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RFP #NPS-FAC-2018-1006 Proposal for: Visitor Management System Due Date: November 26th, 2018 at 8:00 A.M.

RFP Response from: LobbyGuard Solutions, LLC 4700 Six Forks Road, Suite 300 Raleigh, NC 27609 866-905-6229 www.lobbyguard.com

RFP #NPS –FAC-2018-1006 1

RFP #NPS-FAC-2018-1006 REQUEST FOR PROPOSAL

ISSUE DATE: Date: 11/13/18

TITLE: NIXA PUBLIC SCHOOLS Visitor Management System

ISSUING AGENCY MAILING ADDRESS: Nixa Public Schools Attn: Zac Rantz 301 S. Main St. Nixa, MO 65714 PH (417) 449-3295, FX (417) 449-3190

LOCATION WHERE RFP #NPS-FAC-2018-1006 CAN BE HAND DELIVERED: Faught Administration Center 301 S. Main St. Nixa, Missouri

PROPOSAL DUE DATE AND TIME: Monday, November 26, 2018 at 8 a.m. (CST). Proposals will be opened in public at 8:15 a.m. (CST) in the second floor meeting room at Faught. Proposals may be mailed or hand delivered but must be received by the due date and time specified.

QUESTIONS/INQUIRIES: E-mail all inquiries for information to the following: zacrantz@nixaschools.net

In Compliance With This Request For Proposal And To All The Conditions Imposed Therein And Hereby Incorporated By Reference, The Undersigned Offers And Agrees To Furnish The Goods/Services In Accordance With The Attached Signed Proposal Or As Mutually Agreed Upon By Subsequent Negotiations.

Name and Address of Firm:

___________________________________________

___________________________________________

________________________________________

Fed ID No: _________________________________

Email: _____________________________________

Date: _____________________________________

By: _____________________________________

Title: _____________________________________

Signature: __________________________________

Phone: ____________________________________

As a political subdivision, employer, recipient of federal funds and educational institution, the Nixa Public Schools are prohibited from, and hereby declares a policy against, engaging in unlawful discrimination, including harassment creating a hostile environment, on the basis of race, color, religion, sex, national origin, ancestry, disability, age or use of leave protected by the Family Medical Leave Act, in its programs, activities and with regard to employment. The board is an equal opportunity employer.

LobbyGuard Solutions, LLC4700 Six Forks Rd, Suite 300

Raleigh, NC 27609

11/19/2018

Kevin Allen

President

919-785-3301 ext 500kevin.allen@lobbyguard.com

20-2442335

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TABLE OF CONTENTS

I. COMPANY PROFILE ........................................................................................................ 4

II. PROPOSAL ITEMS:......................................................................................................... 5

PRICING……………………………………………………………………………………………………………………5

PRODUCT ABILITIES…………………………………………………………………………………7

III. FEES/OTHER EXPENSES .............................................................................................. 14

ATTACHEMENT A: VENDOR VERIFICATION FORMS ....................................................... 15

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November 19th, 2018

Nixa Public Schools 301 S. Main St. Nixa, MO 65714

To Whom It May Concern;

Enclosed please find the response to your RFP # NPS-FAC-2018-1006 for Visitor Management System. We are confident LobbyGuard Solutions, LLC will exceed the Nixa Public Schools needs and requirements.

LobbyGuard development began in 2001 and the product was first installed in 2003 to schools in Wake County, NC. Sales to schools in and around NC soon followed, and the holding company LobbyGuard Solutions, LLC was formed in March 2005 as a result of investor funding. LobbyGuard has grown to serve thousands of customer locations in the United States and 18 foreign countries, specializing in the needs of public school systems. LobbyGuard focuses heavily on customer service, quality product and flexible product pricing models. LobbyGuard is still managed and operated by the original founders of the firm and all work is performed from the Raleigh, NC office. The firm’s unique approach to a secure, efficient self-service and front-desk-operated model make it unique in the visitor management arena.

LobbyGuard has a strong commitment to school safety and is the major sponsor of the National School Safety Conference each year.

