargain) for conduct constituting a crime?

Yes No

f) Been convicted of a criminal offense pursuant to any administrative and/or regulatory action taken by any federal, New York State, New York City, or New York local government entity ?

Yes No

g) Initiated or been the subject of any bankruptcy proceedings, whether or not closed, or is any bankruptcy proceeding pending?

Yes No

For each “Yes,” provide an explanation of the issue(s), identify the Associated Entity’s name(s), EIN(s), primary business activity, relationship to the Reporting Entity, relevant dates, the government entity involved, any remedial or corrective action(s) taken and the current status of the issue(s). Provide answer below or attach additional sheets with numbered responses.




Page 9 of 10

X. FREEDOM OF INFORMATION LAW (FOIL)

10. Indicate whether any information supplied herein is believed to be exempt from disclosure under the Freedom of Information Law (FOIL).Note: A determination of whether such information is exempt from FOIL will be made at the time of any request for disclosure under FOIL.

Yes No

If “Yes,” indicate the question number(s) and explain the basis for the claim.

XI. AUTHORIZED CONTACT FOR THIS QUESTIONNAIREName Telephone

ext.

Fax

Title Email




Page 10 of 10

Certification

The undersigned: (1) recognizes that this questionnaire is submitted for the express purpose of assisting New York State government entities (including the Office of the State Comptroller (OSC)) in making responsibility determinations regarding award or approval of a contract or subcontract and that such government entities will rely on information disclosed in the questionnaire in making responsibility determinations; (2) acknowledges that the New York State government entities and OSC may, in their discretion, by means which they may choose, verify the truth and accuracy of all statements made herein; and (3) acknowledges that intentional submission of false or misleading information may result in criminal penalties under State and/or Federal Law, as well as a finding of non-responsibility, contract suspension or contract termination.

The undersigned certifies that he/she:

is knowledgeable about the submitting Business Entity’s business and operations; has read and understands all of the questions contained in the questionnaire; has not altered the content of the questionnaire in any manner; has reviewed and/or supplied full and complete responses to each question; to the best of his/her knowledge, information and belief, confirms that the Business Entity’s responses are true,

accurate and complete, including all attachments, if applicable; understands that New York State government entities will rely on the information disclosed in the

questionnaire when entering into a contract with the Business Entity; and is under an obligation to update the information provided herein to include any material changes to the

Business Entity’s responses at the time of bid/proposal submission through the contract award notification, and may be required to update the information at the request of the New York State government entities or OSC prior to the award and/or approval of a contract, or during the term of the contract.

Signature of Owner/Official

Printed Name of Signatory

Title

Name of Business

Address

City, State, Zip

Sworn to before me this day of , 20 ;

Notary Public

SDVOB Utilization Plan – SDVOB 100 (9/16)

SDVOB UTILIZATION PLAN Initial Plan Revised plan Contract/Solicitation #

INSTRUCTIONS: This Utilization Plan must contain a detailed description of the supplies and/or services to be provided by each NYS Certified Service-Disabled Veteran-Owned Business (SDVOB) under the contract. By submission of this Plan, the Bidder/Contractor commits to making good faith efforts in the utilization of SDVOB subcontractors and suppliers as required by the SDVOB goals contained in the Solicitation/Contract. Making false representations or providing information that shows a lack of good faith as part of, or in conjunction with, the submission of a Utilization Plan is prohibited by law and may result in penalties including, but not limited to, termination of a contract for cause, loss of eligibility to submit future bids, and/or withholding of payments. Firms that do not perform commercially useful functions may not be counted toward SDVOB utilization. Attach additional sheets if necessary.

BIDDER/CONTRACTOR INFORMATION SDVOB Goals In ContractBidder/Contractor Name: NYS Vendor ID: %

Bidder/Contractor Address (Street, City, State and Zip Code):

Bidder/Contractor Telephone Number: Contract Work Location/Region:

Contract Description/Title:

CONTRACTOR INFORMATIONPrepared by (Signature): Name and Title of Preparer: Telephone Number: Date:

Email Address:

If unable to meet the SDVOB goals set forth in the solicitation/contract, bidder/contractor must submit a request for waiver on the SDVOB Waiver Form.SDVOB Subcontractor/Supplier Name:

Please identify the person you contacted: Federal Identification No.: Telephone No.:

Address: Email Address:

Detailed description of work to be provided by subcontractor/supplier:

Dollar Value of subcontracts/supplies/services (When $ value cannot be estimated, provide the estimated % of contract work the SDVOB will perform): $ or %

SDVOB Subcontractor/Supplier Name:



Detailed Description of work to be provided by subcontractor/supplier:


FOR [Agency] USE ONLY[Agency] Authorized Signature: Accepted Accepted as Noted Notice of Deficiency

NAME (Please Print): SDVOB%/$

Date Received: Date Processed:

Comments:NYS CERTIFIED SDVOB SUBCONTRACTOR/SUPPLIER INFORMATION: The directory of New York State Certified SDVOBs can be viewed at: https://ogs.ny.gov/Veterans/default.aspNote: All listed Subcontractors/Suppliers will be contacted and verified by [Agency].

SDVOB Utilization Form extra (9/16)

Contract/Solicitation #Bidder/Contractor Name:

ADDITIONAL SHEET




















Dollar Value of subcontracts/supplies/services (When $ value cannot be estimated, provide the estimated % of contract work the SDVOB will perform)): $ or %






Attachment 14 NYS Office of Information Technology Services (ITS) Competitive Procurement for: IFB# C000579 Page 1 of 1NYEnet Fiber Maintenance and Locating Services

Affirmative Statements - Sworn to by the Bidder

DO NOT ADD, REMOVE OR REARRANGE ANY COLUMNS OR ROWS.

An authorized signatory for the bidder must initial the fields in yellow. Bidder Name-

Affirmative Statement Response1. Bidder affirms that the proposal was signed and executed by an individual with the capacity and legal authority to bind the Bidder in its offer to the State.2. Bidder affirms that it accepts all of the terms and conditions set forth in this IFB, including all amendments, appendices and attachments, and must agree to enter a contractual agreement containing, at a minimum, the terms and conditions identified in this IFB.

