52
REQUEST FOR PROPOSALS FOR ENERGY SAVINGS PLAN DEVELOPMENT AND IMPLEMENTATION FOR THE <Owner Name> Attention: <Contact Name> Proposals Due: <month, day, year>

REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

  • Upload
    others

  • View
    2

  • Download
    0

Embed Size (px)

Citation preview

Page 1: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

REQUEST FOR PROPOSALS

FOR

ENERGY SAVINGS PLAN DEVELOPMENT AND IMPLEMENTATION

FOR THE

<Owner Name>

Attention: <Contact Name>

Proposals Due: <month, day, year>

Page 2: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

Request for Proposals for Development and Implementation of an Energy Savings Plan Introduction Letter

[Use Official Letterhead] <Name of Owner’s Representative> Phone: <Number> <Title> Fax: <Number> E-mail: <Address> <Date> To: Interested Energy Services Companies: The <Owner> is requesting proposals from prequalified Energy Services Companies (“ESCOs”) to develop and potentially implement a comprehensive Energy Savings Plan (“ESP”) as part of undertaking an Energy Savings Implementation Program (“ESIP”) for our facilities. As the first step of our Energy Savings Improvement Program, we have <participated in the New Jersey Board of Public Utilities' Local Government Energy Audit Program><completed an energy audit>. The completed audit is available online at <web link or other direction> <or attached to this document>. The <Owner> will select an Energy Services Company through the competitive contracting process to develop an Energy Savings Plan and implementation of same. In order to be considered the ESCO must be prequalified by the Department of Treasury, Division of Property Management and Construction as an Energy Services Company Class C036. Your proposal for an Energy Savings Plan and implementation shall be in accordance with the attached Request for Proposals and fully comply with:

• <Public School Contracts Law N.J.S.A. 18A:18A-1 et seq< <Local Public Contracts Law, N.J.S.A. 40A:11-1 et seq.>

• Energy Savings Improvement Program Legislation, N.J.S.A. 40A:11-4.6 or 18A:18A:4.6) • Local Finance Notice 2009-11, Implementing an Energy Savings Improvement Plan • Board of Public Utilities Directives and Regulations

An optional pre-proposal conference will be held on <date> at <location>. Attendance at the pre-proposal conference is strongly encouraged, but is not mandatory. Attention is called to Section 4 of the RFP governing Requests for Information, Clarifications and Submission of Sample agreements for consideration. The deadline for proposals is <time> on <day and date>. Thank you for your interest. Sincerely, <Name of official> <Title>

Page 3: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

TABLE OF CONTENTS Part A. INSTRUCTIONS TO PROPOSERS ..............................................................................1 Part B. TERMS AND CONDITIONS ..........................................................................................7 Part C. SCOPE OF WORK ........................................................................................................17

Part D. PROPOSAL EVALUATION…………………………………………………………21 Part E. FORM OF PROPOSAL AND CONTENT ..................................................................24 Part F. APPENDIX

A. Covered Facilities Report 26 B. Questions or Requests for Clarification Form 27 C. Project Case Study Form 28 D. Americans with Disabilities Act of 1990 29 E. Equal Employment Opportunity Act 30 F. (If Necessary) List of Agencies with Elected Officials Required for

Political Contribution Disclosure 32 Part G. PROPOSAL FORMS

Proposal Cover Form 33

Proposal Form 1: Proposer Information, Certification and Representations 34

Proposal Form 2: Energy Services Company Fee Proposal 36

Proposal Form 3: Sample Project Development Agreement 38

Proposal Form 4: Energy Savings Projection 39

Proposal Form 5: Proposer’s Checklist 40

Proposal Requirement #1: Consent of Surety 41

Proposal Requirement #2: Ownership Disclosure Statement 42 Proposal Requirement #3: Affidavit of Debarred, Suspended or Disqualified Contractors

43

Proposal Requirement #4: Non-Collusion Affidavit 44

Proposal Requirement #5: Required Submission Of State Forms 45

Proposal Requirement #6: Required Proposer’s Certifications 46 Proposal Requirement #7: Certification of Absence of Conflict of Direct or Indirect Interests

47

(Board of Education Only) Proposal Requirement #8: C.271 Political Contribution Disclosure Form

48

Page 4: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 1 

PART A. INSTRUCTIONS TO PROPOSERS A-1. INTENT The intent of this Request for Proposals (RFP) is to solicit proposals to obtain the comprehensive services of an Energy Savings Company (ESCO) to assist the <Owner> (Owner) to develop an Energy Savings Plan (ESP) designed to improve energy efficiency within the Owner’s facilities, and the financing thereof, through implementation and installation of energy conservation, capital improvements and other measures which will be paid for with the verified savings from reduced energy costs. It is also the intent, upon independent third party verification of the ESP, and upon Owner review and approval thereof, to have the ESCO implement the Energy Savings Improvement Program (ESIP), by taking actions including, but not limited to, designing the improvements, preparing the bid documents, arranging for financing, managing the construction, overseeing commissioning, <providing an energy savings performance guarantee>, preparing and providing a maintenance schedule for the improvements, and providing training for Owner’s staff. The Owner reserves the right to accept or reject any proposed energy savings guarantee. <The Owner has participated in the Local Government Energy Audit Program through the Board of Public Utilities (“BPU”) or <has conducted an audit using a DPMC classified auditing firm> and has received a completed Energy Audit>. The completed audit is available online at <web link or other direction> <or attached to this document>. In preparing the ESP the ESCO will be expected to analyze the audit and assess current energy usage and costs, and to identify, analyze, and recommend Energy Conservation Measures (ECM), renewable energy systems including, but not limited to solar and geothermal energy, develop specifications for capital improvements and propose financing alternatives thereof with the ultimate goals of reducing the energy costs to improve energy efficiency. The Owner has identified the specific facilities to be covered under this RFP and included any additional guidance to proposers in Appendix A. The services shall be performed in two parts in accordance with the Energy Savings Improvement Program Act:

• Phase I: The Proposer shall develop an Energy Savings Plan (ESP) to be reviewed and approved by the Owner. Subsequent to the approval of the ESP, the Owner, in its sole discretion, may authorize the ESCO to proceed to the next phase.

• Phase II: The Energy Savings Implementation Program (ESIP). The Owner is under no obligation to proceed past the receipt and review of the ESP.

All proposers must be prequalified by the New Jersey Department of Treasury, Division of Property Management and Construction, pursuant to N.J.S.A. 52:35-1 e seq. and N.J.A.C. 17:19-1.1 as Construction Class Code C036 to be eligible to participate in the RFP process. This RFP is being issued as a “Competitive Contract” pursuant to <N.J.S.A. 40A:11-4.6(b)(1)/N.J.S.A. 18A:18A-4.6(b)(1)>, and is conducted pursuant to <N.J.S.A. 40A:11-4.1 et seq/N.J.S.A. 18A:18A-4.1 et seq.> and N.J.A.C. 5:34-4. In this context the terms RFP or “bid” are used interchangeably with reference to submissions and documentation.

Page 5: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 2 

The Proposal for an ESP and its implementation must be in compliance with the terms and conditions of this RFP and specifically comply with:

• <The Public School Contracts Law, N.J.S.A. 18A:18A-1 et seq.> <Local Public Contracts Law, N.J.S.A. 40A:11-1 et seq.>

• The Energy Savings Improvement Program Act, <N.J.S.A. 18A:18A-4.6 and 18A:18A-42> <N.J.S.A. 40A:11-4.6 and 40A:11-15>

• Local Finance Notices 2009-11– Implementing an Energy Savings Improvement Plan, and 2011-17, Update on Implementing Energy Savings Improvement Programs issued by the Division of Local Government Services in the New Jersey Department of Community Affairs (www.nj.gov/dca/lgs/lfns/09lfns/2009-11.doc and (www.nj.gov/dca/lgs/lfns/11lfns/2011-17.doc)

• N.J. Board of Public Utilities, Office of Clean Energy Requirements, Guidelines, Orders and Protocols (www.njcleanenergy.com/commercial-industrial/home/home)

A-2. RESPONSE TO REQUEST FOR PROPOSALS (RFP) ESCOs must meet or exceed the professional, administrative and financial qualifications and requirements set forth in the RFP and shall provide all of the information requested herein. Proposers may submit supplemental information that it deems would be useful for the Owner in evaluating its proposal and may provide alternate solutions as may be consistent with the Energy Savings Improvement Program Act. Proposers are encouraged to be clear, factual, and concise in presentation of information. Proposers are cautioned, however, that the response must meet the minimum RFP requirements. Failure to comply with the requirements of this RFP may disqualify the Proposer’s response from consideration. A-3. DEADLINE FOR RESPONSES/OWNER’S REPRESENTATIVE Responses to the RFP must be submitted to the Owner’s Representative no later than XXX p.m. on <date, xx, 20XX.> Proposals must be in a sealed opaque envelope and clearly marked “Energy Savings Plan Development and Implementation for <Owner Name>.” Proposals should identify a contact person, and the name and office of the person who prepared the proposal and must be signed by a person authorized to bind the entity submitting the proposal. Submit <#> original and <x> copy(ies) and <#> electronic copy of the proposal on a compact disc (CD). Responses may be mailed, hand-delivered or sent via courier to the Owner’s Representative. Owner’s Representative: The Owner’s Representative is <insert name of individual/title as required>. Submit information for the Owner’s Representative to:

<Name of Owner’s Representative> <Owner Name>

<Address> <Owner’s Representative telephone number> <Owner’s Representative fax phone number>

<Owner’s Representative email>

Page 6: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 3 

The Owner shall not be responsible for submissions mis-mailed or misdirected. Responses received by the Owner after the date and time specified above will not be considered and rejected upon receipt.

A-4. QUESTIONS OR REQUESTS FOR CLARIFICATION (See Appendix B) Proposers shall direct all questions or requests for information in writing using the form included as Appendix B, by certified mail, facsimile, or e-mail to the Owner’s Representative. All questions and/or requests for information must contain an address where responses can be directed. <The Owner may also want to create a website where all proposers can post questions and all can see answers. Information on that should be included here.> All proposers should note that under the Competitive Contracting provisions of the <Local Public> <Public School> Contracts Law, the Owner may not negotiate the terms of a proposal. See N.J.S.A. <18A:18A-4.5(b)> <40A:11-4.5(b)>. Accordingly, any issues that a proposer may have with regard to the legal or technical terms of the request for proposals or any anticipated exceptions, including any indemnification or other terms of contract thereto must be raised in the question period and resolved before the submission of a proposal. Accepted proposals will be subject to the terms contained herein. All questions and/or requests for information should reference the section or addendum of the RFP and page number to which they pertain and should be asked in consecutive order, from beginning to end, following the organization of the RFP. Except for brief procedural matters, there will be no response to oral inquiries. Questions must be submitted no later than <insert date>. Potential proposers are urged to submit questions pertaining to core Terms of Agreement as soon as possible, but no later that the date provided, above, so available time is maximized to resolve those questions before the proposal is due. All questions must be submitted on Appendix B. The final form of the Agreement will be subject to all public contracting statutes, rules and regulations applicable to the Owner. Any provision of any submitted Project Development Agreement or of the Proposal that is in conflict with the foregoing shall be null and void, ab initio unless otherwise approved pursuant to the requirements for exceptions, below.

