Certificate of Experience.pdf

PDF 26 KB Posted

Attached to
RFB-RC-2024-135 Vertical Mast Lifts
Solicitation number
RFB-ROCKLAND-24-000042
Issued by
New York

About this file

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The document is a Certificate of Experience form issued by the County of Rockland's Department of General Services (DGS) Purchasing Division, located at 50 Sanatorium Road in Pomona, New York. This standardized form is designed to be completed by vendors bidding on the RFB-RC-2024-135 Vertical Mast Lifts contract, requiring bidders to provide detailed information about their prior work experience within the last three years. The form allows vendors to list up to five previous business contracts, including the name of the business, contact information, contract amount, type of work performed, and contact details.

The form is a mandatory submission requirement for the bidding process, serving as a mechanism for the County of Rockland to assess vendor qualifications and past performance. Bidders must comprehensively fill out the form, providing verifiable references that demonstrate their capability and experience in performing similar work. The form includes fields for the bidder's name, title, and signature, ensuring accountability and allowing the purchasing department to validate the submitted information. While the specific details of the vertical mast lifts procurement are not elaborated in this document, the Certificate of Experience is a critical component of the vendor evaluation process for this public procurement opportunity.

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Other files

File Type Posted
Appendix A General Terms and Conditions - Commodities and Non-Professional Services.pdf PDF
RFB-RC-2024-135 Vertical Mast Lifts.pdf PDF
Addendum #1.docx DOCX document
Statement of Disclosures.pdf PDF

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PAGE: 1

COUNTY OF ROCKLAND - DGS-PURCHASING

BLDG. A., 6th FLOOR, 50 SANATORIUM RD, POMONA, NY 10970

TELEPHONE: 845-364-3820 / TELEFAX: 845-364-3809

CERTIFICATE OF EXPERIENCE

(THIS FORM MUST BE COMPLETED BY VENDOR AND SUBMITTED WITH BID)

I _____________________________________________ HEREBY CERTIFY THAT (COMPANY) ____________________________

_____________________________________ HAS PERFORMED THE FOLLOWING WORK WITHIN THE LAST THREE YEARS:

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ____________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

FAX NO.: _______________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ____________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

FAX NO.: _______________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ____________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

FAX NO.: _______________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ____________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

FAX NO.: _______________________________________

NAME OF BUSINESS: ___________________________________ CONTACT NAME: ____________________________________

ADDRESS: ________________________________________________________________________________________________

AMOUNT OF CONTRACT: ________________________________ TELEPHONE NO.: ____________________________________

TYPE OF WORK: _________________________________________EMAIL ADDRESS: __________________________________

FAX NO.: _______________________________________

NAME OF BIDDER: _____________________________________________ BY: ___________________________________________________

TITLE: ________________________________________________________ SIGNATURE_____________________________________________

RF

NAME OF BIDDER: _____________________________________________ BY: ___________________________________________________

I:
HEREBY CERTIFY THAT COMPANY:
HAS PERFORMED THE FOLLOWING WORK WITHIN THE LAST THREE YEARS:
NAME OF BUSINESS:
CONTACT NAME:
ADDRESS:
AMOUNT OF CONTRACT:
TELEPHONE NO:
TYPE OF WORK:
EMAIL ADDRESS:
FAX NO:
NAME OF BUSINESS1:
CONTACT NAME1:
ADDRESS1:
AMOUNT OF CONTRACT1:
TELEPHONE NO1:
TYPE OF WORK1:
EMAIL ADDRESS1:
FAX NO1:
NAME OF BUSINESS2:
CONTACT NAME2:
ADDRESS2:
AMOUNT OF CONTRACT2:
TELEPHONE NO2:
TYPE OF WORK2:
EMAIL ADDRESS2:
FAX NO2:
NAME OF BUSINESS3:
CONTACT NAME3:
ADDRESS3:
AMOUNT OF CONTRACT3:
TELEPHONE NO3:
TYPE OF WORK3:
EMAIL ADDRESS3:
FAX NO3:
NAME OF BUSINESS4:
CONTACT NAME4:
ADDRESS4:
AMOUNT OF CONTRACT4:
TELEPHONE NO4:
TYPE OF WORK4:
EMAIL ADDRESS4:
FAX NO4:
NAME OF BIDDER:
BY:
TITLE:
Text Field0:

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