We appreciate the invitation to respond and the careful consideration of the district to our enclosed response.

Please contact me with any questions.

Sincerely;

Kevin Allen, President LobbyGuard Solutions, LLC 4700 Six Forks Rd, Suite 300 Raleigh, NC 27615 www.lobbyguard.com (919) 785-3301 x500kevin.allen@lobbyguard.com

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I. COMPANY PROFILE

LobbyGuard Solutions, LLC is the firm behind the LobbyGuard® line of visitor management and front office automation systems. Corporate offices are located in Raleigh, North Carolina. The company is a recognized leader in the visitor management industry. Founded in 2005, LobbyGuard was one of the first companies to introduce products in the visitor management sector and was the first to offer a self-service sign-in kiosk. Today LobbyGuard handles 1,000,000+ visitor sign-ins each week at school, corporate, government, medical and 30+ additional vertical markets all over the world. The LobbyGuard product line has been the subject of numerous local and national media stories as an important and well-received part of corporate, government and public education security initiatives.

The following are additional important points about LobbyGuard’s approach to its customers that will be of interest to Nixa Public Schools:

A Commitment to Technical Support – LobbyGuard consistently displaces competing products due to an inability on the part of the customer to reach competitor’s tech support in a timely manner. LobbyGuard is dedicated to providing live technician support M-F 7AM – 6PM EST and maintains a full array of web-based support options that area available 24/7/365.

A Commitment to Research & Development – LobbyGuard dedicates a great deal of time and resources to ongoing research, design and development. The visitor management needs of schools around the country have changed and advanced many times over the past 15 years and LobbyGuard has lead the way with new innovations and creative ways to facilitate a secure and efficient sign-in experience. LobbyGuard releases new software every three weeks and is constantly adding features that are available at no additional charge to its customers.

A Commitment to Customer Training – LobbyGuard has developed an effective on-site and web-based training approach that is designed to verify the customer’s understanding of important aspects of the LobbyGuard product as well as advanced features. LobbyGuard offers weekly training webinars that are free for customers to join to keep up with new features and changes to the product.

This proposal demonstrates that LobbyGuard Solutions, LLC is uniquely positioned to meet the specific needs of Nixa Public Schools. The proposal represents over 15 years of experience responding to the needs of school districts all over the country and presenting self-service solutions that combine the needed features of the district: enhanced school safety and automation of the operations at the front office. LobbyGuard is the only offeror in the industry able to combine both these approaches in an intuitive easy-to-use touchscreen product. This proposal incorporates best practices derived from collective knowledge of thousands of schools around the country since 2003, including the following areas:

• Training and Installation• Product features, including a proven foundation of self-service and mobile app products that offer

convenience without sacrificing security.• Ongoing service and warranty policies• Pricing that represents the value of the product while remaining competitive in the marketplace

LobbyGuard Solutions, LLC is pleased to be a part of this process with Nixa Public Schools and moving the district into a more sophisticated and secure method for visitor management.

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II. PROPOSAL ITEMS:

PRICING Pricing for a trial run for January-June of 2019 with the ability to load IDs of parents and others from October-December 2018. This pricing would be for 2 elementary and 1 intermediate schools. Full implementation of system would be in the 2019-2020 school year.

LobbyGuard is responding with 2 separate systems to provide a choice to Nixa Public Schools: The LobbyGuard SL product that can be installed on district PC hardware or the LobbyGuard Defender All-In-One Kiosk product that requires no additional hardware. We are also providing pricing for on-site installation and training options, as well as costs of future supplies.

OPTION 1 – LobbyGuard SL Package The LobbyGuard SL package (“Software License”) provides Nixa Public Schools with software and a hardware bundle that can be installed on any available Windows 7, 8 or 10 32-bit or 64-bit PC, laptop or tablet. The LobbyGuard SL package consists of the LobbyGuard Visitor Management software and a peripheral component package consisting of HD Camera, Zebra DS457 bar code / driver license scanner, and Student Late Pass Kit (Dymo 450 Thermal dual spool visitor badge printer, box of visitor badges and box of student late pass paper) Nixa Public Schools will be responsible for providing a compatible PC and monitor and optional mouse/keyboard. The LobbyGuard SL package can run on a dedicated PC as a standalone visitor management system or can be installed on a desktop PC that is used for other purposes. It can be set up as a self-service system or can be operated by front office personnel.