3. Bidder affirms that its Administrative, Technical and Financial Proposals remain open and valid for at least 180 days from the due date of this IFB, unless the time for awarding the Contract is extended by mutual consent of ITS and the Bidder.4. Bidder affirms that its Administrative, Technical and Financial Proposals shall continue to remain an effective offer, firm and irrevocable, subsequent to such 180 day period until either tentative award of the Contract by ITS is made or withdrawal of the proposal in writing by Bidder. Tentative award of the Contract shall consist of written notice to that effect by ITS to a successful Bidder, who shall thereupon be obligated to execute a formal Contract.

5. Bidder affirms that in its fulfillment of obligations as proposed in its response to the IFB, it does not violate any existing contracts or agreements between the Bidder and the State.

6. Bidder affirms that, in its fulfillment of obligations as proposed in its response to the IFB, it does not or will not create any conflict of interest, or perception thereof, with any current role or responsibility the Bidder has with regard to any existing contracts or agreements between the Bidder and the State.

7. Bidder affirms that, in its fulfillment of obligations as proposed in the response, it does not and will not compromise the Bidder’s ability to carry out its obligations under any existing contracts between the Bidder and the State.

8. Bidder affirms that during the negotiation and execution of any contract resulting from this IFB, the Bidder will not knowingly take any action or make any decision which creates a potential for conflict of interest or might cause a detrimental impact to the State as a whole, including but not limited to, any action or decision to divert resources from one State project to another.

9. Bidder affirms that in fulfilling obligations under each of its State contracts, including any contract which results from this IFB, the Bidder will act in accordance with the terms of each of its State contracts and will not knowingly take any action or make any decision which might cause a detrimental impact to the State as a whole including but not limited to, any action or decision to divert resources from one State project to another.

10. Bidder affirms that the Bidder commits to obtaining all necessary proof of insurance with their proposal (see Appendix C-1 for detailed insurance requirements).

11. Bidder affirms that if awarded a contract, the Bidder must provide proof of current insurance, certifications, licensing, etc. throughout the contract term.

12. Bidder affirms that it shall be fully responsible to ITS for the acts and omissions of, and the performance of Project Services by, all subcontractors and/or persons either directly or indirectly employed by such subcontractors. This statement must acknowledge that the Bidder shall not in any way be relieved of any programmatic or financial responsibility under the Contract by the terms of its agreement with any subcontractor.

13. Bidder affirms that if selected, the successful Bidder is prepared to commence performance of services described herein.

14. Bidder affirms that it will comply with Federal Executive Order 11246, the Copeland “Anti-Kickback Act” (18 USC 874), Section 508 of the Federal Clean Air Act, and Section 306 of the Federal Clean Water Act.

15. Bidder affirms that neither it nor its principals are debarred or suspended from Federal financial assistance programs and activities.

16. Bidder affirms that it will comply with the provisions of Section 5151-5160 of the Drug-Free Workplace Act of 1988 (Pub. L. 100-690, Title V, Subtitle D; 41 U.S.C. 701 et seq.).

17. Bidder affirms that no Federal funds will be used to lobby or influence a Federal officer or a Member of Congress.

IFB C000579 – NYEnet Fiber Maintenance and Locating ServicesAttachment 15: Technical Plan

1

When completing the Technical Plan Content, DO NOT include any pricing information, only include the following information in the order enumerated below.

PART 1: TECHNICAL PLAN OVERVIEW1.1 Executive SummaryProvide a brief description (not more than two pages) that summarizes your proposed approach and work effort.

1.2 Table of ContentsUse the following Table of Contents that reflects the areas identified in the Technical Bid. The Table of Contents should identify each major section of the Bid, along with its initial-page number.

Part 1: Technical Plan Overview.................................................................................................................. 1

1.1 Executive Summary......................................................................................................................... 1

1.2 Table of Contents............................................................................................................................. 1

Part 2: Bidder’s Experience......................................................................................................................... 3

2.1 Corporate/Business Background of Primary Bidder.........................................................................3

2.2 Corporate/Business Background of Subcontractor..........................................................................4

2.3 Past Performance and Experience..................................................................................................5

3. History of working with proposed subcontractor..............................................................................7

Part 3 - Engagement Approach – (limited to 30 pages)...............................................................................8

3.1 MANDATORY SERVICE REQUIREMENTS......................................................................................8

3.1.1 General Requirements.................................................................................................................... 8

3.1.2 Conduit, Manhole, Handholes, Fiber Repairs..................................................................................9

3.1.3 Design Consultation and MAC-D Work/Process...........................................................................10

3.1.4 Right of Way Management............................................................................................................11

3.1.5 Construction Inspection.................................................................................................................11

3.1.6 Review of and Response to Dig Safely NY Tickets.......................................................................11

3.1.7 Locating Services Including GIS Mapping.....................................................................................12

3.1.8 GIS Mapping................................................................................................................................. 13

3.1.9 System Patrolling and Inspections................................................................................................14

3.1.10 Emergency Repairs..................................................................................................................... 15

3.1.11 Communications Requirements, Experience and Project Management Plan.............................16

3.1.12 Knowledge Transfer and Training Requirements........................................................................17

Part 3.2 - Key Personnel Roles and Requirements...................................................................................18

Key Personnel........................................................................................................................................ 18

Staffing Plan........................................................................................................................................... 18


2

Part 4 - Service Level Requirements.........................................................................................................19

4.1 General Service requirements..........................................................................................................19

4.2 Locating Services............................................................................................................................. 19

4.3 Repair Response Times...................................................................................................................20

4.4 Service Level Credits.......................................................................................................................21

Description of the company’s corporate profile core business


3

PART 2: BIDDER’S EXPERIENCEThe Technical Plan must demonstrate to ITS that the Bidder has experience delivering services similar in scale and scope to the engagement described in this IFB. Complete the Bidder’s Experience form below to describe your company’s background and past experience.

