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Finance Committee - Agenda - 8/3/2022 - P67

By dnadmin on Sun, 11/06/2022 - 21:46
Document Date
Thu, 07/28/2022 - 10:40
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 08/03/2022 - 00:00
Page Number
67
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__080320…

City of Nashua

Administrative Services Division

(603) 589-3020
229 Main Street - Nashua, NH 03060

To: Mayor Donchess
Finance Committee

Date: July 26, 2022
Re: Contract — ESRI GIS Enterprise Agreement

This request is for the Annual Agreement between the City of Nashua/Pennichuck Corp. and ESRI
(Environmental Systems Research Institute, Inc.)

Funding: GIS 34.1.500 — 54407 Software, City of Nashua cost $38,436 for FY23, $115,308 3 Yr.
Total Cost

Annually the City of Nashua and Pennichuck Corp. renews the annual contract with ESRI for our GIS
Enterprise License. In the past, the renewal for the Small Government Term Enterprise License has
been $50,000. split between the City of Nashua and Pennichuck Corp. The renewal agreements have
consistently been renewed for a period of three years, the most recent covering 2019, 2020 and
2021, expiring July of 2022.

The attached contract renewal covers 2022, 2023 and 2024 at annual cost to the City of $38,436.
The change in price reflects both an increase in the base cost of the Small Government Term
Enterprise License from $50,000 to $64,872, as well as the addition of a program costing $6,000 for
the City of Nashua and $5,500 for Pennichuck Corp.

We request the approval of the Finance committee and the Board of Aldermen for the three year
contract renewal with ESRI at an annual cost to the City of Nashua of $38,436.

Kimberly Kleiner

Administrative Services Division Director

Ce: A. Girard
J. Graziano

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Finance Committee - Agenda - 8/3/2022 - P67

Finance Committee - Agenda - 9/4/2019 - P33

By dnadmin on Mon, 11/07/2022 - 13:03
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
33
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

EXHIBIT C - FORMS

THE FOLLOWING PAGES MUST BE FILLED

24

Page Image
Finance Committee - Agenda - 9/4/2019 - P33

Finance Committee - Agenda - 9/4/2019 - P34

By dnadmin on Mon, 11/07/2022 - 13:03
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
34
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

Date:

Firm:

FTA BUS TESTING CERTIFICATION

I. NEW BUS MODEL TO BE TESTED

In accordance with 49 CFR Part 665, “Bus Testing Program,” the Proposer certifies that the bus
model being proposed for this Contract is a new bus model or a bus model with a major change in
configuration or components (as described in Subpart A of the interim rule). Bidder, at its own
expense, will arrange for the required testing at the FTA Bus Testing Facility at Altoona, Pennsylvania
prior to the Authority's acceptance of the first vehicle in a manner that the Time for Performance
outlined in the Contract Specifications will not be impacted. Sellerwill provide a copy of the Test
Report prepared for this bus model prior to acceptance.

OR

Hl. BUS MODEL ALREADY TESTED

In accordance with 49 CFR Part 665, “Bus Testing Program,” the Proposer certifies that the bus
model being proposed for this Contract is not a new bus model and does not incorporate a major
change in configuration or components (as described in Subpart A of the interim rule). The
Sellerwill provide, upon request of the Authority, a copy of the Test Report prepared for the bus
model accepted under this Contract.

(CHECK ONE BOX ONLY)

Signature:

Title:

25

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Finance Committee - Agenda - 9/4/2019 - P34

Finance Committee - Agenda - 9/4/2019 - P35

By dnadmin on Mon, 11/07/2022 - 13:03
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
35
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

CERTIFICATE OF

TVM DBE

COMPLIANCE

(TO BE FILLED OUT BY MANUFACTURER'S OF ROLLING STOCK ONLY)
In connection with the contract to be awarded as a result of the invitation to bid issued by the Nashua Transit
System:

| hereby certify that the (name of company) has complied with
the requirements of 49 CFR 26, participation by Disadvantage Business in DOT Programs, and that our goals
have not been disapproved by the Federal Transit Administration.

