11-STATEMENT OF BIDDER Qualificationdocx.pdf

STATEMENT OF BIDDER’S QUALIFICATIONS

All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, add separate sheets for items marked with an asterisk(*).

1. Name of Bidder: ______________________________________________________

2. Permanent main office address: _________________________________________

3. Year Organized: __________ 4. State where incorporated: __________________

5. How many years have you been engaged in the contracting business under your present firm name?___________

6. *Contracts on hand: (Schedule these, showing gross amount of each contract and the approximate anticipated dates of completion.)

Contract

Gross Amount

Anticipated Date of Completion

7. *General character of work performed by your company. Explain._____________________

8. Have you ever failed to complete any work awarded to you? ___ Yes ___ No If yes, explain where and why._________________________________________________

9. *Have you ever defaulted on a contract? ____ Yes ____ No If yes, explain____________________________________________________________

10. *If applicable to this bid, list the more important structures recently erected by your company, approximate cost for each, and the month and year completed.

Structure

Cost

MM/YY

Completed

11. *List your major equipment available for this contract ____________________________

12. *If applicable to this bid, experience in construction work similar in importance to this project._____________________________________________________________________

13. *Background and experience of the principal members of your personnel, including the officers. Furnish resume(s) if available.

14. *Credit available; furnish written evidence.

15. *Financial statement no more than sixty (60) days old and containing not less than that required in the following form.

FORM OF STATEMENT OF BIDDER’S QUALIFICAITONS

(Name of Firm)

BALANCE SHEET

AS OF ________________________

CURRENT ASSETS

Cash $__________________ Joint Venture Accounts $__________________ Accounts Receivable $__________________ Notes Receivable $__________________ Accrued Interest on Notes $__________________ Deposits $__________________ Materials & Prepaid Expense $_________________

Total Current Assets $_________________

FIXED ASSETS - NET $_________________

OTHER ASSETS $_________________

TOTAL ASSETS $______________

LIABILITIES AND CAPITAL

CURRENT LIABILITIES

Account Payable $__________________ Notes Payable $__________________ Accrued Interest on Notes $__________________ Provision for Income Taxes $__________________ Advances Received from Owners $__________________ Accrued Salaries $__________________ Accrued Payroll Taxes $__________________ Other $__________________ Total Current Liabilities $__________________

OTHER LIBILITIES $__________________

CAPITAL

Capital Stock $__________________ Authorized & Outstanding Shares Par Value $__________________ Earned Surplus $__________________

TOTAL LIABILITIES AND CAPITAL $_____________

16. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the Authority? _____Yes ____No

17. The undersigned hereby authorized and requests any person, firm, or corporation to furnish any information requested by the Authority in verification of the recitals comprising this State of Bidder’s Qualifications.

Date at __________________________________this______day of ___________20_____.

(Name of Bidder

BY___________________________

TITLE__________________________

STATE OF ________________________)

COUNTY OF _________________________)

___________________________________________Being duly sworn deposes and says that he is _____________________________________ of _________________________

_________________________________________and that the answers to the foregoing (Name of Organization) Questions and all statements therein contained are true correct.

Sworn to before me this _______________________day of _____________, 20___

(Notary Public)

My Commission Expires: _________________________________________

Bidder may submit additional information if desired.

In order to be considered for award of contract, bidders must complete all sections of this Statement of Qualifications with the bid submittal, including the Financial Statement.

However, bidders may elect to enclose a Financial Statement in a sealed envelope marked Financial Statement with their bid. The Housing Authority shall open this sealed envelope only if the bid submitted is the lowest responsible bid. Otherwise, the Housing Authority shall return the sealed envelope to the respective bidder.