2.1 Corporate/Business Background of Primary BidderBidder’s Firm/Company Information

Firm Name

Firm Address

Parent Company

Affiliates

Other Locations/ Branches (if any)

Bidder’s Primary Contact

Name, Title

Address

Email Address

Telephone Number

Company Profile

Description of the company’s corporate profile core business


4

Service Offerings

Description of Service Years the Service has been provided

Fiber Leasing

Fiber Maintenance

Fiber Installation

2.2 Corporate/Business Background of SubcontractorNote: copy and complete this section for each subcontractor proposed

Subcontractor Firm/Company Information

Firm Name

Firm Address

Parent Company

Affiliates

Other Locations/ Branches (if any)

Subcontractor’s Primary Contact

Name, Title

Address

Email Address

Telephone Number

Subcontractor Profile

Engagement Conducted By (Bidder/Subcontractor Company Name)

Start Date End DateName of Client

Engagement Description - #


5

Service Offerings related to this IFB

Description of service Years the Service has been provided

2.3 Past Performance and Experience

Note: copy and complete this section for each engagement identifiedThe Bidder must describe its previous experience that qualifies the Bidder to provide the Services.

1. Within the past ten (10) years, the Bidder must have a minimum of five (5) years of fiber optic cabling installation, locating, and maintenance experience.

Services Experience

Engagement Conducted By (Bidder/Subcontractor Company Name)

Start Date End DateName of Client

Engagement Description - #


6

2. The Bidder must have five (5) years of experience of maintaining a minimum of thirty (30) miles of fiber optic backbone cabling along highway and municipality right of ways (ROW) infrastructure. This must include a minimum of ten (10) miles of buried conduit and fiber.

Nature of Client’s businessClient Contact Information (Name, address, phone, email)

Description of services Provided

Number and skills of staff involved

Engagement results and benefits delivered to the client

Engagement budget

Size and complexity of engagement, including the number of sites and users within the Continental US

Number of engagements worked together:

Start DateEnd DateEngagementPercent budget splitbudgetbetween firms

Engagement # - Describenature of relationship


7

3. History of working with proposed subcontractor

If subcontractors are part of the Bid, prior engagement descriptions may include engagements conducted by the subcontractor(s). The description of Bidder's prior experience must include information about its history working with the proposed subcontractors (e.g., nature of relationship, number of engagements worked together, duration of engagements, budget of engagement, percent split between firms).

Note: copy and complete this section for each engagement described

Nature of Client’s businessClient Contact Information (Name, address, phone, email)

Description of services Provided

Number and skills of staff involved

Engagement results and benefits delivered to the client

Engagement budget

Size and complexity of engagement, including the number of sites and users within the Continental US


8

PART 3 - ENGAGEMENT APPROACH – (LIMITED TO 30 PAGES)In this section of the Technical Proposal, Bidders should demonstrate that they will fulfill the requirements set forth in the IFB.

3.1 MANDATORY SERVICE REQUIREMENTS3.1.1 General Requirements

The Contractor must provide maintenance, construction, locating, and repair services for the Tributary Fibers. Under the terms of the resulting contract, the Contractor must perform the following:

1. The Contractor must maintain a staff of qualified maintenance personnel to perform maintenance and repair of the Tributary Fibers on a twenty-four (24) hour a day, seven (7) day a week basis. Maintenance personnel must be certified in the operation of optical transmission equipment. Personnel must also be experienced in operating fiber optic testing equipment including OTDRs, BERT, Optical power meters, fiber optic trouble shooting and repair equipment (Fusion Splicing Rig) and electromagnetic radio detection cable locating equipment, and ground penetrating radar. The Contractor’s Project Manager (“PM”) and maintenance personnel must also be knowledgeable in all areas of fiber optic safety, OSHA regulations, and proper NYS Department of Transportation (“DOT”) traffic management techniques.

2. The Contractor must adhere with all NYS Department of Labor guidelines regarding prevailing wages. Please note PRC# 2019010547 has been assigned for the purposes of this solicitation and any resultant contract (see Exhibit H – Prevailing Wage).

3. The Contractor must adhere to OSHA requirements, https://www.osha.gov/, while working for ITS. Prior to starting work, the Contractor must provide ITS with satisfactory evidence that all current OSHA requirements will be adequately addressed. At a minimum, the Contractor must provide a written Safety and Health Plan which documents the Contractor’s company policy relative to safety, and which addresses specific safety and health concerns to be encountered during the term of the contract resulting from this solicitation. At a minimum the plan must include the following items: identification of the project and company safety officers; hazardous materials communication plan; employee safety training program; procedures for compelling worker compliance with safety and health requirements; and procedures to address project safety and health concerns (e.g., site specific fall protection plan, silica exposure control plans).

4. The Contractor must work with the NYSTA, their Operations and Maintenance Provider, and other entities regarding any activities that may affect their operations within the NYSTA Right of Way, regeneration facilities, or any municipality.

5. The Contractor must provide reporting and other documentation in a manner approved by ITS. This may require providing reports and other corresponding documentation as requested by ITS. The required reports are detailed in the Sections below. The reports will be tied to payment schedules. If reporting is not completed as required by ITS, Contractor will be notified and will need to correct prior to the current invoice being approved.

6. The Contractor will be held fully liable for failure to adhere to the mandatory requirements within this IFB that result in damages to any Tributary Fibers.


9

7. The Contractor must propose labor rates for all billable employees used to perform repair, monitoring, and relocation services to the Tributary Fibers using the Contractor’s Financial Bid. These rates will be utilized in the evaluation of the bids prior to award. The Contractor must identify any Labor Mark- up and Overhead rates that will be utilized in final billing in Attachment 12 – Financial Bid Workbook. Please note that the proposed rates must be inclusive of all direct and indirect costs, fees, profit and all overhead expenses, including, but not limited to, all training, travel costs, parking fees, and other ancillary fees and costs including permits, licenses, and insurance.

