5-Form - Qualifications Questionnaire.pdf
PDF 76 KB Posted
- Attached to
- Annual Bid to Furnish and Deliver Polymer
- Solicitation number
- 2027002
- Issued by
- Indian River County, Florida
About this file
This Qualifications Questionnaire is a pre-bid evaluation document used by the State of Florida for the Annual Bid to Furnish and Deliver Polymer solicitation covering the period October 1, 2026, through September 30, 2027. The questionnaire requires prospective bidders to demonstrate their qualifications and experience providing polymer delivery services. Bidders must document their years of service experience, Florida registration numbers, and provide detailed information on at least five previous government agencies or private firms for which they have completed similar work, including contact information, service descriptions, and dates of service. Additionally, bidders must identify any subcontractors involved in performing the work, listing the type of work and associated license numbers for each subcontractor.
The questionnaire mandates that bidders provide their e-Verify.gov registration date and disclose all litigation cases from the past three years in which the contractor has been a named party, including the year filed, case number, venue, and case description. Bidders are required to submit supporting documentation including an occupational license or business tax receipt, proof of current liability insurance, and a completed W-9 form. This qualification package serves to establish baseline capability and compliance requirements before firms proceed to formal bid submission for the polymer delivery services contract.
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Text version
Qualifications Questionnaire
1. How many years has your organization been providing these services? ________
2. List State of Florida Registration Number(s):
3. List government agencies and private firm(s) with whom you have completed similar work:
Agency/Firm Name:
Address:
Contact Name: Title: _______________________________ E-Mail: Phone: _____________________________ Services Provided:
Dates of Service:
Agency/Firm Name:
Address:
Contact Name: Title: _______________________________ E-Mail: Phone: _____________________________ Services Provided:
Dates of Service:
Agency/Firm Name:
Address:
Contact Name: Title: _______________________________ E-Mail: Phone: _____________________________ Services Provided:
Dates of Service:
Agency/Firm Name:
Address:
Contact Name: Title: _______________________________ E-Mail: Phone: _____________________________ Services Provided:
Dates of Service:
Agency/Firm Name:
Address:
Contact Name: Title: _______________________________ E-Mail: Phone: _____________________________ Services Provided:
Dates of Service:
4. Subcontractors:
Type of Work Subcontractor Name License Number
5. Date Registered with e-Verify.gov:
6. List all ligation cases during the past three (3) years in which the Contractor has been a named party. Use additional sheets, as necessary.
Year filed
Case number Venue Description
Attach Occupational License/Business Tax Receipt, proof of current liability insurance and W-9.
File details come from the government source that posted it. Updated .