STATE OF NEW JERSEY

BIDDER DATA SHEET

THIS FORM WILL BE USED IN ASSESSING A BIDDER’S QUALIFICATIONS AND CAPABILITY TO PERFORM THE

CONTRACT SCOPE OF WORK.

CUSTOMER SERVICE CONTACT DATA

NAME OF BIDDER’S REPRESENTATIVE TO BE CONTACTED IF INFORMATION, SERVICE, OR PROBLEM-SOLVING IS REQUIRED BY THE USERS OF THE CONTRACT. THIS SERVICE SHALL BE AVAILABLE AT NO ADDITIONAL CHARGE.

Name of Bidding Entity: Telephone Number:

Name of Representative: Fax Number:

Address: Number of Years Conducting Business:

City: State: Zip:

REFERENCE - SATISFACTORY CUSTOMER SERVICE

COMPLETE REFERENCE INFORMATION FOR TABLES 1 and 2. NOTE: FOR EACH REFERENCE LISTED, ALL FIELDS

SHOULD BE COMPLETED. IF NO REFERENCES, INDICATE “NONE” IN THE APPROPRIATE TABLE.

1. LIST CONTRACT AWARDS TO YOUR COMPANY BY THE STATE OF NEW JERSEY WITHIN THE LAST THREE (3) YEARS

AND PROVIDE THE INFORMATION REQUESTED FOR EACH COLUMN.

CONTRACT/PROJECT NAME CONTRACT

NUMBER AGENCY NAME AGENCY CONTACT

REPRESENTATIVE

TELEPHONE

NUMBER

2. LIST OTHER CONTRACTS OF SIMILAR SIZE AND SCOPE PERFORMED WITHIN THE LAST THREE (3) YEARS AND

PROVIDE THE INFORMATION REQUESTED FOR EACH COLUMN.

CONTRACT/ PROJECT NAME CONTRACT

DURATION CLIENT NAME CLIENT CONTACT

REPRESENTATIVE

TELEPHONE

NUMBER

TERMINATED CONTRACTS

PROVIDE A LIST OF CONTRACTS TERMINATED FOR CAUSE PRIOR TO THEIR NATURAL EXPIRATION DATE DURING THE LAST THREE (3) YEARS AND PROVIDE THE INFORMATION REQUESTED IN EACH COLUMN. NOTE: IF NO CONTRACTS

WERE TERMINATED FOR CAUSE DURING THE LAST THREE YEARS, ENTER “NONE”.

CLIENT NAME CONTACT NAME TELEPHONE

NUMBER REASON FOR TERMINATION