7-Supporting Documents 6 Statement of Bidders Questionnare Responses.pdf

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Attached to
Additional Lead Abatement Contractors Needed - Lead-Safe and Healthy Homes Program
Solicitation number
US.261862
Issued by
Delaware County, Pennsylvania

About this file

This is a Statement of Questionnaire Responses form for RFI 2026-005c related to lead abatement contractors for the City of Chester, Pennsylvania. The City of Chester is soliciting information from qualified and certified lead abatement contractors to be included in a prequalified contractor pool to provide lead remediation services for approximately 120 residential properties over a three-year period. The program, known as the Lead-Safe and Healthy Homes Program, is administered by the City of Chester's Bureau of Health and funded primarily through a Lead Hazard Reduction Grant awarded by the U.S. Department of Housing and Urban Development (HUD). The document serves as an affidavit form wherein bidders must provide responses to questionnaire items and attest under oath that all answers and statements contained therein are true and correct, with execution before a notary public.

The questionnaire response form requires bidders to execute the document with their name, title, and the state and county of residence. The form mandates notarization, with the notary public signing and dating the document and indicating their commission expiration date. No specific pricing terms, set-asides, response dates, or due dates are detailed within this form itself; rather, it functions as a compliance and verification document to accompany bidders' responses to the underlying questionnaire for the lead abatement contractor prequalification pool.

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Text version

STATEMENT OF QUESTIONNAIRE

RESPONSES RFI 2026-005c

LEAD ABATEMENT CONTRACTORS

Dated this ___________day of _______________________________ ,202__.

(Name of Bidder)

By ____________________________________

Title ___________________________________

State of _______________________

County of______________________

____________________________________ being duly sworn deposes and says that he/she is __________________of__________________________

__________________________________________ and that the answers to the foregoing questions and all statements therein contained are true and correct.

Subscribed and sworn to before me this _________day of _______________ ,202__

(Notary public)

My commission expires ____________________, 20__

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