Request for Quotations

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FY26-29 CIHA Interior Rehabilitation Project

1222 Moccasin Run Inchelium, WA 99138

Description:

One (1) Single Family Home: 1222 Moccasin Run Inchelium, WA 99138

Furnish Labor and Materials to:

1. Demo existing materials scheduled to be replaced with new per Scope of Work.

2. Domestic waterline replacement.

3. Drywall repair, window and closet door wraps.

4. Install paint and primer, all interior walls and ceilings.

5. Install new fire-rated door, sealants, flashings and associated trims.

6. Underlayment, crawlspace access, flooring and cove base.

7. Handrails, stair treads and risers.

8. Install new interior doors, door handles, door stops and associated trims.

9. Install window sills and aprons.

10. Closet and utility room shelving.

11. Paint interior doors, exterior doors, shelving and associated trims.

12. Install new kitchen, bathroom and utility room cabinets and countertops as supplied by CIHA.

13. Install new kitchen sink, faucet, drain, stops and supply lines.

14. Install new tub/shower combos, shower faucets/valves, tub spouts, shower arms, shower heads,

shower curtain rods and drain/overflow assemblies.

15. Install new toilets, bathroom sinks, bathroom sink faucets, supply lines, stops, drains, medicine

cabinets, towel bars, robe hooks and toilet paper holders.

16. Install new utility room sink, faucet, supply lines, stops and drain.

17. Water heater, supply lines, stops, foam, pan and seismic straps.

18. Install new electrical breakers, switches, outlets, covers, light fixtures, range hood, smoke/carbon

monoxide detectors and bathroom exhaust fan/light combo.

19. Install new baseboard heaters and thermostats.

20. Clothes dryer duct.

21. Install kitchen range and refrigerator.

22. Install new woodstove, hearth and fresh air kit.

23. Install new window blinds.

24. Clean home to move-in ready condition.

25. Clean up and disposal.

The Colville Indian Housing Authority is requesting quotations to furnish labor and material for the

above items as contained in the attached Scope of Work.

All work and materials will be as shown in the Scope of Work and Provisions to the Contract.

The following documents are attached and will be included in and become part of the Contract Documents:

1. Form of Quote

2. Non Collusion Affidavit (filled out and submitted with quote)

3. Statement Regarding Indian Preference (filled out and submitted with quote)

4. HUD Form 5369A (Filled out and submitted with quote)

5. CCT Solid Waste Disposal Form (filled out and submitted with quote)

6. Small Purchase Contract (Sample)

7. System for Award Management (SAM) Clause

8. Davis Bacon Determined Wages (Ferry County)

9. Indian Enterprise Qualifications Statement (MUST be included or on file with CIHA for

Indian Preference points)

10. TERO Compliance and Utilization Plan (filled out and submitted with quote)

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Quotations must be submitted on the Form of Quotation, along with all attachments, as required

in the Contract Documents and Specifications. All written quotations must be delivered to:

Colville Indian Housing Authority

P.O. Box 528

42 Convalescent Center Boulevard

Nespelem, Washington 99155

Faxed copies or e-mailed PDF version of quotations are acceptable. CIHA is not responsible for incomplete

or late fax transmissions. FAX# (509) 634-2335/ E-mail: toria.jackson.hsg@colvilletribes.com

CIHA will receive quotations no later than 3:00 PM (local time), September 09, 2026.

Any quotations received after the above time will not be considered and will be returned to the proposer.

An optional pre-proposal meeting will be held on-site August 26, 2026 at 10:00 AM.

Site location by Google Maps: https://maps.app.goo.gl/uYgrAdTTiQSV7pNA9

CIHA reserves the right to reject any and all quotations or to cancel or modify this RFQ at its sole discretion

if it determines it is in the best interest of CIHA to do so.

Award of contract will be based on small purchase methods of procurement as required by the Code

of Federal Regulations, Title 2 Part 200.

Award based on price. CIHA shall make award to the qualified Indian-owned economic enterprise or

organization with the lowest responsive quotation if it is reasonable and no more than I 0% higher than the

lowest responsive quotation received. If no responsive quotation from a qualified Indian- owned economic

enterprise or organization is within 10% of the lowest responsive quotation from any qualified source, then

award shall be made to the source with the lowest quotation.

NOTE: Before a contract can be executed the Contractor and any sub-contractors must provide proof of

liability insurance and auto insurance. They must provide Washington State Industrial Insurance or

equivalent if the Contractor or Sub Contractor plans to hire employees.

All TERO and TOSHA regulations shall be adhered to in the performance of this contract work.

Indian preference will be given in the award of contracts "to the greatest extent feasible" as determined in

sec 7(b) of the Indian Self Determination and Education Act (25 U.S.C. 450e (b).

For additional information concerning this Request for Quotations, please contact Eric Eberlein at

(509) 634-2198 or e-mail at eric.eberlein.hsg@colvilletribes.com

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Scope of Work and Provisions to the Contract

FY26-29 CIHA Interior Rehabilitation Project

1222 Moccasin Run Inchelium, WA 99138

Description:

One Single Family Home: 1222 Moccasin Run Inchelium, WA 99138

Furnish Labor and Materials to:

1. Demo existing materials scheduled to be replaced with new per Scope of Work.

2. Domestic waterline replacement.

3. Drywall repair, window and closet door wraps.

4. Install paint and primer, all interior walls and ceilings.

5. Install new fire-rated door, sealants, flashings and associated trims.

6. Underlayment, crawlspace access, flooring and cove base.

7. Handrails, stair treads and risers.

8. Install new interior doors, handles, door stops and associated trim.

9. Install window sills and aprons.

10. Closet and utility room shelving.

11. Paint interior doors, exterior doors, shelving and associated trims.

12. Install new kitchen, bathroom and utility room cabinets and countertops as

supplied by CIHA.

13. Install new kitchen sink, faucet, drain, stops and supply lines.

14. Install new tub/shower combos, shower faucets/valves, tub spouts, shower valve

trims, shower arms, shower heads, shower curtain rods and drain/overflow

assemblies.

15. Install new toilets, bathroom sinks, bathroom sink faucets, drains, stops, supply

lines, medicine cabinets, towel bars, robe hooks and toilet paper holders.

16. Install new utility room sink, faucet, supply lines, stops and drain.

17. Water heater, supply lines, stops, foam, pan and seismic straps.

18. Install new electrical breakers, switches, outlets, covers, light fixtures, range

hood, smoke/carbon monoxide detectors and bathroom exhaust fan/light

combo.

19. Install new baseboard heaters and thermostats.

20. Clothes dryer duct.

21. Install kitchen range and refrigerator.

22. Install wood stove, hearth and fresh air kit.

23. Install new window blinds.

24. Clean home to move in ready condition.

25. Clean up and disposal.

Provisions to the Contract:

A. The contractor is responsible for contacting the Tribal Employment Rights Office (TERO)

and confirm their requirements regarding contracting on the Colville Indian Reservation. The

Colville Indian Housing Authority will support TERO in their implementation and

enforcement of their program in connection with contract work. The contractor will provide

the authorized TERO Compliance and Utilization Plan to CIHA before beginning work. All

fees and cost related to TERO should be considered when preparing a cost estimate for

work.

B. Any omissions or additions from or to the attached scope of work must be requested in

writing by the contractor and approved in writing by the contracting officer or authorized

designee.

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C. Products: All products used for this project shall be new, provided in original packaging

from the manufacturer, without defect and covered by the manufacturer’s full warranty. All

materials needed to complete the work spelled out in this scope will be furnished by the

Contractor. The Contractor is responsible for providing material takeoff’s and schedule all

deliveries of materials ordered. Storage and security for the materials delivered become the

responsibility of the Contractor. All materials shall be stored out of the weather and harm’s

way.

D. To the greatest extent possible, protect all trees, bushes, and other items that may be in the

proximity of the work being performed. The Contractor is responsible for any damage that

might occur in relation to the work being performed and at no additional cost to CIHA.

E. Prior to commencement of contract work, the Contractor is required to submit to the CIHA

a copy of their approved Compliance and Utilization Disposal Plan. The plan is required

by CCT Tribal Ordinance Chapter 4.13 Solid Waste. During and after completion of work,

remove all debris from the jobsite and dispose of as required at no added expense to CIHA.

Clean the jobsite daily. Remove construction debris daily.

F. No payment for work will be made until work has been inspected and approved by the

contracting officer or designated representative. Request for payments will be made on the

approved form provided by CIHA.

G. Davis Bacon wages will be observed on this contract work. Weekly payroll reports will

be necessary. The contractors' payments can be delayed until proper payroll reports are

received.

H. The Contractor shall furnish all manpower, tools, scaffolding, vehicles, and safety

equipment as required by T.O.S.H.A., as well as any other equipment necessary to complete

the work as described. The Contractor shall provide all labor, materials, and equipment

necessary for protection of personnel, equipment, furnishings, buildings, and facility

accessories (such as, but not limited to, parking lots, fences, etc.) from damage. Fixed items

shall be removed, if necessary, and replaced in their original locations. Equipment,

furnishings, buildings, and facility accessories damaged due to work performed under the

scope of work shall be repaired or replaced to their original construction and finish by this

Contractor at no additional cost to CIHA.

I. Before a contract can be executed, the Contractor and any Sub-Contractors must provide

proof of Auto Insurance and Commercial General Liability (min. $1,000,000.00 Injury,

General Aggregate, Products, $100,000.00 Fire and $5,000.00 Medical Expense). They

must provide Washington State Industrial Insurance or equivalent if the Contractor or

Sub-Contractor plans to hire employees.

J. Before submitting a quote, each bidder shall carefully read the specifications and all addenda.

Each Bidder shall fully inform themselves prior to submitting a bid as to all existing conditions

and limitations under which work is to be performed. No allowance will be made to any Bidder

because lack of such examination or knowledge. Submission of a quote, will be construed as

conclusive evidence that the Bidder has made such examination.

K. All electrical work shall be performed by a licensed electrician and a Washington State

L&I Electrical Permit shall be issued.

L. All plumbing shall meet current and applicable IRC codes. Contractor shall pressure test

all plumbing for leaks with CCT Building Inspector present.

M. CIHA will obtain and pay for CCT Building Permit.

N. All required permitting for this project will be required to be inspected and approved by

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governing entity before project is to be considered complete.

FY26-29 Unit 1222 Moccasin Run: Start of Schedule Requirements

Schedule of completion shall not exceed 60 consecutive calendar days.

FY26-29 Unit 1222 Moccasin Run: End of Schedule Requirements

FY26-29 Unit 1222 Moccasin Run: Start of Scope of Work

1. Demolition:

Furnish labor and tools to remove all remaining materials that are scheduled to be replaced

with new as outlined in this Scope of Work. Any materials still onsite when rehab project starts

will be the awarded Contractors responsibility for disposal. Dispose of materials and items per

approved CCT Solid Waste Disposal Plan.

2. Domestic waterline replacement:

Remove and dispose of all existing domestic waterline piping and connections from

entry point in crawlspace of home, this will include main shut-off valve if present. Install new,

complete potable water distribution system. The new system shall adhere to all current and

applicable IRC plumbing codes.

All existing domestic waterlines under lower level concrete slab shall be abandoned,

capped and sealed. Route and secure new waterlines through walls, ceilings or floor

framing per all current and applicable IRC plumbing codes. All drywall surfaces

disturbed during rerouting shall be patched. Structural framing shall not be

compromised by rerouting of waterlines. Contractor shall remove drywall as needed to

allow CIHA and CCT Building Dept. to inspect and approve location of new rerouted

waterlines

a. Installation: New piping must be handled and installed according to the manufacturers

recommendations and in compliance with all applicable codes. All connections shall be

watertight and pressure tested to confirm integrity with CCT Building Inspector and CIHA

present, prior to being concealed.

b. Materials PEX Tubing: All new hot and cold waterlines including mains, branches and

stub outs to fixtures shall be constructed exclusively with PEX-B cross linked polyethylene

tubing. PEX-A and PEX-C products are not acceptable for this project. All tubing must be

certified to meet ASTM F876 (PEX tubing) and ASTM F877 (PEX hot and cold water

distribution systems). All tubing shall carry the highest possible rating for chlorinated

water to ensure durability.

c. Materials PEX Fittings: Fittings shall be brass, barb style with stainless steel crimp/pinch

style clamps. All fittings must comply with ASTM F1807 or ASTM F2159. All fittings

must meet the lead-free requirements of the U.S. Safe Drinking Water Act.

d. Main Shut-Off Valve: Install new ¼ turn ball valve of the correct size, where

underground main waterline enters home and prior to the new PEX-B waterlines.

e. Protective sleeves or grommets shall be used where PEX tubing passes through abrasive

surfaces.

f. Install new exterior frost free spigot/s in same location as existing. Install 1 ½” x 6” x 6”

“Smart Trim” block with spigot/s centered to the exterior of home. Install spigot/s with an

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18” loop of PEX in the crawlspace to allow for future replacement of spigot/s.

g. All new waterline connections to fixtures, water heaters and other appliances shall be

completed to ensure a fully functional and leak free system.

h. It shall be the responsibility of the Contractor to properly size all components related to the

waterline replacement.

i. If unable to reuse existing new washing machine outlet box and PEX piping, install new

“Oatey Quadtro”, Model # 38528, ½” x ½” PEX compatible washing machine outlet box

with ¼ turn valves (or approved equal).

3. Drywall repair, window and closet door wraps:

a. Drywall repair: Inspect the condition of the walls and ceilings to determine the needed

drywall repairs.

b. Furnish all labor and material to repair holes, nicks, gouges, water damage, mold,

discolorations, graffiti and any other defects on all drywall areas.

c. Tubs/Showers: Water/moisture resistant ½” drywall shall be used in bathroom for all

repairs. Remove existing drywall from sides and back wall above tubs/showers. Cut

drywall to center of closest stud outside of tub/shower sides from floor to ceiling. Install

solid wood 2 x 4 or 2 x 6 blocking around outside perimeter of tub/shower for a secure

installation. Install solid wood 2 x 8 backing continuously and horizontally at 36” on

center above tub/shower floor, blocking to be installed on both ends and back wall of unit,

Blocking is for future installation of grab bars. Install new tub/shower, taking care to

install level plumb and square per manufacturers installation instructions. Install ½”

water/moisture resistant drywall to sides and back walls, shim as needed for correct fit

around tub/shower.

d. Remove all mounted door stops.

e. Patch holes and repair drywall area where curtain rods were removed.

f. Repair all areas as needed at baseboard locations.

g. Contractor is responsible for providing the correct repair materials.

h. It may be necessary to texture an entire wall or ceiling to match existing finish.

i. Window wraps: Remove all existing window trim and wraps.

j. Install fiberglass insulation as needed between window and existing framing.

k. Shim and install ½” drywall to top and two (2) sides of rough window opening. Ensure the

window reveal is even on all three sides. Contractor will install window sill as described

later in this Scope of Work.

l. Install inside and outside corner bead as needed for repairs.

m. Apply joint compound and feather the outside edges with a minimum 6” knife. Sand smooth.

n. Apply texture to blend in with surrounding texture.

o. Bedroom closet opening wraps: Furnish and install ½” drywall to the header and sides

of the bedroom closet openings only. Doors will not be installed on all bedroom closet

openings.

p. Install outside corner bead around perimeter of opening.

q. Apply joint compound and feather outside edges with a minimum 6” knife. Sand smooth.

r. Apply texture to blend in with surrounding texture.