A-5. PRE-PROPOSAL CONFERENCE There will be an optional pre-proposal conference held in the <insert location> as provided, above, on <insert date>. Following the conference, there will be a facilities walk-through for interested ESCOs. Attendance is strongly recommended. Attendees will receive proposal evaluation credit for attending.

A-6. ANTICIPATED SCHEDULE OF EVENTS

Step # Item Date 1. Request for Proposal Published 2. Pre-Proposal Conference 3. Facilities Walk-through By appointment 4. Cut off for Questions and Clarifications

5. Energy Services Companies submit “Energy Savings Plan Development and Implementation” Proposal

6. Interview finalists As Needed/TBD 7. Board Vote to Award Project Development Agreement

Page 7: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 4 

A-7. AMBIGUITY, CONFLICT OR ERRORS IN THE RFP If a Proposer discovers any ambiguity, conflict, discrepancy, omission or error in the RFP, the Proposer shall immediately notify the Owner’s Representative of such error in writing which can be delivered by hand, mail, overnight carrier, or email addressed as described in Section 3 of this Part. A-8. REVISIONS TO THIS RFP In the event it becomes necessary to clarify or revise this RFP, such clarification or addendum shall be issued by the Owner by written addendum to the RFP.

Any RFP addendum shall be delivered by hand, certified mail, facsimile, or delivery by courier service that certifies delivery. Only those proposers who have already received the proposal documentation directly from the Owner will be provided the addendum unless the person notifies the Owner’s Representative that it seeks to be included on the distribution list for any addenda.

Any addendum, clarification and/or revision to this RFP shall become part of this RFP and part of the contract arising from the RFP. Proposers shall include a listing of received RFP Addendums as part of the Proposal on Proposal Form #1. A-9. PROPOSAL FORM Each proposer must submit an original proposal and (#) additional copies. Proposers must also submit <x> copy of the proposal on compact disc (CD) as provided in paragraph 3, above. Each proposal shall be duly executed. All corrections, white-outs, erasures or other forms of alteration to prices must be initialed in ink and dated by the proposer. A-10. PROPOSER REPRESENTATION Proposal must be signed by a duly authorized signatory and shall provide the full business address on the signature form provided in this proposal. Proposals by partnerships shall be signed with the partnership name by one of the members or by an authorized representative. Proposals by corporations or other business entities shall be signed with the name of the corporation or other business entity followed by the signature and title designation of an individual authorized to bind the corporation or business entity in the matter.

A-11. SPECIFICATION CHANGES, ADDITIONS AND DELETIONS All changes to proposal documents shall be through written addendum, clearly marked and furnished to the Owner at the aforementioned address only prior to the opening date of the proposals. Verbal information obtained otherwise will not be considered in awarding of proposals. Proposers shall not be permitted to alter the terms of their proposal after the time and date of the submission thereof, however, the Proposer may request that the proposal be returned prior to the closing date of the RFP, in which case the Proposer may submit a new RFP prior to the closing date. A-12. ELECTRONIC PROPOSAL SUBMITTAL PROHIBITED Proposals sent by electronic, telephonic or facsimile devices (including email) are NOT acceptable and will be rejected upon receipt. Proposing firms will be expected to allow adequate time for delivery of their Proposal either by express courier, postal service or other means. The Owner shall not be responsible for premature opening or late delivery of Proposals not properly marked or addressed, or for late delivery by mail or delivery service.

Page 8: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 5 

A-13. CONDITIONAL PROPOSALS Conditional proposals will not be accepted. Proposals may be withdrawn prior to the advertised time for receipt of proposals or authorized postponement prior thereof. Proposals received after the advertised time will not be considered and will be rejected upon receipt. A-14. COSTS The Owner assumes no responsibility and bears no liability for costs incurred by proposers in the preparation and submittal of responses to this RFP. A-15. PROPOSAL OPENING Examination of the proposals will commence after opening at <time and date> and an evaluation process will be initiated. At the opening of the proposals, the name of the vendor and price of the proposal will be announced. No proposal information or results will be given over the telephone. No proposal may be withdrawn for a period of 60 calendar days of the proposal opening date. Proposals, amendments thereto or withdrawal requests received after the time advertised for proposal opening will be rejected regardless of when they were mailed. A-16. REJECTION OF RESPONSES The Owner reserves the right to accept or reject in part or in whole any or all responses to this RFP submitted. The Owner shall reject the response of any proposer who is determined not to be responsible or whose response is deemed to be non-responsive.

The Owner reserves the right to waive minor variances in responses to this RFP. Any such waiver shall not modify any remaining RFP requirements nor excuse any proposer from full compliance with the RFP specifications and other contract requirements if the proposer is awarded the contract.

The failure of a proposer to supply information concerning its responsibility may be grounds for a determination of non-responsibility. A-17. BASIS OF PROPOSAL AWARD Award of proposal shall be made to the proposer determined to be the most responsible, price and other factors considered, as determined by the Owner, in its sole discretion. Proposal evaluation criteria are stated in Section D of this RFP. A-18. DISCLAIMERS The Owner reserves the right to withdraw this RFP at any time and for any reason and to issue such clarifications, modifications, and/or amendments as it may deem appropriate. Receipt by the Owner of a response to this RFP confers no rights upon the proposer, nor obligations upon the Owner in any manner.

A-19. GENERAL INSTRUCTIONS It is intended that this RFP describe the requirements and response format in sufficient detail to secure comparable proposals. Proposers shall submit responses that are complete, thorough and accurate. Sales brochures and other similar material should not be included in a proposer’s response. The response shall be descriptive and contain sections in the same order as provided in the section entitled “Proposal Content.” Proposers are instructed to clearly identify any requirement of this RFP that the proposer

Page 9: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 6 

cannot satisfy. A proposer’s failure to comply with all provisions of this RFP may disqualify the proposer’s response. A-20. COMPETITIVENESS AND INTEGRITY The proposal process is designed to prevent biased evaluations and to preserve the competitiveness and integrity of contract awards. Proposers are to direct all communications regarding this proposal to the Owner’s Representative and are not to contact other Owner officials or employees directly unless specifically directed by the Owner’s Representative. Attempts to circumvent this requirement will be viewed negatively and may result in rejection of the offer of the firm found to be in noncompliance.

Page 10: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 7 

PART B. TERMS AND CONDITIONS B-1. LAWS AND REGULATIONS All applicable federal, state, and local laws and regulations, as well as policies of the Owner shall apply to the proposal process and any resulting contract, and are incorporated here by reference. B-2. SUBCONTRACTING/ASSIGNMENT No portion of this proposal may be subcontracted or assigned without the prior written approval by the Owner, except to the extent required or permitted pursuant to <N.J.S.A. 18A:18A-4.6> <N.J.S.A. 40A:11-4.6> or other law. To the extent subcontracting is required pursuant to statute the subcontractors must be obtained through the public bidding process, must comply with the public bidding laws and requirements, and must be classified by the N.J. Department of Treasury, Division of Property Management and Construction, as applicable. B-3. MODIFICATIONS OF AGREEMENT No modification of the scope of the award or the resulting contract shall be binding upon the Owner unless duly approved and made in writing and signed by the Owner’s Representative. B-4. QUALIFICATIONS OF PROPOSERS (Proposal Requirement #5) All proposers must be prequalified by the New Jersey Department of Treasury, Division of Property Management and Construction (DPMC), pursuant to N.J.S.A. 52:35-1 e seq. and N.J.A.C. 17:19-1.1 as Construction Class Code C036 to be eligible to participate in the RFP process. All subcontractors working on the preparation of the ESP must be similarly prequalified or classified as appropriate to the work by DPMC. The Owner may make such investigation as it deems necessary to determine the ability of the Proposer to perform the work. The Proposer shall furnish any information and data for this purpose as the Owner may request. All proposers are required to submit a sworn statement (Proposal Requirement #3) indicating whether the Proposer is, at the time of the proposal opening, included on the New Jersey State Treasurer’s list of debarred, suspended or disqualified contractors as a result of action taken by any State or Federal Owner; www.state.nj.us/treasury/debarred/debarsearch.htm. B-5. OWNERSHIP DISCLOSURE REQUIRED (Proposal Requirement #2) N.J.S.A. 52:25-24.2 provides that no corporation or partnership shall be awarded any contract for the performance of any work or the furnishing of any goods and services, unless, prior to the receipt of the bid or accompanying the bid of said corporation or partnership, bidders shall submit a statement setting forth the names and addresses of all stockholders in the corporation or partnership who own ten percent or more of its stock of any class, or of all individual partners in the partnership who own a ten percent or greater interest therein. The included Statement of Ownership shall be completed and attached to the bid proposal. This requirement applies to all forms of corporations and partnerships, including, but not limited to, sole proprietorships, limited partnerships, limited liability corporations, limited liability partnerships, joint ventures and Subchapter S corporations. Failure to submit the Ownership Disclosure document shall result in rejection of the bid. The reference herein to “bid” or “bidders” applies to this RFP as the RFP and proposers.

Page 11: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 8 

B-6. NON-COLLUSION AFFIDAVIT (Proposal Requirement #4) The Proposer shall submit with its bid, a statement of non-collusion as per the attached affidavit. B-7. FORM OF CONTRACT The resulting Contract (“Contract” or “Agreement”) shall meet the minimum requirements established in this RFP and shall include the requirements thereof unless specifically stated to the contrary in the RFP. The Contract will be subject to all statutes, rules and regulations applicable to public contracts under the laws of New Jersey as well as the requirements applicable to the design, implementation, financing, commissioning, maintenance and training for energy savings programs by public agencies. Proposers are strongly encouraged to submit proposed form of agreement (project development agreement) meeting the minimum requirements of this RFP as provided herein. B-8. NEW JERSEY BUSINESS REGISTRATION REQUIREMENTS

(Certificate and Sales and Use Tax Requirements, N.J.S.A. 52:32-44 et seq.) The contractor shall provide to the contracting agency its proof of business registration with a public bid or request for proposals or no later than award of the contract, purchase order or other contracting document that evidences the agreement. The contractor shall also maintain and submit to the contracting agency a list of subcontractors that knowingly provide goods or services to the <name of Owner> or the contractor in fulfillment of the contract with the <name of Owner>, and their addresses that may be updated form time to time during the course of the contract performance. A complete and accurate list shall be submitted before final payment and the contractor shall attest to same before final payment is made. At the sole option of the Owner, the requirement that a contractor provide proof of business registration may be fulfilled by the contractor providing the contracting agency sufficient information for the contracting agency to verify proof of registration of the contractor through a computerized system maintained by the State. No contract with a subcontractor that knowingly provide goods or services to the <name of Owner> or the contractor in fulfillment of the contract with the <name of Owner>, shall be entered into by any contractor under any contract with a contracting agency unless the subcontractor first provides the contractor with proof of a valid business registration. For the term of the contract and thereafter, the contractor and each of its affiliates and a subcontractor and each of its affiliates (N.J.S.A. 52:32-44(g)(3)) shall collect and remit to the Director, New Jersey Division of Taxation, the use tax due pursuant to the Sales and Use Tax Act on all sales of tangible personal property delivered into this State, regardless of whether the tangible personal property is intended for a contract with a contracting agency. A business organization that fails to provide a copy of a business registration as required pursuant to N.J.S.A. 52:32-44 et al. or subsection e. or f. N.J.S.A. 5:12-92, or that provides false business registration information under the requirements of either of those sections, shall be liable for a penalty of $25 for each day of violation, not to exceed $50,000 for each business registration copy not properly provided under a contract with a contracting agency.

