City of North Las Vegas Official Web Site



CITY OF NORTH LAS VEGAS

PUBLIC WORKS DEPARTMENT

REQUEST FOR PROPOSAL

NORTH 5TH AND CHEYENNE AVE. INTERSECTION IMPROVEMENTS

RFP No. 007-063

NDOT Highway Agreement No. PR 110-14-063, CNLV Project No. 10379

Project Specifications and Instructions

for Submitting a Proposal

City of North Las Vegas is seeking professional services to perform preliminary engineering, final design, surveying, mapping, bid phase support, and construction management support for the improvements at the intersection of North 5th Street and Cheyenne Avenue located in the City of North Las Vegas, Nevada. The preliminary design will be accompanied by a preliminary design report that will assess the level of service, intersection control requirements, lane assignment, intersection geometric properties, right-of-way requirements, operational characteristics, traffic circulation pattern, existing and latent demand, signal progression and timing, and other relevant intersection characteristics to assess, evaluate and identify strategies to improve the level of service, traffic circulation, safety, mobility for all modes of transportation, and progression. Said study will provide various design alternatives culminating in a recommendation of which option the City should pursue. The preliminary engineering shall also include preparation of engineering related documents that include survey, plans, specifications, drainage report, geotechnical/foundation analysis, traffic impact analysis report, utility conflict assessment, design criteria requirements, pavement structural recommendation, environmental clearance documentation meeting NEPA requirements, structural engineering elements, and viable alternatives with the associated costs of each option proposed and right-of-way requirements for each scheme. Final Design shall incorporate the findings in the preliminary engineering and encapsulate the preferred alternative that will advance the plans, specifications, and engineer’s cost estimate to bid quality level associated with intermediate submittals. The Bid Phase support shall perpetuate the design and engineering completed under the Final Design task to assist the City of North Las Vegas in securing adequate bids that may include revisions, in whole or in part to the plans, specifications, and engineer’s cost estimate based on inquiries posed by stakeholders, prospective bidders, and all other affected and impacted parties during said solicitation period. Construction Management Support shall provide the necessary coordination effort between the City of North Las Vegas selected contractor, and the City of North Las Vegas to ensure that the construction activities, material, schedule, conflicts, request for information (RFI), contract change orders, line item extensions, and the overall breadth and scope of the construction work meets the requirements set forth in the construction documents prepared by the Applicant.

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SECTION I - INSTRUCTIONS TO APPLICANT

The City of North Las Vegas (City) is soliciting interested parties to perform professional engineering work to improve the operational characteristics at the intersection of North 5th Street and Cheyenne Avenue, North Las Vegas, Nevada.

The Applicant shall submit one (1) hard copy and one CD that contains one (1) typewritten, legible proposal with applicable attachments. Said attachments shall include the evaluation criteria items identified herein. Faxed and emailed proposals will not be accepted. Written proposals must be received NO LATER THAN 5:00 P.M. PST, on November 20, 2014, and addressed exactly as follows:

Allan Fajardo, P.E., PTOE, MBA

City of North Las Vegas

Public Works Department

Engineering and Construction Services Division

2250 Las Vegas Boulevard N., Suite 610

North Las Vegas, NV 89030

Proposals received after the specified deadline or submitted to the wrong location will not be considered and will be disposed of in an appropriate manner suitable to the City.

Any proposal received prior to the date and time specified above for receipt of proposals may be withdrawn or modified by written request of the Applicant. A written request to withdraw the proposal or the modified proposal must be received before the time and date specified above for receipt of Proposals. At the sole discretion of the City, oral interviews may be conducted for each firm that submits a written proposal. In the event that the City elects to conduct oral interviews, each applicant in the competitive range will be advised of the format for such interview and will be provided with a schedule for such interview. Competitive range means a list of the most highly rated proposals based on the initial ranking of the proposals. The ranking is based on the initial rating of each proposal measured against all evaluation criteria identified in this solicitation.

Confidential information, trade secrets and/or proprietary information must be sealed in a separate package and each page must be clearly marked “Confidential.” The failure to separate and mark this information as per relevant statutes in NRS 333 shall constitute a complete waiver of any and all claims for damages caused by release of the information by the City. If the City reviews the confidential information and determines that the information is not considered confidential per NRS 333, the City will contact the Applicant. The Applicant must advise the City whether it either accepts the City’s determination that the information is not confidential or withdraw the information. The Applicant will not be allowed to alter the submittal after the date and time set for receipt of Proposals shown above. Applicant accepts and acknowledges that the City retains its immunity pursuant to the provisions of NRS 239.012 for any “good faith” release of information and the immunities from liability provided to it pursuant to NRS Chapter 41.

There will be no pre-submittal meeting. The submission shall be based on the requirements identified herein.

Issuance of this solicitation shall in no way constitute a commitment by the City to execute a Consultant Agreement. The City reserves the right to reject any or all proposals received in response to this solicitation, or to cancel this solicitation if it is deemed in the best interest of the public to do so.

The City reserves the right to issue supplemental releases (addenda) to this solicitation prior to the closing date. In the event it becomes necessary to supplement any part of this solicitation, City will make copies of such addenda available via the City’s Website at and Demandstar at on or November 13, 2014. It is the applicant’s responsibility to secure any addenda issued by periodically checking said websites.

The City assumes no financial responsibility in connection with the costs incurred by the Applicant in the preparation and submission of the Applicant’s proposal packets or the costs to attend the oral interviews, if such interviews are conducted by the City.

The prime Applicant and its Project Manager shall comply with the Registration Requirements of Chapter 625 of the Nevada Revised Statutes (NRS), Professional Engineers and Land Surveyors, at the time of submission of the proposal. Such individual(s) must actually be employed by the firm that is submitting the proposal for consideration by the City. A firm cannot meet the registration requirements of NRS, Chapter 625, for prequalification purposes, by “borrowing” such a person from another firm under the guise of a “Joint Venture” submission. If the Proposal is being submitted by a Joint Venture, a copy of the documents by which such joint venture is formed must be submitted with the Proposal. Only those entities that have authority to sign on behalf of the joint venture or the members of the joint venture, as applicable, may sign the Proposal. However, if a proposal is submitted from a “Joint Venture” in response to a Request for Proposal (RFP) for an engineering discipline, only one Nevada licensed Professional Engineer/Land Surveyor need to be identified as a member of the team being proposed. The individual so named must be a Nevada licensed Professional Engineer/Land Surveyor at the time of submission. Pending licenses do not qualify.