Item Unit Price / Description QTY Total Cost

LobbyGuard SL Visitor Management System

$1,500.00 / location LobbyGuard SL installs the LobbyGuard Visitor Management System on existing district PC hardware. This package includes a web cam, 2D driver license / bar code scanner and student late pass kit (dual spool visitor badge printer, box of visitor badges and box of student late pass paper) Provides unlimited user account access to LobbyGuard FrontDesk, the web-based customer portal for accessing visitor records, running reports, managing volunteers and faculty, and a host of other features. Remote based installation and training provided for Nixa Public Schools staff.

3 $4,500.00

Annual software renewal and maintenance

$250.00 / unit / January 2019-June2019 LobbyGuard Visitor Management Software Site License Renewal Yearly Subscription: This fee covers up to 5 LobbyGuard products per physical street address. Unlimited LobbyGuard Data Hosting. Access to LobbyGuard Technical Support. Access to the LobbyGuard Background Checking Services. New Product Features and Releases.

3 $750.00

Shipping and Handling $30.00 Shipping for Devices

3 $90.00

TOTAL $5,340.00

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OPTION 2 – LobbyGuard Defender Package

The LobbyGuard Defender package provides Nixa Public Schools with an ELO Public-Use All-In-One PC running Windows 10 Pro with LobbyGuard software pre-installed. The Defender includes a built-in HD camera, Zebra DS-457DL Bar Code/Driver License Scanner, and Student Late Pass Kit (Dymo 450 Thermal dual spool visitor badge printer, box of visitor badges and box of student late pass paper)

Item Unit Price / Description QTY Total Cost

LobbyGuard Defender Visitor Management System

$3,500.00 / location The LobbyGuard Defender is an ELO public use all- in- one kiosk that includes everything needed to start using LobbyGuard out of the box with no additional hardware required by the district: hd camera, 2D driver license / bar code scanner and student late pass kit (dual spool visitor badge printer, box of visitor badges and box of student late pass paper). Provides unlimited user account access to LobbyGuard FrontDesk, the web-based customer portal for accessing visitor records, running reports, managing volunteers and faculty, and a host of other features. Remote based installation and training provided for all Nixa Public Schools staff.

3 $10,500.00

Annual software renewal and maintenance

$500.00 / unit / January 2019-June 2019 LobbyGuard Visitor Management Software Site License Renewal Yearly Subscription: This fee covers up to 5 LobbyGuard products per physical street address. Unlimited LobbyGuard Data Hosting. Access to LobbyGuard Technical Support. Access to the LobbyGuard Background Checking Services. New Product Features and Releases.

3 $750.00

Shipping and Handling $100.00 Shipping for Devices

3 $300.00

TOTAL $11,550.00

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PRODUCT ABILITIES Please demonstrate if your product has any of the following abilities • Ability to have printed visitor IDs (stickers) with photo The LobbyGuard visitor badge is printed at the conclusion of visitor sign-in and is designed to allow unlimited flexibility and design configuration to best meet the needs of each individual school. These badges are generated digitally. Any information gathered during the sign-in process, including but not limited to date, time, photo, visitor name, person being visited, reason for visit, visitor type, etc. can be included on the printed badge. Each “visitor type” can have a different badge design; for example the design of the visitor badge for “Parent” might be very different from the design of the visitor badge for “Volunteer”.

The visitor badge stock offered by LobbyGuard is available in 7 different colors, providing an easy way to invalidate yesterday’s visitor badge – simply replace the roll each morning with a different color. This process takes about 15 seconds to complete. LobbyGuard also supports the printing of one visitor type from one color roll of badges and the other visitor types from another roll using a dual spool badge printer.

LobbyGuard has worked closely with its badge stock supplier to provide the most advanced badge paper available. Below are some highlights of the visitor badge and an example of one of the many badge designs that are included with the LobbyGuard software.

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• What the background check screens (sex offender, warrants, other things) and what system/program the background check goes through LobbyGuard provides instant checks against the individual state databases for registered sex offenders through its partnership with the nation’s leading source of sex offender data, Family Watchdog. This includes all 50 US States plus Washington DC, Puerto Rico, Guam, the Virgin Islands, and U.S. Indian tribal councils.

Through LobbyGuard’s partnership with Family Watchdog, we are able to provide the most accurate and most frequent data available. Critical to the success of any background checking scenario is the manner and frequency with which the data is sourced and prepared. The “patchwork” nature of the individual states’ offender databases means it is very important to work with an organization that specializes in this type of effort. The database is updated twice daily except in cases where the individual state does not update its database daily; for example Texas only updates its registry every Monday, Wednesday and Friday.

In order to provide the most secure possible environment for Nixa Public Schools, all queries to the National Sex Offender database are live. There are no local copies of this data maintained anywhere on the actual LobbyGuard installation or at the district. In the event of an internet outage at the district / school, the LobbyGuard software will instantly detect the outage and place the station in “suspended” mode to prevent visitors from signing in until the outage is corrected. This is to prevent visitors from bypassing the background check.

When a visitor is closely matched to an offender record based on the first name, last name and date of birth, LobbyGuard instantly notifies relevant staff via email and/or text message.

Sample Email/Text Message Background Failure Notifications

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The visitor signing in to the LobbyGuard system will see a message on the screen informing him/her to speak to building / facility staff before proceeding. This same message is printed on the visitor badge for this visitor in the form of a “VOID” message.

The visitor record is made available for review by school staff via the LobbyGuard FrontDesk customer portal:

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This review involves presenting the visitor detail (photo, name, date of birth, physical address, height / hair / eyes) side-by-side with the exact same level of detail on the offender to whom this visitor was matched. This provides sufficient information for the school to choose “MATCH” or “NOT A MATCH”. If the visitor is matched to the offender, the school would follow its prescribed procedures for dealing with an offender on campus. If the visitor is chosen to be “not a match” to the offender record, LobbyGuard will instantly sign this visitor IN, print a normal visitor badge for this visitor and will make note of the visitor details so as not to match this particular visitor with that particular offender record in the future, thus reducing any chance of a future “false positive”. LobbyGuard has stopped thousands of registered sex offenders from gaining entry into public schools around the country since 2005.

Full details and screenshots of the background checking process for sex offenders is available at www.lobbyguard.com/void. The entire process takes approximately 30 seconds to complete. LobbyGuard has stopped over thousands of registered sex offenders attempting to gain entry into public schools around the country since 2005.

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LobbyGuard also provides a “Red Flag List” feature that allows the school or district to enter the names of people who are banned from the school(s) for any reason. Visitors who match entries in this list are treated the same as the above description for sex offender matches, including notification of relevant personnel via email or text. Each school can customize the list of notification recipients to best fit their needs.

LobbyGuard has the ability to pull any orders of protection from you SIS nightly via TFP. This includes matching parent/guardian to students at each school. LobbyGuard encourages our customers to be cautious about expanding scope of background checking beyond sex offender and your own internal and organizational database / red flag list. Going beyond these checks introduces a number of considerations: Cost – More extensive background checks are charged per search. Time – The more records searched at the visitor check-in the longer it will take to get a return. The LobbyGuard check against 800,000 sex offenders takes less than one second. Expanding beyond this search can greatly extend the time spent signing in. Accuracy - Criminal records often do not contain mug shots or other identifying information that allows school staff to accurately determine if the visitor at the school is in fact the person or persons returned by the broader criminal search. Actionable Information – LobbyGuard advises customers to only check against criminal records that will provide actionable information for the facility. Information about sex offenders and red flag offenders is actionable. For example: what would the school do with information on a visitor who served prison time 30 years ago. Working in conjunction with Nixa Public Schools LobbyGuard can work with local police and sheriff departments to provide integration with specific areas of criminal interest to the district. As an example we integrate directly with the Shelby County TN Sheriff Department warrant database at their juvenile detention center. It’s important for Nixa Public Schools to consider what level of background check you want to provide. Full criminal background checks cost money, time, accuracy and actionable information with each criminal background check. LobbyGuard does provide another form of criminal background checking for volunteers and employees that is not instant. Through our integrated partnership with Verified Volunteers we provide a streamlined, quality, volunteer background screening solution that aims to help increase the safety of students, parents, teachers, and staff within schools. Verified Volunteers allows the district or individual schools to tailor the level and type of background check performed against volunteer applicants.