4. Install paint and primer, all interior walls and ceilings:

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a. Wall cleaner: TSP

b. Primer: Repaired drywall areas and closet wraps, apply one (1) coat of Latex PVA primer

to all newly textured and repaired areas. Walls and ceilings with stains, graffiti or painted

other colors than white shall have one (1) coat of an opaque primer such as Kilz (or

approved equal) applied.

c. Wall, door and trim paint: Glidden Diamond interior semi-gloss color matched to

Colville White (see CIHA for color information).

d. Paint prep: Prepare all surfaces for painting by cleaning. If necessary, wash walls and

ceilings with “TSP” or similar cleaner prior to priming and painting. All trim and

woodwork to be painted shall have all scrapes, gouges, dents or any other blemishes filled

with caulk or wood filler, scraped and sanded as needed. Apply masking on all areas and

attachments not to receive paint such as but not limited to vinyl windows, glass, door

hardware, wall mounted hardware, flooring, cabinets, counters, furnishings of any kind,

plumbing, appliances, etc.

e. Apply two (2) coats of paint to all surfaces to receive paint including walls, shelves, trim,

interior doors, inside of exterior doors and other surfaces determined by the Contracting

Officer or Authorized Designee. All surfaces may be painted using an airless paint sprayer

and back rolled with a roller or brushed and rolled. All painted surfaces shall be free from

runs, drips, holidays and over spray.

f. Cleaning, repairs, drywall texture, prep work, priming and painting must be

approved by Contracting Officer or Authorized Designee before any priming or

painting can take place.

Install new, fire-rated door, sealants, flashings and associated

trims:

a. Remove existing door and trim between laundry/utility room and garage. Install one (1)

new, pre-hung “Therma-Tru” 20-minute fire-rated, six panel, bored for deadbolt mortised

backsets only, match style, size, jamb width and swing of existing door. Install door in

rough opening using shims to guarantee a level, plumb, square and accurate fit. Ensure the

reveal between the jamb and door is uniform on all sides and top between 1/8” and ¼”.

Secure the hinges with adequate size screws that penetrate into framing a minimum of 1

½” to prevent sagging. Check operation of doors to ensure they are not hinge bound or

collapsed below bottom hinge.

b. Install exterior flashings, trims and sealant per door manufacturers recommendations so as

to guarantee a weatherproof seal.

c. Install “Loctite” model # 2866858, Fire Block, foam sealant (or approved equal) between

door jamb and framing prior to installing interior trim (provide pictures of sealant before

installing trim or have CIHA inspect). Use 1 x 3 MDF flat stock trim on interior door

legs. Use 1 x 4 MDF flat stock trim for interior of door header. Install trim with proper

reveal at edge of casing and jamb. Miter all casing for an accurate fit at the junction of the

casing head and leg.

d. Use proper size nails for jamb and casing trim.

e. Fill nail holes and mitered joints prior to painting and sand smooth.

f. Install wall mounted spring stops.

g. Install CIHA provided lockset and deadbolt on fire door. Fire door between laundry/utility

room and garage shall have self-closing and self-latching hardware.

Underlayment, crawlspace access, flooring and cove base:

a. Floor Repairs: This work may be done before painting and interior door installation. It is

the Contractors responsibility to protect all preceding work. Inspect the area to receive

flooring and the areas connecting to determine what kind of installation may be needed.

Contractor is responsible for all repairs of damaged subfloor this also includes any

necessary blocking or framing repairs as needed for proper repair of subfloor. All flaws or

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problems that might interfere with proper installation of the new underlayment shall be

corrected. Repair all squeaks in subfloor by screwing through the existing subfloor and into

the floor joist. It may be necessary to screw down a large portion of the existing subfloor.

Ensure screws penetrate the floor joist a minimum of 1”.

Underlayment: Install 3/4” APA A-C plugged plywood with fully sanded face

(approximately 1060 sq. ft.). Lay all plywood sheets perpendicular to floor joists. Install

the underlayment with 2” divergent tip staples or with proper length screws that penetrate

all of the existing floor surfaces. All fasteners shall be countersunk below the surface of

the underlayment. Fasteners shall be spaced 4” o.c. at perimeter and 8” o.c. in the field.

Prep the new underlayment to accept LVT flooring using ARDEX K-15 floor leveler (or

approved equal) as filler over the countersunk fasteners and any voids, sand to even the

surface.

Crawlspace Access, crawlspace inspection: Install new 4” thick concrete floor in

area in front of crawlspace access (approximately 3’ x 3’) and level with existing concrete

footing. Install three (3) # 4 rebar each way, dowel rebar into existing concrete. Install

Ardex 15 floor leveler as needed prior to install of LVT flooring. Install outside corner, as

specified by flooring manufacturer, to protect LVT flooring at step area. Install trim on

sides and header of crawlspace access door. Paint trim and access door. Inspect crawlspace

insulation, replace missing or damaged insulation and reinstall insulation that has fallen

down. Repair or replace any damaged or missing plastic vapor barrier in crawlspace.

Remove all garbage and debris from crawlspace.

Luxury Vinyl Tile: Install Luxury Vinyl Tiles (LVT), “Mohawk Reconnected” Mocha #

259 (or approved equal) in all areas throughout the unit (excludes garage), approximately

1450 sq. ft. Follow all manufacturers recommended installation requirements for layout,

adhesives, installation, underlayment, prep and cleaning. Install all tiles tight with no gaps

between the tiles. Wipe off all residual adhesive from the tile surface, seams, walls or other

areas. Ensure that all fits at the walls are tight enough for the cove base to cover the edge

of the tile. Install manufacturers recommended transition strips at all areas where the tile

changes direction. Layout the tile in a manner which prevents small pieces at the walls or

openings. Pay attention to toilet flange, adjust if necessary to provide best seal for toilet.

Cove base: Install continuously, “Roppe” 700 series, brown, 4” rubber cove base (or

approved equal) in bathrooms, kitchen and utility room (approximately 120 lin. ft.). Install

“Roppe” 700 series, brown, 2 ½” rubber cove base (or approved equal) in all other areas

(approximately 220 lin. ft.). Install at all wall areas and stair risers where LVT is installed.

Make proper cuts, fits and transitions where they occur at all inside and outside corners.

Use adhesive as recommended by manufacturer. Clean up all excess adhesive from

flooring and wall. In bathrooms, clear 100% silicone is to be applied at the toe of the base

to floor and at base of shower surround to prevent water intrusion. Follow all manufacturer

recommended installation guidelines.

Handrails, stair treads, risers and nosings:

a. Handrails: Clean existing metal handrails (2) and prep for paint. Install “Krylon” model #

K00779008, semi-gloss, black spray paint, two (2) coats on handrails prior to installation.

Install 2x6 solid wood backing as needed to fasten handrails securely. Repair drywall,

texture and paint as needed. Install handrails per code.

b. Stair treads and risers: Remove existing finishes on stair treads and risers, do not remove

existing skirt boards. Save and protect existing skirt boards on sides of stairways if

possible. If not possible to reuse skirt boards, replace with like material and size. Skirt

board paint will be same brand, color and sheen as trim paint. It may be necessary to add ½

in. underlayment to risers to maintain building code riser heights and tolerances.

Furnish and install Luxury Vinyl Tiles (LVT), “Mohawk Reconnected” Mocha # 259 (or

approved equal) for stair treads and risers. Follow all manufacturers recommended

installation requirements for layout, adhesives, installation, underlayment, prep and

cleaning. Install all tiles tight with no gaps between the tiles. Wipe off all residual adhesive

from the tile surface, seams, walls or other areas.

c. Stair nosings: Furnish and install “Johnsonite”, model # VDL-XX-RD, beige, vinyl stair

nosings (or approved equal).

8. Install new interior doors, handles, door stops and associated trim:

a. Interior doors: Install ten (10) new pre-hung doors. Doors shall be white, 6 panel, 1 3/8”

thickness, height shall be 6’ 8”, bored for 2 ¾” mortised backsets. No drive-in backsets

will be allowed. Solid core door locations will be bathrooms and bedrooms all other

locations may be hollow core doors. Install new right-hand out swing door at hall closet on

lower floor (this door is on left side of lower bathroom when walking down stairs). Match

existing door opening width as close as possible. The closet had cabinet style door

previously. The opening will need to be reframed for correct installation of new door. The

closet shelving may have to be modified or replaced to accommodate new door. New

interior door between utility room and kitchen to be pre-hung, six (6) panel, metal door,

match door swing to existing door.

b. All door hardware, knobs, hinges and stops shall be satin nickel finish.

c. Locksets: Install new “Schlage” Orbit Model # F40 satin nickel (or approved equal)

locksets. Privacy locksets to be installed on master bedroom and bathroom doors only,

passage locksets to be installed on all other doors. Test and adjust all locksets for smooth

operation and proper latch. Lubricate the backset if necessary.

d. Door Stops: 3 1/8” spring door stop or adjustable hinge stop. Install wall mounted spring

stops unless impractical. Where not practical install two (2) adjustable hinge stops.

e. Install pre-hung doors with swing and size to match opening. Install doors in rough

openings using shims to guarantee a level, plumb, square and accurate fit. Ensure the reveal

between the jamb and door is uniform on all sides and top between 1/8” and ¼”. Secure top

and bottom hinge with adequate size screw that penetrates into framing a minimum of 1 ½”

to prevent sagging. Check operation of door to ensure it is not hinge bound or collapsed

below bottom hinge. Adjust stops on the jambs to prevent door rattle.

f. Install 1 x 3 MDF flat stock trim on sides of door jambs and 1 x 4 MDF flat stock on header

of jamb. Ensure proper reveal at edge of casing and jamb. Miter all casing for an accurate

fit at the junction of the casing head and leg. Use proper size nails for jamb and casing. Fill

nail holes and mitered joints with wood filler and sand smooth prior to painting.

g. Materials installed by Contractor found to be split, warped or damaged are not acceptable

and will be replaced at Contractors expense.

9. Install window sills and aprons:

a. After demo inspect each window opening on the interior and weather seal as

needed, using fiberglass insulation.

b. Install 1 x 6 or proper width (Contractor to verify width) sills. Sills to be finger

jointed pine (or approved equal). Aprons may be 1 x 3 MDF or finger jointed pine.

c. Sills will be installed with a minimum of 1” overhang and 1” past window opening

on right and left sides. Use shims to ensure reveals remain consistent in relation to

the newly installed drywall in the window opening and with the window frame.

Smooth any sharp edges on ends of sills.

d. Aprons will be installed 1” back on right and left ends of the sills and have a 22.5º

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back cut.

e. Attach the sills and aprons with proper sized galvanized finish nails (minimum 15

gauge). Countersink nail holes, fill and sand smooth prior to painting.

10. Closet and utility room shelving:

a. Remove and replace any damaged shelving found in bedroom and hall closets. Match all

new shelving style and depth as close as possible to existing. Install new shelving in same

location where previously removed.

b. Remove existing utility room shelving and supports. Replace with like material, width,

length, thickness and spacing between supports. Attach shelf supports with proper size

screws or nails that penetrate a minimum of 1 ½” into wall studs. Attach shelving to

supports with galvanized finish nails (minimum 15 gauge). Countersink screw and nail

holes, fill and sand smooth prior to painting.

c. All bedroom closet, hall closet and utility room shelving perimeters shall be caulked prior

to painting, this includes top, bottom and sides.

11. Paint interior doors, exterior doors, shelves and associated trims:

a. Paint all interior doors, exterior doors, door jambs, closet shelving, pantry shelving, utility

room shelving and all associated trim. Use “Glidden Diamond” interior semi-gloss for

interior areas. use “Glidden Premium” exterior semi-gloss for exterior areas, color match

both to Colville White (see CIHA for color information).

b. Ensure all nail holes and screw holes are filled and sanded smooth prior to painting.

c. Primer any material that has an exposed cut end prior to painting.

12. Install new kitchen, bathroom and utility room cabinets and countertops:

a. Cabinets and countertops to be installed will be purchased and supplied by CIHA.

b. Contractor will be responsible for unloading and safe storage upon delivery.

c. Install cabinets and countertops in the configuration as shown in the cabinet and

countertop suppliers drawings (see attached).

Cabinet install: Attach all cabinets with proper length screws to framing members and

each other. Cabinets are to be installed straight, level, plumb and square as recommended

by the cabinet manufacturer. Use concealed cedar shims as needed. Install all necessary

filler strips, spacers, side panels, back panels, end panels and trim as needed for a

complete installation. Furnish (unless supplied by cabinet manufacturer) and install

matching scribe mold (solid wood, stained to match), as supplied by the cabinet

manufacturer at upper cabinets, ceilings and walls. Miter all joints at a 45⁰ angle. Fill all

nail holes with color matching putty.

d. Countertop installation: Attach preformed laminate countertops with proper size screws

to the cabinets at corner locations to ensuring the top is properly secured. Use care not to

use screws that might penetrate to the surface of the countertop. Any countertop with

laminate that has been perforated will require replacement at the Contractors expense. End

splashes are required on all countertops which terminate at a wall.

e. Range backsplash: Furnish and install sheet laminate “Wilsonart Plastic Laminate” (or

approved equal) Model # 1573-60 Frosty White on the wall behind the range as a grease

shield, attach with contact cement.

f. Use only white, 100% silicone, tub and tile caulking at the junction of the backsplash, end

splashes and wall. Wipe off residual caulking to ensure a professional application.

Page | 8

13. Install new kitchen sink, faucet, drain, stops and supply lines.

a. Kitchen sink: Install new 22” x 33” four (4) hole, double bowl, stainless steel sink

with a minimum depth of 8” in countertop at sink base location.

b. Faucet: Install new “Moen Chateau” # 7430 (or approved equal) single lever

handle kitchen faucet w/spray, chrome finish.

c. Drain, stops and supply lines: Install new ¼ turn compression stops. Install new

stainless steel, flex, no burst supply lines. Install new drain assembly, P-trap, ABS

loop vent (if necessary) and “Watts Qwik Fit” stainless steel, double cup basket

strainers.

d. All plumbing fixtures to be installed per manufacturer installation instructions.

e. All plumbing connections shall be inspected and leak free.

14. Install new tub/shower combos, shower faucet/valves and trim, tub spouts, shower

arms, shower heads, shower curtain rods and drain/overflow assemblies.

a. Demo existing tub/shower, tub/shower faucet, valve, tub spout, shower head and arm,

drain/overflow assembly and supply line from faucet to showerhead.

b. Install new tub/shower, tub/shower faucet/valve, tub spout, shower arm, shower head,

shower curtain rod and shower drain/overflow assembly. Install new supply line plumbing

pipes/connections for shower valve, tub spout, shower head and drain/overflow assembly.

c. Bathtub/Shower Combination: “Sterling Traverse”, Model # 71520110-10,

32” wide x 60” long x 77” high, white, 4 piece, left hand drain.

d. Tub and Shower Faucet with Valve, Shower Arm, Shower Head and Tub Spout:

“Moen Adler”, Model # 82603 (or approved equal), single handle, chrome finish.

e. Tub/Shower Drain Assembly: “Illusionary Overflow” (or approved equal) 12 in. x 4 in.

PVC Bath Waste/Overflow Bath Drain Chrome Model # 494244H-26.

f. Shower Curtain Rod: “Glacier Bay” Model # HD14016, 60”, aluminum, chrome finish.

15. Bathrooms: Toilets, bathroom sinks, bathroom sink faucets, drains, stops, supply lines,

medicine cabinets, towel bars, robe hooks and toilet paper holders.

a. Toilet: Install two (2) new “Eljer Savoy/Patriot”, Tanks Model # 141-0220, Bowls Model

# 131-2175, 1.6 GPF, ADA height (or approved equal), install with Fluidmaster Wax-Free

bowl gasket Model # 7500. Install new ¼ turn compression stops. Install new stainless

steel, flex, no burst supply lines. Install toilets level and secure. Shim toilets if necessary.

