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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)

Company

Signed By

Name

Title

Date

12|Page

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. Ifa contract is entered into, a copy
ofthis statement shall 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 part thereof.

Delinquent Personal Property Tax *
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

13 |Page

City of Nashua

Purchasing Department
Administrative Services Division (603) 589-3330
229 Main Street - Nashua, NH 03060 Fax (603) 594-3233

April 14, 2021
Memo #21-106

TO: Mayor Donchess
Finance Committee

SUBJECT: Vehicle: Service Truck in the amount of $79,783.52 funded from accounts CERF/81500
Vehciles

Please see attached communications from Camille Pattison, Transportation Manager, dated April 1, 2021
for project specific details related to this purchase. Below please find a summary of the purchase approval
request:

Item: 2022 Ford 350XL Truck which includes a plow, sander, trailer hitch & mounted
lights

Value: $79,783.52

Vendor: MHQ

Department: 186 Transportation
Source Fund: $15,956.70 CERF/S63,826.82 Federal Transit Administration

Ordinance: Pursuant to § 5-84 Special purchase procedures A/(3) Purchases which can be
procured through cooperative intergovernmental purchase agreements with
other governmental jurisdictions

The Community Development Division: Nashua Transit, and the Purchasing Department respectfully
request your approval of this contract.

Regards,
Kelly Parkinson

Purchasing Manager

Ce: S Marchant
J Graziano
C Pattison

. Community Development 589-3095
City of Nashua Planning and Zoning 589-3090

. soe Building Safety 589-3080
Community Development Division Code Enforcement 589-3100
City Hall, 229 Main Street, PO Box 2019 Cea erograms mission covntoe
Nashua, New Hampshire 03061-2019 Transportation 880-0100
www.nashuanh.gov FAX 989-3119

Date: April 1, 2021
To: Jim Donchess, Mayor
From: Camille Pattison, Transit Administrator

Re: Finance Committee — Purchase of 1 Transit Utility Truck

The Transportation Department needs to replace the existing model year 2009 Chevy 3500 KS
utility truck. This vehicle is essential to the Transportation Department’s daily operations
including:

Plowing;

Landscaping;

Junk Removal;

Transporting staff while dropping off buses for maintenance and repairs;

Service calls for maintenance issues with the fleet;

Transportation to and from shelters for snow clearing, graffiti removal and general
maintenance;

Purchasing parts and supplies; and

e Transporting generators, power washers and other equipment between facilities.

The utility truck is included for replacement in the Nashua Transit System Transit Asset
Management Plan.

Nashua Transit System has negotiated a competitive price with MHQ, 401 Elm Street,
Marlborough, MA to provide (1) new and unused, model year 2021 Ford 350 XL truck. MHQ is a
responsive and responsible bidder. The vehicle will include a snowplow, sander, trailer hitch and
mounted lights.

The total cost of the replacement vehicle is $79,783.52, with 20% of funds coming from the CERF,
in the amount of $15,956.70, and 80% of funds from the Federal Transit Administration in the
amount of $63,826.82

CONTRACT TITLE: NTS UTILITY SERVICE TRUCK VEHICLE

The City of Nashua, Nashua Transit System (NTS), 11 Riverside Street, Nashua, NH 03062 selects MHQ,
401 Elm Street, Marlborough, MA 01752, to provide (1) new and unused, model year 2021 Ford 350 XL
truck vehicle. FTA Requirement/Clauses are attached as Exhibit A.

All Shipping costs must be included in the contract. The vehicle is to be delivered to the following
address between the hours of 8:00 am and 4:00 pm:

Nashua Transit System
11 Riverside Street
Nashua, NH 03062

The following will be used for required specifications for a TOTAL COST of $79,783.52

VEHICLE INFORMATION

VEH98 Vehicle #:

Exterior Color:

Oxford White

Year: 2021 Interior Color: Grey
Make: Ford Engine (as 6.7L Power Stroke Diesel
quoted):

Model: F350 Cylinders: 8

Trim Level & Drive XL Primary Fuel Type: | Diesel

Train:

Body Code & Equip F3H Secondary Fuel

Code: Type:

