4-Bidders Qualifications.pdf

BQ-1

STATEMENT OF BIDDER’S QUALIFICATIONS

Prospect Street Sewer Relocation Project

All questions must be answered and the data given must be clear and comprehensive. This statement must be notarized. If necessary, questions may be answered on separate, attached sheets. The Bidder may submit any additional information he/she desires.

1. Name of Bidder. ____________________________________________________________________________

2. Bidder’s permanent main office address. ___________________________________________________

3. Date organized. _________________________

4. If a corporation, where incorporated. _________________________

5. How many years have you been engaged in the contracting business under your present firm or trade name? ________________________________

6. Contracts on hand: (Provide a Schedule showing amount of each contract and the appropriate anticipated dates of completion.)

7. Describe the general character of work performed by your company. ____________________

8. Have you ever failed to complete any work awarded to you? If so, where and why?

9. Have you ever defaulted on a contract? If so, where and why?

10. List the more important projects recently completed by your company, stating the approximate cost of each, and the month and year completed.

11. List any projects completed within the last two years for which you have not been paid in full and present the reason for non-payment. Please provide name, address and phone number of any agency who refused payment to your firm.

12. List your major equipment to be used for this contract.

13. List the background and experience of the principal members of your organization who will be involved in the completion of this project.

14. Credit available: $ ___________________________________________.

15. Give Bank reference: ________________________________________.

16. Will you, upon request, fill out a detailed financial statement, and furnish any other information that may be required by the “Owner”? ___________________________

17. (A) Have you ever been a party to, or otherwise involved in, any action or legal proceeding involving matters related to race, color, nationality, or religion? If so, give full details.

(B) Have you ever been accused of discrimination based upon race, color, nationality, or religion in any action or legal proceeding including any proceeding related to any Federal Agency? If so, please give full details.

BQ-2

18. All prospective Bidders are required to present proof of an acceptable disposal method approved by the Pennsylvania Department of Environmental Resources. This proof may consist of a copy of a State Solid Waste Disposal Permit issued to the prospective bidder by the Pennsylvania

Department of Environmental Resources for the use of a proposed or existing disposal facility which has a permit or is under review for a permit. Same to be in accordance with Section 7(a) application and permits, Pennsylvania Solid Waste Management - “Act 241.”

19. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the “Owner” in verification of the recitals comprising this Statement of

Bidder’s Qualifications.

Dated this ______ day of ______ _________ , 20 __ _ .

(Name of Bidder)

By: ___________________________________

Title:

State of: ________________________ . County of: ________________________ .

_____________________________________________ , being duly sworn, deposes and says that he/she is

(Name)

_____________________________________________ of , (Title) (Name of Organization) and that the answers to the foregoing questions and all statements therein contained are true and correct.

Subscribed and sworn to before me this __________ day of _____________________ , 20 ___ .

Notary Public

My Commission Expires .