Page 12: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 9 

B-9. AMERICANS WITH DISABILITIES ACT It shall be a condition that any company, firm or corporation supplying goods or services must be in compliance with the appropriate areas of the Americans with Disabilities Act of 1990 as enacted, and from time to time amended, and any other applicable Federal regulation. The compliance requirement is included as Appendix D. B-10. STATEMENT OF POLITICAL CONTRIBUTIONS N.J.S.A. 19:44A-20.13 requires that contractors receiving contracts which, in the aggregate, exceed $50,000.00 from public entities within a calendar year, file an annual disclosure statement of political contributions with the New Jersey Election Law Enforcement Commission. The successful proposer must determine if filing is necessary.

B-11. POLITICAL CONTRIBUTION DISCLOSURE <For entities under the Local Public Contracts Law This proposal is being solicited through a Fair and Open Process in accordance to the N.J.S.A. 19:44A-20.4 et seq. for the basis of awarding a contract for the desired goods and services under the law. No specific documentation filing is required under this procedure.> <For entities under the Public School Contracts Law Pursuant to N.J.A.C. 6A:23A-6.3 this proposal is subject to the following provisions:

a) N.J.A.C. 6A:23A-6.3(a)(1) provides that “No board of education will vote upon or award any contract in the amount of $17,500 or greater to any business entity which has made a contribution reportable by the recipient under P.L.1973, c. 83 (codified at N.J.S.A. 19:44A-1 et seq.) to a member of the board of education during the preceding one year period.”

b) N.J.A.C. 6A:23A-6.3(a)(2 and 3) provides that “Contributions reportable by the recipient under P.L. 1973, c. 83 (N.J.S.A. 19:44A-1 et seq.) to any member of the school board from any business entity doing business with the school district are prohibited during the term of the contract.”

c) N.J.A.C. 6A:23A-6.3(a)(4) requires all bidders to comply with requirement to submit an executed Chapter 271 Political Contribution Disclosure Form pursuant to N.J.S.A. 19:44A-20.26 no later than 10 days prior to award of contract.

To facilitate compliance with this requirement, all bidders shall submit with their bid package a completed and signed “Chapter 271 Political Contribution Disclosure Form” (Bid Requirement 8). The Chapter 271 form will be reviewed by the district to determine whether the vendor is in compliance with N.J.A.C. 6A:23A-6.3 (a2). Detailed instructions for the completion of the Form are on the reverse side of the form. A list of agencies with elected officials covered by the political contribution disclosure requirement is included as Appendix F. <The Owner should create its own Appendix F, or download from www.nj.gov/dca/lgs/p2p a county-based, customizable form.>>

B-12. COMMON LANGUAGE Unless otherwise specified in this document, all words shall have a common language unless the context in which they are used clearly requires a different meaning. Words in the singular number include the plural, and in the plural include the singular. Additionally, words in the masculine gender

Page 13: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 10 

include the feminine and the neuter and when the sense so indicates, words of the neuter gender may refer to any gender. B-13. PROPRIETARY INFORMATION All information included in any proposal that is of a proprietary nature must be clearly marked as such. The Owner shall be held harmless from any claims arising from the release of proprietary information not clearly designated as such by the proposing firm. Because of the need for public accountability, the following information concerning the proposal will not be considered proprietary, even if such information is clearly marked as such: prices of proposal, non-financial information concerning compliance with specifications, guarantees and warranties. In addition, the Owner cannot guarantee that information marked proprietary may not otherwise be required to be disclosed by New Jersey law and the Owner shall not be liable for any information released in good faith compliance with the Open Public Records Act. B-14. USE OF AGENCY’S NAME Except as otherwise provided in this RFP, the successful proposer shall not use the Owner’s name in advertising unless the request is received in writing and approved in writing by the Owner. Any license to utilize the Owner’s name will be contingent upon mutual agreement on the amount of compensation to be provided to the Owner for such use. B-15. PAYMENTS Payments will be made by the Owner in accordance with the terms and conditions of the resulting contract. In the event the Owner declines to proceed with the Program Implementation, payment will be made for the Plan Development in accordance with the resulting contract. B-16. INSURANCE

a) The successful proposer and any and all subcontractors retained during the performance of the work shall continuously maintain insurance and other security for adequate protection at all his work from damage and shall protect the Owner’s property from damage, injury, or loss arising in connection with the Contract.

b) The successful Proposer shall:

i. Completely, indemnify the Owner in regard to damage, injury, or loss pursuant to Section 16, Liability below.

ii. Take all necessary precautions for the safety of personnel on the work site and shall comply with all applicable provisions of federal, state, and municipal safety laws and building codes to prevent accidents or injury to persons on, about or adjacent to the premises where the work is being performed.

iii. Erect and properly maintain at all times, as required by the conditions and progress of the work, all necessary safeguards for the protection of workmen and the public.

c) If it becomes necessary for the proposer, either as principal or by agent or employee, to enter upon the premises or property of the Owner in order to construct, erect, inspect, make deliveries, or remove property hereunder, the proposer hereby covenants and agrees to take, use, provide and make all proper, necessary and sufficient precautions, safeguards, and protection

Page 14: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 11 

against the occurrence of happenings of any accidents, injuries, damages, or hurt to any person or property during the progress of the work herein covered, and to be responsible for and to indemnify and save harmless the Owner from the payment of all sums of money by reason of all, or any, such accidents, injuries, damages, or hurt that may happen or occur upon or about such work. The Owner shall be named as additional insured on all policies.

d) The Proposer shall procure and maintain:

i. Workers Compensation and Employer’s Liability in conformance with all statutory requirements prescribed by law, including Employer’s Liability at a limit of $1,000,000 each accident, which shall be maintained in force during the life of the resulting Contract by the Proposer, covering all employees engaged in performance of this Contract in accordance with the applicable statue.

ii. Comprehensive General Liability Insurance, including Contractors Protective, Completed Operations and Contractual Liability Insurance with limits of not less than $1,000,000 for any one person and $1,000,000 for any one accident for bodily injury and $1,000,000 aggregate for property damage. The Property Damage Liability Insurance shall include the Broad Form Property Damage Liability Endorsement and coverage for explosion, collapse and underground (XCU) hazards. All liability coverage shall be on an occurrence basis and shall be maintained in force during the life of the Contract by the Proposer.

iii. Umbrella or Excess Policy: The Proposer shall procure and maintain an Umbrella or Excess Policy with limits of not less than $10,000,000 for any one person or any one accident for bodily injury. In the event more than one insured is named in the policy, a cross-liability endorsement shall be included which provides that the employees of each of the named insured are not excluded under the policy in respect to claims that are made against other named insured.

iv. Automobile Liability Insurance covering bidder for claims arising from owned, hired and non-owned vehicles with limits of not less than $1,000,000 for any one person and 1,000,000 for any one accident for bodily injury and $1,000,000 each accident for property damage, shall be maintained in force during the life of this Contract by the Proposer.

v. Professional Liability Insurance (Errors and Omissions) $1,000,000 each claim. A Design Consultant and/or a Construction Management Firm who is performing Design Work must maintain Professional Liability Insurance (Errors & Omissions), with coverage retroactive to the earlier of the date of the resulting Agreement or the date of the Notice-to-Proceed for the Design Phase, covering any and all bodily injury and property damage arising from the work hereunder. Such coverage must be maintained for a period of five (5) years after the date of final payment by the Authority or if said coverage is not commercially available for such term, then for such term as is commercially available.

vi. Builder’s Risk Insurance When the proposer serves as General Contractor with overall contractual responsibility for delivering all of the construction services needed to complete the Project, the proposer must maintain Builder’s Risk Insurance, providing coverage for all risk of physical loss or damage to the property described hereunder in

Page 15: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 12 

an amount equal to the completed value of the work contracted.

e) Certificates of the required insurance as listed above with a thirty (30) day notice of cancellation provision shall be submitted to the Owner listed as additional insured and the certificate holder listed as follows:

<Owner Name> <Address>

<Contact Name>

All policies shall be issued by insurance companies authorized to conduct such business under the laws of the State of New Jersey and rated as “A-” or better, as determined by A.M. Best Company and evidence thereof must be submitted prior to commencement of the work in the resulting contract. In addition, the successful Proposer must provide copies of the policies to the Owner upon request.

B-17. LIABILITY Successful Proposer agrees to assume all risk of loss and to indemnify and hold the Owner, its officers, agents, and employees, harmless from and against any and all liability, demands, claims, suits, losses, damages, causes of action, fines or judgments, including costs, attorney’s and witnesses’ fees, and expenses incident thereto, for injuries to persons (including death) and for loss of damage to, or destruction of property (including property of the Owner) arising out of any act or omission of the successful Proposer, its employees or agents in the performance of the contract awarded in response to the proposal. Successful Proposer agrees to reimburse the Owner for all costs and attorneys’ fees expended by the Owner in enforcement of this indemnity provision.

Successful Proposer shall indemnify, defend and hold the Owner harmless from and against any claim that all or any aspect of the work performed or goods provided as a part of this Agreement infringes upon a patent, copyright, trademark or other intellectual property right by paying all amounts in settlement of the claim or as otherwise awarded by a court of law or other judicial or quasi-judicial body having jurisdiction over any such claim. The successful Proposer shall also reimburse Owner for all reasonable expenses incurred by Owner. B-18. WARRANTIES The proposer shall warrant that the proposal is true, accurate and complete. The proposer shall provide such other warranties as are required or recommended. B-19. TERMINATION OF CONTRACT For the term of the Agreement, to the extent consistent with N.J.S.A. <40A:11-4.6> <18A:18A-4.6>, the Owner may terminate the contract in the event of a material breach by the other party. Notice of such breach shall be provided in writing and the breaching party shall be afforded a period of thirty (30) days to cure the breach. If the breach is not cured during such period, the Owner may then terminate the contract.

