HomeMy WebLinkAboutIFB 2026111-02 Delivery of Election Equipment and Supplies FINALINVITATION FOR BIDS
Notice is hereby given that sealed bids will be received by the Franklin County Controller's Office, Franklin
County Administration Building, 272 North Second Street, Chambersburg, PA 17201 for the Delivery and Pick-
Up of Election Equipment and Supplies until 4:00 PM prevailing time on Tuesday, March 3, 2026. All bids so
received will be publicly opened and read on Wednesday, March 4, 2026, at 10:00 AM prevailing time at the
Franklin County Commissioners’ Office, 272 North Second Street, Chambersburg, PA 17201.
Specifications, instructions and bid form will be furnished by the Franklin County Procurement Office upon
request at 272 North Second Street, Chambersburg, PA 17201, or by calling (717) 261-3890.
An optional pre-bid conference for prospective bidders will be held at the Franklin County Administration
Building at 272 North Second Street Chambersburg, PA 17201 on February 17, 2026, at 9:00 AM ET.
The Franklin County Commissioners reserve the right to reject any or all bids and to waive any or all defects,
errors, omissions, irregularities or informalities in any bid.
Awards shall be made only to responsible bidders that possess the potential to perform successfully under
the terms and conditions of this procurement. Consideration shall be given to such matters as bidder
integrity, compliance with public policy, record of past performance as well as financial and technical
resources when determining responsibility.
FRANKLIN COUNTY COMMISSIONERS
Dean A. Horst, Chairman
John T. Flannery
Robert G. Ziobrowski
LEGAL AD
Request for Bid for the Delivery and Pick-Up of Election Equipment and Supplies.
Proof of Publication Requested
Please Publish -February 10, 2026 and February 13, 2026
INVITATION FOR BID
DELIVERY AND PICK-UP OF ELECTION EQUIPMENT AND SUPPLIES
FOR THE COUNTY OF FRANKLIN, PA
COUNTY OF FRANKLIN, PENNSYLVANIA
IFB# 2026111-02
County of Franklin, PA 272 North Second Street
Chambersburg, PA 17201
TABLE OF CONTENTS
INTRODUCTION ....................................................................................................................................................1
1 GENERAL INFORMATION. ................................................................................................................................... 1
2 OBJECTIVE. ........................................................................................................................................................... 1
3 DESCRIPTION OF THE GOVERNMENT. ................................................................................................................ 1
4 TIME REQUIREMENTS. ........................................................................................................................................ 1
INSTRUCTIONS TO BIDDERS ..................................................................................................................................1
1 PREPARATION OF BID. ........................................................................................................................................ 1
2 AWARD AND EXECUTION OF THE CONTRACT. ................................................................................................... 2
3 WITHDRAWAL OF BIDS. ...................................................................................................................................... 2
4 RIGHT TO REJECT BIDS. ....................................................................................................................................... 2
5 TERM. .................................................................................................................................................................. 2
6 EXEMPTION FROM FEDERAL EXCISE AND PENNSYLVANIA SALES TAX. ............................................................ 2
7 PROTECTION BY VENDOR. .................................................................................................................................. 3
8 PRE-BID CONFERENCE. ........................................................................................................................................ 3
9 QUESTION AND ANSWER PERIOD. ..................................................................................................................... 3
10 LETTER OF CREDIT ............................................................................................................................................... 3
11 INSURANCE COVERAGE....................................................................................................................................... 3
12 NON-DISCRIMINATION CLAUSE. ......................................................................................................................... 4
13 CONTRACT PROVISIONS. ..................................................................................................................................... 5
BID SPECIFICATIONS ...............................................................................................................................................6
ATTACHMENT A NON-COLLUSION AFFIDAVIT
ATTACHMENT B QUALIFICATION QUESTIONNAIRE
ATTACHMENT C W-9
ATTACHMENT D POLL LOCATIONS
ATTACHMENT E AGREEMENT
BID FORM
BID CHECKLIST
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INTRODUCTION
1 GENERAL INFORMATION.
The County of Franklin, PA ("County") is requesting bids from qualified contractors to provide for the pick-up
and delivery of election equipment and supplies.
2 OBJECTIVE.
This project consists of the pick-up, delivery and setup of booths, tables, chairs and election equipment
to 73 voting poll locations, twice a year with delivery on the Monday prior to each election and return
on the Wednesday after each election.
3 DESCRIPTION OF THE GOVERNMENT.
The County of Franklin, PA was incorporated on September 9, 1784 and is a fourth-class county with a
population of 155,932 (2020 Census). It operates under a three-member elected Board of
Commissioners. The County provides services to its citizens such as judicial administration, human
services, public safety, public works, economic development and general administration. The Franklin
County Board of Elections is charged with oversight and regulation of all elections, complying with
state and federal laws.
4 TIME REQUIREMENTS.
Request for Bid Issued: February 10, 2026
Optional Pre-Bid Meeting: Tuesday February 17, 2026 9:00 AM
Questions/Answers Ends: February 24, 2026, 4:00 PM
Due Date for Bids: March 3, 2026, 4:00 PM
Bid Opening: March 4, 2026, 10:00 AM
INSTRUCTIONS TO BIDDERS
1 PREPARATION OF BID.
1.1 Bids shall be addressed to and will be received by the Franklin County Controller's Office, Franklin
County Administration Building, 272 North Second Street, Chambersburg, PA 17201 until 4:00 PM
prevailing time on Tuesday March 3, 2026. All bids so received will be publicly opened and read at the
Franklin County Commissioners meeting on Wednesday March 4, 2026 at 10:00 AM at the Franklin
County Commissioners’ Office, 272 North Second Street, Chambersburg, PA 17201.
1.2 Bids shall be enclosed in sealed opaque envelopes. Bids shall be identified by disclosing on the face of the
envelope the name of the project, IFB # 2026111-02; Delivery and Pick-Up of Election Equipment and
Supplies and the name of the bidder.
1.3 Attention is directed to the Bid Form in the Bidding Documents. Failure to fill out, execute and submit the
form as specified is sufficient reason for rejection.
1.4 Bids must be signed by an owner, partner, or in the case of a corporation, by the President or Vice
President and attested by the Secretary, with Corporate Officer, a Power-of-Attorney must be attached
to the bid.
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1.5 All applicable blank spaces in the bid shall be filled in clearly where indicated, either typed or written in
ink. Altering and/or changing any part of this bid will be sufficient reason for rejection.
1.6 Where so indicated by the makeup of the Bid Form, sums shall be expressed in both words and figures,
and in the case of discrepancy between the two, the amount written in words shall govern.
1.7 The owner reserves the rights to award the contracts to the other than lowest bidder if, in its opinion,
the products included within such bids are not equal to the standard established for such projects in the
specifications.
1.8 Each bidder shall be required to execute a Non-collusion Affidavit and affix it to the Bid Form. No bid
shall be considered unless accompanied by such executed affidavits. See Attachment A.
1.9 Each bidder shall complete and include the qualification questionnaire in their submission. See Attachment
B.
1.10 Each bidder shall include a current and completed W-9 with their submission. See Attachment C.
2 AWARD AND EXECUTION OF THE CONTRACT.
2.1 When the bid has been accepted by the County, notification of such acceptance will be mailed to the
successful bidder, at the address designated by the bidder on the BID FORM.
2.2 Award shall be to the lowest responsible and responsive bidder who demonstrates the ability to
complete the work.
2.3 The County reserves the right to correct minor math errors. The County shall be the sole judge as to
what constitutes a minor math error.
3 WITHDRAWAL OF BIDS.
3.1 Bids may not be modified, withdrawn or cancelled by the bidder for thirty (30) days after the time
designated for the receipt of bids.
4 RIGHT TO REJECT BIDS.
4.1 The County reserves the right in its discretion to reject any or all bids and to waive irregularities or
information in any bid and to award contracts on an item-by-item basis. Awards shall be made only to
responsible bidders that possess the potential ability to perform successfully under the terms and
conditions of this procurement. Consideration shall be given to such matters as bidder integrity,
compliance with public policy, record of past performance, and financial and technical resources when
determining responsibility.
5 TERM.
5.1 The contract shall begin upon execution of the Agreement and end on November 30, 2028. There shall
be an option to extend the contract term for up to 2 additional one (1) year periods.
6 EXEMPTION FROM FEDERAL EXCISE AND PENNSYLVANIA SALES TAX.
6.1 The County of Franklin, PA is exempt from Federal Excise Taxes and Pennsylvania Sales Taxes as a
political subdivision of the Commonwealth of Pennsylvania. Prices as shown in the bid shall exclude
such Federal and State Taxes.
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7 PROTECTION BY VENDOR.
7.1 The vendor agrees to indemnify and save harmless the County of Franklin, PA, its representatives,
employees and agents, from all claims, demands, actions, suits and liabilities arising from the Vendor’s
own fault or negligence or through the negligence or fault of the manufacturer or goods and reasonable
attorney fees incurred by the county in response to such claims, demands, actions or liabilities, provided
it ultimately determined that such claims result from the vendor’s or manufacturer’s fault or negligence.
7.2 The vendor shall not assign or otherwise transfer any of its responsibilities or obligations under the
contract to any other person or entity without prior written consent of the County.
