1-RFP-03-Authorized Signature and Questionnaire.pdf
PDF 139 KB Posted
- Attached to
- RFP Acoustic Leak Survey
- Solicitation number
- 26-0023
- Issued by
- Tarrant County, Texas
About this file
This is an Authorized Signature and Questionnaire form issued by the City of Fort Worth Purchasing Division for RFP Ref. #26-0023 regarding Acoustic Leak Detection services for the Water Department. The City of Fort Worth seeks qualified vendors to provide acoustic leak survey detection services on an as-needed basis. Prospective bidders must complete and submit the questionnaire along with their proposal, providing detailed responses to 17 questions addressing company qualifications, experience, staffing, equipment resources, service capabilities, and past contract performance with other municipalities. Vendors must indicate their availability for same-day service response, describe their processes for leak detection and reporting, and confirm whether subcontractors meet experience requirements of 2-5 years in acoustic leak survey services.
The form requires bidders to provide standard business information including legal name, Federal ID number, authorized representative details, and contact information for up to three company representatives. Bidders must disclose any ongoing litigation, criminal investigations, or involvement adverse to the City and answer questions regarding cooperative purchasing participation and prompt payment discount terms. Vendors must identify any proprietary information in their proposals and confirm whether they made any modifications to the vendor service agreements included in the RFP documentation. The questionnaire serves as a responsiveness assessment tool to evaluate bidders' qualifications, capacity, and suitability for delivering acoustic leak detection services to the City of Fort Worth's Water Department.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 3-RFP-07-Reference Sheet.pdf | ||
| 7-RFP-05-Draft Vendor Service Agreement.pdf | ||
| 6-RFP-04-Forms.pdf | ||
| 4-RFP-01-Instruction to Proposers.pdf | ||
| 5-RFP-06-Deviations.xlsx | XLSX spreadsheet | |
| 2-RFP-02-Scope of Services.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION
AUTHORIZED SIGNATURE AND QUESTIONNAIRE
RFP Ref. #: 26-0023 Doc. Ref#: RFP-03 Page 1 of 5 RFP Title: Acoustic Leak Detection
City of Fort Worth Bidder/Supplier ID:____________________________________ Legal Name of Proposer:
D/B/A Name of Proposer:
Federal Id Number (TIN):______________________________________________ Address:
Name of the Authorized Representative: __________________________________ Title: _____________________________________________________________ The undersigned, by his/her signature, represents that he/she is submitting a binding Proposal and is authorized to bind the respondent to fully comply with the solicitation document contained herein. The Respondent, by submitting and signing below, acknowledges that he/she has received and read the entire document packet for this RFP and agrees to be bound by the terms therein.
The undersigned agrees if the Proposal is accepted, to furnish any and all items and/or services upon which prices are offered, at the price(s) and upon the terms, conditions, and scope/specifications contained in this RFP.
Signature of the Authorized Representative: _____________________________ Email: Phone:
Name of Contact Person - 1:
Title of Contact Person - 1:
Email: Phone:
Name of Contact Person - 2:
Title of Contact Person - 2:
Email: Phone:
Name of Contact Person - 3:
Title of Contact Person - 3:
Email: Phone:
RFP Ref. #: 26-0023 Doc. Ref#: RFP-03 Page 2 of 5
Please answer each question below thoroughly. Responses to the questions will be used to assess the Proposal’s responsiveness. Bidders may use a separate sheet if needed, as long as each answer is labeled with the corresponding question number.
1.0 Length of time in business: _______________________________________
2.0 Is your business or any of its principals currently involved in litigation adverse to the City? Yes_______ No________
3.0 Is your business or any of its principals under criminal investigation?
Yes_______ No________ Have you answered Yes to either Question 1 or 2 above? Please provide the details outlining the situation on a separate document with the submission of this form.
4.0 Cooperative Purchasing - Should other governmental entities decide to participate in this contract, would you, the Vendor, agree that all terms, conditions, specifications, and pricing would apply?
Yes_______ No________
5.0 Prompt Payment Discount Terms: ____ Percent _______ Days (i.e. 3% Net 15, etc.)
6.0 Proprietary Information - If a Bidder believes certain information in their proposal is proprietary and wishes to prevent its disclosure, they must clearly identify those pages and information in the chart below, for more information see RFP-01, Section 15.4.
Pages with information believed to be Proprietary
Please indicate if only specific sections on the page are believed to be Proprietary
7.0 Is your company able to respond to City locations on the same day service is called for?
RFP Ref. #: 26-0023 Doc. Ref#: RFP-03 Page 3 of 5
8.0 How many field service technicians are on your staff as full-time employees and part-time employees?
Full-Time ________________________ Part-Time________________________
9.0 How many years has your company been providing acoustic leak surveys?
10.0 Please provide the availability of resources to provide leak survey services and years of experience with each piece of equipment (equipment and personnel).
11.0 Please provide the contractor’s qualifications and experience with performing leak detection services.
12.0 Please provide the company’s approach to perform the services needed as described in the specifications.
RFP Ref. #: 26-0023 Doc. Ref#: RFP-03 Page 4 of 5
13.0 Please list all cities, counties, or other municipalities your company has or currently holds a contract with as it relates to this solicitation’s scope of service.
14.0 Describe your processes for reporting mapping discrepancies and high volume leaks?
15.0 What's your process for correlating and pinpointing leaks?
RFP Ref. #: 26-0023 Doc. Ref#: RFP-03 Page 5 of 5
16.0 If your company subcontracts services, do they have 2-5 years of experience?
If your company does not provide acoustic leak survey, write N/A.
17.0 Did you make any changes to RFP-03-Drafts Vendor Service Agreements?
File details come from the government source that posted it. Updated .