BPM007689 ATT D Qualifications.pdf
PDF 415 KB Posted
- Solicitation number
- BPM007689
- Issued by
- Gila County, Arizona
About this file
Summary
This is a Bidder's Statement of Qualifications form (Attachment D) for solicitation BPM007689, issued by the Arizona Department of Administration General Services Division for the DEMA-Bellemont Roof Removal and Installation project affecting Buildings 239 and 241 at Camp Navajo (Project No. NG-25-003). The form requires bidders to provide comprehensive organizational information including years in business, legal structure, current and past construction projects, key personnel experience, licensing status, and bonding capacity. A non-mandatory pre-bid conference and site visit is scheduled for September 2, 2026, at 10:00 AM Arizona Time at Camp Navajo in Bellemont, Arizona. Prospective bidders must complete form BPM007689 ATT 1 19B and submit it to Douglas Taylor at douglas.taylor@azdema.gov prior to August 27, 2026, at 5:00 PM Arizona Time to gain facility access. The solicitation requires bidders to review and understand the Camp Navajo-Specific Contract Provisions (BPM007689 ATT 2 1141) before the site walk, which DEMA personnel will review at the beginning of the on-site meeting.
The qualifications statement requires bidders to identify all anticipated subcontractors with their percentage of work, provide bank and trade references, list bonding and insurance company information with maximum bonding capacity, and certify the availability of a current financial statement within seven days after bid opening. Bidders must hold active Arizona Contractor licenses and provide photocopies with their bid proposal. The form also requires disclosure of any past contract failures, officer or partner involvement with failed construction contracts, and the percentage of work normally performed with the contractor's own forces, organized by trade.
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ATTACHMENT D
BIDDER'S STATEMENT OF QUALIFICATIONS
The Undersigned certifies the truth and correctness of all statements and of all answers to questions made hereinafter.
COMPANY NAME:
PRINCIPAL OFFICE ADDRESS:
BRANCH OFFICE ADDRESS:
1. How many years has your organization been in business as a Contractor?
2. How many years has your organization been in business under its present business name?
3. If a Corporation, answer the following:
Date of Incorporation:
State of Incorporation:
President:
Vice President(s):
Secretary:
Treasurer:
4. If a Partnership, answer the following:
Date of organization:
Type of Partnership:
(General/Limited/Assoc.)
Name and Address of all partners.
5. If other than a Corporation or Partnership, describe Organization and name Principals:
Solicitation No.
BPM007689Project
Name: DEMA- Bellemont-Roof
Removal and Install Bldg 239 and 241 CN Agency Project No.
NG-25-003
Arizona Department of Administration
General Services Division 1400 W Washington St., Suite B200
Phoenix, AZ 85007
6. What percent of the work do you normally perform with your own forces?
List trades and percents:
7. Have you ever failed to complete any work awarded to you? If so, indicate when, where and why:
8. Has any Officer or Partner of your Organization ever been an Officer or Partner of another Organization that failed to complete a construction contract? If so, state circumstances:
9. List major construction projects your Organization has under contract on this date:
Project Name Name, Email
Address & Telephone Number of Owner
Project Location
Contract Amount
Contract Date
Percent Complete
Scheduled Completion
10. List similar construction projects your Organization has completed in the past five years:
Project Name
Name, Email Address & Telephone Number of
Owner
Project Location
Contract Amount
Date Awarded
Date Completed
Percent with Own
Forces
11. List the construction experience of the principal individuals in your Organization:
Individual's Name
Construction Experience -
Years
Within Your Organization
Present Position & Years
Experience Dollar Volume Responsibility
Previous Position &
Years Experience
12. List states and categories in which your Organization is legally qualified to do business:
13. List all Arizona Contractor licenses currently held by your Organization; the status of each license; and provide a photocopy of each license with your bid proposal.
License Class / # Status 1.
2.
3.
4.
Please attach a list of additional Arizona Contractor licenses, if any.
14. Bank References:
15. Trade References:
16. Name of Bonding and Insurance Companies and Name and Address of Agents: Maximum Bonding Capacity
17. The Undersigned agrees to furnish, upon request by the Owner, within seven days after the Bid Opening, a current Statement of Financial Conditions, including Contractor's latest regular dated financial statement or balance sheet which must contain the following items:
Current Assets: (Cash, joint venture accounts, accounts receivable, notes receivable, accrued interest on notes, deposits, and materials and prepaid expenses), net fixed assets and other assets.
Current Liabilities: (Accounts payable, notes payable, accrued interest on notes, provision for income taxes, advances received from owners, accrued salaries, accrued payroll taxes), other liabilities, and capital (capital stock, authorized and outstanding shares par values, earned surplus).
Date of statement or balance sheet:
Name of firm preparing statement:
By:
(Agent and Capacity)
18. List of Subcontractors. The following is a breakdown of all subcontractors anticipated to be used for completing this project and their approximate percentage of work to be performed.
The Bidder certifies that all Subcontractors listed are eligible to perform Work on public projects.
Subcontractor Description of Work % of Total Project
Total % of all Subcontractor's work on project
Total % for Prime Contractor
19. Dated at this day of , Name of Organization:
By:
Title:
** END OF SECTION **
| HAZARD COMMUNICATION PROGRAM FOR |
| CONTAINER LABELING: |
| MATERIAL SAFETY DATA SHEETS: |
| EMPLOYEE TRAINING AND INFORMATION: |
| A. Minimum Information Provided: |
| GENERAL INDUSTRY |
| B. Minimum Training Provided: |
| INFORMING CONTRACTORS: |
| CONTRACTORS INFORMING EMPLOYERS: |
| CONTRACTOR: |
| COMPANY NAME: |
| PRINCIPAL OFFICE ADDRESS: |
| BRANCH OFFICE ADDRESS: |
| How many years has your organization been in business under its present business name: |
| Date of Incorporation: |
| State of Incorporation: |
| Vice Presidents: |
| undefined_2: |
| Secretary: |
| Treasurer: |
| Date of organization: |
| Type of Partnership: |
| Name and Address of all partners 1: |
| Name and Address of all partners 2: |
| Name and Address of all partners 3: |
| If other than a Corporation or Partnership describe Organization and namePrincipals: |
| List trades and percents 1: |
| List trades and percents 2: |
| 1: |
| 2: |
| 1_2: |
| 2_2: |
| and why 1: |
| and why 2: |
| and why 3: |
| circumstances 1: |
| circumstances 2: |
| Project NameRow1: |
| Name Email Address Telephone Number of OwnerRow1: |
| Project LocationRow1: |
| Contract AmountRow1: |
| Contract DateRow1: |
| Percent CompleteRow1: |
| Scheduled CompletionRow1: |
| Project NameRow2: |
| Name Email Address Telephone Number of OwnerRow2: |
| Project LocationRow2: |
| Contract AmountRow2: |
| Contract DateRow2: |
| Percent CompleteRow2: |
| Scheduled CompletionRow2: |
| Project NameRow3: |
| Name Email Address Telephone Number of OwnerRow3: |
| Project LocationRow3: |
| Contract AmountRow3: |
| Contract DateRow3: |
| Percent CompleteRow3: |
| Scheduled CompletionRow3: |
| Project NameRow1_2: |
| Name Email Address Telephone Number of OwnerRow1_2: |
| Project LocationRow1_2: |
| Contract AmountRow1_2: |
| Date AwardedRow1: |
| Date CompletedRow1: |
| Percent with Own ForcesRow1: |
| Project NameRow2_2: |
| Name Email Address Telephone Number of OwnerRow2_2: |
| Project LocationRow2_2: |
| Contract AmountRow2_2: |
| Date AwardedRow2: |
| Date CompletedRow2: |
| Percent with Own ForcesRow2: |
| Project NameRow3_2: |
| Name Email Address Telephone Number of OwnerRow3_2: |
| Project LocationRow3_2: |
| Contract AmountRow3_2: |
| Date AwardedRow3: |
| Date CompletedRow3: |
| Percent with Own ForcesRow3: |
| Individuals NameRow1: |
| Construction Experience YearsRow1: |
| Present Position Years ExperienceRow1: |
| Dollar Volume ResponsibilityRow1: |
| Previous Position Years ExperienceRow1: |
| Individuals NameRow2: |
| Construction Experience YearsRow2: |
| Present Position Years ExperienceRow2: |
| Dollar Volume ResponsibilityRow2: |
| Previous Position Years ExperienceRow2: |
| Individuals NameRow3: |
| Construction Experience YearsRow3: |
| Present Position Years ExperienceRow3: |
| Dollar Volume ResponsibilityRow3: |
| Previous Position Years ExperienceRow3: |
| Individuals NameRow4: |
| Construction Experience YearsRow4: |
| Present Position Years ExperienceRow4: |
| Dollar Volume ResponsibilityRow4: |
| Previous Position Years ExperienceRow4: |
| List states and categories in which your Organization is legally qualified to do business 1: |
| List states and categories in which your Organization is legally qualified to do business 2: |
| List states and categories in which your Organization is legally qualified to do business 3: |
| License Class: |
| 2_3: |
| 3: |
| 4: |
| Status 1: |
| Status 2: |
| Status 3: |
| Status 4: |
| Bank References 1: |
| Bank References 2: |
| Bank References 3: |
| Trade References 1: |
| Trade References 2: |
| Trade References 3: |
| Name of Bonding and Insurance Companies and Name and Address ofAgents Maximum: |
| Bonding Capacity 1: |
| Bonding Capacity 2: |
| outstanding shares par values earned surplus: |
| Date of statement or balance sheet: |
| Name of firm preparing statement: |
| 1_3: |
| 2_4: |
| 3_2: |
| 4_2: |
| 5: |
| 1_4: |
| 2_5: |
| 3_3: |
| 4_3: |
| 5_2: |
| Total Project 1: |
| Total Project 2: |
| Total Project 3: |
| Total Project 4: |
| Total Project 5: |
| undefined_3: |
| Total of all Subcontractors work on project: |
| Dated at: |
| day of: |
| undefined_4: |
| Name of Organization 1: |
| Name of Organization 2: |
| undefined_5: |
| Years: |
| President: |
| Yes/No: |
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