3rd Main RFP Attach ACITY OF Kalispell
Development Services Department
3rd & Main Development RFP
Attachment A
AFFIDAVIT
Assurances
The undersigned proposer hereby submits to the City of Kalispell (City) the enclosed proposal
based upon all terms and conditions set forth in the City 's Request for Proposals (RFP) and
referenced materials. Proposer further specifically agrees hereby to provide services in the
manner set forth in the proposal submitted by the proposer.
The undersigned proposer acknowledges and states, under penalty of perjury, as follows:
1. The City is relying on proposer's submitted information and the representation that proposer
has the capability to successfully undertake and complete the responsibilities and obligations
submitted in its proposal and in the resulting agreement.
2. The City has the right to make any further inquiry it deems appropriate to substantiate or
supplement information supplied by proposer.
3. Proposer has read and fully understands all the provisions and conditions set forth in the RFP
documents, upon which its proposal is based.
4. The forms and information requested in the RFP are complete and made part of the proposal.
The City is not responsible for any proposer errors or omissions.
5. This proposal may be withdrawn by requesting such withdrawal in writing at any time prior to
the proposal deadline but may not be withdrawn after such date and time.
6. The City reserves the right to reject any and all proposals and to accept the proposal that, in
its judgment, will provide the best quality development to the City.
7. This proposal is valid for a minimum of 120 days after the RFP proposal submission deadline
8. All costs incurred by proposer in connection with this proposal shall be borne solely by
proposer. Under no circumstances shall the City be responsible for any costs associated with
proposer's proposal or the RFP process.
9. Proposer has not in any manner, directly or indirectly, conspired with any person or party to
unfairly compete or compromise the competitive nature of the RFP process.
10. The contents of this proposal have not been communicated by the undersigned nor by any
employee or agent to any other person engaged in this type of business prior to the official
opening of this proposal.
11. To the best of the proposer's knowledge, the information provided in its proposal is true and
correct and neither the undersigned proposer nor any partner, corporate officer or managing
employee have ever been convicted of a felony or a crime involving moral turpitude.
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CITY OF Kalispell
Development Services Department
3rd & Main Development RFP
Legal Status
1. Proposer intends to operate the business as (check one):
Corporation*
Government Entity
Limited Liability Corporation*
Other (Please describe:
Non -Profit 501(c)(3)
Partnership*
Sole Proprietorship
Identify the members, if LLC, partners, if a partnership, or officers, if a corporation, of the
proposer (add lines as needed).
For the purpose of this RFP, addenda and exhibits, any questions regarding the principals are
referring to the officers, partners and members as disclosed.
2. In the past 10 years, have you personally, or any business with which you have been involved,
been declared bankrupt, filed a petition in any bankruptcy court, filed for protection from
creditors in bankruptcy court, or had involuntary proceedings filed in bankruptcy court? If
"Yes," provide date, court jurisdiction, case name, case number, amount of liabilities, amount
of assets and the status of each occurrence. Yes( ) No( )
3. Has the proposer or any of its principals or its principal's affiliates been declared to be in
default under any obligation to or contract with the City? If "Yes," please provide details
concerning the nature of the default, including the City contract number. Yes( ) No( )
4. Are there any pending liens, claims or litigation in excess of $500,000 involving proposer, or
any corporation or other entity that has, directly or indirectly, a controlling interest in the
proposer, or any subsidiary of the proposer or other entity in which the proposer has a
controlling interest or any of the proposer's principals, officers, or directors? If "Yes," provide
detailed information regarding complaints. Yes ( ) No ( )
5. Has the proposer, or any corporation or other entity that has, directly or indirectly, a controlling
interest in the proposer, or any subsidiary of the proposer or other entity in which the proposer
has a controlling interest or any of the proposer's principals, officers, or directors, been
involved in any lawsuits in the past 10 years? If "Yes," provide list. Yes ( ) No ( )
6. Has the proposer's or any of its principals or its principals' affiliate's contracts been terminated
prior to their expiration terms, voluntarily or involuntarily, within the last 10 years? If "Yes,"
provide name, location, and date of the contract(s). Yes ( ) No ( )
7. Has the proposer, or any corporation or other entity that has, directly or indirectly, a controlling
interest in the proposer, or any subsidiary of the proposer or other entity in which the proposer
has a controlling interest or any of the proposer's principals, officers, or directors ever been
barred from bidding on federal, state, or local government contracts? If "Yes," provide the
current status of such suspension or debarment proceedings. Yes ( ) No ( )
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CITY OF Kalispell
Development Services Department
3rd & Main Development RFP
Proposer shall furnish the names and contact information for 3 clients for whom the proposer is furnishing
or has furnished services similar to those described in this RFP. Do not list City of Kalispell employees or
officials as references.
1. Company and Reference Name:
Telephone and E-Mail:
2. Company and Reference Name:
Telephone and E-Mail:
3. Company and Reference Name:
Telephone and E-Mail:
Signature(s)
Proposer's Legal Name'
' The proposer must be authorized to transact business in Montana and be in good standing prior to
submitting this proposal.
Printed Name of Authorized Representative*:
Title:
Business Mailing Address:
Telephone and Email Address:
Signature:
*Proposal must be signed by an individual authorized to contractually bind the proposer.
Name of Joint Venture Partner (if applicable):
Printed Name of Authorized Representative*:
Title:
Business Mailing Address:
Telephone and Email Address:
Signature:
*Proposal must be signed by an individual authorized to contractually bind the joint venture partner.
Signed and sworn before me this
Notary Signature:
My Commission Expires-
, day of
Affix Seal:
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