7.3 The vendor agrees that a failure to complete all work specified hereunder by the contractual completion
date shall result in damages to the County in an amount that is substantial and difficult to calculate, and that
such failure shall subject the vendor to the imposition of reasonable, non-penal liquidated damages as set
by the contract between the parties.
8 PRE-BID CONFERENCE.
8.1 An optional pre-bid conference for prospective bidders will be held on Tuesday February 17, 2026 at
9:00 AM local time at the Franklin County Administration Building, 272 North Second Street,
Chambersburg, PA 17201. Bidder’s shall meet in the building’s main lobby.
9 QUESTION AND ANSWER PERIOD.
9.1 Questions will be accepted until 4:00 PM Tuesday February 24, 2026 via email
at procurement@franklincountypa.gov. Answers will be posted at
https://www.franklincountypa.gov/current-solicitation-opportunities/.
10 LETTER OF CREDIT
10.1 Upon execution of the agreement, the contractor shall issue an irrevocable Letter of Credit in the amount of
twelve thousand dollars and no cents ($12,000.00) in favor of the County of Franklin, PA valid and
enforceable for the entire term of the contract.
11 INSURANCE COVERAGE.
11.1 The successful bidder shall be required to provide the following insurance coverage and submit evidence
of the coverage required below in the form of an ACORD certificate of insurance. The County of Franklin
shall be named as Additional Insured for the project. Liability Insurance shall include all major divisions
of coverage and be on a comprehensive basis including:
11.1.1 Premises Operations (including X, C and U as applicable). 11.1.2 Independent Contractors’ Protective.
11.1.3 Products and Completed Operations.
11.1.4 Personal Injury Liability with Employment Exclusion deleted.
11.1.5 Contractual Liability.
11.1.6 Broad Form Property Damage including Completed Operations.
11.2 If the General Liability coverages are provided by a Commercial General Liability Policy on a claims made
basis, the policy date or retroactive date shall predate the Contract; the termination date of the policy
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or applicable extended reporting period shall be no earlier than the termination date of the coverages
required to be maintained after the final payment. The County of Franklin should be listed as Additional
Insured under the Contractor’s General Liability Policy.
11.3 The Contract and all subcontractors, at their own expense, shall provide and maintain insurance in
companies acceptable to the Owner as follows:
11.3.1 Workers’ Compensation: As required by all applicable Federal, State, Maritime or other laws
including Employers’ Liability with a limit of at least $100,000.
11.3.2 Comprehensive General Liability: Including Contractor’s Liability; Contingent Liability; Contractual
Liability; Completed Operations and Products Liability all on the occurrence basis with Personal
exclusion relating to Explosion, Collapse and Underground Property Damage. Completed
Operations Liability shall be kept in force for at least two years after the date of final completion.
Minimum limits to be as follows:
Bodily Injury
Each Occurrence $1,000,000.00
Aggregate $2,000,000.00
Property Damage
Each Occurrence $1,000,000.00
Aggregate $2,000,000.00
11.3.3 Combined Single Limit $1,000,000.00
11.3.4 Umbrella/Excess Policy $5,000,000.00
11.4 If this insurance is written on the Comprehensive General Liability policy form, the Certificates shall be
AIA Document G705, Certificate of Insurance. If this insurance is written on a Commercial General
Liability policy form, ACORD form 25S will be acceptable.
11.5 Furnish one copy of certificates herein required for each copy of Agreement naming the County of
Franklin, PA as certificate holder; specifically set forth evidence of all coverage required by
subparagraphs 12.1 through 12.3. Furnish to the owner copies of any endorsements that are issued
subsequently, amending coverage or limits.
11.6 Owner Liability Insurance: The contractor shall provide an Owner’s and Contractor’s Protective Liability
Policy in the name of the Owner with the limits as follows:
Bodily Injury
Each Occurrence $500,000.00
Aggregate $500,000.00
Property Damage
Each Occurrence $500,000.00
Aggregate $500,000.00
12 NON-DISCRIMINATION CLAUSE.
12.1 Franklin County assures that no person shall be excluded from participating in, be denied the benefits
of, or be otherwise subjected to discrimination on the grounds of race, gender, creed, color, sexual
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orientation, gender identity or expression, or in violation of the Pennsylvania Human Relations Act,
which prohibits discrimination on the basis of race, color, religious creed, ancestry, age, sex, national
origin, handicap or disability, or in violation of any applicable local, state, or federal laws. With advance
notification accommodations may be provided for those with special needs to language, speech, sight or
hearing. If you have a request for a special need, wish to file a complaint, or desire additional
information please contact the Risk Management Department at (717) 261-3819 or
riskmgt@franklincountypa.gov.
13 CONTRACT PROVISIONS.
13.1 After Franklin County makes its selection, it shall proceed to negotiate a contract based on the bid and
scope of work for the project. If the County is unable to negotiate a satisfactory contract with the most
highly qualified bidder, the County shall formally end negotiations with that bidder and begin to
negotiate with the second most highly qualified bidder. Negotiations shall continue in this sequence
until a contract is agreed upon.
13.2 The performance of this contract shall be in accordance with all Federal, State and local laws as may be
applicable. Any contract between Franklin County and the awarded bidder shall be subject to the rules
and regulations of any agencies where funding is being requested. Franklin County reserves the right to
reject any and all bids, and to waive irregularities. Additionally, in the event that Franklin County
procures grant funding assistance, the contract shall contain all necessary provisions of that grant award
contract.
13.3 The contract between the County and the selected bidder will include the following non-negotiable
contract provisions:
13.3.1 Indemnification of the County.
13.3.2 Non-Indemnification of the contractor.
13.3.3 Forum Selection (Franklin County, PA Court of Common Pleas).
13.3.4 Choice of law (Commonwealth of Pennsylvania).
13.3.5 Termination for convenience/termination for cause by the County/nonappropriation.
13.3.6 Prevailing party attorneys’ fees.
13.3.7 Non-discrimination.
13.3.8 Suspension and debarment.
13.3.9 Release of liability in favor of the County.
13.3.10 Non-release of liability of the contractor.
13.3.11 Insurance Coverage and County status as an additional insured as set forth in Section 11 herein.
13.3.12 Terms of payment and invoicing, including 45-day payment period after acceptance.
13.3.13 Data security, confidentiality, and use of County data and information.
13.3.14 Any and all federal and state provisions required as a result of grant funding.
13.4 The County reserves the right to request additional contract provisions it deems necessary as needed to
protect the best interest of the County .
13.5 See Attachment E for the Agreement.
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BID SPECIFICATIONS
Bidders shall comply with all relevant federal, state, and local rules and regulations related to the services or
equipment provided, including licenses, permits, and insurance.
Elections
In Pennsylvania, there are 2 elections a year: a Primary Election is held on the third Tuesday of May except in years
with a Presidential Election when it is normally held the fourth Tuesday of April; and the November Election which is
always held the first Tuesday after the first Monday in November. In 2026, the General Primary is expected to be
held on Tuesday, May 19th, and the November Election will be held on Tuesday, November 3rd. Note, in the event
that the dates are changed by legislative act during the term of this contract, the contractor shall provide the service
for the new dates.
Pick-Up and Delivery (Loading and Unloading)
The election equipment and supplies shall be picked up and loaded on trucks in the three (3) days prior to the
Monday delivery dates from a location in Chambersburg, Pennsylvania. The exact schedule shall be coordinated with
Franklin County staff. There are seventy-three (73) polling/delivery locations. All equipment and supplies shall be
delivered to the designated delivery locations on or before the Monday prior to the election and set up at that
location as directed by Franklin County staff. Franklin County staff will work with the contractor and locations to
coordinate exact delivery date and time. See Attachment D for the current list of all seventy-three (73) locations.
Note that while the County plans no changes in polling locations, from time to time the exact location of a location
may change due to circumstances beyond our control. In that case the contractor shall deliver to any established
alternate location.
The contractor shall ensure safe and secure storage of all supplies and equipment while in possession of the
contractor. The County shall approve of any location where locked trucks are parked.
The election equipment and supplies shall be broken down and loaded on trucks on the Wednesday directly after
elections and returned to the Chambersburg storage area. Franklin County staff shall coordinate exact pickup times
and order.
The County requires that the contractor provides a minimum of five (5) 24-foot trucks. Each truck shall be staffed
with 2 contractor staff and 1 County staff person. In the past it has taken approximately 1 hour per truck to load the
equipment at our location and 8 hours per truck to deliver/pick up the equipment and supplies. The total estimated
work time is eighteen (18.0) hours per truck or ninety (90) hours total for five (5) trucks. In the event that additional
trucks and staff are required to deliver and setup all the equipment and supplies, the contract shall provide
additional trucks to allow for movement of all equipment and supplies in the required timeframe.
A Franklin County staff member shall accompany the contractor’s personnel to each polling place and supervise the
unloading and setting up of the equipment and supplies as well as the return of the equipment and supplies.
Election equipment and supplies
Equipment and supplies for each of the 73 delivery locations consists of:
• One precinct counter weighing approximately 60 lbs. (on wheels),
• One ExpressVote weighing approximately 15 lbs.
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• Ballot Booths weighing approximately 80 lbs. or less, and
• Tables, chairs and yard signs.