Vehicle Quantity: 1 Contract Base S

1 ) ) Price: ) —— )

ADDED FACTORY OPTIONS AND PACKAGES (PER VEHICLE)

Quantity | Supplier Factory | Package | MSRP: Discoun | Contra | Total Per Vehicle:

per Name: Code: / Option t%: ct Unit

Vehicle: Descripti Price:
on:

1 Ford 18B Running | $320.00 | 1% $316.8 | $316.80
Boards 0

1 Ford 41H Engine $100.00 | 1% $99.00 | $99.00
Block
Heater

1 Ford 41P Tranfer $100.00 | 1% $99.00 | $99.00
Case Skid
Plates

1 Ford 43C 110V/40 | $175.00 | 1% $173.2 | $173.25
ow 5
outlet

1|Page

1 Ford 473 Snow $250.00 | 1% $247.5 | $247.50
Plow 0
Prep

1 Ford 512 Spare $350.00 | 1% $346.5 | $346.50
Tire and 0
Wheel

1 Ford 52B Elec. $270.00 | 1% $267.3 | $267.30
Trailer 0
Brk.
Control

1 Ford 54L Power $632.00 | 1% $625.6 | $625.68
Heated 8
Tow
Mirrors

1 Ford 595 Fog $130.00 | 1% $128.7 | $128.70
Lamps 0

1 Ford 61S Front $75.00 1% $74.25 | $74.25
Splash
Gaurdes

1 Ford 67B 397 Amp | $115.00 | 1% $113.8 | $113.85
Alt. 5

1 Ford 872 Rear $415.00 | 1% $410.8 | $410.85
Veiw 5
Camera

1 Ford 90L Power $865.00 | 1% $856.3 | $856.35
Equip. 5
Group

1 Ford 98R Operator | $250.00 | 1% $247.5 | $247.50
Comman 0
d Regen.

1 Ford TBM AllTerain | $165.00 | 1% $163.3 | $163.35
Tires 5

1 Ford x4N Limted $360.00 | 1% $356.4 | $356.40
Slip Axle 0
w/4.30
Gear

If factory options exceed this space, include as a Factory Options $4,526.28

separate list & summarize above.

Total (per vehicle):

ADDED DISCOUNTS / INCENTIVES / CREDITS (PER VEHICLE)

Notes:

Grants $0.00
Tax Credits/Rebates $0.00
Promotional $0.00
Discounts

Volume Discounts $0.00

Total Additional

Incentives:

$0.00

2|Page

QUOTE FORM SUMMARY

Vehicle Leadtime to Dealer: Total Factory Options per $4,526.28
vehicle:

Upfit/Transfer Leadtime at Total Upfit per vehicle (next $34,907.24

Dealer: page):

TOTAL Order to Delivery Total Transfer per vehicle (next | $0.00

Leadtime: page):

{in weeks / Executive Agencies Contract Base Vehicle Price: $40,350.00

to Westboro)

Trade-in Details *(value listed to *Trade in Value:

the right): Total Additional Incentives: $0.00

(does not apply to Executive

Agencies)

TOTAL COST PER VEHICLE (including all add-ons and incentives): $79,783.52

VEHICLE QUANTITY: 1

TOTAL PURCHASE PRICE (including Trade-In Value): $79,783.52

ADDED ACCESSORIES/UPFIT (PER VEHICLE)

Quantity
per
Vehicle:

Supplier
Name:

Supplie
r
Option

#:

Accessor
y / Upfit
Descripti
on:

MSRP:

Discoun
t%:

Contra
ct Unit
Price:

Total Per Vehicle:

1 Reading

9' Low
profile
Utility
Body

$8,895.
00

1%

$8,806.

05

$8,806.05

1 Reading

Sliding
Draw
option, 2
L front
compart
ment, 1
in each
center
Compart
ment

$1,445.
00

1%

$1,430.

55

$1,430.55

1 Ctech

Mechani
cs Tool
Box

$1,286.
71

1%

$1,299.

