6 INFORMATION REQUIRED OF BIDDERS.pdf

INFORMATION REQUIRED OF BIDDERS

CA\DD\02000.50112\2924468.10 Rev 02272024 27157.00020\46007162.1

A. INFORMATION ABOUT BIDDER

[***Indicate not applicable (“N/A”) where appropriate.***]

NOTE: Where Bidder is a joint venture, pages shall be duplicated and information provided for all parties to the joint venture.

1.0 Name of Bidder: ___________________________________________

2.0 Type, if Entity: ___________________________________________

3.0 Bidder Address: ___________________________________________

Email Address Telephone Number

4.0 ___________________________ ____________________________ License Number DIR Registration Number

5.0 How many years has Bidder’s organization been in business as a Contractor?

6.0 How many years has Bidder’s organization been in business under its present name? ________________________

6.1 Under what other or former names has Bidder’s organization operated?:_______________________________________________

7.0 If Bidder’s organization is a corporation, answer the following:

7.1 Date of Incorporation: ________________________________

7.2 State of Incorporation: ________________________________

7.3 President’s Name: ________________________________

7.4 Vice-President’s Name(s): ________________________________

Docusign Envelope ID: 584E14D8-EAEC-8CB5-82CC-535F5EF98E3A

7.5 Secretary’s Name: ________________________________

7.6 Treasurer’s Name: ________________________________

8.0 If an individual or a partnership, answer the following:

8.1 Date of Organization: ______________________________________

8.2 Name and address of all partners (state whether general or limited partnership):

9.0 If other than a corporation or partnership, describe organization and name principals:

10.0 List other states in which Bidder’s organization is legally qualified to do business.

11.0 What type of work does the Bidder normally perform with its own forces?

12.0 Has Bidder ever failed to complete any work awarded to it? If so, note when, where, and why:

13.0 Has Bidder entered into a settlement agreement involving a public works project of more than $100,000 within the last two years with any City or public agency? If so, note when, where, and why. This information may be the basis for rejecting the bid as nonresponsive or the Bidder as nonresponsible following a hearing.

14.0 Within the last five years, has any officer or partner of Bidder’s organization ever been an officer or partner of another organization when it failed to complete a contract? If so, attach a separate sheet of explanation:

15.0 Have you been or are you on any federal state list of debarred or suspended bidders?

If yes, state the beginning and ending dates of the period of disbarment:

16.0 List Trade References:

17.0 List Bank References (Bank and Branch Address):

18.0 Name of Bonding Company and Name and Address of Agent:

B. LIST OF CURRENT PROJECTS (Backlog)

[***Duplicate Page if needed for listing additional current projects.***]

Project Description of Bidder’s Work

Completion Date

Cost of Bidder’s Work

Contact Name & Phone

C. LIST OF COMPLETED PROJECTS - LAST THREE YEARS

[***Duplicate Page if needed for listing additional completed projects.***]

Please include only those projects which are similar enough to demonstrate Bidder’s ability to perform the required Work.

Project Client Description of Bidder’s Work

Period of Performance

Cost of Bidder’s Work

Contact Name & Phone

D. EXPERIENCE AND TECHNICAL QUALIFICATIONS QUESTIONNAIRE

Personnel:

The Bidder shall identify the key personnel to be assigned to this project in a management, construction supervision or engineering capacity.

1. List each person’s job title, name and percent of time to be allocated to this project:

2. Summarize each person’s specialized education:

3. List each person’s years of construction experience relevant to the project:

4. Summarize such experience:

Bidder agrees that personnel named in this Bid will remain on this Project until completion of all relevant Work, unless substituted by personnel of equivalent experience and qualifications approved in advance by the City.

Additional Bidder’s Statements:

If the Bidder feels that there is additional information which has not been included in the questionnaire above, and which would contribute to the qualification review, it may add that information in a statement here or on an attached sheet, appropriately marked:

E. SAFETY REQUIREMENTS/VIOLATIONS

Number of Serious OSHA Violations within the last two (2) years and the number of Willful OSHA violations within the last five (5) years (must state zero if none):

___ Serious ___ Willful ___ Repeat ___ Other ___ Unclass ___ Total

F. VERIFICATION AND EXECUTION

These Bid Forms shall be executed only by a duly authorized official of the Bidder:

I declare under penalty of perjury under the laws of the State of California that the foregoing information is true and correct:

Name of Bidder

Signature

Name

Title

Dated