8-Attachment C-2 Contractors Qualification Statement.docx

ATTACHMENT C-2

BIDDER'S QUALIFICATIONS (PAGE 1 of 4)

All questions must be answered and the data given must be clear and comprehensive. If necessary, questions may be answered on separate sheets. The Bidder may submit any additional information he desires. This statement must be notarized.

1. Name of Bidder:

2. Federal Taxpayer Identification No.

3. Phone No. Email address or website:

4. Permanent Main Office Address:

5. When Organized:

6. Check Type of Organization:

Individual Proprietorship Partnership Corporation

7. If a corporation, where incorporated:

8. How many years have you been engaged in the contracting business under your present firm or trade name?

9. Contract on hand: (Schedule these, showing amount of each contract and the owner, the owner's phone number and the approximate anticipated dates of completion.)

10. Describe the general character of work performed by your company.

11. Have you ever failed to complete any work awarded to you? If so, where and why?

South Central Transit Authority

BIDDING AND CONTRACT REQUIREMENTS

Project Manual 5/6/24 00 21 13

ATTACHMENT C-2

BIDDER'S QUALIFICATIONS (PAGE 2 of 4)

12. Have you ever defaulted on a contract? If so, where and why?

13. List the more important contracts recently completed by your company, stating the owner, the owner's phone number, the approximate cost for each, and the month and year completed.

14. List your major equipment available for this contract.

15. Cite experience in work similar in kind and scope to this contract. Provide similar project references requirement here or attach. Minimum 5 in the last 5 years. Include contact information.

16. List background and experience of the principal member of your organization including the officers.

17. Give bank reference:

18. Bonding Company and current Standard & Poor’s rating:

BIDDER'S QUALIFICATIONS (PAGE 3 of 4)

19. Total Bondable Amount: $

20. Single Project Bond Limit: $

21. Will you, upon request, fill out a detailed financial statement and furnish any other information that may be required by the South Central Transit Authority (SCTA)?

22. Do you have Programs that meet the requirements of the Federal and State Equal Employment Opportunity sections of General Conditions?

23. Do all subcontractors proposed to be used in the execution of the contract have Programs that meet the Federal and State EEO requirements?

24. List of Proposed Subcontractors for this Project, including contact person, address, phone number, type of work and DBE status, if applicable:

25. Have you ever been denied an award of a contract or ever had funds withheld from your firm for failure to comply with the Federal Equal Employment Provisions required by Executive Order No. 11246 or the Commonwealth of Pennsylvania Affirmative Action Provisions required by Executive Order 1988-1?

26. List all of the Parties of Interest in the Business Entity and the extent of their respective interest and, in the event any other parties have a beneficial interest, their names and the extent of such interest.

28. Has the company or Parties in Interest filed for bankruptcy in the last five (5) years?

BIDDER'S QUALIFICATIONS (PAGE 4 of 4)

This Form Prepared By:

Title:

Date:

(Sign and Notarize below)

The undersigned hereby authorizes and requests any person, firm or corporation to furnish any information requested by the South Central Transit Authority (SCTA) in verification of the recitals comprising this Statement of Bidder's Qualifications.

Date this day of , 20 .

BIDDER

By

Title

State of )

) SS

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 , 20

Notary

My commission expires , 20