The following rules of contact shall apply during this procurement for the Project:

1. After release of the RFP, the Applicant shall ONLY correspond with the Public Works Department, Engineering and Construction Services Division regarding this RFP through the City of North Las Vegas’s from the following designated representative;

Allan Fajardo, PE, PTOE, MBA

City of North Las Vegas

Public Works Department

Engineering and Construction Services Division

2250 Las Vegas Boulevard N., Suite 610

North Las Vegas, NV 89030

702-633-2044

fajardoa@

2. The Applicant shall not other contact City of North Las Vegas employees, including department heads, members of the evaluation committee(s) and/or any official who will participate in the decision to award the Agreement, regarding the Project, except through the process identified above;

3. Any communications determined to be improper may result in disqualification, at the sole discretion of the City;

4. Any official information regarding the request for proposal (RFP) will be disseminated from the Public Works Department, Engineering and Construction Services. Specific information necessary for the preparation of Proposals will be disclosed to all Applicants; and,

5. The City will not be responsible for any oral exchange or any other information or exchange that occurs outside the official process specified herein.

6.

A. APPLICANT QUESTIONS

The Public Works Department will respond to questions regarding the RFP, including requests for clarification and requests to correct errors, submitted in writing by Applicant. Only written requests as described above will be considered. No oral requests will be considered.

Any questions raised by Applicant must be submitted in writing to the Public Works, Allan Fajardo, PTOE, MBA, Public Works Department, Engineering and Construction Services, 2250 Las Vegas Boulevard N., Suite 610, Las Vegas, Nevada 89030, faxed to (702) 633-1158 or emailed to fajardoa@ and received by 5:00 p.m. PST, on November 5, 2014. If warranted, written responses will be posted on the City’s website at and Demandstar at by the City on or before November 13, 2014.

SECTION II – SCHEDULE

|Task |Date/Time |

|Request for Proposal (RFP) Issued |October 21, 2014 |

|Dates Advertised (Las Vegas Review Journal) |October 26 and November 2, 2014 |

|Applicant Questions Submittal Due Date |November 5, 2014 |

|City of North Las Vegas Response to Applicant Questions |November 13, 2014 |

|RFP Due Date |November 20 @ 5:00 p.m. PST |

|Negotiation Completion Date |* December of 2014 |

|City Council Docket |*January/February of 2015 |

*Dependent on successfully coming to terms with the Consultant Agreement. In the event that both parties do not come to terms, City will proceed successively in order of ranking until such time as an agreement is reached. City, at its sole discretion, could elect to terminate the solicitation for this RFP at any time during this RFP process.

SECTION III - DBE & OTHER FEDERAL REQUIREMENTS

This contract is subject to Title 49, Code of Federal Regulations, Part 26 entitled “Participation by Disadvantaged Business Enterprises in Department of Transportation Programs; Final Rule.” Disadvantaged Business Enterprise utilization shall be in accordance with the Federal Contract Provision. Nevada Department of Transportation and City of North Las Vegas have established a DBE participation goal of 10%. A DBE must be certified by the Nevada Unified Certification Program (UCP) at the time of the due date of this RFP before credit may be allowed toward the DBE participation goal. Information regarding firms that are certified or how to become certified may be obtained by contacting the Nevada Department of Transportation Contract Compliance Office, 1263 South Stewart Street, Carson City, NV 89712, telephone number (775) 888-7497 or at . DBE status continually changes; therefore, it is imperative that the Applicant verify certification with the Contract Compliance Office prior to submitting the RFP.

The DBE information provided shall verify the Applicant’s accomplishments toward meeting the contract goals or documentation detailing the Applicant’s good faith efforts. Failure by the Applicant to submit this information at the RFP submission due date will render the Applicant as non-responsive and the RFP will be rejected and no further consideration will be given.

The DBE information is subject to verification by the City of North Las Vegas which may require additional information or clarification subsequent to the RFP submission and due date. As a minimum, the DBE information shall include:

• Name, address, and telephone numbers of DBEs to be used;

• A complete description of the work to be provided by the DBE(s);

• The percentage amount of the contract for work awarded to each DBE;

• Written notice from each DBE firm named in the RFP stating that they agree to perform the work committed to at the time of the RFP submission. Applicant is aware that once a professional fee is negotiated and both parties have come to terms, the sum of each DBE used will need to equal the DBE participation goal of 10%.

Fees will not be identified under the cover of this RFP, but will be covered once the City of North Las Vegas selects the most qualified applicant based on the qualifications identified by the applicant under this RFP.

In addition, Applicant will need to submit documentation on which DBE firms were contacted, and if not selected by the Applicant, explanation on why a particular DBE firm was not used.

Failure by the Applicant to fulfill the DBE contract requirements and to demonstrate good faith efforts constitutes a breach of the Consultant Agreement. In such instance, the City may:

• Withhold progress payments or portion thereof;

• Deduct as damages an amount equal to the unmet portion of the DBE commitment not achieved;

• Terminate the contract;

• Refer the matter for criminal prosecution; or

• If not already awarded by the City of North Las Vegas, reject the Applicant’s RFP.

During the performance of the Consultant Agreement, the Applicant, for itself, its assignees, and successor in interest (hereinafter referred to as the “Consultant”) agrees to as follows:

• Compliance with Regulations (Item #1): The Consultant (hereinafter includes consultants) will comply with the Acts and the Regulations relative to Non-discrimination in Federally-assisted programs of the U.S. Department of Transportation, as they may be amended from time to time, which are herein incorporated by reference and made a part of this contract.

• Non-discrimination (Item #2): The Consultant, with regard to the work performed by it during the contract, will not discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The Consultant will not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers any activity, project, or program set forth in Appendix B of 49 CFR Part 21.

