3-05 - Business Questionnaire.pdf
PDF 13 KB Posted
- Solicitation number
- RFP 25-19083-YB
- Issued by
- Hunt 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 detailed information about a business's background, operational history, and past performance, including whether the business has ever failed to complete a contract, been involved in litigation, been declared "not responsible", or faced debarment from public contracting.
The questionnaire seeks comprehensive disclosure about a business's financial and operational integrity, with specific yes/no questions covering topics such as subsidiary status, contract defaults, pending legal proceedings, arrears on contracts or debts, and any instances of liquidated damages being assessed against the business. The form is structured to provide city officials with a thorough assessment of a potential contractor's reliability, financial stability, and past performance before entering into a public contract, serving as a critical due diligence tool in the municipal procurement process.
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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 .