8. Quantities and types of materials utilized for repairs and alterations must be identified on invoicing. The purchase invoices for the materials utilized by the Contractor must accompany billing to ITS. The Contractor must identify their percentage mark-up, or Discount on Manufacturers Suggested Retail Price, on materials used in Attachment 12 – Financial Bid Workbook. These rates will be utilized in the evaluation of the bids prior to award.

9. ITS reserves the right to add or delete maintenance on a specific Tributary Fiber Route(s) as business needs dictate. A three (3) month notice shall be provided to the Contractor prior to adding or deleting maintenance.

3.1.2 Conduit, Manhole, Handholes, Fiber RepairsThe Contractor must maintain the underground conduits, duct banks and fiber optic cables in accordance with EIA/TIA industry standard. The Contractor will be responsible for any damage to the Tributary Fibers and will restore all working circuits in accordance with the Service Levels identified in Section 4 of this solicitation.

1. New fiber installations will utilize armored cable to allow the cable to be located. Attachment points for locating shall be maintained.

2. All fiber optic splicing will be performed within a climate-controlled environment and allow the splicer the ability to perform work to meet EIA/TIA industry standards.

3. All splice enclosures must be properly sealed to prevent water infiltration.

4. The Contractor must label all cables at every access point including manholes and pull boxes.

5. The Contractor must install jumpers as requested by ITS and be tested bi-directionally; all fibers will be tested bi-directionally at 1310nm and 1550nm with electronic reports provided with traces to ITS upon completion of all work.

6. Conduits will be buried at 36” when possible and encased in concrete or in a steel sleeve in locations where road traffic will cross them.

7. Pull boxes or manholes, as appropriate, shall be used at intervals of no more than 500’. A pull box or manhole will be installed in any conduit run that utilizes two (2) consecutive 90-degree conduit turns.

8. The Contractor is responsible for making any necessary changes to the conduit system due to changes requested by the entity with direct ownership of the property in which the conduit is located, e.g., changes in street elevation. These changes may frequently involve fiber optic cable repair work including, but not limited to, segment splicing cables, installing cable segments and ring splicing. The physical work is expected to be provided on a time and materials basis to be billable back to ITS and will require a Bid from the Contractor. ITS will not be responsible for the costs in developing the Bid for such work.

9. For any damages to the Tributary Fibers, the Contractor must assist ITS in determining the cause of the damage and work with ITS to assess charges for any repairs to any party identified as causing the damage.


10

10. The Contractor must work with ITS to identify ITS’ pro-rata share of any work that is required, but is not able to be billed, to other entities. Work requested by entities requesting a work agreement (e.g., DOT) must be reviewed and executed by ITS prior to the Contractor beginning work.

11. Fiber and conduit occupied by Lessees requires the Contractor to work with the Lessee to negotiate payment for relocation of their fiber facilities and a pro-rata share of moving the conduit.

12. Depending upon how User Agreements are structured with conduit Lessees, the Contractor may be required to provide facility access and monitoring of Lessee’s fiber installers and repair crews to protect the Tributary Fibers.

13. The Contractor must adjust manhole elevations in any of the municipalities where the Tributary Fiber pass through to accommodate community paving schedules and to facilitate manhole cover repairs. The Contractor will notify ITS with a proper estimate for any manhole elevation repair work that needs to be performed. ITS will review and provide approval for the work. Contractor will invoice ITS separately for such services based upon time and materials using the labor rates and percentage mark-up or discount on MSRP. On average, there are 10 – 12 manhole elevation changes annually.

14. The Contractor will be responsible for accessing manholes and pull boxes, including any water removal as necessary, as needed for locating, maintenance, repair, labeling or at the request of ITS staff for information discovery.

15. The Contractor must make splice changes as required to maintain the Tributary Fibers to technical specifications. This will include changes within a manhole as well as splicing changes within. For example, a NYS Facility, pull box, manhole, or regeneration site. The Contractor will invoice ITS separately for such services based upon time and materials using the labor rates and percentage mark-up or discount on MSRP. On average this will occur 3 – 5 times per year.

16. The Contractor must conduct OTDR testing as requested by ITS.

3.1.3 Design Consultation and MAC-D Work/Process

1. The Contractor must review and provide recommendations to ITS about feasibility studies, route design plans or system alterations that may have an impact on the Tributary Fibers and Rights of Way. The Contractor’s recommendations will include, but not be limited to the following areas: installation, relocation or replacement of ducts, conduit, fiber optic cables, manholes and handholes. The Contractor must include such costs in its maintenance rates in their Financial Bid. On average this will occur 2 – 3 times per year.

2. For MAC-D Work, the Contractor must: develop and provide cost estimates for the scope of the work based upon the labor rates and material discounts/markups provided in their Financial Bid; provide a turnkey solution; ensure proper permits (e.g., construction permits) are secured; and inspect the work to ensure adherence to the requirements set forth in this solicitation. ITS reserves the right to reject cost estimates submitted, request new cost estimates, or obtain quotes from other contractors.

3. The Contractor must provide a mutually acceptable design for system alterations that satisfies ITS, Lessees, and any other entities that are requiring Tributary Fiber alterations.

4. The Contractor must ensure that any modifications, e.g., to fiber, conduit, manholes, etc., in conjunction with these alterations are tested to the pre-modification performance levels and adhere to the requirements of this IFB.

5. As MAC-D work is performed and fiber and/or conduit repairs are made, and as site conditions change, the “As-Built” drawings must be updated to reflect any changes.


11

3.1.4 Right of Way Management

1. The Contractor will assist NYS ITS with management and oversight of existing Right of Way (“ROW”) agreements pertaining to the Tributary Fibers (see Exhibit E Table of ROW Agreements).

2. The Contractor must assist ITS in establishing any new ROW agreements for any alterations or extensions of the Tributary Fibers.

3. NYS ITS will pay any ROW maintenance fees as a part of the contract resulting from this solicitation.

4. The Contractor must provide recommendations for necessary alterations to the ROW and ROW agreements.

5. The Contractor must provide bi-annual reporting on ROW agreement status, fees, maintenance and expiration dates if applicable.

6. The Contractor will be responsible for complying with any Federal, State and Local laws, rules, regulations, guidelines, statutes, ordinances, and codes regarding work and use of the applicable ROW. The Contractor will be expected to work with all authorities having jurisdiction to ensure proper safety procedures are followed while working in the public right of way.

3.1.5 Construction InspectionThe Contractor must provide inspection services during any construction work performed by others near the Tributary Fibers, as required in this IFB or as requested by ITS. The Contractor must monitor the construction work and be available to make field decisions related to the protection of the Tributary Fibers. The Contractor must also be prepared to repair any damages to the fiber facilities (including excavation, repairing or replacing innerduct or conduit) that may occur during the work pursuant to Section 3.1.1.

General requirements for construction inspections in the proximity of the Tributary Fibers:

1. The Contractor must physically monitor/inspect all construction activities that are within ten (10) feet of the Tributary Fibers.

2. The Contractor must notify ITS and each Lessee as soon as the Contractor is aware of the scheduled start date of any construction activities and keep all parties apprised of any situational changes (i.e., damage, work stoppage, impending danger, etc.).

3. The Contractor must maintain communication with the construction crew(s) performing the work to ensure the schedule of activities have not been altered and to maintain close control of maintenance activities.

4. The Contractor must track and maintain records of all construction related activities along the Tributary Fibers and include in a quarterly report. Additional construction activity reporting may be required more frequently due to the nature of the project and Lessee requirements.

3.1.6 Review of and Response to Dig Safely NY TicketsThe Contractor must maintain, manage, and oversee ITS’ Tributary Fiber listing on the Dig Safely NY system. The Contractor must perform all duties and responsibilities outlined below including, but not limited to, the following:

1. The Contractor must be able to identify and locate the Tributary Fibers.


12

2. The Contractor must adhere to all rules and regulations set forth by the New York State Department of Public Service regarding the protection of underground facilities.

3. The Contractor must have an account with Dig Safely NY to establish a payment plan and method of delivery of locating tickets. The Contractor may receive tickets in any manner provided by Dig Safely NY that is most cost effective to them. The Contractor must pay all Dig Safely NY invoices for providing locating tickets and update the member profile.

4. The Contractor must accept all tickets from Dig Safely NY, respond to those ticket requests within the time frames established by the Dig Safely Organization, and determine if the Tributary Fibers are in danger of being damaged.

5. The Contractor must update Dig Safely NY with all changes to Tributary Fiber locations covered under the contract resulting from this solicitation.

6. The Contractor must collect digital location data (see Sections 3.1.7 and 3.1.8 of this IFB) while in the field responding to tickets, update the GIS database (geodatabase), and provide such data to ITS in quarterly reporting.

7. The Contractor must mark-out any Tributary Fibers utilizing the latest locating technologies available. Mark-outs must be with paint and/or flags that will identify the Tributary Fiber as belonging to ITS with the Contractor’s contact number affixed to each flag.

8. The Contractor must photograph all NYS mark-outs for Dig Safely NY tickets and maintain a record of the markings in the event the Tributary Fibers are damaged during excavation. The record must contain a copy of the ticket, the date of the mark-out and/or refresh of the mark- outs.

9. The Contractor must comply with the Service Level Requirements set forth in Section 4.2 below, clear all tickets with Dig Safely NY, and provide monthly reporting information on all Dig Safely NY tickets received which must include the following information:

i. Date and time requests are received from Dig Safely NY;

ii. Date and time the Locating Technician arrives on site;

iii. Location for the dig safely request;

iv. Request number; and

v. Resolution of the ticket, (cleared, marked-out, refreshed mark-outs, dispatched technician).

3.1.7 Locating Services Including GIS Mapping

The Contractor must perform all of the following duties and responsibilities outlined below, including, but not limited to:

1. The Contractor must be able to identify and locate the Tributary Fibers.

2. The Contractor must be available for all calls to open manholes to assist in identifying existing cable infrastructure within a conduit system.

3. The Contractor must mark-out any Tributary Fibers utilizing the latest locating technologies available. Mark-outs must be with paint and/or flags that will identify the Tributary Fiber as belonging to ITS with the Contractor’s contact number affixed to each flag.


13

4. The Contractor must gather photographic evidence of the mark-out and maintain files with these records for future use in the event the Tributary Fibers are damaged by excavators.

5. The Contractor must enter manholes or pull boxes and attach locating equipment to the Tributary Fibers for locating purposes.

6. If the Tributary Fibers need to be accessed, the Contractor must verify that cables are labeled. If cables are not labeled, the Contractor must label them with a weatherproof wrap-around label with “NYS ITS”, and a cable ID number to be provided by ITS.

7. The Contractor must collect digital location data while locating conduit network routes and use the data to update and/or improve the locational accuracy of ITS’ ESRI ArcGIS geodatabase. The Contractor must deliver updated copies of the geodatabase to ITS on a quarterly basis (see Section 3.1.8).

8. The Contractor must provide a monthly report that includes at least the following information: location data, number of locates made, and date of locates.

3.1.8 GIS Mapping

The Contractor must provide GIS Services suitable for maintaining the accuracy and completeness of ITS’ ESRI ArcGIS geodatabase which catalogs ITS’ cable pathways and related telecommunication assets located within each Tributary Fiber area. Existing maps identifying the Tributary Fibers to be located under this proposed engagement were created using the current geodatabase and are provided under Exhibit A- NYS Tributary Fiber Maps. The Contractor will be supplied with a copy of the geodatabase used to create the maps and linear footage table by ITS upon contract award.

1. ITS recognizes that the information identified in the ITS ESRI geodatabase may not be 100% accurate. The Contractor must collect the requisite data to ensure the accuracy of the geodatabase.

2. The Contractor must have software that is compatible with the ESRI ArcGIS geodatabase.

3. Over the contract term, the Contractor must collect Global Positioning System (“GPS”) coordinate data associated with the physical location of the Tributary Fibers.