Overall there are approximately 147 booths, 73 tables and 7 chairs combined across all locations. Also, some
locations will have miscellaneous items such as power strips, lights, extension cords and/or rope dividers. Note that
some equipment is electronic and will need to be handled with extreme care.
Other
The Contractor is responsible for all licenses, taxes, permits, fees, insurance and bonding costs for this project. All
costs must be included in the bid price.
Any damage to buildings or property caused by the contractor shall result in the contractor repairing or replacing
the damaged item(s) at no additional cost to the County.
Within three (3) weeks of the execution of the Agreement, the awarded contractor shall have a kick-off meeting
with County Elections staff to review the project. Three (3) weeks before the election, the awarded contractor shall
participate in a training/preparation meeting at the County storage site.
No later than two (2) weeks before each election, the awarded contractor shall submit a Pennsylvania State Police
Criminal Background Check for each person who will be working on this project for review and approval by the
County. In the event of an occurrence that would alter the results of the approved background screen, the
Contractor shall notify the County within one (1) business day of said occurrence.
ATTACHMENT A
INSTRUCTIONS FOR NON-COLLUSION AFFIDAVIT
1. This Non-Collusion Affidavit is material to any contract awarded pursuant to this bid and in
accordance with the Pennsylvania Antibid-Rigging Act, 73 P.S. 1611 et seq.
2. This Non-Collusion Affidavit must be executed by the member, officer or employer of the Bidder who
makes the final decision on prices and the amount quoted in the bid.
3. Bid rigging and other efforts to restrain competition, and the making of false sworn statements in
connection with the submission of bids are unlawful and may be subject to criminal prosecution. The
person who signs the Affidavit should examine it very carefully before signing and assure himself or
herself that each statement is true and accurate, making diligent inquiry, as necessary, of all other
persons employed by or associated with the bidder with responsibilities for the preparation,
approval, or submission of the bid.
4. In the case of a bid submitted by a joint venture, each party to the venture must be identified in the
bid documents, and an Affidavit must be submitted separately on behalf of each party.
5. The term "Complementary Bid" as used in the Affidavit has the meaning commonly associated with
the term in the bidding process, and includes the knowing submission of bids higher than the bid of
another firm, any intentionally high or noncompetitive bid, and any other form of bid submitted for
the purpose of giving a false appearance of competition.
6. Failure to file an Affidavit in compliance with these instructions will result in disqualification of the
bid.
7. A person's affidavit stating that the person has been convicted or found liable of any act prohibited
by State or Federal law in any jurisdiction involving conspiracy or collusion with respect to bidding in
any public contract within the last three (3) years does not prohibit a governmental agency from
accepting a bid or awarding a contract to that person, but may be a ground for administration,
suspension or debarment in the discretion of a governmental agency under the rules and regulations
of that agency, or, in the case of a governmental agency with no administrative suspension or
debarment regulations or procedures, may be a ground for consideration on the question whether
such agency should decline to award the contract to that person on the basis of a lack of
responsibility.
NON-COLLUSION AFFIDAVIT
Contract/Bid No: 2026111-02
State of:
:ss
County of:
I state that I am of
and that I am authorized to make this affidavit on behalf of my firm, and its owners, directors, and officers. I am
the person responsible in my firm for the price(s) and the amount of this bid.
I state that:
1. The price(s) and amount of this bid have been arrived at independently and without consultation,
communication or agreement with any other contractor, bidder or potential bidder.
2. Neither the price(s) nor the amount of this bid, and neither the approximate price(s) nor approximate
amount of this bid, have been disclosed to any other firm or person who is a bidder or potential bidder, and
they will not be disclosed before bid opening.
3. No attempt has been made or will be made to induce any firm or person to refrain from bidding on this
contract, or to submit to a bid higher than this bid, or to submit any intentionally high or noncompetitive
bid or other form of complementary bid.
4. The bid of my firm is made in good faith and not pursuant to any agreement or discussion with, or
inducement from, any firm or person to submit a complementary or other noncompetitive bid.
5. its affiliates, subsidiaries, officers, directors, and (Firm) employees are not
currently under investigation by any governmental agency and have not in the last four years been
convicted or found liable for any act prohibited by State or Federal Law in any jurisdiction, involving
conspiracy or collusion with respect to bidding on any public contract, except as follows:
6. has or has not been convicted or found liable for any act prohibited by State
or Federal Law in any jurisdiction involving conspiracy or collusion with respect to bidding on any public
contract within the last three (3) years.
(Title) (Firm)
I state that understands and
(Firm)
acknowledges that the above responsibilities are material and important and
will be relied on by the Owner in awarding the contract(s) for which this Bid is
submitted. I understand and my firm understands that any misstatement in this
affidavit is and shall be treated as fraudulent concealment from the Owner of
the true facts relating to the submission of bids for this contract.
Name
Company Position
SWORN TO AND
SUBSCRIBED BEFORE ME
THIS DAY OF
Notary Public
My Commission Expires:
ATTACHMENT B
QUALIFICATION QUESTIONNAIRE
BIDDER (Name and Address):
OWNER: COUNTY OF FRANKLIN PROJECT: FRANKLIN COUNTY
272 North Second Street DELIVERY OF ELECTION
Chambersburg, PA 17201 SUPPLIES & EQUIPMENT
1. Companies bidding on this Project must submit this Qualification Statement to COUNTY
OF FRANKLIN (“Owner”).
2. Only companies that are deemed to be responsible contractors under the laws and
regulations of the Contract Documents will be designated as qualified bidders at the time
that awards are made on the prime contracts offered on the Project.
3. The Instructions to Bidders and other bidding documents govern Owner’s consideration of this
Statement.
4. Bidder shall answer all questions on this form, supplying the requested documents using
the spaces indicated (and additional pages if necessary) and attaching documents as
required.
5. Bidder may submit additional information as desired.
I. Capability
1. Name of Bidder:
2. State the address of Bidder’s principal place of business (main office or headquarters):
3. State Bidder’s form of organization (sole proprietorship, partnership, corporation, limited
liability company, etc.):
4. If Bidder is a corporation, state:
a. Date of incorporation:
b. State of incorporation:
c. Names and titles of all officers:
d. Provide the names of all of Bidder’s subsidiaries or parent organization and all affiliated
organizations, stating the relationship of each to Bidder:
5. If Bidder is a limited liability company, state:
a. Date of filing of the certificate of organization:
b. State where filed:
c. Names and titles of all officers:
d. Provide the names of all of Bidder’s subsidiaries or parent organization and all affiliated
organizations, stating the relationship of each to Bidder:
6. If Bidder is a partnership (including a joint venture), state:
a. Date of formation: _______
b. State under which partnership formed: _______
c. Whether partnership is general or limited: _______
d. Names and home addresses of all partners (indicate any limited partners):
_________________________________________________________________________________
_________________________________________________________________________________
e. Provide the names of all of organizations controlled by Bidder or any of its partners:
_______
________________________________________________________________________________
_________________________________________________________________________________
7. If Bidder is a sole proprietorship or some other form of organization other than a corporation,
limited liability company, or partnership, attach the operating agreement or other
documentation governing the activities of the organization and state:
a. Type of organization: ______
b. Date of formation: ______
c. Names and home addresses of all principals: ______
________________________________________________________________________________
________________________________________________________________________________
d. Provide the names of all organizations controlled by Bidder or any of its principals:
_____
8. Regarding ownership and control:
a. List all organizations and individuals who have a financial interest greater than five percent
(5%) in Bidder: ________
b. Identify any other organization or individual who controls or substantially influences
the bidding or operation of Bidder: _______
9. Provide the numbers, categories, and locations of all employees and officers:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
10. Is Bidder currently registered to do business in Pennsylvania: If not, does
Bidder have a pending application for registration: ______
11. Does Bidder hold all necessary licenses to perform the work for which it desires to be considered
for the Project? If so, identify those licenses. _____________________________________
If not, identify all pending applications for those licenses: _____________________________
12. Identify all of Bidder’s offices located in Franklin County: _______
________________________________________________________________________________________
________________________________________________________________________________________
13. Identify all of Bidder’s offices located in Pennsylvania: _______
________________________________________________________________________________________
________________________________________________________________________________________
14. List the number of years Bidder has been engaged in business under its present business
name:
15. The equipment Bidder owns or leases that is available for the Project:
a. Owned:
Leased:
b. A list of all collective bargaining agreements to which you are bound:
16. Identify any work Bidder has performed for COUNTY OF FRANKLIN, including the location of the
project, the nature of the contract, the contract amount, the kind of work, and the nature of the
project:
__________________________________________________________________
__________________________________________________________________
17. List three projects/references that involve the same type of work that Bidder has completed,
identifying the name and address of the owner, the location of the project, the nature of the
contract.