Name of Company

Signature of Authorized Official

Name and Title of Authorized Official

Date

26

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Finance Committee - Agenda - 9/4/2019 - P35

Finance Committee - Agenda - 9/4/2019 - P36

By dnadmin on Mon, 11/07/2022 - 13:03
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
36
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

BUY AMERICA CERTIFICATE OF COMPLIANCE WITH FTA
REQUIREMENTS FOR BUSES, OTHER ROLLING STOCK,
OR ASSOCIATED EQUIPMENT

(To be submitted with a bid or offer exceeding the small purchase threshold for Federal
assistance programs, currently set at $150,000.)

Certificate of Compliance

The bidder hereby certifies that it will comply with the requirements of 49 U.S.C.
Section 5323(j)(2)(C), Section 165(b)(3) of the Surface Transportation Assistance
Act of 1982, as amended, and the regulations of 49 CFR 661.11:

Date:

Signature:

Company Name:

Title:

Certificate of Non-Compliance

The bidder hereby certifies that it cannot comply with the requirements of 49 U.S.C. Section
5323(j)(2)(C) and Section 165(b)(3) of the Surface Transportation Assistance Act of 1982,
as amended, but may qualify for an exception to the requirements consistent with 49
U.S.C. Sections 5323(j)(2)(B) or (j)(2)(D), Sections 165(b)(2) or (b)(4) of the Surface
Transportation Assistance Act, as amended, and regulations in 49 CFR 661.7.

Date:

Signature:

Company Name:

Title:

27

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Finance Committee - Agenda - 9/4/2019 - P36

Finance Committee - Agenda - 9/4/2019 - P37

By dnadmin on Mon, 11/07/2022 - 13:03
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
37
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

Federal Motor Vehicle Safety Standards

The Proposer and (if selected) Seller shall submit (1) manufacturer's FMVSS self-certification sticker
information that the vehicle complies with relevant FMVSS or (2) manufacturer's certified statement that the
contracted buses will not be subject to FMVSS regulations.

Company name:
Name of signer:
Title:

Authorized signature Date

28

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Finance Committee - Agenda - 9/4/2019 - P37

Finance Committee - Agenda - 9/4/2019 - P38

By dnadmin on Mon, 11/07/2022 - 13:04
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
38
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion

- Lower Tier Covered Transaction

(1) The prospective lower tier participant certifies, by submission of this bid or proposal, that neither it
nor its "principals" [as defined at 49 CFR § 29.105(p)] is presently debarred, suspended, proposed
for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by
any Federal department or agency.

(2) When the prospective lower tier participant is unable to certify to the statements in this certification,
such prospective participant shall attach an explanation to this proposal.

The bidder respondent and all subcontractors hereby certifies that he/she has not been debarred or
suspended from participation in Federal contracts. Please note - separate certification may be photo
copied and submitted by each subcontractor. (Pursuant to 49 CFR, Part 29)

CERTIFIED (Contractor) CERTIFIED (Sub-Contractor(s))

| | | |
Company Company
| | | |
Signed By Signed By

| | |
Name & Title Name & Title
| | | |
Date Date

29

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Finance Committee - Agenda - 9/4/2019 - P38

Finance Committee - Agenda - 9/4/2019 - P39

By dnadmin on Mon, 11/07/2022 - 13:04
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
39
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

DISCLOSURE OF LOBBYING ACTIVITIES

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

(1) No Federal appropriated 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
an 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 contract, the making of
any Federal grant, the making 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 making lobbying contacts to 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 Federai contract, grant, ioan, or cooperative agreement, the undersigned
shall complete and submit Standard Form--LLL, "Disclosure Form to Report Lobbying,” in
accordance with its instructions [as amended by "Government wide Guidance for New
Restrictions on Lobbying," 61 Fed. Reg. 1413 (1/19/96). Note: Language in paragraph (2)
herein has been modified in accordance with Section 10 of the Lobbying Disclosure Act of
1995 (P.L. 104-65, to be codified at 2 U.S.C. 1601, et seq.)]

