Certificate of Experience.pdf

PDF 26 KB Posted

Attached to
RFB-RC-2025-019 Pillow Block Bearings-Fully Assembled
Solicitation number
RFB-ROCKLAND-24-000054
Issued by
New York

About this file

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This document is a Certificate of Experience form from the County of Rockland's Department of General Services (DGS) Purchasing Division, located at 50 Sanatorium Road in Pomona, New York. The form is specifically designed for vendors to complete and submit with their bid for the RFB-RC-2025-019 Pillow Block Bearings-Fully Assembled procurement opportunity. The form requires bidders to provide detailed information about their previous work experience, including the names of businesses they have worked with, contract amounts, types of work performed, contact information, and addresses for at least five past projects completed within the last three years.

The form is a standard qualification document that allows the County of Rockland to assess a vendor's professional background, competency, and track record before awarding a contract. By requiring vendors to document their recent work history, the county can evaluate the bidder's capabilities, reliability, and expertise in performing similar types of work or providing comparable products and services. The form must be signed by an authorized representative of the bidding company, with spaces provided for the bidder's name, title, and signature, demonstrating the vendor's commitment to the accuracy of the information provided.

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Other files

File Type Posted
Appendix A General Terms and Conditions - Commodities and Non-Professional Services.pdf PDF
FEDERAL CONTRACT CLAUSE FILLABLE_.pdf PDF
RFB-RC-2025-019- Pillow Block Bearing .docx~1.pdf PDF
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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