Cut and cap toilet anchor bolts. Caulk toilet base to floor leaving 4” opening in rear of

toilet.

b. Sink: Install two (2) new “Sterling Sanibel” Model # 442004 (or approved equal), 20” x

17” oval, self-rimming, vitreous china sinks.

c. Sink Faucet: Install two (2) new “Moen Adler” Model # WS84503 (or approved equal)

single lever handle faucets with pop up assembly, chrome finish.

d. Drain, Stops and Supply Lines: Install new P-trap assembly, ¼ turn compression stops

and stainless steel flex no burst supply lines for the new bathroom sinks.

e. Medicine Cabinet: Remove and dispose of existing medicine cabinets. Install two (2) new

“Glacier Bay” Model # 45406, 16 in. W x 26 in. H, white, frameless, recessed/surface

mount with mirror medicine cabinet (or approved equal). Install in location of previously

removed medicine cabinets.

f. Towel Bars: Install four (4) new “Moen” Aspen series, Model # 5824CH (or approved

equal). Location is Contractors responsibility. Towel bars will be mounted om 1 x 4 solid

wood flat stock, edges are to be beveled and painted to match wall finish. Two (2) per

bathroom.

Page | 9

g. Robe Hook: Install two (2) new “Moen” Aspen series Model # 5802CH (or approved

equal) in bathrooms. Location is Contractors responsibility. One (1) per bathroom.

h. Toilet Paper Holder: Install two (2) new “Moen” Aspen series Model # 5808CH toilet

paper holders (or approved equal). Location is Contractor’s responsibility.

16. Install new utility room sink, faucet, supply lines, stops and drain.

a. Utility Room Sink: Install one (1) new “Mustee” Model # HD67655-008D2,

22in. x 25 in. x 13.75 in. molded, fiberglass, white, drop-in utility sink (or

approved equal). Install per manufacturer instructions.

b. Faucet: Install one (1) new “Glacier Bay” Model # HD67655-0008D2 4 inch on

center, 2 two handle, centerset, stainless steel, pull out laundry faucet (or approved

equal).

c. Supply Lines, Stops and Drains: Install new stainless steel reinforced supply

lines, ¼ turn compression stops and P-trap assembly.

d. All plumbing connections shall be inspected and leak free.

17. Water heater, supply lines, stops, foam, pan and seismic straps.

a. Install water heater per all current IRC codes.

b. Water Heater: Supplied by CIHA, stored onsite and installed by the Contractor.

c. Supply Lines, Foam, Pan and Seismic Straps: To be supplied by CIHA (picked

up and installed by Contractor). Contractor to provide materials list to CIHA

which will include all connecting fittings and mounting hardware.

d. All plumbing connections shall be tested and leak free.

18. Install new electrical breakers, switches, outlets, covers, light fixtures, range hood and

smoke/carbon monoxide detectors, bathroom exhaust fan/light combo (plans attached).

a. Electrical Breakers: Install new AFCI/GFCI combo breakers to comply

project with current NEC codes

b. Switches, Outlets and Covers: Remove and dispose of all existing switches,

outlets and covers. Install new “white color” switches, outlets and covers and

comply with all current building and NEC codes. Range and dryer outlets are to be

replaced. New range and dryer outlets shall have metal double gang covers. Install

“Intermatic” white, 30-minute timer with timer/light switch cover to control

ceiling exhaust fan.

c. Light Fixtures: Remove and dispose of all existing interior light fixtures, this will

also include the living room ceiling fan. Install new light fixtures to all current

NEC codes. Install new fixtures in locations where light fixtures and ceiling fan

were previously removed.

d. Light Fixture Schedule:

• Kitchen: “Honeywell” Model # KT148D401100, 48 in., rectangular, flush

mount, white, LED (or approved equal)

• Kitchen sink: “Commercial Electric” Model # IPF3011L-3/WHT, 9 in., white,

LED, flush mount (or approved equal)

• Bathrooms: “Hampton Bay” Woodbury, Model # C06023301A, 24 in.,

brushed nickel, LED (or approved equal).

Page | 10

Bedrooms: “Hampton Bay” Flaxmere, Model # HB3687-07, 14 in., chrome,

LED, flush mount ceiling light, frosted white glass shade (or approved equal).

• Hallways: “Hampton Bay” Flaxmere, Model # HB3687-07, 14 in., chrome,

LED, flush mount ceiling light, frosted white glass shade (or approved equal).

• Utility room: “Hampton Bay” Flaxmere, Model # HB3687-07, 14 in., chrome,

LED, flush mount ceiling light, frosted white glass shade (or approved equal).

“Hampton Bay” Woodbury, Model # C06023301A, 24 in., 1 light, brushed

nickel, LED (or approved equal), mount above utility sink.

• Living room/dining room: “Hampton Bay” Flaxmere, Model # HB3687-07, 14

in., chrome, LED, flush mount ceiling light, frosted white glass shade (or

approved equal).

Include new LED light bulbs as necessary in all light fixtures. Follow

manufactures recommendation on proper wattage and bulb type for each

fixture.

e. Range Hood: “Broan” 42000 Series, Model # 423001D, 30 in., under cabinet,

white, 230 cfm., round duct, with light and damper (or approved equal). Install new

7 in. round, solid, galvanized duct from range hood to existing roof jack. Ducting

to be sealed at all joints by manufacturers recommended UL heat resistant tape.

Inspect and ensure that all ductwork is fully supported in the attic space. Range

hoods that provide ducted and ductless features or have square or rectangle

duct will not be accepted.

f. Smoke/Carbon Monoxide Detectors: Install one (1) Smoke/Carbon Monoxide

Detector in each sleeping room. Install one (1) Smoke/Carbon Monoxide Detector

in the immediate vicinity of sleeping rooms. Smoke Detector/Carbon Monoxide

Detectors shall have wire-free, voice interconnect and they must also have 10-year

tamper proof sealed battery.

g. Bathroom Exhaust Fan/Light Combo: Install two (2) “Delta Breez” Model #

GBR80HLED, 80 CFM, ceiling exhaust fans with LED light, white, one (1) in

each bathroom. Install new 4”, smooth, metal ducting with louvered vent cap to

exterior of home. Fan light shall be switched separately from wall mounted vanity

light.

•

All circuits altered to complete electrical work must be AFCI protected.

19. Install new heaters and thermostats.

a. Remove and dispose of any remaining baseboard heaters and thermostats.

b. Install new “Cadet” electric baseboard heaters at previous baseboard heater

locations.

c. Upstairs Bathroom: Install one (1) new, “Cadet” Model # CDT-UCH183, under

cabinet, fan forced, electric heater

d. Downstairs Bathroom: Install one (1) new, “Cadet” Model # CSC102W, 240 volt,

1000 watt, In-wall, fan forced heater, white. CIHA will determine location.

e. Install new “Cadet” Model # T522-W, wall mounted, white, line voltage

thermostats at previous thermostat locations.

Page | 11

f. Heater Schedule:

•

Kitchen: One (1) 2’4” baseboard heater.

Dining Room: One (1) 7 ft. baseboard heater.

Living Room: One (1) 8’ baseboard heater.

Utility Room: One (1) 8 ft. baseboard heater.

Upstairs Bathroom: One (1) toe-kick heater.

Upstairs Bedroom: One (1) 6’ baseboard heater.

Upstairs Bedroom: One (1) 6 ft. baseboard heater.

Downstairs Bedroom: One (1) 6 ft. baseboard heater.

Downstairs Bathroom: One (1) wall heater.

20. Clothes dryer ducting.

Inspect existing clothes dryer ducting for function. damage, cleanliness or missing parts. Replace

any damaged or missing parts with new. Clean ducting as needed to ensure no lint or other clogs.

Make sure ducting is routed outside of building and damper is installed. Make sure ducting is

supported properly in crawlspace with no sagging.

21. Install kitchen range and refrigerator.

Contractor shall pick up and install kitchen range and refrigerator as supplied by CIHA.

Contractor shall install appliances per all manufacturer’s installation guidelines.

22. Install new wood stove, hearth and fresh air kit.

a. Pick up new woodstove and hearth (supplied by CIHA).

b. Install new wood stove per manufacturer’s installation instructions.

c. Install new 48 in. x 48 in. hearth pad.

d. Install new wood stove fresh air kit (supplied by contractor). Install per wood stove

manufacturer recommendations.

23. Install new window blinds.

a. Mini Blinds: “Bali Classics” 1 in., aluminum, creamy beige (or approved equal).

b. Fit inside window opening, cut to width and height.

c. Install mini blinds in all window openings.

24. Clean home to move-in ready condition:

Clean entire home to move-in ready condition. Including but not limited to windows, exhaust fan

grilles and ducting, bathtubs and surrounds, walls, floors, ceilings, cabinets, countertops, plumbing

fixtures etc.

25. Clean up and disposal:

Clean up and dispose of all materials and construction debris from interior and exterior of building

upon completion of project per approved CCT Solid Waste Disposal Plan. Additional cleanup will be

necessary each time Contractor enters the home to perform punchlist or incomplete work.

FY26-29 Unit 1222 Moccasin Run: End of Scope of Work

_______________________________________________________________________________

Page | 12

Submittal Requirements:

•

Submittals for products as specified above can be in the form of a product sample or a signed

quote for materials or invoice (if all manufacturers numbers are included).

If proposing to furnish “equal products” the Contractor must submit manufacturers

specifications, all technical data and installation instructions on all materials submitted for use

with the proposal.

Contracting Officer or Authorized Designee will determine the use of “equal products” based

on the information supplied by the Contractor. If there is not sufficient information to make a

comparison the substitution will not be allowed.

Electrical:

•

All electrical work performed shall be completed per current NEC electrical codes.

All AFCI and GFCI codes per current NEC shall be adhered to.

All smoke detectors and carbon monoxide detectors shall be tested for correct operation.

Plumbing:

• Contractor shall pressure test all plumbing for leaks with CIHA and CCT Building

Inspector present.

_____________________________________________________________________________________

Page | 13

Map to Unit 1222 Moccasin Run Inchelium, WA 99138

North

Unit 1222 Moccasin Run

Unit 1222 Moccasin Run Floor Plan

For Reference Only

Unit 1222 Moccasin Run Lower Level Floor Plan

For Reference Only

Upper Bathroom

Unit 1222 Cabinet Locations

For reference only.

Yellow highlighted area indicates base cabinets

Red highlighted area indicates upper cabinets

Lower Bathroom

Kitchen and Utility Room

For reference only.

Unit 1222 Kitchen Cabinet Elevations

1222 Moccasin Run Electrical Plan Main Level

For Reference Only

Unit 1222 Moccasin Run Electrical Plan Lower Level

For Reference Only

10.

Form of Quote

Non-Collusion Affidavit

Statement Regarding Indian Preference

HUD Form 5369-A

Solid Waste Disposal Form

Contract Template

SAM Clause

Davis Bacon Wage Determination

Indian Enterprise Qualification

Statement

TERO Compliance and Utilization Plan

COLVILLE INDIAN HOUSING AUTHORITY

FORM OF QUOTE

PAGE - 1

QUOTE FOR: FY26-29 CIHA Interior Rehabilitation Project

1222 Moccasin Run Inchelium, WA 99138

TO:

COLVILLE INDIAN HOUSING AUTHORITY

P. O. BOX 528 / 42 CONVALESCENT CENTER BOULEVARD NESPELEM, WASHINGTON

99155

Gentlemen:

I, ________________________________________ the undersigned, have familiarized myself

with the local conditions affecting the cost of the work and with the Specifications (including

Request for Quotations, this Form of Quote, the General Scope of Work, and drawings. If any

thereto, as prepared by Owner’s Representative and on file in the office of the CIHA, hereby

proposes to furnish all labor, materials, equipment and services required to complete work related

to the project scope of work, all in accordance therewith, for the sum of:

BASIC QUOTE

______________________________________________DOLLARS ($___________________)

Quote for services must include all potential TERO fees.

Site Investigation: The Contractor acknowledges that he has satisfied himself as to the nature

and location of the work, the general and local conditions, particularly those bearing upon

transportation, disposal, handling and storage of materials, availability of labor, water, electrical

power, roads and uncertainties of weather, ground water table or similar physical conditions at

the site, the conformation and conditions of the ground surface, the character, quality and

quantity of surface materials to be encountered, the character of equipment and facilities needed

prior to and during the prosecution of the work or the cost thereof under this Contract. Any failure

by the Contractor to acquaint himself with all of the available information concerning these

conditions will not relieve him from responsibility for estimating properly the difficulty or cost of

successfully performing the work.

Amendment Receipt:

Receipt of the following addenda is acknowledged:

Amendment No. :

Date:

COLVILLE INDIAN HOUSING AUTHORITY

FORM OF QUOTE

PAGE - 2

II.

In submitting this Quote, it is understood that the right is reserved by the CIHA to reject

any and all Quotes. If written notice of the acceptance of this Quote is mailed,

telegraphed, faxed, or delivered to the undersigned within sixty (60) days after the

opening thereof, or at any time thereafter before this Quote is withdrawn, the undersigned

agrees to execute and deliver a Contract in the prescribed form.

IV.

Attached hereto is an affidavit in proof that the undersigned has not entered into any

collusion with any person in respect to this quote or any other quote or the submitting of

quotes for the contract for which this quote is submitted.

The Bidder represents that he ( ) has, ( ) has not, participated in a previous contract or

subcontract subject to the equal opportunity clause prescribed by Executive Orders

10925, 11114, or 11246 or the Secretary of Labor; that he ( ) has, ( ) has not, filed all

required compliance reports; and that representations indicating submission of required

compliance reports, signed by proposed subcontractors, will be obtained prior to

subcontract awards. (The above representation need not be submitted in connection

with contracts or subcontracts that are exempt from the clause.)

VII.

I have enclosed with this bid the following items per Instruction to Bidders.

Non-Collusion Affidavit

Statement Regarding Indian Preference

HUD Form 5369A

CCT Solid Waste Disposal Form

Indian Enterprise Qualifications Statement (MUST be included or on file with CIHA for

Indian Preference points)

6. TERO Compliance and Utilization Plan

NOTE:

The penalty for making false statements in offers is prescribed in 18 U.S.C. 1001.

DATE __________________________

__________________________

FIRM NAME

OFFICIAL ADDRESS:

__________________________

_______________________________

__________________________

TITLE

_______________________________

TELEPHONE

END OF FORM OF QUOTE

Non-Collusion Affidavit

CIHA Form 05/2018

Non-Collusion Affidavit

I, ____________________________, being first duly sworn under oath, do hereby attest and

affirm as follows:

1. That I am a duly authorized officer or agent of __________________________, the offeror

submitting the competitive proposal attached to this Affidavit, for the purpose of certifying the

facts pertaining to the existence of collusion among the offerors or between this offeror and any

officer, agent or employee of Colville Indian Housing Authority (CIHA) or the Colville

Confederated Tribes (Tribe), as well as facts pertaining to the giving or offering things of value to

officers, agents or employees of CIHA or the Tribe in return for special consideration in the

letting of any contract pursuant to the attached competitive bid.

2. That I am fully aware of the facts and circumstances surrounding the making of the

competitive proposal and has been personally and directly involved in the proceedings leading to

the submission of such proposal.

3. That the proposal submitted is genuine and is not the product of any collusion and is not a

sham proposal, and that all statements in the proposal are true.

4. That neither the offeror named above nor anyone subject to the offeror’s direction or control

has been a party:

a. to any collusion among offerors to agree to bid at a fixed price or to refrain from

submitting a proposal, or as to quantity, quality, cost element, profit, overhead, or price in

the prospective contract or as to any other term of the prospective contract;

b. to any collusion with any CIHA or Tribal officer, agent or employee as to quantity,

quality, cost element, profit, overhead, or price in the prospective contract or as to any

other term of the prospective contract;

c. to any discussions between offerors or between this offeror and any officer, agent or

employee of CIHA or the Tribe pertaining to the giving or offering things of value to

officers, agents or employees of CIHA or the Tribe in return for special consideration in

the letting of any contract pursuant to the attached proposal.

So sworn this ___ day of ______________, 20___.