(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts
under grants, loans, and cooperative agreements) and that all subrecipients 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 31, U.S.C. § 1352 (as amended by the Lobbying
Disclosure Act of 1995). 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.

[Note: Pursuant to 31 U.S.C. § 1352(c)(1)-(2)(A), any person who makes a prohibited expenditure
or fails to file or amend a required certification or disclosure form shall be subject to a civil penalty
of not less than $10,000 and not more than $100,000 for each such expenditure or failure.]

The Seller_certifies or affirms the truthfulness and accuracy of each statement of its certification
and disclosure, if any. In addition, the Sellerunderstands and agrees that the provisions of 314
U.S.C. A 3801, ef seg., apply to this certification and disclosure, if any.

Executed this day of , 20.

Name of Bidder

Address

City/State/Zip

| | | |

Name of Contractor's Authorized Official Signature of Contractor's Authorized Official

| |

Title of Contractor's Authorized Official

30

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Finance Committee - Agenda - 9/4/2019 - P39

Finance Committee - Agenda - 9/4/2019 - P40

By dnadmin on Mon, 11/07/2022 - 13:04
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
40
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

DELINQUENT PERSONAL PROPERTY STATEMENT

, hereby affirms under oath, pursuant to New Hampshire State
Code, that at the time the bid was submitted by_(company) was / was not (please circle one) charged with
delinquent personal property taxes on the General Tax List of Personal Property for Hillsborough County, New
Hampshire.

If such charge for delinquent personal property tax exists on the General Tax List of Personal Property for
Hillsborough County, New Hampshire, the amount of such due and unpaid delinquent taxes, including due
and unpaid penalties and interest shall be set forth below. A copy of this statement shall be transmitted to
the Hillsborough County Treasurer within thirty (30) days of the date it is submitted. If a contract is entered
into, a copy of this statement shali also be incorporated into the contract between NTS and the bidder and no
payment shall be made with respect to any contract unless such statement has been so incorporated as a

Delinquent Personal Property Tax *

part thereof.
Penalties *
Interest *

Company

Signed By

Name & Title

Date

State of

County of

SWORN TO BEFORE ME THIS DAY OF. ,20_

NOTARY PUBLIC

SEAL

MY COMMISSION EXPIRES

* Mark “N/A” if not applicable

31

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Finance Committee - Agenda - 9/4/2019 - P40

Finance Committee - Agenda - 9/4/2019 - P41

By dnadmin on Mon, 11/07/2022 - 13:04
Document Date
Fri, 08/30/2019 - 13:47
Meeting Description
Finance Committee
Document Type
Agenda
Meeting Date
Wed, 09/04/2019 - 00:00
Page Number
41
Image URL
https://nashuameetingsstorage.blob.core.windows.net/nm-docs-pages/fin_a__090420…

NON-COLLUSIONAFFIDAVIT

This affidavit is to be filled out and executed by the bidder; if a corporation makes the bid, then by its properly
executed agent. The name of the individual swearing to the affidavit should always appear on the line marked
"Name of Affidavit.". The affidavit's capacity, when a partner or officer of a corporation, should be inserted on
lines marked "Capacity." The affidavit should sign individual name at end not partnership or corporation name,
and swear to said affidavit before a notary public, who must attach his/her seal.

State of ,

County of. ,

I, being first duly sworn, do hereby state that
(Name of Affidavit)

lam of
(Capacity) (Name of Firm, Partnership, Corporation)

whose business is

and who resides at

and that

(Give names of all persons, firms, or corporation interested in the bid)

is/are the only person(s) with me/us in ihe profits of the herein contained contract; that the contract is made
without any connection or interest in the profits thereof with any persons making any bid or proposal for said
work; that the said contract is on my/our part, in all respects fair and without coliusion or fraud, and also that no
members of the Board of Trustees, head of any department or bureau, or employee therein, or any employee
of the Authority, is directly or indirectly interested therein.

SIGNATURE OF AFFIDAVIT

SWORN TO BEFORE ME THIS DAY OF ,20_.
NOTARY PUBLIC

SEAL
MY COMMISSION EXPIRES

32

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Finance Committee - Agenda - 9/4/2019 - P41

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