• Solicitations for Subcontracts, Including Procurements of Materials and Equipment (Item #3): In all solicitations, either by competitive bidding, or negotiation made by the Consultant for work to be performed under a subcontract, including procurements of materials, or lease of equipment, each potential subcontractor or supplier will be notified by the Consultant of the Consultant’s obligation under the Consultant Agreement and the Acts and Regulations relative to Non-discrimination on the grounds of race, color, or national origin.

• Information and Reports (Item #4): The Consultant will provide all information and reports required by the Acts, the Regulations, and directives issued pursuant thereto and will permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the Recipient to be pertinent to ascertain compliance with such Acts, Regulations, and instructions. Where any information required of a Consultant is in the exclusive possession of another who fails or refuses to furnish the information, the Consult will so certify to the Recipient, as appropriate, and will set forth what efforts it has made to obtain the information.

• Sanctions for Noncompliance (Item #6): In the event of a Consultant’s noncompliance with Non-discrimination provisions of the Consultant Agreement, the Recipient will impose such contract sanctions as it may determine to be appropriate, including but not limited to:

o Withholding payments to the Consultant under the Consultant Agreement until the Consultant complies; and/or

o Cancelling, terminating, or suspending the Consultant Agreement, in whole or in part.

• Incorporation of Provisions (Item #7): The Consultant will include the provisions of items one through six in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts, the Regulations and directives issues pursuant thereto. The Consultant will take action with respects to any subcontract or procurement as the Recipient may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided that if the Consultant becomes involved in, or is threatened with litigation by a subconsultant, or supplier that if the Consultant becomes involved in, or is threatened with litigation by a subconsultant, or supplier because of such direction, the Consultant may request the Recipient to enter into any litigation to protect the interests of the Recipient. In addition, the Consultant may request the United States to enter into the litigation to protect the interests of the United States.

•

During the performance of the Consultant Agreement, the Applicant, for itself, its assignees, and successor in interest (hereinafter referred to as the “Consultant”) agrees to comply with the following non-discrimination statues and authorities; including but not limited to:

Pertinent Non-Discrimination Authorities:

• Title VI of the civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin); and 49 CFR Part 21.

• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects);

• Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the basis of sex);

• Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27;

• The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits discrimination on the basis of age);

• Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended, (prohibits discrimination based on race, creed, color, national origin, or sex);

• The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms “programs or activities” to include all of the programs or activities of the Federal-aid recipients, sub-recipients and contractors, whether such programs or activities are Federally funded or not):

• Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131-12189) as implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38;

• The Federal Aviation Administration’s Non-discrimination statute (49 U.S.C. § 47123) (prohibits discrimination on the basis of race, color, national origin, and sex);

• Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations;

• Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of limited English proficiency (LEP). To ensure compliance with Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed. Reg. at 74087 to 74100);

• Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sec in education programs or activities (20 U.S.C. 1681 et seq).

Provided in the attached Appendix are forms that must accompany the submittal of this RFP. Failure to do so will constitute the RFP as non-responsive and will not be considered from further consideration. Form identified as “Attachment A”, Affidavit Required Under Section 112(c) of Title 23 United States Code, Act of August 27, 1958 and Part 29 of Title 49, Code of Federal Regulations, November 17, 1987, requires that the form be signed and notarized. The three page form identified as “Attachment B” provided for in the attached

Appendix, Certification Required by Section 1352 of Title 31, United States Code Restrictions of Lobbying Using Appropriated Federal Funds, requires the Applicant’s signature along with filling out the “Disclosure of Lobbying Activities” section of said form.

SECTION IV – NEVADA BUSINESS LICENSE REQUIREMENT

The selected firm, prior to doing business in the State of Nevada, must be appropriately licensed by the Office of the Secretary of State pursuant to NRS 76.100. Information regarding the Nevada State Business License can be found at . Firms must provide the following:

• Nevada State Business License Number;

• Legal Entity’s Name; and,

• Is the “Legal Entity Name” the same name under which Applicant is doing business? [ ] Yes [ ] No

If “No,” provide an explanation.

Additionally, if the firm is a corporation, LLC, LP, LLP, or LLLP, or non-profit corporation based out of state, they must be registered as a foreign business entity equivalent in Nevada, in active status, and in good standing with the Nevada Secretary of State.

Each Applicant shall clearly state, at time of its submittal, its willingness to adhere to this requirement by providing a copy of its Nevada State Business License, a copy of its application to the Secretary of State Office or a copy of the entity’s status that can be obtained from the Nevada Business Search found on the homepage of the Secretary of State’s website sos.state.nv.us.

Award of this RFP is contingent on an Applicant having and holding an active and a valid Nevada State Business License. An Applicant must satisfy this requirement at the time of submission of the RFP. If the Applicant is unable or unwilling to adhere to this requirement, the City will deem the Applicant as non-responsive and their application shall be removed from further consideration.

SECTION V - SELECTION PROCESS

Selection will be based on the Applicant’s response to the “Evaluation Criteria Items” (See Section IX, A), providing the license requirements identified herein, meeting the DBE goal outlined in this RFP or providing justification that that a good-faith effort was made in meeting such DBE goal, completing the forms provided for in the attached Appendix, and the responsiveness of the Applicant based on the instructions identified herein. A Review Committee will be formed and the recommendation set forth by said group will be elevated to a Selection Committee.

At its sole discretion, if the Review Committee elects to conduct oral interviews, each Applicant in the competitive range shall be notified of the interview schedule via electronic mail and will be required to confirm their willingness to attend the oral interview. The questions and content of the interview shall be formulated at the sole discretion of the Selection Review Committee. Failure of the Applicant to appear at the oral interview, if the Review Committee elects to conduct such interviews, will be considered non-responsive, and that firm will be eliminated from any further consideration. The composition of the committees will be composed of City staff and possibly other staff members representing local entities who shall remain anonymous to protect the integrity of the procurement process.

All evaluators will use the information in the firm’s RFP package to arrive at the final ranking. The firms will be ranked and an agreement shall be negotiated following the selection of the most qualified Applicant. If an acceptable agreement cannot be reached with the highest ranked Applicant, the City shall proceed to negotiate with the next highest ranked Applicant and so on until an acceptable agreement is negotiated or the City, in its sole discretion, elects to terminate the solicitation.

