03_Statement of Qualifications Form _ GW_GA.pdf

This is a Statement of Qualifications Form for Grant Writing and Administration services, likely for Community Development Block Grant (CDBG) projects administered by a state or local government entity in Georgia. The form requests that interested firms provide comprehensive information about their qualifications and experience to perform grant writing and grant administration services. Prospective contractors must demonstrate their capability through documentation of their business history, years in operation, organizational structure including officer names and addresses, and up to five relevant projects that showcase their expertise in CDBG work. The form also requires identification of key personnel who would be involved in the projects, including their qualifications and specific roles in CDBG-related activities, along with three professional references with contact information.

Pricing information must be submitted in two components: a fee for writing the grant application and a proposed fee structure for grant administration services, which may be expressed as percentages but will ultimately be converted to lump sum amounts in any resulting agreement. The form includes questions regarding Section 3 Business Concern status, which requires submission of additional certification documentation, a previous certification, and an action plan if the firm is claiming Section 3 preference. All responses must be certified under oath by an authorized officer of the firm, with answers attested to be true and correct. The form does not specify application due dates, contract award dates, or contract terms within the document itself.