2706 Camden HVAC Pumps STATEMENT OF BIDDER QU.docx

STATEMENT OF BIDDER'S QUALIFICATIONS:

(To be subscribed and sworn to before a notary public.)

The bidder submits the following statement of bidder’s qualifications for consideration by the Owner.

Bidder’s Address: __________________________________________________________

LEGAL BUSINESS ADDRESS (NO P.O. BOX, MUST BE PHYSICAL ADDRESS)

CITY STATE ZIP

MAILING ADDRESS IF DIFFERENT FROM ABOVE

Telephone Number: ___________ ______________________ POC Email: ______________________

AREA CODE NUMBER

The full names of persons and firms interested in the foregoing bid as principals are as follows:

(1)____________________________________________________________________ Circle One: President Partner Owner Other

(2)____________________________________________________________________ Circle One: Vice President Secretary Partner Other

(3)____________________________________________________________________ Circle One: Vice President Secretary Partner Other

Note: If incorporated: The names of both the President and Corporate Secretary must be indicated. If a partnership, all partners must be indicated.

Social Security Number or FEIN: _____________________________________

Contractor’s Georgia License Type and Number:

Contractor’s Federal Employment Verification Certification: (Must include completed Contractor Affidavit as found in Section 7 of the Contract)

The Contractor is registered with, authorized to use, is using and will continue to use, the federal work authorization program throughout the term of the contract, and holds the following authorization:

User Identification Number:

Date of Authorization:

State Where Organized or Incorporated: ______________________________

Plan of Organization: (Circle One) Proprietorship Corporation Partnership Joint Venture Other (Describe)

Years Engaged in Construction Contracting in Present Firm Organization: ____________ years.

Bidder Hereby Certifies that bidder:

a. Has never refused to sign a contract at the original bid on a public works contract except as allowed under Georgia law.

b. Has never been terminated for cause on a public works contract.

c. Has had no (criminal or felony) convictions, suspensions, or debarments of the bidder, its officers, or its principals for building code violations, bid rigging, or bribery in the last ten years.

d. Is not and its organization or its principals are not debarred, suspended, declared ineligible, or otherwise excluded by any Federal or State department or agency from doing business with the Federal Government or a State.

e. Has insurance required by the Contract Documents in place or has arranged to obtain it from an insurer authorized to do business in the State of Georgia.

f. Has sufficient bonding capacity to obtain a payment and performance bond from a surety meeting the requirements of the Contract Documents and authorized to do business in the State of Georgia.

g. Has sufficient cash flow to perform this Project.

Remarks or explanations of the above paragraphs a through g:

Bidder Certification Certification under Oath. Under oath I certify that I am a principal or other representative of the bidder, and that I am authorized by it to execute the foregoing Statement of Bidder’s Qualifications is true and correct, including any explanation above and submitted under oath.

BY: __________________________________________

Authorized Signature (BLUE INK PLEASE)

Printed Name Title

Sworn to and subscribed before me this Day of , 20 .

Notary Public

My commission expires: ______________

(SEAL)

NOTE: THE NOTARY SEAL MUST BE APPLIED UNDER GEORGIA LAW, WHETHER OR NOT THE LAW OF THE STATE WHERE EXECUTED PERMITS OTHERWISE.

Statistical Information. This request is made for statistical purposes only.

PLEASE INDICATE BELOW WHICH OF THE FOLLOWING DESCRIPTIONS APPLY TO YOUR COMPANY:

____ MINORITY BUSINESS ENTERPRISE (MBE) – One of the following statements describes this business: a) Owned by a member of a minority race; or b) a partnership of which a majority of interest is owned by one or more members of a minority race; or c) a public corporation of which a majority of the common stock is owned by one or more members of a minority race. A member of a minority race is defined as a person who is a member of a race that comprises less than fifty percent of the total population of the State of Georgia. For recordkeeping purposes, this includes, but is not limited to, persons who are Black, Hispanic, Asian-Pacific American, Native American, or Asian-Indian American.

____ GEORGIA MINORITY BUSINESS ENTERPRISE (GMBE) – Business meets the definition of a minority-owned business and, in addition, meets the following criteria: a) was organized in the State of Georgia; or b) reports income from the business for Georgia Income Tax purposes; or c) minority stockholders report earnings for Georgia Minority Business Enterprise.

____ NEITHER DESCRIPTION APPLIES TO YOUR COMPANY.

BID REQUIREMENTS

BID SECURITY FORM

NOTE TO CONTRACTOR: Use of Surety’s standard Bid Bond form is acceptable as long as it substantially complies with the following:

KNOW ALL BY THESE PRESENT, That we, {Insert Contractor’s Legal Name and Address} as Principal, hereinafter called the Principal, and {Insert Legal Name and Address of Surety}, a corporation duly organized under the laws of the State of {Insert State of Corporate Organization}, as Surety, hereinafter called the Surety, are held and firmly bound unto:

OWNER:

Attention:

Phone Number:

Facsimile Number:

as Obligee, hereinafter called the Obligee in the sum of ______________________________________________ (Not less than five percent of the Bid) Dollars ($ _______________________ ), for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, the Principal has submitted a Bid for CCGA-2610 Student Activity Center Fascia_and Soffit Replacement_;

NOW, THEREFORE, if the Obligee shall accept the Bid of the Principal and (1) the Principal shall enter into a Contract with the Obligee in accordance with the terms of such Bid, and the Principal shall execute the Contract and give such bond or bonds as may be specified in the Bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof; or (2) in the event of the failure of the Principal to enter such Contract and give such bond or bonds, and the Principal shall pay to the Obligee the difference not to exceed the difference hereof between the amount specified in said Bid and such larger amount for which the Obligee may in good faith contract with another party to perform the Work covered by said Bid; then this obligation shall be null and void, otherwise to remain in full force and effect.

Signed and sealed this _______ Day of _______________, 20___

Title

Name of Surety:

(*) Attach Power of Attorney image1.png