8-RFP-03-Authorized Signature and Questionnaire.pdf

CITY OF FORT WORTH - PURCHASING DIVISION

AUTHORIZED SIGNATURE AND QUESTIONNAIRE

RFP Ref. #: 26-0005 Doc. Ref#: RFP-03 Page 1 of 4 RFP Title: Disaster Recovery – Home Repair Services

City of Fort Worth Bidder/Supplier ID:____________________________________ Legal Name of Proposer:

D/B/A Name of Proposer:

Federal Id Number (TIN):______________________________________________ Address:

Name of the Authorized Representative: __________________________________ Title: _____________________________________________________________ The undersigned, by his/her signature, represents that he/she is submitting a binding Proposal and is authorized to bind the respondent to fully comply with the solicitation document contained herein. The Respondent, by submitting and signing below, acknowledges that he/she has received and read the entire document packet for this RFP and agrees to be bound by the terms therein.

The undersigned agrees if the Proposal is accepted, to furnish any and all items and/or services upon which prices are offered, at the price(s) and upon the terms, conditions, and scope/specifications contained in this RFP.

Signature of the Authorized Representative: _____________________________ Email: Phone:

Name of Contact Person - 1:

Title of Contact Person - 1:

Email: Phone:

Name of Contact Person - 2:

Title of Contact Person - 2:

Email: Phone:

Name of Contact Person - 3:

Title of Contact Person - 3:

Email: Phone:

RFP Ref. #: 26-0005 Doc. Ref#: RFP-03 Page 2 of 4 RFP Title: Disaster Recovery – Home Repair Services

Please answer each question below thoroughly. Responses to the questions will be used to assess the Proposal’s responsiveness. Proposers may use a separate sheet if needed, as long as each answer is labeled with the corresponding question number.

1.0 Length of time in business: _______________________________________

2.0 Is your business or any of its principals currently involved in litigation adverse to the City? Yes No

3.0 Is your business or any of its principals under criminal investigation?

Yes No If answered Yes to either Question 1 or 2 above, please provide the details outlining the situation on a separate document with the submission of this form.

4.0 Cooperative Purchasing - Should other governmental entities decide to participate in this contract, would you, the Vendor, agree that all terms, conditions, specifications, and pricing would apply?

Yes No

5.0 Please indicate any prompt payment discount terms your offer (e.g., 3% Net 15 Days). If none, enter “0%”.

Prompt Payment Discount: ____ Percent _______ Days

6.0 Proprietary Information - If a Bidder believes certain information in their proposal is proprietary and wishes to prevent its disclosure, they must clearly identify those pages and information in the chart below, for more information see RFP-01, Section 15.4.

Pages with information believed to be Proprietary

Please indicate if only specific sections on the page are believed to be Proprietary

7.0 In the past two (2) years, how many home repair or rehabilitation projects has your company completed?

RFP Ref. #: 26-0005 Doc. Ref#: RFP-03 Page 3 of 4 RFP Title: Disaster Recovery – Home Repair Services

8.0 In the past two (2) years, of the projects that were not completed, please provide a brief description or reason for failure to complete the project.

9.0 Please list all cities, counties, or other municipalities your company has or currently holds a contract with as it relates to this RFP’s scope of service.

Include the number of home repair or rehabilitation projects completed under each contract.

10.0 Describe your company’s experience working with homes that are 50 years or older, including considerations for historic preservation, building code compliance, and aging infrastructure.

RFP Ref. #: 26-0005 Doc. Ref#: RFP-03 Page 4 of 4 RFP Title: Disaster Recovery – Home Repair Services

11.0 Identify your company’s experience performing work under federally funded programs (e.g., CDBG, HOME, CDBG-Disaster Recovery). Include project name, year, funding source, and contract value.

12.0 Describe your familiarity with federal grant compliance requirements, including Davis-Bacon, Section 3, and Fair Housing provisions.

13.0 Describe your company’s capacity to manage multiple projects concurrently.

13.1 Provide the average number of active projects your company handles at one time.

14.0 Describe your process for handling unforeseen site conditions (e.g., structural damage, mold, or code violations).