ESBD_375911_1725659965160_Attachment F - Contractor's Qualification Form.docx

RFP 24-0000513

Fire Extinguisher Inspection, Maintenance and Replacement, Austin, TX

RFP 24-0000513

Fire Extinguisher Inspection, Maintenance and Replacement, Austin, TX

ATTACHMENT F – CONTRACTOR’S QUALIFICATIONS FORM

Respondent Instructions: Complete the form below and submit with response as per Attachment I – RFP Submission Instructions and Guidelines. This form or a reasonable likeness must be returned with response. Failure to do so will result in disqualification. Failure to complete the form may result in disqualification of response.

COMPANY INFORMATION:

Company Name:

Federal EIN Number:

(Attach W9 to this form)

Company Description

Number of Years in Business:

Primary Contact Name:

Primary Contact Phone:

Primary Contact Email:

FINANCIAL HISTORY

Indicate if your company or any of its subsidiaries filed or met criteria for bankruptcy within the past five years. If yes, provide explanation.

Indicate if your firm is currently in default on any loan agreement or financial agreement institution, or other entity. If so, specify date(s), details, circumstances, and prospect resolution.

Identify if your company is currently for sale or involved in any transaction to expand or become acquired by another business entity. If so, explain the impact both in organization and company direction.

Indicate if your company has had a contract terminated for default or convenience within the past five years. If yes, provide explanation

MAIN/HOME OFFICE LOCATION INFORMATION:

Main Office Address:

# of Permanent, FT Employees:

# of Permanent, PT Employees:

RELEVANT EXPERIENCE AND QUALIFICATIONS

OFFICE THAT WILL SERVICE THIS CONTRACT INFORMATION:

Servicing Office Address:

# of Permanent, FT Employees:

# of Permanent, PT Employees:

# of FEL Technicians:

Geographic Service Area Served:

1. What certifications, licenses, or permits are required to perform fire alarm inspection, maintenance and replacement services in Austin, TX?

2. Explain how you meet the requirements stated in question 1 above.

Provide the names and licenses held by staff that will perform services, if awarded this contract.

PROPOSED METHODOLOGY

Describe how you propose to fulfill the requirements outlined in Attachment E – Statement of Work. Answer should include: (1) How will monthly inspections be performed; (2) How will inspections be logged and tracked; (3) How will Contract Manager be kept informed of ongoing inspections; (4) Describe how noted changes in fire extinguisher counts and locations are communicated to contract administrator and updated in monthly billing;

QUALITY AND SAFETY:

Describe how inspections and will be tracked to ensure inspections are done on time.

Describe how contractor staff are monitored to ensure inspections are actually occurring and reported correctly.

Provide on insurance letterhead, the Workers’ Compensation Modification rate for the past five years. Attach as a separate document. Below, provide explanation for any rating above a value of one (1).