18. In the last three (3) years, has Bidder been in a reorganization under Chapter 11 of the United
States Bankruptcy Code or in any other manner seeking an arrangement or debt adjustment
with its creditors? If so, explain:
19. Identify any parent, subsidiary, or other company affiliated with Bidder that has declared
bankruptcy or has been placed into bankruptcy in the past ten (10) years:
20. Have any of Bidder’s officers or principal operating personnel been employed or associated
with a company that has been in bankruptcy or ceased to operate at any time in the past ten
(10) years? If so, state the person’s name, title, and the name of the company involved:
II. Conduct
1. List all felony convictions, all bidding-related offenses, and all misdemeanor convictions
involving moral turpitude of Bidder, its affiliates, its owners holding more than five percent (5%)
interest, its officers, and its administrators, managers, and superintendents that may be
assigned to the Project:
2. List all debarments, suspensions, and denials of pre-qualification of Bidder, its affiliates, and its
holders owning more than five percent (5%) interest, for any federal, state, local, or other
governmental contracting.
Bidder hereby authorizes and requests that any person, firm, or corporation may furnish any information
requested by the COUNTY OF FRANKLIN to verify the information contained in this Statement.
___________________________________
Signature
___________________________________
Printed Name
___________________________________
Title
___________________________________
Firm
___________________________________
Date
ATTACHMENT C
Form W-9
(Rev. March 2024)
Request for Taxpayer
Identification Number and Certification
Department of the Treasury
Internal Revenue Service Go to www.irs.gov/FormW9 for instructions and the latest information.
Give form to the
requester. Do not
send to the IRS.
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.Print or type. See Specific Instructions on page 3.1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded
entity’s name on line 2.)
2 Business name/disregarded entity name, if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
only one of the following seven boxes.
Individual/sole proprietor C corporation S corporation Partnership Trust/estate
LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) ....
Note: Check the “LLC” box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
box for the tax classification of its owner.
Other (see instructions)
3b If on line 3a you checked “Partnership” or “Trust/estate,” or checked “LLC” and entered “P” as its tax classification,
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
this box if you have any foreign partners, owners, or beneficiaries. See instructions .........
4 Exemptions (codes apply only to
certain entities, not individuals;
see instructions on page 3):
Exempt payee code (if any)
Exemption from Foreign Account Tax
Compliance Act (FATCA) reporting
code (if any)
(Applies to accounts maintained
outside the United States.)
5 Address (number, street, and apt. or suite no.). See instructions.
6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later.
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter.
Social security number
––
or
Employer identification number
–
Part II Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign
Here
Signature of
U.S. person Date
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/FormW9.
What’s New
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the “LLC” box and enter its appropriate tax classification.
New line 3b has been added to this form. A flow-through entity is
required to complete this line to indicate that it has direct or indirect
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow-through entity in which it has an ownership interest. This
change is intended to provide a flow-through entity with information
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X Form W-9 (Rev. 3-2024)
Form W-9 (Rev. 3-2024)Page 2
must obtain your correct taxpayer identification number (TIN), which
may be your social security number (SSN), individual taxpayer
identification number (ITIN), adoption taxpayer identification number
(ATIN), or employer identification number (EIN), to report on an
information return the amount paid to you, or other amount reportable
on an information return. Examples of information returns include, but
are not limited to, the following.
• Form 1099-INT (interest earned or paid).
• Form 1099-DIV (dividends, including those from stocks or mutual
funds).
• Form 1099-MISC (various types of income, prizes, awards, or gross
proceeds).
• Form 1099-NEC (nonemployee compensation).
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers).
• Form 1099-S (proceeds from real estate transactions).
• Form 1099-K (merchant card and third-party network transactions).
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
and 1098-T (tuition).
• Form 1099-C (canceled debt).
• Form 1099-A (acquisition or abandonment of secured property).
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
Caution: If you don’t return Form W-9 to the requester with a TIN, you
might be subject to backup withholding. See What is backup
withholding, later.
By signing the filled-out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued);
2. Certify that you are not subject to backup withholding; or
3. Claim exemption from backup withholding if you are a U.S. exempt
payee; and
4. Certify to your non-foreign status for purposes of withholding under
chapter 3 or 4 of the Code (if applicable); and
5. Certify that FATCA code(s) entered on this form (if any) indicating
that you are exempt from the FATCA reporting is correct. See What Is
FATCA Reporting, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TIN, you must use the requester’s form if
it is substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S. person if you are:
• An individual who is a U.S. citizen or U.S. resident alien;
• A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
• An estate (other than a foreign estate); or
• A domestic trust (as defined in Regulations section 301.7701-7).
Establishing U.S. status for purposes of chapter 3 and chapter 4
withholding. Payments made to foreign persons, including certain
distributions, allocations of income, or transfers of sales proceeds, may
be subject to withholding under chapter 3 or chapter 4 of the Code
(sections 1441–1474). Under those rules, if a Form W-9 or other
certification of non-foreign status has not been received, a withholding
agent, transferee, or partnership (payor) generally applies presumption
rules that may require the payor to withhold applicable tax from the
recipient, owner, transferor, or partner (payee). See Pub. 515,
Withholding of Tax on Nonresident Aliens and Foreign Entities.
The following persons must provide Form W-9 to the payor for
purposes of establishing its non-foreign status.
• In the case of a disregarded entity with a U.S. owner, the U.S. owner
of the disregarded entity and not the disregarded entity.
• In the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S. grantor or other U.S. owner of the grantor trust and
not the grantor trust.
• In the case of a U.S. trust (other than a grantor trust), the U.S. trust
and not the beneficiaries of the trust.
See Pub. 515 for more information on providing a Form W-9 or a
certification of non-foreign status to avoid withholding.
Foreign person. If you are a foreign person or the U.S. branch of a
foreign bank that has elected to be treated as a U.S. person (under
Regulations section 1.1441-1(b)(2)(iv) or other applicable section for
chapter 3 or 4 purposes), do not use Form W-9. Instead, use the
appropriate Form W-8 or Form 8233 (see Pub. 515). If you are a
qualified foreign pension fund under Regulations section 1.897(l)-1(d), or
a partnership that is wholly owned by qualified foreign pension funds,
that is treated as a non-foreign person for purposes of section 1445
withholding, do not use Form W-9. Instead, use Form W-8EXP (or other
certification of non-foreign status).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax
treaties contain a provision known as a saving clause. Exceptions
specified in the saving clause may permit an exemption from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on certain types of income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the income.
3. The article number (or location) in the tax treaty that contains the
saving clause and its exceptions.
4. The type and amount of income that qualifies for the exemption
from tax.
5. Sufficient facts to justify the exemption from tax under the terms of
the treaty article.
Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes if their stay in the
United States exceeds 5 calendar years. However, paragraph 2 of the
first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the
provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of the first
Protocol) and is relying on this exception to claim an exemption from tax
on their scholarship or fellowship income would attach to Form W-9 a
statement that includes the information described above to support that
exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233.
Backup Withholding
What is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IRS 24% of such
payments. This is called “backup withholding.” Payments that may be
subject to backup withholding include, but are not limited to, interest,
tax-exempt interest, dividends, broker and barter exchange
transactions, rents, royalties, nonemployee pay, payments made in
settlement of payment card and third-party network transactions, and
certain payments from fishing boat operators. Real estate transactions
are not subject to backup withholding.
You will not be subject to backup withholding on payments you receive
if you give the requester your correct TIN, make the proper certifications,
and report all your taxable interest and dividends on your tax return.
Payments you receive will be subject to backup withholding if:
1. You do not furnish your TIN to the requester;
2. You do not certify your TIN when required (see the instructions for
Part II for details);
3. The IRS tells the requester that you furnished an incorrect TIN;
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only); or
5. You do not certify to the requester that you are not subject to
backup withholding, as described in item 4 under “By signing the filled-
out form” above (for reportable interest and dividend accounts opened
after 1983 only).
Form W-9 (Rev. 3-2024)Page 3
Certain payees and payments are exempt from backup withholding.
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information.
See also Establishing U.S. status for purposes of chapter 3 and
chapter 4 withholding, earlier.
What Is FATCA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all U.S. account
holders that are specified U.S. persons. Certain payees are exempt from
FATCA reporting. See Exemption from FATCA reporting code, later, and
the Instructions for the Requester of Form W-9 for more information.
Updating Your Information
You must provide updated information to any person to whom you
claimed to be an exempt payee if you are no longer an exempt payee
and anticipate receiving reportable payments in the future from this
person. For example, you may need to provide updated information if
you are a C corporation that elects to be an S corporation, or if you are
no longer tax exempt. In addition, you must furnish a new Form W-9 if
the name or TIN changes for the account, for example, if the grantor of a
grantor trust dies.
Penalties
Failure to furnish TIN. If you fail to furnish your correct TIN to a
requester, you are subject to a penalty of $50 for each such failure
unless your failure is due to reasonable cause and not to willful neglect.
Civil penalty for false information with respect to withholding. If you
make a false statement with no reasonable basis that results in no
backup withholding, you are subject to a $500 penalty.
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of TINs. If the requester discloses or uses TINs in violation of
federal law, the requester may be subject to civil and criminal penalties.
Specific Instructions
Line 1
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
If this Form W-9 is for a joint account (other than an account
maintained by a foreign financial institution (FFI)), list first, and then
circle, the name of the person or entity whose number you entered in
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S. person must
provide a Form W-9.
• Individual. Generally, enter the name shown on your tax return. If you
have changed your last name without informing the Social Security
Administration (SSA) of the name change, enter your first name, the last
name as shown on your social security card, and your new last name.
Note for ITIN applicant: Enter your individual name as it was entered
on your Form W-7 application, line 1a. This should also be the same as
the name you entered on the Form 1040 you filed with your application.