4. The Contractor must use this GPS coordinate data to add features (facilities) and improve the positional accuracy of existing features in the geodatabase in the course of responding to Dig Safely NY tickets and performing Locating Services.

5. The Contractor must use the data collected while in the course of responding to Dig Safely NY tickets and performing Locating Services to update the ESRI ArcGIS geodatabase.

6. The geodatabase contains five (5) tables. Two (2) tables must be maintained by the Contractor. The tables and their data fields that must be maintained are:

Table 1: Cable Pathways (1709 records currently exist in this table)

o Table 1 fields: DIG_SAFE, OWNERSHIP, TYPE, ROUTE, MUNI, COMMENTS, DATEMODATT, DATEMODGEO

Table 2: Manholes (1147 records currently exist in this table)

o Table 2 fields: CATEGORY, OWNERSHIP, ORIGINAL ID, FIBER ID, ROUTE, STATUS, MANHOLE PROFILES, SLACK LOOP, SPLICE POINT, COMMENTS, DATEMODATT, DATEMODGEO


14

7. ITS’ geodatabase conforms to the following coordinate system and projection: NAD 1983 (2011) UTM Zone 18N using the Transverse Mercator projection (WKID 6347).

8. The Contractor must make positional updates to the geodatabase with sub-meter accuracy.

9. The Contractor must use data from the NYSDOT Continuously Operating Reference Stations (“CORS”) network (http://cors.dot.ny.gov/spiderweb/frmIndex.aspx) to post process GPS data collected in the field.

10. The data format (ESRI geodatabase), data schema (tables and fields) and geographic coordinate system projection must be maintained as is, unless changes are agreed to in writing by ITS.

11. The Contractor must update the DATEMODATT and/or the DATEMODGEO fields with the date a new feature is added, or an existing feature is modified, including the situation where only an attribute is updated.

12. The Contractor must deliver updated copies of the geodatabase to ITS on a quarterly basis.

3.1.9 System Patrolling and Inspections

System patrolling consists of identifying and minimizing potential hazards to the Tributary Fibers. This includes, but is not limited to: verifying locates that have been requested and completed; replacing missing or damaged buried cable markers; observation of others excavating around the Tributary Fibers who failed to notify Dig Safely NY; and looking for degrading site conditions such as erosion, flood or rodent damage, or site alterations that could potentially impact the Tributary Fibers.

1. The Contractor must patrol the entire system once every two weeks. System patrolling must generally consist of drive-by patrols, while more detailed field inspections will occur on foot as deemed necessary by the Contractor or as directed by ITS.

2. The Contractor must look for excavation activities that may potentially interfere with the Tributary Fibers and determine if the excavator has submitted the proper UFPO request prior to excavation activities. If it has been determined that the excavator has not done so, the Contractor is responsible for verbally telling the excavator to cease and desist then provide a written notice, to be provided by ITS, informing them of the legal and financial risks associated with damaging underground facilities.

3. The Contractor must provide a detailed inspection with reporting on the status of the entire system, minimally, on a quarterly basis. This detailed inspection and the report must include:

a. A visual inspection of all handholes (HH), manholes (MH), and splice points.i. Verification that all HH/MH are either buried, locked or otherwise secured. The

Contractor must ensure that all covers are in place and buried or locked.ii. The Contractor must verify the operation of locating balls within various MH and

HH structures. The Contractor must install locating balls as necessary to facilitate locating MH and HH structures if they are malfunctioning or not found. It is unknown how many MH or HH structures currently have these locating balls. Reporting will detail which MH/HH have these balls and which are lacking.

b. Conduit / duct bank inspectioni. The Contractor must inspect for sinkholes, hazardous equipment in vicinity of

system, etc.


15

c. Bridge attachment inspectionsi. The Contractor must rate the condition of the Tributary Fiber on a per-span basis,

including pipes, ducts, conduits, wires, junction boxes, expansion joints, couplings, pipe installation, and support bracing.

ii. The Contractor must inspect for breaks, cracks, loose coverings, expansion joint problems, and rust on the conduit pipes, ducts, and metallic pull boxes.

iii. The Contractor must check for rodent activity and take necessary steps to eliminate or prevent rodent activity.

iv. The Contractor must inspect the supports for corrosion, loose connections, or lack of rigidity.

v. The Contractor must check for any damage to the conduit support structure.vi. The Contractor must take pictures as necessary to accurately document the field

conditions.vii. The Contractor must perform repairs as the situation dictates.viii. The Contractor must provide reporting on any deficiencies.

4. The Contractor must keep daily logs for all patrolling and inspection activities. The Contractor must provide individual system patrolling and inspection logs upon request to ITS. The Contractor must submit reports summarizing the System Patrolling and Inspection activities monthly. Reports must be organized by Tributary Fiber (see Exhibit D – NYSTA Fiber System Links Overview Drawing) and must contain the inspector’s name, dates and times of patrols, mile posts, potential hazards found, hazards reported, actions taken, pictures for documentation, and final conditions. Reports must be signed by the inspectors and the PM. A sample report can be found in Exhibit G – Forms. The Contractor may use this format or submit a draft report template for approval by ITS within ten(10) business days of final contract award.

5. The Contractor must notify ITS by phone at (518) 408-6302 Monday through Friday between the hours of 7:30am and 5:00pm, or the ITS Network Operations Center (NOC) (1-800-234-5364) during off hours, and provide notification in writing to ITS if damage is discovered to a Tributary Fiber, by no later than the end of that business day. Correction of any problems will be addressed under Emergency Repairs or Non-Emergency Repairs at the direction of ITS. In the event that the Tributary Fiber is in imminent danger of service disruption, the Contractor must contact ITS immediately to determine a course of action and begin repairs as directed, in conformance with the Service Level Requirements set forth in Section 4 of this IFB. Any Emergency Repairs must be completed in accordance with the time and material rates established in Attachment 12 – Financial Bid Workbook. Some examples of damages to Tributary Fibers are, rotted metallic pull-boxes, exposed fiber or copper cables, damaged manhole/pull box lids or covers, shifting of manhole rings, sagging or deteriorated aerial messenger strand, etc.

