8-8 REQUIRED Responsible Vendor Review Form.docx
DOCX document 45 KB Posted
- Attached to
- Pavement Preservation Services
- Solicitation number
- IFB-028-26-RM
- Issued by
- Leon County, Florida
About this file
This is a Responsible Vendor Review Form required by the City of Tallahassee for vendor participation in the Pavement Preservation Services solicitation in Florida. The form establishes the criteria and certification process for determining vendor responsibility and capability to perform chip seal pavement surface treatment services, which involve applying bituminous surface treatments (single, double, or triple applications) to prepared road bases in conformance with County specifications. Vendors are required to complete the form by certifying their qualifications and answering detailed questions regarding their business history, professional standing, and operational capacity to fulfill contract obligations.
The form requires vendors to disclose any affirmative answers to eight specific questions regarding actions taken against the vendor or its officers, directors, or owners within the past ten years in Florida or any other state or federal jurisdiction, including revocations, suspensions, debarments, administrative complaints, contract terminations, criminal convictions, governmental investigations, or fraud judgments. Vendors must also confirm possession of necessary organizational structure, experience, accounting controls, operational capabilities, and professional technical skills to meet contract obligations while considering existing commitments. Vendors with active State Term Contracts or General Administrative Services contracts similar in scope are requested to provide contract documentation. All responses must be certified as true and complete by an authorized representative, and vendors are obligated to provide immediate written notice of any information that becomes erroneous prior to contract execution.
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Other files
| File | Type | Posted |
|---|---|---|
| 5-5. DRAFT CONTRACT CONSTRUCTION .doc | DOC document | |
| 2-2. REQUIRED BID SUMMARY.xlsx | XLSX spreadsheet | |
| 6-6. REQUIRED Representations Certifications.docx | DOCX document | |
| 4-4. REQUIRED Non Collusion Affidavit of Respondent.docx | DOCX document | |
| 7-7. REQUIRED Local Vendor Affidavit.docx | DOCX document | |
| 3-3. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf | ||
| 1-1-1. REQUIRED IFB 028-26-RM REQUIRED IFB SECTIONS 123.docx | DOCX document | |
| 9-9. REQUIRED Vendor Conflict of Interest.docx | DOCX document |
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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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