Contractor_Responsibility_Certification.pdf
PDF 80 KB Posted
- Solicitation number
- RTSX-260048-DS
- Issued by
- Alachua County, Graceville City, Florida
About this file
This is a Contractor Responsibility Certification document required by the City of Gainesville for the Special Inspections for Eastside Bus Transfer Facility project in Graceville City, Florida. The certification form requires bidders to attest to their compliance with contractor responsibility standards through a series of yes/no questions covering suspension or debarment history, felony convictions of firm officers, project defaults, license revocations, legal violations resulting in fines exceeding $1,000, bankruptcy proceedings, and satisfactory performance history within the past three years. Additionally, bidders must confirm they possess all required business licenses and certifications, have adequate experience and resources to perform the work or will obtain them through qualified subcontractors, and meet all applicable insurance requirements including general liability, workers' compensation, and automobile liability coverage. The certification must be executed under penalty of perjury by an authorized representative of the firm with knowledge and authority to verify the submitted information.
The document establishes that Graceville City reserves the right to request supporting documentation at any time to substantiate the certifications provided and may require additional information to evaluate contractor responsibility. Bidders are required to acknowledge their understanding of these requirements and agree to provide any documentation or supplemental information as requested. The certification form includes designated spaces for the company name, authorized representative's name and title, signature, and date of execution. This responsibility certification is a mandatory prerequisite for bid submission and serves as a baseline screening mechanism to ensure bidder qualification and integrity in the procurement process.
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CONTRACTOR RESPONSIBILITY CERTIFICATION
The Bidder is required to certify compliance with the following contractor responsibility standards by checking appropriate boxes. For purposes hereof, all relevant time periods are calculated from the date this Certification is executed.
YES NO
1. Has the firm been suspended and/or debarred by any federal, state or local government agency or authority in the past three years?
2. Has any officer, director, or principal of the firm been convicted of a felony relating to your business industry?
3. Has the firm defaulted on any project in the past three (3) years?
4. Has the firm had any type of business, contracting or trade license revoked or suspended for cause by any government agency or authority in the past three (3) years?
5. Has the firm been found in violation of any other law relating to its business, including, but not limited to antitrust laws, licensing laws, tax laws, wage or hour laws, environmental or safety laws, by a final unappealed decision of a court or government agency in the past three (3) years, where the result of such adjudicated violation was a payment of a fine, damages or penalty in excess of $1,000?
6. Has the firm been the subject of voluntary or involuntary bankruptcy proceedings at any time in the past three (3) years?
7. Has the firm successfully provided similar products or performed similar services in the past three (3) years with a satisfactory record of timely deliveries or on-time performance?
8. Does the firm currently possess all applicable business, contractor and/or trade licenses or other appropriate licenses or certifications required by applicable state or local laws to engage in the sale of products or services?
9. Does the firm have all the necessary experience, technical qualifications and resources, including but not limited to equipment, facilities, personnel and financial resources, to successfully provide the referenced product(s) or perform the referenced service(s), or will obtain same through the use of qualified, responsible subcontractors?
10. Does the firm meet all insurance requirements per applicable law or bid specifications including general liability insurance, workers’ compensation insurance, and automobile liability insurance?
11. Firm acknowledges that it must provide appropriate documentation to support this Contractor Responsibility Certification if so requested by the City of Gainesville. The firm also understands that the City of Gainesville may request additional information or documents to evaluate the responsibility of firm. Firm agrees to provide such additional information or supporting documentation for this Certification.
Under the penalty of perjury, the Bidder’s authorized representative hereby certifies that all responses marked in this form or otherwise submitted for purposes of determining the Bidder’s status as a responsible contractor is true, complete and accurate and that he/she has knowledge and authority to verify the information in this certification or otherwise submitted on behalf of the Bidder by his or her signature below.
Company:
Name: ___________________________________________________________________________________________
Title: ____________________________________________________________________________________________
Signature: Date: ______________
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