______________________________

Signature of Affiant

(Certification on page 2)

1|Page

Non-Collusion Affidavit

CIHA Form 05/2018

Certification

County of _____________

State of _______________

)

)ss

)

I, the undersigned, a duly commissioned and sworn notary public, do hereby certify that

on the ___ day of ____________, 20___, the above-signed _____________________ personally

appeared before me and was personally known to me, and executed the within instrument and

acknowledged that he/she signed the same as his/her free and voluntary act and deed, for the uses

and purposes therein mentioned.

__________________________________

Notary Public for ____________________

My Commission Expires:______________

2|Page

Statement Regarding Indian Preference

If successful, the offeror (through its duly authorized and undersigned

representative) hereby agrees and certifies that it will:

To the greatest extent feasible, give preference in the award of any subcontracts to

Indian organizations and Indian-owned economic enterprises, and adopt and

implement, for all subcontracts, the Indian Preference Requirements of 24 CFR

1000.48 – 52, the Tribes’ Tribal Employment Rights Ordinance (Chapter 10-1 of

the Colville Tribal Code, hereinafter “TERO”) and the CIHA Procurement Policy

to the greatest extent feasible. Copies of these provisions are attached hereto.

To the greatest extent feasible, give preference in opportunities for training and

employment to Indians, and adopt and implement, for hiring, training, and

promotion, the Indian Preference provisions of 24 CFR 1000.48 – 52, the TERO,

and the CIHA Personnel Manual. Copies of these provisions are attached hereto.

Supply information to CIHA and, where required, to the Tribal Employment

Rights Office as established under the TERO, on a periodic basis during

performance of its duties under the contract demonstrating its efforts to apply

Indian preference in hiring, promotion, training, and subcontracting, including

what steps were taken to solicit Indian businesses for subcontracting and Indian

people for hiring, promotion, and training.

Submit, and cause each subcontractor to submit, a certification and supporting

evidence to CIHA whenever it is not feasible to provide Indian preference in

subcontracting.

Offerer acknowledges and understands that improper subcontracting or false

certification as to Indian preference in hiring and training, or as to subcontracting with

Indian enterprises or organizations, shall be grounds for termination of the contract and

for seeking penalties against the Contractor.

Dated this ____ day of ________________, 20____.

________________________________

Signature

On behalf of:

________________________________

Printed Name

______________________________

Name of Offeror

________________________________

Title

U.S. Department of Housing

and Urban Development

Office of Public and Indian Housing

Representations, Certifications,

and Other Statements of Bidders

Public and Indian Housing Programs

Previous edition is obsolete

form HUD-5369-A (11/92)

Representations, Certifications,

and Other Statements of Bidders

Public and Indian Housing Programs

Table of Contents

Clause

Page

Certificate of Independent Price Determination

Contingent Fee Representation and Agreement

Certification and Disclosure Regarding Payments

to Influence Certain Federal Transactions

Organizational Conflicts of Interest Certification

Bidder's Certification of Eligibility

Minimum Bid Acceptance Period

Small, Minority, Women-Owned Business Concern

Representation

Indian-Owned Economic Enterprise and Indian

Organization Representation

Certification of Eligibility Under the Davis-Bacon Act

10. Certification of Nonsegregated Facilities

11. Clean Air and Water Certification

12. Previous Participation Certificate

13. Bidder's Signature

bidder must furnish with its bid a signed statement setting forth in

detail the circumstances of the disclosure.

[ ] [Contracting Officer check if following paragraph is applicable]

(d) Non-collusive affidavit. (applicable to contracts for construction

and equipment exceeding $50,000)

(1) Each bidder shall execute, in the form provided by the PHA/

IHA, an affidavit to the effect that he/she has not colluded with any

other person, firm or corporation in regard to any bid submitted in

response to this solicitation. If the successful bidder did not submit

the affidavit with his/her bid, he/she must submit it within three (3)

working days of bid opening. Failure to submit the affidavit by that

date may render the bid nonresponsive. No contract award will be

made without a properly executed affidavit.

(2) A fully executed "Non-collusive Affidavit" [ ] is, [ ] is not

included with the bid.

Certificate of Independent Price Determination

Contingent Fee Representation and Agreement

(a) Definitions. As used in this provision:

(a) The bidder certifies that-(1) The prices in this bid have been arrived at independently,

without, for the purpose of restricting competition, any consultation,

communication, or agreement with any other bidder or competitor

relating to (i) those prices, (ii) the intention to submit a bid, or (iii) the

methods or factors used to calculate the prices offered;

(2) The prices in this bid have not been and will not be

knowingly disclosed by the bidder, directly or indirectly, to any other

bidder or competitor before bid opening (in the case of a sealed bid

solicitation) or contract award (in the case of a competitive proposal

solicitation) unless otherwise required by law; and

(3) No attempt has been made or will be made by the bidder to

induce any other concern to submit or not to submit a bid for the

purpose of restricting competition.

(b) Each signature on the bid is considered to be a certification by

the signatory that the signatory-(1) Is the person in the bidder's organization responsible for

determining the prices being offered in this bid or proposal, and that

the signatory has not participated and will not participate in any

action contrary to subparagraphs (a)(l) through (a)(3) above; or

(2) (i) Has been authorized, in writing, to act as agent for the

following principals in certifying that those principals have not

participated, and will not participate in any action contrary to

subparagraphs (a)(l) through (a)(3) above.

_______________________________________________ [insert

full name of person(s) in the bidder's organization responsible for

determining the prices offered in this bid or proposal, and the title of

his or her position in the bidder's organization];

(ii) As an authorized agent, does certify that the principals

named in subdivision (b)(2)(i) above have not participated, and will

not participate, in any action contrary to subparagraphs (a)(1)

through (a)(3) above; and

Previous edition is obsolete

(iii) As an agent, has not personally participated, and will

not participate in any action contrary to subparagraphs (a)(1)

through (a)(3) above.

Page1 of 3

"Bona fide employee" means a person, employed by a bidder

and subject to the bidder's supervision and control as to time, place,

and manner of performance, who neither exerts, nor proposes to

exert improper influence to solicit or obtain contracts nor holds out

as being able to obtain any contract(s) through improper influence.

"Improper influence" means any influence that induces or tends

to induce a PHA/IHA employee or officer to give consideration or to

act regarding a PHA/IHA contract on any basis other than the merits

of the matter.

(b) The bidder represents and certifies as part of its bid that, except

for full-time bona fide employees working solely for the bidder, the

bidder:

(1) [ ] has, [ ] has not employed or retained any person or

company to solicit or obtain this contract; and

(2) [ ] has, [ ] has not paid or agreed to pay to any person or

company employed or retained to solicit or obtain this contract any

commission, percentage, brokerage, or other fee contingent upon or

resulting from the award of this contract.

bidder shall make an immediate and full written disclosure to the

PHA/IHA Contracting Officer.

(d) Any misrepresentation by the bidder shall give the PHA/IHA the

right to (1) terminate the contract; (2) at its discretion, deduct from

contract payments the amount of any commission, percentage,

brokerage, or other contingent fee; or (3) take other remedy

pursuant to the contract.

Certification and Disclosure Regarding Payments to

Influence Certain Federal Transactions (applicable to

contracts exceeding $100,000)

(a) The definitions and prohibitions contained in Section 1352 of

title 31, United States Code, are hereby incorporated by reference

in paragraph (b) of this certification.

form HUD-5369-A (11/92)

(b) The bidder, by signing its bid, hereby certifies to the best of his

or her knowledge and belief as of December 23, 1989 that:

(1) No 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

on his or her behalf in connection with the awarding of a contract

resulting from this solicitation;

(2) If any funds other than Federal appropriated funds (including profit or fee received under a covered Federal transaction) 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 on his or her behalf in connection with this

solicitation, the bidder shall complete and submit, with its bid, OMB

standard form LLL, "Disclosure of Lobbying Activities;" and

(3) He or she will include the language of this certification in all

subcontracts at any tier and require that all recipients of subcontract

awards in excess of $100,000 shall certify and disclose accordingly.

for making or entering into this contract imposed by section 1352,

title 31, United States Code. Any person who makes an expenditure

prohibited under this provision or who fails to file or amend the

disclosure form to be filed or amended by this provision, shall be

subject to a civil penalty of not less than $10,000, and not more than

$100,000, for each such failure.

(d) Indian tribes (except those chartered by States) and Indian

organizations as defined in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450B) are exempt

from the requirements of this provision.

Organizational Conflicts of Interest Certification

The bidder certifies that to the best of its knowledge and belief and

except as otherwise disclosed, he or she does not have any

organizational conflict of interest which is defined as a situation in

which the nature of work to be performed under this proposed

contract and the bidder's organizational, financial, contractual, or

other interests may, without some restriction on future activities:

(a) Result in an unfair competitive advantage to the bidder; or,

(b) Impair the bidder's objectivity in performing the contract work.

[ ] In the absence of any actual or apparent conflict, I hereby certify

that to the best of my knowledge and belief, no actual or apparent

conflict of interest exists with regard to my possible performance of

this procurement.

Bidder's Certification of Eligibility

(a) By the submission of this bid, the bidder certifies that to the best

of its knowledge and belief, neither it, nor any person or firm which

has an interest in the bidder's firm, nor any of the bidder's subcontractors, is ineligible to:

(1) Be awarded contracts by any agency of the United States

Government, HUD, or the State in which this contract is to be

performed; or,

(2) Participate in HUD programs pursuant to 24 CFR Part 24.

(b) The certification in paragraph (a) above is a material representation of fact upon which reliance was placed when making award.

If it is later determined that the bidder knowingly rendered an

erroneous certification, the contract may be terminated for default,

and the bidder may be debarred or suspended from participation in

HUD programs and other Federal contract programs.

Previous edition is obsolete

Page 2 of 3

Minimum Bid Acceptance Period

(a) "Acceptance period," as used in this provision, means the

number of calendar days available to the PHA/IHA for awarding a

contract from the date specified in this solicitation for receipt of bids.

(b) This provision supersedes any language pertaining to the

acceptance period that may appear elsewhere in this solicitation.

[Contracting Officer insert time period] calendar days.

(d) In the space provided immediately below, bidders may specify

a longer acceptance period than the PHA's/IHA's minimum requirement. The bidder allows the following acceptance period:

calendar days.

(e) A bid allowing less than the PHA's/IHA's minimum acceptance

period will be rejected.

(f) The bidder agrees to execute all that it has undertaken to do, in

compliance with its bid, if that bid is accepted in writing within (1) the

acceptance period stated in paragraph (c) above or (2) any longer

acceptance period stated in paragraph (d) above.

Small, Minority, Women-Owned Business Concern

Representation

The bidder represents and certifies as part of its bid/ offer that it -(a) [ ] is, [ ] is not a small business concern. "Small business

concern," as used in this provision, means a concern, including its

affiliates, that is independently owned and operated, not dominant

in the field of operation in which it is bidding, and qualified as a small

business under the criteria and size standards in 13 CFR 121.

(b) [ ] is, [ ] is not a women-owned business enterprise. "Womenowned business enterprise," as used in this provision, means a

business that is at least 51 percent owned by a woman or women

who are U.S. citizens and who also control and operate the business.

business enterprise," as used in this provision, means a business

which is at least 51 percent owned or controlled by one or more

minority group members or, in the case of a publicly owned business,

at least 51 percent of its voting stock is owned by one or more

minority group members, and whose management and daily operations are controlled by one or more such individuals. For the purpose

of this definition, minority group members are:

(Check the block applicable to you)

[ ] Black Americans

[ ] Asian Pacific Americans

[ ] Hispanic Americans

[ ] Asian Indian Americans

[ ] Native Americans

[ ] Hasidic Jewish Americans

Indian-Owned Economic Enterprise and Indian

Organization Representation (applicable only if this

solicitation is for a contract to be performed on a project for an

Indian Housing Authority)

The bidder represents and certifies that it:

(a) [

] is, [

] is not an Indian-owned economic enterprise.

"Economic enterprise," as used in this provision, means any commercial, industrial, or business activity established or organized for

the purpose of profit, which is at least 51 percent Indian owned.

"Indian," as used in this provision, means any person who is a

member of any tribe, band, group, pueblo, or community which is

recognized by the Federal Government as eligible for services from

the Bureau of Indian Affairs and any "Native" as defined in the Alaska

Native Claims Settlement Act.

(b) [ ] is, [ ] is not an Indian organization. "Indian organization,"

as used in this provision, means the governing body of any Indian

tribe or entity established or recognized by such governing body.

Indian "tribe" means any Indian tribe, band, group, pueblo, or

form HUD-5369-A (11/92)

community including Native villages and Native groups (including

corporations organized by Kenai, Juneau, Sitka, and Kodiak) as

defined in the Alaska Native Claims Settlement Act, which is

recognized by the Federal Government as eligible for services from

the Bureau of Indian Affairs.

Certification of Eligibility Under the Davis-Bacon

Act (applicable to construction contracts exceeding $2,000)

(a) By the submission of this bid, the bidder certifies that neither it

nor any person or firm who has an interest in the bidder's firm is a

person or firm ineligible to be awarded contracts by the United States

Government by virtue of section 3(a) of the Davis-Bacon Act or 29

CFR 5.12(a)(1).

(b) No part of the contract resulting from this solicitation shall be

subcontracted to any person or firm ineligible to be awarded

contracts by the United States Government by virtue of section 3(a)

of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

S. Criminal Code, 18 U.S.C. 1001.

10. Certification of Nonsegregated Facilities (applicable

to contracts exceeding $10,000)

(a) The bidder's attention is called to the clause entitled Equal

Employment Opportunity of the General Conditions of the Contract for Construction.

(b) "Segregated facilities," as used in this provision, means any

waiting rooms, work areas, rest rooms and wash rooms, restaurants

and other eating areas, time clocks, locker rooms and other storage

or dressing areas, parking lots, drinking fountains, recreation or

entertainment areas, transportation, and housing facilities provided

for employees, that are segregated by explicit directive or are in fact

segregated on the basis of race, color, religion, or national origin

because of habit, local custom, or otherwise.

and will not maintain or provide for its employees any segregated

facilities at any of its establishments, and that it does not and will not

permit its employees to perform their services at any location under

its control where segregated facilities are maintained. The bidder

agrees that a breach of this certification is a violation of the Equal

Employment Opportunity clause in the contract.

(d) The bidder further agrees that (except where it has obtained

identical certifications from proposed subcontractors for specific

time periods) prior to entering into subcontracts which exceed

$10,000 and are not exempt from the requirements of the Equal

Employment Opportunity clause, it will:

(1) Obtain identical certifications from the proposed subcontractors;

(2) Retain the certifications in its files; and

(3) Forward the following notice to the proposed subcontractors (except if the proposed subcontractors have submitted identical

certifications for specific time periods):

Notice to Prospective Subcontractors of Requirement for

Certifications of Nonsegregated Facilities

A Certification of Nonsegregated Facilities must be submitted before

the award of a subcontract exceeding $10,000 which is not exempt

from the provisions of the Equal Employment Opportunity clause of

the prime contract. The certification may be submitted either for

each subcontract or for all subcontracts during a period (i.e.,

quarterly, semiannually, or annually).

Note: The penalty for making false statements in bids is prescribed

in 18 U.S.C. 1001.

11. Clean Air and Water Certification (applicable to contracts exceeding $100,000)

The bidder certifies that:

(a) Any facility to be used in the performance of this contract [ ]

is, [ ] is not listed on the Environmental Protection Agency List of

Violating Facilities:

(b) The bidder will immediately notify the PHA/IHA Contracting

Officer, before award, of the receipt of any communication from the

Administrator, or a designee, of the Environmental Protection

Agency, indicating that any facility that the bidder proposes to use

for the performance of the contract is under consideration to be

listed on the EPA List of Violating Facilities; and,

this certification, including this paragraph (c), in every nonexempt

subcontract.

12. Previous Participation Certificate (applicable to

construction and equipment contracts exceeding $50,000)

(a) The bidder shall complete and submit with his/her bid the Form

HUD-2530, "Previous Participation Certificate." If the successful

bidder does not submit the certificate with his/her bid, he/she must

submit it within three (3) working days of bid opening. Failure to

submit the certificate by that date may render the bid nonresponsive.

