Loading...
BCRUA-2025-020 - 6/25/2025 RESOLUTION NO.BCRUA-2025-020 WHEREAS, the Brushy Creek Regional Utility Authority, Inc. ("BCRUA") has duly advertised for bids to purchase water treatment chemicals and for related goods and services; and WHEREAS, Chemrite, Incorporated has submitted the lowest responsible bid for Sodium Permanganate, herein"Water Treatment Chemicals"; and WHEREAS, the BCRUA wishes to accept the bid of Chemrite, Incorporated for Water Treatment Chemicals, Now Therefore BE IT RESOLVED BY THE BOARD OF DIRECTORS OF THE BRUSHY CREEK REGIONAL UTILITY AUTHORITY: That the Board President is hereby authorized and directed to execute on behalf of the BCRUA an Agreement Between the BCRUA and Chemrite, Incorporated for the purchase of Water Treatment Chemicals, a copy of said Agreement being attached hereto as Exhibit"A" and incorporated herein. The Board of Directors hereby finds and declares that written notice of the date, hour, place and subject of the meeting at which this Resolution was adopted was posted and that such meeting was open to the public as required by law at all times during which this Resolution and the subject matter hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act, Chapter 551, Texas Government Code, as amended. RESOLVED this 25th day of June, 2025. .41 OLVtivrwearyt___ NA'COLE THOMPSON, President Brushy Creek Regional Utility Authority ATTEST: REN1 FLORES, Sec 0330.4634-A;4923-3053-4990 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 -1 - IFB # 04-29-225-BC-370 Subject: Water Treatment Chemicals Due: May 16, 2025 at 2:00 PM Central Submit Bids to: Brushy Creek Regional Utility Authority c/o City of Cedar Park Purchasing Department 450 Cypress Creek Road, Bldg. 2 Cedar Park, Texas 78613 EXHIBIT A 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 2 - BCRUA 450 Cypress Creek Rd. Bldg. 1 Cedar Park Texas 78613 Table of Contents 1. BIDDER’S CHECKLIST ................................................................................................................... 3 2. STANDARD TERMS AND CONDITIONS ..................................................................................... 4 3. SPECIAL CONDITIONS................................................................................................................... 9 3.1 Insurance .................................................................................................................................... 9 3.2 Damage Provision .................................................................................................................... 10 3.3 Bid Terms ................................................................................................................................. 10 4. SPECIFICATIONS ........................................................................................................................... 12 5. BID ..................................................................................................................................................... 15 6. DEMONSTRATION OF EXPERIENCE ....................................................................................... 18 7. LIST OF MACHINERY AND EQUIPMENT ............................................................................... 20 8. VENDOR PROFILE ........................................................................................................................ 21 9. BID RESPONSE FORM .................................................................................................................. 22 10. REFERENCES .................................................................................................................................. 23 11. DEVIATION OR COMPLIANCE FORM ..................................................................................... 24 12. RELEASE AND INDEMNIFICATION ......................................................................................... 25 13. NON-COLLUSION ACKNOWLDGEMENT ............................................................................... 26 14. SUSPENSION OR DEBARMENT CERTIFICATE ..................................................................... 26 15. COOPERATIVE PURCHASING ................................................................................................... 27 16. CONFLICT OF INTEREST AND QUESTIONAIRE .................................................................. 28 17. DISCLOSURE OF INTERESTED PARTIES ............................................................................... 29 18. W-9 FORM ........................................................................................................................................ 30 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 3 - 1. BIDDER’S CHECKLIST ☐ Provided Pricing. ☐ Demonstration of Experience form filled in. ☐ List of Machinery and Equipment form filled in, if applicable. ☐ Vendor Profile form filled in. ☐ Bid Response Form **IMPORTANT** Failure to sign and return this form may result in disqualification. ☐ Provided Safety Data Sheets (SDS) for all chemicals bid. ☐ References provided. ☐ Deviation or Compliance form filled in. ☐ Release and Indemnification form filled and signed. ☐ Non-Collusion Acknowledgement form filled and signed. ☐ Suspension or Debarment Certificate filled and signed. ☐ Cooperative Purchasing form filled and signed. ☐ Access latest Conflict of Interest Questionnaire here. Please fill out and return with submission. If no conflicts exist, write N/A on the “Name of Officer” line. ☐ Access latest W-9 form here. Please fill out, and return with your submission. Important Notes: Question deadline is May 2, 2025 at 5:00 PM. Any questions submitted after this time will not be answered. Questions should be submitted in writing via email to Andy Portillo at andy.portillo@cedarparktexas.gov. Submissions will be submitted electronically on BidNet Direct: https://www.bidnetdirect.com/texas/Authority-of-cedar-park Persons signing subsequent sections of the Bid shall have the authority to sign the Bid on Bidder’s behalf and shall be an officer or person authorized to bind the entity they represent to this Bid. Award of Contract(s) will be made based on Best Value as permitted by Section 252.043 of Texas Local Government Code. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 4 - This is an Invitation for Bid Date Issued: April 16, 2025 Subject: Water Treatment Chemicals IFB. No.: 04-29-225-BC-370 Due Date: May 16, 2025 Time Due: 2:00 PM Central Tentative Award Date: June 2025 2. STANDARD TERMS AND CONDITIONS 2.1 General Description of Work - The Brushy Creek Regional Utility Authority ("BCRUA") is in need of water treatment chemicals for the Water Plant located at 1906 Hur Industrial, Cedar Park, TX 78613. The intent of this solicitation is to allow BCRUA to enter into a contract or multiple contracts for the procurement of the products specified in Section 5 of this IFB at a fixed price for a twelve (12) month period. 2.2 This Invitation to Bid (“IFB”) shall be on file in the BCRUA Finance Department, from 8:00 a.m. until 5:00 p.m., Monday through Friday, and available to interested individuals and entities (“Bidders”) from the date issued until the due date and time. 2.3 All general information questions should be directly emailed to Andy Portillo at andy.portillo@cedarparktexas.gov. 2.4 Bidders are expected to examine all documents that make up this IFB. Bidders shall promptly notify the Authority of any omission, ambiguity, inconsistency, or error that they may discover upon examination of the IFB. The Authority assumes no responsibility for errors or misrepresentations that result from the use of incomplete Bids. READ THIS IFB FULLY AND CAREFULLY. BIDS SHALL BE COMPLETE UPON SUBMISSION, INCLUDING ALL FORMS AND ATTACHMENTS REQUIRED HEREIN. FAILURE TO STRICTLY COMPLY WITH THESE STATED TERMS OF SUBMISSION MAY RESULT IN REJECTION OF THE BID. 2.5 All responses to this IFB shall be submitted on the attached response forms. Bids must be received at BCRUA Finance Department at or before 2:00 PM Central on May 16, 2025. Each Bid must be properly identified with the subject title and date and time due. Bidders shall electronically submit through the Texas BidNetDirect website. PHYSICAL BIDS, FAXED BIDS, AND E-MAILED BIDS AND/OR LATE SUBMISSIONS WILL NOT BE ACCEPTED. 2.6 All Bids shall be addressed as shown below: Invitation to Bid: Water Treatment Chemicals Reference Number: 04-29-225-BC-370 Due Date and Time: May 16, 2025 at 2:00 PM Central 2.7 During the pendency of this IFB, Bidder shall not contact any Authority staff except those designated herein this IFB or subsequent addendums or correspondence. Any questions or concerns should be addressed in writing to Andy Portillo at andy.portillo@cedarparktexas.gov at 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 5 - least 14 days prior to the due date of May 16, 2025. Please reference the above-designated IFB number and the line number being referenced. Non-compliance with this provision may result in rejection of the Bid. No phone calls related to IFB will be accepted. 2.8 Any material information provided one Bidder concerning this IFB shall be provided to all Bidders via the Texas BidNet Direct website. An addendum will be issued if necessary. Bidders that have not registered with Texas BidNet Direct will be responsible for checking for new information or addendums on the website. 2.9 All information required of the Bidder, unless otherwise specified, must be completed on the forms provided by the Authority. Failure to sign the Bid Response Form will disqualify Bidder. Persons signing the Bid shall have the authority to sign the Bid on Bidder’s behalf and shall be an officer or person authorized to bind the entity they represent to this Bid. 2.10 Each and every deviation from the terms, conditions, specifications, or performance requirements of this IFB shall be listed on the Deviation Form upon submission of your Bid. Listing of deviations is an integral and required part of your Bid. Any deviations not listed on the Deviation Form upon submission of your Bid will not become part of the contract awarded by the Authority pursuant to this IFB. 2.11 Bids will be opened on May 16, 2025 at 2:00 PM Central at the BCRUA Finance Department. Bids cannot be altered or amended after the deadline. Alterations made before opening must be signed by the Bidder or Bidder’s agent. No Bid may be withdrawn after the date and time of opening without approval of the Purchasing Manager. 2.12 The Authority, in its sole discretion, may negotiate changes to any submitted Bid, including price, after submitted Bids have been opened. 2.13 The Authority reserves the right to accept and/or reject any and all submitted Bids or any part thereof, waive immaterial errors, and award the contract in the best interest of the Authority. 2.14 The Authority shall be sole interpreter of the terms, conditions, specifications, and performance requirements of this IFB. 2.15 In case of a discrepancy between the unit price and the extended total for an item, the figure that is most advantageous to the Authority will apply. An opened Bid may not be changed to correct any error by the Bidder or Bidder’s agent. 2.16 It is not the policy of the Authority to award a contract on the basis of price alone. The Authority reserves the right to award the contract to the lowest responsible Bidder who provides the specified goods and services at the best value to the Authority. To determine best value to the Authority, the Authority may, in accordance with Texas Local Government Code Section 252.043, consider: the purchase price; reputation of the Bidder and of the Bidder’s goods and services; the quality of the Bidder’s goods or services; the extent to which the goods or services me et the Authority’s needs; the Bidder’s past relationship with the Authority; the impact on the ability of the Authority to comply with laws and rules relating to contracting with historically underutilized businesses and nonprofit organizations employing persons with disabilities; the total long-term cost to the Authority; and any other relevant criteria specifically listed, herein. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 6 - 2.17 If, at any time, the successful Bidder fails to fulfill or abide by the terms, conditions, specifications, or performance requirements of this IFB, or any contract awarded and entered pursuant thereto, the Authority reserves the right to: 2.17.1 Purchase Water Treatment Chemicals services on the open market and charge Bidder the difference between its contract price and new contractor’s price; 2.17.2 Deduct charges from the successful Bidder the difference between its contract price and new contractor’s price; 2.17.3 Terminate any awarded contract without penalty on the Authority, by furnishing written notice of termination to Bidder, and select another Bidder and award a contract to its Bidder pursuant to the terms thereof. 2.18 At the Authority’s sole discretion and convenience, the Authority may terminate any awarded contract without regard to cause without penalty, and pay for the authorized services provided to the date of termination. 2.19 If it is determined that any benefit to secure favorable treatment was offered, elicited, or provided by Bidder or Bidder’s employee, affiliate, representative, partner, subcontractor, or agent, to any officer or employee of the Authority, Bidder will be disqualified from consideration and/or the awarded contract will be terminated. 2.20 All goods, raw materials, and products provided pursuant to the awarded contract must be new and not used, shop worn, or reconditioned. 2.21 All work must be in compliance with and conform to any and all applicable state or local laws, ordinances, regulations, codes, rules, policies, and interpretations thereof. 2.22 Once a Bid has been selected, items or processes may be substituted only by furnishing an equal or superior quality and/or grade product or process than originally specified at no additional cost to the Authority. Any such substitution shall be pre-approved by the Authority, and the acceptance of any such substitution shall be in the Authority’s sole discretion. 2.23 Any contract awarded pursuant to this IFB is only assignable, upon written consent of both parties, which consent shall not be unreasonably withheld. 2.24 The Authority is tax exempt under Tax Code, Subtitle E. SALES, EXCISE, AND USE TAXES, CHAPTER 151, section 151.309, as amended. 2.25 Invoices for partial payment must be approved in advance by the Purchasing Manager. 2.26 Bidder shall include a Safety Data Sheet (SDS). 2.27 Undisputed payments will be submitted to Bidder within thirty (30) days from receipt of original invoice. 2.28 Any contract awarded pursuant to this IFB shall be governed by the Uniform Commercial Code, if applicable. Wherever the “Uniform Commercial Code” is used, it shall be construed as meaning the Uniform Commercial Code as adopted in the State of Texas effective and in force on the date of any such agreement between the Authority and Bidder. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 7 - 2.29 Trade secrets and confidential information contained in a Bid are subject to the Texas Public Information Act. Pricing is not confidential information. Bidders who include information in a Bid that is legally protected as a trade secret or confidential information must clearly indicate the specific protected information by highlighting that information and marking it “Trade Secret” or “Confidential” at the appropriate place. The Authority will not be responsible for any public disclosure of the trade secret or confidential information if it is not marked as provided above. An awarded Bid in its entirety is not confidential. If a request is made under the Texas Public Information Act to inspect information designated as trade secret or confidential in a Bid, Bidder shall, upon notification by the Authority, immediately furnish sufficient written reasoning as to why the information should be protected from disclosure in a timely manner to the Texas Attorney General for final determination at the address below: Office of the Attorney General Open Records Division P.O. Box 12548 Austin, TX 78711 Fax 512-463-2092 2.30 The obligations of the parties under a contract awarded through this IFB are primarily performable in Williamson County, Texas. Exclusive venue shall be Williamson County, Texas, and any contract awarded under this IFB shall be governed by the laws of the State of Texas. 2.31 The Authority may, at its option, offset any amounts due and payable under a contract awarded under this IFB against any debt (including taxes) lawfully due to the Authority from the successful Bidder, regardless of whether the amount due arises pursuant to the terms of the contract or otherwise, and regardless of whether or not the debt due to the Authority has been reduced to judgment by a court. 2.32 No member of the Authority Board or any Authority employee shall have any financial interests in the profits of any contract, service or other work performed by the Bidder(s) or personally profit directly or indirectly from any contract, purchase, sale or service between the Authority and any person or company. 2.33 TEXAS GOVERNMENT CODE/PROHIBITION OF BOYCOTT ISRAEL: Bidder verifies that it does not Boycott Israel and agrees that during the term of this Agreement will not Boycott Israel as that term is defined in Texas Government Code Section 808.001/2270.001, as amended. By signing a Bid, the Bidder certifies that it does not boycott Israel and will not boycott Israel during the term of this contract. 2.34 TEXAS GOVERNMENT CODE/PROHIBITION OF BOYCOTT FIREARMS AND AMMUNITION INDUSTRIES: Senate Bill 19, Effective September 1, 2021, amended Subtitle F, Title 10 of the Texas Government Code to add Chapter 2274 which prohibits a political subdivision of the State of Texas from entering into a contract with a company that discriminates against the firearms and ammunition industries. By signing below, Bidder certifies that it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association as defined by Chapter 2274 of the Texas Government Code, and will not so discriminate during the term of the contract. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 8 - 2.35 TEXAS GOVERNMENT CODE/PROHIBITION OF BOYCOTT ENERGY COMPANIES: Senate Bill 13, effective September 1, 2022, amended Subtitle F, Title 10 of the Texas Government Code to add Section 2274.002 which prohibits a political subdivision of the State of Texas from entering into a contract with a company that discriminates against energy companies. By signing a Bid, the Bidder certifies that it does not boycott energy companies and will not boycott energy companies during the term of this contract. 2.36 The awarded contract is subject to the appropriation of funds by the Authority Board in the Authority’s budget adopted for any fiscal year for the specific purpose of making payments pursuant to the awarded contract for that fiscal year. The obligation of the Authority pursuant to the awarded contract in any fiscal year for which the awarded contract is in effect shall constitute a current expense of the Authority for that fiscal year only, and shall not constitute an indebtedness of the Authority of any monies other than those lawfully appropriated in any fiscal year. In the event of non-appropriation of funds in any fiscal year to make payments pursuant to the awarded contract, the awarded contract may be terminated. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 9 - 3. SPECIAL CONDITIONS 3.1 Insurance The successful Bidder shall procure and maintain in force during the terms of any contract awarded pursuant to this IFB, at its own cost, the following minimum insurance coverage: A. Workers’ Compensation and Employer’s Liability: a. State of Texas: $1,000,000 Each Accident b. Employer’s Liability: $100,000 Each Accident $500,000 Disease-Policy Limit $100,000 Disease-Each Employee c. Waiver of Subrogation B. Commercial General Liability: a. Bodily Injury and Property Damage General Aggregate Limit: $1,000,000 b. Personal and Advertising Injury Limit: $500,000 c. Each Occurrence Limit: $1,000,000 The policy shall be on an Occurrence Form and include the following coverage: Premises Operations; Personal and Advertising Injury; Medical Payments; Liability assumed under an Insured Contract; Independent Contractors; and Broad Form Property Damage. Coverage provided should be at least as broad as found in Insurance Services Office (ISO) form CG0001. C. Commercial Automobile Liability Limits: a. Bodily Injury and Property Damage General Aggregate Limit: $1,000,000 b. Medical Payments: $5,000 Per Person c. Uninsured/Underinsured Motorist: $100,000 Prior to the execution of any awarded contract by the Authority, the successful Bidder shall forward Certificates of Insurance to the Purchasing Manager. The required insurance policies shall be procured and maintained in full force and effect for the duration of the awarded contract. Certificate Holder shall be the BCRUA at 450 Cypress Creek Rd., Cedar Park, Texas 78613. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 10 - 3.2 Damage Provision If in performance pursuant to an awarded contract, successful Bidder, or Bidder’s employee, affiliate, representative, partner, subcontractor, or agent, damages the Authority’s real or personal property, Bidder shall compensate the Authority for the cost of repair or replacement, whichever the Authority determines is appropriate under the circumstances. In such event, the Authority will provide to successful Bidder an invoice stating the actual cost of repairing or replacing the damaged property. Successful Bidder shall provide payment of the invoiced amount within thirty (30) days of its receipt of said invoice. Should successful Bidder refuse to compensate the Authority for the damage incurred, said invoiced amount shall be withheld from the amount payable to successful Bidder for services rendered pursuant to the awarded contract. This provision does not waive or diminish the Authority’s right to pursue any and all legal remedies to collect for damages caused by Bidder, or Bidder’s employee, affiliate, representative, partner, subcontractor, or agent. 3.3 Bid Terms By signing and submitting a Bid, Bidder agrees: 3.3.1 To hold this Bid open for one hundred twenty (120) days after the Due Date for review of the Bid. 3.3.2 That orders will be delivered, “F.O.B. Destination, Inside Delivery” within the time specified in the Bid after receipt of order by fax, in-person, or by mail. 3.3.3 To furnish goods and services in strict compliance with the terms, conditions, specifications, and performance requirements of this IFB. 3.3.4 That payment(s) will only be made from an original invoice, not from any statement, and invoices for payment shall be submitted via e-mail to accounts.payable@cedarparktexas.gov or via mail, courier, or personal delivery to: BCRUA Attn: Accounts Payable 450 Cypress Creek Rd. Bldg. 1 Cedar Park, Texas 78613 3.3.5 Invoices shall not include Federal Excise, State, or Authority sales taxes, as the Authority shall furnish a tax exemption certificate. 3.3.6 The Authority shall notify the successful Bidder of any contested invoice(s) in writing, and the Authority and successful Bidder shall mutually resolve such disputed invoice(s) within sixty (60) days of successful Bidder’s receipt of said notice of dispute. 3.4 The term of contract shall be for one year, beginning on the date of execution of the contract, and shall automatically renew for up to four (4) additional one (1) year periods. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 11 - 3.5 Limit Award The Authority reserves the right to award multiple contracts for portions of this work to others, based on the Bids submitted, if it is in the best interest of the BCRUA. Alternatively, the Authority may, at its option, award by line item as opposed to awarding the entire Bid to the same vendor. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 12 - 4. SPECIFICATIONS 4.1 General Conditions 4.1.1 Certified Analysis: Each bid shall be accompanied by an affidavit stating the purity of the product to be provided and its suitability for the intended uses of BCRUA. 4.1.2 During the bid evaluation process, BCRUA may require Bidders to submit samples and specifications of each chemical to be tested to determine the accuracy of the Bidders’ stated purity, chemical validity, and compatibility to operating equipment. Analysis of the sample shall be performed in a laboratory of BCRUA’s choice. If the sample purity is less than the stated purity, the cost of the analysis shall be paid by the Bidder. 4.1.3 BCRUA reserves the right to have each shipment analyzed and to reject the shipment if it does not meet AWWA and NSF/ANSI standards. 4.1.4 If Bidder needs to test polymer chemicals (Aqualum, Hyper+Ion, Aqua Hawk) in order to provide an accurate bid, they may do so ONLY between the hours of 10 AM and 2 PM on April 29th & 30th at: BCRUA Water Treatment Plant 1906 Hur Industrial Blvd. Cedar Park, Tx. 78613 4.1.5 Orders shall be placed as required. After award of bid, the contact will be BCRUA Water Treatment Plant Superintendents or a designee. Contact the superintendent or the designee twenty-four (24) hours prior to delivery or with any technical questions you may have. 4.1.6 Sampling and Testing Prior to Unloading: BCRUA reserves the right to subject samples of the chemicals to complete analyses to ensure that it meets specifications. Any load tested by BCRUA that fails to comply with the Specification shall constitute grounds for rejection of that load. No payment shall be made for chemicals that are rejected. In the event that the load is rejected, the Vendor shall have twenty-four (24) hours to supply another shipment. In the event that the Vendor is unable or unwilling to supply another shipment within this time period, BCRUA has the right to procure a shipment from another source and charge the Vendor the price difference, if any. Three rejections of a l oad or shipment during any period of this agreement may constitute automatic termination of the Vendor’s agreement with BCRUA. 4.1.7 Sampling and Test of Shipment after Unloading: BCRUA reserves the right to subject samples of the chemicals to complete analyses to ensure that it meets specifications. Three failures during any period of this purchase order may constitute automatic termination of the Vendor’s agreement from BCRUA. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 13 - 4.2 Delivery 4.2.1 BCRUA may request the successful Bidder (“Vendor”) to email a Certificate of Analysis (COA) of the product lot to be delivered. 4.2.2 Packaging and shipment of chemicals shall conform to all current regulations of the State of Texas, the United States Department of Transportation (DOT) and all other applicable regulatory agencies. 4.2.3 BCRUA reserves the right to change quantities and delivery dates at its discretion with a 24-hour notice before scheduled delivery. 4.2.4 Before unloading and upon arrival to the site, the driver shall notify Operations, and present the Bill of Lading, the Certificate, and any other applicable order/delivery documents to the Operations representative. After review and approval of the delivery documents, Operations staff will then escort the driver to the appropriate unloading station. BCRUA reserves the right to reject the delivery based on inadequate or nonconforming information in these documents. All other documentation prescribed by DOT, ICC, other regulatory bodies and statutes must be provided when the chemical is delivered. 4.2.5 The Vendor will be required to transport the shipments to the site and unload the product in an area designated by BCRUA. All labor and equipment costs required for the loading and unloading of the product shall be borne by the vendor. Vendor shall bear all expenses associated with any chemical removal, site cleaning and material disposal due to an error on Vendor’s or their subcontractors’ part to transfer the chemical into the correct storage area. 4.2.6 The transporting equipment shall be clean and free of residue that may contaminate the Vendor’s product or impede the unloading process. It is the Vendor’s responsibility to verify the cleanliness of the transporting equipment before loading. BCRUA may reject a load if the equipment is not properly cleaned. 4.2.7 All delivery vehicle drivers shall have a proper commercial driver’s license with a Hazardous Material endorsement. BCRUA reserves the right to check driver’s license. 4.2.8 Vendor is fully responsible for delivering the chemicals to the designated location without impacting the facility operation and/or condition. The Vendor shall be responsible for any spillage or leakage resulting from the failure of Vendor’s or its subcontractor’s delivery equipment or from failure of attendant delivery personnel in the proper performance of their duties. Proper performance shall require delivery personnel’s constant inspection and observation of unloading operations and knowledgeable response to problems and emergencies, which would most commonly be expected to occur. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 14 - 4.2.9 BCRUA reserves the right to refuse any and all deliveries made with equipment that is poorly maintained and/or leaking chemical. The Vendor shall observe the entire unloading operation and shall immediately report any spills caused during operations. 4.2.10 The Vendor shall indemnify and hold BCRUA harmless for any failure to properly report and/or comply with Federal and State rules/regulations regarding vendor caused spills or releases. The Vendor shall take immediate and appropriate actions to clean up any spilled/leaked liquid chlorine. 4.2.11 All delivery vehicles shall be fully equipped with all necessary container repair kits and self-contained breathing apparatus to properly respond to an emergency arising from uncontrolled discharge of the material provided. 4.2.12 Vendor shall provide an emergency response crew at no cost to BCRUA. Bidders shall state what emergency response crew will be used and a separate emergency telephone list. The emergency response crew must be capable of responding to an emergency within two (2) hours of notification that an emergency exists. If the spill is not cleaned up in a timely fashion, BCRUA will hire a qualified company to clean up the spill, and the cost of such service will charged to the Vendor and deducted from the amount due to the Vendor. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 15 - --FORMS TO BE RETURNED WITH BID— 5. BID The undersigned hereby declares: to have carefully examined the contract documents, including all addenda; have a clear understanding of said documents and premises; propose to provide the necessary tools, machinery, apparatus and other means of maintenance; and to furnish all labor, materials and services specified in the contract or called for in the contract documents for the prices as indicated below. BCRUA is in need of water treatment chemicals for BCRUA’s Water Plant located at 1906 Hur Industrial Blvd, Cedar Park, TX 78613. The intent of this solicitation is to allow the BCRUA to enter into a contract or multiple contracts for the procurement of the products specified on the following page at a fixed price for a twelve (12) month period. BCRUA will make award(s) based on Best Value as permitted in Section 252.043 of Texas Local Government Code. BCRUA will accept partial bids. Bidder shall submit pricing for any and all chemicals they wish to be considered for. If multiple Bidders bid on the same chemical, BCRUA reserves the right to award a primary vendor for each chemical (lowest bid) and one or more back up vendors in ascending bid order. PRICE INCREASE: Agreement prices for chemicals shall remain firm throughout the first twelve (12) month period of the Agreement. A price increase to the Agreement may be considered at renewal time each year thereafter and shall be equal to the lesser of: 1) consumer price index for that year, or 2) 5%. And at no time can the total increase be greater than 25% of the original unit price. CONSUMER PRICE INDEX (CPI): Price adjustments will be made in accordance with the percentage change in the U.S. Department of Labor Consumer Price Index for all Urban Consumers (CPI-U), All Items. The Price adjustment rate will be determined by comparing the percentage difference between: (a) the six month average unadjusted CPI using the most recent six months of available data at time of request, and (b) the six month average unadjusted CPI for the same six month period in the preceding year. The percentage difference between (a) and (b) will be the maximum allowable price adjustment rate. Please see the example provided below. No retroactive Agreement price adjustments will be allowed. CPI data can be found at the Bureau of Labor Statistics, Consumer Price Index website here: http://www.bls.gov/cpi/ PROCEDURE TO REQUEST INCREASE: Email the written price increase request with the rate detail comparison and comprehensive calculation to BCRUA's Purchasing Department a minimum of 30 days, but no sooner than 60 days, prior to each renewal period. The detailed written calculation will be verified and confirmed. All written requests for increases must include the BCRUA contract number, solicitation reference information, and contact information for the authorized representative requesting the increase. Price increase requests shall be sent by mail to: BCRUA Attn: Purchasing Department 450 Cypress Creek Rd, Bldg 1 Cedar Park, TX 78613 purchasing@cedarparktexas.gov 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 16 - Upon receipt of the request, BCRUA reserves the right to either accept the escalation and make changes to the Agreement within 30 days of the request, negotiate with the Vendor, or cancel the Agreement if an agreement cannot be reached on the value of the increase. Example Scenario and Calculation: 1. Agreement renewal date of December 1, 2024. 2. Price increase request due by: November 1, 2024. 3. Current period six month average will be calculated using unadjusted CPI data from May – October 2024. 4. Previous period six month average will be calculated using unadjusted CPI data from May – October 2023. 5. Current period six month average = 314.758 6. Previous period six month average = 306.236 7. Calculate % difference: (314.758 - 306.236) / 306.236 x 100 = 2.782 8. Max allowable price increase at renewal is 2.8% CONTRACT TIME: The Bidder agrees, if awarded the Contract, to commence work within ten (10) calendar days after receipt of a notice of award or in accordance with the schedule provided by owner. The term of this agreement shall be for one (1) year, beginning on the date of the execution of the agreement, and shall automatically renew for up to four (4) additional one (1) year periods. DOCUMENTS: Each Bidder by submittal of their IFB response represents and warrants that they are satisfied as to the requirements and provisions of the IFB for this project and the documents describing the scope of work. Signature: Aaron Opp Title: President Date: 5/15/2025 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 17 - PRICING SHEET *** BIDDER MUST ATTACH SAFETY DATA SHEETs (SDS) FOR ALL CHEMICALS BID *** Chemical Approximate Delivery Quantity Approximate Delivery Frequency Delivery Location Approximate Annual Quantity Unit Unit Price (delivered) Can you deliver within 5 business days? (Y or N) Sodium Hypochlorite - 12% Bleach 5000Gal Every 1-2 weeks 1906 Hur Industrial Blvd Cedar Park Texas 78613 195,000 Gallons Liquid Ammonium Sulfate 48,000lbs Every 4-6 weeks 1906 Hur Industrial Blvd Cedar Park Texas 78613 936,000 Pounds Aqualum 3003 35,200lbs Every 10-12 weeks 1906 Hur Industrial Blvd Cedar Park Texas 78613 176,000 Pounds Aqualum 3003 6 totes Every 4-6 months 1906 Hur Industrial Blvd Cedar Park Texas 78613 28,584 Pounds Aluminum Chlorohydrate + 4% LCS 48,000lbs Every 3-4 weeks 1906 Hur Industrial Blvd Cedar Park Texas 78613 624,000 Pounds Aqua Hawk 9937 6 totes Every 4-6 months 1906 Hur Industrial Blvd Cedar Park Texas 78613 32,410 Pounds Fluorosilic Acid 23% 35,200 Every 6-8 weeks 1906 Hur Industrial Blvd Cedar Park Texas 78613 211,200 Pounds Sodium Permanganate 3000 4-6 months 1906 Hur Industrial Blvd Cedar Park Texas 78613 6000 Gallons $11.519 yes 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 18 - 6. DEMONSTRATION OF EXPERIENCE Years in business under present business name: 36 years Total years of experience in work of the type called for in this contract: 36 years List in table below the contracts of similar scope and scale to the Authority’s IFB has your organization completed. List most recent FIRST: Contract Amount Type of Work Date Completed Owner’s Name & Contact Info Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. List in the table below what contracts your organization currently has: Contract Amount Type of Work Projected Date of Completion Owner’s Name & Contact Info Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap to enter a date. Click or tap here to enter text. If you have any additional experience or work that you would like to submit, please provide separate additional documentation upon submittal. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 19 - Have you ever failed to complete any contract awarded to you? ☒ Yes ☐ No If “Yes”, state where and why. Only during Covid Are you at present in any major litigation or lawsuits involving work of any type? ☐ Yes ☒ No If “Yes”, explain: Click or tap here to enter text. Explain in detail the manner in which you have inspected the work proposed in this contract: Click or tap here to enter text. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 20 - 7. LIST OF MACHINERY AND EQUIPMENT It is required that a Contractor be able to perform the requested services. It is represented as part of this Bid that the below listed equipment is available for use on the work covered by the Scope of Work. As a part of the Bid evaluation BCRUA may inspect the availability and capability of the equipment of the Contractor submitting the winning Bid. Units Types of Equipment Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 21 - 8. VENDOR PROFILE Company Name: Chemrite, Incorporated and D/B/A: Click or tap here to enter text. Telephone Numbers: Phone: 770-271-5576 877-248-0017 Fax: 770-271-4068 If there is no toll free number, does the company accept collect calls? ☐ Yes ☒ No Contacts: Corporate Contact for this Bid: Name: Aaron Opp Address: 5202 Belle Wood Ct., Ste 104 Authority, State, Zip: Buford, GA 30518 Phone: 770-271-5576 Fax: 770-271-4068 E-mail: orders@chemrite.com Website: www.chemrite.com If local contact is the same as corporate contact, check here ☐ Local Contact for this Bid: Name: Click or tap here to enter text. Address: Click or tap here to enter text. Authority, State, Zip: Click or tap here to enter text. Phone: Click or tap here to enter text. Fax: Click or tap here to enter text. E-mail: Click or tap here to enter text. Number of years the company has been in business under this name: 36 years Other company names used with dates, from/to: Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 22 - 9. BID RESPONSE FORM By signing and submitting this Bid, Bidder acknowledges that they have inspected the specifications, are capable and willing to perform and/or provide the required services and/or products, and shall complete this project within the amount of time and dollar amount specified. The undersigned certifies that the prices contained in this Bid have been carefully checked and submitted as correct and final. All unit prices include the cost of delivery. The undersigned is authorized to bind themselves or the entity they represent to a contract. ☐ An individual proprietorship ☐ A partnership ☒ A corporation chartered under the laws of the State of Georgia, acting by its officers pursuant to its by-laws or a resolution of its Board of Directors Signature: Aaron OPp Printed Name: Aaron Opp Title: President Date: 5/15/2025 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 23 - 10. REFERENCES Bidder shall submit a list of at least three (3) references for which Bidder has provided like products or services. References will include contact name and telephone number. Bids submitted without three references may be disqualified from consideration. Cedar Park/Austin area references are preferred. Company: Click or tap here to enter text. Contact name: Click or tap here to enter text. Phone number: Click or tap here to enter text. Email: Click or tap here to enter text. Company: Click or tap here to enter text. Contact name: Click or tap here to enter text. Phone number: Click or tap here to enter text. Email: Click or tap here to enter text. Company: Click or tap here to enter text. Contact name: Click or tap here to enter text. Phone number: Click or tap here to enter text. Email: Click or tap here to enter text. Company: Click or tap here to enter text. Contact name: Click or tap here to enter text. Phone number: Click or tap here to enter text. Email: Click or tap here to enter text. Company: Click or tap here to enter text. Contact name: Click or tap here to enter text. Phone number: Click or tap here to enter text. Email: Click or tap here to enter text. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 24 - 11. DEVIATION OR COMPLIANCE FORM DEVIATIONS: In the event the undersigned Bidder intends to deviate from the general terms, conditions, special conditions or specifications contrary to those listed in the “Terms and Conditions” and other information attached hereto, all such deviations must be LISTED ON THIS PAGE, with complete and detailed conditions and information also being attached (attach additional pages as necessary). NO DEVIATIONS: In the absence of any deviation entry on this page, Bidder assures the Authority of Bidder’s compliance with the Terms, Conditions, Specifications, and information contained in this IFB. Deviation # Deviation Title IFB Reference (related to the deviation) Detailed Deviation Description Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. Click or tap here to enter text. 