Attachment 3 - Bidder Data Sheet~5.pdf
PDF 282 KB Posted
- Solicitation number
- 26DPP01196
- Issued by
- New Jersey
About this file
Summary: Attachment 3 - Bidder Data Sheet
This bidder data sheet is related to New Jersey Department of Transportation's (NJDOT) contract opportunity T2507 for Microsurfacing and Slurry Seal Pavement System services. The document appears to be a standardized form designed to collect essential information from bidders participating in the procurement process. The sheet requests bidder identification details, including company name, contact information, and relevant qualifications or certifications necessary to perform microsurfacing and slurry seal pavement work. The form serves as a mechanism for NJDOT to organize and track bidder submissions and ensure all participating contractors meet baseline requirements for consideration.
This data sheet functions as a screening and organizational tool within the bidding process, requiring bidders to provide standardized information that allows NJDOT to efficiently evaluate submissions and maintain accurate records of all bid participants. The completion of this form is typically a mandatory requirement for bid submission and may be used to verify bidder eligibility, insurance status, and other compliance factors relevant to pavement maintenance and rehabilitation projects.
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Text version
STATE OF NEW JERSEY
DEPARTMENT OF THE TREASURY
DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
DPP Rev. 9.15.17 Page 1 of 2
BIDDER DATA SHEET
BID SOLICITATION #: VENDOR/BIDDER:
THIS FORM WILL BE USED IN ASSESSING A VENDOR’S/BIDDERS’S QUALIFICATIONS
AND CAPABILITY TO PERFORM THE CONTRACT SCOPE OF WORK.
PART I - CONTRACTS OF SIMILAR SIZE AND SCOPE
List prior contracts performed by the Vendor/Bidder. Emphasis should be placed on contracts that are similar in size and scope to the work required by this Bid Solicitation as evidence of the Vendor’s/Bidder’s ability to successfully complete the scope of work required by this Bid Solicitation. If the Vendor/Bidder has not had any prior contracts enter “None” below.
Contracting Agency / Entity:
Contract/Project Name:
Contract Number:
Contract Term:
Summary of Contract
Scope of Work:
Contact Name:
Contact Phone No.: Contact Email:
Contract Number:
Contract Term:
Contract Number:
Contract Term:
Contract Number:
Contract Term:
Attach additional sheets if necessary.
PART II - CONTRACTS TERMINATED FOR CAUSE
Provide a list of all contracts terminated for cause within the last five (5) years prior to the normal contract expiration date.
The Vendor/Bidder should provide a summary of any negative action, including negative audit findings, taken on any contract of a similar size and scope. The disclosure should include, but is not limited to, receipt of letters of potential default, default, notice(s) to cure, termination of services for cause, or other similar notifications/processes. Additionally, the Vendor/Bidder should provide details, including any negative audits, reports, or findings by any governmental agency for which the
Vendor/Bidder is/was the Vendor/Contractor on any Contract of similar scope. If no contracts were terminated for cause during the last five (5) years, enter “None” below.
Contract Number:
Contract Term:
Summary of Termination:
Contract Number:
Contract Number:
Contract Number:
Attach additional sheets if necessary.
| BID SOLICITATION: 26DPP01196 |
| VENDORBIDDER: |
| Contracting Agency Entity: |
| ContractProject Name: |
| Contract Number: |
| Contract Term: |
| Summary of Contract Scope of Work: |
| Summary of Contract Scope of Work_2: |
| Summary of Contract Scope of Work_3: |
| Contact Name: |
| Contact Phone No: |
| Contact Email: |
| Contracting Agency Entity_2: |
| ContractProject Name_2: |
| Contract Number_2: |
| Contract Term_2: |
| Summary of Contract Scope of Work_4: |
| Summary of Contract Scope of Work_5: |
| Summary of Contract Scope of Work_6: |
| Contact Name_2: |
| Contact Phone No_2: |
| Contact Email_2: |
| Contracting Agency Entity_3: |
| ContractProject Name_3: |
| Contract Number_3: |
| Contract Term_3: |
| Summary of Contract Scope of Work_7: |
| Summary of Contract Scope of Work_8: |
| Summary of Contract Scope of Work_9: |
| Contact Name_3: |
| Contact Phone No_3: |
| Contact Email_3: |
| Contracting Agency Entity_4: |
| ContractProject Name_4: |
| Contract Number_4: |
| Contract Term_4: |
| Summary of Contract Scope of Work_10: |
| Summary of Contract Scope of Work_11: |
| Summary of Contract Scope of Work_12: |
| Contact Name_4: |
| Contact Phone No_4: |
| Contact Email_4: |
| Contracting Agency Entity_5: |
| ContractProject Name_5: |
| Contract Number_5: |
| Contract Term_5: |
| Summary of Termination: |
| Summary of Termination_2: |
| Summary of Termination_3: |
| Contact Name_5: |
| Contact Phone No_5: |
| Contact Email_5: |
| Contracting Agency Entity_6: |
| ContractProject Name_6: |
| Contract Number_6: |
| Contract Term_6: |
| Summary of Termination_4: |
| Summary of Termination_5: |
| Summary of Termination_6: |
| Contact Name_6: |
| Contact Phone No_6: |
| Contact Email_6: |
| Contracting Agency Entity_7: |
| ContractProject Name_7: |
| Contract Number_7: |
| Contract Term_7: |
| Summary of Termination_7: |
| Summary of Termination_8: |
| Summary of Termination_9: |
| Contact Name_7: |
| Contact Phone No_7: |
| Contact Email_7: |
| Contracting Agency Entity_8: |
| ContractProject Name_8: |
| Contract Number_8: |
| Contract Term_8: |
| Summary of Termination_10: |
| Summary of Termination_11: |
| Summary of Termination_12: |
| Contact Name_8: |
| Contact Phone No_8: |
| Contact Email_8: |
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