ESBD_377739_1727372924394_303-2-01738 Attachment G - Contractor's Qualification Form.docx

RFP 303-2-01738

Refrigeration Repairs and Services

ATTACHMENT G - CONTRACTOR’S QUALIFICATIONS FORM

RFP 303-2-01738

Refrigeration Repairs and Services Respondent Instructions: Complete the form below and submit with response as per Attachment K – 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. Failure to submit Attachment G – Contractor’s Qualifications Form through the Bonfire online system will result in disqualification of submitted 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 Service Technicians:

|_| Houston |_| Waco |_| Fort Worth |_| El Paso

(Checked service area should have an Attachment E – Compensation and Fees filled in)

1. What certifications, licenses, or permits are required to perform refrigeration repairs and maintenance as requested in this RFP?

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

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

List any specialized Safety Materials Training Provided to Staff Relevant to Statement of Work

PROPOSED METHODOLOGY

Describe how you propose to fulfill the requirements outlined in Attachment A – Service Contract Draft, Section 1.01, Statement of Work. Answer should include, when called out please explain your process on: how equipment will be tested and repaired; how services are scheduled and requested as-needed; available service times; explain the turnaround of parts (i.e. do you keep any parts in stock); explain your warranty process when replacing or repairing equipment; explain your emergency response protocol; and any additional information we would need to know going into the contract.

SAFETY:

Describe safety training program provided to employees relevant to Statement of Work.

Describe the safety equipment issued and provided to employees performing services relevant to Statement of Work.

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).

REFERENCES: Contractor shall submit three (3) references for which the contractor has provided services of similar size, scope and complexity within the last three (3) years. Additional information may be submitted or attached at Respondent’s discretion to provide a detailed summary of Qualifications & Experience of similar/relevant scope.

Point of Contact:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of Contract:

Description of Scope of Work:

Point of Contact:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of Contract:

Description of Scope of Work:

Point of Contact:

Telephone:

Email:

Facility Name:

Facility Address:

Start Date of Contract:

End Date of Contract:

Description of Scope of Work: