Certificate of Experience.pdf

PDF 26 KB Posted

Attached to
RFB-RC-2024-110- Getac Laptop & Accessories or approved equal
Solicitation number
RFB-ROCKLAND-24-000020
Issued by
New York

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The document is a Certificate of Experience form from the County of Rockland's Department of General Services (DGS) Purchasing Division, located at 50 Sanatorium Rd, Pomona, NY 10970. This form is a mandatory submission requirement for bidders participating in the RFB-RC-2024-110 solicitation for Getac Laptops & Accessories, requiring vendors to detail their prior contract work experience from the last three years. The form provides space for bidders to document five separate business references, including name of business, contact information, contract amount, type of work, and contact details.

The form is designed to help the County of Rockland evaluate vendor qualifications and past performance by requiring bidders to demonstrate their professional experience relevant to the laptop and accessories procurement. Each reference section allows vendors to showcase their professional history, with designated fields for comprehensive documentation of previous contracts. The form must be completed in full and submitted with the bid, serving as a key component of the vendor assessment process for this specific procurement opportunity.

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Other files

File Type Posted
RFB-RC-2024-110-Getac Laptops~1.pdf PDF
Statement of Disclosures.pdf PDF
Appendix A General Terms and Conditions - Commodities and Non-Professional Services.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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