71

$1,299.71

1 Rhino

Rhino
inluding
Compart
ment
Tops

$905.00

1%

$895.7

$895.95

3|Page

MHQ Under $505.00 | 1% $499.9 | $499.95
Coat 5
Body

MHQ D-Rings $30.00 | 1% $29.70 | $118.80

back rack Half $565.00 | 1% $559.3 | $559.35
Louvered 5
Cab
Protector

back rack LBeacon | $49.00 | 1% $48.51 | $48.51
Mount

back rack R Beacon | $49.00 | 1% $48.51 | $48.51
Mount

back rack Center $49.00 | 1% $48.51 | $48.51
Light Bar
Mount

Whelen Mini $995.00 | 1% $985.0 | $985.05
Liberty 5
Light Bar

Whelen M7 $235.00 | 1% $232.6 | $465.30
Warning 5
lights

whelen lon $200.00 | 1% $198.0 | $396.00
Warning 0
Lights

MHQ Trailer $195.00 | 1% $193.0 | $193.05
Tow Plug 5

MHQ Receiver | $600.00 | 1% $594.0 | $594.00
Style 0
Trailer
Hitch

Reese Slide in $160.00 | 1% $158.4 | $158.40
plate 0
combo
Pintle/Ba
ll

Fisher 8 1/2'- $8,695. | 1% $8,695. | $8,608.05
11' 00 00
Expanabl
e
Stainless
Snow
Plow
Pkg.

Fisher Rubber $475.00 | 1% $470.2 | $470.25
Snow 5
Foil

4|Page

1 Tarco 1.86 Yard | $7,595. | 1% $7,519. | $7,519.05
Stainlees | 00 05
Sander
w/ Gas
Pony
Motor
2 Tarco Spill $435.00 | 1% $430.6 | $861.30
Sheilds 5
1 Go Light LED Mag | $705.00 | 1% $697.9 | $697.95
Mount 5
Go Light
1 Weath. Floor $130.00 | 1% $128.7 | $128.70
Tech Mats 0
1 Weath. Vent $75.00 1% $74.25 | $74.25
Tech Visors
If added accessories & upfits exceed this space, include | Added Acc/Upfit $34,907.24

as a separate list & summarize above.

Total (per vehicle):

5|Page

Record of Returns -- Municipal Election -- Nashua, NH -- November 7, 2017 [*] denotes winner(s)
Charter sec. 23: The Board of Aldermen "on the Tues. next following such election...shalf canvass the returns and declare the result"

Total Ballots Cast 1767 1086 1458 573 1428 887 929 1255 1347 10730
Absentee Ballots Cast 39 23 57 i4 24 33 34 37 39 300
Beginning Voter Registration 6806 6630 5988 4794 6997 5787 5643 7118 6997 56760
New Voter Registration 45 31 50 32 29 22 28 28 32 297
Total Election Day Registration 6851 6661 6038 4826 7026 5809 5671 7146 7029 57057
Turnout Percentage 25.79% 16.30% 24.15% 11.87% 20.32% 15.27% 16.38% 17.56% 19.16% 18.81%

David C. Tencza* 823 557 699 287 707 452 460 727 654 5366
Mark S. Cookson 738 283 448 159 442 257 286 328 392 3333
Daniel T. Moriarty 667 388 506 183 573 307 332 444 559 3959
Chris Williams 700 401 544 188 629 300 337 467 570 4136
Shoshanna Kelly* 773 569 660 295 688 402 429 609 572 4997
Brandon Laws* 644 473 655 247 498 316 367 472 520 4192

Dotty Oden* 879 527 610 238 685 398 425 500 546 4808
Heather Raymond* 885 563 644 242 680 415 420 560 601 5010
Gloria J. Timmons* 648 475 511 226 587 352 357 443 500 4099
George E. Farrington 669 306 400 140 436 204 238 383 375 3151
Raymend Guarino* 692 445 516 216 589 345 383 483 497 4166
Haley Goodspeed 275 158 245 124 266 213 157 195 232 1865
Sandra Ziehm 551 317 466 157 445 266 347 407 430 3386
Burton H. Janz 295 156 241 69 194 86 131 166 194 1532
Jamila Scales 381 217 332 143 295 175 202 309 395 2449

Ken Marquis
Anthony B. Patti IIt* 963 551 727 279 721 444 491 583