3-RFP-03-Authorized Signature and Questionnaire.docx
DOCX document 42 KB Posted
- Attached to
- RFP Safety Footwear
- Solicitation number
- 26-0140
- Issued by
- Tarrant County, Texas
About this file
This is an Authorized Signature and Questionnaire form for the City of Fort Worth's Request for Proposal (RFP) 26-0140 for Safety Footwear procurement. The document serves as the official submission form requiring authorized representatives to certify their binding proposal and acknowledge receipt of all RFP documentation. Bidders must provide detailed company information including legal name, Federal ID number, address, and authorized representative contact details. The form requires vendors to confirm their ability to meet specific service requirements, including providing mobile units or mobile shoe services with trained personnel to size individuals at all city locations, conducting initial fitting and measuring sessions for accurate footwear sizing, meeting specified delivery and response times, maintaining a full-time permanent business address within 25 miles of City Hall, and remaining accessible via email and telephone.
The questionnaire section assesses bidder qualifications and proposal responsiveness through nine substantive questions addressing business tenure, litigation or criminal investigation involvement, willingness to extend terms to other governmental entities through cooperative purchasing, prompt payment discount terms, proprietary information identification, and service delivery capabilities. Bidders must thoroughly answer each question, with the option to provide supplemental documentation on separate sheets as needed. The form requires disclosure of any proprietary information for confidentiality protection and establishes baseline requirements for vendor eligibility, ensuring that only qualified suppliers capable of meeting the City's operational and service standards are considered for contract award.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-RFP-02-Scope of Services.pdf | ||
| 6-RFP-01-Instruction to Proposers (1).pdf | ||
| 1-RFP-05-Forms.pdf | ||
| 2-RFP-06-Small Business Utilization Form V1.docx | DOCX document | |
| 7-RFP-07-Deviations.xlsx | XLSX spreadsheet | |
| 8-RFP-08-Discount Calculator.xlsx | XLSX spreadsheet | |
| 5-RFP-04-Draft Vendor Services Agreement.pdf |
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Text version
CITY OF FORT WORTH - PURCHASING DIVISION AUTHORIZED SIGNATURE AND QUESTIONNAIRE
| RFP Ref. #: 26-0140 |
| Doc. Ref#: RFP-03 |
| Page 1 of 2 |
RFP Title: RFP Safety Footwear
City of Fort Worth Bidder/Supplier ID:____________________________________ Legal Name of Proposer:
D/B/A Name of Proposer:
Federal Id Number (TIN):______________________________________________ Address:
Name of the Authorized Representative: __________________________________ Title: _____________________________________________________________ The undersigned, by his/her signature, represents that he/she is submitting a binding Proposal and is authorized to bind the respondent to fully comply with the solicitation document contained herein. The Respondent, by submitting and signing below, acknowledges that he/she has received and read the entire document packet for this RFP and agrees to be bound by the terms therein.
The undersigned agrees if the Proposal is accepted, to furnish any and all items and/or services upon which prices are offered, at the price(s) and upon the terms, conditions, and scope/specifications contained in this RFP.
Signature of the Authorized Representative: _____________________________ Email: Phone:
Name of Contact Person - 1:
Title of Contact Person - 1:
Email: Phone:
Name of Contact Person - 2:
Title of Contact Person - 2:
Email: Phone:
Name of Contact Person - 3:
Title of Contact Person - 3:
Email: Phone:
Please answer each question below thoroughly. Responses to the questions will be used to assess the Proposal’s responsiveness. Bidders may use a separate sheet if needed, as long as each answer is labeled with the corresponding question number.
| 1.0 | Length of time in business: _______________________________________ |
| 2.0 | Is your business or any of its principals currently involved in litigation adverse to the City? Yes_______ No________ |
| 3.0 | Is your business or any of its principals under criminal investigation? Yes_______ No________ |
Have you answered Yes to either Question 2 or 3 above? Please provide the details outlining the situation on a separate document with the submission of this form.
4.0 Cooperative Purchasing - Should other governmental entities decide to participate in this contract, would you, the Vendor, agree that all terms, conditions, specifications, and pricing would apply?
Yes_______ No________
| 5.0 | Prompt Payment Discount Terms: ____ Percent _______ Days (i.e. 3% Net 15, etc.) |
| 6.0 | Proprietary Information - If a Bidder believes certain information in their proposal is proprietary and wishes to prevent its disclosure, they must clearly identify those pages and information in the chart below, for more information see RFP-01, Section 15.4. |
| Pages with information believed to be Proprietary | |
| Please indicate if only specific sections on the page are believed to be Proprietary |
| 7.0 | Can your company provide a mobile unit or mobile shoe service equipped with trained personnel to size individuals for all locations? | |
| Yes _______ | No________ | |
| If no please list which one and explain why? _________________________ | ||
| _____________________________________________________________ | ||
| _____________________________________________________________ | ||
| _____________________________________________________________ | ||
| 8.0 | Is your company able to provide an initial fitting and measuring session to determine the accurate size of the desired footwear for City personnel as listed in section 2.2 of of RFP-02- Scope of Services? | |
| Yes _______ | No________ | |
| 9.0 | Meet the Delivery and Response Times stated in section 5.0 of RFP-02- Scope of Services and Method of Award? | |
| Yes _______ | No________ | |
| 10.0 | Does your company have and operate a full-time, permanent business address located within 25 miles of the City Hall, with the ability to be reached by email and telephone? | |
| Yes _______ | No________ |
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