SECTION VI - BACKGROUND

N. 5th Street is designated as a 150-feet limited access super arterial oriented in a north/south direction with its right-of-way currently owned and maintained by the City of North Las Vegas. The east/west intersecting 100-foot arterial street of Cheyenne Avenue (SR 593) is currently maintained by the Nevada Department of Transportation. The subject intersection is located approximately 0.5 mile west of the Interstate 15 (I-15) corridor. Cheyenne Avenue is one of the most traveled and heavily used roadway segments in the City of North Las Vegas. With the majority of the area developed along the alignment consisting of various commercial/industrial developments and outlining residential subdivisions, there are a mixture of vehicles types, transit, and pedestrian movement sharing the roadway cross section. With the improvements of N. 5th Street south of Cheyenne Avenue that includes an above grade crossing over I-15 and Losee Road, it is anticipated that this alignment will alleviate and provide relief to the I-15 corridor. With its close proximity to I-15, the industrial and commercial development that exists in this general area, the advent and development of the N. 5th Street corridor that will promote and accommodate the anticipated latent dement, the subject intersection experiences excessive delays accompanied by poor level of service and safety concerns.

Both the northwest and southeast corners of the subject intersection are currently undeveloped. The northeast corner is housed by a commercial development used as a helicopter training school. The southwest corner is currently owned and operated by the City of North Las Vegas as a municipal golf course and park.

N. 5th Street is currently under construction as part of the North 5th Street Improvements, Phase 1D from just north of the I-15 (at the Union Pacific Rail Road) to Cheyenne Avenue. The work will be completed within 560 days commencing at or around July of 2014. The improvements include a grade separation over Losee Road touching down approximately 1,100 feet south of Brooks Avenue. Brooks Avenue is located approximately 1,300 feet south of Cheyenne Avenue. The 150-foot cross section along N. 5th Street is carried throughout the improvements where three lanes of travel in each direction is provided; however, where the elevated section of N.5th Street meets grade to Cheyenne Avenue, the cross section is reduced whereby decreasing the capacity to two lanes of travel in each direction. Under the cover of the Phase 1D CIP (Capital Improvement Project) deliverable, the intersection remains skewed in the north-south direction; however, improvements will provide for a dedicated left turning movement on both the north and south approaches. Southbound lane assignments will include a dedicated right-turning pocked with two thru lanes. Northbound will provide for one thru- and one shared thru- and right turning movement. The east-west lane assignments along Cheyenne Avenue will mirror one another that include a dedicated left turn bay, two thru-lanes, and a shared thru- and right turning movement. The intersection is currently signalized and modification to the traffic signal will be performed to accommodate said lane configuration during the Phase 1D CIP deliverable.

Relevant engineering related documents associated with the above noted improvements, other CIP work performed at the City of North Las Vegas municipal golf course and park independent of the Phase 1D CIP improvement, and planning studies associated with the overall N. 5th Street improvements include:

• Conformed set of plans entitled “North 5th Street Improvements – Phase 1D – Carey Avenue to Cheyenne Avenue” dated March of 2014.

• “North 5th Street Preliminary Traffic Operations Analysis” dated May of 2007.

• “City View Park Conversion – Environmental Assessment” dated August of 2010.

• “North 5th Street Project Development Report – Owens Avenue to Cheyenne Avenue – Volume 1” dated August of 2007

• “North 5th Street Corridor Study – North Las Vegas, Nevada” dated of 2004.

Said documents can be viewed and retrieved at web address.

Though the Applicant will be charged with developing a viable construction cost estimate, the current anticipated construction budget to improve the intersection of Cheyenne Avenue and N. 5th Street is at or around $2.6M.

SECTION VII - SCOPE OF SERVICES

The Applicant shall tender professional services in the following areas:

1. Preliminary Engineering. The tasks related under this category shall encompass various disciplinary functions that include preparation of plans, specifications, Engineer’s cost estimate, supporting engineering studies that include geotechnical/foundation analysis, traffic impact analysis report, drainage study, ancillary structural engineering analysis, utility conflict review that identifies responsible party in performing the relocations, topographic survey, right-of-way evaluation, review of property ownership, environmental assessment meeting NDOT and FHWA guidelines, and recommendations on viable alternatives supported by said studies. The environmental assessment will review and prepare the type of environmental clearance document needed to perform the work that will identify if the project qualifies for a Categorical Exclusion (CE) or if a more robust evaluation is needed prompting an Environmental Impact Statement (EIS) or Environmental Assessment (EA) document in conformance with the National Environmental Policy Act (NEPA). Right-of-way and easements needed to accomplish each option recommended shall be provided. Under this task, multiple options will need to be generated that could include grade separation, at grade improvements, re-configuration of the intersection layout or combination thereof, or other mitigation strategies not already mentioned. Within the scope of this task, an intermediate submittal entitled “Feasibility Study” will be provided showcasing the various alternatives reviewed, supporting calculations, inferences, and assumptions, benefits and challenges of each alternative reviewed, and recommendation of which option the City should pursue. Once review and consensus has been reached on which alternative to move forward with, all other related tasks mentioned under this task shall be completed.

2. Final Design. This portion of the work further refines the findings and recommendation defined in the preliminary engineering phase and shall promote the plans, specifications, and Engineer’s cost estimate to bid quality level. The plans and specifications will expand the City preferred option provided for in the Preliminary Engineering phase and will include the necessary details in the plans and specifications that complies with local, State, and Federal requirements and guidelines. Detailed surveying, updates to the supporting engineering studies (drainage study, traffic impact analysis report, geotechnical study, structural report) maybe needed, securing the necessary permits (NDOT occupancy permit, right-of-way setting approval from NDOT, utility clearance approval from NDOT, among others), identifying and designing for utility conflicts, and obtaining approvals from all impacted and affected agencies along with securing utility certification letters is also part of the effort under this element of the agreement. Right-of-way, easements, and temporary easement requirements shall be identified and mapped accordingly supported by legal descriptions prepared by the Applicant.

3. Bid Phase Support. During this stage of the project, the plans, specifications, and Engineer’s cost estimate have been completed and have been advertised to the public soliciting interested parties in performing the construction activities outlined in said documents. The work shall involve interaction with City staff to address prospective bidder’s questions and concerns that may include modifying, in whole in part the plans, specifications, and Engineer’s cost estimate that in turn would be released to the public in a form of an addendum. The work shall also include evaluation of bids received and providing recommendation on the merit of the bids submitted and recommendation on awarding of the construction contract.

