15-15 REQUIRED Responsible Vendor Review Form.docx
DOCX document 45 KB Posted
- Attached to
- Pump Station 92 Replacement
- Solicitation number
- IFB-044-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Responsible Vendor Review Form required by the City of Tallahassee for the Pump Station 92 Replacement project in Florida. The form establishes vendor eligibility criteria and must be completed by all bidders responding to the solicitation. The project involves construction of a new quadruplex submersible pump station to replace the existing Pump Station 92 located at 6636 Buck Lake Rd. Construction scope includes deep foundations with micropiles, stormwater retention area, gravity and force main sanitary sewer piping, electrical and water service, generator installation, motor control equipment, shade structures, and demolition of the existing station. The project also encompasses associated work such as sheeting and shoring, dewatering, erosion control, and as-built documentation. A mandatory pre-bid meeting is scheduled for March 16, 2026 at 2:00 PM EST via Microsoft Teams.
Vendors must certify their responsibility and capability to perform all contract requirements through accurate completion of the form. The review evaluates vendor integrity and reliability based on information provided in the form, solicitation response, and independent research including System for Award Management (SAM) records. Vendors must disclose any adverse history within the past ten years in Florida or other jurisdictions, including permit/license actions, government contract suspensions or debarments, contract terminations for cause, criminal convictions related to contracting, and civil fraud judgments. Vendors must also confirm possession of necessary organization, experience, accounting controls, and technical skills to meet contract obligations. Additionally, vendors should indicate whether they hold active State Term Contracts or GSA contracts similar to the project scope. Vendors must notify the Procurement Officer immediately if any submitted information becomes erroneous prior to contract execution.
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Text version
A contract can only be awarded to a “responsible vendor”. A responsible vendor has the capability in all respects to fully perform the contract requirements and the integrity and reliability that will assure good faith performance.
To assist in making this determination, Vendors responding to this Solicitation are required to fully and accurately answer each of the questions below. For each “Yes” answer to questions 1.1 through 1.8, Vendor must provide a detailed explanation and attach copies of any relevant document cited in the explanation. Answering “Yes” to questions 1.1 through 1.8 will not necessarily disqualify a Vendor from participating in this Solicitation. However, failure to provide additional information as requested by the City of Tallahassee may disqualify a Vendor.
The City of Tallahassee (COT) will base its determination of a Vendor’s responsibility on: (a) information provided by Vendor in response to this form; (b) information provided elsewhere in a Vendor’s response to the Solicitation (including financial information) and (c) information obtained from independent research (including information COT obtains from the internet or third parties, including System for Award Management (SAM)).
Vendors shall provide immediate written notice to COT if any time prior to contract execution, a Vendor learns that the information provided in connection with this form was erroneous when submitted or has become erroneous for reason of changed circumstances. Vendor must contact the Procurement Officer with any questions regarding this form.
1.0 Within the last ten (10) years, in the State of Florida or any State or Federal jurisdiction has the Vendor or any of its officers, directors or owner:
| 1.1 |
| Been, subject to a revocation, suspension, disbarment, administrative complaint, sanction, fine, adverse action, or disciplinary action relating to any business or professional permit, certification, and/or license? |
| · Yes |
· No
| 1.2 |
| Been suspended, debarred, or disqualified from any government contracting process or agreed to voluntary exclusion from any government procurement process? |
| · Yes |
· No
| 1.3 |
| Been subject to formal monitoring agreement or corrective action plan as part of a contract with a government entity? |
| · Yes |
· No
| 1.4 |
| Been subject to an indictment, administrative proceeding, civil action or judgment in connection with any government contract? |
| · Yes |
· No
| 1.5 |
| Had a government contract terminated for cause? |
| · Yes |
· No
Responsible Vendor Review Form
| 1.6 |
| Been convicted of a crime related to governmental or nongovernmental contracting? |
| · Yes |
· No
| 1.7 |
| Been subject to governmental investigation relating to alleged violation of any statutory regulatory violation? |
| · Yes |
· No
| 1.8 |
| Had a judgement entered in a civil lawsuit based on an allegation of fraud? |
| · Yes |
· No
| 2.0 |
| Does the vendor have the necessary organization, experience, accounting and operational controls, and professional and technical skills to meet its obligations under the proposed contract with COT, taking into consideration all existing commercial and governmental business commitments? |
| · Yes |
· No
| 3.0 |
| General Information |
Do you have an active State Term Contract (STC) or General Administrative Services (GSA) Contract similar to the scope of services for this solicitation. If yes, provide an attachment with links to the contract(s)
· STC
· GSA
· Not Applicable
By my signature below, I certify that I am an authorized representative of the Vendor named below and that all of the information provided above is true and complete to the best of my knowledge.
Name and Title Vendor Name
Signature Date
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