For the ESP portion of the contract term, the Owner may terminate the contract on sixty (60) days written notice, with or without cause. Termination fees are only permitted to the extent provided in paragraph 5 of the Scope of Work.

Page 16: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 13 

Without prejudice to any other right or remedy available to the Owner at law or in equity of any event described below, this Agreement may be terminated by the Owner if the successful proposer, or any parent company of the proposer, shall:

(a) have an order for relief entered with respect to it, commence a voluntary case or have an involuntary case filed against it under any applicable bankruptcy, insolvency or other similar law now or hereafter in effect (and such order or case is not stayed, withdrawn or settled within sixty (60) days thereafter). It is the intent of the parties hereto that the provisions of Section 365(e)(2)(A) of Title 11 of the United States Code, as amended, or any successor statue thereto, be applicable to this Agreement;

(b) file for reorganization, become insolvent or have a receiver or other officer having similar powers over it appointed for its affair in any court of competent jurisdiction, whether or not with its consent (unless dismissed, bonded or discharged within sixty (60) days thereafter); or,

(c) admit in writing its inability to pay its debts as such debts become due.

B-20. PROPOSAL GUARANTEE (Form of Proposal, Section E-7) Proposer shall submit with the bid a certified check, cashier's check or bid bond in the amount of ten percent (10%) of the total price bid of the Energy Savings Plan fee, but not in excess of $20,000, payable unconditionally to the Owner. When submitting a Bid Bond, it shall contain Power of Attorney for full amount of Bid Bond from a surety company authorized to do business in the State of New Jersey and acceptable to the Owner. The check or bond of the unsuccessful proposer(s) shall be returned pursuant to N.J.S.A. <40A:11-24(a)> <18A:18A-36>. The check or bond of the proposer to whom the contract is awarded shall be retained until a contract is executed and the required performance bond or other security is submitted. The check or bond of the successful proposer shall be forfeited if the bidder fails to enter into a contract pursuant to N.J.S.A. <40A:11-21> <18A:18A-24>. Failure to submit a bid guarantee shall result in rejection of the proposal. B-21. CONSENT OF SURETY (Proposal Requirement #1) Proposer shall submit with the proposal a Certificate (Consent of Surety) with Power of Attorney for full amount of proposal price from a Surety Company authorized to do business in the State of New Jersey and acceptable to the Owner stating that it will provide said proposer with a Performance Bond in the full amount of the proposal to develop the Energy Savings Plan. This certificate shall be obtained in order to confirm that the proposer to whom the contract is awarded will furnish Performance and Payment Bonds from an acceptable surety company on behalf of said proposer, any or all subcontractors or by each respective subcontractor or by any combination thereof which results in performance security equal to the total amount of the contract, pursuant to N.J.S.A. <40A:11-22> <18A:18A-25>. Failure to submit a consent of surety form shall result in rejection of the proposal. B-22. PERFORMANCE BOND a) Proposer shall simultaneously with the delivery of the executed contract to develop the Energy Savings Plan, submit an executed bond in the amount of one hundred percent (100%) of the accepted

Page 17: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 14 

proposal for the Energy Savings Plan as security for the faithful performance of the Energy Savings Plan Development portion of this contract. b) Proposer shall simultaneously with the delivery of the executed contract to implement the Energy Savings Plan shall submit an executed bond in the amount of one hundred percent (100%) of the estimated value of the cost of the improvements (including but not limited to site and construction work, professional and ESCO fees, but not including value of energy savings). The performance bonds provided shall not be released until final acceptance of the whole work of the development and implementation phases and then only if any liens or claims have been satisfied. The surety on such bond or bonds shall be a duly authorized surety company authorized to do business in the State of New Jersey pursuant to N.J.S.A. 17:31-5. Failure to submit said performance bond with the executed contract for each phase of the work shall be cause for declaring the contract null and void.

B-23. EMPLOYMENT PRACTICES No firm may be issued a contract unless it complies with the affirmative action provisions of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27-1 et seq. as found in Appendix E. B-24. BUY AMERICAN Proposer agrees that in the performance of the work only manufactured and farm products of the United States will be used in the work, wherever available pursuant to N.J.S.A. <18A:18A-20> < 40A:11-18>. B-25. GOVERNING LAWS AND DISPUTE RESOLUTION This contract is to be governed by the laws of the State of New Jersey. Proposer agrees that any action or proceeding in any way, manner or respect arising out of the RFP or Contract, or arising from any dispute or controversy arising in connection with or related to the RFP or Contract, shall be litigated only in the courts having status within <name of Owner’s county> County, State of New Jersey, and the Proposer consents and submits to the jurisdiction of Superior Court in <name of Owner’s county> County, New Jersey. If a dispute arises between the Owner and any entity or individual as to which the Owner is bound to the arbitration of such disputes, then the Proposer agrees that the Proposer can be joined as a party to such a mediation, binding arbitration or non-binding arbitration with respect to disputes that may arise. Any and all disputes which exist only between the Owner and the Proposer, or among the Owner, the Proposer and others as to which the Owner is not bound to the mediation, binding arbitration or non-binding arbitration of disputes, shall be subject to the provisions of this Section. Dispute resolution practices shall not apply to disputes concerning the proposal solicitation or award process or to the formation of contents or subcontractors to be entered into pursuant to <Public School Contracts or Local Public Contracts Law>. B-26. AMERICAN RECOVERY AND REINVESTMENT ACT COMPLIANCE

Page 18: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 15 

To the extent any portion of the Contract is being paid in part with funds made available from The American Recovery and Reinvestment Act of 2009 (“ARRA”), the Contractor, it’s employees, agents, representatives or subcontractors, shall agree to be bound by all terms and conditions required by the ARRA. B-27. ASSIGNMENT OF CONTRACT Proposer may not assign, reassign, or sublet the contract award at any time during the life of the contract unless otherwise permitted by the RFP or required by law. In the event the Proposer subcontracts work to be performed during the ESIP portion of the contract, the Proposer and all subcontractors and suppliers shall comply with all requirements for public contracts applicable to the Owner, including, but not limited to the <Public School Contracts> <Local Public Contracts Law>, Equal Employment Opportunity, and Prevailing Wage Laws rules and regulations.

B-28. PERIOD OF CONTRACT The term of the Agreement will be for the term of development of the Energy Savings Plan, and if accepted, construction through acceptance and extended by any applicable performances, equipment and workmanship warranties, and guarantees. Any performance guarantee must be proposed through the Energy Savings Plan and is subject to acceptance of the Owner, and may be for a term not to exceed fifteen (15) years. In the event the Owner determines not to implement the Energy Savings Plan, the successful contractor will be paid in accordance to the amounts provided in the Agreement.

The license for any software provided pursuant to the term of the Agreement will be perpetual, and the proposal for software maintenance for the software will include pricing for the term of the agreement, with an initial one-year commitment for maintenance and subsequent one year renewals. B-29. PREVAILING WAGES The Successful Proposer and all subcontractors shall be subject to the provisions of the “New Jersey Prevailing Wage Act, (N.J.S.A. 34:11-25 et seq.)” for the construction, reconstruction, demolition, alteration, repair or maintenance of a public building in accordance with the Energy Savings Improvement Program Law, for the Implementation Phase of the Project. B-30. LICENSES The Successful Proposer shall, at its own expense, be required to provide and maintain any and all permits and licenses as required by law. B-31. PUBLIC WORKS CONTRACTOR REGISTRATION When the proposer serves as the General Contractor with overall contractual responsibility for delivering all of the construction services needed to complete the Project, the proposer shall hold a valid Public Works Contractor Registration (N.J.S.A. 34:11-56.48, et seq.) pursuant to law at the time the Proposal is submitted. B-32. N.J. SALES TAX EXEMPTION Materials, supplies, and services for exclusive use in erecting, structures, or buildings, or otherwise improving, altering or repairing real property of the Owner’s facilities are exempt from the State sales tax. Proposers should take into consideration the exemption provided under N.J.S.A. 54:32B-8.22 when

Page 19: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 16 

calculating material and costs for work done under this RFP and the Energy Savings Plan. Further, the Owner cannot be charged sales tax directly as it is exempt under N.J.S.A. 54:32B-9(a)(1). B-33. ADDITIONAL INFORMATION OR ORAL PRESENTATIONS Subsequent to the receipt of Proposals, the Owner’s Representative may require the submission of additional information before the award of a contract, at no charge to the Owner, in order to ascertain whether or not the services will be suitable to meet the needs as set forth in the RFP. In addition, the Owner, in its sole discretion, may request one or more Proposers to provide oral presentations to assist in the evaluation of the proposals. B-34. SUMMARY OF APPENDIX DOCUMENTS (Section F) The following documents are referenced in this Request for Proposals and should be reviewed and used as appropriate by the Proposer. They are found after Section E of this document.

• Appendix A: Covered Facilities Report

• Appendix B: Requests for Clarifications Form

• Appendix C: Project Case Studies Format

• Appendix D: Americans with Disabilities Act contract language

• Appendix E: Mandatory Equal Employment Opportunity Contract Language

• <PSCL Agencies Only> Appendix F: List of Agencies with Elected Officials Required for Political Contribution Disclosure

Page 20: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 17 

PART C. SCOPE OF WORK C-1. INTRODUCTION AND BACKGROUND Plan: The Owner is requesting proposals from an Energy Savings Company (ESCO) to assist the <Owner Name> develop an Energy Savings Plan (ESP) designed to improve energy efficiency within the Owner facilities and if approved by the Owner, manage the implementation and installation of energy conservation, capital improvements and other measures which will be paid for with the verified savings from reduced energy costs. The facilities that are part of this proposal and areas of concern to be addressed by the ESP are listed in Appendix A. Implementation: It is also the intent, upon independent third party verification of the ESP, and upon Owner review and approval thereof, to have the ESCO implement the Energy Savings Plan by taking actions including, but not limited to, designing the improvements, preparing the bid documents, managing the construction, arranging for and overseeing commissioning, and providing training for Owner staff. The ESCO will be asked to provide a financing proposal for the implementation of the plan, though the Owner reserves the right to develop and use alternative financing.

Audit: As the first step of ESP, the Owner has <participated in the New Jersey Board of Public Utilities' Local Government Energy Audit Program>or <has conducted an audit using a DPMC classified auditing firm> <Insert here link to audit or explain where completed audit may be found>. C-2. SCOPE OF WORK Covered Facilities Report (Appendix A): The Owner has reviewed the Audit and has identified the facilities to be included in the Energy Savings Plan and has also identified conditions and policy considerations concerning each facility that reflect the minimum goals of the Owner. These are reflected in Appendix A. Energy Savings Projection (Proposal Form 4): Using information provided in the Energy Audit and Appendix A, proposers shall include with their proposal, preliminary Energy Conservation Measures and estimated savings that will accrue if those measures are implemented. This Energy Savings Projection and the associated Energy Conservation Measures are intended to be and will be treated as a good-faith preliminary estimate based on the Owner’s audit and proposer’s analysis, and is subject to modification in the final Energy Savings Plan. Subject to the foregoing conditions, proposers are encouraged to make recommendations and proposals that expand the scope of the Covered Facilities and include recommendations and explanations of alternatives that may provide additional energy savings.