4. Construction Management Support. The final element of the improvements include providing assistance to the City in monitoring the construction activities that may include addressing request for information (RFI), evaluating change orders (CCA), reviewing shop drawings, field inspections, developing punch list items, recommending if notice-of-completion should be issued, and evaluating if the construction work meets the requirements set forth in the plans and specifications prepared by the Applicant.

SECTION VIII - PROJECT SCHEDULE

The following schedule is subject to change. The Applicant shall not use the below dates as the basis to seek punitive damages as a result of the dates not being incorporated in the Consultant Agreement. The Consultant Agreement shall serve as the basis for any contractual obligations that each party must adhere to and the below time line may deviate from the period identified in said agreement:

1. Upon issuance of the official notice-to-proceed for this task, the Preliminary Engineering shall be completed within 120-days. The first submittal under this task entitled “Feasibility Study” shall be completed within 60 days. A four (4) week review period for will ensue for each milestone submittal and upon receipt of all agency comments, the revised documents shall be re-packaged and remitted back to all agencies within three (3) weeks. Applicant understands that the review period noted is limited to the City of North Las Vegas. Longer periods maybe experienced from non-City owned utility agencies, NDOT/FHWA, and other stakeholders who will perform a review.

2. Upon issuance of the official notice-to-proceed for this task, the Final Design shall be completed within one hundred and twenty (120) days for the 70% submittal and another sixty (60) days for the pre-final submittal. A four (4) week review period will ensue for each milestone submittal and upon receipt of all agency comments; the document shall be revised and remitted back to all agencies within three (3) weeks. Applicant understands that the review period noted is limited to the City of North Las Vegas review. Longer periods maybe experienced from non-City owned utility agencies, NDOT/FHWA, and other stakeholders who will perform a review.

3. The bid phase support may last up to twelve (12) weeks.

4. The construction duration shall be based on the recommendation of the Applicant during the Final Design phase.

SECTION IX - PROPOSAL CONTENT

Proposals shall be brief and to the point. One section of the Proposal shall be devoted to each topic listed below with such sections separated by a tabbed divider page. The cover letter shall not exceed one single-spaced, single-sided 8½” x 11" page and shall include the Applicant’s contact person with his/her mailing address, telephone number, and email address, The proposal must be signed by the individual(s) legally authorized to bind the Firm.

No pricing information is to be provided with the Proposal. The selection is based solely on qualification. The fees associated with the anticipated scope of work shall be negotiated with the most qualified firm after conclusion of the evaluation criteria items.

The proposals shall include:

A. EVALUATION CRITERIA ITEMS

1. Project Approach & Design Acumen:

a. Describe your team’s understanding of project requirements contained in the Scope of Services.

b. Identify specific methods to be used to complete each project requirement.

c. Identify potential complications or difficulties that might be encountered in the implementation of required services along with suggested resolutions for each.

d. Describe the coordination efforts that will be needed for this project and identify the stakeholders you anticipate will be part of this project.

e. Describe the approach that will be used to ensure that both the design and construction budget will be maintained.

f. Identify the governing criteria that will be used in developing the engineering and design of the project.

g. Provide two (2) palliative alternative intersection designs that would improve the operational characteristics.

h. Describe your experience in authoring technical specifications and NEPA environmental clearance documents.

i. Outline the NEPA requirements that maybe needed for this project.

j. With Federal funding used, identify the unique features that would need to be included in the Specifications to satisfy NDOT/FHWA requirements.

2. Project Team:

a. Provide a summary of the education, license and/or certification that each team member holds that would support their competency in this type of work, along with past experience with similar projects for each member of the Applicant’s staff who will be assigned to this project, including resumes for the principal project manager, and the key support staff.

b. For each team member, identify how many years experience they hold in the discipline related to this project, how many years they have been with your firm, and how many years they have held their respective license and/or certification (ex. PE license, PTOE certification, etc.) relevant to the scope of the project.

c. Describe your team’s experience working with the Nevada Department of Transportation and Local Public Agency (LPA) agreements.

d. Include a current organizational chart of the project team, including subconsultant(s) with responsibilities of team members identified therein.

e. For each subconsultant proposed to be used, list and identify the projects your firm has worked with the subconsultant for the last four (4) years and the challenges and accomplishments that both parties have faced while working with one another.

f. Provide a percentage of time each team member will provide to this project.

3. Past Performance:

a. Describe your firm’s experience (within the past three (3) years) with similar projects.

b. Provide a detailed description of each project listed.

c. Provide information as to whether or not your firm met the time and budget requirements for each project listed. If not, explain the circumstances that prompted such a delay, scope creep, and/or increase in the budget and how your firm addressed these challenges.

d. Provide a reference name and phone number for each project listed.

4. Availability and Capacity:

a. Provide a listing of your firm’s equipment which will support this effort.

b. Provide a matrix or chart which lists all current projects of the Project Team, the number of hours remaining for completion of each such project and the estimated completion date for each project.

c. In view of the information provided in “4b”, describe your team’s ability to meet the time lines established for this project.

d. Identify the availability of Applicant’s staff to attend meetings and interact with City staff on short notice.

5. Proximity of Project Team:

a. Describe your firm’s location in the geographical area of the project.

b. Describe your knowledge of the locality of the project.

c. Identify the location(s) where actual work will be completed.

d. Provide a percentage of work to be completed at each location.

e. Identify the location of the office which will provide primary project control for this project.

B. PROPOSAL LIMITATIONS

The written proposals shall be limited by the following:

1. With the exception of Item 1 (Project Approach and Design Acumen), the response to each of the other four (4) items posed in the “Evaluation Criteria Items” shall not exceed three (3) pages per item, single-sided, limited to 8 1/2” x 11” or 11”x17” media size. Section 1 (Project Approach and Design Acumen) shall not exceed five (5) pages and the entire proposal shall not exceed seventeen (17) pages. For clarity, response to Item 1 (Project Approach & Design Acumen) is limited five (5) pages, Item 2 (Project Team) is limited to three (3) pages, Item 3 (Past Performance) is limited to three (3) pages, Item 4 (Availability and Capacity) is limited to three (3) pages, and Item 5 (Proximity of Project Team) is limited to three (3) pages. The use of 11”x17” media size shall count as two pages. Resumes or any other attachments included in the Proposal will count toward the maximum pages allotted.

