6-Bidder’s Qualification Form - Rev001.pdf

180 KB Posted

Attached to
Automated External Defibrillators (AED)
Solicitation number
ITB No. 2026-007
Issued by
Palm Beach County, Florida

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The document is a Bidder's Qualification Form issued by the Town of Palm Beach, designed to gather comprehensive information from potential vendors seeking to participate in a municipal contract opportunity. The form requires detailed company information, including legal name, address, business structure (corporation, partnership, or individual), incorporation details, length of time in business, and any potential conflicts of interest involving town employees. The purpose of this form is to enable the Town of Palm Beach to assess a bidder's qualifications, capability, and suitability to perform required services efficiently and satisfactorily.

The qualification form mandates that vendors hold a County and/or Municipal Tax Receipt (Occupational License) and requires disclosure of principal officers, business tenure, and any connections to town employees. Bidders must specify their business type, incorporation date and state, and provide information about any out-of-state corporate authorizations. The form also includes a transparency provision requiring vendors to disclose any town employees who have a direct or indirect interest in the bidding firm. These requirements ensure a comprehensive evaluation of potential contractors and promote transparency in the municipal procurement process.

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TOWN OF PALM BEACH

Bidder’s Qualification Form

Note: Information requested herein and submitted by the proposers will be analyzed by the Town of Palm Beach and will be a factor considered in awarding any resulting contract. The purpose is to ensure that the Proposers, in the sole opinion of the Town of Palm Beach, can sufficiently and efficiently perform all the required services in a timely and satisfactory manner as will be required by the subject contract. If there are any terms and/or conditions that are in conflict, the most stringent requirement shall apply.

The Vendor, as a result of this bid proposal, must hold a County and/or Municipal Tax Receipt (Occupational License) in the area of their fixed business location. Each proposer must complete the following information and submit with their proposal in order to be considered:

1. Legal Name and Address:

Name: ___________________________________________________________________________

Address: _________________________________________________________________________

Email: ___________________________________________________________________________

City, State, Zip: ____________________________________________________________________

Phone/Fax: _______________________________________________________________________

2. Check One: Corporation ( ) Partnership ( ) Individual ( )

3. If Corporation, state:

Date of Incorporation: ____________________________

State in which Incorporated: _______________________

4. If an out-of-state Corporation, currently authorized to do business in Florida, give date of such authorization: ___________________________________

5. Name and Title of Principal Officers: Date Elected:

6. The Vendor’s length of time in business: _____ years

7. The Vendor’s length of time (continuous) in business as a service organization in Florida: _____ years

8. All bidders must disclose with their bid the name of any officer, director or agent who is also an employee of the Town. Further, all bidders must disclose the name of any Town employee who owns, directly or indirectly, an interest in the bidder’s firm or any of its branches.

Name: ___________________________________________________________________________

Percentage of Interest: _____ %

Name:
Address:
Email:
City State Zip:
PhoneFax:
Date of Incorporation:
State in which Incorporated:
authorization:
Name and Title of Principal Officers 1:
Name and Title of Principal Officers 2:
Name and Title of Principal Officers 3:
Name and Title of Principal Officers 4:
Date Elected 1:
Date Elected 2:
Date Elected 3:
Date Elected 4:
The Vendors length of time in business:
The Vendors length of time continuous in business as a service organization in Florida:
Name_2:
Percentage of Interest:
Group1: Off

File details come from the government source that posted it. Updated .