Attachment E-Bid Form Certification-final (2).pdf
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- Solicitation number
- IFB-128698
- Issued by
- Prince William County, Virginia
About this file
This is a Bid Form Certification document for Invitation for Bids (IFB) No. 027-002 issued by Virginia Railway Express (VRE) for the Woodbridge Station East Elevator Modernization project. The project involves modernizing the east elevator located within the parking garage at VRE's Woodbridge Station in Woodbridge, Virginia, which serves five floors. The bid form requires contractors to provide company information, authorized signatory certification, references for past and present experience, documentation of any terminated contracts within the past five years, and subcontractor information if applicable. Bidders must complete the certification section affirming authorization to provide the specified goods and services in compliance with the scope of work and technical specifications at the proposed price.
The document establishes that bidders must submit references demonstrating relevant experience, including original contract value, contract value at completion, contract dates, and work descriptions for prime contractor experience. Bidders are required to disclose any contracts terminated within the past five years due to failure to meet time frames, liquidated damages, or penalties. For any subcontractors utilized, bidders must provide company details, work descriptions, estimated contract amounts, and verify Small, Woman-owned and Minority-owned Business (SWaM) certification status if applicable. All subcontractors must include certifications for debarment and suspension status, lobbying restrictions, non-collusion affidavits, and federal tax liability and felony conviction certifications as specified in Attachment B of the solicitation.
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Text version
IFB No. 027-002
IFB Title: Woodbridge Station East Elevator
Modernization
Virginia Railway Express
ATTACHMENT E
BID FORM CERTIFICATION
Company Name: ____________________________________________
A. BID CERTIFICATION
By my signature, I certify that I am authorized to bind this company/individual to provide the goods/services specified herein, in compliance with the scope of work/technical specifications, and other terms and conditions in this Invitation for Bids at the price provided in the Bid Form.
Signature _____________________________Print ____________________________________
Title ___________________________________Date ___________________________________
Company Name__________________________________________________________________
Address_________________________________________________________________________
City, State ________________________________Zip Code______________________________
Phone Number ____________________________Email_________________________________
B. BID FORM
BID FORM PROVIDED AS A SEPARATE ATTACHMENT IN
EXCEL FORMAT ENTITLED “ATTACHMENT E1- BID FORM”
C. REFERENCES (PAST AND PRESENT EXPERIENCE)
(Bidders shall make additional copies of this form.)
1. Company: __________________________________________________
2. Address: ________________________________________________________
3. Point of Contact: ______________________________________________________
4. Title: ________________________________________________________
5. Telephone No.: ______________________________________________________
6. Email Address: _______________________________________________________
7. Contract Title/Contract No.: ____________________________________________
8. Original Contract Value: ____________________________________________
9. Contract Value at Completion: ______________________________________
10. Contract Commencement Date: ______________________________________
11. Contract Completion Date: ______________________________________
12. Description of the Work: _______________________________________________
(Prime Contractor)
D. REFERENCES (PAST AND PRESENT EXPERIENCE) Continued
Terminated Contracts
List below any contracts within the past five (5) years, if any, on which failure to complete the work within the specified time frame resulted either in the assessment of liquidated damages, penalties or contract termination.
(Bidders shall make additional copies of this form as necessary.)
Check if not applicable ( )
1. Company: __________________________________________________
2. Address: ________________________________________________________
3. Point of Contact: ______________________________________________________
4. Title: ________________________________________________________
5. Telephone No.: ______________________________________________________
6. Email Address: _______________________________________________________
7. Contract Title/Contract No.: ____________________________________________
8. Original Contract Value: ____________________________________________
9. Contract Value at Completion: ______________________________________
10. Contract Commencement Date: ______________________________________
11. Contract Completion Date: ______________________________________
12. Description of the Work: _______________________________________________
E. SUBCONTRACTOR FORM
(Bidders shall make additional copies of this form as necessary.)
No Subcontractors will be utilized.
1. Company Name:
2. Address: _
3. Contact: Title: _
4. Phone No.: Email Address: _
5. Check () all of the following which apply:
Small, Woman-owned and Minority-owned Business (SWaM)
*Certified by:
*(The SWaM certification must be attached)
6. Annual Gross Receipts:
Indicate by checking ( ) the appropriate block that applies to the Subcontractor:
Less than $7,500,000
More than $7,500,000
7. Type of work to be performed by the Subcontractor: _______________________
8. Location of work:
9. Estimated dollar amount of the work: $
NOTE: The following certifications included in ATTACHMENT B must be attached for each Subcontractor:
1) Certification of Primary Participating Debarment, Suspension, and Other
Ineligibility and Voluntary Exclusion
2) Certification of Restrictions on Lobbying
3) Non-Collusion Affidavit
4) Federal Tax Liability and Recent Felony Convictions Certification
File details come from the government source that posted it. Updated .