APPENDIX A Contractor Information.docx
DOCX document 29 KB Posted
- Attached to
- IFB 26. 0001 Allen Elementary Boiler Replacement
- Solicitation number
- IFB 26.0001 Allen Elementary Boiler Replacement
- Issued by
- Washtenaw County, Michigan
About this file
This document is an Appendix A Contractor Information Form for Invitation for Bid (IFB) 26.0001 for Allen Elementary Boiler Replacement in Michigan, requiring comprehensive contractor details for a school district boiler replacement project. The solicitation seeks a contractor to replace three boilers at Allen Elementary School, with the form designed to capture critical information about potential bidders, including business history, financial standing, experience, safety record, qualifications, and references.
The form requires detailed disclosure of the contractor's business structure, financial performance, licensing, project experience, safety compliance, personnel qualifications, and professional references. Key evaluation criteria include the contractor's years in business, financial stability (with gross sales for 2022-2024), licensing status, past project performance, safety record, workforce composition (including master and journeyperson ratios), and ability to demonstrate successful completion of similar school district infrastructure projects within the past five years. The document also requests an executive summary and allows for potential follow-up financial statement reviews by the district.
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Other files
| File | Type | Posted |
|---|---|---|
| APPENDIX E Ichat packet 5-2021.pdf | ||
| APPENDIX D Familial Disclosure Form (ONLY REQUIRED FOR CONSTRUCTION).docx | DOCX document | |
| APPENDIX B Certification Form.docx | DOCX document | |
| APPENDIX H BID PRICING FORM.docx | DOCX document | |
| APPENDIX I Prevaliling Wage.pdf | ||
| APPENDIX G MECHANICAL PLANS MODIFIED.pdf | ||
| APPENDIX F SPECIFICATIONS.docx | DOCX document | |
| APPENDIX C Iran Economic Sanctions Form.docx | DOCX document | |
| IFB 26.0001 ALLEN ELEMENTARY BOILER REPLACEMENT.docx | DOCX document |
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Text version
IFB 26.0001 ALLEN ELEMENTARY BOILER REPLACEMENT
APPENDIX A – CONTRACTOR INFORMATION FORM
1. Contractor Information
Contractor Name: __________
Address: ______ _________________ ______
Number of years in business as the Contractor named above ____ ________
Physical Business Headquarters Address: _____________________________________________
Previous Contractor Names: _______________________________________________________
Explanation for Contractor Name Change: _____________________________________________
Phone Number: ____________________ Contact Email: _________________________________
2. Financial
Annual gross sales for last three (3) years:
2024______________2023___________ 2022 ___________ _
Federal ID Number: ________________
Dun & Bradstreet (D-U-N-S) Number: _____________________
Financial statements could be requested by the District for review.
3. Business Structure
Corporation Partnership Individual Joint Venture Other _________________
State of Incorporation: ___________
States in which qualified to do business: _______________
4. Licenses Provide all State and local licenses and license numbers held by Contractor:
5. Experience Years of experience with same projects as specified within RFP? ____________________________ Has the Contractor in the past five (5) years ever?
a. Failed to complete awarded work? __________________________________________
b. Been removed from awarded work? _________________________________________
c. Has the owner/principal(s) of the company ever filed bankruptcy? ______________________________________________________________________
d. Has the Contractor ever bonded a job for completion? ______________________________________________________________________
e. Are there any judgements, claims, arbitration proceedings, or suits pending or outstanding against the Contractor or its Officers? ____________________________________________________________________
6. Safety In the last five (5) years has the Contractor or subcontractor companies have any violations of state, federal or local laws or regulations, including OSHA/MIOSHA, state of federal prevailing wages, wage and hour laws, workers’ compensation or unemployment compensation laws rules or regulations issued against the Contractor. If yes, explain violation(s).
Attach a copy of the Contractor’s MIOSHA approved safety-training program for employees that shall be posted at each job site.
Provide workman compensation experience modification rating_____________
7. Qualifications Provide qualification of the management and supervisory personnel to be assigned to this project. Attach resumes to this document.
Provide the qualifications and experience of personnel to be assigned to this project; include licensure as Master, journeyperson, or other qualifications. Attach resumes to this document.
Provide the ratio of masters or journeypersons to apprentices proposed to be used on this construction project, if apprentices are to be used on this project.
If using subcontractors on this project, provide what segments of work they will provide.
8. References
Provide Organization name, contact and telephone numbers of three (3) customers that have completed similar project for within the past five (5) years, preferably school districts or intermediate school districts.
Organization / School District __________________________________________________
Contact Name: _____________________________Telephone:________________________
Organization / School District __________________________________________________
Contact Name:_____________________________Telephone:________________________
Organization / School District __________________________________________________
Contact Name:_____________________________Telephone:________________________
Provide a list of comparable projects you have completed within the last five (5) years.
9. Executive Summary Provide a one-page executive summary attached to this form.
File details come from the government source that posted it. Updated .