No contract award will be made without a properly executed certificate.

(b) A fully executed "Previous Participation Certificate"

[ ] is, [ ] is not included with the bid.

13. Bidder's Signature

The bidder hereby certifies that the information contained in these

certifications and representations is accurate, complete, and

current.

__________________________________________________________________

(Signature and Date)

__________________________________________________________________

(Typed or Printed Name)

__________________________________________________________________

(Title)

__________________________________________________________________

(Company Name)

(Company Address)

Previous edition is obsolete

Page 3 of 3

form HUD-5369-A (11/92)

SOLID WASTE DISPOSAL FORM

The Confederated Tribes of the Colville Reservation

Public Works Department/Solid Waste

12 Lakes Street P.O. Box 150

Nespelem, WA 99155

509-634-2808

RECEIPTS FROM THE LAND FILL MUST BE RETURNED TO THE PUBLIC WORKS DEPARTMENT WITHIN 5

DAYS OF DISPOSAL. FAILURE TO COMPLY WITH THIS REQUIREMENT WILL RESULT IN FINES AS A RESULT

OF ILLEGAL DUMPING.

PROPERTY OWNER: ________________________________ PHONE NUMBER: ________________________________

OWNER ADDRESS: _________________________________ EMAIL: __________________________________________

CONTRACTOR(S): ____________________________________ START DATE: ___________________________________

•

SITE LOCATION:______________________________________________________________________________

___________________________________________________________________________________________

•

SCOPE OF WORK: ____________________________________________________________________________

•

IF THERE IS NO WASTE FOR THE PROJECT APPLICANT MUST STILL SIGN & DATE THIS FORM

WASTE TYPE: CHECK ALL THAT APPLY

CEMENT/FOUNDATION

METAL

CARDBOARD

OTHER_______________

INSULATION ELECTRICAL/WIRING PLUMBING ROOFING/TAR PAPER

PLASTIC SHEET ROCK/SIDING

ACM/MATERIALS CONTAINING LEAD

*IN ORDER FOR THIS FORM TO BE CONSIDERED COMPLETE A DISPOSAL SITE MUST BE SELECTED/NAMED,

THIS FORM MUST ALSO BE SIGNED AND DATED*

THE TRIBAL DUMP IS NOT AN OPTION FOR CONSTRUCTION WASTE

CIRCLE DISPOSAL SITE BELOW (IF SITE NOT LISTED WRITE IN SITE): NO WASTE CHECK HERE:

OKANOGAN COUNTY LANDFILL, OKANOGAN WA

STEVENS COUNTY LANDFILL, KETTLE FALLS, WA

DELANO LANDFILL, GRAND COULEE, WA

GRAHAM ROAD, AIRWAY HEIGHTS, WA

WRITE IN: _______________________________

APPLICANT OR CONTRACTOR SIGNATURE: ___________________________________ DATE: _____________

SOLID WASTE MANAGER APPROVAL SIGNATURE: _______________________________ DATE: _______________

4.13.6 Disposal

(b) All building contractors and any person as defined by Section 4.136.2(k) are required by this Chapter to submit to the department for review and approval a Solid Waste Disposal Plan

prior to commencement of work to dispose of work site waste materials through the department or at the nearest approved landfill. The department shall issue a notice of noncompliance to any building contractor who fails to submit the plan, and impose a fine of $100 per day for each day that the Solid Waste Plan is not submitted to the department.

(Amended 11/7/02, Resolution 2002-675)

CONSTRUCTION AND CONSTRUCTION-RELATED SERVICES

SMALL PURCHAS E CONTRACT BETWEEN

COLVILLE INDIAN HOUSING AUTHORITY

AND

_________________________________

This Contract is entered into on the Confederated Tribes of the Colville Indian Reservation, between the Colville

Indian Housing Authority (“CIHA”) and ______________________ (“CONTRACTOR”), for the purpose of

securing the services of CONTRACTOR to provide the construction or construction-related services set out in Section 3

herein.

CONTRACT DOCUMENTS

1.1

1.2

1.3

CONTRACTOR enters into this Contract and remains throughout the term of this Contract as an

independent contractor and not an employee.

1.1.1

CONTRACTOR is not subject to the day-to-day supervision of CIHA, but is contracted

independently to complete the project(s) oversight described herein.

1.1.2

CONTRACTOR shall be directly responsible to CIHA for all purposes contractual,

supervisory, and performance-related under this Contract.

1.1.3

CONTRACTOR is not entitled to the rights of benefits afforded to Tribal or CIHA

employees, including, but not limited to, disability or unemployment insurance, workers’

compensation, medical insurance, annual or sick leave, or any other employment benefit

accorded to Tribal or CIHA employees.

1.1.4

CONTRACTOR is responsible for providing, at CONTRACTOR’s expense, employer’s

taxes, applicable worker’s compensation and unemployment insurance, appropriate liability

insurance, and applicable licenses for CONTRACTOR.

Contract documents consist solely of this written Contract signed by both parties, the submitted

quotation, by CONTRACTOR, dated _____________, the Contract Documents and Specifications,

dated ______________, and Amendment(s) ______ which are incorporated herein by reference.

1.2.1

If CONTRACTOR is retained to render services under contracts or grants received by CIHA,

CONTRACTOR also shall be bound by the terms of those contracts or grants.

1.2.2

CIHA assumes no further obligations to CONTRACTOR other than those set forth in this

Contract.

CIHA’s Contracting Officer for the purposes of this Contract is:_______________________

TERM OF CONTRACT. The term of this contract shall be __________________, unless extended pursuant

to the terms of this Contract.

SERVICES TO BE PERFORMED BY CONTRACTOR

3.1

CONTRACTOR is retained to provide the following construction or construction -related services:

3.1.1

;

3.1.2

;

3.1.3

;

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Page 1 of 17

3.1.4

;

3.1.5

;

3.1.6

3.2

CONTRACTOR will identify the need, if any, for consultants, subcontractors, or related business

professional services, and provide such analysis to CIHA. CIHA will make the final determination,

after consulting with CONTRACTOR, whether such consultants, subcontractors, or related business

professional services are needed for the project. CONTRACTOR will procure such services through

the applicable procurement process and consistent with all applicable competitive procurement

requirements.

3.3

All work product generated under this Contract by CONTRACTOR, outside consultants, or

subcontractors, shall be based upon CONTRACTOR’s knowledge, experience, and professional

judgment;

3.4

CONTRACTOR shall adhere to all laws, regulations, or standards applicable to such work in the

performance of this Contract.

COMPENSATION

4.1

CIHA shall compensate CONTRACTOR for services rendered under this contract as

follows:________________________________________.

4.2

CIHA shall pay compensation on the tenth of each month for the previous month’s work, upon

submission by CONTRACTOR of properly itemized invoices and receipts, or credit card itemized

billings, to CIHA’s Executive Director.

4.3

In the event that this Contract is terminated without cause before completion of the Contract term,

CONTRACTOR shall be paid such compensation as may be determined equitable to date of

termination. In the event this Contract is terminated for cause, CONTRACTOR shall receive such

compensation as is due under this contract to the date of termination set forth in such notice, so long

as CONTRACTOR is performing in conformity with the terms of this contract and all Tribal and

CIHA property is returned to CIHA.

4.4

Except in an emergency, advanced written approval shall be obtained from CIHA for additional

amounts for fees and expenses.

CONDITIONAL CONSENT TO REPRES ENT OTHER CLIENTS . During the term of this Contract,

CONTRACTOR shall not engage or participate in any activity that conflicts with, or business that is in direct

competition with, the business of CIHA.

GENERAL PROVISIONS

6.1

Integration. This Contract expresses the complete understanding of the parties, and supersedes any

and all other contracts or agreements, either oral or in writing, between the parties with respect to the

terms of this Contract. Each party to this Contract acknowledges that no representation, inducements,

promises, or agreements, orally or otherwise, have been made by any party, or anyone dealing on

behalf of any party, which are not embodied herein; and that no other agreement, statement, or

promise not contained in this Contract shall be valid or binding on either party, except that any other

written agreement dated concurrent with or after this Contract shall be valid as between the signing

parties.

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Page 2 of 17

6.2

Modifications. Any modification of this Contract will be effective only if it is in writing and signed

by both parties.

6.3.

Property of Parties

6.4

6.3.1

All records, of any nature, whether existing at the time of this Contract, produced through the

efforts of CONTRACTOR, or obtained by CONTRACTOR from any other source, and

whether prepared by CONTRACTOR or otherwise, shall remain the exclusive property of

CIHA.

6.3.2

All Tribal or CIHA equipment, books, and files/records utilized by CONTRACTOR in

performing CONTRACTOR’s duties under this Contract shall be returned immediately to

CIHA by CONTRACTOR on expiration or termination of this Contract, regardless of

whether any dispute exists between CIHA and CONTRACTOR at and/or following the

expiration or termination of this Contract.

6.3.3

Intellectual Property.

6.3.3.1

If this Contract involves performance of experimental, developmental, or

research work funded in whole or in part by the Federal government,

CONTRACTOR and CIHA shall comply with the requirements of 37 CFR Part

401, "Rights to Inventions Made by Nonprofit Organizations and Small

Business Firms Under Government Grants, Contracts and Cooperative

Agreements," and any implementing regulations issued by the awarding

agency.

6.3.3.2

Except as provided in Section 6.3.3.1, above, CONTRACTOR agrees that

ownership of all materials developed under this Contract shall be in CIHA.

6.3.3.3

CONTRACTOR may retain all personal notes relating to work under this

Contract, and may retain copies of documents generated by CONTRACTOR

pursuant to this Contract; provided, however, that copies of all notes and

ORIGINAL copies of all documents created in the performance of this

Contract, shall be provided to CIHA.

Waiver.

6.4.1

The failure of either party to insist on strict compliance with any terms, covenants, or

conditions of this Contract by the other party shall not be deemed waiver of that term,

covenant, or condition; nor shall any waiver or relinquishment of any right or power at any

one time or times be deemed a waiver or relinquishment of that right or power of all and or

any other times.

6.4.2

Nothing in this Contract shall be construed to waive CIHA’s sovereign immunity from suit.

6.5

Governing Law. The Laws of the Confederated Tribes of the Colville Indian Reservation shall

govern this Contract.

6.6

Insurance. CONTRACTOR shall be liable for any damages to CIHA resulting from

CONTRACTOR’s acts and omissions, as well as the acts and omissions of any of CONTRACTOR’s

employees, agents, or officers, and CONTRACTOR shall carry insurance in the following amounts:

6.6.1

General Liability:

$________

6.6.2

Automobile Liability:

$________

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Page 3 of 17

6.6.3

Professional Liability: $________

6.7

CONTRACTOR’S Responsibility for Work. The CONTRACTOR’s responsibility will terminate

when all work reasonably inferable has been completed, the final inspection made, and final

acceptance of the work by the Contracting Officer. The CONTRACTOR will then be released from

further obligation except as required by the warranties specified elsewhere in the Contract.

6.8

Termination.

6.8.1

CIHA may terminate this Contract in whole, or from time to time in part, for CIHA's

convenience or the failure of the CONTRACTOR to fulfill the contract obligations (default).

CIHA shall terminate by delivering to the CONTRACTOR a written Notice of Termination

specifying the nature, extent, and effective date of the termination. Upon receipt of the

notice, the CONTRACTOR shall: (i) immediately discontinue all services affected (unless

the notice directs otherwise); and (ii) deliver to CIHA all information, reports, papers, and

other materials accumulated or generated in performing this contract, whether completed or

in process.

6.8.2

If the termination is for the convenience of CIHA, CIHA shall be liable only for payment for

services rendered and adequately performed before the effective date of the termination.

6.8.3

If the termination is due to the failure of CONTRACTOR to fulfill its obligations under the

Contract (default), CIHA may (i) require CONTRACTOR to deliver to it, in the manner and

to the extent directed by CIHA, any work as described in Section 6.8.1 above, and

compensation be determined in accordance with the Changes clause herein; (ii) take over the

work and prosecute the same to completion by contract or otherwise, and CONTRACTOR

shall be liable for any additional cost incurred by CIHA; (iii) withhold any payments to

CONTRACTOR, for the purpose of off-set or partial payment, as the case may be, of

amounts owed to CIHA by CONTRACTOR.

6.8.4

If, after termination for failure to fulfill contract obligations (default), it is determined that

CONTRACTOR had not failed, the termination shall be deemed to have been effected for

the convenience of CIHA, and CONTRACTOR shall be entitled to payment as described in

Section 6.8.2 above.

6.8.5

Upon the occurrence of any Event of Default by CIHA, and at any time as long as such

Event of Default by CIHA continues, CONTRACTOR may, at its option, declare this

Contract to be in default and exercise any one or more of the following remedies: (i)

Terminate this Contract by written notice to CIHA, which termination shall be effective upon

delivery of such notice to CIHA; (ii) Exercise all rights and remedies available to

CONTRACTOR at law or in equity under the laws of the Colville Confederated Tribes.

6.8.6

In the event of the death or disability of CONTRACTOR, this Contract may be terminated by

CIHA, and CIHA shall pay to the administrator or personal representative of

CONTRACTOR's estate any compensation due CONTRACTOR hereunder.

6.8.7

Any disputes with regard to this clause are expressly made subject to the terms of clause

titled Dispute Resolution herein.

6.9 It is recognized and agreed by CIHA and the CONTRACTOR that it is extremely difficult to measure the

harm to CIHA resulting from delayed completion of the Project. Potential damages include costs for: the

temporary relocation of and alternate housing for residents of the Project, similar difficulties in

calculating damages. Accordingly, CIHA and the Contractor agree that the CONTRACTOR shall have

assessed against it and shall pay to CIHA liquidated damages as follows. If CONTRACTOR fails to

complete the work within the time specified in the contract, or any extension, as specified in the clause

entitled Default of this contract, CONTRACTOR shall pay to the TDHE as liquidated damages, the sum

Construction Contract

Page 4 of 17

of ______ [Contracting Officer insert amount] for each day of delay [If no amount inserted, the amount of

liquidated damages shall be $100 per day]. If different completion dates are specified in the contract for

separate parts or stages of the work, the amount of liquidated damages shall be assessed on those parts or

stages which are delayed. To the extent that the Contractor's delay or nonperformance is excused under

another clause in this contract, liquidated damages shall not be due CIHA. CONTRACTOR remains liable

for damages caused other than by delay. If no amount is inserted in this paragraph, CONTRACTOR shall

pay to CIHA the actual amount of all damages sustained by the CIHA as a result of such delay.

INDIAN PREFERENCE (Section 7(b) Clause).

7.1

Contractor shall comply with all applicable laws, ordinances, rules, regulations, and lawful orders of the

Colville Confederated Tribes, CIHA, and the United States governing performance of the Scope of

Services. This Contract is subject applicable governing law, which includes, but is not limited to: the

Tribal employment and contracting preferences of the Colville Confederated Tribes, if any.

7.2

If the Colville Confederated Tribes does not have Tribal employmen t and contracting preferences, and

only until such time as the Colville Confederated Tribes adopts such preferences through law or

regulation, the following Indian preference provisions shall apply.

7.3

Indian Preference (Section 7(b)) Clause: The work to be performed under this contract is on a

project subject to section 7(b) of the Indian Self-Determination and Education Assistance Act (25

U.S.C. 450e(b)) (the Indian Act). Section 7(b) requires that to the greatest extent feasible:

7.3.1

Preferences and opportunities for training and employment shall

be given to Indians; and

7.3.2

Preferences in the award of contracts and subcontracts shall be

given to Indian organizations and Indian-owned economic enterprises.

7.3.3

CONTRACTOR shall comply with the provisions of section 7(b) of the Indian Act.

