7-8. REQUIRED Responsible Vendor Review Form.docx
DOCX document 45 KB Posted
- Solicitation number
- IFB-039-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Responsible Vendor Review Form for the City of Tallahassee, Florida, related to the Dog House Pump Stations Replacements project (PS 25, 49, 59, 85). The project involves the replacement of existing Smith & Loveless wet well-mounted pump stations, with the base scope covering PS-85 and PS-49, Bid Alternate #1 adding PS-59, and Bid Alternate #2 adding both PS-59 and PS-25. Work 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, a new generator at PS-59, electrical site work for future generators at other stations, reconnection to existing force mains, electrical modifications, fencing work, concrete removal and replacement, landscaping removal and replanting, site restoration, material disposal, traffic maintenance, and pavement restoration. A mandatory pre-bid meeting is scheduled for February 18, 2026 at 2:00 PM EST via Microsoft Teams.
The form requires vendors to certify their responsibility by disclosing any adverse history within the past ten years regarding business or professional permits, suspensions, debarments, government contract monitoring, indictments, contract terminations for cause, criminal convictions related to contracting, governmental investigations, or civil fraud judgments. Vendors must also confirm they possess the necessary organization, experience, accounting and operational controls, and professional and technical skills to meet contract obligations. The form requests information regarding active State Term Contracts or GSA Contracts similar to the solicitation scope. Vendors must provide detailed explanations and supporting documentation for any affirmative responses to the responsibility questions, with failure to provide requested information potentially resulting in disqualification.
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Text version
A contract can only be awarded to a “responsible vendor”. A responsible vendor has the capability in all respects to fully perform the contract requirements and the integrity and reliability that will assure good faith performance.
To assist in making this determination, Vendors responding to this Solicitation are required to fully and accurately answer each of the questions below. For each “Yes” answer to questions 1.1 through 1.8, Vendor must provide a detailed explanation and attach copies of any relevant document cited in the explanation. Answering “Yes” to questions 1.1 through 1.8 will not necessarily disqualify a Vendor from participating in this Solicitation. However, failure to provide additional information as requested by the City of Tallahassee may disqualify a Vendor.
The City of Tallahassee (COT) will base its determination of a Vendor’s responsibility on: (a) information provided by Vendor in response to this form; (b) information provided elsewhere in a Vendor’s response to the Solicitation (including financial information) and (c) information obtained from independent research (including information COT obtains from the internet or third parties, including System for Award Management (SAM)).
Vendors shall provide immediate written notice to COT if any time prior to contract execution, a Vendor learns that the information provided in connection with this form was erroneous when submitted or has become erroneous for reason of changed circumstances. Vendor must contact the Procurement Officer with any questions regarding this form.
1.0 Within the last ten (10) years, in the State of Florida or any State or Federal jurisdiction has the Vendor or any of its officers, directors or owner:
| 1.1 |
| Been, subject to a revocation, suspension, disbarment, administrative complaint, sanction, fine, adverse action, or disciplinary action relating to any business or professional permit, certification, and/or license? |
| · Yes |
· No
| 1.2 |
| Been suspended, debarred, or disqualified from any government contracting process or agreed to voluntary exclusion from any government procurement process? |
| · Yes |
· No
| 1.3 |
| Been subject to formal monitoring agreement or corrective action plan as part of a contract with a government entity? |
| · Yes |
· No
| 1.4 |
| Been subject to an indictment, administrative proceeding, civil action or judgment in connection with any government contract? |
| · Yes |
· No
| 1.5 |
| Had a government contract terminated for cause? |
| · Yes |
· No
Responsible Vendor Review Form
| 1.6 |
| Been convicted of a crime related to governmental or nongovernmental contracting? |
| · Yes |
· No
| 1.7 |
| Been subject to governmental investigation relating to alleged violation of any statutory regulatory violation? |
| · Yes |
· No
| 1.8 |
| Had a judgement entered in a civil lawsuit based on an allegation of fraud? |
| · Yes |
· No
| 2.0 |
| Does the vendor have the necessary organization, experience, accounting and operational controls, and professional and technical skills to meet its obligations under the proposed contract with COT, taking into consideration all existing commercial and governmental business commitments? |
| · Yes |
· No
| 3.0 |
| General Information |
Do you have an active State Term Contract (STC) or General Administrative Services (GSA) Contract similar to the scope of services for this solicitation. If yes, provide an attachment with links to the contract(s)
· STC
· GSA
· Not Applicable
By my signature below, I certify that I am an authorized representative of the Vendor named below and that all of the information provided above is true and complete to the best of my knowledge.
Name and Title Vendor Name
Signature Date
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