• Sole proprietor. Enter your individual name as shown on your Form
1040 on line 1. Enter your business, trade, or “doing business as” (DBA)
name on line 2.
• Partnership, C corporation, S corporation, or LLC, other than a
disregarded entity. Enter the entity’s name as shown on the entity’s tax
return on line 1 and any business, trade, or DBA name on line 2.
• Other entities. Enter your name as shown on required U.S. federal tax
documents on line 1. This name should match the name shown on the
charter or other legal document creating the entity. Enter any business,
trade, or DBA name on line 2.
• Disregarded entity. In general, a business entity that has a single
owner, including an LLC, and is not a corporation, is disregarded as an
entity separate from its owner (a disregarded entity). See Regulations
section 301.7701-2(c)(2). A disregarded entity should check the
appropriate box for the tax classification of its owner. Enter the owner’s
name on line 1. The name of the owner entered on line 1 should never
be a disregarded entity. The name on line 1 should be the name shown
on the income tax return on which the income should be reported. For
example, if a foreign LLC that is treated as a disregarded entity for U.S.
federal tax purposes has a single owner that is a U.S. person, the U.S.
owner’s name is required to be provided on line 1. If the direct owner of
the entity is also a disregarded entity, enter the first owner that is not
disregarded for federal tax purposes. Enter the disregarded entity’s
name on line 2. If the owner of the disregarded entity is a foreign person,
the owner must complete an appropriate Form W-8 instead of a Form
W-9. This is the case even if the foreign person has a U.S. TIN.
Line 2
If you have a business name, trade name, DBA name, or disregarded
entity name, enter it on line 2.
Line 3a
Check the appropriate box on line 3a for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3a.
IF the entity/individual on line 1
is a(n) . . .
THEN check the box for . . .
• Corporation Corporation.
• Individual or
• Sole proprietorship
Individual/sole proprietor.
• LLC classified as a partnership
for U.S. federal tax purposes or
• LLC that has filed Form 8832 or
2553 electing to be taxed as a
corporation
Limited liability company and
enter the appropriate tax
classification:
P = Partnership,
C = C corporation, or
S = S corporation.
• Partnership Partnership.
• Trust/estate Trust/estate.
Line 3b
Check this box if you are a partnership (including an LLC classified as a
partnership for U.S. federal tax purposes), trust, or estate that has any
foreign partners, owners, or beneficiaries, and you are providing this
form to a partnership, trust, or estate, in which you have an ownership
interest. You must check the box on line 3b if you receive a Form W-8
(or documentary evidence) from any partner, owner, or beneficiary
establishing foreign status or if you receive a Form W-9 from any
partner, owner, or beneficiary that has checked the box on line 3b.
Note: A partnership that provides a Form W-9 and checks box 3b may
be required to complete Schedules K-2 and K-3 (Form 1065). For more
information, see the Partnership Instructions for Schedules K-2 and K-3
(Form 1065).
If you are required to complete line 3b but fail to do so, you may not
receive the information necessary to file a correct information return with
the IRS or furnish a correct payee statement to your partners or
beneficiaries. See, for example, sections 6698, 6722, and 6724 for
penalties that may apply.
Line 4 Exemptions
If you are exempt from backup withholding and/or FATCA reporting,
enter in the appropriate space on line 4 any code(s) that may apply to
you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from
backup withholding.
• Except as provided below, corporations are exempt from backup
withholding for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments
made in settlement of payment card or third-party network transactions.
• Corporations are not exempt from backup withholding with respect to
attorneys’ fees or gross proceeds paid to attorneys, and corporations
that provide medical or health care services are not exempt with respect
to payments reportable on Form 1099-MISC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space on line 4.
1—An organization exempt from tax under section 501(a), any IRA, or
a custodial account under section 403(b)(7) if the account satisfies the
requirements of section 401(f)(2).
Form W-9 (Rev. 3-2024)Page 4
2—The United States or any of its agencies or instrumentalities.
3—A state, the District of Columbia, a U.S. commonwealth or territory,
or any of their political subdivisions or instrumentalities.
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities.
5—A corporation.
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
territory.
7—A futures commission merchant registered with the Commodity
Futures Trading Commission.
8—A real estate investment trust.
9—An entity registered at all times during the tax year under the
Investment Company Act of 1940.
10—A common trust fund operated by a bank under section 584(a).
11—A financial institution as defined under section 581.
12—A middleman known in the investment community as a nominee or
custodian.
13—A trust exempt from tax under section 664 or described in section
4947.
The following chart shows types of payments that may be exempt
from backup withholding. The chart applies to the exempt payees listed
above, 1 through 13.
IF the payment is for . . .THEN the payment is exempt
for . . .
• Interest and dividend payments All exempt payees except
for 7.
• Broker transactions Exempt payees 1 through 4 and 6
through 11 and all C corporations.
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
• Barter exchange transactions
and patronage dividends
Exempt payees 1 through 4.
• Payments over $600 required to
be reported and direct sales over
$5,0001
Generally, exempt payees
1 through 5.2
• Payments made in settlement of
payment card or third-party
network transactions
Exempt payees 1 through 4.
1 See Form 1099-MISC, Miscellaneous Information, and its instructions.
2 However, the following payments made to a corporation and
reportable on Form 1099-MISC are not exempt from backup
withholding: medical and health care payments, attorneys’ fees, gross
proceeds paid to an attorney reportable under section 6045(f), and
payments for services paid by a federal executive agency.
Exemption from FATCA reporting code. The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions. Therefore, if
you are only submitting this form for an account you hold in the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution is
subject to these requirements. A requester may indicate that a code is
not required by providing you with a Form W-9 with “Not Applicable” (or
any similar indication) entered on the line for a FATCA exemption code.
A—An organization exempt from tax under section 501(a) or any
individual retirement plan as defined in section 7701(a)(37).
B—The United States or any of its agencies or instrumentalities.
C—A state, the District of Columbia, a U.S. commonwealth or
territory, or any of their political subdivisions or instrumentalities.
D—A corporation the stock of which is regularly traded on one or
more established securities markets, as described in Regulations
section 1.1472-1(c)(1)(i).
E—A corporation that is a member of the same expanded affiliated
group as a corporation described in Regulations section 1.1472-1(c)(1)(i).
F—A dealer in securities, commodities, or derivative financial
instruments (including notional principal contracts, futures, forwards,
and options) that is registered as such under the laws of the United
States or any state.
G—A real estate investment trust.
H—A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
Company Act of 1940.
I—A common trust fund as defined in section 584(a).
J—A bank as defined in section 581.
K—A broker.
L—A trust exempt from tax under section 664 or described in section
4947(a)(1).
M—A tax-exempt trust under a section 403(b) plan or section 457(g)
plan.
Note: You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This is where the requester of this Form W-9 will mail your information
returns. If this address differs from the one the requester already has on
file, enter “NEW” at the top. If a new address is provided, there is still a
chance the old address will be used until the payor changes your
address in their records.
Line 6
Enter your city, state, and ZIP code.
Part I. Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. If you are a resident alien and
you do not have, and are not eligible to get, an SSN, your TIN is your
IRS ITIN. Enter it in the entry space for the Social security number. If you
do not have an ITIN, see How to get a TIN below.
If you are a sole proprietor and you have an EIN, you may enter either
your SSN or EIN.
If you are a single-member LLC that is disregarded as an entity
separate from its owner, enter the owner’s SSN (or EIN, if the owner has
one). If the LLC is classified as a corporation or partnership, enter the
entity’s EIN.
Note: See What Name and Number To Give the Requester, later, for
further clarification of name and TIN combinations.
How to get a TIN. If you do not have a TIN, apply for one immediately.
To apply for an SSN, get Form SS-5, Application for a Social Security
Card, from your local SSA office or get this form online at
www.SSA.gov. You may also get this form by calling 800-772-1213. Use
Form W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an ITIN, or Form SS-4, Application for Employer
Identification Number, to apply for an EIN. You can apply for an EIN
online by accessing the IRS website at www.irs.gov/EIN. Go to
www.irs.gov/Forms to view, download, or print Form W-7 and/or Form
SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and
have Form W-7 and/or Form SS-4 mailed to you within 15 business
days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and enter “Applied For” in the space for the TIN, sign and date
the form, and give it to the requester. For interest and dividend
payments, and certain payments made with respect to readily tradable
instruments, you will generally have 60 days to get a TIN and give it to
the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
you provide your TIN to the requester.
Note: Entering “Applied For” means that you have already applied for a
TIN or that you intend to apply for one soon. See also Establishing U.S.
status for purposes of chapter 3 and chapter 4 withholding, earlier, for
when you may instead be subject to withholding under chapter 3 or 4 of
the Code.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
Form W-9 (Rev. 3-2024)Page 5
Part II. Certification
To establish to the withholding agent that you are a U.S. person, or
resident alien, sign Form W-9. You may be requested to sign by the
withholding agent even if item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN is shown in Part I
should sign (when required). In the case of a disregarded entity, the
person identified on line 1 must sign. Exempt payees, see Exempt payee
code, earlier.
Signature requirements. Complete the certification as indicated in
items 1 through 5 below.