7.3.4

In connection with this Contract, CONTRACTOR shall, to the greatest extent feasible, give

preference in the award of any subcontracts to Indian organizations and Indian -owned

economic enterprises, and preferences and opportunities for training and employment to

Indians.

7.3.5

CONTRACTOR shall include this section 7(b) clause in every subcontract in connection

with the project, and shall, at the direction of CIHA take app ropriate action pursuant to the

subcontract upon a finding by the recipient or HUD that the subcontractor has violated the

section 7(b) clause of the Indian Act.

DISPUTE RESOLUTION.

8.1

"Claim" as used in this clause, means a written demand or written assertion by one of the contracting

parties seeking, as a matter of right, the payment of money in a sum certain, the adjustment or

interpretation of Contract terms, or other relief arising under or relating to the Contract. A claim

arising under the Contract, unlike a claim relating to the Contract, is a claim that can be resolved

under a Contract clause that provides for the relief sought by the claimant. A voucher, invoice, or

other routine request for payment that is not in dispute when submitted is not a claim. The submission

may be converted to a claim by complying with the requirements of this clause, if it is disputed either

as to liability or amount or is not acted upon in a reasonable time.

8.2

All disputes arising under or relating to this Contract, including any claims for damages for the

alleged breach thereof which are not disposed of by agreement, shall be resolved exclusively under

this clause.

Construction Contract

Page 5 of 17

8.3

The details and supporting documents of all claims by CONTRACTOR for additional compens ation,

or for an extension of time of performance, or for any dispute regarding a question of fact, or for

interpretation of the Contract, shall be made in writing and submitted to the Contracting Officer for a

written decision within ten (10) calendar days from the date of the occurrence of the dispute.

CONTRACTOR agrees that unless these written notices are provided, CONTRACTOR will have no

entitlement to additional time or compensation for such act, event or condition and such failure to

provide such notice shall constitute a waiver of the claims.

8.4

Presenting Claim. In presenting the claim and supporting documentation, CONTRACTOR shall

specifically include, to the extent then possible, the following:

8.4.1

Certification signed by CONTRACTOR that the claim is made in good faith, that the

supporting data is accurate and complete to the best of CONTRACTOR's knowledge and

belief, and that the amount requested accurately reflects the Contract adjustment for which

CONTRACTOR believes CIHA is liable.

8.4.2

A narrative which describes the facts and outlines the analysis of responsibility and causal

connection of the claim including: (i) A brief summary of the claim and the facts pertinent to

the claim; (ii) The specific Contract provisions on which the claim is based; (iii) A

description of the relative responsibilities of each party giving rise to the claims; (iv) A

description of the cause and effect relationship between the relevant acts and omissions of

the specific responsible parties and the damages or additional costs claimed; (v)

Documentation which supports the narrative including schedules, graphs, charts,

photographs, and any other pertinent documents or information; (vi) Quantitative analysis

and presentation of requested additional compensation and/or the additional time including:

(A) A summary of additional compensation and/or additional time requested; (B) Supporting

calculations, subcalculations, cost data and documents including proof of expenditures to

support the claimed additional compensation and/or additional time.

8.5

All claims by CONTRACTOR shall be made in writing and submitted to the Contracting Officer for a

written decision.

8.6

The Contracting Officer shall, within ____________ (60 unless otherwise indicated) days after receip t

of the request, decide the claim or notify CONTRACTOR of the date by which the decision will be

made.

8.7

The Contracting Officer's decision shall be final unless CONTRACTOR appeals in writing to a higher

level in CIHA in accordance with CIHA's applicable policy and procedures for such appeals, if any.

In the event that CIHA does not have a policy and procedures for such an appeal, an appeal may be

made to the governing body of CIHA. Such appeal must be made within ________________(10

unless otherwise indicated) days after receipt of the Contracting Officer's decision.

8.8

CONTRACTOR shall proceed diligently with performance of this Contract, pending final resolution

of any request for relief, claim, appeal, or action arising under or relating to the Contract, and comply

with any decision of the Contracting Officer.

8.9

Nothing in this Contract, or any action taken by CIHA or any of its agents or employees in connection

with this Contract shall be deemed to be a waiver of the sovereign immunity of CIHA or the Tribe.

8.10

CONTRACTOR hereby acknowledges and irrevocably consents to the exclusive personal and subject

matter jurisdiction of the Tribal Court or other Tribal dispute resolution entity or mechanism of the

Tribe over any dispute, suit or other legal action that may be filed relating to the Contract, provided

that this provision shall not be deemed to be a waiver of the sovereign immunity of the Tribe or

CIHA, which immunity is hereby expressly asserted, and provided further that any order, judgment or

award of such Court or dispute resolution entity or mechanism in favor of CIHA and against

CONTRACTOR may be registered or enforced in any court of competent jurisdiction.

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Page 6 of 17

8.11

10.

Time is of the essence for the CIHA to learn about and address claims and disputes. CONTRACTOR

must comply with all notification requirements, and bring any and all claims within the time frames

set out in this Section or such claims shall be permanently waived and deemed resolved. Further,

notwithstanding any other provision of this Contract, CONTRACTOR may not bring any kind of

cumulative or aggregate claim at any time.

CHANGES

9.1

CIHA may at any time, by written order, and without notice to the sureties, if any, make changes

within the general scope of this Contract in the services to be performed or supplies to be delivered.

9.2

If any such change causes an increase or decrease in the hourly rate, the not-to-exceed amount of the

Contract, or the time required for performance of any part of the work under this contract, whether or

not changed by the order, or otherwise affects the conditions of this contract, CIHA shall make an

equitable adjustment in the not-to-exceed amount, the hourly rate, the delivery schedule, or other

affected terms, and shall modify the contract accordingly.

9.3

CONTRACTOR must assert its right to an equitable adjustment under this clause within 10 days from

the date of receipt of the written order. However, if CIHA decides that the facts justify it, CIHA may

receive and act upon a proposal submitted before final payment of the Contract.

9.4

Failure to agree to any adjustment shall be a dispute under clause Disputes, herein. However, nothing

in this clause shall excuse the Contractor from proceeding with the contract as changed. (e) No

services for which an additional cost or fee will be charged by the Contractor shall be furnished

without the prior written consent of CIHA.

Prevailing Wage Rates

10.1

If the Colville Confederated Tribes has adopted Tribal prevailing wage laws, regulations, and rates

governing the work provided under this Contract, those laws, regulations and rates shall govern. If

not, then the remainder of this Section 10 shall apply.

10.2

Minimum Wages.

10.2.1 All laborers and mechanics employed under the Contract in the construction or development

of the project(s) involved will be paid unconditionally and not less often than once a week,

and without subsequent deduction or rebate on any account (except such payroll deductions as

are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29

CFR Part 3)), the full amount of wages and bona fide fringe b enefits (or cash equivalents

thereof) due at time of payment computed at rates not less than those contained in the wage

determination of the Secretary of Labor which is attached hereto and made a part hereof,

regardless of any contractual relationship which may be alleged to exist between the

Contractor and such laborers and mechanics. Contributions made or costs reasonably

anticipated for bona fide fringe benefits under Section 1(b)(2) of the Davis -Bacon Act on

behalf of laborers or mechanics are considered wages paid to such laborers or mechanics,

subject to the provisions of 29 CFR 5.5(a)(1)(iv); also, regular contributions made or costs

incurred for more than a weekly period (but not less often than quarterly) under plans, funds,

or programs which cover the regular weekly period, are deemed to be constructively made or

incurred during such weekly period. Such laborers and mechanics shall be paid the

appropriate wage rate and fringe benefits in the wage determination for the classification of

work actually performed, without regard to skill, except as provided in 29 CFR 5.5(a)(4).

Laborers or mechanics performing work in more than one classification may be compensated

at the rate specified for each classification for the time actually worked therein; provided, that

the employer’s payroll records accurately set forth the time spent in each classification in

which work is performed. The wage determination (including any additional classification and

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wage rates conformed under 29 CFR 5.5(a)(1)(ii) and the Davis-Bacon poster (WH-1321)

shall be posted at all times by the Contractor and its subcontractors at the site of the work in a

prominent and accessible place where it can be easily seen by the workers.

10.2.2

(A) Any class of laborers or mechanics, including helpers, which is not listed in the wage

determination and which is to be employed under the contract shall be classified in

conformance with the wage determination. HUD shall approve an additional classification

and wage rate and fringe benefits therefor only when all the following criteria have been met:

(1)

(2)

(3)

The work to be performed by the classification requested is not performed by a

classification in the wage determination; and

The classification is utilized in the area by the construction industry; and

The proposed wage rate, including any bona fide fringe benefits, bears a reasonable

relationship to the wage rates contained in the wage determination.

(B) If the Contractor and the laborers and mechanics to be employed in the classification (if

known), or their representatives, and HUD or its designee agree on the classification and

wage rate (including the amount designated for fringe benefits where appropriate), a report of

the action shall be sent by HUD or its designee to the Administrator of the Wage and Hour

Division, Employee Standards Administration, U.S. Department of Labor, Washington, DC

20210. The Administrator, or an authorized representative, will approve, modify, or

disapprove every additional classification action within 30 days of receipt and so advise

HUD or its designee or will notify HUD or its designee within the 30-day period that

additional time is necessary.

classification or their representatives, and HUD or its designee do not agree on the proposed

classification and wage rate (including the amount designated for fringe benefits, where

appropriate), HUD or its designee shall refer the questions, including the views of all

interested parties and the recommendation of HUD or its designee, to the Administrator of

the Wage and Hour Division for determination. The Administrator, or an authorized

representative, will issue a determination within 30 days of receipt and so advise HUD or its

designee or will notify HUD or its designee within the 30-day period that additional time is

necessary.

(D) The wage rate (including fringe benefits where appropriate) determined pursuant to this

clause shall be paid to all workers performing work in the classification under this contract

from the first day on which work is performed in the classification.

10.2.3

Whenever the minimum wage rate prescribed in the contract for a class of laborers or

mechanics includes a fringe benefit which is not expressed as an hourly rate, the Contractor

shall either pay the benefit as stated in the wage determination or shall pay another bona fide

fringe benefit or an hourly cash equivalent thereof.

10.2.4

If the Contractor does not make payments to a trustee or other third person, the Contractor

may consider as part of the wages of any laborer or mechanic the amount of any costs

reasonably anticipated in providing bona fide fringe benefits under a plan or program;

provided, that the Secretary of Labor has found, upon the written request of the Contractor,

that the applicable standards of the Davis -Bacon Act have been met. The Secretary of Labor

may require the Contractor to set aside in a separate account assets for the meeting of

obligations under the plan or program.

10.2.5

Withholding of Funds. CIHA shall, upon its own action or upon written request of an

authorized representative of the Department of Labor, withhold or cause to be withheld from

the Contractor under this contract or any other Federal contract with the same prime

Contractor, or any other Federally-assisted contract subject to Davis -Bacon prevailing wage

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requirements, which is held by the same prime Contractor, so much of the accrued payments

or advances as may be considered necessary to pay laborers and mechanics, including

apprentices, trainees, and helpers, employed by the Contractor or any subcontractor the full

amount of wages required by the contract. In the event of failure to pay any laborer or

mechanic, including any apprentice, trainee, or helper, employed or working in the

construction or development of the project, all or part of the wages required by the contract,

HUD or its designee may, after written notice to the Contractor, take such action as may be

necessary to cause the suspension of any further payment, advance, or guarantee of funds

until such violations have ceased. HUD or its designee may, after written notice to the

Contractor, disburse such amounts withheld for and on account of the Contractor or

subcontractor to the respective employees to whom they are due.

10.2.6

Payrolls and Basic Records.

(A) Payrolls and basic records relating thereto shall be maintained by the Contractor during

the course of the work and preserved for a period of three years thereafter for all laborers

and mechanics working in the construction or development of the project. Whenever the

Secretary of Labor has found, under 29 CFR 5.5(a)(1)(iv), that the wages of any laborer

or mechanic include the amount of costs reasonably anticipated in pro viding benefits

under a plan or program described in section 1(b)(2)(B) of the Davis -Bacon Act, the

Contractor shall maintain records which show that the commitment to provide such

benefits is enforceable, that the plan or program is financially responsible, and that the

plan or program has been communicated in writing to the laborers or mechanics

affected, and records which show the costs anticipated or the actual cost incurred in

providing such benefits.

(B) (1) The Contractor shall submit weekly for each week in which any contract work is

performed a copy of all payrolls to the Contracting Officer. The payrolls submitted shall

set out accurately and completely all of the information required to be maintained under

subparagraph (c)(1) of this clause. This information may be submitted in any form

desired.

(2) Each payroll submitted shall be accompanied by a “Statement of Compliance,”

signed by the Contractor or subcontractor or his or her agent who pays or supervises the

payment of the persons employed under the contract and shall certify the following:

(i) That the payroll for the payroll period contains the information required to be

maintained under this clause and that such information is correct and complete;

(ii) That each laborer or mechanic (including each helper, apprentice, and trainee)

employed on the contract during the payroll period has been paid the full weekly

wages earned, without rebate, either directly or indirectly, and that no deductions

have been made either directly or indirectly from the full wages earned, other than

permissible deductions as set forth in 29 CFR Part 3; and

(iii) That each laborer or mechanic has been paid not less than the applicable wage

rates and fringe benefits or cash equivalents for the classification of work

performed, as specified in the applicable wage determination incorporated into the

contract.

(3) The falsification of any of the above certifications may subject the Contractor or

subcontractor to civil or criminal prosecution under Section 1001 of Title 18 and

Section 3729 of Title 31 of the United States Code.

available for inspection, copying, or transcription by authorized representatives of

CIHA, HUD or its designee, the Contracting Officer, or the Department of Labor and

shall permit such representatives to interview employees during working hours on the

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job. If the Contractor or subcontractor fails to submit the required records or to make

them available, CIHA or its designee may, after written notice to the Contractor, take

such action as may be necessary to cause the suspension of any further payment,

advance, or guarantee of funds. Furthermore, failure to submit the required records upon

request or to make such records available may be grounds for debarment action pursuant

to 29 CFR 5.12.

10.2.7

Apprentices.

(A) Apprentices will be permitted to work at less than the predetermined rate for the work

they performed when they are employed pursuant to and individually registered in a

bona fide apprenticeship program registered with the U.S. Department of Labor,

Employment and Training Administration, Office of Apprenticeship Training, Employer

and Labor Services (OATELS), or with a State Apprenticeship Agency recognized by

OATELS, or if a person is employed in his or her first 90 days of probationary

employment as an apprentice in such an apprenticeship program, who is not individually

registered in the program, but who has been certified by OATELS or a State

Apprenticeship Agency (where appropriate) to be eligible for probationary employment

as an apprentice.

(B) The allowable ratio of apprentices to journeymen on the job site in any craft

classification shall not be greater than the ratio permitted to the Contractor as to the

entire work force under the registered program. Any worker listed on a payroll at an

apprentice wage rate, who is not registered or otherwise employed as stated in this

paragraph, shall be paid not less than the applicable wage rate on the wage determination

for the classification of work actually performed. In addition, any apprentice performing

work on the job site in excess of the ratio permitted under the registered program shall

be paid not less than the applicable wage rate on the wage determinat ion for the work

actually performed. Where a contractor is performing construction on a project in a

locality other than that in which its program is registered, the ratios and wage rates

(expressed in percentages of the journeyman’s hourly rate) specified in the Contractor’s

or subcontractor’s registered program shall be observed. Every apprentice must be paid

at not less than the rate specified in the registered program for the apprentice’s level of

progress, expressed as a percentage of the journeyman ho urly rate specified in the

applicable wage determination. Apprentices shall be paid fringe benefits in accordance

with the provisions of the apprenticeship program. If the apprenticeship program does

not specify fringe benefits, apprentices must be paid the full amount of fringe benefits

listed on the wage determination for the applicable classification. If the Administrator of

the Wage and Hour Division determines that a different practice prevails for the

applicable apprentice classification, fringes shall be paid in accordance with that

determination. In the event OATELS, or a State Apprenticeship Agency recognized by

OATELS, withdraws approval of an apprenticeship program, the Contractor will no

longer be permitted to utilize apprentices at less than the applicable predetermined rate

for the work performed until an acceptable program is approved.

