7 - T1057 Vendor Bidder Data Sheet 092017~1.docx
DOCX document 248 KB Posted
- Attached to
- T1057 - WIC Infant Formula Rebate:DOH
- Solicitation number
- 18DPP00157
- Issued by
- New Jersey
About this file
This document is a Bidder Data Sheet for a state contract solicitation by the State of New Jersey Department of the Treasury Division of Purchase and Property. The contract opportunity is for the T1057 - WIC Infant Formula Rebate:DOH, which is seeking vendors to provide services related to this contract. The document requests information from vendors on their prior contracts of similar size and scope, as well as any contracts that were terminated for cause within the last five years. The contract opportunity is limited to Mercer County, New Jersey.
The document does not provide details on pricing terms, set asides, incumbents, funding requirements or sources, or other salient commercial information. It is focused solely on gathering background information on the bidders to assess their qualifications and capability to perform the required scope of work.
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Text version
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
BIDDER DATA SHEET
| BID SOLICITATION #: |
| 18DPP00157 |
T1057-WIC Infant Formula Rebate:DOH
VENDOR/BIDDER:
THIS FORM WILL BE USED IN ASSESSING A VENDOR’S/BIDDERS’S QUALIFICATIONS
AND CAPABILITY TO PERFORM THE CONTRACT SCOPE OF WORK.
PART I - CONTRACTS OF SIMILAR SIZE AND SCOPE
List prior contracts performed by the Vendor/Bidder. Emphasis should be placed on contracts that are similar in size and scope to the work required by this Bid Solicitation as evidence of the Vendor’s/Bidder’s ability to successfully complete the scope of work required by this Bid Solicitation. If the Vendor/Bidder has not had any prior contracts enter “None” below.
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract Scope of Work:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Contact Name:
Contact Phone No.:
Contact Email:
Attach additional sheets if necessary.
PART II - CONTRACTS TERMINATED FOR CAUSE
Provide a list of all contracts terminated for cause within the last five (5) years prior to the normal contract expiration date. The Vendor/Bidder should provide a summary of any negative action, including negative audit findings, taken on any contract of a similar size and scope. The disclosure should include, but is not limited to, receipt of letters of potential default, default, notice(s) to cure, termination of services for cause, or other similar notifications/processes. Additionally, the Vendor/Bidder should provide details, including any negative audits, reports, or findings by any governmental agency for which the Vendor/Bidder is/was the Vendor/Contractor on any Contract of similar scope. If no contracts were terminated for cause during the last five (5) years, enter “None” below.
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Termination:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Termination:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Termination:
Contact Name:
Contact Phone No.:
Contact Email:
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Termination:
Contact Name:
Contact Phone No.:
Contact Email:
Attach additional sheets if necessary.
| DPP Rev. 7.25.17 |
| Page 1 of 2 |
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