1. Interest, dividend, and barter exchange accounts opened
before 1984 and broker accounts considered active during 1983.
You must give your correct TIN, but you do not have to sign the
certification.
2. Interest, dividend, broker, and barter exchange accounts
opened after 1983 and broker accounts considered inactive during
1983. You must sign the certification or backup withholding will apply. If
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 in the
certification before signing the form.
3. Real estate transactions. You must sign the certification. You may
cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN. “Other payments” include
payments made in the course of the requester’s trade or business for
rents, royalties, goods (other than bills for merchandise), medical and
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third-party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys (including payments to corporations).
5. Mortgage interest paid by you, acquisition or abandonment of
secured property, cancellation of debt, qualified tuition program
payments (under section 529), ABLE accounts (under section 529A),
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account:Give name and SSN of:
1. Individual The individual
2. Two or more individuals (joint account)
other than an account maintained by
an FFI
The actual owner of the account or,
if combined funds, the first individual
on the account1
3. Two or more U.S. persons
(joint account maintained by an FFI)
Each holder of the account
4. Custodial account of a minor
(Uniform Gift to Minors Act)
The minor2
5. a. The usual revocable savings trust
(grantor is also trustee)
The grantor-trustee1
b. So-called trust account that is not
a legal or valid trust under state law
The actual owner1
6. Sole proprietorship or disregarded
entity owned by an individual
The owner3
7. Grantor trust filing under Optional
Filing Method 1 (see Regulations
section 1.671-4(b)(2)(i)(A))**
The grantor*
For this type of account:Give name and EIN of:
8. Disregarded entity not owned by an
individual
The owner
9. A valid trust, estate, or pension trust Legal entity4
10. Corporation or LLC electing corporate
status on Form 8832 or Form 2553
The corporation
11. Association, club, religious, charitable,
educational, or other tax-exempt
organization
The organization
12. Partnership or multi-member LLC The partnership
13. A broker or registered nominee The broker or nominee
14. Account with the Department of
Agriculture in the name of a public
entity (such as a state or local
government, school district, or prison)
that receives agricultural program
payments
The public entity
15. Grantor trust filing Form 1041 or
under the Optional Filing Method 2,
requiring Form 1099 (see Regulations
section 1.671-4(b)(2)(i)(B))**
The trust
1 List first and circle the name of the person whose number you furnish.
If only one person on a joint account has an SSN, that person’s number
must be furnished.
2 Circle the minor’s name and furnish the minor’s SSN.
3 You must show your individual name on line 1, and enter your business
or DBA name, if any, on line 2. You may use either your SSN or EIN (if
you have one), but the IRS encourages you to use your SSN.
4 List first and circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entity itself is not designated in the account title.)
* Note: The grantor must also provide a Form W-9 to the trustee of the
trust.
** For more information on optional filing methods for grantor trusts, see
the Instructions for Form 1041.
Note: If no name is circled when more than one name is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal information,
such as your name, SSN, or other identifying information, without your
permission to commit fraud or other crimes. An identity thief may use
your SSN to get a job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
• Protect your SSN,
• Ensure your employer is protecting your SSN, and
• Be careful when choosing a tax return preparer.
If your tax records are affected by identity theft and you receive a
notice from the IRS, respond right away to the name and phone number
printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you
think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity, or a questionable credit report, contact the IRS
Identity Theft Hotline at 800-908-4490 or submit Form 14039.
For more information, see Pub. 5027, Identity Theft Information for
Taxpayers.
Form W-9 (Rev. 3-2024)Page 6
Victims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help in resolving tax problems that
have not been resolved through normal channels, may be eligible for
Taxpayer Advocate Service (TAS) assistance. You can reach TAS by
calling the TAS toll-free case intake line at 877-777-4778 or TTY/TDD
800-829-4059.
Protect yourself from suspicious emails or phishing schemes.
Phishing is the creation and use of email and websites designed to
mimic legitimate business emails and websites. The most common act
is sending an email to a user falsely claiming to be an established
legitimate enterprise in an attempt to scam the user into surrendering
private information that will be used for identity theft.
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this message to phishing@irs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury Inspector
General for Tax Administration (TIGTA) at 800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
spam@uce.gov or report them at www.ftc.gov/complaint. You can
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338).
If you have been the victim of identity theft, see www.IdentityTheft.gov
and Pub. 5027.
Go to www.irs.gov/IdentityTheft to learn more about identity theft and
how to reduce your risk.
Privacy Act Notice
Section 6109 of the Internal Revenue Code requires you to provide your
correct TIN to persons (including federal agencies) who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage interest you paid; the
acquisition or abandonment of secured property; the cancellation of
debt; or contributions you made to an IRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above information.
Routine uses of this information include giving it to the Department of
Justice for civil and criminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and territories for use in
administering their laws. The information may also be disclosed to other
countries under a treaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and intelligence
agencies to combat terrorism. You must provide your TIN whether or not
you are required to file a tax return. Under section 3406, payors must
generally withhold a percentage of taxable interest, dividends, and
certain other payments to a payee who does not give a TIN to the payor.
Certain penalties may also apply for providing false or fraudulent
information.
ATTACHMENT D
VOTING POLL LOCATIONS
Antrim 1 Greencastle Baptist Church Greene 1 New LIFE Worship Center COG
2377 Buchanan Trail W. 7798 Lincoln Way E.
Greencastle, PA 17225 Fayetteville, PA 17222
Antrim 2 Kauffman Ruritan Club Comm. Bldg. Greene 2 Scotland Community Center
7289 Ruritan Dr. 3832 Scotland Main St.
Chambersburg, PA 17201 Scotland, PA 17254
Antrim 3 Shady Grove Community Center Greene 3 Kenny's Auction
11972 Community Center Ln 4401 Philadelphia Ave.
Shady Grove, PA 17256 Chambersburg, PA 17201
Antrim 4 State Line Community Center Greene 4 St. Paul Lutheran Church
15841 Park Dr. 44 E. Main St.
State Line, PA 17263 Fayetteville, PA 17222
Antrim 5 Grace Bible Church Greene 5
Mt. Pleasant United Brethren
Church
2327 Hoffman Rd. 2509 Black Gap Rd.
Greencastle, PA 17225 Chambersburg, PA 17201
Chambersburg
1-1 St. Paul United Methodist Church Greene 6 Salem United Brethren Church
750 Norland Ave. 4349 Letterkenny Rd.
Chambersburg, PA 17201 Chambersburg, PA 17201
Chambersburg
1-2
Park Avenue United Methodist
Church Guilford 1 Grace Brethren Church
125 Park Ave. 315 S. Edwards Ave.
Chambersburg, PA 17201 Chambersburg, PA 17202
Chambersburg
2-1 CASD Administration Building Guilford 2 New Guilford BIC Church
435 Stanley Ave. 1575 Mont Alto Rd.
Chambersburg, PA 17201 Chambersburg, PA 17201
Chambersburg
2-2 CASD Administration Building Guilford 3 New Franklin Community Bldg.
435 Stanley Ave. 2500 New Franklin Rd.
Chambersburg, PA 17201 Chambersburg, PA 17201
Chambersburg
3-1 Chambersburg Rec Center, Bard Hall Guilford 4 Heidelburg Fellowship Hall
235 S. Third St. 144 Colorado St.
Chambersburg, PA 17201 Marion, PA 17235
Chambersburg
4-1 First Lutheran Church Guilford 5 South Mtn. Volunteer Fire Co.
43 W. Washington St. 11207 Loop Rd.
Chambersburg, PA 17201 Fayetteville, PA 17222
Chambersburg
4-2 Falling Spring Presbyterian Church Guilford 6
Calvary United Methodist
Church
221 N. Main St. 150 Norlo Dr.
Chambersburg, PA 17201 Fayetteville, PA 17222
Chambersburg
5-1 Chambersburg Bible Church Hamilton 1
West Side Brethren in Christ
Church
810 Orchard Dr. 2665 Lincoln Way West
Chambersburg, PA 17201 Chambersburg, PA 17202
Chambersburg
5-2 Chambersburg Baptist Church Hamilton 2 Christian Life Church
741 S. Coldbrook Ave 1400 Warm Spring Rd
Chambersburg, PA 17201 Chambersburg, PA 17202
Fannett -
Concord Doylesburg Area Community Center Hamilton 3 Crider's United Brethren Church
21102 Path Valley Rd. 2380 Loudon Rd.
Dry Run, PA 17220 Chambersburg, PA 17201
Fannett - Dry
Run Fannett-Metal Fire & Ambulance Co.
Letterkenny
1
Pleasant Hall Volunteer Fire
Dept.
18778 Dry Run Road West 9722 Cumberland Highway
Dry Run, PA 17220 Pleasant Hall, PA 17246
Fannett -
Amberson United Methodist
Church
Letterkenny
2 Salem United Brethren Church
Sulphur
Springs 18889 Amberson Rd. 4349 Letterkenny Rd.
Amberson, PA 17210 Chambersburg, PA 17201
Greencastle 1 Grace United Church of Christ Lurgan
Lurgan Township Supervisors'
Office
128 E. Baltimore St. 8650 McClays Mill Rd.
Greencastle, PA 17225 Newburg, PA 17240
Greencastle 2 Greencastle Church of the Brethren Mercersburg
MMP&W Vol. Fire & Amb. Co.