10.2.8

Trainees.

(A) Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than

the predetermined rate for the work performed unles s they are employed pursuant to and

individually registered in a program which has received prior approval, evidenced by

formal certification by the U.S. Department of Labor, Employment and Training

Administration. The ratio of trainees to journeymen on th e job site shall not be greater

than permitted under the plan approved by the Employment and Training

Administration.

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(B) Every trainee must be paid at not less than the rate specified in the approved program for

the trainee’s level of progress, expressed as a percentage of the journeyman hourly rate

specified in the applicable wage determination. Trainees shall be paid fringe benefits in

accordance with the provisions of the trainee program. If the trainee program does not

mention fringe benefits, trainees s hall be paid the full amount of fringe benefits listed in

the wage determination unless the Administrator of the Wage and Hour Division

determines that there is an apprenticeship program associated with the corresponding

journeyman wage rate in the wage determination which provides for less than full fringe

benefits for apprentices. Any employee listed on the payroll at a trainee rate who is not

registered and participating in a training plan approved by the Employment and Training

Administration shall be paid not less than the applicable wage rate in the wage

determination for the classification of work actually performed. In addition, any trainee

performing work on the job site in excess of the ratio permitted under the registered

program shall be paid not less than the applicable wage rate in the wage determination

for the work actually performed. In the event the Employment and Training

Administration withdraws approval of a training program, the Contractor will no longer

be permitted to utilize trainees at less than the applicable predetermined rate for the

work performed until an acceptable program is approved.

10.2.9

Equal Employment Opportunity. The utilization of apprentices, trainees, and journeymen

under this clause shall be in conformity with the equal employment opportunity requirements

of Executive Order 11246, as amended by Executive Order 11375, and as further amended

by Executive Order 13672, and as it may be subsequently amended, and implementing

regulations at 41 CFR Part 60, and as supplemented in Department of Labor regulations,

rules, and orders.

10.2.10 Compliance with Copeland Act Requirements . The Contractor shall comply with the

requirements of 29 CFR Part 3, which are hereby incorporated by reference in this contract.

10.2.11 Contract Termination; Debarment. A breach of the labor standards clauses in this

contract may be grounds for termination of the contract and for debarment as a Contractor

and a subcontractor as provided in 29 CFR 5.12.

10.2.12 Compliance with Davis-Bacon and related Act Requirements. All rulings and

interpretations of the Davis -Bacon Act, as amended (40 U.S.C. 3141–3148), the Copeland

“Anti–Kickback” Act (40 U.S.C. 3145), as supplemented by Department of Labor

regulations, and related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated

by reference in this contract. The CIHA must place a copy of the current prevailing wage

determination issued by the Department of Labor in each solicitation. The decision to award

a contract or subcontract must be conditioned upon the acceptance of the wage

determination. The CIHA must report all suspected or reported violations to the Federal

awarding agency. When required by Federal program legislation, this clause applies to all

prime construction contracts in excess of $2,000 awarded by non–Federal entities.

10.2.13 Disputes Concerning Labor Standards . Disputes arising out of the labor standards

provisions of this clause shall be subject to the general disputes clause of this contract, except

that disputes related to the Copeland Act and the Contract Work Hours and Safety Act shall

be resolved in accordance with the procedures of the Department of Labor set forth in 29

CFR Parts 5, 6, and 7. Disputes within the meaning of this clause include disputes be tween

the Contractor (or any of its subcontractors) and the CIHA, HUD, the U.S. Department of

Labor, or the employees or their representatives.

10.2.14 Certification of Eligibility.

(A) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor

any person or firm who has an interest in the Contractor’s firm is a person or firm

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ineligible to be awarded contracts by the United States Government by virtue of section

3(a) of the Davis-Bacon Act or 29 CFR 5.12(a)(1).

(B) No part of this contract shall be subcontracted to any person or firm ineligible for award

of a United States Government contract by virtue of section 3(a) of the Davis -Bacon Act

or 29 CFR 5.12(a)(1).

U.S.C. 1001.

10.2.15 Subcontracts. The Contractor or subcontractor shall insert in any subcontracts all the

provisions contained in this clause, and such other clauses as HUD or its designee may by

appropriate instructions require, and also a clause requiring the subcontractors to include

these provisions in any lower tier subcontracts. The prime Contractor shall be responsible for

the compliance by any subcontractor or lower tier subcontractor with all these provisions .

11.

MISCELLANEOUS TERMS AND CONDITIONS

11.1

Lead-Based Paint Poisoning Prevention. CONTRACTOR will comply with the lead-based paint

poisoning prevention requirements set out in 24 CFR 1000.40.

11.2

Section 3 of the Housing and Urban Development Act of 1968. CONTRACTOR will comply with

Section 3 of the Housing and Urban Development Act of 1968, as and only to the extent required by

24 CFR 1000.42.

11.3

Contract Work Hours and Safety Standards Act. In contracts awarded by CIHA in excess of

$100,000 that involve the employment of mechanics or laborers, CONTRACTOR will comply with

40 U.S.C. 3702 and supplemented by Department of Labor regulations as set out in 29 CFR Part 5.

Under 40 U.S.C. 3702, CONTRACTOR must compute the wages of every mechanic and laborer on

the basis of a standard work week of 40 hours. Work in excess of the standard work week is

permissible provided that the worker is compensated at a rate of not less than one and a ha lf times the

basic rate of pay for all hours worked in excess of 40 hours in the work week. The requirements of 40

U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be

required to work in surroundings or under working conditions which are unsanitary, hazardous or

dangerous. These requirements do not apply to the purchases of supplies or materials or articles

ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

11.4

Prevailing Wage Requirements . CONTRACTOR will pay prevailing wages as required by 25

U.S.C. § 4114 of the Native American Housing Assistance and Self-Determination Act, and as set out

elsewhere in this Contract.

11.5

Use of Debarred, Suspended or Ineligible Contractors. CONTRACTOR will comply with

Executive Orders 12549 and 12689, and OMB implementation guidelines as set out in 2 CFR 180. A

contract award must not be made to parties listed on the government wide exclusions in the System

for Award Management (SAM), “Debarment and Suspension.” SAM Exclusions contains the names

of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared

ineligible under statutory or regulatory authority other than Executive Order 12549. CONTRACTOR

will comply with the prohibitions set out in 24 CFR Part 24, 2 CFR Part 200, 2 CFR Part 2424, as

well as any Tribal and CIHA requirements, with regard to the use of debarred, suspended or ineligible

subcontractors. (24 CFR 1000.44).

11.6

Drug-Free Workplace. CONTRACTOR will comply with the Drug-Free Workplace Act of 1988,

HUD’s implementing regulations at 24 CFR Part 24, and any tribal requirements as set out in 24 CFR

1000.46.

11.7

Equal Employment Opportunity. CONTRACTOR will comply with Executive Order 11246 of

September 24, 1965, entitled "Equal Employment Opportunity,'' as amended by Executive Order

11375 of October 13, 1967, as further amended by Executive Order 13672 of July 21, 2014, and as it

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may be subsequently amended, and implementing regulations at 41 CFR Part 60, and as supplemented

in Department of Labor regulations, rules, and orders

11.8

Conflicts of Interest (24 CFR 1000.32). Based on federal regulations (24 CFR 1000.32) and where

24 CFR 1000.32 applies, in all cases not governed by 2 CFR 200.318(c), the following conflict of

interest provisions shall apply: No person who participates in the decision -making process or who

gains inside information with regard to NAHASDA assisted activities may obtain a personal or

financial interest or benefit from such activities, except for the use of NAHASDA funds to pay

salaries or other related administrative costs. Such persons include anyone with an interest in any

contract, subcontract or agreement or proceeds thereunder, either for themselves or others with whom

they have business or immediate family ties. Immediate family ties are determined by the CIHA in its

operating policies.

11.9

No Liens. The parties hereby acknowledge that the work is to be performed on the reservation of the

Colville Confederated Tribes, which is comprised of lands held in trust by the United States for the

benefit of the Tribe. As such, there is no authority for CONTRACTOR to assert or perfect a

construction, mechanics’, or other such lien on the property, and CONTRACTOR shall not attempt to

assert or perfect any such lien, nor permit any subcontractors to do so.

11.10

Indemnity. CONTRACTOR shall indemnify CIHA against and hold CIHA harmless from any and

all claims, actions, damages, costs, expenses (including reasonable attorneys' fees), obligations,

liabilities and liens (including any of the foregoing arising or imposed under the doctrines of "strict

liability" or "product liability" and including, without limitatio n, the cost of any fines, remedial action,

damage to the environment and cleanup and the fees and costs of consultants and experts), arising out

of the services provided by CONTRACTOR pursuant to this Contract, or for any other activities of

CONTRACTOR or CONTRACTOR’s officers, agents, or employees, excluding, however, any of the

foregoing resulting from the sole negligence or willful misconduct of CIHA. CONTRACTOR agrees

that upon written notice by CIHA of the assertion of such a claim, action, damage, obligation, liability

or lien, CONTRACTOR shall assume full responsibility for the defense thereof. CONTRACTOR’s

choice of counsel shall be mutually acceptable to both CIHA and CONTRACTOR.

11.11

Assignment.

11.11.1 Neither party may assign this Contract or any interest in this Contract without the express

prior written consent of the other party, which consent shall not be unreasonably withheld;

provided, however, that CIHA may assign its rights under this Contract to an affiliate of

CIHA or to the Colville Confederated Tribes in the event of a merger, reorganization, or

consolidation as a result of which CIHA is not a surviving legal entity. CIHA may attach

any reasonable condition or limitation to the employment of any such subcontractor or third

party. In the event of any such assignment by either party, that party’s assignee shall have all

the rights, powers, privileges, remedies and obligations of the assigning party set forth in this

Contract.

11.11.2 This Contract shall be binding upon and inure to the benefit of CIHA and CONTRACTOR

and their respective permitted successors and assigns.

11.12

Copyrights and Rights in Data. The United States Department of Housing and Urban Development

reserves an irrevocable, non-exclusive, and royalty-free license to reproduce, publish, or otherwise

use, for Federal government purposes only and to the extent otherwise permitted by law, (a) the

(b) any rights of copyright to which a grantee, subgrantee, or contractor purchases ownership with

grant support.

11.13

Examination and Retention of Contractor’s Records .

11.13.1 CIHA, HUD, and the Comptroller General of the United States, and any of their duly

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authorized representatives, shall, until three years after final payment is made under this

Contract, have access to and the right to examine any of CONTRACTOR’s directly pertinent

books, documents, papers, or other records involving transactions related to this Cont ract, for

the purpose of making audit, examination, excerpts, and transcriptions.

11.13.2 CONTRACTOR agrees to include in all subcontracts under this Contract at any tier a clause

substantially the same as subparagraph 11.1.1 above.

11.13.3 The periods of access and examination in subparagraphs 11.12.1 and 11.12.2 above for

records relating to (1) appeals under the disputes clause of this Contract, (2) litigation or

settlement of claims arising from the performance of this Contract, or (3) costs or expe nses

of this Contract to which CIHA, HUD, or the Comptroller General or any of their duly

authorized representatives have taken exception shall continue until the disposition of such

appeals, litigation, claims, or exceptions.

11.14

Environmental Laws and Regulations. CONTRACTOR shall comply with all applicable standards,

orders, regulations, or requirements issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671(q ))

the Federal Water Pollution Act Control Act as amended (33 U.S.C. 1251-1387), Executive Order

11738, and Environmental Protection Agency regulations (40 CFR Part 15). This clause applies only

to contracts and subgrants in excess of $150,000. Violations must be reported to the Federal awarding

agency and the Regional Office of the Environmental Protection Agency (EPA).

11.15

Energy Policy and Conservation Act. CONTRACTOR shall comply with all applicable mandatory

standards and policies relating to energy efficiency which are contained in the state energy

conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub. L. 94-163,

89 Stat. 871).

11.16

Restrictions on Lobbying. CONTRACTOR shall comply with Restrictions on Lobbying (Public

Law 101-121, Section 319) as supplemented by applicable HUD regulations. CONTRACTOR shall

comply with the Byrd Anti–Lobbying Amendment (31 U.S.C. 1352). CONTRACTOR must

complete a certification form on lobbying activities related to a specific Federal loan or grant that is a

funding source for this Contract for an award exceeding $100,000. Each tier certifies to the tier above

that it will not and has not used Federal appropriated funds to pay any person or organization for

influencing or attempting to influence an officer or employee of any agency, a membe r of Congress,

officer or employee of Congress, or an employee of a member of Congress in connection with

obtaining any Federal contract, grant or any other award as set out in 31 U.S.C. 1352. Each tier must

also disclose any lobbying with non–Federal funds that takes place in connection with obtaining any

Federal award. Such disclosures are forwarded from tier to tier up to the non –Federal award. .

Certifications and disclosures are forwarded from tier to tier up to the CIHA. Necessary certification

and disclosure forms shall be provided by CIHA.

11.17

Notices. Any notice, request, demand, statement, authorization, approval or consent required or

permitted under this Contract shall be in writing and shall be made by, and deemed duly given upon,

(a) deposit in the mail, postage prepaid, registered or certified, return receipt requested, (b) personal

delivery, (c) delivery to an overnight courier of recognized reputation, or (d) facsimile transmission

(with confirmation by mail), as follows, or to such other address and/or such additional parties as

either party may specify by written notice given in accordance with this section:

If to CONTRACTOR:

_____________________________

Attention: ____________________

If to CIHA:

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Colville Indian Housing Authority

42 Convalescent Boulevard

P.O. Box 528

Nespelem, Washington 99155

Attention: Executive Director

All such notices and communications hereunder shall be deemed given upon personal delivery, seven

business days after deposit in the mail, two business days following deposit with any international

courier service of recognized reputation or one business day after transmission by telefax.

11.18

Certificate and Release. Prior to final payment under this Contract, or prior to settlement upon

termination of this Contract, and as a condition precedent thereto, CONTRACTOR shall execute and

deliver to CIHA a certificate and release, in a form acceptable to CIHA, of all claims against CIHA by

CONTRACTOR under and by virtue of this Contract, other than such claims, if any, as may be

specifically excepted by the Contractor in stated amounts set forth therein.

11.19

No Third Party Beneficiaries. Neither this Contract nor any provision hereof, nor any document or

instrument executed or delivered pursuant hereto, shall be deemed to create any right in favor of or

impose any obligation upon any person or entity other than the parties hereto and their respective

permitted successors and assigns, except for those provisions which recognize the rights of certain

agencies of the United States.

11.20

Legal Advice and Construction of Contract. Each party represents that it has received independent

legal advice with respect to the preparation of, and the advisability of entering into, this Contract and

neither has been entitled to rely upon nor has in fact relied upon the legal or other advice of the other

party or such other party's counsel in entering into this Contract. Each party has participated in the

drafting and preparation of this Contract, and, accordingly, in any construction or interpretation of this

Contract, the same shall not be construed against either party by reason of the source of drafting.

11.21

Parties' Understandi ng. Each party represents that it has carefully read this Contract, that this

Contract has been fully explained to it by its attorney, that it fully understands the final and binding

effect of this Contract, that the only promises made to it to sign this Contract are those stated above,

and that it is signing this Contract voluntarily.

11.22

Force Majeure. No party hereto shall be deemed in default if its performance of obligations

hereunder is delayed or becomes impossible or impractical by reason o f any act of God, war, fire,

earthquake, strike, civil commotion, epidemic or any other cause beyond such party's reasonable

control.

