CUBA-RUSHFORD CENTRAL SCHOOL DISTRICT 5476 ROUTE 305 CUBA, NEW YORK ******** BID FORM FOR. Truck 2018 or Newer ********

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CUBA-RUSHFORD CENTRAL SCHOOL DISTRICT 5476 ROUTE 305 CUBA, NEW YORK 14727 ******** BID FORM FOR Truck 2018 or Newer ******** In accordance with the provisions of Section 103 of the General Municipal Law, an advertisement for bids was published in the Olean Times Herald and the Wellsville Daily Reporter. As stated in such notice, bids will be publicly opened and read in the Board Room at the Middle High School, 5476 Route 305, Cuba, NY on Thursday, June 7, 2018 at 2 PM. All bids must be submitted in a sealed, opaque envelope and marked Truck. ******** The Board of Education reserves the right to accept or reject any bid. Name of Bidder: Address of Bidder: Telephone Number: Fax Number: Email Address: Ask for:

SPECIFICATIONS AND BID FORM FOR TRUCK BID The Cuba Rushford Central School District is requesting bids for a 2018 Chevrolet Silverado as specified per the Cuba- Rushford CSD standardization policy. 2018 OR NEWER 2018 Chevrolet Silverado 4WD Reg Cab 133.6 WB GVRW Increase to 11,400 from 9,500 Work Truck Preferred Equipment Group Key equipment, two additional keys for single key system Backup alarm, 97 decibels Power Windows Seat adjuster, driver 10-way power Remote Keyless Entry Seats, front 40/20/40 split-bench, 3-passenger GVRW, 11,400 lbs (5171 kg) with single rear wheels Bed Liner, Spray-on Mirror, inside rearview auto-dimming Mirrors, outside heated power-adjustable vertical trailering, upper glass, manual-folding and extending, black Pickup box Graphite Metallic Rear axle, 3.73 ratio Dark Ash with Jet Black Interior Accents, cloth seat trim Audio system, Chevrolet MyLink Radio with 7 diagonal color touchscreen, AM/FM stereo Trailer brake controller, integrated Engine block heater Exhaust brake Power outlet, 110-volt AC Alternator, 220 amps Engine, Duramax 6.6L Turbo-Diesel V8, B20-Diesel compatible Transmission, Allison 1000 6-speed automatic, electronically controlled Wheel, 18 X 8 (45.7cm X 20.3cm) full-size, steel spare Emissions

Transfer case, electronic shift with rotary dial controls Underbody Shield, frame-mounted shields WT Fleet Convenience Package Wheels, 18 (45.7cm) painted steel Tires, LT265/70R18E all-terrain, blackwall Fleet Free Maintenance Credit LPO, Assist steps- 4 Black-round 18 LED Permanent Mount Light Bar Yellow Lamps, Smoked Amber roof marker Cover, 1-piece License plate kit, front Snow Plow Prep Package Suspension Package, Standard Tire, spare LT265/70R18E all-season, blackwall Paint, solid Capped Fuel Fill Battery, heavy-duty dual 730 cold-cranking amps/70 Amp-hr Trailer Hitch Package 7Pin trailer hook up Plow Western wide out plow 8 to 10 Ultra Finish Ultra mount 2 Rubber snow deflector Back drag edge Sander Western Tornado 8 1.8 Cubic yards Dual work lights Strobe light kit Lift gate Waltco medium duty rail lift gate Model PTN 16

1600 lbs capacity TRADE IN 2014 Chevy 3/4 ton pickup. 19,000 miles Lift Gate Western v plow Tool boxes BID PRICE INCLUDINGTRADE IN $ Delivery time, how many days from order. Bidder: Signed by: Title: Date:

IRAN DIVESTMENT ACT CERTIFICATION By submission of this bid, (Truck), or by assuming the responsibility of a Contract awarded hereunder, each bidder and each person signing on behalf of any bidders, certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of its knowledge and belief: That each bidder/contractor/assignee is not on the Entities Determined To Be Non-Responsive Bidders/Offerers Pursuant to The New York State Iran Divestment Act of 2012 list created pursuant to paragraph (b) subdivision 3 of section 165-a of the New York State Finance Law and posted on the OGS website at http://www.ogs.ny.gov/about/regs/docs/listofentities.pdf and further certifies that it will not utilize on such Contract any subcontractor that is identified on the Prohibited Entities List. Additionally, Bidder/Contractor is advised that should it seek to renew or extend a Contract awarded in response to the solicitation, it must provide the same certification at the time the Contract is renewed or extended. (See paragraph 31 in the specifications and conditions section of this document.) NAME OF COMPANY: Individual or Legal Name of Firm or Corporation MAILING ADDRESS: CITY/STATE/ZIP CODE: BY: Signature of Representative of Firm or Corporation NAME: Please Print TITLE: Please Print DATED: SWORN to before me this day of 20 Notary Public:

NON-COLLUSIVE BIDDING CERTIFICATION By submission of this bid, each bidder and each person signing on behalf of any bidders, certifies, and in the case of a joint bid each party thereto certifies as to its own organization, under penalty of perjury, that to the best of knowledge and belief: 1) The prices in this bid have been arrived at independently without collusion, consultation, communication or agreement, for the purpose of restricting competition, as to any matter relating to such prices with any other bidder or with any competitor: 2) Unless otherwise required by law, the prices that have been quoted in this bid have not knowingly been disclosed by the bidder and will not knowingly be disclosed by the bidder prior to opening, directly or indirectly, to any other bidder or to any competitor; and 3) No attempt has been made or will be made by the bidder to induce any other person, partnership or corporation to submit or not to submit a bid for the purpose of restricting competition. NAME OF COMPANY: Individual or Legal Name of Firm or Corporation MAILING ADDRESS: CITY/STATE/ZIP CODE: BY: Signature of Representative of Firm or Corporation NAME: Please Print TITLE: Please Print DATED: