5-Attachment D - Respondent Information - Certification.pdf
PDF 108 KB Posted
- Attached to
- Construction Manager At Risk (CMAR) Services for the South County Drinking Water Facility Project
- Solicitation number
- CMAR-26-00264
- Issued by
- Hillsborough County, Florida
About this file
Attachment D is a Respondent Information and Certification form used by Hillsborough County Water Resources Department in Florida for their Construction Manager At-Risk (CMAR) Services qualification proposal process for the South County Drinking Water Facility Project. The form requires respondents to provide their legal business name and entity type, contact person information, local and primary business addresses, and telephone and fax numbers. Respondents must submit qualification proposals demonstrating experience in CMAR project delivery methods. Questions and requests for interpretation must be received no later than 14 calendar days after the solicitation issuance date, site visit, or pre-bid conference, whichever is later. The project is estimated at $145,000,000.00.
The certification form requires respondents to affirm compliance with all RFQ requirements, confirm no conflicts of interest, certify the proposal was prepared without collusion or fraud, verify no arrearages or defaults with Hillsborough County, and declare that no county employees have financial interest in the proposal. Respondents must also confirm receipt and examination of all amendments issued prior to opening and attest that all statements in the proposal are true and accurate as of the submittal date. The form must be executed with an authorized signature in ink, witnessed, and include the printed name and title of the signer along with the date signed. A corporate seal should be affixed where appropriate.
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Text version
Attachment D Respondent Information/Certification
1. Legal Name of Respondent. Indicate if the Respondent is a Corporation, Joint Venture, Partnership, etc.:
2. Name/title of contact person for the Respondent
3. Local business and mailing address:
4. Primary business and mailing address:
5. Telephone number: Fax:
The above-named Respondent affirms and declares:
A. That the Respondent understands all requirements of the RFQ and states that as a serious Respondent it will comply with all the stipulations included in the RFQ package.
B. That the Respondent is of lawful age and that no other person, firm or corporation has any interest in this Proposal or in the contract proposed to be entered into except as expressly stated below:
C. That this qualification proposal is made without any understanding, agreement, or connection with any other person, firm or corporation making a proposal for the same purpose, and is in all respects fair and without collusion or fraud except as expressly stated below:
D. That the Respondent is not in arrears to Hillsborough County upon debt or contract and is not a defaulter, as surety or otherwise, upon any obligation to Hillsborough County except as expressly stated below:
E. That no officer or employee or person whose salary is payable in whole or in part from the County Treasury is, shall be or become interested, directly or indirectly, surety or otherwise in this Proposal: in the performance of this Contract; in the supplies, materials, equipment, and work or labor to which they relate; or in any portion of the profits thereof.
F. That the Respondent has received and carefully examined all Amendment issued prior to Opening.
G. All statement made by the Respondent in the proposal are true and accurate as of the proposal submittal date.
IN WITNESS WHEREOF, this Proposal is hereby signed and sealed as of the date indicated.
ATTEST: RESPONDENT:
BY:___________________________________(SEAL)
Witness (Authorized signature in ink)
Witness (Printed name of signer)
(Printed Title of signer)
CORPORATE SEAL _______________________________________
(Where appropriate) (Date signed)
| Attachment D |
| Respondent Information/Certification |
File details come from the government source that posted it. Updated .