8-8. REQUIRED Responsible Vendor Review Form.docx
DOCX document 45 KB Posted
- Attached to
- Delivery Of Aluminum Sulfate
- Solicitation number
- IFB-045-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Responsible Vendor Review Form issued by the City of Tallahassee for a requirements contract soliciting bids for the furnishing, delivery, and pumping of bulk liquid aluminum sulfate. The specification calls for Liquid Alum with an Aluminum Sulfate Solution (AL2(SO4)3) equivalent to AL2O3 at 8.3%. Estimated quantities are provided only as guidelines, and the City reserves the right to increase or decrease the number of items purchased. Bidders are required to familiarize themselves with product specifications and inspect equipment and locations prior to submission. The contract is a requirements-based agreement with quantities described as estimates only, and delivery or performance shall be made only as authorized by orders issued by the City. Failure to inspect sites does not relieve the successful bidder from performing according to specifications at awarded prices.
Pricing for the contract shall be bid on a per dry ton basis and must represent the complete cost, including delivery. Vendors responding to this solicitation must complete the Responsible Vendor Review Form by fully and accurately answering all questions regarding business conduct, legal history, and professional qualifications within the last ten years in Florida or any state or federal jurisdiction. A "Yes" answer to questions 1.1 through 1.8 (covering revocation, suspension, debarment, indictment, contract termination, conviction, investigation, or fraud judgment) requires detailed explanation and supporting documentation but will not necessarily disqualify a vendor. The City will determine vendor responsibility based on information provided in the form, financial information in the solicitation response, and independent research including the System for Award Management (SAM). Vendors must have the necessary organization, experience, accounting and operational controls, and professional and technical skills to meet contract obligations.
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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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