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• Ability to sync with PowerSchool, and if a sync is possible, what information is synced and what capabilities the PowerSchool sync allows LobbyGuard has the capability to perform a nightly update / synchronization with PowerSchool. Any information entered into PowerSchool will be used by LobbyGuard the following school day, including custody modifications, trespass flags, etc. LobbyGuard is a Clever partner and will be able to utilize the Clever program for Nixa Public Schools data integrations. • Ability to have visitors leaving to checkout through barcode or QR code scanning The LobbyGuard Visitor Badges contain a bar code that can be scanned at the kiosk for instant sign-out.

• Ability to scan barcode or QR code for parent pick-up of students. If you have the capability, it would be used for our car line or parent walk-in pickup. Nixa Public Schools parents / frequent visitors can us the LobbyGuard Frequent Visitor keytags, keycards or barcode stickers. This keytag has the LobbyGuard logo on one side and a unique bar code on the other. The logo can be replaced with school or district logo. Visitors with this keytag are “registered”

with the district and can walk up to the LobbyGuard installation and scan the bar code under the bar code scanner. LobbyGuard instantly recognizes this person and will process the visitor in less than 2 seconds. Complete background checks and visitor badge printing can still performed on these visitors. The individual school can disable any keytag at any time, making it useless to scan at that LobbyGuard installation.

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LobbyGuard also offers the same functionality as above with its “Stick-On Bar Code” feature. This item is a 1.5” x ¼” bar code sticker that can be adhered to existing Employee ID or other item for added convenience during sign-in/sign-out and does not require adding a keytag to the user’s keychain. LobbyGuard GO – a free mobile phone app that runs on iOS and Android mobile phones allowing the user to sign in/out from the smartphone. The school has complete control over whether or not it wishes to use LobbyGuard GO and who can use the product for sign in/out. GO functions exactly like the kiosk / self-service products, including support for workflows, instant background checks and visitor badging. LobbyGuard GO is the perfect solution for parents / guardians in the car pool lane after school where the guardian is not visiting the front office to sign in. LobbyGuard GO also allows for thousands of visitors to sign in at the same time, making the product a great solution for large events and sporting events. Every question / input that can be asked at the kiosk is supported with the LobbyGuard GO product and all visitor records / activity are available via LobbyGuard FrontDesk alongside any kiosk / self-service records.

• Ability to scan staff IDs when they enter and exit a building Nixa Public Schools faculty IDs that have 3 of 9 barcodes can be scanned in the same manner as the LobbyGuard Frequent Visitor Keytags for instant sign-in and sign-out at any LobbyGuard station. LobbyGuard will provide Nixa Public Schools with 500 barcode stickers for IDs that do not have 3 of 9 barcodes for scanning at the LobbyGuard kiosk. LobbyGuard GO is also an effective way to track employee sign in/out for faculty or employees who do not visit the front office before reporting to the classroom or other areas of the school.

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III. FEES/OTHER EXPENSES 1. Provide detailed fees and/ or additional/other expense estimates associated with the PROPOSAL ITEMS

that you will require or for additional services you make available with respect to the PROPOSAL ITEMS.