2. DBE Certifications, items requested under Section III (DBE-Requirements) along with back-up documentation justifying the DBE good faith effort if the DBE goal was not met, Nevada State Business License, forms provided for in the attached Appendix, Submission Checklist, cover letter, section dividers without text (label or title of the section divider announcing the succeeding pages is allowed and can be provided) or graphics, and the front and back cover included in the RFP do not count toward the total number of pages.

3. For ease of evaluation, the proposal must be presented in a format that corresponds to and references those sections outlined within this RFP and must be presented in the same order as listed in this RFP. Responses to each section and subsection must be labeled to indicate which item of this RFP is being addressed. Exceptions to these stated limitations will be considered during the evaluation process and may, at the City’s sole discretion, result in a Proposal being considered non-responsive.

SECTION X – AWARD PROCESS

A. NOTIFICATIONS

Upon successfully negotiating a palatable agreement between the City and the Applicant, Public Works Department will issue a Notice-of-Recommendation that will be posted on the City’s Website at and Demandstar at . If no protest is filed, Public Works Department shall present to City Council for approval. Upon approval, City will issue an official Notice-to-Proceed.

Negotiations shall be confidential and not subject to disclosure to competing firms. The terms agreed to by the parties shall be confidential until an agreement is finalized and accepted by City of North Las Vegas Council. If the parties can’t come terms, the City, at its sole discretion and upon written notice to all firms who submitted a Proposal, may negotiate a contract with the next highest ranking firm or withdraw the RFP and cancel this procurement.

SECTION XI - TERMS, CONDITIONS AND EXCEPTIONS

The City reserves the right to alter, amend, or modify any provisions of this RFP, or to withdraw this RFP, at any time prior to the award of a contract pursuant hereto, if, in the sole discretion of the City, it is in the best interest of the public to do so.

The City reserves the right to waive informalities and minor irregularities in proposals received.

The City reserves the right to reject any or all proposals received prior to contract award.

Any irregularities or lack of clarity in the RFP must be brought to the City’s attention as soon as possible so that corrective addendum may be furnished to all Applicants.

Alterations, modifications or variations to a proposal may not be considered unless authorized by the RFP or by an addendum or an amendment to the RFP.

Proposals which appear unrealistic in the terms of technical commitments, lack of technical competence, or are indicative of failure to comprehend the complexity and risk of this contract, may be rejected.

All materials submitted in accordance with the prescribed deadline become the property of the City and will not be returned. The City’s selection or rejection of a Proposal does not affect this right. The master copy of each proposal shall be retained for official files and will become public record after execution of a contract. Only specific parts of the proposal may be labeled a “trade secret,” provided that the Applicant agrees to defend and indemnify the City for honoring such a designation; unsuccessful proposals containing “trade secrets” will be returned. The failure to so label any information shall constitute a complete waiver of any and all claims for damages caused by any release of such information by the City. The City shall not be liable for disclosure or release of information when authorized or required by law to do so pursuant to NRS 239.012.

A proposal submitted in response to this RFP must identify any subconsultants, and outline the contractual relationship between the awarded Applicant and each such subconsultant. An official of each proposed subconsultant must sign, and include as part of the proposal submitted in response to this RFP, a statement to the effect that the subconsultant has read this RFP and agrees to abide by the awarded Applicant’s obligations. A subconsultant’s compliance with these requirements does not create a contractual relationship between the subconsultant and the City.

The awarded Applicant will be the sole point of contract responsibility. The City will look solely to the awarded Applicant for the performance of all contractual obligations which may result from an award based on this RFP, and the awarded Applicant shall not be relieved for the non-performance of any or all of its subconsultants.

The awarded Applicant must maintain, for the duration of its contract, insurance coverage’s as set forth in the Consultant Agreement executed in response to this RFP. Work on the contract shall not begin until after the awarded Applicant has submitted to the City acceptable evidence of the required insurance coverage and a Notice-to-Proceed has been issued. Failure to maintain any required insurance coverage or alternative method of insurance acceptable to the City will be deemed a breach of contract. All cost incurred by the City to enforce or secure insurance for the Applicant shall be borne by the Applicant. The insurance to be maintained shall include the following:

1. Workers’ Compensation Insurance. Such insurance must be provided by an insurance company authorized to provide workers’ compensation insurance in Nevada by the Nevada Department of Business and Industry, Division of Insurance. Such insurance must protect Consultant and City from employee claims based on Project related sickness, disease or accident.

2. Comprehensive General Liability (bodily injury and property damage) insurance with respect to Consultant’s agents and vehicles assigned to the prosecution of work under this Agreement in a policy limit of not less than $1,000,000 for combined single limit per occurrence. Consultant’s General Liability insurance policies shall be endorsed as to include City as an additional insured.

3. Professional Liability insurance, for the protection from claims arising out of performance of professional services caused by a negligent act, error, or omission for which the insured is legally liable; such Professional Liability insurance will provide for coverage in an amount of not less than $1,000,000 for each occurrence and $2,000,000 in the aggregate for the period of time covered by this Agreement. Consultant will provide City thirty (30) calendar days notice in writing of any cancellation of, or material change in, the above described policy.

4. Consultant’s Comprehensive General Liability policy shall automatically include or be endorsed to cover Consultant’s contractual liability to City, to waive subrogation against City, its officers, agents, servants and employees, and to provide that City will be given thirty (30) calendar days notice in writing of any cancellation of, or material change in, the policy.

5. The certificates and endorsements for each insurance policy are to be signed by a person authorized by that insurer and licensed by the State of Nevada. All deductibles and self-insured retentions shall be fully disclosed in the Certificate of Insurance. No deductible or self-insured retention may exceed $250,000 without the written approval of City.