C-3. ENERGY SAVINGS PLAN DEVELOPMENT The ESP is the core of the ESIP process. It describes the energy conservation measures that are planned and the cost calculations that support how the plan will pay for itself in reduced energy costs. Pursuant to the ESIP law, the ESP must address the following elements as appropriate to the circumstances:

a) the results of the energy audit;

Page 21: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 18 

b) a description of the energy conservation measures that will comprise the program;

c) an estimate of greenhouse gas reductions resulting from those energy savings;

d) identification of all design and compliance issues that require the professional services of an architect or engineer and identify who will provide these services;

e) an assessment of risks involved in the successful implementation of the plan;

f) identify the eligibility for, and costs and revenues associated with the PJM Independent System Operator for demand response and curtailable service activities;

g) schedules showing calculations of all costs of implementing the proposed energy conservation measures and the projected energy savings;

h) maintenance requirements necessary to ensure continued energy savings, including a description of how they will be provided. Service contracts are not part of the ESP scope and are subject to the Owner’s procurement laws as per ESIP Legislation P.L. 2009, c. 4 and Local Finance Notice 2009-11 - Implementing an Energy Savings Improvement Plan;

i) a description of and cost estimate of any proposed energy savings guarantee; and

j) cost of the preparation of construction plans and specifications for selected measures

k) Financing options available to the Owner, i.e. 15 year lease purchase (or 20 years if for combined heat and power or cogeneration), or Energy Savings obligations as permitted by law (mandatory requirement).

The plan must be verified by an independent third party measurement and verification service to ensure that the calculations were made in accordance with the BPU standards and that all required elements of the ESP are covered. The Owner will be responsible for procuring third party measurement and verification services. After verification is completed, the Owner must formally adopt the plan. At that point, the plan must be submitted to the BPU where it will be posted on its website. BPU approval is not required. The plan will also be posted on the Owner’s website.

C-4. ENERGY SAVINGS PLAN IMPLEMENTATION If the ESP is formally adopted, the Owner intends to issue a contract to the ESCO to implement the ESP. This may include any or all of the following tasks:

• Serve as the general contractor for the project, and shall, following the public bidding and public works contracting laws and requirements that the Owner is otherwise subject to, contract with subcontractors appropriately classified by the Division of Property Management and Construction, and perform other duties traditionally performed by a general contractor, including, but not limited to:

o project management;

o oversee project schedules;

o supervise subcontractors and installation work, oversee performance and quality of the work through project completion;

Page 22: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 19 

o commissioning and savings implementation; and,

o payments to subcontractors and suppliers.

• Handle allocation of applicable financial incentives; except that the ongoing sales of S-RECs, demand response service contracts, or other long-term revenue agreements shall be separately contracted by the Owner.

• Be responsible for the successful commissioning of ECMs by working with the Owner’s staff, contractors and subcontractors.

• Once commissioning is completed, an independent third party must review the system to make sure the standards set by the ESP are met – ensure the system is meeting the requirements of the plan. This party could be the commissioning agent if independent from other contractors (and the ESCO), or could be the original auditor or ESP verifier. If this is successfully completed the Owner can be assured, that with proper maintenance, the system will perform as planned and energy savings goals realized. The ESCO will be responsible to allocate time to facilitate this with the third party measurement and verification agent hired by the Owner;

• The ESCO will be responsible for preparing reports concerning the implementation of the ESIP as requested by the BPU;

• Apply for and manage the delivery of all applicable N.J. Board of Public Utilities Office of Clean Energy or federal rebates, credits and other incentives, and

• Any other provisions deemed necessary by the parties. All ESIP work that meets the traditional definition of “public work” contracting (N.J.S.A. 34:11-56.26) is subject to prevailing wages and public bidding. This includes the requirements that follow a public works contract, such as bid specifications, listing of required subcontractors, surety bonding, DPMC classification of contractors, submission of public works contractor registration, award to the lowest responsible bidder, and other routine public works construction contracting procedures of the local unit including but not limited to requirements regarding public bidding, bid security, performance guarantees, insurance, and other requirements that are applicable to public works contracts. C-5. FEE PROPOSAL (Proposal Form 2) For the development of the ESP, he proposer shall provide an amount the Owner shall pay to the proposer in the event the proposer is awarded this RFP but the Owner decides not to implement the Energy Savings Plan. For the implementation of the ESP, proposers shall provide the ESCO fee as a percentage of the total of construction work or as a fixed fee.

• The ESCO Fee must include all costs and fees, over and above the cost of the subcontract trades, which are required to fully and completely develop and implement the ESP. The ESCO will procure all professional services and subcontract trades according to applicable New Jersey Local or Public School Contracts Laws.

• The approved ESCO shall be responsible for all payments to subcontractors and suppliers for implementation of the ESP. The Owner shall make payments to the ESCO in accordance with the terms of the approved ESP.

Page 23: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 20 

C-6. SAMPLE PROJECT DEVELOPMENT AGREEMENT (Proposal Form 3) Proposer shall submit a model Project Development Agreement (contract) that defines the terms and conditions of all elements necessary for the development and implementation of the Energy Savings Plan. Agreements with language contradictory to the RFP must be submitted during the question and answer period. The Project Development Agreement shall be in two parts and each shall be subject to execution in turn pursuant to the provisions of this RFP: the development of the Energy Savings Plan, and the implementation of the Energy Savings Plan.

Page 24: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 21 

PART D. PROPOSAL EVALUATION D-1. PROPOSAL EVALUATION Proposal evaluation will be performed by the Owner. The award of the contract shall be made to the responsible Proposer whose responsive proposal is determined to be the most advantageous to the Owner, price and other factors considered, taking into consideration the proposal criteria set forth below. Proposers may be contacted for clarification regarding their proposals. Documented poor performance of proposers on previous contracts with the Owner will be considered during evaluation and may be sufficient cause not to award. D-2. EVALUATION CRITERIA All proposals will be reviewed by Owner. Only those proposals found by the Owner to be fully responsive to the submission requirements will be evaluated pursuant to these criteria. The Owner may conduct interviews with finalists to clarify information provided in the proposals. Any presentation shall address only those matters pertaining to the proposer’s submission, pursuant to N.J.A.C. 5:34-4.3. The Owner will make a final selection of proposers to interview based upon such factors as deemed to be in the Owner’s best interests, in Owner’s sole and absolute discretion. The following evaluation criteria, not necessarily listed in order of significance, will be used to evaluate responses to this RFP. <Owner should review recommended percentages and examples of metrics to ensure consistency with local needs and policy.>

a) Company Overview and Qualifications (10%) Preference will be given to proposers demonstrating strong capabilities, experience and proven track record and reputation in undertakings similar to those described in this RFP including a:

• record of industry experience in developing energy savings plans, and managing the installation of energy conservation measures in public facilities,

• reliable contract compliance and timely performance of services,

• and completion of projects within budgetary requirements. Example of Metrics That Will Be Used In Evaluation:

• Number of projects with specific Energy Conservation Measures as listed in energy audit or recommended by ESCO

• At least 5 projects where energy savings were calculated and verified as occurring;

• Experience in similarly sized agencies and work in New Jersey

• Number of references provided on successful, similar ECMs

• Familiarity with New Jersey public works construction

• Experience designing similar ECMs

• Background and experience of project and management teams

Page 25: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 22 

Availability and quality of personnel, facilities, equipment and other resources including documentation of experience of proposed staff in performing similar work; Example of Metrics That Will Be Used In Evaluation:

• Organizational structure for energy projects

• Experience in similar ECMs and energy projects by personnel

• Type of testing equipment and software used in energy projects

• Methods used to ensure savings are occurring

b) Approach to Energy Savings Plan Development (15%) Proposals should include a detailed and sound technical approach to meeting Owner’s energy efficiency objectives. Proposers should demonstrate their capabilities and methodologies regarding development, training, staff support, management, and associated programs proposed. The Owner must be satisfied that the Proposer has the experience, qualifications and resources to develop an appropriate plan. Example of Metrics That Will Be Used In Evaluation:

• Number of projects that included state and federal incentives such as Pay for Performance; SmartStart; and the like with documented rebates

• Type of technologies used to ensure savings

• Number of projects that used energy modeling approved by government entities

• Number and type of training programs offered

• Types of existing services used to identify energy savings opportunities; team experience with specific types of ECMs

• Number of projects developed with similar ECMs in <Owner’s type of government agency>

• Sample implementation plan and timelines

c) Ability to Implement Project (20%) Preference will be given to proposals demonstrating an ability to carry out the tasks and responsibilities outlined in the proposal, including the procurement of subcontractors, equipment, and any necessary financing in a prompt and efficient manner with minimal disruption to the Owner. Preference will be given to firms who can provide a track record of developing, managing and implementing energy conservation measures in projects similar to the anticipated Energy Savings Plan. Experience must include contracts involving government construction management in New Jersey. The Owner must be satisfied that the Proposer has the experience, qualifications and resources to implement all aspects of the energy savings program. Example of Metrics That Will Be Used In Evaluation:

• Number of projects that required managing multiple subcontractors;

Formatted: Font: Not Bold

Page 26: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 23 

• In context of the projects anticipated in the Energy Audit:

o size of projects that required managing multiple subcontractors

o number and size of project that ESCO developed using multiple subcontractors

o number of projects implemented with similar ECMs in <Owner’s type of agency> in New Jersey

d) Energy Savings Projection (25%)

The Owner will evaluate the proposed Energy Savings Projections for consistency with the Covered Facilities Report (Appendix A), the proposed Energy Conservation Measures, and the proposed savings. Examples of Metrics That Will Be Used in Evaluation

• Consistency of proposed ECMs with Covered Facilities Report and the audit

• Comparison of savings to other proposers

• Credibility of additional ECMs for added savings

e) Fee Proposal (30%) Preference will be given to proposals that responsibly maximize the net economic benefit to the Owner while minimizing the risk. Comparison of the costs proposed to other similarly scored proposals. Example of Metrics That Will Be Used In Evaluation:

• ESP preparation fee and its impact on the risk of not implementing the project

• Highest rating will go to lowest cost proposal, lowest rating to highest cost proposal (exclusive of S-REC values)

Page 27: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 24 

PART E. FORM OF PROPOSAL Proposal must be submitted in the format outlined in this section. Each proposal will be reviewed to determine if it is complete prior to actual evaluation. The Owner reserves the right to eliminate from further consideration any proposal deemed to be substantially or materially unresponsive to the requests for information contained herein.