11.23

Limitation of Damages. Except as expressly set forth herein, in any action or proceeding arising out

of, relating to or concerning this Contract, including, without limitation, any claim of breach of

contract, liability shall be limited to compensatory damages proximately caused by such breach and

no party shall, under any circumstances, be liable to the other party fo r consequential, incidental,

indirect or special damages, including but not limited to lost profits or income, even if such party has

been apprised of the likelihood of such damages occurring.

11.24

Entire Agreement. This Contract constitutes the entire agreement between the parties with respect to

the subject matter covered by this Contract and supersedes all previous discussions, negotiations, oral

or written, representations, statements, arrangements, agreements and understandings, if any, by and

between the parties with respect to the subject matter covered by this Contract other than those herein,

and any such discussions, negotiations, oral or written, representations, statements, arrangements,

agreements and understandings are hereby canceled and terminated in all respects. This Contract may

not be amended, changed or modified except by a writing duly executed by the parties hereto or their

duly authorized representatives. The parties have made no representations or warranties not expressly

set forth in this Contract.

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11.25

Warranty of Work and Materials. Contractor warrants to CIHA for a period of one year after the date

of any specific services provided that the materials and equipment incorporated in the services provided

will be new unless otherwise specified and that the work performed will be free from faults and defects

unless CIHA has previously given Contractor an acceptance of such condition. Contractor’s warranty

excludes remedy for damage or defect caused by abuse, modifications not done by Contractor, improper

or insufficient maintenance, improper operation, normal wear and tear under normal usage or the acts or

omissions of CIHA, its employees, agents, contractors and all those claiming by, through or under them.

Contractor shall, upon final completion of any specific project and upon receipt by Contractor of the final

payment, assign to CIHA all warranties for materials and equipment incorporated in the work, to the

extent such warranties are assignable.

11.26

Licenses and Permits. Contractor hereby represents and warrants that all of its employees, officers, and

agents possess the licenses and permits necessary under applicable law to perform the scope of services

under this Contract.

11.27

Employment Eligibility Verification. Federal law requires Contractor and all subcontractors to

employ only those individuals who may legally work in the United States – either U.S. citizens, or

foreign citizens who have the necessary authorization. Contractor, and all subcontractors who a re

providing goods or services valued at $3000 or higher must register with the United States

Department of Homeland Security E-Verify system to confirm the eligibility of their employees to

work in the United States.

11.28

References to Federal and Tribal Laws; No Waiver of Sovereign Immunity. All federal and

tribal laws and regulations referenced in this Contract are deemed incorporated into this Contract in

their entirety. However, reference to and incorporation of such laws and regulations shall no t be

construed to waive CIHA’s sovereign immunity with regard to such laws and regulations, nor shall

such laws and regulations be construed to apply to or govern the activities of CIHA, and no phrase,

clause, or provision of this Contract may be construed to be a waiver of the sovereign immunity of

CIHA, which immunity is hereby expressly asserted.

11.29

Severability. In the event any provision of this Contract or the application thereof to any

circumstance shall be held by a court of competent jurisdiction to be invalid, illegal or unenforceable,

it shall be construed to be limited or reduced so as to be enforceable to the maximu m extent allowed

by applicable law as it shall then be in force, and if such construction shall not be feasible, then such

provision shall be deemed to be deleted herefrom in any action before that court, and all other

provisions of this Contract shall remain in full force and effect.

11.30

Remedies. All rights and remedies of the parties are separate and cumulative, an d no one of them,

whether exercised or not, shall be deemed to be to the exclusion of or to limit or prejudice any other

legal or equitable rights or remedies which the parties may have. The parties shall not be deemed to

waive any of their rights or remedies under this Contract unless such waiver is in writing and signed

by the party to be bound. No delay or omission on the part of either party in exercising any right or

remedy shall operate as a waiver of such right or remedy or any other right or remedy. A waiver on

any one occasion shall not be construed as a bar to or waiver of any right or remedy on any future

occasion.

11.31

Headings. The headings contained in this Contract are for convenience only and are not a part of this

Contract, and do not in any way interpret, limit or amplify the scope, extent or intent of this Contract,

or any of the provisions of this Contract.

11.32

Counterparts. This Contract may be executed in counterparts, each of which shall constitute an

original, but which together shall constitute one and the same agreement.

Construction Contract

Page 16 of 17

11.33

Expenses. Except as otherwise expressly provided for in this Contract, each of the parties shall pay its

own expenses in connection with the negotiation, preparation and execution of this Contract or ot her

related documents and the consummation of the transactions consummated herein and therein.

IN WITNESS HEREOF, we the undersigned have executed this Contract:

CIHA

CONTRACTOR

By:____________________________

Dale R. Schrock, Jr.

Executive Director

Colville Indian Housing Authority

Date:____________________________

_____________________________

Date:____________________________

Construction Contract

Page 17 of 17

SYST EM FOR A WARD M ANAGEMENT REGIST RAT ION (SAM)

REQUIRED CONT RACT AND SOLICIT AT ION LANGUAGE , FAR 4.1105

(a) Definitions. As used in this provision—

“Electronic Funds Transfer (EFT) indicator means a four-character suffix to the unique entity

identifier. The suffix is assigned at the discretion of the commercial, nonprofit, or Government entity to

establish additional System for Award Management records for identifying alternative EFT accounts

(see subpart 32.11) for the same entity.

“Registered in the System for Award Management (SAM)” means that –

(1) The Offeror has entered all mandatory information, including the unique en tity identifier and

the EFT indicator, if applicable, the Commercial and Government Entity (CAGE) code, as well as data

required by the Federal Funding Accountability and Transparency Act of 2006 (see subpart 4.14) into

SAM

(2) The offeror has completed the Core, Assertions, and Representations and Certifications, and

Points of Contact sections of the registration in SAM;

(3) The Government has validated all mandatory data fields, to include validation of the Taxpayer

Identification Number (TIN) with the Internal Revenue Service (IRS). The offeror will be required to

provide consent for TIN validation to the Government as a part of the SAM registration process; and

(4) The Government has marked the record “Active”.

“Unique entity identifier” means a number or other identifier used to identify a specific commercial,

nonprofit, or Government entity. See www.sam.gov for the designated entity for establishing unique entity

identifiers.

(b)

(1) An Offeror is required to be registered in SAM when submitting an offer or quotation, and shall

continue to be registered until time of award, during performance, and through final payment of any

contract, basic agreement, basic ordering agreement, or blanket purchasing agreement resulting from this

solicitation.

(2) The Offeror shall enter, in the block with its name and address on the cover page of its offer,

the annotation “Unique Entity Identifier” followed by the unique entity identifier that identifies the

Offeror's name and address exactly as stated in the offer. The Offero r also shall enter its EFT indicator, if

applicable. The unique entity identifier will be used by the Contracting Officer to verify that the Offeror is

registered in the SAM.

at www.sam.gov for establishment of the unique entity identifier directly to obtain one. The Offeror should

be prepared to provide the following information:

(1) Company legal business name.

(2) Tradestyle, doing business, or other name by which your entity is commonly recognized.

Required SAM Language

Page 1 of 2

(3) Company physical street address, city, state, and Zip Code.t

(4) Company mailing address, city, state and Zip Code (if separate from physical).

(5) Company telephone number.

(6) Date the company was started.

(7) Number of employees at your location.

(8) Chief executive officer/key manager.

(9) Line of business (industry).

(10) Company headquarters name and address (reporting relationship within your entity).

(d) Processing time should be taken into consideration when registering. Offerors who are not

registered in SAM should consider applying for registration immediately upon receipt of this solicitation.

See https://ww.sam.gov for information on registration.

Required SAM Language

Page 2 of 2

INDIAN ENTERPRISE QUALIFICATION STATEMENT

NOTE: Submit completed questionnaire to the Colville Indian Housing Authority within the

time frame specified. Use additional sheets to complete answer if needed.

The Undersigned certifies under oath the truth and correctness of all answers to questions made

hereinafter:

Applicant wishes to qualify as:

An "Economic Enterprise" as defined in Section 3(e) of the Indian Financing Act

of 1974 (P.L. 93-262); that is "any Indian-Owned...commercial, industrial or

business activity established or organized for the purpose of profit”; Provided,

that such Indian Ownership shall constitute not less than 51 percent of the

enterprise:

--or-An "Organization" as defined in Section 3(f) of the Indian Financing Act (P.L.

93-262); that is “the governing body of any Indian tribe, as defined in subsection

by such governing body for the purposes of [Chapter 17 of Title 25 of the United

States Code].”

2. Name of Enterprise or Organization: _____________________________

Address:

_____________________________________________

Telephone No.: __________________________________________

3. Check One:

___

Corporation

___

Joint Venture

___

Partnership

___

Other:

___

Sole Proprietorship

4. Answer the following:

Page 1 of 9

If a Corporation:

a. Date of incorporation:________________________________

b. Tribe or State of incorporation: _____________________________

c. Give the names and addresses of the officers of this Corporation and establish whether

they are Indian (I) or Non-Indian (NI).

Name and

Social Security No.

I or

Title

____________________ ____ President

Address

% of Stock

Ownership

_________________________

_____

____________________ ____ Vice-President

_____

____________________ ____

_________________________

_____

_________________________

_____

Secretary

or Clerk

____________________ ____ Treasurer

____________________ _____ ________ __________________________ _____

____________________ ____ _________ __________________________

_____

____________________ _____ ________ __________________________ _____

____________________ ____ _________ __________________________

_____

____________________ ____ _________ __________________________

_____

d. Complete the following information on all stockholders who are not listed in c. above,

owning O% or more of the stock. Establish whether they are Indian (I) or Non-Indian (NI).

Name and

Social Security No.

I or

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

Address

If a Sole Proprietorship or Partnership:

Page 2 of 9

% of Stock

Ownership

a. Date of Organization: _____________________

b. Give the following information on the individual or partners and establish whether

they are Indian (I) or Non-Indian (NI).

Name and

Social Security No.

I or

Address

% of Stock

Ownership

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

_____________________

____

__________________________________

_________

If a Joint Venture:

a. Date of Joint Venture Agreement: _________________

b. Attach the information for each member of the joint venture prepared in the

appropriate format given above.

5. Give the name, address, and telephone number of the principal spokesperson of your

organization: ___________________________________________________________

___________________________________________________________________________

6. Has any officer or partner of your organization listed in #4 been an officer or partner of

another organization that failed in the last ten years to complete a contract? ______

If yes, state circumstances:

____________________________________________________________

Page 3 of 9

____________________________________________________________

7. Has this enterprise failed in the last ten years to complete any work awarded to it or to

complete the work on time? ___

If so, note when, where and why:

___________________________________________________________

8. Will any officer or partner listed in #4 be engaged in out-side employment?

____ Yes

____ No

If Yes, complete:

Hours Per Week

Name/Title

Outside the Enterprise

___________________________

________

___________________________

________

___________________________

________

___________________________

________

___________________________

________

9. If the enterprise or anyone listed in #4 above, currently subject to an administrative sanction

issued by any department or agency of the Federal Government?

____ Yes

____ No

If Yes, complete:

Date of Type of

Page 4 of 9

Department

Name of person/business

Action

or Agency

____________________________ ______ ______ ___________

10. Does this enterprise have any subsidiaries or affiliates or is it a subsidiary or affiliate of

another concern?

____ Yes

____ No

If Yes, complete:

Name and address of subsidiary,

affiliate or other concern

Description

of Relationship

_________________________________________

_______________

_________________________________________

_______________

_________________________________________

_______________

_________________________________________

_______________

11. Does this enterprise or any person listed in #4 above have or intend to enter into any type of

agreement with any other concern or person which relates to or affects the on-going

administration, management or operations of this enterprise? These include but are not limited

to management, and joint venture agreements and any arrangement or contract involving the

provision of such compensated services as administrative assistance, data processing,

management consulting of all types, marketing, purchasing, production and other types of

compensated assistance.

____ Yes

____ No

If yes, attach a copy of any written agreement or an explanation of any oral or

intended agreement.

12. Has this enterprise ever been subject to a judgment of any court or administrative sanction

(Federal, State, or Tribal)?

____ Yes

____ No

Page 5 of 9

Has any individual listed in #4 ever been subject to judgment of any court or administrative

sanction (Federal, State, or Tribal)?

____ Yes

____ No

If the answer is Yes to either question, furnish details in a separate attachment.

13. Has any tax lien or other collection procedure been instituted against this enterprise or the

individuals listed in #4 as a sole proprietor or partner in their capacities with this enterprise or

other enterprise?

____ Yes

____ No

If yes, furnish details in a separate exhibit.

14. Has this enterprise or any person listed in #4 ever been involved in a bankruptcy or

insolvency proceeding?

____ Yes

____ No

If yes, provide details in an attachment.

15. What dollar amount of Working Capital is available to your enterprise prior to the start of

construction?

$_______________

Explain the source of these funds: ________________________

___________________________________________________________

Include a copy of the Company's most recent audited financial statement.

16. How will project development bookkeeping and payroll be maintained: (check one)

By contract with an outside professional accounting

firm: _____

Name: ___________________ Address: _____________

_________________________ Telephone: ___________

Records are to be kept by enterprise personnel: _____

If "b" has been checked--state the qualifications of

Page 6 of 9

your personnel to perform this function:

______________________________________________________

Other: _________________________________________________

______________________________________________________

17. Trade References (include addresses and phone numbers):

___________________________________________________________

18. Bank and credit references (including addresses and phone numbers):

___________________________________________________________

19. Indicate the core crew employees in your work force, their job titles, and whether they are

Indian or Non-Indian. Core crew is defined as an individual who is either a current bonafide

employee or who is not a current employee but who is regularly employed in a supervisory or

other key skilled position when work is available.

______________________________________________________

Page 7 of 9

______________________________________________________

b. Over the past three years, what has been the average number of employees:

_______________

20. Attach certification by a tribe or other evidence of enrollment in a federally recognized tribe

for each officer, partner or individual designated as an Indian in #4.

21. Attach a certified copy of the charter, article of incorporation, by-laws, partnership

agreement, joint venture agreement and/or other pertinent organizational documentation.

22. Explain in narrative form the stock ownership, structure, management, control, financing,

and salary or profit sharing arrangements of the enterprise, if not covered in answers to specific

questions heretofore. Attach copies of all shareholder agreements, including voting trust,

employment contracts, agreements between owners and enterprise. Include information on

salaries, fees, profit sharing, material purchases, and equipment lease or purchase arrangements.

Evidence relating to structure, management, control, and financing should be specifically

included. Also, list the specific management responsibilities of each principal, sole proprietor,

partner, or party to a joint venture (as appropriate) listed in response to #4.

23. Attach evidence that the enterprise (or an individual in it) is appropriately licensed for the

type of work that is to be performed. Include Federal ID Number.

24. Attach a brief resume of the education, technical training, business, employment, design

and/or construction experience for each officer, partner or sole proprietor listed in #4. Include

references.

NOTES:

I. Omission of any information may be cause for this statement not receiving timely and

complete consideration.

II. The persons signing below certify that all information in this INDIAN ENTERPRISE

QUALIFICATION STATEMENT, including exhibits and attachments, is true and correct.

III. Print and type name below all signatures.

Page 8 of 9

If applicant is Sole Proprietor, Sign Below:

________________________________________

Name

_________________

Date

If applicant is in a Partnership or Joint Venture, all Partners must sign below:

________________________________________

Name

_________________

Date

________________________________________

Name

________________

Date

If applicant is a corporation, affix corporate seal

________________________________________

Corporate Seal

By: _____________________________________

President's Signature

________________

Date

Attested by: ______________________________

Corporate Secretary's Signature

________________

Date

WARNING: U.S. Criminal Code, Section 1010, Title 18, U.S.C. provides in part:

"Whoever...makes, passes, utters, or publishes any statement, knowing the same to be

false...shall be fined not more than $5,000 or imprisoned not more than two years, or both."

Page 9 of 9

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.