4-02 Bidder Information Form - Required.pdf
PDF 122 KB Posted
- Attached to
- Hot Crack Sealant
- Solicitation number
- Bid #34-01-27
- Issued by
- Bell County, Texas
About this file
This is a Bidder Information Form for an Invitation to Bid (ITB) issued by the City of Temple, Texas, for the purchase and delivery of hot crack sealant for the Streets Department. The City intends to award the contract in its entirety to the lowest responsive and responsible bidder. The form requires bidders to provide company information, contact details, and acknowledge receipt of any addenda issued through the Euna Procurement e-procurement portal. Bidders must confirm authorized personnel who may enter into an agreement, verify their ability to execute the purchase agreement and comply with insurance requirements, and provide three customer references if they have not provided similar products or services to the City within the previous three years. The form also requires bidders to disclose any exceptions taken to bid terms and be signed by an authorized representative.
The estimated annual value of this agreement is $45,000. The City reserves the right to conduct a credit check on potential vendors to determine financial responsibility before award. Bidders must authorize the City, credit bureaus, or investigative agencies employed by the City to investigate their credit history and financial responsibility as a condition of submitting a bid. No specific response deadline, award date, contract term, or renewal options are detailed in this form document.
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Text version
Bid #34-01-27 Hot Crack Sealant 15
FORM 5.1. - BIDDER INFORMATION FORM
1. Company Information
Company Name: _______________________________________________________
Business Address: ______________________________________________________
Remit-to Address, if different: _____________________________________________
Tax Identification Number: ________________________________________________
Contact Person: _______________________________________________________
Phone: _______________________________________________________________
Email: _______________________________________________________________
2. Addenda
Our company has reviewed and formally acknowledges receipt of all addenda, if any, provided in the Euna Procurement e-procurement portal. Please record the number of addenda acknowledged here:
____________ (number of addenda acknowledged)
3. Credit Check Authorization The City is required to determine whether a bidder who may be awarded a purchase agreement is financially responsible. The City may run a credit check on the potential vendor before award of the agreement. By signing this Bidder Information Form, I hereby authorize the City of Temple, credit bureau, or other investigative agency employed by the City of Temple to investigate my credit history and financial responsibility.
4. Authorized Personnel State your firm’s personnel authorized enter into an agreement, if any, resulting from your bid:
Name Phone Number Email Address
Bid #34-01-27 Hot Crack Sealant 16
5. Agreement
The successful bidder shall be able to execute the attached purchase agreement and be able to comply with the insurance requirements as stated within the agreement.
Please confirm your ability to execute this contract.
____________ (initial to confirm)
6. References If your company has not provided like-kind products/services to the City in the last three
(3) years, please provide three (3) customer references:
Entity Name Contact Person Phone # Email
7. Exceptions Taken by Bidder State exceptions taken to any terms of this bid, if any.
8. Authorization Authorized Signature: ___________________________________________________
Print Name: ___________________________________________________________
Title: __________________________________ Date: _______________________
Email Address: ________________________________________________________
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