The first page that should appear is the Proposal Cover Form. This shall include the name and address of the company along with the name, address, telephone number, fax number, and e-mail address of the individual responsible for the preparation of the proposal. Thereafter, the Proposal should contain the following numbered sections: E-1. EXECUTIVE SUMMARY The executive summary should be no more than two pages and be suitable for those audiences who do not require the entire proposal. The Executive Summary should briefly describe the proposer’s understanding and experience in the development and implementation of the Energy Savings Plan, including the goods and services to be provided and explaining why the Proposer is best qualified to provide the services to the Owner. E-2. RESPONSE TO TECHNICAL SPECIFICATIONS This Section of the proposal should contain the proposer’s response to all of the Technical Specifications in Section C of this Request for Proposal followed by such additional information as the Proposer believes would be helpful to the Owner in evaluating proposer’s ability to both develop and implement an Energy Savings Plan.

It should address all elements of the Technical Specifications and include but not be limited to the approach to developing an Energy Savings Plan and demonstrating the ability to arrange or provide: project management; construction management, including any proprietary or other equipment and/or software specification development; public bidding; financing; energy savings calculations; and guarantees and coordination and other essential services. E-3. ENERGY SAVINGS PROJECTION (Proposal Form 4) Complete and provide Proposal Form 4, Projected Annual Energy Savings Data Form and Energy Conservation Measures on which the estimates are based. E-4. COMPANY PROFILE Provide a profile of the company and specify contact/responsibility information relative to the contract, i.e., management, staffing, number of representatives to be assigned to this contract and primary contacts. Provide a description of proposer’s experience in performing services of the type described in this RFP. Specifically identify client size and specific examples of work within the scope of services required under this RFP in similarly sized agencies. It is imperative to show experience in similarly sized agencies and work in New Jersey. Indicate if the firm is or has any affiliation with a product, manufacturer or utility and describe any such relationship(s).

Proposer shall also provide the location of the primary office or offices responsible for the engagement and describe the company presence in New Jersey.

Page 28: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 25 

E-5. EXPERIENCE, QUALIFICATIONS AND ABILITY TO IMPLEMENT This Section of the proposal should contain all of the information that the Owner will reasonably require to evaluate Proposer’s experience, qualifications and ability to implement that was not provided in response to Technical Specifications Requirements Sections. This shall include a staffing plan and organization chart listing those persons who will be assigned to the engagement if the ESCO is selected, including the designation of the person who would be the Proposer’s officer responsible for all services required under the contract. This portion of the proposal should include the relevant resume information for individuals who will be assigned, including, at a minimum, a description of the person’s relevant professional experience, years and type of experience, and number of years with the ESCO. Include a sample implementation plan with suggested timelines. E-6. REFERENCES AND EXPERIENCE Provide at least five references, including at least two projects completed in the last five years as case studies (use the included Project Case Study Form, Appendix C) that demonstrate the scope of the proposer’s ability to develop and implement the ESP. The selection should include contracts that demonstrate the proposer’s familiarity with New Jersey public works construction practices. In submitting the projects, the Proposer grants the Owner the authority to contact the Owners of those projects to discuss the project and the Proposer with them (documented on Appendix C). E-7. PROPOSAL GUARANTEE Include here the proposer’s Proposal Guarantee (see Part B-20). E-8. REQUIRED FORMS Section 8 must contain the all Proposal Forms and Proposal Requirements that the Proposer shall sign and submit with the proposal, including any documentation or other information required in conjunction with those forms, except as required above.

• Proposal Cover Form • Proposal Form 1: Proposer Information, Certification and Representations • Proposal Form 2: Energy Services Company Fee Proposal • Proposal Form 3: Sample Project Development Agreement • Proposal Form 4: Energy Savings Projection • Proposal Form 5: Proposer’s Checklist

• Proposal Requirement 1: Consent of Surety • Proposal Requirement 2: Stockholder Disclosure Statement • Proposal Requirement 3: Affidavit of Debarred, Suspended or Disqualified Contractors • Proposal Requirement 4: Non-Collusion Affidavit • Proposal Requirement 5: Required Submission Of State Forms • Proposal Requirement 6: Required Proposer’s Certifications • Proposal Requirement 7: Certification of Absence of Conflict of Direct or Indirect Interests • For PSCL RFPs Only: Bid Requirement 8: C. 271 Political Contribution Disclosure Form

Page 29: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 26 

APPENDIX A COVERED FACILITIES REPORT

The following facilities and related Energy Savings Considerations are to be included with the response to this RFP. ESCOs are expected to propose preliminary Energy Conservation Measures (Proposal Form 4) that address and resolve the specific areas of concern identified below and in the Audit and calculate projected savings.

Facility # Facility Name and Address

Facility Size: Square Footage

Energy Savings Considerations

1. SqFt

2. SqFt

3. SqFt

4. SqFt

5. SqFt

6. SqFt

7. SqFt

8. SqFt

9. SqFt

10. SqFt

11. SqFt

12. SqFt

13. SqFt

14. SqFt

15. SqFt

.

Page 30: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 27 

APPENDIX B

QUESTIONS, REQUESTS FOR CLARIFICATION AND EXCEPTIONS FORM Pursuant to Section A-4 of the RFP: Any issues that a proposer may have with regard to the legal or technical terms of the request for proposals must be raised in the question period and resolved before the submission of a proposal. Accepted proposals will be subject to the minimum terms contained herein. If a proposer has a form of agreement, license agreement or other terms and conditions that are intended to be part of the proposer’s proposal, the proposer should submit such agreement or terms and conditions during the question period and ask if they are acceptable. If the Proposer seeks to request consideration of forms of agreement, license agreements or to modify core terms and conditions of the specifications or proposal criteria contained in this RFP and any addenda, they must be clearly stated below and on separate pages if necessary and attached to this page to be returned with your proposal.

Name of Firm:

Address:

Signature of Principal Contact

Name of Principal Contact: Title:

E-mail: Telephone:

REQUESTED MODIFICATIONS, CLARIFICATIONS OR DOCUMENTS TO BE CONSIDERED ARE NOTED AS FOLLOWS: Please attach copies of any documents to be considered. Exceptions for consideration are also noted on the ___________ pages attached.

Page 31: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 28 

APPENDIX C

PROJECT CASE STUDIES FORM Case Study pursuant to Section E-6 using the format below. In submitting this project, the Proposer grants the Owner the authority to contact the Owners of those projects to discuss the project and the Proposer with them. (Copy this form and submit additional pages as necessary.) Case Study No: of 5

OWNER:

PROJECT NAME:

PROJECT DATA:

Project Start Date:

Project Completion Date:

Project Duration:

Project Cost:

Project Size (sq.ft.):

PROJECT DESCRIPTION: Succinct summary of the completed energy efficiency work scope, construction scope, etc.

PROJECT FUNDING: Brief description of how project was funded.

PROJECT INVOLVEMENT: Brief description of your direct involvement in the project from inception to completion.

PROJECT REFERENCES, AS APPLICABLE Owner:

Contact name/title at project completion:

Phone: E-mail:

Page 32: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 29 

APPENDIX D

AMERICANS WITH DISABILITIES ACT OF 1990 Equal Opportunity for Individuals with Disability

(Form of Agreement at Execution of Contract)

The contractor and the <Name of Owner> (hereafter “owner”) do hereby agree that the provisions of Title 11 of the Americans With Disabilities Act of 1990 (the "Act") (42 U.S.C. S121 01 et seq.), which prohibits discrimination on the basis of disability by public entities in all services, programs, and activities provided or made available by public entities, and the rules and regulations promulgated pursuant there unto, are made a part of this contract. In providing any aid, benefit, or service on behalf of the owner pursuant to this contract, the contractor agrees that the performance shall be in strict compliance with the Act. In the event that the contractor, its agent, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this contract, the contractor shall defend the owner in any action or administrative proceeding commenced pursuant to this Act. The contractor shall indemnify, protect, and save harmless the owner, its agent, servants, and employees from and against any and all suits, claims, losses, demands, or damages, of whatever kind or nature arising out of or claimed to arise out of the alleged violation. The contractor shall, at its own expense, appear, defend, and pay any and all charges for legal services and any and all costs and other expenses arising from such action or administrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the owner’s grievance procedure, the contractor agrees to abide by any decision of the owner which is rendered pursuant to said grievance procedure. If any action or administrative proceeding results in an award of damages against the owner, or if the owner incurs any expense to cure a violation of the ADA which has been brought pursuant to its grievance procedure, the contractor shall satisfy and discharge the same at its own expense. The owner shall, as soon as practicable after a claim has been made against it, give written notice thereof to the contractor along with full and complete particulars of the claim, If any action or administrative proceeding is brought against the owner or any of its agents, servants, and employees, the owner shall expeditiously forward or have forwarded to the contractor every demand, complaint, notice, summons, pleading, or other process received by the owner or its agents. It is expressly agreed and understood that any approval by the owner of the services provided by the contractor pursuant to this contract will not relieve the contractor of the obligation to comply with the Act and to defend, indemnify, protect, and save harmless the owner pursuant to this paragraph. It is further agreed and understood that the owner assumes no obligation to indemnify or save harmless the contractor, its agents, servants, employees and subcontractors for any claim which may arise out of their performance of this Agreement. Furthermore, the contractor expressly understands and agrees that the provisions of this indemnification clause shall in no way limit the contractor’s obligations assumed in this Agreement, nor shall they be construed to relieve the contractor from any liability, nor preclude the owner from taking any other actions available to it under any other provisions of the Agreement or otherwise at law.

Page 33: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 30 

APPENDIX E EQUAL EMPLOYMENT OPPORTUNITY ACT

MANDATORY EQUAL EMPLOYMENT OPPORTUNITY LANGUAGE

(REVISED 4/10)

N.J.S.A. 10:5-31 et seq. (P.L. 1975, C. 127) N.J.A.C. 17:27

GOODS, PROFESSIONAL SERVICE AND GENERAL SERVICE CONTRACTS

During the performance of this contract, the contractor agrees as follows: The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. Except with respect to affectional or sexual orientation and gender identity or expression, the contractor will ensure that equal employment opportunity is afforded to such applicants in recruitment and employment, and that employees are treated during employment, without regard to their age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. Such equal employment opportunity shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Officer setting forth provisions of this nondiscrimination clause. The contractor or subcontractor, where applicable will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex. The contractor or subcontractor will send to each labor union, with which it has a collective bargaining agreement, a notice, to be provided by the agency contracting officer, advising the labor union of the contractor's commitments under this chapter and shall post copies of the notice in conspicuous places available to employees and applicants for employment. The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer pursuant to N.J.S.A. 10:5-31 et seq., as amended and supplemented from time to time and the Americans with Disabilities Act. The contractor or subcontractor agrees to make good faith efforts to meet targeted county employment goals established in accordance with N.J.A.C. l7:27-5.2. The contractor or subcontractor agrees to inform in writing its appropriate recruitment agencies including, but not limited to, employment agencies, placement bureaus, colleges, universities, and labor unions, that it does not discriminate on the basis of age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.

