2025 Annual Utilities - Bidder Special Questionnaire rev.pdf

OCAT 00030-1 Annual Utility Repairs and Maintenance 03.18.2025

OCAT GEN 2529

BIDDER SPECIAL QUESTIONNAIRE

This special questionnaire is intended to provide the prequalification for the natural gas piping work included in this contract and to provide additional information on the bidder’s qualifications. Submission of this questionnaire does not constitute prequalification.

THIS QUESTIONNAIRE IS REQUIRED FOR SUBMISSION WITH THE BID ON THE DATE IDENTIFIED IN THE CONTRACT DOCUMENTS. IF THE SPECIAL QUESTIONNAIRE IS NOT RECEIVED, THE CITY

CLERK MAY REJECT THE BIDDER'S BID.

Please complete the information below.

1. BIDDER INFORMATION

BIDDER (Show Complete Legal Name)

STREET ADDRESS

MAILING ADDRESS

CITY STATE ZIP PHONE #

CONTACT PERSON E-MAIL FAX #

CONTRACTOR I.D. NO./ FEDERAL TAX I.D. NO.

APPLICATION SUBMITTED BY TITLE

HOW MANY YEARS HAS YOUR ORGANIZATION BEEN IN BUSINESS UNDER YOUR PRESENT

BUSINESS NAME? YEARS

HAS ANY OFFICER OR PARTNER OF YOUR ORGANIZATION EVER BEEN AN OFFICER OR

PARTNER OF THIS OR ANOTHER ORGANIZATION THAT FAILED TO COMPLETE A CONSTRUCTION

CONTRACT? YES NO IF YES, STATE NAME OF INDIVIDUAL, OTHER ORGANIZATION

AND REASON THEREFOR:

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LIST ANY LITIGATION WITH THE OWNERS OF PROJECTS IN THE PAST FIVE YEARS:

HAVE YOU EVER FAILED TO QUALIFY OR PREQUALIFY AS A BIDDER? YES NO IF YES,

WHEN, WHERE AND WHY?

Under what other or former names has the bidder operated?

1.

2.

3.

If the bidder is a corporation, provide the following information.

1. Date of incorporation

2. State of incorporation

3. President's name

4. Vice presidents name

5. Secretary's name

6. Treasurer's name

7. Do you have a certificate of good standing issued by the Oklahoma Corporation Commission?

YES NO Certificate #

If the bidder is a partnership, provide the following information.

1. Date of organization

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2. Type of partnership

3. General partner(s) names

If the bidder is individually owned, provide the following information.

1. Date of organization

2. Owner's name

If the bidder is a joint venture, provide the following information.

1. Primary bidder

2. Secondary bidder

3. Date of organization

2. Emergency Response, Technical Requirements, and Past Projects

Are you able to comply with the emergency call-out requirements of this contract? Reference Section OCAT 00641 Paragraph 5.

YES NO

Are you prequalified in accordance with the requirements of the City of Oklahoma City as a Water Pipeline Contractor “C” or higher?

YES NO

Section 02510 “Exterior Cold Water Piping” requires the Contractor or subcontractor to have a minimum of 2 years of successful installation experience on exterior cold water piping projects. Please list the names of the principal agents and employees that will be dedicated to this project with a detailed description of where and how their experience was obtained. Failure to demonstrate the required experience will result in disqualification of the bidder.

Section 02515 “Exterior Fire Protection” requires the Contractor or subcontractor to have a minimum of 2 years of successful installation experience on exterior fire protection piping projects. Please list the names of the principal agents and employees that will be dedicated to this project with a detailed description of where and how their experience was obtained. Failure to demonstrate the required experience will result in disqualification of the bidder.

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Are you prequalified in accordance with the requirements of the City of Oklahoma City as a Stormwater Contractor “C” or higher?

YES NO

Are you prequalified in accordance with the requirements of the City of Oklahoma City as a Wastewater Pipeline Contractor “C” or higher?

YES NO

Section 02530 “Storm and Sanitary Sewer Systems” requires the Contractor or subcontractor to have a minimum of 2 years of successful installation experience on storm and sanitary sewer projects. Please list the names of the principal agents and employees that will be dedicated to this project with a detailed description of where and how their experience was obtained. Failure to demonstrate the required experience will result in disqualification of the bidder.

Section 15195 “Facility Natural-Gas Piping” requires the Contractor or subcontractor to have a minimum of 2 years of successful installation or maintenance experience on natural gas distribution piping systems exceeding 10 psi. Please list the names of the principal agents and employees that will be dedicated to this project with a detailed description of where and how their experience was obtained. Failure to demonstrate the required experience will result in disqualification of the bidder.

Do you or your subcontractor employ Journeyman Plumbers that meet all requirements of 49 CFR 192 “Transportation of Natural and Other Gas by Pipeline”, including valve maintenance and polyfusion of PE piping?

YES NO

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3. Subcontractors

Do you plan to utilize a subcontractor to perform any portion of this contract?

YES NO

If so, who?

What work will they perform?

Proposed subcontractors, if any, shall also submit Sections 1 and 2 of this Questionnaire along with the Contractor with the bid.

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The bidder hereby agrees that all the information submitted above is true and correct.

This Bid will not be considered unless this form has been fully completed and signed by the Bidder, and notarized, dated and completed by the Notary Public.

Name of Individual, Partnership, Limited Liability Company, or Corporation herein called Bidder

Signature of Bidder or Authorized Agent

Type or print name and title of person who signed above

STATE OF )

) ss.

COUNTY OF )

This instrument was subscribed, acknowledged and sworn to before me this day of , 20 , by (type or print the name of person signing above) as the above named BIDDER, or

Bidder's Authorized Agent.

My Commission expires:

Notary Public

THIS FORM IS REQUIRED TO BE SUBMITTED WITH THE BIDDER’S BID.