6. Certificates indicating that such insurance is in effect shall be delivered to City before work is begun under this Agreement. If Consultant is underwritten on a claims-made basis, the retroactive date shall be prior to or coincident with the date of this Agreement, and the Certificate of Insurance shall state that coverage is claims-made and the retroactive date. Consultant shall provide City annually with a Certificate of Insurance as evidence of such insurance. It is further agreed that Consultant and/or Insurance Carrier shall provide City with 30-day advance written notice of policy cancellation of any insurance policy required to be maintained by Consultant.

Each Applicant must disclose any existing or potential conflict of interest relative to the performance of the contractual services resulting from this RFP. Any such relationship that might be perceived or represented as a conflict must be disclosed. By submitting a proposal in response to this RFP, Applicant acknowledges that they have not given, nor intend to give at any time hereafter, any economic opportunity, future employment, gift, loan, gratuity, special discount, trip, favor, or service to a public servant or any employee or representative of same, in connection with this procurement. Any attempt to intentionally or unintentionally conceal or obfuscate a conflict of interest will automatically result in the disqualification of an Applicant’s proposal. An award will not be made where a conflict of interest exists. The City, in its sole discretion, will determine whether a conflict of interest exists and whether it may reflect negatively on the City’s selection of the Applicant. The City reserves the right in its sole discretion to impose additional requirements upon the Applicant to mitigate such conflict of interest or to disqualify any Applicant on the grounds of an actual or an apparent conflict of interest.

The City reserves the right to negotiate final contract terms with any Applicant selected. The contract between the parties will consist of the final executed contract commonly referred to as the Consultant Agreement. The Applicant accepts that the exact language of the scope of work may deviate from what was identified herein. However, the intent and spirit of the work shall not change significantly and the discipline involved in performing the work shall not diverge from what was outlined herein.

Applicant understands and acknowledges that the representations above are material and important, and will be relied on by the City in its evaluation of a proposal. Any misrepresentation by an Applicant shall be treated as fraudulent concealment from the City of the true facts relating to the proposal.

No announcement concerning the award of a contract as a result of this RFP can be made without the prior written approval of the City.

SECTION XII – PROTEST PROCEDURE

Protests may be filed only with respect to:

1. Allegations that the terms of the RFP are wholly ambiguous, contrary to legal requirements applicable to the procurement, or exceed the City’s authority, and/or

2. A determination as to whether a Proposal is responsive to the requirements of the RFP or failed any Pass/Fail criteria, as applicable, and/or Award of an Agreement.

A. DEADLINES FOR PROTESTS

Protests concerning the issues described in Section XII(1) and contained in the RFP must be filed no later than ten (10) calendar days prior to the Proposal due date, and those contained in any amendment to the RFP must be filed no later than three (3) business days after the City distributes the related addenda.

Protests concerning the issues described in Section XII(2) must be filed within five (5) calendar days after the City issues its notice to an Applicant that its Proposal was deemed nonresponsive or failed any pass/fail criteria.

City will not accept any protests received after the above-stated deadlines for receipt of such protests.

B. PROTEST CONTENTS

Protests shall include information about the protesting firm, including firm name, mailing address, phone number, and name of the individual responsible for submission of the protest. Protests shall completely and succinctly state the grounds for protest, its legal authority, its factual basis, and shall include all factual and legal documentation in sufficient detail to establish the merits of the protest. The submission shall include all back-up documentation that supports the protestor’s claim. Statements shall be sworn and submitted under penalty of perjury.

C. FILING OF PROTEST

Protests shall be in writing and filed by hand delivery on or before the applicable deadline to:

City Clerk

City of North Las Vegas

2250 Las Vegas Boulevard N., Suite 800

North Las Vegas, NV 89030

The Applicant filing the protest shall concurrently submit a copy of the protest to other applicants whose addresses may be obtained from the Public Works Department.

D. COMMENTS FROM OTHER APPLICANTS

Other Applicants may file statements in support of or in opposition to the protest within five (5) calendar days of the filing of the protest. The City shall promptly forward copies of all such statements to the protester. Any statements shall be sworn and submitted under penalty of perjury.

E. BURDEN OF PROOF

The protester shall have the burden of proving the basis of its protest. The City may, in its sole discretion, discuss the protest with the protester and other applicants. No hearing will be held on the protest. The protest shall be decided on the basis of written submissions.

F. DECISION ON PROTEST

The Public Works Director or designee shall issue a written decision regarding the protest within thirty (30) calendar days after the filing of the detailed statement of protest. If necessary to address the issues raised in a protest, the City may, in its sole discretion, make appropriate revisions to the RFP by issuing addenda.

G. PROTESTER'S PAYMENT OF COSTS

If a protest is denied, the Applicant filing the protest shall be liable for the City’s costs reasonably incurred to defend against or resolve the protest, including attorney’s fees, consultant fees and costs, and any reasonably unavoidable damages sustained by the City as a consequence of the protest.

H. RIGHTS AND OBLIGATIONS OF APPLICANTS

Each Applicant, by submitting its Proposal, expressly recognizes the limitation on its rights to protest provided in this Section XII and expressly waives all other rights and remedies and agrees that the decision on the protest is final and conclusive. If an Applicant disregards, disputes, or does not follow the exclusive protest remedies provided in this section, it shall indemnify and hold harmless the City and its officers, employees, agents, and consultants from and against all liabilities, fees and costs, including legal and consultant fees and costs, and damages incurred or suffered as a result of such Applicant’s actions. Each Applicant, by submitting a Proposal, shall be deemed to have irrevocably and unconditionally agreed to this indemnity obligation.

No Stay Pending Final Determination: Agreement negotiations with the selected Applicant shall not be stayed during the pendency of any protest. Any agreement with the selected Applicant shall be made contingent upon the outcome of any pending protest.

Attachment: Submission Checklist

SUBMISSION CHECKLIST

This checklist is provided for Applicant’s convenience only and identifies documents that must be submitted with each package in order to be considered responsive. Any proposals received without these requisite documents in the number and form set forth in the Submittal Instructions may, in the sole discretion of the City of North Las Vegas be deemed non-responsive and not considered for contract award. To better facilitate the review, applicant shall include this checklist in the proposal.

