Emergency Response Form (1).pdf
PDF 193 KB Posted
- Attached to
- Traffic Management System Maintenance
- Solicitation number
- 147288
- Issued by
- Polk County, Florida
About this file
This is an Emergency Response Capability Form (Exhibit E) for a Traffic Management System Maintenance contract opportunity with the State of Florida. The form requires bidders to provide comprehensive emergency contact information, including a primary emergency contact, secondary emergency contact, and a 24-hour hotline, with all contacts required to be available continuously throughout the year at 365 days per year. Bidders must certify their capability to respond to emergency service requests within two (2) hours as specified in the solicitation, and must identify their operations location address and distance in miles from the District. The form requires bidders to attest that they possess the necessary personnel, equipment, and operational capability to meet the emergency response requirements, with the understanding that failure to meet the required response time may constitute a material breach of contract.
Award for the Traffic Management System Maintenance contract will be made to the lowest responsive and responsible bidder based on a weighted evaluation formula applied to four sample projects: 0.6A + 0.2B + 0.1C + 0.1D. Bidders must submit the completed Emergency Response Form with their bid response. No specific pricing information, set-asides, incumbent information, or funding details are detailed within this form document itself.
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Text version
Exhibit E Emergency Response Capability Form
Bid Number:
Bid Title:
List Emergency Contact Information
Contact Type Name Phone Number Email Address Primary Emergency Contact Secondary Emergency Contact 24-Hour Hotline, if applicable
NOTE: Emergency contacts must be available 24 hours per day, 7 days per week, for 365 days a year.
Emergency Response Capability The Bidder certifies the capability of responding to emergency service requests within the timeframe specified within the solicitation.
Required Response Time:
Two (2) Hours Other:____________
Operations Location
Address: __________________________________________________________
City/State/Zip: ______________________________________________________
Approximately ________ miles away from the District.
Business Information and Signature:
By signing below, the Bidder certifies they possess the personnel, equipment, and operational capability necessary to meet the emergency response requirements specified in the solicitation. Failure to meet the required response time may constitute a material breach of contract.
Business Name:
Signature:
Submit completed form with your bid response.
v.03.26
| Bid Number: |
| Bid Title: |
| NamePrimary Emergency Contact: |
| Phone NumberPrimary Emergency Contact: |
| Email AddressPrimary Emergency Contact: |
| NameSecondary Emergency Contact: |
| Phone NumberSecondary Emergency Contact: |
| Email AddressSecondary Emergency Contact: |
| Name24Hour Hotline if applicable: |
| Phone Number24Hour Hotline if applicable: |
| Email Address24Hour Hotline if applicable: |
| Other: |
| Address: |
| CityStateZip: |
| Approximately: |
| Business Name: |
| Check Box1: Off |
| Check Box2: Off |
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