Act. Ctr.
36 S. Carlisle St. 20 Veterans Way
Greencastle, PA 17225 Mercersburg, PA 17236
Metal 1 Metal Twp. Fire & Amb. Co. 21 St. Thomas 1 Edenville Community Center
10862 Path Valley Rd. 2047 Community Center Rd
Fannettsburg, PA 17221 St. Thomas, PA 17252
Metal 2 Metal Twp. Fire & Amb. Co. 21 St. Thomas 2 St. Thomas Fire Dept.
10862 Path Valley Rd. 34 School House Rd.
Fannettsburg, PA 17221
St. Thomas, PA 17252
Metal 3
Upper Path Valley Presbyterian
Church St. Thomas 3 Williamson Community Center
16950 Main Street 5583 Kennedy Ave.
Spring Run, PA 17262 St. Thomas, PA 17252
Mont Alto Mont Alto United Methodist Church Warren Warren Twp. Municipal Bldg.
10 S Main Street 11367 Little Cove Rd.
Mont Alto, PA 17237 Mercersburg, PA 17236
Montgomery
1 Tuscarora Senior Activity Center
Washington
1 The Church of Transfiguration
11300 Ft. Loudon Rd. 13646 Summit Ave.
Mercersburg, PA 17236 Blue Ridge Summit, PA 17214
Montgomery
2 Montgomery BIC Church
Washington
2 Rouzerville Community Center
6727 Montgomery Church Rd. 11962 Old Route 16
Mercersburg, PA 17236 Waynesboro, PA 17268
Montgomery
3 Montgomery Twp. Supervisors Bldg.
Washington
3 Church of the Apostles
11364 Ft. Loudon Rd. 336 Barnett Ave.
Mercersburg, PA 17236 Waynesboro, PA 17268
Orrstown LSL Sportsmen's Club
Washington
4 Zullinger Community Center
3549 Orrstown Rd. 4569 Buchanan Trail E.
Orrstown, PA 17244 Zullinger, PA 17272
Peters 1 Charlestown U.M. Church
Washington
5 Waynesboro Bible Church
13826 Buchanan Trail W. 8216 Stottlemeyer Rd.
Mercersburg, PA 17236 Waynesboro, PA 17268
Peters 2 Ft. Loudon Community Center Bldg. Waynesboro
Presbyterian Church of
Waynesboro
142 Mullen St. 1-1 105 E. Main St.
Ft. Loudon, PA 17224-0063 Waynesboro, PA 17268
Peters 3 Peters Twp. Municipal Bldg. Waynesboro
Waynesboro Church of the
Brethren
5000 Steele Ave. 1-2 117 S. Church St.
Lemasters, PA 17236 Waynesboro, PA 17268
Quincy 1 Quincy Community Center Waynesboro Trinity United Church of Christ
8098 Anthony Highway 2-1 30 W. North St.
Quincy, PA 17247 Waynesboro, PA 17268
Quincy 2 Central Baptist Church Waynesboro Waynesboro Ambulance Squad
6025 Anthony Hwy. 2-2 603 W. Main St.
Waynesboro, PA 17268 Waynesboro, PA 17268
Quincy 3 Five Forks BIC Church Waynesboro Calvary Assembly of God Church
9244 Five Forks Rd. 3-1 116 Snider Ave.
Waynesboro, PA 17268 Waynesboro, PA 17268
Quincy 4 South Mountain Bible Church Waynesboro Fairview Ave. BIC Church
11275 S. Mountain Road 3-2 152 Fairview Ave.
Fayetteville, PA 17222 Waynesboro, PA 17268
Southampton
- Living Faith Chapel Waynesboro Otterbein Church Youth Center
East 8770 Possum Hollow Rd. 3-3 900 South Potomac Street
Shippensburg, PA 17257 Waynesboro, PA 17268
Southampton
- Southampton Supervisors Bldg. West End - Branch Creek Place
Mt. Rock 705 Municipal Dr. Shippensburg 115 N. Fayette St.
Shippensburg, PA 17257 Shippensburg, PA 17257
Southampton
- Tall Timbers Park
West 3159 Orrstown Rd.
Orrstown, PA 17244
ATTACHMENT E
AGREEMENT
THIS AGREEMENT, made this ___ day of _________________ 2026, by and between the COUNTY OF
FRANKLIN, PENNSYLVANIA, by and through the FRANKLIN COUNTY COMMISSIONERS, a political subdivision
existing under the laws of the Commonwealth of Pennsylvania, (hereinafter called “County”), and
______________________ with a business address of _____________________________________
(hereinafter called “Contractor”).
WITNESSETH, that for, and in consideration of, the mutual promises, covenants, and
agreements by each of the parties hereto to the other made, the parties hereto, with the intention to be
legally bound, do covenant, promise, and agree as follows:
1. The Scope of the Work. The Contractor shall supply all work and comply with all requirements
of the Contract Documents, as defined herein and as referenced on the Invitation for Bid No. IFB
_________________, Delivery and Pick-Up of Election Equipment and Supplies for the County of Franklin, PA
(hereinafter the “Invitation for Bid” or “IFB”).
The scope of the work shall be as defined in the Invitation for Bid Specifications attached to the IFB
(hereinafter the “Work”).
2. The Contract Documents. The term "Contract Documents" means and includes the following:
a) Request for Proposal No. IFB _______________, including all Attachments and Questions and
Answers;
b) Completed Bid Form;
c) Contractor’s Response to the IFB, including all Attachments and/or Exhibits;
d) This Agreement;
e) Instructions for Non-Collusion Affidavit;
f) Non-Collusion Affidavit;
g) Certificate of Insurance;
h) Any and all notices, disclosures, affidavits, certifications of compliance as required per statute
or regulation and that were part of the IFB;
i) Addenda, if any:
No. __________ Dated: ________________
No. __________ Dated: ________________
No. __________ Dated: ________________
All of the above-listed documents are hereby incorporated by reference into this Agreement.
3. Payment to Contractor; Schedule of Payments. The County will pay the Contractor all sums as
outlined in Contractor’s completed Bid Form.
All invoices shall be due upon presentation and shall be considered past due if not paid within forty-
five (45) days of the date of the invoice.
The Contractor shall be responsible for the payment of all sales and use taxes required by law on all
materials, products and/or equipment which may be purchased for use in and which will become part of the
Work. County may be exempt from sales and use taxes for certain Products to be incorporated into the Work.
Contractor shall obtain legal advice to determine how and to what extent the County's tax exemption may be
utilized by the Contractor. County will provide, at Contractor's request, required documentation to assist
Contractor in obtaining any applicable tax exemptions. County shall not be directly or indirectly responsible
for costs of sales and use tax when Contractor fails to obtain any applicable tax exemption.
4. Term. The term of this Agreement shall begin upon execution hereof and end on November 30,
2028. The County shall have the option to extend this Agreement for two (2) consecutive one (1) year terms.
The County shall exercise this option by notifying the Contractor within thirty (30) days of the expiration of the
then-current term.
5. Scheduling; Mobilization; Time Requirements shall be as specified in the Specification section of
the IFB.
6. Damages. The Contractor acknowledges and agrees that the Work is time-sensitive and cannot
be delayed or rescheduled. In the event that Contractor, for any reason whatsoever, is unable to perform the
Work hereunder, Contractor understands that the County shall be entitled to retain a substitute contractor to
perform the Work on an emergency basis, and Contractor shall be responsible and liable for all fees, costs,
expenses, charges, and/or assessments resulting therefrom. The Contractor acknowledges and agrees that
the damages set forth herein are foreseeable and would be incurred as a direct and proximate consequence of
a breach of this Agreement. The damages set forth in this paragraph shall in no way prohibit or limit the
County’s right to recover all other damages which are or may be recoverable under this Agreement or under
applicable law, including, but not limited to ordinary contractual, consequential, and/or incidental damages,
and are recoverable in addition to any other damages for harm or loss suffered by the County.
7. Insurance. Contractor specifically acknowledges and reaffirms its responsibility to obtain and
maintain all insurance coverages set forth in Section 11 of the IFB, which is incorporated herein by reference.
8. Letter of Credit. Upon execution of the agreement, the contractor shall issue an irrevocable
Letter of Credit in the amount of twelve thousand dollars and no cents ($12,000.00) in favor of the County of
Franklin, PA valid and enforceable for the entire term of the contract.
9. Indemnification and Release. Contractor agrees to indemnify and hold harmless the County, its
successors, administrators, board members, commissioners, assigns, attorneys, insurers, employees, and
agents (the “County Releasees”) from and against, and to reimburse the County Releasees with respect to, any
and all claims, demands, causes of action, losses, damages, liabilities, penalties, assessments, costs, and
expenses (including reasonable attorneys’ fees and other costs and expenses incident to any claim, suit, action
or proceeding) arising out of or resulting from the Work pursuant to this Agreement, including all claims of
third party personal injury and/or property damage, and the business relationship between the parties,
including, without limitation, any and all known or unknown, foreseen or unforeseen, matured or unmatured
claims and the consequences thereof.