1. Required number of Technical proposals _________

2. Correct number of pages submitted _________

3. DBE Documentation

(DBE Certification, Good faith effort documentation (if necessary),

DBE firms contacted and justification on why particular DBE firm was

not used, & signed statement from DBE firm named stating to agree to

perform the work committed to. Applicant is aware that once a

Professional fee is negotiated and both parties come to terms, the

sum of each DBE used will need to equal the DBE

participation goal of 10%. See Section III) _________

4. Copy of State of Nevada State Business License _________

5. Secretary of the State Entity Status _________

6. Evidence of a Professional Engineer’s License _________

7. Signed statement from the sub-consultant(s) that they have read this RFP

and agree to abide by the awarded applicant’s obligations (See Section XI) _________

8. Response to “Evaluation Criteria Items” (See Section IX) _________

9. Completed form “Attachment A” (See Section III & Appendix) _________

10. Completed form “Attachment B” (See Section III & Appendix) _________

APPENDIX

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Attachment B

CERTIFICATION REQUIRED BY SECTION 1352 OF TITLE 31, UNITED STATES CODE

RESTRICTIONS OF LOBBYING USING APPROPRIATED FEDERAL FUNDS

The undersigned certifies, to the best of his or her knowledge and belief that:

(1) No Federal appropriate funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

__________________________________

Name (please type or print)

___________________________________

Signature

____________________________________

Title

INSTRUCTIONS FOR COMPLETION OF SF-LLL, DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether sub-awardee or prime Federal recipient, at the initiation or receipt of a covered Federal action, or material change to a previous filing, pursuant to title 31 U.S.C. section 1352. The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with a covered Federal action. Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered Federal action for which lobbying activity in and/or has been secured to influence the outcome of a covered Federal action.

2. Identify the status of the covered Federal action.

3. Identify the appropriate classification of this report. If this is a follow up report caused b y a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last previously submitted report by this reporting entity for this covered Federal action.

4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District, if known. Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub-award recipient. Identify the tier of the sub-awardee, e.g., the first sub-awardee of the prime is the 1st tier. Sub-awards include but are not limited to subcontracts, sub-grants and contract awards under grants.

5. If the organization filing the report in item 4 checks "Sub-awardee", then enter the full name, address, city, state and zip code of the prime Federal recipient. Include Congressional District, if known.

6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the Federal program name or description for the covered Federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments.

8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1 (e.g., Request for Proposal (RFP) number; Invitation for Bid (IFB) number ; grant announcement number; the contract, grant, or loan award number; the application/proposal control number assigned by the Federal agency). Include prefixes, e.g., "RFP-DE-90-001."

9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5.

10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action.

(b) Enter the full names of the individual(s) performing services, and include full address if different from 10 (a). Enter Last Name, first Name, and Middle Initial (MI).

11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (item 4) to the lobbying entity (item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. It this is a material change report, enter the cumulative amount of payment made or planned to be made.

12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment.

13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.

14. Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to perform, and the date(s) of any services rendered. Include all preparatory and related activity, not just time spent in actual contact with Federal officials. Identify the Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s), or Member(s) of Congress that were contacted.

15. Check whether or not a SF-LL-A Continuation Sheet(s) is attached.

16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.

| |

|Public reporting burden for this collection of information is estimated to average 30 minutes per response, including time for reviewing instructions, searching|

|existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the |

|burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, |

|Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. |

| |

|DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB |

|Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352 0348-0046 |

| | | |

|1. Type of Federal Actions: |2. Status of Federal Action: |3. Report Type: |

|a. contract |a. bid/offer/application |a. initial filing |

|b. grant |c. Initial award |b. material change |

|c. cooperative agreement |d. post-award | |

|d. loan | |For Material Change Only: |

|e. loan guarantee | |year _________ quarter ______________ |

|f. loan insurance | |date of last report ___________________ |

| | |

|4. Name and Address of Reporting Entity: |5. If Reporting Entity in No. 4 is Sub-awardee, Enter Name and Address of |

|Prime Sub-awardee |Prime: |

|Tier _______, if known: | |

| | |

| | |

| | |

| | |

| | |

| | |

|Congressional District, if known: |Congressional District, if known: |

|6. Federal Department/Agency: |7. Federal Program Name/Description: |

| | |

| | |

| |CFDA Number, if applicable: __________________ |

|8. Federal Action Number, if know: |9. Award Amount, if known: |

| |$ |

|10. a. Name and Address of Lobbying Entity |b. Individuals Performing Services (including address if |

|(if individual, last name, first name, MI): |different from No. 10a) |

| |(last name, first name, MI): |

| | |

| | |

| | |

| | |

| | |

|(attach Continuation Sheet(s) SF-LLL-A, if necessary) |(attach Continuation Sheet(s) SF-LLL-A, if necessary) |

|11. Amount of Payment (check all that apply): |13. Type of Payment (check all that apply): |

| | |

|$ ________________________ actual planned |a. retainer |

| |b. one-time fee |

| |c. commission |

| |d. contingent fee |

| |e. deferred |

| |f. other; specify: __________________________ |

|12. Form of Payment (check all that apply): | |

| a. cash | |

|b. in-kind; specify: nature ________________________ | |

|value ________________________ | |

|14. Brief Description of Services Performed or to be Performed and Date(s) of Service, including officer(s), employee(s), or Member(s) contacted, for Payment|

|indicated in Item 11: |

| |

| |

| |

| |

| |

| |

| |

|(attach Continuation Sheet(s) SF-LLL-A, if necessary) |

|15. Continuation Sheet(s) SF-LLL-A attached: Yes No |

|16. Information requested through this form is authorized by title 31 U.S.C. | |

|section 1352. This disclosure of lobbying activities is a material |Signature: ____________________________________________ |

|representation of fact upon which reliance was placed by the tier above when |Print Name: ___________________________________________ |

|this transaction was made or entered into. This disclosure is required |Title: ________________________________________________ |

|pursuant to 31 U.S.C. 1352. This information will be reported to the |Telephone No.: ___________________ Date: ______________ |

|Congress semi-annually and will be available for public inspection. Any | |

|person who fails to file the required disclosure shall be subject to a civil | |

|penalty of not less than $10,000 and not more than $100,000 for each such | |

|failure. | |

| | | | |

|Federal Use Only: | | |Authorized for Local Reproduction Standard Form - LLL |

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