6. Completion of minor repairs, such as replacing buried cable markers and signs, must be considered incidental to routine maintenance services and no separate payments will be made. However, the Contractor must provide written documentation of these repairs, including the materials used. Large repairs (over $5000 in value) will require the MAC-D process set forth in Section 3.1.3 and will need a detailed cost estimate to facilitate the repairs. The cost estimate must be provided to ITS for funding approval before proceeding with repairs. Any material purchases must be made in accordance with the rates and discounts established in Attachment 12 – Financial Bid Workbook.

3.1.10 Emergency RepairsIn addition to the definition of “emergency’ in Appendix C, for purposes of this solicitation, and the resulting


16

contract, “emergency” shall be defined as any event to occur that disrupts service or seriously threatens to


17

cause a service outage, or causes significant damage to any portion of the Tributary Fibers including damages to the following:

Manholes

Handholes

Fiber cable cuts

Fiber cable hits (by machine or by hand excavation).

Direct buried duct hits (HDPE, PVC, steel, Flexible and Rigid, etc.)

Facility conduit entrances

Buried fiber markers and signs

Messenger cables

Poles

Lashing

The Contractor must respond to all reports of service interruption as an Emergency Response with a crew prepared to restore services. Restoration may involve splicing fiber, conduit restoration, coordination with other utilities, coordination with local municipalities, and traffic management.

These services will be provided on a time and materials basis in accordance with the labor rates and material discounts/markups provided by Contractor in their Financial Bid. The Contractor must identify the personnel positions involved in the repair and restoration, the number of hours each position was utilized, and any materials utilized in the repairs when submitting for payment. All pricing must adhere to submissions identified in Attachment 12 – Financial Bid Workbook. The Contractor must be able to verify the number of hours for each position utilized.

Repair response times and delay penalties are defined in Section 4 of this IFB.

3.1.11 Communications Requirements, Experience and Project Management Plan

1. Contractor must have a detailed communication plan approved by ITS.2. General coordination meetings will be held monthly. However, during periods of heavy construction

activity in a Tributary Fiber area, these meetings will be held more frequently. However, more or fewer meetings will be held as needs dictate. The Contractor must draft minutes following each meeting, as well as submit them to ITS’ Web Based Project Management System (e.g., SharePoint).

3. The Contractor must coordinate with ITS’ Project Manager or designee, and such other third parties and stakeholders as ITS may designate, to determine the needs and schedule for specific maintenance and other fiber related activities. This will include active and upcoming construction contracts and evaluating general construction schedules to determine if there will be potential impacts to the Tributary Fibers.

4. The Contractor must provide a detailed transition plan ten (10) business days after the contract is awarded.

5. As part of the Technical Bid (Attachment 11 and Attachment 15), Contractors must submit a detailed and comprehensive project management plan that includes, but is not limited to: a description of how the Contractor will meet the requirements set forth in this solicitation; a staffing organization chart that identifies key roles; a description of the Contractor’s ability to manage the size and scope of theTributary Fibers, and the Contractor’s ability to complete the scope of services efficiently and cost effectively.


18

6. The Contractor will receive detailed AutoCAD documentation in the form of fiber optic/conduit as-built drawings that contain details regarding locations of ducts, manholes, and handholes, and the varied amount of fiber contained within such ducts across the State. The Contractor will be responsible for maintaining these records and providing ITS with up to date records in AutoCAD format on a bi- annual basis. This shall include any adjustment prompted by MAC-D. The Contractor will meet bi- annually with ITS to review the documented changes.

7. The Contractor must maintain a designated phone number, or contact, that is available to be answered/contacted on a 24 hour per day, 7 day per week, 365 days per year basis that can dispatch maintenance staff as needed.

a. The Contractor must log all daily network activities. (see the Trouble Reporting Form in Exhibit G).

b. The Contractor must, after consultation with ITS, categorize any troubles reported as Major (service affecting), Critical (also service affecting), or Minor (non-service affecting).

c. The Contractor must dispatch the appropriate technical staff to address any trouble tickets that are issued.

d. The Contractor must create trouble tickets (see the Trouble Ticket Log Form in Exhibit G) that contain the following information:

i. An individual ticket identification number.ii. A description of the problem.iii. The month, day, year and time reported.iv. Name of the person or company reporting the problem.v. The contact information for that person, phone number, cell phone number and email

address.vi. The month, day, year and time dispatched.vii. The name of the Field Technicians dispatched.viii. The actions taken to resolve the problem.ix. The month, day, year and time of resolution.x. Any follow up actions required.

e. A log of trouble tickets issued (see the Trouble Ticket Log Form in Exhibit G) must be maintained by the Contractor. The log will contain the ticket identification number, date and time the ticket was opened, the name of the personnel opening and closing the ticket.

8. The Contractor must maintain and complete a pending construction activities form (see Pending Construction Activities Form in Exhibit G). The Field Technicians must complete this form as needed and copies will be maintained by the Contractor and provided at the monthly meeting.

3.1.12 Knowledge Transfer and Training RequirementsDuring the Transition Period when the term of the contract resulting from this solicitation is scheduled to expire, as described in Appendix C – ITS Standard Contract Clauses, the Contractor must provide knowledge transfer services for a time period to be determined by ITS, not to exceed sixty (60) days, should ITS or a third-party take over the responsibilities of the contract resulting from this solicitation.


19

PART 3.2 - KEY PERSONNEL ROLES AND REQUIREMENTSIn this section of the Technical Proposal, Bidders should demonstrate that proposed staff have the necessary knowledge and demonstrated ability to provide the services required by this IFB. ITS reserves the right to reject any personnel proposed by Bidder and will review and approve any substitutions in staff from those proposed by the Bidder in its Proposal.

Key PersonnelThe Proposal shall include experience profiles/resumes for all proposed Key Personnel (including any subcontractors) for the following roles using the format below.