Item Description QTY Total Cost

Annual Software Renewal and Maintenance

500.00 / unit / year LobbyGuard Visitor Management Software Site License Renewal Yearly Subscription: This fee covers up to 5 LobbyGuard products per physical street address. Unlimited LobbyGuard Data Hosting. Access to LobbyGuard Technical Support. Access to the LobbyGuard Background Checking Services. New Product Features and Releases.

3 $1,500.00

On Site Training $1,500.00 On-Site Training at Nixa Public Schools at a central location, consisting of up to 3 identical training sessions. 5 webinar training sessions dedicated to Nixa Public Schools staff to be scheduled at the district's discretion and hosted by a LobbyGuard Certified Trainer. Additional training available per the schedule at www.lobbyguard.com/training

1 $1,500.00

On-Site Installation

$1,500.00 One-time fee for On-Site Installation of LobbyGuard at each Nixa Public Schools location.

1 $1,500.00

Visitor Badges $120.00 / box 1 box of LobbyGuard Visitor badges includes 10 rolls of 250 badges for a total of 2500 badges per box.

1 $120.00

Student Late Pass Paper

$60.00 / box 1 box of LobbyGuard Student Late Pass Paper includes 5 rolls of 500 student late passes for a total of 2500 student late passes per box.

1 $60.00

Frequent Visitor Keytags

$20.00 / each 1 sheet of 20 Keytags

1 $20.00

Frequent Visitor Barcode Stickers

$10.00 / each 1 sheet of 20 barcode stickers

1 $10.00

*LobbyGuard will provide Nixa Public Schools with 500 barcode stickers for employee ID cards at no cost upon award of RFP.

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ATTACHEMENT A: VENDOR VERIFICATION FORMS

FILE: DJF-AF2 Critical

Page 1

NOTICE TO VENDORS AND BIDDERS

Section 285.525-285.550 R.S.Mo – Effective January 1, 2009

Effective January 1, 2009 and pursuant to the State of Missouri’s R.S.Mo 285.530 (1), No business entity or

employer shall knowingly employ, hire for employment, or continue to employ an unauthorized alien to perform

work within the state of Missouri.

As a condition for the award of any contract or grant in excess of five thousand dollars by the state or by any

political subdivision of the state (e.g., Nixa Public Schools, Nixa, MO) to a business entity…, the business entity

(Company) shall, by sworn affidavit and provision of documentation, affirm its enrollment and participation in a

federal work authorization program with respect to the employees working in connection with the contracted

services. Every such business entity shall sign an affidavit affirming that it does not knowingly employ any person

who is an unauthorized alien in connection with the contracted services. (R.S.Mo 285.530 (2))

Nixa Public Schools, Nixa, MO will put into their bid documents the following requirement to comply with State of

Missouri statute R.S.Mo 285.525-285.550.

Nixa Public Schools encourages companies that are not already enrolled and participating in a federal work

authorization program to do so. E-Verify is an example of this type of program. Information regarding E-Verify is

available at http://www.dhs.gov/xprevprot/programs/gc_1185221678150.shtm or by calling 888-464-4218.

In summary, as a condition for any contract in excess of $5,000.00, Nixa Public Schools, Nixa, MO will require the

bidder to:

1. Complete Nixa Public School’s affidavit, (http://www.nixapublicschools.net), and

2. Provide documentation of enrollment in a federal work authorization program (e.g. E-Verify)

If you have questions, please contact Nixa Public Schools, Business Office at 417-875-5400.

Required Affidavit for Contracts Over $5,000.00 (US) – Effective 1-1-2009, Company shall comply with the

provisions of Section 285.525 through 285.550 R.S.Mo. Contract award is contingent on Company providing an

acceptable notarized affidavit stating:

1. that Company is enrolled in and participates in a federal work authorization program with respect to the

employees working in connection with the contracted services; and

2. that Company does not knowingly employ any person who is an unauthorized alien in connection with

the contracted services.

Copy of the affidavit can be found and downloaded at Nixa Schools website: http://www.nixapublicschools.net

Additionally, Company must provide documentation evidencing current enrollment in a federal work

authorization program (e.g. electronic signature page from E-Verify Program’s Memo of Understanding (MOU).