Contractor, for and in consideration of the mutual promises contained in this Agreement, hereby
remises, releases and forever discharges the County Releasees, and, by these presents, does, for its
successors, administrators, assigns, heirs, executors, and agents, remise, completely release and forever
discharge the County Releasees, of and from any and all past, present or future claims, demands, obligations,
actions, causes of action, rights, damages, costs, fees, including attorneys’ fees, expenses and compensation
of any nature whatsoever, whether based on a tort, contract, or any other theory of recovery, and whether for
compensatory, statutory, or punitive damages, which Contractor now has, or which may hereafter accrue or
otherwise be acquired, on account of, or in any way growing out of, or in any way related to any personal
injury or property damage, of any kind or sort whatsoever, arising out of the Work, the Invitation for Bid and
response thereto, and this Agreement, including, without limitation, any and all known or unknown, foreseen
or unforeseen, matured or unmatured claims and the consequences thereof.
10. Governing Law and Forum Selection. This Agreement shall be governed and interpreted under
the laws of the Commonwealth of Pennsylvania. All claims arising hereunder shall be filed only in the Court of
Common Pleas for the Thirty-Ninth Judicial District of Pennsylvania-Franklin County Branch.
11. Termination. If either party fails to fulfill in a timely or proper manner its obligations under this
Agreement, or if either party violates any of the covenants or stipulations of this Agreement, the party injured
thereby shall have the right to terminate this Agreement by providing written notice of such termination and
specifying the effective date thereof. No less than thirty (30) days’ notice shall be provided before the
effective date of such termination. Notwithstanding the foregoing, the County shall have the right to
terminate this Agreement for convenience and/or for nonappropriation upon fourteen (14) days’ written
notice to the Contractor. In the event that the County elects to terminate this Agreement for convenience
prior to Contractor’s completion for the work required hereunder, the Contractor shall be compensated for all
work satisfactorily completed in an amount proportionate to services actually provided by Contractor.
12. Prevailing Party Attorneys’ Fees. If an action at law or in equity is necessary to enforce or
interpret the terms of this Agreement, the prevailing party shall be entitled to recover, in addition to any other
relief, reasonable attorneys' fees, costs and disbursements.
13. Nondiscrimination. In carrying out the terms of this Agreement, both parties agree not to
discriminate against any employee or other person because of gender, ancestry, age, race, color, sex, religious
creed, national origin, marital status, handicap or disability, sexual orientation or in violation of the
Pennsylvania Human Relations Act, federal, state or local laws. The Contractor and the County shall comply
with the Contract Compliance Regulations of the Pennsylvania Human Relations Commission, any pertinent
Executive Order of the Governor, the Federal Civil Rights Act of 1964, the Multi-Ethnic Placement Act of 1994,
the Small Business Job Protection Act of 1996 and with all other laws, regulations, or directives prohibiting
discrimination in hiring or employment opportunities.
14. Suspension and Debarment.
A. The Contractor certifies that it is not currently under suspension or debarment by any
federal, state or local government or agency, and if the Contractor cannot so certify, then it agrees to submit a
written explanation of why such certification cannot be made.
B. If the Contractor enters into subcontracts or employs under this Agreement any
subcontractors/individuals who are currently suspended or debarred by the County, Commonwealth or
federal government, or who become suspended, or debarred, by the Commonwealth or federal government
during the term of this Agreement, or any extension or renewals thereof, the County or Commonwealth shall
have the right to require the Contractor to terminate such subcontracts or employment.
C. The Contractor agrees to reimburse the County or Commonwealth for the reasonable
costs of investigating the Contractor’s compliance with terms of this or any other Agreement between the
Contractor and the County or Commonwealth which result in the suspension or debarment of the Contractor
or its subcontractor. Such costs shall include, but are not limited to, salaries of the investigators, including
overtime, travel and lodging expenses, and expert witness and documentary fees. The Contractor shall not be
responsible for investigative costs that do not result in the Contractor’s or subcontractor’s suspension or
debarment.
D. The Contractor may obtain the current list of suspended and debarred contractors by
contacting the:
Department of General Services
Office of Chief Counsel
603 North Office Building
Harrisburg, PA 17125
Phone: (717) 763-6472
FAX: (717) 787-9138
15. Licenses and Compliance with Law. The Contractor shall obtain and pay for all permits, fees,
licenses, and inspections required by any government agencies necessary for the proper performance and
completion of the Work. The Contractor shall further comply with all applicable laws and regulations, whether
federal, state or local, with respect to the Work. The Contractor shall be responsible for the correction of the
Work to comply with any said permits, fees, licenses and inspections and to ensure compliance with law,
including, but not limited to, payment of all costs to such correction.
16. Security. The Contractor acknowledges the special security and public safety risk inherent with
the performance of the Work. The Contractor expressly agrees that all subcontractors shall be subject to
preapproval by the County, and that all subcontractors shall strictly comply with the security measures and
requirements applicable to the Contractor. The preapproval or withholding of preapproval by County shall be
at County’s absolute discretion, and shall not be subject to review or appeal. The Contractor shall submit all of
its employees, agents, servants, contractor and/or subcontractors who shall perform any part of the Work for
a Pennsylvania State Police background check.
17. Confidentiality. The parties agree that that location(s) of any and all voting equipment and
transit route(s) of said equipment are highly confidential, and that the County would suffer from irreparable
harm in the event that said locations and/or routes were disclosed. The Contractor, for itself and its
employees, contractors, agents, and/or servants, warrants and agrees to maintain all information related to
the locations and transit routes of all voting equipment as strictly confidential. Contractor further agrees to
reimburse the County for all fees, costs, charges, and/or assessments related to the security and relocation of
said voting equipment in the event that the Contractor or any of its employees, contractors, agents and/or
servants breach this warranty.
18. Entire Agreement. This Agreement, including all of the Contract Documents set forth in
Paragraph 2, contains the entire agreement between the parties, and no other agreements, oral or otherwise,
regarding the subject matter of the Agreement shall be deemed to exist or bind any of the parties.
19. Modification and Amendment. This Agreement shall not be modified except by a written
document signed by the parties hereto.
20. Time. The parties agree that time is of the essence with respect to this Agreement and the
Work.
21. Notices. Notices required hereunder, or any correspondence concerning this Agreement shall
be directed to the following addresses and shall be deemed properly given (a) if delivered by hand, (b) if sent
by certified mail, return receipt requested, postage prepaid, or by recognized overnight courier service
(including, without limitation, Federal Express or United
Parcel Service overnight service), charges prepaid; or (c) if sent by facsimile, with a copy sent by
first class U.S. Mail, postage prepaid.
(A) If to Contractor
(B) If to County:
County of Franklin, Pennsylvania
272 North Second Street
Chambersburg, PA 17201
Notices and communications hereunder shall be deemed sufficiently given when dispatched pursuant
to the foregoing provisions. Notices and communications delivered by hand shall be effective upon receipt;
notices and communications sent by fax, with a copy by first class U.S. Mail, shall be effective upon dispatch;
notices and communications sent be recognized overnight courier service shall be effective on the business
day following dispatch; and notices sent by certified mail shall be effective on the third business day following
dispatch.
(THIS SPACE LEFT BLANK INTENTIONALLY)
22. Successors and Assigns. This Agreement shall be binding upon all parties hereto and their
respective heirs, executors, administrators, successors, and assigns, but it may not be assigned by the
Contractor without the express written consent of the County.
IN WITNESS WHEREOF, the County of Franklin, Pennsylvania have caused these presents to be
executed and its corporate seal affixed thereto and the Contractor has caused these presents to be executed
in a like manner the days and year above written.
ATTEST:
_____________________ ____________________________
By:
ATTEST: COUNTY OF FRANKLIN, PA
_____________________ ______________________________
Dean A. Horst, Chairperson
______________________________
John T. Flannery, Commissioner
______________________________
Robert G. Ziobrowski, Commissioner
BID FORM
IFB 2026111-02 – DELIVERY AND PICK-UP OF ELECTION EQUIPMENT AND SUPPLIES
To: Franklin County Controller’s Office Franklin
County Administration Building
272 North Second Street
Chambersburg, PA 17201
The undersigned, having carefully examined the specifications and instructions to bidders, and being
familiar with the various requirements concerning the work involved, agree to furnish all materials and
perform all work necessary in strict accordance with the contract documents for consideration in the
following amount:
Year 1 (2026) Year 2 (2027) Year 3 (2028)
1 Travel time per truck in hours
2 Work time per truck 80.00 80.00 80.00
3 Total time per truck (add lines 1 & 2)
4 Hourly Cost per truck with 2 staff
5 Fuel Surcharge per truck travel hour
6 Subtotal – Charge per truck (line 3 x line 4)
7 Subtotal – Fuel Surcharge per truck (line 1 x line 5)
8 Total Annual Cost (add lines 6 & 7)
Grand total (add all columns of line 8)
***Remainder of page left blank***
Notice of acceptance, or request for additional information, may be addressed to the undersigned at the address
set forth below.
The undersigned hereby declares that this bid is made without connection with any other person or persons
making a bid for the same work and is without collusion or fraud.
Submitted by:
(Type Name)
Signed by:
Title:
Business Name:
Address:
Phone:
E-mail:
Date:
BID CHECKLIST
Bid Form
Non-Collusion Affidavit
___ Qualification Questionnaire
Current W-9