Attachment 2, Questionnaire (Q-27CT).xlsx

Instructions

- The worksheets numbered from 1 to N represent question sets.

- For each question set, select a response from the dropdown (if applicable) and enter a response comment for each question in the table.

- If specific instructions have been provided for a given subset, they will appear as a tooltip for a purple cell. Mouse-over to review them.

- When pasting content, please use Paste Special as Text without any formatting.

- You can only submit text based responses, please do not use special characters like emojis.

- Please do not change the structure of any of the worksheets. Changing the structure will invalidate your submission.

- Any additional information outside of the given structure of the worksheets will not be visible to the purchaser.

- Please do not save this file in a different format. Saving this file in a different format will invalidate your submission.

- Please do not use Excel formulas in your responses.

- Please follow the instructions provided along with this file to submit it back to Euna Procurement.

- If you have any questions regarding the content of this file, please contact the appropriate purchaser.

- If you have any technical problems, please contact Euna Procurement at support.bonfire@eunasolutions.com.

e74c292fe8b63c93795bcd2305a3636581d706fd5e7eba287484ad054841ca22839e57b3833f45a36ab9d70b1c8f2d8dccc6f1dec3ffafb48b2aa42689552067E75G9uqcsmNL9pKJDd8dRlN4QveSvnGV6duPlu5X1rarNfkwNeImCBsE0zcp8o6e

Summary

Question Set 1: Company Profile

Legal Business Name

Number of Years in Business

DBA

Federal Employer ID

Principal Place of Business Address (Corporate Office)

Website address

Name of Authorized Contact for Offer

Authorized Contact Telephone

Authorized Contact Email Address

Type of Business

Is the company incorporated in the State of Arizona?

Name and Title of Each Principal, Owner, Officer, Major Stockholder (more than 3% or whose annual income from dividends, including the value of stock dividends, from the corporation exceeds five percent of the total annual income for such officer or employee and any other payments made to him/her by the corporation exceeds five percent of his/her total annual income):

Does your firm use or have you used in the past five years, any other business name, FEIN, or DBA other than provided herein? If yes, provide all related details.

Is there any potential conflict of interest or relationship between the Offeror and any District employee, official or Governing Board member who functions or has responsibilities in the review, approval, undertaking or carrying out of the project or purchase? *If Yes, all relevant details must be included on the Conflict of Interest Disclosure Attachment.

A judgment or conviction for any business related conduct constituting a crime under federal, state or local government law including, but not limited to, fraud, extortion, bribery, racketeering, price-fixing, or bid collusion or any crime related to truthfulness and/or business conduct?

A criminal investigation or indictment for any business related conduct constituting a crime under federal, state or local government law including, but not limited to, fraud, extortion, bribery, racketeering, price-fixing or bid collusion or any crime related to truthfulness and/or business conduct?

An unsatisfied judgment, injunction or lien for any business related conduct obtained by any federal, state or local government agency including, but not limited to judgments based on taxes owed and fines and penalties assessed by any federal, state or local government agency?

An investigation for a civil or criminal violation for any business related conduct by any federal, state or local agency?

A grant of immunity for any business related conduct constituting a crime under federal, state, or local governmental law including, but not limited to, fraud, extortion, bribery, racketeering, price- fixing, bid collusion or any crime related to truthfulness and/or business conduct?

A federal, state or local government contract suspension or termination for cause prior to the completion of the term of a contract?

A federal, state or local government suspension or debarment from the contracting process?

A federal, state or local government denial of lease or contract award for non-responsibility?

An administrative proceeding or civil action seeking specific performance or restitution in connection with any federal, state or local contract or lease?

A federal state or local determination of willful violation of any public works or labor law or regulation?

A sanction imposed as a result of judicial or administrative proceedings relative to any business or professional license?

An Occupational Safety and Health Act citation and notification of Penalty containing a violation classified as serious or willful?

Is the vendor in good standing with its primary financial institution? Offeror should provide evidence of financial stability and capability to fund all costs associated with providing the requested materials/services requested in this solicitation. *A letter from primary financial institution should be included for confirmation.

Does the Offeror confirm the company’s bonding capacity adequately covers this Scope of Work and understand that both performance and payment bonds are required upon contract award? Does the Offeror agree that no further costs will be allocated for any required bonds outside of the awarded contract pricing?

Does the vendor lack the financial resources necessary to fulfill the requirements of the proposed contract in any way? If yes, attach a letter of explanation.

Gross amount of contract value in hand as of the date of this bid.

During the past three years, has the vendor failed to file returns or pay any applicable federal, state or local government taxes? *If yes, identify the taxing jurisdiction, type of tax, liability year(s) and tax liability amount the company failed to file/pay and the current status of the liability.

Has the Offeror filed (or had filed against it) any bankruptcy or insolvency proceeding, whether voluntary or involuntary, or undergone the appointment of a receiver, trustee, or assignee for the benefit of creditors in the past ten (10) years? If yes, provide an explanation with all relevant details.

Have there been any deficiency orders issued against the contractor by the Arizona Registrar of Contractors over the past five (5) years?

Will the Offeror provide a Certificate of Insurance (COI) with the required coverages, as outlined in the Special Terms and Conditions with the District listed as an Additional Insured?

Will the Offeror require any additional agreement for this project, such as warranty, sales or maintenance agreement? If yes, a copy must be provided.

Does the Offeror conduct Background Clearance (Registered Sex Offender)

Does the Offeror conduct fingerprint clearances?

Does the Offeror conduct drug-free screening?

Does Bidder warrantee all work for a minimum two years from date of final completion? If not, provide explanation.

Provide a tentative construction schedule using the dates provided in the IFB. A schedule illustration should be included and attached separately.

Does your firm have a working knowledge of federal requirements? Indicate confirmation of understanding the related requirements outlined in the Uniform Terms and Conditions, including but not limited to certified payroll and Davis Bacon wages.

Identify the key personnel and titles, e.g., Superintendent, Foreman, or Project Manager, that will be assigned to work on this project. Include the number of years with the firm and total years of related experience that is relevant to this Scope of Work, such as similar project size, timeline, etc.

Provide at least three (3) references for projects that are similar to this Scope of Work that were completed within the past five (5) years. Include Owner Name, Point of Contact, Point of Contact phone and email address and overall project type and contract value. References should be public entity references and related to the same type of project work. Performance as a subcontractor or references provided by a third-party representative shall not be considered. The district may, at its sole discretion, contact additional customers not presented as references.

Authorized contact hereby states and certifies that the information given for this Questionnaire is true, accurate and complete. It is further acknowledged that the District will rely upon the information contained herein and within the overall response to determine responsiveness and responsibility of the Offeror for contract award. The District may, at its discretion, verify the truth and accuracy of all statements made herein by any means which it may choose.

Response Options (hidden)

cc3c6fe99f6d1f2a4222baefda93b93c.png