5-6. REQUIRED IFB-26-RM Representations Certifications.docx
DOCX document 31 KB Posted
- Solicitation number
- IFB-039-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Representations and Certifications form for the Dog House Pump Stations Replacements project (PS 25, 49, 59, 85) issued by the State of Florida. The project requires the contractor to provide labor, materials, equipment, supplies, services, skills, supervision, and necessary tools for the replacement of existing Smith & Loveless wet well-mounted pump stations, with options to include additional stations through bid alternates. The scope includes removal and replacement of gravity inflow sewer mains, bypass pumping assemblies, above-ground pump stations, rehabilitation of existing wet wells, installation of new kingpin manholes, generators, electrical site work, fencing modifications, concrete work, landscaping restoration, traffic maintenance, and material disposal. A mandatory pre-bid meeting is scheduled for February 18, 2026, at 2:00 PM EST via Microsoft Teams. The contractor must demonstrate capability to perform all services in a timely and workmanlike manner in accordance with the solicitation documents.
The form requires respondents to submit a completed Federal Form W-9 for taxpayer identification and to provide official company information including name, mailing address, telephone, fax, and website URL. Respondents must also designate a company contact for contract management, provide a payment remittance address, identify a contact for invoice inquiries, and specify where purchase orders should be sent. The form serves as a standard representation and certification document to establish the respondent's identity, point of contact, and payment information prior to bid evaluation.
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Text version
REPRESENTATIONS/CERTIFICATIONS
TAXPAYER IDENTIFICATION
Respondent must complete Federal Form W-9 and submit it with their bid.
OFFICIAL COMPANY INFORMATION AS REGISTERED (Type/Print)
COMPANY NAME:
MAILING ADDRESS:
(City)
| (State) |
| (Zip Code + 4) |
TELEPHONE NO.:
| (Toll-Free Preferred) |
| VOICE: |
EXTENSION:
OTHER:
FAX:
WEBSITE URL:
COMPANY CONTACT FOR CONTRACT MANAGEMENT (Type/Print)
NAME:
TELEPHONE NO.:
| (Toll-Free Preferred) |
| VOICE: |
EXTENSION:
OTHER:
FAX:
EMAIL ADDRESS:
PAYMENT REMITTANCE ADDRESS (Type/Print)
NAME:
MAILING ADDRESS:
(City)
| (State) |
| (Zip Code + 4) |
TELEPHONE NO.:
| (Toll-Free Preferred) |
| VOICE: |
EXTENSION:
OTHER:
FAX:
EMAIL ADDRESS:
CONTACT FOR INVOICE INQUIRIES
NAME:
TELEPHONE NO.:
| (Toll-Free Preferred) |
| VOICE: |
EXTENSION:
OTHER:
FAX:
EMAIL ADDRESS:
WHERE TO SEND PURCHASE ORDER (IF APPLICABLE)
COMPANY NAME:
MAILING ADDRESS:
(City)
| (State) |
| (Zip Code + 4) |
EMAIL ADDRESS:
File details come from the government source that posted it. Updated .