1-02 Bidder Information Form.pdf
PDF 125 KB Posted
- Attached to
- Traffic Signal Equipment & Supplies
- Solicitation number
- Bid #28-01-26
- Issued by
- Bell County, Texas
About this file
This document is a Bidder Information Form for Bid #28-01-26 for Traffic Signal Equipment & Supplies issued by the City of Temple. The form requires potential bidders to provide comprehensive company information, acknowledge any addenda, authorize a credit check, list authorized personnel, confirm agreement compliance, provide customer references, and declare any exceptions to the bid terms. The form is part of a procurement process for traffic signal-related equipment and supplies.
The form requires bidders to provide detailed contact information, tax identification numbers, and authorization for the City to conduct a credit investigation. Bidders must confirm their ability to comply with the General Purchase Agreement and, if they have not previously provided similar products/services to the City within the last three years, must supply three customer references. The form includes sections for potential bidders to note any exceptions to the bid terms and provides space for an authorized company representative's signature, printed name, title, and date of submission.
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Text version
Bid #28-01-26 Traffic Signal Equipment & Supplies 14
FORM 5.1. - BIDDER INFORMATION FORM
1. Company Information
Company Name: ________________________________________________________
Business Address: ______________________________________________________
Remit-to Address, if different: ______________________________________________
Tax Identification Number: _________________________________________________
Contact Person: ________________________________________________________
Phone: _______________________________________________________________
Email: ________________________________________________________________
2. Addenda
Our company has reviewed and formally acknowledges receipt of all addenda, if any, provided in the Bonfire e-procurement portal. Please record the number of addenda acknowledged here:
____________ (number of addenda acknowledged)
3. Credit Check Authorization The City is required to determine whether a bidder who may be awarded a contract is financially responsible. The City may run a credit check on the potential contractor before award of the contract. By signing this Bidder Information Form, I hereby authorize the City of Temple, credit bureau, or other investigative agency employed by the City of Temple to investigate my credit history and financial responsibility.
4. Authorized Personnel State your firms’ personnel authorized to give representations regarding your bid or resulting contract, if any:
Name Phone Number Email Address
Bid #28-01-26 Traffic Signal Equipment & Supplies 15
5. Agreement
The successful bidder shall be able to comply with General Purchase Agreement as specified in herein. Please confirm your ability to comply.
____________ (initial to confirm)
6. References If your company has not provided like-kind products/services to the City in the last three
(3) years, please provide three (3) customer references:
Entity Name Contact Person Phone # Email
7. Exceptions Taken by Bidder State exceptions taken to any terms of this bid, if any.
8. Authorization Authorized Signature: ____________________________________________________
Print Name: ____________________________________________________________
Title: ___________________________________ Date: _______________________
| b. Termination for Cause or Convenience for Contracts Exceeding $10,000 |
| c. Equal Employment Opportunity |
| Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause provided under 41 CFR 60-1.4(b), in a... |
| d. Davis-Bacon Act as amended (40 U.S.C. 3141-3148) |
| When required by Federal program legislation, all prime construction contracts in excess of $2,000, Vendor shall comply with the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “L... |
| The City must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. Vendor agrees that for any purchase to which this requirement applies, the award is conditioned upon Vendor’s acceptance of... |
| subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non-Federal entity must ... |
| e. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708) |
| Where applicable, all contracts awarded by the City in excess of $100,000 that involve the employment of mechanics or laborers, Vendor agrees to comply with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). U... |
| f. Rights to Inventions Made Under a Contract or Agreement |
| If the Federal award meets the definition of “funding agreement” under 37 CFR §401.2 (a) and the recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assi... |
| g. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended. |
| Where applicable, all contracts awarded by the City in excess of $150,000, Vendor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control... |
| h. Debarment and Suspension (Executive Orders 12549 and 12689) |
| A contract award (see 2 CFR 180.220) must not be made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 19... |
| i. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352) |
| Vendors that apply or bid for an award exceeding $100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or att... |
| Vendor agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that vendor certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above. |
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