2-05 - Business Questionnaire.pdf
PDF 13 KB Posted
- Solicitation number
- RFP 25-18978-TF
- Issued by
- Henderson County, Texas
About this file
This document is a Business Questionnaire from the City of Lubbock, Texas Purchasing and Contract Management department, designed to be completed by potential contractors and subcontractors. The form requires businesses to provide detailed information about their operational history, corporate status, and past performance, including whether they have been involved in contract defaults, litigation, debarment, or other potentially disqualifying circumstances.
The questionnaire seeks comprehensive background information to assess a business's reliability and eligibility for municipal contracting opportunities. Key areas of inquiry include the business type (individual, corporation, partnership, or joint venture), years in operation, potential subsidiary status, past contract completion history, pending litigation, previous declarations of non-responsibility, debarment history, and any outstanding contractual or financial obligations. Businesses must answer a series of yes/no questions that probe their professional track record and potential risk factors, with space provided for the owner's signature and details to validate the information provided.
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Text version
City of Lubbock, TX
Purchasing and Contract Management
Business Questionnaire
This questionnaire must be submitted for all potential Contractors and subcontractors listed on the
Schedule of Participation.
1. Name of Proposed Contractor ("Business", herein):
Doing Business As:
(other business name, if applicable)
2. Business Mailing Address:
Street Address
City State Zip Code
3. Business Telephone Number: ( ) Fax Number: ( )
4. Business Type: Individual Corporation Partnership Joint Venture
5. Number of Years in Business:
13. Please provide a brief description of your materials and/or services:
14. Is the Business a subsidiary of another entity? Yes No
15. Has the Business, or any officer or partner thereof, failed to complete a contract? Yes No
16. Is any litigation pending against the Business? Yes No
17. Has the Business ever been declared "not responsible"? Yes No
18. Has the Business been debarred, suspended, proposed for debarment, declared ineligible, voluntarily excluded or otherwise disqualified from bidding, proposing or contracting? Yes No
19. Has the Business been a defaulter, as principal, surety or otherwise? Yes No
20. Has the government or other public entity requested or required enforcement of any of its rights under a surety agreement on the basis of a default or in lieu of declaring the Business in default?
Yes No
21. Is the Business in arrears upon a contract or debt? Yes No
22. Are there any proceedings pending relating to the Business' responsibility, debarment, suspension, voluntary exclusion or qualification to receive a public contract? Yes No
23. Have liquidated damages or penalty provisions been assessed against the Business for failure to complete the work on time or for any other reason? Yes No
Printed Name: Title
Signature of Owner: Date:
File details come from the government source that posted it. Updated .