Attachment E - Statement of Qualifications.pdf

PDF 177 KB Posted

Attached to
Garfield County Coroner’s Office RTU Replacement
Solicitation number
IFB-GC-FM-07-25
Issued by
Gilpin County, Colorado

About this file

This document is a Statement of Qualifications (SOQ) for the Garfield County Coroner's Office RTU (Replacement) project, solicited under the Invitation for Bid (IFB) number GC-FM-07-25. The form is designed for potential bidders to provide comprehensive company information and demonstrate their qualifications for the project. The document requires detailed company history, including verification of standing with the Colorado Secretary of State, years of business operation, and disclosure of any legal issues such as lawsuits, public procurement disqualifications, or bankruptcy proceedings.

The SOQ template includes sections for previous work experience, references, and a certification statement where the company representative affirms the accuracy of the submitted information. Potential bidders must disclose whether they have previously provided similar goods or services to Garfield County, provide reference contacts, and sign a certification acknowledging their authority to submit the document. The form is part of the procurement process for the Coroner's Office RTU Replacement project, allowing Garfield County to evaluate and assess the qualifications of prospective contractors before making a final selection.

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Text version

ATTAC

HMENT E

STATEMENT OF QUALIFICATIONS

IFB-GC-FM-07-25

Garfield County Coroner's Office RTU Replacement

COMPANY INFORMATION

Legal Name of Company:

Trade Name, if any, of Company:

Street Address:

City, State & Zip Code:

Principal Owner/Officer Name:

Title:

Federal Employer Identification Number: ______

Telephone Number:

Facsimile Number:

Company E-mail Address:

Primary Contact and Title:

Contact E-mail Address:

If a Colorado corporation or limited liability company, is the company in “good standing” with the Colorado Secretary of State? yes no

If a foreign corporation or limited liability company, is the foreign corporation or limited liability company registered to do business in Colorado and in “good standing” with the Colorado Secretary of State? yes no

How long has the company been in business in Colorado? years

How long has the company been in business in Garfield County? years

Has the company, or any officer or director acting in an official capacity, ever been successfully sued? yes no

If yes, complete the chart below, and any additional pages if necessary:

Court Case Number Year Judgment Amount

Has the company, or any of its officers or directors, ever been disbarred, suspended, or disqualified from any public procurement? yes no

If yes, complete the chart below, and any additional pages if necessary:

Agency Agency Number Year Length of Disqualification

Has the company, or any of its officers or directors, ever been involved in a voluntary or involuntary bankruptcy proceeding? yes no

If yes, complete the chart below, and any additional pages if necessary:

Court Case Number Year Judgment Amount

(Attach additional sheets if needed to fully respond to the above questions.)

COMPA NY HISTORY

Has your company ever provided goods or services similar to the goods or services that are the subject of this solicitation for Garfield County? yes no

If yes, what was the total dollar amount of that contract? $___________ __________________

REFERENCES

Name Telephone Number Company Name Relationship

Name Telephone Number Company Name Relationship

Name Telephone Number Company Name Relationship

CERTIFICATION

The undersigned, as an authorized representative of the company, states that the undersigned has actual authority to sign this Statement of Qualifications; and, to the best of my knowledge, information, and belief, the information submitted in this Statement of Qualifications is true and accurate as of the date of this Statement of Qualifications is submitted.

By:

Printed Name:

Legal Title:

Date: ______________________________

PREVIOUS WO RK EXPERIENCE

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