Dispute_Disclosure_10-4-11.pdf
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- Attached to
- Water Materials Alliance
- Solicitation number
- PR8286
- Issued by
- Orange County, Orlando City, Florida
About this file
The document is a Dispute Disclosure form intended for submission as part of the Orlando Utilities Commission's (OUC) Water Materials Alliance procurement process. The form requires vendors to disclose any professional disciplinary actions, contract defaults, or legal disputes within the past five years by marking "YES" or "NO" to three specific questions. The form serves as a transparency mechanism for potential suppliers to report any significant historical issues that might impact their qualification for the strategic alliance contract.
The disclosure document mandates complete honesty, with an explicit warning that any misstatement or falsification of facts will result in forfeiture of rights for further project consideration. While the form itself does not contain pricing or detailed contract specifics, it is part of the OUC's comprehensive vetting process for selecting a water materials and supply chain services provider. The form requires an authorized firm representative's signature, date, officer title, and printed name to validate the disclosed information, thereby ensuring accountability and providing OUC with critical background information about potential suppliers' professional history and reliability.
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Text version
DISPUTE DISCLOSURE
Answer the following questions by placing an "X" in the appropriate "YES" or "NO" box. If you answer "YES", please explain In the space provided, or via attachment.
Has your firm, or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulation or any other regulatory agency or professional association within the last five (5) years?
YES NO
Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years?
YES NO
Has your firm had filed against it or filed any requests for equitable adjustment, contract claims or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business?
YES NO
If yes, state the nature of the request for equitable adjustment, contract claim or litigation, a brief description of the case, the outcome or status of suit and the monetary amounts or extended contract time involved.
I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation or falsification of facts shall be cause for forfeiture of rights for further consideration of this project.
Firm Date
Authorized Signature Officer Title
Printed or Typed Name
File details come from the government source that posted it. Updated .