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 25 - 12. RELEASE AND INDEMNIFICATION TO THE MAXIMUM EXTENT PERMITTED BY LAW, BIDDER HEREBY AGREES AND CONSENTS FOR ITSELF, INDIVIDUALLY, AND ON BEHALF OF THE BUSINESS ENTITY, TO FULLY AND UNCONDITIONALLY RELEASE, INDEMNIFY, DEFEND, AND HOLD HARMLESS THE BCRUA, TEXAS, INCLUDING ITS OFFICERS, AGENTS AND EMPLOYEES, AND TO DEFEND AND HOLD IT HARMLESS FROM AND AGAINST ANY AND ALL COSTS, EXPENSES, ATTORNEY FEES, CLAIMS, SUITS, DEMANDS, LOSSES, OR LIABILITY FOR INJURIES TO REAL OR PERSONAL PROPERTY AND INJURIES TO PERSONS INCLUDING DEATH, INCLUDING BIDDER’S EMPLOYEES, AFFILIATES, REPRESENTATIVES, PARTNERS, AGENTS, OR THOSE WORKING ON BIDDER’S BEHALF, FROM ANY AND ALL OTHER COSTS, EXPENSES, ATTORNEY FEES, CLAIMS, SUITS, DEMANDS, LOSSES OR LIABILITIES OF ANY AND EVERY NATURE WHATSOEVER ARISING IN ANY MANNER, DIRECTLY OR INDIRECTLY, OUT OF OR IN CONNECTION WITH ANY CONTRACT AWARDED PURSUANT TO THIS IFB AND IN THE PERFORMANCE THEREOF, REGARDLESS OF CAUSE OR OF THE SOLE, JOINT, COMPARATIVE OR CONCURRENT NEGLIGENCE OR GROSS NEGLIGENCE, SAVE AND EXCEPT THE SOLE AND EXCLUSIVE NEGLIGENCE OF THE AUTHORITY. THIS PROVISION SHALL APPLY TO ALL IMPUTED OR ACTUAL JOINT ENTERPRISE AND JOINT VENTURE LIABILITY, IF ANY. Signature: Aaron Opp Printed Name: Aaron Opp Title: President Date: 5/15/2025 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 26 - 13. NON-COLLUSION ACKNOWLDGEMENT The undersigned Bidder affirms that they are duly authorized to execute this Bid, that this company, corporation, firm, partnership or individual has not prepared this Bid in collusion with any other Bidder, and that the contents of this Bid as to prices, terms and conditions thereof have not been communicated by the undersigned Bidder, nor by Bidder’s employee, affiliate, representative, partner, subcontractor, or agent, to any other individual or entity engaged in this type of business prior to the official opening of this IFB. Company Name: Chemrite, Incorporated Signature of Company Officer: Aaron Opp Company Officer Printed Name: Aaron Opp Title: President Date: 5/15/2025 14. SUSPENSION OR DEBARMENT CERTIFICATE Non-Federal entities are prohibited from contracting with or making subcontract awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement for goods or services equal to or in excess of $100,000.00. Contractors receiving individual awards for $100,000.00 or more and all subcontract recipients must certify that the organization and its principals are not suspended or debarred. By submitting this offer and signing this certificate, Bidder certifies that no suspension or disbarment is in place, which would preclude receiving a federally funded contract under the Federal OMB, A-102, Common Rule, as may be amended. Company Name: Chemrite, Incorporated Signature of Company Officer: Aaron Opp Company Officer Printed Name: Aaron Opp Title: President Date: 5/15/2025 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 27 - 15. COOPERATIVE PURCHASING Interlocal Cooperative Contracting/Purchasing: Authority for local governments to contract with one another to perform certain governmental functions and services, including but not limited to purchasing functions, is granted under Government Code, Title 7, Chapter 791 Interlocal Cooperation Contracts, Subchapter B and Subchapter C, and Local Government Code, Title 8, Chapter 271, Subchapter F, Section 271.101 and Section 271.102. Other governmental entities within the State of Texas may be extended the opportunity to purchase off of the BCRUA’s IFB, with the consent and agreement of the successful Bidder(s) and the BCRUA. Such consent and agreement shall be conclusively inferred from lack of exception to this clause in Bidder’s Bid. However, all parties indicate their understanding and all parties hereby expressly agree that the BCRUA is not an agent of, partner to, or representative of those outside agencies or entities and that the BCRUA is not obligated or liable for any action or debts that may arise out of such independently-negotiated cooperative procurements. Other governmental entities utilizing Interlocal agreements with the BCRUA, may desire, but are not obligated, to purchase goods and services defined in this Bid from the successful Bidder. All purchases by governmental entities, other than the BCRUA, will be billed directly to and paid by that governmental entity. The BCRUA will not be responsible for other governmental entities debts. Each governmental entity will place their own orders with the successful Bidder and be responsible for ensuring full compliance with the specifications. Prior to other governmental entities placing orders, the BCRUA will notify the successful Bidder of their intent. Please indicate below if you will permit other governmental entities to purchase from your agreement with the BCRUA. ☒ Yes, others can purchase; ☐ No, only the BCRUA can purchase. Signature: Aaron Opp Printed Name: Aaron Opp Title: President Date: 5/15/2025 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 28 - 16. CONFLICT OF INTEREST AND QUESTIONAIRE Please sign, if applicable The Texas Ethics Commission adopted the attached Conflict of Interest Questionnaire (Form CIQ) pursuant to Texas Local Government Code Chapter 176, as amended. For questions about these forms, please see the Texas Ethics Commission at: https://www.ethics.state.tx.us/data/forms/conflict/CIQ.pdf Bidder shall answer each question in the attached Form CIQ in relation to the following individuals and submit a completed form with its Bid: Local Government Officer Title Local Government Officer Title Na’Cole Thompson President of Board of Directors Anne Duffy Vice President of Board of Directors Rene Flores Secretary Jason Anderson Citizen Director Hilda Montgomery Citizen Director Mel Kirkland Citizen Director Sam Roberts General Manager Christian Culver Superintendent Jennifer Baumeister Administrative Support Assistant Ryan Manilla Supervisor 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 29 - 17. DISCLOSURE OF INTERESTED PARTIES Prior to entering into a contract that is at least $1 million in value, the Bidder must submit a “Certificate of Interested Parties” Form, in accordance with Texas Government Code Section 2252.908, as amended. Within 30 days of receipt of the form, the Authority must submit a copy to the Texas Ethics Commission. 18. W-9 FORM 450 Cypress Creek Rd. Bldg. 1 * Cedar Park, Texas 78613 * www.cedarparktexas.gov * (512) 401-5000 * Fax: (512) 258-6083 -30- 450 Cypress Creek Rd. Bldg. 1 • Cedar Park, Texas 78613 • www.cedarparktexas.gov • (512) 401-5000 • Fax: (512) 258-6083 - 30 - 18. W-9 FORM