3-RFP-04-Authorized Signature and Questionnaire.pdf

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Attached to
RFP Hydrovac Waste Material
Solicitation number
26-0185
Issued by
Tarrant County, Texas

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This document is an Authorized Signature and Questionnaire form for the City of Fort Worth Purchasing Division's Request for Proposals (RFP Ref. #26-0128) for Waste Disposal of Hydrovac Material. The City of Fort Worth seeks proposals for hydrovac waste disposal services for the Water Department on an as-needed basis. The RFP requires proposers to submit comprehensive responses addressing their qualifications, experience, and service capabilities. Bidders must confirm their ability to accept a minimum of two hydrovac trucks per day and up to 100 cubic yards per week, provide their maximum daily and weekly capacity, and state their average unloading turnaround time per truck. All required documents and technical response forms must be included with submissions to avoid disqualification at the City's discretion.

The questionnaire requires bidders to provide detailed information including their length of time in business, years of experience operating Municipal Solid Waste facilities, and specific experience accepting hydrovac waste, sewer grit, lift station debris, and storm drain sediment. Proposers must supply their current Texas Commission on Environmental Quality (TCEQ) Municipal Solid Waste permit number and type, disclose any litigation or criminal investigations involving the business or its principals, and report any violations, enforcement actions, or permit suspensions within the past five years. Bidders must indicate whether they agree to extend all terms, conditions, specifications, and pricing to other governmental entities participating in cooperative purchasing arrangements and provide prompt payment discount terms. Additionally, proposers must declare any modifications made to the draft Vendor Service Agreements and submit a sample invoice with their proposal.

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6-RFP-06-Small Business Utilization Form V1.pdf PDF
9-RFP-03-Draft Vendor Service Agreement.pdf PDF
2-RFP-09-Discount Calculator.xlsx XLSX spreadsheet
7-RFP-01-Instruction to Proposers.pdf PDF
1-RFP-05-Forms.pdf PDF
5-RFP-07-Deviations.xlsx XLSX spreadsheet
8-RFP-08-Reference Sheet.pdf PDF
4-RFP-02-Scope of Services.pdf PDF

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CITY OF FORT WORTH - PURCHASING DIVISION

AUTHORIZED SIGNATURE AND QUESTIONNAIRE

RFP Ref. #: 26-0128 Doc. Ref#: RFP-04 Page 1 of 4 RFP Title: Waste Disposal of Hydrovac Material

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:

RFP Ref. #: 26-0128 Doc. Ref#: RFP-04 Page 2 of 4

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 1 or 2 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 How many years has your firm operated a Municipal Solid Waste facility?

RFP Ref. #: 26-0128 Doc. Ref#: RFP-04 Page 3 of 4

8.0 Describe your experience accepting hydrovac waste, sewer grit, lift station debris, and storm drain sediment.

9.0 Provide your current TCEQ MSW permit number and type

10.0 A proposal may be deemed to be non-responsive and may be disqualified, at the City’s discretion, if the Proposal fails to include all requested documents.

Are all required documents, response forms, and technical response documents attached to your submission? Yes__ No__

12.0 Did you make any changes to RFP-03-Drafts Vendor Service Agreements?

13.0 Have you received any notices of violation, enforcement actions, or permit suspensions within the past five (5) years? If yes, explain.

RFP Ref. #: 26-0128 Doc. Ref#: RFP-04 Page 4 of 4

14.0 State maximum daily and weekly capacity.

15.0 State average unloading turnaround time per truck.

16.0 Confirm ability to accept a minimum of two (2) hydrovac trucks per day and up to 100 cubic yards per week

17.0 Provide sample invoice.

City of Fort Worth BidderSupplier ID:
Legal Name of Proposer:
DBA Name of Proposer:
Federal Id Number TIN:
Address:
Name of the Authorized Representative:
Title:
Email:
Phone:
Name of Contact Person 1:
Title of Contact Person 1:
Email_2:
Phone_2:
Name of Contact Person 2:
Title of Contact Person 2:
Email_3:
Phone_3:
Name of Contact Person 3:
Title of Contact Person 3:
Email_4:
Phone_4:
Length of time in business:
adverse to the City Yes:
No:
Yes:
No_2:
Yes_2:
No_3:
Prompt Payment Discount Terms:
Percent:
70 How many years has your firm operated a Municipal Solid Waste facility:
debris and storm drain sediment 1:
debris and storm drain sediment 2:
debris and storm drain sediment 3:
debris and storm drain sediment 4:
debris and storm drain sediment 5:
90 Provide your current TCEQ MSW permit number and type 1:
90 Provide your current TCEQ MSW permit number and type 2:
90 Provide your current TCEQ MSW permit number and type 3:
90 Provide your current TCEQ MSW permit number and type 4:
90 Provide your current TCEQ MSW permit number and type 5:
120 Did you make any changes to RFP03Drafts Vendor Service Agreements 1:
120 Did you make any changes to RFP03Drafts Vendor Service Agreements 2:
120 Did you make any changes to RFP03Drafts Vendor Service Agreements 3:
120 Did you make any changes to RFP03Drafts Vendor Service Agreements 4:
120 Did you make any changes to RFP03Drafts Vendor Service Agreements 5:
suspensions within the past five 5 years If yes explain 1:
suspensions within the past five 5 years If yes explain 2:
suspensions within the past five 5 years If yes explain 3:
suspensions within the past five 5 years If yes explain 4:
suspensions within the past five 5 years If yes explain 5:
1:
2:
140 State maximum daily and weekly capacity 1:
140 State maximum daily and weekly capacity 2:
140 State maximum daily and weekly capacity 3:
150 State average unloading turnaround time per truck 1:
150 State average unloading turnaround time per truck 2:
150 State average unloading turnaround time per truck 3:
up to 100 cubic yards per week 1:
up to 100 cubic yards per week 2:
up to 100 cubic yards per week 3:
170 Provide sample invoice 1:
170 Provide sample invoice 2:

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