FILE: DJF-AF2 Critical

Page 2

Affidavit of Compliance with Section 285.525 R.S.Mo

For all Agreements in excess of $5,000.00.

Effective January 1, 2009

STATE OF )

)ss.

COUNTY OF )

Before me, the undersigned Notary Public, in and for the County of ,

State of , personally appeared (Name)

who is (Title) of (Name

of Company), (a corporation), (a partnership), (a sole proprietorship), (a limited liability company), and is

authorized to make this affidavit, and being duly sworn upon oath deposes and says as follows:

1. that said company is enrolled in and participates in a federal work authorization program with

respect to the employees working in connection with the contracted services; and

2. that said company does not knowingly employ any person who is an unauthorized alien in

connection with the contracted services.

The terms used in this affidavit shall have the meaning set forth in Section 285.525 R.S.Mo, et seq.

Documentation of participation in a federal work authorization program is attached to this

affidavit.

Signature

Name:

Subscribed and sworn to before me this day of , .

Notary Public

My commission expires:

* * * * * * *

Administrative Note: The reader is encouraged to review policies and/or procedures for related

information in this administrative area.

Implemented: 04/01/2009 NSD

Nixa Public Schools, Nixa, Missouri

Kevin Allen

Notarized form sent with mailed hard copy

Page 13 of 17 E-Verify MOU for Employers | Revision Date 06/01/13

Company ID Number:

Approved by:

Employer

Name (Please Type or Print) Title

Signature Date

Department of Homeland Security – Verification Division

Name (Please Type or Print) Title

Signature Date

671566

LobbyGuard Solutions LLC

Patricia Nicholson

Electronically Signed 05/14/2013

USCIS Verification Division

Electronically Signed 05/14/2013

Page 14 of 17 E-Verify MOU for Employers | Revision Date 06/01/13

Company ID Number:

Information Required for the E-Verify Program

Information relating to your Company:

Company Name

Company Facility Address

Company Alternate Address

County or Parish

Employer Identification Number

North American Industry Classification Systems Code

Parent Company

Number of Employees

Number of Sites Verified for

671566

LobbyGuard Solutions LLC

4700 Six Forks RoadSte 300Raleigh, NC 27609

WAKE

202442335

541

LobbyGuard Solutions LLC

10 to 19

1

16

[Type here] [Type here] [Type here]

Updated 06/29/2010

VENDOR VERIFICATION FORM

Nixa Public Schools 301 S. Main St. Nixa, MO 65714

Phone 417-875-5400 Fax 417-449-3190

Must complete and mail to address above in order to be added to approved vendor list.

Legal Name of Company (as recorded with the IRS)

Owners/Partners of Company

Physical Address City / State Zip Code

Mailing Address City / State Zip Code

Business Phone ______________ ____________ Fax

Years in Business ________ Incorporated: Yes __ No ______

Type of Merchandise/Service Business Provides

Are you or a family member employed by Nixa Public Schools? Yes No

If yes, name of employee ____ Relationship: ____________________

Will Accept Purchase Orders ______ Yes No

Will Accept MasterCard ______ Yes No

Per IRS regulations, the District must have a W-9 on file for every vendor. YOU WILL NOT BE ADDED TO THE NIXA

PUBLIC SCHOOLS APPROVED VENDOR LIST WITHOUT W-9 INFORMATION. A copy of the Form W-9 is available on

the IRS website at http://www.irs.gov/pub/irs-pdf/fw9.pdf?portlet=3

Tax Identification Number

_____ Social Security Number OR

_____ Employer Tax Identification Number

To Be Completed by Nixa Public Schools Business Office

Date Received Approved Not Approved

Verification Completed By Date

LobbyGuard Solutions, LLC

4700 Six Forks Rd Suite 300 Raleigh, NC 27609

4700 Six Forks Rd Suite 300 Raleigh, NC 27609

919-785-3301

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Visitor Management Solutions

X

X

X

X

2 0 2 4 4 2 3 3 5

N/A