Page 34: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 31 

The contractor or subcontractor agrees to revise any of its testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job-related testing, as established by the statutes and court decisions of the State of New Jersey and as established by applicable Federal law and applicable Federal court decisions. In conforming with the targeted employment goals, the contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and layoff to ensure that all such actions are taken without regard to age, race, creed, color, national origin, ancestry, marital status, affectional or sexual orientation, gender identity or expression, disability, nationality or sex, consistent with the statutes and court decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions. The contractor shall submit to the public agency, after notification of award but prior to execution of a goods and services contract, one of the following three documents:

• Letter of Federal Affirmative Action Plan Approval

• Certificate of Employee Information Report

• Employee Information Report Form AA302 (electronically provided by the Division and distributed to the public agency through the Division’s website at www.state.nj.us/treasury/contract_compliance)

The contractor and its subcontractors shall furnish such reports or other documents to the Division of Public Contracts Equal Employment Opportunity Compliance as may be requested by the office from time to time in order to carry out the purposes of these regulations, and public agencies shall furnish such information as may be requested by the Division of Public Contracts Equal Employment Opportunity Compliance for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code at N.J.A.C. 17:27.

b). AFFIRMATIVE ACTION If, prior to or at the time the Agency submits a contract for signing, a Proposer does not submit to the Agency evidence of an existing federally approved or sanctioned Affirmative Action Program; then, no later than three (3) days after the Proposer signs the contract, the Proposer shall complete and submit the appropriate forms to the Agency and the Affirmative Action Office. The Proposer should retain the copy marked “Proposer,” submit the copy marked “Public Agency” to the Agency, and the remaining copies shall be immediately forwarded to:

Division of Public Contracts Equal Employment Opportunity Compliance PO Box 209

Trenton, New Jersey 08625

Proposers shall be required to comply with the provisions of N.J.A.C. 17:27-1 et seq., regarding Affirmative Action.

Page 35: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 32 

APPENDIX F

<For PSCL Agencies only>

List of Agencies with Elected Officials Required for Political Contribution Disclosure N.J.S.A. 19:44A-20.26

County Name: State: Governor, and Legislative Leadership Committees Legislative District #s:

State Senator and two members of the General Assembly per district. County: Freeholders County Clerk Sheriff {County Executive} Surrogate Municipalities (Mayor and members of governing body, regardless of title):

USERS SHOULD CREATE THEIR OWN FORM, OR DOWNLOAD FROM WWW.NJ.GOV/DCA/LGS/P2P A COUNTY-BASED, CUSTOMIZABLE FORM.

Page 36: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 33 

Proposal Cover Form

PROPOSAL FOR ENERGY SAVINGS PLAN DEVELOPMENT AND

IMPLEMENTATION

FOR THE

(Owner Name)

SUBMITTED BY:

Name of Firm:

Address:

Name of Principal Contact:

E-mail: Telephone:

Page 37: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 34 

PROPOSAL FORM 1

PROPOSER INFORMATION, CERTIFICATION AND REPRESENTATIONS FROM ENERGY SERVICES COMPANY PROPOSER:

Name of Firm:

Address:

The undersigned Proposer being duly authorized and on behalf of the firm named above: A. Having examined these documents and having full knowledge of the condition under which the

products and services described herein must be performed, hereby proposes that the proposer (we) shall fulfill the obligations contained herein in accordance with all terms, conditions, specifications and proposal criteria set forth, and that will furnish all required products and payments in strict conformity with these documents for the stated process as payment in full.

B. In signing this proposal, we hereby certify that:

1. We possess the qualifications and credentials to perform the contract outline in the Request for Proposals.

2. We have reviewed the contract documents, site, facilities, and all local conditions and laws and regulations that in any manner may affect cost, progress, or performance.

3. We have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit a proposal; that this proposal has been independently arrived at without collusion with any other proposer, competitor or potential competitor; that this proposal has not been knowingly disclosed prior to the opening of proposals to any other proposer or competitor; and that the above statement is accurate under penalty of perjury.

4. We have read and fully understand the Energy Audit provided with this Request for Proposals. This proposal is submitted with having had any and all questions answered and fully and satisfactorily explained.

5. Acknowledge receipt of the applicable addendum:

ADDDENDUM # DATE

(Proposal Form Continued on Next Page)

Page 38: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 35 

C. The undersigned certifies his/her position as a representative of the named firm and is authorized by the Proposer to submit the Proposal for, and bind the above named firm and that the said Proposal is executed with full authority to do so.

D. This proposal is valid for a minimum 120 days from the date of the opening of proposals. E. Certification:

Authorized Signature:

Title:

Printed Name:

E-mail: Telephone:

FEIN OR Tax ID Number: Fax:

Subscribed and sworn to before me this ____ day of _______, 20__. ______________________________ (Seal) Notary Public of New Jersey/(Specify Other State) My Commission Expires ______________ 20__.

THIS FORM SHALL BE COMPLETED, SIGNED, AND NOTARIZED

Page 39: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 36 

PROPOSAL FORM 2 ENERGY SERVICES COMPANY FEE PROPOSAL

Company:

The ESCO Fee must include all costs and fees, over and above the cost of the subcontract trades that are required to fully and completely develop and implement the Energy Savings Plan. The ESCO will procure all subcontract trades according to applicable NJ Public Schools Contracts Laws and Public Works Contractor Registration requirements. All ESIP work that meets the traditional definition of “public works” contracting (N.J.S.A. 34:11-56.26) is subject to prevailing wages and public bidding. This includes the requirements that follow a public works contract if procured by the Owner, such as bid specifications, listing of required subcontractors, surety bonding, public works contractor registration, and award to the lowest responsible bidder, etc. The routine public works construction contracting procedures of the local unit are followed. This includes requirements regarding public bidding: bid guarantee, consent of surety, performance guarantee, maintenance bonds, insurance, and other requirements that are applicable to public works contracts. Note: The public bids should only include scope that meets the traditional definition of “public works”, all other costs must be in the ESCO fee. The ESCO fee must be a not-to-exceed fee for the project. It should be predicated on the scope and considerations listed on Appendix A. The ESCO fees include but are not limited to the following:

• All Architectural & Engineering: All auditing, solution development, design, engineering, architectural, creation of bid specification documents.

• All Estimating & Procurement: All pre-bid cost estimating and scoping of bid packages and work categories. Upon completion of plans and specifications for scope of work, the ESCO shall assemble bidding documents into appropriate bidding packages. This includes, but is not limited to, creation of bid specifications, listing of required subcontractors, Department of Property Management and Construction prequalification, prevailing wage inclusion, surety bonding, Public Works Contractor Registration, Business Registration Certificate, Equal Employment Opportunity Compliance, and award to the lowest responsible bidder.

• All Program Development. All pertinent costs and fees associated with general development of the program.

• All General Conditions and General Requirements. The General Conditions will include all costs necessary to build the project. These are items of work that do not become part of the permanent construction, such as on-site management (Direct Personnel Expense for Project Management, Job Superintendent, etc), trailer costs, equipment for performing work, and utilities such as electric and gas. This also includes General Requirements , which encompasses such items as temporary facilities and controls such as fencing, barricades, weather protection; temporary heat during construction, power for construction including the utility usage, dumpsters, portable toilets, and surveying and testing activities.

Page 40: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 37 

• All Insurance and Bonds.

• All Overhead, Profit and Risk costs.

• Any other cost or fee required to fully and completely implement the ESP, to the extent permitted by law.

Note: the costs must not include the cost of maintenance, guarantees or third party verification of energy conservation measures. As per the RFP, these costs will be contracted separately by the Owner.

ESCO fee as a percentage of the total cost of all construction work: %

Optional: ESCO fee as a fixed amount: $

(Optional fee in words):

Energy Savings Plan Fee (ONLY to be paid in the event the Owner elects not to implement the Plan):

$

(in words):

Page 41: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 38 

PROPOSAL FORM 3

PROJECT DEVELOPMENT AGREEMENT (PDA) Please provide a sample Project Development Agreement.

Page 42: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 39 

PROPOSAL FORM 4 ENERGY SAVINGS PROJECTION

Company:

The projected annual savings for each fuel type MUST be completed using the following format. Data should be given in the form of fuel units that appear in the utility bills. This form must be accompanied with a list the Energy Conservation Measures proposed to achieve these results.

Energy/Water ESCO Developed Baseline (Units) (2)

ESCO Developed Baseline (Costs $) (2)

Proposed Annual Savings (Units) (3)

Proposed Annual Savings (Costs $) (3)

Electric Demand

KW

Electric Energy

KWH

Natural Gas

(ccf)

Fuel Oil (Gallons)

Steam (Lbs)

Water

(Gallons)

Other (Specify)

(Units)

Other (Specify)

(Units)

AVOIDED

EMISSIONS (1)

Provide in Pounds (Lbs)

NOX

Lbs

SO2

Lbs

CO2

Lbs

1. ESCOs are to use NJ DEP standard emission rates to calculate Avoided Emissions. Calculation for all project energy savings and greenhouse gas reductions will be conducted in accordance with adopted NJBPU protocols.

2. “Developed Baseline”: The Owner’s current annual usage and costs as determined by the proposer; based off the Owner’s utility information as provided in the Audit.

3. “Proposed Annual Savings”: ESCO estimated annual savings resulting from the Owner’s implementation of the proposed ESP, as based upon “Developed Baseline.”

Page 43: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 40 

PROPOSAL FORM 5 PROPOSER’S CHECKLIST

Company:

The following checklist shall be completed with the proposal and submitted to the Owner as part of the proposal. Initial each item to confirm its inclusion.

SECTION # AND ITEM INITIAL

Proposal Cover Form 1. Executive Summary 2. Response to Technical Specifications 3. Energy Savings Projection 4. Company Profile 5. Experience, Qualifications, and Ability to Implement 6. References and Experience (Project Case Study Form) 7. Proposal Guarantee 8. Required Forms:

Proposal Form 1: Proposer Information, Certification and Representations Proposal Form 2: Energy Services Company Fee Proposal Proposal Form 3: Sample Project Development Agreement Proposal Form 4: Energy Savings Projection Proposal Form 5: Proposer’s Checklist Proposal Requirement #1: Consent of Surety Proposal Requirement #2: Ownership Disclosure Statement Proposal Requirement #3: Affidavit of Debarred, Suspended or Disqualified Contractors

Proposal Requirement #4: Non-Collusion Affidavit Proposal Requirement #5: Required Submission Of State Forms Proposal Requirement #6: Required Proposer’s Certifications Proposal Requirement #7: Certification of Absence of Conflict of Direct or Indirect Interests

NOTE: Failure to complete and submit all of the above documents as required and on forms where provided within will result in a rejection of your proposal.

By placing my initials in the boxes provided above, I acknowledge having read and fully understand all the requirements of each of the documents referenced herein.