Project Manager New York State Professional Engineer CAD Technician Splicing Technician Locating Manager Locating Technician Registered Communications Distribution Designer (RDCC)

Person Name: Proposed Role:

Professional associations, certifications, and degrees:

Number of years of relevant experience in the proposed role:

Description of relevant experience:

Staffing PlanBidders are required to complete a staffing plan that provides the following. (Limited to 5 pages)

If subcontractors are to be used, the staffing plan shall describe the specific need for the expertise of the subcontractor and describe the contractual arrangements with the subcontractor.

A description of the experience and actual training completed by existing staff to be assigned to the Contract

A description of the training to be provided by Bidder to new hires before they are assigned to the Contract.


20

A description of whether staff will be dedicated to this engagement or shared with other engagement.

A plan to notify ITS of any proposed changes for the key personnel. Include proposed procedures to replace the Key Personnel with someone possessing equal or greater qualifications if required by ITS.

PART 4 - SERVICE LEVEL REQUIREMENTSIn this section of the Technical Proposal, Bidders should demonstrate that they can fulfil the Service Level Requirements set forth in the IFB.

4.1 General Service requirements1. The Contractor must be available 24 hours a day, 7 days a week, 365 days a year to perform all

services as outlined in this IFB.

2. The Contractor must have one phone number that is answered 24 hours a day, 7 days a week, 365 days a year.

3. The Contractor must maintain communications with the ITS Network Operations Center (NOC) (1- 800-234-5364) when responding to locating services or repair activities until problem resolution is achieved. The ITS NOC will engage the appropriate level of ITS staff to work with the Contractor. It is pertinent that ITS NOC be notified prior to any activity that may potentially affect user services.

4.2 Locating ServicesCoverage is required for Locating Services by skilled and trained Locating Technicians, Monday through Friday, 8:00 AM to 5:00 PM prevailing time (NYS Business Hours). However, the Contractor may be requested to respond to service calls during off-hours. Should the Contractor require ITS assistance during off-hours, they must contact the ITS NOC at 1-800-234-5364, ([email protected]) during off-hours of 5pm-8am Monday-Friday and on weekends, and request that the NOC contact the Physical Design and Network Operations on-call staff for assistance.

Support Levels Maximum Response Time

Minimum Service Level Met

Chargeback/Service Credit

Emergency Response

Technicians must be onsite within four(4) hours from the point of initial call from Dig Safely NY

95% 4% of monthly invoice

Routine Response

Technicians must be onsite within twenty-four (24) hours from the point of initial call from Dig Safely NY

95% 2% of monthly invoice

ITS reserves the right to categorize requests based on need.

The Contractor must contact the ITS NOC at 1-800-234-5364 to report when they arrive on site.


21

4.3 Repair Response TimesWhen the Contractor receives notification of a problem, the Contractor maintenance staff must initiate repair/response activities as appropriate and necessary for the type of problem being reported. Problems must be classified according to the following definitions:

i. Major: A Major Failure is defined as a failure of a Tributary Fiber resulting in an outage condition (e.g., fiber cuts). The Contractor must have its first maintenance technician onsite within two (2) hours after the time Contractor becomes aware of a major event, unless delayed by a force majeure event as defined in the contract resulting from this solicitation. Repairs must begin within four (4) hours of initial notification pursuant to Section 3.1.10 of this IFB. - Emergency Repair Services.

ii. Minor/Service Affecting: A Minor/Service Affecting Failure is defined as a failure of the Tributary Fiber affecting some, but not all, of the services provided. Such failures include the loss of a single strand for which spare/unused fiber exists. The Contractor must have its first maintenance technician onsite within eight (8) hours of a Minor/Service Affecting failure, unless delayed by a force majeure event as defined in the contract resulting from this solicitation. Repairs must begin within two (2) hours of being on site.

iii. Minor/Non-Service Affecting: A Minor/Non-Service Affecting Failure is any failure that is not currently affecting the ability of the Tributary Fiber to provide service. The Contractor must have its first maintenance technician onsite within seventy-two (72) hours of a Minor/Non-Service Affecting, excluding Saturdays, Sundays, and holidays, unless delayed by a force majeure event as defined in the contract resulting from this solicitation. Repairs must begin within two (2) hours of being on site.

If a temporary repair is required, the Contractor must begin permanent repair within 24 hours pursuant to Sections 3.1.10 of this IFB.

The Contractor must prompt ITS, or Lessees, to properly identify the classification of the failure (Major, Minor/Service Affecting, Minor/Non-Service Affecting) to ensure the appropriate response is initiated. ITS reserves the right to categorize requests based on need.

The Contractor must contact the ITS NOC at 1-800-234-5364 to report when they arrive on site, when they begin repairs, and when service is restored.

Support Levels Maximum Response Time

Maximum Service Restoration Time

Minimum Service Level Met

Chargeback/Service Credit

Major 2 hours for technician to arrive; 4 hours for repairs to begin

6 hours 100% of the time 10 % of quarterly maintenance charges.

Minor/Service Affecting 8 hours for technician toarrive; 2 hours



22

for repairs to begin

Minor/Non-Service Affecting 72 hours for atechnician to arrive; 2 hours


for repairs tobegin

4.4 Service Level Credits

Contractor’s failure to satisfy performance standards or requirements set forth herein may result in a credit or chargeback in an amount pre-determined by the parties. The Chargeback shall be paid to ITS in the form of a credit to ITS against the Contractor’s invoice submitted to ITS immediately following the period in which the Contractor was notified by ITS that it failed to satisfy the standard or requirement. Invoices that do not reflect these service credits will be rejected by ITS.

In the event that the Contractor fails to meet the required response time or fails to begin repairs within the required time, the Contractor may submit, in writing, an explanation of extenuating circumstances (incidents on the roadway delaying arrival, need for specialized equipment, etc.) to ITS for consideration. In its sole discretion, ITS will evaluate the circumstances and provide a written response accepting the explanation provided or assessing the appropriate service credits.

Documents

NEW YORK STATE Office of Information Technology Services ... · Web viewCE-200, Certificate of Attestation of Exemption from New York State Workers Compensation and/or Disability