____________________________________ PROPOSER (Signature) PROPOSER (Print Name) DATED: _______________________________

Page 44: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 41 

PROPOSAL REQUIREMENT # 1

CONSENT OF SURETY A performance bond will be required from the successful contractor on this project, and consequently, all bidders shall submit, with their bid, a consent of surety in substantially the following form: To: _________________________________________________ (Owner)

Re: ________________________________________________ (Contractor) ______________________________________________________________________ (Project Description) This is to certify that the ____________________________________________________ (Surety Company) will provide to _________________________________________ a performance bond in (Owner) the full amount of awarded contract in the event that said contractor is awarded a contract for the above project. __________________________________________________________

(CONTRACTOR) ___________________________________________________________ (Authorized Agent of Surety Company)

Date:________________________

CONSENT OF SURETY MUST BE SIGNED BY AN AUTHORIZED AGENT

OR REPRESENTATIVE OF A SURETY COMPANY AND NOT BY THE

INDIVIDUAL OR COMPANY REPRESENTATIVE SUBMITTING THE BID.

Page 45: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 42 

PROPOSAL REQUIREMENT # 2 OWNERSHIP DISCLOSURE CERTIFICATION

Name of Business:

� I certify that the list below contains the names and home addresses of all stockholders holding 10% or more of the issued and outstanding stock of the undersigned business organization.

OR

� I certify that the bidder is a corporation and the list below contains the names and addresses of all stockholders who own 10% or more of the stock of any class of the corporation.

OR

� I certify that no one stockholder owns 10% or more of the issued and outstanding stock of the undersigned. Check the box that represents the type of business organization:

�Partnership �Corporation �Sole Proprietorship �Limited Partnership

�Limited Liability Corporation �Limited Liability Partnership �Subchapter S Corporation Sign and notarize the form below, and, if necessary, complete the stockholder list below and copy form if additional space is needed). Name: Name:

Home Address:

Home Address:

Name: Name:

Home Address:

Home Address:

Name:

Name:

Home Address:

Home Address:

Subscribed and sworn before me this ___ day of ___________ , 20__. (Notary Public) My Commission expires:

_________________________________________

(Affiant)

________________________________ (Print name & title of affiant)

_______________________________ (Name of business)

(Corporate Seal)

Page 46: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 43 

PROPOSAL REQUIREMENT # 3 AFFIDAVIT REGARDING LIST OF DEBARRED,

SUSPENDED OR DISQUALIFIED CONTRACTORS STATE OF NEW JERSEY/______________________________ Specify, of Other COUNTY OF______________________________

I, ______________________________________, of the (City, Town, Borough) of

______________________________ State of ______________________________, of full age, being

duly sworn according to law on my oath depose and say that:

I am ______________________________ of the firm of ______________________________, the

Proposer making the Proposal for the above named Project, and that I executed the said Proposal with

full authority to do so; that said Proposer is not at the time of the making this proposal included on the

State of New Jersey Consolidated Debarment Report as a result of action taken by any New Jersey state

or local Owner.

Subscribed and sworn before me this ___ day of ___________ , 2 __. (Notary Public) My Commission expires:

__________________________________________

(Affiant)

________________________________ (Print name & title of affiant)

_______________________________

(Name of business) (Corporate Seal)

THIS FORM SHALL BE COMPLETED, SIGNED, AND NOTARIZED

Page 47: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 44 

PROPOSAL REQUIREMENT # 4 NON-COLLUSION AFFIDAVIT

STATE OF NEW JERSEY/______________________________ Specify, of Other COUNTY OF______________________________

I, _________________________________________, of the (City, Town, Borough) of

______________________________ State of ______________________________, of full age, being

duly sworn according to law on my oath depose and say that:

I am ______________________________ of the firm of ______________________________, the Proposer making the Proposal for the above named ESCO Project , and that I executed the said Proposal with full authority to do so; that said Proposer has not, directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free and open competition in connection with the above named ESCO Project; and that all statements contained in said Proposal and in this affidavit are true and correct, and made with full knowledge, and the State of New Jersey relies upon the truth of the statements contained in this affidavit in awarding the contract for the said ESCO Project. I further warrant that no person or selling agency has been employed or retained to solicit or secure such contract upon an agreement or understanding for a commission, percentage, brokerage or contingent fee, except bona fide employees or bona fide established commercial or selling agencies maintained by this organization. Subscribed and sworn before me this ___ day of ___________ , 2 __. (Notary Public) My Commission expires:

__________________________________________

(Affiant)

________________________________ (Print name & title of affiant)

_______________________________

(Name of business) (Corporate Seal)

THIS FORM SHALL BE COMPLETED, SIGNED, AND NOTARIZED

Page 48: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 45 

PROPOSAL REQUIREMENT # 5 REQUIRED SUBMISSION OF STATE FORMS

Include here the following forms: 1) Proof of Classification: N.J. Department of Treasury, Division of Property Management and Construction (Section A-1). Provide proof of classification by the Department of Treasury, Division of Property Management and Construction classification as an Energy Services Company (“ESCO”), C036. 2) N.J. Department of Labor and Workforce Development Public Works Contractor Registration If including the Proposer’s Department of Labor Public Works Contractor Registration Form, include it here (See Section B-31). 3) If including the Proposer’s and any subcontractor Business Registration Certificate(s) with this proposal, include it here (B-8).

Page 49: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 46 

PROPOSAL REQUIREMENT # 6

REQUIRED PROPOSER’S CERTIFICATIONS By signing below, the undersigned hereby certifies to the following requirements of this proposal: 1) CERTIFICATE OF INSURANCE STATEMENT: The Proposer fully understands the insurance requirements as stated in the Request for Proposals and agrees to provide all insurance required documents prior to award of contract. 2) BUSINESS REGISTRATION CERTIFICATE STATEMENT: The Proposer fully understands the requirements of the Business Registration Certificate Statement as stated in the Request for Proposals, and shall provide a Business Registration Certificate for itself with this submission or prior to contract award, and that of any and all subcontractors, if applicable, performing work under this contract. 3) TOTAL AMOUNT OF UNCOMPLETED CONTRACTS: It is certified that the amount of uncompleted work on contracts is $ ________________________. The amount claimed includes uncompleted portions of all currently held contracts from all sources (public and private) in accordance with N.J.A.C. 17:19-2.13. I further certify that the amount of this proposal, including all outstanding incomplete contracts does not exceed my prequalification dollar limit. 4) VERIFICATION OF QUALIFICATIONS: The undersigned, being hereby authorized, requests any person, firm or corporation to furnish any information requested by the Owner in verification of the recitals comprising this proposal. 5) CHANGE IN DPMC CLASSIFICATION AFFIDAVIT: The proposer is classified by the State of New Jersey under N.J.S.A. 52:35-1 e seq. and N.J.A.C. 17:19-1.1. This Classification became effective (Date) and a copy of said classification has been included with this proposal. It is certified that there has been no changes in ownership or substantial change in the qualification information subsequent to the latest statement submitted as required under N.J.A.C. 17:19-2.12, except as set forth herewith (list any material adverse changes below or indicate “none”).

Subscribed and sworn before me this ___ day of ___________ , 2 __. (Notary Public) My Commission expires:

Certified by: ________________________________________

(Affiant)

________________________________ (Print name & title of affiant)

____________________________

(Name of business) (Corporate Seal)

THIS FORM SHALL BE COMPLETED, SIGNED, AND NOTARIZED

Page 50: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 47 

PROPOSAL REQUIREMENT # 7

CERTIFICATION OF ABSENCE OF CONFLICT OF DIRECT OR INDIRECT INTERESTS

I declare and certify that no member of the <Owner>, nor any officer or employee or person whose salary is payable in whole or in part by the <Owner>, or their immediate family members are directly or indirectly interested in this proposal or in the supplies, materials, equipment, work or services to which it relates, or in any portion of profits thereof.

�Check here and also sign below if there is a condition where an Owner employee, officer of the board or other individual has an interest in the proposal or is otherwise in conflict at above, and attach a letter of explanation to this document, duly signed by the president of the firm or company.

THIS FORM SHALL BE COMPLETED, SIGNED, AND NOTARIZED

Subscribed and sworn before me this ___ day of ___________ , 2 __. (Notary Public) My Commission expires:

__________________________________________

(Affiant)

________________________________ (Print name & title of affiant)

_______________________________

(Name of business) (Corporate Seal)

Page 51: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 48 

BOARDS OF EDUCATION ONLY PROPOSAL REQUIREMENT #8 (page 1)

C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Required Pursuant to N.J.S.A. 19:44A-20.26

This form or its permitted facsimile must be submitted to the local unit

no later than 10 days prior to the award of the contract.

Part I – Vendor Information Vendor Name: Address: City: State: Zip:

The undersigned being authorized to certify, hereby certifies that the submission provided herein represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions accompanying this form.

_________________________ ____________________________ _________________________ Signature Printed Name Title

Part II – Contribution Disclosure Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable political contributions (more than $300 per election cycle) over the 12 months prior to submission to the committees of the government entities listed on the form provided by the local unit.

Check here if disclosure is provided in electronic form.

Contributor Name Recipient Name Date Dollar Amount $

Check here if the information is continued on subsequent page(s)

Page 52: REQUEST FOR PROPOSALS - NJ Clean Energy Model RFP Template V… · Proposal Requirement #4: Non-Collusion Affidavit 44 Proposal Requirement #5: Required Submission Of State Forms

<Owner’s Name> ESCO Request for Proposals 

Ver. 1.0 6/8/2011    Page 49 

PROPOSAL REQUIREMENT #8 (page 2) Contractor Instructions

C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair and open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (N.J.S.A. 19:44A-20.26). This law provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions to:

• any State, county, or municipal committee of a political party • any legislative leadership committee* • any continuing political committee (a.k.a., political action committee)

any candidate committee of a candidate for, or holder of, an elective office: of the public entity awarding the contract of that county in which that public entity is located of another public entity within that county or of a legislative district in which that public entity is located or, when the public entity is

a county, of any legislative district which includes all or part of the county. The disclosure must list reportable contributions to any of the committees that exceed $300 per election cycle that were made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on reportable contributions.

N.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a natural person. This includes the following:

• individuals with an “interest” ownership or control of more than 10% of the profits or assets of a business entity or 10% of the stock in the case of a business entity that is a corporation for profit

• all principals, partners, officers, or directors of the business entity or their spouses • any subsidiaries directly or indirectly controlled by the business entity • IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business

entity and filing as continuing political committees, (PACs).

When the business entity is a natural person, “a contribution by that person’s spouse or child, residing therewith, shall be deemed to be a contribution by the business entity.” [N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the disclosure.

Any business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an amount to be determined by the Commission which may be based upon the amount that the business entity failed to report.

The enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor’s responsibility to identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed information may exceed the minimum requirement.

The enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the Open Public Records Act.

The contractor must also complete the attached Ownership Disclosure Certification. This will assist the Owner in meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts. * N.J.S.A. 19:44A-3(s): “The term "legislative leadership committee" means a committee established, authorized to be established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the General Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65 (C.19:44A-10.1) for the purpose of receiving contributions and making expenditures.